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Lyu Z, Li J, Zhen J, Shi W, Meng Q, Zhou W, An J, Yao K, Dong F. A Hospital-Based and Cross-Sectional Investigation on Clinical Characteristics of Pediatric Streptococcus pneumoniae Isolates in Beijing from 2015 to 2021. Infect Drug Resist 2023; 16:499-508. [PMID: 36726384 PMCID: PMC9885871 DOI: 10.2147/idr.s398549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/14/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Streptococcus pneumoniae (S. pneumoniae) is a major pathogen causing death in children. Few studies have evaluated the importance of S. pneumoniae in the identified bacteria in clinical work. This retrospective study aimed to reveal the rank of S. pneumoniae in determined bacteria isolated from children in Beijing, China, as well as the antimicrobial resistance of this pathogen. Methods The number of specimen for bacterial culture and of bacterial species were cumulated and ranked based on the data of the two largest children's hospitals in Beijing from 2015 to 2021. The temporal change of S. pneumoniae culture, as well as the clinical data of S. pneumoniae isolates were collected and analyzed. The minimum inhibitory concentrations of antimicrobial agents were determined by BD Phoenix 100 automated system or Vitek 2 automated system for antimicrobial susceptibility testing. The breakpoints recommended by CLSI were adopted. Results During the 7-year study period, a total of 45,631 bacterial isolates were cultured from 462,144 submitted specimens, in which S. pneumoniae was the third frequent agent following S. aureus and H. influenza, and accounting for 8.79% of the isolates (4011/45,631). In the 4011 S. pneumoniae isolates, 2239 and 997 ones were, respectively, isolated from sputum and bronchial lavage fluid. Most of S. pneumoniae strains were identified in winter (34.7%) and spring (26.1%), and were mainly isolated from patients under 5 years old (77.1%). Low susceptible rate (27.6%) of CSF isolates was determined to penicillin according to the parenteral meningitis breakpoints, while high susceptible rate (56.9%) of non-CSF isolates was obtained according to the parenteral non-meningitis breakpoints. The isolates showed low sensitivity to erythromycin and tetracycline (<5%). All isolates were susceptible to vancomycin and linezolid. Conclusion The present results demonstrated that S. pneumoniae was one of the most commonly detected bacteria in current pediatric clinical tests, especially in young children under 5 years old, which emphasized the importance of prevention. Penicillin could still be the first empiric choice to treat non-meningitis pneumococcal infections, while erythromycin should not be involved in the treatment.
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Affiliation(s)
- Zhiyong Lyu
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Jing Li
- Department of Clinical Laboratory, Capital Institute of Pediatrics, Beijing, People’s Republic of China
| | - Jinghui Zhen
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Wei Shi
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Qingying Meng
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Wei Zhou
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Jingyun An
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Kaihu Yao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Fang Dong
- Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China,Correspondence: Fang Dong; Kaihu Yao, Department of Clinical Laboratory Center, Beijing Children’s Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, People’s Republic of China, Email ;
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Pérez-Torres Lobato MR, Mejías Trueba M, Rodríguez Ramallo H, Álvarez Del Vayo Benito C, Iglesias Aguilar MDC, Gaboli M. Prolonged treatment with inhaled ampicillin in children with non-cystic fibrosis bronchiectasis. Arch Bronconeumol 2021; 57:662-664. [PMID: 35702908 DOI: 10.1016/j.arbr.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/02/2020] [Indexed: 06/15/2023]
Affiliation(s)
| | - Marta Mejías Trueba
- Servicio de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | - Mirella Gaboli
- Unidad de Neumología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
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Pérez-Torres Lobato MR, Mejías Trueba M, Rodríguez Ramallo H, Álvarez Del Vayo Benito C, Iglesias Aguilar MDC, Gaboli M. Prolonged Treatment With Inhaled Ampicillin in Children With Non-cystic Fibrosis Bronchiectasis. Arch Bronconeumol 2020; 57:S0300-2896(20)30538-X. [PMID: 33494941 DOI: 10.1016/j.arbres.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Marta Mejías Trueba
- Servicio de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España
| | | | | | | | - Mirella Gaboli
- Unidad de Neumología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, España.
