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Kaur J, Singh H, Sethi T. Emerging trends in antimicrobial resistance in bloodstream infections: multicentric longitudinal study in India (2017-2022). THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 26:100412. [PMID: 38757091 PMCID: PMC11097075 DOI: 10.1016/j.lansea.2024.100412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
Background Antimicrobial resistance (AMR) has escalated to pandemic levels, posing a significant global health threat. This study examines the patterns and trends of AMR in Bloodstream Infections (BSIs) across India, aiming to inform better surveillance and intervention strategies. Methods Six-year data from 21 tertiary care centers in the Indian Council of Medical Research's AMR Surveillance Network (IAMRSN) were retrospectively analyzed to estimate cluster-robust trends in resistance. Time-series analysis was used to discern lead/lag relationships between antibiotic pairs and the directional influence of resistance in community and hospital-acquired BSIs(CA/HA BSIs). A data-driven Bayesian network ensemble averaged over 301 bootstrap samples was modelled to uncover systemic associations between AMR and Sustainable Development Goals (SDGs). Findings Our findings indicate significant (p < 0.001) monthly increases in Imipenem and Meropenem resistance for Klebsiella, E. coli, and Acinetobacter BSIs. Importantly, Carbapenem resistance in HA-BSIs preceded that in CA-BSIs for Klebsiella and Acinetobacter (p < 0.05). At a national level, Cefotaxime resistance emerged as a potential early indicator for emerging Carbapenem resistance, proposing a novel surveillance marker. In Klebsiella BSIs, states with higher achievement of SDG3 goals showed lower Imipenem resistance. A model-based AMR scorecard is introduced for focused interventions and continuous monitoring. Interpretation The identified spatiotemporal trends and drug resistance associations offer critical insights for AMR surveillance aligning with WHO GLASS standards.The escalation of carbapenem resistance in BSIs demands vigilant monitoring and may be crucial for achieving SDGs by 2030. Implementing the proposed framework for data-driven evidence can help nations achieve proactive AMR surveillance. Funding No specific funding was received for this analysis.
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Affiliation(s)
- Jasmine Kaur
- Center of Excellence in Healthcare, Indraprastha Institute of Information Technology Delhi, New Delhi, India
- Department of Computational Biology, Indraprastha Institute of Information Technology Delhi, New Delhi, India
- Division of Biomedical Informatics, Indian Council of Medical Research, Delhi, India
| | - Harpreet Singh
- Division of Biomedical Informatics, Indian Council of Medical Research, Delhi, India
| | - Tavpritesh Sethi
- Center of Excellence in Healthcare, Indraprastha Institute of Information Technology Delhi, New Delhi, India
- Department of Computational Biology, Indraprastha Institute of Information Technology Delhi, New Delhi, India
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Cosimato I, Santella B, Rufolo S, Sabatini P, Galdiero M, Capunzo M, Boccia G, Folliero V, Franci G. Current Epidemiological Status and Antibiotic Resistance Profile of Serratia marcescens. Antibiotics (Basel) 2024; 13:323. [PMID: 38666999 PMCID: PMC11047617 DOI: 10.3390/antibiotics13040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/29/2024] Open
Abstract
The spread of antibiotic resistance represents a serious worldwide public health issue, underscoring the importance of epidemiology research in determining antimicrobial strategies. The purpose of this research was to investigate antibiotic resistance in Serratia marcescens isolates from clinical samples over seven years at the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in Salerno, Italy. S. marcescens is an important opportunistic pathogen associated with a wide spectrum of clinical diseases, including pneumonia, keratitis, meningitis, and urinary tract and wound infections. Outbreaks of nosocomial infections by S. marcescens strains have been documented in high-risk settings, mainly affecting immunocompromised patients and newborns. The primary objective of this study is to assess the rates of antibiotic resistance over the years to deal with a future emergency which includes the failure of various therapies due to antibiotic resistance. During the investigation, a total of 396 species of S. marcescens were isolated from various clinical samples, mainly from broncho-aspirates and sputum (31.6%) and blood cultures (21.5%). Antibiotics that showed the greatest susceptibility included ceftazidime/avibactam, amikacin, trimethoprim/sulfamethoxazole, and selected members of the cephalosporin class. However, a disconcerting trend of increasing rates of carbapenem resistance was outlined over the observation period. The absence of effective countermeasures, combined with growing antibiotic resistance that negates the effectiveness of multiple antibiotics, highlights the potential for S. marcescens infections to trigger serious clinical complications and increased mortality rates. The surveillance of Serratia marcescens infections constitutes a pivotal element in refining empiric therapy to mitigate the dissemination of antimicrobial resistance.
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Affiliation(s)
- Ilaria Cosimato
- U.O.C. of Virology and Microbiology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (I.C.)
| | - Biagio Santella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
| | - Sandra Rufolo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
| | - Paola Sabatini
- Unit of Virology and Microbiology, Nocera Inferiore, Umberto I Hospital, 84018 Salerno, Italy;
| | - Massimiliano Galdiero
- U.O.C. of Virology and Microbiology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (I.C.)
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa, U.O.C. Patologia Clinica e Microbiologia, A.O.U. San Giovanni di Dio e Ruggi D’Aragona, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa, U.O.C. Patologia Clinica e Microbiologia, A.O.U. San Giovanni di Dio e Ruggi D’Aragona, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Veronica Folliero
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (B.S.); (S.R.); (M.C.); (G.B.); (V.F.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa, U.O.C. Patologia Clinica e Microbiologia, A.O.U. San Giovanni di Dio e Ruggi D’Aragona, Largo Città di Ippocrate, 84131 Salerno, Italy
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Aygun U, Yagin FH, Yagin B, Yasar S, Colak C, Ozkan AS, Ardigò LP. Assessment of Sepsis Risk at Admission to the Emergency Department: Clinical Interpretable Prediction Model. Diagnostics (Basel) 2024; 14:457. [PMID: 38472930 DOI: 10.3390/diagnostics14050457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
This study aims to develop an interpretable prediction model based on explainable artificial intelligence to predict bacterial sepsis and discover important biomarkers. A total of 1572 adult patients, 560 of whom were sepsis positive and 1012 of whom were negative, who were admitted to the emergency department with suspicion of sepsis, were examined. We investigated the performance characteristics of sepsis biomarkers alone and in combination for confirmed sepsis diagnosis using Sepsis-3 criteria. Three different tree-based algorithms-Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), Adaptive Boosting (AdaBoost)-were used for sepsis prediction, and after examining comprehensive performance metrics, descriptions of the optimal model were obtained with the SHAP method. The XGBoost model achieved accuracy of 0.898 (0.868-0.929) and area under the ROC curve (AUC) of 0.940 (0.898-0.980) with a 95% confidence interval. The five biomarkers for predicting sepsis were age, respiratory rate, oxygen saturation, procalcitonin, and positive blood culture. SHAP results revealed that older age, higher respiratory rate, procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, plaque, leukocyte particle concentration, as well as lower oxygen saturation, systolic blood pressure, and hemoglobin levels increased the risk of sepsis. As a result, the Explainable Artificial Intelligence (XAI)-based prediction model can guide clinicians in the early diagnosis and treatment of sepsis, providing more effective sepsis management and potentially reducing mortality rates and medical costs.
