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1.
J Pharm Biomed Anal ; 206: 114377, 2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34563978

RESUMO

The evaluation of true penicillin allergy is significant to reduce its occurrence and the overdiagnosis before anti-infective treatment. However, the currently available methods with high specificity still face the problem of low sensitivity, thereby easily leading to false negatives. Herein, an alkyne responsive surface-enhanced Raman scattering (SERS) immunosensor is reported for ultrasensitive detection of penicillin allergen penicilloyl protein (P-protein) by using Au-Ag alloy nanoparticles@(antibody + alkyne probe) (as SERS immunoprobe) together with Ag nanofilm modified by antibody (as SERS capture substrate). The SERS immunoassay integrates the interference-free Raman response of high wavenumber region (2212 cm-1) and specific capture antibody with high affinity to selectively recognize P-protein from complicated sample. Meanwhile, the target-induced near-field coupling effect between localized surface plasmon resonances of individual SERS immunoprobe and capture substrate enables the detection of P-protein as low as pg/mL level, and the limit of detection can reach 0.329 pg/mL that is about 6 orders of magnitude lower than the limit defined protein residue (causing penicillin allergy). With the ultrasensitivity and specific selectivity, the proposed SERS immunoassay platform can precisely evaluate the content of P-protein in blood sample or penicillin drugs. It will be a potential tool to monitor allergic reaction to penicillin and better understand the mechanism of penicillin hypersensitivity.


Assuntos
Técnicas Biossensoriais , Hipersensibilidade , Nanopartículas Metálicas , Alcinos , Ouro , Humanos , Imunoensaio , Penicilinas , Prata , Análise Espectral Raman
2.
Am J Case Rep ; 22: e932467, 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34379615

RESUMO

BACKGROUND Neurosyphilis is a bacterial infection of the brain and the spinal cord, caused by Treponema pallidum. Its nonspecific clinical presentation includes cognitive impairment and motor and/or sensory function compromise. Neurosyphilis infections in patients with HIV have increased over the past few years and many cases of neurosyphilis manifest in patients with HIV who have low CD4 T-cell counts and high viral loads (VL). However, there is extremely limited acknowledgement in the literature about neurosyphilis presentations in patients with HIV who have normal CD4 counts. CASE REPORT We present a neurosyphilis and HIV coinfection in a patient with a normal CD4 count and an undetectable VL. A 69-year-old woman with a medical history of HIV was on a prescribed antiretroviral treatment regimen. She presented in the Emergency Room in an unresponsive state, although this had been preceded by a period of rapidly progressive cognitive decline. Her brain computed tomography scan without contrast was unremarkable. Laboratory test results were within normal limits, except for a positive result for the microhemagglutination assay for Treponema pallidum antibodies and rapid plasma regain (RPR) test, which was highly suggestive of neurosyphilis as a presumed diagnosis. She showed remarkable clinical improvement after the initiation of conventional treatment for neurosyphilis, which is a 14-day regimen of intravenous penicillin G. CONCLUSIONS Given the broad neurological manifestations of neurosyphilis and its increasing incidence in patients with HIV, it is important to consider neurosyphilis in the differential diagnosis after ruling out other causes of encephalopathy, especially in patients with an undetectable VL and a normal CD4 count.


Assuntos
Infecções por HIV , Neurossífilis , Idoso , Contagem de Linfócito CD4 , Feminino , HIV , Infecções por HIV/complicações , Humanos , Neurossífilis/complicações , Neurossífilis/diagnóstico , Neurossífilis/tratamento farmacológico , Penicilinas , Carga Viral
3.
J Allergy Clin Immunol Pract ; 9(8): 2947-2956, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34366093

RESUMO

In the western world, up to 10% of the general population and more than 15% of hospitalized patients report penicillin allergy. After a comprehensive evaluation, more than 95% of patients who report a penicillin allergy can subsequently tolerate this antibiotic. Traditionally, the most widely accepted protocol to evaluate beta-lactam (BL) allergy consisted of skin testing (ST) followed by a drug provocation test (DPT) in ST-negative patients. DPT is the gold standard for proving or excluding BL allergy and is considered the final and definitive step in the evaluation. Recently, studies have been published that support the use of direct DPTs without preceding ST for both pediatric and adult patients who report a low-risk historical reaction to BLs. However, these studies use various risk-stratification criteria to determine eligibility for a direct DPT. A standardized protocol for DPT is also lacking. In this review, we assess the current literature and evidence for performing direct DPT in the pediatric and adult populations. On the basis of this evidence, we also present risk-based algorithms for the evaluation of BL allergy in pediatric and adult populations based on a description of the historical reaction.


