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Balasubramanian R, Van Boeckel TP, Carmeli Y, Cosgrove S, Laxminarayan R. Global incidence in hospital-associated infections resistant to antibiotics: An analysis of point prevalence surveys from 99 countries. PLoS Med 2023; 20:e1004178. [PMID: 37310933 DOI: 10.1371/journal.pmed.1004178] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/19/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Hospital-associated infections (HAIs) are an important cause of morbidity and mortality around the world. Many HAIs are caused by drug-resistant bacterial pathogens, but there are major gaps in our understanding of the number of hospital-associated drug-resistant infections (HARIs) worldwide. As such, we estimated trends in prevalence of HARIs caused by high priority pathogens (Escherichia coli, Acinetobacter spp., Klebsiella spp., Staphylococcus aureus, Enterobacter spp., and Pseudomonas spp.) in 195 countries. METHODS AND FINDINGS Resistance prevalence estimates were extracted from 474-point prevalence surveys (PPS) from 99 countries published between 2010 and 2020 coupled with country-level estimates of hospitalization rates and length of stay. Prevalence estimates were transformed in yearly incidence of HARIs per year by country and income group. We estimate the global number of HARIs per year to be 136 million (95% credible interval (CI) 26 to 246 million) per year, with the highest burden in China (52 million, 95% CI 10 to 95 million), Pakistan (10 million, 95% CI 2 to 18 million), and India (9 million, 95% CI 3 to 15 million). Among income groups, middle-income countries bore the highest burden of HARIs per year (119 million, 95% CI 23 to 215 million). Our analysis was constrained by the limited number of PPS for HARIs, lack of community-associated data on antibiotic-resistant infections, and our population level analysis. CONCLUSIONS In this study, we observe, in the absence of systematic surveillance systems for HARIs, a baseline overview of their rates. Our yearly estimates highlight the global threat of HARIs and may help define strategies to tackle resistance in hospital settings.
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Affiliation(s)
| | - Thomas P Van Boeckel
- One Health Trust, New Delhi, India
- Health Geography and Policy Group, ETH Zurich, Zurich, Switzerland
| | - Yehuda Carmeli
- Division of Epidemiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sara Cosgrove
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ramanan Laxminarayan
- One Health Trust, New Delhi, India
- Princeton University, Princeton, New Jersey, United States of America
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Tran HD, Bach Nguyen YT, Thanh Tran T, Thu Le TT, Thu Nguyen HT, Minh Nguyen C, Bach Le HT, Ngoc Phan TT, Thanh Vo TT, Ngoc Bui HT, Tuong Mai V, Yong N, Nguyen T, Tran HG. Community-acquired pneumonia-causing bacteria and antibiotic resistance rate among Vietnamese patients: A cross-sectional study. Medicine (Baltimore) 2022; 101:e30458. [PMID: 36086715 PMCID: PMC10980443 DOI: 10.1097/md.0000000000030458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/01/2022] [Indexed: 12/24/2022] Open
Abstract
Due to the overuse of antibiotics in treatment and regional variation in disease factors, community-acquired pneumonia (CAP) has a relatively high morbidity and mortality rate. This study determined the prevalence of bacteria that cause CAP and the rate of antibiotic resistance. From April 2018 to May 2019, a cross-sectional study was conducted on 254 CAP patients at hospitals and medical centers in the province of Vinh Long. Based on interviews and medical records, SPSS 18.0 was used to analyze the data. CAP-causing bacteria, antibiotic susceptibility, and extended-spectrum β-lactamase production of bacteria were determined by performing Identification and Antibiotic Susceptibility Testing on sputum specimens using the VITEK 2 Automated instrument. With a total of 254 patients, the age of 60s accounted for the highest prevalence. Streptococcus pneumonia was the leading factor, accounting for 12.6%, followed by Klebsiella pneumonia and Pseudomonas aeruginosa at 12.2% and 8.3%, respectively. The Enterobacteriaceae group was the highest at 36.5%, followed by other gram-negative bacteria (34%) and gram-positive bacteria (29.5%). Amoxicillin/clavulanic acid ranked the highest in antibiotic resistance, accounting for 31.4% of Enterobacteriaceae and 91.7% of non-Enterobacteriaceae. S. pneumonia resisted erythromycin at a high prevalence (84.4%), followed by clindamycin (71.9%) and tetracycline (78.1%). The age of 60s was the leading group in community pneumonia and had increased resistance to amoxicillin/clavulanic acid and cefuroxime.
