Performance and incidence of diarrhea in suckling Jersey calves supplemented with mineral-vitamin complex and Virginiamycin.

The rearing of calves is an essential activity of a dairy system, as it impacts the future production of these animals. This study aims to evaluate the incidence of diarrhea, performance, and blood parameters of suckling calves that received mineral-vitamin supplementation in milk plus virginiamycin that was offered in milk (via the abomasum) or by esophageal tube (via the rumen). Twenty-seven calves were used, from the first week to 60 days of age, submitted to the following treatments: CONTROL, without supplementation; MILK, supplementation of 20 g of a mineral-vitamin complex with 100 mg of virginiamycin, diluted in milk; RUMEN, supplementation of 20 g of a mineral-vitamin complex diluted in milk and 100 mg of virginiamycin in gelatin capsules via an esophageal applicator. MILK and RUMEN calves had lower fecal consistency scoring, fewer days with scores 2 and 3 throughout the experimental period, and lower spending on medication compared to the CONTROL animals. Supplemented calves had higher fat and protein intake and reached feed intake of 600 g earlier than CONTROL animals, but did not differ in performance and hematological parameters. Supplementation with virginiamycin and vitamin-mineral complex for suckling calves reduced the incidence and days of diarrhea, and reduced medication costs, with no difference in performance, but the supplemented animals had higher initial protein and fat intake and reached targeted feed intake earlier to begin the weaning process.

Quantifying Human Health Risks from Virginiamycin Use in Food Animals in China.

Virginiamycin (VM), a streptogramin antibiotic, has been used to promote healthy growth and treat illnesses in farm animals in the United States and other countries. The combination streptogramin Quinupristin-Dalfopristin (QD) was approved in the United States in 1999 for treating patients with vancomycin-resistant Enterococcus faecium (VREF) infections. Many chickens and swine test positive for QD-resistant E. faecium, raising concerns that using VM in food animals might select for streptogramin-resistant strains of E. faecium that could compromise QD effectiveness in treating human VREF infections. Such concerns have prompted bans and phase-outs of VM as growth promoters in the United States and Europe. This study quantitatively estimates potential human health risks from QD-resistant VREF infections due to VM use in food animals in China. Plausible conservative (risk-maximizing) quantitative risk estimates are derived for future uses, assuming 100% resistance to linezolid and daptomycin and 100% prescription rate of QD to high-level (VanA) VREF-infected patients. Up to one shortened life every few decades to every few thousand years might occur in China from VM use in animals, although the most likely risk is zero (e.g., if resistance is not transferred from bacteria in food animals to bacteria infecting human patients). Sensitivity and probabilistic uncertainty analyses suggest that this conclusion is robust to several data gaps and uncertainties. Potential future human health risks from VM use in animals in China appear to be small or zero, even if QD is eventually approved for use in human patients.

Differences in major bacterial populations in the intestines of mature broilers after feeding virginiamycin or bacitracin methylene disalicylate.

AIMS: The purpose of this study was to compare the effects of feeding virginiamycin or bacitracin methylene disalicylate (BMD), two in-feed antibiotics typically used by commercial poultry producers in the United States, on the chicken gastrointestinal microbiota. METHODS AND RESULTS: 454 pyrosequencing of the V6-V8 region of the 16S rRNA gene and quantitative PCR were employed to examine the bacterial microbiota and Clostridium perfringens, respectively, in the jejunum and caecum of market-age broiler chickens over four replicate grow-outs. CONCLUSIONS: Our results suggest that virginiamycin has a more pronounced impact on broiler gastrointestinal tract bacterial communities, relative to BMD, manifested primarily through significant enrichments in the genus Faecalibacterium in the caecum and a distinct population of Lactobacillus, OTU_02, in both the jejunum and caecum. No evidence for a difference among the diets in Cl. perfringens levels in the jejunum or caecum was observed. SIGNIFICANCE AND IMPACT OF THE STUDY: This work represents the highest resolution comparison to date of the jejunum and caecum microbiota in broilers fed either virginiamycin or BMD, and provides evidence for specific bacterial OTUs potentially involved in the health and performance benefits typically attributed to these in-feed antibiotics.