Assuntos
Hipersensibilidade a Drogas , beta-Lactamas , Adulto , Antibacterianos/efeitos adversos , Criança , Hipersensibilidade a Drogas/diagnóstico , Humanos , Penicilinas/efeitos adversos , Testes Cutâneos , beta-Lactamas/efeitos adversos
4.
Ned Tijdschr Geneeskd ; 1652021 07 08.
Artigo em Holandês | MEDLINE | ID: mdl-34346594

RESUMO

In this Commentary on a British study of congenital malformations after use of macrolide antibiotics by pregnant women with data from general practitioners, the importance of high-quality healthcare databases for pharmacovigilance is emphasized. The authors of the British study compared three groups during the study period January 1990 through June 2016: 104,605 children from mothers treated during pregnancy with a macrolide or penicillin, a group of 53,735 siblings, and 82,314 children whose mothers were treated with a macrolide before conception. A significantly increased risk of 55% of congenital malformations was seen for use of macrolides during the first semester in comparison to use of penicillins, especially cardiovascular malformations. Although this well-performed study is the largest up till now, some potential limitations are discussed such as potential exposure and outcome misclassification, as well as confounding by indication.


Assuntos
Macrolídeos , Gestantes , Antibacterianos/efeitos adversos , Criança , Atenção à Saúde , Feminino , Humanos , Macrolídeos/efeitos adversos , Penicilinas , Gravidez
5.
Appl Microbiol Biotechnol ; 105(18): 6909-6920, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34463802

RESUMO

From the previous transcriptome analysis (Hirasawa et al. Biotechnol J 13:e1700612, 2018), it was found that expression of genes whose expression is regulated by stress-responsive transcriptional regulators was altered during penicillin-induced glutamic acid production in Corynebacterium glutamicum. Therefore, we investigated whether stress treatments, such as copper and iron addition, could induce glutamic acid production in C. glutamicum and found that the addition of copper did induce glutamic acid production in this species. Moreover, we also determined that glutamic acid production levels upon copper addition in a gain-of-function mutant strain of the mechanosensitive channel, NCgl1221, involved in glutamic acid export, were comparable to glutamic acid levels produced upon penicillin addition and biotin limitation in the wild-type strain. Furthermore, disruption of the odhI gene, which encodes a protein responsible for the decreased activity of the 2-oxoglutarate dehydrogenase complex during glutamic acid production, significantly diminished glutamic acid production induced by copper. These results indicate that copper can induce glutamic acid production and this induction requires OdhI like biotin limitation and penicillin addition, but a gain-of-function mutation in the NCgl1221 mechanosensitive channel is necessary for its high-level glutamic acid production. However, a significant increase in odhI transcription was not observed with copper addition in both wild-type and NCgl1221 gain-of-function mutant strains. In addition, disruption of the csoR gene encoding a copper-responsive transcriptional repressor enhanced copper-induced glutamic acid production in the NCgl1221 gain-of-function mutant, indicating that unidentified CsoR-regulated genes may contribute to copper-induced glutamic acid production in C. glutamicum. KEY POINTS: • Copper can induce glutamic acid production by Corynebacterium glutamicum. • Copper-induced glutamic acid production requires OdhI protein. • Copper-induced glutamic acid production requires a gain-of-function mutation in the mechanosensitive channel NCgl1221, which is responsible for the production of glutamic acid.


Assuntos
Corynebacterium glutamicum , Proteínas de Bactérias/genética , Cobre , Corynebacterium glutamicum/genética , Ácido Glutâmico , Penicilinas
6.
Mol Med Rep ; 23(5)2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34240225

