Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 47.563
Filtrar
1.
Microbiology (Reading) ; 168(2)2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35130141

RESUMEN

Transferable linezolid resistance due to optrA, poxtA, cfr and cfr-like genes is increasingly detected in enterococci associated with animals and humans globally. We aimed to characterize the genetic environment of optrA in linezolid-resistant Enterococcus faecalis isolates from Scotland. Six linezolid-resistant E. faecalis isolated from urogenital samples were confirmed to carry the optrA gene by PCR. Short read (Illumina) sequencing showed the isolates were genetically distinct (>13900 core SNPs) and belonged to different MLST sequence types. Plasmid contents were examined using hybrid assembly of short and long read (Oxford Nanopore MinION) sequencing technologies. The optrA gene was located on distinct plasmids in each isolate, suggesting that transfer of a single plasmid did not contribute to optrA dissemination in this collection. pTM6294-2, BX5936-1 and pWE0438-1 were similar to optrA-positive plasmids from China and Japan, while the remaining three plasmids had limited similarity to other published examples. We identified the novel Tn6993 transposon in pWE0254-1 carrying linezolid (optrA), macrolide (ermB) and spectinomycin [ANT(9)-Ia] resistance genes. OptrA amino acid sequences differed by 0-20 residues. We report multiple variants of optrA on distinct plasmids in diverse strains of E. faecalis. It is important to identify the selection pressures driving the emergence and maintenance of resistance against linezolid to retain the clinical utility of this antibiotic.


Asunto(s)
Enterococcus faecium , Infecciones por Bacterias Grampositivas , Animales , Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Enterococcus faecalis/genética , Enterococcus faecium/genética , Linezolid/farmacología , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Plásmidos/genética
2.
Microbiology (Reading) ; 168(2)2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35118938

RESUMEN

The polymyxin and lipopeptide classes of antibiotics are membrane-targeting drugs of last resort used to treat infections caused by multi-drug-resistant pathogens. Despite similar structures, these two antibiotic classes have distinct modes of action and clinical uses. The polymyxins target lipopolysaccharide in the membranes of most Gram-negative species and are often used to treat infections caused by carbapenem-resistant species such as Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa. By contrast, the lipopeptide daptomycin requires membrane phosphatidylglycerol for activity and is only used to treat infections caused by drug-resistant Gram-positive bacteria such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. However, despite having distinct targets, both antibiotic classes cause membrane disruption, are potently bactericidal in vitro and share similarities in resistance mechanisms. Furthermore, there are concerns about the efficacy of these antibiotics, and there is increasing interest in using both polymyxins and daptomycin in combination therapies to improve patient outcomes. In this review article, we will explore what is known about these distinct but structurally similar classes of antibiotics, discuss recent advances in the field and highlight remaining gaps in our knowledge.


Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Polimixinas , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Humanos , Lipopéptidos/farmacología , Polimixinas/farmacología
3.
BMC Health Serv Res ; 22(1): 613, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35524209

RESUMEN

Sepsis causes 20% of global deaths, particularly among children and vulnerable populations living in developing countries. This study investigated how sepsis is prioritised in Malawi's health system to inform health policy. In this mixed-methods study, twenty multisectoral stakeholders were qualitatively interviewed and asked to quantitatively rate the likelihood of sepsis-related medium-term policy outcomes being realised. Respondents indicated that sepsis is not prioritised in Malawi due to a lack of local sepsis-related evidence and policies. However, they highlighted strong linkages between sepsis and maternal health, antimicrobial resistance and COVID-19, which are already existing national priorities, and offers opportunities for sepsis researchers as policy entrepreneurs. To address the burden of sepsis, we recommend that funding should be channelled to the generation of local evidence, evidence uptake, procurement of resources and treatment of sepsis cases, development of appropriate indicators for sepsis, adherence to infection prevention and control measures, and antimicrobial stewardship.


