1
|
Uskudar-Guclu A, Danyildiz S, Mirza HC, Akcil Ok M, Basustaoglu A. In vitro activity of cefiderocol against carbapenem-resistant Acinetobacter baumannii carrying various β-lactamase encoding genes. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04831-w. [PMID: 38652417 DOI: 10.1007/s10096-024-04831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES This study aimed to determine the in vitro efficacy of cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB) isolates and evaluate the disk-diffusion (DD) method as an alternative method to broth-microdilution (BMD). METHODS Totally 89 CRAB isolates were included. Cluster analysis was determined by Pulsed-Field Gel Electrophoresis (PFGE). Resistance genes; blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-58,blaPER-1, blaNDM, blaIMP and mcr-1 were screened. Cefiderocol susceptibility testing was performed by both DD and BMD. Interpretation was made according to EUCAST and CLSI. Categorical agreement (CA), minor errors (mEs), major errors (MEs), and very major errors (VMEs) were determined. RESULTS PFGE revealed 5 distinct pulsotypes; 86 of the isolates were extensively drug-resistant (XDR). All the isolates were negative for blaNDM, blaIMP, mcr-1, while positive for blaOXA-58 and blaOXA51. blaPER-1 was positive for 33.7%; blaOXA-23 for 74.2%; blaOXA-24 for 12.3%. According to CLSI, the MEs rate was 1.85%, mEs was 7.86% and there were no VMEs. According to EUCAST, MEs rate was 3.70%, there were no mEs and VMEs. CA was 91% for CLSI and 97.8% for EUCAST. MICs of cefiderocol against A. baumannii isolates ranged from 0.06 to > 128 mg/L, with MIC50 and MIC90 values of 0.5 and > 128 mg/L, respectively. CONCLUSIONS Cefiderocol susceptibility was 60.7% in CRAB isolates. MIC50, MIC90 of blaPER-1 positive and blaPER-1 negative groups were > 128/>128 and 0.25/>128 mg/L. A correlation between the presence of blaPER-1 and cefiderocol resistance was observed (p < 0.0001). Among colistin-resistant isolates, the presence of blaPER-1 was 47.1% and 75% of them were resistant to cefiderocol respectively.
Collapse
Affiliation(s)
- Aylin Uskudar-Guclu
- Department of Medical Microbiology, Baskent University Faculty of Medicine, Ankara, Türkiye.
| | - Salih Danyildiz
- Department of Medical Microbiology, Baskent University Faculty of Medicine, Ankara, Türkiye
| | - Hasan Cenk Mirza
- Department of Medical Microbiology, Baskent University Faculty of Medicine, Ankara, Türkiye
| | - Mehtap Akcil Ok
- Department of Nutrition and Dietetics, Baskent University Faculty of Health Sciences, Ankara, Türkiye
| | - Ahmet Basustaoglu
- Department of Medical Microbiology, Baskent University Faculty of Medicine, Ankara, Türkiye
| |
Collapse
|
2
|
Albusaidi MT, Jabri AA, Hadhrami AAA, Al Khaldi MO, Shummo MA, Haridi KM, Din ASE, Ghawas SM, Saleh AE, Jacob J, Alsafy T, Elias AT, Al-Busaidi S. Analysis of Blood Cultures from Major Burns Patients in a Tertiary Care Burn Unit in Oman. Sultan Qaboos Univ Med J 2024; 24:99-102. [PMID: 38434472 PMCID: PMC10906757 DOI: 10.18295/squmj.12.2023.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/14/2023] [Accepted: 11/05/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives This study aimed to review the blood stream infections of major burn patients in a tertiary care burn unit to determine the most prevalent infecting organisms in order to have a better empirical therapy protocol. Methods This retrospective study analysed the blood stream infection of 155 major burn (>20% Total Body Surface Area [TBSA]) patients in Khoula Hospital, Muscat, Oman between January 2014 to December 2019. Results The median age was 33 years and 57.42% of patients were male. The median TBSA was 38%, mortality was 25.16% and 50.9% of patients had positive blood cultures. The expired patients had higher TBSAs, Abbreviated Burns Severity Index scores and earlier first positive blood cultures. Candida was commonly grown in all the blood cultures, but the most prevalent organisms were Acinetobacter, Staphylococci, Klebsiella, Enterococcus and Pseudomonas. All Acinetobacter species are multidrug resistant. Of the 17 patients who had Kelbsiella grown in the blood culture, 8 grew multidrug-resistant Klebsiella. Only 4 patients' blood cultures grew methicillin-resistant Staphylococcus aureus. The number of blood culture samples taken ranged between 1-28 (median = 6). The first positive blood culture showed that Staphylococcus epidermidis and Acinetobacter were the most common infecting organisms. Conclusions Multidrug-resistant Acinetobacter was the most predominant microorganism grown from the blood cultures of major burn patients in a tertiary care burn unit. Empirical therapy should include antibiotics that are effective against this organism to reduce the mortality.
Collapse
Affiliation(s)
| | - Ahmed Al Jabri
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Al Anood Al Hadhrami
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Mutazz O. Al Khaldi
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Moath A. Shummo
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Karim M. Haridi
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Ahmed Salah El Din
- Department of Plastic and Reconstructive Surgery, Sultan Qaboos Hospital, Salalah, Oman
| | - Salim M. Ghawas
- Department of Plastic and Reconstructive Surgery, Sultan Qaboos Hospital, Salalah, Oman
| | - Aml E. Saleh
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| | - Joe Jacob
- Department of Plastic and Reconstructive Surgery, Sultan Qaboos Hospital, Salalah, Oman
| | - Taif Alsafy
- Department of Plastic and Reconstructive Surgery, Sultan Qaboos Hospital, Salalah, Oman
| | - Anish T. Elias
- Department of Plastic and Reconstructive Surgery, Sultan Qaboos Hospital, Salalah, Oman
| | - Said Al-Busaidi
- Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Oman
| |
Collapse
|
3
|
Hasanuzzaman M, Bang CS, Gong EJ. Antibiotic Resistance of Helicobacter pylori: Mechanisms and Clinical Implications. J Korean Med Sci 2024; 39:e44. [PMID: 38288543 PMCID: PMC10825452 DOI: 10.3346/jkms.2024.39.e44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
Helicobacter pylori is a pathogenic bacterium associated with various gastrointestinal diseases, including chronic gastritis, peptic ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. The increasing rates of H. pylori antibiotic resistance and the emergence of multidrug-resistant strains pose significant challenges to its treatment. This comprehensive review explores the mechanisms underlying the resistance of H. pylori to commonly used antibiotics and the clinical implications of antibiotic resistance. Additionally, potential strategies for overcoming antibiotic resistance are discussed. These approaches aim to improve the treatment outcomes of H. pylori infections while minimizing the development of antibiotic resistance. The continuous evolution of treatment perspectives and ongoing research in this field are crucial for effectively combating this challenging infection.
Collapse
Affiliation(s)
- Md Hasanuzzaman
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Jeong Gong
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
| |
Collapse
|
4
|
Gutiérrez-Santana JC, Coria-Jiménez VR. Diagnosis and Therapeutic Strategies Based on Nucleic Acid Aptamers Selected against Pseudomonas aeruginosa: The Challenge of Cystic Fibrosis. ChemMedChem 2024; 19:e202300544. [PMID: 38016927 DOI: 10.1002/cmdc.202300544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 11/30/2023]
Abstract
Antimicrobial resistance (AMR) is a rapidly spreading global health problem, and approximately five million deaths associated with AMR pathogens were identified prior to the COVID-19 pandemic. Pseudomonas aeruginosa has developed increasing AMR, and in patients with cystic fibrosis (CF) colonized by this bacterium, rare phenotypes have emerged that complicate the diagnosis and treatment of the hosts, in addition to multiple associated "epidemic strains" with high morbidities and mortalities. The conjugation of aptamers with fluorochromes or nanostructures has allowed the design of new identification strategies for Pseudomonas aeruginosa with detection limits of up to 1 cell ⋅ mL-1 , and the synergy of aptamers with antibiotics, antimicrobial peptides and nanostructures has exhibited promising therapeutic qualities. Some selected aptamers against this bacterium have shown intrinsic antimicrobial activity. However, these aptamers have been poorly evaluated in clinical isolates and have shown decreased interactions for CF isolates, demonstrating, in these cases, uncommon phenotypes resulting from the selective qualities of this disease as well as the great adaptive capacity of the pathogen. Therefore, finding an aptamer or set of aptamers that have the ability to recognize strange phenotypes of this bacillus is crucial in the battle against AMR.
Collapse
Affiliation(s)
- Juan Carlos Gutiérrez-Santana
- Laboratorio de Bacteriología Experimental, Instituto Nacional de Pediatría, Insurgentes sur 3700-C, Col. Insurgentes Cuicuilco Coyoacán, 04530, Ciudad de México, México
| | - Victor Rafael Coria-Jiménez
- Laboratorio de Bacteriología Experimental, Instituto Nacional de Pediatría, Insurgentes sur 3700-C, Col. Insurgentes Cuicuilco Coyoacán, 04530, Ciudad de México, México
| |
Collapse
|
5
|
Cárdenas Soriano P, Cantero Escribano JM, Molina Cabrero FJ, Gómez-Juárez Sango A, García Guerrero J. [Multiple PCR ALLPLEX TM ENTERO-DR for multidrug-resistant Enterobacteriaceae management at Albacete University Hospital]. Rev Esp Salud Publica 2023; 97:e202312110. [PMID: 38088124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE Multi-resistant Enterobacteriaceae (MRE) are a public health threat, with screening and isolation strategies being important to stop its dissemination. Multiplex PCR is a novel method capable of rapid diagnosis with high sensitivity and specificity. In this study, our objective was to evaluate its application to multidrug-resistant Enterobacteriaceae management since its implementation in our hospital. METHODS An observational retrospective descriptive study of multiplex PCR ALLPLEX TM ENTERO-DR results to screen inpatients colonized by MRE took place from November 2019 to May 2021. We calculated the percentage of positive, negative, non-identifiable or invalid results, identified microorganisms, reason for requesting it and subsequent actions. Median and I.R. from sampling time to partial and theoretical culture time, and since last colonization/infection depending on test results were calculated. RESULTS Resistance mechanisms were detected in 31.47% of tests, being E. coli ESBL (68.99%) the most frequently isolated microorganism. Median time to partial result was 5.75 hours (I.R.: 2.67), having statistically significant differences with theoretical time. The most important reason to request the test was screening (80.12%) and the most frequent action taken was not to isolate (41.70 %). Whenever forty-nine months or more since last colonization/infection have passed, only 14.81% of the samples tested positive. CONCLUSIONS Multiplex PCR is a useful test to manage colonized patients, capable of giving a rapid result and allowing for quicker decision-making, contributing to a good use of resources and patient comfort.
