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Viseskul N, Kasatpibal N, Kaewsakol C, Kunkhet A, Viriyachetkun S, Turale S. Nurses' satisfaction with an educational web application to prevent transmission of multidrug-resistant organisms. Nurs Health Sci 2024; 26:e13126. [PMID: 38754867 DOI: 10.1111/nhs.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 04/07/2024] [Accepted: 04/21/2024] [Indexed: 05/18/2024]
Abstract
Multidrug-resistant organism infections are a serious health problem globally, and can result in patient mortality and morbidity. In this descriptive study, we produced the first web application for transmission prevention specific to the situation based on nursing experience, knowledge, and practice guidelines and to evaluate web application satisfaction among Thai nurses. The sample comprised 282 Thai registered nurses experienced in caring for patients with multidrug-resistant organisms in a tertiary hospital. A demographic form and knowledge test were completed anonymously online. Data were analyzed using descriptive statistics. The application emphasized crucial topics for which participants had low preliminary knowledge and included tutorial sessions, pictures, video clips, drills, and a post-test. The application was piloted with a random sample of 30 nurses, and an instrument tested their satisfaction with this. Results revealed that preliminary knowledge scores for preventing transmission were moderate, and participants were highly satisfied with the application. Findings suggest the application is suitable for Thai nurses and could be applied to nursing practice elsewhere. However, further testing is recommended before implementing it into nursing practice.
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Affiliation(s)
- Nongkran Viseskul
- Division of Nursing Science, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Nongyao Kasatpibal
- Division of Nursing Science, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | | | - Arus Kunkhet
- College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sue Turale
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Chand U, Kushawaha PK. Silibinin-loaded chitosan-capped silver nanoparticles exhibit potent antimicrobial, antibiofilm, and anti-inflammatory activity against drug-resistant nosocomial pathogens. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024:1-23. [PMID: 38787751 DOI: 10.1080/09205063.2024.2355744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Nanoparticles capped with natural products can be a cost-effective alternative to treat drug-resistant nosocomial infections. Therefore, silibinin-loaded chitosan-capped silver nanoparticles (S-C@AgNPs) were synthesized to evaluate their antimicrobial and anti-inflammatory potential. The S-C@AgNPs plasmon peak was found at 430 nm and had a particle size distribution of about 130 nm with an average hydrodynamic diameter of 101.37 nm. The Scanning Electron Microscopy images showed the presence of sphere-shaped homogeneous nanoparticles. The Fourier Transform Infrared Spectroscopy analysis confirmed the loading of silibinin and chitosan on the AgNPs surface. The minimum inhibitory concentration of the S-C@AgNPs was reported between 3.12 μg/ml to 12.5 μg/ml and a minimum bactericidal concentration between 6.25 μg/ml to 25 μg/ml against drug-resistant nosocomial pathogens. Moreover, concentration-dependent significant inhibition of the biofilm formation was reported against P. aeruginosa (70.21%) and K. pneumoniae (71.02%) at 30 μg/ml, and the highest destruction of preformed biofilm was observed at 100 μg/ml against P. aeruginosa (89.74%) and K. pneumoniae (77.65%) as compared to individual bacterial control. Additionally, the fluorescence live/dead assay for bacterial biofilm confirmed that 100 µg/ml effectively inhibits the biofilm formed by these pathogens. S-C@AgNPs also showed anti-inflammatory activity, which is evident by the significant decrease in the proinflammatory cytokines and chemokines level in THP1 cells treated with LPS. This study concluded that S-C@AgNPs have potent antimicrobial, antibiofilm, and anti-inflammatory properties and could be a potential option for treating drug resistant nosocomial infections.
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Affiliation(s)
- Umesh Chand
- Department of Microbiology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Pramod Kumar Kushawaha
- Department of Microbiology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
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3
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Okeke IN, de Kraker MEA, Van Boeckel TP, Kumar CK, Schmitt H, Gales AC, Bertagnolio S, Sharland M, Laxminarayan R. The scope of the antimicrobial resistance challenge. Lancet 2024:S0140-6736(24)00876-6. [PMID: 38797176 DOI: 10.1016/s0140-6736(24)00876-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
Each year, an estimated 7·7 million deaths are attributed to bacterial infections, of which 4.95 million are associated with drug-resistant pathogens, and 1·27 million are caused by bacterial pathogens resistant to the antibiotics available. Access to effective antibiotics when indicated prolongs life, reduces disability, reduces health-care expenses, and enables access to other life-saving medical innovations. Antimicrobial resistance undoes these benefits and is a major barrier to attainment of the Sustainable Development Goals, including targets for newborn survival, progress on healthy ageing, and alleviation of poverty. Adverse consequences from antimicrobial resistance are seen across the human life course in both health-care-associated and community-associated infections, as well as in animals and the food chain. The small set of effective antibiotics has narrowed, especially in resource-poor settings, and people who are very young, very old, and severely ill are particularly susceptible to resistant infections. This paper, the first in a Series on the challenge of antimicrobial resistance, considers the global scope of the problem and how it should be measured. Robust and actionable data are needed to drive changes and inform effective interventions to contain resistance. Surveillance must cover all geographical regions, minimise biases towards hospital-derived data, and include non-human niches.
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Affiliation(s)
- Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
| | - Marlieke E A de Kraker
- Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; WHO Collaborating Centre on AMR, Geneva, Switzerland
| | - Thomas P Van Boeckel
- Health Geography and Policy Group, Department of Environmental Systems Science, ETH Zürich, Zürich, Switzerland; One Health Trust, Bengaluru, India
| | | | - Heike Schmitt
- Centre for Zoonoses and Environmental Microbiology, Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands; Environmental Biotechnology, Faculty of Applied Sciences, Delft University of Technology, Delft, Netherlands
| | - Ana C Gales
- Division of Infectious Diseases, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Silvia Bertagnolio
- Department of Surveillance, Control, and Prevention of Antimicrobial Resistance, WHO, Geneva, Switzerland
| | - Mike Sharland
- Centre for Neonatal and Paediatric Infection, St George's, University London, London, UK
| | - Ramanan Laxminarayan
- One Health Trust, Bengaluru, India; High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA.
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Piano S, Bunchorntavakul C, Marciano S, Rajender Reddy K. Infections in cirrhosis. Lancet Gastroenterol Hepatol 2024:S2468-1253(24)00078-5. [PMID: 38754453 DOI: 10.1016/s2468-1253(24)00078-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 05/18/2024]
Abstract
Cirrhosis is an immune dysfunction state, and as such, patients with cirrhosis are susceptible to bacterial, fungal, and viral infections. Because of infection, these patients have a propensity to develop multiorgan failure, which is associated with high mortality. Bacterial infections are the most prevalent type of infection in patients with cirrhosis, with the prevalence of bacterial infections in patients admitted for an acute decompensating event ranging from 24% to 29%. Together with invasive fungal infections, bacterial infections are the most severe. Multidrug-resistant organisms have been evolving at a rapid and alarming rate around the world, which presents enormous challenges. The development of effective measures for the prevention, early detection, and treatment of infections in patients with cirrhosis is challenging, given the rising incidence of infections in this patient population.
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Affiliation(s)
- Salvatore Piano
- Unit of Internal Medicine and Hepatology, Department of Medicine, University and Hospital of Padova, Padova, Italy
| | | | - Sebastian Marciano
- Department of Clinical Investigation, Italian Hospital, Buenos Aires, Argentina
| | - K Rajender Reddy
- Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
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Tarantino B, Wood M, Hancock D, Shah K. Does pre-injury anticoagulation make chest tubes any less safe? A nationwide retrospective analysis. Am J Emerg Med 2024; 82:47-51. [PMID: 38788529 DOI: 10.1016/j.ajem.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/26/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Oral anticoagulation is becoming more common with the aging population, which raises concern for the risk of invasive procedures that can cause bleeding, such as chest tube placement (thoracostomy). With the increase in CT imaging, more pneumothoraces and hemothoraces are being identified. The relative risk of thoracostomy in the presence of anticoagulation is not well-established. The objective of this study was to determine whether pre-injury anticoagulation affects the relative risk of tube thoracostomy following significant chest trauma. METHODS This retrospective cohort study used data from the 2019 American College of Surgeons-Trauma Quality Program (ACS-TQP) database using R version 4.2.2. Data from the database was filtered based on inclusion and exclusion criteria. Outcomes were then assessed with the population of interest. Demographics, vitals, comorbidities, and injury parameters were also collected for each patient. This study included all adult patients (≥18 years) presenting with traumatic hemothorax, pneumothorax, or hemopneumothorax. Patients with missing data in demographics, vitals, comorbidities, injury parameters, or outcomes, as well as those with no signs of life upon arrival, were excluded from the study. Patients were stratified into groups based on whether they had pre-injury anticoagulation and whether they had a chest tube placed in the hospital. The primary outcome was mortality, and the secondary outcome was hospital length of stay (LOS). Logistic and standard regressions were used by a statistician to control for age, sex, and Injury Severity Score (ISS). RESULTS Our study population included 72,385 patients (4250 with pre-injury anticoagulation and 68,135 without pre-injury anticoagulation). Pre-injury anticoagulation and thoracostomy were each independently associated with increased mortality and LOS. However, there was a non-significant interaction term between pre-injury anticoagulation and thoracostomy for both outcomes, indicating that their combined effects on mortality and LOS did not differ significantly from the sum of their individual effects. CONCLUSION This study suggests that both pre-injury anticoagulation and thoracostomy are risk factors for mortality and increased LOS in adult patients presenting with hemothorax, pneumothorax, or hemopneumothorax, but they do not interact with each other. We recommend further study of this phenomenon to potentially improve clinical guidelines. LEVEL OF EVIDENCE Therapeutic, Level III.
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Affiliation(s)
| | - Myles Wood
- Weill Cornell Medicine, United States of America
| | | | - Kaushal Shah
- Weill Cornell Medicine, United States of America
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Montoya AM, Roncancio G, Franco L, López L, Vargas AR, de Jesús Suárez S, Garcés CG, Gumán M, Vanegas JM. Preventive Strategies In Paediatric Cardiovascular Surgery: Impact On Surgical Site Infections And Beyond. J Hosp Infect 2024:S0195-6701(24)00162-2. [PMID: 38740302 DOI: 10.1016/j.jhin.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/22/2024] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAI) can impede these efforts. This study analysed the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery program. METHODS Cohort study including children under 12 years of age with CHD who underwent cardiovascular surgery between 2010-2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control program databases. Impact of various preventive interventions was assessed using a Poisson model. A p-value less than 0.05 was considered statistically significant. RESULTS 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%) and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (p=0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR:0.56; 95%CI:0.32-0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% infections. No significant risk reduction was observed for other HAI with the implemented interventions. CONCLUSION Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.
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Affiliation(s)
| | - Gustavo Roncancio
- Department of Infectious diseases, Clínica Cardio Vid. Medellín, Colombia
| | - Liliana Franco
- Department of Microbiology, Clínica Cardio Vid. Medellín, Colombia
| | - Lucelly López
- School of Health Sciences, Universidad Pontificia Bolivariana. Medellín, Colombia
| | | | | | | | - Mónica Gumán
- Department of Paediatrics, Clínica Cardio Vid. Medellín, Colombia
| | - Johanna M Vanegas
- School of Health Sciences, Universidad Pontificia Bolivariana. Medellín, Colombia.
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Tanveer T, Ali S, Ali NM, Farooq MA, Summer M, Hassan A, Ali F, Irfan M, Kanwal L, Shahzad H, Islam R. Evaluating the Effect of pH, Temperature and Concentration on Antioxidant and Antibacterial Potential of Spectroscopically, Spectrophotometrically and Microscopically Characterized Mentha Spicata Capped Silver Nanoparticles. J Fluoresc 2024; 34:1253-1267. [PMID: 37523138 DOI: 10.1007/s10895-023-03322-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023]
Abstract
The use of traditional plants has been tremendously increased due to their higher biological impact, minimal side effects, and comparatively low cost. Moreover, the emergence of antibacterial resistance is also shifting the scientific community to reconsider herbal remedies which provide relatively safer, cheap and biologically tolerable solutions. The present research was designed to fabricate the Mentha spicata conjugated silver nanoparticles (Me-AgNPs). Furthermore, the assessment of the bactericidal potential of Me-AgNPs against various bacterial strains was another motive behind this study. Fabricated NPs were characterized with the help of the UV-Visible spectrophotometric analysis, Fourier transform infrared spectroscopy (FTIR) and Scanning electron microscopy (SEM). Me-AgNPs showed a significant zone of inhibition (23 ± 0.2 mm) at 8 mg/mL against Staphylococcus aureus and a 4.0 ± 0.2 mm zone of growth inhibition at 2 mg/mL against Aeromonas veronii. The stability of Me-AgNPs was assessed at various pH (4, 7 and 11) and temperatures (25 °C, 4 °C, 37 °C, 75 °C). The significant zones of inhibition (11.3 ± 0.3 mm, 8.3 ± 0.3mm, 14.3 ± 0.3 mm, and 7.6 ± 0.2 mm) were observed at pH 11 against Escherichia coli, Staphylococcus aureus, Bacillus subtilis, and Klebsiella pneumoniae, respectively. Growth inhibition zones (14.0 ± 0.5 mm and 13.0 ± 0.5 mm) were also determined against B. subtilis and S. aureus at 25 °C. DPPH bioassay was conducted to find the antioxidant properties of Me-AgNPs. The highest (38.66 ± 0.2%) free radical scavenging activity was shown by Me-AgNPs at 4 mg/mL. Present study results concluded that biogenic Me-AgNPs have bactericidal as well as anti-oxidative potential. Moreover, these green synthesized Me-AgNPs could maintain their potency and stability at a wide range of pH and temperature.
