The photo-based treatment technology simultaneously removes resistant bacteria and resistant genes from wastewater.

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.

Impact of residual antibiotics on microbial decomposition of livestock manures in Eutric Regosol: Implications for sustainable nutrient recycling and soil carbon sequestration.

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.

Antimicrobial Prescription Patterns for Acute Sinusitis 2015-2022: A Comparison to Published Guidelines.

BACKGROUND: Acute rhinosinusitis (ARS) is one of the most encountered conditions in primary care and otolaryngology clinics. However, little is known about how antibiotic prescription practices following a diagnosis of ARS compare to guidelines set forth by the American Academy of Otolaryngology in 2015. OBJECTIVE: To investigate the epidemiology of ARS and the corresponding antibiotic prescribing practices by physicians and compare to published guidelines. METHODS: Using the TriNetX Live database, we identified all patients diagnosed with ARS using the ICD10 code J01 between April 2015 and December 2022 across the state of Tennessee. After investigating the demographics of this cohort, we compared the first prescribed antibiotic within one day of ARS diagnosis to published guidelines. Antibiotics were grouped into their respective classes. RESULTS: Of 81 310 patients diagnosed with ARS identified in the specified time frame, 66% were Female, 49% were African American, 44% were White, and the mean age was 47 ± 20 years. The six most common initial antibiotics prescribed for ARS were erythromycins/macrolides [14 609 (25.8%)], amoxicillin/clavulanate [14 322 (25.3%)], amoxicillin [9300 (16.4%)], third generation cephalosporins [7733 (13.6%)], quinolones [3648 (6.4%)] and tetracyclines [2235 (3.9%)]. Of this cohort, 56 719 patients (69.8%) of patients were prescribed an antibiotic within one day of diagnosis. CONCLUSION: Despite published guidelines recommending amoxicillin with or without clavulanic acid as first-line treatment for ARS, only 42.2% of prescribed antibiotics followed this guideline in our cohort. While accounting for patients with penicillin allergy, the second-most represented antibiotics were erythromycins/macrolides, which are specifically recommended against due to high rates of S. Pneumoniae resistance. Our results suggest that further investigation into the causes of erythromycin/macrolide prescriptions as first line treatment for ARS and practices at other institutions should be conducted. In addition, building awareness around published ARS guidelines for physicians may be useful in improving antibiotic stewardship in treatment of ARS.

Heat-Killed Lactobacillus acidophilus Promotes Growth by Modulating the Gut Microbiota Composition and Fecal Metabolites of Piglets.

Probiotics can improve animal growth performance and intestinal health. However, understanding the effects of paraprobiotics on the growth performance and gut microbiota of piglets and how the paraprobiotics exert their impact are still limited. The present study was conducted to investigate the effects of heat-killed Lactobacillus acidophilus IFFI 6005 supplementation on the growth performance, intestinal microbiota, and fecal metabolites of piglets. First, a feed-additive sample of heat-killed Lactobacillus acidophilus IFFI 6005 was prepared by culture. Second, 96 (initial BW = 14.38 ± 0.67 kg, weaning age of 40 days) healthy piglets were selected and randomized into four treatment groups. Each treatment group consisted of three replicates (n = 8). Pigs were fed a basal diet (NC), basal diet plus antibiotics (PC), basal diet plus Lactobacillus acidophilus IFFI 6005 at 600 g/t (LA, 1.0 × 1010 cfu/g), and basal diet plus heat-killed Lactobacillus acidophilus IFFI 6005 at 600 g/t (HKLA), respectively; the trial lasted for 30 days. The results showed that the ratios of feed to gain (F:G) and diarrhea rate of both the HKLA and PC groups were significantly lower compared with the NC and LA groups (p < 0.05); however, there was no significant difference between the HKLA and PC group (p > 0.05). In addition, the average daily weight gain (ADG) of the HKLA group was significantly higher (p < 0.05) than that of the other three groups in terms of growth performance. Finally, 16S rRNA sequencing and metabolome analysis based on fecal samples further elaborated that the addition of heat-killed Lactobacillus acidophilus IFFI 6005 to the feed improved the intestinal microbial diversity and abundance (p < 0.05) and reduced the abundance of pathogenic bacteria (p < 0.05), but it did not affect the abundance of Lactobacillus (p > 0.05). Through the comparison of microbial abundance and metabolite content between the two groups (NC_vs_HKLA), the largest differences were found in six microorganisms and 10 metabolites in the intestine (p < 0.05). These differential metabolites were involved in the digestion, absorption and utilization of protein and starch, as well as in oxidative stress. In summary, addition of heat-killed Lactobacillus acidophilus IFFI 6005 as a new feed additive in piglets has beneficial effects on the growth performance, intestinal bacteria and metabolites, and can be used as an alternative to antibiotics.

