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1.
Expert Rev Anti Infect Ther ; 18(10): 1005-1020, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32538209

RESUMO

INTRODUCTION: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged in China. There are no available vaccines or antiviral drugs for COVID-19 patients. Herein, we represented possible therapeutic agents that may stand as a potential therapy against COVID-19. AREAS COVERED: We searched PubMed, Google Scholar, and clinicaltrials.gov for relevant papers. We showed some agents with potentially favorable efficacy, acceptable safety as well as good pharmacokinetic profiles. Several therapies are under assessment to evaluate their efficacy and safety for COVID-19. However, some drugs were withdrawn due to their side effects after demonstrating some clinical efficacy. Indeed, the most effective therapies could be organ function support, convalescent plasma, anticoagulants, and immune as well as antiviral therapies, especially anti-influenza drugs due to the similarities between respiratory viruses regarding viral entry, uncoating, and replication. We encourage giving more attention to favipiravir, remdesivir, and measles vaccine. EXPERT OPINION: A combination, at least dual or even triple therapy, of the aforementioned efficacious and safe therapies is greatly recommended for COVID-19. Further, patients should have a routine assessment for their coagulation and bleeding profiles as well as their inflammatory and cytokine concentrations.


Assuntos
Anti-Infecciosos/uso terapêutico , Betacoronavirus/genética , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Anti-Infecciosos/classificação , Humanos , Pandemias
2.
Vet Clin North Am Food Anim Pract ; 36(2): 487-496, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32451037

RESUMO

Bovine respiratory disease (BRD) is often attributed to complex interactions between the host, pathogen, and the environment. Likewise, many BRD treatment failures result from interactions between the host, pathogen, environment, drug, and drug administrator. Investigating and addressing the underlying causes of BRD treatment failures can improve clinical outcomes and animal welfare of future cases, improve morale of employees, reduce direct costs of dealing with BRD treatment failures, refine antimicrobial prescribing practices, and advance antimicrobial stewardship. This article discusses these interactions and provides guidance to veterinary practitioners on evaluating the success of treatment protocols.


Assuntos
Anti-Infecciosos/administração & dosagem , Complexo Respiratório Bovino/tratamento farmacológico , Animais , Anti-Infecciosos/classificação , Complexo Respiratório Bovino/microbiologia , Bovinos , Falha de Tratamento
3.
PLoS One ; 15(2): e0228555, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040513

RESUMO

Antimicrobial resistance is a growing global health concern. Antimicrobial stewardship (AMS) curbs resistance rates by encouraging rational antimicrobial use. However, data on antimicrobial stewardship in developing countries is scarce. The objective of this study was to characterize antimicrobial use at the University Teaching Hospital (UTH) in Lusaka, Zambia as a guiding step in the development of an AMS program. This was a cross-sectional, observational study evaluating antimicrobial appropriateness and consumption in non-critically ill adult medicine patients admitted to UTH. Appropriateness was defined as a composite measure based upon daily chart review. Sixty percent (88/146) of all adult patients admitted to the general wards had at least one antimicrobial ordered and were included in this study. The most commonly treated infectious diseases were tuberculosis, pneumonia, and septicemia. Treatment of drug sensitive tuberculosis is standardized in a four-drug combination pill of rifampicin, isoniazid, pyrazinamide and ethambutol, therefore appropriateness of therapy was not further evaluated. The most common antimicrobials ordered were cefotaxime (n = 45), ceftriaxone (n = 28), and metronidazole (n = 14). Overall, 67% of antimicrobial orders were inappropriately prescribed to some extent, largely driven by incorrect dose or frequency in patients with renal dysfunction. Antimicrobial prescribing among hospitalized patients at UTH is common and there is room for optimization of a majority of antimicrobial orders. Availability of certain antimicrobials must be taken into consideration during AMS program development.


Assuntos
Anti-Infecciosos/uso terapêutico , Gestão de Antimicrobianos , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/epidemiologia , Adulto , Antibacterianos/classificação , Antibacterianos/uso terapêutico , Anti-Infecciosos/classificação , Gestão de Antimicrobianos/organização & administração , Gestão de Antimicrobianos/normas , Gestão de Antimicrobianos/estatística & dados numéricos , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Farmácias/estatística & dados numéricos , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Zâmbia/epidemiologia
4.
Genes (Basel) ; 11(2)2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32024145

RESUMO

Antimicrobial peptides (AMPs) are evolutionarily ancient molecules that play an essential role in innate immunity across taxa from invertebrates to vertebrates. The evolution system of AMP system has not been well explained in the literature. In this study, we cloned and sequenced AMP transcriptomes of three frog species, namely Rana dybowskii, Rana amurensis, and Pelophylax nigromaculatus, which are partially sympatric in northeast Asia, but show different habitat preferences. We found that each species contained 7 to 14 families of AMPs and the diversity was higher in species with a large geographic range and greater habitat variation. All AMPs are phylogenetically related but not associated with the speciation process. Most AMP genes were under negative selection. We propose that the diversification and addition of novel functions and improvement of antimicrobial efficiency are facilitated by the expansion of family members and numbers. We also documented significant negative correlation of net charges and numbers of amino acid residues between the propiece and mature peptide segments. This supports the Net Charge Balance Hypothesis. We propose the Cut Point Sliding Hypothesis as a novel diversification mechanism to explain the correlation in lengths of the two segments.