Effect of plant extracts derived from thyme on male broiler performance.

The effect of dietary thyme-oil extract (TOE) supplementation on immune functions of broilers were assessed by feeding graded levels (50, 100, 200, or 400 ppm) of TOE to male broiler chicks during a 42-d feeding trial compared with negative- or positive-control diets. Dietary control treatments included a negative-control diet with no feed-additive supplementation and 2 positive-control groups supplemented with either virginiamycin or zinc bacitracin. In total, 300 1-day-old Ross × Ross male broilers were randomly assigned to 6 dietary treatments that consisted of 5 replicates of 10 birds each. On d 21 and 42, 2 birds from each replicate were killed by cervical cutting to measure the relative weights of spleen and bursa of Fabricius. At 25 d of age, chicks were injected with 0.5 mL of 10% SRBC suspension. Broilers fed with 200 ppm of TOE had heavier weights of bursa of Fabricius than those fed other dietary treatments at d 42 of age. Furthermore, dietary inclusion of 100 ppm of TOE resulted in higher (P < 0.05) total immunoglobulin response in primary antibody titer against sheep erythrocytes compared with other dietary treatments. On the other hand, diet modifications had no significant effect on blood leukocyte subpopulations and heterophil-to-lymphocyte ratio. These results suggest that dietary supplementation with TOE, especially at the level of 100 ppm, can improve immunological responses of broiler chicks.

Synergy of streptogramin antibiotics occurs independently of their effects on translation.

Streptogramin antibiotics are divided into types A and B, which in combination can act synergistically. We compared the molecular interactions of the streptogramin combinations Synercid (type A, dalfopristin; type B, quinupristin) and NXL 103 (type A, flopristin; type B, linopristin) with the Escherichia coli 70S ribosome by X-ray crystallography. We further analyzed the activity of the streptogramin components individually and in combination. The streptogramin A and B components in Synercid and NXL 103 exhibit synergistic antimicrobial activity against certain pathogenic bacteria. However, in transcription-coupled translation assays, only combinations that include dalfopristin, the streptogramin A component of Synercid, show synergy. Notably, the diethylaminoethylsulfonyl group in dalfopristin reduces its activity but is the basis for synergy in transcription-coupled translation assays before its rapid hydrolysis from the depsipeptide core. Replacement of the diethylaminoethylsulfonyl group in dalfopristin by a nonhydrolyzable group may therefore be beneficial for synergy. The absence of general streptogramin synergy in transcription-coupled translation assays suggests that the synergistic antimicrobial activity of streptogramins can occur independently of the effects of streptogramin on translation.

Optimizing therapy for vancomycin-resistant enterococcal bacteremia in children.

PURPOSE OF REVIEW: Uncertainties exist regarding the optimal treatment for vancomycin-resistant enterococcal (VRE) bloodstream infections, particularly in settings in which ampicillin cannot be used. RECENT FINDINGS: Quinupristin-dalfopristin, linezolid, and daptomycin, all approved between 1999 and 2003, represent the mainstays of therapy for VRE bacteremia, although only linezolid has been specifically approved by the United States Food and Drug Administration for this indication. The main objective of this review is to compare the relative efficacies, dosing strategies, and side-effect profiles of quinupristin-dalfopristin, linezolid, and daptomycin for VRE bacteremia in the pediatric population. A brief description of recently approved broad-spectrum Gram-positive agents that may have a role in the management of VRE bacteremia in upcoming years is also provided. SUMMARY: Linezolid, despite its bacteriostatic activity against VRE, may be the most versatile of the available drugs. It has activity against both Enterococcus faecalis and E. faecium, can be administered orally, and resistance appears to be less of a concern with linezolid compared with the other agents. Additionally, the results of two recent meta-analyses demonstrate more favorable outcomes with linezolid compared with daptomycin for the treatment of VRE bacteremia. The clinical pharmacokinetics of linezolid have been well described in children. The most notable concern with linezolid, however, is toxicities associated with prolonged use. Until more prospective data are available, we favor linezolid as first-line therapy for the treatment of VRE bacteremia in children.