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Tsuzuki S, Akiyama T, Matsunaga N, Yahara K, Shibayama K, Sugai M, Ohmagari N. Improved penicillin susceptibility of Streptococcus pneumoniae and increased penicillin consumption in Japan, 2013-18. PLoS One 2020; 15:e0240655. [PMID: 33091045 PMCID: PMC7580930 DOI: 10.1371/journal.pone.0240655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To examine the association between penicillin susceptibility of Streptococcus pneumoniae and penicillin consumption in Japan. METHODS We used Japan Nosocomial Infection Surveillance data on the susceptibility of S. pneumoniae and sales data obtained from IQVIA Services Japan K.K. for penicillin consumption. We analysed both sets of data by decomposing them into seasonality and chronological trend components. The cross-correlation function was checked using Spearman's rank correlation coefficient to examine the correlation between susceptibility and consumption. RESULTS After adjusting for seasonality, the susceptibility of S. pneumoniae to penicillins gradually improved (55.7% in 2013 and 60.6% in 2018, respectively) and penicillin consumption increased during the same period (0.76 defined daily doses per 1,000 inhabitants per day [DID] in 2013, and 0.89 DID in 2018). The results showed positive cross-correlation (coefficient 0.801, p-value < 0.001). In contrast, cephalosporin consumption decreased (3.91 DID in 2013 and 3.19 DID in 2018) and showed negative cross-correlation with susceptibility of S. pneumoniae to penicillins (coefficient -0.981, p-value < 0.001). CONCLUSIONS The rates of penicillin-susceptible S. pneumoniae isolates did not negatively correlate with penicillin consumption at the population level. Increased penicillin consumption might not impair the penicillin susceptibility of S. pneumoniae.
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Affiliation(s)
- Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Takayuki Akiyama
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Sallam M, Abbadi J, Natsheh A, Ababneh NA, Mahafzah A, Özkaya Şahin G. Trends in Antimicrobial Drug Resistance of Streptococcus pneumoniae Isolates at Jordan University Hospital (2000⁻2018). Antibiotics (Basel) 2019; 8:E41. [PMID: 31013803 PMCID: PMC6628336 DOI: 10.3390/antibiotics8020041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 01/28/2023] Open
Abstract
Antimicrobial drug resistance (AMR) in pneumococci complicates the treatment of serious pneumococcal infections. Country-specific AMR patterns can help to establish guidelines for empiric therapy. The aim of the current study was to analyze the distribution of AMR among Streptococcus pneumoniae isolates at Jordan University Hospital (JUH) during 2000⁻2018. Paper-based and electronic clinical data registry records from 2000 to 2018 were retrospectively analyzed to study the AMR among pneumococcal isolates at JUH. Temporal trend analysis was done using two-tailed linear-by-linear test for association. The total number of unique pneumococcal isolates that were identified was 556, of which 544 isolates had antimicrobial susceptibility testing results. The most frequent specimens were eye (n = 117, 21.0%), bloodstream (n = 93, 16.7%) and sputum (n = 81, 14.6%). Invasive infections represented 23.6% of all unique isolates. The overall susceptibility of S. pneumoniae isolates during the study period to different antimicrobials was: 100% to vancomycin, 97.7% to ceftriaxone, 97.1% to cefotaxime, 94.9% to chloramphenicol, 89.7% to penicillin, 83.8% to levofloxacin, 67.7% to clindamycin and 52.1% to erythromycin. The prevalence of multi-drug resistance (MDR) was 8.6% (95% confidence interval: 6.4⁻11.5%). Trend analysis showed an increase in the prevalence of non-susceptibility to erythromycin, clindamycin and levofloxacin (p < 0.001). MDR prevalence increased from 1.6% in the first quarter to 14.6% in the fourth quarter (p < 0.001). The incidence of invasive infections declined over the study period (p < 0.001). The increase in the prevalence of AMR and MDR among pneumococcal isolates in Jordan demands judicious use of antimicrobials and regular surveillance of resistance.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22362 Malmö, Sweden.
| | - Jumana Abbadi
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Anas Natsheh
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Nidaa A Ababneh
- Cell Therapy Center (CTC), The University of Jordan, Amman, Jordan.
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22362 Malmö, Sweden.
- Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, 22362 Lund, Sweden.