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Affiliation(s)
- Tahreem Tanveer
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Shaukat Ali
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan.
| | - Nazish Mazhar Ali
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Muhammad Adeel Farooq
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Muhammad Summer
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Ali Hassan
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Fareha Ali
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Muhammad Irfan
- Department of Biotechnology, University of Sargodha, Sargodha, Pakistan
| | - Lubna Kanwal
- Department of Zoology, University of Okara, Okara, Pakistan
| | - Hafsa Shahzad
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
| | - Rahila Islam
- Applied Entomology and Medical Toxicology Laboratory, Department of Zoology, Government College University, 54000, Lahore, Pakistan
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Helmi RT, Al-Maqbali JS, Gamal S, Ba Wazir H, Al Sulemani Y, Al Za'abi M. Short-term effects of antimicrobial stewardship programs on antibiotics usage, clinical outcomes, and multidrug resistant organisms in the post COVID-19 era. J Infect Public Health 2024; 17:819-824. [PMID: 38537576 DOI: 10.1016/j.jiph.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Antimicrobial resistance is associated with increasing mortality rates and the emergence of multidrug-resistant (MDR) organisms. There is scarcity of data on the short-term impact of Antimicrobial Stewardship Programs (ASP) on antibiotic usage, clinical outcome and MDR organisms' pattern following the COVID-19 pandemic. This study evaluated the short-term effects of ASP on antibiotic usage, clinical outcomes and MDR organisms' pattern in the post COVID-19 era. METHODS Conducted at a tertiary academic health center, this observational study involved adult patients (≥18 years) in the general medical unit, treated with oral or intravenous antibiotics from May 1, 2021, to April 30, 2022. The applied ASP strategy was a prospective audit and feedback where a weekly meeting was held to discuss the antimicrobial therapy of admitted patient, after which recommendations were made regarding antimicrobial use. RESULTS The study included 301 patients with 166 (55.1%) pre-ASP and 135 (44.9%) post-ASP. The median (IQR) age was 69 (55-77) years with 56.1% were female. Antibiotic usage dropped by 25.2% post-ASP. The length of hospital stay (LOS) was longer post-ASP (7 days vs. 7.9 days, p = 0.001), with MDR infections being a significant predictor (OR: 0.486, p < 0.001). There were no significant differences in 28-day readmission, recurrence of infections and all-cause mortality. Post-ASP, MDR pathogens increased (17.0% vs. 6.6%, p = 0.013), however, after separating post-ASP into two three-months periods, MDROs numbers decreased slightly (13 vs. 10). CONCLUSION Short-term ASP implementation post COVID-19 reduced antibiotic usage while other clinical outcomes remained unchanged. Nonetheless an increase in MDR pathogens and LOS was observed. Further research is required to assess ASP's long-term impact on MDR infections rates and specific patient group outcomes.
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Affiliation(s)
- Rania Tarek Helmi
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Juhaina Salim Al-Maqbali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman; Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sarah Gamal
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hashim Ba Wazir
- Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman; Department of Medicine, Sultan Qaboos Hospital, Salalah, Oman
| | - Yousuf Al Sulemani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
| | - Mohammed Al Za'abi
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman.
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Thornburg JA, Nguy P, Mortland KM, Mortland KM, Sloup RE, Naylor BK, Topp RV, Matson JS, Bigioni TP. In Vitro and In Vivo Testing of Microbe Growth on Antimicrobial Nursing Scrubs. Clin Nurs Res 2024; 33:253-261. [PMID: 38494871 DOI: 10.1177/10547738241238250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Around 5% to 10% of hospitalized patients develop a hospital-acquired infection (HAI). Scrubs are a potential vector of HAIs. To compare the antimicrobial characteristics of scrubs with and without an antimicrobial fabric coating, as tested in the laboratory (in vitro) and hospital (in vivo) environments. Two protocols were conducted to address the purpose. The in vitro protocol was a laboratory study that involved observing the microbe growth after inoculating coated and uncoated scrub fabric swatches with S. aureus and then processing them in moist and dry environments. The in vivo protocol was a clinical trial that measured microbe growth on coated and uncoated scrubs prior to and following nursing staff completing a 12-hr shift on an acute care unit, as measured by colony forming units (CFUs). For high-humidity environments, the in vitro study indicated that swatches treated with an antimicrobial coating exhibited minimal microbe growth, while untreated swatches exhibited significant microbe growth. For low-humidity environments, coated and uncoated swatches were all found to exhibit minimal microbe growth. In the in vivo study, the CFUs increased on scrubs worn by nurses over a 12-hr shift with no significant difference in CFUs for coated and uncoated scrubs. For bacteria in a warm and moist environment, the antimicrobial coating was found to be important for inhibiting growth. For bacteria in a warm and dry environment, both coated and uncoated fabrics performed similarly as measured at 24 hr, with minimal bacterial growth observed. In a hospital environment, microbe growth was observed, but no significant difference was detected when comparing coated and uncoated scrubs. This may have been due to the short time between exposure and culturing the scrubs for analysis immediately at the end of the shift not allowing for enough time to kill or inhibit growth. Contact time between the bacteria and scrub fabric (coated or uncoated) in the in vivo study more directly correlated with the 0-hr observations for the in vitro study, suggesting that the ineffectiveness of the treated scrubs in the clinical results may be due in part to short residence times before collection.
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Affiliation(s)
| | - Phong Nguy
- The University of Toledo, Toledo, OH, USA
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Alshamrani MM, El-Saed A, Al Zunitan M, Abalkhail M, Abagguey D, Farahat FM. Novel preventive bundle for multidrug-resistant organisms in intensive care setting; tertiary care experience. Heliyon 2024; 10:e28072. [PMID: 38560124 PMCID: PMC10981014 DOI: 10.1016/j.heliyon.2024.e28072] [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: 08/01/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background A widely-accepted standardized preventive bundle targeting multidrug-resistant organisms (MDROs) is lacking. The objective was to describe the components, implementation, compliance, and impact of a novel MDROs bundle in intensive care units (ICUs). Methods Cohort study of surveillance activities on the components of MDROs bundle (July 2019 to June 2022) and the incidence of MDROs (April 2016 to June 2022). The implementation of MDROs bundle were preceded by ICPs-led education of the staff working in target ICUs about the importance and components of the MDROs bundle. These included the overall use of antimicrobials, appropriate environmental cleaning, appropriate contact precautions, and hand hygiene compliance. Results During implementation, the overall use of antimicrobials was 57.8 days of therapy per 100 patient-days (44,492/76,933). It was higher in adult compared with pediatric/neonatal ICUs (p < 0.001). Appropriate environmental cleaning was 74.8% (12,409/16,582), appropriate contact precautions was 83.8% (10,467/12,497), and hand hygiene compliance was 86.9% (27,023/31,096). The three components were significantly higher in pediatric/neonatal compared with adult ICUs (p = 0.027, p < 0.001, p = 0.006, respectively). The MDROs rates per 10,000 patient-days were 71.8 before (April 2016 to June 2019) and 62.0 during (July 2019 to June 2022) the bundle implementation (858/119,565 versus 891/143,649 p = 0.002). The reduction in MDROs rates were replicated in adult (p = 0.001) but not pediatric/neonatal ICUs (p = 0.530). Conclusions The finding of this study indicate that the implementation of the current bundle was associated with a modest decrease in MDROs rates in adult ICUs. The provided detailed definitions and methodology will facilitate its use by other healthcare facilities.
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Affiliation(s)
- Majid M. Alshamrani
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Aiman El-Saed
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Al Zunitan
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed Abalkhail
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Infection Prevention and Control Department, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Doris Abagguey
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Fayssal M. Farahat
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Dewi RR, Nuryawan A, Jajere SM, Sihombing JM, Tambunan IJ. Antimicrobial resistance profiles of Escherichia coli derived from an integrated agroforestry-livestock system in Deli Serdang Regency, Indonesia. Vet World 2024; 17:690-699. [PMID: 38680150 PMCID: PMC11045535 DOI: 10.14202/vetworld.2024.690-699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/05/2024] [Indexed: 05/01/2024] Open
Abstract
Background and Aim Antimicrobial resistance (AMR) has become a significant global concern. Epidemiological data do not provide a robust description of the potential risks associated with AMR in the integrated agroforestry-livestock systems in Indonesia. Thus, the present study investigated the phenotypic and multidrug resistance (MDR) profiles of Escherichia coli strains isolated from the feces of livestock raised in the agro-silvopastoral system in Deli Serdang Regency, North Sumatra Province. Materials and Methods A standard microbiological culture procedure was followed to isolate the organism and test antibiotic susceptibility using the Kirby-Bauer disk diffusion protocol. Furthermore, the multiple antibiotic resistance index was determined. Univariate analysis was conducted to identify the risk factors associated with AMR. Results The vast majority (77.5%) of livestock farmers were aged >30 years. All farmers were men and had no higher education (100% of them). The majority of the animal species managed were cattle and goats (37.5% each) and the livestock grazing pasture system (67.5%). In addition, the majority of farmers reported high antimicrobial use on their farms (87.5%). Of the samples (n = 142) analyzed, n = 70 were positive, with an overall prevalence of 44.4%. The species-specific prevalences of E. coli were 32.5%, 47.8%, and 50% in buffalo, goat, and cattle, respectively. Ampicillin and tetracyclines exhibited high resistance levels among the studied animal species. A relatively lower MDR for E. coli was associated with grazing on the pasture. Conclusion The findings from the current study provide baseline epidemiological information for future robust studies aimed at elucidating the drivers and patterns of AMR in agro-silvopastoral systems in the study area or elsewhere.
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Affiliation(s)
- Rita Rosmala Dewi
- Department of Animal Husbandry, Faculty of Science and Technology, Universitas Tjut Nyak Dhien, Medan, Indonesia
| | - Arif Nuryawan
- Department of Forestry, Faculty of Forestry, Universitas Sumatera Utara, Medan, Indonesia
| | - Saleh Mohammed Jajere
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Juli Mutiara Sihombing
- Department of Animal Husbandry, Faculty of Science and Technology, Universitas Tjut Nyak Dhien, Medan, Indonesia
| | - Ika Julianti Tambunan
- Department of Pharmacy, Faculty of Pharmacy, Universitas Tjut Nyak Dhien, Medan, Indonesia
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12
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Ruiz Ramos J, Santolaya Perrín MR, González Del Castillo J, Candel FJ, Quirós AM, López-Contreras González J, Jiménez AJ, Suárez-Lledó Grande A. Design of a panel of indicators for antibiotic stewardship programs in the Emergency Department. FARMACIA HOSPITALARIA 2024; 48:57-63. [PMID: 37481455 DOI: 10.1016/j.farma.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVE To develop a panel of indicators to monitor antimicrobial stewardship programs activity in the emergency department. METHODS A multidisciplinary group consisting of experts in the management of infection in emergency departments and the implementation of antimicrobial stewardship programs (ASP) evaluated a proposal of indicators using a modified Delphi methodology. In the first round, each expert classified the relevance of each proposed indicators in two dimensions (healthcare impact and ease of implementation) and two attributes (prioritization level and frequency). The second round was conducted based on the modified questionnaire according to the suggestions raised and new indicators suggested. Experts modified the prioritization order and rated the new indicators in the same manner as in the first round. RESULTS 61 potential indicators divided into four groups were proposed: consumption indicators, microbiological indicators, process indicators, and outcome indicators. After analyzing the scores and comments from the first round, 31 indicators were classified as high priority, 25 as intermediate priority, and 5 as low priority. Moreover, 18 new indicators were generated. Following the second round, all 61 initially proposed indicators were retained, and 18 new indicators were incorporated: 11 classified as high priority, 3 as intermediate priority, and 4 as low priority. CONCLUSIONS The experts agreed on a panel of ASP indicators adapted to the emergency services prioritized by level of relevance. This is as a helpful tool for the development of these programs and will contribute to monitoring the appropriateness of the use of antimicrobials in these units.
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Affiliation(s)
- Jesús Ruiz Ramos
- Servicio de Farmacia, Hospital Santa Creu y San Pau, Barcelona, España.
| | | | | | - Francisco Javier Candel
- Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario San Carlos, Madrid, España
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13
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Ruiz-Ramos J, Santolaya-Perrín MR, González-Del-Castillo J, Candel FJ, Martín-Quirós A, López-Contreras-González J, Julián-Jiménez A, Suárez-Lledó-Grande A. [Translated article] Design of a panel of indicators for antibiotic stewardship programs in the Emergency Department. FARMACIA HOSPITALARIA 2024; 48:T57-T63. [PMID: 38148256 DOI: 10.1016/j.farma.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE To develop a panel of indicators to monitor antimicrobial stewardship programs activity in the emergency department. METHODS A multidisciplinary group consisting of experts in the management of infection in emergency departments and the implementation of antimicrobial stewardship programs (ASP) evaluated a proposal of indicators using a modified Delphi methodology. In the first round, each expert classified the relevance of each proposed indicators in two dimensions (healthcare impact and ease of implementation) and two attributes (prioritisation level and frequency). The second round was conducted based on the modified questionnaire according to the suggestions raised and new indicators suggested. Experts modified the prioritisation order and rated the new indicators in the same manner as in the first round. RESULTS 61 potential indicators divided into four groups were proposed: consumption indicators, microbiological indicators, process indicators, and outcome indicators. After analysing the scores and comments from the first round, 31 indicators were classified as high priority, 25 as intermediate priority, and 5 as low priority. Moreover, 18 new indicators were generated. Following the second round, all 61 initially proposed indicators were retained, and 18 new indicators were incorporated: 11 classified as high priority, 3 as intermediate priority, and 4 as low priority. CONCLUSIONS The experts agreed on a panel of ASP Indicators adapted to the emergency services prioritised by level of relevance. This is as a helpful tool for the development of these programs and will contribute to monitoring the appropriateness of the use of antimicrobials in these units.
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Affiliation(s)
- Jesús Ruiz-Ramos
- Servicio de Farmacia, Hospital Santa Creu y San Pau, Catalonia, Spain.
| | | | | | - Francisco Javier Candel
- Infectious diseases-Clinical Microbiology, Hospital Clínico Universitario San Carlos, Madrid, Spain
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14
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Hamilton RA, Lond B, Wilde L, Williamson I. Understanding the lived-experience and support-needs of people living with antimicrobial resistance in the UK through interpretative phenomenological analysis. Sci Rep 2024; 14:3403. [PMID: 38337017 PMCID: PMC10858033 DOI: 10.1038/s41598-024-53814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
In the UK nearly 54,000 infections were caused by serious resistant bacteria in 2022 but there is a lack of evidence regarding the long-term impact on patients' lives nor what support they need. This research aimed to answer the question: "What are the key elements of experience and support needs of people living with AMR in the UK?". In-depth semi-structured interviews were undertaken with nine people who had been living with resistant infections or colonisation for 12-months or longer. Interpretive Phenomenological Analysis was used to study the accounts and illustrate individuals' experiences and support-needs. Participants experienced marginalisation and isolation but also empowerment; described across three major themes: (1) I live in fear and stigma: The long-term impact of AMR; (2) I am battling on my own: A journey toward self-advocacy; and (3) I like to share my story: The role of AMR communities. All participants perceived a lack of knowledge, information, and support from clinicians; difficulties accessing reliable and understandable information; and lack of understanding from family and friends. Charities and online groups provided support with coping with their situation and improving mental health and wellbeing. Understandable and relatable information regarding the science of AMR, transmission, prevention, and living with AMR needs to be provided by clinicians and healthcare services around the time of diagnosis to readily available after diagnosis.