Asunto(s)
COVID-19 , Sepsis , Antibacterianos/uso terapéutico , COVID-19/epidemiología , Niño , Farmacorresistencia Bacteriana , Femenino , Salud Global , Humanos , Malaui/epidemiología , Sepsis/tratamiento farmacológico , Sepsis/epidemiología
4.
Microbiome ; 10(1): 71, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524279

RESUMEN

Although the rapid spread of antimicrobial resistance (AMR), particularly in relation to clinical settings, is causing concern in many regions of the globe, remote, extreme environments, such as Antarctica, are thought to be relatively free from the negative impact of human activities. In fact, Antarctica is often perceived as the last pristine continent on Earth. Such remote regions, which are assumed to have very low levels of AMR due to limited human activity, represent potential model environments to understand the mechanisms and interactions underpinning the early stages of evolution, de novo development, acquisition and transmission of AMR. Antarctica, with its defined zones of human colonisation (centred around scientific research stations) and large populations of migratory birds and animals, also has great potential with regard to mapping and understanding the spread of early-stage zoonotic interactions. However, to date, studies of AMR in Antarctica are limited. Here, we survey the current literature focussing on the following: i) Dissection of human-introduced AMR versus naturally occurring AMR, based on the premise that multiple drug resistance and resistance to synthetic antibiotics not yet found in nature are the results of human contamination ii) The potential role of endemic wildlife in AMR spread There is clear evidence for greater concentrations of AMR around research stations, and although data show reverse zoonosis of the characteristic human gut bacteria to endemic wildlife, AMR within birds and seals appears to be very low, albeit on limited samplings. Furthermore, areas where there is little, to no, human activity still appear to be free from anthropogenically introduced AMR. However, a comprehensive assessment of AMR levels in Antarctica is virtually impossible on current data due to the wide variation in reporting standards and methodologies used and poor geographical coverage. Thus, future studies should engage directly with policymakers to promote the implementation of continent-wide AMR reporting standards. The development of such standards alongside a centralised reporting system would provide baseline data to feedback directly into wastewater treatment policies for the Antarctic Treaty Area to help preserve this relatively pristine environment. Video Abstract.


Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Animales , Animales Salvajes , Regiones Antárticas , Antibacterianos/farmacología , Bacterias , Aves
5.
BMC Infect Dis ; 22(1): 438, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35525923

RESUMEN

BACKGROUND: Monitoring of antimicrobial resistance (AMR) is of great importance due to the frequency of strains becoming increasingly resistant to antibiotics. This review, using a public health focused approach, which aims to understand and describe the current status of AMR in Morocco in relation to WHO priority pathogens and treatment guidelines. METHODS: PubMed, ScienceDirect and Google Scholar Databases and grey literature are searched published articles on antimicrobial drug resistance data for GLASS priority pathogens isolated from Morocco between January 2011 and December 2021. Articles are screened using strict inclusion/exclusion criteria. AMR data is extracted with medians and IQR of resistance rates. RESULTS: Forty-nine articles are included in the final analysis. The most reported bacterium is Escherichia coli with median resistance rates of 90.9%, 64.0%, and 56.0%, for amoxicillin, amoxicillin-clavulanic acid, and co-trimoxazole, respectively. Colistin had the lowest median resistance with 0.1%. A median resistance of 63.0% is calculated for amoxicillin-clavulanic acid in Klebsiella pneumonia. Imipenem resistance with a median of 74.5% is reported for Acinetobacter baumannii. AMR data for Streptococcus pneumonie does not exceed 50.0% as a median. CONCLUSIONS: Whilst resistance rates are high for most of GLASS pathogens, there are deficient data to draw vigorous conclusions about the current status AMR in Morocco. The recently join to the GLASS system surveillance will begin to address this data gap.


Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Combinación Amoxicilina-Clavulanato de Potasio/farmacología , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Escherichia coli , Humanos , Marruecos/epidemiología
6.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(5): 468-474, 2022 May 12.
Artículo en Chino | MEDLINE | ID: mdl-35527462

