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Pillay L, Rikhotso RE. Antibiotic prescribing pattern of oral health practitioners before and during the COVID-19 pandemic at Wits Oral Health Centre. Br J Oral Maxillofac Surg 2024; 62:619-625. [PMID: 38987056 DOI: 10.1016/j.bjoms.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 07/12/2024]
Abstract
The purpose of the study was to determine the antibiotic prescribing pattern of oral health practitioners before and during the Coronavirus disease 2019 (COVID-19) pandemic at Wits Oral Health Centre, South Africa. A retrospective, descriptive study was conducted using a systematic random sample of 698 records of patients who were prescribed antibiotics. The records were categorised into two groups: pre-COVID-19 and COVID-19 pandemic periods. For each group, data collected and analysed included variables such as patient demographics, prescriber discipline, medical history, dental condition, dental procedure, type of antibiotic, dose, frequency, and duration. Most patients in both the pre-COVID-19 and COVID-19 groups (70.3% and 73%, respectively) were healthy. The most common indication for prescribing antibiotics was a painful tooth (58.7%). Amoxycillin and metronidazole remain the antibiotics of choice for most dental conditions. More patients were treated with antibiotics only in the COVID-19 group than the pre-COVID-19 group (46.8% vs 33.7%). A significant proportion of the prescribed antibiotics were not indicated in both the pre-COVID-19 and COVID-19 groups (53.1% and 54.3%, respectively). The increased antibiotic usage during the COVID-19 period, in spite of the decrease in the number of patients consulted, underscores the need for more strategies to be implemented to strengthen antimicrobial resistance surveillance and stewardship initiatives.
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Affiliation(s)
- Lingeswara Pillay
- Department of Maxillofacial and Oral Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Risimati Ephraim Rikhotso
- Department of Maxillofacial and Oral Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Constantinescu S, Niculescu AG, Hudiță A, Grumezescu V, Rădulescu D, Bîrcă AC, Irimiciuc SA, Gherasim O, Holban AM, Gălățeanu B, Oprea OC, Ficai A, Vasile BȘ, Grumezescu AM, Bolocan A, Rădulescu R. Silver/Graphene Oxide Nanostructured Coatings for Modulating the Microbial Susceptibility of Fixation Devices Used in Knee Surgery. Int J Mol Sci 2023; 25:246. [PMID: 38203420 PMCID: PMC10779033 DOI: 10.3390/ijms25010246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Exploring silver-based and carbon-based nanomaterials' excellent intrinsic antipathogenic effects represents an attractive alternative for fabricating anti-infective formulations. Using chemical synthesis protocols, stearate-conjugated silver (Ag@C18) nanoparticles and graphene oxide nanosheets (nGOs) were herein obtained and investigated in terms of composition and microstructure. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) characterizations revealed the formation of nanomaterials with desirable physical properties, while X-ray diffraction (XRD) analyses confirmed the high purity of synthesized nanomaterials. Further, laser-processed Ag@C18-nGO coatings were developed, optimized, and evaluated in terms of biological and microbiological outcomes. The highly biocompatible Ag@C18-nGO nanostructured coatings proved suitable candidates for the local modulation of biofilm-associated periprosthetic infections.
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Affiliation(s)
- Sorin Constantinescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari St. 8, 050474 Bucharest, Romania; (S.C.); (D.R.); (A.B.); (R.R.)
| | - Adelina-Gabriela Niculescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania; (A.-G.N.); (A.M.H.)
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, Gh. Polizu St. 1-7, 060042 Bucharest, Romania; (A.C.B.); (A.F.); (B.Ș.V.)
| | - Ariana Hudiță
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania; (A.-G.N.); (A.M.H.)
- Department of Biochemistry and Molecular Biology, University of Bucharest, 050095 Bucharest, Romania;
| | - Valentina Grumezescu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor St., 077125 Magurele, Romania; (V.G.); (S.A.I.); (O.G.)
| | - Dragoș Rădulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari St. 8, 050474 Bucharest, Romania; (S.C.); (D.R.); (A.B.); (R.R.)
| | - Alexandra Cătălina Bîrcă
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, Gh. Polizu St. 1-7, 060042 Bucharest, Romania; (A.C.B.); (A.F.); (B.Ș.V.)
| | - Stefan Andrei Irimiciuc
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor St., 077125 Magurele, Romania; (V.G.); (S.A.I.); (O.G.)
| | - Oana Gherasim
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor St., 077125 Magurele, Romania; (V.G.); (S.A.I.); (O.G.)
| | - Alina Maria Holban
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania; (A.-G.N.); (A.M.H.)