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Affiliation(s)
| | - Benjamin Lond
- Department of Psychology, De Montfort University, Leicester, UK
| | - Lucina Wilde
- School of Pharmacy, De Montfort University, Leicester, UK
| | - Iain Williamson
- Department of Psychology, De Montfort University, Leicester, UK
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15
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Anantharajah A, Goormaghtigh F, Nguvuyla Mantu E, Güler B, Bearzatto B, Momal A, Werion A, Hantson P, Kabamba-Mukadi B, Van Bambeke F, Rodriguez-Villalobos H, Verroken A. Long-term intensive care unit outbreak of carbapenemase-producing organisms associated with contaminated sink drains. J Hosp Infect 2024; 143:38-47. [PMID: 38295006 DOI: 10.1016/j.jhin.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Between 2018 and 2022, a Belgian tertiary care hospital faced a growing issue with acquiring carbapenemase-producing organisms (CPO), mainly VIM-producing P. aeruginosa (PA-VIM) and NDM-producing Enterobacterales (CPE-NDM) among hospitalized patients in the adult intensive care unit (ICU). AIM To investigate this ICU long-term CPO outbreak involving multiple species and a persistent environmental reservoir. METHODS Active case finding, environmental sampling, whole-genome sequencing (WGS) analysis of patient and environmental strains, and implemented control strategies were described in this study. FINDINGS From 2018 to 2022, 37 patients became colonized or infected with PA-VIM and/or CPE-NDM during their ICU stay. WGS confirmed the epidemiological link between clinical and environmental strains collected from the sink drains with clonal strain dissemination and horizontal gene transfer mediated by plasmid conjugation and/or transposon jumps. Environmental disinfection by quaternary ammonium-based disinfectant and replacement of contaminated equipment failed to eradicate environmental sources. Interestingly, efflux pump genes conferring resistance to quaternary ammonium compounds were widespread in the isolates. As removing sinks was not feasible, a combination of a foaming product degrading the biofilm and foaming disinfectant based on peracetic acid and hydrogen peroxide has been evaluated and has so far prevented recolonization of the proximal sink drain by CPO. CONCLUSION The persistence in the hospital environment of antibiotic- and disinfectant-resistant bacteria with the ability to transfer mobile genetic elements poses a serious threat to ICU patients with a risk of shifting towards an endemicity scenario. Innovative strategies are needed to address persistent environmental reservoirs and prevent CPO transmission.
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Affiliation(s)
- A Anantharajah
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium.
| | - F Goormaghtigh
- Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - E Nguvuyla Mantu
- Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - B Güler
- Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - B Bearzatto
- Center for Applied Molecular Technologies, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Momal
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Werion
- Department of Intensive Care, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - P Hantson
- Department of Intensive Care, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - B Kabamba-Mukadi
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - F Van Bambeke
- Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - H Rodriguez-Villalobos
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Verroken
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium; Department of Prevention and Control Infection, Cliniques universitaires Saint-Luc, Brussels, Belgium
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16
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Souza ZN, Córdula CR, Cavalcanti IMF. The potential usage of Caatinga natural products against multi-drug-resistant bacteria. Fitoterapia 2024; 172:105752. [PMID: 37981022 DOI: 10.1016/j.fitote.2023.105752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
New sources of antibacterial drugs have become urgent with increasing bacterial resistance. Medicinal plants are attractive sources for antimicrobial compounds with fewer side effects and cheaper obtention. Brazil contains six biomes, including Caatinga, a semi-arid tropical vegetation exclusively from Brazil that contains over thousand vascular plant species. This review presents the potential of using Caatinga plant products to treat multidrug-resistant bacteria. This review used the keywords of antimicrobial resistance, resistance profile, multidrug resistance, Caatinga biome, and pathogenic bacteria to search in Scientific Electronic Library Online, the U.S. National Library of Medicine, and Google Scholar. Plant species as Schinopsis brasiliensis Engl., Annona vepretorum Mart., Croton pulegioides Baill., Myracrondruon urundeuva Allemo, Cereus jamacaru DC., Opuntia ficus-indica L., Bauhinia forficata L., Eucalyptus globulus, Croton sonderianus Muell. Arg., Campomanesia pubescens, and Abarema cochliacarpos showed bacteriostatic activity. Encholirium spectabile Mart., Hymenaea courbaril L., Neoglaziovia variegata Mez, Selaginella convoluta Spring, Encholirium spectabile Mart., Bromelia laciniosa Mart., Hymenaea martiana, Commiphora leptophloeos, and Mimosa tenuiflora presented bactericidal activity. Those extracts inhibited clinical-importance bacteria, such as Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Therefore, Caatinga biome plants are a valuable source of active biomolecules against pathogenic bacteria, and their therapeutic potential must be further explored.
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Affiliation(s)
- Zion N Souza
- Federal University of Pernambuco (UFPE), Keizo Asami Institute (iLIKA), Recife, Pernambuco, Brazil
| | - Carolina R Córdula
- Federal University of Pernambuco (UFPE), Keizo Asami Institute (iLIKA), Recife, Pernambuco, Brazil
| | - Isabella M F Cavalcanti
- Federal University of Pernambuco (UFPE), Keizo Asami Institute (iLIKA), Recife, Pernambuco, Brazil; Federal University of Pernambuco (UFPE), Laboratory of Microbiology and Immunology, Academic Center of Vitória (CAV), Vitória de Santo Antão, Pernambuco, Brazil.
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17
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Joseph A, Edet U, Asanga E, Udoeyop FA, Ubi BI, Bebia G, Akindele AFI, Odu R, Nwaokorie F. Spice-Induced Metal Contamination and Microbiological Risk Assessment of Instant Noodles Prepared for Human Consumption. Biol Trace Elem Res 2023:10.1007/s12011-023-04018-y. [PMID: 38150117 DOI: 10.1007/s12011-023-04018-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Abstract
With the rising worries of potential metal contamination in cooked noodles, this study aimed at unravelling, for the first time, the possible source of metal contamination in cooked noodles. Noodles cooked with full spices (CWFS), cooked with half spices (CWHS), cooked with quarter spices (CWQS), and cooked with no spices (CWNS: control) and their spices were analysed for metals using inductively coupled plasma-atomic emission spectrometry. The microbiological quality of the noodles was also evaluated. Metal concentrations in cooked noodles varied with spice quantity. Noodles CWFS had the highest significant (p < 0.05) concentration of Pb (0.36 ± 0.12 mg/kg), Ni (1.05 ± 0.01 mg/kg), Cd (0.07 ± 0.04 mg/kg), Co (0.02 ± 0.002 mg/kg), and Na (9.45 ± 0.04 mg/kg), compared to the control (CWNS). The mean Pb and Ni of spice and cooked noodles were above the WHO acceptable limits for food and could be harmful to consumers. Pearson's correlation and PCA showed that packed noodle spices introduced metals into the cooked noodles. Although the hazard indices (adults and children) in all noodle's groups were less than 1, children still had the potential to contract cancer from Ni exposure because the carcinogenic risk values of CWQS (2.87 × 10-4), CWHS (3.03 × 10-4), and CWFS (3.21 × 10-4) were greater than 10-4. Microbiological analysis revealed the presence of potential pathogens that showed multidrug resistance and the ability to elaborate protease and amylase enzymes. Given the impending chronic health risks inherent in processed noodles, consistent consumption should be avoided.
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Affiliation(s)
- Akaninyene Joseph
- Department of Biosciences and Biotechnology, Faculty of Science, University of Medical Sciences, Ondo City, Ondo State, Nigeria.
- Key Laboratory of Integrated Regulation and Resource Development On Shallow Lake, College of Environment, Hohai University, Nanjing, 210098, People's Republic of China.
| | - Uwem Edet
- Department of Biological Sciences, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Akpabuyo, Cross River State, Nigeria
| | - Edet Asanga
- Department of Chemical Sciences, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Akpabuyo, Cross River State, Nigeria
| | - Favor Akpakpan Udoeyop
- Department of Biochemistry, Faculty of Basic Medical Sciences, PAMO University of Medical Science, Port Harcourt, Rivers State, Nigeria
| | - Bassey Ini Ubi
- Department of Microbiology, Faculty of Biological Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Glory Bebia
- Department of Medical Microbiology/Parasitology, Faculty of Medical Laboratory Science, University of Calabar, Calabar, Cross River State, Nigeria
| | - Ajoke F I Akindele
- Department of Biosciences and Biotechnology, Faculty of Science, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | - Regina Odu
- Department of Biological Sciences, Faculty of Natural and Applied Sciences, Arthur Jarvis University, Akpabuyo, Cross River State, Nigeria
| | - Francisca Nwaokorie
- Department of Medical Laboratory Science, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
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18
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Al-Tohamy A, Grove A. Targeting bacterial transcription factors for infection control: opportunities and challenges. Transcription 2023:1-28. [PMID: 38126125 DOI: 10.1080/21541264.2023.2293523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
The rising threat of antibiotic resistance in pathogenic bacteria emphasizes the need for new therapeutic strategies. This review focuses on bacterial transcription factors (TFs), which play crucial roles in bacterial pathogenesis. We discuss the regulatory roles of these factors through examples, and we outline potential therapeutic strategies targeting bacterial TFs. Specifically, we discuss the use of small molecules to interfere with TF function and the development of transcription factor decoys, oligonucleotides that compete with promoters for TF binding. We also cover peptides that target the interaction between the bacterial TF and other factors, such as RNA polymerase, and the targeting of sigma factors. These strategies, while promising, come with challenges, from identifying targets to designing interventions, managing side effects, and accounting for changing bacterial resistance patterns. We also delve into how Artificial Intelligence contributes to these efforts and how it may be exploited in the future, and we touch on the roles of multidisciplinary collaboration and policy to advance this research domain.Abbreviations: AI, artificial intelligence; CNN, convolutional neural networks; DTI: drug-target interaction; HTH, helix-turn-helix; IHF, integration host factor; LTTRs, LysR-type transcriptional regulators; MarR, multiple antibiotic resistance regulator; MRSA, methicillin resistant Staphylococcus aureus; MSA: multiple sequence alignment; NAP, nucleoid-associated protein; PROTACs, proteolysis targeting chimeras; RNAP, RNA polymerase; TF, transcription factor; TFD, transcription factor decoying; TFTRs, TetR-family transcriptional regulators; wHTH, winged helix-turn-helix.
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Affiliation(s)
- Ahmed Al-Tohamy
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
- Department of Cell Biology, Biotechnology Research Institute, National Research Centre, Cairo, Egypt
| | - Anne Grove
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
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19
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Aljasham AT, Damra EM, Alkahtani NS, Alouffi A, Al Salem WS, Alshabanah AO, Alotaibi M, Tanaka T, Ali A, Almutairi MM. Isolation, identification and antimicrobial susceptibility of the bacteria isolated from Hyalomma dromedarii infesting camels in Al-Jouf province, Saudi Arabia. Front Vet Sci 2023; 10:1227908. [PMID: 38155762 PMCID: PMC10752931 DOI: 10.3389/fvets.2023.1227908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
Ticks are important ectoparasites that transmit various pathogens causing morbidity and mortality in humans and animals. Saudi Arabia faces several challenges that can contribute to the emergence and spread of antimicrobial resistance (AMR) bacteria. These challenges require collaborative efforts to successfully achieve significant control of AMR in the country. The present study aims to isolate bacteria from camels' tick Hyalomma dromedarii in Al-Jouf province to identify and determine these isolates' antimicrobial susceptibilities. Forty-nine ticks were collected from dromedary camels and morphologically classified as H. dromedarii. Ticks were then homogenized and plated individually, which resulted in the isolation of 55 bacteria. The results showed that the bacterial isolates belong to 20 different species. About 71% (n = 39) of the total isolates were identified as Gram-positive bacteria comprised of 11 different species, while 29% (n = 16) of the total isolates were Gram-negative bacteria comprised of 9 different species. The most prevalent isolate within the total samples was Staphylococcus lentus (22.45%, 11/49), followed by Staphylococcus pseudintermedius (18.37%, 9/49) and Sphingomonas paucimobilis (16.33% 8/49). The antimicrobial susceptibility profile of Gram-positive bacteria showed that 100% (n = 31) were resistant to benzylpenicillin; 90.3% (n = 28) were resistant to oxacillin; 58.1% (n = 18) were resistant to clindamycin; 48.4% (n = 15) were resistant to vancomycin. In addition, 32.3% (n = 10) were resistant to trimethoprim/sulfamethoxazole and rifampicin; 25.8% (n = 8) were resistant to erythromycin; 16.1% (n = 5) were resistant to teicoplanin; 6.5% (n = 2) were resistant to tetracycline. All Gram-positive bacteria were 100% susceptible to linezolid, gentamicin, tobramycin, levofloxacin, moxifloxacin, tigecycline, and nitrofurantoin. In antimicrobial susceptibility tests for the Gram-negative bacteria, 57.14% (n = 8) of the identified bacteria were resistant to ampicillin, whereas 50% (n = 7) were resistant to cefoxitin and ceftazidime. About 28.57% (n = 4) of the Gram-negative bacteria were resistant to ceftriaxone, trimethoprim/sulfamethoxazole. In addition, 21.43% (n = 3) were resistant to amoxicillin/clavulanic acid and cephalothin; 14.29% (n = 2) were resistant to cefepime and nitrofurantoin; 7.14% (n = 1) were resistant to piperacillin/tazobactam and tigecycline. However, all Gram-negative bacteria were susceptible to other examined antimicrobials. This is the first study that investigates the role of the hard tick as a potential reservoir for AMR pathogens within our region.