RESUMO

Tracheal stenosis following injury cannot be effectively treated. The current study compared the protective effects of different anti­inflammatory drugs on tracheal stenosis and investigated their possible mechanisms. Rabbit tracheal stenosis models following injury were constructed and confirmed using hematoxylin and eosin (H&E) staining. A total of 30 rabbits were divided into the control (CON), penicillin (PEN), erythromycin (ERY), budesonide (BUD) and PEN + ERY + BUD groups (n=6). Stenotic tracheal tissue, serum and bronchoalveolar lavage fluid (BALF) were collected 10 days after continuous treatment. Pathological changes in the tracheas were observed by H&E staining. Histone deacetylase 2 (HDAC2) expression in tracheal tissues was detected by immunofluorescence. Immunohistochemistry was performed to detect collagen I (Col­I) and collagen III (Col­III) levels in tracheal tissues. Transforming growth factor ß1 (TGF­ß1), vascular endothelial growth factor (VEGF) and interleukin 8 (IL­8) levels in serum and BALF samples were determined using ELISA kits. Western blotting detected HDAC2, IL­8, TGF­ß1 and VEGF levels in tracheal tissues. H&E staining demonstrated that tracheal epithelial hyperplasia and fibroblast proliferation in the ERY and PEN + ERY + BUD groups markedly improved compared with the CON group. Furthermore, in tracheal tissues, HDAC2 expression was significantly increased and IL­8, TGF­ß1, VEGF, Col­I and Col­III levels were significantly decreased in the ERY and PEN + ERY + BUD groups compared with the CON group. Additionally, the results for the PEN + ERY + BUD were more significant compared with the ERY group. In serum and BALF samples, IL­8, TGF­ß1 and VEGF levels in the ERY and PEN + ERY + BUD groups were significantly lower compared with the CON group, with the results of the PEN + ERY + BUD group being more significant compared with the ERY group. There were no significant differences between the PEN, BUD and CON groups. ERY inhibited tracheal granulation tissue proliferation and improved tracheal stenosis following injury and synergistic effects with PEN and BUD further enhanced these protective effects. The mechanism may involve HDAC2 upregulation and inhibition of local airway and systemic inflammatory responses.


Assuntos
Anti-Inflamatórios/uso terapêutico , Budesonida/uso terapêutico , Eritromicina/uso terapêutico , Penicilinas/uso terapêutico , Substâncias Protetoras/uso terapêutico , Estenose Traqueal/metabolismo , Estenose Traqueal/prevenção & controle , Animais , Anti-Inflamatórios/farmacologia , Líquido da Lavagem Broncoalveolar/química , Budesonida/farmacologia , Colágeno/metabolismo , Modelos Animais de Doenças , Eritromicina/farmacologia , Tecido de Granulação/efeitos dos fármacos , Histona Desacetilase 2/genética , Histona Desacetilase 2/metabolismo , Hiperplasia/tratamento farmacológico , Hiperplasia/metabolismo , Interleucina-8/sangue , Interleucina-8/metabolismo , Penicilinas/farmacologia , Substâncias Protetoras/farmacologia , Coelhos , Traqueia/lesões , Traqueia/patologia , Estenose Traqueal/etiologia , Estenose Traqueal/patologia , Fator de Crescimento Transformador beta1/sangue , Fator de Crescimento Transformador beta1/metabolismo , Regulação para Cima/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/sangue , Fator A de Crescimento do Endotélio Vascular/metabolismo
7.
BMJ Open ; 11(7): e045406, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285004

RESUMO

OBJECTIVES: Transparent reporting of trials is necessary to assess their internal and external validity. Currently, little is known about the quality of reporting in antibiotics trials. Our study investigates the reporting of adverse events, conflicts of interest and funding information in trials of penicillins, cephalosporins and macrolides. DESIGN: A secondary analysis of trials included in a convenience sample of three systematic reviews. METHODS: All randomised controlled trials included in the systematic reviews were included, although duplicates were removed. Eligible trials compared the specified antibiotics to placebo, for any indication. Author pairs independently extracted the data on reporting of adverse events from parent reviews, and data on funding and conflict of interest information from the trial reports. We calculated the overall proportion of trials reporting adverse events, conflict of interest information and funding information, and their proportion before and after the publication of the Consolidated Standards of Reporting Trials (CONSORT) 2001 Statement. RESULTS: We included 432 trials. Overall, 62% of trials reported adverse events of any kind, although reporting of deaths or antibiotic resistance was less frequent (20% and 37%, respectively). Conflict-of-interest information was provided in 26% of the trials, and funding information was provided in 66% of the trials. There was no significant difference in reporting of adverse events before and after the publication of CONSORT 2001 Statement (62% vs 62%, p=0.92). Conflict of interest statements were provided more frequently (2% vs 55%, p<0.001) and conflict was present more often (0% vs 14%, p<0.001). There was no difference in the provision of the information about trial funding before (62%) and after (70%) CONSORT 2001 publication. CONCLUSIONS: Information about adverse events, conflict of interest and funding, remains under-reported in trials of antibiotics.