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Affiliation(s)
- Hung Do Tran
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | | | | | | | | | | | | | | | | | | | - Vi Tuong Mai
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Navy Yong
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Thang Nguyen
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Hung Gia Tran
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
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Rosyid AN, Endraswari PD, Kusmiati T, Puspitasari AD, Purba AKR, Effendi WI, Soedarsono, Nasronudin, Amin M. The spectrum of Cefditoren for Lower Respiratory Tract Infections (LRTIs) in Surabaya. CURRENT DRUG THERAPY 2021. [DOI: 10.2174/1574885517666211220150412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Empirical antibiotics among outpatients with Lower Respiratory Tract Infections (LRTIs) are scarcely allocated in Indonesia. The study aims to evaluate the pathogens causing LRTIs, drug sensitivity test and the minimum inhibitory concentrations of 90% (MIC90) of Cefditoren, Azithromycin, Amoxicillin-Clavulanic Acid, and Cefixime
Methods:
The study was performed in adult outpatients with LRTI that can be expectorated. Patients with diabetes mellitus, HIV, lung tuberculosis, renal or hepatic failure, and hemoptysis were excluded. We performed bacterial culture, antibiotic sensitivity, and MIC measurement of four antibiotics.
Results:
There were 126 patients with LRTIs, and 61 patients were eligible for the study. We identified 69 bacteria. We found Klebsiella pneumonia (n=16; 26.23%), Staphylococcus aureus (n=11; 18%), Pseudomonas aeruginosa (n=8; 13.11%), Acinetobacter baumanii complex (n= 4; 6.55%), Streptococcus pneumonia (n=3; 4.9%) and others bacteria as causa of LRTI. Testing MIC90 of Cefditoren and three empiric antibiotics on LRTI found that Cefditoren has a lower MIC of 90 for K. pneumonia (0.97(2.04) µg.mL-1) and S. pneumonia (0.06(0.00)µg.mL-1) than other antibiotics, but almost the same as Cefixime ((0.05(0.16)µg.mL-1) and (0.38(0.17)µg.mL-1). MIC90 Cefditoren for S.aureus (3.18(3.54)µg.mL-1) and P.aeruginosa (9.2(3.53)µg.mL-1) is lower than Cefixime but higher than Azithromycin and Amoxicillin-Clavulanic acid. Reference data MIC90 of Cefditoren for LRTI bacteria is lower than the other three oral empirical antibiotics.
Conclusions:
In vitro studies of an outpatient LRTI in Surabaya found gram-negative bacteria dominant. Cefditoren can inhibit K.pneumonia and S.pneumonia has lower MIC90 compared to other antibiotics. Cefditoren can inhibit gram-negative and positive bacteria causing LRTI.