Assuntos
Anti-Infecciosos/classificação , Peptídeos Catiônicos Antimicrobianos/classificação , Peptídeos Catiônicos Antimicrobianos/genética , Anuros/classificação , Evolução Molecular , Mutação , Sequência de Aminoácidos , Animais , Anti-Infecciosos/química , Anti-Infecciosos/metabolismo , Peptídeos Catiônicos Antimicrobianos/química , Anuros/genética , Ásia , Filogenia , Homologia de Sequência , Simpatria/genética , Transcriptoma
5.
Vet Microbiol ; 241: 108540, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31928695

RESUMO

Urinary tract infections (UTIs), many of which are caused by bacterial pathogens, are some of the most common infections in dogs. To effectively treat UTIs, it is important to identify the predominant bacterial pathogens and their susceptibility to antimicrobial agents. In this study, we collected 326 samples from cases with UTIs or other urinary system diseases at the China Agricultural University Veterinary Teaching Hospital, Beijing, from 2016-2018. In total, 129 non-duplicate bacterial isolates were recovered from 103 clinical samples. The proportion of positive female samples was higher than that of males. The predominant Gram-negative bacteria were Escherichia coli and Klebsiella spp., while Staphylococcus spp. were the predominant Gram-positive bacteria. Broth microdilution-based antimicrobial susceptibility testing showed that 39 % of E. coli and 51.5 % of Staphylococcus spp. isolates were multidrug-resistant. Specifically, E. coli isolates showed high rates of resistance to ampicillin (40.5 %), ceftazidime (59.5 %), and florfenicol (42.9 %), but limited resistance to amikacin (2.38 %), meropenem (7.14 %), and polymyxin E (7.14 %). In comparison, Staphylococcus spp. showed high rates of resistance to erythromycin (60.6 %), trimethoprim-sulfamethoxazole (54.6 %), and penicillin (45. 5 %), but low resistance rates to vancomycin (6.06 %) and nitrofurantoin (6.06 %). Pulsed-field gel electrophoresis (PFGE)-based typing identified 31 PFGE patterns among the 43 E. coli isolates. These results suggested that multiple bacterial strains, many of which are multidrug-resistant, can cause UTIs in dogs. Thus, basic antimicrobial susceptibility tests should be performed to provide guidance for the selection of first-line clinical therapeutics, and to help prevent the occurrence and spread of induced antimicrobial resistance.


Assuntos
Anti-Infecciosos/farmacologia , Doenças do Cão/microbiologia , Farmacorresistência Bacteriana , Infecções Urinárias/veterinária , Animais , Anti-Infecciosos/classificação , Bacteriúria/microbiologia , Bacteriúria/veterinária , Doenças do Cão/tratamento farmacológico , Cães , Eletroforese em Gel de Campo Pulsado/veterinária , Feminino , Bactérias Gram-Negativas/classificação , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/classificação , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana/veterinária , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia
6.
Life Sci Alliance ; 2(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31740563

RESUMO

Antimicrobial peptides (AMPs) are part of the innate immune response to pathogens in all of the kingdoms of life. They have received significant attention because of their extraordinary variety of activities, in particular, as candidate drugs against the threat of super-bacteria. A systematic study of the relation between the sequence and the mechanism of action is urgently needed, given the thousands of sequences already in multiple web resources. ADAPTABLE web platform (http://gec.u-picardie.fr/adaptable) introduces the concept of "property alignment" to create families of property and sequence-related peptides (SR families). This feature provides the researcher with a tool to select those AMPs meaningful to their research from among more than 40,000 nonredundant sequences. Selectable properties include the target organism and experimental activity concentration, allowing selection of peptides with multiple simultaneous actions. This is made possible by ADAPTABLE because it not only merges sequences of AMP databases but also merges their data, thereby standardizing values and handling non-proteinogenic amino acids. In this unified platform, SR families allow the creation of peptide scaffolds based on common traits in peptides with similar activity, independently of their source.


