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1.
Rev. Esc. Enferm. USP ; 53: e03486, Jan.-Dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020393

RESUMO

RESUMO Objetivo Avaliar o impacto das Infecções Relacionadas à Assistência à Saúde no custo da hospitalização de crianças. Método Estudo de coorte, prospectivo, quantitativo, envolvendo crianças admitidas nas Unidades de Internação e de Terapia Intensiva Pediátrica de um hospital universitário público. Os dados foram analisados por meio do software SPSS por distribuição de frequências, medidas de tendência central e dispersão. Para todas as análises foi considerado o nível de significância estatística de p<0,05. Resultados A amostra foi composta de 173 crianças, destas, 18,5% desenvolveram infecção relacionada à assistência à saúde, que aumentou em 4,2 vezes (p<0,001) o custo da hospitalização. Maior impacto de custo foi observado entre pacientes com dois ou mais sítios infecciosos (R$ 81.037,57, p=0,010) e sepse (R$ 46.315,63 p<0,001). Crianças colonizadas por microrganismos multirresistentes, com prevalência de E. coli e A. baumannii ESBL, geraram custos maiores, R$ 35.206,15 e R$ 30.692,52, respectivamente. Conclusão As infecções relacionadas à assistência à saúde aumentaram significativamente os custos da hospitalização de crianças, em especial entre aquelas com mais de dois sítios infecciosos, que desenvolveram sepse e colonizadas por microrganismos multirresistentes.


RESUMEN Objetivo Evaluar el impacto de las Infecciones Relacionadas con la Asistencia Sanitaria en el costo de la hospitalización de niños. Método Estudio de cohorte, prospectivo, cuantitativo, involucrando a niños ingresados en las Unidades de Hospitalización y de Cuidados Intensivos Pediátricos de un hospital universitario público. Los datos fueron analizados mediante el software SPSS por distribución de frecuencias, medidas de tendencia central y dispersión. Para todos los análisis, se consideró el nivel de significación estadística de p<0,05. Resultado La muestra estuvo compuesta de 173 niños, de estos el 18,5% desarrollaron infección relacionada con la asistencia sanitaria, que aumentó 4,2 veces (p<0,001) el costo de la estancia hospitalaria. Mayor impacto de costo fue observado entre pacientes con dos o más sitios infecciosos (R$ 81.037,57, p=0,010) y sepsis (R$ 46.315,63 p<0,001). Niños colonizados por microorganismos multirresistentes, con prevalencia de E. coli y A. baumannii ESBL, generaron costos mayores, R$ 35.206,15 y R$ 30.692,52, respectivamente. Conclusión Las infecciones relacionadas con la asistencia sanitaria aumentaron significativamente los costos de la hospitalización de niños, en especial entre los con más de dos sitios infecciosos, que desarrollaron sepsis y colonizados por microorganismos multirresistentes.


ABSTRACT Objective To evaluate the impact of Healthcare-Associated Infections on the hospitalization cost of children. Method A prospective, quantitative cohort study involving children admitted to the Inpatient and Pediatric Intensive Care Units of a public university hospital. The data were analyzed through SPSS software by frequency distribution, central tendency measures and dispersion. The level of statistical significance was set at p<0.05 for all analyzes. Results The sample consisted of 173 children, of whom 18.5% developed Healthcare-Associated Infections, which increased the hospitalization costs 4.2 times (p<0.001). A greater cost impact was observed among patients with two or more infectious sites (R$81,037.57; p=0.010) and sepsis (R$46,315.63; p<0.001). Children colonized by multiresistant microorganisms with a prevalence of E. coli and A. baumannii ESBL also generated higher costs of R$35,206.15 and R$30,692.52, respectively. Conclusion Healthcare-Associated Infections significantly increased the hospitalization costs for children, especially among those with more than two infectious sites, who developed sepsis or were colonized by multiresistant microorganisms.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Criança Hospitalizada , Infecção Hospitalar , Custos de Cuidados de Saúde , Resistência Microbiana a Medicamentos , Unidades de Terapia Intensiva Pediátrica , Estudos de Coortes , Hospitais Universitários
2.
Arch Virol ; 164(11): 2819-2822, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31482204