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Affiliation(s)
- Alfian Nur Rosyid
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr.Soetomo Hospital, Indonesia
| | - Pepy Dwi Endraswari
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga – Dr.Soetomo Hospital, Indonesia
| | - Tutik Kusmiati
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr.Soetomo Hospital, Indonesia
| | | | | | - Wiwin Is Effendi
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr.Soetomo Hospital, Indonesia
| | - Soedarsono
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr.Soetomo Hospital, Indonesia
| | - Nasronudin
- Universitas Airlangga Hospital; fIndonesian Society of Respirology, Indonesia
| | - Muhammad Amin
- Universitas Airlangga Hospital; fIndonesian Society of Respirology, Indonesia
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Liu Z, Huo JH, Dong WT, Sun GD, Li FJ, Zhang YN, Qin ZW, Pengna J, Wang WM. A Study Based on Metabolomics, Network Pharmacology, and Experimental Verification to Explore the Mechanism of Qinbaiqingfei Concentrated Pills in the treatment of Mycoplasma Pneumonia. Front Pharmacol 2021; 12:761883. [PMID: 34803705 PMCID: PMC8599429 DOI: 10.3389/fphar.2021.761883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Qinbaiqingfei concentrated pills (QB) are a commonly used medicine for the treatment of mycoplasma pneumonia in China, and the mechanism of action of QB needs to be studied further. Therefore, we use a combination of metabolomics and network pharmacology to clarify the mechanism of QB. Nontarget metabolomics studies were performed on rat serum, urine, and lung tissues, and 56 therapeutic biomarkers were found. Subsequently, the components of QB absorbed into the blood and lung tissues were clarified, and based on this finding, the core target of network pharmacology was predicted. The enrichment analysis of biomarkers–genes finally confirmed their close relationship with the NF-κB signaling pathway. By western blotting expression of the proteins in the lung tissue–related signaling pathways, it is finally confirmed that QB inhibits the NF-κB signaling pathway through SIRT1, IL-10 and MMP9, CTNNB1, EGFR, and other targets. It plays a role in regulating immunity, regulating metabolism, and treating diseases.
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Affiliation(s)
- Zheng Liu
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jin-Hai Huo
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Wen-Ting Dong
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Guo-Dong Sun
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Feng-Jin Li
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Ya-Nan Zhang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Zhi-Wei Qin
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jiang Pengna
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wei-Ming Wang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
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Zhao C, Xie Y, Zhang F, Wang Z, Yang S, Wang Q, Wang X, Li H, Chen H, Wang H. Investigation of Antibiotic Resistance, Serotype Distribution, and Genetic Characteristics of 164 Invasive Streptococcus pneumoniae from North China Between April 2016 and October 2017. Infect Drug Resist 2020; 13:2117-2128. [PMID: 32753907 PMCID: PMC7342493 DOI: 10.2147/idr.s256663] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/09/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae infections are the major cause of global morbidity and mortality among children and patients aged more than 65 years. This study aimed to investigate the antimicrobial resistance, bacterial serotype distribution, and genetic characteristics of invasive S. pneumoniae from different cities in North China. MATERIALS AND METHODS A total of 164 invasive S. pneumoniae strains were collected from 8 hospitals in 5 regions of North China between April 2016 and October 2017. Minimum inhibitory concentrations (MICs) were determined using the agar dilution method. Capsular serotypes were identified using the Quellung reaction test. Molecular epidemiology was investigated using multilocus sequence typing. RESULTS S. pneumoniae isolates were highly resistant to macrolides, clindamycin, and tetracycline in all age groups. The overall rate of resistance to penicillin was 56.7%. However, fluoroquinolones and vancomycin maintained excellent antimicrobial activities. The rate of resistance to β-lactam in strains isolated from children aged less than 18 years was significantly higher than that in strains from other age groups. The most prevalent serotypes were 14 (22.6%), 19F (16.5%), non-vaccine types (14.0%), 19A (9.8%), and 23F (9.1%). The coverage for PCV10 and PCV13 was 59.8% and 75.6%, respectively. The vaccine coverage rate was the highest among children aged less than 5 years. The proportion of penicillin-resistant isolates was higher among vaccine-covered strains compared with non-covered strains. S. pneumoniae showed considerable clonal dissemination, and ST876 (28, 17.1%), ST271 (22, 13.4%), ST81 (17, 10.4%) and ST320 (14, 8.5%) were the major STs. CONCLUSION All the 164 invasive S. pneumoniae isolates demonstrated high resistance to antibiotics. The coverage of S. pneumoniae vaccine was higher in children than in adults.
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Affiliation(s)
- Chunjiang Zhao
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Yuhao Xie
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Feifei Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Zhanwei Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Shuo Yang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Qi Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xiaojuan Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Henan Li
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Hongbin Chen
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
| | - Hui Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, People's Republic of China
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