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Lemos-Luengas EV, Rentería-Valoyes S, Muñoz DMA, Gonzalez CKG, Guerrón-Gómez G, Ramos-Castaneda JA. In vitro activity of ceftazidime-avibactam against gram-negative bacteria in patients with bacteremia and skin and soft-tissue infections in Colombia 2019-2021. Diagn Microbiol Infect Dis 2024; 109:116235. [PMID: 38458096 DOI: 10.1016/j.diagmicrobio.2024.116235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Ceftazidime-avibactam (CAZ-AVI) is an option for infections caused by MDR gram-negative bacilli. In this study, we aimed to analyze the in vitro antimicrobial activity of CAZ-AVI and other antimicrobial agents against gram-negative bacilli that were collected in Colombia between 2019 and 2021 from patients with bacteremia and skin and soft-tissue infections (SSTIs). METHODS A total of 600 Enterobacterales and 259 P. aeruginosa strains were analyzed. The phenotypic resistance of isolates, particularly non-susceptibility to meropenem, multidrug-resistant (MDR) isolates, and difficult-to-treat (DTR) P. aeruginosa, was evaluated according to CLSI breakpoints. RESULTS Enterobacterales had the most susceptibility to CAZ-AVI (96.5 %) and tigecycline (95 %). Tigecycline and CAZ-AVI were the antimicrobial agents with the most in vitro activity against carbapenem-resistant Enterobacterales (CRE). CAZ-AVI was the antimicrobial treatment with the most activity against P. aeruginosa. CONCLUSIONS Tigecycline and CAZ-AVI were the antimicrobial agents with the most activity against CRE and MDR Enterobacterales. For P. aeruginosa, CAZ-AVI was the antimicrobial treatment with the most in vitro activity.
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Affiliation(s)
- Elkin Vladimir Lemos-Luengas
- Medical Affairs Pfizer Colombia, Colombia; Foundation For Development And Support In International Health (FUDASAI), Miami, FL, USA.
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Ou Y, Liu D, Feng J, Xu X, Lin T, Zhang Y, Luo L, Wu M, Cui Y. Subcutaneous infection caused by Mycobacterium abscessus following botulinum toxin injections: A case report and literature review. J Cosmet Dermatol 2024; 23:1527-1532. [PMID: 38178368 DOI: 10.1111/jocd.16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/30/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The rapid development of cosmetic injections has led to an increased incidence of nontuberculous mycobacterial (NTM) infection. PATIENTS AND METHODS Here, we presented a case of cutaneous Mycobacterium abscessus infection subsequent to botulinum toxin injection for treating masseter hypertrophy, and reviewed the literature on skin and soft tissue infections caused by NTM after cosmetic injections. RESULTS AND CONCLUSIONS The patient underwent surgical excision and regular antibiotic therapy and has had nearly 2 months of follow-up without any signs of infection. The diagnosis and treatment of NTM infection have always been challenging, and further research is needed to standardize and guide the treatment.
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MESH Headings
- Adult
- Female
- Humans
- Anti-Bacterial Agents/administration & dosage
- Anti-Bacterial Agents/adverse effects
- Anti-Bacterial Agents/therapeutic use
- Botulinum Toxins, Type A/adverse effects
- Botulinum Toxins, Type A/administration & dosage
- Cosmetic Techniques/adverse effects
- Hypertrophy
- Masseter Muscle/abnormalities
- Mycobacterium abscessus/isolation & purification
- Mycobacterium Infections, Nontuberculous/drug therapy
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/etiology
- Mycobacterium Infections, Nontuberculous/microbiology
- Skin Diseases, Bacterial/diagnosis
- Skin Diseases, Bacterial/microbiology
- Skin Diseases, Bacterial/drug therapy
- Skin Diseases, Bacterial/etiology
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Affiliation(s)
- Yanting Ou
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Dandan Liu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Feng
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiangwen Xu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Tingyin Lin
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Yihan Zhang
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Lin Luo
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Mengfan Wu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yongyan Cui
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
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Burillo A, Pulido-Pérez A, Bouza E. Current challenges in acute bacterial skin infection management. Curr Opin Infect Dis 2024; 37:71-79. [PMID: 38179868 DOI: 10.1097/qco.0000000000000989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW There are aspects of skin and soft tissue infections (SSTIs) that remain unresolved, such as current numbers, classification criteria, how best to define severity and predict the outcome, what diagnostic tests to perform, what new treatment options are available, or what the duration of antibiotic treatment should be. We have reviewed the literature over the last 18 months to clarify these issues and provide our opinion. RECENT FINDINGS SSTIs are common and among the top 10 most frequent infections worldwide. They represent a burden on the healthcare system and have a major impact on the quality of life of patients. Regarding classification, the Infectious Diseases Society of America (IDSA) provides a practical guide that distinguishes between uncomplicated and complicated infections, acute and chronic wound infections, and necrotising and nonnecrotizing infections based on skin extension and tissue necrosis. With new microbiological and imaging diagnostic techniques, SSTIs can now be better diagnosed. New PCR techniques are available, and mass spectrometry can be applied to samples collected in liquid transport media. Moreover, new treatment methods such as photodynamic therapy, reactive oxygen, and phages are emerging. SSTI patients can be treated with shorter antibiotic courses if they receive an active drug with good tissue penetration. Antibiotic treatment in necrotizing infections can be shortened to 48 h after the last debridement. SUMMARY SSTIs remain a challenge regarding rapid and accurate diagnosis and clinical management.
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Affiliation(s)
- Almudena Burillo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute, (IiSGM)
| | - Ana Pulido-Pérez
- Gregorio Marañón Health Research Institute, (IiSGM)
- Department of Dermatology, Hospital General Universitario Gregorio Marañón
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón
- Medicine Department, School of Medicine, Universidad Complutense de Madrid
- Gregorio Marañón Health Research Institute, (IiSGM)
- CIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain
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Montravers P, Soussan R, Tanaka S. Identifying patients with difficult-to-treat acute bacterial skin infections. Curr Opin Infect Dis 2024; 37:87-94. [PMID: 38037891 DOI: 10.1097/qco.0000000000000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE OF REVIEW The early recognition of acute bacterial skin infections (ABSIs) and their swift and adequate care are the major determinants of success. The features that can hamper or delay surgical and medical management can lead to 'difficult-to-treat' ABSIs. RECENT FINDINGS Delayed diagnosis and belated management are the key obstacles to be overcome. Clinicians should be careful about underestimating the severity of ABSIs and overlooking comorbidities, especially immunosuppression. Many conditions can lead to delayed source control, including a misdiagnosis, interhospital transfers, delayed re-exploration, or extensive injuries. Difficult therapeutic issues can occur, including rapidly destructive infections from highly pathogenic microorganisms (Group-A-streptococci, Vibrio spp., Clostridium spp. and Staphylococcus aureus ) or inadequate antibiotic therapy resulting from multidrug-resistant bacteria. Impaired pharmacokinetic capacities of antibiotic agents should also be considered as a source of clinical failure due to insufficient antimicrobial activity at the site of infection. SUMMARY Microbiological samples should be used for guiding antimicrobial therapy. Risk factors for multidrug-resistant bacteria should be considered, including local epidemiology and comorbidities. The optimization of antibiotic therapy should be achieved. Optimized care should be achieved through multidisciplinary management involving professionals with sufficient and appropriate training.
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Affiliation(s)
- Philippe Montravers
- Université Paris Cité
- AP-HP Nord, Anaesthesiology and Intensive Care Department, Bichat-Claude Bernard University Hospital
- PHERE, Physiopathology and Epidemiology of Respiratory Diseases, French Institute of Health and Medical Research (INSERM) U1152, Paris
| | - Romy Soussan
- Université Paris Cité
- AP-HP Nord, Anaesthesiology and Intensive Care Department, Bichat-Claude Bernard University Hospital
| | - Sébastien Tanaka
- AP-HP Nord, Anaesthesiology and Intensive Care Department, Bichat-Claude Bernard University Hospital
- DéTROI, Institute of Health and Medical Research (INSERM) U1188, Saint-Pierre, Reunion Island, France
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Castaldo N, Vena A, Limongelli A, Giacobbe DR, Bassetti M. Emerging treatment options for skin and soft tissue infections tailoring drug selection to individual patients. Curr Opin Infect Dis 2024; 37:80-86. [PMID: 38277175 DOI: 10.1097/qco.0000000000001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
PURPOSE OF REVIEW To provide a brief overview of drugs in Phase II and III of development for the treatment of acute bacterial skin and skin structure infections (ABSSSI), offering insights into potential customized treatment options. RECENT FINDINGS Several drugs are currently in advanced stages of evaluation for the treatment of ABSSSI, and numerous molecules are entering in the early development phases. Notably, many of these drugs exhibit unique mechanisms of action and interesting antimicrobial spectrum. SUMMARY Tailoring antibiotic therapy based on patient characteristics, likely pathogens, type, site and severity of ABSSSI is crucial. Given the inherent limitations of available treatments, the development of novel agents is a pivotal avenue. Such advancements hold promise for enhancing treatment efficacy and simplifying drug selection for ABSSSI in everyday clinical practice.
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Affiliation(s)
- Nadia Castaldo
- Department of Pulmonology, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine
| | - Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa
- Clinica Malattie Infettive, IRCCS San Martino polyclinic Hospital, Genoa, Italy
| | - Alessandro Limongelli
- Department of Health Sciences (DISSAL), University of Genoa
- Clinica Malattie Infettive, IRCCS San Martino polyclinic Hospital, Genoa, Italy
| | - Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa
- Clinica Malattie Infettive, IRCCS San Martino polyclinic Hospital, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa
- Clinica Malattie Infettive, IRCCS San Martino polyclinic Hospital, Genoa, Italy
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Martínez-Campreciós J, Moreno M, Salvador F, Barrio-Tofiño ED, Nindia A, Aznar ML, Molina I. Impact of traditional cutaneous scarification on anthrax lesions: A series of cases from Cubal, Angola. Int J Infect Dis 2024; 140:104-109. [PMID: 38195038 DOI: 10.1016/j.ijid.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common. CASE PRESENTATION This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death. CONCLUSION Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.
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Affiliation(s)
- Joan Martínez-Campreciós
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Fernando Salvador
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Maria Luisa Aznar
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Israel Molina
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Maher E, Anokhin A. Bacterial Skin and Soft Tissue Infections in Older Adults. Clin Geriatr Med 2024; 40:117-130. [PMID: 38000856 DOI: 10.1016/j.cger.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
This article focuses on bacterial infections that commonly affect geriatric patients. The elderly population is at a higher risk of contracting bacterial infections due to weakened immune systems and comorbidities. The article explores the cause, pathogenesis, clinical manifestations, and treatment options of these infections. Additionally, antibiotic resistance is a growing concern in the treatment of bacterial infections. The article highlights the importance of preventing these infections through proper hygiene and wound care. This article aims to provide an understanding of bacterial infections in geriatric patients and inform health-care providers on the most effective ways to manage and prevent these infections.
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Affiliation(s)
- Eamonn Maher
- Department of Dermatology, University of Minnesota, Phillips-Wangensteen Building, 516 Delaware Street SE, Suite 1-400, Minneapolis, MN 55455, USA.
| | - Anya Anokhin
- University of Missouri, Phillips-Wangensteen Building, 516 Delaware Street SE, Suite 1-400, Minneapolis, MN 55455, USA
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8
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Mou Y, Liu J, Ji C, Cheng W, Ren H, Mou X, Hu W. Diagnosis of cutaneous primary nocardiosis in patients with normal immune function by metagenomic next-generation sequencing. Australas J Dermatol 2024; 65:67-70. [PMID: 37985465 DOI: 10.1111/ajd.14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Nocardia primarily affects immunocompromised individuals, and Infection with Nocardia is uncommon and primary cutaneous nocardiosis caused by percutaneous inoculation is even rarer. Primary cutaneous nocardiosis remains a diagnostic challenge and should be considered in the differential diagnosis for any superficial cutaneous infection that arises in patients with normal immune function. We report a case that was diagnosed with primary cutaneous Nocardia by metagenomic next-generation sequencing technology.