Collapse
Affiliation(s)
- Pilar Cárdenas Soriano
- Unidad de Medicina Preventiva; Hospital Universitario Fundación Alcorcón. Alcorcón. España
- Escuela Internacional de Doctorado; Universidad Rey Juan Carlos. Madrid. España
| | | | | | - Ana Gómez-Juárez Sango
- Sección de Medicina Preventiva y Salud Pública; Complejo Hospitalario Universitario de Albacete. Albacete. España
| | - Jesús García Guerrero
- Sección de Medicina Preventiva y Salud Pública; Complejo Hospitalario Universitario de Albacete. Albacete. España
| |
Collapse
|
6
|
Hammour KA, Abu-Farha R, Itani R, Karout S, Allan A, Manaseer Q, Hammour WA. The prevalence of Carbapenem Resistance Gram negative pathogens in a Tertiary Teaching Hospital in Jordan. BMC Infect Dis 2023; 23:634. [PMID: 37759305 PMCID: PMC10523830 DOI: 10.1186/s12879-023-08610-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND With the absence of new antimicrobial drugs being developed to replace those facing resistance, bacterial resistance continues to grow. Despite previous studies conducted in various countries, there is a lack of comprehensive local reporting on the occurrence of carbapenem resistance among gram-negative bacteria. OBJECTIVE This study aims to identify the prevalence of carbapenem-resistant gram-negative bacterial isolates. METHOD A retrospective cross-sectional study was conducted at an academic hospital in Jordan over an eight-month period, spanning from November 2021 to June 2022. The study involved screening electronic medical records to identify patients with clinical cultures showing the growth of Gram-negative bacteria. Antimicrobial susceptibility results of the Gram-negative isolates were recorded. RESULTS A total of 1,043 isolated Gram-negative bacteria were analyzed for carbapenem susceptibility. Among the species tested, the most common carbapenem-resistant bacteria were Acinetobacter baumannii (153/164, 93.3%), followed by Klebsiella pneumonia (184/311, 59.2%), and Pseudomonas aeruginosa (67/160, 41.9%). The least commonly isolated species resistant to carbapenem were Escherichia coli (25/361, 6.9%) and Proteus mirabilis (1/30, 3.3%). None of Serratia marcescens or Proteus vulgaris isolates were resistant to carbapenem (0%). Overall, the prevalence of carbapenem-resistance gram-negative isolates was 41.2% (430 out of 1,043). CONCLUSION This study provides population-specific data that are crucial for guiding empirical antimicrobial treatment decisions not only within the participating hospital but also in other nearby healthcare facilities. The results underscore the urgent need for coordinated efforts to address antibiotic resistance in Jordan. Comprehensive measures such as strict infection control methods, annual nationwide surveillance programs, and effective antimicrobial stewardship programs at the national level are imperative to reduce the overuse of broad-spectrum antibiotics.
Collapse
Affiliation(s)
- Khawla Abu Hammour
- Department of Clinical Pharmacy and Biopharmaceutics, Faculty of pharmacy, University of Jordan, Amman, Jordan
| | - Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, 11931, Amman, Jordan
| | - Rania Itani
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, 1107 2809, 11-5020, Beirut, Lebanon.
| | - Samar Karout
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, 1107 2809, 11-5020, Beirut, Lebanon
| | - Aya Allan
- Pharmacy Department, Jordan University Teaching Hospital, Amman, Jordan
| | - Qusai Manaseer
- Department of Orthopedic surgery, Jordan University Teaching Hospital, Amman, Jordan
| | | |
Collapse
|
7
|
Rowlands J, Dufort E, Chaturvedi S, Zhu Y, Quinn M, Bucher C, Erazo R, Haley V, Kuang J, Ostrowsky B, Southwick K, Vallabhaneni S, Greenko J, Tserenpuntsag B, Blog D, Lutterloh E. Candida auris admission screening pilot in select units of New York City health care facilities, 2017-2019. Am J Infect Control 2023; 51:866-870. [PMID: 36736380 PMCID: PMC10902794 DOI: 10.1016/j.ajic.2023.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND This pilot project implemented admission screening for Candida auris (C. auris) using real-time polymerase chain reaction (rt-PCR) in select high-risk units within health care facilities in New York City. METHODS An admission screening encounter consisted of collecting 2 swabs, to be tested by rt-PCR, and a data collection form for individuals admitted to ventilator units at 2 nursing homes (NHA and NHB), and the ventilator/pulmonary unit, intensive care unit, and cardiac care unit at a hospital (Hospital C) located in New York City from November 2017 to November 2019. RESULTS C. auris colonization was identified in 6.9% (n = 188/2,726) of admissions to participating units. Rates were higher among admissions to NHA and NHB (20.7% and 22.0%, respectively) than Hospital C (3.6%). Within Hospital C, the ventilator/pulmonary unit had a higher rate (5.7%) than the intensive care unit (3.8%) or cardiac care unit (2.5%). DISCUSSION Consistent with prior research, we found that individuals admitted to ventilator units were at higher risk of C. auris colonization. CONCLUSIONS This project demonstrates the utility of admission screening using rt-PCR testing to rapidly identify C. auris colonization among admissions to health care facilities so that appropriate transmission-based precautions and control measures can be implemented rapidly to help decrease transmission.
Collapse
Affiliation(s)
| | | | - Sudha Chaturvedi
- New York State Department of Health, Wadsworth Center, Albany, NY, USA; School of Public Health, Epidemiology and Biostatistics, and Department of Biomedical Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - YanChun Zhu
- New York State Department of Health, Wadsworth Center, Albany, NY, USA
| | - Monica Quinn
- New York State Department of Health, Albany, NY, USA
| | | | - Richard Erazo
- New York State Department of Health, Albany, NY, USA
| | - Valerie Haley
- New York State Department of Health, Albany, NY, USA; School of Public Health, Epidemiology and Biostatistics, and Department of Biomedical Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - Jiankun Kuang
- New York State Department of Health, Albany, NY, USA
| | - Belinda Ostrowsky
- New York State Department of Health, Albany, NY, USA; Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Jane Greenko
- New York State Department of Health, Albany, NY, USA
| | | | - Debra Blog
- New York State Department of Health, Albany, NY, USA
| | - Emily Lutterloh
- New York State Department of Health, Albany, NY, USA; School of Public Health, Epidemiology and Biostatistics, and Department of Biomedical Sciences, State University of New York, University at Albany, Albany, NY, USA
| |
Collapse
|
8
|
Ndugire W, Truong D, Hasitha Raviranga NG, Lao J, Ramström O, Yan M. Turning on the Antimicrobial Activity of Gold Nanoclusters Against Multidrug-Resistant Bacteria. Angew Chem Int Ed Engl 2023; 62:e202214086. [PMID: 36642692 PMCID: PMC10356176 DOI: 10.1002/anie.202214086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 01/17/2023]
Abstract
In this work, we show that the addition of thiourea (TU) initiated broad-spectrum antimicrobial activity of otherwise inactive D-maltose-capped gold nanoclusters (AuNC-Mal). For example, AuNC-Mal/TU was effective against multidrug-resistant Pseudomonas aeruginosa with a minimum inhibitory concentration (MIC) of 1 μg mL-1 (2.5 μM [Au]) while having 30-60 times lower in vitro cytotoxicity against mammalian cells. The reaction of AuNC-Mal and TU generated the antimicrobial species of [Au(TU)2 ]+ and smaller AuNCs. TU increased the accumulation of Au in bacteria and helped maintain the oxidation state as AuI (vs. AuIII ). The modes of action included the inhibition of thioredoxin reductase, interference with the CuI regulation and depletion of ATP. Moreover, the antimicrobial activity did not change in the presence of colistin or carbonyl cyanide 3-chlorophenylhydrazone, suggesting that AuNC-Mal/TU was indifferent to the outer membrane barrier and to bacterial efflux pumps.
Collapse
Affiliation(s)
- William Ndugire
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
| | - Dang Truong
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
| | - N G Hasitha Raviranga
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
| | - Jingzhe Lao
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
| | - Olof Ramström
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
- Department of Chemistry and Biomedical Sciences, Linnaeus University, 39182, Kalmar, Sweden
| | - Mingdi Yan
- Department of Chemistry, University of Massachusetts Lowell, One University Ave., Lowell, MA-01854, USA
| |
Collapse
|
9
|
Choi H, Mok J, Kang YA, Jeong D, Kang HY, Kim HJ, Kim HS, Jeon D. Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011-2017: A Retrospective Cohort Study (Korean TB-POST). J Korean Med Sci 2023; 38:e33. [PMID: 36747362 PMCID: PMC9902661 DOI: 10.3346/jkms.2023.38.e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/30/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The treatment outcomes of patients with multidrug/rifampin-resistant (MDR/RR) tuberculosis (TB) are important indicators that reflect the current status of TB management and identify the key challenges encountered by TB control programs in a country. METHODS We retrospectively evaluated the treatment outcomes as well as predictors of unfavorable outcomes in patients with MDR/RR-TB notified from 2011 to 2017, using an integrated TB database. RESULTS A total of 7,226 patients with MDR/RR-TB were included. The treatment success rate had significantly increased from 63.9% in 2011 to 75.1% in 2017 (P < 0.001). Among unfavorable outcomes, the proportion of patients who failed, were lost to follow up, and were not evaluated had gradually decreased (P < 0.001). In contrast, TB-related death rate was not significantly changed (P = 0.513), while the non-TB related death rate had increased from 3.2% in 2011 to 11.1% in 2017 (P < 0.001). Older age, male sex, immigrants, low household income, previous history of TB treatment, and comorbidities were independent predictors of unfavorable outcomes. Of the 5,308 patients who were successfully treated, recurrence occurred in 241 patients (4.5%) at a median 18.4 months (interquartile range, 9.2-32.4) after completion treatment. CONCLUSION The treatment outcomes of patients with MDR/RR-TB has gradually improved but increasing deaths during treatment is an emerging challenge for MDR-TB control in Korea. Targeted and comprehensive care is needed for vulnerable patients such as the elderly, patients with comorbidities, and those with low household incomes.
Collapse
Affiliation(s)
- Hongjo Choi
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Young Ae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dawoon Jeong
- Research and Development Center, the Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Cheongju, Korea
| | - Hee-Yeon Kang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Central Training Institute, Korean National Tuberculosis Association, Seoul, Korea
| | - Hee-Sun Kim
- Department of Health Policy Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Doosoo Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
| |
Collapse
|
10
|
Hoque MN, Jahan MI, Hossain MA, Sultana M. Genomic diversity and molecular epidemiology of a multidrug-resistant Pseudomonas aeruginosa DMC30b isolated from a hospitalized burn patient in Bangladesh. J Glob Antimicrob Resist 2022; 31:110-118. [PMID: 36058512 DOI: 10.1016/j.jgar.2022.08.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/02/2022] [Accepted: 08/29/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Pseudomonas aeruginosa is a key opportunistic pathogen causing a wide range of community- and hospital-acquired infections in immunocompromised or catheterized patients. Here, we report the complete genome sequence of a multidrug-resistant (MDR) P. aeruginosa DMC30b to elucidate the genetic diversity, molecular epidemiology, and underlying mechanisms for antimicrobial resistance and virulence. METHODS P. aeruginosa DMC30b was isolated from septic wound swab of a severe burn patient. Whole-genome sequencing was performed under Ion Torrent platform. The genome was assembled using the SPAdes v. 3.12.01 in an integrated Genome Analysis Platform for Ion Torrent sequence data. The genome was annotated using the National Center for Biotechnology Information (NCBI) Prokaryotic Genome Annotation Pipeline. In-silico predictions of antimicrobial resistance genes, virulence factor genes, and metabolic functional potentials were performed using different curated bioinformatics tools. RESULTS P. aeruginosa DMC30b was found as a MDR strain and belonged to sequence type 244 (ST244). The complete genome size is 6 994 756 bp with a coverage of 76.76x, guanine-cytosine content of 65.7% and a Benchmarking Universal Single-Copy Orthologs score of 100. The genome of P. aeruginosa DMC30b harboured two predicted plasmid replicons (e,g. IncP-6; 78 007 bp and ColRNAI; 9359 bp), 35 resistomes (antimicrobial resistance genes) conferring resistance to 18 different antibiotics (including four beta-lactam classes), and 214 virulence factor genes. It was identified as the 167th ST244 strain among ∼ 5800 whole-genome sequences of P. aeruginosa available in the NCBI database. CONCLUSION The MDR P. aeruginosa DMC30b was identified as the 167th ST244 complete genome to be submitted to the NCBI, and the first ST244 isolate sequenced from Bangladesh. The complete genome data with high genetic diversity and underlying mechanisms for antimicrobial resistance and virulence of P. aeruginosa DMC30b will aid in understanding the evolution and phylogeny of such high-risk clones and provide a solid basis for further research on MDR or extensively drug resistant strains.