Effects of mannan oligosaccharide and virginiamycin on the cecal microbial community and intestinal morphology of chickens raised under suboptimal conditions.

There is an increasing movement against use of antibiotic growth promoters in animal feed. Prebiotic supplementation is a potential alternative to enhance the host's natural defense through modulation of gut microbiota. In the present study, the effect of mannan oligosaccharide (MOS) and virginiamycin (VIRG) on cecal microbial ecology and intestinal morphology of broiler chickens raised under suboptimal conditions was evaluated. MOS and VIRG induced different bacterial community structures, as revealed by denaturing gradient gel electrophoresis of 16S rDNA. The antibiotic treatment reduced cecal microbial diversity while the community equitability increased. A higher bacterial diversity was observed in the cecum of MOS-supplemented birds. Quantitative polymerase chain reaction results indicated that MOS changed the cecal microbiota in favor of the Firmicutes population but not the Bacteroidetes population. No difference was observed in total bacterial counts among treatments. MOS promoted the growth of Lactobacillus spp. and Bifidobacterium spp. in the cecum and increased villus height and goblet cell numbers in the ileum and jejunum. These results provide a deeper insight into the microbial ecological changes after supplementation of MOS prebiotic in poultry diets.

Supplementation of direct-fed microbials as an alternative to antibiotic on growth performance, immune response, cecal microbial population, and ileal morphology of broiler chickens.

An experiment was conducted to investigate the supplementation of direct-fed microbials (DFM) as an alternative to antibiotics on growth performance, immune response, cecal microbial population, and ileal morphology of broiler chickens. A total of 800 one-day-old male broiler chicks (Ross × Ross) were randomly allotted to 4 dietary treatments with 4 replicate pens per treatment (50 birds/replicate pen). The 4 dietary treatments fed for 35 d were a corn-soybean meal basal diet (control); control plus 0.1% virginiamycin, as an antibiotic growth promoter (AGP); control plus 0.1% direct-fed microbials that contained Lactobacillus reuteri (DFM 1); and control plus 0.1% direct-fed microbials that contained a mixture of L. reuteri, Bacillus subtilis, and Saccharomyces cerevisiae (DFM 2). Results showed that dietary AGP and DFM supplementation significantly increased (P < 0.05) the BW gain of broilers during 0 to 21 d. The feed intake was reduced, whereas the feed conversion was improved significantly when birds were fed DFM 2 at 0 to 7 d of age. The white blood cell and monocyte levels were significantly higher in the DFM 2 group compared with the control. In addition, feeding DFM significantly (P < 0.05) increased the plasma immunoglobulin levels where a higher level was observed in DFM 2 compared with those of the other treatments. Neither DFM nor AGP treatments affected the cecal Lactobacillus and Salmonella content; however, cecal Escherichia coli content significantly decreased in broiler chickens fed DFM and AGP. The ileal villus height, and width and total thickness of muscularis externa were significantly increased when birds were fed DFM compared with AGP and control. These results indicate that the dietary supplementation of DFM increases the growth performance of birds at an early age, stimulates the immune response, decreases the number of E. coli, and improves the ileal morphology of broiler chickens. Thus, DFM that contained a mixture of several beneficial microorganisms could be a viable alternative to antibiotics in the broiler diets.

Continuous feeding of antimicrobial growth promoters to commercial swine during the growing/finishing phase does not modify faecal community erythromycin resistance or community structure.