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Affiliation(s)
- Alanoud T. Aljasham
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Eman M. Damra
- Department of Agriculture, Ministry of Environment, Water, and Agriculture, Riyadh, Saudi Arabia
| | - Nora S. Alkahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alouffi
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Waleed S. Al Salem
- Department of Agriculture, Ministry of Environment, Water, and Agriculture, Riyadh, Saudi Arabia
| | - Aljoharah O. Alshabanah
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Moureq Alotaibi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Tetsuya Tanaka
- Laboratory of Infectious Diseases, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Abid Ali
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Mashal M. Almutairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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20
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Abou Yassine K, El-Saed A, Othman F, Ramou S, Al Alwan BH, Ameer K, Hawthan M, Al Zunitan M, Alshamrani MM. Awareness of health care workers with appropriate infection control practices related to multi-patient use of Close Loop Medication Administration device. Infect Prev Pract 2023; 5:100323. [PMID: 38028360 PMCID: PMC10665828 DOI: 10.1016/j.infpip.2023.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/01/2023] [Indexed: 12/01/2023] Open
Abstract
Background Portable computerized devices represent a potential source of healthcare infections. The objective was to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) toward infection control practices used with Close Loop Medication Administration (CLMA) devices. Additionally, to quantify the impact of education and training on the bacterial burden on CLMA devices. Methods The study design consisted of two steps: a cross-sectional study was conducted among HCWs working in a tertiary care center in Riyadh, Saudi Arabia. A 32-item questionnaire was used to assess KAP information. The second step was environmental samples collected from the surfaces of CLMA devices before and after implementing a multifaceted intervention. Result A total of 325 HCWs were included in the study. The mean age was 32.6±7.4 years. The majority were females (92%) and nurses (91.3%). The overall KAP score was 74.8%, 74.2% adequate knowledge, 79.3% positive attitude, and 71.3% appropriate practices. KAP score was better (≥ median KAP score) among HCWs working in laboratory and organ transplant units (P<0.001). It was also better among those with a longer duration of work experience (P<0.001) and those who received related training (P<0.001). Approximately 75% of HCWs expressed their need for more information about CLMA. Post-interventional samples had much lower bacterial burden, with the positive rate reduced from 51.4% before intervention to 16.8% after intervention (P<0.001). Conclusions Awareness and behavior of HCWs about appropriate infection control practices related to portable devices is still inadequate. A multifaceted intervention including education and training significantly reduces the bioburden on portable devices.
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Affiliation(s)
- Kassem Abou Yassine
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Aiman El-Saed
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Fatmah Othman
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sarr Ramou
- Microbiology Laboratory, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Bassam H. Al Alwan
- Microbiology Laboratory, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Kholoud Ameer
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mustafa Hawthan
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Al Zunitan
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Majid M. Alshamrani
- Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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21
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Kamara MN, Lakoh S, Kallon C, Kanu JS, Kamara RZ, Kamara IF, Moiwo MM, Kpagoi SSTK, Adekanmbi O, Manzi M, Fofanah BD, Shewade HD. Hand Hygiene Practices and Promotion in Public Hospitals in Western Sierra Leone: Changes Following Operational Research in 2021. Trop Med Infect Dis 2023; 8:486. [PMID: 37999605 PMCID: PMC10674222 DOI: 10.3390/tropicalmed8110486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/09/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
Hand hygiene is the most important intervention for preventing healthcare-associated infections and can reduce preventable morbidity and mortality. We described the changes in hand hygiene practices and promotion in 13 public hospitals (six secondary and seven tertiary) in the Western Area of Sierra Leone following the implementation of recommendations from an operational research study. This was a "before and after" observational study involving two routine cross-sectional assessments using the WHO hand hygiene self-assessment framework (HHSAF) tool. The overall mean HHSAF score changed from 273 in May 2021 to 278 in April 2023; it decreased from 278 to 250 for secondary hospitals but increased from 263 to 303 for tertiary hospitals. The overall mean HHSAF score and that of the tertiary hospitals remained at the "intermediate" level, while secondary hospitals declined from "intermediate" to "basic" level. The mean score increased for the "system change" and "institutional safety climate" domains, decreased for "training and education" and "reminders in the workplace" domains, and remained the same for the "evaluation and feedback" domain. Limited resources for hand hygiene promotion, lack of budgetary support, and formalized patient engagement programs are the persistent gaps that should be addressed to improve hand hygiene practices and promotion.
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Affiliation(s)
- Matilda N Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Christiana Kallon
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Joseph Sam Kanu
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Rugiatu Z Kamara
- US Center for Disease Control and Prevention, Freetown 00232, Sierra Leone
| | | | - Matilda Mattu Moiwo
- Republic of Sierra Leone Armed Forces, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Satta S T K Kpagoi
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Olukemi Adekanmbi
- Department of Medicine, University of Ibadan, Ibadan 200005, Nigeria
- Department of Medicine, University College Hospital, Ibadan 200005, Nigeria
| | | | | | - Hemant Deepak Shewade
- Division of Health Systems Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India
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22
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Agodi A, Montineri A, Manuele R, Noto P, Carpinteri G, Castiglione G, Grassi P, Lazzara A, Mattaliano AR, Granvillano G, La Mastra C, La Rosa MC, Maugeri A, Barchitta M. Molecular Typing and Resistance Profile of Acinetobacter baumannii Isolates during the COVID-19 Pandemic: Findings from the "EPIRADIOCLINF" Project. Antibiotics (Basel) 2023; 12:1551. [PMID: 37887252 PMCID: PMC10603994 DOI: 10.3390/antibiotics12101551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Due to the COVID-19 pandemic, there has been a shift in focus towards controlling the spread of SARS-CoV-2, which has resulted in the neglect of traditional programs aimed at preventing healthcare-associated infections and combating antimicrobial resistance. The present work aims to characterize the colonization or infection with Acinetobacter baumannii of COVID-19 patients and to identify any clonality between different isolates. Specifically, data and resistance profiles of A. baumannii isolates were prospectively collected from patients recruited by the EPIRADIOCLINF project. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were used for molecular typing. Overall, we analyzed 64 isolates of A. baumannii from 48 COVID-19 patients. According to our analysis, we have identified the spread of a clonally related isolate, referred to as B. The PFGE pattern B includes four subtypes: B1 (consisting of 37 strains), B2 (11), B3 (5), and B4 (2). Furthermore, in the isolates that were examined using MLST, the most observed sequence type was ST/281. In terms of resistance profiles, 59 out of the total isolates (92.2%) were found to be resistant to gentamicin, carbapenems, ciprofloxacin, and tobramycin. The isolation and identification of A. baumannii from COVID-19 patients, along with the high levels of transmission observed within the hospital setting, highlight the urgent need for the implementation of effective prevention and containment strategies.
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Affiliation(s)
- Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (C.L.M.); (M.C.L.R.); (A.M.); (M.B.)
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Arturo Montineri
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Rosa Manuele
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Paola Noto
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Giuseppe Carpinteri
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Giacomo Castiglione
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Patrizia Grassi
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Antonio Lazzara
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Anna Rita Mattaliano
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Giuseppa Granvillano
- Azienda Ospedaliero-Universitaria Policlinico AOUP “G. Rodolico-San Marco”, 95123 Catania, Italy; (A.M.); (R.M.); (G.C.); (A.L.); (A.R.M.)
| | - Claudia La Mastra
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (C.L.M.); (M.C.L.R.); (A.M.); (M.B.)
| | - Maria Clara La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (C.L.M.); (M.C.L.R.); (A.M.); (M.B.)
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (C.L.M.); (M.C.L.R.); (A.M.); (M.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (C.L.M.); (M.C.L.R.); (A.M.); (M.B.)
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23
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Ruiz-Ramos J, Escolà-Vergé L, Monje-López ÁE, Herrera-Mateo S, Rivera A. The Interventions and Challenges of Antimicrobial Stewardship in the Emergency Department. Antibiotics (Basel) 2023; 12:1522. [PMID: 37887223 PMCID: PMC10604141 DOI: 10.3390/antibiotics12101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/25/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
Over the last decades, we have witnessed a constant increase in infections caused by multi-drug-resistant strains in emergency departments. Despite the demonstrated effectiveness of antimicrobial stewardship programs in antibiotic consumption and minimizing multi-drug-resistant bacterium development, the characteristics of emergency departments pose a challenge to their implementation. The inclusion of rapid diagnostic tests, tracking microbiological results upon discharge, conducting audits with feedback, and implementing multimodal educational interventions have proven to be effective tools for optimizing antibiotic use in these units. Nevertheless, future multicenter studies are essential to determine the best way to proceed and measure outcomes in this scenario.
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Affiliation(s)
- Jesus Ruiz-Ramos
- Pharmacy Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain;
- Sant Pau Institute of Biomedical Research (IIb Sant Pau), 08025 Barcelona, Spain (A.R.)
| | - Laura Escolà-Vergé
- Infectious Diseases Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain;
- CIBERINFEC, ISCIII—CIBER, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Álvaro Eloy Monje-López
- Pharmacy Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain;
- Sant Pau Institute of Biomedical Research (IIb Sant Pau), 08025 Barcelona, Spain (A.R.)
| | - Sergio Herrera-Mateo
- Sant Pau Institute of Biomedical Research (IIb Sant Pau), 08025 Barcelona, Spain (A.R.)
- Emergency Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Alba Rivera
- Sant Pau Institute of Biomedical Research (IIb Sant Pau), 08025 Barcelona, Spain (A.R.)
- Microbiology Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
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24
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Zuniga-Chaves I, Eggers S, Kates AE, Safdar N, Suen G, Malecki KMC. Neighborhood socioeconomic status is associated with low diversity gut microbiomes and multi-drug resistant microorganism colonization. NPJ Biofilms Microbiomes 2023; 9:61. [PMID: 37640705 PMCID: PMC10462741 DOI: 10.1038/s41522-023-00430-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
Social disparities continue to limit universal access to health care, directly impacting both lifespan and quality of life. Concomitantly, the gut microbiome has been associated with downstream health outcomes including the global rise in antibiotic resistance. However, limited evidence exists examining socioeconomic status (SES) associations with gut microbiome composition. To address this, we collected information on the community-level SES, gut microbiota, and other individual cofactors including colonization by multidrug-resistant organisms (MDROs) in an adult cohort from Wisconsin, USA. We found an association between SES and microbial composition that is mediated by food insecurity. Additionally, we observed a higher prevalence of MDROs isolated from individuals with low diversity microbiomes and low neighborhood SES. Our integrated population-based study considers how the interplay of several social and economic factors combine to influence gut microbial composition while providing a framework for developing future interventions to help mitigate the SES health gap.
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Affiliation(s)
- Ibrahim Zuniga-Chaves
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI, USA
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Shoshannah Eggers
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Ashley E Kates
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Garret Suen
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI, USA.
| | - Kristen M C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
- Environmental and Occupational Health Sciences, School of Public Health, University of Chicago Illinois, IL, Chicago, USA.
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25
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Schinas G, Skintzi K, De Lastic AL, Rodi M, Gogos C, Mouzaki A, Akinosoglou K. Patterns, Cost, and Immunological Response of MDR vs. Non MDR-Bacteremia: A Prospective Cohort Study. Pathogens 2023; 12:1044. [PMID: 37624004 PMCID: PMC10458260 DOI: 10.3390/pathogens12081044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a significant global health concern, posing a critical challenge for the effective management of infectious diseases. This study aimed to compare the immunological response, clinical outcomes, and associated costs in patients with bacteremia due to antibiotic-resistant vs. susceptible bacterial microorganisms. METHODS This study was a single-center, prospective cohort study conducted from May 2017 to November 2019. The study population consisted of patients admitted with a confirmed diagnosis of bacteremia. RESULTS A total of 116 patients were included, with 53 (45.7%) harboring non-multidrug-resistant (non-MDR) bacterial isolates and 63 (54.3%) harboring multidrug-resistant (MDR) bacterial isolates. Patients with MDR bacteremia had more severe clinical presentations, as indicated by higher SOFA and APACHE II scores. Results revealed higher all-cause mortality rates (39.7% vs. 17%) and median healthcare costs (€4791 vs. €2843.5) in the MDR bacteremia group. Moreover, MDR bacteremia was linked to higher levels of TNF-a, indicating a differential immune response. Furthermore, MDR bacteremia was found to be an independent predictor of mortality (OR = 3.216, 95% CI: 1.338-7.730, p = 0.009) and increased healthcare costs (effect size of approximately 27.4%). CONCLUSION These findings underscore the significant impact of antimicrobial resistance in healthcare settings, highlighting the urgency of addressing the challenges posed by MDR microorganisms.
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Affiliation(s)
- Georgios Schinas
- School of Medicine, University of Patras, Rion, 26504 Patras, Greece; (G.S.); (K.S.); (C.G.); (A.M.)
| | - Katerina Skintzi
- School of Medicine, University of Patras, Rion, 26504 Patras, Greece; (G.S.); (K.S.); (C.G.); (A.M.)
| | - Anne-Lise De Lastic
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Rion, 26504 Patras, Greece; (A.-L.D.L.); (M.R.)
| | - Maria Rodi
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Rion, 26504 Patras, Greece; (A.-L.D.L.); (M.R.)
| | - Charalambos Gogos
- School of Medicine, University of Patras, Rion, 26504 Patras, Greece; (G.S.); (K.S.); (C.G.); (A.M.)
| | - Athanasia Mouzaki
- School of Medicine, University of Patras, Rion, 26504 Patras, Greece; (G.S.); (K.S.); (C.G.); (A.M.)
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Rion, 26504 Patras, Greece; (A.-L.D.L.); (M.R.)
| | - Karolina Akinosoglou
- School of Medicine, University of Patras, Rion, 26504 Patras, Greece; (G.S.); (K.S.); (C.G.); (A.M.)
- Department of Internal Medicine and Division of Infectious Diseases, University General Hospital of Patras, Rion, 26504 Patras, Greece
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26
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Edi D, Ejiohuo O, Ordinioha B. Occurrence and prevalence of bacteria on door handles at the University of Port Harcourt Teaching Hospital and the multidrug resistance implications. Access Microbiol 2023; 5:acmi000615.v4. [PMID: 37601439 PMCID: PMC10436018 DOI: 10.1099/acmi.0.000615.v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/16/2023] [Indexed: 08/22/2023] Open
Abstract
Background. The coronavirus disease 2019 (COVID-19) pandemic has heightened concerns regarding transmitting hospital-acquired infections through high-contact points in healthcare facilities, such as door handles, which can serve as reservoirs for pathogenic micro-organisms. With the increased infectivity of the serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, there is greater awareness of the risk of multidrug-resistant bacteria on these surfaces, necessitating strict surveillance prevention protocols. Objective. This study assesses the occurrence and prevalence of bacteria on toilet door handles at the University of Port Harcourt Teaching Hospital in Nigeria and the multidrug resistance implications. We examined the hospital infection level and overall sanitary conditions. Method. Experimental data from our study on hospital door handles in different locations were assessed. Eighty-six samples were collected from toilet door handles at the University of Port Harcourt Teaching Hospital. Ethical approval was obtained from the hospital departments and the university research ethics committee. Samples from private offices and doors without handles were excluded. Bacteria were isolated from the samples, and antibiotic sensitivity testing was performed. Result. Of the 329 bacteria isolated, 55.5 % were Gram-positive and 44.4 % Gram-negative. The most prevalent bacteria were Staphylococcus epidermidis , followed by Bacillus sp. The prevalence of multidrug-resistant bacteria was also low, with Enterococcus sp. having the highest prevalence of 28.57%, followed by Micrococcus sp. at 3.45 % and S. epidermidis at 1.96 %. Conclusion The results show that, despite the occurrence of pathogenic micro-organisms, there has been a reduction in the prevalence of multidrug-resistant bacteria strains. This study can be used as an example for environmental microbiological surveillance in suspected outbreak investigations and assessment of sanitary conditions and the prevalence of multidrug-resistant bacteria in healthcare facilities.
