1
|
Safarabadi M, Motallebirad T, Azadi D, Jadidi A. Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic. J Intensive Care Med 2024:8850666241249162. [PMID: 38711296 DOI: 10.1177/08850666241249162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The current review article provides a comprehensive analysis of nosocomial infections in pediatric and adult intensive care units (ICUs) in Iran. We examine the risk factors and etiology of nosocomial infections, with a particular focus on molecular epidemiology and antimicrobial sensitivity. In this article, we explore a range of prevention strategies, including hand hygiene, personal protective equipment, environmental cleaning, antibiotic stewardship, education, and training. Moreover, we discuss the impact of the COVID-19 pandemic on infection control measures in ICUs and provide valuable insights for healthcare professionals and policymakers seeking to address this critical public health issue. In conclusion, this review article can serve as a valuable resource for those interested in understanding and improving infection control in ICUs and beyond.
Collapse
Affiliation(s)
- Mehdi Safarabadi
- Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran
| | - Tahereh Motallebirad
- Department of Research and Development, Satras Biotechnology Company, Islamic Azad University of Khomein, Khomein, Iran
| | - Davood Azadi
- Department of Research and Development, Satras Biotechnology Company, Islamic Azad University of Khomein, Khomein, Iran
- Department of Biology, Faculty of Basic Sciences, Lorestan University, Khorramabad, Iran
| | - Ali Jadidi
- School of Nursing, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
2
|
Chukamnerd A, Saipetch N, Singkhamanan K, Ingviya N, Assanangkornchai N, Surachat K, Chusri S. Association of biofilm formation, antimicrobial resistance, clinical characteristics, and clinical outcomes among Acinetobacter baumannii isolates from patients with ventilator-associated pneumonia. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13732. [PMID: 38286744 PMCID: PMC10784708 DOI: 10.1111/crj.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/05/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Biofilm formation is an important virulence factor of Acinetobacter baumannii. Here, we examined the biofilm formation of archived A. baumannii causing ventilator-associated pneumonia (VAP). METHODS Eighteen and twenty isolates of A. baumannii causing bacteremic pneumonia and non-bacteremic pneumonia were included, respectively. Antimicrobial susceptibility testing was performed by broth microdilution method, while biofilm formation was evaluated by microtiter dish biofilm formation assay. RESULTS All 38 isolates were still susceptible to colistin and tigecycline, whereas almost all isolates were non-susceptible (intermediate to resistant) to several antimicrobial agents, especially ceftriaxone and cefotaxime. Approximately, 44% of bacteremic isolates and 50% of non-bacteremic isolates were classified as carbapenem-resistant A. baumannii (CRAB). Biofilm formation was detected in 42% of the studied isolates. Bacteremia among the patients infected with biofilm-producing isolates was significantly higher than in those infected with non-biofilm-producing isolates. The antimicrobial susceptibilities of A. baumannii with biofilm formation were lower than those without biofilm formation, but the differences did not have statistical significance. The patients infected with non-biofilm-producing isolates had good clinical and non-clinical outcomes than those infected with biofilm-producing isolates. The survival rate of patients diagnosed with VAP due to biofilm-producing A. baumannii was lower than in those patients diagnosed with VAP due to non-biofilm-producing isolates. CONCLUSION Biofilm formation of A. baumannii causing VAP was associated with antimicrobial resistance and bacteremia as well as unfavorable clinical outcomes.