AIMS: To investigate the effect of continuous feeding of antimicrobial growth promoters (tylosin or virginiamycin) on the swine faecal community. METHODS AND RESULTS: The study consisted of two separate on-farm feeding trials. Swine were fed rations containing tylosin (44 or 88 mg kg(-1) of feed) or virginiamycin (11 or 22 mg kg(-1) of feed) continuously over the growing/finishing phases. The temporal impact of continuous antimicrobial feeding on the faecal community was assessed and compared to nondosed control animals through anaerobic cultivation, the analysis of community 16S rRNA gene libraries and faecal volatile fatty acid content. Feeding either antimicrobial had no detectable effect on the faecal community. CONCLUSIONS: Erythromycin methylase genes encoding resistance to the macrolide-lincosamide-streptogramin B (MLS(B) ) antimicrobials are present at a high level within the faecal community of intensively raised swine. Continuous antimicrobial feeding over the entire growing/finishing phase had no effect on community erm-methylase gene copy numbers or faecal community structure. SIGNIFICANCE AND IMPACT OF THE STUDY: Antimicrobial growth promoters are believed to function by altering gut bacterial communities. However, widespread MLS(B) resistance within the faecal community of intensively raised swine likely negates any potential effects that these antimicrobials might have on altering the faecal community. These findings suggest that if AGP-mediated alterations to gut communities are an important mechanism for growth promotion, it is unlikely that these would be associated with the colonic community.

Streptogramins for the treatment of infections caused by Gram-positive pathogens.

INTRODUCTION: Streptogramins (pristinamycin and quinupristin-dalfopristin) can be interesting options for the treatment of infections due to Gram-positive cocci, especially multidrug-resistant isolates. AREAS COVERED: This review provides an updated overview of structural and activity characteristics, mechanisms of action and resistance, pharmacokinetic/pharmacodynamic, and clinical use of streptogramins. EXPERT OPINION: The streptogramin antibiotics act by inhibition of the bacterial protein synthesis. They are composed of two chemically distinct compounds, namely type A and type B streptogramins, which exert a rapid bactericidal activity against a wide range of Gram-positive bacteria (including methicillin-resistant staphylococci and vancomycin-resistant enterococci). Several mechanisms of resistance have been identified in staphylococci and enterococci but the prevalence of streptogramin resistance among clinical isolates remains very low. Even if only a few randomized clinical trials have been conducted, the efficacy of pristinamycin has been largely demonstrated with an extensive use for 50 years in France and some African countries. Despite its effectiveness in the treatment of severe Gram-positive bacterial infections demonstrated in several studies and the low rate of reported resistance, the clinical use of quinupristin-dalfopristin has remained limited, mainly due to its poor tolerance. Altogether, streptogramins (especially pristinamycin) can be considered as potential alternatives for the treatment of Gram-positive infections.

Efficacy of quinupristin/dalfopristin versus vancomycin, alone or in combination with rifampicin, against methicillin-resistant Staphylococcus aureus in a rabbit arthritis model.

We compared the efficacy of quinupristin/dalfopristin versus vancomycin, alone or in combination with rifampicin, in a rabbit model of methicillin-resistant Staphylococcus aureus-induced arthritis. Vancomycin, alone or in combination with rifampicin, and quinupristin/dalfopristin+rifampicin were significantly more effective than quinupristin/dalfopristin alone.

The characterization of lactic acid producing bacteria from the rumen of dairy cattle grazing on improved pasture supplemented with wheat and barley grain.

