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Solomonian L, Blesoff J, Garofalo L, Lucas S, Picardo A, Garber A, Wilson M, Leach M. Naturopathic Management of Acute Pediatric Respiratory Infections: A Modified Delphi Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:181-195. [PMID: 36827416 DOI: 10.1089/jicm.2022.0669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Objective: Both the United Nations and the World Health Organization have identified antimicrobial resistance as a significant threat to global health. The Centers for Disease Control and Prevention identified five pediatric respiratory conditions as requiring particular scrutiny in terms of antibiotic stewardship. This study sought to identify strategies used by experienced naturopathic practitioners to treat acute respiratory infections in children. The authors theorize that naturopathic strategies safely fill the gap between watchful waiting and antibiotic prescription, thus reducing the use of antibiotics. Methods: Naturopathic practitioners in Canada, the United States, and Australia with a minimum of 5 years of experience in clinical naturopathic care of children were recruited for a modified Delphi study. A 14-person panel of practitioners was selected to complete a series of four iterative surveys assessing agreement to statements in five domains of knowledge/attitudes, assessment/diagnosis, management, monitoring, and education. Items were deemed to have reached consensus if they reached a predetermined threshold of 70% agreement, or failed to reach a threshold of 40% agreement. Items between these boundaries were modified and retested until either consensus was reached or the four surveys had been completed. Results: Results yielded a large degree of agreement on core naturopathic approaches to the management of acute pediatric respiratory infections, especially lifestyle strategies, including adequate rest and dietary recommendations. The use of vitamins C and D was strongly supported, as were herbs, particularly echinacea and elderberry. Some hydrotherapy and topical applications specific to the individual focus on infection also reached consensus. Results suggested that most respondents, even if they have the authority to prescribe antibiotics, rarely deem it necessary to do so. Conclusion: Findings of this study provide (1) clarity on the role of naturopathic doctors in the management of pediatric health concerns and the stewardship of antibiotics; and (2) initial guidance to less experienced naturopathic practitioners. The findings also identify key priorities for research into the safety and effectiveness of naturopathic interventions to reduce the unnecessary prescribing of antibiotics.
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Affiliation(s)
| | - Jamine Blesoff
- National University of Health Sciences, Lombard, IL, USA
| | | | - Sandra Lucas
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrea Picardo
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Anna Garber
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Mariah Wilson
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
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Bhat AA, Tandon N, Tandon R. Pyrrolidine derivatives as antibacterial agents, current status and future prospects: a patent review. Pharm Pat Anal 2022; 11:187-198. [PMID: 36366974 DOI: 10.4155/ppa-2022-0015] [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: 11/13/2022]
Abstract
Bacterial infections are increasingly epitomizing major global health concerns, with rising death rates. Since the most complete assessment of the worldwide impact of antimicrobial resistance to date, with over 1.2 million people dead in 2019 as a direct result of antibiotic-resistant bacterial infections. The majority of antimicrobial drugs have been associated with a multitude of adverse effects including financial costs as well. Pyrrolidine derivatives have sparked the interest of researchers to create novel synthetic molecules with minimal side effect and drawbacks. To close the research gap, the current review discusses the synthetic compounds with active pyrrolidine scaffolds, critical findings and most crucially the structure-activity relationship that affects the activity of the ring over the last one and half decade.
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Affiliation(s)
- Aeyaz A Bhat
- School of Chemical Engineering & Physical Science, Lovely Professional University, Phagwara, 144402, Punjab
| | - Nitin Tandon
- School of Chemical Engineering & Physical Science, Lovely Professional University, Phagwara, 144402, Punjab
| | - Runjhun Tandon
- School of Chemical Engineering & Physical Science, Lovely Professional University, Phagwara, 144402, Punjab
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Islam M, Karmakar PC, Tusher-Al-Arafat, Arifuzzaman M, Karim N, Akhtar N, Asaduzzaman SM. Human Amniotic Membrane and Titanium Dioxide Nanoparticle Derived Gel for Burn Wound Healing in a Rat Model. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2022. [DOI: 10.1007/s40883-022-00280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Noergaard M, Gotfredsen DR, Sørensen AMS, Andersen J. Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study. BJOG 2022; 129:1503-1511. [PMID: 34954900 PMCID: PMC9544954 DOI: 10.1111/1471-0528.17083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the association between maternal exposure to ciprofloxacin and the risk of miscarriage and major malformations. DESIGN A nationwide register-based cohort study. SETTING Data were obtained from the Medical Birth Registry, the National Hospital Registry, the Danish National Prescription Registry and Statistics Denmark. POPULATION Data were collected in the period between 1997 and 2016 and included all registered pregnancies that ended in an elective termination, miscarriage, stillbirth or a live birth. Exposure was defined as redeeming one or more prescriptions of ciprofloxacin. METHODS Miscarriage was defined as a diagnosis given before 22 weeks without any medical intervention. Major malformations were classified according to EUROCAT 1.4. We matched ciprofloxacin-exposed pregnancies to unexposed pregnancies on the propensity score in a ratio 1:4. To estimate the hazard ratio (HR) of miscarriage a Cox proportional hazard regression model was used. A log binomial model was used to estimate the relative risk ratio (RR) of major malformations. MAIN OUTCOME MEASURES HR of miscarriage and the RR of major malformations. RESULTS A total of 1 650 649 pregnancies were identified. Of these, 10 250 (2050 ciprofloxacin-exposed) and 6100 (1220 ciprofloxacin-exposed) were included in the miscarriage and major malformation analysis, respectively. The HR of miscarriage was 0.99 (95% confidence interval [CI] 0.84-1.17). For major malformation, the RR was 1.01 (95% CI 0.72-1.40). For the organ-specific major malformations and the sensitivity analyses, no significant increased risks were identified. CONCLUSION We demonstrated no association between miscarriage and maternal ciprofloxacin exposure within the first 22 weeks of pregnancy, or between major malformations and maternal exposure during the first trimester. TWEETABLE ABSTRACT No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