RESUMO

A recent study by Ghosh et al. compared the gut microbiomes of 20 preschool children from India and found an association between the gut microbiome and the nutritional status of the child. Here, we explored these metagenomes for the presence of genomic signatures of prokaryotic and eukaryotic viruses. Several of the viral signatures found in all 20 metagenomes belonged to giant viruses (GVs). In addition, we found hits for bacteriophages to several major human pathogens, including Shigella, Salmonella, Escherichia, and Enterobacter. Concurrently, we also detected several antibiotic resistance genes (ARGs) in the metagenomes. All of the ARGs detected in this study (beta-lactam, macrolide, metronidazole, and tetracycline) are associated with mobile genetic elements (MGEs) and have been reported to cause high levels of resistance to their respective antibiotics. Despite recent reports of giant viruses and their genomic signatures in gut microbiota, their role in human physiology remains poorly understood. The effect of cooccurrence of ARGs and GVs in the gut needs further investigation.


Assuntos
Bacteriófagos/genética , Microbioma Gastrointestinal/genética , Genoma Viral/genética , Vírus Gigantes/genética , Metagenoma/genética , Pré-Escolar , Resistência Microbiana a Medicamentos/genética , Enterobacter/genética , Escherichia/virologia , Vírus Gigantes/isolamento & purificação , Humanos , Índia , Sequências Repetitivas Dispersas/genética , Salmonella/virologia , Shigella/virologia
3.
Bioresour Technol ; 293: 122096, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493731

RESUMO

The microbial community characteristics, functional and antibiotic resistance genes (ARGs), anammox performance under individual and combined oxytetracycline (OTC) and sulfamethoxazole (SMX) were tested under environmentally relevant levels. The results showed that anammox performance was inhibited when the OTC or SMX concentration increased from 0.5 to 1.0 mg L-1. The absolute abundance of tetX in OTC (3.03 × 106 copies mg-1), SMX (2.80 × 106 copies mg-1) and OTC + SMX (2.03 × 106 copies mg-1) was the highest and one more order of magnitude higher than that of tetG, tetM, intI1, or sul2. The anammox performance in the presence of OTC or SMX was lower than that sum of their independent effects. The enrichment of sludge resistomes with prolonged exposure time and increasing OTC and SMX doses might be due to succession of bacterial hosts and potential elevation of ARGs by horizontal transfer.


Assuntos
Microbiota , Oxitetraciclina , Antibacterianos , Resistência Microbiana a Medicamentos , Genes Bacterianos , Sulfametoxazol
4.
Bioresour Technol ; 293: 122092, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31505392

RESUMO

The effects of nanoscale zero-valent iron (nZVI) on the performance of food waste anaerobic digestion and the fate of antibiotic resistance genes (ARGs) were investigated in thermophilic (TR) and mesophilic (MR) reactors. Results showed that nZVI enhanced biogas production and facilitated ARGs reduction. The maximum CH4 production was 212.00 ±â€¯4.77 ml/gVS with 5 g/L of nZVI in MR. The highest ARGs removal ratio was 86.64 ±â€¯0.72% obtained in TR at nZVI of 2 g/L. nZVI corrosion products and their contribution on AD performance were analyzed. The abundance of tetracycline genes reduced significantly in nZVI amended digesters. Firmicutes, Chloroflexi, Proteobacteria and Spirochaetes showed significant positive correlations with various ARGs (p < 0.05) in MR and TR. Redundancy analysis indicated that microbial community was the main factor that influenced the fate of ARGs. nZVI changed microbial communities, with decreasing the abundance bacteria belonging to Firmicutes and resulting in the reduction of ARGs.


Assuntos
Antibacterianos , Ferro , Anaerobiose , Bactérias , Resistência Microbiana a Medicamentos
5.
J Environ Sci (China) ; 85: 17-34, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31471024

