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Pakistan Journal of Medical Sciences Jul 2024Metallic copper alloys have gained attention recently as a cutting-edge antibacterial weapon for areas where surface hygiene is crucial. The present study aimed to...
OBJECTIVE
Metallic copper alloys have gained attention recently as a cutting-edge antibacterial weapon for areas where surface hygiene is crucial. The present study aimed to assess copper coupons (99% Cu) for their potential to decrease the viability of various strains from inanimate hospital surfaces.
METHODS
This in vitro-experimental study was conducted at the Microbiology Laboratory, Faculty of Natural and Life Sciences and Earth and Universe Sciences, University of Guelma, and Khodja Ahmed Public Hospital Establishment, Algeria, for a period of six months from January to May 2022. A total of 85 samples were collected from patient room door handles and bed rails at the government hospital in Guelma State, from which 12 enterobacterial isolates were obtained. These isolates were evaluated for susceptibility to copper and polyvinyl chloride (PVC) coupons using plate counts to determine bacterial viability after 72 hours of incubation at 37°C or room temperature (25°C). Antibiotic sensitivity testing was then carried out using a modified Kirby-Bauer disc diffusion method. Copper coupons' ability to either select for or create antibiotic resistance is also determined.
RESULTS
Copper showed a bactericidal effect after three hours for and six hours for . Whereas it was shown that within three days of selection, 83.33% of strains are capable of rapidly acquiring Cu resistance. Indeed, the increase in temperature reduced the effects of Cu (p<0.05; Student's t-test). Antimicrobial susceptibility testing revealed that the copper-resistant bacteria were less sensitive than their predecessors. strains showed the highest incidence of multidrug resistance. The most significant findings included widespread resistance to beta-lactams (100%-75%) and chloramphenicol (66.67%).
CONCLUSION
These results suggest that prolonged copper usage may contribute to the development of antibiotic resistance, which could have significant ramifications.
PubMed: 38952496
DOI: 10.12669/pjms.40.6.8435 -
Pakistan Journal of Medical Sciences Jul 2024Identification of MBL, AmpC and ESBLs in colistin intrinsic and acquired resistant uropathogenic gram negative bacteria.
OBJECTIVE
Identification of MBL, AmpC and ESBLs in colistin intrinsic and acquired resistant uropathogenic gram negative bacteria.
METHOD
Urine samples were collected from Hayatabad Medical Complex, Peshawar during 17 January to 30 June 2019. Collected urine samples were aseptically transported microbiology lab of Health Research Institution (HRI), National Institute of Health (NIH), Khyber Medical College, Peshawar and streaked on different media. Positive growth was identified by API-10s. Antibiotic sensitivity profile was done by Modified Kirby Bauer disc diffusion method. Detection of metallo βlactamases (MBL) production by Imipenem EDTA synergy test, Double Disc Synergy Test (DDST) for detection of ESBLs and D-test for the detection of inducible AmpC beta lactamases test was used. Colistin resistance was identified via broth micro dilution according to CLSI manual. Colistin resistant bacteria was divided in two categories; acquired and intrinsic resistant bacteria according to CLSI manual.
RESULTS
Out of 2000 urine samples, 281(14%) gram-negative bacteria were isolated. Among positive samples, acquired colistin resistant bacteria were 241 and intrinsic resistant bacteria were 40 isolates. MBL was produce by twenty one (11.7%) and seventeen (40.5 and were ESBLs producing bacteria. AmpC production was prevalent in fourteen (7.8%) and twelve (28.6. Fifty-five samples showed resistance to colistin out of 241 samples. In colistin resistant bacteria, two were MBL, ESBLs, while one was ESBLs, AmpC co-producing bacteria. The most prevalent extended drug resistant bacteria were 6.1%), While 155(86.6%) , 25 (59.5%) and 22 (95.7%) was multi drug resistant bacteria.
CONCLUSION
Current study concluded that ESBL, MBL AmpC enzymes and their co-expression was observed with colistin resistance in and .