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Shi Y, Jiang K, Zheng R, Fu J, Yan L, Gu Q, Zhang Y, Lin F. Design, Microwave‐Assisted Synthesis and in Vitro Antibacterial and Antifungal Activity of 2,5‐Disubstituted Benzimidazole. Chem Biodivers 2019; 16:e1800510. [DOI: 10.1002/cbdv.201800510] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 11/16/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Yanpeng Shi
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Kai Jiang
- School of life SciencesJilin University Changchun 130012 P. R. China
| | - Ran Zheng
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Jiaxu Fu
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Liuqing Yan
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Qiang Gu
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Yumin Zhang
- College of ChemistryJilin University Changchun 130012 P. R. China
| | - Feng Lin
- School of life SciencesJilin University Changchun 130012 P. R. China
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Molecular detection of genes responsible for macrolide resistance among Streptococcus pneumoniae isolated in North Lebanon. J Infect Public Health 2017; 10:745-748. [DOI: 10.1016/j.jiph.2016.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 10/10/2016] [Accepted: 11/18/2016] [Indexed: 11/23/2022] Open
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Lee HY, Wu TL, Su LH, Li HC, Janapatla RP, Chen CL, Chiu CH. Invasive pneumococcal disease caused by ceftriaxone-resistant Streptococcus pneumoniae in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 51:500-509. [PMID: 28690025 DOI: 10.1016/j.jmii.2016.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 10/26/2016] [Accepted: 12/03/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Invasive pneumococcal disease (IPD) was associated with mortality, but the risk factors associated with mortality remains controversial. METHODS A retrospective cohort study was designed. All patients with IPD from 2011 to 2013 admitted in a medical center were screened and collected for their clinical presentations and laboratory characteristics. RESULTS Approximately half of the 134 IPD isolates derived from these patients belonged to three major serotypes (19A, 6A and 3), which are included in 13-valent pneumococcal conjugate vaccine (PCV13), but not in 7-valent pneumococcal conjugate vaccine (PCV7). Ceftriaxone resistance according to non-meningitis criteria was identified in 38% of the IPD isolates, and was the major independent risk factor associated with inappropriate initial therapy that subsequently contributed to mortality of the patients. Infection by serotype 6A, 15B, 19A, 19F, or 23F was the major independent risk factor associated with ceftriaxone resistance (non-meningitis criteria). 77.6% of these isolates belonged to additional PCV13 serotypes, with more than 40% expressing resistance to ceftriaxone. In terms of serotype coverage, PCV13 covered 94.1% of the IPD isolates with ceftriaxone resistance, in comparison to 21.6% only by PCV7. CONCLUSIONS The increase of ceftriaxone resistance in pneumococci in part driven by PCV7 vaccination in Taiwan is worrisome. The use of PCV13 in children as well as in the elderly population is likely to offer protection from the infection caused by ceftriaxone-resistant pneumococci. It is important to give an effective drug such as penicillin, fluoroquinolones or vancomycin in 2 days for improving outcome of IPD patients.
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Affiliation(s)
- Hao-Yuan Lee
- Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Tsu-Lan Wu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan
| | - Lin-Hui Su
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsin-Chieh Li
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | - Chyi-Liang Chen
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Abstract
PURPOSE OF REVIEW Pneumococcal infections are a major cause of morbidity and mortality worldwide. In recent years, Streptococcus pneumoniae has shown increasing resistance to a several antibiotics, becoming a worldwide problem. The impact of antibiotic resistance of S. pneumoniae on clinical outcomes is still controversial. The principal reason for this controversy is the existence of several factors related to the patients and to the pathogen that may influence how antibiotic resistance patterns affect clinical outcomes. The aim of this review is to discuss current knowledge of the epidemiological data on antibiotic resistance; we also discuss mechanisms and risk factors for antibiotic resistance. RECENT FINDINGS The phenomenon of serotype replacement after the introduction of conjugate pneumococcal vaccinations and the escalation of antibiotic resistance worldwide remains an important issue in terms of their impact on clinical outcomes in pneumococcal disease. Antimicrobial resistance of pneumococcus leads to changes in the clinical presentation of pneumococcal disease, making it more difficult to diagnose and to treat. Consumption of antibiotics in the community is directly proportional to antimicrobial resistance. Carriage of S. pneumoniae and infection with antibiotic-resistant pneumococcus is associated with prior antibiotic therapy, extremes of age, presence of comorbidities (i.e. COPD), attendance at child day care centers, crowded conditions, intra-familial transmission, and nursing home residence. SUMMARY Antibiotic-resistant S. pneumoniae is a worldwide problem. The implementation of several strategies including vaccine campaigns, prudent use of current antibiotics, and programs for the surveillance of pneumococcal infections, could limit the increasing resistance of this pathogen to antimicrobials.
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Liu S, Xu E, Liu Y, Xu Y, Wang J, Du J, Zhang X, Che X, Gu W. Factors associated with pneumococcal vaccination among an urban elderly population in China. Hum Vaccin Immunother 2015; 10:2994-9. [PMID: 25483646 DOI: 10.4161/21645515.2014.972155] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate the coverage of the 23-valent pneumococcal polysaccharide vaccine (23-PPV) in the Chinese urban elderly population and to understand the attitudes, knowledge and beliefs of this population toward the 23-PPV vaccination. METHODS A cross-sectional approach was employed to survey the willingness of this population to receive the 23-PPV vaccination. Two thousand 9 hundred 2 six subjects over the age of 60 y were enrolled via a multi-stage random sampling method from the urban community population in Hangzhou, China. The relationships between the variables and the willingness to receive the 23-PPV vaccination were computed as odds ratios (ORs) by multivariate analysis. RESULTS Of the participants, 21.77% were willing to undergo 23-PPV vaccination, and 61.65% of the subjects agreed that pneumonia is a serious disease among elderly people. The rate of reasonable perceptions about vaccination, including the perception about vaccine efficacy and safety, among the subjects was below 50%. Only 1.23% of subjects had been vaccinated with 23-PPV, and a similarly low rate was observed for the seasonal influenza vaccine (4.17%). The factors that were independently related to the willingness to receive the 23-PPV vaccine included consensus with the hazards of pneumonia (OR = 1.67, 95% CI: 1.28 - 2.17), the safety of vaccination (OR = 2.00, 95% CI: 1.54 - 2.59), advice about the 23-PPV vaccination from family members (OR = 2.37, 95% CI: 1.39 - 4.40), influenza vaccination history (OR = 2.57, 95% CI: 1.66 - 3.98) and pneumococcal vaccination history (OR = 7.48, 95% CI: 2.4-22.92). CONCLUSION The administration of the 23-PPV vaccine among the urban elderly population is not optimistic in China. Emphasis on persuasion from families and the improvement of knowledge about vaccination might encourage elderly people to get the 23-PPV vaccination. Suggestions from physicians did not affect the participants' willingness to get the 23-PPV vaccination in multivariate analysis, but elderly people typically visited the Community Health Center (CHC) in their residential districts, and thus, systematic encouragement from healthcare physicians might be the key to increasing 23-PPV vaccination.