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Affiliation(s)
- Mia Noergaard
- Department of Clinical PharmacologyCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
| | - Ditte Resendal Gotfredsen
- Department of Clinical PharmacologyCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
| | - Anne Mette Skov Sørensen
- Department of Clinical PharmacologyCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
| | - Jon Trærup Andersen
- Department of Clinical PharmacologyCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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Ricky R, Chiampo F, Shanthakumar S. Efficacy of Ciprofloxacin and Amoxicillin Removal and the Effect on the Biochemical Composition of Chlorella vulgaris. Bioengineering (Basel) 2022; 9:134. [PMID: 35447694 PMCID: PMC9032391 DOI: 10.3390/bioengineering9040134] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Antibiotics are frequently detected in the aquatic environment due to their excessive usage and low-efficiency removal in wastewater treatment plants. This can provide the origin to the development of antibiotic-resistant genes in the microbial community, with considerable ecotoxicity to the environment. Among the antibiotics, the occurrence of ciprofloxacin (CIP) and amoxicillin (AMX) has been detected in various water matrices at different concentrations around the Earth. They are designated as emerging contaminants (ECs). Microalga Chlorella vulgaris (C. vulgaris) has been extensively employed in phycoremediation studies for its acclimatization property, non-target organisms for antibiotics, and the production of value-added bioproducts utilizing the nutrients from the wastewater. In this study, C. vulgaris medium was spiked with 5 mg/L of CIP and AMX, and investigated for its growth-stimulating effects, antibiotic removal capabilities, and its effects on the biochemical composition of algal cells compared to the control medium for 7 days. The results demonstrated that C. vulgaris adapted the antibiotic spiked medium and removed CIP (37 ± 2%) and AMX (25 ± 3%), respectively. The operating mechanisms were bioadsorption, followed by bioaccumulation, and biodegradation, with an increase in cell density up to 46 ± 3% (CIP) and 36 ± 4% (AMX), compared to the control medium. Further investigations revealed that, in the CIP stress-induced algal medium, an increase in major photosynthetic pigment chlorophyll-a (30%) and biochemical composition (lipids (50%), carbohydrates (32%), and proteins (65%)) was observed, respectively, compared to the control medium. In the AMX stress-induced algal medium, increases in chlorophyll-a (22%), lipids (46%), carbohydrates (45%), and proteins (49%) production were observed compared to the control medium. Comparing the two different stress conditions and considering that CIP is more toxic than AMX, this study provided insights on the photosynthetic activity and biochemical composition of C. vulgaris during the stress conditions and the response of algae towards the specific antibiotic stress. The current study confirmed the ability of C. vulgaris to adapt, bioadsorb, bioaccumulate, and biodegrade emerging contaminants. Moreover, the results showed that C. vulgaris is not only able to remove CIP and AMX from the medium but also can increase the production of valuable biomass usable in the production of various bioproducts.
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Affiliation(s)
- Rajamanickam Ricky
- Department of Environmental and Water Resources Engineering, School of Civil Engineering, Vellore Institute of Technology (VIT), Vellore 632014, India; (R.R.); (S.S.)
| | - Fulvia Chiampo
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Subramaniam Shanthakumar
- Department of Environmental and Water Resources Engineering, School of Civil Engineering, Vellore Institute of Technology (VIT), Vellore 632014, India; (R.R.); (S.S.)
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Scholtz V, Vaňková E, Kašparová P, Premanath R, Karunasagar I, Julák J. Non-thermal Plasma Treatment of ESKAPE Pathogens: A Review. Front Microbiol 2021; 12:737635. [PMID: 34712211 PMCID: PMC8546340 DOI: 10.3389/fmicb.2021.737635] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/09/2021] [Indexed: 01/19/2023] Open
Abstract
The acronym ESKAPE refers to a group of bacteria consisting of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. They are important in human medicine as pathogens that show increasing resistance to commonly used antibiotics; thus, the search for new effective bactericidal agents is still topical. One of the possible alternatives is the use of non-thermal plasma (NTP), a partially ionized gas with the energy stored particularly in the free electrons, which has antimicrobial and anti-biofilm effects. Its mechanism of action includes the formation of pores in the bacterial membranes; therefore, resistance toward it is not developed. This paper focuses on the current overview of literature describing the use of NTP as a new promising tool against ESKAPE bacteria, both in planktonic and biofilm forms. Thus, it points to the fact that NTP treatment can be used for the decontamination of different types of liquids, medical materials, and devices or even surfaces used in various industries. In summary, the use of diverse experimental setups leads to very different efficiencies in inactivation. However, Gram-positive bacteria appear less susceptible compared to Gram-negative ones, in general.