PubMed: 38952491
DOI: 10.12669/pjms.40.6.8516 -
Drug Design, Development and Therapy 2024The WHO Global Status Report on Oral Health 2022 reveals that oral diseases caused by infection with oral pathogenic microorganisms affect nearly 3.5 billion people... (Review)
Review
The WHO Global Status Report on Oral Health 2022 reveals that oral diseases caused by infection with oral pathogenic microorganisms affect nearly 3.5 billion people worldwide. Oral health problems are caused by the presence of and in the oral cavity. Synthetic anti-infective drugs have been widely used to treat oral infections, but have been reported to cause side effects and resistance. Various strategies have been implemented to overcome this problem. Synthetic anti-infective drugs have been widely used to treat oral infections, but they have been reported to cause side effects and resistance. Therefore, it is important to look for safe anti-infective alternatives. Ethnobotanical and ethnopharmacological studies suggest that Red Betel leaf ( Ruiz & Pav) could be a potential source of oral anti-infectives. This review aims to discuss the pathogenesis mechanism of several microorganisms that play an important role in causing health problems, the mechanism of action of synthetic oral anti-infective drugs in inhibiting microbial growth in the oral cavity, and the potential of red betel leaf ( Ruiz & Pav) as an herbal oral anti-infective drug. This study emphasises the importance of researching natural components as an alternative treatment for oral infections that is more effective and can meet global needs.
Topics: Humans; Piper; Mouth Diseases; Anti-Infective Agents; Plant Extracts; Plant Leaves; Mouth
PubMed: 38952486
DOI: 10.2147/DDDT.S453375 -
Transplant International : Official... 2024Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected... (Review)
Review
Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources.
Topics: Humans; Organ Transplantation; Drug Resistance, Multiple, Bacterial; Transplant Recipients; Anti-Bacterial Agents; Prevalence; Gram-Negative Bacterial Infections; Developing Countries
PubMed: 38952482
DOI: 10.3389/ti.2024.12469 -
Frontiers in Microbiology 2024The unique dormancy of plays a significant role in the major clinical treatment challenge of tuberculosis, such as its long treatment cycle, antibiotic resistance,...
INTRODUCTION
The unique dormancy of plays a significant role in the major clinical treatment challenge of tuberculosis, such as its long treatment cycle, antibiotic resistance, immune escape, and high latent infection rate.
METHODS
To determine the function of MtrA, the only essential response regulator, one strategy was developed to establish its regulatory network according to high-quality genome-wide binding sites.
RESULTS AND DISCUSSION
The complex modulation mechanisms were implied by the strong bias distribution of MtrA binding sites in the noncoding regions, and 32.7% of the binding sites were located inside the target genes. The functions of 288 potential MtrA target genes predicted according to 294 confirmed binding sites were highly diverse, and DNA replication and damage repair, lipid metabolism, cell wall component biosynthesis, cell wall assembly, and cell division were the predominant pathways. Among the 53 pathways shared between dormancy/resuscitation and persistence, which accounted for 81.5% and 93.0% of the total number of pathways, respectively, MtrA regulatory genes were identified not only in 73.6% of their mutual pathways, but also in 75.4% of the pathways related to dormancy/resuscitation and persistence respectively. These results suggested the pivotal roles of MtrA in regulating dormancy/resuscitation and the apparent relationship between dormancy/resuscitation and persistence. Furthermore, the finding that 32.6% of the MtrA regulons were essential and/or for provided new insight into its indispensability. The findings mentioned above indicated that MtrA is a novel promising therapeutic target for tuberculosis treatment since the crucial function of MtrA may be a point of weakness for .
PubMed: 38952446
DOI: 10.3389/fmicb.2024.1415554 -
Journal of Korean Medical Science Jul 2024A 30-year-old Korean man with myelodysplastic syndrome admitted hospital due to undifferentiated fever and recurrent skin lesions. He received combination therapy with...
A 30-year-old Korean man with myelodysplastic syndrome admitted hospital due to undifferentiated fever and recurrent skin lesions. He received combination therapy with high doses of meropenem, tigecycline and amikacin, yielding carbapenem resistant (CRKP) harboring carbapenemase (KPC)-2 from blood cultures on hospital day (HD) 23. Ceftazidime/avibactam was started at HD 37 and CRKP was eradicated from blood cultures after 5 days. However, ceftazidime/avibactam-resistant CRKP carrying KPC-44 emerged after 26 days of ceftazidime/avibactam treatment and then ceftazidime/avibactam-resistant, carbapenem-susceptible carrying KPC-135 was isolated on HD 65. The 3-D homology of KPC protein showed that hot spot changes in the omega loop could be attributed to ceftazidime/avibactam resistance and loss of carbapenem resistance. Whole genome sequencing of serial isolates supported that phenotypic variation was due to clonal evolution than clonal replacement. The treatment regimen was changed from CAZ/AVI to meropenem-based therapy (meropenem 1 g iv q 8 hours and amikacin 600 mg iv per day) starting with HD 72. CAZ/AVI-susceptible CRKP was presented again from blood cultures on HD 84, and the patient expired on HD 85. This is the first Korean report on the acquisition of ceftazidime/avibactam resistance through the emergence of variants.