Collapse
Affiliation(s)
- Arnon Chukamnerd
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Niwat Saipetch
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Kamonnut Singkhamanan
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Natnicha Ingviya
- Department of Pathology, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Nawaporn Assanangkornchai
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Komwit Surachat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
- Translational Medicine Research Center, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| | - Sarunyou Chusri
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
| |
Collapse
|
3
|
Habib G, Gul H, Ahmad P, Hayat A, Rehman MU, Mohamed Moussa I, Elansary HO. Teicoplanin associated gene tcaA inactivation increases persister cell formation in Staphylococcus aureus. Front Microbiol 2023; 14:1241995. [PMID: 37901830 PMCID: PMC10611510 DOI: 10.3389/fmicb.2023.1241995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Staphylococcus aureus is part of normal human flora and is widely associated with hospital-acquired bacteremia. S. aureus has shown a diverse array of resistance to environmental stresses and antibiotics. Methicillin-resistant S. aureus (MRSA) is on the high priority list of new antibiotics discovery and glycopeptides are considered the last drug of choice against MRSA. S. aureus has developed resistance against glycopeptides and the emergence of vancomycin-intermediate-resistant, vancomycin-resistant, and teicoplanin-resistant strains is globally reported. Teicoplanin-associated genes tcaR-tcaA-tcaB (tcaRAB) is known as the S. aureus glycopeptide resistance operon that is associated with glycopeptide resistance. Here, for the first time, the role of tcaRAB in S. aureus persister cells formation, and ΔtcaA dependent persisters' ability to resuscitate the bacterial population was explored. We recovered a clinical strain of MRSA from a COVID-19 patient which showed a high level of resistance to teicoplanin, vancomycin, and methicillin. Whole genome RNA sequencing revealed that the tcaRAB operon expression was altered followed by high expression of glyS and sgtB. The RNA-seq data revealed a significant decrease in tcaA (p = 0.008) and tcaB (p = 0.04) expression while tcaR was not significantly altered. We knocked down tcaA, tcaB, and tcaR using CRISPR-dCas9 and the results showed that when tcaA was suppressed by dCas9, a significant increase was witnessed in persister cells while tcaB suppression did not induce persistence. The results were further evaluated by creating a tcaA mutant that showed ΔtcaA formed a significant increase in persisters in comparison to the wild type. Based on our findings, we concluded that tcaA is the gene that increases persister cells and glycopeptide resistance and could be a potential therapeutic target in S. aureus.
Collapse
Affiliation(s)
- Gul Habib
- Department of Microbiology, Abbottabad University of Science and Technology, Abbottabad, Pakistan
| | - Haji Gul
- College of Animal Science and Technology, Anhui Agricultural University, Hefei, China
- Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - Prevez Ahmad
- Department of Physics, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | - Azam Hayat
- Department of Microbiology, Abbottabad University of Science and Technology, Abbottabad, Pakistan
| | - Mujaddad Ur Rehman
- Department of Microbiology, Abbottabad University of Science and Technology, Abbottabad, Pakistan
| | - Ihab Mohamed Moussa
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Hosam O. Elansary
- Plant Production Department, College of Food & Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
4
|
Raoofi R, Namavari N, Rahmanian V, Dousthaghi MH. Evaluation of antibiotics resistance in Southern Iran in light of COVID-19 pandemic: A retrospective observational study. Health Sci Rep 2023; 6:e1153. [PMID: 36938144 PMCID: PMC10017310 DOI: 10.1002/hsr2.1153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
Background and Aims Antimicrobial resistance (AMR) was taken as one of the high-priority long-lasting public health issues, although it might have been underrated in terms of COVID-19 pandemic emergence. Regarding limited data on assessing the pandemic effect on AMR trend in Iran, this study aimed to describe the epidemiology of antibiotics resistance during the COVID pandemic in southern Iran. Methods This descriptive study was conducted on 2675 patients' samples collected and processed in a referral COVID-19 center hospital in southern Iran from March 21, 2019, to February 18, 2020 (prepandemic), and February 19, 2020, to March 21, 2021 (pandemic). Susceptibility test results in sensitivity and resistance levels were compared in prepandemic and pandemic periods. Results Compared to prepandemic, the inpatient number has increased almost three times. On the other hand, there are around four times fewer outpatients now. More than 85% of the specimens were found in urine samples. In all, 92.22% of all bacteria samples were Gram-negative isolates, with Escherichia coli accounting for 59.19% of them. The change rate of Gram-negative bacteria resistance to antimicrobials is an average of 7.74% (p < 0.001). On the other hand, the average change rate of Gram-positive bacteria resistant to antibiotics has decreased by 19.3% (p = 008). As a forerunner among other Gram-negative bacteria, the average change rate for Pseudomonas aeruginosa and Klebsiella pneumonia resistance to monitored antibiotics was 89% and 66.3%, respectively (p < 0.001). Conclusion During the Covid-19 pandemic, the increase in AMR among Gram-negative bacteria, particularly P. aeruginosa and K. pneumonia, was observed compared to the prepandemic. This further limits treatment options, and endangers global public health.
