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1.
J Hazard Mater ; 474: 134697, 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-38823102

RESUMO

Airborne pathogens severely threaten public health worldwide. Air disinfection is essential to ensure public health. However, excessive use of disinfectants may endanger environmental and ecological security due to the residual disinfectants and their by-products. This study systematically evaluated disinfection efficiency, induction of multidrug resistance, and the underlying mechanisms of disinfectants (NaClO and H2O2) on airborne bacteria. The results showed that airborne bacteria were effectively inactivated by atomized NaClO (>160 µg/L) and H2O2 (>320 µg/L) after 15 min. However, some bacteria still survived after disinfection by atomized NaClO (0-80 µg/L) and H2O2 (0-160 µg/L), and they exhibited significant increases in antibiotic resistance. The whole-genome sequencing of the resistant bacteria revealed distinct mutations that were responsible for both antibiotic resistance and virulence. This study also provided evidences and insights into possible mechanisms underlying the induction of antibiotic resistance by air disinfection, which involved intracellular reactive oxygen species formation, oxidative stress responses, alterations in bacterial membranes, activation of efflux pumps, and the thickening of biofilms. The present results also shed light on the role of air disinfection in inducing antibiotic resistance, which could be a crucial factor contributing to the global spread of antibiotic resistance through the air.


Assuntos
Bactérias , Desinfetantes , Desinfecção , Peróxido de Hidrogênio , Peróxido de Hidrogênio/farmacologia , Desinfetantes/farmacologia , Desinfecção/métodos , Bactérias/efeitos dos fármacos , Bactérias/genética , Microbiologia do Ar , Biofilmes/efeitos dos fármacos , Hipoclorito de Sódio/farmacologia , Farmacorresistência Bacteriana/genética , Farmacorresistência Bacteriana/efeitos dos fármacos , Antibacterianos/farmacologia , Cloro/farmacologia , Espécies Reativas de Oxigênio/metabolismo
2.
Yale J Biol Med ; 95(4): 445-463, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36568838

RESUMO

Microbial resistance to antibiotics is an ancient and dynamic issue that has brought a situation reminiscent of the pre-antibiotic era to the limelight. Currently, antibiotic resistance and the associated infections are widespread and pose significant global health and economic burden. Thus, the misuse of antibiotics, which has increased resistance, has necessitated the search for alternative therapeutic agents for combating resistant pathogens. Antimicrobial peptides (AMPs) hold promise as a viable therapeutic approach against drug-resistant pathogens. AMPs are oligopeptides with low molecular weight. They have broad-spectrum antimicrobial activities against pathogenic microorganisms. AMPs are nonspecific and target components of microbes that facilitate immune response by acting as the first-line defense mechanisms against invading pathogenic microbes. The diversity and potency of AMPs make them good candidates for alternative use. They could be used alone or in combination with several other biomaterials for improved therapeutic activity. They can also be employed in vaccine production targeting drug-resistant pathogens. This review covers the opportunities and advances in AMP discovery and development targeting antimicrobial resistance (AMR) bacteria. Briefly, it presents an overview of the global burden of the antimicrobial resistance crisis, portraying the global magnitude, challenges, and consequences. After that, it critically and comprehensively evaluates the potential roles of AMPs in addressing the AMR crisis, highlighting the major potentials and prospects.


Assuntos
Antibacterianos , Peptídeos Antimicrobianos , Farmacorresistência Bacteriana , Imunidade Inata , Humanos , Antibacterianos/imunologia , Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos Antimicrobianos/imunologia , Peptídeos Antimicrobianos/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/imunologia , Imunidade Inata/efeitos dos fármacos , Imunidade Inata/imunologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/imunologia , Carga Global da Doença , Descoberta de Drogas , Desenvolvimento de Medicamentos
3.
PLoS One ; 16(11): e0260003, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34780520

