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1.
J Environ Sci (China) ; 147: 498-511, 2025 Jan.
Article in English | MEDLINE | ID: mdl-39003065

ABSTRACT

The land application of livestock manure has been widely acknowledged as a beneficial approach for nutrient recycling and environmental protection. However, the impact of residual antibiotics, a common contaminant of manure, on the degradation of organic compounds and nutrient release in Eutric Regosol is not well understood. Here, we studied, how oxytetracycline (OTC) and ciprofloxacin (CIP) affect the decomposition, microbial community structure, extracellular enzyme activities and nutrient release from cattle and pig manure using litterbag incubation experiments. Results showed that OTC and CIP greatly inhibited livestock manure decomposition, causing a decreased rate of carbon (28%-87%), nitrogen (15%-44%) and phosphorus (26%-43%) release. The relative abundance of gram-negative (G-) bacteria was reduced by 4.0%-13% while fungi increased by 7.0%-71% during a 28-day incubation period. Co-occurrence network analysis showed that antibiotic exposure disrupted microbial interactions, particularly among G- bacteria, G+ bacteria, and actinomycetes. These changes in microbial community structure and function resulted in decreased activity of urease, ß-1,4-N-acetyl-glucosaminidase, alkaline protease, chitinase, and catalase, causing reduced decomposition and nutrient release in cattle and pig manures. These findings advance our understanding of decomposition and nutrient recycling from manure-contaminated antibiotics, which will help facilitate sustainable agricultural production and soil carbon sequestration.


Subject(s)
Anti-Bacterial Agents , Livestock , Manure , Soil Microbiology , Animals , Soil/chemistry , Carbon Sequestration , Carbon/metabolism , Phosphorus , Recycling , Soil Pollutants/metabolism , Cattle , Swine , Nitrogen/analysis , Oxytetracycline
2.
J Environ Sci (China) ; 148: 243-262, 2025 Feb.
Article in English | MEDLINE | ID: mdl-39095161

ABSTRACT

Because of the recent widespread usage of antibiotics, the acquisition and dissemination of antibiotic-resistance genes (ARGs) were prevalent in the majority of habitats. Generally, the biological wastewater treatment processes used in wastewater treatment plants have a limited efficiencies of antibiotics resistant bacteria (ARB) disinfection and ARGs degradation and even promote the proliferation of ARGs. Problematically, ARB and ARGs in effluent pose potential risks if they are not further treated. Photocatalytic oxidation is considered a promising disinfection technology, where the photocatalytic process generates many free radicals that enhance the interaction between light and deoxyribonucleic acid (DNA) for ARB elimination and subsequent degradation of ARGs. This review aims to illustrate the progress of photocatalytic oxidation technology for removing antibiotics resistant (AR) from wastewater in recent years. We discuss the sources and transfer of ARGs in wastewater. The overall removal efficiencies of ultraviolet radiation (UV)/chlorination, UV/ozone, UV/H2O2, and UV/sulfate-radical based system for ARB and ARGs, as well as the experimental parameters and removal mechanisms, are systematically discussed. The contribution of photocatalytic materials based on TiO2 and g-C3N4 to the inactivation of ARB and degradation of ARGs is highlighted, producing many free radicals to attack ARB and ARGs while effectively limiting the horizontal gene transfer (HGT) in wastewater. Finally, based on the reviewed studies, future research directions are proposed to realize specific photocatalytic oxidation technology applications and overcome current challenges.