Collapse
Affiliation(s)
- Rahim Raoofi
- School of Medicine, Department of Infectious DiseasesJahrom University of Medical SciencesJahromIran
| | - Negin Namavari
- School of MedicineJahrom University of Medical ScienceJahromIran
| | - Vahid Rahmanian
- Department of Public HealthTorbat Jam Faculty of Medical SciencesTorbat JamIran
| | | |
Collapse
|
5
|
Mohammadi M, Saffari M, Siadat SD, Hejazi SH, Shayestehpour M, Motallebi M, Eidi M. Isolation, characterization, therapeutic potency, and genomic analysis of a novel bacteriophage vB_KshKPC-M against carbapenemase-producing Klebsiella pneumoniae strains (CRKP) isolated from Ventilator-associated pneumoniae (VAP) infection of COVID-19 patients. Ann Clin Microbiol Antimicrob 2023; 22:18. [PMID: 36829156 PMCID: PMC9955523 DOI: 10.1186/s12941-023-00567-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a significant clinical problem, given the lack of therapeutic options. The CRKP strains have emerged as an essential worldwide healthcare issue during the last 10 years. Global expansion of the CRKP has made it a significant public health hazard. We must consider to novel therapeutic techniques. Bacteriophages are potent restorative cases against infections with multiple drug-resistant bacteria. The Phages offer promising prospects for the treatment of CRKP infections. OBJECTIVE In this study, a novel K. pneumoniae phage vB_KshKPC-M was isolated, characterized, and sequenced, which was able to infect and lyse Carbapenem-resistant K. pneumoniae host specifically. METHODS One hundred clinical isolates of K. pneumoniae were collected from patients with COVID-19 associated with ventilator-associated acute pneumonia hospitalized at Shahid Beheshti Hospital, Kashan, Iran, from 2020 to 2021. Initially, all samples were cultured, and bacterial isolates identified by conventional biochemical tests, and then the ureD gene was used by PCR to confirm the isolates. The Antibiotic susceptibility test in the disc diffusion method and Minimum inhibitory concentrations for Colistin was done and interpreted according to guidelines. Phenotypic and molecular methods determined the Carbapenem resistance of isolates. The blaKPC, blaNDM, and blaOXA-23 genes were amplified for this detection. Biofilm determination of CRKP isolates was performed using a quantitative microtiter plate (MTP) method. The phage was isolated from wastewater during the summer season at a specific position from Beheshti Hospital (Kashan, Iran). The sample was processed and purified against the bacterial host, a CRKP strain isolated from a patient suffering from COVID-19 pneumoniae and resistance to Colistin with high potency for biofilm production. This isolate is called Kp100. The separated phages were diluted and titration by the double overlay agar plaque assay. The separate Phage is concentrated with 10% PEG and stored at -80 °C until use. The phage host range was identified by the spot test method. The purified phage morphology was determined using a transmission electron microscope. The phage stability tests (pH and temperature) were analyzed. The effect of cationic ions on phage adsorption was evaluated. The optimal titer of bacteriophage was determined to reduce the concentration of the CRKP strain. One-step growth assays were performed to identify the purified phage burst's latent cycle and size. The SDS-PAGE was used for phage proteins analysis. Phage DNA was extracted by chloroform technique, and the whole genome of lytic phage was sequenced using Illumina HiSeq technology (Illumina, San Diego, CA). For quality assurance and preprocessing, such as trimming, Geneious Prime 2021.2.2 and Spades 3.9.0. The whole genome sequence of the lytic phage is linked to the GenBank database accession number. RASTtk-v1.073 was used to predict and annotate the ORFs. Prediction of ORF was performed using PHASTER software. ResFinder is used to assess the presence of antimicrobial resistance and virulence genes in the genome. The tRNAs can-SE v2.0.6 is used to determine the presence of tRNA in the genome. Linear genome comparisons of phages and visualization of coding regions were performed using Easyfig 2.2.3 and Mauve 2.4.0. Phage lifestyles were predicted using the program PHACTS. Phylogenetic analysis and amino acid sequences of phage core proteins, such as the major capsid protein. Phylogenies were reconstructed using the Neighbor-Joining method with 1000 bootstrap repeat. HHpred software was used to predict depolymerase. In this study, GraphPad Prism version 9.1 was used for the statistical analysis. Student's t-test was used to compare the sets and the control sets, and the significance level was set at P ≤ 0.05. RESULTS Phage vB_KshKPC-M is assigned to the Siphoviridae, order Caudovirales. It was identified as a linear double-stranded DNA phage of 54,378 bp with 50.08% G + C content, had a relatively broad host range (97.7%), a short