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British Medical Journal Jul 1968
Topics: Bacitracin; Humans; Polymyxins; Pseudomonas aeruginosa; Wound Infection
PubMed: 4298662
DOI: No ID Found -
Clinical Microbiology Reviews Jan 2001Giardia lamblia is both the most common intestinal parasite in the United States and a frequent cause of diarrheal illness throughout the world. In spite of its... (Review)
Review
Giardia lamblia is both the most common intestinal parasite in the United States and a frequent cause of diarrheal illness throughout the world. In spite of its recognition as an important human pathogen, there have been relatively few agents used in therapy. This paper discusses each class of drugs used in treatment, along with their mechanism of action, in vitro and clinical efficacy, and side effects and contraindications. Recommendations are made for the preferred treatment in different clinical situations. The greatest clinical experience is with the nitroimidazole drugs, i.e., metronidazole, tinidazole, and ornidazole, which are highly effective. A 5- to 7-day course of metronidazole can be expected to cure over 90% of individuals, and a single dose of tinidazole or ornidazole will cure a similar number. Quinacrine, which is no longer produced in the United States, has excellent efficacy but may be poorly tolerated, especially in children. Furazolidone is an effective alternative but must be administered four times a day for 7 to 10 days. Paromomycin may be used during early pregnancy, because it is not systematically absorbed, but it is not always effective. Patients who have resistant infection can usually be cured by a prolonged course of treatment with a combination of a nitroimidazole with quinacrine.
Topics: Animals; Antiprotozoal Agents; Bacitracin; Benzimidazoles; Feces; Female; Furazolidone; Giardia; Giardiasis; Humans; Lactation; Male; Microscopy, Electron, Scanning; Nitroimidazoles; Paromomycin; Pregnancy; Pregnancy Complications, Parasitic; Quinacrine; Time Factors; Treatment Outcome
PubMed: 11148005
DOI: 10.1128/CMR.14.1.114-128.2001 -
The Breast Journal 2022Triple-antibiotic irrigation of breast implant pockets is a mainstay of infection prophylaxis in breast reconstruction and augmentation. The recall of bacitracin for...
BACKGROUND
Triple-antibiotic irrigation of breast implant pockets is a mainstay of infection prophylaxis in breast reconstruction and augmentation. The recall of bacitracin for injection due to risk of anaphylaxis and nephrotoxicity in January 2020, a staple component of the irrigation solution, has raised concern for worsened postoperative sequelae. This study aimed to investigate pre- and post-recall implant-based breast surgery to analyze the impact of bacitracin in irrigation solutions on infection rates.
METHODS
All implant-based breast reconstruction or augmentation surgeries from January 2019 to February 2021 were retrospectively reviewed. In a regression discontinuity study design, patients were divided into pre- and post-recall groups. Patient demographics, surgical details, and outcomes including infection rates were collected. Differences in complication rates were compared between groups and with surgical and patient factors.
RESULTS
254 implants in 143 patients met inclusion criteria for this study, with 172 implants placed before recall and 82 placed after recall. Patients in each cohort did not differ in age, BMI, smoking status, or history of breast radiation or capsular contracture ( > 0.05). All breast pockets were irrigated with antibiotic solution, most commonly bacitracin, cefazolin, gentamycin, and povidone-iodine before recall (116,67.4%) and cefazolin, gentamycin, and povidone-iodine after recall (59,72.0%). There was no difference in incidence of infection (6.4% vs. 8.5%, =0.551) or cellulitis (3.5% vs. 3.7%, =0.959) before and after recall. Implant infection was associated with smoking history ( < 0.001) and increased surgical time (=0.003).
CONCLUSIONS
Despite the recent recall of bacitracin from inclusion in breast pocket irrigation solutions, our study demonstrated no detrimental impact on immediate complication rates. This shift in irrigation protocols calls for additional investigations into optimizing antibiotic combinations in solution, as bacitracin is no longer a viable option, to improve surgical outcomes and long-term benefits.
Topics: Anti-Bacterial Agents; Bacitracin; Breast Implants; Breast Neoplasms; Cefazolin; Female; Gentamicins; Humans; Povidone-Iodine; Retrospective Studies; Treatment Outcome
PubMed: 36105366
DOI: 10.1155/2022/1389539 -
The Cochrane Database of Systematic... Mar 2017Clostridium difficile (C. difficile) is recognized as a frequent cause of antibiotic-associated diarrhoea and colitis. This review is an update of a previously published... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Clostridium difficile (C. difficile) is recognized as a frequent cause of antibiotic-associated diarrhoea and colitis. This review is an update of a previously published Cochrane review.