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Affiliation(s)
- Shijun Liu
- a Hangzhou Center for Disease Control and Prevention ; Hangzhou , China
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Yayan J. The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumoniae. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 8:1733-43. [PMID: 25336917 PMCID: PMC4199971 DOI: 10.2147/dddt.s71349] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Community-acquired pneumonia (CAP) is an acute inflammation of the lungs, which is often caused by Streptococcus pneumoniae. CAP is the leading cause of death by infectious disease in industrialized countries. Therefore, an immediate and effective antibiotic therapy is of great importance for the nonfatal outcome of the disease. The literature contains increasing data about the development of resistance to antibiotics that are used for the treatment of CAP caused by S. pneumoniae; this article also examines the possible development of resistance to antibiotics in S. pneumoniae in recent years. Methods Within the study period of 2004–2014, all hospital charts from patients with CAP caused by S. pneumoniae were collected from the Department of Internal Medicine, Saarland University Medical Center, Homburg/Saar, Germany. The tracheal secretions of S. pneumoniae in CAP patients were obtained by bronchoalveolar lavage; bronchial aspirates were obtained through flexible bronchoscopy and directly from sputum, and blood cultures were examined microbiologically for microorganisms. Results From a total of 100 patients with CAP caused by S. pneumoniae, 23 (53.49% [34.78% female], 95% confidence interval, 38.58–68.4) patients with a mean age of 59.78±15.77 years met the inclusion criteria of this investigation. These patients were compared to a total of 20 (46.51% [35% female], 95% confidence interval, 31.6–61.42) patients with a mean age of 58.9±13.36 years with CAP who were infested with S. pneumoniae. In the latter group, the streptococcal antigen was detected in pulmonary aspirations by bronchoscopy or in urine using polymerase chain reaction and a rapid pneumococcal test. Penicillin G and vancomycin had a high rate of sensitivity on the antibiogram for S. pneumoniae, which was obtained by bronchoalveolar lavage, bronchial aspirates through flexible bronchoscopy, and directly from sputum. Even though the rates obtained were without statistical significance, S. pneumoniae had a high resistance to macrolides, namely erythromycin, in patients with CAP. Macrolides, specifically erythromycin (17.39%) and azithromycin (4.35%) and other classes of antibiotics such as tetracycline (4.35%), had a statistically significant resistance to streptococcal pneumonia in patients with CAP (P=0.0009). Conclusion Increased resistance was found for macrolides and tetracycline in patients with CAP by S. pneumoniae.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Saarland University Medical Center, Homburg/Saar, Germany
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Levofloxacin-ceftriaxone combination attenuates lung inflammation in a mouse model of bacteremic pneumonia caused by multidrug-resistant Streptococcus pneumoniae via inhibition of cytolytic activities of pneumolysin and autolysin. Antimicrob Agents Chemother 2014; 58:5164-80. [PMID: 24957840 DOI: 10.1128/aac.03245-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In this study, our objective was to determine whether a synergistic antimicrobial combination in vitro would be beneficial in the downregulation of pneumococcal virulence genes and whether the associated inflammation of the lung tissue induced by multidrug-resistant Streptococcus pneumoniae infection in vivo needs to be elucidated in order to consider this mode of therapy in case of severe pneumococcal infection. We investigated in vivo changes in the expression of these virulence determinants using an efficacious combination determined in previous studies. BALB/c mice were infected with 10(6) CFU of bacteria. Intravenous levofloxacin at 150 mg/kg and/or ceftriaxone at 50 mg/kg were initiated 18 h postinfection; the animals were sacrificed 0 to 24 h after the initiation of treatment. The levels of cytokines, chemokines, and C-reactive protein (CRP) in the serum and lungs, along with the levels of myeloperoxidase and nitric oxide the inflammatory cell count in bronchoalveolar lavage fluid (BALF), changes in pneumolysin and autolysin gene expression and COX-2 and inducible nitric oxide synthase (iNOS) protein expression in the lungs were estimated. Combination therapy downregulated inflammation and promoted bacterial clearance. Pneumolysin and autolysin expression was downregulated, with a concomitant decrease in the expression of COX-2 and iNOS in lung tissue. Thus, the combination of levofloxacin and ceftriaxone can be considered for therapeutic use even in cases of pneumonia caused by drug-resistant isolates.