Electrochemical Sensors for Antibiotic Detection: A Focused Review with a Brief Overview of Commercial Technologies.

Antimicrobial resistance (AMR) poses a significant threat to global health, powered by pathogens that become increasingly proficient at withstanding antibiotic treatments. This review introduces the factors contributing to antimicrobial resistance (AMR), highlighting the presence of antibiotics in different environmental and biological matrices as a significant contributor to the resistance. It emphasizes the urgent need for robust and effective detection methods to identify these substances and mitigate their impact on AMR. Traditional techniques, such as liquid chromatography-mass spectrometry (LC-MS) and immunoassays, are discussed alongside their limitations. The review underscores the emerging role of biosensors as promising alternatives for antibiotic detection, with a particular focus on electrochemical biosensors. Therefore, the manuscript extensively explores the principles and various types of electrochemical biosensors, elucidating their advantages, including high sensitivity, rapid response, and potential for point-of-care applications. Moreover, the manuscript investigates recent advances in materials used to fabricate electrochemical platforms for antibiotic detection, such as aptamers and molecularly imprinted polymers, highlighting their role in enhancing sensor performance and selectivity. This review culminates with an evaluation and summary of commercially available and spin-off sensors for antibiotic detection, emphasizing their versatility and portability. By explaining the landscape, role, and future outlook of electrochemical biosensors in antibiotic detection, this review provides insights into the ongoing efforts to combat the escalating threat of AMR effectively.

Efficacy of prophylactic antibiotics in the adjuvant treatment of alcohol-related liver disease (ALD): a Systematic review and meta-analysis: Prophylactic antibiotics in ALD.

INTRODUCTION AND OBJECTIVES: This research aims to evaluate the efficacy and safety of prophylactic antibiotics in patients with alcohol-related liver disease (ALD). MATERIALS AND METHODS: We systematically searched databases including PubMed, Embase, Cochrane, and Web of Science up to October 2023. Our scope encompassed the influence of prophylactic antibiotics on all-cause mortality, infection, variceal bleeding, hepatic encephalopathy (HE), hepatorenal syndrome (HRS), adverse events (AE), fungal infection, clostridioides difficile infection (CDI), and multidrug-resistant (MDR) bacterial infection. Additionally, total bilirubin, creatinine, platelet counts, and plasma endotoxin levels were also analyzed. RESULTS: After comprehensive selection, 10 studies with 974 participants were included for further analysis. The study demonstrated that prophylactic antibiotic therapy was associated with reductions in infection rates, HE incidence, variceal bleeding, and all-cause mortality. The treatment did not increase the incidence of AE, fungal infection, and CDI, but it did raise the MDR bacteria infection rate. The analysis revealed no significant protective effect of antibiotic prophylaxis on total bilirubin and creatinine levels. Furthermore, the administration of antibiotics led to marginal increases in platelet counts, a minor reduction in endotoxin concentrations, and a subtle enhancement in HRS; however, these changes did not reach statistical significance. CONCLUSIONS: Prophylactic antibiotic therapy was an effective and safe treatment for advanced ALD. To mitigate the risk of MDR bacterial infections, a strategy of selective intestinal decontamination could be advisable. Future investigations should prioritize varied ALD patient populations with extended follow-up periods and assorted antibiotic regimens to solidify the efficacy and safety of ALD treatments.