Subject(s)
Waste Disposal, Fluid , Wastewater , Wastewater/chemistry , Waste Disposal, Fluid/methods , Bacteria , Disinfection/methods , Drug Resistance, Bacterial/genetics , Ultraviolet Rays , Water Purification/methods
3.
BMC Infect Dis ; 24(1): 791, 2024 Aug 06.
Article in English | MEDLINE | ID: mdl-39107703

ABSTRACT

Diabetic foot infection imposes a significant burden and is the major cause of nontraumatic limb amputation. Adequate patient management with effective antibiotic therapy is crucial.This retrospective cohort study aimed to characterize the microbiology and resistance patterns of moderate to severe neuropathic diabetic foot infection in patients hospitalized at a tertiary referral hospital between January 2020 and June 2023. Deep tissue specimens from ulcers were collected for culture.Sixty inpatients were included (62% male, mean age 59.1 ± 11.5 years). Osteomyelitis was present in 90% of the patients. Among 102 microorganisms (average of 1.91 ± 1.25 pathogens per patient), 60.8% were gram-positive bacteria, 31.4% were gram-negative, 3.92% were anaerobic bacteria, and 3.92% were fungi. Staphylococcus aureus (19%) and Enterococcus faecium (17%) were the most common. Pseudomonas aeruginosa (8%) and bacteria of the Enterobacterales family (24%) accounted for all the isolated gram-negative bacteria. Sixteen percent of Staphylococcus aureus and 67% of coagulase-negative Staphylococci were resistant to methicillin. Resistance to ampicillin was found in 11% of Enterococci. All Pseudomonas aeruginosa isolates were sensitive to piperacillin-tazobactam, ceftazidime, or cefepime. Among the Enterobacterales, resistance rates were 35% for piperacillin-tazobactam, 38% for ceftazidime, 21% for cefepime, and 13% for carbapenems.Although the prevalence of methicillin-resistant staphylococci was lower than that in other studies, carbapenem resistance among gram-negative bacteria warrants attention. This study highlights the importance of understanding local epidemiology for effective diabetic foot infection management and resistance mitigation.


Subject(s)
Anti-Bacterial Agents , Diabetic Foot , Tertiary Care Centers , Humans , Diabetic Foot/microbiology , Diabetic Foot/drug therapy , Male , Middle Aged , Retrospective Studies , Tertiary Care Centers/statistics & numerical data , Female , Aged , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology , Portugal/epidemiology , Microbial Sensitivity Tests , Osteomyelitis/microbiology , Osteomyelitis/drug therapy , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacteria/classification , Bacteria/isolation & purification , Bacteria/classification , Bacteria/drug effects , Bacteria/genetics , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/isolation & purification , Gram-Positive Bacteria/classification
4.
Infect Drug Resist ; 17: 3425-3438, 2024.
Article in English | MEDLINE | ID: mdl-39145118

ABSTRACT

Purpose: Early empiric antibiotics were prescribed to numerous patients during the Coronavirus disease 2019 (COVID-19) pandemic. However, the potential impact of empiric antibiotic therapy on the clinical outcomes of patients hospitalized with COVID-19 is yet unknown. Methods: In this retrospective cohort study, early antibiotics use cohort was defined as control group, which was compared with no antibiotic use and delayed antibiotic use cohorts for all-cause mortality during hospitalization. The 1:2 propensity score matched patient populations were further developed to adjust confounding factors. Survival curves were compared between different cohorts using a Log rank test to assess the early antibiotic effectiveness. Results: We included a total of 1472 COVID-19 hospitalized patients, of whom 87.4% (1287 patients) received early antibiotic prescriptions. In propensity-score-matched datasets, our analysis comprised 139 patients with non-antibiotic use (with 278 matched controls) and 27 patients with deferred-antibiotic use (with 54 matched controls). Patients with older ages, multiple comorbidities, severe and critical COVID-19 subtypes, higher serum infection indicators, and inflammatory indicators at admission were more likely to receive early antibiotic prescriptions. After adjusting confounding factors likely to influence the prognosis, there is no significant difference in all-cause mortality (HR=1.000(0.246-4.060), p = 1.000) and ICU admission (HR=0.436(0.093-2.04), p = 0.293), need for mechanical ventilation (HR=0.723(0.296-1.763), p = 0.476) and tracheal intubation (HR=1.338(0.221-8.103), p = 0.751) were observed between early antibiotics use cohort and non-antibiotic use cohort. Conclusion: Early antibiotics were frequently prescribed to patients in more severe disease condition at admission. However, early antibiotic treatment failed to demonstrate better clinical outcomes in hospitalized patients with COVID-19 in the propensity-score-matched cohorts.