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Affiliation(s)
- Yue Mou
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
| | - Jiaqi Liu
- Graduate School, Jinzhou Medical University, Jinzhou, China
| | - Chaochao Ji
- Lianyungang Clinical College of Nanjing Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Wenhao Cheng
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
| | - Hong Ren
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
- Department of Dermatology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
| | - Xudong Mou
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
| | - Wenlong Hu
- Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
- Lianyungang Clinical College of Nanjing Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
- Department of Dermatology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
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Johnson AW, Bloomquist RF, Fowler TE, Bloomquist DT. Framboesiform Facial Lesions and Chorioretinopathy as Presenting Signs of Syphilis in an Immunocompetent Patient. Sex Transm Dis 2024; 51:81-83. [PMID: 38100818 DOI: 10.1097/olq.0000000000001883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
ABSTRACT Syphilis has long been considered the "great masquerader," notorious for its varying presentations and ability to affect most organ systems in the body. We report the case of a 41-year-old immunocompetent man who presented to ophthalmology with rapidly progressive visual complaints from bilateral panuveitis and concomitant verrucous facial lesions initially disregarded by the patient as acne. Serum testing for syphilis was positive, and he was admitted for 14 days of intravenous (IV) penicillin with multiservice care from dermatology, ophthalmology, and infectious disease. We present photographic documentation showing his stepwise resolution of his facial and retinal involvement with penicillin treatment course. This case is unusual in the concomitant presentation of ocular and facial syphilitic findings in an immunocompetent patient and highlights the need to include syphilis in the differential for unusual appearances.
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Affiliation(s)
- Alex W Johnson
- From the Department of Ophthalmology, Medical College of Georgia at Augusta University, Augusta, GA
| | | | - Teresa E Fowler
- From the Department of Ophthalmology, Medical College of Georgia at Augusta University, Augusta, GA
| | - Doan T Bloomquist
- Department of Ophthalmology, Charlie Norwood Veterans Affairs Medical Center, Augusta GA
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Nguyen DC, Buettner AM, Dousa KM. Case Commentary: Another prong of attack? Topical antibiotic instillation with negative pressure wound therapy for nontuberculous mycobacterial skin and soft tissue infections. Antimicrob Agents Chemother 2023; 67:e0104823. [PMID: 38014943 PMCID: PMC10720531 DOI: 10.1128/aac.01048-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Nontuberculous mycobacteria (NTM) skin infections remain therapeutically challenging. Given the diversity in infections, host responses, and antimicrobials, clinical guidelines are often built on case series and observational studies. In this commentary, we respond to a paper by Stemkens et al. that introduces an emerging strategy: adjunctive negative pressure wound therapy with instillation and dwell time combined with topical antibiotics for refractory NTM skin and soft tissue infections. We delve into the primary considerations surrounding this innovative approach.
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Affiliation(s)
- David C. Nguyen
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Rush Medical College, Chicago, Illinois, USA
- Department of Internal Medicine, Division of Infectious Diseases, Rush Medical College, Chicago, Illinois, USA
| | - Angel M. Buettner
- Department of Hyperbaric Medicine and Wound Care, Advocate Aurora Healthcare System, Sheboygan, Wisconsin, USA
| | - Khalid M. Dousa
- Department of Medicine, Case Western Reserve University and Medicine Service, Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA
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Ji Y, Su F, Hong X, Chen M, Zhu Y, Cheng D, Ge Y. Successful treatment with amoxicillin-clavulanic acid: cutaneous nocardiosis caused by Nocardia brasiliensis. J DERMATOL TREAT 2023; 34:2229467. [PMID: 37394975 DOI: 10.1080/09546634.2023.2229467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/04/2023] [Indexed: 07/04/2023]
Abstract
AIM To emphasize the role of non-sulfonamides in the treatment of Nocardia infection and reduce the adverse reactions caused by sulfonamides. METHODS We retrospectively analyzed a case of cutaneous nocardiosis in an immunocompetent individual. The colonies obtained by staining the pus in the lesion with antacid and culturing the agar plates were identified by flight mass spectrometry. The pathogenic identification showed Nocardia brasiliensis infection and the patient was treated with amoxicillin-clavulanic acid. RESULTS After treatment with amoxicillin and clavulanic acid, the ulcer gradually peeled and crusted, leaving dark pigmentation. The patient has finally recovered. CONCLUSION Sulfonamides are the first-line antibacterial agents for years in treatment of nocardiosis but are of great toxicity and side effects. This patient was successfully treated with amoxicillin-clavulanic acid and it provided a reference protocol for patients with sulfonamide-resistant Nocardia or sulfonamides intolerance.
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Affiliation(s)
- Youqi Ji
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fang Su
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Xin Hong
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- Department of Green Pharmaceutical Collaborative Innovation Center, School of Pharmacy, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Mengyuan Chen
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Yongze Zhu
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Dongqing Cheng
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yumei Ge
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Department of Green Pharmaceutical Collaborative Innovation Center, School of Pharmacy, Zhejiang University of Technology, Hangzhou, Zhejiang, China
- Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang province, Hangzhou, Zhejiang, China
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12
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Strazzulla A, Ballarin M, Postorino MC, Lee R, Leroy P, Castan B, Diamantis S. Knowledge of recommended antibiotic treatments for community-acquired infections in general medical practice: a cross-sectional study in Occitanie region, France. Sci Rep 2023; 13:17312. [PMID: 37828124 PMCID: PMC10570346 DOI: 10.1038/s41598-023-43809-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/28/2023] [Indexed: 10/14/2023] Open
Abstract
To assess and analyse the knowledge of recommended antibiotic treatments, focusing on the appropriate drugs and treatment durations for the most common community-acquired infections in general medical practice in Occitanie region, France. A web-based survey was conducted over a 3-month period, from October, 2018 to January, 2019. All participants answered directly through the online platform. For the analysis of overtreatment risk, a score based system was adopted and two scores were produced: the duration score and the treatment score. 413 general practitioners completed the survey. The overall rate of concordance with guidelines in terms of both drug choice and treatment length was 2974/4956 (60%) answers. Diseases with at least 70% good answers included cystitis, group A streptococcal pharyngitis, and bacterial superficial skin infections. Diseases with fewer than 50% good answers included pyelonephritis, dog bite wounds, and community-acquired pneumonia in patients aged ≥ 65 years. Factors associated with the risk of overtreatment were age > 40 years, country setting and hospital employment. Knowledge of treatment durations is satisfactory with 60% of recommendations being met. However, varying levels were observed according to different diseases. This study highlighted a very high rate of adherence when recommendations were clear. In contrast, low levels of adherence were observed when recommendations were ambiguous or when conflicting guidelines existed.
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Affiliation(s)
- Alessio Strazzulla
- Internal Medicine Unit, Groupe Hospitalier Sud Ile de France, Melun, France.
| | - Manuel Ballarin
- Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France
| | | | - Raphaël Lee
- Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France
| | - Pierre Leroy
- Public Health Unit, Groupe Hospitalier Sud Ile de France, Melun, France
| | - Bernard Castan
- Infectious Diseases Unit, Centre Hospitalier de Périgueux, Périgueux, France
| | - Sylvain Diamantis
- Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France
- Public Health Unit, Groupe Hospitalier Sud Ile de France, Melun, France
- Research Unit "DYNAMIC", Université Paris-Est Créteil, Créteil, France
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Wang H, Xie Y, Chen Y, Zhao H, Lv X, Zhang Z, Li G, Pan J, Wang J, Liu Z. Transdermal Delivery of Photosensitizer-Catalase Conjugate by Fluorinated Polyethylenimine for Enhanced Topical Photodynamic Therapy of Bacterial Infections. Adv Healthc Mater 2023; 12:e2300848. [PMID: 37178381 DOI: 10.1002/adhm.202300848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Pathogenic bacteria induce subcutaneous infections pose serious threats to global public health. Recently, photodynamic therapy (PDT) has been proposed as a non-invasive approach for anti-microbial treatment without the risk to induce drug resistance. However, due to the hypoxic environment of most anaerobiont-infected sites, the therapeutic efficacy of oxygen consuming PDT has been limited. Herein, a transdermal delivery system is reported to allow effective delivery of photosensitizers into infected skin for PDT treatment of skin infections by bacteria. Considering the overproduction of hydrogen peroxide (H2 O2 ) in the abscess area, catalase (CAT), an enzyme that triggers H2 O2 decomposition to generate O2 , is conjugated with chlorine e6 (Ce6) to form a photosensitizer conjugate (Ce6-CAT) as an enhanced PDT agent against Staphylococcus Aureus. After screening a series of fluorinated low molecular weight polyethylenimine (F-PEI) with different fluorination degrees, the optimized F-PEI formulation is identified with the best transdermal delivery ability system. Upon mixing, the formed Ce6-CAT@F-PEI nanocomplex shows effective transdermal penetration after being applied to the skin surface. With light exposure of the infected skin, highly effective in vivo anti-bacterial PDT therapeutic effect with Ce6-CAT@F-PEI is observed. This work proposes a transdermal PDT therapeutic nanomedicine particularly promising for the anti-bacterial treatment of skin infections.
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Affiliation(s)
- Hairong Wang
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Yi Xie
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Yanling Chen
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - He Zhao
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Xinjing Lv
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Zimu Zhang
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Gen Li
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Jian Pan
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Jian Wang
- Children's Hospital of Soochow University, Pediatric Research Institute of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Zhuang Liu
- Institute of Functional Nano & Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials & Devices, Soochow University, Suzhou, Jiangsu, 215123, China
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14
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Durante-Mangoni E, Riccardi A, Guarino M, Cesaro F, Lugarà M, Mascolo S, Morelli L, Natale V, Andreoni M. Emergency department care of ABSSSI with dalbavancin infusion, direct discharge, and outpatient telemedicine follow up: a study protocol. J Chemother 2023; 35:397-403. [PMID: 36264157 DOI: 10.1080/1120009x.2022.2134616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 10/24/2022]
Abstract
Novel therapeutic strategies such as the long-acting lipoglycopeptide antibiotics allow for the treatment and discharge of selected emergency department (ED) patients with Acute Bacterial Skin and Skin Structure Infections (ABSSSI), who require intravenous antibiotics and would otherwise be hospitalized. The COVID-19 pandemic highlighted the need to develop strategies that may reduce hospitalization. The telehealth approach has shown success in remote management of cellulitis patients and could aid in the remote follow up of overall ABSSSI patients. This article describes a study protocol for the telemedicine follow up of patients diagnosed with ABSSSI in the ED, requiring intravenous treatment, receiving a single dalbavancin dose, and directly discharged. A telehealth system for remote follow up is evaluated as well as the possible inclusion of point-of-care ultrasound for the appropriate diagnosis of ABSSSI. The study will be conducted in compliance with regulatory requirements; and all collected data will be kept strictly confidential and in accordance with all relevant legislation on the control and protection of personal information. Dissemination of the study protocol may help increasing knowledge and awareness on this topic, with the aim of optimizing patient management, reducing hospitalization and lower the impact on healthcare associated costs.