AIMS: To identify and characterize the major lactic acid bacteria in the rumen of dairy cattle grazing improved pasture of rye grass and white clover and receiving a maize silage and grain supplement with and without virginiamycin. METHODS AND RESULTS: Eighty-five bacterial isolates were obtained from the rumen of 16 Holstein-Friesian dairy cows. The isolates were initially grouped on the basis of their Gram morphology and by restriction fragment length polymorphism analysis of the PCR amplified 16S rDNA. A more definitive analysis was undertaken by comparing the 16S rDNA sequences. Many of the isolates were closely related to other previously characterized rumen bacteria, including Streptococcus bovis, Lactobacillus vitulinus, Butyrivibrio fibrisolvens, Prevotella bryantii and Selenomonas ruminantium. The in vitro production of L- and/or D-lactate was seen with all but five of the isolates examined, many of which were also resistant to virginiamycin. CONCLUSION: Supplementation of grain with virginiamycin may reduce the risk of acidosis but does not prevent its occurrence in dairy cattle grazing improved pasture. SIGNIFICANCE AND IMPACT OF THE STUDY: This study shows that lactic acid production is caused, not only by various thoroughly researched types of bacteria, but also by others previously identified in the rumen but not further characterized.

Antibiotic resistance in Escherichia coll and Enterococcus spp. isolates from commercial broiler chickens receiving growth-promoting doses of bacitracin or virginiamycin.

Antibacterial agents such as zinc bacitracin (ZB) and virginiamycin (VG) are used as growth promoting agents (GP) in broiler chicken production. The objective of this study was to evaluate the effect of the use of ZB and VG on the emergence of antibacterial resistance in a commercial broiler chicken farm. Three trials were conducted using 3 different diets: one without antibacterial agents, one containing VG, and one with ZB. Escherichia coli and Enterococcus spp. strains were isolated and tested for their susceptibility to various antibacterial agents. The occurrence of the resistance genes vatD, ermB, and bcrR in Enterococcus spp. isolates was determined by polymerase chain reaction (PCR). Comparative quantification of vatD and bcrR genes in total deoxyribonucleic acid (DNA) extracts from litter was done by SYBR Green Real-Time PCR (QPCR). Escherichia coli and Enterococcus spp. isolates from diet groups had different levels of resistance to various antibacterial agents over time. These GPs did not select for specific antibacterial agent resistance (AAR) in Enterococcus spp. The use of GPs seemed to lower the percentage of E. coli isolates resistant to some antibacterial agents. The presence of the bcrR gene could not explain all resistant phenotypes to ZB. Genes other than vatD and ermB might be involved in the resistance to VG in Enterococcus spp. Use of GPs was not associated with presence of the bcrR gene in DNA extracts from litter, but use of VG was associated with vatD presence.

Influence of in-feed virginiamycin on the systemic and mucosal antibody response of chickens.

Subtherapeutic and prophylactic doses of virginiamycin are capable of altering the intestinal microbiota as well as increasing several growth parameters in chickens. In spite of the fact that the microbiota plays a role in shaping the host's immune system, little information is available on the effects of in-feed antibiotics on the chicken immune system. The objective of this study was to examine the effects of an antibiotic, virginiamycin, on the development of antibody responses. Chickens were fed diets containing no antibiotics, along with either subtherapeutic (11 ppm) or prophylactic (22 ppm) doses of virginiamycin. Chickens were then immunized with keyhole limpet hemocyanin (KLH) and sheep red blood cells systemically, and with BSA and KLH orally. Although antibodies were detected against BSA in the intestinal contents of birds that were orally immunized, there was no difference among different treatment groups. Systemic IgG, and to a lesser extent IgM, antibody responses to KLH were greater (P < 0.05) in birds fed a diet containing 11 or 22 ppm of virginiamycin compared with control birds fed no antibiotic. No treatment effect was found in the sheep red blood cell-immunized birds. Results of the present study implicate virginiamycin in enhancing antibody responses to some antigens in chickens. Further studies are required to determine to what extent these effects on antibody response are mediated through changes in the composition of the microbiota.

Fatty acid profile and carcass traits of feedlot Nellore cattle fed crude glycerin and virginiamycin.

