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Zaykova K, Nikolova S, Pancheva R, Serbezova A. A survey of knowledge, attitudes and use of antibiotics among Bulgarian population. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2022.2145237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Silviya Nikolova
- Department of Social Medicine and Organization of Healthcare, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
| | - Rouzha Pancheva
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
| | - Asena Serbezova
- Department of Health Policy and Management, Faculty of Public Health, Medical University of Sofia, Sofia, Bulgaria
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Su DQ, Huang HL, Zhuo ZQ. Pathogen distribution and bacterial resistance in children with severe pneumonia: A single-center retrospective study. Medicine (Baltimore) 2021; 100:e27128. [PMID: 34477157 PMCID: PMC8415946 DOI: 10.1097/md.0000000000027128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/24/2021] [Accepted: 08/18/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT To examine the etiological distribution of pathogens in pediatric patients with severe pneumonia and analyze the drug resistance of major pathogen species.Nasopharyngeal secretion specimens were collected for bacterial culture from pediatric patients admitted to the Xiamen children's hospital who were diagnosed with severe pneumonia from January 2016 to December 2019. Pathogen species were detected by quantitative polymerase chain reaction, direct immunofluorescence, and bacterial culture and we examined the drug susceptibility of the bacterial pathogens.At least 1 species of the pathogen was detected in 576 of 734 patients and a total of 444 bacterial samples were isolated, of which 284 were gram-negative and 160 were gram-positive. The most frequently detected bacteria were Haemophilus influenzae, Streptococcus pneumonia, Staphylococcus aureus, Klebsiella pneumoniae, and Escherichia coli. In addition, we isolated 186 viral samples, of which the majority were respiratory syncytial virus (n = 90) and adenovirus (n = 70) as well as 142 Mycoplasma pneumonia samples.Gram-negative bacteria are dominant among the pathogens causing severe pneumonia in pediatric patients and the major pathogen species are resistant to a variety of antibiotics. Appropriate antibiotic use has an important role in preventing the emergence of resistant strains.
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Delic S, Mijac V, Gajic I, Kekic D, Ranin L, Jegorovic B, Culic D, Cirkovic V, Siljic M, Stanojevic M, Paragi M, Markovic M, Opavski N. A Laboratory-Based Surveillance Study of Invasive Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae Diseases in a Serbian Pediatric Population-Implications for Vaccination. Diagnostics (Basel) 2021; 11:diagnostics11061059. [PMID: 34207530 PMCID: PMC8228891 DOI: 10.3390/diagnostics11061059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to present the epidemiology of invasive diseases caused by Neisseria meningitidis and Streptococcus pneumoniae in the pre-vaccine period, and Haemophilus influenzae in the post-vaccine period in a pediatric population from Serbia. Among the meningococci, serogroup B dominated (83%), followed by serogroup C (11.3%). High antigenic diversity was found, with fine type P1.5-1,10-4 being the most frequent. Moderate susceptibility to penicillin was common (55%). Within pneumococci, serotypes 19F, 14, 6B, 6A, 18C, 23F, 3, and 7F prevailed, while 19A was rare (3.6%). The coverages of PCV10 and PCV13 were 68% and 84%, respectively. Major sequence types were ST320, ST15, ST273, ST271, and ST81. Non-susceptibility to penicillin (66.7%), cefotaxime (37%), and macrolides (55%) was predominantly detected in vaccine-related serotypes. Among the 11 invasive H. influenzae isolates collected, there were six Hib, three non-type b, and two non-typeable strains (ntHi) that were antibiotic susceptible. These results imply a potential benefit of future Men-B vaccine implementations. For pneumococci, as PCV10 was recently introduced, a significant reduction of morbidity and antibiotic resistance might be expected. The efficiency of Hib vaccination is evident, but a shift towards non-type b and ntHi strains may be anticipated.
