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Abumansour H, Abusara OH, Khalil W, Abul-Futouh H, Ibrahim AIM, Harb MK, Abulebdah DH, Ismail WH. Biological evaluation of levofloxacin and its thionated derivatives: antioxidant activity, aldehyde dehydrogenase enzyme inhibition, and cytotoxicity on A549 cell line. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03075-x. [PMID: 38613572 DOI: 10.1007/s00210-024-03075-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
Levofloxacin (LVX) is among the fluoroquinolones antibiotics that has also been studied in vitro and in vivo for its anticancer effects. In this study, we used LVX and novel LVX thionated derivatives; compounds 2 and 3, to evaluate their antioxidant activity, aldehyde dehydrogenase (ALDH) enzymes activity inhibition, and anticancer activity. Combination treatments with doxorubicin (DOX) were investigated as well. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was used to determine the antioxidant activity. The NADH fluorescence spectrophotometric activity assay was used to determine the ALDH inhibitory effects. Resazurin dye method was applied for cell viability assays. Molecular Operating Environment software was used for the molecular docking experiments. Compared to ascorbic acid, DPPH assay showed that compound 3 had the highest antioxidant activity among the tested compounds with approximately 35% scavenging activity. On ALDH enzymes, compound 3 showed a significant ALDH activity inhibition compared to compound 2 at 200 µM. The IC50 values for the tested compounds were approximately 100 µM on A549 cell line, a non-small cell lung cancer (NSCLC) cell line. However, significant enhancement of cytotoxicity and reduction of IC50 values were observed by combining DOX and synergism was achieved with LVX with a combination index value of 0.4. The molecular docking test showed a minimum binding energy with a good affinity for compound 3 towards ALDH enzymes. Thionated LVX derivatives, may be repurposed for NSCLC therapy in combination with DOX, taking into account the antioxidant activity, ALDH activity inhibition, and the molecular docking results of compound 3.
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Affiliation(s)
- Hamza Abumansour
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan.
| | - Osama H Abusara
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Wiam Khalil
- Department of Pharmacology, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Hassan Abul-Futouh
- Department of Chemistry, Faculty of Science, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Ali I M Ibrahim
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Mohammad K Harb
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Dina H Abulebdah
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Worood H Ismail
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
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2
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Liu J, Zhao SY, Hu JY, Chen QX, Jiao SM, Xiao HC, Zhang Q, Xu J, Zhao JF, Zhou HB, Zheng JX, Sun PH. Novel Coumarin Derivatives Inhibit the Quorum Sensing System and Iron Homeostasis as Antibacterial Synergists against Pseudomonas aeruginosa. J Med Chem 2023; 66:14735-14754. [PMID: 37874867 DOI: 10.1021/acs.jmedchem.3c01268] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is well-known to cause biofilm-associated drug resistance and infections that often lead to treatment failure. Herein, we reported a dual-acting antibiofilm strategy by inhibiting both the bacterial quorum sensing system and the iron uptake system. A series of coumarin derivatives were synthesized and evaluated, and compound 4t was identified as the most effective biofilm inhibitor (IC50 = 3.6 μM). Further mechanistic studies have confirmed that 4t not only inhibits the QS systems but also competes strongly with pyoverdine as an iron chelator, causing an iron deficiency in P. aeruginosa. Additionally, 4t significantly improved the synergistic antibacterial effects of ciprofloxacin and tobramycin by more than 200-1000-fold compared to the single-dose antibiotic treatments. Therefore, our study has shown that 4t is a potentially novel antibacterial synergist candidate to treat bacterial infections.
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Affiliation(s)
- Jun Liu
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510632, P. R. China
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Si-Yu Zhao
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Jia-Yi Hu
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Qiu-Xian Chen
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Shu-Meng Jiao
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Hai-Chuan Xiao
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Qiang Zhang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Jun Xu
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Jian-Fu Zhao
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Hai-Bo Zhou
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
| | - Jun-Xia Zheng
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, Guangdong 510006, P. R. China
| | - Ping-Hua Sun
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510632, P. R. China
- College of Pharmacy, Shihezi University, Shihezi, Xinjiang 832099, P. R. China
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510632, P. R. China
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3
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Efficacy of empiric macrolides versus fluoroquinolones in community-acquired pneumonia associated with atypical bacteria: A meta-analysis. Respir Med Res 2022; 82:100931. [DOI: 10.1016/j.resmer.2022.100931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/11/2022] [Accepted: 06/04/2022] [Indexed: 11/22/2022]
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Design and Synthesis of Thionated Levofloxacin: Insights into a New Generation of Quinolones with Potential Therapeutic and Analytical Applications. Curr Issues Mol Biol 2022; 44:4626-4638. [PMID: 36286031 PMCID: PMC9600924 DOI: 10.3390/cimb44100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2022] Open
Abstract
Levofloxacin is a widely used fluoroquinolone in several infectious diseases. The structure–activity relationship of levofloxacin has been studied. However, the effect of changing the carbonyl into thiocarbonyl of levofloxacin has not been investigated up to the date of this report. In this work, levofloxacin structure was slightly modified by making a thionated form (compound 3), which was investigated for its antibacterial activity, biocompatibility, and cytotoxicity, as well as spectroscopic properties. The antibacterial susceptibility testing against five different bacteria showed promising minimum inhibitory concentrations (MICs), particularly against B. spizizenii and E. coli, with an MIC value of 1.9 µM against both bacteria, and 7.8 µM against P. mirabilis. The molecular docking experiment showed similar binding interactions of both levofloxacin and compound 3 with the active site residues of topoisomerase IV. The biocompatibility and cytotoxicity results revealed that compound 3 was more biocompatible with normal cells and more cytotoxic against cancer cells, compared to levofloxacin. Interestingly, compound 3 also showed an excitation profile with a distinctive absorption peak at λmax 404 nm. Overall, our results suggest that the thionation of quinolones may provide a successful approach toward a new generation with enhanced pharmacokinetic and safety profiles and overall activity as potential antibacterial agents.
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Singla A, Simbassa SB, Chirra B, Gairola A, Southerland MR, Shah KN, Rose RE, Chen Q, Basharat A, Baeza J, Raina R, Chapman MJ, Hassan AM, Ivanov I, Sen A, Wu HJ, Cannon CL. Hetero-Multivalent Targeted Liposomal Drug Delivery to Treat Pseudomonas aeruginosa Infections. ACS APPLIED MATERIALS & INTERFACES 2022; 14:40724-40737. [PMID: 36018830 PMCID: PMC9480101 DOI: 10.1021/acsami.2c12943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Pseudomonas aeruginosa is the leading nosocomial and community-acquired pathogen causing a plethora of acute and chronic infections. The Centers for Disease Control and Prevention has designated multidrug-resistant isolates of P. aeruginosa as a serious threat. A novel delivery vehicle capable of specifically targeting P. aeruginosa, and encapsulating antimicrobials, may address the challenges associated with these infections. We have developed hetero-multivalent targeted liposomes functionalized with host cell glycans to increase the delivery of antibiotics to the site of infection. Previously, we have demonstrated that compared with monovalent liposomes, these hetero-multivalent liposomes bind with higher affinity to P. aeruginosa. Here, compared with nontargeted liposomes, we have shown that greater numbers of targeted liposomes are found in the circulation, as well as at the site of P. aeruginosa (PAO1) infection in the thighs of CD-1 mice. No significant difference was found in the uptake of targeted, nontargeted, and PEGylated liposomes by J774.A1 macrophages. Ciprofloxacin-loaded liposomes were formulated and characterized for size, encapsulation, loading, and drug release. In vitro antimicrobial efficacy was assessed using CLSI broth microdilution assays and time-kill kinetics. Lastly, PAO1-inoculated mice treated with ciprofloxacin-loaded, hetero-multivalent targeted liposomes survived longer than mice treated with ciprofloxacin-loaded, monovalent targeted, or nontargeted liposomes and free ciprofloxacin. Thus, liposomes functionalized with host cell glycans target P. aeruginosa resulting in increased retention of the liposomes in the circulation, accumulation at the site of infection, and increased survival time in a mouse surgical site infection model. Consequently, this formulation strategy may improve outcomes in patients infected with P. aeruginosa.