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Affiliation(s)
- Umran Aygun
- Department of Anesthesiology and Reanimation, Malatya Yesilyurt Hasan Calık State Hospital, Malatya 44929, Turkey
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey
| | - Burak Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey
| | - Seyma Yasar
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey
| | - Ahmet Selim Ozkan
- Department of Anesthesiology and Reanimation, Malatya Turgut Ozal University School of Medicine, Malatya 44210, Turkey
| | - Luca Paolo Ardigò
- Department of Teacher Education, NLA University College, 0166 Oslo, Norway
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Shao H, Zhang X, Li Y, Gao Y, Wang Y, Shao X, Dai L. Epidemiology and drug resistance analysis of bloodstream infections in an intensive care unit from a children's medical center in Eastern China for six consecutive years. Int Microbiol 2024:10.1007/s10123-024-00481-2. [PMID: 38233723 DOI: 10.1007/s10123-024-00481-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Children in the intensive care unit (ICU) who suffer from severe basic diseases and low immunity are usually in critical condition. It is crucial to assist clinicians in selecting the appropriate empirical antibiotic therapies for clinical infection control. METHODS We retrospectively analyzed data from 281 children with bloodstream infection (BSI). Comparisons of basic data, pathogenic information, and drug resistance of the main bacteria were conducted. RESULTS We detected 328 strains, including Gram-positive bacteria (223, 68%), mainly coagulase-negative Staphylococci (CoNS); Gram-negative bacteria (91, 27.7%); and fungi (14, 4.3%). The results of the binary logistic regression analysis showed that the main basic disease was an independent risk factor for death. Compared with Escherichia coli, Klebsiella pneumoniae exhibited a higher proportion of extended-spectrum β-lactamases (ESBLs), and its resistance to some β-lactamides and quinolones antibiotics were lower. Twenty-seven isolates of multidrug-resistant (MDR) bacteria were detected, of which carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the highest proportion (13, 48.2%). CONCLUSIONS CoNS was the principal pathogen causing BSI in children in the ICU of children, and Escherichia coli was the most common Gram-negative pathogen. The main basic disease was an independent risk factor for death. It is necessary to continuously monitor patients with positive blood cultures, pay special attention to detected MDR bacteria, and strengthen the management of antibiotics and prevention and control of nosocomial infections.
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Affiliation(s)
- Huijiang Shao
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China
| | - Xin Zhang
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, 215025, China
| | - Yang Li
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, 215025, China
| | - Yuanyuan Gao
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China
| | - Yunzhong Wang
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China
| | - Xuejun Shao
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China.
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, 215025, China.
| | - Ling Dai
- Department of Clinical Laboratory, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215025, China.
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, 215025, China.
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Opare‐Asamoah K, Acquah SE, Vicar EK, Quaye L, Alhassan A, Majeed SF, Yakong VN, Yankson S. Predictors of the onset of neonatal sepsis at the Neonatal Intensive Care Unit of a tertiary hospital in Ghana: A cross-sectional study. Health Sci Rep 2023; 6:e1673. [PMID: 37927539 PMCID: PMC10620847 DOI: 10.1002/hsr2.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Background and Aim Neonatal sepsis is a systemic inflammatory response to infection during the first 4 weeks of an infant's life. It is a significant cause of neonatal morbidity and mortality in low- and middle-income countries. This study aimed to determine the predictors of the onset of sepsis at the Neonatal Intensive Care Unit of the Tamale Teaching Hospital, Ghana. Methods A cross-sectional study was conducted among 275 mothers and their singleton neonates diagnosed clinically with sepsis. A univariate and multivariate logistic regression analysis adjusted for maternal occupational status was performed to determine the maternal and neonatal predictors of early-onset (EOS) and late-onset sepsis (LOS), respectively. Results Single motherhood (AOR = 1.882, 95% CI = 0.926-3.822, p = .08) and home delivery (AOR = 3.667, 95% CI = 0.584-23.026, p = .17) were predictors of EOS, with single motherhood being the predictor for LOS (AOR = 2.906, 95% CI = 0.715-11.805, p = .14) in a univariate analysis. When maternal occupation was adjusted for in a multivariate analysis, single mother (AOR = 2.167, 95% CI = 1.010-4.648, p = .04) was the main predictor of EOS, with low neonatal birth weight being the main predictor of LOS (AOR = 0.193, 95% CI = 0.038-0.971, p = .04). Conclusion Maternal marital status is a significant predictor of both EOS and LOS, with predictors of EOS being lower gestational age and low birth weight, while for LOS, low birth weight is the main predictor. Findings from this study can serve as a commencement point for developing predictive models for the onset of sepsis in neonates in the study facility.
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Affiliation(s)
- Kwame Opare‐Asamoah
- Department of Biological Sciences, Faculty of BiosciencesUniversity for Development StudiesTamaleGhana
| | - Samuel E. Acquah
- Department of Clinical Microbiology, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Ezekial Kofi Vicar
- Department of Clinical Microbiology, School of MedicineUniversity for Development StudiesTamaleGhana
| | - Lawrence Quaye
- Department of Biomedical Laboratory Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Abdul‐Mumin Alhassan
- Department of Pediatrics and Child Health, School of MedicineUniversity for Development StudiesTamaleGhana
| | - Saeed F. Majeed
- Department of Biological Sciences, Faculty of BiosciencesUniversity for Development StudiesTamaleGhana
| | - Vida Nyagre Yakong
- Department of Preventive Health Nursing, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Samuel Yankson
- Department of Physiology and Biophysics, School of MedicineUniversity for Development StudiesTamaleGhana
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Feng Y, Wang Z, Hao Z, Du J, Jiang H. Rising Drug Resistance Among Gram-Negative Pathogens in Bloodstream Infections: A Multicenter Study in Ulanhot, Inner Mongolia (2017-2021). Med Sci Monit 2023; 29:e940686. [PMID: 37828733 PMCID: PMC10583603 DOI: 10.12659/msm.940686] [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: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Bloodstream infections, which arise when pathogenic microorganisms infiltrate the bloodstream, present a grave health risk. Their potentially lethal nature combined with the ability to severely impair physiological functions underscore the importance of understanding and mitigating such infections. This study aimed to elucidate drug sensitivity profiles and distribution of these pathogens in hospitals in Ulanhot, Inner Mongolia. MATERIAL AND METHODS From 2017 to 2021, we gathered blood culture-positive samples from several hospitals across Ulanhot. Using combined diagnostic techniques, including the instrument method, paper diffusion, and Epsilometer test (E-test), we determined the identity of pathogens and assessed their drug sensitivity. Subsequent data processing with WHONET 5.6 software provided insights into the patterns of microbial distribution and extent of drug resistance. RESULTS Of 2498 pathogenic strains identified, 35.83% were gram-positive, 62.45% were gram-negative, and a smaller fraction of 1.72% were fungi. Escherichia coli and Klebsiella pneumoniae were the primary bacteria, contributing to 35.15% and 15.73% of infections, respectively. Alarmingly, methicillin-resistant strains exhibited pronounced resistance to drugs, notably penicillin G (resistance rates of 80.87% to 100.00%) and erythromycin (resistance rates of 91.16% to 97.28%). Acinetobacter baumannii had a particularly high resistance profile, surpassing Pseudomonas aeruginosa, which exhibited a resistance rate below 30.00%. CONCLUSIONS Ulanhot's primary bloodstream infection agents were gram-negative bacteria, specifically E. coli and K. pneumoniae. The growing drug resistance observed, particularly among strains like A. baumannii, highlights the pressing need for rigorous drug resistance surveillance and the strategic use of antibiotics, ensuring their efficacy is preserved for future medical needs.
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Affiliation(s)
- Yinxia Feng
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Zhijun Wang
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Zelin Hao
- Department of Laboratory Medicine, Ulanhot People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
| | - Jinlong Du
- Department of Laboratory Medicine, Keyou Qianqi People’s Hospital, Xing’an League, Tongliao, Inner Mongolia, PR China
| | - Hui Jiang
- Department of Laboratory Medicine, Xing’an League People’s Hospital, Xing’an League, Ulanhot, Inner Mongolia, PR China
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Folliero V, Dell’Annunziata F, Santella B, Roscetto E, Zannella C, Capuano N, Perrella A, De Filippis A, Boccia G, Catania MR, Galdiero M, Franci G. Repurposing Selamectin as an Antimicrobial Drug against Hospital-Acquired Staphylococcus aureus Infections. Microorganisms 2023; 11:2242. [PMID: 37764086 PMCID: PMC10535345 DOI: 10.3390/microorganisms11092242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/19/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023] Open
Abstract
The emergence of multidrug-resistant strains requires the urgent discovery of new antibacterial drugs. In this context, an antibacterial screening of a subset of anthelmintic avermectins against gram-positive and gram-negative strains was performed. Selamectin completely inhibited bacterial growth at 6.3 μg/mL concentrations against reference gram-positive strains, while no antibacterial activity was found against gram-negative strains up to the highest concentration tested of 50 μg/mL. Given its relevance as a community and hospital pathogen, further studies have been performed on selamectin activity against Staphylococcus aureus (S. aureus), using clinical isolates with different antibiotic resistance profiles and a reference biofilm-producing strain. Antibacterial studies have been extensive on clinical S. aureus isolates with different antibiotic resistance profiles. Mean MIC90 values of 6.2 μg/mL were reported for all tested S. aureus strains, except for the macrolide-resistant isolate with constitutive macrolide-lincosamide-streptogramin B resistance phenotype (MIC90 9.9 μg/mL). Scanning Electron Microscopy (SEM) showed that selamectin exposure caused relevant cell surface alterations. A synergistic effect was observed between ampicillin and selamectin, dictated by an FIC value of 0.5 against methicillin-resistant strain. Drug administration at MIC concentration reduced the intracellular bacterial load by 81.3%. The effect on preformed biofilm was investigated via crystal violet and confocal laser scanning microscopy. Selamectin reduced the biofilm biomass in a dose-dependent manner with minimal biofilm eradication concentrations inducing a 50% eradication (MBEC50) at 5.89 μg/mL. The cytotoxic tests indicated that selamectin exhibited no relevant hemolytic and cytotoxic activity at active concentrations. These data suggest that selamectin may represent a timely and promising macrocyclic lactone for the treatment of S. aureus infections.