OBJECTIVES
The aim of this review is to investigate the efficacy and safety of antibiotic therapy for C. difficile-associated diarrhoea (CDAD), or C. difficile infection (CDI), being synonymous terms.
SEARCH METHODS
We searched MEDLINE, EMBASE, CENTRAL and the Cochrane IBD Group Specialized Trials Register from inception to 26 January 2017. We also searched clinicaltrials.gov and clinicaltrialsregister.eu for ongoing trials.
SELECTION CRITERIA
Only randomised controlled trials assessing antibiotic treatment for CDI were included in the review.
DATA COLLECTION AND ANALYSIS
Three authors independently assessed abstracts and full text articles for inclusion and extracted data. The risk of bias was independently rated by two authors. For dichotomous outcomes, we calculated the risk ratio (RR) and corresponding 95% confidence interval (95% CI). We pooled data using a fixed-effect model, except where significant heterogeneity was detected, at which time a random-effects model was used. The following outcomes were sought: sustained symptomatic cure (defined as initial symptomatic response and no recurrence of CDI), sustained bacteriologic cure, adverse reactions to the intervention, death and cost.
MAIN RESULTS
Twenty-two studies (3215 participants) were included. The majority of studies enrolled patients with mild to moderate CDI who could tolerate oral antibiotics. Sixteen of the included studies excluded patients with severe CDI and few patients with severe CDI were included in the other six studies. Twelve different antibiotics were investigated: vancomycin, metronidazole, fusidic acid, nitazoxanide, teicoplanin, rifampin, rifaximin, bacitracin, cadazolid, LFF517, surotomycin and fidaxomicin. Most of the studies were active comparator studies comparing vancomycin with other antibiotics. One small study compared vancomycin to placebo. There were no other studies that compared antibiotic treatment to a placebo or a 'no treatment' control group. The risk of bias was rated as high for 17 of 22 included studies. Vancomycin was found to be more effective than metronidazole for achieving symptomatic cure. Seventy-two per cent (318/444) of metronidazole patients achieved symptomatic cure compared to 79% (339/428) of vancomycin patients (RR 0.90, 95% CI 0.84 to 0.97; moderate quality evidence). Fidaxomicin was found to be more effective than vancomycin for achieving symptomatic cure. Seventy-one per cent (407/572) of fidaxomicin patients achieved symptomatic cure compared to 61% (361/592) of vancomycin patients (RR 1.17, 95% CI 1.04 to 1.31; moderate quality evidence). Teicoplanin may be more effective than vancomycin for achieving a symptomatic cure. Eightly-seven per cent (48/55) of teicoplanin patients achieved symptomatic cure compared to 73% (40/55) of vancomycin patients (RR 1.21, 95% CI 1.00 to 1.46; very low quality evidence). For other comparisons including the one placebo-controlled study the quality of evidence was low or very low due to imprecision and in many cases high risk of bias because of attrition and lack of blinding. One hundred and forty deaths were reported in the studies, all of which were attributed by study authors to the co-morbidities of the participants that lead to acquiring CDI. Although many other adverse events were reported during therapy, these were attributed to the participants' co-morbidities. The only adverse events directly attributed to study medication were rare nausea and transient elevation of liver enzymes. Recent cost data (July 2016) for a 10 day course of treatment shows that metronidazole 500 mg is the least expensive antibiotic with a cost of USD 13 (Health Warehouse). Vancomycin 125 mg costs USD 1779 (Walgreens for 56 tablets) compared to fidaxomicin 200 mg at USD 3453.83 or more (Optimer Pharmaceuticals) and teicoplanin at approximately USD 83.67 (GBP 71.40, British National Formulary).
AUTHORS' CONCLUSIONS
No firm conclusions can be drawn regarding the efficacy of antibiotic treatment in severe CDI as most studies excluded patients with severe disease. The lack of any 'no treatment' control studies does not allow for any conclusions regarding the need for antibiotic treatment in patients with mild CDI beyond withdrawal of the initiating antibiotic. Nonetheless, moderate quality evidence suggests that vancomycin is superior to metronidazole and fidaxomicin is superior to vancomycin. The differences in effectiveness between these antibiotics were not too large and the advantage of metronidazole is its far lower cost compared to the other two antibiotics. The quality of evidence for teicoplanin is very low. Adequately powered studies are needed to determine if teicoplanin performs as well as the other antibiotics. A trial comparing the two cheapest antibiotics, metronidazole and teicoplanin, would be of interest.