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Affiliation(s)
- Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli" and Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Napoli, Italy
| | | | - Mario Guarino
- Unit of Emergency Medicine, Ospedale CTO, A.O.R.N. Ospedali dei Colli, Napoli, Italy
| | - Flavio Cesaro
- Unit of Emergency Medicine, Ospedale CTO, A.O.R.N. Ospedali dei Colli, Napoli, Italy
| | - Marina Lugarà
- Unit of General Medicine, Ospedale del Mare, ASL Napoli 1 Centro, Napoli, Italy
| | - Silvia Mascolo
- Unit of Immunodeficiency and Gender Infectious Diseases, A.O.R.N. Ospedali dei Colli - Ospedale Cotugno, Napoli, Italy
| | - Lucia Morelli
- Unit of Emergency Medicine, Ospedale San Paolo, ASL Napoli 1 Centro, Napoli, Italy
| | - Vincenzo Natale
- Unit of Emergency Medicine, ASP Vibo Valenzia, and SIMEU Calabria, Vibo Valentia, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Infectious Diseases Unit, University Hospital "Tor Vergata", Roma, Italy
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15
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Weant KA, Gregory H. The Potential Utility of Single-Dose Long-Acting Intravenous Antibiotics for Acute Bacterial Skin and Skin-Structure Infections in the Emergency Department. Adv Emerg Nurs J 2023; 45:177-186. [PMID: 37501267 DOI: 10.1097/tme.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Acute bacterial skin and skin-structure infections (ABSSSIs) are frequent clinical presentations to emergency departments (EDs) across the nation that can require substantial resources to treat due to several factors. These include an increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) as the causative organism, limited availability of oral antibiotics that treat ABSSSIs secondary to MRSA, absorption and pharmacodynamic concerns with oral therapy, and regimen adherence. In patients who are unable to tolerate oral therapy, or are unable to adhere to prescribed antibiotics, inpatient admission for intravenous (IV) antibiotics may be necessary. Although inpatient IV antibiotics used to treat MRSA, such as vancomycin, are relatively inexpensive, hospital admission itself incurs significant associated costs. The introduction of the long-acting lipoglycopeptides, dalbavancin and oritavancin, has many potential advantages for the treatment of ABSSSIs including one- or two-dose regimens, allowing patients to receive their dose in the ED or infusion center and avoid inpatient admission altogether. Existing data have borne out these results, demonstrating that these agents can significantly reduce the length of hospital stay and the overall treatment cost of ABSSSIs. However, as these agents have nontraditional therapeutic regimens compared with alternative IV and oral agents that require consistent dosing, it is imperative to have decision support tools in place to ensure that this therapy is utilized in appropriate patients with ABSSSIs and that its true benefits can be realized for both the patient and the health care system.
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Affiliation(s)
- Kyle A Weant
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia (Dr Weant); and Department of Pharmacy Services, University of Florida Health Shands, Gainesville (Dr Gregory)
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16
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Hooper J, Beltrami EJ, Santoro F, Murphy MJ. Remember the Fite: A Case of Cutaneous Mycobacterium fortuitum Infection. Am J Dermatopathol 2023; 45:214-215. [PMID: 36729795 DOI: 10.1097/dad.0000000000002336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Jette Hooper
- Department of Dermatology, UConn Health, Farmington, CT
| | - Eric J Beltrami
- University of Connecticut School of Medicine, Farmington, CT
| | - Frank Santoro
- Department of Dermatology, Hartford Hospital, Hartford, CT
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17
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Giorgobiani M, Burroughs MH, Antadze T, Carrothers TJ, Riccobene TA, Patel R, Lin T, Stefanova P. The Safety and Efficacy of Dalbavancin and Active Comparator in Pediatric Patients With Acute Bacterial Skin and Skin Structure Infections. Pediatr Infect Dis J 2023; 42:199-205. [PMID: 36476623 PMCID: PMC9935565 DOI: 10.1097/inf.0000000000003798] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Acute bacterial skin and skin structure infections (ABSSSIs) are a significant source of morbidity in children. Dalbavancin, approved for the treatment of adults and children with ABSSSI, has a well-established safety profile in adults. We report safety and descriptive efficacy data for the treatment of ABSSSI in children. METHODS Children with ABSSSI (birth-<18 years old) or sepsis (<3 months old) known/suspected to be caused by susceptible Gram-positive organisms were enrolled in this phase 3, multicenter, open-label, comparator-controlled study (NCT02814916). Children ≥3 months old were randomized 3:3:1 to receive single-dose dalbavancin, 2-dose dalbavancin, or a comparator antibiotic in 4 age cohorts; those <3 months old received single-dose dalbavancin. Clinical response and microbiologic efficacy were evaluated 48-72 hours and 14, 28 and 54 days posttreatment. Bowel flora testing and audiology were collected in a subset of patients at baseline and day 28. Adverse events (AEs) were collected throughout the study. RESULTS Treatment-emergent AEs occurred in 7.2%, 9.0% and 3.3% of patients in dalbavancin single-dose, dalbavancin 2-dose and comparator arms, respectively. Three serious AEs occurred in the dalbavancin single-dose arm; no treatment-related AEs, serious AEs, or AEs leading to study discontinuation were reported. Favorable clinical response at 48-72 hours was documented in 97.4%, 98.6% and 89.7% of patients. Safety and efficacy were comparable across age cohorts. The microbiologic intent-to-treat population had comparable clinical response for all baseline pathogens, including methicillin-resistant Staphylococcus aureus . CONCLUSION The safety profile of dalbavancin was consistent in children and adults with ABSSSI. No new safety signals were identified.
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Affiliation(s)
| | | | | | | | | | | | - Tao Lin
- AbbVie Inc., Madison, New Jersey
| | - Penka Stefanova
- Medical University of Plovdiv and University Hospital “St. George,” Plovdiv, Bulgaria
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18
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Li S, Ji B, Teng Y, Tang H, Cui H, Tao X, Fan Y, Huang Y. Erythema Nodosum following Nocardia Infection: A Case Report. Medicina (Kaunas) 2022; 58:medicina58121873. [PMID: 36557075 PMCID: PMC9785723 DOI: 10.3390/medicina58121873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Cutaneous nocardiosis is a rare bacterial infection that can result in various dermatologic manifestations such as actinomycetoma, lymphocutaneous infection, superficial skin infection, and secondary infection due to hematogenous dissemination. We report on a Chinese patient with erythema nodosum-like exanthema, possibly secondary to nocardiosis. Our diagnosis for this patient was based on the clinical presentation, histopathological evidence, and microbiological findings. Given the protean manifestation of Nocardia, persistent reports on new presentations of the disease are important for early identification and treatment.
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Affiliation(s)
- Sujing Li
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu 233030, China
| | - Bingzhou Ji
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410000, China
| | - Yan Teng
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
| | - Hui Tang
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu 233030, China
| | - Hong Cui
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
| | - Xiaohua Tao
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
| | - Yibin Fan
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu 233030, China
- Correspondence: (Y.F.); (Y.H.)
| | - Youming Huang
- Department of Dermatology, Health Management Center, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China
- Correspondence: (Y.F.); (Y.H.)
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19
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Canetti D, Riccardi N, Antonello RM, Nozza S, Sotgiu G. Mycobacterium marinum: A brief update for clinical purposes. Eur J Intern Med 2022; 105:15-19. [PMID: 35864075 DOI: 10.1016/j.ejim.2022.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Mycobacterium marinum (M. marinum) is a free-living, slow grower nontuberculous mycobacteria (NTM), strictly related to Mycobacterium tuberculosis, that causes disease in fresh and saltwater fish and it is one of the causes of extra-pulmonary mycobacterial infections, ranging in human from simple cutaneous lesions to disseminated forms in immunocompromised hosts. The first human cases of M. marinum infection were reported from skin lesions of swimmers in a contaminated pool, in 1951, in Sweden by Norden and Linell. Two conditions are required to develop M. marinum infection: (1) skin solution of continuity and (2) exposure to the contaminated water or direct contact with fish or shellfish. The so-called "fish-tank granuloma", the most frequent cutaneous manifestation of M. marinum infection, is characterized by a single papulonodular, verrucose and/or ulcerated granulomatous lesion in the inoculum site. Careful patient's history collection, high clinical suspicion and appropriate sample (e.g. cutaneous biopsy) for microbiological culture are crucial for a timely diagnosis. The treatment is not standardized yet and relies on administration of two active antimycobacterial agents, always guided by antimicrobial susceptibility test on culture, with macrolides and rifampin as pivotal drugs, as well as prompt surgery when feasible. In this narrative review, we provide to Clinicians an updated report of epidemiology, microbiological characteristics, clinical presentation, diagnosis, and management of M. marinum infection.
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Affiliation(s)
- Diana Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
| | | | - Silvia Nozza
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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20
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Truong DH, Fontaine JL, Malone M, Wukich DK, Davis KE, Lavery LA. A Comparison of Pathogens in Skin and Soft-Tissue Infections and Pedal Osteomyelitis in Puncture Wound Injuries Affecting the Foot. J Am Podiatr Med Assoc 2022; 112:20-206. [PMID: 33141882 DOI: 10.7547/20-206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/03/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND To compare pathogens involved in skin and soft-tissue infections (SSTIs) and pedal osteomyelitis (OM) in patients with and without diabetes with puncture wounds to the foot. METHODS We evaluated 113 consecutive patients between June 1, 2011, and March 31, 2019, with foot infection (SSTIs and OM) from a puncture injury sustained to the foot. Eighty-three patients had diabetes and 30 did not. We evaluated the bacterial pathogens in patients with SSTIs and pedal OM. RESULTS Polymicrobial infections were more common in patients with diabetes mellitus (83.1% versus 53.3%; P = .001). The most common pathogen for SSTIs and OM in patients with diabetes was Staphylococcus aureus (SSTIs, 50.7%; OM, 32.3%), whereas in patients without diabetes it was Pseudomonas (25%) for SSTIs. Anaerobes (9.4%) and fungal infection (3.1%) were uncommon. Pseudomonas aeruginosa was identified in only 5.8% of people with diabetes. CONCLUSIONS The most common bacterial pathogen in both SSTIs and pedal OM was S aureus in patients with diabetes. Pseudomonas species was the most common pathogen in people without diabetes with SSTIs.
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Affiliation(s)
- David H Truong
- *Surgical Service, Podiatry Section, Veterans Affairs North Texas Health Care System, Dallas, TX
- †Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Javier La Fontaine
- †Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- ‡Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matthew Malone
- §Infectious Diseases and Microbiology, School of Medicine, Western Sydney University, Sydney, Australia
- ‖South West Sydney Limb Preservation and Wound Research, Liverpool Hospital, South Western Sydney LHD, Sydney, Australia
| | - Dane K Wukich
- †Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kathryn E Davis
- ‡Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Lawrence A Lavery
- †Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- ‡Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
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21
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Li H, Liang X, Mo G, Guo S, Chen X, Li Y. Efficacy and safety of optional parenteral antimicrobial therapy for complicated skin and soft tissue infections: A systematic review and Bayesian network meta-analysis. Medicine (Baltimore) 2022; 101:e30120. [PMID: 36042624 PMCID: PMC9410650 DOI: 10.1097/md.0000000000030120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Skin and soft tissue infections (SSTIs) carry significant economic burden, as well as morbidity and mortality, especially when caused by methicillin-resistant Staphylococcus aureus. This study aims to investigate the efficacy and safety of optional antimicrobial therapy for the treatment of complicated SSTIs (cSSTIs). METHODS We searched PubMed, Medline (Via Ovid SP), Embase (Via Ovid SP), and the Cochrane Central Register of Controlled Trials from their inception to March 22, 2021 for randomized controlled trials (RCTs) that studied the use of optional antimicrobial therapy for cSSTIs. Citations' screening, study selection, data extraction, and risk of bias assessment were independently performed by 2 authors. The primary outcomes were clinical and microbiological treatment success, and adverse events (AEs) were also assessed. RESULTS A total of 48 trials covering 24,381 patients assessing 20 types of antimicrobial treatment modalities were included. Overall, omadacycline was associated with the highest beneficial effect on clinical and microbiological treatment success and with the largest rank probability based on surface under the cumulative ranking curve values, avarofloxacin was closely followed. Both had, however, omadacycline was related to moderately safety profiles. Lefamulin ranked as the best option was associated with the lowest risk of severe AEs. Subgroup analysis showed similar results. The quality of primary outcomes was moderate to low. CONCLUSIONS The use of omadacycline was associated with higher rates of clinical and microbiological treatment success for the treatment of cSSTIs, with a relative low risk of AEs. Due to the limitations of the included RCTs, high-quality and well-designed RCTs are needed to further confirm the results.