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Affiliation(s)
- Akshi Singla
- Department
of Chemical Engineering, Texas A&M University, College Station, Texas 77843, United States
| | - Sabona B. Simbassa
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Bhagath Chirra
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Anirudh Gairola
- Department
of Chemical Engineering, Texas A&M University, College Station, Texas 77843, United States
| | - Marie R. Southerland
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Kush N. Shah
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Robert E. Rose
- Comparative
Medicine Program, Texas A&M University, College Station, Texas 77843, United States
| | - Qingquan Chen
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Ahmed Basharat
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Jaime Baeza
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Rohit Raina
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Morgan J. Chapman
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Adel M. Hassan
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
| | - Ivan Ivanov
- Department
of Veterinary Physiology and Pharmacology, Texas A&M University, College
Station, Texas 77843, United States
| | - Anindito Sen
- Microscopy
and Imaging Center, Texas A&M University, College Station, Texas 77843, United States
| | - Hung-Jen Wu
- Department
of Chemical Engineering, Texas A&M University, College Station, Texas 77843, United States
| | - Carolyn L. Cannon
- Department
of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan Texas 77807, United States
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Alhajj N, O'Reilly NJ, Cathcart H. Developing ciprofloxacin dry powder for inhalation: A story of challenges and rational design in the treatment of cystic fibrosis lung infection. Int J Pharm 2021; 613:121388. [PMID: 34923051 DOI: 10.1016/j.ijpharm.2021.121388] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 12/11/2022]
Abstract
Cystic fibrosis (CF) is an inherited multisystem disease affecting the lung which leads to a progressive decline in lung function as a result of malfunctioning mucociliary clearance and subsequent chronic bacterial infections. Pseudomonas aeruginosa is the predominant cause of lung infection in CF patients and is associated with significant morbidity and mortality. Thus, antibiotic therapy remains the cornerstone of the treatment of CF. Pulmonary delivery of antibiotics for lung infections significantly reduces the required dose and the associated systemic side effects while improving therapeutic outcomes. Ciprofloxacin is one of the most widely used antibiotics against P. aeruginosa and the most effective fluoroquinolone. However, in spite of the substantial amount of research aimed at developing ciprofloxacin powder for inhalation, none of these formulations has been commercialized. Here, we present an integrated view of the diverse challenges associated with delivering ciprofloxacin dry particles to the lungs of CF patients and the rationales behind recent formulations of ciprofloxacin dry powder for inhalation. This review will discuss the challenges in developing ciprofloxacin powder for inhalation along with the physiological and pathophysiological challenges such as ciprofloxacin lung permeability, overproduction of viscous mucus and bacterial biofilms. The review will also discuss the current and emerging particle engineering approaches to overcoming these challenges. By doing so, we believe the review will help the reader to understand the current limitations in developing an inhalable ciprofloxacin powder and explore new opportunities of rational design strategies.
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Affiliation(s)
- Nasser Alhajj
- Pharmaceutical and Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford, Ireland.
| | - Niall J O'Reilly
- Pharmaceutical and Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford, Ireland; SSPC - The Science Foundation Ireland Research Centre for Pharmaceuticals, Ireland
| | - Helen Cathcart
- Pharmaceutical and Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford, Ireland
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Millanao AR, Mora AY, Villagra NA, Bucarey SA, Hidalgo AA. Biological Effects of Quinolones: A Family of Broad-Spectrum Antimicrobial Agents. Molecules 2021; 26:7153. [PMID: 34885734 PMCID: PMC8658791 DOI: 10.3390/molecules26237153] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/28/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022] Open
Abstract
Broad antibacterial spectrum, high oral bioavailability and excellent tissue penetration combined with safety and few, yet rare, unwanted effects, have made the quinolones class of antimicrobials one of the most used in inpatients and outpatients. Initially discovered during the search for improved chloroquine-derivative molecules with increased anti-malarial activity, today the quinolones, intended as antimicrobials, comprehend four generations that progressively have been extending antimicrobial spectrum and clinical use. The quinolone class of antimicrobials exerts its antimicrobial actions through inhibiting DNA gyrase and Topoisomerase IV that in turn inhibits synthesis of DNA and RNA. Good distribution through different tissues and organs to treat Gram-positive and Gram-negative bacteria have made quinolones a good choice to treat disease in both humans and animals. The extensive use of quinolones, in both human health and in the veterinary field, has induced a rise of resistance and menace with leaving the quinolones family ineffective to treat infections. This review revises the evolution of quinolones structures, biological activity, and the clinical importance of this evolving family. Next, updated information regarding the mechanism of antimicrobial activity is revised. The veterinary use of quinolones in animal productions is also considered for its environmental role in spreading resistance. Finally, considerations for the use of quinolones in human and veterinary medicine are discussed.
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Affiliation(s)
- Ana R. Millanao
- Facultad de Ciencias, Instituto de Farmacia, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Aracely Y. Mora
- Programa de Doctorado en Bioquímica, Universidad de Chile, Santiago 8380544, Chile;
| | - Nicolás A. Villagra
- Escuela de Tecnología Médica, Universidad Andres Bello, Santiago 8370071, Chile;
| | - Sergio A. Bucarey
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820808, Chile;
| | - Alejandro A. Hidalgo
- Escuela de Química y Farmacia, Universidad Andres Bello, Santiago 8370071, Chile
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Jeon G, Ahn J. Evaluation of phage adsorption to Salmonella Typhimurium exposed to different levels of pH and antibiotic. Microb Pathog 2021; 150:104726. [PMID: 33400986 DOI: 10.1016/j.micpath.2020.104726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/17/2022]
Abstract
This study was designed to evaluate the physicochemical properties of phage P22 in different pH and antibiotic levels as measured by growth kinetics, phage adsorption, and lytic activity. P22 was susceptible to acidic pHs and stable above pH 4. The latent period of P22 was 45 min and burst size was 34 phages/cell. The adsorption ability of phage to Salmonella Typhimurium was varied depending on the multiplicity of infections (MOIs). The latent period was reduced to 6.84, 4.02, and 1.72 h, respectively, on the levels of the host at 104, 106, and 108 CFU/ml. No significant differences in adsorption were observed between pH 4 and pH 7, but the lytic activities were significantly enhanced at the presence of ceftriaxone (CEA) and ciprofloxacin (CIP) at pH 7. Therefore, the phages combined with antibiotics can be a promising therapeutic tool to control antibiotic-resistant bacteria. This results provide a better understanding of host-phages interactions in different environmental conditions.
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Affiliation(s)
- Gibeom Jeon
- Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon, Gangwon, 24341, Republic of Korea
| | - Juhee Ahn
- Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon, Gangwon, 24341, Republic of Korea.
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Benedini L, Laiuppa J, Santillán G, Baldini M, Messina P. Antibacterial alginate/nano-hydroxyapatite composites for bone tissue engineering: Assessment of their bioactivity, biocompatibility, and antibacterial activity. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 115:111101. [DOI: 10.1016/j.msec.2020.111101] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 10/24/2022]
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10
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Krishna A, Sarveswari S. One‐Pot Synthesis of 2‐Amino‐6‐(1,2‐dihydro‐4‐hydroxy‐2‐oxoquinolin‐3‐yl)‐4‐arylpyridine‐3‐carbonitriles Catalysed by NbCl
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and Their In Vitro Antimicrobial Studies. ChemistrySelect 2019. [DOI: 10.1002/slct.201901866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alla. Krishna
- Department of ChemistryVellore Institute of Technology 632014, Tamilnadu Vellore India
- LGC Promochem private limited Bangalore
| | - S. Sarveswari
- Department of ChemistryVellore Institute of Technology 632014, Tamilnadu Vellore India
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Lee CC, Yang CY, Lee CH, Hsieh CC, Hong MY, Tang HJ, Ko WC. Clinical Benefit of Empiric High-Dose Levofloxacin Therapy for Adults With Community-onset Enterobacteriaceae Bacteremia. Clin Ther 2019; 41:1996-2007. [PMID: 31421908 DOI: 10.1016/j.clinthera.2019.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/10/2019] [Accepted: 07/01/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Levofloxacin is commonly prescribed to treat varied community-acquired gram-negative infections; knowledge of the therapeutic efficacies of high-dose (HD) administration is helpful to improve patient care. METHODS In this 6-year cohort, adults with community-onset Enterobacteriaceae bacteremia were retrospectively studied in 2 hospitals. To overcome the confounding factors in the dosage choice of empiric administration, patients receiving empiric intravenous HD (750 mg/d) therapy were matched with those receiving the conventional dose (CD; 500 mg/d) by using individual propensity scores, calculated by the independent predictors of 30-day crude mortality. FINDINGS Initially, more patients with critical illness (Pitt bacteremia score [PBS] ≥4) at bacteremia onset and comorbid malignancies and the higher 15- and 30-day mortality rate were recorded in 136 patients receiving HD therapy, compared to 103 receiving CD therapy. After appropriate matching, differences in patient demographic and clinical characteristics between the HD (n = 103) and CD (n = 103) groups were nonsignificant. Consequently, crude mortality rates at 3, 15, or 30 days after onset of bacteremia did not differ. However, the period of time to defervescence, total intravenous antimicrobial administration, and hospital stay was shorter in the HD group than in the CD group. Similarly, regardless if patients had more critical illness (PBS ≥2) or stabilized illness (PBS <2), the advantage of empiric HD therapy on defervescence remained significant. Within 60 days after discontinuation of intravenous levofloxacin therapy, the proportion of recurrent bacteremia, posttreatment overall infections, and posttreatment crude mortality was similar between the HD and CD groups. IMPLICATIONS For adults with community-onset Enterobacteriaceae bacteremia, empiric administration of HD levofloxacin was as effective as CD levofloxacin in reducing mortality and, notably, led to more rapid defervescence compared with CD administration.