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Affiliation(s)
- Vladimír Scholtz
- Department of Physics and Measurements, University of Chemistry and Technology, Prague, Czechia
| | - Eva Vaňková
- Department of Physics and Measurements, University of Chemistry and Technology, Prague, Czechia.,Department of Biotechnology, University of Chemistry and Technology, Prague, Czechia
| | - Petra Kašparová
- Department of Physics and Measurements, University of Chemistry and Technology, Prague, Czechia
| | - Ramya Premanath
- Nitte University, Nitte University Centre for Science Education and Research, Mangalore, India
| | - Iddya Karunasagar
- Nitte University, Nitte University Centre for Science Education and Research, Mangalore, India
| | - Jaroslav Julák
- Department of Physics and Measurements, University of Chemistry and Technology, Prague, Czechia.,Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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Khan SJ, Osborn AM, Eswara PJ. Effect of Sunlight on the Efficacy of Commercial Antibiotics Used in Agriculture. Front Microbiol 2021; 12:645175. [PMID: 34140934 PMCID: PMC8203823 DOI: 10.3389/fmicb.2021.645175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Antibiotic stewardship is of paramount importance to limit the emergence of antibiotic-resistant bacteria in not only hospital settings, but also in animal husbandry, aquaculture, and agricultural sectors. Currently, large quantities of antibiotics are applied to treat agricultural diseases like citrus greening disease (CGD). The two commonly used antibiotics approved for this purpose are streptomycin and oxytetracycline. Although investigations are ongoing to understand how efficient this process is to control the spread of CGD, to our knowledge, there have been no studies that evaluate the effect of environmental factors such as sunlight on the efficacy of the above-mentioned antibiotics. We conducted a simple disc-diffusion assay to study the efficacy of streptomycin and oxytetracycline after exposure to sunlight for 7- or 14-day periods using Escherichia coli and Bacillus subtilis as the representative strains of Gram-negative and Gram-positive organisms, respectively. Freshly prepared discs and discs stored in the dark for 7 or 14 days served as our controls. We show that the antibiotic potential of oxytetracycline exposed to sunlight dramatically decreases over the course of 14 days against both E. coli and B. subtilis. However, the effectiveness of streptomycin was only moderately impacted by sunlight. It is important to note that antibiotics that last longer in the environment may play a deleterious role in the rise and spread of antibiotic-resistant bacteria. Further studies are needed to substantively analyze the safety and efficacy of antibiotics used for broader environmental applications.
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Affiliation(s)
| | | | - Prahathees J. Eswara
- Department of Cell Biology, Microbiology and Molecular Biology, University of South Florida, Tampa, FL, United States
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8
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Iqbal Z, Ahmed S, Tabassum N, Bhattacharya R, Bose D. Role of probiotics in prevention and treatment of enteric infections: a comprehensive review. 3 Biotech 2021; 11:242. [PMID: 33968585 PMCID: PMC8079594 DOI: 10.1007/s13205-021-02796-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
Microorganisms that inhabits human digestive tract affect global health and enteric disorders. Previous studies have documented the effectiveness and mode of action of probiotics and classified as human-friendly biota and a competitor to enteric pathogens. Statistical studies reported more than 1.5 billion cases of gastrointestinal infections caused by enteric pathogens and their long-term exposure can lead to mental retardation, temporary or permanent physical weakness, and leaving the patient susceptible for opportunistic pathogens, which can cause fatality. We reviewed previous literature providing evidence about therapeutic approaches regarding probiotics to cure enteric infections efficiently by producing inhibitory substances, immune system modulation, improved barrier function. The therapeutic effects of probiotics have shown success against many foodborne pathogens and their therapeutic effectiveness has been exponentially increased using genetically engineered probiotics. The bioengineered probiotic strains are expected to provide a better and alternative approach than traditional antibiotic therapy against enteric pathogens, but the novelty of these strains also raise doubts about the possible untapped side effects, for which there is a need for further studies to eliminate the concerns relating to the use and safety of probiotics. Many such developments and optimization of the classical techniques will revolutionize the treatments for enteric infections.
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Affiliation(s)
- Zunaira Iqbal
- Department of Microbiology, University of Central Punjab, Johar Town, 1-Khayaban-e-Jinnah Road, Lahore, Pakistan
| | - Shahzaib Ahmed
- Department of Biotechnology, University of Central Punjab, Johar Town, 1-Khayaban-e-Jinnah Road, Lahore, Pakistan
| | - Natasha Tabassum
- Department of Biotechnology, University of Central Punjab, Johar Town, 1-Khayaban-e-Jinnah Road, Lahore, Pakistan
| | - Riya Bhattacharya
- Faculty of Applied Sciences and Biotechnology, School of Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh India
| | - Debajyoti Bose
- Faculty of Applied Sciences and Biotechnology, School of Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh India
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9
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Matthew AN, Leidner F, Lockbaum GJ, Henes M, Zephyr J, Hou S, Desaboini NR, Timm J, Rusere LN, Ragland DA, Paulsen JL, Prachanronarong K, Soumana DI, Nalivaika EA, Yilmaz NK, Ali A, Schiffer CA. Drug Design Strategies to Avoid Resistance in Direct-Acting Antivirals and Beyond. Chem Rev 2021; 121:3238-3270. [PMID: 33410674 PMCID: PMC8126998 DOI: 10.1021/acs.chemrev.0c00648] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Drug resistance is prevalent across many diseases, rendering therapies ineffective with severe financial and health consequences. Rather than accepting resistance after the fact, proactive strategies need to be incorporated into the drug design and development process to minimize the impact of drug resistance. These strategies can be derived from our experience with viral disease targets where multiple generations of drugs had to be developed to combat resistance and avoid antiviral failure. Significant efforts including experimental and computational structural biology, medicinal chemistry, and machine learning have focused on understanding the mechanisms and structural basis of resistance against direct-acting antiviral (DAA) drugs. Integrated methods show promise for being predictive of resistance and potency. In this review, we give an overview of this research for human immunodeficiency virus type 1, hepatitis C virus, and influenza virus and the lessons learned from resistance mechanisms of DAAs. These lessons translate into rational strategies to avoid resistance in drug design, which can be generalized and applied beyond viral targets. While resistance may not be completely avoidable, rational drug design can and should incorporate strategies at the outset of drug development to decrease the prevalence of drug resistance.