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Affiliation(s)
- Deinmo Edi
- The Department of Preventive and Social Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Ovinuchi Ejiohuo
- Department of Pharmacognosy and Biomaterials, Poznan University of Medical Sciences, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Best Ordinioha
- The Department of Preventive and Social Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
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27
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Spatenkova V, Bradac O, Mareckova Z, Suchomel P, Hradil J, Kuriscak E, Halacova M. Incidence of surgical site infections after cervical spine surgery: results of a single-center cohort study adhering to multimodal preventive wound control protocol. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:1997-2004. [PMID: 36102993 PMCID: PMC10276122 DOI: 10.1007/s00590-022-03379-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The incidence of surgical site infections is considered a relevant indicator of perioperative and postoperative care quality. The aim of this study is to analyze and evaluate SSIs after elective cervical spine surgery under the guidance of our preventive multimodal wound protocol. METHODS A monocentric observational cohort study analyzed 797 patients who underwent cervical spine surgery from 2005 to 2010 (mean age 51.58 ± 11.74 year, male 56.09%, mean BMI 26.87 ± 4.41, ASA score 1-2 in 81.68% of patients), fulfilling the entry criteria: (1) cervical spine surgery performed by neurosurgeons (degenerative disease 85.19%, trauma 11.04%, tumor 3.76%), (2) elective surgery, (3) postoperative care in our neurointensive care unit. Our preventive wound control protocol management focused mainly on antibiotic prophylaxis, wound hygiene regime, and drainage equipment. All wound complications and surgical site infections were monitored up for 1 year after surgery. RESULTS We had only 2 (0.25%) patients with SSI after cervical spine surgery-one organ/space infection (osteomyelitis, primary due to liquorrhea) after anterior surgical approach, and one deep surgical site infection (due to dehiscence) after posterior approach. We had 17 (2.13%) patients with some wound complications (secretion 7, dehiscence 4, hematoma 1, edema 3, and liquorrhea 2) that were not classified as SSI according to the CDC guidelines. CONCLUSION Concerning our study population of patients undergoing elective cervical surgery, with ASA scores 1-2 in 81.68% of our patients, the incidence of SSI was 0.14% after anterior surgical approach, 1.4% after posterior surgical approach, and 0.25% altogether in the referred cohort.
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Affiliation(s)
- Vera Spatenkova
- Neurocenter, Neurointensive Care Unit, Regional Hospital, Husova 357/10, 46063 Liberec, Czech Republic
- Department of Anaesthesia and Intensive Care, 3 Medical Faculty, Charles University, Srobarova 50, 100 34 Prague, Czech Republic
- Institute of Physiology, First Medical Faculty, Charles University in Prague, Albertov 5, 12800 Prague 2, Czech Republic
- Faculty of Health Studies, Technical University of Liberec, Studentská 1402/2, 461 17 Liberec 1, Czech Republic
| | - Ondrej Bradac
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Úvalu 84/1, 150 06 Prague, Czech Republic
| | - Zuzana Mareckova
- Neurocenter, Department of Neurosurgery, Regional Hospital, Husova 357/10, 46063 Liberec, Czech Republic
| | - Petr Suchomel
- Faculty of Health Studies, Technical University of Liberec, Studentská 1402/2, 461 17 Liberec 1, Czech Republic
- Neurocenter, Department of Neurosurgery, Regional Hospital, Husova 357/10, 46063 Liberec, Czech Republic
| | - Jan Hradil
- Neurocenter, Department of Neurosurgery, Regional Hospital, Husova 357/10, 46063 Liberec, Czech Republic
| | - Eduard Kuriscak
- Institute of Physiology, First Medical Faculty, Charles University in Prague, Albertov 5, 12800 Prague 2, Czech Republic
| | - Milada Halacova
- Department of Clinical Pharmacology, Na Homolce Hospital, Roentgenova 37/2, 150 30 Prague 5, Czech Republic
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28
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Adukauskiene D, Ciginskiene A, Adukauskaite A, Koulenti D, Rello J. Clinical Features and Outcomes of VAP Due to Multidrug-Resistant Klebsiella spp.: A Retrospective Study Comparing Monobacterial and Polybacterial Episodes. Antibiotics (Basel) 2023; 12:1056. [PMID: 37370375 DOI: 10.3390/antibiotics12061056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/10/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
VAP due to multidrug-resistant (MDR) bacteria is a frequent infection among patients in ICUs. Patient characteristics and mortality in mono- and polybacterial cases of VAP may differ. A single-centre, retrospective 3-year study was conducted in the four ICUs of a Lithuanian referral university hospital, aiming to compare both the clinical features and the 60-day ICU all-cause mortality of monobacterial and polybacterial MDR Klebsiella spp. VAP episodes. Of the 86 MDR Klebsiella spp. VAP episodes analyzed, 50 (58.1%) were polybacterial. The 60-day mortality was higher (p < 0.05) in polybacterial episodes: overall (50.0 vs. 27.8%), in the sub-group with less-severe disease (SOFA < 8) at VAP onset (45.5 vs. 15.0%), even with appropriate treatment (41.7 vs. 12.5%), and the sub-group of extended drug-resistant (XDR) Klebsiella spp. (46.4 vs. 17.6%). The ICU mortality (44.0 vs. 22.5%) was also higher in the polybacterial episodes. The monobacterial MDR Klebsiella spp. VAP was associated (p < 0.05) with prior hospitalization (61.1 vs. 40.0%), diabetes mellitus (30.6 vs. 5.8%), obesity (30.6 vs. 4.7%), prior antibiotic therapy (77.8 vs. 52.0%), prior treatment with cephalosporins (66.7 vs. 36.0%), and SOFA cardiovascular ≥ 3 (44.4 vs. 10.0%) at VAP onset. Patients with polybacterial VAP were more likely (p < 0.05) to be comatose (22.2 vs. 52.0%) and had a higher SAPS II score (median [IQR] 45.0 [35.25-51.1] vs. 50.0 [40.5-60.75]) at VAP onset. Polybacterial MDR Klebsiella spp. VAP had distinct demographic and clinical characteristics compared to monobacterial, and was associated with poorer outcomes.
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Affiliation(s)
- Dalia Adukauskiene
- Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Ausra Ciginskiene
- Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Agne Adukauskaite
- Department of Cardiology and Angiology, University Hospital of Innsbruck, 6020 Innsbruck, Austria
| | - Despoina Koulenti
- Second Critical Care Department, Attikon University Hospital, 12462 Athens, Greece
- UQ Centre for Clinical Research (UQCCR), Faculty of Medicine, The Univesrity of Queensland, 4029 Brisbane, Australia
| | - Jordi Rello
- Vall d'Hebron Institute of Research, Vall d'Hebron Campus Hospital, 08035 Barcelona, Spain
- Clinical Research, CHU Nîmes, 30900 Nîmes, France
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Vieira B, Padrão J, Alves C, Silva CJ, Vilaça H, Zille A. Enhancing Functionalization of Health Care Textiles with Gold Nanoparticle-Loaded Hydroxyapatite Composites. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:nano13111752. [PMID: 37299655 DOI: 10.3390/nano13111752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
Hospitals and nursing home wards are areas prone to the propagation of infections and are of particular concern regarding the spreading of dangerous viruses and multidrug-resistant bacteria (MDRB). MDRB infections comprise approximately 20% of cases in hospitals and nursing homes. Healthcare textiles, such as blankets, are ubiquitous in hospitals and nursing home wards and may be easily shared between patients/users without an adequate pre-cleaning process. Therefore, functionalizing these textiles with antimicrobial properties may considerably reduce the microbial load and prevent the propagation of infections, including MDRB. Blankets are mainly comprised of knitted cotton (CO), polyester (PES), and cotton-polyester (CO-PES). These fabrics were functionalized with novel gold-hydroxyapatite nanoparticles (AuNPs-HAp) that possess antimicrobial properties, due to the presence of the AuNPs' amine and carboxyl groups, and low propensity to display toxicity. For optimal functionalization of the knitted fabrics, two pre-treatments, four different surfactants, and two incorporation processes were evaluated. Furthermore, exhaustion parameters (time and temperature) were subjected to a design of experiments (DoE) optimization. The concentration of AuNPs-HAp in the fabrics and their washing fastness were critical factors assessed through color difference (ΔE). The best performing knitted fabric was half bleached CO, functionalized using a surfactant combination of Imerol® Jet-B (surfactant A) and Luprintol® Emulsifier PE New (surfactant D) through exhaustion at 70 °C for 10 min. This knitted CO displayed antibacterial properties even after 20 washing cycles, showing its potential to be used in comfort textiles within healthcare environments.
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Affiliation(s)
- Bárbara Vieira
- CITEVE, Technological Centre for the Textile & Clothing Industry, 4760-034 Vila Nova de Famalicão, Portugal
- Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal
| | - Jorge Padrão
- Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal
| | - Cátia Alves
- Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal
| | - Carla Joana Silva
- CITEVE, Technological Centre for the Textile & Clothing Industry, 4760-034 Vila Nova de Famalicão, Portugal
| | - Helena Vilaça
- CITEVE, Technological Centre for the Textile & Clothing Industry, 4760-034 Vila Nova de Famalicão, Portugal
| | - Andrea Zille
- Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal
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Cao F, Kinthada R, Boehm T, D' Cunha N, Leus IV, Orth C, Zgurskaya HI, Walker JK. Identification and structure-activity relationships for a series of N, N-disubstituted 2-aminobenzothiazoles as potent inhibitors of S. aureus. Bioorg Med Chem Lett 2023; 89:129301. [PMID: 37094726 DOI: 10.1016/j.bmcl.2023.129301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/02/2023] [Accepted: 04/19/2023] [Indexed: 04/26/2023]
Abstract
An internal collection of commercial and synthetically derived small molecule compounds was screened against several drug-resistant bacterial pathogens. Compound 1, a known N, N-disubstituted 2-aminobenzothiazole, was found to be a potent inhibitor of Staphylococcus aureus and several associated clinically relevant strains of methicillin-resistant S. aureus suggesting a possible novel mechanism of inhibition. It failed to show activity in any of the Gram-negative pathogens it was tested in. Evaluation in Escherichia coli BW25113 and Pseudomonas aeruginosa PAO1, as well as in their respective hyperporinated and efflux pump-deletion mutants revealed that activity in Gram-negative bacteria is diminished because this benzothiazole scaffold is a substrate for bacterial efflux pumps. Several analogs of 1 were synthesized to generate basic structure-activity relationships for the scaffold which highlighted that the N-propyl imidazole moiety was critical for the observed antibacterial activity.
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Affiliation(s)
- Feng Cao
- John Cochran Division, Department of Veteran Affairs Medical Center, St. Louis, MO, 63106, United States
| | - Ramakumar Kinthada
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63110, United States
| | - Terri Boehm
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63110, United States
| | - Napoleon D' Cunha
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63110, United States
| | - Inga V Leus
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73072, United States
| | - Cari Orth
- John Cochran Division, Department of Veteran Affairs Medical Center, St. Louis, MO, 63106, United States
| | - Helen I Zgurskaya
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73072, United States
| | - John K Walker
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, MO, 63110, United States.
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Baek OD, Hjermitslev CK, Dyreborg L, Baunwall SMD, Høyer KL, Rågård N, Hammeken LH, Povlsen JV, Ehlers LH, Hvas CL. Early Economic Assessment of Faecal Microbiota Transplantation for Patients with Urinary Tract Infections Caused by Multidrug-Resistant Organisms. Infect Dis Ther 2023; 12:1429-1436. [PMID: 37062804 DOI: 10.1007/s40121-023-00797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
INTRODUCTION The use of faecal microbiota transplantation (FMT) to eradicate intestinal carriage of multidrug-resistant organisms (MDRO) has been described in case reports and small case series. Although few in numbers, these patients suffer from recurrent infections that may exacerbate both the patients' comorbidities and their healths. In the current study, we hypothesized that FMT for MDRO-related urinary tract infections (UTIs) reduces hospitalisations and associated costs. METHODS In a cohort of patients referred for FMT from 2015 to 2020, we selected all patients who had consecutively been referred for eradication of MRDO carriage with UTIs. An early economic assessment was performed to calculate hospital-related costs. The overall study cohort was registered at ClinicalTrials, study identifier NCT03712722. RESULTS We consecutively included five patients with UTIs caused by MDROs. Four of the patients were renal transplant recipients. Patients were followed for median 126 days (range 60-320), where the follow-up duration for each patient was aligned with the number of days from the first UTI to FMT. The median number of UTIs per patient dropped from 4 to 0. Investigating hospital costs, hospital admission days dropped by 87% and monthly hospital costs by 79%. CONCLUSIONS FMT was effective in reducing the occurrence of UTIs and mediated a marked reduction in hospital costs. We suggest that this strategy is cost-effective. TRIAL REGISTRATION ClinicalTrials, study identifier NCT03712722.
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Affiliation(s)
- Olivia Dybro Baek
- Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark.
| | - Camilla K Hjermitslev
- Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark
| | - Line Dyreborg
- Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark
| | - Simon M D Baunwall
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Katrine L Høyer
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Nina Rågård
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Lianna H Hammeken
- Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark
| | - Johan V Povlsen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars H Ehlers
- Department of Clinical Medicine, Danish Centre for Healthcare Improvements, Aalborg University, Aalborg, Denmark
| | - Christian Lodberg Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
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Gideskog M, Falkeborn T, Welander J, Melhus Å. Source Control of Gram-Negative Bacteria Using Self-Disinfecting Sinks in a Swedish Burn Centre. Microorganisms 2023; 11:microorganisms11040965. [PMID: 37110388 PMCID: PMC10143680 DOI: 10.3390/microorganisms11040965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Several retrospective studies have identified hospital sinks as reservoirs of Gram-negative bacteria. The aim of this study was to prospectively investigate the bacterial transmission from sinks to patients and if self-disinfecting sinks could reduce this risk. Samples were collected weekly from sinks (self-disinfecting, treated with boiling water, not treated) and patients in the Burn Centre at Linköping University Hospital, Sweden. The antibiotic susceptibility of Gram-negative isolates was tested, and eight randomly chosen patient isolates and their connected sink isolates were subjected to whole genome sequencing (WGS). Of 489 sink samples, 232 (47%) showed growth. The most frequent findings were Stenotrophomonas maltophilia (n = 130), Pseudomonas aeruginosa (n = 128), and Acinetobacter spp. (n = 55). Bacterial growth was observed in 20% of the samplings from the self-disinfecting sinks and in 57% from the sinks treated with boiling water (p = 0.0029). WGS recognized one transmission of Escherichia coli sampled from an untreated sink to a patient admitted to the same room. In conclusion, the results showed that sinks can serve as reservoirs of Gram-negative bacteria and that self-disinfecting sinks can reduce the transmission risk. Installing self-disinfecting sinks in intensive care units is an important measure in preventing nosocomial infection among critically ill patients.