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Affiliation(s)
- Ching-Chi Lee
- Department of Adult Critical Care Medicine, Tainan Sin-Lau Hospital, Tainan, Taiwan; Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Yung Yang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hsun Lee
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chia Hsieh
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Yuan Hong
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Jen Tang
- Department of Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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12
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Benedini L, Placente D, Ruso J, Messina P. Adsorption/desorption study of antibiotic and anti-inflammatory drugs onto bioactive hydroxyapatite nano-rods. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:180-190. [PMID: 30889690 DOI: 10.1016/j.msec.2019.01.098] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/05/2019] [Accepted: 01/22/2019] [Indexed: 01/19/2023]
Abstract
The use of high doses of antibacterial and anti-inflammatory drugs for patients with bone diseases, associated to implants or bone filling, can develop adverse effects; and consequently, it promotes to think new strategies to avoid this problem. In this work, it has been described the adsorption/release (or desorption) behavior of two drugs, ciprofloxacin (CIP) and ibuprofen (IBU), onto hydroxyapatite (nano-HA) at 37 °C. Through Ultraviolet-Visible (UV-Vis) spectroscopy, the concentrations of both drugs in adsorption, kinetic and desorption processes were obtained. The Fourier Transformed-Infrared (FT-IR) spectroscopy, Zeta-potential (ζ-potential), High-Resolution Transmission Electron Microscopy (H-TEM) and x-Ray Diffraction (xRD) were also used to characterize bared nanoparticles and those with adsorbed drugs. Five adsorption models (Langmuir, Freundlich, Sips, Temkin and Dubinin-Radushkevich) were used for describing the behavior of both active compounds. The adsorption processes (CIP/nano-HA and IBU/nano-HA) were better predicted by the Sips model than by the others. The kinetic adsorption data were processed, for both active agents, by application of Avrami's model. Desorption/release process (of both drugs) was evaluated though Korsmeyer-Peppas (K-P) model. Owing to the predictability of these systems, we propose the use of these active ceramics as potential bone filler for improving the treatment against bacterial bone infections and to avoid its associated inflammatory process.
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Affiliation(s)
- Luciano Benedini
- Department of Chemistry, Universidad Nacional del Sur, B8000CPB Bahía Blanca, INQUISUR-CONICET, Argentina.
| | - Damián Placente
- Department of Chemistry, Universidad Nacional del Sur, B8000CPB Bahía Blanca, INQUISUR-CONICET, Argentina
| | - Juan Ruso
- Soft Matter and Molecular Biophysics Group, Department of Applied Physics, University of Santiago de Compostela, 15782, Spain
| | - Paula Messina
- Department of Chemistry, Universidad Nacional del Sur, B8000CPB Bahía Blanca, INQUISUR-CONICET, Argentina
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Rehman A, Patrick WM, Lamont IL. Mechanisms of ciprofloxacin resistance in Pseudomonas aeruginosa: new approaches to an old problem. J Med Microbiol 2019; 68:1-10. [DOI: 10.1099/jmm.0.000873] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Attika Rehman
- 1Department of Biochemistry, University of Otago, New Zealand
| | - Wayne M. Patrick
- 1Department of Biochemistry, University of Otago, New Zealand
- 2School of Biological Sciences, Victoria University of Wellington, New Zealand
| | - Iain L. Lamont
- 1Department of Biochemistry, University of Otago, New Zealand
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Asadipour A, Moshafi MH, Khosravani L, Moghimi S, Amou E, Firoozpour L, Ilbeigi G, Beiki K, Soleimani E, Foroumadi A. N-substituted piperazinyl sarafloxacin derivatives: synthesis and in vitro antibacterial evaluation. ACTA ACUST UNITED AC 2018; 26:199-207. [PMID: 30392156 PMCID: PMC6279671 DOI: 10.1007/s40199-018-0226-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/23/2018] [Indexed: 11/26/2022]
Abstract
Background Fluoroquinolones (FQs) are compounds of major interest with broad antimicrobial activities against community and hospital-acquired infections such as respiratory tract infections (nosocomial pneumonia, chronic bronchitis and tuberculosis), skin and soft tissue infections, bone and joint infections, intra-abdominal infections and sexually transmitted diseases. This broad range of activities along with favorable pharmacokinetic and low toxicity introduced this class of compounds as important antimicrobial chemotherapy agents. The rapid increase in prevalence of FQs resistant microbes in environment motivated medicinal chemists to discover new quinolone-based compounds with potent activities against Gram-positive bacteria. Methods The designed compounds were prepared through the two-component reaction between aromatic α-haloketones or α-halooximes and sarafloxacin in the presence of NaHCO3 in DMF, affording the corresponding N-[2-(aryl-3-yl) ethyl] piperazinyl quinolone derivatives in good yields. All synthesized compounds were evaluated for antibacterial activities against Gram-positive [Staphylococcus aureus ATCC 6538p, Micrococcus luteus, ATCC 1110, Staphylococcus epidermidis ATCC 12228 and Bacillus subtilis ATCC 6633] and Gram-negative [Escherichia coli ATCC 8739, Klebsiella pneumoniae ATCC 10031 Pseudomonas aeruginosa ATCC 9027 and Serratia marcescens PTCC 1111] bacteria. Results The antibacterial activities of 24 new compounds were reported as MIC values in comparison to sarafloxacin. The most active compound, 4 g, exhibited similar inhibitory activity against Gram-positive bacteria including S. aureus, S. epidermidis and B. subtilis compared to positive control. Furthermore, benzyloxime incorporated derivatives (4 s-4x) showed poor activity against all tested strains, except 4x. Conclusion The obtained results indicated that the synthesized compounds containing substituted piperazine moiety at the C-7 position displayed same or weak inhibitory activities compared to sarafloxacin. ᅟ ![]()
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Affiliation(s)
- Ali Asadipour
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran.,Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hassan Moshafi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Khosravani
- Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Moghimi
- Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Amou
- Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Loghman Firoozpour
- Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Ilbeigi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Keivan Beiki
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Soleimani
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Foroumadi
- Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
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ÇAKMAKLIOĞULLARI MURAT, KAL ÇAKMAKLIOĞULLARI ELÇİN. THE INVITRO SENSITIVITY OF BACTERIAL CONJUNCTIVITIS AGENTS TO ROUTINELY USED ANTIBIOTICS. KONURALP TIP DERGISI 2018. [DOI: 10.18521/ktd.432264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Changotra R, Guin JP, Varshney L, Dhir A. Assessment of reaction intermediates of gamma radiation-induced degradation of ofloxacin in aqueous solution. CHEMOSPHERE 2018; 208:606-613. [PMID: 29890499 DOI: 10.1016/j.chemosphere.2018.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
Gamma radiolytic degradation of an antibiotic, ofloxacin (OFX) was investigated under different experimental conditions. The parameters such as initial OFX concentration, solution pH, absorbed dose and the concentrations of inorganic (CO32-) and organic (t-BuOH) additives were optimized to achieve the efficient degradation of OFX. The degradation dose constant values of OFX were calculated as 2.364, 1.159, 0.776 and 0.618 kGy-1 for the initial OFX concentrations of 0.05, 0.1, 0.15 and 0.2 mM with their corresponding (G (-OFX)) values of 0.481, 0.684, 1.755 and 1.971, respectively. Degradation rate of OFX was significantly increased with increase in the absorbed dose and decrease in the initial OFX concentration under acidic condition when compared to neutral or alkaline condition. Reaction of OFX in the presence of CO32- and t-BuOH showed that the degradation was primarily caused by the reaction of OFX with radiolytically generated reactive hydroxyl radicals. Mineralization extent of OFX was determined in terms of percentage reduction in total organic carbon (TOC) and results revealed that the addition of H2O2 enhanced the mineralization of OFX from 29% to 36.1% with H2O2 dose of 0.5 mM at an absorbed dose of 3.0 kGy. Based on the LC-QTOF-MS analysis, gamma radiolytic degradation intermediates/products of OFX were identified and the possible degradation pathways of OFX were proposed. Cytotoxicity study of the irradiated OFX solutions showed that gamma radiation has potential to detoxify OFX.