RESUMO

Is our food safe and free of the crisis of antibiotics and antibiotic resistance (AR)? And will the derived food waste (FW) impose AR risk to the environment after biological treatment? This study used restaurant FW leachates flowing through a 200 tons-waste/day biological treatment plant as a window to investigate the fate of antibiotics and antibiotic-resistance genes (ARGs) during the acceptance and treatment of FW. Sulfonamides (sulfamethazine, sulfamethoxazole) and quinolones (ciprofloxacin, enrofloxacin, ofloxacin) were detected during FW treatment, while tetracyclines, macrolides and chloramphenicols were not observable. ARGs encoding resistance to sulfonamides, tetracyclines and macrolides emerged in FW leachates. Material flow analysis illustrated that the total amount of antibiotics (except sulfamethazine) and ARGs were constant during FW treatment processes. Both the concentration and total amount of most antibiotics and ARGs fluctuated during treatment, physical processes (screening, centrifugation, solid-liquid and oil-water separation) did not decrease antibiotic or ARGs concentrations or total levels permanently; the affiliated wastewater treatment plant appeared to remove sulfonamides and most ARGs concentrations and total amount. Heavy metals Ni, Co and Cu were important for disseminating antibiotics concentrations and MGEs for distributing ARGs concentrations. Humic substances (fulvic acids, hydrophilic fractions), C-associated and N-associated contents were essential for the distribution of the total amounts of antibiotics and ARGs. Overall, this study implied that human food might not be free of antibiotics and ARGs, and FW was an underestimated AR pool with various determinants. Nonetheless, derived hazards of FW could be mitigated through biological treatment with well-planned daily operations.


Assuntos
Antibacterianos/análise , Resistência Microbiana a Medicamentos/genética , Eliminação de Resíduos Líquidos , Poluentes Químicos da Água/análise , Genes Bacterianos , Metais Pesados/análise , Restaurantes , Águas Residuárias/química , Águas Residuárias/microbiologia
6.
J Glob Health ; 9(2): 010412, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31489183

RESUMO

Background: Antimicrobial resistance (AMR) driven by antibiotic consumption is a growing global health threat. However, data on antimicrobial consumption patterns in low- and middle-income countries (LMICs) is sparse. Here, we investigate the patterns of antibiotic sales in humans and livestock in urban Nairobi, Kenya, and evaluate the level of awareness and common behaviours related to antibiotic use and AMR amongst human and veterinary pharmacists. Methods: A total of 40 human and 19 veterinary drug store pharmacists were interviewed in Nairobi in 2018 using a standard questionnaire. Data recorded included demographic variables, types of antibiotics sold, antibiotic customers, antibiotic prescribing practices and knowledge of antibiotic use and AMR. Results: Our study shows that at the retail level, there is a considerable overlap between antibiotic classes (10/15) sold for use in both human and veterinary medicine. Whilst in our study, clinical training significantly influenced knowledge on issues related to antibiotic use and AMR and respondents had a relatively adequate level of knowledge about AMR, several inappropriate prescribing practices were identified. For example, we found that most veterinary and human drug stores (100% and 52% respectively) sold antibiotics without a prescription and noted that customer preference was an important factor when prescribing antibiotics in half of the drug stores. Conclusion: Although more research is needed to understand the drivers of antibiotic consumption in both human and animal populations, these findings highlight the need for immediate strategies to improve prescribing practices across the pharmacists in Nairobi and by extension other low- and middle-income country settings.


Assuntos
Antibacterianos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos/psicologia , Adulto , Animais , Estudos Transversais , Resistência Microbiana a Medicamentos , Feminino , Humanos , Prescrição Inadequada/estatística & dados numéricos , Quênia , Masculino , Farmacêuticos/estatística & dados numéricos , Inquéritos e Questionários
7.
Rev Saude Publica ; 53: 68, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432930

RESUMO

OBJECTIVE: To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials. METHODS: A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II). RESULTS: The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006-0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003-0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05). CONCLUSIONS: The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.


Assuntos
Antibacterianos/administração & dosagem , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/prevenção & controle , Resistência Microbiana a Medicamentos , Uso Excessivo de Medicamentos Prescritos/legislação & jurisprudência , Brasil , Estudos de Coortes , Monitoramento de Medicamentos , Uso de Medicamentos/legislação & jurisprudência , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Uso Excessivo de Medicamentos Prescritos/efeitos adversos , Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos , beta-Lactamases/efeitos dos fármacos
8.
Vestn Oftalmol ; 135(3): 109-112, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31393454

RESUMO

Despite the lack of convincing data on the effectiveness of antibiotic therapy in the prevention of Post-Injection Endophthalmitis (PIE), the use of topical antibiotics for intravitreal injections is still a common practice. Frequent, monthly use of antibiotics results in changes of the composition of conjunctival flora and spontaneous mutations of bacteria, and leads to selective survival of resistant and virulent strains that can cause serious damage inside the eye.