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Affiliation(s)
- Maria Gideskog
- Department of Communicable Disease and Infection Control, Linköping University Hospital, SE-581 85 Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Tina Falkeborn
- Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Department of Clinical Microbiology, Linköping University Hospital, SE-581 85 Linköping, Sweden
| | - Jenny Welander
- Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Department of Clinical Microbiology, Linköping University Hospital, SE-581 85 Linköping, Sweden
| | - Åsa Melhus
- Section of Clinical Microbiology, Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
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Lu J, Zhu Y, Parkington HC, Hussein M, Zhao J, Bergen P, Rudd D, Deane MA, Oberrauch S, Cornthwaite-Duncan L, Allobawi R, Sharma R, Rao G, Li J, Velkov T. Transcriptomic Mapping of Neurotoxicity Pathways in the Rat Brain in Response to Intraventricular Polymyxin B. Mol Neurobiol 2023; 60:1317-1330. [PMID: 36443617 DOI: 10.1007/s12035-022-03140-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/17/2022] [Indexed: 11/30/2022]
Abstract
Intraventricular or intrathecal administration of polymyxins are increasingly used to treat multidrug-resistant (MDR) Gram-negative bacteria caused infections in the central nervous system (CNS). However, our limited knowledge of the mechanisms underpinning polymyxin-induced neurotoxicity significantly hinders the development of safe and efficacious polymyxin dosing regimens. To this end, we conducted transcriptomic analyses of the rat brain and spinal cord 1 h following intracerebroventricular administration of polymyxin B into rat lateral ventricle at a clinically relevant dose (0.5 mg/kg). Following the treatment, 66 differentially expressed genes (DEGs) were identified in the brain transcriptome while none for the spinal cord (FDR ≤ 0.05, fold-change ≥ 1.5). DEGs were enriched in signaling pathways associated with hormones and neurotransmitters, including dopamine and (nor)epinephrine. Notably, the expression levels of Slc6a3 and Gabra6 were decreased by 20-fold and 4.3-fold, respectively, likely resulting in major perturbations of dopamine and γ-aminobutyric acid signaling in the brain. Mass spectrometry imaging of brain sections revealed a distinct pattern of polymyxin B distribution with the majority accumulating in the injection-side lateral ventricle and subsequently into third and fourth ventricles. Polymyxin B was not detectable in the left lateral ventricle or brain tissue. Electrophysiological measurements on primary cultured rat neurons revealed a large inward current and significant membrane leakage following polymyxin B treatment. Our work demonstrates, for the first time, the key CNS signaling pathways associated with polymyxin neurotoxicity. This mechanistic insight combined with pharmacokinetic/pharmacodynamic dosing strategies will help guide the design of safe and effective intraventricular/intrathecal polymyxin treatment regimens for CNS infections caused by MDR Gram-negative pathogens.
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Affiliation(s)
- Jing Lu
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Yan Zhu
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Helena C Parkington
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Maytham Hussein
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Jinxin Zhao
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Phillip Bergen
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - David Rudd
- Drug Delivery, Disposition and Dynamics, Faculty of Pharmacy and Pharmaceutical Sciences, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, 3010, Australia
| | - Mary A Deane
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Sara Oberrauch
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Linda Cornthwaite-Duncan
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Rafah Allobawi
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Rajnikant Sharma
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - Gauri Rao
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27514, USA.
| | - Jian Li
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia.
| | - Tony Velkov
- Department of Pharmacology & Biochemistry, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia. .,Department of Microbiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia.
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Beyene AM, Andualem T, Dagnaw GG, Getahun M, LeJeune J, Ferreira JP. Situational analysis of antimicrobial resistance, laboratory capacities, surveillance systems and containment activities in Ethiopia: A new and one health approach. One Health 2023. [DOI: 10.1016/j.onehlt.2023.100527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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Maugeri A, Barchitta M, Puglisi F, Agodi A. Socio-economic, governance and health indicators shaping antimicrobial resistance: an ecological analysis of 30 european countries. Global Health 2023; 19:12. [PMID: 36829210 PMCID: PMC9951828 DOI: 10.1186/s12992-023-00913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/14/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Previous evidence shows that antibiotic use and antimicrobial resistance (AMR) spread are not always perfectly correlated within and between countries. We conducted an ecological analysis to evaluate how demographic, economic, governance, health, and freedom characteristics of 30 European countries contribute to antibiotic consumption and AMR. METHODS Using three sources of data (World Bank DataBank, ECDC atlas, and the ESAC-Net database), we created a dataset of: 22 indicators of demographics, health, economic, governance, and freedom; AMR proportions for 25 combinations of pathogens and antibiotics; consumption of antibiotics in the community. We also computed five indexes of demographic, health, economic, governance, and freedom, and an aggregate AMR measure. Relationships between indexes, antibiotic consumption, and AMR proportions were explored using bivariate, multivariable, multivariate, and mediation analyses. RESULTS Multivariate analysis identified three clusters of countries that mainly differed for demographic, health, governance, and freedom indexes. AMR proportion was lower in countries with better indexes (p < 0.001), but not necessarily with lower antibiotic consumption. In multivariable models including all five indexes, an increase in the governance index resulted in significant decreases of overall antibiotic consumption (p < 0.001) and AMR proportion (p = 0.006). Mediation analysis showed that the governance index had an indirect effect on AMR via reducing antibiotic consumption, which accounted only for 31.5% of the total effect. CONCLUSIONS These findings could be - at least partially - explained by the contagion theory, for which other factors contribute to high levels of AMR in countries with poor governance. As a result of this evidence, reducing antibiotic use alone is unlikely to solve the AMR problem, and more interventions are needed to increase governance efficiency at global level.
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Affiliation(s)
- Andrea Maugeri
- grid.8158.40000 0004 1757 1969Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Martina Barchitta
- grid.8158.40000 0004 1757 1969Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Federico Puglisi
- grid.8158.40000 0004 1757 1969Department of Economics and Business, University of Catania, Corso Italia 55, 95129 Catania, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123, Catania, Italy.
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E Silva LGA, de Maio Carrilho CMD, Talizin TB, Cardoso LTQ, Lavado EL, Grion CMC. Risk factors for hospital mortality in intensive care unit survivors: a retrospective cohort study. Acute Crit Care 2023; 38:68-75. [PMID: 36935536 PMCID: PMC10030242 DOI: 10.4266/acc.2022.01375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Deaths can occur after a patient has survived treatment for a serious illness in an intensive care unit (ICU). Mortality rates after leaving the ICU can be considered indicators of health care quality. This study aims to describe risk factors and mortality of surviving patients discharged from an ICU in a university hospital. METHODS Retrospective cohort study carried out from January 2017 to December 2018. Data on age, sex, length of hospital stay, diagnosis on admission to the ICU, hospital discharge outcome, presence of infection, and Simplified Acute Physiology Score (SAPS) III prognostic score were collected. Infected patients were considered as those being treated for an infection on discharge from the ICU. Patients were divided into survivors and non-survivors on leaving the hospital. The association between the studied variables was performed using the logistic regression model. RESULTS A total of 1,025 patients who survived hospitalization in the ICU were analyzed, of which 212 (20.7%) died after leaving the ICU. When separating the groups of survivors and non-survivors according to hospital outcome, the median age was higher among non-survivors. Longer hospital stays and higher SAPS III values were observed among non-survivors. In the logistic regression, the variables age, length of hospital stay, SAPS III, presence of infection, and readmission to the ICU were associated with hospital mortality. CONCLUSIONS Infection on ICU discharge, ICU readmission, age, length of hospital stay, and SAPS III increased risk of death in ICU survivors.
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Affiliation(s)
| | | | | | | | - Edson Lopes Lavado
- Departamento de Fisioterapia, Universidade Estadual de Londrina, São Paulo, Brazil
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Daneman N, Fridman D, Johnstone J, Langford BJ, Lee SM, MacFadden DM, Mponponsuo K, Patel SN, Schwartz KL, Brown KA. Antimicrobial resistance and mortality following E. coli bacteremia. EClinicalMedicine 2023; 56:101781. [PMID: 36618891 PMCID: PMC9813674 DOI: 10.1016/j.eclinm.2022.101781] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Global estimates suggest millions of deaths annually are associated with antimicrobial resistance (AMR) but these are generated from scarce data on the relative risk of death attributable to drug-resistant versus drug-sensitive infections. METHODS We examined all episodes of E. coli bloodstream infection in Ontario, Canada between 2017 and 2020, and measured 90 day mortality among those with resistant versus sensitive isolates for each of 8 commonly used antibiotic classes and a category of difficult to treat resistance (DTTR). We used multivariable logistic regression to calculate an adjusted odds of mortality associated with AMR, after accounting for patient demographics, comorbidities, and prior healthcare exposure. FINDINGS Among 14,548 eligible episodes of E. coli bloodstream infection, resistance was most common to aminopenicillins (46.8%), followed by first generation cephalosporins (38.8%), fluoroquinolones (26.5%), sulfonamides (24.1%), third generation cephalosporins (13.8%), aminoglycosides (11.7%), beta-lactam-beta-lactamase-inhibitors (9.1%) and carbapenems (0.2%). Only 18 (0.1%) episodes exhibited DTTR. For each antibiotic class, the unadjusted odds of mortality (OR) were higher among resistant isolates, but after accounting for patient characteristics the adjusted odds (aOR) of mortality were attenuated: aminopenicillins (OR 1.22, 95% CI 1.12-1.33; aOR 1.09, 95% CI 0.99-1.20), first generation cephalosporins (OR 1.24, 95% CI 1.14-1.35; aOR 1.07, 95% CI 0.97-1.18), third generation cephalosporins (OR 1.64, 95% CI 1.47-1.82; aOR 1.29, 95% CI 1.15-1.46), beta-lactam-beta-lactamase-inhibitors (OR 1.69, 95% CI 1.52-1.89, aOR 1.28, 95% CI 1.13-1.45), carbapenems (OR 3.11, 95% CI 1.52-6.34; aOR 2.06, 95% CI 0.91-4.66), sulfonamides (OR 1.19, 95% CI 1.07-1.31, aOR 1.06, 95% CI 0.95-1.18), fluoroquinolones (OR 1.49, 95% CI 1.36-1.64, aOR 1.16, 95% CI 1.05-1.29), aminoglycosides (OR 1.43, 95% CI 1.27-1.62; aOR 1.27, 95% CI 1.11-1.46), and DTTR (OR 3.71, 95% CI 1.46-9.41; aOR 2.58, 95% CI 0.87-7.66). INTERPRETATION AMR is associated with substantial increased mortality among patients with E. coli bloodstream infection, particularly for resistance to classes commonly used as empiric treatment. Surveillance for AMR-associated mortality should incorporate adjustment for patient characteristics and prior healthcare utilization. FUNDING This work was supported by a project grant from CIHR (grant number 159503). This study was also supported by ICES, which is funded by an annual grant from Ontario Ministry of Health and Long-Term Care (MOHLTC).
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Affiliation(s)
- Nick Daneman
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Corresponding author.
| | | | - Jennie Johnstone
- Division of Infectious Diseases, Department of Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Derek M. MacFadden
- ICES, Toronto, Ontario, Canada
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kwadwo Mponponsuo
- Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | | | - Kevin L. Schwartz
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kevin A. Brown
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Terra C, de Mattos ÂZ, Chagas MS, Torres A, Wiltgen D, Souza BM, Perez RM. Impact of multidrug resistance on the management of bacterial infections in cirrhosis. World J Clin Cases 2023; 11:534-544. [PMID: 36793638 PMCID: PMC9923851 DOI: 10.12998/wjcc.v11.i3.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/22/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023] Open
Abstract
Patients with cirrhosis have an increased risk of infection and differently from other complications, that over the years are improving in their outcomes, infections in cirrhotic patients are still a major cause of hospitalization and death (up to 50% in-hospital mortality). Infections by multidrug-resistant organisms (MDRO) have become a major challenge in the management of cirrhotic patients with significant prognostic and cost-related impact. About one third of cirrhotic patients with bacterial infections is infected with MDR bacteria and their prevalence has increased in recent years. MDR infections have a worse prognosis compared to infections by non-resistant bacteria because they are associated with lower rate of infection resolution. An adequate management of cirrhotic patients with infections caused by MDR bacteria depends on the knowledge of some epidemiological aspects, such as the type of infection (spontaneous bacterial peritonitis, pneumonia, urinary tract infection and spontaneous bacteremia), bacteriological profile of antibiotic resistance at each health care unit and site of infection acquisition (community acquired, healthcare associated or nosocomial). Furthermore, regional variations in the prevalence of MDR infections determine that the choice of empirical antibiotic therapy must be adapted to the local microbiological epidemiology. Antibiotic treatment is the most effective measure to treat infections caused by MDRO. Therefore, optimizing antibiotic prescribing is critical to effectively treat these infections. Identification of risk factors for multidrug resistance is essential to define the best antibiotic treatment strategy in each case and the choice of an effective empirical antibiotic therapy and its early administration is cardinal to reduce mortality. On the other hand, the supply of new agents to treat these infections is very limited. Thus, specific protocols that include preventive measures must be implemented in order to limit the negative impact of this severe complication in cirrhotic patients.