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Affiliation(s)
- Huijuan Li
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Xueyan Liang
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Guangyan Mo
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Sitong Guo
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Xiaoyu Chen
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Yan Li
- Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
- *Correspondence: Yan Li, Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, People’s Republic of China (e-mail: )
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22
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Grossi AP, Ruggieri A, Vecchio AD, Comandini A, Corio L, Calisti F, Loreto GD, Almirante B. Skin infections in Europe: a retrospective study of incidence, patient characteristics and practice patterns. Int J Antimicrob Agents 2022; 60:106637. [PMID: 35820533 DOI: 10.1016/j.ijantimicag.2022.106637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/06/2022] [Accepted: 07/05/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Acute bacterial skin and skin structure infections (ABSSSIs) are associated with considerable morbidity and a heavy healthcare burden. The primary objectives of this two-phase study were to determine the incidence of skin infections and ABSSSIs in hospitalized patients (Phase A), and to describe the characteristics and treatment of hospitalized patients with ABSSSIs (Phase B). METHODS This non-interventional, retrospective study was based on data collected from adult patients hospitalized for skin infections in six European countries (Czech Republic, Greece, Italy, Portugal, Russia and Spain) between January 2014 and June 2016. RESULTS In Phase A, the total hospital incidence of skin infections and ABSSSIs was 2.4 and 1.8 per 1000 patient-days, respectively. Overall, 73.6% of 50,469 hospitalizations for skin infections were for ABSSSIs. Among the 750 patients with ABSSSIs included in Phase B, Gram-positive bacteria were isolated in 24.9%, most commonly methicillin-susceptible Staphylococcus aureus (11.5%). Empirical therapy was administered to 98.1% of patients, most often with a penicillin, with or without a β-lactamase inhibitor (42.1%). Complete cure was achieved in 46.5% and 34.5% of patients after initial treatment and treatment modification, respectively. Overall, 22.7% of patients had at least one additional ABSSSI-related hospitalization, 47.1% of patients visited the emergency room, 19.3% of patients visited primary care clinics, and 34.8% of patients visited a specialist. CONCLUSION Treatment of ABSSSIs in Europe is associated with a heavy healthcare burden, highlighting the need for optimized management strategies that may reduce healthcare utilization.
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Affiliation(s)
- Antonio Paolo Grossi
- Department of Medicine and Surgery, Section of Infectious Diseases, University of Insubria, Varese, Italy
| | | | | | | | | | | | | | - Benito Almirante
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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23
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Sacdal JPA, Cheon E, Stilwell AM, Acquisto NM, Treu CN. Oritavancin versus oral antibiotics for treatment of skin and skin structure infections in the emergency department. Am J Emerg Med 2022; 60:223-224. [PMID: 35835659 DOI: 10.1016/j.ajem.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- John Paul A Sacdal
- Department of Pharmacy, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States of America
| | - Eunah Cheon
- Department of Pharmacy, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States of America
| | - Allison M Stilwell
- Department of Pharmacy, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States of America
| | - Nicole M Acquisto
- Department of Pharmacy, Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Cierra N Treu
- Department of Pharmacy, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States of America.
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Mikamo H, Nagashima M, Kusachi S, Fujimi S, Oshima N, De Anda C, Takase A. Efficacy and safety of tedizolid for the treatment of ventilated gram-positive hospital-acquired or ventilator-associated bacterial pneumonia in Japanese patients: Results from a subgroup analysis of a phase 3, randomized, double-blind study comparing tedizolid and linezolid. J Infect Chemother 2022; 28:1235-1241. [PMID: 35718656 DOI: 10.1016/j.jiac.2022.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The results from the phase 3 study that evaluated the efficacy and safety of tedizolid phosphate, an oxazolidinone drug, for the treatment of gram-positive ventilated hospital-acquired bacterial pneumonia (vHABP)/ventilator-associated bacterial pneumonia (VABP) compared with linezolid (VITAL study), have been previously reported. We conducted a subgroup analysis to report the data obtained from Japanese patients enrolled in this study. METHODS Patients aged ≥18 years with vHABP/VABP likely to be caused by gram-positive cocci were randomized 1:1 to tedizolid phosphate 200 mg once daily for 7 days or linezolid 600 mg twice daily for 10 days. In both treatment groups, patients with concurrent gram-positive bacteremia were treated for 14 days. Primary efficacy endpoints were day 28 all-cause mortality (ACM) and investigator-assessed clinical response at test-of-cure (TOC) in the intention-to-treat population. Safety outcomes included assessment of treatment-emergent adverse events. RESULTS Fifty-three Japanese patients were randomized at received study drug (tedizolid, n = 28; linezolid, n = 25). Demographics and characteristics were generally similar between treatment groups. Rates of day 28 ACM were 10.7% and 20.0% with tedizolid and linezolid, respectively (difference, 9.3%; 95% CI, -10.1 to 28.7). Rates of investigator-assessed clinical cure at TOC were 78.6% and 72.0% with tedizolid and linezolid, respectively (difference, 6.6%; 95% CI, -16.7 to 29.8). Tedizolid phosphate was generally well tolerated and no new safety concerns were observed in the Japanese subgroup. CONCLUSION The results from this subgroup analysis suggest generally favorable efficacy and safety of tedizolid in adult Japanese patients with vHABP/VABP. (ClinicalTrials.gov identifier: NCT02019420).
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Affiliation(s)
- Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Shinya Kusachi
- Department of Surgery, Toho Kamagaya Hospital, 594 Awano, Kamagaya, Chiba, 273-0132, Japan
| | - Satoshi Fujimi
- Department of Emergency Medicine, Osaka General Medical Center, 3-1-56 Bandai Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Nobuyuki Oshima
- Japan Development, MSD K.K., 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan
| | - Carisa De Anda
- Global Clinical Development, Merck & Co., Inc., Rahway, NJ, USA
| | - Akiko Takase
- Japan Development, MSD K.K., 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan.
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Vacalis S, Brunton S, Gindi J. Omadacycline in Skin Infections and Pneumonia: A Review of the Evidence. J Fam Pract 2022; 71:S10-S21. [PMID: 35776862 DOI: 10.12788/jfp.0424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Given the growing prevalence of antibiotic resistance globally, there is an urgent need for new therapy options that are effective and well tolerated for treatment of common infections such as bacterial skin infections and pneumonia. Here, we summarize the findings of 3 phase 3 clinical trials of omadacycline, a novel tetracycline-derived aminomethylcycline, in patients with acute bacterial skin and skin structure infections (ABSSSI; OASIS-1 [NCT02378480] and OASIS-2 [NCT02877927]) or community-acquired bacterial pneumonia (CABP; OPTIC [NCT02531438]). The primary endpoint in all studies was early clinical response (early response) at 2 to 3 days (skin studies) or 3 to 5 days (pneumonia study) after the first dose. Other endpoints included post-treatment evaluation (late response) and safety evaluations. Early and late responses were similar for omadacycline (85% to 88%) and linezolid (83% to 86%) in the skin infection studies. Similarly in the pneumonia study, early and late responses were similar for omadacycline and moxifloxacin: 81% and 88% vs 83% and 85%, respectively. No differences were observed in subgroup analyses, and high rates of clinical response were seen for all treatments against common pathogens. The most frequent adverse event reported was nausea, which was mostly associated with the loading dose in the oral-only regimen in OASIS-2. Overall, omadacycline was well tolerated and showed high rates of clinical response in patients with skin infections and pneumonia, including in those with comorbidities.
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Affiliation(s)
| | | | - Jeff Gindi
- Hackensack Meridian, Southern Ocean Medical Center, Manahawkin, NJ
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Sanford JA, Rush WL, Klassen-Fischer MK, Allbritton JI. Cutaneous Actinomycosis of the Perineum in an Immunocompetent Man. Am J Dermatopathol 2022; 44:272-275. [PMID: 34726184 DOI: 10.1097/dad.0000000000002095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We present a case of primary cutaneous actinomycosis of unclear pathogenesis. A 30-year-old-man with no significant medical or surgical history presented to the emergency department with a 2-week history of a tender perineal mass. The patient denied trauma or perforating injury to the area. Examination of the area revealed an indurated, nonfluctuant, erythematous papulonodule located 2 cm from the anus. The lesion was unresponsive to oral and topical antibiotics and was therefore excised. The excision specimen revealed a dense mixed infiltrate partially filling the reticular dermis and extending into the subcutaneous fat. The infiltrate surrounded grains of basophilic material with an outer rim of eosinophilic radiating Splendore-Hoeppli material. Within the grains, filamentous bacteria were highlighted with Periodic acid-Schiff and Grocott's methenamine silver. The organisms were gram-positive and acid-fast negative. Given the clinical and histopathologic findings, actinomycosis was diagnosed. Two weeks later, the patient reported resolution of symptoms. The patient was lost to follow-up. This case highlights an unusual presentation of actinomycosis and the crucial role histopathology plays in diagnosis.
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Affiliation(s)
- Jeffrey A Sanford
- Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD
| | - Walter L Rush
- Division of Dermatopathology, Joint Pathology Center; and
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Dumic I, Brown A, Magee K, Elwasila S, Kaljevic M, Antic M, Igandan O, Cardozo M, Rueda Prada L, Paulson M. Primary Lymphocutaneous Nocardia brasiliensis in an Immunocompetent Host: Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58040488. [PMID: 35454327 PMCID: PMC9030709 DOI: 10.3390/medicina58040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Nocardia spp. is a Gram-positive, partially acid-fast aerobic bacterium usually associated with infection in immunocompromised people. The most common sites of infection are the skin, lungs, and the brain, however disease can disseminate and affect every organ. Clinical manifestations of cutaneous disease are varied and frequently misdiagnosed. We present a case of an immunocompetent 66-year-old man who sustained a left finger injury while gardening. He was misdiagnosed on several occasions and treated with inappropriate antibiotics against Streptococcus spp. and Staphylococcus spp. When infection spread cutaneously, sporotrichoid (lymphocutaneous) nocardiosis was suspected and the patient was started on appropriate therapy with Bactrim which resulted in a cure. We also summarize the literature on lymphocutaneous infection by Nocardia brasiliensis. By reporting this case, we want to raise awareness among clinicians about unusual causes of cellulitis, the differential diagnosis of lymphocutaneous infection and the importance of obtaining a detailed exposure history to assist in the prompt diagnosis of nocardiosis.
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Affiliation(s)
- Igor Dumic
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA; (O.I.); (M.C.); (L.R.P.); (M.P.)
- Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA
- Correspondence:
| | - Alethea Brown
- Hospital Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Kyle Magee
- Department of Microbiology, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Sammer Elwasila
- Department of Infectious Disease, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Marija Kaljevic
- Department of Hospital Medicine, University of Connecticut, Hartford, CT 06032, USA;
| | - Marina Antic
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA;
| | - Oladapo Igandan
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA; (O.I.); (M.C.); (L.R.P.); (M.P.)
- Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA
| | - Milena Cardozo
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA; (O.I.); (M.C.); (L.R.P.); (M.P.)
- Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA
| | - Libardo Rueda Prada
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA; (O.I.); (M.C.); (L.R.P.); (M.P.)
- Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA
| | - Margaret Paulson
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA; (O.I.); (M.C.); (L.R.P.); (M.P.)
- Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, USA
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Schweitzer B, Balázs VL, Molnár S, Szögi-Tatár B, Böszörményi A, Palkovics T, Horváth G, Schneider G. Antibacterial Effect of Lemongrass (Cymbopogon citratus) against the Aetiological Agents of Pitted Keratolyis. Molecules 2022; 27:molecules27041423. [PMID: 35209211 PMCID: PMC8878996 DOI: 10.3390/molecules27041423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 02/01/2023] Open
Abstract
Pitted keratolysis (PK) is a bacterial skin infection mostly affecting the pressure-bearing areas of the soles, causing unpleasant symptoms. Antibiotics are used for therapy, but the emergence of antiobiotic resistance, makes the application of novel topical therapeutic agents necessary. The antibacterial effects of 12 EOs were compared in the first part of this study against the three known aetiological agents of PK (Kytococcus sedentarius, Dermatophilus congolensis and Bacillus thuringiensis). The results of the minimal inhibitory concentration, minimal bactericidal concentration and spore-formation inhibition tests revealed that lemongrass was the most effective EO against all three bacterium species and was therefore chosen for further analysis. Seventeen compounds were identified with solid-phase microextraction followed by gas chromatography–mass spectrometry (HS-SPME/GC-MS) analysis while thin-layer chromatography combined with direct bioautography (TLC-BD) was used to detect the presence of antibacterially active compounds. Citral showed a characteristic spot at the Rf value of 0.47, while the HS-SPME/GC-MS analysis of an unknown spot with strong antibacterial activity revealed the presence of α-terpineol, γ-cadinene and calamenene. Of these, α-terpineol was confirmed to possess an antimicrobial effect on all three bacterium species associated with PK. Our study supports the hypothesis that, based on their spectrum, EO-based formulations have potent antibacterial effects against PK and warrant further investigation as topical therapeutics.
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Affiliation(s)
- Bettina Schweitzer
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary; (B.S.); (T.P.)
| | - Viktória Lilla Balázs
- Department of Pharmacognosy, University of Pécs, Rókus u. 2, H-7624 Pécs, Hungary; (V.L.B.); (G.H.)
| | - Szilárd Molnár
- Research Institute for Viticulture and Oenology, University of Pécs, Pázmány Péter u. 4, H-7634 Pécs, Hungary;
| | - Bernadett Szögi-Tatár
- Department of Pharmacognosy, Semmelweis University, Üllői u. 26., H-1085 Budapest, Hungary; (B.S.-T.); (A.B.)
| | - Andrea Böszörményi
- Department of Pharmacognosy, Semmelweis University, Üllői u. 26., H-1085 Budapest, Hungary; (B.S.-T.); (A.B.)
| | - Tamás Palkovics
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary; (B.S.); (T.P.)
| | - Györgyi Horváth
- Department of Pharmacognosy, University of Pécs, Rókus u. 2, H-7624 Pécs, Hungary; (V.L.B.); (G.H.)
| | - György Schneider
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary; (B.S.); (T.P.)
- Correspondence: ; Tel.: +36-72-536 200 (ext. 1908)
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de Souza GS, de Jesus Sonego L, Santos Mundim AC, de Miranda Moraes J, Sales-Campos H, Lorenzón EN. Antimicrobial-wound healing peptides: Dual-function molecules for the treatment of skin injuries. Peptides 2022; 148:170707. [PMID: 34896165 DOI: 10.1016/j.peptides.2021.170707] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022]
Abstract
Chronic non-healing wounds caused by microbial infections extend the necessity for hospital care and constitute a public health problem and a great financial burden. Classic therapies include a wide range of approaches, from wound debridement to vascular surgery. Antimicrobial peptides (AMPs) are a preserved trait of the innate immune response among different animal species, with known effects on the immune system and microorganisms. Thus, AMPs may represent promising candidates for the treatment of chronic wounds with dual functionality in two of the main agents that lead to this condition, proliferation of microorganisms and uncontrolled inflammation. Here, our goal is to critically review AMPs with wound healing properties. We strongly believe that these dual-function peptides alone, or in combination with other wound healing strategies, constitute an underexplored field that researchers can take advantage of.
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Affiliation(s)
| | | | | | | | - Helioswilton Sales-Campos
- Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Universidade Federal de Goiás, Goiás, Brazil
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Wurcel AG, Essien UR, Ortiz C, Fu X, Mancini C, Zhang Y, Blumenthal KG. Variation by Race in Antibiotics Prescribed for Hospitalized Patients With Skin and Soft Tissue Infections. JAMA Netw Open 2021; 4:e2140798. [PMID: 34940871 PMCID: PMC8703249 DOI: 10.1001/jamanetworkopen.2021.40798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This cohort study examines antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs).
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Affiliation(s)
- Alysse G. Wurcel
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
- Tufts University School of Medicine, Boston, Massachusetts
| | - Utibe R. Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Xiaoqing Fu
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston
| | - Christian Mancini
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston
| | - Yuqing Zhang
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Kimberly G. Blumenthal
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
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Zhao C, Chen R, Chen Z, Lu Q, Zhu H, Bu Q, Yin J, He H. Bioinspired Multifunctional Cellulose Nanofibril-Based In Situ Liquid Wound Dressing for Multiple Synergistic Therapy of the Postoperative Infected Wound. ACS Appl Mater Interfaces 2021; 13:51578-51591. [PMID: 34666485 DOI: 10.1021/acsami.1c18221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A smart in situ-formed wound dressing with excellent antibacterial ability against drug-resistance bacterial, antitumor, and biofilm-eliminating activities to promote effective wound closure is highly desirable in therapeutic and clinical applications. Herein, we designed and developed a multifunctional; shape-adaptable; and pH, temperature, and near-infrared radiation (NIR) multiple responsive cellulose nanofibril (CNF)-based in situ liquid wound dressing, using a pH-sensitive CNF grafted with terminated amino hyperbranched polyamines (HBP-NH2) as a substrate, along with poly(N-isopropylacrylamide) and indocyanine green (ICG) loaded as the temperature and NIR on/off switches, respectively. The 3D nanocage network structure of CNF and the nanocavities in the hyperbranched structure of HBP-NH2 endow the dressing with a high loading capacity for active drugs (doxorubicin and ICG) simultaneously. Moreover, the responsiveness of the dressing to multiple stimuli enables controllable and efficient drug release to the wound area. The bioinspired dressing demonstrates excellent antibacterial activity against common bacteria and methicillin-resistant Staphylococcus aureus, antitumor activity against A375 tumor cells, and biofilm-eliminating capability. In addition, the developed dressing synergistically combines multiple therapeutic strategies for effective wound healing, specifically photothermal therapy, photodynamic therapy, and chemotherapy. The design provides an ideal clinical intervention strategy for irregular tumor postoperative infected wounds.
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Affiliation(s)
- Chao Zhao
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Rimei Chen
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Zhiping Chen
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Qin Lu
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Hongxiang Zhu
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Qing Bu
- The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Jiali Yin
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
| | - Hui He
- School of Light Industry and Food Engineering, Guangxi University, Nanning 530004, P.R. China
- Guangxi Key Laboratory of Clean Pulp & Papermaking and Pollution Control, Nanning 530004, P.R. China
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Bittner Fialová S, Rendeková K, Mučaji P, Nagy M, Slobodníková L. Antibacterial Activity of Medicinal Plants and Their Constituents in the Context of Skin and Wound Infections, Considering European Legislation and Folk Medicine-A Review. Int J Mol Sci 2021; 22:ijms221910746. [PMID: 34639087 PMCID: PMC8509446 DOI: 10.3390/ijms221910746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
Bacterial infections of skin and wounds may seriously decrease the quality of life and even cause death in some patients. One of the largest concerns in their treatment is the growing antimicrobial resistance of bacterial infectious agents and the spread of resistant strains not only in the hospitals but also in the community. This trend encourages researchers to seek for new effective and safe therapeutical agents. The pharmaceutical industry, focusing mainly on libraries of synthetic compounds as a drug discovery source, is often failing in the battle with bacteria. In contrast, many of the natural compounds, and/or the whole and complex plants extracts, are effective in this field, inactivating the resistant bacterial strains or decreasing their virulence. Natural products act comprehensively; many of them have not only antibacterial, but also anti-inflammatory effects and may support tissue regeneration and wound healing. The European legislative is in the field of natural products medicinal use formed by European Medicines Agency (EMA), based on the scientific work of its Committee on Herbal Medicinal Products (HMPC). HMPC establishes EU monographs covering the therapeutic uses and safe conditions for herbal substances and preparations, mostly based on folk medicine, but including data from scientific research. In this review, the medicinal plants and their active constituents recommended by EMA for skin disorders are discussed in terms of their antibacterial effect. The source of information about these plant products in the review is represented by research articles listed in scientific databases (Science Direct, PubMed, Scopus, Web of Science, etc.) published in recent years.
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Affiliation(s)
- Silvia Bittner Fialová
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, Odbojárov 10, 832 32 Bratislava, Slovakia; (K.R.); (P.M.); (M.N.)
- Correspondence: ; Tel.: +421-250-117-206
| | - Katarína Rendeková
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, Odbojárov 10, 832 32 Bratislava, Slovakia; (K.R.); (P.M.); (M.N.)
| | - Pavel Mučaji
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, Odbojárov 10, 832 32 Bratislava, Slovakia; (K.R.); (P.M.); (M.N.)
| | - Milan Nagy
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, Odbojárov 10, 832 32 Bratislava, Slovakia; (K.R.); (P.M.); (M.N.)
| | - Lívia Slobodníková
- Institute of Microbiology, Faculty of Medicine and the University Hospital in Bratislava, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia;
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In brief: Oritavancin (Kimyrsa) for skin and skin structure infections. Med Lett Drugs Ther 2021; 63:e1-2. [PMID: 34544104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Wunderink RG, Roquilly A, Croce M, Rodriguez Gonzalez D, Fujimi S, Butterton JR, Broyde N, Popejoy MW, Kim JY, De Anda C. A Phase 3, Randomized, Double-Blind Study Comparing Tedizolid Phosphate and Linezolid for Treatment of Ventilated Gram-Positive Hospital-Acquired or Ventilator-Associated Bacterial Pneumonia. Clin Infect Dis 2021; 73:e710-e718. [PMID: 33720350 PMCID: PMC8326538 DOI: 10.1093/cid/ciab032] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) are associated with high mortality rates. We evaluated the efficacy and safety of tedizolid (administered as tedizolid phosphate) for treatment of gram-positive ventilated HABP/VABP. METHODS In this randomized, noninferiority, double-blind, double-dummy, global phase 3 trial, patients were randomized 1:1 to receive intravenous tedizolid phosphate 200 mg once daily for 7 days or intravenous linezolid 600 mg every 12 hours for 10 days. Treatment was 14 days in patients with concurrent gram-positive bacteremia. The primary efficacy end points were day 28 all-cause mortality (ACM; noninferiority margin, 10%) and investigator-assessed clinical response at test of cure (TOC; noninferiority margin, 12.5%) in the intention-to-treat population. RESULTS Overall, 726 patients were randomized (tedizolid, n = 366; linezolid, n = 360). Baseline characteristics, including incidence of methicillin-resistant Staphylococcus aureus (31.3% overall), were well balanced. Tedizolid was noninferior to linezolid for day 28 ACM rate: 28.1% and 26.4%, respectively (difference, -1.8%; 95% confidence interval [CI]: -8.2 to 4.7). Noninferiority of tedizolid was not demonstrated for investigator-assessed clinical cure at TOC (tedizolid, 56.3% vs linezolid, 63.9%; difference, -7.6%; 97.5% CI: -15.7 to 0.5). In post hoc analyses, no single factor accounted for the difference in clinical response between treatment groups. Drug-related adverse events occurred in 8.1% and 11.9% of patients who received tedizolid and linezolid, respectively. CONCLUSIONS Tedizolid was noninferior to linezolid for day 28 ACM in the treatment of gram-positive ventilated HABP/VABP. Noninferiority of tedizolid for investigator-assessed clinical response at TOC was not demonstrated. Both drugs were well tolerated. CLINICAL TRIALS REGISTRATION NCT02019420.