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Affiliation(s)
- Snezana Delic
- Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia; (S.D.); (D.C.)
| | - Vera Mijac
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Ina Gajic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Dusan Kekic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Lazar Ranin
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Boris Jegorovic
- Clinical Centre of Serbia, University Hospital for Infectious and Tropical Diseases, 11000 Belgrade, Serbia;
| | - Davor Culic
- Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia; (S.D.); (D.C.)
| | - Valentina Cirkovic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
| | - Marina Siljic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
| | - Maja Stanojevic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
| | - Metka Paragi
- National Laboratory of Health Environment and Food, Department for Public Health Microbiology, 1000 Ljubljana, Slovenia;
| | - Milos Markovic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
| | - Natasa Opavski
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia; (I.G.); (D.K.); (L.R.); (V.C.); (M.S.); (M.S.); (M.M.); (N.O.)
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
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The Role of PK/PD Analysis in the Development and Evaluation of Antimicrobials. Pharmaceutics 2021; 13:pharmaceutics13060833. [PMID: 34205113 PMCID: PMC8230268 DOI: 10.3390/pharmaceutics13060833] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Pharmacokinetic/pharmacodynamic (PK/PD) analysis has proved to be very useful to establish rational dosage regimens of antimicrobial agents in human and veterinary medicine. Actually, PK/PD studies are included in the European Medicines Agency (EMA) guidelines for the evaluation of medicinal products. The PK/PD approach implies the use of in vitro, ex vivo, and in vivo models, as well as mathematical models to describe the relationship between the kinetics and the dynamic to determine the optimal dosing regimens of antimicrobials, but also to establish susceptibility breakpoints, and prevention of resistance. The final goal is to optimize therapy in order to maximize efficacy and minimize side effects and emergence of resistance. In this review, we revise the PK/PD principles and the models to investigate the relationship between the PK and the PD of antibiotics. Additionally, we highlight the outstanding role of the PK/PD analysis at different levels, from the development and evaluation of new antibiotics to the optimization of the dosage regimens of currently available drugs, both for human and animal use.
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Neculai-Valeanu AS, Ariton AM, Mădescu BM, Rîmbu CM, Creangă Ş. Nanomaterials and Essential Oils as Candidates for Developing Novel Treatment Options for Bovine Mastitis. Animals (Basel) 2021; 11:1625. [PMID: 34072849 PMCID: PMC8229472 DOI: 10.3390/ani11061625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
Nanomaterials have been used for diagnosis and therapy in the human medical field, while their application in veterinary medicine and animal production is still relatively new. Nanotechnology, however, is a rapidly growing field, offering the possibility of manufacturing new materials at the nanoscale level, with the formidable potential to revolutionize the agri-food sector by offering novel treatment options for prevalent and expensive illnesses such as bovine mastitis. Since current treatments are becoming progressively more ineffective in resistant bacteria, the development of innovative products based on both nanotechnology and phytotherapy may directly address a major global problem, antimicrobial resistance, while providing a sustainable animal health solution that supports the production of safe and high-quality food products. This review summarizes the challenges encountered presently in the treatment of bovine mastitis, emphasizing the possibility of using new-generation nanomaterials (e.g., biological synthesized nanoparticles and graphene) and essential oils, as candidates for developing novel treatment options for bovine mastitis.
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Affiliation(s)
- Andra Sabina Neculai-Valeanu
- Research and Development Station for Cattle Breeding Dancu, Sos. Iasi-Ungheni no. 9, 707252 Dancu, Romania; (A.M.A.); (B.M.M.)
| | - Adina Mirela Ariton
- Research and Development Station for Cattle Breeding Dancu, Sos. Iasi-Ungheni no. 9, 707252 Dancu, Romania; (A.M.A.); (B.M.M.)
- Department of Fundamental Sciences in Animal Husbandry, Faculty of Food and Animal Sciences, Iasi University of Life Sciences (IULS), Mihail Sadoveanu Alley no. 8, 700490 Iasi, Romania;
| | - Bianca Maria Mădescu
- Research and Development Station for Cattle Breeding Dancu, Sos. Iasi-Ungheni no. 9, 707252 Dancu, Romania; (A.M.A.); (B.M.M.)