RESUMEN

Objective: To detect the effects of four efflux pump inhibitors on the minimum inhibitory concentration of clarithromycin (CLA) against Mycobacterium abscessus (M. abscessus) in vitro, and to explore the role of efflux pump in CLA resistance of M. abscessus. Methods: Four frequently-used efflux pump inhibitors (Carbonyl Cyanide 3-chlorophenylhydrazone, CCCP, N, N'-dicyclohexylcarbodiimide, DCC, Verapamil, VP, Reserpine, RSP) were evaluated in this study. The minimum inhibitory concentration (MIC) values of clarithromycin against M. abscessus reference strain and 60 clinical strains with or without efflux pump inhibitors were detected by Alamar Blue method. Sequence analysis of erm(41) and rrl genes known to be associated with CLA resistance in M. abscessus was performed to analyze the correlation between the effect of efflux pump inhibitors on MIC and mutation of resistance-related genes. Results: CCCP, DCC, VP and RSP could reduce the MIC of M. abscessus to CLA, and the effect of RSP was weaker than the other three efflux pump inhibitors. Among the sixty M. abscessus clinical strains, ten strains were resistant to clarithromycin, seven of which had rrl gene mutation. The CLA resistance rate of smooth phenotype isolates was higher than that of rough phenotype isolates. At 3 day of clarithromycin incubation, the MICs of resistant strains were all reduced by efflux pump inhibitors. Compared with the strains with rrl gene mutation, efflux pump inhibitors had a greater effect on the strains without rrl gene mutation. At 14 day of clarithromycin incubation, 83% of M. abscessus subsp. abscessus, were induced to be resistant, and all of them were T28 sequence type of erm(41). With the occurrence of induced drug resistance, the effect of efflux pump inhibitor on CLA MIC decreased. Efflux pump inhibitors had no statistically significant diffence in the effect of effcux pump inhibitors on CLA MIC levels in different phenotypes of isolates. Conclusions: Efflux pump is involved in the resistance process of M. abscessus to CLA. Efflux pump inhibitors reduce the drug resistance to clarithromycin against M. abscessus in different degrees. The use of efflux pump inhibitors may provide a new way to alleviate the drug resistance of M. abscessus.


Asunto(s)
Infecciones por Mycobacterium no Tuberculosas , Mycobacterium abscessus , Antibacterianos/farmacología , Carbonil Cianuro m-Clorofenil Hidrazona , Claritromicina/farmacología , Farmacorresistencia Bacteriana/genética , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Infecciones por Mycobacterium no Tuberculosas/microbiología , Mycobacterium abscessus/genética
7.
Euro Surveill ; 27(18)2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35514307

RESUMEN

Because cefixime and ceftriaxone resistance in Neisseria gonorrhoeae and gonorrhoea treatment failures were increasing, a response plan to control and manage multidrug-resistant N. gonorrhoeae (MDR-NG) in Europe was published in 2012. The three main areas of the plan were to: (i) strengthen surveillance of antimicrobial resistance (AMR), (ii) implement monitoring of treatment failures and (iii) establish a communication strategy to increase awareness and disseminate AMR results. Since 2012, several additional extensively drug-resistant N. gonorrhoeae (XDR-NG) strains have emerged, and strains with high-level ceftriaxone resistance spread internationally. This prompted an evaluation and review of the 2012 European Centre for Disease Prevention and Control (ECDC) response plan, revealing an overall improvement in many aspects of monitoring AMR in N. gonorrhoeae; however, treatment failure monitoring was a weakness. Accordingly, the plan was updated in 2019 to further support European Union/European Economic Area (EU/EEA) countries in controlling and managing the threat of MDR/XDR-NG in Europe through further strengthening of AMR surveillance and clinical management including treatment failure monitoring. The plan will be assessed biennially to ensure its effectiveness and its value. Along with prevention, diagnostic, treatment and epidemiological surveillance strategies, AMR surveillance is essential for effective control of gonorrhoea.


Asunto(s)
Gonorrea , Neisseria gonorrhoeae , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Ceftriaxona/farmacología , Ceftriaxona/uso terapéutico , Farmacorresistencia Bacteriana , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana
8.
Euro Surveill ; 27(18)2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35514308

RESUMEN

BackgroundEffective surveillance of antimicrobial resistance (AMR) in Neisseria gonorrhoeae is required for the early detection of resistant strains and to ensure that treatment guidelines are appropriate for the setting in which they are implemented. AMR in N. gonorrhoeae has been identified as a global health threat.AimWe performed a systematic review to identify and describe surveillance systems targeting AMR in N. gonorrhoeae.MethodsWe searched Medline, PubMed, Global Health, EMBASE, CINAHL, Web of Science and ProQuest databases and grey literature between 1 January 2012 and 27 September 2020. Surveillance systems were defined as the continuous, systematic collection, analysis and interpretation of N. gonorrhoeae resistance data. The key components of surveillance systems were extracted, categorised, described and summarised.ResultsWe found 40 publications reporting on N. gonorrhoeae AMR surveillance systems in 27 countries and 10 multi-country or global surveillance reports. The proportion of countries with surveillance systems in each of the WHO's six regions ranged from one of 22 countries in the Eastern Mediterranean and five of 54 in Africa, to three of 11 countries in South East Asia. Only four countries report systems which are both comprehensive and national. We found no evidence of a current surveillance system in at least 148 countries. Coverage, representativeness, volume, clinical specimen source, type and epidemiological information vary substantially and limit interpretability and comparability of surveillance data for public health action.ConclusionGlobally, surveillance for N. gonorrhoeae AMR is inadequate and leaves large populations vulnerable to a major public health threat.