Assuntos
Anti-Infecciosos/química , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos/farmacologia , Sequência de Aminoácidos , Anti-Infecciosos/classificação , Peptídeos Catiônicos Antimicrobianos/classificação , Bactérias/metabolismo , Bases de Dados Factuais , Bases de Dados de Proteínas
7.
N Z Med J ; 132(1501): 21-32, 2019 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-31465324

RESUMO

AIM: Outpatient parenteral antimicrobial therapy (OPAT) has become an established option for management infections requiring intravenous therapy. As the uptake of OPAT has increased, the clinical governance has changed and is now managed via virtual clinics and increased use of district nurses in addition to specialist outpatient review. The aim of this study was to report the characteristics, diagnoses, treatment and outcomes of patients managed by the service over 12 months in 2015/6 and compared these features with those of patients treated with OPAT in 1999. METHODS: Cases for 2015/6 were identified from the OPAT service database which records prospectively all information on diagnosis, antibiotic choice and duration of treatment, complications and requirement for review by the ID physicians and OPAT nurses prospectively. The outcomes, complications and readmissions were found by reviewing computerised records of Christchurch Hospital. All results were entered into a Microsoft® Excel database for analysis. Statistical analyses were performed using OpenEpi software. Data for 1999 was taken from an earlier publication. RESULTS: OPAT treatment in 12 months from 1 July 2015 was administered 407 times to 385 patients, which represented a 2.7 times increase in treatment courses than in 1999. The median age was 55 years in 1999 and 61 in 2015/6. There was a substantial increase in the proportion of bone and joint, abdominal and urinary tract infections but a fall in cellulitis and soft tissue infection. The number and proportion of patients treated with broad spectrum agents including piperacillin + tazobactam, ceftriaxone and carbapenems increased from 1% in 1999 to 20% in 2015/6. Unplanned readmission to hospital increased from 15 (10%) in 1999 to 62 patients (15%) in 2015/6. The most common reason for readmission in 2015/6 was for ongoing symptoms or progression of the infection requiring OPAT. Eight patients (2%) required readmission from adverse reactions to antimicrobial therapy. Two patients on palliative care died while on OPAT and 35 (9%) within 12 months of the index admission. CONCLUSION: OPAT use has increased and is used to treat patients with comorbidities, who are older, and with a different case-mix than 1999. Safety has not been compromised but the risk of treatment failure has increased. A better understanding of the reasons for treatment failure would improve patient selection and management with OPAT.


Assuntos
Assistência Ambulatorial , Anti-Infecciosos , Doenças Ósseas Infecciosas/tratamento farmacológico , Supervisão de Enfermagem/organização & administração , Dermatopatias Infecciosas/tratamento farmacológico , Infecções dos Tecidos Moles/tratamento farmacológico , Assistência ao Convalescente/métodos , Idoso , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/efeitos adversos , Anti-Infecciosos/classificação , Feminino , Serviços de Assistência Domiciliar/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Avaliação de Processos e Resultados em Cuidados de Saúde , Readmissão do Paciente/estatística & dados numéricos , Autoadministração/métodos , Resultado do Tratamento
8.
Molecules ; 24(14)2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340530

RESUMO

Solidago species are often used in traditional medicine as anti-inflammatory, diuretic, wound-healing and antimicrobial agents. Still, the bioactive compounds and biological activities of some species have not been studied. The present work aimed to investigate the polyphenolic profile and the biological properties of Solidago graminifolia L. Salisb., a poorly explored medicinal plant. The hydroalcoholic extracts from aerial parts were evaluated for total phenolic content (TPC), total flavonoid content (TFC) and the polyphenolic compounds were investigated by HPLC-MS. The antioxidant potential in vitro was determined using DPPH and FRAP assays. Antibacterial and antifungal effects were evaluated by dilution assays and MIC, MBC and MFC were calculated. The results showed that Solidago graminifolia aerial parts contain an important amount of total phenolics (192.69 mg GAE/g) and flavonoids (151.41 mg RE/g), with chlorogenic acid and quercitrin as major constituents. The hydroalcoholic extracts showed promising antioxidant and antimicrobial potential, with potent antibacterial activity against Staphylococcus aureus and important antifungal effect against Candida albicans and C. parapsilosis. The obtained results indicated that the aerial parts of Solidago graminifolia could be used as novel resource of phytochemicals in herbal preparations with antioxidant and antimicrobial activities.


Assuntos
Anti-Infecciosos/isolamento & purificação , Antioxidantes/isolamento & purificação , Ácido Clorogênico/isolamento & purificação , Flavonoides/isolamento & purificação , Fenóis/isolamento & purificação , Quercetina/análogos & derivados , Solidago/química , Anti-Infecciosos/classificação , Anti-Infecciosos/farmacologia , Antioxidantes/classificação , Antioxidantes/farmacologia , Compostos de Bifenilo/antagonistas & inibidores , Candida albicans/efeitos dos fármacos , Candida albicans/crescimento & desenvolvimento , Candida parapsilosis/efeitos dos fármacos , Candida parapsilosis/crescimento & desenvolvimento , Clorofórmio/química , Ácido Clorogênico/farmacologia , Etanol/química , Flavonoides/classificação , Flavonoides/farmacologia , Metanol/química , Testes de Sensibilidade Microbiana , Fenóis/classificação , Fenóis/farmacologia , Picratos/antagonistas & inibidores , Componentes Aéreos da Planta/química , Extratos Vegetais/química , Quercetina/isolamento & purificação , Quercetina/farmacologia , Solventes/química , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento
9.
Poult Sci ; 98(11): 5456-5464, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31247639

