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Liu J, Huang T, Xu Z, Mao Y, Soteyome T, Liu G, Qu C, Yuan L, Ma Q, Zhou F, Seneviratne G. Sub-MIC streptomycin and tetracycline enhanced Staphylococcus aureus Guangzhou-SAU749 biofilm formation, an in-depth study on transcriptomics. Biofilm 2023; 6:100156. [PMID: 37779859 PMCID: PMC10539642 DOI: 10.1016/j.bioflm.2023.100156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023] Open
Abstract
Staphylococcus aureus is a major human pathogen, a potential "Super-bug" and a typical biofilm forming bacteria. With usage of large amount of antibiotics, the residual antibiotics in clinical settings further complicate the colonization, pathogenesis and resistance of S. aureus. This study aimed at investigating the phenotypical and global gene expression changes on biofilm formation of a clinical S. aureus isolate treated under different types of antibiotics. Firstly, an isolate Guangzhou-SAU749 was selected from a large sale of previously identified S. aureus isolates, which exhibited weak biofilm formation in terms of biomass and viability. Secondly, 9 commonly prescribed antibiotics for S. aureus infections treatment, together with 10 concentrations ranging from 1/128 to 4 minimum inhibitory concentration (MIC) with 2-fold serial dilution, were used as different antibiotic stress conditions. Then, biofilm formation of S. aureus Guangzhou-SAU749 at different stages including 8 h, 16 h, 24 h, and 48 h, was tested by crystal violet and MTS assays. Thirdly, the whole genome of S. aureus Guangzhou-SAU749 was investigated by genome sequencing on PacBio platform. Fourthly, since enhancement of biofilm formation occurred when treated with 1/2 MIC tetracycline (TCY) and 1/4 MIC streptomycin (STR) since 5 h, the relevant biofilm samples were selected and subjected to RNA-seq and bioinformatics analysis. Last, expression of two component system (TCS) and biofilm associated genes in 4 h, 8 h, 16 h, 24 h, and 48 h sub-MIC TCY and STR treated biofilm samples were performed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Although most antibiotics lowered the biomass and cell viability of Guangzhou-SAU749 biofilm at concentrations higher than MIC, certain antibiotics including TCY and STR promoted biofilm formation at sub-MICs. Additionally, upon genome sequencing, RNA-seq and RT-qPCR on biofilm samples treated with sub-MIC of TCY and STR at key time points, genes lytR, arlR, hssR, tagA, clfB, atlA and cidA related to TCS and biofilm formation were identified to contribute to the enhanced biofilm formation, providing a theoretical basis for further controlling on S. aureus biofilm formation.
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Affiliation(s)
- Junyan Liu
- College of Light Industry and Food Science, Guangdong Provincial Key Laboratory of Lingnan Specialty Food Science and Technology, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, 510225, China
- Key Laboratory of Green Processing and Intelligent Manufacturing of Lingnan Specialty Food, Ministry of Agriculture, Guangzhou, 510225, China
| | - Tengyi Huang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhenbo Xu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yuzhu Mao
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Engineering Research Center of Starch and Vegetable Protein Processing Ministry of Education, South China University of Technology, Guangzhou, 510640, China
| | - Thanapop Soteyome
- Home Economics Technology, Rajamangala University of Technology Phra Nakhon, Bangkok, Thailand
| | - Gongliang Liu
- College of Light Industry and Food Science, Guangdong Provincial Key Laboratory of Lingnan Specialty Food Science and Technology, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, 510225, China
- Key Laboratory of Green Processing and Intelligent Manufacturing of Lingnan Specialty Food, Ministry of Agriculture, Guangzhou, 510225, China
| | - Chunyun Qu
- College of Light Industry and Food Science, Guangdong Provincial Key Laboratory of Lingnan Specialty Food Science and Technology, Academy of Contemporary Agricultural Engineering Innovations, Zhongkai University of Agriculture and Engineering, Guangzhou, 510225, China
- Key Laboratory of Green Processing and Intelligent Manufacturing of Lingnan Specialty Food, Ministry of Agriculture, Guangzhou, 510225, China
| | - Lei Yuan
- School of Food Science and Engineering, Yangzhou University, Yangzhou, Jiangsu, 225127, PR China
| | - Qin Ma
- Sericultural & Agri-Food Research Institute Guangdong Academy of Agricultural Sciences/Key Laboratory of Functional Foods, Ministry of Agriculture /Guangdong Key Laboratory of Agricultural Products Processing, Guangzhou, 510610, China
| | - Fang Zhou
- The First Affiliated Hospital, Sun Yan-Sen University, Guangzhou, 510080, China
| | - Gamini Seneviratne
- National Institute of Fundamental Studies, Hantana road, Kandy, Sri Lanka