Assuntos
Antibacterianos , Conflito de Interesses , Ensaios Clínicos Controlados Aleatórios como Assunto , Antibacterianos/efeitos adversos , Cefalosporinas , Humanos , Macrolídeos , Penicilinas
8.
BMJ Case Rep ; 14(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34257106

RESUMO

Actinomycosis is a subacute-to-chronic bacterial infection caused by gram-positive, filamentous, non-acid-fast, facultative anaerobic bacteria. It is a normal commensal bacterium found in the oral cavity and the lower reproductive tract of women. We present a case of primary actinomycosis of the breast. A postmenopausal woman, complicated by penicillin allergy, presented with a left breast lump clinically simulating malignancy. The first line of treatment for actinomycosis is penicillin. Due to a penicillin allergy, the patient was initially treated with doxycycline. However, doxycycline was discontinued due to tremors, and was replaced by clindamycin. The patient had a good clinical response with resolution of the abscess.


Assuntos
Actinomicose , Hipersensibilidade a Drogas , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Antibacterianos/efeitos adversos , Clindamicina , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/tratamento farmacológico , Hipersensibilidade a Drogas/etiologia , Feminino , Humanos , Penicilinas/efeitos adversos
9.
J Antimicrob Chemother ; 76(12 Suppl 2): ii60-ii67, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34312656

RESUMO

OBJECTIVES: The quality of antibiotic consumption in the community can be assessed using 12 drug-specific quality indicators (DSQIs) developed by the European Surveillance of Antimicrobial Consumption (ESAC) project. We compared quality in 2009 and 2017 in the EU/European Economic Area (EEA) and evaluated the impact of using different DDD values (ATC/DDD indices 2011 and 2019) for the 2009 quality assessment using these DSQIs and a joint scientific opinion (JSO) indicator. METHODS: We calculated the 12 DSQIs and the JSO indicator for 2017 and for 2009 for EU/EEA countries able to deliver values. For each of the indicators we grouped the 2017 and 2009 indicator values into four quartiles. To evaluate changes in quality between 2009 and 2017, we used the quartile distribution of the 2009 indicator values in 30 EU/EEA countries as benchmarks. In addition, we compared the quality assessment for 2009 using the ATC/DDD indices 2011 and 2019. RESULTS: In 2017, a difference in the quality of antibiotic consumption in the community between northern and southern EU/EEA countries remained, but also several eastern EU/EEA countries shifted towards lower quality. Quality of antibiotic consumption decreased between 2009 and 2017 in particular indicator values for penicillin, quinolone, relative ß-lactam and broad- versus narrow-spectrum antibiotic consumption, and seasonal variation. Using different ATC/DDD indices did not substantially change countries' ranking based on their DSQI values. CONCLUSIONS: The quality of antibiotic consumption in the community as measured by the DSQIs further decreased between 2009 and 2017, especially in Southern and Eastern European countries. A continuous effort to improve antibiotic consumption is essential to reduce antibiotic consumption in general and the use of broad-spectrum antibiotics in particular.


Assuntos
Antibacterianos , Quinolonas , Antibacterianos/uso terapêutico , Uso de Medicamentos , Europa (Continente) , União Europeia , Humanos , Penicilinas
10.
J Antimicrob Chemother ; 76(12 Suppl 2): ii14-ii21, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34312657

RESUMO

OBJECTIVES: Data on consumption of penicillins in the community were collected from 30 EU/European Economic Area (EEA) countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main subgroups of penicillins. METHODS: For the period 1997-2017, data on consumption of penicillins, i.e. ß-lactam antibacterials, penicillins (ATC group J01C), in the community aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Consumption of penicillins was analysed based on ATC-4 subgroups, and presented as trends, seasonal variation, presence of change-points and compositional changes. RESULTS: In 2017, consumption of penicillins in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 4.9 between countries with the highest (Spain) and the lowest (the Netherlands) consumption. An increase in consumption of penicillins, which was not statistically significant, was observed between 1997 and 2003 and up to 2010. A decrease, which was not statistically significant, was observed from 2010 onwards. Proportional consumption of combinations of penicillins, including ß-lactamase inhibitors (J01CR) increased during 1997-2017, which coincided with a decrease in the proportional consumption of extended-spectrum penicillins (J01CA) and narrow-spectrum penicillins (J01CE). CONCLUSIONS: Considerable variation in the patterns of consumption of penicillins was observed between EU/EEA countries. The consumption of penicillins in the EU/EEA community did not change significantly over time, while the proportional consumption of combinations of penicillins increased.