Forty-eight bulls with an initial body weight (BW) of 408.4 ±â€¯22.2 kg (age = 21 ±â€¯2 months) were used in a randomized complete block design arranged in a 2 × 2 factorial design. The treatments were diets without virginiamycin (VM-) or with virginiamycin, at 25 mg/kg of dry matter (DM, VM+), and diets without crude glycerin (CG-) or with crude glycerin, at 100 g/kg DM (CG+). The cold carcass weight and cold carcass dressing (P ≤ 0.05) was greater in bulls fed crude glycerin diets. Total unsaturated fatty acids (UFA) were 6.08% higher, and cooking weight loss was 10% lower in bulls fed CG+ diets, compared to bulls fed CG- diets (P = 0.0081). Crude glycerin at 100 g/kg DM could be a suitable replacement for VM, as it led to a slight increase in UFA deposition in meat. However, simultaneous administration of VM and CG did not positively affect performance and carcass traits of feedlot Nellore cattle.

Effect of Dietary Fructooligosaccharide (FOS) Supplementation on Ileal Microbiota in Broiler Chickens.

The dietary effect of fructooligosaccharide (FOS) supplementation as an alternative to antibiotics on ileal mucosa and digesta microbiota was investigated in broiler chickens (n = 180). The study included three dietary treatments from d1 to 21: 1) positive control (PC), a wheat-corn-soybean meal based diet containing antibiotics (virginiamycin and monensin); 2) negative control (NC), as wheat-corn-soybean meal based diet without antibiotics; and 3) NC + FOS, as NC diet supplemented 0.5% of FOS. Ileal mucosa and digesta were collected and subjected to 16S rRNA-based next generation sequencing. No significant difference on α-, ß-diversity and bacterial phyla was observed between ileal mucosa and digesta or between the three dietary treatments. Partial least square discriminant analysis and Venn analysis showed that different bacterial genera were associated with different ileal sites or diets. A distinct distance on ileal mucosa bacteria communities were observed between PC and NC + FOS dietary treatments. FOS supplementation increased the number of unique genera and resulted in a more diverse microbiota in the ileal mucosa when compared with PC and NC groups. Furthermore, microorganisms that have pathogenic properties such as Helicobacter and Desulfovibrio were found significantly reduced when compared between NC and NC + FOS groups in the ileal mucosa. Lachnospiraceae (f) was greater in the ileal mucosa than that in the digesta, particularly among the NC + FOS dietary group. Overall, supplementing FOS in broiler chicken diets may be able to modulate gut microbiota in favor of chicken health, which in turn, can be used as an alternative method to replace antibiotic growth promoters (AGPs). Future investigation on the mechanism of FOS and other prebiotic products as dietary supplements is warranted.

Does virginiamycin supplementation affect the metabolism and performance of Nellore bulls grazing under low and high gain rates?

This study aimed to evaluate the effect of virginiamycin on the metabolism and performance of growing Nellore bulls under low and high gain rates on pasture. In experiment 1, 80 Nellore bulls (age = 12 ± 2 months, body weight = 258 ± 15 kg) were assigned to 16 paddocks in a 2 × 2 randomized block factorial arrangement. In experiment 2, 12 cannulated Nellore bulls were assigned to three 4 × 4 balanced Latin squares. The factors were: (1) mineral salt without or with virginiamycin, and (2) low or high gain rate. No interaction was noted between factors (p > .10). Animals fed virginiamycin had greater average daily gain (14%, p < .01), body weight (11 kg, p = .05), plasma nonesterified fatty acid (20%, p < .01), serum calcium concentration (2.62%, p = .04), and total protozoa (p = .03) and had the same bacterial proportion (p > .27). Animals with a low gain rate had greater serum urea concentration (19.6%, p < .01) and ruminal ammonia nitrogen (62%, p < .01). Thus, virginiamycin increases the performance and changes the metabolism of growing Nellore bulls under low and high gain rates on pasture.

[Therapeutic perspectives of linezolid in the management of infections due to multiresistant Gram-positive pathogens]. / Le prospettive terapeutiche di linezolid nelle infezioni da patogeni Gram-positivi multiresistenti.