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Affiliation(s)
- Rahil Changotra
- School of Energy and Environment, Thapar Institute of Engineering and Technology, Patiala 147004, India
| | - Jhimli Paul Guin
- Radiation Technology Development Division, Bhabha Atomic Research Centre, Mumbai 400085, India.
| | - Lalit Varshney
- Radiation Technology Development Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Amit Dhir
- School of Energy and Environment, Thapar Institute of Engineering and Technology, Patiala 147004, India.
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17
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Phenotypic and genetic characteristics of fluoroquinolone- and methicillin-resistant Staphylococcus aureus. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.eimce.2017.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Moreno-Flores A, Potel-Alvarellos C, Otero-Fernández S, Álvarez-Fernández M. Phenotypic and genetic characteristics of fluoroquinolone- and methicillin-resistant Staphylococcus aureus. Enferm Infecc Microbiol Clin 2018; 36:403-408. [DOI: 10.1016/j.eimc.2017.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/15/2017] [Accepted: 06/16/2017] [Indexed: 11/29/2022]
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19
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Pfaller MA, Flamm RK, McCurdy SP, Pillar CM, Shortridge D, Jones RN. Delafloxacin In Vitro Broth Microdilution and Disk Diffusion Antimicrobial Susceptibility Testing Guidelines: Susceptibility Breakpoint Criteria and Quality Control Ranges for an Expanded-Spectrum Anionic Fluoroquinolone. J Clin Microbiol 2018; 56:e00339-18. [PMID: 29848564 PMCID: PMC6062791 DOI: 10.1128/jcm.00339-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/23/2018] [Indexed: 11/20/2022] Open
Abstract
Delafloxacin, a recently approved anionic fluoroquinolone, was tested within an international resistance surveillance program. The in vitro susceptibilities of 7,914 indicated pathogens causing acute bacterial skin and skin structure infections (ABSSSI) were determined using Clinical and Laboratory Standards Institute (CLSI) broth microdilution MIC testing methods. The U.S. Food and Drug Administration (FDA) susceptibility testing breakpoints and quality control ranges for routine broth microdilution and disk diffusion methods were confirmed. The delafloxacin MIC50/90 (% susceptibility) results were as follows: Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), 0.008/0.25 μg/ml (92.8%); Staphylococcus lugdunensis, 0.016/0.03 μg/ml (99.3%); Streptococcus pyogenes, 0.016/0.03 μg/ml (100.0%); Streptococcus anginosus group, 0.008/0.016 μg/ml (100.0%); Enterococcus faecalis, 0.12/1 μg/ml (66.2%); and Enterobacteriaceae, 0.12/4 μg/ml (69.5%). The FDA clinical breakpoints were used to assess intermethod test agreement between delafloxacin MIC and disk diffusion methods for the indicated pathogens. The intermethod susceptibility test categorical agreement for delafloxacin was acceptable, with only 0.4% very major, false-susceptible errors among S. aureus strains. Across all FDA-indicated species, the selected breakpoints produced only 0.0 to 1.7% rates of serious (very major and major errors) intermethod error. Quality control ranges for these standardized delafloxacin susceptibility test methods were calculated from three multilaboratory (12 total sites) studies for six control organisms. In conclusion, the application of FDA MIC breakpoints for delafloxacin against contemporary (2014 to 2016) isolates of ABSSSI pathogens provides additional support for the use of delafloxacin in the treatment of adults with ABSSSI. Delafloxacin MIC and disk diffusion susceptibility testing methods have been standardized for clinical application, achieving high intermethod categorical agreement.
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Affiliation(s)
| | - R K Flamm
- JMI Laboratories, North Liberty, Iowa, USA
| | - S P McCurdy
- Melinta Therapeutics, New Haven, Connecticut, USA
| | | | | | - R N Jones
- JMI Laboratories, North Liberty, Iowa, USA
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20
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Affiliation(s)
- Tiffany Chan
- Department of Medicine (Chan, Bunce), University of Toronto; Division of Infectious Diseases (Bunce), University Health Network, Toronto, Ont
| | - Paul E Bunce
- Department of Medicine (Chan, Bunce), University of Toronto; Division of Infectious Diseases (Bunce), University Health Network, Toronto, Ont.
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Zahoor AF, Yousaf M, Siddique R, Ahmad S, Naqvi SAR, Rizvi SMA. Synthetic strategies toward the synthesis of enoxacin-, levofloxacin-, and gatifloxacin-based compounds: A review. SYNTHETIC COMMUN 2017. [DOI: 10.1080/00397911.2017.1300921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ameer Fawad Zahoor
- Institute of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Yousaf
- Institute of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Rabia Siddique
- Institute of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sajjad Ahmad
- Department of Chemistry, University of Engineering and Technology Lahore, Faisalabad Campus, Faisalabad, Pakistan
| | - Syed Ali Raza Naqvi
- Institute of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
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In Vitro Activity of Delafloxacin against Contemporary Bacterial Pathogens from the United States and Europe, 2014. Antimicrob Agents Chemother 2017; 61:AAC.02609-16. [PMID: 28167542 PMCID: PMC5365668 DOI: 10.1128/aac.02609-16] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 01/31/2017] [Indexed: 12/01/2022] Open
Abstract
The in vitro activities of delafloxacin and comparator antimicrobial agents against 6,485 bacterial isolates collected from medical centers in Europe and the United States in 2014 were tested. Delafloxacin was the most potent agent tested against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus, Streptococcus pneumoniae, viridans group streptococci, and beta-hemolytic streptococci and had activity similar to that of ciprofloxacin and levofloxacin against certain members of the Enterobacteriaceae. Overall, the broadest coverage of the tested pathogens (Gram-positive cocci and Gram-negative bacilli) was observed with meropenem and tigecycline in both Europe and the United States. Delafloxacin was shown to be active against organisms that may be encountered in acute bacterial skin and skin structure infections, respiratory infections, and urinary tract infections.
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Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy. Antimicrob Agents Chemother 2017; 61:AAC.02174-16. [PMID: 27855072 DOI: 10.1128/aac.02174-16] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 10/31/2016] [Indexed: 12/23/2022] Open
Abstract
Both fluoroquinolones (FQs) and third-generation cephalosporins (3rd-GCs) are commonly prescribed to treat bloodstream infections, but comparative efficacies between them were rarely studied. Demographics and clinical characteristics of 733 adults with polymicrobial or monomicrobial community-onset bacteremia empirically treated by an appropriate FQ (n = 87) or 3rd-GC (n = 646) were compared. A critical illness (respectively, 8.0% versus 19.0%; P = 0.01), an initial syndrome with severe sepsis (33.3% versus 50.3%; P = 0.003), or a fatal outcome at 28 days (4.6% versus 10.5%; P = 0.08) was less common in the FQ group. A total of 645 (88.0%) patients were febrile at initial presentation, and the FQ group with (FQ group versus 3rd-GC group, respectively, 7.6 days versus 12.0 days; P = 0.04) and without (3.8 days versus 5.4 days; P = 0.001) a critical illness had a shorter time to defervescence than the 3rd-GC group. By the propensity scores, 87 patients with appropriate FQ therapy were matched with 435 treated by 3rd-GC therapy at a ratio of 1:5, and there were no significant differences in terms of bacteremia severity, comorbidity severity, major comorbidities, causative microorganisms, and bacteremia sources between groups. Moreover, crude mortality rates at 28 days (FQ group versus 3rd-GC group, respectively, 4.6% versus 7.8%; P = 0.29) did not differ significantly. However, the time to defervescence was shorter in the FQ group (4.2 ± 3.6 versus 6.2 ± 7.6 days; P < 0.001). Conclusively in the adults with community-onset bacteremia, appropriate empirical FQ therapy was related to shorter time to defervescence than with 3rd-GC therapy, at least for those without a critical illness.