RESUMO

Mycobacterium abscessus (Mab) is one of the most drug resistant bacteria with a high treatment failure rate. Antimicrobial peptides (AMPs) are alternative therapeutic agents against this infection. This study was aimed to assess the in vitro activities of thirteen AMPs (S5, S52, S6, S61, S62, S63, KLK, KLK1, KLK2, Pug-1, Pug-2, Pug-3 and Pug-4) that have never been investigated against drug resistant Mab isolates. Only four novel modified AMPs (S61, S62, S63 and KLK1) provided the lowest minimum inhibitory concentration (MIC) values ranging from 200-400 µg/ml against the Mab ATCC19977 strain. These four potential AMPs were further tested with 16 clinical isolates of clarithromycin resistant Mab. The majority of the tested strains (10/16 isolates, 62.5%) showed ~99% kill by all four AMPs within 24 hours with an MIC <50 µg/ml. Only two isolates (12.5%) with acquired clarithromycin resistance, however, exhibited values <50 µg/ml of four potential AMPs, S61, S62, S63 and KLK1 after 3-days-incubation. At the MICs level, S63 showed the lowest toxicity with 1.50% hemolysis and 100% PBMC viability whereas KLK1 showed the highest hemolysis (10.21%) and lowest PBMC viability (93.52%). S61, S62 and S63 were further tested with clarithromycin-AMP interaction assays and found that 5/10 (50%) of selected isolates exhibited a synergistic interaction with 0.02-0.41 FICI values. This present study demonstrated the potential application of novel AMPs as an adjunctive treatment with clarithromycin against drug resistant Mab infection.


Assuntos
Peptídeos Antimicrobianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium abscessus/crescimento & desenvolvimento , Claritromicina/farmacologia , Eritrócitos/efeitos dos fármacos , Genoma Bacteriano , Hemólise , Humanos , Testes de Sensibilidade Microbiana , Viabilidade Microbiana , Mycobacterium abscessus/efeitos dos fármacos , Mycobacterium abscessus/genética , Mycobacterium abscessus/isolamento & purificação , Sequenciamento Completo do Genoma
4.
Elife ; 102021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34289932

RESUMO

Bacterial adaptation to antibiotic combinations depends on the joint inhibitory effects of the two drugs (drug interaction [DI]) and how resistance to one drug impacts resistance to the other (collateral effects [CE]). Here we model these evolutionary dynamics on two-dimensional phenotype spaces that leverage scaling relations between the drug-response surfaces of drug-sensitive (ancestral) and drug-resistant (mutant) populations. We show that evolved resistance to the component drugs - and in turn, the adaptation of growth rate - is governed by a Price equation whose covariance terms encode geometric features of both the two-drug-response surface (DI) in ancestral cells and the correlations between resistance levels to those drugs (CE). Within this framework, mean evolutionary trajectories reduce to a type of weighted gradient dynamics, with the drug interaction dictating the shape of the underlying landscape and the collateral effects constraining the motion on those landscapes. We also demonstrate how constraints on available mutational pathways can be incorporated into the framework, adding a third key driver of evolution. Our results clarify the complex relationship between drug interactions and collateral effects in multidrug environments and illustrate how specific dosage combinations can shift the weighting of these two effects, leading to different and temporally explicit selective outcomes.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Bactérias/efeitos dos fármacos , Bactérias/genética , Interações Medicamentosas , Farmacorresistência Bacteriana/efeitos dos fármacos , Modelos Biológicos , Mutação
5.
Lancet Infect Dis ; 21(6): e170-e174, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33865461

RESUMO

Antimicrobial resistance (AMR) is a major threat to human health globally. Surveillance is a key activity to determine AMR burden, impacts, and trends and to monitor effects of interventions. Surveillance systems require efficient capture and onward sharing of high-quality laboratory data. Substantial investment is being made to improve laboratory capacity, particularly in low-income and middle-income countries (LMICs) with high disease burdens. However, building capacity for effective laboratory data management remains an under-resourced area, which, unless addressed, will limit progress towards comprehensive AMR surveillance in LMICs. The lack of a fit-for-purpose and open-source laboratory information management system software is of particular concern. In this Personal View, we summarise the technical requirements for microbiology laboratory data management, provide a snapshot of laboratory data management in LMIC laboratories, and describe the key steps required to improve the situation. Without action to improve information technology infrastructure and data management systems in microbiology laboratories, the ongoing efforts to develop capacity for AMR surveillance in LMICs might not realise their full potential.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Coleta de Dados/estatística & dados numéricos , Farmacorresistência Bacteriana/efeitos dos fármacos , Informática/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Vigilância em Saúde Pública/métodos , Confiabilidade dos Dados , Humanos
6.
Ann Lab Med ; 41(3): 285-292, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33303713