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Affiliation(s)
- Veronica Folliero
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
| | - Federica Dell’Annunziata
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (A.D.F.); (M.G.)
| | - Biagio Santella
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
| | - Emanuela Roscetto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80138 Naples, Italy; (E.R.); (M.R.C.)
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (A.D.F.); (M.G.)
| | - Nicoletta Capuano
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
| | - Alessandro Perrella
- Division Emerging Infectious Disease and High Contagiousness, Hospital D Cotugno, 80131 Naples, Italy;
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (A.D.F.); (M.G.)
| | - Giovanni Boccia
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84126 Salerno, Italy
- Hospital Hygiene and Epidemiology Complex Operating Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84126 Salerno, Italy
| | - Maria Rosaria Catania
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80138 Naples, Italy; (E.R.); (M.R.C.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (A.D.F.); (M.G.)
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gianluigi Franci
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.F.); (F.D.); (B.S.); (N.C.); (G.B.)
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84126 Salerno, Italy
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Massarine NCM, de Souza GHDA, Nunes IB, Salomé TM, Barbosa MDS, Faccin I, Rossato L, Simionatto S. How Did COVID-19 Impact the Antimicrobial Consumption and Bacterial Resistance Profiles in Brazil? Antibiotics (Basel) 2023; 12:1374. [PMID: 37760671 PMCID: PMC10526034 DOI: 10.3390/antibiotics12091374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
The indiscriminate use of antibiotics has favored the selective pressure of multidrug resistance among microorganisms. This research evaluated the pattern of antibiotic prescriptions among the Brazilian population between January 2018 and December 2021. Additionally, the study sought to analyze the incidence rates of central line-associated bloodstream infection (CLABSI) and examine the profiles of antibiotic resistance. We assessed the hospital and community antimicrobial consumption from the National Health Surveillance Agency Database and correlated it to microorganisms. The consumption of antimicrobials in the hospital environment increased by 26% in 2021, highlighting polymyxin B, which increased by 204%. In 2021, 244,266 cases of CLABSI were reported, indicating a nosocomial infection rate of 7.9%. The rate of resistance to polymyxin B was higher in Pseudomonas aeruginosa (1400%) and Klebsiella pneumoniae (514%). Azithromycin emerged as the predominant antibiotic utilized within the community setting, accounting for 24% of the overall consumption. Pearson's correlation analysis revealed a significant and positive correlation (r = 0.71) between the elevated usage of azithromycin and the incidence of COVID-19. Our results indicate an increase in antimicrobial consumption during the COVID-19 pandemic and reinforce the fact that the misuse of antimicrobials may lead to an expansion in antimicrobial resistance.
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Serretiello E, Manente R, Dell’Annunziata F, Folliero V, Iervolino D, Casolaro V, Perrella A, Santoro E, Galdiero M, Capunzo M, Franci G, Boccia G. Antimicrobial Resistance in Pseudomonas aeruginosa before and during the COVID-19 Pandemic. Microorganisms 2023; 11:1918. [PMID: 37630478 PMCID: PMC10458743 DOI: 10.3390/microorganisms11081918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/28/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Pseudomonas aeruginosa (PA) is a major Gram-negative opportunistic pathogen causing several serious acute and chronic infections in the nosocomial and community settings. PA eradication has become increasingly difficult due to its remarkable ability to evade antibiotics. Therefore, epidemiological studies are needed to limit the infection and aim for the correct treatment. The present retrospective study focused on PA presence among samples collected at the San Giovanni di Dio and Ruggi D'Aragona University Hospital in Salerno, Italy; its resistance profile and relative variations over the eight years were analyzed. Bacterial identification and antibiotic susceptibility tests were performed by VITEK® 2. In the 2015-2019 and 2020-2022 timeframes, respectively, 1739 and 1307 isolates of PA were obtained from respiratory samples, wound swabs, urine cultures, cultural swabs, blood, liquor, catheter cultures, vaginal swabs, and others. During 2015-2019, PA strains exhibited low resistance against amikacin (17.2%), gentamicin (25.2%), and cefepime (28.3%); moderate resistance against ceftazidime (34.4%), imipenem (34.6%), and piperacillin/tazobactam (37.7%); and high resistance against ciprofloxacin (42.4%) and levofloxacin (50.6%). Conversely, during the 2020-2022 era, PA showed 11.7, 21.1, 26.9, 32.6, 33.1, 38.7, and 39.8% resistance to amikacin, tobramycin, cefepime, imipenem, ceftazidime, ciprofloxacin, and piperacillin/tazobactam, respectively. An overall resistance-decreasing trend was observed for imipenem and gentamicin during 2015-2019. Instead, a significant increase in resistance was recorded for cefepime, ceftazidime, and imipenem in the second set of years investigated. Monitoring sentinel germs represents a key factor in optimizing empirical therapy to minimize the spread of antimicrobial resistance.
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Affiliation(s)
- Enrica Serretiello
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio and Ruggi D’Aragona University Hospital, 84131 Salerno, Italy; (E.S.); (M.C.); (G.F.)
| | - Roberta Manente
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (F.D.); (M.G.)
| | - Federica Dell’Annunziata
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (F.D.); (M.G.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Veronica Folliero
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Domenico Iervolino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Alessandro Perrella
- Division Emerging Infectious Disease and High Contagiousness, Hospital D Cotugno, 80131 Naples, Italy;
| | - Emanuela Santoro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (F.D.); (M.G.)
| | - Mario Capunzo
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio and Ruggi D’Aragona University Hospital, 84131 Salerno, Italy; (E.S.); (M.C.); (G.F.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Gianluigi Franci
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio and Ruggi D’Aragona University Hospital, 84131 Salerno, Italy; (E.S.); (M.C.); (G.F.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
| | - Giovanni Boccia
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio and Ruggi D’Aragona University Hospital, 84131 Salerno, Italy; (E.S.); (M.C.); (G.F.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.F.); (V.C.); (E.S.)
- UOC Hospital and Epidemiological Hygiene, San Giovanni di Dio and Ruggi D’Aragona University Hospital, 84131 Salerno, Italy
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10
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Alnimr A. Bloodstream Infections Caused by Drug Resistant Ralstonia species: A Case Series During the COVID-19 Pandemic. Infect Drug Resist 2023; 16:1339-1344. [PMID: 36923211 PMCID: PMC10010739 DOI: 10.2147/idr.s403830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
Ralstonia spp. is an emerging, non-fermentative Gram-negative rod that demonstrates multidrug resistance. Herein, four cases of bloodstream infections (BSI) caused by R. mannitolilytica or R. pickettii are presented. All the cases had comorbidities that predisposed them to this opportunistic infection. The microbiological assessment showed carbapenemase genes carried out in two strains with minimal inhibitory concentrations > 32 μg/mL to imipenem and meropenem. Fluoroquinolones and trimethoprim-sulphamethoxazole were the most potent agents showing activity against 3/4 strains (75%), although treatment should be susceptibility-dependent for each strain. This case series highlights the possibility of co-infection by a rare organism during the COVID-19 pandemic and the importance of the readiness of diagnostic laboratories to support the diagnosis of uncommon pathogens.