Assuntos
Antibacterianos , Penicilinas , Antibacterianos/uso terapêutico , Uso de Medicamentos , Europa (Continente) , União Europeia , Humanos , Espanha/epidemiologia
11.
Inorg Chem ; 60(15): 11081-11089, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34242020

RESUMO

A CuI-TbIII heterometallic MOF, namely 1·DMF, was obtained via a coordination assembly process of isonicotinic acid with CuI and TbIII. 1·DMF can be switched to 1·MeOH in methanol with a luminescent emission response. Meanwhile, 1·MeOH exhibits a reversible single-crystal transformation to 1·DMF after immersion in DMF. Both MOFs have superior physicochemical stability. The 1·DMF-based biosensor has a remarkable sensing performance toward penicillin.


Assuntos
Cobre/química , Luminescência , Compostos Organometálicos/química , Penicilinas/análise , Térbio/química , Teoria da Densidade Funcional , Modelos Moleculares , Conformação Molecular , Penicilinas/química
12.
BMC Infect Dis ; 21(1): 679, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256734

RESUMO

BACKGROUND: Oral beta-lactam antimicrobials are not routinely tested against Streptococcus pneumoniae due to presumed susceptibility based upon penicillin minimum inhibitory concentration (MIC) testing. Currently, Clinical and Laboratory Standards Institute provides comments to use penicillin MIC ≤0.06 to predict oral cephalosporin susceptibility. However, no guidance is provided when cefotaxime MIC is known, leading to uncertainty with interpretation. The purpose of this study was to evaluate cefotaxime and penicillin MICs and their respective correlation to oral beta-lactam categorical susceptibility patterns. METHODS: 249 S. pneumoniae isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-ToF) and then tested by broth microdilution method to penicillin, cefotaxime, amoxicillin, cefdinir, cefpodoxime, and cefuroxime. RESULTS: Using Clinical and Laboratory Standards Institute (CLSI) non-meningitis breakpoints for cefotaxime, 240/249 isolates were classified as susceptible. Of the cefotaxime susceptible isolates, 23% of the isolates are misrepresented as cefdinir susceptible. Amoxicillin correlated well with penicillin MIC breakpoints with only 1 discordant isolate out of 249. CONCLUSION: The correlation between amoxicillin and penicillin creates a very reliable predictor to determine categorical susceptibility. However oral cephalosporins were not well predicted by either penicillin or cefotaxime leading to the possible risk of treatment failures. Caution should be used when transitioning to oral cephalosporins in cefotaxime susceptible isolates, especially with higher cefotaxime MICs.


Assuntos
Amoxicilina/farmacologia , Cefotaxima/farmacologia , Testes de Sensibilidade Microbiana/métodos , Penicilinas/farmacologia , Pneumonia Pneumocócica , Streptococcus pneumoniae , Administração Oral , Antibacterianos/farmacologia , Cefalosporinas/classificação , Cefalosporinas/farmacologia , Humanos , Pneumonia Pneumocócica/tratamento farmacológico , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , beta-Lactamas/farmacologia
13.
BMC Pediatr ; 21(1): 327, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315435