5.
J Hazard Mater ; 478: 135505, 2024 Aug 13.
Article in English | MEDLINE | ID: mdl-39146587

ABSTRACT

Struvite recovery shows significant potential for simultaneously recovering nitrogen (N) and phosphorus (P) from swine wastewater but is challenged by the occurrence and transformation of antibiotic residuals. Electrochemically mediated struvite precipitation with sacrificial magnesium anode (EMSP-Mg) is promising due to its automation and chemical-free merits. However, the fate of antibiotics remains underexplored. We investigated the behavior of sulfadiazine (SD), an antibiotic frequently detected but less studied than others within the EMSP-Mg system. Significantly less SD (≤ 5%) was co-precipitated with recovered struvite in EMSP-Mg than conventional chemical struvite precipitation (CSP) processes (15.0 to 50.0%). The reduced SD accumulation in struvite recovered via EMSP was associated with increased pH and electric potential differences, which likely enhanced the electrostatic repulsion between SD and struvite. In contrast, the typical strategies used in enhancing P removal in the EMSP-Mg system, including increasing the Mg/P ratio or the Mg-release rates, have shown negligible effects on SD adsorption. Furthermore, typical coexisting ions (Ca2+, Cl-, and HCO3-) inhibited SD adsorption onto recovered products. These results provide new insights into the interactions between antibiotics and struvite within the EMSP-Mg system, enhancing our understanding of antibiotic migration pathways and aiding the development of novel EMSP processes for cleaner struvite recovery.

6.
Cell Host Microbe ; 32(8): 1444-1454.e6, 2024 Aug 14.
Article in English | MEDLINE | ID: mdl-39146801

ABSTRACT

Pregnant women undergoing a cesarean section (CS) typically receive antibiotics prior to skin incision to prevent infections. To investigate if the timing of antibiotics influences the infant gut microbiome, we conducted a randomized controlled trial (NCT06030713) in women delivering via a scheduled CS who received antibiotics either before skin incision or after umbilical cord clamping. We performed a longitudinal analysis on 172 samples from 28 infants at 8 post-birth time points and a cross-sectional analysis at 1 month in 79 infants from 3 cohorts. Although no significant associations with bacterial composition, metabolic pathways, short-chain fatty acids, and bile acids were found, we observed subtle differences between the groups at the bacterial strain level and in the load of antibiotic resistance genes. Rather, feeding mode was a predominant and defining factor impacting infant microbial composition. In conclusion, antibiotic administration during CS has only limited effects on the early-life gut microbiome.


Subject(s)
Anti-Bacterial Agents , Antibiotic Prophylaxis , Cesarean Section , Gastrointestinal Microbiome , Humans , Gastrointestinal Microbiome/drug effects , Female , Antibiotic Prophylaxis/methods , Pregnancy , Anti-Bacterial Agents/administration & dosage , Infant , Infant, Newborn , Adult , Cross-Sectional Studies , Bacteria/genetics , Bacteria/drug effects , Bacteria/classification , Longitudinal Studies , Bile Acids and Salts/metabolism , Feces/microbiology
7.
Bioresour Technol ; : 131274, 2024 Aug 13.
Article in English | MEDLINE | ID: mdl-39147106

ABSTRACT

This study examined the elimination of sulfonamide antibiotics (SAs) by constructed wetland substrates with NaOH-modified corn straw biochar and assessed the impact of environmental conditions on the effectiveness of SAs removal. The study demonstrated that the constructed wetland substrate with NaOH-modified biochar significantly eliminated eight SAs, with a removal rate of over 94 %. During the removal process, the intermediates will undergo regeneration of the parent compounds under low DO concentrations. This was based on the linear stepwise regression analysis and Geodetector models. The results showed that SA types COD, NH4+-N, TN, and DO had a stronger influence. The dominant bacteria in the constructed wetland system were mainly affected by antibiotic concentration, DO, NH4+-N and NO3--N, which affected the removal of antibiotics. Overall, the constructed wetland substrate with NaOH-modified corn straw biochar can be effectively employed as an ecological method for eliminating SAs from the environment.