Collapse
Affiliation(s)
- M Nazmul Hoque
- Department of Gynaecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh
| | - M Ishrat Jahan
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | - M Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | - Munawar Sultana
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh.
| |
Collapse
|
11
|
Alghamdi RH, Ahmed F, Ibrahim SM, Pushparaj PN, Schulten HJ, Abuzenadah AM, Almalki AL. Molecular determinants of etoposide resistance in HL60 cells. Bioinformation 2022; 18:894-899. [PMID: 37654838 PMCID: PMC10465782 DOI: 10.6026/97320630018894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 09/02/2023] Open
Abstract
Chemotherapy resistance is the main reason for treatment failure in acute myeloid leukemia (AML) and the major cause of its mortality. Etoposide is a DNA topoisomerase-II inhibitor that is used either as a single agent or in combination with cytarabine, azacytidine, vinca alkaloids, and anthracyclines for the treatment of relapsed /refractory AML. In this study, we sought to determine and understand the mechanism of etoposide resistance in AML using the HL60 cell line.HL60 cells were treated with incremental doses of etoposide and resistant colonies were isolated by culturing the resistant cells in semi-solid culture media. Three clones were selected for etoposide resistance namely, HL60-EtopR H1A, HL60-EtopR H1B, and HL60-EtopR H1C which demonstrated 4.78, 2.39, and 4.42-fold higher resistance to etoposide compared with the parental cells. To determine molecular differences between the etoposide-resistant HL60-EtopR cells and the parental cells, microarray-based gene expression profiling was performed. We found up regulation of members of the src tyrosine kinase family genes in the etoposide resistant cells. Further studies are required to evaluate the role of Src inhibitors in targeting etoposide resistant cells.
Collapse
Affiliation(s)
- Rasha H Alghamdi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah21589, Kingdom of Saudi Arabia
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80218, Jeddah21589, Kingdom of Saudi Arabia
- Department of Chemistry, Faculty of Science, Taif University, P. O. Box 11099, Taif 21944, Kingdom of Saudi Arabia
| | - Farid Ahmed
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah21589, Kingdom of Saudi Arabia
- Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia
| | - Sara M Ibrahim
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80218, Jeddah21589, Kingdom of Saudi Arabia
| | - Peter N Pushparaj
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah21589, Kingdom of Saudi Arabia
- Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia
| | - Hans Jurgen Schulten
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah21589, Kingdom of Saudi Arabia
| | - Adel M Abuzenadah
- Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia
- King Fahad Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah21589, Kingdom of Saudi Arabia
| | - Abdulrahman L Almalki
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80218, Jeddah21589, Kingdom of Saudi Arabia
| |
Collapse
|
12
|
Lord J, Carter C, Smith J, Locke S, Phillips E, Odoi A. Antimicrobial resistance among Streptococcus equi subspecies zooepidemicus and Rhodococcus equi isolated from equine specimens submitted to a diagnostic laboratory in Kentucky, USA. PeerJ 2022; 10:e13682. [PMID: 36164606 PMCID: PMC9508889 DOI: 10.7717/peerj.13682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/14/2022] [Indexed: 01/17/2023] Open
Abstract
Background Surveillance of antimicrobial resistance (AMR) among veterinary pathogens is necessary to identify clinically relevant patterns of AMR and to inform antimicrobial use practices. Streptococcus equi subsp. zooepidemicus and Rhodococcus equi are bacterial pathogens of major clinical importance in horses and are frequently implicated in respiratory tract infections. The objectives of this study were to describe antimicrobial resistance patterns and identify predictors of AMR and multidrug resistance (MDR) (resistance to three or more antimicrobial classes) among equine S. zooepidemicus and R. equi isolates. Methods Antimicrobial susceptibility data from equine specimens submitted to the University of Kentucky Veterinary Diagnostic Laboratory between 2012 and 2017 were used in the study. Temporal trends in AMR and MDR were assessed using the Cochran-Armitage test. Logistic regression was used to identify associations between patient characteristics and the following outcomes: (a) MDR among S. zooepidemicus isolates, and (b) resistance to macrolides and ansamycins (rifampin) among R. equi isolates. Logistic regression was also used to investigate whether resistance of S. zooepidemicus and R. equi isolates to an antimicrobial class could be predicted by resistance to other drug classes. Results The vast majority of S. zooepidemicus (99.6%) and R. equi isolates (83%) were resistant to at least one antimicrobial agent, but no significant temporal trends in AMR were observed. Approximately half (53.3%) of the S. zooepidemicus isolates were multidrug-resistant, and there was a significant (p < 0.001) increasing temporal trend of MDR among S. zooepidemicus isolates. Resistance to penicillin, which is typically recommended for treatment of suspected S. zooepidemicus infections, also increased during the study period, from 3.3% to 9.5%. Among R. equi isolates, 19.2% were resistant to one or more macrolide antibiotics, 24% were resistant to rifampin, and 15.6% were resistant to both macrolide(s) and rifampin. For both organisms, resistance to an antimicrobial class could be predicted based on resistance profiles to other drug classes. For instance, significant (p < 0.01) predictors of β-lactam resistance among S. zooepidemicus isolates included resistance to macrolides (Odds Ratio (OR) = 14.7) and ansamycins (OR = 9.3). Resistance to phenicols (OR = 3.7) and ansamycins (OR = 19.9) were associated with higher odds of macrolide resistance among R. equi isolates. Conclusions The increase in MDR among S. zooepidemicus isolates is concerning. The observed levels of resistance to macrolides and rifampin among R. equi are also worrisome given the limited number of antimicrobials available for treatment of this organism. The findings of this study highlight the importance of ongoing surveillance of AMR to guide treatment decisions and directions for future research.
Collapse
Affiliation(s)
- Jennifer Lord
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, United States of America
| | - Craig Carter
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, KY, United States of America
| | - Jacqueline Smith
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, KY, United States of America
| | - Stephan Locke
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, KY, United States of America
| | - Erica Phillips
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, KY, United States of America
| | - Agricola Odoi
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, United States of America
| |
Collapse
|
13
|
Hemmati-Dinarvand M, Kheirandish S, Khodadadian A, Mostafazadeh M, Seghatoleslam A. Blockage of Wnt/β-catenin Signaling Pathway in Colorectal Cancer Resistant Cells by Nitazoxanide Effects on Peptidylarginine Deiminases Expression. Asian Pac J Cancer Prev 2022; 23:3215-3222. [PMID: 36172687 PMCID: PMC9810304 DOI: 10.31557/apjcp.2022.23.9.3215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Multidrug resistance (MDR) is a major cause of unsuccessful cancer treatment in which drugs are not effective. Therefore, it is necessary to identify the critical mechanisms of the development of MDR and target those with novel compounds. Accordingly, the current study is the first to investigate the combination effect and molecular mechanism of nitazoxanide (NTZ) and oxaliplatin (OXP) on LS174T/OXP-resistant cells. METHODS The effect of NTZ on OXP cytotoxicity in LS174T and LS174T/OXP cell lines was evaluated by MTT assay. Changes in expression levels of MDR1, MRP1, CTNNB1, peptidylarginine deiminase (PAD)2, and PAD4 genes and proteins were evaluated by RT-qPCR and western blotting methods, respectively. Lastly, the apoptosis assay was performed by flow cytometer. RESULTS OXP resistant and sensitive cells were identified based on the IC50 values (11567 nM vs. 1745 nM, p<0.05 for 24 h treatment; and 5161 nM vs. 882 nM, p<0.05 for 48 h incubation). The combination of NTZ and OXP for 48 h led to a reduction in IC50 values in resistant cells (2154 nM, p<0.05). The effect of NTZ plus OXP significantly decreased the expression of MDR1 (p<0.001), MRP1 (p<0.05), and CTNNB1 (p<0.001), while PAD2 and PAD4 expression was significantly increased (p<0.001). This combination therapy enhanced the percentage of the sub-G1 population (apoptosed) compared to other groups. CONCLUSION The results showed that NTZ leads to notable upregulation of PAD2 and PAD4, which can disrupt the Wnt/β-catenin signaling pathway and reverse the MDR by reducing MDR1 and MRP1 expression.
Collapse
Affiliation(s)
- Mohsen Hemmati-Dinarvand
- Department of Clinical Biochemistry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shahnaz Kheirandish
- Department of Medical Genetics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Ali Khodadadian
- Department of Medical Genetics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mostafa Mostafazadeh
- Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Atefeh Seghatoleslam
- Department of Clinical Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
14
|
Limniatis G, Georges E. Down-regulation of ABCB1 by Collateral Sensitivity Drugs Reverses Multidrug Resistance and Up-regulates Enolase I. J Biochem 2022; 172:37-48. [PMID: 35471238 DOI: 10.1093/jb/mvac032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
The emergence of drug resistance remains an obstacle in the clinical treatment of cancer. Recent developments in the studies of drug resistance have identified compounds such as verapamil and tamoxifen that specifically target ABCB1-expressing multidrug resistant (MDR) cells, through an ATP-dependent ROS-generating mechanism. In this report, we demonstrate that treatment of ABCB1-expressing multidrug resistant cells (CHORC5 or MDA-Doxo400) or individual clones of the latter with sub-lethal concentrations of tamoxifen or verapamil down-regulates ABCB1 protein and mRNA expression in surviving clones. Consequently, tamoxifen- and verapamil-treated cells show increased sensitivity to chemotherapeutic drugs (e.g., colchicine and doxorubicin) and decreased sensitivity to collateral sensitivity drugs (e.g., verapamil and tamoxifen). Importantly, we show for the first time that down-regulation of ABCB1 expression resulting from tamoxifen treatment and CRISPR-knockout of ABCB1 expression up-regulate α-enolase (enolase I) protein levels and activity. These findings demonstrate a possible effect of ABCB1 expression on the metabolic homeostasis of MDR cells. Moreover, given the use of tamoxifen to prevent the recurrence of estrogen receptor-positive breast cancer, the findings of this study may be clinically important in modulating activity of other drugs.
Collapse
Affiliation(s)
| | - Elias Georges
- Institute of Parasitology, McGill University, Quebec, Canada
| |
Collapse
|
15
|
Abstract
Multidrug resistance protein 1 (MRP1/ABCC1) is an ATP-dependent efflux transporter, and responsible for the transport of a broad spectrum of xenobiotics, toxins, and physiological substrates across the plasma membrane. As an efflux pump, it plays a significant role in the absorption and disposition of drugs including anticancer drugs, antivirals, antimalarials, and antibiotics and their metabolites across physiological barriers in cells. MRP1 is also known to aid in the regulation of several physiological processes such as redox homeostasis, steroid metabolism, and tissue defense. However, its overexpression has been reported to be a key clinical marker associated with multidrug resistance (MDR) of several types of cancers including lung cancer, childhood neuroblastoma, breast and prostate carcinomas, often resulting in a higher risk of treatment failure and shortened survival rates in cancer patients. Aside MDR, overexpression of MRP1 is also implicated in the development of neurodegenerative and cardiovascular diseases. Due to the cellular importance of MRP1, the identification and biochemical/molecular characterization of modulators of MRP1 activity and expression levels are of key interest to cancer research and beyond. This review primarily aims at highlighting the physiological and pharmacological importance of MRP1, known MRP1 modulators, current challenges encountered, and the potential benefits of conducting further research on the MRP1 transporter.