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Affiliation(s)
- Amani Alnimr
- Department of Medical Microbiology, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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11
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Novel biosynthesis of tellurium nanoparticles and investigation of their activity against common pathogenic bacteria. J Taibah Univ Med Sci 2022; 18:400-412. [PMID: 37102074 PMCID: PMC10124139 DOI: 10.1016/j.jtumed.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/17/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives Tellurium has received substantial attention for its remarkable properties. This study performed in vitro and in vivo testing of the antibacterial action of tellurium nanoparticles biosynthesized in actinomycetes against methicillin-resistant Staphylococcus aureus (MRSA), a common blood bacterial pathogen. Methods Nine actinomycete isolates were tested for their potential to reduce potassium tellurite (K2TeO3) and form tellurium nanoparticles (TeNPs). The most efficient actinomycete isolate in producing Tellerium nanoparticles was identified through molecular protocols. The generated TeNPs were characterized using UV, TEM, EDX, XRD and FTIR. The bacterial species implicated in bloodstream infections were detected at El Hussein Hospital. Bacterial identification and antibiotic susceptibility testing were performed using Vitek 2. An animal infection model was used to test the efficacy of the produced TeNPs against the most commonly isolated methicillin-resistant S. aureus using survival assays, colony counting, cytokine assessment and biochemical testing. Results The most efficient actinomycete isolate was identified as Streptomyces graminisoli and given the accession number (OL773539). The mean particle size of the produced TeNPs was 21.4 nm, and rods and rosette forms were observed. Methicillin-resistant S. aureus (MRSA) was the main bacterium (60%) causing blood stream infections, and was followed by Escherichia coli (25%) and Klebsiella pneumoniae (15%). The produced TeNPs were tested against MRSA, the bacterium most frequently isolated from blood, and showed a promising action inhibition zone of 24 ± 0.7 mm and an MIC of 50 μg/ml. An animal infection model indicated the promise of TeNPs alone or in combination with standard drugs to combat MRSA in a rat intravenous infection model. Conclusion TeNPs combined with vancomycin have successive impact to combat bacteremia for further verification of results.
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12
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Zannella C, Chianese A, De Bernardo M, Folliero V, Petrillo F, De Filippis A, Boccia G, Franci G, Rosa N, Galdiero M. Ophthalmic Solutions with a Broad Antiviral Action: Evaluation of Their Potential against Ocular Herpetic Infections. Microorganisms 2022; 10:microorganisms10091728. [PMID: 36144330 PMCID: PMC9506079 DOI: 10.3390/microorganisms10091728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022] Open
Abstract
HSV-1 can be associated with severe and recurrent eye infections characterized by a strong inflammatory response that leads to blepharoconjunctivitis, epithelial and stromal keratitis, and retinal necrosis. The incidence of HSV-1 keratitis is 1.5 million every year worldwide, including more than 40,000 new cases exhibiting serious visual failures. Generally, the therapy uses antiviral drugs to promote healing; however, there are currently no compounds that are able to completely eradicate the virus. In addition, the phenomenon of resistance is rapidly spreading among HSV-1 strains, creating mutants developing resistance to the common antiviral drugs; therefore, deep research on this issue is warranted. The efficacy of different ophthalmic solutions already on the market was evaluated for reducing HSV-1 infection. Different plaque assays were set up on epithelial cells, revealing that two ophthalmic solutions were able to inhibit viral replication in the early stages of infection. The data were further confirmed by molecular tests analyzing the expression levels of the principal genes involved in HSV-1 infection, and a strong reduction was observed after only 1 min of eye-drop treatment. Collectively, these results suggested the use of ophthalmic solutions as potential antiviral options for the treatment of ocular herpetic infection.
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Affiliation(s)
- Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Veronica Folliero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Petrillo
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
- Correspondence: (N.R.); (M.G.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: (N.R.); (M.G.)
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13
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Pan D, Peng P, Fang Y, Lu J, Fang M. Distribution and Drug Resistance of Pathogenic Bacteria and Prognosis in Patients with Septicemia Bloodstream Infection with Renal Insufficiency. Infect Drug Resist 2022; 15:4109-4116. [PMID: 35924018 PMCID: PMC9342692 DOI: 10.2147/idr.s373665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/20/2022] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study was to investigate the distribution and drug resistance of pathogenic bacteria and the prognosis of patients with sepsis bloodstream infection with renal insufficiency. Methods One hundred and twelve patients with septicemic bloodstream infection with renal insufficiency and 112 patients with septic bloodstream infection without renal insufficiency were selected as study group and control group, respectively. We compare the distribution of pathogenic bacteria, analyze the drug resistance of major bacteria, and compare the efficacy, the incidence of septic shock, duration of mechanical ventilation, hospitalization time, and duration of antimicrobial drug administration between the two groups. Results A total of 140 pathogenic strains were isolated from blood cultures in the study group, and 136 strains were isolated from blood cultures in the control group. The sepsis bloodstream infection was mainly caused by Gram-negative bacteria, accounting for 59.42% (164/276). Among the gram-negative bacteria, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii had higher resistance rates to levofloxacin, ceftazidime, piperacillin sodium tazobactam, and amikacin. Among the gram-positive bacteria, Streptococcus pneumoniae, Enterococcus, and Staphylococcus aureus had high resistance rates to clindamycin, cefazolin, penicillin G, gentamicin, azithromycin, and levofloxacin. The rate of extended spectrum β-lactamase (ESBLs)-producing enterobacteria and multi-drug resistant Pseudomonas aeruginosa (MDR-PA) infection was significantly higher in the study group than in the control group; there was no difference in multi-drug resistant Acinetobacter baumannii (MDR-AB), vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) between the two groups. The duration of hospitalization and the duration of antimicrobial drug administration were longer in the study group than in the control group. Conclusion The pathogenic bacteria in patients with sepsis bloodstream infection with renal insufficiency are mainly Gram-negative bacteria, are more difficult to be cured, have a longer course of treatment, and need to use antibacterial drugs for a long time.
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Affiliation(s)
- Deng Pan
- Department of Infectious Disease, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei, People’s Republic of China
| | - Pin Peng
- Intensive Care Unit, Wuhan Asia General Hospital, Wuhan, Hubei, People’s Republic of China
| | - Yu Fang
- Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Jun Lu
- Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Minghao Fang
- Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
- Correspondence: Minghao Fang, Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, People’s Republic of China, Tel +86-15071157405, Email
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14
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Shi N, Kang J, Wang S, Song Y, Yin D, Li X, Guo Q, Duan J, Zhang S. Bacteriological Profile and Antimicrobial Susceptibility Patterns of Gram-Negative Bloodstream Infection and Risk Factors Associated with Mortality and Drug Resistance: A Retrospective Study from Shanxi, China. Infect Drug Resist 2022; 15:3561-3578. [PMID: 35833010 PMCID: PMC9271686 DOI: 10.2147/idr.s370326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study was to analyze the epidemiological of gram-negative bloodstream infection (GNBSI) and establish a risk prediction model for mortality and acquiring multidrug resistant (MDR), the extended spectrum beta-lactamases (ESBLs) producing and carbapenem-resistant (CR) GNBSI. Methods This retrospective study covered five years from January 2015 to December 2019. Data were obtained from Hospital Information System (HIS) and microbiology department records. The risk factors for mortality and acquiring MDR, ESBLs-producing and CR GNBSI were analyzed by univariable and multivariable analysis. Results A total of 1018 GNBSI cases were collected. A majority of GNBSI patients were in hematology ward (23.77%). There were 38.61% patients who were assigned in the 41–60 age group. Escherichia coli was the most common gram-negative organism (49.90%). Among isolates of GNBSI, 40.47% were found to be MDR strains, 34.09% were found to be ESBLs-producing strains and 7.06% were found to be CR strains. Escherichia coli was the most common MDR (71.36%) and ESBLs-producing strain (77.81%). Acinetobacter baumannii was the most common CR isolate (46.15%). Multivariate analysis indicated that diabetes mellitus, solid organ tumor, non-fermentative bacteria, MDR strain, central venous cannula, urinary catheter, therapy with carbapenems or tigecycline prior 30 days of infection were independent mortality risk factors for GNBSIs. Over all, therapy with tigecycline prior 30 days of infection was the mutual predictor for mortality of GNBSI, acquiring MDR, ESBLs-producing and CR GNBSI (OR, 8.221, OR, 3.963, OR, 3.588, OR, 9.222, respectively, all p < 0.001). Conclusion Collectively, our study implies that patients who were diagnosed as GNBSI had a younger age. Therapy with tigecycline was the mutual and paramount predictor for mortality of GNBSI, acquiring MDR, ESBLs-producing and CR GNBSI. Our investigation had provided a theoretical basis for the use of antibiotics and prevention and control of hospital infection in our region.