RESUMO

BACKGROUND: One health is a flexible concept with many facets, including the environment, community, and the nosocomial super-bacteria resistance network. We investigated the molecular prevalence of extended-spectrum-ß-lactamase-producing Escherichia coli (ESBL-EC) in workers, livestock, and the farm environment in Korea. METHODS: ESBL-EC isolates were obtained from samples from 19 swine farms, 35 retail stores, seven slaughterhouses, and 45 related workers throughout Korea from August 2017 to July 2018, using ChromID ESBL (BioMérieux, Marcy l'Etoile, France) agar and enrichment broth. The presence of ESBL and mobilized colistin resistance (mcr) genes and antimicrobial resistance were determined. Clonality was evaluated with pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). RESULTS: In total, 232 ESBL-EC isolates were obtained from 1,614 non-duplicated samples (14.4% positive rate). The ESBL-EC isolates showed regional and source-related differences. blaCTX-M-55 (N=100), blaCTX-M-14 (N=65), blaCTX-M-15 (N=33), and blaCTX-M-65 (N=23) were common ESBL types. The ESBL-EC isolates showed high resistance rates for various antimicrobial classes; however, all isolates were susceptible to carbapenem. One swine-originating colistin-resistant isolate did not carry any known mcr gene. PFGE was successful for 197 of the 232 isolates, and most PFGE types were heterogeneous, except for some dominant PFGE types (O, R, T, U, and V). MLST of 88 isolates was performed for representative PFGE types; however, no dominant sequence type was observed. CONCLUSIONS: The proportion of ESBL-EC in swine industry-related samples was significant, and the isolates harbored common clinical ESBL gene types. These molecular epidemiologic data could provide important evidence for antimicrobial-resistance control through a one health approach.


Assuntos
Infecções por Escherichia coli , Saúde Única , Animais , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Escherichia coli/genética , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Prevalência , República da Coreia , Suínos , beta-Lactamases
7.
Euro Surveill ; 25(43)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33124553

RESUMO

BackgroundWidespread ceftriaxone antimicrobial resistance (AMR) threatens Neisseria gonorrhoeae (NG) treatment, with few alternatives available. AMR point-of-care tests (AMR POCT) may enable alternative treatments, including abandoned regimens, sparing ceftriaxone use. We assessed cost-effectiveness of five hypothetical AMR POCT strategies: A-C included a second antibiotic alongside ceftriaxone; and D and E consisted of a single antibiotic alternative, compared with standard care (SC: ceftriaxone and azithromycin).AimAssess costs and effectiveness of AMR POCT strategies that optimise NG treatment and reduce ceftriaxone use.MethodsThe five AMR POCT treatment strategies were compared using a decision tree model simulating 38,870 NG-diagnosed England sexual health clinic (SHC) attendees; A micro-costing approach, representing cost to the SHC (for 2015/16), was employed. Primary outcomes were: total costs; percentage of patients given optimal treatment (regimens curing NG, without AMR); percentage of patients given non-ceftriaxone optimal treatment; cost-effectiveness (cost per optimal treatment gained).ResultsAll strategies cost more than SC. Strategy B (azithromycin and ciprofloxacin (azithromycin preferred); dual therapy) avoided most suboptimal treatments (n = 48) but cost most to implement (GBP 4,093,844 (EUR 5,474,656)). Strategy D (azithromycin AMR POCT; monotherapy) was most cost-effective for both cost per optimal treatments gained (GBP 414.67 (EUR 554.53)) and per ceftriaxone-sparing treatment (GBP 11.29 (EUR 15.09)) but with treatment failures (n = 34) and suboptimal treatments (n = 706).ConclusionsAMR POCT may enable improved antibiotic stewardship, but require net health system investment. A small reduction in test cost would enable monotherapy AMR POCT strategies to be cost-saving.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Gonorreia , Testes Imediatos , Instituições de Assistência Ambulatorial , Antibacterianos/economia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Azitromicina/economia , Azitromicina/farmacologia , Azitromicina/uso terapêutico , Ceftriaxona/economia , Ceftriaxona/farmacologia , Ceftriaxona/uso terapêutico , Análise Custo-Benefício , Farmacorresistência Bacteriana/efeitos dos fármacos , Inglaterra , Gonorreia/tratamento farmacológico , Gonorreia/microbiologia , Humanos , Neisseria gonorrhoeae/efeitos dos fármacos , Saúde Sexual
8.
FEMS Microbiol Lett ; 367(19)2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33016321