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Affiliation(s)
- Ashley N. Matthew
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Virginia Commonwealth University
| | - Florian Leidner
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Gordon J. Lockbaum
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Mina Henes
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Jacqueto Zephyr
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Shurong Hou
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Nages Rao Desaboini
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Jennifer Timm
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Rutgers University
| | - Linah N. Rusere
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Raybow Pharmaceutical
| | - Debra A. Ragland
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- University of North Carolina, Chapel Hill
| | - Janet L. Paulsen
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Schrodinger, Inc
| | - Kristina Prachanronarong
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Icahn School of Medicine at Mount Sinai
| | - Djade I. Soumana
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
- Cytiva
| | - Ellen A. Nalivaika
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Nese Kurt Yilmaz
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Akbar Ali
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Celia A Schiffer
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
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Aghaee BL, Khan Mirzaei M, Alikhani MY, Mojtahedi A, Maurice CF. Improving the Inhibitory Effect of Phages against Pseudomonas aeruginosa Isolated from a Burn Patient Using a Combination of Phages and Antibiotics. Viruses 2021; 13:334. [PMID: 33670028 PMCID: PMC7926668 DOI: 10.3390/v13020334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
Antibiotic resistance causes around 700,000 deaths a year worldwide. Without immediate action, we are fast approaching a post-antibiotic era in which common infections can result in death. Pseudomonas aeruginosa is the leading cause of nosocomial infection and is also one of the three bacterial pathogens in the WHO list of priority bacteria for developing new antibiotics against. A viable alternative to antibiotics is to use phages, which are bacterial viruses. Yet, the isolation of phages that efficiently kill their target bacteria has proven difficult. Using a combination of phages and antibiotics might increase treatment efficacy and prevent the development of resistance against phages and/or antibiotics, as evidenced by previous studies. Here, in vitro populations of a Pseudomonas aeruginosa strain isolated from a burn patient were treated with a single phage, a mixture of two phages (used simultaneously and sequentially), and the combination of phages and antibiotics (at sub-minimum inhibitory concentration (MIC) and MIC levels). In addition, we tested the stability of these phages at different temperatures, pH values, and in two burn ointments. Our results show that the two-phages-one-antibiotic combination had the highest killing efficiency against the P. aeruginosa strain. The phages tested showed low stability at high temperatures, acidic pH values, and in the two ointments. This work provides additional support for the potential of using combinations of phage-antibiotic cocktails at sub-MIC levels for the treatment of multidrug-resistant P. aeruginosa infections.
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Affiliation(s)
- Bahareh Lashtoo Aghaee
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan 65178-38678, Iran;
| | - Mohammadali Khan Mirzaei
- Institute of Virology, Helmholtz Center Munich and Technical University of Munich, 85764 Neuherberg, Germany;
- Department of Microbiology & Immunology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 0B1, Canada
| | - Mohammad Yousef Alikhani
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan 65178-38678, Iran;
| | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht 41938-33697, Iran
| | - Corinne F. Maurice
- Department of Microbiology & Immunology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 0B1, Canada
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Gómez J, Sierra D, Cárdenas C, Guzmán F. Bio-organometallic Peptide Conjugates: Recent Advances in Their Synthesis and Prospects for Biomedical Application. CURR ORG CHEM 2020. [DOI: 10.2174/1385272824666200309093938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
One area of organometallic chemistry that has attracted great interest in recent
years is the syntheses, characterization and study of organometallic complexes conjugated
to biomolecules with different steric and electronic properties as potential therapeutic
agents against cancer and malaria, as antibiotics and as radiopharmaceuticals. This minireview
focuses on the unique structural diversity that has recently been discovered in α-
amino acids and the reactions of metallocene complexes with peptides having different
chemical behavior and potential medical applications. Replacing α-amino acids with metallocene
fragments is an effective way of selectively influencing the physicochemical,
structural, electrochemical and biological properties of the peptides. Consequently, research
in the field of bioorganometallic chemistry offers the opportunity to develop bioactive
metal compounds as an innovative and promising approach in the search for pharmacological control of
different diseases.