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Affiliation(s)
- Nan Shi
- Department of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Jianbang Kang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Shuyun Wang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Yan Song
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Donghong Yin
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Xiaoxia Li
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Qian Guo
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
- Correspondence: Jinju Duan; Shuqiu Zhang, Email ; ;
| | - Shuqiu Zhang
- Department of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
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15
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Filbrun AB, Richardson JC, Khanal PC, Tzeng Y, Dickson RM. Rapid, label‐free antibiotic susceptibility determined directly from positive blood culture. Cytometry A 2022; 101:564-576. [DOI: 10.1002/cyto.a.24560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/19/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Alexandra B. Filbrun
- School of Chemistry and Biochemistry and Petit Institute of Bioengineering and Bioscience Georgia Institute of Technology Atlanta GA
| | - Joseph C. Richardson
- School of Chemistry and Biochemistry and Petit Institute of Bioengineering and Bioscience Georgia Institute of Technology Atlanta GA
| | - Prakash C. Khanal
- School of Chemistry and Biochemistry and Petit Institute of Bioengineering and Bioscience Georgia Institute of Technology Atlanta GA
| | - Yih‐Ling Tzeng
- Division of Infectious Disease, Department of Medicine Emory University School of Medicine Atlanta GA
| | - Robert M. Dickson
- School of Chemistry and Biochemistry and Petit Institute of Bioengineering and Bioscience Georgia Institute of Technology Atlanta GA
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Tai CH, Tang HJ, Lee CH. Clinical Outcomes and Adverse Effects in Septic Patients with Impaired Renal Function Who Received Different Dosages of Cefoperazone–Sulbactam. Antibiotics (Basel) 2022; 11:antibiotics11040460. [PMID: 35453212 PMCID: PMC9026488 DOI: 10.3390/antibiotics11040460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 01/31/2023] Open
Abstract
This study aimed to compare clinical outcomes and adverse effects in septic patients with impaired renal function who received different dosages of cefoperazone–sulbactam (CFP–SUL 1 g/1 g or 2 g/2 g every 12 h). The retrospective study was conducted using the Chang Gung Research Database to include adult patients who had renal insufficiency presented with septicemia caused by Gram-negative organisms and had received CFP–SUL for more than 1 week. A total of 265 patients (44 in the CFP–SUL 1 g/1 g group and 221 in the CFP–SUL 2 g/2 g group) were eligible to be included in this study. After 1:3 propensity score matching, 41 and 123 patients in the CFP–SUL 1 g/1 g and CFP–SUL 2 g/2 g groups, respectively, were included for analyses. There were no significant between-group differences in all-cause mortality rates and adverse effects, including prolonged prothrombin time. A logistic regression model showed that the Pitt bacteremia score was related to all-cause mortality rate and prolonged prothrombin time was associated with renal replacement therapy. The adverse effects of CFP–SUL did not increase in septic patients with impaired renal function receiving CFP–SUL 2 g/2 g Q12H. However, this study may be underpowered to reveal a difference in all-cause mortality.
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Affiliation(s)
- Chien-Hsiang Tai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan 710, Taiwan;
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Sciences, Tainan 717, Taiwan
| | - Chen-Hsiang Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Correspondence:
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17
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Dunbar SA, Gardner C, Das S. Diagnosis and Management of Bloodstream Infections With Rapid, Multiplexed Molecular Assays. Front Cell Infect Microbiol 2022; 12:859935. [PMID: 35372128 PMCID: PMC8966137 DOI: 10.3389/fcimb.2022.859935] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/21/2022] [Indexed: 12/14/2022] Open
Abstract
Bloodstream infection is a major health concern, responsible for considerable morbidity and mortality across the globe. Prompt identification of the responsible pathogen in the early stages of the disease allows clinicians to implement appropriate antibiotic therapy in a timelier manner. Rapid treatment with the correct antibiotic not only improves the chances of patient survival, but also significantly reduces the length of hospital stay and associated healthcare costs. Although culture has been the gold standard and most common method for diagnosis of bloodstream pathogens, it is being enhanced or supplanted with more advanced methods, including molecular tests that can reduce the turnaround time from several days to a few hours. In this article, we describe two rapid, molecular bloodstream infection panels that identify the most common pathogens and associated genetic determinants of antibiotic resistance – the Luminex® VERIGENE® Gram-Positive Blood Culture Test and the VERIGENE® Gram-Negative Blood Culture Test. We conducted a search on PubMed to retrieve articles describing the performance and impact of these tests in the clinical setting. From a total of 48 articles retrieved, we selected 15 for inclusion in this review based on the type and size of the study and so there would be minimum of three articles describing performance and three articles describing the impact post-implementation for each assay. Here we provide a comprehensive review of these publications illustrating the performance and clinical utility of these assays, demonstrating how genotypic tests can benefit diagnostic and antimicrobial stewardship efforts.
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18
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Occurrence and Resistance Pattern of Gram-Negative Bacteremia and Sepsis in A Tertiary Care Hospital - A Four-Year Study. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.1.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The rise in antibiotic resistance has been a major source of public health concern. As a result, mortality and morbidity rates have risen significantly. This study was done to identify gram-negative organisms causing bacteremia/sepsis, study their prevalence rates, and antimicrobial resistance patterns, as evidence-based knowledge of gram-negative organisms causing sepsis and their resistance profiles is essential for effective hospital control and better management of infections caused by resistant bacteria. A retrospective study, conducted from January 2016 to December 2019, blood samples were collected using aseptic guidelines and cultured using automated blood culture methods. Biochemical tests were done according to microbiology standard procedures, while antimicrobial testing was done according to CLSI guidelines. A total of 13,808 blood samples were received within the study period of four years. Of the total, 2079 showed significant growth, with 765 being GNB isolates. The most common isolates were Escherichia coli (35.42%), Klebsiella pneumonia (19.74%), Acinetobacter species (9.67%), and other non-fermenting gram-negative bacilli (11.76%). Escherichia coli showed yearly resistance to aminoglycosides, cephalosporins, penicillin, fluoroquinolones, and B-lactam combination agents. Routine surveillance and awareness of the prevalence, etiological agents, and antibiotic resistance of gram-negative bacteria causing bacteremia/sepsis is critical for individual therapy, hospital control, and the effectiveness of preventive interventions.
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Montella E, Ferraro A, Sperlì G, Triassi M, Santini S, Improta G. Predictive Analysis of Healthcare-Associated Blood Stream Infections in the Neonatal Intensive Care Unit Using Artificial Intelligence: A Single Center Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052498. [PMID: 35270190 PMCID: PMC8909182 DOI: 10.3390/ijerph19052498] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/22/2022]
Abstract
Background: Neonatal infections represent one of the six main types of healthcare-associated infections and have resulted in increasing mortality rates in recent years due to preterm births or problems arising from childbirth. Although advances in obstetrics and technologies have minimized the number of deaths related to birth, different challenges have emerged in identifying the main factors affecting mortality and morbidity. Dataset characterization: We investigated healthcare-associated infections in a cohort of 1203 patients at the level III Neonatal Intensive Care Unit (ICU) of the “Federico II” University Hospital in Naples from 2016 to 2020 (60 months). Methods: The present paper used statistical analyses and logistic regression to identify an association between healthcare-associated blood stream infection (HABSIs) and the available risk factors in neonates and prevent their spread. We designed a supervised approach to predict whether a patient suffered from HABSI using seven different artificial intelligence models. Results: We analyzed a cohort of 1203 patients and found that birthweight and central line catheterization days were the most important predictors of suffering from HABSI. Conclusions: Our statistical analyses showed that birthweight and central line catheterization days were significant predictors of suffering from HABSI. Patients suffering from HABSI had lower gestational age and birthweight, which led to longer hospitalization and umbilical and central line catheterization days than non-HABSI neonates. The predictive analysis achieved the highest Area Under Curve (AUC), accuracy and F1-macro score in the prediction of HABSIs using Logistic Regression (LR) and Multi-layer Perceptron (MLP) models, which better resolved the imbalanced dataset (65 infected and 1038 healthy).