RESUMO

BACKGROUND: Infectious morbidity and mortality in the first week of life is commonly caused by early-onset neonatal Group B streptococcus (GBS) disease. This infection is spread from GBS positive mothers to neonates by vertical transmission during delivery and results in serious illness for newborns. Intrapartum prophylactic antibiotics have decreased the incidence of early-onset neonatal GBS disease by 80%. Patients labeled with a penicillin allergy (PcnA) alternatively receive either vancomycin or clindamycin but effectiveness is controversial. We evaluated the influence of a reported PcnA label versus no PcnA label on inpatient maternal and neonatal outcomes. METHODS: Our goal was to examine the relationship between a PcnA label, maternal and neonatal outcomes, and hospital costs. We collected retrospective data with institutional IRB approval from 2016 - 2018 for hospitalized patients who were GBS positive, pregnant at time of admission, ≥ 18 years of age, received antibiotic prophylaxis for GBS, were labeled as PcnA or non-PcnA, and completed a vaginal delivery. Patient characteristics and maternal/neonatal outcomes were examined. Statistical tests included calculations of means, medians, proportions, Mann-Whitney, two-sample t-tests, Chi-squared or Fisher's Exact tests, and generalized linear and logistic regression models. Significance was set at p < 0.05. RESULTS: Most PcnA patients were white, older, had a higher median body mass index and mean heart rate, and a greater proportion used tobacco than non-PcnA patients. In regression analyses, PcnA hospitalized patients received a shorter duration of antibiotic treatment than non-PcnA patients [incidence rate ratio (IRR): 0.45, 95% CI: 0.38-0.53]. PcnA patients were also more likely to have their baby's hospital LOS be > 48 h [adjusted odds ratio (AOR): 1.35, 95% CI: 1.07-1.69] even though the PcnA mothers' LOS was not different from non-PcnA mothers. Cost of care, mortality, intensive care, median parity, mean gravidity, and miscarriage were similar between the groups. CONCLUSIONS: In hospitalized obstetric patients, a PcnA label was associated with a shorter maternal course of antibiotic treatment and a longer neonatal LOS. Further prospective studies are needed to clarify the underlying reasons for these outcomes.


Assuntos
Hipersensibilidade a Drogas , Complicações Infecciosas na Gravidez , Infecções Estreptocócicas , Antibacterianos/efeitos adversos , Antibioticoprofilaxia , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/prevenção & controle , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães , Penicilinas/efeitos adversos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/prevenção & controle , Estudos Retrospectivos , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae
14.
J Food Sci ; 86(8): 3505-3516, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34287896

RESUMO

In this experiment, we designed an electrochemical sensor using penicillinase (Pen X)-rhombus porous carbon (RPC) as the detection element and hematoxylin as the indicator to detect low concentrations of penicillin sodium (Pen G). A differential pulse voltammetry (DPV) method was used to detect Pen G in the concentration range of 10-8 -10-5 mg·mL-1 under optimal experimental conditions. The results showed that the peak current value and the logarithm of Pen G concentration showed a good linear relationship (R2 = 0.9915), and the LOD was 2.68 × 10-7 mg·mL-1 (S/N = 3). The actual milk samples were detected by the addition method and compared with the high-performance liquid phase method; no significant difference was found in the detection results. The working electrode prepared by cross-linking method not only extends the service life of the sensor, but also improves the sensitivity and reproducibility of the sensor. It can also be used to detect the Pen G residue in the actual milk samples repeatedly. PRACTICAL APPLICATION: In this study, an electrochemical sensor for the rapid detection of penicillin sodium in milk was prepared, which has good sensitivity and fast detection speed.


Assuntos
Técnicas Biossensoriais , Carbono , Análise de Alimentos , Hematoxilina , Penicilinase , Penicilinas , Animais , Carbono/química , Técnicas Eletroquímicas , Eletrodos , Análise de Alimentos/métodos , Hematoxilina/química , Limite de Detecção , Leite/química , Penicilinas/análise , Porosidade , Reprodutibilidade dos Testes
15.
Eur Heart J ; 42(34): 3338-3348, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34263296

RESUMO

Rheumatic heart disease (RHD) is the result of episodes of acute rheumatic fever with valvular (and other cardiac) damage caused by an abnormal immune response to group A streptococcal infections, usually during childhood and adolescence. As a result of improved living conditions and the introduction of penicillin, RHD was almost eradicated in the developed world by the 1980s. However, being a disease of poverty, its burden remains disproportionately high in the developing world, despite being a fundamentally preventable disease. Rheumatic heart disease generates relatively little attention from the medical and science communities, in contrast to other common infectious problems (such as malaria, HIV, tuberculosis), despite the major cardiovascular morbidity/mortality burden imposed by RHD. This relative neglect and paucity of funding have probably contributed to limited fundamental medical advances in this field for over 50 years. Given the importance of prevention before the onset of major valvular damage, the main challenges for RHD prevention are improving social circumstances, early diagnosis, and effective delivery of antibiotic prophylaxis. Early identification through ultrasound of silent, subclinical rheumatic valve lesions could provide an opportunity for early intervention. Simple echocardiographic diagnostic criteria and appropriately trained personnel can be valuable aids in large-scale public health efforts. In addition, a better understanding of the immunogenic determinants of the disease may provide potential routes to vaccine development and other novel therapies.