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Affiliation(s)
- Carlos Terra
- Gastroenterology-Liver Unit, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Liver Unit, Casa de Saúde São José-Rede Santa Catarina, Rio de Janeiro 22271-080, Rio de Janeiro, Brazil
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Liver Unit, Federal Hospital of Lagoa, Rio de Janeiro 22470-050, Rio de Janeiro, Brazil
| | - Ângelo Zambam de Mattos
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90020-090, Rio Grande do Sul, Brazil
- Gastroenterology and Hepatology Unit, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Rio Grande do Sul, Brazil
| | - Marcelo Souza Chagas
- Gastroenterology-Liver Unit, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Internal Medicine, Federal Hospital of Lagoa, Rio de Janeiro 22470-050, Rio de Janeiro, Brazil
| | - Andre Torres
- Gastroenterology-Liver Unit, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Denusa Wiltgen
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Department of Internal Medicine, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90020-090, Brazil
| | - Barbara Muniz Souza
- Gastroenterology-Liver Unit, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | - Renata Mello Perez
- Alliance of Brazilian Centers for Cirrhosis Car, The ABC Group, Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
- Hepatology Division, Federal University of Rio de Janeiro, Rio de Janeiro 21941-617, Rio de Janeiro, Brazil
- IDOR, D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Rio de Janeiro, Brazil
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Pardo-Freire M, Domingo-Calap P. Phages and Nanotechnology: New Insights against Multidrug-Resistant Bacteria. BIODESIGN RESEARCH 2023; 5:0004. [PMID: 37849463 PMCID: PMC10521656 DOI: 10.34133/bdr.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/21/2022] [Indexed: 10/19/2023] Open
Abstract
Bacterial infections are a major threat to the human healthcare system worldwide, as antibiotics are becoming less effective due to the emergence of multidrug-resistant strains. Therefore, there is a need to explore nontraditional antimicrobial alternatives to support rapid interventions and combat the spread of pathogenic bacteria. New nonantibiotic approaches are being developed, many of them at the interface of physics, nanotechnology, and microbiology. While physical factors (e.g., pressure, temperature, and ultraviolet light) are typically used in the sterilization process, nanoparticles and phages (bacterial viruses) are also applied to combat pathogenic bacteria. Particularly, phage-based therapies are rising due to the unparalleled specificity and high bactericidal activity of phages. Despite the success of phages mostly as compassionate use in clinical cases, some drawbacks need to be addressed, mainly related to their stability, bioavailability, and systemic administration. Combining phages with nanoparticles can improve their performance in vivo. Thus, the combination of nanotechnology and phages might provide tools for the rapid and accurate detection of bacteria in biological samples (diagnosis and typing), and the development of antimicrobials that combine the selectivity of phages with the efficacy of targeted therapy, such as photothermal ablation or photodynamic therapies. In this review, we aim to provide an overview of how phage-based nanotechnology represents a step forward in the fight against multidrug-resistant bacteria.
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Affiliation(s)
- Marco Pardo-Freire
- Institute for Integrative Systems Biology, I2SysBio, Universitat de València-CSIC, 46980 Paterna, Spain
| | - Pilar Domingo-Calap
- Institute for Integrative Systems Biology, I2SysBio, Universitat de València-CSIC, 46980 Paterna, Spain
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40
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Stern Bauer T, Yakobi R, Hurevich M, Yitzchaik S, Hayouka Z. Impedimetric Bacterial Detection Using Random Antimicrobial Peptide Mixtures. SENSORS (BASEL, SWITZERLAND) 2023; 23:561. [PMID: 36679359 PMCID: PMC9866871 DOI: 10.3390/s23020561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The biosensing of bacterial pathogens is of a high priority. Electrochemical biosensors are an important future tool for rapid bacteria detection. A monolayer of bacterial-binding peptides can serve as a recognition layer in such detection devices. Here, we explore the potential of random peptide mixtures (RPMs) composed of phenylalanine and lysine in random sequences and of controlled length, to form a monolayer that can be utilized for sensing. RPMs were found to assemble in a thin and diluted layer that attracts various bacteria. Faradaic electrochemical impedance spectroscopy was used with modified gold electrodes to measure the charge-transfer resistance (RCT) caused due to the binding of bacteria to RPMs. Pseudomonas aeruginosa was found to cause the most prominent increase in RCT compared to other model bacteria. We show that the combination of highly accessible antimicrobial RPMs and electrochemical analysis can be used to generate a new promising line of bacterial biosensors.
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Affiliation(s)
- Tal Stern Bauer
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - Ravit Yakobi
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - Mattan Hurevich
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - Shlomo Yitzchaik
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - Zvi Hayouka
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
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41
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Retamar-Gentil P, Cantón R, de Medrano VAL, Barberán J, Blasco AC, Gutiérrez CD, García-Vidal C, Escartín NL, Lora-Tamayo J, Marcos FJM, Ruíz CM, Liaño JP, Rascado P, Peláez ÓS, Girao GY, Horcajada JP. Antimicrobial resistance in Gram-negative bacilli in Spain: an experts' view. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:65-81. [PMID: 36510684 PMCID: PMC9910669 DOI: 10.37201/req/119.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Antibiotic resistance in Gram-negative bacilli poses a serious problem for public health. In hospitals, in addition to high mortality rates, the emergence and spread of resistance to practically all antibiotics restricts therapeutic options against serious and frequent infections. OBJECTIVE The aim of this work is to present the views of a group of experts on the following aspects regarding resistance to antimicrobial agents in Gram-negative bacilli: 1) the current epidemiology in Spain, 2) how it is related to local clinical practice and 3) new therapies in this area, based on currently available evidence. METHODS After reviewing the most noteworthy evidence, the most relevant data on these three aspects were presented at a national meeting to 99 experts in infectious diseases, clinical microbiology, internal medicine, intensive care medicine, anaesthesiology and hospital pharmacy. RESULTS AND CONCLUSIONS Subsequent local debates among these experts led to conclusions in this matter, including the opinion that the approval of new antibiotics makes it necessary to train the specialists involved in order to optimise how they use them and improve health outcomes; microbiology laboratories in hospitals must be available throughout a continuous timetable; all antibiotics must be available when needed and it is necessary to learn to use them correctly; and the Antimicrobial Stewardship Programs (ASP) play a key role in quickly allocating the new antibiotics within the guidelines and ensure appropriate use of them.
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Affiliation(s)
- Pilar Retamar-Gentil
- UGC Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla. Departamento de Medicina, Universidad de Sevilla/ IBiS /CSIC. Sevilla. Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III. Madrid. Spain
| | - Rafael Cantón
- CIBER de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III. Madrid. Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Madrid. Spain.,Correspondence: Rafael Cantón. Servicio de Microbiología. Hospital Universitario Ramón y Cajal-IRYCIS. Madrid. Phone: (+34) 91336883030; (+34) 913368832. E-mail:
| | | | - José Barberán
- Servicio de Medicina Interna-Enfermedades Infecciosas, Hospital Universitario HM Montepríncipe. Universidad San Pablo CEU. Madrid. Spain
| | - Andrés Canut Blasco
- Servicio de Microbiología, Hospital Universitario de Álava. Vitoria-Gasteiz. Spain
| | - Carlos Dueñas Gutiérrez
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario. Valladolid. Spain
| | - Carolina García-Vidal
- Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario de Barcelona. Barcelona. Spain
| | - Nieves Larrosa Escartín
- CIBER de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III. Madrid. Spain.,Servicio de Microbiología, Hospital Universitario Vall d’Hebron de Barcelona and Vall d’Hebron Institut de Recerca (VHIR). Barcelona. Spain
| | - Jaime Lora-Tamayo
- CIBER de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III. Madrid. Spain.,Servicio de Medicina Interna. Hospital Universitario 12 de Octubre. Instituto de Investigación Biomédica “imas12” Hospital 12 de Octubre. Madrid. Spain
| | | | - Carlos Martín Ruíz
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Cáceres. Cáceres. Spain
| | - Juan Pasquau Liaño
- Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves. Granada. Spain
| | - Pedro Rascado
- Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de Santiago Compostela. Santiago de Compostela. Spain
| | - Óscar Sanz Peláez
- Unidad de Enfermedades Infecciosas, Hospital Universitario Dr. Negrín. Las Palmas de Gran Canaria. Spain
| | - Genoveva Yagüe Girao
- Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigaciones Biomédicas (IMIB). Universidad de Murcia. Murcia. Spain
| | - Juan P. Horcajada
- CIBER de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III. Madrid. Spain.,Servicio de Enfermedades Infecciosas. Hospital del Mar. Instituto Hospital del Mar de Investigaciones Médicas (IMIM). Universitat Pompeu Fabra (UPF). Barcelona. Spain
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Nassar Júnior AP, Bezerra IL, Malheiro DT, Diaz MDM, Schettino GPP, Pereira AJ. Patient-level costs of central line-associated bloodstream infections caused by multidrug-resistant microorganisms in a public intensive care unit in Brazil: a retrospective cohort study. Rev Bras Ter Intensiva 2023; 34:529-533. [PMID: 36888835 PMCID: PMC9987001 DOI: 10.5935/0103-507x.20220313-pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/30/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
- Antonio Paulo Nassar Júnior
- IMPACTO-MR Program, Health Economics, Hospital Israelita Albert
Einstein - São Paulo (SP), Brazil
- Corresponding author: Antonio Paulo Nassar Junior,
IMPACTO-MR Program, Health Economics,, Hospital Israelita Albert Einstein, Av.
Albert Einstein, 627/701, 4° andar, prédio D - Morumbi, Zip code: 05652-
900 - São Paulo (SP), Brazil, E-mail:
| | - Isabella Lott Bezerra
- IMPACTO-MR Program, Health Economics, Hospital Israelita Albert
Einstein - São Paulo (SP), Brazil
| | - Daniel Tavares Malheiro
- IMPACTO-MR Program, Health Economics, Hospital Israelita Albert
Einstein - São Paulo (SP), Brazil
| | - Maria Dolores Montoya Diaz
- Economics Department, Faculdade de Economia, Administração,
Contabilidade e Atuária, Universidade de São Paulo - São Paulo (SP), Brazil
| | | | - Adriano José Pereira
- IMPACTO-MR Program, Health Economics, Hospital Israelita Albert
Einstein - São Paulo (SP), Brazil
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43
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Dewayani A, Afrida Fauzia K, Alfaray RI, Waskito LA, Doohan D, Rejeki PS, Alshawsh MA, Rezkitha YAA, Yamaoka Y, Miftahussurur M. Gastric microbiome changes in relation with Helicobacter pylori resistance. PLoS One 2023; 18:e0284958. [PMID: 37200323 DOI: 10.1371/journal.pone.0284958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 04/12/2023] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Inadequate antimicrobial treatment has led to multidrug-resistant (MDR) bacteria, including Helicobacter pylori (H. pylori), which one of the notable pathogens in the stomach. Antibiotic-induced changes in the microbiota can negatively affect the host. This study aimed to determine the influence of H. pylori resistance on the diversity and abundance of the stomach microbiome. METHODS Bacterial DNA was extracted from biopsy samples of patients presenting dyspepsia symptoms with H. pylori positive from cultures and histology. DNA was amplified from the V3-V4 regions of the 16S rRNA gene. In-vitro E-test was used to detect antibiotic resistance. Microbiome community analysis was conducted through α-diversity, β-diversity, and relative abundance. RESULTS Sixty-nine H. pylori positive samples were eligible after quality filtering. Following resistance status to five antibiotics, samples were classified into 24 sensitive, 24 single resistance, 16 double resistance, 5 triple resistance. Samples were mostly resistant to metronidazole (73.33%; 33/45). Comparation of four groups displayed significantly elevated α-diversity parameters under the multidrug resistance condition (all P <0.05). A notable change was observed in triple-resistant compared to sensitive (P <0.05) and double-resistant (P <0.05) groups. Differences in β-diversity by UniFrac and Jaccard were not significant in terms of the resistance (P = 0.113 and P = 0.275, respectively). In the triple-resistant group, the relative abundance of Helicobacter genera was lower, whereas that of Streptococcus increased. Moreover, the linear discriminant analysis effect size (LEfSe) was associated with the presence of Corynebacterium and Saccharimonadales in the single-resistant group and Pseudomonas and Cloacibacterium in the triple-resistant group. CONCLUSION Our results suggest that the resistant samples showed a higher trend of diversity and evenness than the sensitive samples. The abundance of H. pylori in the triple-resistant samples decreased with increasing cohabitation of pathogenic bacteria, which may support antimicrobial resistance. However, antibiotic susceptibility determined by the E-test may not completely represent the resistance status.
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Affiliation(s)
- Astri Dewayani
- Oita University Faculty of Medicine, Department of Infectious Disease Control, Yufu, Oita, Japan
- Faculty of Medicine, Department of Anatomy, Histology and Pharmacology, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
| | - Kartika Afrida Fauzia
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
- Oita University Faculty of Medicine, Department of Environmental and Preventive Medicine, Yufu, Oita, Japan
- Faculty of Medicine, Department of Public Health and Preventive Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ricky Indra Alfaray
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
- Oita University Faculty of Medicine, Department of Environmental and Preventive Medicine, Yufu, Oita, Japan
| | - Langgeng Agung Waskito
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Department of Medical Physiology and Biochemistry, Universitas Airlangga, Surabaya, Indonesia
| | - Dalla Doohan
- Faculty of Medicine, Department of Anatomy, Histology and Pharmacology, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
| | - Purwo Sri Rejeki
- Faculty of Medicine, Department of Medical Physiology and Biochemistry, Universitas Airlangga, Surabaya, Indonesia
| | - Mohammed Abdullah Alshawsh
- Faculty of Medicine, Department of Pharmacology, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine, School of Clinical Sciences, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Yudith Annisa Ayu Rezkitha
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Department of Internal Medicine, University of Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Yoshio Yamaoka
- Oita University Faculty of Medicine, Department of Environmental and Preventive Medicine, Yufu, Oita, Japan
- Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, Texas, United States of America
- Research Center for Global and Local Infectious Diseases, Oita University, Yufu, Oita, Japan
- Faculty of Medicine, Department of Internal Medicine, Division of Gastroentero-Hepatology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Miftahussurur
- Institute of Tropical Disease, Helicobacter pylori and Microbiota Study Group, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Department of Internal Medicine, Division of Gastroentero-Hepatology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
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Abubakar U, Amir O, Rodríguez-Baño J. Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies. J Pharm Policy Pract 2022; 15:99. [PMID: 36494700 PMCID: PMC9733066 DOI: 10.1186/s40545-022-00500-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is limited data to describe the point-prevalence of healthcare-associated infections (HAIs) among patients at a regional level in Africa. This study estimated the pooled prevalence of HAIs and described the distribution of HAIs as well as the pathogens identified from African studies. METHODS PubMed, Scopus and Google Scholar databases were searched to find point-prevalence studies of HAIs in Africa. Studies conducted in Humans that reported the prevalence of HAIs among hospitalized patients and published in English language from January 2010 to March 2022 were selected. Longitudinal studies of HAIs and unpublished studies were excluded. The reference list of the selected studies was checked to find additional studies. A meta-analysis was conducted using RevMan 5.4 and the pooled prevalence of HAIs was determined using a random effect model. RESULTS Of the 6094 articles identified from the databases, fifteen eligible articles were selected. The studies were conducted in the North, South, East and West African regions with Tunisia (n = 4) and South Africa (n = 2) having the highest number of studies. Most of the studies (n = 12, 80.0%) had good quality. The pooled prevalence of HAIs was 12.76% (95% confidence interval [CI] 10.30-15.23) with a high degree of heterogeneity (I2 = 90.0%). The prevalence of HAIs varied between wards with the highest rate found in the ICU (25.2%-100%), followed by neonatal ICU/ward (7.0%-53.6%) and paediatric medical ward (2.7%-33.0%). Surgical site infection was the most common HAIs and accounted for 41.6% of all HAIs (95% CI 23.55-59.80), followed by bloodstream infection (17.07%, 95% CI 11.80-22.33) and respiratory tract infections/pneumonia (17.04%, 95% CI 13.21-20.87). Recent hospitalization (adjusted odds ratio [AOR]: 4.17, 95% CI 1.85-9.41), presence of peripheral vascular catheter (AOR: 2.87, 95% CI 1.54-5.36) and having diabetes mellitus (AOR: 2.46, 95% CI 1.45-4.17) were the strongest predictors of HAIs in Africa. Only 37.9% of HAIs had documented positive microbiological culture result with gram negative bacteria including Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii and Citrobacter been the most common microorganisms and accounted for 40%-100% of the pathogens. CONCLUSIONS The pooled point-prevalence of HAIs in Africa is more than two times higher than the rate reported in developed countries. The prevalence varied between the countries and was highest in the ICU and neonatal ICU/ward. Surgical site infection and bloodstream infection were the most common HAIs reported in African studies. Recent hospitalization, presence of peripheral vascular catheter and having diabetes mellitus were the strongest predictors of HAIs in African studies. Most of the HAIs are preventable with appropriate infection control measures and antimicrobial stewardship. Additional studies are needed especially in the Central African region. Future studies should be designed using standardized protocol and standardized definition to reduce heterogeneity among the studies.