9.
Front Mol Biosci ; 11: 1412325, 2024.
Article in English | MEDLINE | ID: mdl-39139812

ABSTRACT

The result of infection of bone with microorganisms is osteomyelitis and septic arthritis. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for most of its cases (more than 50%). Since MRSA is resistant to many treatments, it is accompanied by high costs and numerous complications, necessitating more effective new treatments. Recently, development of gelatin nanoparticles have attracted the attention of scientists of biomedicine to itself, and have been utilized as a delivery vehicle for antibiotics because of their biocompatibility, biodegradability, and cost-effectiveness. Promising results have been reported with gelatin modification and combinations with chemical agents. Although these findings have been suggested that gelatin has the potential to be a suitable option for continuous release of antibiotics in osteomyelitis and septic arthritis treatment, they still have not become routine in clinical practices. The most deliver antibiotic using gelatin-derived composites is vancomycin which is showed the good efficacy. To date, a number of pre-clinical studies evaluated the utility of gelatin-based composites in the management of osteomyelitis. Gelatin-based composites were found to have satisfactory performance in the control of infection, as well as the promotion of bone defect repair in chronic osteomyelitis models. This review summarized the available evidence which provides a new insight into gelatin-derived composites with controlled release of antibiotics.

10.
Chemosphere ; 364: 143071, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39128776

ABSTRACT

Two microwave (MW) responsive heterojunction nanocomposite catalysts, i.e., α-Bi2O3/CoFe2O4 (BO/CFO) and ZnO/CoFe2O4 (ZO/CFO), with weight% ratio of 70/30, 50/50, 30/70 were synthesized by sequential thermal decomposition and co-precipitation methods, and used for the degradation of tetracycline (TC) under MW irradiation. The formation of desired catalysts was confirmed through the characterization results of XRD, FT-IR, SEM, VSM, UV-DRS, XPS, BET, etc. Using batch MW experiments, the catalyst dose, pH, initial TC concentration, reaction temperature, and MW power were optimized for TC removal. Under the following reaction conditions: catalyst dose ∼1 g/L, initial TC concentration ∼1 mg/L, temperature ∼90 °C, MW ∼450 W, BO/CFO, and ZO/CFO showed ∼97.55% and 88.23% TC degradation, respectively, after 5 min. The difference in the catalytic response against TC degradation indicated the difference in reflective loss (RL) between these two catalysts. The presence of other competitive anions has affected the removal efficiency of TC due to the scavenging effect. The radical trapping study revealed the significant contribution of TC degradation by hydroxyl radicals in the case of ZO/CFO, whereas for BO/CFO, superoxide (●O2-) and hydroxyl radicals (●OH) both played influential roles. The Z-scheme heterojunction of BO/CFO allowed the formation of ●O2- but the same was inhibited in type-II heterojunction of ZO/CFO due to the valance band position. The dielectric loss, magnetic loss, interfacial polarization, and high electrical conductivity, 'hotspots' were produced over the catalyst surface alongside electron-hole separation at heterojunctions, which were responsible for the generation of reactive oxygen species. In addition, Co3+/Co2+ and Fe3+/Fe2+ redox cycles have promoted ●O2- and sulfate radical production during persulfate application. Among the two MW responsive catalysts, BO/CFO could be a potential material for rapidly destroying emerging organic pollutants from wastewater without applying other oxidative chemicals under MW irradiation.