Assuntos
Febre Reumática , Cardiopatia Reumática , Infecções Estreptocócicas , Adolescente , Humanos , Penicilinas , Febre Reumática/diagnóstico , Febre Reumática/epidemiologia , Febre Reumática/prevenção & controle , Cardiopatia Reumática/epidemiologia , Cardiopatia Reumática/prevenção & controle , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/prevenção & controle , Ultrassonografia
16.
J Allergy Clin Immunol Pract ; 9(10): 3629-3637.e2, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34293501

RESUMO

BACKGROUND: Coronavirus disease-2019 (COVID-19) ranges from asymptomatic to severe. Several comorbidities are associated with worse clinical outcomes. Antibiotic use is common in COVID-19 and penicillin (PCN) allergy can affect antibiotic choice and may influence COVID-19 outcomes. OBJECTIVE: To investigate the impact of PCN allergy label on COVID-19 outcomes. METHODS: For this retrospective, cohort study, a Web-based tool for population cohort research, TriNetX, was used to identify adult COVID-19 patients with and without PCN allergy label. The two cohorts were matched using 1:1 propensity score matching for baseline demographics and conditions associated with risk for severe COVID-19. The 30-day risks for hospitalization, acute respiratory failure, intensive care unit requirement, mechanical ventilation requirement, and mortality were then compared between groups. Because bacterial infection can drive alternative antibiotic regimens, additional analyses focused on patients without bacterial infection. RESULTS: After propensity score matching, each cohort consisted of 13,183 patients. COVID-19 patients with PCN allergy had higher risks for hospitalization (risk ratio [RR] = 1.46; 95% confidence interval [CI], 1.41-1.52) acute respiratory failure (RR = 1.25; 95% CI, 1.19-1.31), intensive care unit requirement (RR = 1.20; 95% CI, 1.08-1.34), and mechanical ventilation (RR = 1.17; 95% CI 1.03-1.32) compared with patients without PCN allergy; however, there was no mortality difference (RR = 1.09; 95% CI, 0.96-1.23). Although the bacterial infection risk was higher in PCN allergic COVID-19 patients, exclusion of patients with bacterial infections yielded similar results. CONCLUSIONS: Penicillin allergic patients have higher risk for worse COVID-19 outcomes and should be considered for risk mitigation strategies.


Assuntos
COVID-19 , Hipersensibilidade a Drogas , Adulto , Estudos de Coortes , Hipersensibilidade a Drogas/epidemiologia , Humanos , Penicilinas , Estudos Retrospectivos , SARS-CoV-2
17.
BMC Fam Pract ; 22(1): 112, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116641

RESUMO

BACKGROUND: Six percent of patients are allergic to penicillin according to their medical records. While this designation protects a small number of truly allergic patients from serious reactions, those who are incorrectly labelled may be denied access to recommended first line treatment for many infections. Removal of incorrect penicillin allergy may have positive health consequences for the individual and the general population. We aimed to explore primary care physicians' (PCPs) and patients' views and understanding of penicillin allergy with a focus on clinical management of infections in the face of a penicillin allergy record. METHODS: We conducted an interview study with 31 patients with a penicillin allergy record, and 19 PCPs in the North of England. Data were analysed thematically. RESULTS: Patients made sense of their allergy status by considering the timing and severity of symptoms. Diagnosis of penicillin allergy was reported to be 'imperfect' with PCPs relying on patient reports and incomplete medical records. PCPs and patients often suspected that an allergy record was incorrect, but PCPs were reluctant to change records. PCPs had limited knowledge of allergy services. PCPs often prescribed alternative antibiotics which were easy to identify. Both patients and PCPs differed in the extent to which they were aware of the negative consequences of incorrect penicillin allergy records, their relevance and importance to their lives, and management of penicillin allergy. CONCLUSIONS: PCPs and patients appear insufficiently aware of potential harms associated with incorrect penicillin allergy records. Some of the problems experienced by PCPs could be reduced by ensuring the details of newly diagnosed reactions to antibiotics are clearly documented. In order for PCPs to overturn more incorrect penicillin records through appropriate use of allergy services, more information and training about these services will be needed.