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Majhi A, Kundu K, Adhikary R, Banerjee M, Mahanti S, Basu A, Bishayi B. Combination therapy with ampicillin and azithromycin in an experimental pneumococcal pneumonia is bactericidal and effective in down regulating inflammation in mice. JOURNAL OF INFLAMMATION-LONDON 2014; 11:5. [PMID: 24565171 PMCID: PMC3936873 DOI: 10.1186/1476-9255-11-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 02/17/2014] [Indexed: 12/21/2022]
Abstract
Objectives Emergence of multidrug resistance among Streptococcus pneumoniae (SP), has limited the available options used to treat infections caused by this organism. The objective of this study was to compare the role of monotherapy and combination therapy with ampicillin (AMP) and azithromycin (AZM) in eradicating bacterial burden and down regulating lung inflammation in a murine experimental pneumococcal infection model. Methods Balb/C mice were infected with 106 CFU of SP. Treatments with intravenous ampicillin (200 mg/kg) and azithromycin (50 mg/kg) either alone or in combination was initiated 18 h post infection, animals were sacrificed from 0 – 6 h after initiation of treatment. AMP and AZM were quantified in serum by microbiological assay. Levels of TNF-α, IFN-γ IL-6, and IL-10 in serum and in lungs, along with myeloperoxidase, inflammatory cell count in broncho alveolar lavage fluid, COX-2 and histopathological changes in lungs were estimated. Results Combination therapy down regulated lung inflammation and accelerated bacterial clearance. This approach also significantly decreased TNF-α, IFN-γ, IL-6 and increased IL-10 level in serum and lungs along with decreased myeloperoxidase, pulmonary vascular permeability, inflammatory cell numbers and COX-2 levels in lungs. Conclusions Combinatorial therapy resulted in comparable bactericidal activity against the multi-drug resistant isolate and may represent an alternative dosing strategy, which may help to alleviate problems with pneumococcal pneumonia.
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Affiliation(s)
| | | | | | | | | | | | - Biswadev Bishayi
- Department of Physiology, Immunology laboratory, University of Calcutta, University Colleges of Science and Technology, 92 APC Road, Calcutta 700009, West Bengal,India.
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Antimicrobial resistance trends among community-acquired respiratory tract pathogens in Greece, 2009-2012. ScientificWorldJournal 2014; 2014:941564. [PMID: 24592201 PMCID: PMC3925540 DOI: 10.1155/2014/941564] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/26/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to determine the antimicrobial resistance trends of respiratory tract pathogens isolated from patients with community-acquired respiratory tract infections (CARTIs) in Crete, Greece, over a 4-year period (2009-2012). A total of 588 community-acquired respiratory pathogens were isolated during the study period. Streptococcus pneumoniae was the most common organism responsible for 44.4% of CARTIs, followed by Haemophilus influenzae (44.2%) and Moraxella catarrhalis (11.4%). Among S. pneumoniae, the prevalence of isolates with intermediate- and high-level resistance to penicillin was 27.2% and 12.3%, respectively. Macrolide resistance slightly decreased from 29.4% over the period 2009-2010 to 28.8% over the period 2011-2012. Multiresistance was observed among 56 (54.4%) penicillin nonsusceptible isolates. A nonsignificant increase in resistance of H. influenzae isolates was noted for β -lactams, cotrimoxazole, and tetracycline. Among the 67 M. catarrhalis tested, 32 produced beta-lactamase and were resistant to ampicillin. Macrolide resistance decreased over the study period. All isolates were susceptible to amoxicillin + clavulanic acid, chloramphenicol, rifampicin, and the fluoroquinolones. Although a decreasing trend in the prevalence of resistance of the three most common pathogens involved in CARTIs was noted, continuous surveillance of antimicrobial susceptibility at the local and national level remains important, in order to guide appropriate empirical antimicrobial therapy.