latency of 20 min, and a high burst size of 260 PFU/cell, and was maintained stable at different pH (3-11) and temperature (45-65 °C). The vB_KshKPC-M genome contains 91 open-reading frames. No tRNA, antibiotic resistance, toxin, virulence-related genes, or lysogen-forming gene clusters were detected in the phage genome. Comparative genomic analysis revealed that phage vB_KshKPC-M has sequence similarity to the Klebsiella phages, phage 13 (NC_049844.1), phage Sushi (NC_028774.1), phage vB_KpnD_PeteCarol (OL539448.1) and phage PWKp14 (MZ634345.1). CONCLUSION The broad host range and antibacterial activity make it a promising candidate for future phage therapy applications. The isolated phage was able to lyse most of the antibiotic-resistant clinical isolates. Therefore, this phage can be used alone or as a phage mixture in future studies to control and inhibit respiratory infections caused by these bacteria, especially in treating respiratory infections caused by resistant strains in sick patients.
Collapse
Affiliation(s)
- Mehrdad Mohammadi
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Pezeshk Blvd, Qotbe Ravandi Blvd, Kashan, 8715973449 Iran
| | - Mahmood Saffari
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Pezeshk Blvd, Qotbe Ravandi Blvd, Kashan, 8715973449 Iran
| | - Seyed Davar Siadat
- Tuberculosis and Pulmonary Research Department, Pasteur Institute of Iran, Tehran, Iran
- Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Hossein Hejazi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Shayestehpour
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Pezeshk Blvd, Qotbe Ravandi Blvd, Kashan, 8715973449 Iran
| | - Mitra Motallebi
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Pezeshk Blvd, Qotbe Ravandi Blvd, Kashan, 8715973449 Iran
| | - Milad Eidi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
6
|
Witt LS, Howard-Anderson JR, Jacob JT, Gottlieb LB. The impact of COVID-19 on multidrug-resistant organisms causing healthcare-associated infections: a narrative review. JAC Antimicrob Resist 2022; 5:dlac130. [PMID: 36601548 PMCID: PMC9798082 DOI: 10.1093/jacamr/dlac130] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) changed healthcare across the world. With this change came an increase in healthcare-associated infections (HAIs) and a concerning concurrent proliferation of MDR organisms (MDROs). In this narrative review, we describe the impact of COVID-19 on HAIs and MDROs, describe potential causes of these changes, and discuss future directions to combat the observed rise in rates of HAIs and MDRO infections.
Collapse
Affiliation(s)
- Lucy S Witt
- Corresponding author. E-mail: ; @drwittID, @JessH_A, @jestjac
| | - Jessica R Howard-Anderson
- Division of Infection Diseases, Emory University School of Medicine, Atlanta, GA, USA,Emory Antibiotic Resistance Group, Emory University, Atlanta, GA, USA
| | - Jesse T Jacob
- Division of Infection Diseases, Emory University School of Medicine, Atlanta, GA, USA,Emory Antibiotic Resistance Group, Emory University, Atlanta, GA, USA
| | - Lindsey B Gottlieb
- Division of Infection Diseases, Emory University School of Medicine, Atlanta, GA, USA,Emory Antibiotic Resistance Group, Emory University, Atlanta, GA, USA
| |
Collapse
|
7
|
Deng J, Li F, Zhang N, Zhong Y. Prevention and treatment of ventilator-associated pneumonia in COVID-19. Front Pharmacol 2022; 13:945892. [PMID: 36339583 PMCID: PMC9627032 DOI: 10.3389/fphar.2022.945892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/07/2022] [Indexed: 07/10/2024] Open
Abstract
Ventilator-associated pneumonia (VAP) is the most common acquired infection in the intensive care unit. Recent studies showed that the critical COVID-19 patients with invasive mechanical ventilation have a high risk of developing VAP, which result in a worse outcome and an increasing economic burden. With the development of critical care medicine, the morbidity and mortality of VAP remains high. Especially since the outbreak of COVID-19, the healthcare system is facing unprecedented challenges. Therefore, many efforts have been made in effective prevention, early diagnosis, and early treatment of VAP. This review focuses on the treatment and prevention drugs of VAP in COVID-19 patients. In general, prevention is more important than treatment for VAP. Prevention of VAP is based on minimizing exposure to mechanical ventilation and encouraging early release. There is little difference in drug prophylaxis from non-COVID-19. In term of treatment of VAP, empirical antibiotics is the main treatment, special attention should be paid to the antimicrobial spectrum and duration of antibiotics because of the existence of drug-resistant bacteria. Further studies with well-designed and large sample size were needed to demonstrate the prevention and treatment of ventilator-associated pneumonia in COVID-19 based on the specificity of COVID-19.