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Affiliation(s)
- Usman Abubakar
- grid.11875.3a0000 0001 2294 3534Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Omalhassan Amir
- grid.442398.00000 0001 2191 0036Department of Clinical Pharmacy, International University of Africa, Khartoum, Sudan
| | - Jesús Rodríguez-Baño
- grid.9224.d0000 0001 2168 1229Infectious Diseases and Microbiology Division, Department of Medicine, Hospital Universitario Virgen Macarena, Biomedicine Institute of Seville (IBiS)/CSIC, University of Seville, Seville, Spain ,grid.413448.e0000 0000 9314 1427CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
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Fukushige M, Syue LS, Morikawa K, Lin WL, Lee NY, Chen PL, Ko WC. Trend in healthcare-associated infections due to vancomycin-resistant Enterococcus at a hospital in the era of COVID-19: More than hand hygiene is needed. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1211-1218. [PMID: 35989164 PMCID: PMC9357275 DOI: 10.1016/j.jmii.2022.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Variable control measures for vancomycin-resistant Enterococcus (VRE) infections were adopted among different hospitals and areas. We investigated the burden and patient characteristics of healthcare-associated VRE infections in 2018-2019 and 2020, when multiple preventive measures for COVID-19 were taken. METHODS During the COVID-19 pandemic, mask waring and hand hygiene were enforced in the study hospital. The incidence densities of healthcare-associated infections (HAIs), including overall HAIs, methicillin-resistant Staphylococcus aureus (MRSA) HAIs, VRE HAIs, and VRE healthcare-associated bloodstream infections (HABSIs), consumption of broad-spectrum antibiotics and hygiene products, demographic characteristics and medical conditions of affected patients, were compared before and after the pandemic. RESULTS The incidence density of both VRE HAIs and VRE HABSIs did not change statistically significantly, however, the highest in 2020 than that in 2018 and 2019. This was in spite of universal mask waring and increased consumption of 75% alcohol in 2020 and consistent implementation of an antibiotic stewardship program in three observed years. The increased prescriptions of broad-spectrum cephalosporins might partially explain the increase of VRE infection. CONCLUSION Increased mask wearing and hand hygiene may not result in the decline in the development of VRE HAIs in the hospital during the COVID-19 pandemic, and continued monitoring of the dynamics of HAIs remains indispensable.
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Affiliation(s)
- Mizuho Fukushige
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Shang Syue
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Center for Infection Control, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - Wen-Liang Lin
- Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Yao Lee
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Center for Infection Control, 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
| | - Po-Lin Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Center for Infection Control, 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
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Center for Infection Control, 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,Corresponding author. Department of Internal Medicine, National Cheng Kung University Hospital, No. 138, Sheng Li Road, Tainan, 704, Taiwan. Fax: +886 6 2752038
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Complete Genomes of Three Pseudomonas aeruginosa Bacteriophages, Kara-mokiny 1, Kara-mokiny 2, and Kara-mokiny 3. Microbiol Resour Announc 2022; 11:e0095522. [DOI: 10.1128/mra.00955-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Here, we present the complete genome sequence of
Pseudomonas aeruginosa
phages Kara-mokiny 1, Kara-mokiny 2, and Kara-mokiny 3. These phages have lytic capabilities against
P. aeruginosa
and belong to the myovirus morphotype. The genomes of Kara-mokiny 1 and Kara-mokiny 2 are 67,075 bp while that of Kara-mokiny 3 is 66,019 bp long.
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Bermeo R, Lal K, Ruggeri D, Lanaro D, Mazzotta S, Vasile F, Imberty A, Belvisi L, Varrot A, Bernardi A. Targeting a Multidrug-Resistant Pathogen: First Generation Antagonists of Burkholderia cenocepacia's BC2L-C Lectin. ACS Chem Biol 2022; 17:2899-2910. [PMID: 36174276 PMCID: PMC9594048 DOI: 10.1021/acschembio.2c00532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Multidrug-resistant pathogens such as Burkholderia cenocepacia have become a hazard in the context of healthcare-associated infections, especially for patients admitted with cystic fibrosis or immuno-compromising conditions. Like other opportunistic Gram-negative bacteria, this pathogen establishes virulence and biofilms through lectin-mediated adhesion. In particular, the superlectin BC2L-C is believed to cross-link human epithelial cells to B. cenocepacia during pulmonary infections. We aimed to obtain glycomimetic antagonists able to inhibit the interaction between the N-terminal domain of BC2L-C (BC2L-C-Nt) and its target fucosylated human oligosaccharides. In a previous study, we identified by fragment virtual screening and validated a small set of molecular fragments that bind BC2L-C-Nt in the vicinity of the fucose binding site. Here, we report the rational design and synthesis of bifunctional C- or N-fucosides, generated by connecting these fragments to a fucoside core using a panel of rationally selected linkers. A modular route starting from two key fucoside intermediates was implemented for the synthesis, followed by evaluation of the new compounds as BC2L-C-Nt ligands with a range of techniques (surface plasmon resonance, isothermal titration calorimetry, saturation transfer difference NMR, differential scanning calorimetry, and X-ray crystallography). This study resulted in a hit molecule with an order of magnitude gain over the starting methyl fucoside and in two crystal structures of antagonist/lectin complexes.
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Affiliation(s)
- Rafael Bermeo
- CNRS,
CERMAV, Univ. Grenoble Alpes, Grenoble 38000, France,Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Kanhaya Lal
- CNRS,
CERMAV, Univ. Grenoble Alpes, Grenoble 38000, France,Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Davide Ruggeri
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Daniele Lanaro
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Sarah Mazzotta
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Francesca Vasile
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | - Anne Imberty
- CNRS,
CERMAV, Univ. Grenoble Alpes, Grenoble 38000, France
| | - Laura Belvisi
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy
| | | | - Anna Bernardi
- Dipartimento
di Chimica, Università degli Studi
di Milano, via Golgi 19, Milano 20133, Italy,
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48
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Rahmati M, Babapoor E, Dezfulian M. Amikacin-loaded niosome nanoparticles improve amikacin activity against antibiotic-resistant Klebsiella pneumoniae strains. World J Microbiol Biotechnol 2022; 38:230. [PMID: 36184645 PMCID: PMC9527143 DOI: 10.1007/s11274-022-03405-2] [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: 10/30/2021] [Accepted: 08/27/2022] [Indexed: 11/30/2022]
Abstract
Amikacin is an aminoglycoside antibiotic used in drug-resistant bacterial infections. The spread of bacterial infections has become a severe concern for the treatment system because of the simultaneous drug resistance bacteria and SARS-CoV-2 hospitalized patients. One of the most common bacteria in the development of drug resistance is Klebsiella strains, which is a severe threat due to the possibility of biofilm production. In this regard, recent nanotechnology studies have proposed using nanocarriers as a practical proposal to improve the performance of antibiotics and combat drug resistance. Among drug nanocarriers, niosomes are considered for their absorption mechanism, drug coverage, and biocompatibility. In this study, niosomal formulations were synthesized by the thin-layer method. After optimizing the synthesized niosomes, their properties were evaluated in terms of stability and drug release rate. The toxicity of the optimal formulation was then analyzed. The effect of free amikacin and amikacin encapsulated in niosome on biofilm inhibition were compared in multi-drug resistant isolated Klebsiella strains, and the mrkD gene expression was calculated. The MIC and MBC were measured for the free drug and amikacin loaded in the noisome. The particle size of synthesized amikacin-loaded niosomes ranged from 175.2 to 248.3 nm. The results showed that the amount of lipid and the molar ratio of tween 60 to span 60 has a positive effect on particle size, while the molar ratio of surfactant to cholesterol has a negative effect. The highest release rate in amikacin-loaded niosomes is visible in the first 8 h, and then a slower release occurs up to 72 h. The cytotoxicity induced by amikacin-loaded niosome is significantly less than the cytotoxicity of free amikacin in HFF cells (***p < 0.001, **p < 0.01). The mrkD mRNA expression level in the studied strains was significantly reduced after treatment with niosome-containing amikacin compared to free amikacin (***p < 0.001). It was confirmed that in the presence of the niosome, the amikacin antibacterial activity increased while the concentration of the drug used decreased, the formation of biofilm inhibited, and reduced antibiotics resistance in MDR Klebsiella strains.
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Affiliation(s)
- Mohamad Rahmati
- Department of Microbiology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Ebrahim Babapoor
- Biotechnology Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Mehrouz Dezfulian
- Biotechnology Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran.
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49
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Murtha-Lemekhova A, Fuchs J, Teroerde M, Rau H, Frey OR, Hornuss D, Billeter A, Klotz R, Chiriac U, Larmann J, Weigand MA, Probst P, Hoffmann K. Study protocol of REpeat versus SIngle ShoT Antibiotic prophylaxis in major Abdominal Surgery (RESISTAAS I): a prospective observational study of antibiotic prophylaxis practice for patients undergoing major abdominal surgery. BMJ Open 2022; 12:e062088. [PMID: 36123092 PMCID: PMC9486288 DOI: 10.1136/bmjopen-2022-062088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Surgical site infections (SSIs) are among the most common complications after abdominal surgery and develop in approximately 20% of patients. These patients suffer a 12% increase in mortality, underlying the need for strategies reducing SSI. Perioperative antibiotic prophylaxis is paramount for SSI prevention in major abdominal surgery. Yet, intraoperative redosing criteria are subjective and whether patients benefit from it remains unclear. METHODS AND ANALYSIS The REpeat versus SIngle ShoT Antibiotic prophylaxis in major Abdominal Surgery (RESISTAAS I) study is a single-centre, prospective, observational study investigating redosing of antibiotic prophylaxis in 300 patients undergoing major abdominal surgery. Adult patients scheduled for major abdominal surgery will be included. Current practice of redosing regarding number and time period will be recorded. Postoperative SSIs, nosocomial infections, clinically relevant infection-associated bacteria, postoperative antibiotic treatment, in addition to other clinical, pharmacological and economical outcomes will be evaluated. Differences between groups will be analysed with analysis of covariance. ETHICS AND DISSEMINATION RESISTAAS I will be conducted in accordance with the Declaration of Helsinki and internal, national and international standards of GCP. The Medical Ethics Review Board of Heidelberg University has approved the study prior to initiation (S-404/2021). The study has been registered on 7 February 2022 at German Clinical Trials Register, with identifier DRKS00027892. We plan to disseminate the results of the study in a peer-reviewed journal. TRIAL REGISTRATION German Clinical Trials Register (DRKS): DRKS00027892.
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Affiliation(s)
- Anastasia Murtha-Lemekhova
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Juri Fuchs
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Miriam Teroerde
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Heike Rau
- Department of Clinical Pharmacy, Heidenheim Hospital, Heidenheim, Germany
| | - Otto R Frey
- Department of Pharmacy, Heidenheim General Hospital, Heidenheim, Germany
| | - Daniel Hornuss
- Department of Medicine II, University of Freiburg, Freiburg im Breisgau, Germany
| | - Adrian Billeter
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Rosa Klotz
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ute Chiriac
- Department of Pharmacy, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Larmann
- Department of Anaesthesia, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus A Weigand
- Department of Anaesthesia, Heidelberg University Hospital, Heidelberg, Germany
| | - Pascal Probst
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Swaziland
| | - Katrin Hoffmann
- General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
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50
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Antibacterial Activities of Monsonia Angustifolia and Momordica Balsamina Linn Extracts against Carbapenem-Resistant Acinetobacter Baumannii. PLANTS 2022; 11:plants11182374. [PMID: 36145776 PMCID: PMC9503486 DOI: 10.3390/plants11182374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Carbapenemase-producing Acinetobacter baumannii (A. baumannii) is resistant to most of the available antibiotics and poses serious therapeutic challenges. The study investigated Monsonia angustifolia (M. angustifolia) and Momordica balsamina Linn (M. balsamina Linn) extracts for antibacterial activity against a clinical isolate of carbapenemase-producing A. baumannii using the Kirby Bauer disc diffusion and TLC coupled with bioautography. MIC determination experiments were conducted on a molecularly characterized A. baumannii isolate identified using VITEK2. Positive PCR detection of blaOXA-51 and blaOXA-23 confirmed isolate identity and the presence of a carbapenemase-encoding gene. Antibacterial activity was observed with the methanolic extract of M. balsamina Linn with a MIC of 0.5 mg/mL. Compounds with Rf values of 0.05; 0.17; 0.39 obtained from M. angustifolia hexane extract; compounds with Rf values of 0.58; 0.78; 0.36; 0.48; 0.5; 0.56; 0.67; 0.9 obtained from M. angustifolia dichloromethane extract; compounds with Rf values of 0.11; 0.56; 0.24; 0.37 obtained from M. angustifolia acetone extract and compounds with Rf values of 0.11; 0.27 obtained from M. angustifolia methanol extract demonstrated a level of antibacterial activity. M. angustifolia and M. balsamina Linn plant extracts have a clinically significant antibacterial activity against a carbapenemase-producing A. baumannii strain.
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