RESUMO

This study was designed to evaluate the synergistic effect of phage (P22) and antibiotic on the inhibition of Salmonella Typhimurium exposed to ceftriaxone (CEF) and ciprofloxacin (CIP). The effect of phage and antibiotic treatments was evaluated by plaque size, disk diffusion, antibiotic susceptibility and phage multiplication assays. The sequential treatment effect of phage and antibiotic was carried out in different treatment order and time for 12 h at 37°C. P22 plaque sizes were increased by 28 and 71%, respectively, in the presence of CEF and CIP. The clear zone sizes in disk diffusion assay were significantly increased to >37 mm in the presence of CEF and CIP compared to the control (28-31 mm). Pre-treatment with P22 enhanced the antimicrobial effect of CIP, showing >2 log reduction after a 12 h incubation. Phage P22 combined with antibiotics (CEF and CIP) effectively inhibited the growth of S. Typhimurium depending on the treatment order and time. These results provide useful information for understanding the synergistic effect of phage and antibiotic treatment which can be an effective option to control antibiotic resistant pathogens.


Assuntos
Bacteriófagos/fisiologia , Ceftriaxona/farmacologia , Ciprofloxacina/farmacologia , Farmacorresistência Bacteriana , Salmonella typhimurium/efeitos dos fármacos , Salmonella typhimurium/virologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Sinergismo Farmacológico , Testes de Sensibilidade Microbiana
9.
J Occup Environ Hyg ; 17(10): 437-446, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32776831

RESUMO

Pharmaceutical workers involved with the production of antimicrobial drugs are exposed to various antimicrobial chemicals in different steps of manufacturing such as grinding, sieving, compression, granulation, mixing, and filling. These exposures may lead to the development of multidrug resistance (MDR) in bacteria. Scientific reports on the occupational health hazard of pharmaceutical workers involved in manufacturing antibiotics are scarce. The present study aimed to compare the degree of bacterial resistance in pharmaceutical workers in India to that of individuals not involved in the pharmaceutical field. Twenty male workers from 5 local pharmaceutical companies and 20 male subjects not involved in the pharmaceutical field (non-pharmaceutical subjects) were randomly selected. Nasal fluid and mucus/cough specimens were collected from each subject and were cultured separately at 37 °C for 24 hr to obtain bacterial growth. The cultured species were then identified, isolated, and subjected to microbial sensitivity testing against 18 different antibiotics from 8 different groups by the disk diffusion method. Staphylococcus spp., Pseudomonas spp., and Escherichia coli were identified and isolated from the culture of nasal fluids and mucuses, respectively. All the isolated species of bacteria exhibited significant enhancement of the degree of MDR in pharmaceutical workers compared with non-pharmaceutical subjects. Workers with a longer working history had greater degree of antibiotic resistance and vice versa. It can be certainly considered that the exposure of pharmaceutical workers to antibiotic agents resulted in a high incidence of multidrug resistance. Effective steps should be taken to minimize inherent exposure of pharmaceutical workers to antibiotics during work to prevent antimicrobial drug resistance.


Assuntos
Antibacterianos/farmacologia , Indústria Farmacêutica , Farmacorresistência Bacteriana/efeitos dos fármacos , Exposição Ocupacional/efeitos adversos , Escherichia coli/efeitos dos fármacos , Humanos , Índia , Masculino , Testes de Sensibilidade Microbiana , Muco/microbiologia , Cavidade Nasal/microbiologia , Pseudomonas/efeitos dos fármacos , Medição de Risco , Staphylococcus/efeitos dos fármacos
11.
J Mol Diagn ; 22(11): 1344-1355, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32818599