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Affiliation(s)
- Emma Montella
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
| | - Antonino Ferraro
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
| | - Giancarlo Sperlì
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
- CINI-ITEM National Lab, Complesso Universitario di Monte S. Angelo Via Cinthia Edificio Centri Comuni, 80126 Naples, Italy
- Correspondence:
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico”, 80131 Naples, Italy
| | - Stefania Santini
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
- CINI-ITEM National Lab, Complesso Universitario di Monte S. Angelo Via Cinthia Edificio Centri Comuni, 80126 Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico”, 80131 Naples, Italy
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20
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Boccella M, Santella B, Pagliano P, De Filippis A, Casolaro V, Galdiero M, Borrelli A, Capunzo M, Boccia G, Franci G. Prevalence and Antimicrobial Resistance of Enterococcus Species: A Retrospective Cohort Study in Italy. Antibiotics (Basel) 2021; 10:antibiotics10121552. [PMID: 34943764 PMCID: PMC8698357 DOI: 10.3390/antibiotics10121552] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/28/2022] Open
Abstract
Antimicrobial resistance represents one of the main threats to healthy ecosystems. In recent years, among the multidrug-resistant microorganisms responsible for nosocomial infections, the Enterococcus species have received much attention. Indeed, Enterococcus have peculiar skills in their ability to acquire resistance genes and to cause severe diseases, such as endocarditis. This study showed the prevalence and antimicrobial resistance rate of Enterococcus spp. isolated from clinical samples, from January 2015 to December 2019 at the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in Salerno, Italy. A total of 3236 isolates of Enterococcus faecalis (82.2%) and Enterococcus faecium (17.8%) were collected from urine cultures, blood cultures, catheters, respiratory tract, and other samples. Bacterial identification and antibiotic susceptibility were performed with VITEK 2. E. faecium showed a high resistance rate against ampicillin (84.5%), ampicillin/sulbactam (82.7%), and imipenem (86.7%), while E. faecalis showed the highest resistance rate against gentamicin and streptomycin high level, but both were highly sensitive to such antibiotics as tigecycline and vancomycin. Studies of surveillance are an important tool to detect changes in the resistance profiles of the main pathogens. These antimicrobial susceptibility patterns are necessary to improve the empirical treatment guideline of infections.
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Affiliation(s)
- Mariarosaria Boccella
- Department of Laboratory and Infectious Disease Sciences, Agostino Gemelli University Hospital IRCCS, 00168 Rome, Italy;
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (B.S.); (M.G.)
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
| | - Massimiliano Galdiero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (B.S.); (M.G.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Anna Borrelli
- Azienda Ospedaliero Universitaria San Giovanni di Dio e Ruggi D’Aragona, 84131 Salerno, Italy;
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence:
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21
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Zamani K, Irajian G, Zahedi Bialvaei A, Zahraei Salehi T, Khormali M, Vosough A, Masjedian Jazi F. Passive immunization with anti- chimeric protein PilQ/PilA -DSL region IgY does not protect against mortality associated with Pseudomonas aeruginosa sepsis in a rabbit model. Mol Immunol 2021; 141:258-264. [PMID: 34896925 DOI: 10.1016/j.molimm.2021.11.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Pseudomonas aeruginosa sepsis is associated with unacceptably high mortality and, for many of those who survive, long-term morbidity. The aims of this study were to production of IgY against chimeric protein pilQ-pilA-DSL region and killed- whole cell Pseudomonas aeruginosa O1 (PAO1) strain and their efficacy for immunoprophylaxis of sepsis caused by P. aeruginosa in a rabbit model. METHODS Specific IgY was obtained by immunization of hens. The purity of IgY was determined by SDS-PAGE analysis. The effect of IgY on growth and hydrophobicity of P. aeruginosa were performed through time-kill assay and microbial adhesion to hydrocarbons test (MATH), respectively. The efficacy of specific IgYs was examined against P. aeruginosa sepsis in a rabbit model. The rabbits were monitored for 72 h to record physiological characters and survival. Hematologic factors, C-reactive protein, pro-inflammatory cytokines, and bacterial count from blood and solid organs were measured, periodically. RESULTS We found that the growth inhibitory effect of the anti- killed whole cell IgY was higher than anti-pilQ-pilA IgY (P < 0.001). The hydrophobicity effect of PAO1 increased when bacteria were opsonized by anti- killed whole cell IgY while the hydrophobicity activity was decreased following incubation of PAO1 with anti-pilQ-pilA IgY in a broth medium (P < 0.001). Following intravenous (IV) administration of produced IgYs, no significant difference was observed in the survival, decrease in inflammatory mediators and clinical symptoms between the groups 48h post infection (P > 0.05). Moreover, no considerable decrease was observed in the bacterial load of blood, lungs and kidneys in rabbits treated with specific IgYs and control groups (P > 0.05). No bacteria were found in the spleen and liver samples from infected rabbits. CONCLUSION Although produced IgYs had a good immunoreactivity, IV immunization of IgYs was not protective against P. aeruginosa sepsis in the rabbit model. Further studies are needed to assess the immune response and decreasing mortality rate using the rabbit sepsis model.
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Affiliation(s)
- Khosrow Zamani
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Irajian
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abed Zahedi Bialvaei
- Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Taghi Zahraei Salehi
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Iran
| | - Mohmood Khormali
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Iran
| | - Araz Vosough
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Garmsar Branch, Islamic University, Garmsar, Iran
| | - Faramarz Masjedian Jazi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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22
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Di Carlo P, Serra N, Lo Sauro S, Carelli VM, Giarratana M, Signorello JC, Lucchesi A, Manta G, Napolitano MS, Rea T, Cascio A, Sergi CM, Giammanco A, Fasciana T. Epidemiology and Pattern of Resistance of Gram-Negative Bacteria Isolated from Blood Samples in Hospitalized Patients: A Single Center Retrospective Analysis from Southern Italy. Antibiotics (Basel) 2021; 10:1402. [PMID: 34827340 PMCID: PMC8614669 DOI: 10.3390/antibiotics10111402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/12/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Blood culturing remains the mainstream tool to inform an appropriate treatment in hospital-acquired bloodstream infections and to diagnose any bacteremia. METHODS A retrospective investigation on the prevalence of Gram-negative bacteria (GNB) and their resistance in hospitalized patients by age, sex, and units from blood cultures (BCs) was conducted from January 2018 to April 2020 at Sant'Elia hospital, Caltanissetta, southern Italy. We divided the patient age range into four equal intervals. RESULTS Multivariate demographic and microbiological variables did not show an association between bacteria distributions and gender and age. The distribution by units showed a higher prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in the intensive care unit (ICU) and Escherichia coli in the non-intensive care units (non-ICUs). The analysis of antibiotic resistance showed that E. coli was susceptible to a large class of antibiotics such as carbapenem and trimethoprim-sulfamethoxazole. K. pneumoniae showed a significant susceptibility to colistin, tigecycline, and trimethoprim-sulfamethoxazole. From the survival analysis, patients with E. coli had a higher survival rate. CONCLUSIONS The authors stress the importance of the implementation of large community-level programs to prevent E. coli bacteremia. K. pneumoniae and E. coli susceptibility patterns to antibiotics, including in the prescription patterns of general practitioners, suggest that the local surveillance and implementation of educational programs remain essential measures to slow down the spread of resistance and, consequently, increase the antibiotic lifespan.
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Affiliation(s)
- Paola Di Carlo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy; (P.D.C.); (M.S.N.); (A.C.); (A.G.)