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Affiliation(s)
- Johana Gómez
- Nucleo de Biotecnologia Curauma, Pontificia Universidad Catolica de Valparaiso, Av. Universidad 330, Valparaiso, Chile
| | - Diego Sierra
- Instituto de Quimica y Bioquimica, Facultad de Ciencias, Universidad de Valparaiso, Av. Gran Bretana 1111, Valparaíso, Chile
| | - Constanza Cárdenas
- Nucleo de Biotecnologia Curauma, Pontificia Universidad Catolica de Valparaiso, Av. Universidad 330, Valparaiso, Chile
| | - Fanny Guzmán
- Nucleo de Biotecnologia Curauma, Pontificia Universidad Catolica de Valparaiso, Av. Universidad 330, Valparaiso, Chile
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Al-Kandari F, Al-Temaimi R, van Vliet AHM, Woodward MJ. Thymol tolerance in Escherichia coli induces morphological, metabolic and genetic changes. BMC Microbiol 2019; 19:294. [PMID: 31842755 PMCID: PMC6915861 DOI: 10.1186/s12866-019-1663-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 11/26/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Thymol is a phenolic compound used for its wide spectrum antimicrobial activity. There is a limited understanding of the antimicrobial mechanisms underlying thymol activity. To investigate this, E. coli strain JM109 was exposed to thymol at sub-lethal concentrations and after 16 rounds of exposure, isolates with a 2-fold increased minimal inhibitory concentration (MIC) were recovered (JM109-Thyr). The phenotype was stable after multiple sub-cultures without thymol. RESULTS Cell morphology studies by scanning electron microscopy (SEM) suggest that thymol renders bacterial cell membranes permeable and disrupts cellular integrity. 1H Nuclear magnetic resonance (NMR) data showed an increase in lactate and the lactic acid family amino acids in the wild type and JM109-Thyr in the presence of thymol, indicating a shift from aerobic respiration to fermentation. Sequencing of JM109-Thyr defined multiple mutations including a stop mutation in the acrR gene resulting in a truncation of the repressor of the AcrAB efflux pump. AcrAB is a multiprotein complex traversing the cytoplasmic and outer membrane, and is involved in antibiotic clearance. CONCLUSIONS Our data suggests that thymol tolerance in E. coli induces morphological, metabolic and genetic changes to adapt to thymol antimicrobial activity.
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Affiliation(s)
- Fatemah Al-Kandari
- Department of Food and Nutrition Science, School of Chemistry, University of Reading, Reading, RG6 6AP UK
- Department of Plant Protection, Public Authority Of Agriculture Affairs & Fish Resources, Al-Rabia, Kuwait
| | - Rabeah Al-Temaimi
- Human Genetics Unit, Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Arnoud H. M. van Vliet
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7AL UK
| | - Martin J. Woodward
- Department of Food and Nutrition Science, School of Chemistry, University of Reading, Reading, RG6 6AP UK
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Henes M, Lockbaum GJ, Kosovrasti K, Leidner F, Nachum GS, Nalivaika EA, Lee SK, Spielvogel E, Zhou S, Swanstrom R, Bolon DN, Yilmaz NK, Schiffer CA. Picomolar to Micromolar: Elucidating the Role of Distal Mutations in HIV-1 Protease in Conferring Drug Resistance. ACS Chem Biol 2019; 14:2441-2452. [PMID: 31361460 PMCID: PMC6941144 DOI: 10.1021/acschembio.9b00370] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Drug resistance continues to be a growing global problem. The efficacy of small molecule inhibitors is threatened by pools of genetic diversity in all systems, including antibacterials, antifungals, cancer therapeutics, and antivirals. Resistant variants often include combinations of active site mutations and distal "secondary" mutations, which are thought to compensate for losses in enzymatic activity. HIV-1 protease is the ideal model system to investigate these combinations and underlying molecular mechanisms of resistance. Darunavir (DRV) binds wild-type (WT) HIV-1 protease with a potency of <5 pM, but we have identified a protease variant that loses potency to DRV 150 000-fold, with 11 mutations in and outside the active site. To elucidate the roles of these mutations in DRV resistance, we used a multidisciplinary approach, combining enzymatic assays, crystallography, and molecular dynamics simulations. Analysis of protease variants with 1, 2, 4, 8, 9, 10, and 11 mutations showed that the primary active site mutations caused ∼50-fold loss in potency (2 mutations), while distal mutations outside the active site further decreased DRV potency from 13 nM (8 mutations) to 0.76 μM (11 mutations). Crystal structures and simulations revealed that distal mutations induce subtle changes that are dynamically propagated through the protease. Our results reveal that changes remote from the active site directly and dramatically impact the potency of the inhibitor. Moreover, we find interdependent effects of mutations in conferring high levels of resistance. These mechanisms of resistance are likely applicable to many other quickly evolving drug targets, and the insights may have implications for the design of more robust inhibitors.
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Affiliation(s)
- Mina Henes
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Gordon J. Lockbaum
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Klajdi Kosovrasti
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Florian Leidner
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Gily S. Nachum
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Ellen A. Nalivaika
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Sook-Kyung Lee
- Department of Biochemistry and Biophysics and the UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Ean Spielvogel
- Department of Biochemistry and Biophysics and the UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Shuntai Zhou
- Department of Biochemistry and Biophysics and the UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Ronald Swanstrom
- Department of Biochemistry and Biophysics and the UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Daniel N.A. Bolon
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States
| | - Nese Kurt Yilmaz
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States,Corresponding authors Celia A. Schiffer: Phone: +1 508 856 8008; , Nese Kurt Yilmaz: Phone: +1 508 856 1867;
| | - Celia A. Schiffer
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, United States,Corresponding authors Celia A. Schiffer: Phone: +1 508 856 8008; , Nese Kurt Yilmaz: Phone: +1 508 856 1867;
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Yañez-Macías R, Muñoz-Bonilla A, De Jesús-Tellez MA, Maldonado-Textle H, Guerrero-Sánchez C, Schubert US, Guerrero-Santos R. Combinations of Antimicrobial Polymers with Nanomaterials and Bioactives to Improve Biocidal Therapies. Polymers (Basel) 2019; 11:E1789. [PMID: 31683853 PMCID: PMC6918310 DOI: 10.3390/polym11111789] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022] Open
Abstract
The rise of antibiotic-resistant microorganisms has become a critical issue in recent years and has promoted substantial research efforts directed to the development of more effective antimicrobial therapies utilizing different bactericidal mechanisms to neutralize infectious diseases. Modern approaches employ at least two mixed bioactive agents to enhance bactericidal effects. However, the combinations of drugs may not always show a synergistic effect, and further, could also produce adverse effects or stimulate negative outcomes. Therefore, investigations providing insights into the effective utilization of combinations of biocidal agents are of great interest. Sometimes, combination therapy is needed to avoid resistance development in difficult-to-treat infections or biofilm-associated infections treated with common biocides. Thus, this contribution reviews the literature reports discussing the usage of antimicrobial polymers along with nanomaterials or other inhibitors for the development of more potent biocidal therapies.