Assuntos
Infecções Oculares Bacterianas , Administração Tópica , Antibacterianos , Antibioticoprofilaxia , Resistência Microbiana a Medicamentos , Humanos , Injeções Intravítreas
9.
Waste Manag ; 96: 190-197, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31376964

RESUMO

Ionizing radiation coupled with peroxymonosulfate (PMS) oxidation was developed to degrade antibiotics and antibiotic resistance genes (ARGs) from the erythromycin fermentation (EryF) residual wastes. The experimental results showed that the ERY content and ARGs abundance decreased with increase of the absorbed dose and PMS dosage and gamma irradiation was more effective to abate ARGs from the EryF wastes. The removal efficiency of ERY reached 49-55% and more than 96-99% of ARGs (1.32-2.55 log) was eliminated with the absorbed dose of 25-50 kGy and PMS dosage of 50-100 mM. Illumina pyrosequencing revealed that 3 bacterial phyla, Proteobacteria, Firmicutes and Fusobacteria were highly enriched and the ARGs-linked hosts were affiliated to the genera Aeromonas, Enterobacteriaceae and Enterobacter in the phylum Proteobacteria. The abundance of the ARGs-linked bacteria decreased by gamma/PMS treatment. Ionizing radiation/PMS treatment with the doses of 25 kGy and 50 mM PMS is proposed for potential practical application.


Assuntos
Antibacterianos , Eritromicina , Resistência Microbiana a Medicamentos , Fermentação , Genes Bacterianos , Peróxidos
10.
Ying Yong Sheng Tai Xue Bao ; 30(8): 2875-2882, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31418214

RESUMO

The contamination of antibiotic resistance genes (ARGs) caused by abuse of antibiotics has attracted more and more attention. Due to their low price, tetracyclines and sulfonamides are widely used. The plenty of residual tetracyclines and sulfonamides is discharged into wastewater treatment plant (WWTPs), with consequent ARGs pollution. To understand the current status of ARGs contamination and removal efficiency, we summarized the distribution and spread mechanism of tetracyclines and sulfonamides ARGs, and further emphasized the ARGs removal efficiency across different treatment technologies. Based on the current knowledge and lack of ARGs, future work were proposed, such as investigating ARGs contamination in WWTPs, improving ARGs removal technologies, exploring spread mechanisms of ARGs.


Assuntos
Resistência Microbiana a Medicamentos/genética , Genes Bacterianos , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/microbiologia , Antibacterianos , Sulfonamidas , Tetraciclinas
11.
Naturwissenschaften ; 106(9-10): 51, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455975

RESUMO

Endophytic actinomycetes, a prolific source of natural products, are well known for their diverse metabolic versatility, and their association with medicinal plants and antimicrobial potential are well worth exploring. We isolated and identified the Streptomyces cavourensis strain MH16 inhabiting the tree Millingtonia hortensis Linn. using phylogenetic analysis based on a 16S rRNA molecular approach. We used the disc diffusion method to evaluate the impact of differences in the compositions of the media on the production of secondary metabolites from strain MH16. The production of antimicrobial metabolites was determined by the observation of inhibition zones on intensive bands when using a TLC-bioautography assay. Biosynthesis of secondary metabolites was optimal when the strain MH16 was cultured in ISP-2 medium as depicted by a zone of inhibition. Strain MH16 effectively inhibited methicillin-resistant Staphylococcus aureus, Escherichia coli, Candida albicans, and other multi drug-resistant pathogens. The minimum inhibitory concentration of the antimicrobial metabolites was 25-100 µg mL-1. The study manifests the optimization and utilization of different fermentation media which best suits for increased production of the secondary metabolites from Streptomyces cavourensis. This research suggests that the antimicrobial metabolites of strain MH16 found in M. hortensis has great potential for the biodiscovery of new anti-infective drugs against a wide range of multidrug-resistant pathogens.