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy; (N.S.); (T.R.)
| | | | | | - Maurizio Giarratana
- Microbiology Unit, Sant’Elia Hospital, 93100 Caltanissetta, Italy; (V.M.C.); (M.G.)
| | - Juan Camilo Signorello
- Hypatia School of Medicine (UNIPA-Caltanissetta), University of Palermo, 90127 Palermo, Italy;
| | - Alessandro Lucchesi
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Giuseppe Manta
- Intensive Cure Unit (ICU), Sant’Elia Hospital, 93100 Caltanissetta, Italy;
| | - Maria Santa Napolitano
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy; (P.D.C.); (M.S.N.); (A.C.); (A.G.)
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy; (N.S.); (T.R.)
| | - Antonio Cascio
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy; (P.D.C.); (M.S.N.); (A.C.); (A.G.)
| | - Consolato Maria Sergi
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada;
| | - Anna Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy; (P.D.C.); (M.S.N.); (A.C.); (A.G.)
| | - Teresa Fasciana
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, University of Palermo, 90127 Palermo, Italy; (P.D.C.); (M.S.N.); (A.C.); (A.G.)
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23
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GÜLER E, HÜRDOĞANOĞLU U, FARHAN ALMASOODİ LH, ÇAKIR N, SÜER K. Distribution of Microorganisms and Antibiotic Resistance Rates Isolated From Blood Cultures: 5-Year Evaluation in a University Hospital in Northern Cyprus. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.949209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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24
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Synthesis of Chitosan-Coated Silver Nanoparticle Bioconjugates and Their Antimicrobial Activity against Multidrug-Resistant Bacteria. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199340] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The increase in multidrug-resistant bacteria represents a true challenge in the pharmaceutical and biomedical fields. For this reason, research on the development of new potential antibacterial strategies is essential. Here, we describe the development of a green system for the synthesis of silver nanoparticles (AgNPs) bioconjugated with chitosan. We optimized a Prunus cerasus leaf extract as a source of silver and its conversion to chitosan–silver bioconjugates (CH-AgNPs). The AgNPs and CH-AgNPs were characterized using transmission electron microscopy (TEM), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FT-IR), ultraviolet–visible spectroscopy (UV–Vis), and zeta potential measurement (Z-potential). The cytotoxic activity of AgNPs and CH-AgNPs was assessed on Vero cells using the 3-[4.5-dimethylthiazol-2-yl]-2.5-diphenyltetrazolium bromide (MTT) cell proliferation assay. The antibacterial activity of AgNPs and CH-AgNPs synthesized using the green system was determined using the broth microdilution method. We evaluated the antimicrobial activity against standard ATCC and clinically isolated multisensitive (MS) and multidrug-resistant bacteria (MDR) Escherichia coli (E. coli), Enterococcus faecalis (E. faecalis), Klebsiella pneumonia (K. pneumoniae), and Staphylococcus aureus (S. aureus), using minimum inhibitory concentration (MIC) assays and the broth dilution method. The results of the antibacterial studies demonstrate that the silver chitosan bioconjugates were able to inhibit the growth of MDR strains more effectively than silver nanoparticles alone, with reduced cellular toxicity. These nanoparticles were stable in solution and had wide-spectrum antibacterial activity. The synthesis of silver and silver chitosan bioconjugates from Prunus cerasus leaf extracts may therefore serve as a simple, ecofriendly, noncytotoxic, economical, reliable, and safe method to produce antimicrobial compounds with low cytotoxicity.
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25
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Kumar S, Anwer R, Azzi A. Virulence Potential and Treatment Options of Multidrug-Resistant (MDR) Acinetobacter baumannii. Microorganisms 2021; 9:microorganisms9102104. [PMID: 34683425 PMCID: PMC8541637 DOI: 10.3390/microorganisms9102104] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022] Open
Abstract
Acinetobacter baumannii is an opportunistic pathogen which is undoubtedly known for a high rate of morbidity and mortality in hospital-acquired infections. A. baumannii causes life-threatening infections, including; ventilator-associated pneumonia (VAP), meningitis, bacteremia, and wound and urinary tract infections (UTI). In 2017, the World Health Organization listed A. baumannii as a priority-1 pathogen. The prevalence of A. baumannii infections and outbreaks emphasizes the direct need for the use of effective therapeutic agents for treating such infections. Available antimicrobials, such as; carbapenems, tigecycline, and colistins have insufficient effectiveness due to the appearance of multidrug-resistant strains, accentuating the need for alternative and novel therapeutic remedies. To understand and overcome this menace, the knowledge of recent discoveries on the virulence factors of A. baumannii is needed. Herein, we summarized the role of various virulence factors, including; outer membrane proteins, efflux pumps, biofilm, penicillin-binding proteins, and siderophores/iron acquisition systems. We reviewed the recent scientific literature on different A. baumannii virulence factors and the effective antimicrobial agents for the treatment and management of bacterial infections.
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Affiliation(s)
- Sunil Kumar
- Department of Biotechnology, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala 133207, India;
| | - Razique Anwer
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia;
| | - Arezki Azzi
- Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia
- Correspondence:
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26
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Petrillo F, Chianese A, De Bernardo M, Zannella C, Galdiero M, Reibaldi M, Avitabile T, Boccia G, Galdiero M, Rosa N, Franci G. Inhibitory Effect of Ophthalmic Solutions against SARS-CoV-2: A Preventive Action to Block the Viral Transmission? Microorganisms 2021; 9:microorganisms9081550. [PMID: 34442628 PMCID: PMC8401441 DOI: 10.3390/microorganisms9081550] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/21/2022] Open
Abstract
In 2020, a global pandemic was declared following the spread of SARS-CoV-2, the pathogen responsible for COVID-19. The risk of infection is high due to the ease of transmission, which can occur orally, through droplets, or via contact with contaminated surfaces and objects. It has also been demonstrated that the ocular surface can constitute a transmission route, especially in hospital settings, where health care workers can become a dangerous source of infection. In order to increase prevention and reduce the spread of the virus on the ocular surface, the antiviral activity of already-marketed eye drops against SARS-CoV-2 was evaluated. Iodim, Ozodrop, Septavis, and Dropsept were tested against SARS-CoV-2 in plaque-assay experiments at different stimulation times. Furthermore, the expression levels of early and late genes were evaluated through molecular assays. Results indicated that three of the four ophthalmic solutions showed a considerable dose-dependent inhibition of viral replication, highlighting their use as potential antiviral drugs against SARS-CoV-2 and preventing other ocular infections.
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Affiliation(s)
- Francesco Petrillo
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy; (F.P.); (T.A.)
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (C.Z.); (M.G.); (M.G.)
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (M.D.B.); (G.B.)
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (C.Z.); (M.G.); (M.G.)
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (C.Z.); (M.G.); (M.G.)
| | - Michele Reibaldi
- Department of Surgical Science, Eye Clinic, University of Turin, 10124 Turin, Italy;
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy; (F.P.); (T.A.)
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (M.D.B.); (G.B.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (C.Z.); (M.G.); (M.G.)
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (M.D.B.); (G.B.)
- Correspondence: (N.R.); (G.F.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (M.D.B.); (G.B.)
- Correspondence: (N.R.); (G.F.)