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Synthesis and characterization of new 3-(4,5-dihydro-5-aryl)isoxazol-3-yl)-4-hydroxyquinolin-2(1H)-ones and 3-(4-styryl)isoxazolo[4,5-c]quinolin-4(5H)-one derivatives. ARAB J CHEM 2016. [DOI: 10.1016/j.arabjc.2011.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Anuforom O, Wallace GR, Buckner MMC, Piddock LJV. Ciprofloxacin and ceftriaxone alter cytokine responses, but not Toll-like receptors, to Salmonella infection in vitro. J Antimicrob Chemother 2016; 71:1826-33. [PMID: 27076102 DOI: 10.1093/jac/dkw092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/28/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Antibiotics that enhance host natural defences to infection offer an alternative approach to treating infections. However, mechanisms underlying such processes are poorly understood. The aim of this study was to investigate the effects of clinically relevant concentrations of two antibiotics on bacterial interactions with murine macrophages. METHODS Adhesion of Salmonella Typhimurium SL1344 to and invasion by Salmonella Typhimurium SL1344 of antibiotic-treated or untreated J774 murine macrophages were measured using a tissue culture infection model. Expression of genes central to the Toll-like receptor (TLR) signalling pathway of macrophages infected with Salmonella was analysed using the RT(2) Profiler PCR Array. Cytokine production was measured by ELISA. RESULTS Adhesion of Salmonella Typhimurium SL1344 to J774 macrophage monolayers was increased when macrophages were exposed to ciprofloxacin and ceftriaxone, while invasion was decreased by ciprofloxacin. Expression of IL-1β and TNF-α mRNA was greater in SL1344-infected macrophages that had been treated with ciprofloxacin or ceftriaxone than in macrophages exposed to antibiotics alone or SL1344 alone. TLR mRNA was down-regulated by SL1344 infection, a response that was not altered by antibiotic pretreatment. CONCLUSIONS Clinically relevant concentrations of two antibiotics differentially enhanced the response of immune cells and their interaction with bacteria, increasing bacterial adhesion to macrophages and increasing cytokine production. As increased expression of IL-1β fosters apoptosis of Salmonella-infected macrophages and clearance by neutrophils, the immunomodulatory potential of these antibiotics may explain, in part, why these two drugs continue to be used to treat salmonellosis successfully.
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Affiliation(s)
- Olachi Anuforom
- Antimicrobials Research Group, Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Graham R Wallace
- Centre for Translational Inflammation, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Michelle M C Buckner
- Antimicrobials Research Group, Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Laura J V Piddock
- Antimicrobials Research Group, Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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Alteration of the Disposition of Quinine in Healthy Volunteers After Concurrent Ciprofloxacin Administration. Am J Ther 2016; 23:e398-404. [PMID: 25406952 DOI: 10.1097/mjt.0000000000000087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study evaluated the effects of concurrent ciprofloxacin administration on the disposition of quinine in healthy volunteers. Quinine (600-mg single dose) was administered either alone or with the 11th dose of ciprofloxacin (500 mg every 12 hours for 7 days) to 15 healthy volunteers in a crossover fashion. Blood samples collected at predetermined time intervals were analyzed for quinine and its major metabolite, 3-hydroxquinine, using a validated high-performance liquid chromatographic method. Administration of quinine plus ciprofloxacin resulted in significant increases (P < 0.05) in the total area under the concentration-time curve, maximum plasma concentration (Cmax), and terminal elimination half-life (T1/2b) of quinine compared with values with quinine dosing alone (AUC: 27.93 ± 8.04 vs. 41.62 ± 13.98 h·mg/L; Cmax: 1.37 ± 0.24 vs. 1.64 ± 0.38 mg/L; T1/2b: 16.28 ± 2.66 vs. 21.43 ± 3.22 hours), whereas the oral plasma clearance markedly decreased (23.17 ± 6.49 vs. 16.00 ± 5.27 L/h). In the presence of ciprofloxacin, there was a pronounced decrease in the ratio of AUC (metabolite)/AUC (unchanged drug) and highly significant decreases in Cmax and AUC of the metabolite (P < 0.05). Ciprofloxacin may increase the adverse effects of concomitantly administered quinine, which can have serious consequences on the patient. Thus, a downward dosage adjustment of quinine seems to be necessary when concurrently administered with ciprofloxacin.
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Linder KE, Nicolau DP, Nailor MD. Predicting and preventing antimicrobial resistance utilizing pharmacodynamics: Part I gram positive bacteria. Expert Opin Drug Metab Toxicol 2016; 12:267-80. [PMID: 26751348 DOI: 10.1517/17425255.2016.1141197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Antimicrobial resistance is a potentially inevitable consequence of widespread use of antibiotics in the healthcare system. An enhanced understanding of pharmacodynamic (PD) targets that prevent antimicrobial resistance development will improve currently availably therapies and help to guide future drug development strategies. Current in vitro methods to predict bacterial resistance to antimicrobials consist of serial dilution experiments, determination of the mutant prevention concentration (MPC), mutant selection window (MSW), and human simulated pharmacodynamics studies. Clinical trial data and real -world surveillance studies can help validate or disprove in vitro modeling. AREAS COVERED This review will discuss methods of predicting development of resistance and how the use of pharmacodynamics can reduce or eliminate the emergence of resistance among Staphylococcus aureus, Streptococcus pneumoniae, and Enterococcus species. EXPERT OPINION Pharmacodynamic targets can be used successfully to guide antimicrobial therapy to prevent resistance development. Currently, PD targets do not take into consideration horizontal resistance gene transfer and various factors may lead to different PD targets based on sites of infection. Further research is necessary to guide future drug development strategies and optimize new drug therapies.
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Affiliation(s)
- Kristin E Linder
- a Department of Pharmacy , Hartford Hospital , Hartford , CT , USA
| | - David P Nicolau
- b Center for Anti-infective Research and Development , Hartford Hospital , Hartford , CT , USA
| | - Michael D Nailor
- a Department of Pharmacy , Hartford Hospital , Hartford , CT , USA.,c Department of Pharmacy Practice , University of Connecticut School of Pharmacy , Storrs , CT , USA
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Buffet-Bataillon S, Tattevin P, Maillard JY, Bonnaure-Mallet M, Jolivet-Gougeon A. Efflux pump induction by quaternary ammonium compounds and fluoroquinolone resistance in bacteria. Future Microbiol 2016; 11:81-92. [DOI: 10.2217/fmb.15.131] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Biocides, primarily those containing quaternary ammonium compounds (QAC), are heavily used in hospital environments and various industries (e.g., food, water, cosmetic). To date, little attention has been paid to potential implications of QAC use in the emergence of antibiotic resistance, especially fluoroquinolone-resistant bacteria in patients and in the environment. QAC-induced overexpression of efflux pumps can lead to: cross resistance with fluoroquinolones mediated by multidrug efflux pumps; stress response facilitating mutation in the Quinolone Resistance Determining Region; and biofilm formation increasing the risk of transfer of mobile genetic elements carrying fluoroquinolone or QAC resistance determinants. By following the European Biocidal Product Regulation, manufacturers of QAC are required to ensure that their QAC-based biocidal products are safe and will not contribute to emerging bacterial resistance.
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Affiliation(s)
| | - Pierre Tattevin
- Service des Maladies Infectieuses, Pontchaillou, 35043 Rennes, France
- INSERM U835, Université de Rennes 1, 35000 Rennes, France
| | - Jean-Yves Maillard
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Martine Bonnaure-Mallet
- EA 1254 Microbiologie, Université de Rennes 1, 35000 Rennes, France
- Pôle Odontologie, Teaching Hospital, 35043 Rennes, France
| | - Anne Jolivet-Gougeon
- Pôle Biologie, Teaching Hospital Pontchaillou, 35043 Rennes, France
- EA 1254 Microbiologie, Université de Rennes 1, 35000 Rennes, France
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Lin SY, Huang CH, Ko WC, Chen YH, Hsueh PR. Recent developments in antibiotic agents for the treatment of complicated intra-abdominal infections. Expert Opin Pharmacother 2015; 17:339-54. [DOI: 10.1517/14656566.2016.1122756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Bassetti M, Righi E. Development of novel antibacterial drugs to combat multiple resistant organisms. Langenbecks Arch Surg 2015; 400:153-65. [PMID: 25667169 DOI: 10.1007/s00423-015-1280-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 02/01/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Infections due to multidrug-resistant (MDR) bacteria are increasing both in hospitals and in the community and are characterized by high mortality rates. New molecules are in development to face the need of active compounds toward resistant gram-positive and gram-negative pathogens. In particular, the Infectious Diseases Society of America (IDSA) has supported the initiative to develop ten new antibacterials within 2020. Principal targets are the so-called ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Enterobacteriaceae). PURPOSE To review the characteristics and the status of development of new antimicrobials including new cephalosporins, carbapenems, beta-lactamase inhibitors, aminoglycosides, quinolones, oxazolidones, glycopeptides, and tetracyclines. CONCLUSIONS While numerous new compounds target resistant gram-positive pathogens and have been approved for clinical use, very few new molecules are active against MDR gram-negative pathogens, especially carbapenemase producers. New glycopeptides and oxazolidinones are highly efficient against methicillin-resistant S. aureus (MRSA), and new cephalosporins and carbapenems also display activity toward MDR gram-positive bacteria. Although new cephalosporins and carbapenems have acquired activity against MRSA, they offer few advantages against difficult-to-treat gram-negatives. Among agents that are potentially active against MDR gram-negatives are ceftozolane/tazobactam, new carbapenems, the combination of avibactam with ceftazidime, and plazomicin. Since a relevant number of promising antibiotics is currently in development, regulatory approvals over the next 5 years are crucial to face the growing threat of multidrug resistance.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Division, Santa Maria Misericordia Hospital, Udine, Italy,
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Bassetti M, Della Siega P, Pecori D, Scarparo C, Righi E. Delafloxacin for the treatment of respiratory and skin infections. Expert Opin Investig Drugs 2015; 24:433-42. [PMID: 25604710 DOI: 10.1517/13543784.2015.1005205] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION There has been a striking increase in the emergence of multidrug-resistant pathogens in recent times. Delafloxacin is a novel, broad-spectrum fluoroquinolone with antimicrobial activity against resistant Gram-positive, Gram-negative and anaerobic organisms. It has the potential to treat a variety of infections including complicated skin and skin structure infections and respiratory tract infections. AREAS COVERED In this review, the authors report the microbiological spectrum of activity of delafloxacin as well as its pharmacokinetic characteristics. They also report the results of recent studies investigating its safety and efficacy. EXPERT OPINION The profile of delafloxacin offers several advantages. Delafloxacin presents a broad spectrum of activity against pathogens involved in respiratory infections and complicated skin and skin structure infections (SSSIs), including methicillin-resistant Staphylococcus aureus. It has also shown activity against Gram-negative pathogens, such as quinolone-susceptible and -resistant strains of Escherichia coli and Klebsiella pneumoniae and quinolone-susceptible Pseudomonas aeruginosa. The availability of an oral formulation supports its use in sequential therapy. The efficacy and tolerability of delafloxacin have been demonstrated in Phase II clinical trials in comparison with moxifloxacin for respiratory infections and linezolid and vancomycin in SSSIs. Compared with other quinolones such as moxifloxacin, delafloxacin showed comparable efficacy and a lower rate of adverse effects. The results of new Phase III studies are awaited to confirm delafloxacin's future applications in the treatment of SSSIs.