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Blasi F, Garau J, Medina J, Ávila M, McBride K, Ostermann H. Current management of patients hospitalized with community-acquired pneumonia across Europe: outcomes from REACH. Respir Res 2013; 14:44. [PMID: 23586347 PMCID: PMC3644236 DOI: 10.1186/1465-9921-14-44] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 04/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Data describing real-life management and treatment of community-acquired pneumonia (CAP) in Europe are limited. REACH (http://NCT01293435) was a retrospective, observational study collecting data on the management of EU patients hospitalized with CAP. METHODS Patients were aged ≥18 years, hospitalized with CAP between March 2010 and February 2011, and requiring in-hospital treatment with intravenous antibiotics. An electronic Case Report Form was used to collect patient, disease and treatment variables, including type of CAP, medical history, treatment setting, antibiotics administered and clinical outcomes. RESULTS Patients (N = 2,039) were recruited from 128 centres in ten EU countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Turkey, UK). The majority of patients were aged ≥65 years (56.4%) and had CAP only (78.8%). Initial antibiotic treatment modification occurred in 28.9% of patients and was more likely in certain groups (patients with comorbidities; more severely ill patients; patients with healthcare-associated pneumonia, immunosuppression or recurrent episodes of CAP). Streamlining (de-escalation) of therapy occurred in 5.1% of patients. Mean length of hospital stay was 12.6 days and overall mortality was 7.2%. CONCLUSION These data provide a current overview of clinical practice in patients with CAP in EU hospitals, revealing high rates of initial antibiotic treatment modification. The findings may precipitate reassessment of optimal management regimens for hospitalized CAP patients.
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Abstract
Background Moxifloxacin, a fluoroquinolone antibiotic, is used for the treatment of respiratory tract, pelvic inflammatory disease, skin, and intra-abdominal infections. Its safety profile is considered favorable in most reviews but has been challenged with respect to rare but potentially fatal toxicities (e.g. hepatic, cardiac, or skin reactions). Objective To analyze and compare the safety profile of moxifloxacin versus comparators in the entire clinical database of the manufacturer. Setting Data on the valid-for-safety population from phase II–IV actively controlled studies (performed between 1996 and 2010) were analyzed. Studies were either double blind (n = 22 369) or open label (n = 7635) and included patients with indications that have been approved in at least one country [acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community-acquired pneumonia, uncomplicated pelvic inflammatory disease, complicated and uncomplicated skin and skin structure infections, and complicated intra-abdominal infections] (n = 27 824) and patients with other indications (n = 2180), using the recommended daily dose (400 mg) and route of administration (oral, intravenous/oral, intravenous only). The analysis included patients at risk (age ≥65 years, diabetes mellitus, renal impairment, hepatic impairment, cardiac disorders, or body mass index <18 kg/m2). Patients with known contraindications were excluded from enrollment by study protocol design, but any patient having entered a study, even if inappropriately, was included in the analysis. Main Outcome Measure Crude incidences and relative risk estimates (Mantel-Haenszel analysis) of patients with any adverse event (AE), adverse drug reaction (ADR), serious AE (SAE), serious ADR (SADR), treatment discontinuation due to an AE or ADR, and fatal outcomes related to an AE or ADR. Results Overall incidence rates of AEs were globally similar in the moxifloxacin and comparator groups. By filtering the data for differences in disfavor of moxifloxacin (i) at ≥2.5% for events with an incidence ≥2.5% or at ≥2-fold for events with an incidence <2.5% in one or both groups and (ii) affecting ≥10 patients in either group, we observed slightly more (i) AEs in double-blind intravenous-only and open-label oral studies, (ii) SAEs in double-blind intravenous-only studies, (iii) ADRs and SADRs in open-label oral studies, (iv) SADRs in open-label intravenous/oral studies, and (v) premature discontinuation due to AEs in open-label intravenous-only studies. The actual numbers of SADRs (in all studies) were small, with clinically relevant differences noted only in intravenous/oral studies and mainly driven by ‘gastrointestinal disorders’ (15 versus 7 patients) and ‘changes observed during investigations’ (23 versus 7 patients [asymptomatic QT prolongation: 11 versus 4 patients in double-blind studies]). Analysis by comparator (including another fluoroquinolone) did not reveal medically relevant differences, even in patients at risk. Incidence rates of hepatic disorders, tendon disorders, clinical surrogates of QT prolongation, serious cutaneous reactions, and Clostridium difficile-associated diarrhea were similar with moxifloxacin and comparators. Conclusion The safety of moxifloxacin is essentially comparable to that of standard therapies for patients receiving the currently registered dosage and for whom contraindications and precautions of use (as in the product label) are taken into account.
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Affiliation(s)
- Paul M Tulkens
- Pharmacologie cellulaire et molculaire Centre de Pharmacie clinique, Louvain Drug Research Institute, Universit catholique de Louvain, Brussels, Belgium.