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Resman F. Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I: step-wise design of an antimicrobial stewardship program. Ther Adv Infect Dis 2020; 7:2049936120933187. [PMID: 32612826 PMCID: PMC7307277 DOI: 10.1177/2049936120933187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022] Open
Abstract
Regardless of one's opinion of antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and includes not only aspects of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name a few. This review aims to take several of these aspects and the scientific evidence of antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based on what we know today? And which are the most essential unanswered questions regarding antimicrobial stewardship on a broader scale? This narrative review is written in two separate parts aiming to provide answers to the two questions. This first part is written as a step-wise approach to designing a stewardship intervention based on the pillars of unmet need, feasibility, scientific evidence and necessary core elements. It is written mainly as a guide to someone new to the field. It is sorted into five distinct steps: (a) focusing on designing aims; (b) assessing performance and local barriers to rational antimicrobial use; (c) deciding on intervention technique; (d) practical, tailored design including core element inclusion; and (e) evaluation and sustainability. The second part, published separately, formulates ten critical questions on controversies in the field of antimicrobial stewardship. It is aimed at clinicians and researchers with stewardship experience and strives to promote discussion, not to provide answers.
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Affiliation(s)
- Fredrik Resman
- Department of Translational Medicine, Clinical
Infection Medicine, Lund University, Rut Lundskogs Gata 3, Plan 6, Malmö, 20502,
Sweden
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Tarrant C, Colman A, Chattoe-Brown E, Jenkins D, Mehtar S, Perera N, Krockow E. Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource. Clin Microbiol Infect 2019; 25:1356-1363. [DOI: 10.1016/j.cmi.2019.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/08/2019] [Accepted: 03/10/2019] [Indexed: 12/18/2022]
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Ekakoro JE, Caldwell M, Strand EB, Strickland L, Okafor CC. A survey of antimicrobial use practices of Tennessee beef producers. BMC Vet Res 2019; 15:222. [PMID: 31266492 PMCID: PMC6604443 DOI: 10.1186/s12917-019-1978-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 06/24/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Inappropriate antimicrobial use (AMU) is a key modifiable factor that leads to the development of antimicrobial resistance (AMR). The objectives of this study were to determine the following among Tennessee beef cattle producers: (1) the opinions on factors driving AMU (2) opinions on alternatives to antimicrobials, (3) the knowledge and perceptions regarding AMU and AMR, and (4) the preferred avenues for receiving information on prudent AMU. A survey questionnaire was made available to participants both in print and online from January 26, 2018 through May 11, 2018. The questions targeted the producers' demographics and their AMU practices; factors driving producer's choice of antimicrobials; perceptions, opinions and concerns about AMU and AMR in cattle production. Ordinal logistic regression was used to test for associations between the captured demographic information and producers' degree of concern about AMR. RESULTS Overall, 231 beef producers responded to all or some of the survey questions. More than 60% of the participants mentioned that they kept up-to-date written records on antimicrobial purchases and AMU. Regarding extra-label use, 169 (84.1%) of the 201 respondents did not practice extra-label AMU. Profitability of the beef operation was a key factor influencing the decisions of many producers to use antimicrobials for disease management and prevention on their farms. Of the 228 producers who completed the question on the rating of their degree of concern about AMR, 50 (21.9%) reported that they were very concerned about AMR, 133 (58.3%) were moderately concerned, and 36 (15.8%) reported that they were not concerned about AMR. Nine producers (4%) did not rate their degree of concern about AMR because they were not familiar with what antimicrobial resistance meant. The inferential analyses suggested that younger beef producers were significantly less concerned about AMR when compared to the older ones (P = 0.019). Regarding avenues for receiving information on prudent AMU, no single medium was most preferred by all the respondents. CONCLUSIONS There is a need to promote the use of written antimicrobial treatment protocols among beef producers in Tennessee. Continued training for beef producers on infection prevention and control and prudent AMU is needed.