Assuntos
Peptídeos Catiônicos Antimicrobianos/biossíntese , Peptídeos Catiônicos Antimicrobianos/farmacologia , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Streptomyces/genética , Streptomyces/metabolismo , Bactérias/efeitos dos fármacos , Meios de Cultura/farmacologia , Fungos/efeitos dos fármacos , Lamiales/microbiologia , Testes de Sensibilidade Microbiana , RNA Ribossômico 16S/genética , Streptomyces/efeitos dos fármacos , Streptomyces/crescimento & desenvolvimento
12.
Rev Panam Salud Publica ; 43, August 2019
Artigo em Espanhol | PAHO-IRIS | ID: phr-51470

RESUMO

[RESUMEN]. Se presenta un consenso latinoamericano que permite estandarizar las definiciones de los diferentes niveles de resistencia a los antimicrobianos en bacterias de importancia en salud pública. Se describen los criterios de inclusión y exclusión para las metodologías a utilizar y para los antibióticos a incluir (por disponibilidad, relevancia y existencia de puntos de corte). Como propuesta piloto se eligieron tres microorganismos gramnegativos de gran impacto en el ambiente hospitalario (Klebsiella pneumoniae, Pseudomonas aeruginosa y Acinetobacter spp.). La falta de puntos de corte para ciertos antibióticos (por ejemplo, tigeciclina, fosfomicina y colistina), claves para el tratamiento de infecciones causadas por estos patógenos que presentan multirresistencia o resistencia extendida, llevó a la necesidad de discutir y consensuar puntos de corte provisorios para la vigilancia de la resistencia a estos fármacos. Se abordó y consensuó también el uso de pruebas de sensibilidad alternativas a los métodos aprobados por las guías internacionales, de aplicación más sencilla como pruebas de rutina en los laboratorios de bacteriología clínica. El principal beneficio de este documento es proporcionar a los laboratorios latinoamericanos un marco estandarizado y consensuado para la identificación y la vigilancia constante y unificada de microorganismos resistentes. Las recomendaciones incluidas en este documento son el resultado consensuado por los representantes de los laboratorios nacionales de referencia de los países que integran la Red Latinoamericana de Vigilancia de la Resistencia a los Antibióticos coordinada por la Organización Panamericana de la Salud


[ABSTRACT]. This document presents a Latin American consensus to standardize definitions of different levels of antimicrobial resistance in bacteria of public health importance. Inclusion and exclusion criteria are described for antibiotics to include (availability, relevance, and existence of cut-off values) and for methodologies to use. Three gram-negative microorganisms with a great impact in the hospital environment (Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp.) were selected as a pilot proposal. The lack of cut-off values for certain antibiotics (e.g., tigecycline, fosfomycin, and colistin), crucial in treating infections caused by multi-drug resistant or extensively drug-resistant pathogens, led to the need to discuss and agree on provisional cut-off values for monitoring resistance to these drugs. The work team also addressed and reached consensus on easier-to-use alternative susceptibility tests, other than methods approved by international guidelines, for routine testing in clinical bacteriology laboratories. The main benefit of this document is to provide Latin American laboratories with a standardized and consensual framework for the identification and constant and unified surveillance of resistant microorganisms. The recommendations included in this document are the result of consensus among representatives of the national reference laboratories in the countries belonging to the Latin American Surveillance Network of Antimicrobial Resistance, coordinated by the Pan American Health Organization.


[RESUMO]. É apresentado um consenso latino-americano para padronizar a definição dos graus de resistência antimicrobiana em bactérias de importância em saúde pública. São descritos os critérios de inclusão e exclusão para os antibióticos a serem incluídos (disponibilidade, relevância e pontos de corte de sensibilidade) e metodologias a serem usadas. Como proposta-piloto, foram selecionados três microrganismos Gram-negativos de grande impacto no ambiente hospitalar (Klebsiella pneumoniae, Pseudomonas aeruginosa e Acinetobacter spp.). Diante da falta de pontos de corte para alguns antibióticos (como tigeciclina, fosfomicina e colistina), essenciais para o tratamento de infecções causadas por patógenos com multirresistência ou resistência ampliada, foram debatidos e aprovados pela maioria pontos de corte provisórios para a vigilância da resistência a estes fármacos. Também foi discutido e aprovado o uso de testes de suscetibilidade alternativos aos métodos aprovados pelas diretrizes internacionais, mais simples de serem realizados como testes de rotina nos laboratórios de bacteriologia clínica. A principal contribuição deste documento é oferecer aos laboratórios latino-americanos um sistema padronizado e consensual para a identificação de microrganismos resistentes e a vigilância contínua e uniforme destes patógenos. As recomendações aqui contidas foram feitas por consenso por representantes dos laboratórios nacionais de referência dos países que integram a Rede Latino-Americana de Vigilância da Resistência Antimicrobiana, coordenada pela Organização Pan-Americana da Saúde (OPAS).