RESUMO

The aim of the study was to evaluate the effects of a cashew nut shell oil and commercial castor oil blend (CNSL-Castor oil) on the performance and microbiota of broiler chickens with and without coccidiosis challenge. A total of 864 one-day-old male chicks (Cobb) were randomly distributed to receive 6 treatments (8 pens/treatment; 18 chicks/pen) in a 3 × 2 factorial, with 3 additives (control [non-additives], 100 ppm sodium monensin, or 0.15% CNSL-Castor oil blend), and 2 levels of coccidiosis challenge at 14 D of age (unchallenged or inoculated by gavage with 1 mL of solution containing oocysts sporulated with Eimeria tenella, Eimeria acervulina, and Eimeria maxima). No differences in productive performance were observed among treatments in the pre-challenge period and in unchallenged birds (P > 0.05). Seven-days post-challenge, birds receiving monensin performed better than birds in the positive control group (non-additive and challenge) or in the CNSL-Castor oil group (P > 0.05). However, 14 D post-challenge, birds supplemented with CNSL-Castor oil presented higher weight gain and better feed conversion (P > 0.05), without any change in feed intake (P > 0.05). During the accumulated period (1 to 42 D of age), the live weight, weight gain, and feed intake did not differ between the CNSL-Castor oil and monensin groups, both of which presented higher values than the positive control. Lactobacillus spp. and Clostridium perfringens numbers were increased in the challenged birds (P < 0.05). CNSL-Castor oil supplementation reduced Clostridium cluster XIV, C. perfringens, and S. aureus, compared with the monensin and control groups (P > 0.05). In addition, the CNSL-Castor oil group presented the highest number of Lactobacillus spp. copies, followed by the monensin and positive control groups (P > 0.05). Thus, monensin and CNSL-Castor oil effectively minimized the impact of coccidiosis at different times. While monensin acts as an antimicrobial, CNSL-Castor oil modulates the intestinal microbiota with antimicrobial action against gram-positive bacteria, mainly C. perfringens and S. aureus.


Assuntos
Anti-Infecciosos/farmacologia , Galinhas/imunologia , Microbioma Gastrointestinal/efeitos dos fármacos , Monensin/farmacologia , Óleos Vegetais/farmacologia , Anacardium/química , Ração Animal/análise , Animais , Anti-Infecciosos/classificação , Óleo de Rícino/farmacologia , Galinhas/crescimento & desenvolvimento , Galinhas/microbiologia , Galinhas/fisiologia , Coccidiose/imunologia , Coccidiose/veterinária , Dieta/veterinária , Suplementos Nutricionais/análise , Eimeria/fisiologia , Masculino , Doenças das Aves Domésticas/imunologia , Distribuição Aleatória
10.
Comput Biol Med ; 107: 172-181, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30831306

RESUMO

Due to increase in antibiotic resistance in recent years, development of efficient and accurate techniques for discovery and design of biologically active peptides such as antimicrobial peptides (AMPs) has become essential. The screening of natural and synthetic AMPs in the wet lab is a challenge due to time and cost involved in such experiments. Bioinformatics methods can be used to speed up discovery and design of antimicrobial peptides by limiting the wet-lab search to promising peptide sequences. However, most such tools are typically limited to the prediction of whether a peptide exhibits antimicrobial activity or not and they do not identify the exact type of the biological activities of these peptides. In this work, we have designed a machine learning based model called AMAP for predicting biological activity of peptides with a specialized focus on antimicrobial activity prediction. AMAP used multi-label classification to predict 14 different types of biological functions of a given peptide sequence with improved accuracy in comparison to existing state of the art techniques. We have performed stringent performance analyses of the proposed method. In addition to cross-validation and performance comparison with existing AMP predictors, AMAP has also been benchmarked on recently published experimentally verified peptides that were not a part of our training set. We have also analyzed features used in this work and our analysis shows that the proposed predictor can generalize well in predicting biological activity of novel peptide sequences. A webserver of the proposed method is available at the URL: http://faculty.pieas.edu.pk/fayyaz/software.html#AMAP.