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Affiliation(s)
- Roberto Yañez-Macías
- Centro de Investigación en Química Aplicada (CIQA), Boulevard Enrique Reyna No. 140, 25294 Saltillo, Mexico.
| | - Alexandra Muñoz-Bonilla
- Instituto de Ciencia y Tecnología de Polímeros (ICTP-CSIC), C/Juan de la Cierva 3, 28006 Madrid, Spain.
| | - Marco A De Jesús-Tellez
- Centro de Investigación y de Estudios Avanzados (CINVESTAV) Unidad Mérida, A.P. 73, Cordemex, 97310 Mérida, México.
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, Humboldtstrasse 10, D-07743 Jena, Germany.
| | - Hortensia Maldonado-Textle
- Centro de Investigación en Química Aplicada (CIQA), Boulevard Enrique Reyna No. 140, 25294 Saltillo, Mexico.
| | - Carlos Guerrero-Sánchez
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, Humboldtstrasse 10, D-07743 Jena, Germany.
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Philosophenweg 7, D-07743 Jena, Germany.
| | - Ulrich S Schubert
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, Humboldtstrasse 10, D-07743 Jena, Germany.
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Philosophenweg 7, D-07743 Jena, Germany.
| | - Ramiro Guerrero-Santos
- Centro de Investigación en Química Aplicada (CIQA), Boulevard Enrique Reyna No. 140, 25294 Saltillo, Mexico.
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15
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Catalán-Matamoros D, Pariente A, Elías-Pérez C. What we know about media communication on antibiotics and antimicrobial resistance: A systematic review of the scientific literature. PATIENT EDUCATION AND COUNSELING 2019; 102:1427-1438. [PMID: 30981412 DOI: 10.1016/j.pec.2019.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Systematically review the literature regarding media communication about antibiotics and anti-microbial resistance (AMR) to synthesise its key characteristics and impact effectiveness, identifying gaps and areas for further research. METHODS A comprehensive systematic review covering five international databases for articles published between 1st September 2008 and 1st September 2018 was performed using the registered protocol (PROSPERO: CRD42018116464). The search using terms related to media communication and antibiotics or AMR yielded 19 eligible studies, which were analysed and qualitatively synthesised. RESULTS Research on media communication regarding antibiotics or AMR has rapidly increased in the last decade. 74% of studies used a media content analysis method, while the remaining studies collected data via surveys. Print media were examined in 53% (n = 10), with 74% (n = 14) focused on English language media. CONCLUSION Currently, knowledge regarding media communication of antibiotics and AMR is very restricted to English-speaking print media. Further research is required to understand communication on this topic from other media (types and geographical regions) as well as how media effects attitude and behaviour change. PRACTICE IMPLICATIONS Better understanding of media communication regarding antibiotics and AMR may be crucial for policymakers and public health experts when planning strategies to tackle this issue.
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Affiliation(s)
- Daniel Catalán-Matamoros
- Department of Journalism and Communication, University Carlos III of Madrid, Madrid, Spain; Research Group of Health Sciences CTS-451, University of Almeria, Almeria, Spain.
| | - Antoine Pariente
- Department of Pharmacology, University of Bordeaux, Bordeaux, France
| | - Carlos Elías-Pérez
- Department of Journalism and Communication, University Carlos III of Madrid, Madrid, Spain
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16
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The impact of paediatric antimicrobial stewardship programmes on patient outcomes. Curr Opin Infect Dis 2019; 31:216-223. [PMID: 29570494 DOI: 10.1097/qco.0000000000000449] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Although there has been an unprecedented global effort to reduce the spread of antimicrobial resistance, little emphasis has been placed on children. This review aims to evaluate the impact of paediatric antimicrobial stewardship programmes as well as providing a practical approach for effectively implementing them in community-based settings and in hospitals. RECENT FINDINGS Although rates of serious bacterial infection are low in children, the rates of antimicrobial use and resistance are comparable with adults. Different strategies are required to implement antimicrobial stewardship in community-based settings compared to in hospitals. Nationally coordinated, whole-system approaches have achieved long-term, sustainable reductions in antimicrobial prescribing, as well as reductions in resistance rates at population level, with no evidence of an increase in rate of serious infection or bacterial complications. SUMMARY Antimicrobial stewardship programmes in neonates and children have unique characteristics and issues. There is currently no consensus on how to measure consumption of antimicrobials in neonates and children. This is a research priority. Benchmarking and clinical networks in neonates and paediatrics are important to share practice and drive best use of antimicrobials.