Tetracycline removal by immobilized indigenous bacterial consortium using biochar and biomass: Removal performance and mechanisms.

The significant influx of antibiotics into the environment represents ecological risks and threatens human health. Microbial degradation stands as a highly effective method for reducing antibiotic pollution. This study explored the potential of immobilized microbial consortia to efficiently degrade tetracycline. Concurrently, the suitability of different immobilization materials were assessed, with reed charcoal-immobilized consortia exhibiting the highest efficiency in removing tetracycline (92%). Similarly, wheat-bran-loaded bacterial consortia displayed a remarkable 11.43-fold increase in tetracycline removal compared with free consortia. Moreover, adding the carriers increased the nutrients, while the activities of both intracellular and extracellular catalases increased significantly post-immobilization, thus highlighting this enzyme's crucial role in tetracycline degradation. Finally, analysis of the microbial communities revealed the prevalence of Achromobacter and Parapedobacter, signifying their potential as key degraders. Overall, the immobilized consortia not only hold promise for application in the bioremediation of tetracycline-contaminated environment but also provide theoretical underpinnings for environmental remediation by microorganisms.

Target attainment of beta-lactam antibiotics and ciprofloxacin in critically ill patients and its association with 28-day mortality.

OBJECTIVES: This study aims to assess pharmacodynamic target attainment in critically ill patients and identify factors influencing target attainment and mortality outcomes. METHODS: We analysed data from the DOLPHIN trial. Beta-lactam and ciprofloxacin peak and trough concentration were measured within the first 36 h (T1) after initiation of treatment. The study outcome included the rate of pharmacodynamic target attainment of 100 % ƒT>1xEpidemiological cut-off value (ECOFF) for beta-lactams, and of fAUC0-24h/ECOFF>125 for ciprofloxacin at T1. RESULTS: The target attainment rates were 78.1 % (n = 228/292) for beta-lactams, and 41.5 % (n = 39/94) for ciprofloxacin, respectively. Lower estimated glomerular filtration rate and higher SOFA score were associated with target attainment. In patients receiving beta-lactams, 28-day mortality was significantly higher in patients who attained 100 % ƒT>1xECOFF (28.9 % vs. 12.5 %; p = 0.01). In the multivariate analysis, attainment of 100 % ƒT>4xECOFF, but not 100 % ƒT>1xECOFF, was associated with a higher 28-day mortality (OR 2.70, 95 % CI 1.36-5.48 vs. OR 1.28, 95 % CI 0.53-3.34). CONCLUSIONS: A high rate of target attainment (100 % ƒT>1xECOFF) for beta-lactams and a lower rate for ciprofloxacin was observed. Achieving exposures of 100 % ƒT>4xECOFF was associated with 28-day mortality. The impact of antibiotic target attainment on clinical outcome needs to be a focus of future research.

Clinical predictors of hospital-acquired bloodstream infections: A healthcare system analysis.

INTRODUCTION: This study was performed to identify patient factors associated with hospital-acquired bloodstream infections (HABSI) to guide blood culture collection and empiric antibiotic therapy. METHODS: A retrospective case-control study reviewed the medical records of 350 patients admitted to our health system from September 2017 to April 2020. The patients were 18 years and older and had at least one set of new positive non-contaminant blood cultures collected after 48 hours of admission, defined as HABSI. We developed clinical variables through a literature review associated with it. Univariate relationships between each variable and bacteremia were evaluated by chi-square test. A predictive model was developed through stepwise multivariate logistic regression. RESULTS: The univariate analysis and stepwise regression analysis showed that temperature >100.4° F (OR: 1.9, CI 1.1 to 3.4), male sex (OR: 1.8, CI 1.0 to 3.0), and platelet count <150,000/µL (OR: 1.8, CI 1.0 to 3.2) were statistically associated with a positive blood culture. CONCLUSIONS: This model helps identify patients with clinical characteristics associated with the likelihood of HABSI. This model can help guide the appropriate initiation of empiric antibiotics in clinical situations and assist with antibiotic stewardship.

Multifunctional SERS Substrate for Simultaneous Detection of Multiple Contaminants and Photothermal Removal of Pathogenic Bacteria.