RESUMO

Antimicrobial resistance in Neisseria gonorrhoeae persists as a major public health concern globally. We developed and evaluated a multiplex assay that relied on high-resolution melting (HRM) technology as a rapid, simple, and cost-effective method for simultaneously detecting and identifying different molecular markers associated with extended-spectrum cephalosporins (ESCs) and azithromycin (AZM) resistance in N. gonorrhoeae. Forty-eight well-characterized N. gonorrhoeae clinical isolates were selected for initial assay establishment. The multiplex HRM assays were able to accurately identify different nucleotide variations of the antimicrobial resistance determinants related to ESCs and AZM resistance. Specificity and cross-reactivity were assessed by testing 15 nongonococcal strains. Then, the assay was validated on 218 archived DNA specimens that had been sequenced using whole-genome sequencing technology. Compared with whole-genome sequencing, these assays had a sensitivity of 98.6%, with a specificity of 99.2%. For further validation of the assay's performance, a total of 338 samples (156 clinical isolates and 182 clinical specimens) were screened using the multiplex HRM assay. The results showed good concordance with the results of PCR sequencing. Given its rapidity (within 90 minutes), ease of performing, and low cost (<$1.00 per sample), this method may be applied to large-scale epidemiologic programs for increasing surveillance of ESCs and AZM resistance in N. gonorrhoeae.


Assuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Cefalosporinas/farmacologia , Análise Mutacional de DNA/métodos , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/genética , Temperatura de Transição , Análise Custo-Benefício , Análise Mutacional de DNA/economia , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Confiabilidade dos Dados , Limite de Detecção , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae/isolamento & purificação , Sequenciamento Completo do Genoma/economia , Sequenciamento Completo do Genoma/métodos
12.
BMC Infect Dis ; 20(1): 514, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677988

RESUMO

BACKGROUND: Worldwide, an increase in antimicrobial resistance (AMR) of Neisseria gonorrhoeae has been observed. Until now, no protocol for an external quality assessment (EQA) has been available for Germany. The German gonococcal resistance network (GORENET) performed an EQA of primary laboratories in Germany in order to assess quality of antibiotic susceptibility testing, to gain information about laboratory procedures and to assess the impact of these procedures on test results. METHODS: Laboratories assessed drug susceptibility to cefixime, ceftriaxone, azithromycin, penicillin and ciprofloxacin for five N. gonorrhoeae strains, using their standard laboratory protocols. Minimal inhibitory concentrations (MICs) were compared to World Health Organisation (WHO) consensus results (or, if not available, reference laboratory results), while deviation by +/- one doubling dilution was accepted. Data on laboratory procedures were collected via a standardised questionnaire. Generalized linear models and conditional inference trees (CTREE) were used to assess relationships between laboratory procedures and testing outcomes. RESULTS: Twenty-one primary laboratories participated in the EQA in June 2018. 96% of ciprofloxacin MICs were reported within accepted deviations, as well as 88% for cefixime, 85% for ceftriaxone, 79% for penicillin and 70% for azithromycin. The use of interpretation standards and general laboratory procedures like agar base, incubation settings or the use of control strains strongly differed between laboratories. In statistical analysis, incubation time of cultures < 24 h was associated with correct measurements. Additionally, a 5% CO2 concentration was associated with correct results regarding azithromycin compared to 3%. CTREE analysis showed that incubation time, humidity and CO2 concentration had the greatest influence on the average deviation from consensus results. CONCLUSIONS: In conclusion, we report the development of a protocol for N. gonorrhoeae antimicrobial susceptibility testing in Germany. While testing results were in accordance with the expected consensus results in 70-96%, depending on the antibiotic agent, laboratory methodology was heterogeneous and may significantly affect the testing quality. We therefore recommend the development of a standard operating procedure (SOP) for N. gonorrhoeae susceptibility testing in Germany.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/efeitos dos fármacos , Gonorreia/tratamento farmacológico , Laboratórios/normas , Ensaio de Proficiência Laboratorial , Neisseria gonorrhoeae/efeitos dos fármacos , Antibacterianos/farmacologia , Azitromicina/farmacologia , Azitromicina/uso terapêutico , Cefixima/farmacologia , Cefixima/uso terapêutico , Ceftriaxona/farmacologia , Ceftriaxona/uso terapêutico , Ciprofloxacina/farmacologia , Ciprofloxacina/uso terapêutico , Alemanha , Gonorreia/microbiologia , Humanos , Ensaio de Proficiência Laboratorial/métodos , Testes de Sensibilidade Microbiana , Penicilinas/farmacologia , Penicilinas/uso terapêutico , Controle de Qualidade , Padrões de Referência , Inquéritos e Questionários
13.
PLoS One ; 15(5): e0232825, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407391