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Prevalence of Ceftriaxon-Sensitive Pneumococci Infection and Use of E- Test for Patients Admitted to Ghaem and Imam Reza Hospitals During a Two-Year Period. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2012. [DOI: 10.5812/archcid.14470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zhao C, Sun H, Wang H, Liu Y, Hu B, Yu Y, Sun Z, Chu Y, Cao B, Liao K, Lei J, Hu Z, Zhang L, Zhang X, Xu Y, Wang Z, Chen M. Antimicrobial resistance trends among 5608 clinical Gram-positive isolates in China: results from the Gram-Positive Cocci Resistance Surveillance program (2005–2010). Diagn Microbiol Infect Dis 2012; 73:174-81. [DOI: 10.1016/j.diagmicrobio.2012.03.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/03/2012] [Accepted: 03/07/2012] [Indexed: 12/01/2022]
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Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: prediction of severity and mortality. Eur J Clin Microbiol Infect Dis 2011; 31:33-47. [PMID: 21533875 DOI: 10.1007/s10096-011-1272-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 04/12/2011] [Indexed: 12/27/2022]
Abstract
Morbidity and mortality in patients with moderate to severe community-acquired pneumonia (CAP) is a global problem, and CAP is a leading cause of death due to infectious diseases. Prompt initiation of expanded-spectrum antimicrobials is essential for the prevention of unnecessary mortality and complications in patients, particularly in the elderly and other at-risk populations, and the treatment decisions made by practitioners have important implications for healthcare systems when hospitalization is required. Empirical antimicrobial treatment and the appropriate management of CAP patients will initially require the proper assessment of severity and patient risk for increased mortality, as well as risk factors for difficult-to-treat bacteria. This review will examine risk factors and scoring systems that may be predictive of moderate to severe CAP, which is often linked to increased risk of mortality. Understanding and recognizing potential risk factors will allow practitioners to proactively identify patients at the highest risk for severe illness or complications, thereby, guiding site-of-care decisions, as well as the choices for empiric antibiotic regimens. The decision to hospitalize a patient with CAP should include not only a clinical perspective and laboratory and radiographic findings, but also at least one objective tool of risk assessment, all in combination with sound clinical judgment.
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Starr JT, Sciotti RJ, Hanna DL, Huband MD, Mullins LM, Cai H, Gage JW, Lockard M, Rauckhorst MR, Owen RM, Lall MS, Tomilo M, Chen H, McCurdy SP, Barbachyn MR. 5-(2-Pyrimidinyl)-imidazo[1,2-a]pyridines are antibacterial agents targeting the ATPase domains of DNA gyrase and topoisomerase IV. Bioorg Med Chem Lett 2009; 19:5302-6. [PMID: 19683922 DOI: 10.1016/j.bmcl.2009.07.141] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 07/29/2009] [Accepted: 07/30/2009] [Indexed: 11/18/2022]
Abstract
Dual inhibitors of bacterial gyrB and parE based on a 5-(2-pyrimidinyl)-imidazo[1,2-a]pyridine template exhibited MICs (microg/mL) of 0.06-64 (Sau), 0.25-64 (MRSA), 0.06-64 (Spy), 0.06-64 (Spn), and 0.03-64 (FQR Spn). Selected examples were efficacious in mouse sepsis and lung infection models at <50mg/kg (PO dosing).
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Affiliation(s)
- Jeremy T Starr
- Pfizer Global Research and Development, 445 Eastern Point Rd., Groton, CT 06340, United States.
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Su LH, Wu TL, Kuo AJ, Chia JH, Chiu CH. Antimicrobial susceptibility of Streptococcus pneumoniae at a university hospital in Taiwan, 2000-07: impact of modified non-meningeal penicillin breakpoints in CLSI M100-S18. J Antimicrob Chemother 2009; 64:336-42. [DOI: 10.1093/jac/dkp209] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hoa NQ, Larson M, Chuc NTK, Eriksson B, Trung NV, Stålsby CL. Antibiotics and paediatric acute respiratory infections in rural Vietnam: health-care providers’ knowledge, practical competence and reported practice. Trop Med Int Health 2009; 14:546-55. [DOI: 10.1111/j.1365-3156.2009.02267.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Drug-resistance in Streptococcus pneumoniae isolates among Spanish middle aged and older adults with community-acquired pneumonia. BMC Infect Dis 2009; 9:36. [PMID: 19320989 PMCID: PMC2667188 DOI: 10.1186/1471-2334-9-36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Accepted: 03/25/2009] [Indexed: 11/30/2022] Open
Abstract
Background Pneumococcal diseases remain a major cause of morbidity and mortality worldwide. Updated data on drug-resistance from different populations may be important to recognize changes in disease patterns. This study assessed current levels of penicilin resistance among Streptococcus Pneumoniae causing pneumonia in Spanish middle age and older adults. Methods Antimicrobial susceptibility was tested for 104 consecutive isolates of Streptococcus pneumoniae recovered from patients 50 years or older with radiographically confirmed pneumonia in the region of Tarragona (Spain) between 2002 and 2007. According to the minimum inhibitory concentration of tested antimicrobials (penicillin, erythromycin, cefotaxime and levofloxacin) strains were classified as susceptible or resistant. Antimicrobial resistance was determined for early cases (2002–2004) and contemporary cases (2005–2007). Results Twenty-seven (25.9%) were penicillin-resistant strains (19 strains with intermediate resistance and 8 strains with high resistance). Penicillin-resistance was higher in 2002–2004 than in 2005–2007 (39.5% vs 18.2%, p = 0.017). Of 27 penicillin-resistant strains, 10 (37%) were resistant to erythromycin, 8 (29.6%) to cefotaxime, 2 (7.4%) to levofloxacin, and 4 (14.8%) were identified as multidrug resistant. Case-fatality rate was higher among those patients who had an infection caused by any penicillin susceptible strain (16.9%) than in those with infections due to penicillin-resistant strains. Conclusion Resistance to penicillin among Streptococcus pneumoniae remains high, but such resistance does not result in increased mortality in patients with pneumococcal pneumonia.