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27
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Lower Respiratory Tract Pathogens and Their Antimicrobial Susceptibility Pattern: A 5-Year Study. Antibiotics (Basel) 2021; 10:antibiotics10070851. [PMID: 34356772 PMCID: PMC8300710 DOI: 10.3390/antibiotics10070851] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/30/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
Lower respiratory tract infections (LRTIs) are the most common infections in humans. It is estimated that 2.74 million deaths worldwide occur each year due to LRTIs. The aim of the study was to determine the frequency and antibiotic susceptibility pattern of microorganisms isolated from respiratory samples of patients with LRTIs. Between January 2015 and December 2019, a total of 7038 sputum and bronchoaspirate samples from suspected LRTI patients were collected. Among them, 2753 samples (39.1%) showed significant microbial growth on culture media. The LRTI rate was higher in patients with male gender (67.1%) and with age between 40–59 years (48.6%). The microorganism identification and antibiotic susceptibility testing were performed with Vitek 2. Out of 4278 isolates species, 3102 (72.5%) were Gram-negative bacteria, 1048 (24.5%) were Gram-positive bacteria, and 128 (3.0%) were Candida spp. Major microorganisms isolated were Acinetobacter baumannii (18.6%), Staphylococcus aureus (15.2%), Pseudomonas aeruginosa (14.2%), and Klebsiella pneumoniae (10.9%). In antimicrobial susceptibility testing, Staphylococcus aureus isolates were mostly resistant to Penicillin G (84.1%) and Oxacillin (48.1%), whereas they demonstrated maximum sensitivity to Tigecycline (100%) and Linezolid (99.5%). Among Gram-negative isolates, Acinetobacter baumannii showed maximum sensitivity to Colistin but was resistant to other antibiotics (95–99%). Klebsiella pneumoniae isolates were mostly resistant to Cefotaxime (72.7%) and sensitive to Gentamicin (54.3%), and Pseudomonas aeruginosa was resistant to Ciprofloxacin (40.3%) and sensitive to Amikacin (85.9%). Gram-negative bacteria represented the species most commonly isolated. A high rate of antimicrobial resistance was observed in this study. In conclusion, the correct identification of causative microorganisms and their susceptibility patterns to antibiotics is crucial for choosing targeted and effective antibiotic therapy in LRTIs, and to prevent the emergence of multidrug-resistant bacteria.
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Antiviral Activity of Vitis vinifera Leaf Extract against SARS-CoV-2 and HSV-1. Viruses 2021; 13:v13071263. [PMID: 34209556 PMCID: PMC8310055 DOI: 10.3390/v13071263] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022] Open
Abstract
Vitis vinifera represents an important and renowned source of compounds with significant biological activity. Wines and winery bioproducts, such as grape pomace, skins, and seeds, are rich in bioactive compounds against a wide range of human pathogens, including bacteria, fungi, and viruses. However, little is known about the biological properties of vine leaves. The aim of this study was the evaluation of phenolic composition and antiviral activity of Vitis vinifera leaf extract against two human viruses: the Herpes simplex virus type 1 (HSV-1) and the pandemic and currently widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). About 40 phenolic compounds were identified in the extract by HPLC-MS/MS analysis: most of them were quercetin derivatives, others included derivatives of luteolin, kaempferol, apigenin, isorhamnetin, myricetin, chrysoeriol, biochanin, isookanin, and scutellarein. Leaf extract was able to inhibit both HSV-1 and SARS-CoV-2 replication in the early stages of infection by directly blocking the proteins enriched on the viral surface, at a very low concentration of 10 μg/mL. These results are very promising and highlight how natural extracts could be used in the design of antiviral drugs and the development of future vaccines.
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Antibacterial Treatment of Selected High-Touch Objects and Surfaces within Provision of Nursing Care in Terms of Prevention of Healthcare-Associated Infections. Healthcare (Basel) 2021; 9:healthcare9060675. [PMID: 34199992 PMCID: PMC8228692 DOI: 10.3390/healthcare9060675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 11/20/2022] Open
Abstract
Prevention of healthcare-associated infections is an important part of providing nursing care. High-touch objects and surfaces that can be contaminated with various bacteria are matters of concern. The possibility of reducing contamination is the use of antibacterial and hydrophobic nanolayers. The aim of this study was to determine, by means of an experimental method, the microbial efficacy of applied antibacterial and hydrophobic nanolayers on high-touch objects and surfaces used in nursing practice in a regional hospital in the Czech Republic. The results show that the antibacterial efficacy of the applied nanolayer was not demonstrated. Furthermore, the results show that selected objects and surfaces can always be contaminated by bacterial agents in about 1/3 of cases. It is mainly contamination with nonpathogenic bacteria; however, the presence of pathogenic bacteria, such as Staphylococcus aureus, has also been detected. The results of this study pinpoint the importance of following the basic rules for the use of decontaminated objects and surfaces used to provide healthcare.
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30
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Chianese A, Santella B, Ambrosino A, Stelitano D, Rinaldi L, Galdiero M, Zannella C, Franci G. Oncolytic Viruses in Combination Therapeutic Approaches with Epigenetic Modulators: Past, Present, and Future Perspectives. Cancers (Basel) 2021; 13:cancers13112761. [PMID: 34199429 PMCID: PMC8199618 DOI: 10.3390/cancers13112761] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Cancer rates have been accelerating significantly in recent years. Despite notable advances having been made in cancer therapy, and numerous studies being currently conducted in clinical trials, research is always looking for new treatment. Novel and promising anticancer therapies comprise combinations of oncolytic viruses and epigenetic modulators, including chromatin modifiers, such as DNA methyltransferase and histone deacetylases, and microRNA. Combinatorial treatments have several advantages: they enhance viral entry, replication, and spread between proximal cells and, moreover, they strengthen the immune response. In this review we summarize the main combination of therapeutic approaches, giving an insight into past, present, and future perspectives. Abstract According to the World Cancer Report, cancer rates have been increased by 50% with 15 million new cases in the year 2020. Hepatocellular carcinoma (HCC) is the only one of the most common tumors to cause a huge increase in mortality with a survival rate between 40% and 70% at 5 years, due to the high relapse and limitations associated with current therapies. Despite great progress in medicine, oncological research is always looking for new therapies: different technologies have been evaluated in clinical trials and others have been already used in clinics. Among them, oncolytic virotherapy represents a therapeutic option with a widespread possibility of approaches and applications. Oncolytic viruses are naturally occurring, or are engineered, viruses characterized by the unique features of preferentially infecting, replicating, and lysing malignant tumor cells, as well as activating the immune response. The combination of oncolytic virotherapy and chemical drugs are arousing great interest in the tumor treatment. In this scenario, novel and promising anticancer therapies comprise combinations of oncolytic viruses and epigenetic modulators or inhibitors of the signalling pathways. Combination treatments are required to improve the immune response and allow viral entry, replication, and diffusion between proximal cells. In this review, we summarize all combination therapies associated with virotherapy, including co-administered inhibitors of chromatin modifiers (combination strategies) and inserted target sites for miRNAs (recombination or arming strategies).
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Affiliation(s)
- Annalisa Chianese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (A.A.); (D.S.); (M.G.)
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Annalisa Ambrosino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (A.A.); (D.S.); (M.G.)
| | - Debora Stelitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (A.A.); (D.S.); (M.G.)
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (A.A.); (D.S.); (M.G.)
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.C.); (A.A.); (D.S.); (M.G.)
- Correspondence: (C.Z.); (G.F.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
- Correspondence: (C.Z.); (G.F.)
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Antimicrobial Resistance in Pathogens Isolated from Blood Cultures: A Two-Year Multicenter Hospital Surveillance Study in Italy. Antibiotics (Basel) 2020; 10:antibiotics10010010. [PMID: 33374232 PMCID: PMC7824585 DOI: 10.3390/antibiotics10010010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Antimicrobial resistance (AMR) is one of the most concerning issues in medicine today. The objectives of this study were to investigate the AMR distribution of the blood-borne pathogens isolated over a two-year period in an Italian region. Methods: A retrospective electronic record review of laboratory-confirmed bloodstream infections (BSIs) was done, and data from three major diagnostic laboratories were used. Twelve invasive clinically important bacteria species were included in the sample. Results: During the study period, 1228 positive BSIs were collected. The most common pathogens were Coagulase-negative Staphylococcus (CoNS) (29.7%), Staphylococcus aureus (19.1%) and Escherichia coli (15.9%). With regard to the AMR pattern, 31.7% of CoNS and 28.1% of Staphylococcus aureus were oxacillin-resistant, and almost half of the Enterococci showed resistance to high-level gentamicin. Among Gram-negative species, 11.7% of Escherichia coli and 39.5% of Klebsiella pneumoniae were carbapenem-resistant. Among the non-fermentative Gram-negative bacteria, the most frequently combined AMR pattern was aminoglycosides and fluoroquinolones (48.4% in A. baumannii and 14.6% in P. aeruginosa). Conclusion: The results display an alarming prevalence of AMR among hospital isolated pathogens, consistently higher than the European average. Information from surveillance systems to better characterize the trend in the incidence of AMR at local and national levels is needed.
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