Asunto(s)
Gonorrea , Neisseria gonorrhoeae , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana
9.
Nat Commun ; 13(1): 2525, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534481

RESUMEN

Antibiotic tolerance, or the ability of bacteria to survive antibiotic treatment in the absence of genetic resistance, has been linked to chronic and recurrent infections. Tolerant cells are often characterized by a low metabolic state, against which most clinically used antibiotics are ineffective. Here, we show that tolerance readily evolves against antibiotics that are strongly dependent on bacterial metabolism, but does not arise against antibiotics whose efficacy is only minimally affected by metabolic state. We identify a mechanism of tolerance evolution in E. coli involving deletion of the sodium-proton antiporter gene nhaA, which results in downregulated metabolism and upregulated stress responses. Additionally, we find that cycling of antibiotics with different metabolic dependencies interrupts evolution of tolerance in vitro, increasing the lifetime of treatment efficacy. Our work highlights the potential for limiting the occurrence and extent of tolerance by accounting for antibiotic dependencies on bacterial metabolism.


Asunto(s)
Antibacterianos , Escherichia coli , Antibacterianos/farmacología , Bacterias , Farmacorresistencia Bacteriana/genética , Tolerancia a Medicamentos/genética , Escherichia coli/genética
10.
BMC Infect Dis ; 22(1): 420, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35501756

RESUMEN

BACKGROUND: Antimicrobial stewardship programs (ASPs) have become a fundamental pillar in optimizing antimicrobial usage, improving patient care, and reducing antimicrobial resistance (AMR). Herein we evaluated the impact of an ASP on antimicrobial consumption and AMR in Colombia. METHODS: We designed a retrospective observational study and measured trends in antibiotic consumption and AMR before and after the implementation of an ASP using interrupted time series analysis over a 4-year period (24 months before and 24 months after ASP implementation). RESULTS: ASPs were implemented according to the available resources in each of the institutions. Before ASP implementation, there was a trend toward an increase in the antibiotic consumption of all measured antimicrobials selected. Afterward, an overall decrease in antibiotic consumption was observed. The use of ertapenem and meropenem decreased in hospital wards, while a decrease in the use of ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, and vancomycin was observed in intensive care units. After ASP implementation, the trend toward an increase of oxacillin-resistant Staphylococcus aureus, ceftriaxone-resistant Escherichia coli, and meropenem-resistant Pseudomonas aeruginosa was reversed. CONCLUSIONS: In our study, we showed that ASPs are a key strategy in tackling the emerging threat of AMR and have a positive impact on antibiotic consumption and resistance.


Asunto(s)
Antiinfecciosos , Programas de Optimización del Uso de los Antimicrobianos , Staphylococcus aureus Resistente a Meticilina , Antibacterianos/uso terapéutico , Ceftriaxona , Colombia , Atención a la Salud , Farmacorresistencia Bacteriana , Humanos , Meropenem/uso terapéutico
11.
Microbiome ; 10(1): 69, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35501925

RESUMEN

BACKGROUND: The spread of antibiotic resistance genes (ARGs) has been of global concern as one of the greatest environmental threats. The gut microbiome of animals has been found to be a large reservoir of ARGs, which is also an indicator of the environmental antibiotic spectrum. The conserved microbiota makes the honeybee a tractable and confined ecosystem for studying the maintenance and transfer of ARGs across gut bacteria. Although it has been found that honeybee gut bacteria harbor diverse sets of ARGs, the influences of environmental variables and the mechanism driving their distribution remain unclear. RESULTS: We characterized the gut resistome of two closely related honeybee species, Apis cerana and Apis mellifera, domesticated in 14 geographic locations across China. The composition of the ARGs was more associated with host species rather than with geographical distribution, and A. mellifera had a higher content of ARGs in the gut. There was a moderate geographic pattern of resistome distribution, and several core ARG groups were found to be prevalent among A. cerana samples. These shared genes were mainly carried by the honeybee-specific gut members Gilliamella and Snodgrassella. Transferrable ARGs were frequently detected in honeybee guts, and the load was much higher in A. mellifera samples. Genomic loci of the bee gut symbionts containing a streptomycin resistance gene cluster were nearly identical to those of the broad-host-range IncQ plasmid, a proficient DNA delivery system in the environment. By in vitro conjugation experiments, we confirmed that the mobilizable plasmids could be transferred between honeybee gut symbionts by conjugation. Moreover, "satellite plasmids" with fragmented genes were identified in the integrated regions of different symbionts from multiple areas. CONCLUSIONS: Our study illustrates that the gut microbiota of different honeybee hosts varied in their antibiotic resistance structure, highlighting the role of the bee microbiome as a potential bioindicator and disseminator of antibiotic resistance. The difference in domestication history is highly influential in the structuring of the bee gut resistome. Notably, the evolution of plasmid-mediated antibiotic resistance is likely to promote the probability of its persistence and dissemination. Video Abstract.