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Ohlsen K, Dandekar G, Schwarz R, Dandekar T. New trends in pharmacogenomic strategies against resistance development in microbial infections. Pharmacogenomics 2008; 9:1711-23. [DOI: 10.2217/14622416.9.11.1711] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This review summarizes some of the new trends in the fight against drug resistant bacteria. We review Gram-positive (e.g., S.aureus) and Gram-negative (e.g., Pseudomonas aeruginosa, Helicobacter pylori) bacteria, the current antibiotic resistance situation, as well as resistance spread and some recently discovered resistance mechanisms, such as those based on integrons and complex transposons. We then summarize several current routes to identify new drugs such as cationic antimicrobial peptides, novel acyldepsipeptides, RNA aptamers and lipopeptides. New drug strategies to treat resistant pathogens include eliciting growth in dormant bacteria, or a new way to attack efflux systems. Typical approaches from pharmacogenomics combined with systems biology and bioinformatics support these routes (simulations, metagenomics and metabolic network modeling), as well as the patient treatment (e.g., haplotyping and immune response).
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Affiliation(s)
- Knut Ohlsen
- Universität Würzburg, Molekulare Infektionsbiologie, 97070 Würzburg, Germany
| | - Gudrun Dandekar
- Universität Würzburg, Bioinformatik, Biozentrum, 97074 Würzburg, Germany
| | - Roland Schwarz
- Universität Würzburg, Bioinformatik, Biozentrum, 97074 Würzburg, Germany
| | - Thomas Dandekar
- Universität Würzburg, Bioinformatik, Biozentrum, 97074 Würzburg, Germany
- European Molecular Biology Laboratory, Postfach 102209, 69120 Heidelberg, Germany
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Leal B, Afonso IF, Rodrigues CR, Abreu PA, Garrett R, Pinheiro LCS, Azevedo AR, Borges JC, Vegi PF, Santos CCC, da Silveira FCA, Cabral LM, Frugulhetti ICPP, Bernardino AMR, Santos DO, Castro HC. Antibacterial profile against drug-resistant Staphylococcus epidermidis clinical strain and structure-activity relationship studies of 1H-pyrazolo[3,4-b]pyridine and thieno[2,3-b]pyridine derivatives. Bioorg Med Chem 2008; 16:8196-204. [PMID: 18701299 DOI: 10.1016/j.bmc.2008.07.035] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 07/15/2008] [Accepted: 07/16/2008] [Indexed: 11/15/2022]
Abstract
Antibacterial resistance is a complex problem that contributes to health and economic losses worldwide. The Staphylococcus epidermidis is an important nosocomial pathogen that affects immunocompromised patients or those with indwelling devices. Currently, there are several resistant strains including S. epidermidis that became an important medical issue mainly in hospital environment. In this work, we report the biological and theoretical evaluations of a 4-(arylamino)-1-phenyl-1H-pyrazolo[3,4-b]pyridine-5-carboxylic acids series (1, 1a-m) and the comparison with a new isosteric ring nucleus series, 4-(arylamino)thieno[2,3-b]pyridine-5-carboxylic acids derivatives (2, 2a-m). Our results revealed the 1H-pyrazolo[3,4-b]pyridine derivatives significant antibacterial activity against a drug-resistant S. epidermidis clinical strain in contrast to the thieno[2,3-b]pyridine series. The minimal inhibitory concentration (MIC) of the most active derivatives (1a, 1c, 1e, and 1f) against S. epidermidis was similar to that of oxacillin and twofold better than chloramphenicol. Interestingly, the position of the functional groups has a great impact on the activity as observed in our structure-activity relationship (SAR) study. The SAR of 1H-pyrazolo[3,4-b]pyridine derivatives shows that the highest inhibitory activity is observed when the meta position is occupied by electronegative substituents. The molecular modeling analysis of frontier molecular orbitals revealed that the LUMO density is less intense in meta than in ortho and para positions for both series (1 and 2), whereas HOMO density is overconcentrated in 1H-pyrazolo[3,4-b]pyridine ring nucleus compared to the thieno[2,3-b]pyridine system. The most active derivatives of series 1 were submitted to in silico ADMET screening, which confirmed these compounds as potential antibacterial candidates.
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Affiliation(s)
- Bruno Leal
- Universidade Federal Fluminense, Instituto de Biologia, Departamento de Biologia Celular e Molecular, LABioMol, 24210-130 Niterói, RJ, Brazil
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