RESUMO

As part of a Germany-wide project that evaluates strategies for the reduction of multi-resistant bacteria along the poultry production chain, the impact of different hatching egg disinfectants on hatchability and health of the broiler chicks was evaluated. Animal trials were conducted with extended-spectrum beta-lactamase- (ESBL) producing Escherichia (E.) coli contaminated hatching eggs and six disinfection protocols that used formaldehyde, hydrogen peroxide, low-energy electron irradiation, peracetic acid and an essential oil preparation. Each protocol was tested on a group of 50 chicks. Equally sized positive and negative control groups were carried along for each trial. Hatchability, mortality and body weight were recorded as performance parameters. During necropsy of half of the animals in each group on day 7 and 14 respectively, macroscopic abnormalities, body weight, weights of liver and gut convolute were recorded and a range of tissue samples for histological examination were collected as part of the health assessment. A decrease in hatchability was recorded for spray application of essential oils. Body weight development was overall comparable, in several groups even superior, to the Ross308 performance objectives, but a reduced performance was seen in the hydrogen peroxide group. Histologically, lymphoid follicles were regularly seen in all sampled organs and no consistent differences were observed between contaminated and non-contaminated groups. Significances were infrequently and inconsistently seen. In conclusion, remarkable findings were a decrease in hatchability caused by the essential oils spray application and a reduced body weight development in the hydrogen peroxide group. Therefore, the essential oils preparation as spray application was deemed inappropriate in practice, while the application of hydrogen peroxide was considered in need of further research. The other trial results indicate that the tested hatching egg disinfectants present a possible alternative to formaldehyde.


Assuntos
Desinfetantes/farmacologia , Desinfecção/métodos , Ovos/microbiologia , Escherichia coli/efeitos dos fármacos , Animais , Galinhas/microbiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Resistência a Múltiplos Medicamentos/efeitos dos fármacos , Escherichia coli/patogenicidade , Alemanha , Humanos , Óleos Voláteis/efeitos adversos , Óleos Voláteis/farmacologia
14.
Helicobacter ; 25(4): e12703, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32453910

RESUMO

BACKGROUND: The aim of this study was to assess the disk diffusion technique against E-test as a routine antibiotic susceptibility testing method for Helicobacter pylori. MATERIALS AND METHODS: Susceptibilities of 301 H pylori clinical isolates were simultaneously profiled by E-test and disk diffusion method for levofloxacin (5-µg disk), clarithromycin (15-µg disk), metronidazole (5-µg disk), amoxicillin (10-µg disk), and tetracycline (30-µg disk). Furazolidone susceptibility was evaluated using a 100-µg disk only. The correlation between MICs by E-test and inhibition zone diameters by disk diffusion was assessed by linear regression analysis. RESULTS: Correlation between inhibition zone diameters and MICs was found for levofloxacin (r = -.932), clarithromycin (r = -.894), and to a minor extent metronidazole (r = -.820). Using the linear regression analysis, the inhibition zone diameter breakpoints were calculated to be 29 mm for levofloxacin, 41 mm for clarithromycin, and 15 mm for metronidazole corresponding to the EUCAST-recommended MIC breakpoints. The susceptibility agreement between E-test and disk diffusion for levofloxacin, clarithromycin, and metronidazole was 98.6%, 96.0%, and 96.7%, respectively. The inhibition zone diameters recorded for the amoxicillin, tetracycline, and furazolidone were large (approximately 60 mm in mean), and a poor correlation was found between inhibition zone diameters and MICs for amoxicillin (r = -.594) and tetracycline (r = -.490). CONCLUSIONS: The disk diffusion can be used as a routine H pylori susceptibility testing method for levofloxacin, clarithromycin, and metronidazole in clinical practice under the described technical conditions. The use of disk diffusion for amoxicillin, tetracycline, and furazolidone susceptibility testing needs to be further studied.