Asunto(s)
Microbioma Gastrointestinal , Microbiota , Animales , Antibacterianos/farmacología , Bacterias/genética , Abejas , Farmacorresistencia Bacteriana/genética , Microbioma Gastrointestinal/genética , Microbiota/genética , Plásmidos/genética
12.
PLoS One ; 17(5): e0264762, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503758

RESUMEN

Staphylococcus aureus (S. aureus) is the most prevalent microorganism associated with mastitis in cattle, which harbours several virulence factors and antibiotic resistance genes. The present study aimed to characterize S. aureus isolated from mastitic milk of the cattle for antibiotic resistance (blaZ and mecA), haemolysins (hla and hlb) and enterotoxins (sea, seb, sec, and sed) genes. A total of 69 staphylococci were isolated and phenotypically characterized for haemolytic properties on 5% sheep blood agar medium. Out of 69 isolates, 55 (79.71%) were identified as S. aureus by polymerase chain reaction assay. Among S. aureus, the majority of the isolates harboured the gene blaZ (92.73%), followed by coa (89.09%), hlb (60%) and hla (49.09%). Gene mecA responsible for methicillin resistance was detected in 23.64% of S. aureus isolates. Enterotoxin genes seb (9.09%), sec (1.82%) and sed (7.27%) responsible for food poisoning were detected at a comparatively lower rate and none of the S. aureus strain was found positive for sea. Additionally, antimicrobial susceptibility study of S. aureus against 18 antimicrobial discs showed maximum resistance to oxytetracycline, penicillin, and fluoroquinolone groups, contrarily, we observed maximum sensitivity to methicillin and cefuroxime antimicrobials. The high occurrence rate of S. aureus harbouring genes for virulence factors and antimicrobial resistance needs appropriate strategies to control the pathogen spread to the human population.


Asunto(s)
Mastitis Bovina , Infecciones Estafilocócicas , Animales , Antibacterianos/farmacología , Bovinos , Farmacorresistencia Bacteriana/genética , Enterotoxinas/genética , Femenino , Humanos , Mastitis Bovina/epidemiología , Ovinos , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/veterinaria , Staphylococcus aureus , Virulencia/genética , Factores de Virulencia/genética
13.
Croat Med J ; 63(2): 156-165, 2022 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-35505649

RESUMEN

AIM: To assess serotype distribution, antibiotic resistance, and vaccine coverage against Streptococcus pneumoniae causing invasive infections in Croatian adults from 2005 to 2019. METHODS: In this retrospective study, invasive pneumococcal strains were collected through a microbiological laboratory network with country coverage >95%. Capsular typing was performed with the Quellung reaction. In vitro susceptibility testing was carried out according to the European Committee on Antimicrobial Susceptibility Twating guidelines. In macrolide-resistant isolates, the presence of ermB and mefA genes was evaluated. RESULTS: During the fifteen-year study period, 1123 invasive pneumococcal isolates were obtained. The most prevalent serotypes were 3, 14, 19A, 9V, 7F, and 23F, comprising 60% of all invasive pneumococcal isolates. Serotype 3 was the dominant serotype, with the highest prevalence in patients ≥65 years of age. Penicillin susceptibility, increased exposure was 18.6%, mostly associated with serotypes 14 and 19A. Resistance to penicillin was low (<1%). Macrolide resistance was 23%, mostly associated with serotypes 14, 19A, and 19F. The coverage with 13-valent conjugate vaccine (PCV13) and 23-valent polysaccharide vaccine (PPV23) was 80.2% and 93.6%, respectively. CONCLUSIONS: The incidence of invasive pneumococcal disease in adults is highest in patients ≥65 years of age. Penicillin susceptibility, increased exposure and macrolide resistance were mostly associated with serotypes 14 and 19A. PCV13 and PPV23 provide very high serotype coverage. Future studies should evaluate the effects of the 10-valent vaccine, introduced in the Croatian National Immunization Program in June 2019, on serotype distribution and antibiotic resistance rates.