Collapse
Affiliation(s)
- Vivian Osei Poku
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, United States of America
| | - Surtaj Hussain Iram
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, United States of America,American University of Iraq, Sulaimaniya, Sulaimani, KRG, Iraq
| |
Collapse
|
16
|
Kang JS, Moon C, Mun SJ, Lee JE, Lee SO, Lee S, Lee SH. Antimicrobial Susceptibility Trends and Risk Factors for Antimicrobial Resistance in Pseudomonas aeruginosa Bacteremia: 12-Year Experience in a Tertiary Hospital in Korea. J Korean Med Sci 2021; 36:e273. [PMID: 34751008 PMCID: PMC8575761 DOI: 10.3346/jkms.2021.36.e273] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/12/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Infections caused by multidrug-resistant Pseudomonas aeruginosa (MDRPA) have been on the rise worldwide, and delayed active antimicrobial therapy is associated with high mortality. However, few studies have evaluated increases in P. aeruginosa infections with antimicrobial resistance and risk factors for such antimicrobial resistance in Korea. Here, we analyzed changes in antimicrobial susceptibility associated with P. aeruginosa bacteremia and identified risk factors of antimicrobial resistance. METHODS The medical records of patients with P. aeruginosa bacteremia who were admitted to a tertiary hospital between January 2009 and October 2020 were retrospectively reviewed. Antibiotic resistance rates were compared among the time periods of 2009-2012, 2013-2016, and 2017-2020 and between the intensive care unit (ICU) and non-ICU setting. Empirical antimicrobial therapy was considered concordant, if the organism was susceptible to antibiotics in vitro, and discordant, if resistant. RESULTS During the study period, 295 patients with P. aeruginosa bacteremia were identified. The hepatobiliary tract (26.8%) was the most common primary site of infection. The rates of carbapenem-resistant P. aeruginosa (CRPA), MDRPA, and extensively drug-resistant P. aeruginosa (XDRPA) were 24.7%, 35.9%, and 15.9%, respectively. XDRPA showed an increasing trend, and CRPA, MDRPA, and XDRPA were also gradually increasing in non-ICU setting. Previous exposure to fluoroquinolones and glycopeptides and urinary tract infection were independent risk factors associated with CRPA, MDRPA, and XDRPA. Previous exposure to carbapenems was an independent risk factor of CRPA. CRPA, MDRPA, and XDRPA were associated with discordant empirical antimicrobial therapy. CONCLUSION The identification of risk factors for antimicrobial resistance and analysis of antimicrobial susceptibility might be important for concordant empirical antimicrobial therapy in patients with P. aeruginosa bacteremia.
Collapse
Affiliation(s)
- Jin Suk Kang
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Chisook Moon
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
| | - Seok Jun Mun
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jeong Eun Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Soon Ok Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Shinwon Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
17
|
ELsheredy A, Yousif Z, Elghazzawi E, Elmenshawy A, Ghazal A. Prevalence of Genes Encoding Aminoglycoside-Modifying Enzymes and armA among Acinetobacter baumannii Clinical Isolates in Alexandria, Egypt. Infect Disord Drug Targets 2021; 21:e300821191828. [PMID: 33632111 DOI: 10.2174/1871526521666210225113041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/25/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Acinetobacter baumannii (A.baumannii ) is a ubiquitous pathogen responsible for serious infections in hospitalized patients with a high propensity to develop resistance to antimicrobial agents. The study aimed to determine the antimicrobial resistance patterns and the prevalence of aminoglycoside resistance genes among A. baumannii clinical isolates from patients in different intensive care units (ICUs) in Alexandria, Egypt. METHODS A total of 100 A. baumannii isolates collected from ICU patients were confirmed as A. baumannii by VITEK 2 and the presence of the blaOXA-51 gene has been reported. Antimicrobial susceptibility testing was performed and Multiplex PCR was done for the detection of aminoglycoside resistance genes. RESULTS Most of the isolates (82%) were resistant to all tested aminoglycosides; resistance was higher for kanamycin and neomycin, followed by amikacin. The predominant AMEs were aphA6 and aphA1 in 86% and 67% of the isolates, respectively; aacA4 and aacC1 were detected in 37% and 8%, respectively, while aadA1 and aadB were present in 34% and 4%, respectively. Furthermore, armA gene was detected in 83% of the isolates. CONCLUSION The results of this study revealed a high level carriage of armA and AMEs which limit the usage of aminoglycoside as a treatment option for A. baumannii and makes treatment extremely difficult.
Collapse
Affiliation(s)
- Amel ELsheredy
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria. Egypt
| | - Zainab Yousif
- Basic Science Department, Faculty of Dentistry, Al Anbar University, Al Anbar. Iraq
| | - Ebtesam Elghazzawi
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria. Egypt
| | - Ahmed Elmenshawy
- Critical Care Medicine Department, Faculty of Medicine, Alexandria University, Alexandria. Egypt
| | - Abeer Ghazal
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria. Egypt
| |
Collapse
|
18
|
Shariat Razavi SM, Mahmoudzadeh Vaziri R, Karimi G, Arabzadeh S, Keyvani V, Behravan J, Kalalinia F. Crocin Increases Gastric Cancer Cells' Sensitivity to Doxorubicin. Asian Pac J Cancer Prev 2020; 21:1959-1967. [PMID: 32711421 PMCID: PMC7573416 DOI: 10.31557/apjcp.2020.21.7.1959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Indexed: 11/27/2022] Open
Abstract
Background: Crocin is one of the substantial constituents of saffron extract. It has multiple clinical effects including anti-cancer effects. The development of the multidrug resistance (MDR) phenotype is one of the principal causes of cancer chemotherapy failure. The multidrug resistance protein 1 (MDR1) is one of the MDR-related protein and is often overexpressed in different cancers. In the present study, we aimed to evaluate the influence of crocin on the expression and function of MDR1 protein in EPG85-257 and EPG85-257RDB gastric cancer cell lines. Methods: The cytotoxicity effect of crocin was evaluated by the MTT assay. The impacts of crocin on the expression and function of MDR1 were assessed by Real-time RT-PCR and MTT assay, respectively. Results: The results demonstrated that crocin decreased cell viability in a dose-dependent manner with higher intensity on the EPG85-257 than the EPG85-257RDB cells. Crocin did not make any significant changes in the MDR1 gene expression level in EPG85-257 and EPG85-257RDB cell lines. In contrast, crocin increased doxorubicin cytotoxicity in drug-resistant cells, which might be induced by reduced MDR1 activity. Conclusion: In summary, although crocin did not affect mRNA expression of MDR1, results of MTT assay suggest that it might inhibit the MDR1 function.
Collapse
Affiliation(s)
- Seyedeh Mahya Shariat Razavi
- Medical Genetics Research Center, Faculty of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Gholamreza Karimi
- Medical Toxicology Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Arabzadeh
- 4Biotechnology Research Center,
Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahideh Keyvani
- Department of Genetics, Faculty of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Javad Behravan
- 4Biotechnology Research Center,
Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Kalalinia
- 4Biotechnology Research Center,
Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
19
|
Chang YC, Kondapuram SK, Yang TH, Syed SB, Cheng SM, Lin TY, Lin YC, Coumar MS, Chang JY, Leung E, Cheung CHA. The SMAC mimetic LCL161 is a direct ABCB1/MDR1-ATPase activity modulator and BIRC5/Survivin expression down-regulator in cancer cells. Toxicol Appl Pharmacol 2020; 401:115080. [PMID: 32497533 DOI: 10.1016/j.taap.2020.115080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 11/20/2022]
Abstract
Upregulation of ABCB1/MDR1 (P-gp) and BIRC5/Survivin promotes multidrug resistance in a variety of human cancers. LCL161 is an anti-cancer DIABLO/SMAC mimetic currently being tested in patients with solid tumors, but the molecular mechanism of action of LCL161 in cancer cells is still incompletely understood. It is still unclear whether LCL161 is therapeutically applicable for patients with ABCB1-overexpressing multidrug resistant tumors. In this study, we found that the potency of LCL161 is not affected by the expression of ABCB1 in KB-TAX50, KB-VIN10, and NTU0.017 cancer cells. Besides, LCL161 is equally potent towards the parental MCF7 breast cancer cells and its BIRC5 overexpressing, hormone therapy resistance subline MCF7-TamC3 in vitro. Mechanistically, we found that LCL161 directly modulates the ABCB1-ATPase activity and inhibits ABCB1 multi-drug efflux activity at low cytotoxic concentrations (i.e. 0.5xIC50 or less). Further analysis revealed that LCL161 also decreases intracellular ATP levels in part through BIRC5 downregulation. Therapeutically, co-treatment with LCL161 at low cytotoxic concentrations restored the sensitivity to the known ABCB1 substrate, paclitaxel, in ABCB1-expressing cancer cells and increased the sensitivity to tamoxifen in MCF7-TamC3 cells. In conclusion, LCL161 has the potential for use in the management of cancer patients with ABCB1 and BIRC5-related drug resistance. The findings of our study provide important information to physicians for designing a more "patient-specific" LCL161 clinical trial program in the future.
Collapse
|
20
|
Tola HH, Khadoura KJ, Jimma W, Nedjat S, Majdzadeh R. Multidrug resistant tuberculosis treatment outcome in children in developing and developed countries: A systematic review and meta-analysis. Int J Infect Dis 2020; 96:12-18. [PMID: 32289559 DOI: 10.1016/j.ijid.2020.03.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND We aimed to compare and contrast the proportions of treatment outcome between developing and developed countries in children treated for multidrug resistance tuberculosis (MDR-TB). METHODS We conducted a systematic review and meta-analysis of articles published on children treated for MDR-TB. We searched published articles from electronic databases: PubMed/Medline, EMBASE, Scopus and Web of Science for English articles without restricting publication year. We employed random-effects meta-analysis model to estimate the pooled proportions of treatment success, death, treatment failure and lost to follow up. RESULTS We pooled data of 1,343 children obtained from 17 included studies, and the overall pooled treatment success was 77.0% (95% Confidence Interval (CI), 69.0-85.0). Pooled treatment success in developing countries was 73.0% (63.0-83.0), while in developed countries 87.0% (81.0-94.0). The overall pooled treatment failure was 3.0% (1.0-6.0), while death 8.0% (4.0-11.0) and lost to follow up 10.0% (6.0-4). CONCLUSION MDR-TB treatment success in children is well achieved in both developed and developing countries by currently available drugs. Improving MDR-TB treatment programme is vital to achieve the maximum treatment successful. Promoting research on pediatric MDR-TB treatment outcome could also help to fill evidence gap.
Collapse
Affiliation(s)
- Habteyes Hailu Tola
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University Medical, Tehran, Iran; Tuberculosis/HIV Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Khalid Jamal Khadoura
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University Medical, Tehran, Iran; Departiment of Internal Medicine, Shifa Complex Hospital, Gaza, Palestine.
| | - Worku Jimma
- Department of Information Science, College of Natural Sciences, Jimma University, Jimma, Ethiopia.