11.
J Pharm Biomed Anal ; 251: 116404, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39154578

ABSTRACT

Sepsis is a life-threatening condition and usually be treated with antibiotics, which however often has severe side effects. This work proposed a novel Chinese traditional medicine JINHONG (JH) decoction for therapy of sepsis. We first identified the chemical constituents of JH decoction by using high-performance liquid chromatography and mass spectrometry (HPLC-MS). Then, we constructed a model mouse for sepsis by using cecal ligation and puncture (CLP). Metagenomic sequencing method was used to compare the diversity and abundance of the gut microbiota between normal, disease model, JH decoction-treatment and antibiotic-treatment mice. Many indices including the number of platelets, CD62p and CD63 content, AQP2 and AQP8 level, as well as the expression level of protein C confirmed that the sepsis resulted in serious pathological damage, while all of these indices could be reversed by JH decoction and antibiotics. The diversity and abundance of intestinal flora decreased in CLP mice, and the decrements aggravated after antibiotic treatment while can be recovered by JH decoction treatment. The abundance of anti-inflammatory Ruminococcaceae increased after JH decoction treatment, indicating that JH decoction could ameliorate pathology associated with sepsis in CLP model via modulating the intestinal flora. This study demonstrates that JH decoction could treat sepsis clinically without obvious adverse effects on gut microbiota.

13.
Sci Total Environ ; : 175579, 2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39154996

ABSTRACT

Soil contamination by antibiotics is a global issue of great concern that contributes to the rise of bacterial antibiotic resistance and can have toxic effects on non-target organisms. This study evaluated the variations of molecular, cellular, and histological parameters in Eisenia fetida earthworms exposed to sulfamethazine (SMZ) and tetracycline (TC), two antibiotics commonly found in agricultural soils. The earthworms were exposed for 14 days to a series of concentrations (0, 10, 100, and 1000 mg/kg) of both antibiotics. SMZ and TC did not affect the survival of E. fetida, however, other effects at different levels of biological complexity were detected. The two highest concentrations of SMZ reduced the viability of coelomocytes. At the highest TC concentration, there was a noticeable decline in cell viability, acetylcholinesterase activity (neurotoxicity), and the relative presence of mucopolysaccharides in the epidermis (mucous production). Glutathione S-transferase activity decreased in all TC treatments and at the highest SMZ concentration. However, levels of malondialdehyde and protein carbonyls did not change, suggesting an absence of oxidative stress. Tetracycline was neurotoxic to E. fetida and changed the integrity of the epidermis. Both antibiotics altered the intestinal microbiota of E. fetida, leading to a reduction in the relative abundance of bacteria from the phyla Proteobacteria and Bacteroidetes, while causing an increase in the phylum Actinobacteroidota. All observed changes indicate that both SMZ and TC can disrupt the earthworms' immune system and gut microbiome, while fostering the growth of bacteria that harbour antibiotic resistance genes. Finally, both antibiotics exerted additional metabolic and physiological effects that increased the vulnerability of E. fetida to pathogens.

14.
Article in English | MEDLINE | ID: mdl-39155346

ABSTRACT

Antibiotic contamination poses a significant global concern due to its far-reaching impact on public health and the environment. This comprehensive review delves into the prevalence of various antibiotic classes in environmental pollution and their interactions with natural ecosystems. Fluoroquinolones, macrolides, tetracyclines, and sulphonamides have emerged as prevalent contaminants in environmental matrices worldwide. The concentrations of these antibiotics vary across diverse environments, influenced by production practices, consumer behaviours, and socio-economic factors. Low- and low-middle-income countries face unique challenges in managing antibiotic contamination, with dominant mechanisms like hydrolysis, sorption, and biodegradation leading to the formation of toxic byproducts. Ecotoxicity reports reveal the detrimental effects of these byproducts on aquatic and terrestrial ecosystems, further emphasizing the gravity of the issue. Notably, monitoring the antibiotic parent compound alone may be inadequate for framing effective control and management strategies for antibiotic pollution. This review underscores the imperative of a comprehensive, multi-sectoral approach to address environmental antibiotic contamination and combat antimicrobial resistance. It also advocates for the development and implementation of tailored national action plans that consider specific environmental conditions and factors. Thus, an approach is crucial for safeguarding both public health and the delicate balance of our natural ecosystems.