- Microbiology and Immunology Department, Faculty of Biology, University of Bucharest, 1-3 Portocalelor Lane, District 5, 77206 Bucharest, Romania
| | - Bianca Gălățeanu
- Department of Biochemistry and Molecular Biology, University of Bucharest, 050095 Bucharest, Romania;
| | - Ovidiu Cristian Oprea
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, University Politehnica of Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania;
- Academy of Romanian Scientists, Spl. Independenței 54, 50085 Bucharest, Romania
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, Gh. Polizu St. 1-7, 060042 Bucharest, Romania; (A.C.B.); (A.F.); (B.Ș.V.)
- Academy of Romanian Scientists, Spl. Independenței 54, 50085 Bucharest, Romania
| | - Bogdan Ștefan Vasile
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, Gh. Polizu St. 1-7, 060042 Bucharest, Romania; (A.C.B.); (A.F.); (B.Ș.V.)
| | - Alexandru Mihai Grumezescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania; (A.-G.N.); (A.M.H.)
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, Gh. Polizu St. 1-7, 060042 Bucharest, Romania; (A.C.B.); (A.F.); (B.Ș.V.)
- Academy of Romanian Scientists, Spl. Independenței 54, 50085 Bucharest, Romania
| | - Alexandra Bolocan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari St. 8, 050474 Bucharest, Romania; (S.C.); (D.R.); (A.B.); (R.R.)
| | - Radu Rădulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari St. 8, 050474 Bucharest, Romania; (S.C.); (D.R.); (A.B.); (R.R.)
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Loaiza WM, Ruiz AKR, Patiño CCO, Vivas MC. Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review. ACTA MEDICA (HRADEC KRALOVE) 2023; 66:1-10. [PMID: 37384803 DOI: 10.14712/18059694.2023.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
PURPOSE In this review we present the status of the prevalence of bacteria resistant to antibiotics and the main antibiotic resistance genes that are reported in infections acquired in intensive care units (ICU) around the world. METHODS A systematic review based on the PRISMA guide was carried out, from the Science Direct, Redalyc, Scopus, Hinari, Scielo, Dialnet, PLOS, ProQuest, Taylor, Lilacs and PubMed/Medline databases. Inclusion criteria of this review were original research study published in a scientific journal in a 10-year time span from 1 January 2017 and 30 April 2022. RESULTS A total of 1686 studies were identified, but only 114 studies were considered eligible for inclusion. Klebsiella pneumoniae and Escherichia coli resistant to carbapenems and producers of extended-spectrum β-lactamases (ESBL) are the most frequently isolated pathogens in ICUs in Asia, Africa and Latin America. The blaOXA and blaCTX were antibiotic resistance genes (ARG) most commonly reported in different geographic regions (in 30 and 28 studies, respectively). Moreover, multidrug-resistant (MDR) strains were reported in higher frequency in hospital-acquired infections. Reports of MDR strains vary between continents, with the majority of publications being in Asia and between countries, with Egypt and Iran being highlighted. There is a predominance of few bacterial clones with MDR phenotype, for example, clonal complex 5 Methicillin-Resistant Staphylococcus aureus (CC5-MRSA) circulates frequently in hospitals in the United States, clone ST23-K. pneumoniae is reported in India and Iran, and clone ST260 carbapenemase-producing P. aeruginosa in the United States and Estonia. CONCLUSION Our systematic review reveals that ESBL- and carbapenemase-producing K. pneumoniae and E. coli are the most problematic bacteria that are reported, mainly in tertiary hospitals in Asia, Africa, and Latin America. We have also found propagation of dominant clones with a high degree of MDR, becoming a problem due to its high capacity to cause morbidity, mortality and additional hospital costs.
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Affiliation(s)
| | | | | | - Mónica Chavez Vivas
- Investigation Group GIMMEIN, Colombia.
- Medicine Program, Faculty of Health Sciences, Universidad Libre, Cali, Colombia.