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Affiliation(s)
- Richard G Wunderink
- Department of Medicine, Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Antoine Roquilly
- Université de Nantes, Centre Hospitalier Universitaire de Nantes, EA3826 Thérapeutiques Anti-Infectieuses, Service d’Anesthésie Réanimation Chirurgicale, Hôtel Dieu, Nantes, F-44000
| | | | | | - Satoshi Fujimi
- Department of Trauma, Critical Care, and Emergency Medicine, Osaka General Medical Center, Sumiyoshi-ku, Osaka, Japan
| | - Joan R Butterton
- Merck Research Laboratories, Merck & Co, Inc, Kenilworth, New Jersey, USA
| | - Natasha Broyde
- Merck Research Laboratories, Merck & Co, Inc, Kenilworth, New Jersey, USA
| | - Myra W Popejoy
- Merck Research Laboratories, Merck & Co, Inc, Kenilworth, New Jersey, USA
| | - Jason Y Kim
- Merck Research Laboratories, Merck & Co, Inc, Kenilworth, New Jersey, USA
| | - Carisa De Anda
- Merck Research Laboratories, Merck & Co, Inc, Kenilworth, New Jersey, USA
- Correspondence: Carisa De Anda, Merck & Co, Inc, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA ()
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Trčko K, Plaznik J, Miljković J. Mycobacterium marinum hand infection masquerading as tinea manuum: a case report and literature review. Acta Dermatovenerol Alp Pannonica Adriat 2021; 30:91-93. [PMID: 34169709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Fish tank granuloma is a rare skin infection caused by Mycobacterium marinum. It occurs after exposure of skin abrasions to contaminated water or infected fish. The majority of M. marinum infections today are fish tank-related. The most common presentation is a solitary nodule, often with sporotrichoid spread. Other presentations do not occur often. The diagnosis is often delayed because of lack of suspicion, nonspecific histopathological findings, and frequently unsuccessful cultivation. Here we present the case of a 37-year-old male with M. marinum skin infection, presenting as erythematous scaling plaques. Because the initial results of laboratory and histopathological examinations were negative for a fungal infection or nontuberculous mycobacteria, the patient was treated empirically with several systemic antibiotics and antifungals without any success. Finally, the diagnosis of fish tank granuloma was confirmed 3 months after the initial presentation of the patient. After the introduction of treatment with rifampicin and clarithromycin, complete clinical remission was observed after 6 months of therapy.
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Affiliation(s)
- Katarina Trčko
- Department of Dermatology and Venereal Diseases, University Medical Centre Maribor, Maribor, Slovenia
| | - Jurij Plaznik
- Department of Dermatology and Venereal Diseases, University Medical Centre Maribor, Maribor, Slovenia
| | - Jovan Miljković
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
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Pai MP, Wilcox MH, Chitra S, McGovern PC. Safety and efficacy of omadacycline by BMI categories and diabetes history in two Phase III randomized studies of patients with acute bacterial skin and skin structure infections. J Antimicrob Chemother 2021; 76:1315-1322. [PMID: 33458763 PMCID: PMC8050767 DOI: 10.1093/jac/dkaa558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/10/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objectives of this post-hoc analysis were to examine the safety and efficacy of omadacycline by BMI categories and diabetes history in adults with acute bacterial skin and skin structure infections (ABSSSI) from two pivotal Phase III studies. PATIENTS AND METHODS OASIS-1 (ClinicalTrials.gov identifier NCT02378480): patients were randomized 1:1 to IV omadacycline or linezolid for 7-14 days, with optional transition to oral medication. OASIS-2 (ClinicalTrials.gov identifier NCT02877927): patients received once-daily oral omadacycline or twice-daily oral linezolid for 7-14 days. Early clinical response (ECR) was defined as ≥20% reduction in lesion size 48-72 h after the first dose. Clinical success at post-treatment evaluation (PTE; 7-14 days after the last dose) was defined as symptom resolution such that antibacterial therapy was unnecessary. Safety was assessed by treatment-emergent adverse events and laboratory measures. Between-treatment comparisons were made with regard to WHO BMI categories and diabetes history. RESULTS Patients were evenly distributed among healthy weight, overweight and obese groups. Clinical success for omadacycline-treated patients at ECR and PTE was similar across BMI categories. Outcomes by diabetes status were similar in omadacycline- and linezolid-treated patients: at ECR, clinical success rates were lower for those with diabetes; at PTE, clinical success was similar between treatment groups regardless of diabetes history. The safety of omadacycline and linezolid was largely similar across BMI groups and by diabetes history. CONCLUSIONS Omadacycline efficacy in patients with higher BMI and in patients with diabetes was consistent with results from two pivotal Phase III ABSSSI trials. Fixed-dose omadacycline is an appropriate treatment for ABSSSI in adults regardless of BMI.
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Affiliation(s)
- Manjunath P Pai
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mark H Wilcox
- University of Leeds & Leeds Teaching Hospitals, Leeds LS2 9JT, UK
| | - Surya Chitra
- Paratek Pharmaceuticals, Inc., King of Prussia, PA 19406, USA
| | - Paul C McGovern
- Paratek Pharmaceuticals, Inc., King of Prussia, PA 19406, USA
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Cristinacce A, Wright JG, Macpherson M, Iaconis J, Das S. Comparing probability of target attainment against Staphylococcus aureus for ceftaroline fosamil, vancomycin, daptomycin, linezolid, and ceftriaxone in complicated skin and soft tissue infection using pharmacokinetic/pharmacodynamic models. Diagn Microbiol Infect Dis 2021; 99:115292. [PMID: 33360809 DOI: 10.1016/j.diagmicrobio.2020.115292] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/31/2019] [Accepted: 12/07/2020] [Indexed: 12/29/2022]
Abstract
For recently licensed antibiotics, such as the cephalosporin ceftaroline fosamil, probability of target attainment (PTA) curves, showing the percentage of patients reaching a predefined pharmacokinetic (PK)/pharmacodynamic (PD) target at different bacterial minimum inhibitory concentrations (MICs), have been used to support and justify dose recommendations across patient populations. However, information on PTA for older antibiotics is limited. A retrospective analysis was conducted to construct PTA curves for 4 antibiotics against Staphylococcus aureus in patients with complicated skin and soft tissue infections (cSSTIs). PK models for vancomycin, linezolid, daptomycin, and ceftriaxone were selected from the literature based on large numbers of subjects with covariates representative of patients in Europe and/or the United States. An existing model was available for ceftaroline fosamil. Standard and high-dosage regimens were used to compare the PTA of each antibiotic at MIC values 0.03 to 64 mg/L for a simulated set of patients with cSSTI caused by S. aureus. These were compared to proportions of S. aureus isolates at each MIC from global surveillance data. Ceftaroline achieved PTAs >99.9% for bacteriostatic and bactericidal targets at the MIC90 (1 mg/L), whereas the comparators failed to achieve PTAs >90%, at bacteriostatic or bactericidal targets, even when clinical doses were increased beyond those recommended. PTA analysis can be used to compare different drugs with the same simulated patient dataset, subject to availability of an appropriate PK model and robust exposure targets. This analysis shows that some antibiotics commonly used to treat cSSTIs may fail to reach high PTAs relative to contemporary MIC90 estimates.
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Affiliation(s)
| | | | | | | | - Shampa Das
- Clinical Pharmacology, AstraZeneca, Macclesfield, UK.
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Costescu Strachinaru DI, Vanbrabant P, Stinga P, Strachinaru M, Soentjens P. Diagnosis of Mycobacterium marinum Infection with Sporotrichoid Pattern. Acta Derm Venereol 2021; 101:adv00414. [PMID: 33686447 PMCID: PMC9366498 DOI: 10.2340/00015555-3777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bradley JS, Antadze T, Ninov B, Tayob MS, Broyde N, Butterton JR, Chou MZ, De Anda CS, Kim JY, Sears PS. Safety and Efficacy of Oral and/or Intravenous Tedizolid Phosphate From a Randomized Phase 3 Trial in Adolescents With Acute Bacterial Skin and Skin Structure Infections. Pediatr Infect Dis J 2021; 40:238-244. [PMID: 33395210 DOI: 10.1097/inf.0000000000003010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tedizolid phosphate is an oxazolidinone prodrug approved in 2014 for treatment of adults with acute bacterial skin and skin structure infections (ABSSSIs); however, efficacy has not previously been evaluated in children. This study compared the safety and efficacy of tedizolid (administered as tedizolid phosphate) with active antibacterial comparators for the treatment of ABSSSIs in adolescents. METHODS This was a randomized, assessor-blind, global phase 3 study of tedizolid versus active comparators for the treatment of Gram-positive ABSSSIs in adolescents (12 to <18 years of age; NCT02276482). Enrolled participants were stratified by region and randomized 3:1 to receive tedizolid phosphate 200 mg (oral and/or intravenous) once daily for 6 days or active comparator, selected by investigator from an allowed list per local standard of care, for 10 days. The primary endpoint was safety; blinded investigator's assessment of clinical success at the test-of-cure visit (18-25 days after the first dose) was a secondary efficacy endpoint. Statistical comparisons between treatment groups were not performed. RESULTS Of the 121 participants enrolled, 120 were treated (tedizolid, n = 91; comparator, n = 29). Treatment-emergent adverse events were balanced between treatment groups (tedizolid, 14.3%; comparator, 10.3%). Overall, 3 participants (3.3%) in the tedizolid group and 1 (3.4%) in the comparator group experienced a single drug-related TEAE. Clinical success rates were high in both treatment groups: 96.7% and 93.1% at the test-of-cure visit for the tedizolid and comparator groups, respectively. CONCLUSIONS Tedizolid demonstrated safety and efficacy similar to comparators for the treatment of ABSSSIs in adolescents.
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Affiliation(s)
- John S Bradley
- From the Merck Research Laboratories, Rady Children's Hospital/UCSD, San Diego, CA
| | - Tinatin Antadze
- Merck Research Laboratories, LTD M. Iashvili Children's Central Hospital, Tbilisi, Georgia
| | - Borislav Ninov
- Merck Research Laboratories, UMHAT Dr. Georgi Stranski EAD, Pleven, Bulgaria
| | - Mohammed S Tayob
- Merck Research Laboratories, Mzansi Ethical Research Centre, Middelburg, South Africa
| | - Natasha Broyde
- Merck Research Laboratories, Merck & Co., Inc., Kenilworth, NJ
| | | | - Margaret Z Chou
- Merck Research Laboratories, Merck & Co., Inc., Kenilworth, NJ
| | | | - Jason Y Kim
- Merck Research Laboratories, Merck & Co., Inc., Kenilworth, NJ
| | - Pamela S Sears
- Merck Research Laboratories, Merck & Co., Inc., Kenilworth, NJ
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Blaskovich MAT, Kavanagh AM, Elliott AG, Zhang B, Ramu S, Amado M, Lowe GJ, Hinton AO, Pham DMT, Zuegg J, Beare N, Quach D, Sharp MD, Pogliano J, Rogers AP, Lyras D, Tan L, West NP, Crawford DW, Peterson ML, Callahan M, Thurn M. The antimicrobial potential of cannabidiol. Commun Biol 2021; 4:7. [PMID: 33469147 PMCID: PMC7815910 DOI: 10.1038/s42003-020-01530-y] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022] Open
Abstract
Antimicrobial resistance threatens the viability of modern medicine, which is largely dependent on the successful prevention and treatment of bacterial infections. Unfortunately, there are few new therapeutics in the clinical pipeline, particularly for Gram-negative bacteria. We now present a detailed evaluation of the antimicrobial activity of cannabidiol, the main non-psychoactive component of cannabis. We confirm previous reports of Gram-positive activity and expand the breadth of pathogens tested, including highly resistant Staphylococcus aureus, Streptococcus pneumoniae, and Clostridioides difficile. Our results demonstrate that cannabidiol has excellent activity against biofilms, little propensity to induce resistance, and topical in vivo efficacy. Multiple mode-of-action studies point to membrane disruption as cannabidiol's primary mechanism. More importantly, we now report for the first time that cannabidiol can selectively kill a subset of Gram-negative bacteria that includes the 'urgent threat' pathogen Neisseria gonorrhoeae. Structure-activity relationship studies demonstrate the potential to advance cannabidiol analogs as a much-needed new class of antibiotics.