- Department of Fundamental Sciences in Animal Husbandry, Faculty of Food and Animal Sciences, Iasi University of Life Sciences (IULS), Mihail Sadoveanu Alley no. 8, 700490 Iasi, Romania;
| | - Cristina Mihaela Rîmbu
- Department of Public Health, Faculty of Veterinary Medicine, Iasi University of Life Sciences (IULS), Mihail Sadoveanu Alley no. 8, 700490 Iasi, Romania;
| | - Şteofil Creangă
- Department of Fundamental Sciences in Animal Husbandry, Faculty of Food and Animal Sciences, Iasi University of Life Sciences (IULS), Mihail Sadoveanu Alley no. 8, 700490 Iasi, Romania;
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Ibar-Bariain M, Rodríguez-Gascón A, Isla A, Solinís MÁ, Canut-Blasco A. Evaluation of the adequacy of the antimicrobial therapy of invasive Haemophilus influenzae infections: A pharmacokinetic/pharmacodynamic perspective. Enferm Infecc Microbiol Clin 2020; 39:65-71. [PMID: 32636039 DOI: 10.1016/j.eimc.2020.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/16/2023]
Abstract
INTRODUCTION In Europe, non-typeable H. influenzae (NTHi) is the leading cause of invasive H. influenzae disease in adults and is associated with high mortality. The goal of this study was to determine whether current antimicrobial treatments for H. influenzae infection in Spain are suitable based on their probability of achieving pharmacokinetic/pharmacodynamic (PK/PD) targets. METHODS Pharmacokinetic parameters for the antibiotics studied (amoxicillin, amoxicillin/clavulanic acid, ampicillin, cefotaxime, ceftriaxone, imipenem and ciprofloxacin) and susceptibility data for H. influenzae were obtained from literature. A Monte Carlo simulation was used to estimate the probability of target attainment (PTA), defined as the probability that at least a specific value of a PK/PD index is achieved at a certain MIC, and the cumulative fraction of response (CFR), defined as the expected population PTA for a specific drug dose and a specific microorganism population. RESULTS Regardless of dosing regimen, all antibiotics yielded CFR values of 100% or nearly 100% for all strains, including BL+, BL- and BLNAR, except amoxicillin and ampicillin for BL+. Thus, if an infection is caused by BL+ strains, treatment with amoxicillin and ampicillin has a high probability of failure (CFR≤8%). For standard doses of amoxicillin, amoxicillin/clavulanic acid and imipenem, PK/PD breakpoints were consistent with EUCAST clinical breakpoints. For the other antimicrobials, PK/PD breakpoints were higher than EUCAST clinical breakpoints. CONCLUSIONS Our study confirms by PK/PD analysis that, with the antimicrobials used as empirical treatment of invasive H. influenzae disease, a high probability of therapeutic success can be expected.
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Affiliation(s)
- Maitane Ibar-Bariain
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz, Spain
| | - Alicia Rodríguez-Gascón
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz, Spain
| | - Arantxa Isla
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz, Spain
| | - María Ángeles Solinís
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de Investigación Lascaray ikergunea, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz, Spain
| | - Andrés Canut-Blasco
- Microbiology Service, Hospital Universitario de Álava (HUA), Instituto de Investigación Sanitaria de Álava (BIOARABA), Servicio Vasco de Salud-Osakidetza, C/Francisco Leandro de Viana s/n, Vitoria-Gasteiz, Spain.