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Affiliation(s)
- Matteo Bassetti
- Santa Maria Misericordia University Hospital, Infectious Diseases Division , Piazzale S. Maria della Misericordia, n. 15, 33100, Udine , Italy + 86 21 38804518; extn. 8319 ; + 39 0432 559360 ;
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Synthesis of 4-Hydroxy-2(1H)-Quinolone Derived Chalcones, Pyrazolines and Their Antimicrobial, In Silico Antimalarial Evaluations. Appl Biochem Biotechnol 2014; 175:43-64. [DOI: 10.1007/s12010-014-1256-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
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Zaffiri L, Gardner J, Toledo-Pereyra LH. History of antibiotics: from fluoroquinolones to daptomycin (Part 2). J INVEST SURG 2014; 26:167-79. [PMID: 23869821 DOI: 10.3109/08941939.2013.808461] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In the Modern Era, physicians attested to the reciprocal influence among a technologically advanced society, rapid scientific progresses in medicine, and the need for new antimicrobials. The results of these changes were not only seen in the prolongation of life expectancy but also by the emergence of new pathogens. We first observed the advent of Gram-negative bacteria as a major source of nosocomial infections. The treatment of these microorganisms was complicated by the appearance and spread of drug resistance. We first focused on the development of two major classes of antimicrobials still currently used for the treatment of Gram-negative bacteria, such as fluoroquinolones and carbapenemes. Subsequently, we directed our attention to the growth of the incidence of infections due to Methicillin-Resistant Staphylococcus aureus (MRSA). Although the first MRSA was already isolated in 1961, the treatment of this new pathogen has been based on the efficacy of vancomycin for more than four decades. Only in the last 15 yr, we assisted in the development of new antimicrobial agents such as linezolid and daptomycin.
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Affiliation(s)
- Lorenzo Zaffiri
- Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
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Pi Y, Feng J, Sun J, Song M, Sun J. Oxidation of ofloxacin by Oxone/Co(2+): identification of reaction products and pathways. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:3031-3040. [PMID: 24174312 DOI: 10.1007/s11356-013-2220-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/04/2013] [Indexed: 06/02/2023]
Abstract
Oxidative degradation of ofloxacin (OFX) by sulfate free radicals (SO4 (-•)) in the UV/Oxone/Co(2+)oxidation process was investigated for the first time, with a special focus upon identifying the transformation products as well as understanding the reaction pathways. Thirteen main compounds were identified after the initial transformation of OFX; the detailed structural information of which were characterized by high-performance liquid chromatography-high resolution mass spectrometry and MS fragmentation analysis. The degradation pathways mainly encompassed ring openings at both the piperazinyl substituent and the quinolone moiety, indicating that the usage of SO4 (-•) aided the oxidative degradation of OFX to undergo more facile routes compared to those in previous reports by using OH(•)/h(+) as the oxidant, where the initial transformation attacks were mainly confined to the piperazine moiety. Moreover, in this study, smart control over the pH conditions of the oxidation system via different modes of Oxone dosage resulted in the selective degradation of the functional sites of OFX molecule, where it was shown that the SO4 (-•)-driven destruction of the quinolone moiety of OFX molecule favored the neutral pH conditions. This would be beneficial for the reduction of bacterial resistance against quinolones in the aqueous environment.
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Affiliation(s)
- Yunqing Pi
- School of Environment, Key Laboratory for Yellow River and Huaihe River Water Environmental and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang, 453007, People's Republic of China
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Shafreen RMB, Selvaraj C, Singh SK, Pandian SK. Exploration of fluoroquinolone resistance in Streptococcus pyogenes: comparative structure analysis of wild-type and mutant DNA gyrase. J Mol Recognit 2013; 26:276-85. [PMID: 23595809 DOI: 10.1002/jmr.2270] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/16/2013] [Accepted: 01/29/2013] [Indexed: 12/20/2022]
Abstract
Quinolone resistance-determining region is known to be the druggability site of the target protein that undergoes frequent mutation and thus renders quinolone resistance. In the present study, ligands were tested for their inhibitory activity against DNA gyrase of Streptococcus pyogenes involved in DNA replication. In silico mutational analysis on modelled gyrase A revealed that GLU85 had the most possible interactions with all the ligands used for the study. The amino acid residue GLU85 had also been predicted with an essential role of maintaining the three-dimensional structure of the protein. When introduced with a mutation (GLU 85 LYS) on this particular residue, it had readily denatured the whole α-helix (from 80 to 90 amino acids). This was confirmed through the molecular dynamics simulation and revealed that this single mutation can cause many functional and structural changes. Furthermore, LYS85 mutation has altered the original secondary structure of the protein, which in turn led to the steric hindrance during the ligand-receptor interaction. The results based on the G-score revealed that ligands have reduced interaction with the mutant protein. The semisynthetic fluoroquinolone 6d, which is an exception, forms a strong interaction with the mutant protein and was experimentally verified using the antimicrobial test. Hence, the present study unravels the fact that mutation at the drug binding site is the major cause for different level of resistance by the S. pyogenes when exposed against the varying concentrations of the fluoroquinolones. Furthermore, a comparative assessment of quinolone derivative with the older generation fluoroquinolones will be of great impact for S. pyogenes-related infections.
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Affiliation(s)
- Raja Mohmed Beema Shafreen
- Bioinformatics Infrastructure Facility, Department of Biotechnology, Alagappa University, Karaikudi 630 003, Tamil Nadu, India
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Kim J, Jeon S, Kim H, Park M, Kim S, Kim S. Multiplex Real-Time Polymerase Chain Reaction-Based Method for the Rapid Detection of gyrA and parC Mutations in Quinolone-Resistant Escherichia coli and Shigella spp. Osong Public Health Res Perspect 2013; 3:113-7. [PMID: 24159500 PMCID: PMC3747644 DOI: 10.1016/j.phrp.2012.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 01/10/2012] [Accepted: 01/16/2012] [Indexed: 11/26/2022] Open
Abstract
Two real-time polymerase chain reaction assays were developed to detect mutations in codons 83 and 87 in gyrA and in codons 80 and 91 in parC, the main sites that causes quinolone resistance in pathogenic Escherichia coli and Shigella spp. isolates. These assays can be employed as a useful method for controlling infections caused by quinolone-resistant E coli and Shigella isolates.