Asunto(s)
Antibacterianos , Streptococcus pneumoniae , Adulto , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Croacia/epidemiología , Farmacorresistencia Bacteriana/genética , Humanos , Macrólidos/farmacología , Pruebas de Sensibilidad Microbiana , Penicilinas/farmacología , Estudios Retrospectivos , Serogrupo , Serotipificación , Streptococcus pneumoniae/genética
14.
Bone Joint J ; 104-B(5): 575-580, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35491584

RESUMEN

Periprosthetic joint infection (PJI) is a difficult complication requiring a comprehensive eradication protocol. Cure rates have essentially stalled in the last two decades, using methods of antimicrobial cement joint spacers and parenteral antimicrobial agents. Functional spacers with higher-dose antimicrobial-loaded cement and antimicrobial-loaded calcium sulphate beads have emphasized local antimicrobial delivery on the premise that high-dose local antimicrobial delivery will enhance eradication. However, with increasing antimicrobial pressures, microbiota have responded with adaptive mechanisms beyond traditional antimicrobial resistance genes. In this review we describe adaptive resistance mechanisms that are relevant to the treatment of PJI. Some mechanisms are well known, but others are new. The objective of this review is to inform clinicians of the known adaptive resistance mechanisms of microbes relevant to PJI. We also discuss the implications of these adaptive mechanisms in the future treatment of PJI. Cite this article: Bone Joint J 2022;104-B(5):575-580.


Asunto(s)
Antiinfecciosos , Artritis Infecciosa , Infecciones Relacionadas con Prótesis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Artritis Infecciosa/tratamiento farmacológico , Farmacorresistencia Bacteriana , Humanos , Infecciones Relacionadas con Prótesis/tratamiento farmacológico
15.
Ned Tijdschr Geneeskd ; 1662022 03 14.
Artículo en Holandés | MEDLINE | ID: mdl-35499541

RESUMEN

OBJECTIVE: Description of the changing patterns of antibiotic resistance in Helicobacter pylori infection in the Netherlands. DESIGN: Retrospective database study using the Dutch infectious disease surveillance information system-antibiotic resistance (ISIS-AR). METHOD: In the ISIS-AR database antibiotic resistance data are reported by 46 microbiologic laboratories in the Netherlands. For the present study, data from 16 centres were used with a 10 year period of reporting H. pylori resistance data, from 1 January 2010 till 1 January 2020, for amoxycillin, levofloxacin, claritrhromycin, tetracyclin and metronidazole. RESULTS: In 2019 Antimicrobial resistance rates in the Netherlands were 1% for tetracycline, 5% for amoxycillin, 23%% for levofloxacin, 46% for metronidazole and 47% for clarithromycin. The combined resistance rate for clarithromycin and metronidazole was 29%. Significantly higher resistance rates were found in female patients for amoxycillin (8% vs 1%), clarithromycin (53% vs 38%) and metronidazole (52% vs 38%). From 2010 to 2019, a significant rise in resistance rates was found for amoxycillin (0% - 5%), clarithromycin (7% - 40%), metronidazole (14% - 45%) and for the clarithromycin and metronidazole combination (2% - 29%). CONCLUSION: There was an important rise in antibiotic resistance rates in H. pylori in the Netherlands. For optimal H. pylori treatment bismuth-based therapies should become available again in the Netherlands. Treatment of H. pylori should be based on the individual antibiotic resistance profile and be in concordance with the principles of antibiotic stewardship. Guidelines for treatment of H. pylori in the Netherlands should be adapted and have a better correlation with International guidelines and best practices.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Amoxicilina , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Claritromicina/farmacología , Claritromicina/uso terapéutico , Farmacorresistencia Bacteriana , Femenino , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , Humanos , Levofloxacino , Metronidazol/farmacología , Metronidazol/uso terapéutico , Países Bajos/epidemiología , Estudios Retrospectivos
16.
Trop Biomed ; 39(1): 150-159, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-35507938