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University Medical, Tehran, Iran; Knowledge Utilization Research Center, Tehran University Medical Sciences, Tehran, Iran.
| | - Reza Majdzadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University Medical, Tehran, Iran; Knowledge Utilization Research Center, Tehran University Medical Sciences, Tehran, Iran.
| |
Collapse
|
21
|
Dante RAS, Ferrer RJE, Jacinto SD. Leaf Extracts from Dillenia philippinensis Rolfe Exhibit Cytotoxic Activity to both Drug-Sensitive and Multidrug-Resistant Cancer Cells. Asian Pac J Cancer Prev 2019; 20:3285-3290. [PMID: 31759350 PMCID: PMC7063009 DOI: 10.31557/apjcp.2019.20.11.3285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Indexed: 01/10/2023] Open
Abstract
Background: Cancer is one of the leading causes of illness and death worldwide. Only palliative therapeutic options are available for many types of cancers, and most anticancer drugs in clinical use exhibit significant side effects. It is therefore important to develop new anticancer drugs that are more effective and less toxic. In this study, we evaluate the bioactivity of a Philippine endemic plant, “katmon” or Dillenia philippinensis, and its potential use in cancer therapy. Methods: The cytotoxicity of the crude leaf extract, partitions, and isocratic column chromatography fractions of Dillenia philippinensis was determined in vitro by MTT assay against drug-sensitive cancer cell lines MCF7 (human breast adenocarcinoma) and HCT 116 (human colorectal carcinoma), as well as against moderately multidrug resistant (MDR) cancer cell line HCT-15 (human colorectal carcinoma) and its highly MDR subline HCT-15/Dox. The selectivity of the extract to cancer cells was determined by computing for the selectivity index (SI) with respect to normal mouse embryonic fibroblasts (NIH/3T3) cell line. To check for a possible mechanism for overcoming cancer multiple drug resistance, Calcein-AM assay was performed to assess the activity of the extract against P-glycoprotein-activated efflux pump. Results: Dillenia philippinensis (DP1) fraction from the hexane partition exhibited cytotoxicity (IC50< 30 µg/ml) against MCF7, HCT 116, HCT-15, and HCT-15/Dox cells. DP1 also exhibited a moderate level of selectivity against cancer cells over normal cells as supported by the SI computed from the IC50 value obtained for the normal cell line. DP1 was able to inhibit P-glycoprotein (P-gp) activity in a dose-dependent manner, suggesting its possible role in targeting cancer cells with overexpressed P-gp. Conclusion: The present findings thus demonstrate the potential chemotherapeutic properties of D. philippinensis which can be promising for future drug development against cancer.
Collapse
Affiliation(s)
- Rachelle Anne S Dante
- Institute of Biology, University of the Philippines, Diliman, Quezon City, Philippines
| | - Regina Joyce E Ferrer
- Institute of Biology, University of the Philippines, Diliman, Quezon City, Philippines
| | - Sonia D Jacinto
- Institute of Biology, University of the Philippines, Diliman, Quezon City, Philippines
| |
Collapse
|
22
|
Bawankar P, Bhattacharjee H, Barman M, Soibam R, Deka H, Chandra Kuri G, Medhi J. Outbreak of Multidrug-resistant Pseudomonas Aeruginosa Endophthalmitis Due to Contaminated Trypan Blue Solution. J Ophthalmic Vis Res 2019; 14:257-266. [PMID: 31660104 PMCID: PMC6815331 DOI: 10.18502/jovr.v14i3.4781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 11/11/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To report the investigation of an outbreak of multidrug-resistant (MDR) Pseudomonas aeruginosa endophthalmitis in 13 patients after cataract surgery and to emphasize on the importance of clinical profile, risk factors, and treatment outcomes Methods This was a hospital-based, retrospective case study with 13 consecutive patients who had man- ual small-incision cataract surgery with intraocular lens (IOL) implantation and developed acute postoperative Pseudomonas aeruginosa endophthalmitis. The anterior chamber taps, vitreous aspirates, and environ- mental surveillance specimens were inoculated for culturing. Antibiotic susceptibility testing was performed using the agar diffusion method. Pulsed-field gel electrophoresis (PFGE) was used to determine the relation- ship between bacterial isolates recovered from study patients and contaminated surveillance samples. Results Pseudomonas aeruginosa was isolated from all 13 eyes with acute postoperative endophthalmitis and the trypan blue solutions used during surgery. Sensitivity tests revealed that all isolates had an identical resistance to multiple drugs and were only susceptible to imipenem. Genomic DNA typing of Pseudomonas aeruginosa isolates recovered from patients and trypan blue solutions showed an identical banding pattern on the PFGE. Despite the prompt use of intravitreal antibiotics and early vitrectomy with IOL explantation in some patients, the outcome was poor in about 50% of patients. Conclusion Positive microbiology and genomic DNA typing results proved that the contaminated trypan blue solutions were the source of infection in this outbreak. Postoperative endophthalmitis caused by Pseudomonas aeruginosa is often associated with a poor visual prognosis despite prompt treatment with intravitreal antibiotics.
Collapse
Affiliation(s)
- Pritam Bawankar
- Department of Vitreo-Retina Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Harsha Bhattacharjee
- Department of Vitreo-Retina Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Manabjyoti Barman
- Department of Vitreo-Retina Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Ronel Soibam
- Department of Vitreo-Retina Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Hemalata Deka
- Department of Vitreo-Retina Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Ganesh Chandra Kuri
- Department of Oculoplastic, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Jnanankar Medhi
- Department of Cornea, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| |
Collapse
|
23
|
Goudarzi M, Fazeli M, Eslami G, Pouriran R, Hajikhani B, Dadashi M. Genetic Diversity Analysis of Methicillin-resistant Staphylococcus aureus Strains Isolated from Intensive Care Unit in Iran. Oman Med J 2019; 34:118-125. [PMID: 30918605 PMCID: PMC6425056 DOI: 10.5001/omj.2019.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objectives Staphylococcus aureus has emerged as a major public health concern. It is a common pathogen in high-risk hospital intensive care units (ICUs). We analyzed the molecular characteristics on the SCCmec and spa genes of S. aureus isolates gathered from ICUs. The antibiotic resistance patterns and carriage of resistance and virulence determinants were also identified. Methods In this cross-sectional study, 84 non-duplicated S. aureus strains isolated from ICU patients in were genotyped using SCCmec and spa typing. The Kirby-Bauer disk diffusion and micro-broth dilution methods were used to determine resistance patterns. Virulence and resistance gene profiling were also determined using the polymerase chain reaction technique. Results All isolates were methicillin-resistant S. aureus and belonged to seven spa types: t388 (36.9%), t852 (14.3%), t924 (13.1%), t790 (11.9%), t064 (10.7%), t037 (9.5%), and t084 (3.6%). They differed in the carriage of resistance and toxin genes. The most common SCCmec type was III detected in 50 isolates (59.5%), followed by type IV in 34 isolates (40.5%). The pvl gene was detected in 14.3% (n = 12) of isolates, of which 66.7% (n = 8) belonged to t852 and 33.3% (n = 4) belonged to t790. Among the tested strains, 9.5% (n = 8) carried the mupA gene and belonged to the t064 spa type. Conclusions The data revealed a high resistance rate to antibiotics, which could be a threat to ICU patients. It is necessary to detect antimicrobial resistance and resistance and toxin-encoding of gene profiles in different molecular types.
Collapse
Affiliation(s)
- Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Fazeli
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramin Pouriran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Onanuga A, Omeje MC, Eboh DD. CARRIAGE OF MULTI-DRUG RESISTANT UROBACTERIA BY ASYMPTOMATIC PREGNANT WOMEN IN YENAGOA, BAYELSA STATE, NIGERIA. Afr J Infect Dis 2018; 12:14-20. [PMID: 30109281 PMCID: PMC6085741 DOI: 10.21010/ajid.v12i2.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Urinary Tract Infections (UTIs) in pregnancy are associated with significant morbidity for both mother and baby but its early detection and treatments can prevent unfavorable complications in pregnancy. This study therefore determined the prevalence of asymptomatic bacteriuria and antimicrobial resistance profile of the urinary bacteria among pregnant women in Yenagoa, Bayelsa State, Nigeria. MATERIALS AND METHODS Mid-stream urine samples were collected from 201 apparently healthy pregnant women attending antenatal clinics in Yenagoa. The samples were analyzed and the organisms identified using standard microbiological methods. Haemolysin production by the organisms was screened and their antimicrobial susceptibility was performed using standard assay methods. RESULTS A high significant bacteriuria of 119 (59.2%) was predominantly recovered from the pregnant women in their second and third trimesters. The bacteria isolated; Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Staphylococcus species had 36 - 67% of haemolysin producers. The bacteria exhibited a very high resistance to most of the antibiotics tested but the resistance to ceftazidime, gentamicin and ciprofloxacin was 28 - 67%. All the Staphylococcus species exhibited 90% and 85% resistance to cefoxitin (methicillin resistant) and vancomycin respectively. An 89 - 100% of the bacteria exhibited multiple antibiotic resistance and 72.3% of the screened bacteria phenotypically expressed Extended-Spectrum Beta-lactamase production. CONCLUSION The high prevalence of significant bacteriuria with high multi-drug resistance among the study pregnant women call for regular education on proper personal hygiene and the need for early screening for UTIs during antenatal clinics as means of controlling the spread of antibiotic resistant organisms and complications in pregnancy.
Collapse
Affiliation(s)
- Adebola Onanuga
- Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| | - Maureen Chinelo Omeje
- Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| | - Darlington Deboh Eboh
- Department of Pharmaceutical Microbiology & Biotechnology, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| |
Collapse
|
25
|
Yan W, Yang T, Yang J, Wang T, Yu Y, Wang Y, Chen Q, Bai P, Li D, Ye H, Qiu Q, Zhou Y, Hu Y, Yang S, Wei Y, Li W, Chen L. SKLB060 Reversibly Binds to Colchicine Site of Tubulin and Possesses Efficacy in Multidrug-Resistant Cell Lines. Cell Physiol Biochem 2018; 47:489-504. [PMID: 29794416 DOI: 10.1159/000489983] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/10/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIMS Many tubulin inhibitors are in clinical use as anti-cancer drugs. In our previous study, a novel series of 4-substituted coumarins derivatives were identified as novel tubulin inhibitors. Here, we report the anti-cancer activity and underlying mechanism of one of the 4-substituted coumarins derivatives (SKLB060). METHODS The anti-cancer activity of SKLB060 was tested on 13 different cancer cell lines and four xenograft cancer models. Immunofluorescence staining, cell cycle analysis, and tubulin polymerization assay were employed to study the inhibition of tubulin. N, N '-Ethylenebis(iodoacetamide) assay was used to measure binding to the colchicine site. Wound-healing migration and tube formation assays were performed on human umbilical vascular endothelial cells to study anti-vascular activity (the ability to inhibit blood vessel growth). Mitotic block reversibility and structural biology assays were used to investigate the SKLB060-tubulin bound model. RESULTS SKLB060 inhibited tubulin polymerization and subsequently induced G2/M cell cycle arrest and apoptosis in cancer cells. SKLB060 bound to the colchicine site of β-tubulin and showed antivascular activity in vitro. Moreover, SKLB060 induced reversible cell cycle arrest and reversible inhibition of tubulin polymerization. A mitotic block reversibility assay showed that the effects of SKLB060 have greater reversibility than those of colcemid (a reversible tubulin inhibitor), indicating that SKLB060 binds to tubulin in a totally reversible manner. The crystal structures of SKLB060-tubulin complexes confirmed that SKLB060 binds to the colchicine site, and the natural coumarin ring in SKLB060 enables reversible binding. CONCLUSIONS These results reveal that SKLB060 is a powerful and reversible microtubule inhibitor that binds to the colchicine site and is effective in multidrug-resistant cell lines.