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17
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Alsan M, Kammili N, Lakshmi J, Xing A, Khan A, Rani M, Kolli P, Relman DA, Owens DK. Poverty and Community-Acquired Antimicrobial Resistance with Extended-Spectrum β-Lactamase-Producing Organisms, Hyderabad, India. Emerg Infect Dis 2019; 24:1490-1496. [PMID: 30014842 PMCID: PMC6056104 DOI: 10.3201/eid2408.171030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The decreasing effectiveness of antimicrobial agents is a global public health threat, yet risk factors for community-acquired antimicrobial resistance (CA-AMR) in low-income settings have not been clearly elucidated. Our aim was to identify risk factors for CA-AMR with extended-spectrum β-lactamase (ESBL)–producing organisms among urban-dwelling women in India. We collected microbiological and survey data in an observational study of primigravidae women in a public hospital in Hyderabad, India. We analyzed the data using multivariate logistic and linear regression and found that 7% of 1,836 women had bacteriuria; 48% of isolates were ESBL-producing organisms. Women in the bottom 50th percentile of income distribution were more likely to have bacteriuria (adjusted odds ratio 1.44, 95% CI 0.99–2.10) and significantly more likely to have bacteriuria with ESBL-producing organisms (adjusted odds ratio 2.04, 95% CI 1.17–3.54). Nonparametric analyses demonstrated a negative relationship between the prevalence of ESBL and income.
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18
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Nelson MM, Waldron CL, Bracht JR. Rapid molecular detection of macrolide resistance. BMC Infect Dis 2019; 19:144. [PMID: 30755177 PMCID: PMC6373131 DOI: 10.1186/s12879-019-3762-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 01/30/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Emerging antimicrobial resistance is a significant threat to human health. However, methods for rapidly diagnosing antimicrobial resistance generally require multi-day culture-based assays. Macrolide efflux gene A, mef(A), provides resistance against erythromycin and azithromycin and is known to be laterally transferred among a wide range of bacterial species. METHODS We use Recombinase Polymerase Assay (RPA) to detect the antimicrobial resistance gene mef(A) from raw lysates without nucleic acid purification. To validate these results we performed broth dilution assays to assess antimicrobial resistance to erythromycin and ampicillin (a negative control). RESULTS We validate the detection of mef(A) in raw lysates of Streptococcus pyogenes, S. pneumoniae, S. salivarius, and Enterococcus faecium bacterial lysates within 7-10 min of assay time. We show that detection of mef(A) accurately predicts real antimicrobial resistance assessed by traditional culture methods, and that the assay is robust to high levels of spiked-in non-specific nucleic acid contaminant. The assay was unaffected by single-nucleotide polymorphisms within divergent mef(A) gene sequences, strengthening its utility as a robust diagnostic tool. CONCLUSIONS This finding opens the door to implementation of rapid genomic diagnostics in a clinical setting, while providing researchers a rapid, cost-effective tool to track antibiotic resistance in both pathogens and commensal strains.
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Affiliation(s)
- Megan M. Nelson
- Department of Biology, American University, Washington, DC 20016 USA
| | | | - John R. Bracht
- Department of Biology, American University, Washington, DC 20016 USA
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19
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Maraolo AE, Gentile I, Pinchera B, Nappa S, Borgia G. Current and emerging pharmacotherapy for the treatment of bacterial peritonitis. Expert Opin Pharmacother 2018; 19:1317-1325. [PMID: 30071176 DOI: 10.1080/14656566.2018.1505867] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Spontaneous bacterial peritonitis (SBP) is the quintessential model of bacterial infection in cirrhotic patients. In these particularly frail subjects, infections clearly worsen prognosis increasing substantially mortality. Furthermore, treatment of SBP has become more challenging because of the growing impact of multidrug-resistant (MDR) bacteria. AREAS COVERED This review addresses the reasons behind the change in therapeutic recommendations for SBP that have occurred in the past few years, by focusing on the following aspects: the importance of an early appropriate empirical treatment, the difference between nosocomial and non-nosocomial forms and the overall microbiological shift (rise of Gram-positive bacteria and MDR strains) that have affected SBP. EXPERT OPINION Until recently, third-generation cephalosporins have represented the cornerstone of SBP treatment, a safe choice covering the most important causative agents, namely Enterobacteriaceae. Unfortunately, massive exposure to health systems makes cirrhotic patients prone to MDR infections, which poses significant challenges, all the while not forgetting to strike a balance between effective antimicrobial activity and the risk of toxicity in these fragile subjects. Moreover, there is sparse information about new antibiotics in cirrhotic patients and about drugs levels in ascitic fluid. Therefore, further research is needed to optimize the treatment of SBP.