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Affiliation(s)
- John E. Ekakoro
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996 USA
| | - Marc Caldwell
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996 USA
| | - Elizabeth B. Strand
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996 USA
| | - Lew Strickland
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996 USA
- Department of Animal Science, University of Tennessee, 2506 River Dr, Knoxville, TN 37996 USA
| | - Chika C. Okafor
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996 USA
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Colman AM, Krockow EM, Chattoe-Brown E, Tarrant C. Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma. PLoS One 2019; 14:e0215480. [PMID: 31002685 PMCID: PMC6474592 DOI: 10.1371/journal.pone.0215480] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/02/2019] [Indexed: 01/08/2023] Open
Abstract
The availability of antibiotics presents medical practitioners with a prescribing dilemma. On the one hand, antibiotics provide a safe and effective treatment option for patients with bacterial infections, but at a population level, over-prescription reduces their effectiveness by facilitating the evolution of bacteria that are resistant to antibiotic medication. A game-theoretic investigation, including analysis of equilibrium strategies, evolutionarily stability, and replicator dynamics, reveals that rational doctors, motivated to attain the best outcomes for their own patients, will prescribe antibiotics irrespective of the level of antibiotic resistance in the population and the behavior of other doctors, although they would achieve better long-term outcomes if their prescribing were more restrained. Ever-increasing antibiotic resistance may therefore be inevitable unless some means are found of modifying the payoffs of this potentially catastrophic social dilemma.
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Affiliation(s)
- Andrew M. Colman
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
- * E-mail:
| | - Eva M. Krockow
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Edmund Chattoe-Brown
- Department of Media, Communication and Sociology, University of Leicester, Leicester, United Kingdom
| | - Carolyn Tarrant
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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Boyd R, Richerson PJ, Meinzen-Dick R, De Moor T, Jackson MO, Gjerde KM, Harden-Davies H, Frischmann BM, Madison MJ, Strandburg KJ, McLean AR, Dye C. Tragedy revisited. Science 2018; 362:1236-1241. [PMID: 30545871 DOI: 10.1126/science.aaw0911] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Robert Boyd
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
| | - Peter J Richerson
- Department of Environmental Science and Policy, University of California, Davis, CA, USA.
| | | | | | - Matthew O Jackson
- Stanford University, Stanford, CA, USA. .,Sante Fe Insitute, Santa Fe, NM, USA.,Canadian Institute For Advanced Research, Toronto, ON, Canada
| | - Kristina M Gjerde
- IUCN Global Marine and Polar Programme and World Commission on Protected Areas, Cambridge, MA, USA.
| | - Harriet Harden-Davies
- Australian National Centre for Ocean Resources and Security (ANCORS), University of Wollongong, NSW, Australia
| | | | | | | | - Angela R McLean
- All Souls College, Oxford University, Oxford OX1 4AL, UK. .,Oxford Martin Programme on Collective Responsibility for Infectious Disease, Oxford University, Oxford OX1 3BD, UK
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Padiyara P, Inoue H, Sprenger M. Global Governance Mechanisms to Address Antimicrobial Resistance. Infect Dis (Lond) 2018; 11:1178633718767887. [PMID: 29686487 PMCID: PMC5900814 DOI: 10.1177/1178633718767887] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/09/2018] [Indexed: 11/17/2022] Open
Abstract
Since their discovery, antibiotics, and more broadly, antimicrobials, have been a cornerstone of modern medicine. But the overuse and misuse of these drugs have led to rising rates of antimicrobial resistance, which occurs when bacteria adapt in ways that render antibiotics ineffective. A world without effective antibiotics can have drastic impacts on population health, global development, and the global economy. As a global common good, antibiotic effectiveness is vulnerable to the tragedy of the commons, where a shared limited resource is overused by a community when each individual exploits the finite resource for their own benefit. A borderless threat like antimicrobial resistance requires global governance mechanisms to mitigate its emergence and spread, and it is the responsibility of all countries and relevant multilateral organizations. These mechanisms can be in the form of legally binding global governance mechanisms such as treaties and regulatory standards or nonbinding mechanisms such as political declarations, resolutions, or guidelines. In this article, we argue that while both are effective methods, the strong, swift, and coordinated action needed to address rising rates of antimicrobial resistance will be better served through legally binding governance mechanisms.