Assuntos
Antibacterianos/farmacologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Helicobacter pylori/efeitos dos fármacos , Testes Diagnósticos de Rotina , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/normas , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos
15.
PLoS One ; 15(5): e0232903, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407346

RESUMO

BACKGROUND: Recent UK antibiotic stewardship policies have resulted in significant changes in primary care dispensing, but whether this has impacted antimicrobial resistance is unknown. AIM: To evaluate associations between changes in primary care dispensing and antimicrobial resistance in community-acquired urinary Escherichia coli infections. METHODS: Multilevel logistic regression modelling investigating relationships between primary care practice level antibiotic dispensing for approximately 1.5 million patients in South West England and resistance in 152,704 community-acquired urinary E. coli between 2013 and 2016. Relationships presented for within and subsequent quarter drug-bug pairs, adjusted for patient age, deprivation, and rurality. RESULTS: In line with national trends, overall antibiotic dispensing per 1000 registered patients fell 11%. Amoxicillin fell 14%, cefalexin 20%, ciprofloxacin 24%, co-amoxiclav 49% and trimethoprim 8%. Nitrofurantoin increased 7%. Antibiotic reductions were associated with reduced within quarter same-antibiotic resistance to: amoxicillin, ciprofloxacin and trimethoprim. Subsequent quarter reduced resistance was observed for trimethoprim and amoxicillin. Antibiotic dispensing reductions were associated with increased within and subsequent quarter resistance to cefalexin and co-amoxiclav. Increased nitrofurantoin dispensing was associated with reduced within and subsequent quarter trimethoprim resistance without affecting nitrofurantoin resistance. CONCLUSIONS: This evaluation of a national primary care stewardship policy on antimicrobial resistance in the community suggests both hoped-for benefits and unexpected harms. Some increase in resistance to cefalexin and co-amoxiclav could result from residual confounding. Randomised controlled trials are urgently required to investigate causality.


Assuntos
Antibacterianos/administração & dosagem , Gestão de Antimicrobianos/legislação & jurisprudência , Prescrições de Medicamentos/normas , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/efeitos dos fármacos , Infecções Urinárias/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Uso de Medicamentos , Inglaterra/epidemiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Adulto Jovem
16.
J Infect Dis ; 221(Suppl 2): S148-S155, 2020 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-32176788

RESUMO

BACKGROUND: An antimicrobial stewardship campaign was launched in 2011 by the Ministry of Health. This study aimed to assess the achievements and trends in the clinical use of antibiotics in secondary and tertiary hospitals following this campaign in China. METHODS: This observational study analyzed nationwide hospital antibiotic procurement and consumption data and antibiotic-resistance surveillance data based on claims filed in 2010-2016. RESULTS: After a 6-year national campaign, the proportion of outpatients and surgical patients who received antibiotic treatment decreased from 19.5% to 8.5% and from 97.9% to 38.3%, respectively. The intensity of antibiotic use among inpatients decreased from 85.3±29.8 defined daily dosage (DDD) per 100 patient days to 48.5±8.0 DDD per 100 patient days. Moreover, the antibiotic procurement expenditure among hospitals declined from 22.3% of total drug procurement costs in 2010 to 12.1% in 2016, although total drug procurement costs doubled during that time. The incidence of methicillin-resistant Staphylococcus aureus isolates also dropped (from 54.4% in 2010 to 34.4% in 2016), as did the proportion of carbapenem-resistant Pseudomonas aeruginosa isolates (from 30.8% to 22.3%). CONCLUSIONS: The 6-year campaign successfully reduced antibiotic consumption and irrational drug use in Chinese hospitals which was associated with declines in the prevalence of common antibiotic-resistant bacteria.


Assuntos
Antibacterianos/uso terapêutico , Gestão de Antimicrobianos/métodos , Farmacorresistência Bacteriana/efeitos dos fármacos , Gastos em Saúde/tendências , Centros de Atenção Terciária , Antibacterianos/economia , Infecções Bacterianas/tratamento farmacológico , China/epidemiologia , Humanos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/isolamento & purificação , Infecções Estafilocócicas/epidemiologia
18.
Annu Rev Public Health ; 41: 141-157, 2020 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-31910712