Topics: Humans; Ceftazidime; Klebsiella pneumoniae; Male; Azabicyclo Compounds; Drug Combinations; Adult; Anti-Bacterial Agents; beta-Lactamases; Klebsiella Infections; Bacteremia; Microbial Sensitivity Tests; Carbapenems; Whole Genome Sequencing; Bacterial Proteins; Meropenem; Drug Resistance, Multiple, Bacterial
PubMed: 38952349
DOI: 10.3346/jkms.2024.39.e208 -
Dalton Transactions (Cambridge, England... Jul 2024Antibiotic resistance is a significant global concern, necessitating the development of either new antibiotics or advanced delivery methods. With this in mind, we report...
Antibiotic resistance is a significant global concern, necessitating the development of either new antibiotics or advanced delivery methods. With this in mind, we report on the synthesis and characterisation of a new family of Metal-Organic Frameworks (MOFs), OnG6 MOFs, designed to act as multi-drug carriers for bacterial infection treatment. OnG6 is based on the pro-drug 4,4'-azodisalicylic acid (AZDH), which produces two equivalents of -aminosalicylic acid (ASA), a crucial drug for treatment. X-ray and computational studies revealed that OnG6 MOFs are mesoporous MOFs with topology and an [M(AZD)] formula (M = Zn, OnG6-Zn; Mg, OnG6-Mg; Cu, OnG6-Cu; and Co, OnG6-Co), featuring 1-dimensional channel type pores of 25 Å diameter. OnG6 MOFs are the first reported MOFs bearing the ligand AZDH, joining the family of mesoporous MOFs arranged in a honeycomb pattern. They absorb isoniazid (INH) and ciprofloxacin (CIPRO) with the former being a specific antibiotic for , and the latter being a broader-spectrum antibiotic. The stability of the MOFs and their capacity for antibiotic uptake depend on the nature of the metal ion, with OnG6-Mg demonstrating the highest drug absorption. The antimicrobial activity of these species was assessed against and , revealing that the carriers containing CIPRO displayed optimal efficacy.
PubMed: 38952206
DOI: 10.1039/d4dt01100g -
Clinical and Translational Science Jul 2024The AIDA randomized clinical trial found no significant difference in clinical failure or survival between colistin monotherapy and colistin-meropenem combination... (Randomized Controlled Trial)
Randomized Controlled Trial
The AIDA randomized clinical trial found no significant difference in clinical failure or survival between colistin monotherapy and colistin-meropenem combination therapy in carbapenem-resistant Gram-negative infections. The aim of this reverse translational study was to integrate all individual preclinical and clinical pharmacokinetic-pharmacodynamic (PKPD) data from the AIDA trial in a pharmacometric framework to explore whether individualized predictions of bacterial burden were associated with the trial outcomes. The compiled dataset included for each of the 207 patients was (i) information on the infecting Acinetobacter baumannii isolate (minimum inhibitory concentration, checkerboard assay data, and fitness in a murine model), (ii) colistin plasma concentrations and colistin and meropenem dosing history, and (iii) disease scores and demographics. The individual information was integrated into PKPD models, and the predicted change in bacterial count at 24 h for each patient, as well as patient characteristics, was correlated with clinical outcomes using logistic regression. The in vivo fitness was the most important factor for change in bacterial count. A model-predicted growth at 24 h of ≥2-log (164/207) correlated positively with clinical failure (adjusted odds ratio, aOR = 2.01). The aOR for one unit increase of other significant predictors were 1.24 for SOFA score, 1.19 for Charlson comorbidity index, and 1.01 for age. This study exemplifies how preclinical and clinical anti-infective PKPD data can be integrated through pharmacodynamic modeling and identify patient- and pathogen-specific factors related to clinical outcomes - an approach that may improve understanding of study outcomes.
Topics: Humans; Acinetobacter baumannii; Meropenem; Middle Aged; Microbial Sensitivity Tests; Female; Male; Anti-Bacterial Agents; Colistin; Adult; Aged; Animals; Treatment Outcome; Mice; Acinetobacter Infections; Translational Research, Biomedical; Drug Therapy, Combination; Models, Biological
PubMed: 38952168
DOI: 10.1111/cts.13870 -
BMC Medical Genomics Jul 2024This study investigates the distribution and characteristics of linezolid and vancomycin susceptibilities among Enterococcus faecalis (E. faecalis) and Enterococcus...