Assuntos
Anti-Infecciosos , Peptídeos Catiônicos Antimicrobianos , Biologia Computacional/métodos , Anti-Infecciosos/química , Anti-Infecciosos/classificação , Anti-Infecciosos/farmacologia , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos Catiônicos Antimicrobianos/classificação , Peptídeos Catiônicos Antimicrobianos/farmacologia , Bases de Dados de Proteínas , Descoberta de Drogas , Escherichia coli/efeitos dos fármacos , Fusarium/efeitos dos fármacos , Aprendizado de Máquina , Software
11.
Med. intensiva (Madr., Ed. impr.) ; 43(supl.1): 7-12, mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188589

RESUMO

Los antisépticos son sustancias químicas que, aplicadas de forma tópica sobre la piel intacta, las mucosas o las heridas, reducen (o eliminan por completo) la población de microorganismos vivos en dichos tejidos. Tenemos a nuestra disposición diferentes tipos de antisépticos. Los más empleados en la práctica clínica habitual son los alcoholes, los compuestos yodados y la clorhexidina. A la hora de decantarnos por uno u otro, debemos tener en cuenta su espectro de actividad antimicrobiana, su latencia, su efecto residual, las posibles interferencias de la presencia de material orgánico en la actividad del antiséptico, sus efectos secundarios, su compatibilidad con otros antisépticos y su coste


Antiseptics are chemical substances that when applied topically onto intact skin, mucous membranes or wounds partially or completely reduces the population of living microorganisms in those tissues. Different types of antiseptics are available - those most commonly used in clinical practice being alcohols, iodinated compounds and chlorhexidine. When using an antiseptic, consideration is required of its spectrum of antimicrobial activity, latency, residual effects, possible interferences of the presence of organic material with the activity of the antiseptic, its side effects, compatibility with other antiseptics, and cost


Assuntos
Humanos , Anti-Infecciosos/classificação , Anti-Infecciosos/normas , Cuidados Críticos , Unidades de Terapia Intensiva/normas , Anti-Infecciosos/efeitos adversos
12.
J Am Geriatr Soc ; 67(3): 539-545, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30584657

RESUMO

OBJECTIVE: To establish consensus recommendations for empirical treatment of uncomplicated cystitis with anti-infectives in noncatheterized older nursing home residents to be implemented in the Improving Outcomes of UTI Management in Long-Term Care Project (IOU) funded by the Agency for Healthcare Research and Quality. DESIGN: Two-round modified Delphi survey. PARTICIPANTS: Expert panel of 19 clinical pharmacists. MEASUREMENTS: Comprehensive literature search and development/review/edit of draft survey by the investigative group (one geriatric clinical pharmacist, two geriatric medicine physicians, and one infectious disease physician). The expert panel members rated their agreement with each of 31 recommendations for drugs of choice, dosing medications at various levels of renal function, drug-drug interactions to avoid, and duration of therapy by sex on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Consensus agreement was defined as a lower 95% confidence limit of 4.0 or higher for the recommendation-specific mean score. RESULTS: The response rate was 95% for the first round, and three recommendations achieved consensus (dosing for nitrofurantoin and trimethoprim/sulfamethoxazole in those without chronic kidney disease, and drug-drug interaction between trimethoprim/sulfamethoxazole and warfarin). In the second round, 90% responded and reached consensus on an additional eight recommendations (two for nitrofurantoin or trimethoprim/sulfamethoxazole as initial drugs of choice, three for dosing ciprofloxacin, nitrofurantoin, and trimethoprim/sulfamethoxazole at various levels of chronic kidney disease, and three drug-drug interactions to avoid: trimethoprim/sulfamethoxazole with phenytoin and ciprofloxacin with theophylline or with tizanidine). CONCLUSION: An expert panel of clinical pharmacists was able to reach consensus on a set of recommendations for the empirical treatment of cystitis with oral anti-infective medications in older nursing home residents. The recommendations were incorporated into a treatment algorithm for uncomplicated cystitis in noncatheterized nursing home residents and used in educational materials for health professionals in an ongoing controlled intervention study. J Am Geriatr Soc 67:539-545, 2019.


Assuntos
Anti-Infecciosos , Cistite , Assistência de Longa Duração , Conduta do Tratamento Medicamentoso/normas , Melhoria de Qualidade/organização & administração , Idoso , Anti-Infecciosos/classificação , Anti-Infecciosos/farmacologia , Consenso , Cistite/diagnóstico , Cistite/tratamento farmacológico , Técnica Delfos , Relação Dose-Resposta a Droga , Interações Medicamentosas , Quimioterapia Combinada/métodos , Quimioterapia Combinada/normas , Feminino , Geriatria/métodos , Geriatria/normas , Humanos , Assistência de Longa Duração/métodos , Assistência de Longa Duração/normas , Masculino , Casas de Saúde/normas , Estados Unidos
13.
Photochem Photobiol Sci ; 18(1): 12-14, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30362478

RESUMO

The use of a separate nomenclature for the application of photosensitisers to the oncological and infectious disease fields represents a sensible approach. There is commonality, of course, in that both utilise light activation and act via the local generation of reactive oxygen species, but the difference in cellular targets is so great that different designs are required to achieve proper selectivity for a clinical end use, whether in human or veterinary medicine. The following represents a personal view, and perhaps a clarification of terms, in what might be considered a major etymological dichotomy existing within photodynamic research, on the 20th anniversary of "PACT".