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Affiliation(s)
- Mark A T Blaskovich
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - Angela M Kavanagh
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Alysha G Elliott
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Bing Zhang
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Soumya Ramu
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Maite Amado
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Gabrielle J Lowe
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Alexandra O Hinton
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Do Minh Thu Pham
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Johannes Zuegg
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Neil Beare
- BDG Synthesis, Wellington, 5045, New Zealand
| | - Diana Quach
- Linnaeus Bioscience Inc., 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Marc D Sharp
- Linnaeus Bioscience Inc., 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Joe Pogliano
- Linnaeus Bioscience Inc., 3210 Merryfield Row, San Diego, CA, 92121, USA
- Division of Biological Sciences, University of California, San Diego, CA, 92093, USA
| | - Ashleigh P Rogers
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, VIC, 3800, Australia
| | - Dena Lyras
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, VIC, 3800, Australia
| | - Lendl Tan
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Nicholas P West
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - David W Crawford
- Perfectus Biomed, LLC (formerly Extherid Biosciences), 3545 S Park Dr, Jackson, WY, 83001, USA
| | - Marnie L Peterson
- Perfectus Biomed, LLC (formerly Extherid Biosciences), 3545 S Park Dr, Jackson, WY, 83001, USA
| | - Matthew Callahan
- Botanix Pharmaceuticals Ltd., Level 1, 50 Angove Street, North Perth, WA, 6005, Australia
| | - Michael Thurn
- Botanix Pharmaceuticals Ltd., Level 1, 50 Angove Street, North Perth, WA, 6005, Australia
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McNally MA, Farooq S, Tschen J, Koshelev MV. Linezolid as a treatment option for cutaneous non-tuberculous mycobacterial infections. Dermatol Online J 2020; 26:13030/qt01q4m0p0. [PMID: 33054940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023] Open
Abstract
Cutaneous non-tuberculous mycobacterial (NTM) infections have rapidly increased in incidence in recent years. Currently there is no standard treatment and the variable and nonspecific ways in which cutaneous NTM infection presents makes it a therapeutic and diagnostic challenge. We describe a 67-year-old immunocompetent woman with cutaneous NTM infection after she recently underwent a root canal procedure. Although the species was not identified and she was unable to tolerate multiple antibiotics, she ultimately responded well to three months of treatment with linezolid. Given that cutaneous NTM infection can present in immunocompetent patients and that the incidence is rising, it is important for clinicians to maintain a high index of clinical suspicion, especially in patients with a recent history of surgery, trauma, or cosmetic procedures. Linezolid has coverage against non-tuberculous mycobacteria and is an effective therapeutic option for cutaneous NTM cases in which identification to the species level is not possible or when adverse effects limit therapeutic options.
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Affiliation(s)
| | | | | | - Misha V Koshelev
- Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, TX.
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Quirke M, Mitchell N, Varley J, Kelly S, Boland F, Moughty A, McKeever J, Fahey T, Wakai A. Prevalence and predictors of oral to intravenous antibiotic switch among adult emergency department patients with acute bacterial skin and skin structure infections: a pilot, prospective cohort study. BMJ Open 2020; 10:e034057. [PMID: 32868346 PMCID: PMC7462158 DOI: 10.1136/bmjopen-2019-034057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To determine the prevalence and predictors of oral to intravenous antibiotic switch among adult emergency department (ED) patients with acute bacterial skin and skin structure infections (ABSSSIs). DESIGN Multicentre, pilot cohort study. SETTING Three urban EDs in Dublin, Ireland. PARTICIPANTS Consecutive ED patients aged >16 years old with ABSSSIs between March 2015 and September 2016. INTERVENTION Oral flucloxacillin 500 mg-1 g four times a day (alternative in penicillin allergy). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was to determine the prevalence and predictors of oral to intravenous antibiotic switch. Secondary outcomes were to determine the prevalence and predictors of receiving an extended course of oral antibiotic treatment and measurement of interobserver reliability for clinical predictors at enrolment. RESULTS Overall, 159 patients were enrolled of which eight were lost to follow-up and five were excluded. The majority of patients were male (65.1%) and <50 years of age (58.2%). Oral to intravenous antibiotic switch occurred in 13 patients (8.9%; 95% CI 4.8% to 14.7%). Increased lesion size (OR 1.74; 95% CI 1.09 to 2.79), white cell count (OR 1.32; 95% CI 1.05 to 1.67), athlete's foot (OR 8.00; 95% CI 2.31 to 27.71) and fungal nail infections (OR 7.25; 95% CI 1.99 to 26.35) were associated with oral to intravenous antibiotic switch. 24.8% (95% CI 18.1% to 33.0%) of patients received an extended course of oral antibiotic treatment. CONCLUSION The prevalence of oral to intravenous antibiotic switch in this pilot study is 8.9% (95% CI 4.8% to 14.7%). We identify the predictors of oral to intravenous switch worthy of future investigation. TRIAL REGISTRATION NUMBER NCT02230813.
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Affiliation(s)
- Michael Quirke
- Emergency Care Research Unit, Royal College of Surgeons Ireland, Dublin, Ireland
- Department of Emergency Medicine, Beaumont Hospital, Dublin, Ireland
| | - Niamh Mitchell
- Department of Emergency Medicine, Connolly Hospital Blanchardstown, Blanchardstown, Dublin, Ireland
| | - Jarlath Varley
- Department of Emergency Medicine, Connolly Hospital Blanchardstown, Blanchardstown, Dublin, Ireland
| | - Stephen Kelly
- Department of Emergency Medicine, Beaumont Hospital, Dublin, Ireland
| | - Fiona Boland
- HRB Centre For Primary Care Research, Department of General Practice, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Adrian Moughty
- Department of Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Joseph McKeever
- Department of Emergency Medicine, Connolly Hospital Blanchardstown, Blanchardstown, Dublin, Ireland
| | - Tom Fahey
- HRB Centre For Primary Care Research, Department of General Practice, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Abel Wakai
- Emergency Care Research Unit, Royal College of Surgeons Ireland, Dublin, Ireland
- Department of Emergency Medicine, Beaumont Hospital, Dublin, Ireland
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Zhou X, Liu Y, Gao Y, Wang Y, Xia Q, Zhong R, Ma C, Zhou M, Xi X, Shaw C, Chen T, Wu D, Kwok HF, Wang L. Enhanced Antimicrobial Activity of N-Terminal Derivatives of a Novel Brevinin-1 Peptide from The Skin Secretion of Odorrana schmackeri. Toxins (Basel) 2020; 12:E484. [PMID: 32751489 PMCID: PMC7472354 DOI: 10.3390/toxins12080484] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial peptides (AMPs) are promising therapeutic alternatives compared to conventional antibiotics for the treatment of drug-resistant bacterial infections. However, the application of the overwhelming majority of AMPs is limited because of the high toxicity and high manufacturing costs. Amphibian skin secretion has been proven to be a promising source for the discovery and development of novel AMPs. Herein, we discovered a novel AMP from the skin secretion of Odorrana schmackeri, and designed the analogues by altering the key factors, including conformation, net charge and amphipathicity, to generate short AMPs with enhanced therapeutic efficacy. All the peptides were chemically synthesised, followed by evaluating their biological activity, stability and cytotoxicity. OSd, OSe and OSf exhibited broad-spectrum antibacterial effects, especially OSf, which presented the highest therapeutic index for the tested bacteria. Moreover, these peptides displayed good stability. The results from scanning electron microscopy and transmission electron microscopy studies, indicated that brevinin-OS, OSd, OSe and OSf possessed rapid bactericidal ability by disturbing membrane permeability and causing the release of cytoplasmic contents. In addition, OSd, OSe and OSf dramatically decreased the mortality of waxworms acutely infected with MRSA. Taken together, these data suggested that a balance between positive charge, degrees of α-helicity and hydrophobicity, is necessary for maintaining antimicrobial activity, and these data successfully contributed to the design of short AMPs with significant bactericidal activity and cell selectivity.
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Affiliation(s)
- Xiaowei Zhou
- Department of Nutrition, Henry Fok School of Food Science and Engineering, Shaoguan University; Shaoguan 512005, China; (X.Z.); (R.Z.)
- Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau SAR
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Yue Liu
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Yitian Gao
- College of Life and Environmental Science, Wenzhou University, Wenzhou 325035, China;
| | - Yuanxing Wang
- State Key Lab of Food Science and Technology, Nanchang University, Nanchang 330047, China;
| | - Qiang Xia
- Department of Food Science and Engineering, Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo 315832, China;
| | - Ruimin Zhong
- Department of Nutrition, Henry Fok School of Food Science and Engineering, Shaoguan University; Shaoguan 512005, China; (X.Z.); (R.Z.)
| | - Chengbang Ma
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Mei Zhou
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Xinping Xi
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Chris Shaw
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Tianbao Chen
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
| | - Di Wu
- Chemical Biology Research Centre, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou 325035, China;
| | - Hang Fai Kwok
- Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau SAR
| | - Lei Wang
- Natural Drug Discovery Group, School of Pharmacy, Queen’s University, Belfast BT9 7BL, Northern Ireland, UK; (Y.L.); (C.M.); (M.Z.); (C.S.); (T.C.); (L.W.)
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Sitarek P, Merecz-Sadowska A, Kowalczyk T, Wieczfinska J, Zajdel R, Śliwiński T. Potential Synergistic Action of Bioactive Compounds from Plant Extracts against Skin Infecting Microorganisms. Int J Mol Sci 2020; 21:ijms21145105. [PMID: 32707732 PMCID: PMC7403983 DOI: 10.3390/ijms21145105] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 01/16/2023] Open
Abstract
The skin is an important organ that acts as a physical barrier to the outer environment. It is rich in immune cells such as keratinocytes, Langerhans cells, mast cells, and T cells, which provide the first line of defense mechanisms against numerous pathogens by activating both the innate and adaptive response. Cutaneous immunological processes may be stimulated or suppressed by numerous plant extracts via their immunomodulatory properties. Several plants are rich in bioactive molecules; many of these exert antimicrobial, antiviral, and antifungal effects. The present study describes the impact of plant extracts on the modulation of skin immunity, and their antimicrobial effects against selected skin invaders. Plant products remain valuable counterparts to modern pharmaceuticals and may be used to alleviate numerous skin disorders, including infected wounds, herpes, and tineas.