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Affiliation(s)
- Ponnu Padiyara
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Hajime Inoue
- UHC and Health Systems, World Health Organization, Geneva, Switzerland
| | - Marc Sprenger
- AMR Secretariat, World Health Organization, Geneva, Switzerland
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Antibiotic-Resistant Bacteria Are Major Threats of Otitis Media in Wollo Area, Northeastern Ethiopia: A Ten-Year Retrospective Analysis. Int J Microbiol 2016; 2016:8724671. [PMID: 26904125 PMCID: PMC4745944 DOI: 10.1155/2016/8724671] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/17/2015] [Accepted: 12/24/2015] [Indexed: 11/28/2022] Open
Abstract
Antibiotic resistance is an increasingly serious threat to human health that needs an urgent action. The aim of this study was to determine the prevalence and antibiotic susceptibility profiles of bacteria isolated from patient ear discharges suspected of otitis media. A retrospective analysis was performed using culture and antibiotic susceptibility test results of 1225 patients who visited Dessie Regional Health Research Laboratory from 2001 to 2011. Results showed a strong association (P < 0.001) between age and the risk of acquiring middle ear infection. The predominant bacterial isolates were Proteus spp. (28.8%), Staphylococcus aureus (23.7%), and Pseudomonas spp. (17.2%). Most of the isolated bacteria showed high resistance to ampicillin (88.5%), ceftriaxone (84.5%), amoxicillin (81.9%), and tetracycline (74.5%). About 72.5% of Proteus spp. and 62.2% of Pseudomonas spp. have developed resistance to one and more antibiotics used to treat them. This retrospective study also revealed the overall antibiotic resistance rate of bacterial isolates was increased nearly twofold (P = 0.001) over the last decade. Relatively, ciprofloxacin and gentamicin were the most effective antibiotics against all the isolates. In conclusion, antibiotic-resistant bacteria are alarmingly increasing in Wollo area, northeastern Ethiopia, and becoming a major public health problem in the management of patients with middle ear infection.
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Halila GC, Junior EH, Otuki MF, Correr CJ. The practice of OTC counseling by community pharmacists in Parana, Brazil. Pharm Pract (Granada) 2015; 13:597. [PMID: 26759614 PMCID: PMC4696117 DOI: 10.18549/pharmpract.2015.04.597] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 10/13/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. OBJECTIVE To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. METHOD A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey(®) platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidence-based practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS(®) (version 22.0) for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05). RESULTS Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product's efficacy (97%) and adverse effects (62.3%) were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. CONCLUSION Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence could be used daily by community pharmacists, especially as regards nonprescription medication counseling.
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Affiliation(s)
- Gerusa C Halila
- Pharmacy Department, Federal University of Parana , Curitiba; & Pharmaceutical Sciences Department, State University of Ponta Grossa, Ponta Grossa, PR ( Brazil ).
| | - Edson H Junior
- Pharmacy Department, Federal University of Parana , Curitiba, PR ( Brazil ).
| | - Michel F Otuki
- Pharmacy Department, Federal University of Parana , Curitiba; & Pharmaceutical Sciences Department, State University of Ponta Grossa, Ponta Grossa, PR ( Brazil ).
| | - Cassyano J Correr
- Pharmacy Department, Federal University of Parana , Curitiba, PR ( Brazil ).
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Levin BR, Baquero F, Johnsen PJ. A model-guided analysis and perspective on the evolution and epidemiology of antibiotic resistance and its future. Curr Opin Microbiol 2014; 19:83-89. [PMID: 25016172 DOI: 10.1016/j.mib.2014.06.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 01/06/2023]
Abstract
A simple epidemiological model is used as a framework to explore the potential efficacy of measures to control antibiotic resistance in community-based self-limiting human infections. The analysis of the properties of this model predict that resistance can be maintained at manageable levels if: first, the rates at which specific antibiotics are used declines with the frequency of resistance to these drugs; second, resistance rarely emerges during therapy; and third, external sources rarely contribute to the entry of resistant bacteria into the community. We discuss the feasibility and limitations of these measures to control the rates of antibiotic resistance and the potential of advances in diagnostic procedures to facilitate this endeavor.
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Affiliation(s)
- Bruce R Levin
- Department of Biology Emory University, Atlanta, GA, USA.
| | - Fernando Baquero
- Ramón y Cajal Institute for Health Research (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain
| | - Pål J Johnsen
- Department of Pharmacy, UiT, The Arctic University, Tromsø, Norway
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