Assuntos
Anti-Infecciosos/classificação , Anti-Infecciosos/uso terapêutico , Doenças Transmissíveis/tratamento farmacológico , Neoplasias/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/classificação , Fármacos Fotossensibilizantes/uso terapêutico , Animais , Doenças Transmissíveis/veterinária , Humanos , Neoplasias/veterinária , Espécies Reativas de Oxigênio/metabolismo
14.
Appl Microbiol Biotechnol ; 103(2): 589-602, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30456577

RESUMO

Biosurfactants are surface-active molecules that are synthesised non-ribosomally by a wide range of microorganisms including bacteria, yeast and filamentous fungi. The bacterial genus Serratia is gaining international interest, as biosurfactants produced by this genus have emerged as a promising source of antimicrobial, antifouling and antitumour compounds that possess emulsification and surface activity. Various species of Serratia have been identified as biosurfactant producers, including Serratia marcescens, Serratia rubidaea and Serratia surfactantfaciens. Members of the Serratia genus have been reported to principally produce two classes of biosurfactants, namely lipopeptides and glycolipids. Lipopeptides produced by Serratia species include serrawettins and stephensiolides, while identified glycolipids include rubiwettins and rhamnolipids. This review will primarily focus on the classification of biosurfactants produced by Serratia species and the genes and mechanisms involved in the biosynthesis of these biosurfactant compounds. Thereafter, an indication of the primary growth conditions and nutrient composition required for the optimum production of biosurfactants by this genus will be outlined. An overview of the latest advances and potential applications of the biosurfactants produced by Serratia in the medical, pharmaceutical, agricultural and petroleum industries is also provided.


Assuntos
Glicolipídeos/química , Glicolipídeos/metabolismo , Lipopeptídeos/química , Lipopeptídeos/metabolismo , Serratia/metabolismo , Tensoativos/química , Tensoativos/metabolismo , Anti-Infecciosos/química , Anti-Infecciosos/classificação , Anti-Infecciosos/metabolismo , Antineoplásicos/química , Antineoplásicos/classificação , Antineoplásicos/metabolismo , Glicolipídeos/classificação , Lipopeptídeos/classificação , Tensoativos/classificação
15.
J Pediatric Infect Dis Soc ; 8(2): 143-151, 2019 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-29579259

RESUMO

BACKGROUND: This study was conducted to assess the variation in prescription practices for systemic antimicrobial agents used for prophylaxis among pediatric patients hospitalized in 41 countries worldwide. METHODS: Using the standardized Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey protocol, a cross-sectional point-prevalence survey was conducted at 226 pediatric hospitals in 41 countries from October 1 to November 30, 2012. RESULTS: Overall, 17693 pediatric patients were surveyed and 36.7% of them received antibiotics (n = 6499). Of 6818 inpatient children, 2242 (32.9%) received at least 1 antimicrobial for prophylactic use. Of 11899 prescriptions for antimicrobials, 3400 (28.6%) were provided for prophylactic use. Prophylaxis for medical diseases was the indication in 73.4% of cases (2495 of 3400), whereas 26.6% of prescriptions were for surgical diseases (905 of 3400). In approximately half the cases (48.7% [1656 of 3400]), a combination of 2 or more antimicrobials was prescribed. The use of broad-spectrum antibiotics (BSAs), which included tetracyclines, macrolides, lincosamides, and sulfonamides/trimethoprim, was high (51.8% [1761 of 3400]). Broad-spectrum antibiotic use for medical prophylaxis was more common in Asia (risk ratio [RR], 1.322; 95% confidence interval [CI], 1.202-1.653) and more restricted in Australia (RR, 0.619; 95% CI, 0.521-0.736). Prescription of BSA for surgical prophylaxis also varied according to United Nations region. Finally, a high percentage of surgical patients (79.7% [721 of 905]) received their prophylaxis for longer than 1 day. CONCLUSIONS: A high proportion of hospitalized children received prophylactic BSAs. This represents a clear target for quality improvement. Collectively speaking, it is critical to reduce total prophylactic prescribing, BSA use, and prolonged prescription.


Assuntos
Anti-Infecciosos/uso terapêutico , Antibioticoprofilaxia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Resistência Microbiana a Medicamentos , Antibacterianos/classificação , Antibacterianos/uso terapêutico , Anti-Infecciosos/classificação , Anti-Infecciosos/normas , Antibioticoprofilaxia/normas , Criança Hospitalizada , Estudos Transversais , Prescrições de Medicamentos/normas , Quimioterapia Combinada , Uso de Medicamentos , Feminino , Pesquisas sobre Serviços de Saúde , Hospitalização , Hospitais Pediátricos , Humanos , Recém-Nascido , Masculino , Prevalência
16.
BMC Infect Dis ; 18(1): 684, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30572843