RESUMO

Antimicrobial use (AMU) in animal agriculture contributes to antimicrobial resistance (AMR) in humans, which imposes significant health and economic costs on society. Economists call these costs negative externalities, societal costs that are not properly reflected in market prices. We review the relevant literature and develop a model to quantify the external costs of AMU in animal agriculture on AMR in humans. Parameters required for this estimate include (a) the health and economic burden of AMR in humans,(b) the impact of AMU in animal agriculture on AMR in animals, (c) the fraction of AMR in humans attributable to animal agriculture, and (d) AMU in animals. We use a well-documented historic case to estimate an externality cost of about US$1,500 per kilogram of fluoroquinolones administered in US broiler chicken production. Enhanced data collection, particularly on the third and fourth parameters, is urgently needed to quantify more fully the externalities of AMU in animal agriculture.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Custos e Análise de Custo/estatística & dados numéricos , Farmacorresistência Bacteriana/efeitos dos fármacos , Gado/crescimento & desenvolvimento , Animais , Galinhas/crescimento & desenvolvimento , Fluoroquinolonas/administração & dosagem , Humanos
19.
Sci Rep ; 10(1): 314, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941935

RESUMO

Heavy metal pollution is one of the most serious environmental and human health risk problem associated with industrial progress. The present study was conducted with the goal of isolation and characterization of metal-resistant lactic acid bacteria (LAB) from the Alexandrian Mediterranean Seacoast, Egypt, with their possible exploitation in metal remediation. Lactobacillus plantarum MF042018 exhibited high degree of resistance, up to 500 and 100 ppm, to both nickel and chromium, respectively, with multiple antibiotic resistance (MAR) index above 0.5. In an attempt to improve chromium removal by L. plantarum MF042018, Plackett-Burman followed by Box-Behnken statistical designs were applied. An initial Cr2+ concentration of 100 ppm and inoculum size of 3% presented the best conditions for the accumulation of chromium by L. plantarum MF042018. The study was also navigated to assess the biosorption capacity of L. plantarum MF042018, the maximum uptake capacity (q) of both Cd2+ and Pb2+ was recorded at pH 2.0 and a temperature of 22 °C after 1 hr. The biosorption process of Cd2+ and Pb2+ was well explained by the Langmuir isotherm model better than the Freundlich isotherm. Furthermore, the results revealed that the use of L. plantarum MF042018 is an effective tool for the treatment of hazardous metal-polluted battery-manufacturing effluent. Therefore, the present study implies that L. plantarum MF042018 can be applied as a promising biosorbent for the removal of heavy metals from industrial wasterwaters.


Assuntos
Biodegradação Ambiental , Lactobacillus plantarum/metabolismo , Metais Pesados/metabolismo , Adsorção , Antibacterianos/farmacologia , Cádmio/metabolismo , Farmacorresistência Bacteriana/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Cinética , Lactobacillus plantarum/química , Chumbo/metabolismo , Espectrometria por Raios X , Temperatura
20.
Biopolymers ; 111(3): e23338, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31696516

RESUMO

A chitosan Schiff base with an aromatic aldehyde was synthesized and characterized by FTIR and NMR spectroscopies. Furthermore, the degree of substitution was calculated based on the ratios of the area of the proton of the imine (Aimine ) and the area of the peak of the proton of the pyranose ring (AH-2 ). The antimicrobial activities were determined against bacterial and fungal strains, as well as multiple drug-resistant (MDR) bacteria. The chitosan Schiff base was also tagged with medicinal plants, for example, Curcuma longa, Peganum harmala, Lepidium sativam, and cruciferous vegetables, and the biological activities determined against pathogenic bacterial and fungal strains. The chitosan Schiff base showed maximum zone of inhibition of 22 mm against Staphylococcus aureus with a minimum zone of inhibition of 15 mm against Bacillus cereus. The chitosan Schiff base was fused with C longa, isothiocyanates and a combined mixture of P harmala and L sativam that has shown activities against Escherichia coli with a zone of inhibition of 28, 24, and 30 mm, respectively. The Schiff base of chitosan fused with medicinal plants also showed significant inhibitory activities against MDR bacteria.


Assuntos
Anti-Infecciosos/química , Quitosana/química , Extratos Vegetais/química , Plantas Medicinais/química , Bases de Schiff/química , Anti-Infecciosos/farmacologia , Bacillus cereus/efeitos dos fármacos , Bactérias/efeitos dos fármacos , Farmacorresistência Bacteriana/efeitos dos fármacos , Fungos/efeitos dos fármacos , Espectroscopia de Ressonância Magnética , Testes de Sensibilidade Microbiana , Modelos Químicos , Estrutura Molecular , Extratos Vegetais/farmacologia , Espectroscopia de Infravermelho com Transformada de Fourier , Staphylococcus aureus/efeitos dos fármacos
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