In this work, a boric-acid-modified Fe3O4@Au@BA-MOF composite material as a multifunctional SERS substrate was ingeniously constructed for detecting both pathogens and antibiotics as well as photothermally inactivating the pathogens. Through improving the dispersity and stability of gold nanoparticles (Au NPs), leveraging the specificity of boric acid (BA) groups in recognizing cis-diol structures, and the ability of SERS technology to provide unique fingerprint spectra of targets, the sensitive and stable detection of pathogens and antibiotics was achieved. Compared with Au NPs and Fe3O4@Au, the SERS enhancement factor of Fe3O4@Au@BA-MOF was 4.31 × 106, which was about 400 times and 16 times higher than the former two, respectively. Among the existing work, the limit of detection for pathogens was lower or comparable, and it exhibited good stability, maintaining consistent performance for 23 days. Additionally, this substrate achieved efficient photothermal inactivation of pathogens under both near-infrared light and natural light excitation. Within 8 min of near-infrared light irradiation, the bactericidal rates for Staphylococcus aureus and Escherichia coli reach 100% and 99.3%, respectively.

Associating prenatal antibiotics exposure with attention deficit hyperactivity disorder symptoms in preschool children: The role of maternal vitamin D.

BACKGROUND: The associations between prenatal antibiotics exposure and attention-deficit/hyperactivity disorder (ADHD) in preschoolers, and the role of maternal vitamin D in these associations, remain to be explored. OBJECTIVES: To evaluate the relationships between multiple maternal urinary antibiotics levels and preschoolers' ADHD symptoms, and to identify the potential modifying effects of maternal vitamin D. METHODS: Based on a prospective birth cohort, the present study included 2033 motherchild pairs. Maternal urine and serum samples were collected during all three trimesters to measure the urinary concentrations of 43 antibiotics (including two metabolites) and the serum vitamin D levels. The ADHD symptoms of preschoolers were assessed using the Diagnostic and Statistical Manual-oriented ADHD problems scale in the Achenbach Child Behavior Checklist. Multiple informant models in the form of logistic regression were conducted to investigate the associations between prenatal antibiotics exposure and preschooler ADHD symptoms, and these associations were stratified by child sex and maternal vitamin D status. RESULTS: Compared with the lowest tertile concentrations, maternal exposure to the middle tertile concentrations of doxycycline and human antibiotics/preferred as human antibiotics (HAs/PHAs), and the highest tertile concentrations of doxycycline during the first trimester were associated with an increased risk of ADHD symptoms in children. An increased risk of ADHD symptoms was observed in girls exposed to the highest tertile levels of sulfamethazine during the second trimester. Furthermore, pregnant women with vitamin D deficiency have a greater risk of ADHD symptoms in their offspring after exposure to doxycycline in the first trimester. CONCLUSIONS: Maternal exposure to doxycycline and HAs/PHAs during the first trimester increases the risk of ADHD symptoms in preschoolers. Mid-pregnancy sulfamethazine exposure increases the risk of ADHD symptoms in girls. Maternal vitamin D deficiency during pregnancy may exacerbate the adverse effects of doxycycline exposure on ADHD symptoms.

Genomic Insights into Prevalence of Virulence and Multi Drug Resistance Genes in Milk Borne Klebsiella pnuemoniae: Face of Emerging Resistance to Last Resort Antibiotics.