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Milojević S, Kekić D, Gajić I, Mijač V, Opavski N. Characterization of Streptococcus pneumoniae strains isolated from patients with meningitis before the introduction of pneumococcal conjugate vaccine in Serbia. MEDICINSKI PODMLADAK 2020. [DOI: 10.5937/mp71-22252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Pneumococcal meningitis is a serious disease which affects mostly children ≤ 2 years, adults ≥ 65 years and immunodeficient patients. The introduction of pneumococcal conjugate vaccine (PCV) into immunization programs worldwide has led to a significant decrease in the incidence of invasive pneumococcal disease, reduction of antibiotic resistance and changes in the distribution of pneumococcal serotypes. In 2018, PCV10 was introduced into the National Immunization Program in Serbia. Aim: The aim of this study was to analyze the serotype distribution and antibiotic susceptibility of pneumococcal strains isolated from meningitis cases in the pre-vaccinal period (2009-2018) in Serbia. Material and methods: Meningeal isolates were sent into the National Reference Laboratory for streptococci between January 2009 and December 2018 for serotyping and antimicrobial susceptibility testing (AST). Serotyping was performed by Quellung reaction, while AST was performed using disk diffusion method and E-test. Results: A total of 199 strains were analyzed and 32 different serotypes have been identified. Among the 55 (27.64%) strains from children ≤16 years, 17 different serotypes were detected of which 19F, 14, 6A, and 6B were the most common. Regarding the 144 (72.36%) adult isolates, 30 different serotypes were present, the most common being 3, 19F, 14, 23F, 6A and 6B. The coverage of pediatric serotypes was 61.82% for PCV10 and 78.18% for PCV13. Statistically significant number of isolates showed resistance to: penicillin (53.26%), erythromycin (45.73%), clindamycin (40.20%), trimethoprim-sulfamethoxazole (34.17%) and tetracycline (34.17%). The isolates from children were more resistant to beta-lactams and macrolides (p < 0.05). Conclusion: During the pre-vaccinal period in Serbia, vaccinal serotypes dominated over non-vaccinal serotypes. Resistance is intermediate to high in the dominant serotypes of children and low in the most common adult serotype 3. Taking into consideration the possible changes in the pneumococcal population in the future, continued monitoring of post-vaccine serotype and resistance trends are essential.
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Dowzicky MJ, Chmelařová E. Antimicrobial susceptibility of Gram-negative and Gram-positive bacteria collected from Eastern Europe: Results from the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.), 2011-2016. J Glob Antimicrob Resist 2018; 17:44-52. [PMID: 30445209 DOI: 10.1016/j.jgar.2018.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/25/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) is a global surveillance programme monitoring the in vitro activity of a panel of antimicrobial agents against clinically important bacterial isolates. Data for Gram-positive and Gram-negative isolates collected in Eastern Europe between 2011 and 2016 are presented here. METHODS Minimum inhibitory concentrations (MICs) were determined by the broth microdilution method using CLSI guidelines. Antimicrobial susceptibility was assessed using EUCAST breakpoints. RESULTS Nine Eastern European countries submitted 4289 isolates. Among Acinetobacter baumannii, resistance to levofloxacin, amikacin and meropenem was 77.5%, 63.4% and 62.2%, respectively. Multidrug resistance among A. baumannii was higher in 2015 than in previous years (44.1% in 2011 and 71.0% in 2015), decreasing to 51.7% in 2016. The multidrug resistance percentage for Pseudomonas aeruginosa was 26.9% and was relatively stable over time. The percentage of extended-spectrum β-lactamase (ESBL)-positive isolates among Escherichia coli and Klebsiella pneumoniae was 20.1% and 55.7%, respectively. Resistance to amikacin, meropenem and tigecycline was low among E. coli and K. pneumoniae and the ESBL-producing subset (≤5.9%). Among Staphylococcus aureus isolates, 36.7% were methicillin-resistant (MRSA); percentages varied year-on-year. No S. aureus isolates, including MRSA, were resistant to linezolid, vancomycin or tigecycline. Among Enterococcus faecium isolates, resistance was 22.6% to vancomycin and 2.3% to linezolid; no isolates were resistant to tigecycline. CONCLUSION This study shows low resistance to meropenem and tigecycline among Enterobacteriaceae isolates and continued activity of linezolid, vancomycin and tigecycline against Gram-positive organisms. However, antimicrobial resistance continues to be problematic in Eastern Europe and requires continued surveillance.
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Affiliation(s)
- Michael J Dowzicky
- Pfizer, Inc., 500 Arcola Road, E Dock, Office F-3232, Collegeville, PA 19426, USA.
| | - Eva Chmelařová
- Department of Microbiology, AGEL Laboratories, Ostrava - Vítkovice, Czech Republic
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