15.
Food Chem ; 461: 140857, 2024 Aug 12.
Article in English | MEDLINE | ID: mdl-39151346

ABSTRACT

The thermal-responsive magnetic molecularly imprinted polymer (TrMMIP) sorbent was synthesized by surface imprinting method, and then used for magnetic solid-phase extraction (MSPE) and subsequent integrated into the ion source for elution and ionization. The shrinking-strength states change of the thermal-responsive polymer chain on TrMMIP alters the wettability of the sorbent when the working temperature crosses the lower critical solution temperature (LCST) of the polymer, and thus affects its behavior of in the extraction and clean-up process. The targeted analytes could be effectively extracted due to the high selectivity of MIPs and well dispersibility of polymer chain under the open state. Additionally, a hydrophilic polymer chain wrapped on the sorbent surface further protected target substances from co-elution during cleanup. Analytical methods for sulfonamide antibiotics (SAs) detection in complex food samples (milk, honey, fish) were developed, demonstrating potential for rapid and sensitive SAs analysis in diverse food and biological samples.

16.
Chemosphere ; : 143102, 2024 Aug 14.
Article in English | MEDLINE | ID: mdl-39151585

ABSTRACT

This work aims to assess the surface coupling of molecularly imprinted polymers (MIP) on carbon adsorbents produced from spent brewery grain, namely biochar (BC) and activated carbon (AC), as a strategy to improve selectivity and the adsorptive removal of the antibiotic sulfamethoxazole (SMX) from water. BC and AC were produced by microwave-assisted pyrolysis, and MIP was obtained by fast bulk polymerization. Two different methodologies were used for the molecular imprinting of BC and AC, the resulting materials being tested for SMX adsorption. Then, after selecting the most favourable molecular imprinting methodology, different mass ratios of MIP:BC or MIP:AC were used to produce and evaluate eight different materials. Molecular imprinting was shown to significantly improve the performance of BC for the target application, and one of the produced composites (MIP1-BC-s(1:3)) was selected for further kinetic and equilibrium studies and comparison with individual MIP and BC. The kinetic behaviour was properly described by both the pseudo-first and pseudo-second order models. Regarding equilibrium isotherms, they fitted the Freundlich and Langmuir models, with MIP1-BC-s(1:3) reaching a maximum adsorption capacity (qm) of 25 ± 1 µmol g-1, 19 % higher than BC. In comparison with other seven pharmaceuticals, the adsorption of SMX onto MIP1-BC-s(1:3) was remarkably higher, as for the specific recognition of this antibiotic by the coupled MIP. The pH study evidenced that SMX removal was higher under acidic conditions. Regeneration experiments showed that MIP1-BC-s(1:3) provided good adsorption performance, which was stable during five regeneration-reutilization cycles. Overall, this study has demonstrated that coupling with MIP may be a suitable strategy to improve the adsorption properties and performance of biochar for antibiotics removal from water, increasing its suitability for practical applications.

17.
Ann Otol Rhinol Laryngol ; : 34894241273159, 2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39152616

ABSTRACT

OBJECTIVE: To characterize the institutional utilization of pneumococcal vaccination during an index hospital admission for acute cerebrospinal fluid (CSF) leakage and associated infectious and clinical outcomes. METHODS: This retrospective cohort study included patients hospitalized and treated for an acute CSF leak from January 2017 to June 2022. The primary outcome evaluated the incidence of pneumococcal vaccination during the index admission in patients without prior vaccination. Secondary outcomes evaluated the incidence of meningitis, time from CSF leak identification to meningitis, and mortality within 1 year of the index admission. RESULTS: A total of 94 patients were included. Nineteen (20.2%) patients received pneumococcal vaccination prior to admission. Of the 75 patients without prior vaccination, 4 (5.3%) patients received vaccination during the admission. Meningitis occurred in 5/94 (5.3%) patients and occurred 4-24 days from CSF leak identification. Mortality was observed in 9/94 (9.6%) patients. None of the meningitis cases were attributed to culture-positive findings of pneumococcal disease. CONCLUSIONS: The results of this study demonstrate an overall low institutional utilization of pneumococcal vaccination in patients with an acute CSF leak. Infectious and clinical outcomes reflected comparable to previous reported literature. Further evaluation into the risk-benefit relationship of vaccination omission is warranted in this patient population.