Spread of hypervirulent and multi-drug resistant Klebsiella pneumoniae in raw milk is public health concern due to its potential impact on food safety and public health. Therefore, this study investigated antibiotic susceptibility test (AST), antibiotic resistance genes (ARGs), mutations conferring ARGs, virulence factor and plasmid replicons to check prevalence of fosfomycin resistant MDR K. pneumoniae isolated from raw milk samples collected from Saurashtra region of Gujarat, India. K. pneumoniae isolated from raw milk and subjected to disk diffusion assay. From that, MDR along with fosfomycin resistant isolates were analysed for multi locus sequence typing, presence of ARGs, mutations conferring resistance, virulence factors and plasmid replicon types by using its whole genome sequence. Results shows that, among 32K. pneumoniae, 8 were phenotypically resistant to fosfomycin. As per WGS analysis, 8 MDR isolates were assigned into different sequence types such as ST3321, ST37, ST2715, ST1087, ST3157, ST299 and ST29. Among that, ST37 is well recognized MDR high risk clone reported worldwide and first time reported from raw milk of Saurashtra region of Gujarat, India. ARGs responsible for resistance to fosfomycin (fosA) were found in all 8 isolates. Other ARGs such as blaSHV, kdeA, OqxA, OqxB, dfrA1, sul1, qnrB4, aadA2 and ere(A) were also detected. High diversity of virulence factors was also identified by detection of genes encoding virulence factors related to iron uptake such as entE, fepD, entA, entB, Irp2, fepG, ybtU, ybtP, fepC, ybtA, ybtE, fepB, ybtS, fyuA, ybtQ, ybtT, ybtX, Irp1, adherence such as yagZ/ecpA, yagV/ecpE, yagX/ecpC, yagV/ecpE, ykgK/ecpR and invasion such as fimA, pla, fimC, fimH, fimB, fimE were detected in eight genomes. Mutations in murA, uhpT and glpT conferring a fosfomycin resistance were also present in genomes of 8 K. pneumoniae. IncF was the most common plasmid replicon type detected in all 8 genomes. The study reports high diversity of virulent and multidrug resistant K. pneumoniae in raw milk. Hence, genomic surveillance plans are urgently required for food borne pathogens.

Quality of life and therapeutic adherence in patients treated for an orthopedic hardware infection: A prospective observational study.

OBJECTIVES: In France, hardware infections occur in 1% of patients following orthopedic surgery. The study aimed to evaluate the quality of life (QoL) and adherence to antibiotic therapy of patients with an orthopedic hardware infection in the postoperative period. PATIENTS AND METHODS: A prospective observational study was conducted at Rouen University Hospital from May 2022 to May 2023. QoL was evaluated using the Short Form Health Survey (SF-36) and therapeutic adherence using the Girerd questionnaire. These forms were filled out by patients during routine follow-up visits at 6- and 12-week follow-up. A cohort of patients with a non-hardware infection was constituted to compare cases and controls. They were paired according to age, sex, and site of index surgery. RESULTS: Seventy-nine patients were enrolled as cases and 158 patients as controls. At six weeks and at 12 weeks, significant decreases were observed in 8/8 and 4/8 sub scores of SF-36, respectively (p < 0.05). Among patients discharged to their homes, at 12 weeks, 30.4 % of patients reported high therapeutic adherence compared to 66.7 % of patients discharged to postoperative care. CONCLUSION: Patients treated for postoperative hardware infections following orthopedic surgery reported a significant decrease in QoL and lower therapeutic adherence, particularly when discharged to their homes.

[Translated article] Therapeutic Drug Monitoring of antibiotic and antifungical drugs in paediatric and newborn patients. Consensus Guidelines of the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Paediatric Infectious Diseases (SEIP).

Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host. In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals-usually used off-label in paediatrics-to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the PK parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, paediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring. The aim of this document, developed jointly by the Spanish Society of Hospital Pharmacy and the Spanish Society of Paediatric Infectious Diseases, is to describe the available evidence on the indications for therapeutic drug monitoring (TDM) of antibiotics and antifungals in newborn and paediatric patients, and to provide practical recommendations for TDM in routine clinical practice to optimise their dosing, efficacy and safety. Of antibiotics and antifungals in the paediatric population.

Spanish Society of Hospital Pharmacy and the Spanish Society of Pediatric Infectious Diseases (SEFH-SEIP) National Consensus Guidelines for therapeutic drug monitoring of antibiotic and antifungal drugs in pediatric and newborn patients. / Documento nacional de consenso de monitorización terapéutica de antibióticos y antifúngicos en el paciente pediátrico y neonatal de la Sociedad Española de Farmacia Hospitalaria (SEFH) y la Sociedad Española de Infectología Pediátrica (SEIP).

Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic parameters, is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised host. In neonates and children, infections account for a high percentage of hospital admissions and anti-infectives are the most used drugs. However, pediatric pharmacokinetic and pharmacodynamic studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals -usually used off-label in pediatrics- to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the pharmacokinetic parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, pediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring. The aim of this document, developed jointly between the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Pediatric Infectious Diseases (SEIP), is to describe the available evidence on the indications for therapeutic drug monitoring of antibiotics and antifungals in newborn and pediatric patients and to provide practical recommendations for therapeutic drug monitoring in routine clinical practice to optimize pharmacokinetic and pharmacodynamic parameters, efficacy and safety of antibiotics and antifungals in the pediatric population.

Detection of Sulfonamide Antibiotics Using an Elastic Hydrogel Microparticles-Based Optical Biosensor.

Sulfonamide antibiotics were the first synthetic antibiotics on the market and still have a broad field of application. Their extensive usage, wrong disposal, and limited degradation technologies in wastewater treatment plants lead to high concentrations in the environment, resulting in a negative impact on ecosystems and an acceleration of antibiotic resistance. Although lab-based analytical methods allow for sulfonamide detection, comprehensive monitoring is hampered by the nonavailability of on-site, inexpensive sensing technologies. In this work, we exploit functionalized elastic hydrogel microparticles and their ability to easily deform upon specific binding with enzyme-coated surfaces to establish the groundwork of a biosensing assay for the fast and straightforward detection of sulfonamide antibiotics. The detection assay is based on sulfamethoxazole-functionalized hydrogel microparticles as sensor probes and the biomimetic interaction of sulfonamide analytes with their natural target enzyme, dihydropteroate synthase (DHPS). DHPS from S. pneumoniae was recombinantly produced by E. coli and covalently coupled on a glass biochip using a reactive maleic anhydride copolymer coating. Monodisperse poly(ethylene glycol) hydrogel microparticles of 50 µm in diameter were synthesized within a microfluidic setup, followed by the oriented coupling of a sulfamethoxazole derivative to the microparticle surface. In proof-of-concept experiments, sulfamethoxazole, as the most used sulfonamide antibiotic in medical applications, was demonstrated to be specifically detectable above a concentration of 10 µM. With its straightforward detection principle, this assay has the potential to be used for point-of-use monitoring of sulfonamide antibiotic contaminants in the environment.

The impact of clinical audit on antibiotic prescribing in dental practice at Taibah University Dental Hospital.

There is evidence that antibiotics are sometimes prescribed inappropriately by dental practitioners, which can lead to undesirable outcomes. This study aimed to assess the impact of a clinical audit on antibiotic prescribing practices at Taibah University Dental Hospital in Madina, Saudi Arabia. The study retrospectively analyzed antibiotic-prescribing data for pediatric patients by dental interns and faculty members over a period of 8-months. The data collected revealed that inappropriate antibiotic prescription was prevalent initially, with a total of 119 antibiotic-prescriptions issued. After implementing an action plan that included the use of guidelines and educational sessions, a second cycle of the audit was conducted over a 4-month period. During the second cycle, the number of antibiotic prescriptions significantly decreased to 58, indicating a reduction of 48%. Across both cycles, amoxicillin emerged as the most frequently prescribed antibiotic, closely followed by Augmentin. Notably, pulpal diseases and peri-radical complications were consistently ranked as the conditions with the highest number of antibiotic prescriptions in both study periods. The results suggest that the clinical audit, along with the implementation of guidelines and educational sessions, had a positive impact on antibiotic prescribing practices at Taibah University Dental Hospital, leading to a significant reduction in inappropriate antibiotic prescriptions.

Azithromycin Prevents Subglottic Stenosis in Mice.