Assuntos
Anti-Infecciosos , Farmacorresistência Bacteriana , Bactérias Gram-Negativas , Consenso , América Latina , Anti-Infecciosos , Resistência a Medicamentos , Bactérias Gram-Negativas , Consenso , América Latina , Anti-Infecciosos , Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas
13.
Zhonghua Wai Ke Za Zhi ; 57(8): 596-600, 2019 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-31422629

RESUMO

Objective: To investigate the microbiological test, antibiotic sensitivity and surgical treatment of periprosthetic joint infection(PJI) cases in post total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. Methods: A retrospective cross-sectional survey was conducted on 318 patients who underwent THA or TKA in 9 clinical centers in Beijing from January 2014 to December 2016.The data of microbiology, antibiotic sensitivity and surgical treatment were collected.The average age of patients was (62.3±13.1) years old (range: 21-86 years old), including 145 males and 173 females.The body mass index was (25.6±3.8) kg/m (2) (range: 15.6-38.1 kg/m(2)). Results: In total, 318 patients had microorganisms detected by periprosthetic tissue culture or synovial fluid culture, 209 cases (65.7%) had Gram-positive bacteria, 29 cases (9.1%) had Gram-negative bacteria, 10 cases (3.1%) had fungi, 3 cases (0.9%) had non-tuberculous mycobacteria, 72 cases (22.6%) were negative, 69 cases (21.7%) had methicillin-resistant bacteria. The antibiotic sensitivity results showed that the overall resistance rate of penicillin, cefuroxime, amoxicillin+clavulanic acid was 79.9%, 69.9%, and 68.1%, respectively; meropenem, vancomycin, and linezolid resistance rate was 0. For the treatment methods of hip and knee PJI, two-stage revision surgery acounted for 72.9% (108/148) and 64.1% (109/170), respectively. One-stage revision surgery accounted for 21.6% (32/148) and 7.6% (13/170), and open debridement surgery accounted for 4.7%(7/148) and 26.4% (45/170). Conclusions: Gram-positive bacteria was still the main pathogen of PJI.The methicillin-resistant bacteria and rare bacteria should be payed attention to. The Majority of hip and knee PJI cases were treated by two-stage revision surgery.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Infecções Relacionadas à Prótese/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Pequim , Estudos Transversais , Resistência Microbiana a Medicamentos , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/cirurgia , Reoperação , Estudos Retrospectivos , Adulto Jovem
14.
Bioresour Technol ; 292: 122011, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31442833

RESUMO

This study explored the effects of Bacillus subtilis at four levels (0, 0.5%, 1%, and 2% w/w compost) on the variations in ARGs, mobile genetic elements (MGEs), and the bacterial community during composting. The composting process had a greater impact on ARGs than Bacillus subtilis. The main ARG detected was sul1. The addition of Bacillus subtilis at 0.5% reduced the relative abundances of ARGs, MGEs, and human pathogenic bacteria (by 2-3 logs) in the mature products. Network and redundancy analyses suggested that intI1, Firmicutes, and pH were mainly responsible for the changes in ARGs, thus controlling these factors might help to inhibit the spread of ARGs.


Assuntos
Compostagem , Animais , Antibacterianos , Bacillus subtilis , Bovinos , Resistência Microbiana a Medicamentos , Genes Bacterianos , Sequências Repetitivas Dispersas , Esterco
15.
BMC Public Health ; 19(1): 899, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286948