RESUMEN

The poultry industry is a major contributor to the Philippine economy. Given the rising concerns in antibiotic resistance and food security, farmers need to maximize profit and output while ensuring safe and ecologically sustainable farming practices. This study surveyed antibiotic use in 12 commercial poultry farms in the Philippines. All farms reported the use of medically important antibiotics either for prophylaxis (91.67%), metaphylaxis (100%), and growth promotion (50%). Considering the widespread use of medically important antibiotics, we then investigated the potential contribution of local antibiotic treatment protocols to the emergence of antibiotic resistance genes in the fecal samples of broiler chickens under a controlled experimental setup. Significantly, we observed the emergence of antibiotic resistance genes ( ermB) in fecal samples of antibiotic-treated broilers after 7 days and 21 days in antibiotic-free broilers raised in the same farming environment. These data were corroborated by antibiotic resistance gene profiles of fecal samples from commercial poultry farms. Antibiotic resistance genes ( tetA, tetB, tetU, tetW, qnrB, qnrS) were prevalent in the fecal samples of antibiotic-treated broilers treated with tetracycline and quinolone antibiotics. Therefore, our study provides concrete evidence for the strong correlation between the use of medically important antibiotics in poultry farming and the emergence of antibiotic resistance genes. Antimicrobial resistance is a major contributor to failures in infectious disease treatment strategies in humans and animals. Therefore, the cost-benefit ratio of poorly regulated antibiotic treatment protocols in poultry farming could have a long-term detrimental impact on our economy and public health. Our study suggests the need to review our current policies and practices in using medically important antibiotics in the Philippine poultry industry.


Asunto(s)
Antibacterianos , Pollos , Agricultura , Animales , Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Granjas , Filipinas , Aves de Corral
17.
Elife ; 112022 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-35535492

RESUMEN

Genetic modifications, such as gene deletion and mutations, could lead to significant changes in physiological states or even cell death. Bacterial cells can adapt to diverse external stresses, such as antibiotic exposure, but can they also adapt to detrimental genetic modification? To address this issue, we visualized the response of individual Escherichia coli cells to deletion of the antibiotic resistance gene under chloramphenicol (Cp) exposure, combining the light-inducible genetic recombination and microfluidic long-term single-cell tracking. We found that a significant fraction (∼40%) of resistance-gene-deleted cells demonstrated a gradual restoration of growth and stably proliferated under continuous Cp exposure without the resistance gene. Such physiological adaptation to genetic modification was not observed when the deletion was introduced in 10 hr or more advance before Cp exposure. Resistance gene deletion under Cp exposure disrupted the stoichiometric balance of ribosomal large and small subunit proteins (RplS and RpsB). However, the balance was gradually recovered in the cell lineages with restored growth. These results demonstrate that bacterial cells can adapt even to lethal genetic modifications by plastically gaining physiological resistance. However, the access to the resistance states is limited by the environmental histories and the timings of genetic modification.


Asunto(s)
Antibacterianos , Proteínas de Escherichia coli , Adaptación Fisiológica/genética , Antibacterianos/farmacología , Cloranfenicol/farmacología , Farmacorresistencia Bacteriana/genética , Farmacorresistencia Microbiana , Escherichia coli/fisiología , Proteínas de Escherichia coli/genética
18.
Indian J Ophthalmol ; 70(5): 1513-1521, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35502016

RESUMEN

Patients with ocular infections are at increased risk of vision impairment and may require immediate medical care to preserve their vision. Management of ocular bacterial infections has evolved in recent years and includes a pragmatic selection of broad-spectrum antibiotics based on the causative bacteria. Nevertheless, the treatment of bacterial ocular infections is increasingly becoming a challenge, as the causative bacterium acquires resistance to antibiotics through intrinsic and acquired methods. From an Indian perspective, along with the challenges of antibiotic resistance, there are other factors such as lack of knowledge on epidemiology, and lack of data on local susceptibility patterns of ocular pathogens that have significant impact on the management of ocular infections. This narrative review summarizes the available knowledge on prescribing antibiotics for five common ocular infections in India. It further highlights the significance of the understanding of antimicrobial susceptibility patterns across India as a cornerstone to promote rational use of ocular antibiotics. This review indicates that large-scale antimicrobial resistance surveillance studies can facilitate the synchronization of ophthalmic antimicrobial prescription policies with local antibiotic resistance patterns. Further, establishment of an antimicrobial stewardship program in ophthalmology can potentially increase the efficacy of diagnostic tools, and implement earlier adoption of effective antibiotics. Overall, this review provides consolidated information and key considerations for treatment decision-making of common ocular infections in India.