OBJECTIVE: Pediatric subglottic stenosis (SGS) is characterized by subglottic narrowing which occurs when pathological fibroblasts deposit extracellular matrix that reduces airway patency. Recent clinical observations have suggested that azithromycin may have favorable impacts on SGS reduction while treating airway infections; furthermore, our recent work in mice demonstrated that the airway microbiome influences SGS. In this work, we characterize the protective effect of azithromycin as an immunomodulatory and antibacterial therapeutic against subglottic stenosis. METHODS: Immunomodulatory and antifibrotic effects of azithromycin were assessed on TGF-ß1-stimulated airway fibroblasts at 10 µg/mL for 5 days. Changes in gene expression were quantified by RT-qPCR and myofibroblast differentiation by α-SMA immunostaining. Murine airways were pretreated (2-weeks) with intranasal azithromycin before SGS injury by a twisted wire brush. Disease severity and immune response were characterized by histology and immunostaining for immune cells. RESULTS: In vitro, azithromycin treatment of TGF-ß1-stimulated fibroblasts exhibited strong reductions in extracellular matrix (COL1A1, LOX) and myofibroblast-related gene expression (ACTA2). Notably, there was a significant reduction in pro-fibrotic expression, which was observed with 10 µg/mL azithromycin. Immunostaining of fibroblasts for α-SMA revealed strong reductions in the number of positive-staining cells and the intensity of each positive cell. In vivo, azithromycin exhibited a significant decrease in lamina propria thickness indicative of reduced stenosis with associated changes in T-cell infiltration. CONCLUSIONS: Overall, we show azithromycin prevents pro-fibrotic gene expression and myofibroblast differentiation and can help protect mice from developing SGS. This introduces azithromycin as a potential treatment for SGS. LEVEL OF EVIDENCE: NA Laryngoscope, 2024.

Occurrence and risk assessment of quinolones and sulfonamides in freshwater aquaculture ponds in Northeast Zhejiang, China.

Antibiotics play an essential role in the aquaculture industry, but their overuse and weak degradability inevitably lead to light to severe residues in natural and aquaculture environments. Most studies were interested in the occurrence, distribution, and ecological risks of a limited number of antibiotics in natural environments (rivers, lakes, and coastal regions) with a minor focus on antibiotic presence in either water, sediments, or organisms in aquaculture environments located in specific regions. In this study, we conducted a comprehensive investigation into the occurrence and distribution of up to 32 antibiotics [including 15 quinolones (QNs) and 17 sulfonamides (SAs)] in organisms and their corresponding environmental matrices from 26 freshwater aquaculture ponds in Northeast Zhejiang, China. A total of 13, 9, 7, and 7 antibiotics were detected in pond water, sediments, feeds, and aquaculture organisms, respectively, with concentration ranges of 0.6-92.2 ng/L, 0.4-1169.3 ng/g dw,

The effect of combinations of a glyphosate-based herbicide with various clinically used antibiotics on phenotypic traits of Gram-negative species from the ESKAPEE group.

The emission of glyphosate and antibiotic residues from human activities threatens the diversity and functioning of the microbial community. This study examines the impact of a glyphosate-based herbicide (GBH) and common antibiotics on Gram-negative bacteria within the ESKAPEE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli). Ten strains, including type and multidrug-resistant strains for each species were analysed and eight antibiotics (cefotaxime, meropenem, aztreonam, ciprofloxacin, gentamicin, tigecycline, sulfamethoxazole-trimethoprim, and colistin) were combined with the GBH. While most combinations yielded additive or indifferent effects in 70 associations, antagonistic effects were observed with ciprofloxacin and gentamicin in five strains. GBH notably decreased the minimum inhibitory concentration of colistin in eight strains and displayed synergistic activity with meropenem against metallo-ß-lactamase (MBL)-producing strains. Investigation into the effect of GBH properties on outer membrane permeability involved exposing strains to a combination of this GBH and vancomycin. Results indicated that GBH rendered strains sensitive to vancomycin, which is typically ineffective against Gram-negative bacteria. Furthermore, we examined the impact of GBH in combination with three carbapenem agents on 14 strains exhibiting varying carbapenem-resistance mechanisms to assess its effect on carbapenemase activity. The GBH efficiently inhibited MBL activity, demonstrating similar effects to EDTA (ethylenediaminetetraacetic acid). Chelating effect of GBH may have multifaceted impacts on bacterial cells, potentially by increasing outer membrane permeability and inactivating metalloenzyme activity.