Topics: Adult; Aminoglycosides; Anti-Bacterial Agents; Bacitracin; Clostridioides difficile; Diarrhea; Enterocolitis, Pseudomembranous; Fidaxomicin; Humans; Metronidazole; Randomized Controlled Trials as Topic; Teicoplanin; Treatment Outcome; Vancomycin
PubMed: 28257555
DOI: 10.1002/14651858.CD004610.pub5 -
BioMed Research International 2018Antibiotic growth promoters have been used for decades in poultry farming as a tool to maintain bird health and improve growth performance. Global concern about the...
Antibiotic growth promoters have been used for decades in poultry farming as a tool to maintain bird health and improve growth performance. Global concern about the recurrent emergence and spreading of antimicrobial resistance is challenging the livestock producers to search for alternatives to feed added antibiotics. The use of phytogenic compounds appears as a feasible option due to their ability to emulate the bioactive properties of antibiotics. However, detailed description about the effects of in-feed antibiotics and alternative natural products on chicken intestinal microbiota is lacking. High-throughput sequencing of 16S rRNA gene was used to study composition of cecal microbiota in broiler chickens supplemented with either bacitracin or a blend of chestnut and quebracho tannins over a 30-day grow-out period. Both tannins and bacitracin had a significant impact on diversity of cecal microbiota. Bacitracin consistently decreased while other bacterial groups were affected only at certain times. Tannins-fed chickens showed a drastic decrease in genus while certain members of order Clostridiales mainly belonging to the families Ruminococcaceae and Lachnospiraceae were increased. Different members of these groups have been associated with an improvement of intestinal health and feed efficiency in poultry, suggesting that these bacteria could be associated with productive performance of birds.
Topics: Animal Feed; Animals; Anti-Bacterial Agents; Bacitracin; Bacteroides; Bifidobacterium; Chickens; Clostridiales; Gastrointestinal Microbiome; Intestines; Microbiota; RNA, Ribosomal, 16S; Tannins
PubMed: 29682522
DOI: 10.1155/2018/1879168 -
Antimicrobial Agents and Chemotherapy Dec 2002Streptococcus mutans is resistant to bacitracin, which is a peptide antibiotic produced by certain species of Bacillus. The purpose of this study was to clarify the... (Review)
Review
Streptococcus mutans is resistant to bacitracin, which is a peptide antibiotic produced by certain species of Bacillus. The purpose of this study was to clarify the bacitracin resistance mechanism of S. mutans. We cloned and sequenced two S. mutans loci that are involved in bacitracin resistance. The rgp locus, which is located downstream from rmlD, contains six rgp genes (rgpA to rgpF) that are involved in rhamnose-glucose polysaccharide (RGP) synthesis in S. mutans. The inactivation of RGP synthesis in S. mutans resulted in an approximately fivefold-higher sensitivity to bacitracin relative to that observed for the wild-type strain Xc. The second bacitracin resistance locus comprised four mbr genes (mbrA, mbrB, mbrC, and mbrD) and was located immediately downstream from gtfC, which encodes the water-insoluble glucan-synthesizing enzyme. Although the bacitracin sensitivities of mutants that had defects in flanking genes were similar to that of the parental strain Xc, mutants that were defective in mbrA, mbrB, mbrC, or mbrD were about 100 to 120 times more sensitive to bacitracin than strain Xc. In addition, a mutant that was defective in all of the mbrABCD genes and rgpA was more sensitive to bacitracin than either the RGP or Mbr mutants. We conclude that RGP synthesis is related to bacitracin resistance in S. mutans and that the mbr genes modulate resistance to bacitracin via an unknown mechanism that is independent of RGP synthesis.
Topics: Anti-Bacterial Agents; Bacitracin; Drug Resistance, Bacterial; Genomic Library; Microbial Sensitivity Tests; Plasmids; Streptococcus mutans
PubMed: 12435673
DOI: 10.1128/AAC.46.12.3756-3764.2002 -
Molecular Microbiology May 2008The extracellular presence of antibiotics is a common threat in microbial life. Their sensitive detection and subsequent induction of appropriate resistance mechanisms...