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Affiliation(s)
- Junyoung Kim
- Division of Enteric Bacterial Infections, Korea National Institute of Health, Osong, Korea
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Cormier R, Burda WN, Harrington L, Edlinger J, Kodigepalli KM, Thomas J, Kapolka R, Roma G, Anderson BE, Turos E, Shaw LN. Studies on the antimicrobial properties of N-acylated ciprofloxacins. Bioorg Med Chem Lett 2012; 22:6513-20. [PMID: 22995622 DOI: 10.1016/j.bmcl.2012.05.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/30/2012] [Accepted: 05/08/2012] [Indexed: 11/18/2022]
Abstract
Fluoroquinolone antibiotics have been a mainstay in the treatment of bacterial diseases. The most notable representative, ciprofloxacin, possesses potent antimicrobial activity; however, a rise in resistance to this agent necessitates development of novel derivatives to prolong the clinical lifespan of these antibiotics. Herein we have synthesized and analyzed the antimicrobial properties of a library of N-acylated ciprofloxacin analogues. We find that these compounds are broadly effective against Gram-positive and Gram-negative bacteria, with many proving more effective than the parental drug, and several possessing MICs ≤1.0 μg/ml against methicillin-resistant Staphylococcus aureus and Bartonella species. An analysis of spontaneous mutation frequencies reveals very low potential for resistance in MRSA compared to existing fluoroquinolones. Mode of action profiling reveals that modification of the piperazinyl nitrogen by acylation does not alter the effect of these molecules towards their bacterial target. We also present evidence that these N-acylated compounds are highly effective at killing intracellular bacteria, suggesting the suitability of these antibiotics for therapeutic treatment.
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Affiliation(s)
- Ryan Cormier
- Center for Molecular Diversity in Drug Design, Discovery, and Delivery, Department of Chemistry, University of South Florida, Tampa, FL 33620, USA
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Jakobsen L, Cattoir V, Jensen KS, Hammerum AM, Nordmann P, Frimodt-Møller N. Impact of low-level fluoroquinolone resistance genes qnrA1, qnrB19 and qnrS1 on ciprofloxacin treatment of isogenic Escherichia coli strains in a murine urinary tract infection model. J Antimicrob Chemother 2012; 67:2438-44. [PMID: 22685162 DOI: 10.1093/jac/dks224] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To study the impact of qnrA1, qnrB19 and qnrS1 on the ciprofloxacin treatment of urinary tract infection (UTI). METHODS From a wild-type (wt) Escherichia coli UTI isolate, three isogenic strains were constructed carrying low-level ciprofloxacin resistance genes qnrA1, qnrB19 or qnrS1 (ciprofloxacin MIC range: 0.19-0.38 mg/L). Time-kill studies were performed for all four isogenic strains at the following concentrations: 1×, 2×, 4×, 8× and 16× MIC. Ciprofloxacin serum and urine pharmacokinetics was determined to calculate a murine dose equivalent (AUC(24)) to the standard human dose of 500 mg twice daily, which corresponded to 0.2 mg/mouse four times daily. In the murine UTI model, mice infected with each of the isogenic qnr strains or the wt strain were treated with ciprofloxacin (0.2 mg/mouse) or saline (only the E. coli wt) subcutaneously four times daily for 3 days starting 24 h after bacterial inoculation. RESULTS In vitro, the strains responded to ciprofloxacin concentrations of 4-16× MIC by several log(10) reductions. In vivo, despite ciprofloxacin reaching urine concentrations far exceeding the MICs for the strains (500 mg/L), ciprofloxacin was significantly less efficient at reducing the urine and bladder bacterial counts of qnrA1-, qnrB19- and qnrS1-positive strains compared with the ciprofloxacin-treated wt strain (P < 0.05). None of the four strains infected the kidneys well, with median cfu counts of <1 log(10). CONCLUSIONS Although qnr genes only confer low levels of resistance to ciprofloxacin, a reduced bactericidal activity of ciprofloxacin was observed in both urine and bladder in the murine model of UTI.
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Affiliation(s)
- Lotte Jakobsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen S, Denmark.
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Mulgaonkar A, Venitz J, Sweet DH. Fluoroquinolone disposition: identification of the contribution of renal secretory and reabsorptive drug transporters. Expert Opin Drug Metab Toxicol 2012; 8:553-69. [PMID: 22435536 DOI: 10.1517/17425255.2012.674512] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Fluoroquinolones (FQs) exist as charged molecules in blood and urine making their absorption, distribution, and elimination likely to be influenced by active transport mechanisms. Greater understanding of in vivo FQ clearance mechanisms should help improve the predictability of drug-drug interactions, enhance the clinical safety and efficacy, and aid future novel drug design strategies. AREAS COVERED The authors present an overview of FQ development and associated drug-drug interactions, followed by systematic quantitative review of the physicochemical and in vivo pharmacokinetic properties for 15 representative FQs using historical clinical literature. These results were correlated with in vitro studies implicating drug transporters in FQ clearance to link clinical and in vitro evidence supporting the contribution of drug transport mechanisms to FQ disposition. Specific transporters likely to handle FQs in human renal proximal tubule cells are also identified. EXPERT OPINION Renal handling, that is, tubular secretion and reabsorption, appears to be the main determinant of FQ plasma half-life, clinical duration of action, and drug-drug interactions. Due to their zwitterionic nature, FQs are likely to interact with organic anion and cation transporters within the solute carrier (SLC) superfamily, including OAT1, OAT3, OCT2, OCTN1, OCTN2, MATE1, and MATE2. The ATP-binding cassette (ABC) transporters MDR1, MRP2, MRP4, and BCRP also may interact with FQs.
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Affiliation(s)
- Aditi Mulgaonkar
- Virginia Commonwealth University, School of Pharmacy, Department of Pharmaceutics, Richmond, VA 23298, USA
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Lautenbach E, Metlay JP, Mao X, Han X, Fishman NO, Bilker WB, Tolomeo P, Wheeler M, Nachamkin I. The prevalence of fluoroquinolone resistance mechanisms in colonizing Escherichia coli isolates recovered from hospitalized patients. Clin Infect Dis 2010; 51:280-5. [PMID: 20597679 PMCID: PMC2897836 DOI: 10.1086/653931] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Fluoroquinolones are the most commonly prescribed antimicrobials. The epidemiology of fecal colonization with Escherichia coli demonstrating reduced susceptibility to fluoroquinolones remains unclear. METHODS During a 3-year period (15 September 2004 through 19 October 2007), all patients hospitalized for >3 days were approached for fecal sampling. All E. coli isolates with reduced susceptibility to fluoroquinolones (minimum inhibitory concentration [MIC] of levofloxacin, 0.125 microg/mL) were identified. We characterized gyrA and parC mutations and organic solvent tolerance. Isolates were compared using pulsed-field gel electrophoresis. RESULTS Of 353 patients colonized with E. coli demonstrating reduced fluoroquinolone susceptibility, 300 (85.0%) had 1 gyrA mutation, 161 (45.6%) had 1 parC mutation, and 171 (48.6%) demonstrated organic solvent tolerance. The mean numbers of total mutations (ie, gyrA and parC) for E. coli isolates with a levofloxacin MIC of 8 microg/mL versus <8.0 microg/mL were 2.70 and 0.82 (P < .001). Of the 136 E. coli isolates with a levofloxacin MIC of 8 microg/mL, 90 (66.2%) demonstrated a nalidixic acid MIC of 16 microg/mL. Significant differences were found over time in the proportion of E. coli isolates demonstrating gyrA mutation, parC mutation, and organic solvent tolerance. There was little evidence of clonal spread of isolates. Conclusions. Gastrointestinal tract colonization with E. coli demonstrating reduced susceptibility to levofloxacin is common. Although 40% of study isolates exhibited a levofloxacin MIC of <8 microg/mL (and would thus be missed by current Clinical and Laboratory Standards Institute breakpoints), nalidixic acid resistance may be a useful marker for detection of such isolates. Significant temporal changes occurred in the proportion of isolates exhibiting various resistance mechanisms.