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Affiliation(s)
- Przemysław Sitarek
- Department of Biology and Pharmaceutical Botany, Medical University of Lodz, 90-151 Lodz, Poland
- Correspondence:
| | - Anna Merecz-Sadowska
- Department of Economic Informatics, University of Lodz, 90-214 Lodz, Poland; (A.M.-S.); (R.Z.)
| | - Tomasz Kowalczyk
- Department of Molecular Biotechnology and Genetics, University of Lodz, 90-237 Lodz, Poland;
| | - Joanna Wieczfinska
- Department of Immunopathology, Medical University of Lodz, 90-752 Lodz, Poland;
| | - Radosław Zajdel
- Department of Economic Informatics, University of Lodz, 90-214 Lodz, Poland; (A.M.-S.); (R.Z.)
| | - Tomasz Śliwiński
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland;
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Jean SS, Ko WC, Hsueh PR. Susceptibility of clinical isolates of meticillin-resistant Staphylococcus aureus and phenotypic non-extended-spectrum β-lactamase-producing Klebsiella pneumoniae to ceftaroline in Taiwan: Results from Antimicrobial Testing Leadership and Surveillance (ATLAS) in 2012-2018 and Surveillance of Multicentre Antimicrobial Resistance in Taiwan (SMART) in 2018-2019. Int J Antimicrob Agents 2020; 56:106016. [PMID: 32422316 DOI: 10.1016/j.ijantimicag.2020.106016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/21/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
Data on ceftaroline (CPT) susceptibility amongst clinical isolates of meticillin-resistant Staphylococcus aureus (MRSA, n=1284) and phenotypic non-extended-spectrum β-lactamase-producing (non-ESBL-P) Klebsiella pneumoniae (n=466), obtained from the Antimicrobial Testing Leadership and Surveillance (ATLAS) programme from 2012 to 2018, and selected MRSA isolates from patients with bloodstream infections (BSIs) (n=95) from the Surveillance of Multicentre Antimicrobial Resistance in Taiwan (SMART) programme from 2018 to 2019 were analysed. The minimum inhibitory concentrations (MICs) of ATLAS isolates were determined using the broth microdilution method, whereas the MICs of SMART BSI-MRSA isolates were determined using the Etest and MicroScan system. The pharmacokinetic profiles and pharmacodynamic parameters of CPT were applied to explore the optimal dosage against infections caused by Taiwanese MRSA and K. pneumoniae isolates. Approximately 7.1% of ATLAS MRSA isolates were susceptible-dose dependent (S-DD) to CPT, and 19.7% of the non-ESBL-P K. pneumoniae isolates were not susceptible to CPT. Amongst the ATLAS MRSA isolates, the S-DD rates to CPT amongst isolates causing lower respiratory tract infections were 11.9% and 8.5% for isolates from intensive care units (ICUs) and general wards (GWs), and those causing skin and soft tissue infections (SSTIs) were 20% and 5.3% for isolates from ICUs and GWs, respectively (P=0.015). Of the SSTI MRSA isolates from GWs, 22.7% displayed vancomycin MICs >1 mg/L. Amongst 95 SMART BSI MRSA isolates, 28 (46.7%) isolates exhibited lower CPT MICs by the Etest compared with 60 isolates with CPT MICs of 1-2 mg/L by the MicroScan system. CPT 600 mg as a 2-h intravenous infusion every 8 h is suggested for treatment of infections caused by MRSA and phenotypic non-ESBL-P K. pneumoniae in Taiwan.
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Affiliation(s)
- Shio-Shin Jean
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Infectious Diseases and Centre for Infection Control, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Mazzei R, Leonti M, Spadafora S, Patitucci A, Tagarelli G. A review of the antimicrobial potential of herbal drugs used in popular Italian medicine (1850s-1950s) to treat bacterial skin diseases. J Ethnopharmacol 2020; 250:112443. [PMID: 31790819 DOI: 10.1016/j.jep.2019.112443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Before the advent of modern antibiotics, microbial infections were treated with herbal medicine or cauterization. Literature from the latter half of the nineteenth to the early mid-twentieth century, when antibiotics became widely available, arguably holds the most progressive information about herbal remedies to treat bacterial skin diseases. The corpus of literature produced in Italy during that period is not easily accessible and mostly out of print. MATERIAL AND METHODS Plant-based remedies utilized in popular Italian medicine to treat anthrax, boils, erysipelas, impetigo, pustules, and whitlow were sourced from literature indexed in and available through the National Library Service website of the Italian Libraries Network. The remedies are assessed for their antimicrobial potential based on a detailed search of the herbal drug species in scientific databases. RESULTS A considerable part of the reviewed recipes included specific excipients (41 out of 139) and others were produced with fresh plant material (48 out of 139). Out of the 52 identified herbal drug species used in popular Italian medicine against dermatologic infections, extracts of 43 were shown to have moderate in vitro activity against Gram-positive and Gram-negative bacteria. CONCLUSION The antibacterial activity of the extracts and pure compounds as reported in the reviewed literature is mostly based on in vitro assays and generally does not encourage follow up studies. The effectiveness of the reported recipes, which include fresh plant material and excipients can only be assessed through in vivo studies. Those remedies including herbal drugs with reported antimicrobial activity might have the potential as complementary therapies. The reviewed plant based antimicrobial recipes might serve as inspirations in the search for alternative topical antibacterial strategies and the search for their synergistic and potentiating ingredients.
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Affiliation(s)
- Rosalucia Mazzei
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy
| | - Marco Leonti
- Department of Biomedical Sciences, University of Cagliari, Via Ospedale 72, 09124, Cagliari, Italy
| | - Santo Spadafora
- Unità Operativa Complessa di Dermatologia -Azienda Ospedaliera di Cosenza, Italy
| | - Alessandra Patitucci
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy
| | - Giuseppe Tagarelli
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036, Rende, CS, Italy.
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Trelease-Bell A. Skin Infections and Outpatient Burn Management: Bacterial Skin Infections. FP Essent 2020; 489:11-15. [PMID: 31995349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patients with bacterial skin and soft tissue infections (SSTIs) commonly present to family physicians. Common uncomplicated bacterial SSTIs include impetigo, ecthyma, cellulitis, erysipelas, abscesses, furuncles, and carbuncles. Risk factors for SSTIs include older age and chronic medical conditions, such as diabetes and cardiopulmonary or renal disease, and immunocompromise. Staphylococci and streptococci are the most common pathogens. Uncomplicated impetigo and ecthyma can be managed with topical antibiotics. Oral antibiotics should be prescribed for patients with complicated impetigo and ecthyma and for patients with cellulitis. For patients with cellulitis and systemic signs of infection, systemic antibiotics are indicated but hospitalization or intravenous administration may not be required. Erysipelas can be managed with oral or intravenous penicillin. Purulent SSTIs by definition involve collections of pus and include abscesses, furuncles, and carbuncles. Larger abscesses are appropriate for incision and drainage. Patients with uncomplicated carbuncles or abscesses may not require antibiotics afterward. However, antibiotics are recommended for patients with systemic inflammatory response syndrome (SIRS), patients with carbuncles or abscesses who have not improved with initial antibiotic therapy, patients with impaired host defenses, and patients with SIRS and hypotension.
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Affiliation(s)
- Amy Trelease-Bell
- Maine-Dartmouth Family Medicine Residency, 15 East Chestnut St, Augusta, ME 04330
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Higuita-Gutiérrez LF, Molina-Garcia V, Acevedo Guiral J, Gómez Cadena L, Roncancio Villamil GE, Jiménez Quiceno JN. Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: a cross-sectional study. BMC Med Educ 2020; 20:22. [PMID: 31992272 PMCID: PMC6986025 DOI: 10.1186/s12909-020-1934-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/13/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND The objective of the present study was to describe the knowledge regarding the antibiotic therapy of students of three medical schools in Medellín, Colombia. METHODS The study population comprised medical students who were enrolled in three universities. The instrument contained questions regarding their current academic term, the university, the perceived quality of the education received on antibiotic therapy and bacterial resistance, and specific questions on upper respiratory tract infections, pneumonia, urinary tract infections, and skin and soft tissue infections. The information was analyzed by calculating frequencies and measures of dispersion and central tendency. Knowledge regarding the treatment for each type of infection was compared using the Mann-Whitney U test and the Kruskal-Wallis H test. RESULTS We included 536 medical students, of which 43.5% students consider that the university has not sufficiently trained them to interpret antibiograms and 29.6% students consider that the quality of information received on the subject at their university ranges from regular to poor. The mean score for knowledge regarding antibiotic therapy for upper respiratory tract infections was 44.2 (9.9) on a scale from 0 to 100. The median score with regard to the treatment of pneumonia was 52.9 (14.7), that of urinary tract infection was 58.7 (14.8), and that of skin and soft tissue infections was 63.1 (19.4). The knowledge regarding antibiotic therapy for upper respiratory tract infections, pneumonia, and urinary tract infection does not improve with the academic term, the university, or perceived quality of the education received. CONCLUSION A large proportion of medical students perceive that the training received from the university is insufficient with regard to antibiotic use and bacterial resistance, which is consistent with the limited knowledge reflected in the selection of antibiotic treatment for respiratory, urinary tract, and skin and soft tissue infections. Overall, the situation was identical among all universities, and it did not significantly increase with the completion of an academic term.
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Affiliation(s)
- Luis Felipe Higuita-Gutiérrez
- Facultad de Medicina Universidad Cooperativa de Colombia, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
| | | | | | | | - Gustavo Eduardo Roncancio Villamil
- Facultad de Medicina Universidad Pontificia Bolivariana, Clinica Cardio VID, Grupo Microba, Universidad de Antioquia, Medellín, Colombia
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Buonomo AR, Maraolo AE, Scotto R, Foggia M, Zappulo E, Congera P, Parente S, Gentile I. Efficacy and safety of ceftolozane/tazobactam as therapeutic option for complicated skin and soft tissue infections by MDR/XDR Pseudomonas aeruginosa in patients with impaired renal function: a case series from a single-center experience. Infection 2020; 48:303-307. [PMID: 31981091 DOI: 10.1007/s15010-020-01390-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/13/2020] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Pseudomonas aeruginosa (PA) is a known cause of skin and soft tissue infections (SSTIs). Therapeutic options against multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of PA are limited, especially in patients with impaired renal function. Ceftolozane/tazobactam (C/T) is a novel beta-lactam/beta-lactamase inhibitor with powerful anti-PA activity. Thanks to its characteristics, it appears to be the best available anti-pseudomonal drug in many clinical scenarios. A case series of four adult patients followed between January 2018 and May 2019 is reported. All subjects presented complicated SSTIs by MDR- or XDR-PA and were affected by chronic kidney disease. RESULTS C/T was used as a monotherapy in three cases and in combination regimen in the remaining case. In two cases, C/T was the first-line option, in the remaining ones was the salvage treatment. All patients were successfully treated without worsening of renal function and without any other adverse events. CONCLUSIONS C/T may represent a useful option against MDR- and XDR-PA strains responsible of complicated SSTIs in patients affected by impaired renal function.
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Affiliation(s)
- A R Buonomo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - A E Maraolo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy.
| | - R Scotto
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - M Foggia
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - E Zappulo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - P Congera
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - S Parente
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
| | - I Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy
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Liu Y, Li Y, Wang Q, Fu J, Ji F. Sporadic human cutaneous anthrax outbreak in Shaanxi Province, China: report of two cases from 2018. Braz J Infect Dis 2020; 24:81-84. [PMID: 31926898 PMCID: PMC9392022 DOI: 10.1016/j.bjid.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/01/2019] [Accepted: 12/08/2019] [Indexed: 11/17/2022] Open
Abstract
China’s compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.
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Affiliation(s)
- Yuanyuan Liu
- The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Department of Infectious Diseases, Xi'an, China
| | - Yongqin Li
- The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Department of Infectious Diseases, Xi'an, China
| | - Qiaoxia Wang
- The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Department of Infectious Diseases, Xi'an, China
| | - Jianjun Fu
- The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Department of Infectious Diseases, Xi'an, China.
| | - Fanpu Ji
- The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Infectious Diseases, Xi'an, China; Xi'an Jiaotong University, The Second Affiliated Hospital, National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, Xi'an, China; Ministry of Education of China, Xi'an Jiaotong University, Key Laboratory of Environment and Genes Related to Diseases, Xi'an, China.
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