Assuntos
Hipersensibilidade a Drogas , Médicos de Atenção Primária , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/terapia , Humanos , Penicilinas/efeitos adversos , Atenção Primária à Saúde , Pesquisa Qualitativa
18.
Artigo em Russo | MEDLINE | ID: mdl-34190492

RESUMO

The analysis of the declassified documents of the Russian State Archive of Economics and the State Archive of the Russian Federation made it possible to establish that the project of the United Nations Relief and Reconstruction Administration was not a priority in the USSR for supplying equipment for penicillin factories to the two Soviet republics. Of greater interest was the acquisition in the United States of expensive high-performance plant equipped with the latest machinery, albeit for cash payment. This prioritization affected time-frame and implementation progress of the UNRRA penicillin project and facilitated manipulation on part of the United States. In aggregate with distrust of the USSR in quality of the supplied equipment and the hope for alternative sources of obtaining necessary scientific and technical information, this resulted in loss of interest to this project. The turned out situation affected correspondingly on the attitude of the Soviet Government to the UNRRA missions operating on the territory of the Soviet Republics and to the leadership of the organization itself and contributed to the further exacerbation the of Soviet-American relations.


Assuntos
Penicilinas , Nações Unidas , Federação Russa , Estados Unidos
19.
Rev Soc Bras Med Trop ; 54: e08612020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34133621

RESUMO

INTRODUCTION: This systematic review aimed to assess antibiotic use in Brazilian hospitals in the 21st century, as well as to understand the different drug utilization metrics adopted to assess the consumption of these drugs. METHODS: We systematically reviewed five databases (MEDLINE [Medical Literature Analysis and Retrieval System Online], CENTRAL [The Cochrane Central Register of Controlled Trials], EMBASE® [Excerpta Medica Database], Scopus [Elsevier's abstract and citation database], and LILACS [Literatura Latino-Americana e do Caribe em Ciências da Saúde]) for observational or experimental studies that assessed antibiotic utilization in Brazilian hospitals. The main outcomes were the drug utilization metrics and the consumption of antibiotics. RESULTS: We included 23 studies, of which 43.5% were carried out in adult and pediatric care units, 39.1% in adult units, and 17.4% in pediatric units. Regarding the complexity of healthcare, 26.1% of the studies were performed in intensive care units. Two drug utilization metrics were used in these studies: the defined daily dose (DDD) and the percentage of antibiotic prescriptions. The most commonly used antibiotic classes were third-generation cephalosporins, carbapenems, fluoroquinolones, and combinations of penicillins when the DDD was the adopted drug utilization metric. CONCLUSIONS: Although few studies have been conducted, existing data indicate a high use of broad-spectrum antibiotics. We found that the lack of standardized antibiotic utilization metrics impaired the mapping of drug consumption at the national level.


Assuntos
Antibacterianos , Penicilinas , Adulto , Antibacterianos/uso terapêutico , Brasil , Carbapenêmicos , Criança , Hospitais , Humanos
20.
APMIS ; 129(9): 566-573, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34120378

RESUMO

Staphylococcus aureus (SA) causes superficial and severe endovascular infections. The present in vitro study investigates the anti-SA mechanisms of hyperbaric oxygen therapy (HBOT) on direct bacterial killing, antibiotic potentiation, and polymorphonuclear leukocyte (PMN) enhancement. SA was exposed to isolated human PMNs, tobramycin, ciprofloxacin, or benzylpenicillin. HBOT was used as one 90-min session. Bacterial survival was evaluated after 4 h by quantitative bacteriology. PMN functionality as reactive oxygen species (ROS) production was measured by means of dihydrorhodamine 123 analysis. We showed that HBOT exhibits significant direct anti-SA effects. HBOT increased the anti-SA effects of PMNs by 18% after PMA stimulation (p = 0.0004) and by 15% in response to SA (p = 0.36). HBOT showed an additive effect as growth reductions of 26% to sub-MICs of tobramycin (p = 0.0057), 44% to sub-MICs of ciprofloxacin (p = 0.0001), and 26% to sub-MICs of penicillin (p = 0.038). The present in vitro study provides evidence that HBOT has differential mechanisms mediating its anti-SA effects. Our observation supports the clinical possibility for adjunctive HBOT to augment the host immune response and optimize the efficacy of antibiotic treatments.


Assuntos
Oxigenação Hiperbárica , Neutrófilos/imunologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/imunologia , Antibacterianos/administração & dosagem , Ciprofloxacina/administração & dosagem , Terapia Combinada , Humanos , Hiperóxia/imunologia , Técnicas In Vitro , Testes de Sensibilidade Microbiana , Neutrófilos/metabolismo , Penicilinas/administração & dosagem , Espécies Reativas de Oxigênio/metabolismo , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/terapia , Tobramicina/administração & dosagem
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