RESUMO

BACKGROUND: Inappropriate antibiotic use is implicated in antibiotic resistance and resultant morbidity and mortality. Overuse is particularly prevalent for outpatient respiratory infections, and perceived patient expectations likely contribute. Thus, various educational programs have been implemented to educate the public. METHODS: We systematically identified public-directed interventions to promote antibiotic awareness in the United States. PubMed, Google Scholar, Embase, CINAHL, and Scopus were queried for articles published from January 1996 through January 2016. Two investigators independently assessed titles and abstracts of retrieved articles for subsequent full-text review. References of selected articles and three review articles were likewise screened for inclusion. Identified educational interventions were coded for target audience, content, distribution site, communication method, and major outcomes. RESULTS: Our search yielded 1,106 articles; 34 met inclusion criteria. Due to overlap in interventions studied, 29 distinct educational interventions were identified. Messages were primarily delivered in outpatient clinics (N = 24, 83%) and community sites (N = 12, 41%). The majority included clinician education. Antibiotic prescription rates were assessed for 22 interventions (76%). Patient knowledge, attitudes, and beliefs (KAB) were assessed for 10 interventions (34%). Similar rates of success between antibiotic prescription rates and patient KAB were reported (73 and 70%, respectively). Patient interventions that did not include clinician education were successful to increase KAB but were not shown to decrease antibiotic prescribing. Three interventions targeted reductions in Streptococcus pneumoniae resistance; none were successful. CONCLUSIONS: Messaging programs varied in their designs, and many were multifaceted in their approach. These interventions can change patient perspectives regarding antibiotic use, though it is unclear if clinician education is also necessary to reduce antibiotic prescribing. Further investigations are needed to determine the relative influence of interventions focusing on patients and physicians and to determine whether these changes can influence rates of antibiotic resistance long-term.


Assuntos
Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Promoção da Saúde/métodos , Uso Excessivo de Medicamentos Prescritos/prevenção & controle , Uso Excessivo de Medicamentos Prescritos/psicologia , Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/psicologia
16.
Sci Total Environ ; 691: 644-653, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31326798

RESUMO

Vermicomposting can significantly attenuate antibiotic resistance genes (ARGs) in the excess activated sludge (EAS). However, the effect of earthworms, especially the effect of gut digestion as a critical step in the vermicomposting process, remains unclarified. The purpose of this study was to investigate the response of ARGs (cell-free and -associated) in EAS to gut digestion of earthworms and to clarify the possible mechanism from the viewpoint of bacterial community through quantitative polymer chain reaction (q-PCR) and high throughput sequencing. Compared to the initial sludge, the earthworm casts were observed to have significantly lower absolute abundances of ARGs, especially qnrS, tetM, and tetX with the removal exceeding 90%. Cell-free and -associated ARGs (except sul1 and tetG) had equivalent contributions to the attenuation of each ARG. Remarkable reductions of bacterial number and alpha diversity (chao1 and Shannon) were detected in the casts. Spearman correlation analysis between the targeted genes and bacterial community indicates that twelve different phyla mainly including Acidobacteria, Euryarchaeota, Deinococcus-Thermus, Chlorobi, Firmicutes, Fibrobacteres, and Proteobacteria are the potential ARGs hosts, suggesting that the fate and behaviour of these hosts during gut digestion of EAS by earthworms substantially determined the dynamics of the ARGs. These findings increase our understanding of earthworm gut digestion as an important process for the attenuation of ARGs in EAS, and contribute towards preventing their release into the total environment.


Assuntos
Microbioma Gastrointestinal , Oligoquetos/microbiologia , Animais , Resistência Microbiana a Medicamentos/genética , Genes Bacterianos
17.
Bioresour Technol ; 291: 121803, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31326686

RESUMO

This study investigated the effects of tylosin (0, 10, and 100 mg/kg dry weight) on the denitrification genes and microbial community during the anaerobic digestion of cattle manure. N2 emissions were reduced and N2O emissions were increased by 10 mg/kg tylosin. Adding 100 mg/kg tylosin increased the emission of both N2O and N2. The different responses of denitrifying bacteria and genes to tylosin may have been due to the presence of antibiotic resistance genes (ARGs). Network analysis indicated that denitrification genes and ARGs had the same potential host bacteria. intI1 was more important for the horizontal transfer of denitrification genes and ARGs during anaerobic digestion than intI2. The anaerobic digestion of manure containing tylosin may increase nitrogen losses and the associated ecological risk.


Assuntos
Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Esterco/microbiologia , Tilosina/farmacologia , Anaerobiose/efeitos dos fármacos , Animais , Bovinos , Desnitrificação/efeitos dos fármacos , Resistência Microbiana a Medicamentos/genética , Microbiota/efeitos dos fármacos , Nitrogênio/metabolismo
18.
Bioresour Technol ; 291: 121847, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31357044