RESUMO

BACKGROUND: Meningitis remains a top cause of premature death and loss of disability-adjusted life years in low-income countries. In resource-limited settings, proper laboratory diagnostics are often scarce and knowledge about national and local epidemiology is limited. Misdiagnosis, incorrect treatment and overuse of antibiotics are potential consequences, especially for viral meningitis. METHODS: A prospective study was conducted over three months in a teaching hospital in Ethiopia with limited laboratory resources. Cerebrospinal fluid (CSF) samples from patients with suspected meningitis were analysed using a multiplex PCR-based system (FilmArray, BioFire), in addition to basic routine testing with microscopy and culture. Clinical data, as well as information on treatment and outcome were collected. RESULTS: Two hundred and eighteen patients were included; 117 (54%) neonates (0-29 days), 63 (29%) paediatrics (1 month-15 years) and 38 (17%) adults (≥16 years). Of 218 CSF samples, 21 (10%) were PCR positive; 4% in neonates, 14% in paediatrics and 18% in adults. Virus was detected in 57% of the PCR positive samples, bacteria in 33% and fungi in 10%. All CSF samples that were PCR positive for a bacterial agent had a white cell count ≥75 cells/mm3 and/or turbid appearance. The majority (90%) of patients received more than one antibiotic for treatment of the meningitis episode. There was no difference in the mean number of different antibiotics received or in the cumulative number of days with antibiotic treatment between patients with a microorganism detected in CSF and those without. CONCLUSIONS: A rapid molecular diagnostic system was successfully implemented in an Ethiopian setting without previous experience of molecular diagnostics. Viral meningitis was diagnosed for the first time in routine clinical practice in Ethiopia, and viral agents were the most commonly detected microorganisms in CSF. This study illustrates the potential of rapid diagnostic tests for reducing antibiotic usage in suspected meningitis cases. However, the cost of consumables for the molecular diagnostic system used in this study limits its use in low-income countries.


Assuntos
Anti-Infecciosos/classificação , Anti-Infecciosos/uso terapêutico , Meningite/diagnóstico , Meningite/tratamento farmacológico , Técnicas de Diagnóstico Molecular , Reação em Cadeia da Polimerase Multiplex , Padrões de Prática Médica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/economia , Criança , Pré-Escolar , Diagnóstico Diferencial , Etiópia , Feminino , Recursos em Saúde , Hospitais de Ensino/economia , Humanos , Lactente , Recém-Nascido , Masculino , Meningite/líquido cefalorraquidiano , Meningite/genética , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/diagnóstico , Meningite Viral/tratamento farmacológico , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/economia , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Diagnóstico Molecular/tendências , Reação em Cadeia da Polimerase Multiplex/economia , Padrões de Prática Médica/economia , Padrões de Prática Médica/normas , Padrões de Prática Médica/tendências , Melhoria de Qualidade , Adulto Jovem
17.
J Nippon Med Sch ; 85(6): 302-308, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30568055

RESUMO

BACKGROUND: Antibiotic resistance of pathogenic bacteria is well recognized among clinicians; however, studies that directly evaluate the bacterial resistance to commonly used disinfectants in clinical settings are lacking. Currently available reports focus on the resistance of single strains to single disinfectants and do not adequately examine the degree of resistance and cross-resistance to antimicrobials in the large-scale clinical use of disinfectants. METHODS: We investigated the resistance capacity to 11 antibiotics and 7 chemical disinfectants by bacterial strains collected from body fluids of patients in 10 hospitals in Beijing, China over a 1-year period. Bacterial resistance to disinfectants was tested using minimum inhibitory concentration and minimum bactericidal concentration using agar dilution methods based on commercially available reference strains. RESULTS: A total of 1,104 pathogenic strains were identified, of which 23% were Gram-positive bacteria, 74% were Gram-negative bacteria, and 3% were fungi. Overall, resistance to antibiotics for the most common strains was significantly higher than their resistance to disinfectants. The least effective antibiotics and disinfectants were aztreonam and glutaral, respectively, exhibiting the highest overall resistance rates; while amikacin and alcohol had the lowest resistance rates. Consistently, Acinetobacter baumannii exhibited the most resistance, while Escherichia coli had the least resistance for both antibiotics and disinfectants. CONCLUSIONS: Based on the pathogen spectrum for bacterial infective pathogens evaluated in this study, as well as the status quo of their resistance to antimicrobial agents and common clinical disinfectants, it is essential for healthcare professionals to pay attention not only to the standardized use of antimicrobial agents but also to the rational application of disinfectants.