Collapse
Affiliation(s)
- Jiayi Deng
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fanglin Li
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Hematology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ningjie Zhang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
8
|
Copur B, Dosler S, Aktas Z, Basaran S, Simsek-Yavuz S, Cagatay A, Oncul O, Ozsut H, Eraksoy H. In vitro activities of antibiotic combinations against mature biofilms of ventilator-associated pneumonia isolates. Future Microbiol 2022; 17:1027-1042. [PMID: 35796076 DOI: 10.2217/fmb-2021-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The authors aimed to determine the efficacy of frequently used antibiotics, alone or in combination, against biofilms of ventilator-associated pneumonia isolates. Materials & methods: The authors determined the MICs, minimum biofilm inhibitory concentrations and minimum biofilm eradication concentrations of meropenem, ciprofloxacin and colistin as well as their combinations against planktonic forms and biofilms of Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii clinical isolates. Results: Generally, the minimum biofilm inhibitory concentrations and minimum biofilm eradication concentrations of the antibiotics were 1000-fold higher than their MICs, and synergy was provided by different concentrations of meropenem-colistin and meropenem-ciprofloxacin combinations with checkerboard and time-kill curve methods. Conclusion: The combination of meropenem and ciprofloxacin seems to be a good candidate for the treatment of biofilm-associated infections; none of the concentrations obtained as a result of the synergy test were clinically significant.
Collapse
Affiliation(s)
- Betul Copur
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Sibel Dosler
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul University, Istanbul, 34116, Turkey
| | - Zerrin Aktas
- Department of Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Seniha Basaran
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Serap Simsek-Yavuz
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Atahan Cagatay
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Oral Oncul
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Halit Ozsut
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Haluk Eraksoy
- Departmant of Infectious Diseases & Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| |
Collapse
|
9
|
Galzitskaya OV, Kurpe SR, Panfilov AV, Glyakina AV, Grishin SY, Kochetov AP, Deryusheva EI, Machulin AV, Kravchenko SV, Domnin PA, Surin AK, Azev VN, Ermolaeva SA. Amyloidogenic Peptides: New Class of Antimicrobial Peptides with the Novel Mechanism of Activity. Int J Mol Sci 2022; 23:5463. [PMID: 35628272 PMCID: PMC9140876 DOI: 10.3390/ijms23105463] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/13/2022] Open
Abstract
Antibiotic-resistant bacteria are recognized as one of the leading causes of death in the world. We proposed and successfully tested peptides with a new mechanism of antimicrobial action "protein silencing" based on directed co-aggregation. The amyloidogenic antimicrobial peptide (AAMP) interacts with the target protein of model or pathogenic bacteria and forms aggregates, thereby knocking out the protein from its working condition. In this review, we consider antimicrobial effects of the designed peptides on two model organisms, E. coli and T. thermophilus, and two pathogenic organisms, P. aeruginosa and S. aureus. We compare the amino acid composition of proteomes and especially S1 ribosomal proteins. Since this protein is inherent only in bacterial cells, it is a good target for studying the process of co-aggregation. This review presents a bioinformatics analysis of these proteins. We sum up all the peptides predicted as amyloidogenic by several programs and synthesized by us. For the four organisms we studied, we show how amyloidogenicity correlates with antibacterial properties. Let us especially dwell on peptides that have demonstrated themselves as AMPs for two pathogenic organisms that cause dangerous hospital infections, and in which the minimal inhibitory concentration (MIC) turned out to be comparable to the MIC of gentamicin sulfate. All this makes our study encouraging for the further development of AAMP. The hybrid peptides may thus provide a starting point for the antibacterial application of amyloidogenic peptides.