BACKGROUND
This study investigates the distribution and characteristics of linezolid and vancomycin susceptibilities among Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) and explores the underlying resistance mechanisms.
METHODS
A total of 2842 Enterococcus clinical isolates from patients were retrospectively collected, and their clinical data were further analyzed. The minimum inhibitory concentrations (MICs) of vancomycin and linezolid were validated by broth dilution method. The resistance genes optrA, cfr, vanA, vanB and vanM were investigated using polymerase chain reaction (PCR). Housekeeping genes and resistance genes were obtianed through whole-genome sequencing (WGS).
RESULTS
Of the 2842 Enterococcus isolates, 88.5% (2516) originated from urine, with E. faecium accounted for 60.1% of these. The vanA gene was identified in 27/28 vancomycin resistant Enterococcus (VRE) isolates, 4 of which carried both vanA and vanM genes. The remaining strain was vanM positive. The optrA gene was identified in all E. faecalis isolates among linezolid resistant Enterococcus (LRE). E. faecium showed a higher multiple antibiotic resistance index (MAR index) compared to E. faecalis. The multi-locus sequence typing (MLST) showed the sequence type of E. faecium mainly belongs to clonal complex (CC) 17, nearly E. faecalis isolates analyzed were differentiated into 7 characteristics of sequence types (STs), among which ST16 of CC16 were the major lineage.
CONCLUSION
Urine was the primary source of VRE and LRE isolates in this study. E. faecium showed higher levels of resistance compared to E. faecalis. OptrA gene was detected in 91.6% of LRE, which could explain linezolid resistance, and van genes were detected in all vancomycin resistant Enterococcus strains, while vanA was a key resistance mechanism in VRE identified in this study.
Topics: Linezolid; Humans; China; Microbial Sensitivity Tests; Enterococcus faecium; Gram-Positive Bacterial Infections; Male; Middle Aged; Enterococcus faecalis; Female; Vancomycin; Anti-Bacterial Agents; Molecular Epidemiology; Adult; Vancomycin Resistance; Aged; Retrospective Studies; Vancomycin-Resistant Enterococci; Young Adult; Enterococcus
PubMed: 38951840
DOI: 10.1186/s12920-024-01948-x -
BMC Primary Care Jul 2024Urinary tract infections (UTI) affect almost two-thirds of all women during their lives and many experience recurrent infections. There are evidence-based guidelines...
BACKGROUND
Urinary tract infections (UTI) affect almost two-thirds of all women during their lives and many experience recurrent infections. There are evidence-based guidelines from multiple international societies for evaluation and treatment; however, recent claims-based analyses have demonstrated that adherence to these guidelines is poor. This study seeks to understand the barriers experienced by U.S. primary care providers (PCPs) to providing guideline-based care for UTI and recurrent UTI (rUTI).
METHODS
Semi-structured interviews of 18 PCPs, recruited from the greater Los Angeles area, examined real-world clinical management of UTI/rUTI episodes, decisions to refer to subspecialty care, and resources guiding counseling and management. Grounded theory methodology served to analyze interview transcripts and identify preliminary and major themes.
RESULTS
Participants expressed the desire to obtain urine cultures for each cystitis episode, but felt pressured to make compromises by patient demands or barriers to care. PCPs had lower thresholds to empirical treatment if patients had a history of rUTIs, were elderly, or declined evaluation. Laboratory data was minimally utilized in clinical decision-making: urinalyses were infrequently considered when interpreting culture data. PCPs treated a broad set of urologic and non-urologic symptoms as UTI, even with negative cultures. PCPs did not feel comfortable initiating UTI prophylaxis, instead seeking specialist evaluation for anatomic causes. They were unaware of management guidelines, typically utilizing UpToDate® as their primary resource. Few evidence-based UTI prevention interventions were recommended by providers.
CONCLUSIONS
Low availability of succinct and clear professional guidelines are substantial barriers to appropriate UTI/rUTI care. Poor useability of clinical guidance documents results in substantial confusion about the role of preventative measures and additional diagnostic testing. Difficulties in patient access to care providers lead to expectations for presumptive treatment. Future studies are needed to determine if improved educational materials for providers and/or management algorithms can improve guideline concordance of UTI management.
Topics: Humans; Urinary Tract Infections; Physicians, Primary Care; Qualitative Research; Female; Guideline Adherence; Male; Practice Guidelines as Topic; Attitude of Health Personnel; Recurrence; Middle Aged; Adult; United States; Practice Patterns, Physicians'; Interviews as Topic; Referral and Consultation
PubMed: 38951826
DOI: 10.1186/s12875-024-02477-3