The extracellular presence of antibiotics is a common threat in microbial life. Their sensitive detection and subsequent induction of appropriate resistance mechanisms is therefore a prerequisite for survival. The bacitracin stress response network of Bacillus subtilis consists of four signal-transducing systems, the two-component systems (TCS) BceRS, YvcPQ and LiaRS, and the extracytoplasmic function (ECF) sigma factor sigma(M). Here, we investigated the mechanism of bacitracin perception and the response hierarchy within this network. The BceRS-BceAB TCS/ABC transporter module is the most sensitive and efficient bacitracin resistance determinant. The ABC transporter BceAB not only acts as a bacitracin detoxification pump, but is also crucial for bacitracin sensing, indicative of a novel mechanism of stimulus perception, conserved in Firmicutes bacteria. The Bce system seems to respond to bacitracin directly (drug sensing), whereas the LiaRS TCS and sigma(M) respond only at higher concentrations and indirectly to bacitracin action (damage sensing). The YvcPQ-YvcRS system is subject to cross-activation via the paralogous Bce system, and is therefore only indirectly induced by bacitracin. The bacitracin stress response network is optimized to respond to antibiotic gradients in a way that maximizes the gain and minimizes the costs of this stress response.
Topics: ATP-Binding Cassette Transporters; Adenosine Triphosphate; Anti-Bacterial Agents; Bacillus subtilis; Bacitracin; Bacterial Proteins; Biological Transport; Drug Resistance, Bacterial; Gene Expression Regulation, Bacterial; Genes, Reporter; Genetic Complementation Test; Hydrolysis; Promoter Regions, Genetic; Protein Structure, Tertiary; Sequence Deletion; Signal Transduction
PubMed: 18394148
DOI: 10.1111/j.1365-2958.2008.06194.x -
MSphere Sep 2018Extensive use of colistin in food animals is deemed a major driving force for the emergence and transmission of However, a non-colistin usage factor(s) contributing to...
Extensive use of colistin in food animals is deemed a major driving force for the emergence and transmission of However, a non-colistin usage factor(s) contributing to mobile colistin resistance may also exist in animal production systems. Given that polymyxin, a bacterium-derived peptide antibiotic, has been successfully used as a surrogate to study bacterial resistance to antimicrobial peptides (AMPs), acquisition of MCR-1 may confer cross-resistance to the unrelated AMPs implicated in practical applications. To test this, we first constructed recombinant strains differing only in the presence or absence of functional MCR-1. Among diverse tested AMPs, MCR-1 was observed to confer cross-resistance to bacitracin, an in-feed antibiotic widely used in animal industry. The significantly (2-fold) increased bacitracin MIC was confirmed by using different bacitracin products, broth media, and laboratory host strains for susceptibility tests. Subsequently, an original gene-bearing plasmid, pSLy21, was conjugatively transferred to eight clinical recipient strains isolated from diarrheic pigs, which also led to significantly increased MICs of both colistin (4-fold to 8-fold) and bacitracin (2-fold). Growth curve examination further demonstrated that MCR-1 provides a growth advantage to various strains in the presence of bacitracin. Given that bacitracin, a feed additive displaying low absorption in the intestine, can be used in food animals with no withdrawal required, imprudent use of bacitracin in food animals may serve as a risk factor to enhance the ecological fitness of MCR-1-positive strains, consequently facilitating the persistence and transmission of plasmid-mediated colistin resistance in agricultural ecosystem. Polymyxins (e.g., colistin) are the drugs of last resort to treat multidrug-resistant infections in humans. To control mobile colistin resistance, there is a worldwide trend to limit colistin use in animal production. However, simply limiting colistin use in animal production may still not effectively mitigate colistin resistance due to an overlooked non-colistin usage factor(s). Using controlled systems, in this study, we observed that MCR-1 confers cross-resistance to bacitracin, a popular in-feed antibiotic used in food animals. Thus, imprudent and extensive usage of bacitracin in food animals may serve as a non-colistin usage risk factor for the transmissible colistin resistance. Further comprehensive and studies are highly warranted to generate science-based information for risk assessment and risk management of colistin resistance, consequently facilitating the development of proactive and effective strategies to mitigate colistin resistance in animal production system and protect public health.
Topics: Animal Feed; Animals; Anti-Bacterial Agents; Bacitracin; Colistin; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Proteins; Microbial Sensitivity Tests; Plasmids
PubMed: 30185515
DOI: 10.1128/mSphere.00411-18 -
Applied and Environmental Microbiology Jun 2020The gastrointestinal (GI) tract harbors a diverse population of microorganisms. While much work has been focused on the characterization of the bacterial community, very...