Collapse
Affiliation(s)
- Oxana V. Galzitskaya
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, 142290 Pushchino, Russia
| | - Stanislav R. Kurpe
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
| | - Alexander V. Panfilov
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
| | - Anna V. Glyakina
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
- Institute of Mathematical Problems of Biology, Russian Academy of Sciences, 142290 Pushchino, Russia
- Keldysh Institute of Applied Mathematics, Russian Academy of Sciences, 125047 Moscow, Russia
| | - Sergei Y. Grishin
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
| | - Alexey P. Kochetov
- The Branch of the Institute of Bioorganic Chemistry, Russian Academy of Sciences, 142290 Pushchino, Russia; (A.P.K.); (V.N.A.)
| | - Evgeniya I. Deryusheva
- Institute for Biological Instrumentation, Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences”, 142290 Pushchino, Russia;
| | - Andrey V. Machulin
- Skryabin Institute of Biochemistry and Physiology of Microorganisms, Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Science”, 142290 Pushchino, Russia;
| | - Sergey V. Kravchenko
- Institute of Environmental and Agricultural Biology (X-BIO), Tyumen State University, 625003 Tyumen, Russia;
| | - Pavel A. Domnin
- Gamaleya Research Centre of Epidemiology and Microbiology, 123098 Moscow, Russia; (P.A.D.); (S.A.E.)
- Biology Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Alexey K. Surin
- Institute of Protein Research, Russian Academy of Sciences, 142290 Pushchino, Russia; (S.R.K.); (A.V.P.); (A.V.G.); (S.Y.G.); (A.K.S.)
- The Branch of the Institute of Bioorganic Chemistry, Russian Academy of Sciences, 142290 Pushchino, Russia; (A.P.K.); (V.N.A.)
- State Research Center for Applied Microbiology and Biotechnology, 142279 Obolensk, Russia
| | - Viacheslav N. Azev
- The Branch of the Institute of Bioorganic Chemistry, Russian Academy of Sciences, 142290 Pushchino, Russia; (A.P.K.); (V.N.A.)
| | - Svetlana A. Ermolaeva
- Gamaleya Research Centre of Epidemiology and Microbiology, 123098 Moscow, Russia; (P.A.D.); (S.A.E.)
| |
Collapse
|
10
|
Boyd S, Nseir S, Rodriguez A, Martin-Loeches I. Ventilator-associated pneumonia in critically ill patients with COVID-19 infection, a narrative review. ERJ Open Res 2022; 8:00046-2022. [PMID: 35891621 PMCID: PMC9080287 DOI: 10.1183/23120541.00046-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/24/2022] [Indexed: 01/08/2023] Open
Abstract
COVID pneumonitis can cause patients to become critically ill. They may require intensive care and mechanical ventilation. Ventilator-associated pneumonia is a concern. This review aims to discuss the topic of ventilator-associated pneumonia in this group. Several reasons have been proposed to explain the elevated rates of VAP in critically ill COVID patients compared to non-COVID patients. Extrinsic factors include understaffing, lack of PPE and use of immunomodulating agents. Intrinsic factors include severe parenchymal damage, immune dysregulation, along with pulmonary vascular endothelial inflammation and thrombosis. The rate of VAP has been reported at 45.4%, with an ICU mortality rate of 42.7%. Multiple challenges to diagnosis exist. Other conditions such as acute respiratory distress syndrome, pulmonary oedema and atelectasis can present with similar features. Frequent growth of gram-negative bacteria has been shown in multiple studies, with particularly high rates of pseudomonas aeruginosa. The rate of invasive pulmonary aspergillosis has been reported at 4–30%. We would recommend the use of invasive techniques when possible. This will enable de-escalation of antibiotics as soon as possible, decreasing overuse. It is also important to keep other possible causes of ventilator-associated pneumonia in mind, such as COVID-19 associated pulmonary aspergillosis, cytomegalovirus, etc. Diagnostic tests such as galactomannan and B-D-glucan should be considered. These patients may face a long treatment course, with risk of re-infection, along with prolonged weaning, which carries its own long-term consequences.
Collapse
|