Multi-antibiotic resistant Gram-positive cocci represent emerging pathogens especially in the setting of the immunocompromised, hospitalized patients, in particular when surgery, invasive procedures, or prosthetic implants are of concern, patients are admitted in intensive care units, or underlying chronic disorders and immunodeficiency are of concern, and broad-spectrum antibiotics and/or immunosuppressive drugs are widely administered. The spectrum of available antimicrobial compounds for an effective management of these relevant infections is significantly impaired in selection and clinical efficacy by the emerging and spread of methicillin-resistant and more recently glycopeptide-resistant Gram-positive microbial strains linezolid, together with the recently licensed quinupristin-dalfopristin, daptomycin and tigecycline, followed by a number of glycopeptides, fluoroquinolones, and other experimental compounds represent an effective response to these concerns, due to their innovative mechanisms of action, their maintained or enhanced activity against multiresistant pathogens, their effective pharmacokinetic/pharmacodynamic properties, their frequent possibility of synergistic activity with other compounds effective against Gram-positive pathogens, and a diffuse potential for a safe and easy administration, also when compromised patients are of concern. The main problems related to the epidemiological and clinical features of multiresistant Gram-positive infection, the potential clinical indications of all recently available compounds compared with the standard of treatment of resistant Gram-positive infections, and updated data on efficacy and tolerability of linezolid have to be clarified.

Evaluation of Aloe vera and synbiotic as antibiotic growth promoter substitutions on performance, gut morphology, immune responses and blood constitutes of broiler chickens.

This study was performed to investigate the effect of dietary supplementation with Aloe vera (AV) powder and synbiotic as growth promoter agents on performance, gut morphology, immune responses, hematology and serum biochemistry in broilers. A total of 240-day-old male broiler chicks (Ross 308) were randomly assigned to six treatments with four replicates. Birds were offered either a corn-soybean meal basal diet (control) or the basal diet supplemented with 200 mg/kg virginiamycin (VM), 1 g/kg synbiotic (Syn), 2.5 g/kg AV (AV1), 5.0 g/kg AV (AV2) or 7.5 g/kg AV (AV3). Chickens fed any of the diets, except diet AV1, exhibited better feed conversion ratios at the 14-28 day period and higher average daily gain and duodenal villus height/crypt depth ratio at 42 days than those fed the control diet. Synbiotic supplementation caused a marked increase in the serum antibody titer against infectious bursal disease and infectious bronchitis vaccines. Feeding diet AV3 significantly increased red blood cell count and hemoglobin concentration, and decreased serum triglyceride level compared to the control group. The results suggested that dietary inclusion of 5 and 7.5 g/kg AV, similar with synbiotic supplementation, can be applied as effective alternatives to in-feed antibiotics for broiler diets.

Role of Combination Antimicrobial Therapy for Vancomycin-Resistant Enterococcus faecium Infections: Review of the Current Evidence.

Enterococcus species are the second most common cause of nosocomial infections in the United States and are particularly concerning in critically ill patients with preexisting comorbid conditions. Rising resistance to antimicrobials that were historically used as front-line agents for treatment of enterococcal infections, such as ampicillin, vancomycin, and aminoglycosides, further complicates the treatment of these infections. Of particular concern are Enterococcus faecium strains that are associated with the highest rate of vancomycin resistance. The introduction of antimicrobial agents with specific activity against vancomycin-resistant Enterococcus (VRE) faecium including daptomycin, linezolid, quinupristin-dalfopristin, and tigecycline did not completely resolve this clinical dilemma. In this review, the mechanisms of action and resistance to currently available anti-VRE antimicrobial agents including newer agents such as oritavancin and dalbavancin will be presented. In addition, novel combination therapies including ß-lactams and fosfomycin, and the promising results from in vitro, animal studies, and clinical experience in the treatment of VRE faecium will be discussed.