Collapse
Affiliation(s)
- Wei Yan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Tao Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Jianhong Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Taijin Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Yamei Yu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Yuxi Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Qiang Chen
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Peng Bai
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Dan Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Haoyu Ye
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Qiang Qiu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Yongzhao Zhou
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yiguo Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Shengyong Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Yuquan Wei
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Weimin Li
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lijuan Chen
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China.,School of Pharmacy, Chengdu University of TCM, The Ministry of Education Key Laboratory of Standardization of Chinese Herbal Medicine, State Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| |
Collapse
|
26
|
Kenworthy R, Bosco DB, DeLigio JT, Zorio DAR. Micro-RNA149 confers taxane resistance to malignant mesothelioma cells via regulation of P-glycoprotein expression. Cancer Biol Ther 2018; 19:181-187. [PMID: 29261027 DOI: 10.1080/15384047.2017.1415677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multidrug resistance (MDR) represents a major hindrance to the efficacy of cancer chemotherapeutics. While surgical resection, radiation, and chemotherapy can be used to reduce tumor size, the subsequent appearance of drug resistant cells is a frequent problem. One of the main contributors to the development of MDR is increased expression of multi-drug resistant protein 1 (MDR1), also known as P-glycoprotein (P-gp). P-gp is a membrane-associated efflux pump that can efficiently remove internalized taxane-base chemotherapeutics thus preventing drug accumulation and maintaining cellular viability. Consequently, investigation into the molecular mechanisms responsible for regulation of P-gp expression is necessary to facilitate treatment of MDR tumors. Using molecular and biochemical approaches, we identified that the micro-RNA, miRNA149, contributes to the development of MDR within malignant mesothelioma cells by regulating the expression of MDR1.
Collapse
Affiliation(s)
- Rachael Kenworthy
- a Department of Math and Sciences , Andrew College , Cuthbert , GA , United States
| | - Dale B Bosco
- c Department of Biomedical Sciences , School of Medicine, Florida State University , Tallahassee , FL , United States
| | - James T DeLigio
- b Department of Biochemistry and Molecular Biology , Virginia Commonwealth University School of Medicine , Richmond , VA , United States
| | - Diego A R Zorio
- c Department of Biomedical Sciences , School of Medicine, Florida State University , Tallahassee , FL , United States
| |
Collapse
|
27
|
Salvia AM, Cuviello F, Coluzzi S, Nuccorini R, Attolico I, Pascale SP, Bisaccia F, Pizzuti M, Ostuni A. Expression of some ATP-binding cassette transporters in acute myeloid leukemia. Hematol Rep 2017; 9:7406. [PMID: 29333226 PMCID: PMC5757415 DOI: 10.4081/hr.2017.7406] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/18/2017] [Indexed: 11/23/2022] Open
Abstract
Hematopoietic cells express ATP binding cassette (ABC) transporters in relation to different degrees of differentiation. One of the known multidrug resistance mechanisms in acute myeloid leukemia (AML) is the overexpression of efflux pumps belonging to the superfamily of ABC transporters such as ABCB1, ABCG2 and ABCC1. Although several studies were carried out to correlate ABC transporters expression with drug resistance, little is known about their role as markers of diagnosis and progression of the disease. For this purpose we investigated the expression, by real-time PCR, of some ABC genes in bone marrow samples of AML patients at diagnosis and after induction therapy. At diagnosis, ABCG2 was always down-regulated, while an up regulated trend for ABCC1 was observed. After therapy the examined genes showed a different expression trend and approached the values of healthy subjects suggesting that this event could be considered as a marker of AML regression. The expression levels of some ABC transporters such as ABCC6, seems to be related to gender, age and to the presence of FLT3/ITD gene mutation.
Collapse
Affiliation(s)
| | | | - Sabrina Coluzzi
- Department of Hematology, San Carlo Hospital, Potenza, Italy
| | | | | | | | | | - Michele Pizzuti
- Department of Hematology, San Carlo Hospital, Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, Potenza
| |
Collapse
|
28
|
Jin L, Xu M, Luo XH, Zhu XF. Stephania Tetrandra and Ginseng-Containing Chinese Herbal Formulation NSENL Reverses Cisplatin Resistance in Lung Cancer Xenografts. Am J Chin Med 2017; 45:385-401. [PMID: 28231742 DOI: 10.1142/s0192415x17500240] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Chinese Herbal Formulation, supplement energy and nourish lung (SENL), effectively enhances chemotherapeutic efficacy in lung cancer treatment and reverses multi-drug resistance (MDR) in lung cancer cells in vitro. The present study is designed to assess the effect of a New SENL (NSENL, modification of SENL) formulation on resistance to chemotherapy of cisplatin (DDP)-resistant human lung cancer cell line (A549/DDP) xenografts in nude mice. We assessed six constituents in NSENL by high performance liquid chromatography (HPLC). BALB/c nude mice harboring A549/DDP cell xenografts were established to assess the antitumor effect of NSENL and its impact on the expression of MDR related genes. The six constituents in NSENL, including ginsenoside Rg1, ginsenoside Rb1, ginsenoside Rg3, astragaloside IV, ophiopogonin D and tetrandrine were quantitated simultaneously by HPLC. The combination of NSENL with DDP significantly inhibited tumor growth at a rate of up to 66.8% ([Formula: see text]). In addition, NSENL as monotherapy or combined with DDP downregulated multidrug resistance-associated protein 1 (MRP1), basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor 1 (FGFR1) at both the mRNA and protein levels ([Formula: see text]), reduced glutathione S-transferase π (GST-π) protein expression and tumor microvascular density as well as decreased phosphorylation of protein kinase B (Akt) and mammalian target of rapamycin (mTOR) ([Formula: see text]). These findings demonstrated that NSENL can reverse MDR in A549/DDP cells in vivo, an effect possibly associated with downregulation of MDR-associated genes as well as inhibition of bFGF/FGFR and phosphatidylinositol 3-kinase (PI3K)/Akt/mTOR signaling pathways.
Collapse
Affiliation(s)
- Ling Jin
- * Department of Oncology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China.,† Department of Traditional Chinese Medicine, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Meng Xu
- * Department of Oncology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Xue-Hua Luo
- † Department of Traditional Chinese Medicine, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Xiao-Feng Zhu
- † Department of Traditional Chinese Medicine, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| |
Collapse
|
29
|
Oliva M, Monno R, D'Addabbo P, Pesole G, Dionisi AM, Scrascia M, Chiara M, Horner DS, Manzari C, Luzzi I, Calia C, D'Erchia AM, Pazzani C. A novel group of IncQ1 plasmids conferring multidrug resistance. Plasmid 2016; 89:22-26. [PMID: 27916622 DOI: 10.1016/j.plasmid.2016.11.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 11/28/2022]
Abstract
The IncQ is a group of non-conjugative but mobilisable plasmids that are found and stably maintained in a wide range of bacteria contributing to the spread of antimicrobial resistance genes and to the insurgence of multidrug resistant bacteria. Here we report the identification, in clinical Salmonella Typhimurium strains, of an IncQ1 plasmid (pNUC) which confers resistance to sulfamethoxazole, streptomycin and tetracycline through the presence of sul2, strAB and tetA genes, respectively. pNUC was detected in five multidrug resistant S. Typhimurium strains collected in Southern Italy from various hospitals and years of isolation. Bioinformatics analyses highlighted the presence of pNUC-like plasmids in pathogenic bacteria of various Enterobacteriaceae genera or species. Taken as a whole, these plasmids constitute a novel group of IncQ1 plasmids that might have originated through recombination events between a tetR-tetA gene cluster (possibly derived from a Tn1721) and a recipient IncQ1 plasmid related to RSF1010. Our findings raise concerns regarding the possible contribution of the newly identified group of IncQ1 plasmids to the spread of tetracycline resistance.
Collapse
Affiliation(s)
- M Oliva
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - R Monno
- Department of Basic Medical Sciences Neurosciences and Sense Organs Medical Faculty, University of Bari Piazza G. Cesare Policlinico, 70124 Bari, Italy
| | - P D'Addabbo
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - G Pesole
- Institute of Biomembranes and Bioenergetics, National Research Council, via Amendola 165A, 70125 Bari, Italy; Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - A M Dionisi
- Department of Infectious, Parasitic and Immuno-Mediated Diseases, Istituto Superiore di Sanità, Rome 00161, Italy
| | - M Scrascia
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - M Chiara
- Department of Biosciences, University of Milano, via Celoria 26, 20131 Milano, Italy
| | - D S Horner
- Department of Biosciences, University of Milano, via Celoria 26, 20131 Milano, Italy
| | - C Manzari
- Institute of Biomembranes and Bioenergetics, National Research Council, via Amendola 165A, 70125 Bari, Italy
| | - I Luzzi
- Department of Infectious, Parasitic and Immuno-Mediated Diseases, Istituto Superiore di Sanità, Rome 00161, Italy
| | - C Calia
- Department of Basic Medical Sciences Neurosciences and Sense Organs Medical Faculty, University of Bari Piazza G. Cesare Policlinico, 70124 Bari, Italy
| | - A M D'Erchia
- Institute of Biomembranes and Bioenergetics, National Research Council, via Amendola 165A, 70125 Bari, Italy; Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - C Pazzani
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy.
| |
Collapse
|
30
|
Tew LS, She LY, Chew CH. Isolation, Antimicrobial Susceptibility Profile and Detection of Sul1, blaTEM, and blaSHV in Amoxicillin-Clavulanate-Resistant Bacteria Isolated From Retail Sausages in Kampar, Malaysia. Jundishapur J Microbiol 2016; 9:e37897. [PMID: 27942365 PMCID: PMC5136445 DOI: 10.5812/jjm.37897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/16/2022] Open
Abstract
Background Due to the overuse of antibiotics in livestock as a growth-promoting agent, the emergence of multi-antibiotic resistant bacteria is becoming a concern. Objectives In this study, we aimed to detect the presence and discover the molecular determinants of foodborne bacteria in retail sausages resistant towards the antibacterial agent amoxicillin-clavulanate. Methods Two grams of sausages were chopped into small pieces and transferred into sterile Luria-Bertani (LB) enrichment broths overnight before they were plated on MacConkey agar petri dishes. The bacteria isolated were then screened for amoxicillin-clavulanate resistance, and an antimicrobial susceptibility test of each isolate was performed by using the disc diffusion method. Double synergy and phenotypic tests were carried out to detect the presence of extended spectrum β-lactamase (ESBL). API 20E kit was used to identify the Enterobacteriaceae. All isolates were further examined by polymerase chain reaction (PCR) for resistant genes blaOXA-1, blaOXA-10, plasmid-mediated AmpC (blaCMY and blaDHA), and the chromosome-mediated AmpC, Sul1, blaTEM, and blaSHV genes. Results A total of 18 amoxicillin-clavulanate resistant isolates were obtained from seven different types of retail sausages. Only half of them were identified as Enterobacteriaceae, but none were ESBL-producers. All the 18 isolated strains demonstrated resistance towards amoxicillin-clavulanate, penicillin and oxacillin (100%), cefotaxime (71.4%), cefpodoxime (66.7%), and ampicillin (83.3%). blaTEM was the most frequently detected β-lactamase gene. Both plasmid- and chromosomal-bound blaTEM genes were detected in all of the isolated Enterobacteriaceae. blaSHV and Sul1 accounted for 22.2% and 11.1% of the amoxicillin-clavulanate resistant isolates, respectively, whereas blaAMPC, blaCMY, blaDHA, blaOXA-1, and blaOXA-10 were not found in any of the isolates. The only one ESBL-producing bacteria detected in this study was Chryseobacterium meningosepticum, which harbored the blaTEM gene. Conclusions The multidrug resistant bacteria that carry antibiotic resistant genes from retail sausages may increase the risk of transmission to humans via the consumption of contaminated sausages. Stricter measures must be taken to address the use of antibiotics in animal agriculture and to consider their potential impact on human health.