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Stefanini I, De Renzi G, Foddai E, Cordani E, Mognetti B. Profile of Bacterial Infections in COVID-19 Patients: Antimicrobial Resistance in the Time of SARS-CoV-2. BIOLOGY 2021; 10:biology10090822. [PMID: 34571699 PMCID: PMC8467430 DOI: 10.3390/biology10090822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022]
Abstract
Simple Summary Since the beginning of COVID-19 pandemic, no specific drugs have been available to treat the SARS-CoV-2 infection, therefore antibiotics have been often used both for prophylactic and therapeutic purposes. Their wide use, though, is known to contribute to the emergence of antimicrobial resistance. Aiming at evaluating the impact of the COVID-19 pandemic on the distribution and characteristics of bacterial infections, and on the frequency of antimicrobial resistance, we investigated the microbial strains identified through laboratory tests on clinical specimens from COVID-19 and non-COVID-19 patients accessing an Italian tertiary hospital over nearly one year. We highlighted that COVID+ patients bore a significantly higher number of bacterial species. Eight out of the 100 species identified were isolated exclusively from COVID+ and most of them are known to establish infections only in immunocompromised patients. Resistance to every tested antibiotic was seen in 8.3% of the isolates with a correlation with the positivity to COVID, but neither all COVID+ or COVID− isolates showed characteristic responses to the tested antibiotics. The predicted increase of antibiotic resistance is not observable yet, but the higher frequency of multi-resistant COVID+ isolates suggests that it is actually occurring, further calling for the definition of alternative treatments of COVID-19 infections. Abstract The global onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infections happened suddenly, hence imposing a rapid definition of effective therapeutic approaches. Antibiotics were included among the prophylactic agents because of both the similarity between SARS-CoV-2 and atypical pneumonia symptoms, and the immune-modulating and anti-inflammatory properties of such drugs. Although, this approach could exacerbate the emergence of antimicrobial resistance. To evaluate the impact of the COVID-19 pandemic on the spread and characteristics of bacterial infections, as well as on the frequency of antimicrobial resistance, we investigated and compared clinical bacterial strains isolated in an Italian hospital from COVID-19 patients and non-COVID-19 patients during and before the COVID-19 outbreak. Data clearly indicate the impact of the COVID-19 pandemic on bacterial infections: not only some bacterial species were found in either COVID-19 positive or in COVID-19 negative patients, but isolates from COVID-19 patients also showed higher levels of antimicrobial resistance. Nevertheless, despite some bacterial species were isolated only before or over the pandemic, no differences were observed among the antimicrobial resistance levels. Overall, these results recapitulate the current situation of microbial infections and could also provide an overview of the impact of COVID-19 on bacterial pathogens spread and resistance.
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Affiliation(s)
- Irene Stefanini
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy;
| | - Giuseppe De Renzi
- SCDO Laboratory of Clinical Pathology and Microbiology, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (G.D.R.); (E.F.); (E.C.)
| | - Elisa Foddai
- SCDO Laboratory of Clinical Pathology and Microbiology, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (G.D.R.); (E.F.); (E.C.)
| | - Elisa Cordani
- SCDO Laboratory of Clinical Pathology and Microbiology, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy; (G.D.R.); (E.F.); (E.C.)
| | - Barbara Mognetti
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia Albertina 13, 10123 Turin, Italy;
- Correspondence: ; Tel.: +39-0116704518
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Gherasim O, Grumezescu AM, Ficai A, Grumezescu V, Holban AM, Gălățeanu B, Hudiță A. Composite P(3HB-3HV)-CS Spheres for Enhanced Antibiotic Efficiency. Polymers (Basel) 2021; 13:989. [PMID: 33807077 PMCID: PMC8004896 DOI: 10.3390/polym13060989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 01/17/2023] Open
Abstract
Natural-derived biopolymers are suitable candidates for developing specific and selective performance-enhanced antimicrobial formulations. Composite polymeric particles based on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and chitosan, P(3HB-3HV)-CS, are herein proposed as biocompatible and biodegradable delivery systems for bioproduced antibiotics: bacitracin (Bac), neomycin (Neo) and kanamycin (Kan). The stimuli-responsive spheres proved efficient platforms for boosting the antibiotic efficiency and antibacterial susceptibility, as evidenced against Gram-positive and Gram-negative strains. Absent or reduced proinflammatory effects were evidenced on macrophages in the case of Bac-/Neo- and Kan-loaded spheres, respectively. Moreover, these systems showed superior ability to sustain and promote the proliferation of dermal fibroblasts, as well as to preserve their ultrastructure (membrane and cytoskeleton integrity) and to exhibit anti-oxidant activity. The antibiotic-loaded P(3HB-3HV)-CS spheres proved efficient alternatives for antibacterial strategies.
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Affiliation(s)
- Oana Gherasim
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (A.F.)
- Lasers Department, National Institute for Lasers, Plasma, and Radiation Physics, RO-77125 Magurele, Romania
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (A.F.)
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (A.F.)
| | - Valentina Grumezescu
- Lasers Department, National Institute for Lasers, Plasma, and Radiation Physics, RO-77125 Magurele, Romania
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
| | - Alina Maria Holban
- Microbiology & Immunology Department, Faculty of Biology, University of Bucharest, 77206 Bucharest, Romania;
| | - Bianca Gălățeanu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91–95 Splaiul Independentei, 050095 Bucharest, Romania; (B.G.); (A.H.)
| | - Ariana Hudiță
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 91–95 Splaiul Independentei, 050095 Bucharest, Romania; (B.G.); (A.H.)
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