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Affiliation(s)
- Alberto Enrico Maraolo
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Ivan Gentile
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Biagio Pinchera
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Salvatore Nappa
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Guglielmo Borgia
- a Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
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20
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Singh D, Narayanamoorthy S, Gamre S, Majumdar AG, Goswami M, Gami U, Cherian S, Subramanian M. Hydroxychavicol, a key ingredient of Piper betle induces bacterial cell death by DNA damage and inhibition of cell division. Free Radic Biol Med 2018; 120:62-71. [PMID: 29550331 DOI: 10.1016/j.freeradbiomed.2018.03.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/21/2018] [Accepted: 03/12/2018] [Indexed: 11/19/2022]
Abstract
Antibiotic resistance is a global problem and there is an urgent need to augment the arsenal against pathogenic bacteria. The emergence of different drug resistant bacteria is threatening human lives to be pushed towards the pre-antibiotic era. Botanical sources remain a vital source of diverse organic molecules that possess antibacterial property as well as augment existing antibacterial molecules. Piper betle, a climber, is widely used in south and south-east Asia whose leaves and nuts are consumed regularly. Hydroxychavicol (HC) isolated from Piper betle has been reported to possess antibacterial activity. It is currently not clear how the antibacterial activity of HC is manifested. In this investigation we show HC generates superoxide in E. coli cells. Antioxidants protected E. coli against HC induced cell death while gshA mutant was more sensitive to HC than wild type. DNA damage repair deficient mutants are hypersensitive to HC and HC induces the expression of DNA damage repair genes that repair oxidative DNA damage. HC treated E. coli cells are inhibited from growth and undergo DNA condensation. In vitro HC binds to DNA and cleaves it in presence of copper. Our data strongly indicates HC mediates bacterial cell death by ROS generation and DNA damage. Damage to iron sulfur proteins in the cells contribute to amplification of oxidative stress initiated by HC. Further HC is active against a number of Gram negative bacteria isolated from patients with a wide range of clinical symptoms and varied antibiotic resistance profiles.
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Affiliation(s)
- Deepti Singh
- Bio-Organic Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | | | - Sunita Gamre
- Bio-Organic Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Ananda Guha Majumdar
- Bio-Organic Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Manish Goswami
- Molecular Biology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Umesh Gami
- Department of Pathology, BARC Hospital, Anushaktinagar, Mumbai 400094, India
| | - Susan Cherian
- Department of Pathology, BARC Hospital, Anushaktinagar, Mumbai 400094, India
| | - Mahesh Subramanian
- Bio-Organic Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India.
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21
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Furfaro LL, Chang BJ, Payne MS. Applications for Bacteriophage Therapy during Pregnancy and the Perinatal Period. Front Microbiol 2018; 8:2660. [PMID: 29375525 PMCID: PMC5768649 DOI: 10.3389/fmicb.2017.02660] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/20/2017] [Indexed: 12/19/2022] Open
Abstract
Pregnant women and their unborn children are a population that is particularly vulnerable to bacterial infection. Physiological changes that occur during pregnancy affect the way women respond to such infections and the options that clinicians have for treatment. Antibiotics are still considered the best option for active infections and a suitable prophylaxis for prevention of potential infections, such as vaginal/rectal Streptococcus agalactiae colonization prior to birth. The effect of such antibiotic use on the developing fetus, however, is still largely unknown. Recent research has suggested that the fetal gut microbiota plays a critical role in fetal immunologic programming. Hence, even minor alterations in this microbiota may have potentially significant downstream effects. An ideal antibacterial therapeutic for administration during pregnancy would be one that is highly specific for its target, leaving the surrounding microbiota intact. This review first provides a basic overview of the challenges a clinician faces when administering therapeutics to a pregnant patient and then goes on to explore common bacterial infections in pregnancy, use of antibiotics for treatment/prevention of such infections and the consequences of such treatment for the mother and infant. With this background established, the review then explores the potential for use of bacteriophage (phage) therapy as an alternative to antibiotics during the antenatal period. Many previous reviews have highlighted the revitalization of and potential for phage therapy for treatment of a range of bacterial infections, particularly in the context of the increasing threat of widespread antibiotic resistance. However, information on the potential for the use of phage therapeutics in pregnancy is lacking. This review aims to provide a thorough overview of studies of this nature and discuss the feasibility of bacteriophage use during pregnancy to treat and/or prevent bacterial infections.
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Affiliation(s)
- Lucy L. Furfaro
- Division of Obstetrics and Gynecology, School of Medicine, The University of Western Australia, Crawley, WA, Australia
| | - Barbara J. Chang
- Marshall Centre for Infectious Disease Research and Training, School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Matthew S. Payne
- Division of Obstetrics and Gynecology, School of Medicine, The University of Western Australia, Crawley, WA, Australia
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Hernández-Marrero P, Martins Pereira S, de Sá Brandão PJ, Araújo J, Carvalho AS. Toward a bioethical framework for antibiotic use, antimicrobial resistance and for empirically designing ethically robust strategies to protect human health: a research protocol. J Int Med Res 2017; 45:1787-1793. [PMID: 28459355 PMCID: PMC5805197 DOI: 10.1177/0300060517697595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/11/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.
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Affiliation(s)
- Pablo Hernández-Marrero
- Instituto de Bioética, Universidade
Católica Portuguesa, Porto, Portugal
- UNESCO Chair in Bioethics, Institute of
Bioethics, Universidade Católica Portuguesa, Porto, Portugal
| | - Sandra Martins Pereira
- Instituto de Bioética, Universidade
Católica Portuguesa, Porto, Portugal
- UNESCO Chair in Bioethics, Institute of
Bioethics, Universidade Católica Portuguesa, Porto, Portugal
| | | | - Joana Araújo
- Instituto de Bioética, Universidade
Católica Portuguesa, Porto, Portugal
- UNESCO Chair in Bioethics, Institute of
Bioethics, Universidade Católica Portuguesa, Porto, Portugal
| | - Ana Sofia Carvalho
- Instituto de Bioética, Universidade
Católica Portuguesa, Porto, Portugal
- UNESCO Chair in Bioethics, Institute of
Bioethics, Universidade Católica Portuguesa, Porto, Portugal
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