Collapse
Affiliation(s)
- Lih-Shin Tew
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar Perak, Malaysia
| | - Li-Yen She
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar Perak, Malaysia
| | - Choy-Hoong Chew
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar Perak, Malaysia
- Corresponding author: Choy-Hoong Chew, Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar Perak, Malaysia. Tel: +605-4688888, Fax: +605-4661676, E-mail:
| |
Collapse
|
31
|
Munivenkatappa S, Anil S, Naik B, Volkmann T, Sagili KD, Akshatha JS, Buggi S, Sharada MA, Kulkarni S, Chadha VK, Moonan PK. Drug-Induced Hypothyroidism during Anti-Tuberculosis Treatment of Multidrug-Resistant Tuberculosis: Notes from the Field. ACTA ACUST UNITED AC 2016; 4:105-110. [PMID: 27595122 PMCID: PMC5007858 DOI: 10.4236/jtr.2016.43013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We followed 188 euthyroidic persons undergoing treatment for multidrug resistant tuberculosis (MDR-TB) in the state of Karnataka, India to determine the incidence of hypothyroidism during anti-tuberculosis treatment. Overall, among MDR-TB patients with valid thyroid stimulating hormone (TSH) values, about 23% developed hypothyroidism (TSH value ≥10 mIU/ml) during anti-tuberculosis treatment; the majority (74%) occurring after 3 months of treatment. Among 133 patients who received a regimen that contained ethionamide, 42 (32%) developed hypothyroidism. Among 17 patients that received a regimen that contained para-aminosalicylate sodium, 6 (35%) developed hypothyroidism. Among 9 HIV positive patients on anti-retroviral treatment, 4 (44%) developed hypothyroidism. These results differ from previously reported 4% incidence of hypothyroidism amongst patients who passively reported thyroidal symptoms during treatment, suggesting routine serologic monitoring of TSH throughout the course of treatment for MDR-TB is warranted.
Collapse
Affiliation(s)
- Somashekar Munivenkatappa
- Drug Resistant Treatment Centre, Bengaluru, India; Sri Devarao Shivaram, Tuberculosis and Rajiv Gandhi Institute of Chest Diseases, Bengaluru, India
| | - Singarajipura Anil
- Revised National Tuberculosis Programme-State of Karnataka, Bengaluru, India
| | - Balaji Naik
- World Health Organization, India Country Office, New Delhi, India
| | - Tyson Volkmann
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karuna D Sagili
- International Union against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | | | - Shashidhar Buggi
- Sri Devarao Shivaram, Tuberculosis and Rajiv Gandhi Institute of Chest Diseases, Bengaluru, India
| | | | | | | | - Patrick K Moonan
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
32
|
Moini AS, Soltani B, Taghavi Ardakani A, Moravveji A, Erami M, Haji Rezaei M, Namazi M. Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran. Jundishapur J Microbiol 2015; 8:e27517. [PMID: 26587220 PMCID: PMC4644348 DOI: 10.5812/jjm.27517] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 06/03/2015] [Accepted: 07/11/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions. OBJECTIVES In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined. PATIENTS AND METHODS In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected. RESULTS The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04). CONCLUSIONS The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.
Collapse
Affiliation(s)
- Atieh Sadat Moini
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Babak Soltani
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Babak Soltani, Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155575840, Fax: +98-3155548900, E-mail:
| | | | - Alireza Moravveji
- Department of Community Medicine, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mahzad Erami
- Department of Microbiology, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mostafa Haji Rezaei
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mansoor Namazi
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| |
Collapse
|
33
|
Serafettin Tekgunduz K, Kara M, Caner I, Demirelli Y. Safety and Efficacy of Intravenous Colistin in Neonates With Culture Proven Sepsis. Iran J Pediatr 2015; 25:e453. [PMID: 26396706 PMCID: PMC4575804 DOI: 10.5812/ijp.453] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 02/28/2015] [Indexed: 11/16/2022]
Abstract
Background: Although it is well described among adults, intravenous colistin use and its associated toxicities in newborns are poorly understood. Objectives: We present our experience of efficacy and safety of intravenous colistin in the treatment of sepsis in term and preterm neonates. Patients and Methods: The records of neonates who received colistin between January 2013 and February 2014 were retrospectively reviewed. All neonates with culture proven nosocomial infections due to multidrug resistant organisms and treated continuously with colistin for more than 72 hours were included in the study. Results: Patients were evaluated for clinical and microbiological response to the drug and its and side effects. Twelve newborn infants with mean 31.8 ± 3.5 weeks gestational age and median 1482 (810 - 3200) gram birth weight were included. 11/12 (91.7%) patients showed microbiological clearance with intravenous colistin. One patient who had recurrent cerebrospinal fluid positive culture was treated with intraventricular colistin. The major side effects observed was hyponatremia and hypokalemia in 2 (16.6%) patients, all infants required magnesium supplementation. Conclusions: Intravenous colistin administration appears to be safe and efficacious for multidrug-resistant gram-negative infections in neonates, including preterm infants. However, we believe that large prospective controlled studies are needed to confirm its efficacy and safety in neonates.
Collapse
Affiliation(s)
- Kadir Serafettin Tekgunduz
- Division of Neonatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
- Corresponding author: Kadir Serafettin Tekgunduz, Division of Neonatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey. Tel: +90-4423446990, Fax: +90-4423447696, E-mail:
| | - Mustafa Kara
- Division of Neonatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ibrahim Caner
- Division of Neonatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Yasar Demirelli
- Division of Neonatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
34
|
Talebi M, Sadeghi J, Rahimi F, Pourshafie MR. Isolation and Biochemical Fingerprinting of Vancomycin-Resistant Enterococcus faecium From Meat, Chicken and Cheese. Jundishapur J Microbiol 2015; 8:e15815. [PMID: 26034532 PMCID: PMC4449848 DOI: 10.5812/jjm.8(4)2015.15815] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/18/2014] [Accepted: 02/12/2014] [Indexed: 11/19/2022] Open
Abstract
Background: Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens and food chain has been considered as an assumed source for dissemination of VRE to human. Objectives: The presence of VRE isolates from food samples and typing of these isolates with Phene plate, a biochemical fingerprinting method, were investigated. Materials and Methods: Thirty samples of meat, chicken and cheese were analyzed for VRE during 2010. Antibiotic susceptibility tests and minimum inhibitory concentration (MIC) were also examined. VRE isolates were typed with the Phene plate system (PhPlate), a biochemical fingerprinting method. Results: A total of 70 VRE isolates were obtained and identified as Enterococcus faecium by species-specific PCR. All the isolates carried vanA, while none of them harbored vanB. The VRE isolates included 35, 27, and 8 isolates from meat, chicken and cheese, respectively. Typing with the PhPlate revealed a diversity index of 0.78 for E. faecium, containing 10 common and four single types. The results of antibiotic susceptibility and MIC tests showed an increased resistance to ciprofloxacin, erythromycin, ampicillin and gentamicin, to which, 100%, 100%, 100%, and 95% of VRE isolates were resistant, respectively. Only 5% of the isolates were resistant to chloramphenicol and the MIC of the isolates for vancomycin and teicoplanin was ≥ 256 µg/mL and for gentamicin-resistant isolates it was 1024 µg/mL. Conventional and molecular identification tests exhibited that all the isolates were E. faecium carrying vanA. None of the isolates harbored vanB. Conclusions: The results showed that enterococci are common contaminants in food. Indeed, this study indicates a high prevalence of multidrug-resistant enterococci in food of animal origin in Iran. Isolating some persisting enterococcal isolates revealed that continuous surveillance of antimicrobial resistance in enterococci from food is essential.
Collapse
Affiliation(s)
- Malihe Talebi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran
| | - Javad Sadeghi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences , Tehran, IR Iran
| | - Fateh Rahimi
- Department of Microbiology, Faculty of Science, University of Isfahan, Isfahan, IR Iran
- Corresponding authors: Fateh Rahimi, Department of Microbiology, Faculty of Science, University of Isfahan, Isfahan, IR Iran. Tel: +98-3137932250, Fax: +98-3137932456, E-mail: ; Mohammad Reza Pourshafie, Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran. Tel: +98-2166405534, Fax: +98-2166405535, E-mail:
| | - Mohammad Reza Pourshafie
- Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran
- Corresponding authors: Fateh Rahimi, Department of Microbiology, Faculty of Science, University of Isfahan, Isfahan, IR Iran. Tel: +98-3137932250, Fax: +98-3137932456, E-mail: ; Mohammad Reza Pourshafie, Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran. Tel: +98-2166405534, Fax: +98-2166405535, E-mail:
| |
Collapse
|
35
|
Erami M, Soltani B, Taghavi Ardakani A, Moravveji A, Haji Rezaei M, Soltani S, Moniri R. Nasal Carriage and Resistance Pattern of Multidrug Resistant Staphylococcus aureus Among Healthy Children in Kashan, Iran. Iran Red Crescent Med J 2014; 16:e21346. [PMID: 25593734 PMCID: PMC4270649 DOI: 10.5812/ircmj.21346] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/11/2014] [Accepted: 08/30/2014] [Indexed: 11/16/2022]
Abstract
Background: Nasal carriage of Staphylococcus aureus is a substantial source of human infections. Detection and treatment of nasal carriage in children with methicillin-resistant and multidrug resistant S. aureus (MRSA and MDRSA, respectively) may be an important modality in prevention of infections. Objectives: This study determined the prevalence, antibiotic resistance patterns and risk factors for nasal carriage of MDRSA among healthy children. Patients and Methods: This cross-sectional study was carried out on 350 one-month to 14-year-old healthy children in Kashan city, Iran. From all health-care centers, four were chosen by simple random sampling. Nasal samples were cultured in blood agar medium for S. aureus and antibiotic susceptibility profile was determined by disc diffusion and E-test. Risk factors for nasal carriage of MDRSA were also determined. Results: A total of 92 (26.3%) S. aureus isolates were obtained, of which 33 (35.9%) were MRSA and 27 (29.3%) were MDRSA. Of MRSA strains, 19 (70.4%) were MDRSA. S. aureus isolates showed 52.2% resistance to cephalothin, 33.7% to co-trimoxazole, 26.1% to clindamycin, 26.1% to ciprofloxacin, 4.3% to vancomycin, and 35.9% to oxacillin. The risk factors for nasal carriage of MDRSA were antibiotic usage during the last three months (P = 0.006), family size of more than four members (P = 0.044), and parental smoking (P = 0.045). Conclusions: MDRSA was not uncommon among healthy children in Kashan and prevention of its spread in the population is judicious.
Collapse
Affiliation(s)
- Mahzad Erami
- Department of Microbiology, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Babak Soltani
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding Author: Babak Soltani, Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155575840, Fax: +98-3155550026, E-mail:
| | | | - Alireza Moravveji
- Department of Community Medicine, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mostafa Haji Rezaei
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Siamak Soltani
- Department of Forensic Medicine, Iran University of Medical Sciences, Tehran, IR Iran
| | - Rezvan Moniri
- Department of Microbiology, Kashan University of Medical Sciences, Kashan, IR Iran
| |
Collapse
|
36
|
Akhter A, Imran M, Akhter F. Antimicrobial resistant coliform bacteria in the Gomti river water and determination of their tolerance level. Bioinformation 2014; 10:167-74. [PMID: 24966515 PMCID: PMC4070044 DOI: 10.6026/97320630010167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 03/13/2014] [Indexed: 11/23/2022] Open
Abstract
UNLABELLED The distribution of resistance to ampicillin, chloramphenicol, sulfonamides, tetracycline, and streptomycin among coliform in the Gomti river water samples was investigated. The coliform populations were isolated on Mac Conky and eosin methylene blue (EMB) agar plates supplemented with antibiotics. The incidence of resistance among the coliform population varied considerably in different drug and water sampling sites. Coliform bacteria showed lower drug resistant viable count in sampling site-III (receiving treated wastewater) as compared to more polluted site-I and site-II. Viable count of coliform population obtained on both medium was recorded higher against erythromycin from sampling site-III. Lower viable count of coliforms was recorded against tetracycline in site-II and III. Similar resistance pattern was obtained in the frequency of E. coli and Enterobacter species from all the three sampling sites. Percentage of antibiotic resistant E. coli was observed higher than Enterobacter spp among the total coliforms against all antibiotics tested without Erythromycin and penicillin in site-I and II respectively. Isolates of E. coli and Enterobacter spp. showed their tolerance level (MIC) in the range of 2-100 against the antibiotics tested. Maximum number of isolates of both genus exhibited their MICs at lower concentration range 2-5µg/ml against ciprofloxacin, tetracyclin and amoxycillin. ABBREVIATIONS EMB - Eosin methylene blue, IMViC tests - Indole, Methyl Red, Voges Proskauer and Citrate Utilization Tests, MIC - Minimum inhibitory concentration.