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Affiliation(s)
- Ebbing Lautenbach
- Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Lin L, Chang LW, Tsai CY, Hsu CH, Chung DT, Aronstein WS, Ajayi F, Kuzmak B, Lyon RA. Dose escalation study of the safety, tolerability, and pharmacokinetics of nemonoxacin (TG-873870), a novel potent broad-spectrum nonfluorinated quinolone, in healthy volunteers. Antimicrob Agents Chemother 2010; 54:405-10. [PMID: 19884368 PMCID: PMC2798534 DOI: 10.1128/aac.00682-09] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 08/04/2009] [Accepted: 09/18/2009] [Indexed: 11/20/2022] Open
Abstract
Nemonoxacin (TG-873870) is a novel nonfluorinated quinolone with potent broad-spectrum activity against Gram-positive and Gram-negative pathogens, including methicillin-resistant Staphylococcus aureus, penicillin- and quinolone-resistant Streptococcus pneumoniae, and vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus. The safety, tolerability, and pharmacokinetics of nemonoxacin were investigated in a double-blind, ascending-single-dose study involving 56 healthy subjects (48 males and 8 females) who were randomly assigned to 1 of 7 dose cohorts. In each successive cohort, two subjects received a placebo and six received single oral doses of 25, 50, 125, 250, 500, 1,000, or 1,500 mg nemonoxacin. Nemonoxacin was well tolerated up to the maximum dose of 1,500 mg. No severe or serious adverse events were observed. The most frequent adverse events were contact dermatitis, pruritus, and erythema. No clinically significant abnormalities were noted in the electrocardiograms, vital signs, or laboratory tests. The plasma concentrations increased over the dose range, and at 500 mg, the free area under the plasma concentration-time curve/MIC(90) ratios and free maximum nemonoxacin concentration/MIC(90) ratios against drug-sensitive/drug-resistant S. pneumoniae and S. aureus were greater than 227 and 24, respectively. The peak time and elimination half-life of nemonoxacin were 1 to 2 h and 9 to 16 h, respectively. The oral clearance was approximately 0.22 liter/h/kg. The plasma protein binding was approximately 16%. The results of this study support further evaluation of the multiple-dose safety, tolerability, and pharmacokinetics of nemonoxacin.
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Affiliation(s)
- Luke Lin
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Li-Wen Chang
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Cheng-Yuan Tsai
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Ching-Hung Hsu
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - David T. Chung
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - William S. Aronstein
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Funmi Ajayi
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Barbara Kuzmak
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
| | - Robert A. Lyon
- TaiGen Biotechnology Company Ltd., Taipei, Taiwan, TI Clinical Trial and Consulting Services Inc., Blue Ash, Ohio 45242, Procter and Gamble Healthcare, Mason, Ohio 45040
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Hopp DC, Rhea J, Jacobsen D, Romari K, Smith C, Rabenstein J, Irigoyen M, Clarke M, Francis L, Luche M, Carr GJ, Mocek U. Neopyrrolomycins with broad spectrum antibacterial activity. JOURNAL OF NATURAL PRODUCTS 2009; 72:276-279. [PMID: 19191549 DOI: 10.1021/np800632f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Three new antibiotics, neopyrrolomycins B (1), C (2), and D (3), with potent activity against Gram-positive pathogens were discovered. They exhibited MIC values < 1 microg/mL versus a number of resistant strains. The compounds were obtained from the ethyl acetate extracts of a Streptomyces sp. after purification by column chromatography and RP-HPLC. Their structures were elucidated using X-ray crystallography (1) and NMR spectroscopy (2 and 3).
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Affiliation(s)
- D Craig Hopp
- AMRI, Bothell Research Center, 18804 North Creek Parkway, Bothell, Washington 98011, USA
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Lautenbach E, Metlay JP, Weiner MG, Bilker WB, Tolomeo P, Mao X, Nachamkin I, Fishman NO. Gastrointestinal tract colonization with fluoroquinolone-resistant Escherichia coli in hospitalized patients: changes over time in risk factors for resistance. Infect Control Hosp Epidemiol 2009; 30:18-24. [PMID: 19046057 DOI: 10.1086/592703] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The prevalence of fluoroquinolone (FQ) resistance in Escherichia coli has increased markedly in recent years. Despite the important role of gastrointestinal tract colonization with FQ-resistant E. coli (FQREC), the prevalence of and risk factors for FQREC colonization among the general hospitalized patient population have not been described, to our knowledge. The objective of this study was to identify the prevalence of and risk factors for FQREC colonization among hospitalized patients. DESIGN Three-year case-control study. Case patients (ie, all subjects with FQREC colonization) were compared with control patients (ie, all subjects without FQREC colonization). SETTING Two large medical centers within an academic health system. PARTICIPANTS All patients hospitalized at the 2 study hospitals. MAIN OUTCOME MEASURE Three annual fecal surveillance surveys were conducted. All patients colonized with FQREC (levofloxacin minimum inhibitory concentration, >or=8 microg/mL) were identified. RESULTS Of the 774 subjects, 89 (11.5%) were colonized with FQREC. Although there was a significant association between prior FQ use and FQREC colonization on bivariable analysis (odds ratio [OR], 2.02 [95% confidence interval {CI}, 1.14-3.46]; P=.01), there was statistically significant effect modification by year of study (P=.005). In multivariable analyses, after controlling for the hospital and for the duration of hospitalization prior to sampling, the association between FQ use and FQREC colonization was as follows: adjusted OR (aOR), 0.97 (95% CI, 0.29-3.23) in 2002; aOR, 1.41 (95% CI, 0.57-3.50) in 2003; and aOR, 9.87 (95% CI, 3.67-26.55) in 2004. CONCLUSIONS The association between prior FQ use and FQREC colonization varied significantly by study year, suggesting that the clinical epidemiology of resistant organisms may change over time. Furthermore, in the context of recent work showing significant changes in FQREC prevalence as well as changes in FQ resistance mechanisms (specifically, efflux overexpression) over the same time period, these results suggest a previously unrecognized complexity in the relationship between the clinical and molecular epidemiology of FQ resistance.
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Affiliation(s)
- Ebbing Lautenbach
- Division of Infectious Diseases, Department of Medicine, the Center for Clinical Epidemiology and Biostatistics, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6021, USA.
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Functional cloning and characterization of the multidrug efflux pumps NorM from Neisseria gonorrhoeae and YdhE from Escherichia coli. Antimicrob Agents Chemother 2008; 52:3052-60. [PMID: 18591276 DOI: 10.1128/aac.00475-08] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Active efflux of antimicrobial agents is one of the most important adapted strategies that bacteria use to defend against antimicrobial factors that are present in their environment. The NorM protein of Neisseria gonorrhoeae and the YdhE protein of Escherichia coli have been proposed to be multidrug efflux pumps that belong to the multidrug and toxic compound extrusion (MATE) family. In order to determine their antimicrobial export capabilities, we cloned, expressed, and purified these two efflux proteins and characterized their functions both in vivo and in vitro. E. coli strains expressing norM or ydhE showed elevated (twofold or greater) resistance to several antimicrobial agents, including fluoroquinolones, ethidium bromide, rhodamine 6G, acriflavine, crystal violet, berberine, doxorubicin, novobiocin, enoxacin, and tetraphenylphosphonium chloride. When they were expressed in E. coli, both transporters reduced the levels of ethidium bromide and norfloxacin accumulation through a mechanism requiring the proton motive force, and direct measurements of efflux confirmed that NorM behaves as an Na(+)-dependent transporter. The capacities of NorM and YdhE to recognize structurally divergent compounds were confirmed by steady-state fluorescence polarization assays, and the results revealed that these transporters bind to antimicrobials with dissociation constants in the micromolar region.
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Is your patient taking the right antimicrobial? Am J Nurs 2008; 108:49-55. [PMID: 18535447 DOI: 10.1097/01.naj.0000324377.09651.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Perfiles de resistencia a fluoroquinolonas en aislamientos clínicos de cocos Gram positivos provenientes de hospitales colombianos, 1994-2004. BIOMÉDICA 2008. [DOI: 10.7705/biomedica.v28i2.99] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Poirel L, Cattoir V, Nordmann P. Is plasmid-mediated quinolone resistance a clinically significant problem? Clin Microbiol Infect 2008; 14:295-7. [DOI: 10.1111/j.1469-0691.2007.01930.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Graham ML, Rieke EF, Wijkstrom M, Dunning M, Aasheim TC, Graczyk MJ, Pilon KJ, Hering BJ. Risk factors associated with surgical site infection and the development of short-term complications in macaques undergoing indwelling vascular access port placement. J Med Primatol 2008; 37:202-9. [PMID: 18331559 DOI: 10.1111/j.1600-0684.2008.00281.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Risk factors associated with surgical site infection (SSI) and the development of short-term complications in macaques undergoing vascular access port (VAP) placement are evaluated in this study. METHODS Records from 80 macaques with VAPs were retrospectively reviewed. Logistic regression was used to identify factors associated with short-term post-operative complications. RESULTS The primary outcome was SSI, which occurred in 21.6% (52.6% in the first 12 months vs. 13% thereafter) of procedures. SSI was associated with major secondary complications including VAP removal (11.4%), wound dehiscence (5.7%), and mechanical catheter occlusion (5.7%). In multivariate modeling, only surgical program progress was a statistically significant predictor of SSI, while animal compliance had a slightly protective effect. CONCLUSIONS Vascular access ports have a moderate risk of complications, provided the surgical program optimizes best practices. Under complex experimental conditions, VAPs represent an important refinement, both improving animals' overall well-being and environment and reducing stress.
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Affiliation(s)
- M L Graham
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
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