Assuntos
Anti-Infecciosos/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/prevenção & controle , Desinfetantes/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Anti-Infecciosos/classificação , Bactérias/classificação , Bactérias/patogenicidade , Infecções Bacterianas/microbiologia , Pequim , Líquidos Corporais/microbiologia , Desinfetantes/classificação , Humanos , Testes de Sensibilidade Microbiana , Virulência
18.
BMC Infect Dis ; 18(1): 590, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458721

RESUMO

BACKGROUND: Men with urinary retention secondary to benign prostatic hyperplasia (BPH) are prone to genitourinary infections. Physicians should be aware of the current antimicrobial susceptibility pattern in this population if empirical treatment is needed. The goal of this study was to evaluate variations in prevalence, composition and antimicrobial susceptibility of bacterial flora in men with indwelling catheters subjected to surgery for BPH in chosen time periods since 1994. Necessary changes in empirical therapy were also assessed. METHODS: All patients with indwelling catheters admitted to a single urological center for BPH surgery in the years 1994-1996, 2004-2006, and 2011-2015 were considered. Catheterization times and results of urine cultures from samples collected at admission were evaluated. Susceptibility for selected antimicrobials was compared separately for Gram negative and Gram positive species. For each agent and for their combinations effectiveness of empirical therapy was calculated dividing the number of patients with bacteriuria susceptible to the agents by the total number of patients with bacteriuria. RESULTS: Bacteriuria was present in 70% of 169, 72% of 132, and 69% of 156 men in the respective time periods. The incidence of Gram-positive strains increased from 10 to 37% (P < 0.001). Their susceptibility to amoxicillin/clavulanate was fluctuating (81, 61, 77%; P=NS). No vancomycin-resistant strain was present. Gram-negative flora composition was stable. Their susceptibility decreased to ciprofloxacin (70 to 53%; P = 0.01) and amoxicillin/clavulanate (56 to 37%; P < 0.01) while it increased to gentamycin (64 to 88%; P < 0.001) and co-trimoxazole (14 to 62%; P < 0.001); susceptibility to amikacin remained high (> 85%). Only two cases of resistance to carbapenems in 2004-2006 were found. In vitro effectiveness of amikacin + amoxicillin/clavulanate in empirical therapy was slowly decreasing (87 to 77%; P=NS). Imipenem was found the most effective single agent (90-95%) and its efficacy was even improved by adding vancomycin (97-98%). CONCLUSIONS: Substantial rise in the incidence of Gram-positive species and fluctuations in antimicrobial susceptibility patterns were found. Empirical therapy of genitourinary infection in catheterized men with BPH should now involve antimicrobial agents effective both to Enterococci and Enterobacteriaceae. Periodic monitoring and publishing data on antimicrobial susceptibility for this population is necessary.


Assuntos
Anti-Infecciosos/uso terapêutico , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Farmacorresistência Bacteriana , Hiperplasia Prostática/microbiologia , Cateteres Urinários/microbiologia , Anti-Infecciosos/classificação , Bacteriúria/epidemiologia , Bacteriúria/microbiologia , Infecções Relacionadas a Cateter/complicações , Infecções Relacionadas a Cateter/tratamento farmacológico , Cateterismo/efeitos adversos , Cateterismo/estatística & dados numéricos , Farmacorresistência Bacteriana/efeitos dos fármacos , Enterobacteriaceae/classificação , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/crescimento & desenvolvimento , Enterobacteriaceae/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Prevalência , Hiperplasia Prostática/complicações , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/terapia , Estudos Retrospectivos , Cateteres Urinários/efeitos adversos , Retenção Urinária/complicações , Retenção Urinária/epidemiologia , Retenção Urinária/microbiologia , Retenção Urinária/terapia
19.
BMC Genomics ; 19(Suppl 7): 672, 2018 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-30255784

RESUMO

BACKGROUND: Antimicrobial peptides are a promising alternative for combating pathogens resistant to conventional antibiotics. Computer-assisted peptide discovery strategies are necessary to automatically assess a significant amount of data by generating models that efficiently classify what an antimicrobial peptide is, before its evaluation in the wet lab. Model's performance depends on the selection of molecular descriptors for which an efficient and effective approach has recently been proposed. Unfortunately, how to adapt this method to the selection of molecular descriptors for the classification of antimicrobial peptides and the performance it can achieve, have only preliminary been explored. RESULTS: We propose an adaptation of this successful feature selection approach for the weighting of molecular descriptors and assess its performance. The evaluation is conducted on six high-quality benchmark datasets that have previously been used for the empirical evaluation of state-of-art antimicrobial prediction tools in an unbiased manner. The results indicate that our approach substantially reduces the number of required molecular descriptors, improving, at the same time, the performance of classification with respect to using all molecular descriptors. Our models also outperform state-of-art prediction tools for the classification of antimicrobial and antibacterial peptides. CONCLUSIONS: The proposed methodology is an efficient approach for the development of models to classify antimicrobial peptides. Particularly in the generation of models for discrimination against a specific antimicrobial activity, such as antibacterial. One of our future directions is aimed at using the obtained classifier to search for antimicrobial peptides in various transcriptomes.


Assuntos
Algoritmos , Anti-Infecciosos/classificação , Peptídeos Catiônicos Antimicrobianos/classificação , Bactérias/efeitos dos fármacos , Evolução Molecular , Reconhecimento Automatizado de Padrão , Anti-Infecciosos/química , Anti-Infecciosos/farmacologia , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos Catiônicos Antimicrobianos/farmacologia , Simulação por Computador , Modelos Moleculares , Relação Quantitativa Estrutura-Atividade
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