RESUMO
Insects are attacked by a diverse range of microbial pathogens in the wild. In herbivorous species, larval host plants frequently play a critical role in mediating susceptibility to infection. Characterizing such plant-mediated effects on herbivore-pathogen interactions can provide insight into patterns of infection across wild populations. In this study, we investigated the effects of host plant use by two North American butterflies, Euphydryas phaeton (Nymphalidae) and Anartia jatrophae (Nymphalidae), on entomopathogen infection across a range of three doses. Both of these herbivores recently incorporated the same exotic plant, Plantago lanceolata (Plantaginaceae), into their host range and are naturally infected by the same entomopathogen, Junonia coenia densovirus (Parvoviridae), in wild populations. We performed two factorial experiments in which E. phaeton and A. jatrophae were reared on either P. lanceolata or a native host plant [Chelone glabra (Plantaginaceae) for E. phaeton; Bacopa monnieri (Plantaginaceae) for A. jatrophae] and inoculated with either a low, medium, or high dose of the virus. In E. phaeton, the outcomes of infection were highly dose-dependent, with inoculation with higher viral doses resulting in faster time to death and greater mortality. However, neither survival nor postmortem viral burdens varied depending upon the host plant that was consumed. In contrast, host plant use had a strong effect on viral burdens in A. jatrophae, with consumption of the exotic plant appearing to enhance host resistance to infection. Together, these results illustrate the variable influences of host plant use on herbivore resistance to infection, highlighting the importance of investigating plant-herbivore relationships within a tritrophic framework.
Assuntos
Borboletas , Densovirus , Animais , Borboletas/virologia , Densovirus/fisiologia , Plantago/virologia , Interações Hospedeiro-Patógeno , Larva/virologia , Larva/crescimento & desenvolvimento , HerbivoriaRESUMO
OBJECTIVES: We aimed to identify rational empirical dosing strategies for cefepime treatment in critically ill patients by utilizing population pharmacokinetics and target attainment analysis. PATIENTS AND METHODS: A prospective and opportunistic pharmacokinetic (PK) study was conducted in 130 critically ill patients in two ICU sites. The plasma concentrations of cefepime were determined using a validated LC-MS/MS method. All cefepime PK data were analysed simultaneously using the non-linear mixed-effects modelling approach. Monte Carlo simulations were performed to evaluate the PTA of cefepime at different MIC values following different dose regimens in subjects with different renal functions. RESULTS: The PK of cefepime in critically ill patients was best characterized by a two-compartment model with zero-order input and first-order elimination. Creatinine clearance and body weight were identified to be significant covariates. Our simulation results showed that prolonged 3 h infusion does not provide significant improvement on target attainment compared with the traditional intermittent 0.5 h infusion. In contrast, for a given daily dose continuous infusion provided much higher breakpoint coverage than either 0.5 h or 3 h intermittent infusions. To balance the target attainment and potential neurotoxicity, cefepime 3 g/day continuous infusion appears to be a better dosing regimen than 6 g/day continuous infusion. CONCLUSIONS: Continuous infusion may represent a promising strategy for cefepime treatment in critically ill patients. With the availability of institution- and/or unit-specific cefepime susceptibility patterns as well as individual patients' renal function, our PTA results may represent useful references for physicians to make dosing decisions.
Assuntos
Antibacterianos , Estado Terminal , Humanos , Cefepima , Antibacterianos/uso terapêutico , Cromatografia Líquida , Estudos Prospectivos , Espectrometria de Massas em Tandem , Método de Monte Carlo , Testes de Sensibilidade MicrobianaRESUMO
In the present study, population pharmacokinetic (PK) analysis was performed based on meropenem data from a prospective study conducted in 114 critically ill patients with a wide range of renal functions and various disease conditions. The final model was a one-compartment model with linear elimination, with creatinine clearance and continuous renal replacement therapy affecting clearance, and total bodyweight impacting the volume of distribution. Our model is a valuable addition to the existing meropenem population PK models, and it could be particularly useful during implementation of a therapeutic drug monitoring program combined with Bayesian forecasting. Based on the final model developed, comprehensive Monte Carlo simulations were performed to evaluate the probability of target attainment (PTA) of 16 different dosing regimens. Simulation results showed that 2 g administered every 8 h with 3-h prolonged infusion (PI) and 4 g/day by continuous infusion (CI) appear to be two empirical dosing regimens that are superior to many other regimens when both target attainment and potential toxicity are considered and renal function information is not available. Following a daily CI dose of 6 g or higher, more than 30% of the population with a creatinine clearance of <60 mL/min is predicted to have neurotoxicity. With the availability of institution- and/or unit-specific meropenem susceptibility patterns, as well as an individual patient's renal function, our PTA results may represent useful references for physicians to make dosing decisions.