RESUMO

Effects of magnetite on methane production and fate of antibiotic resistance genes (ARGs) during anaerobic digestion (AD) of swine manure were investigated. Results showed that methane production was increased by maximum 16.1%, and magnetite could enhance the acetoclastic methanogenesis not hydrogenotrophic methanogenesis reflected by the functional gene quantification and microbial community analysis. The propionate degradation rate was improved, and it was syntrophic oxidized into H+/e-/CO2 for direct interspecies electron transfer (DIET) and acetate, where DIET was further enhanced by magnetite and the acetate was transformed into methane through syntrophic acetate oxidation (SAO) pathway. Magnetite mainly influenced the ARGs at the interim period of AD, where ARGs especially ermF were significantly enriched. Magnetite did not influence the total ARGs abundance at the end, although the tetM was enriched and mefA was reduced finally. Statistical analysis indicated that magnetite influenced the ARGs fate mainly through the changes of microbial community.


Assuntos
Óxido Ferroso-Férrico/farmacologia , Esterco , Metano/biossíntese , Anaerobiose/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos/genética , Transporte de Elétrons , Microbiota/efeitos dos fármacos , Oxirredução , Suínos
19.
BMC Public Health ; 19(1): 858, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266477

RESUMO

BACKGROUND: When microorganisms (such as bacteria or viruses) are highly exposed to antimicrobial drugs, they can develop the capacity to defeat the drugs designed to eradicate them. Long-term accumulation of adaptations to survive drug exposure can lead to the development of antimicrobial resistance (AMR). The success of antibiotics has led to their widespread overuse and misuse in humans, animals and plants. MAIN TEXT: AMR is a global concern and solutions are not vertical actions in a single buy business model. Even if a transectoral approach is key, there is a lack of multi-disciplinary partnerships that allow for strategic cooperation between different sectors such as the pharmaceutical industry, agro-alimentary complex, patient care and education, NGOs and research and development. Global public health voices should lead this integration to align the progress of existing AMR successes. Maintaining the public's trust in preventive medicine, health systems and food production safety, together with public health driven, non-profit drug development, is a key factor. In its "Call for integrated action on AMR", signed by about 70 national and international organizations the World Federation of Public Health Associations (WFPHA) called "on all governments, the private sector, non-governmental organizations, health professionals, public and private research organizations, and all stakeholders to ensure that public health remains at the centre of all policy and scientific endeavours in the field of antimicrobial resistance". CONCLUSIONS: The "Global Charter for the Public's Health", developed by the WFPHA in association with WHO, is proposed in this article as a tool for implementation of complex public health actions such as AMR.


Assuntos
Resistência Microbiana a Medicamentos , Saúde Global , Saúde Pública , Sociedades/organização & administração , Organização Mundial da Saúde/organização & administração , Humanos
20.
Sci Total Environ ; 690: 313-320, 2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31299566

RESUMO

The Gram-negative bacterium Aeromonas salmonicida subsp. salmonicida is an aquatic pathogen which causes furunculosis to salmonids, especially in fish farms. The emergence of strains of this bacterium exhibiting antibiotic resistance is increasing, limiting the effectiveness of antibiotherapy as a treatment against this worldwide disease. In the present study, we discovered an isolate of A. salmonicida subsp. salmonicida that harbors two novel plasmids variants carrying antibiotic resistance genes. The use of long-read sequencing (PacBio) allowed us to fully characterize those variants, named pAsa5-3432 and pRAS3-3432, which both differ from their classic counterpart through their content in mobile genetic elements. The plasmid pAsa5-3432 carries a new multidrug region composed of multiple mobile genetic elements, including a Class 1 integron similar to an integrated element of Salmonella enterica. With this new region, probably acquired through plasmid recombination, pAsa5-3432 is the first reported plasmid of this bacterium that bears both an essential virulence factor (the type three secretion system) and multiple antibiotic resistance genes. As for pRAS3-3432, compared to the classic pRAS3, it carries a new mobile element that has only been identified in Chlamydia suis. Hence, with the identification of those two novel plasmids harboring mobile genetic elements that are normally encountered in other bacterial species, the present study puts emphasis on the important impact of mobile genetic elements in the genomic plasticity of A. salmonicida subsp. salmonicida and suggests that this aquatic bacterium could be an important reservoir of antibiotic resistance genes that can be exchanged with other bacteria, including human and animal pathogens.


Assuntos
Aeromonas salmonicida/genética , Resistência Microbiana a Medicamentos/genética , Animais , Genes Bacterianos , Genoma Bacteriano , Suínos , Fatores de Virulência/genética
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