The gastrointestinal (GI) tract harbors a diverse population of microorganisms. While much work has been focused on the characterization of the bacterial community, very little is known about the fungal community, or mycobiota, in different animal species and chickens in particular. Here, we characterized the biogeography of the mycobiota along the GI tract of day 28 broiler chicks and further examined its possible shift in response to bacitracin methylene disalicylate (BMD), a commonly used in-feed antibiotic, through Illumina sequencing of the internal transcribed spacer 2 (ITS2) region of fungal rRNA genes. Out of 124 samples sequenced, we identified a total of 468 unique fungal features that belong to four phyla and 125 genera in the GI tract. Ascomycota and Basidiomycota represented 90% to 99% of the intestinal mycobiota, with three genera, i.e., and , accounting for over 80% of the total fungal population in most GI segments. Furthermore, these fungal genera were dominated by ( is the anamorph form of ), , and two species. We also revealed that the mycobiota are more diverse in the upper than lower GI tract. The cecal mycobiota transitioned from being dominant on day 14 to dominant on day 28. Furthermore, 2-week feeding of 55 mg/kg BMD tended to reduce the cecal mycobiota α-diversity. Taken together, we provided a comprehensive biogeographic view and succession pattern of the chicken intestinal mycobiota and its influence by BMD. A better understanding of intestinal mycobiota may lead to the development of novel strategies to improve animal health and productivity. The intestinal microbiota is critical to host physiology, metabolism, and health. However, the fungal community has been often overlooked. Recent studies in humans have highlighted the importance of the mycobiota in obesity and disease, making it imperative that we increase our understanding of the fungal community. The significance of this study is that we revealed the spatial and temporal changes of the mycobiota in the GI tract of the chicken, a nonmammalian species. To our surprise, the chicken intestinal mycobiota is dominated by a limited number of fungal species, in contrast to the presence of hundreds of bacterial taxa in the bacteriome. Additionally, the chicken intestinal fungal community is more diverse in the upper than the lower GI tract, while the bacterial community shows an opposite pattern. Collectively, this study lays an important foundation for future work on the chicken intestinal mycobiome and its possible manipulation to enhance animal performance and disease resistance.
Topics: Animals; Antifungal Agents; Bacitracin; Chickens; Fungi; Gastrointestinal Microbiome; Intestines; Male; Mycobiome; Salicylates
PubMed: 32358003
DOI: 10.1128/AEM.00304-20 -
Poultry Science Jul 2021Spray-dried plasma (SDP) contains immunoglobulins and glycoproteins that possess antibacterial properties. Two floor-pen trials were conducted to determine the efficacy...
Spray-dried plasma (SDP) contains immunoglobulins and glycoproteins that possess antibacterial properties. Two floor-pen trials were conducted to determine the efficacy of dietary SDP and bacitracin methylene disalicylate (BMD) antibiotic in reducing intestinal colonization by Salmonella Enteritidis (SE) in broiler chickens. Experiment 1 was a 2-wk, 3 × 2 factorial design consisting of 6 treatments. Treatment CON consisted of chicks fed unmedicated corn-soybean meal (SBM) basal without SDP. Treatment BMD consisted of chicks given unmedicated corn-SBM basal into which BMD was added at 0.055g/kg diet. Treatment SDP consisted of chicks given unmedicated corn-SBM basal into which SDP was added at 30g/kg diet. Treatments CON-SE, BMD-SE, and SDP-SE consisted of chicks that were given diets similar to CON, BMD, and SDP, respectively, and were each inoculated with 7.46 × 10 CFU SE /mL at 1 day of age. Experiment 2 was a 42-day trial that was similar to Experiment 1 in design, except that chicks were placed on fresh clean litter. On d 3, 7, 14, and 28 post-challenge (PC), ceca SE concentration was enumerated on xylose lysine tergitol-4 (XLT4) agar. Body weight gain (BWG) and feed conversion ratio (FCR) were also recorded. Results for d 3 showed that BMD- and SDP-fed chicks had similar (P > 0.05) cecal SE (3.39 log CFU / g and 3.58 log CFU / g, respectively), but these levels were lower (P < 0.05) than that of CON-fed chicks (5.68 log CFU / g). A similar trend was observed on d 7 and 14 PC. The BMD- and SDP-fed chicks also had higher BWG and FCR (P < 0.05) when compared with CON-fed chicks up to d 14. Thereafter, only BMD treatment sustained this growth-promoting effect till d 42 in SE-challenged birds. In conclusion, BMD and SDP showed similar efficacy in reducing cecal Salmonella and in mitigating consequent growth-depressing effect(s) in broiler chicks up to 2 wk of age.
Topics: Animal Feed; Animals; Bacitracin; Cecum; Chickens; Diet; Salmonella enteritidis
PubMed: 34089939
DOI: 10.1016/j.psj.2021.101134