18.
Article in English | MEDLINE | ID: mdl-39152871

ABSTRACT

Bacterial vaginosis (BV), characterised by an imbalance in vaginal microbiota, frequently leading to recurrent episodes, has garnered recent research attention due to the significance of biofilms in its pathogenesis. BV biofilms contribute to recurrence by providing a shelter for harmful bacteria, rendering them resistant to conventional treatment. Objectives of this review include characterising BV biofilms, evaluating the limitations of current antibiotic therapy, highlighting emerging solutions and emphasising multifaceted approaches. The review presents data from clinical studies and trials on biofilm-focused treatments which might reduce BV recurrence, with the ultimate goal of improving the quality of life of women with BV and reducing its burden on their reproductive health.

19.
J Surg Res ; 302: 398-402, 2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39153361

ABSTRACT

INTRODUCTION: In the era of rising antimicrobial resistance and successful protocols for empiric and prophylactic antimicrobial therapy in elective surgical procedures, it is important to consider the specific needs of the trauma population based on injury location, severity, and environmental exposures. In this study, we aim to compare outcomes of high-activation trauma patients who received antibiotics during initial evaluation with those who did not. METHODS: A retrospective chart review of patients focusing on antimicrobial administration who presented as the highest trauma activation criteria during the year 2021 was conducted at a single urban institution. Patient demographic, injury, and outcome data ere collected through manual data abstraction from our institutional trauma registry. RESULTS: Nearly half of all trauma patients in our study received antibiotics after initial evaluation and age was found to be significantly associated with antibiotic administration within the first 1.5 h. Young men with penetrating injuries were more likely to receive antibiotic treatment. Seventy-eight percent of patients who received early antibiotics underwent a procedure, while 61% of those who did not receive early antibiotics did not (P < 0.001). CONCLUSIONS: These findings emphasize the importance of individualizing antibiotic treatment based on the patient's age and specific injury pattern. They also underscore the need for trauma providers to prioritize antibiotic stewardship.

20.
Environ Res ; : 119808, 2024 Aug 15.
Article in English | MEDLINE | ID: mdl-39153565

ABSTRACT

The widespread application of macrolide antibiotics has caused antibiotic resistance pollution, threatening the river ecological health. In this study, five macrolide antibiotics (azithromycin, clarithromycin, roxithromycin, erythromycin, and anhydro erythromycin A) were monitored in the Zao River across three hydrological periods (April, July, and December). Simultaneously, the changes in antibiotic resistance genes (ARGs), mobile genetic elements (MGEs), and planktonic bacterial communities were determined using metagenomic sequencing. A clear pollution gradient was observed for azithromycin and roxithromycin, with the concentrations in the dry season surpassing those in other seasons. The highest concentration was observed for azithromycin (1.36 µg/L). The abundance of MLS resistance genes increased along the Zao River during the dry season, whereas the opposite trend was obtained during the wet season. A significant correlation between the levels of MLS resistance genes and macrolide antibiotics was identified during the dry season. Notably, compared with the reference site, the abundance of transposase in the effluent from wastewater treatment plants (WWTPs) was significantly elevated in both dry and wet seasons, whereas the abundance of insertion sequences (IS) and plasmids declined during the dry season. The exposure to wastewater containing macrolide antibiotics altered the diversity of planktonic bacterial communities. The bacterial host for ARGs appeared to be Pseudomonas, primarily associated with multidrug subtypes. Moreover, the ARG subtypes were highly correlated with MGEs (transposase and istA). The partial least-squares path model (PLS-PM) demonstrated a positive correlation between the abundance of MGEs and ARGs, indicating the significance of horizontal gene transfer (HGT) in the dissemination of ARGs within the Zao River. Environmental variables, such as TN and NO3--N, were significantly correlated with the abundance of MGEs, ARGs, and bacteria. Collectively, our findings could provide insights into the shift patterns of the microbiome and ARGs across the contamination gradient of AZI and ROX in the river.

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