Collapse
Affiliation(s)
- Asma Akhter
- Department of Biosciences, Integral University, Lucknow-226026, India
| | - Mohd Imran
- Department of Biosciences, Integral University, Lucknow-226026, India
| | - Firoz Akhter
- Department of Bioengineering, Integral University, Lucknow - 226026, India
| |
Collapse
|
37
|
Peng J, Qi T, Liao J, Chu B, Yang Q, Qu Y, Li W, Li H, Luo F, Qian Z. Mesoporous magnetic gold "nanoclusters" as theranostic carrier for chemo-photothermal co-therapy of breast cancer. Am J Cancer Res 2014; 4:678-92. [PMID: 24883118 PMCID: PMC4038750 DOI: 10.7150/thno.7869] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 02/28/2014] [Indexed: 02/05/2023] Open
Abstract
Photothermal therapy (PTT) is proved to be an efficient manner for superficial tumor therapy in preclinical studying. The tumor suppression of chemotherapy can be enhanced by combining with PTT. In this study, we reported a mesoporous magnetic gold “nanoclusters” (MMGNCs) structure as theranostic carrier for chemo-photothermal co-therapy. MMGNCs were successfully prepared and they exhibited efficient photo-thermal effect for PTT. The mesoporous structure provided MMGNCs with high drug loading capacity. By in vitro cytotoxicity testing, we revealed that the combination of PTT and chemotherapy could cause more damage than chemotherapy or PTT did alone. By topically targeting mediated by the extra-magnetic field (MF), MMGNCs can be targeted to the tumor site efficiently. In vivo chemo-photothermal co-therapy of 4T1 breast cancer, under the combinational treatments of chemo-photothermal co-therapy and extra-MF targeting, the tumor growth has been efficiently inhibited, and the pulmonary and mediastinal metastasis have also been prevented. The survival of the cancer bearing mice was prolonged. The bio-imaging applications of this system and the mechanism of the metastasis prevention are ongoing.
Collapse
|
38
|
Premkumar L, Kurth F, Neyer S, Schembri MA, Martin JL. The multidrug resistance IncA/C transferable plasmid encodes a novel domain-swapped dimeric protein-disulfide isomerase. J Biol Chem 2013; 289:2563-76. [PMID: 24311786 DOI: 10.1074/jbc.m113.516898] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The multidrug resistance-encoding IncA/C conjugative plasmids disseminate antibiotic resistance genes among clinically relevant enteric bacteria. A plasmid-encoded disulfide isomerase is associated with conjugation. Sequence analysis of several IncA/C plasmids and IncA/C-related integrative and conjugative elements (ICE) from commensal and pathogenic bacteria identified a conserved DsbC/DsbG homolog (DsbP). The crystal structure of DsbP reveals an N-terminal domain, a linker region, and a C-terminal catalytic domain. A DsbP homodimer is formed through domain swapping of two DsbP N-terminal domains. The catalytic domain incorporates a thioredoxin-fold with characteristic CXXC and cis-Pro motifs. Overall, the structure and redox properties of DsbP diverge from the Escherichia coli DsbC and DsbG disulfide isomerases. Specifically, the V-shaped dimer of DsbP is inverted compared with EcDsbC and EcDsbG. In addition, the redox potential of DsbP (-161 mV) is more reducing than EcDsbC (-130 mV) and EcDsbG (-126 mV). Other catalytic properties of DsbP more closely resemble those of EcDsbG than EcDsbC. These catalytic differences are in part a consequence of the unusual active site motif of DsbP (CAVC); substitution to the EcDsbC-like (CGYC) motif converts the catalytic properties to those of EcDsbC. Structural comparison of the 12 independent subunit structures of DsbP that we determined revealed that conformational changes in the linker region contribute to mobility of the catalytic domain, providing mechanistic insight into DsbP function. In summary, our data reveal that the conserved plasmid-encoded DsbP protein is a bona fide disulfide isomerase and suggest that a dedicated oxidative folding enzyme is important for conjugative plasmid transfer.
Collapse
Affiliation(s)
- Lakshmanane Premkumar
- From the Institute for Molecular Bioscience, Division of Chemistry and Structural Biology and
| | | | | | | | | |
Collapse
|
39
|
Yamagishi T, Sahni S, Sharp DM, Arvind A, Jansson PJ, Richardson DR. P-glycoprotein mediates drug resistance via a novel mechanism involving lysosomal sequestration. J Biol Chem 2013; 288:31761-71. [PMID: 24062304 PMCID: PMC3814770 DOI: 10.1074/jbc.m113.514091] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/16/2013] [Indexed: 11/06/2022] Open
Abstract
Localization of the drug transporter P-glycoprotein (Pgp) to the plasma membrane is thought to be the only contributor of Pgp-mediated multidrug resistance (MDR). However, very little work has focused on the contribution of Pgp expressed in intracellular organelles to drug resistance. This investigation describes an additional mechanism for understanding how lysosomal Pgp contributes to MDR. These studies were performed using Pgp-expressing MDR cells and their non-resistant counterparts. Using confocal microscopy and lysosomal fractionation, we demonstrated that intracellular Pgp was localized to LAMP2-stained lysosomes. In Pgp-expressing cells, the Pgp substrate doxorubicin (DOX) became sequestered in LAMP2-stained lysosomes, but this was not observed in non-Pgp-expressing cells. Moreover, lysosomal Pgp was demonstrated to be functional because DOX accumulation in this organelle was prevented upon incubation with the established Pgp inhibitors valspodar or elacridar or by silencing Pgp expression with siRNA. Importantly, to elicit drug resistance via lysosomes, the cytotoxic chemotherapeutics (e.g. DOX, daunorubicin, or vinblastine) were required to be Pgp substrates and also ionized at lysosomal pH (pH 5), resulting in them being sequestered and trapped in lysosomes. This property was demonstrated using lysosomotropic weak bases (NH4Cl, chloroquine, or methylamine) that increased lysosomal pH and sensitized only Pgp-expressing cells to such cytotoxic drugs. Consequently, a lysosomal Pgp-mediated mechanism of MDR was not found for non-ionizable Pgp substrates (e.g. colchicine or paclitaxel) or ionizable non-Pgp substrates (e.g. cisplatin or carboplatin). Together, these studies reveal a new mechanism where Pgp-mediated lysosomal sequestration of chemotherapeutics leads to MDR that is amenable to therapeutic exploitation.
Collapse
Affiliation(s)
- Tetsuo Yamagishi
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| | - Sumit Sahni
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| | - Danae M. Sharp
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| | - Akanksha Arvind
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| | - Patric J. Jansson
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| | - Des R. Richardson
- From the Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales 2006, Australia
| |
Collapse
|
40
|
Kumar Y, Sharma A, Mani KR. Antibiogram Profile of Salmonella enterica Serovar Typhi in India - A Two Year Study. Trop Life Sci Res 2013; 24:45-54. [PMID: 24575241 PMCID: PMC3799410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Typhoid fever continues to remain a major health problem in the developing world, and the emergence of multidrug-resistant (MDR) strains has further reduced therapeutic options for treatment of the disease. The National Salmonella and Escherichia Centre in Kasauli, India received 128 Salmonella Typhi isolates during 2008-2009. These were evaluated for antimicrobial resistance, prevalent resistotypes and the proportion of MDR strains, using standard methods for 11 antimicrobials. An abrupt decrease in the proportion of MDR strains was observed. Only 4.7% of the isolates were found to be MDR with resistotypes chloramphenicol-ampicillin-streptomycin-nalidixic acid-trimethoprim (C-AS-Na-Tr) and chloramphenicol-ampicillin-nalidixic acid-trimethoprim (C-A-Na-Tr), which is very low compared to other studies from India. Nalidixic acid resistance was found to be present in 93.8% of the isolates. Moreover, the difference in the mean minimum inhibitory concentration (MIC) of ciprofloxacin for nalidixic acid-resistant and nalidixic acid-sensitive strains was found to be statistically significant (p<0.001), which calls into question the further use of ciprofloxacin for the treatment of typhoid fever because of potential treatment failures. The low proportion of MDR strains increases the possibility of first-line drugs for the treatment of typhoid fever.
Collapse
Affiliation(s)
- Yashwant Kumar
- National Salmonella and Escherichia Centre, Central Research Institute, Kasauli 173204, Himachal Pradesh, India
| | - Anshu Sharma
- National Salmonella and Escherichia Centre, Central Research Institute, Kasauli 173204, Himachal Pradesh, India
| | - Kavaratty Raju Mani
- National Salmonella and Escherichia Centre, Central Research Institute, Kasauli 173204, Himachal Pradesh, India
| |
Collapse
|
41
|
Maurya IK, Thota CK, Sharma J, Tupe SG, Chaudhary P, Singh MK, Thakur IS, Deshpande M, Prasad R, Chauhan VS. Mechanism of action of novel synthetic dodecapeptides against Candida albicans. Biochim Biophys Acta Gen Subj 2013; 1830:5193-203. [PMID: 23876294 DOI: 10.1016/j.bbagen.2013.07.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 07/03/2013] [Accepted: 07/15/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Three de novo designed low molecular weight cationic peptides (IJ2, IJ3 and IJ4) containing an unnatural amino acid α,β-didehydrophenylalanine (∆Phe) exhibited potent antifungal activity against fluconazole (FLC) sensitive and resistant clinical isolates of Candida albicans as well as non-albicans and other yeast and filamentous pathogenic fungi. In the present study, their synthesis, susceptibility of different fungi and the mechanism of anti-candidal action have been elucidated. METHODS The antimicrobial peptides (AMPs) were synthesized by solid-phase method and checked for antifungal activity against different yeasts and fungi by broth microdilution method. Anti-candidal mode of action of the peptides was investigated through detecting membrane permeabilization by confocal microscopy, Reactive Oxygen Species (ROS) generation by fluorometry, apoptosis and necrosis by flow cytometry and cell wall damage using Scanning and Transmission Electron Microscopy. RESULTS AND CONCLUSIONS The MIC of the peptides against C. albicans and other yeast and filamentous fungal pathogens ranged between 3.91 and 250μM. All three peptides exhibited effect on multiple targets in C. albicans including disruption of cell wall structures, compromised cell membrane permeability leading to their enhanced entry into the cells, accumulation of ROS and induction of apoptosis. The peptides also showed synergistic effect when used in combination with fluconazole (FLC) and caspofungin (CAS) against C. albicans. GENERAL SIGNIFICANCE The study suggests that the AMPs alone or in combination with conventional antifungals hold promise for the control of fungal pathogens, and need to be further explored for treatment of fungal infections.
Collapse
Affiliation(s)
- Indresh Kumar Maurya
- Membrane Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | | | | | | | | | | | | | | | | | | |
Collapse
|