Asunto(s)
Antiinfecciosos , Programas de Optimización del Uso de los Antimicrobianos , Infecciones Bacterianas del Ojo , Infecciones del Ojo , Antibacterianos/uso terapéutico , Bacterias , Farmacorresistencia Bacteriana , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Bacterianas del Ojo/epidemiología , Humanos
19.
Drug Deliv ; 29(1): 1007-1024, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35363104

RESUMEN

This review provides a synthesis of the last ten years of research on nanodelivery systems used for the delivery of essential oils (EOs), as well as their potential as a viable alternative to antibiotics in human and veterinary therapy. The use of essential oils alone in therapy is not always possible due to several limitations but nanodelivery systems seem to be able to overcome these issues. The choice of the essential oil, as well as the choice of the nanodelivery system influences the therapeutic efficacy obtained. While several studies on the characterization of EOs exist, this review assesses the characteristics of the nanomaterials used for the delivery of essential oils, as well as impact on the functionality of nanodelivered essential oils, and successful applications. Two classes of delivery systems stand out: polymeric nanoparticles (NPs) including chitosan, cellulose, zein, sodium alginate, and poly(lactic-co-glycolic) acid (PLGA), and lipidic NPs including nanostructured lipid carriers, solid lipid NPs, nanoemulsions, liposomes, and niosomes. While the advantages and disadvantages of these delivery systems and information on stability, release, and efficacy of the nanodelivered EOs are covered in the literature as presented in this review, essential information, such as the speed of emergence of a potential bacteria resistance to these new systems, or dosages for each type of infection and for each animal species or humans is still missing today. Therefore, more quantitative and in vivo studies should be conducted before the adoption of EOs loaded NPs as an alternative to antibiotics, where appropriate.


Asunto(s)
Quitosano , Aceites Volátiles , Animales , Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Aceites Volátiles/farmacología , Polímeros/química
20.
Front Cell Infect Microbiol ; 12: 839257, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35444955

RESUMEN

Objectives: This is a comparative cohort study aiming to evaluate the mortality risk factors for patients with nosocomial meningitis (NM) induced by multidrug-resistant Enterobacteriaceae (MDRE) in China. The clinical features and therapies of patients and the resistance mechanisms of MDRE pathogens were also assessed. Methods: MDRE-NM patients from two neurosurgical centers in China from 2014 to 2019 were included in this study. Clinical features were extracted from the medical record databases of the two centers. The molecular mechanisms underlying the microbiological resistance mechanisms of each MDRE pathogen were determined, Kaplan-Meier survival analysis was conducted, and multivariable analyses were performed using a Cox proportional hazard model. Results: Ninety MDRE-NM patients were included in this study. Klebsiella pneumoniae accounted for the highest proportion of causative pathogens (46/90, 51.1%), and 40 causative pathogens (44.4%) were meropenem-resistant. blaKPC (27/40, 67.5%) was the predominant carbapenem resistance gene. Multivariate Cox analysis showed that external ventricular drainage (EVD) [hazard ratio (HR) = 2.524, 95% confidence interval (CI) = 1.101-5.787, p = 0.029] and a Glasgow Coma Scale (GCS) score ≤;8 (HR = 4.033, 95% CI = 1.526-10.645, p = 0.005) were mortality risk factors for patients with MDRE-NM. A total of 90.0%, 94.4%, and 97.8% of MDRE-NM patients received antibiotic prophylaxis (AP), antibiotic empirical therapy (AET), and antibiotic definitive therapy (ADT), respectively. Conclusions: NM caused by MDRE is an important sign of the failure of neurosurgery. MDRE possesses multiple drug resistance genotypes, and EVD and a GCS score ≤;8 are independent mortality risk factors for patients with MDRE-NM, which deserve the attention of microbiologists and neurosurgical clinicians.


Asunto(s)
Infección Hospitalaria , Fiebre Hemorrágica Ebola , Meningitis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , China/epidemiología , Estudios de Cohortes , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana , Farmacorresistencia Bacteriana Múltiple/genética , Enterobacteriaceae/genética , Humanos , Estudios Longitudinales , Pruebas de Sensibilidad Microbiana
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...