Journal articles on the topic 'Antimicrobial infections'
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Hosoglu, Salih, Zafer Parlak, Mehmet Faruk Geyik, and Yilmaz Palanci. "Critical evaluation of antimicrobial use - A Turkish university hospital example." Journal of Infection in Developing Countries 7, no. 11 (November 15, 2013): 873–79. http://dx.doi.org/10.3855/jidc.2921.
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Introduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients’ data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialists
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Uy, Natalie, Rupak Datta, Noffar Bar, and Manisha Juthani-Mehta. "2678. Characterizing Hospitalizations and Infections Among Older Adults Receiving Palliative Chemotherapy for Hematologic Malignancies." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S940. http://dx.doi.org/10.1093/ofid/ofz360.2356.
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Abstract Background As cancer survivorship improves, the number of patients with hematologic malignancies receiving palliative chemotherapy will grow. Older adults with hematologic malignancies often carry poor prognoses and experience high risks of infection. We evaluated the frequency of CDC criteria confirmed infection and antimicrobial use during hospitalizations following initiation of palliative chemotherapy. Methods We conducted a cohort study of patients aged ≥65 years who received non-curative palliative chemotherapy between January 1, 2016 and September 30, 2017 and were subsequently hospitalized by January 31, 2018. Hematologic malignancies were verified with medical record review. Infections were identified using CDC criteria, and antimicrobials were categorized by indication for use. Results We identified 268 patients receiving palliative chemotherapy for hematologic malignancies (Table 1) who had a total 591 hospitalizations (Table 2) during follow-up. There were 162 readmissions (27%) among 92 patients. Among all patients, 128 (48%) died during follow-up. Forty-one (15%) deaths were within 30 days of discharge. The most common site of death was hospice, in and outpatient (27%). Two hundred forty-nine (42%) admissions were for infectious causes; of the 34 patients who died inpatient (non hospice), 56% had been admitted for infectious causes. Antimicrobials were prescribed for prophylaxis in 57% (n = 337/591) of hospitalizations. Antimicrobials were prescribed for suspected infection in 48% (n = 282/591) of hospitalizations. Only 30% (n = 178/591) of hospitalizations had antimicrobials given for CDC confirmed infections. Figure 1 shows the most common indications for antimicrobial use. Conclusion Infections are an important cause of the morbidity and mortality in older adults receiving palliative chemotherapy for hematology malignancies. Hospitalizations for infectious causes were frequent in our cohort. Nearly half of hospitalizations involved antimicrobial use for suspected infection, but CDC confirmed infections were less common. This population warrants further investigation to improve antimicrobial use. Future studies should identify the subset of patients at high risk for recurrent admissions to optimize medical care. Disclosures All authors: No reported disclosures.
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Queirós, Catarina Soares, and João Borges da Costa. "Gonorrhea: Antimicrobial Resistance and New Drugs." Journal of the Portuguese Society of Dermatology and Venereology 77, no. 3 (October 10, 2019): 233–38. http://dx.doi.org/10.29021/spdv.77.3.1089.
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The global burden of sexually transmitted infections remains high, with significant associated morbidity and mortality. Gonorrhea is the second most notified sexually transmitted infection in Europe, and its incidence has been increasing in the last years. Although traditionally considered a treatable infection, antimicrobial resistance of Neisseria gonorrhoeaeincludes at present also macrolides, tetracyclines, sulfonamides and trimethoprim combinations, quinolones, and even cephalosporins. These high levels of gonococcal resistance to antimicrobials resulting in untreatable infections in the future may become one of the greatest challenges to the prevention and control of sexually transmitted infections, which may be a significant major public health issue. Therefore, the development of novel antimicrobials and/or new dual antimicrobial therapy regimens is urgently needed. In this paper, evolution of antimicrobial resistance of Neisseria gonorrhoeae is reviewed, along with new drugs currently under development for the treatment of this infection.
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Viola, George M., Issam I. Raad, and Kenneth V. Rolston. "Breast Tissue Expander—Related Infections: Perioperative Antimicrobial Regimens." Infection Control & Hospital Epidemiology 35, no. 1 (January 2014): 75–81. http://dx.doi.org/10.1086/674390.
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Objective.The rate of postmastectomy tissue expander (TE) infection remains excessively high, ranging between 2% and 24%. We hypothesized that current perioperative antimicrobial regimens utilized for breast TE reconstruction may be outdated as a result of recent changes in microflora and susceptibility patterns.Design and Methods.We reviewed the records of all patients who had a TE reconstructive procedure and developed a definite breast TE infection between 2003 and 2010 at MD Anderson Cancer Center. Antimicrobials were stratified into 3 groups: systemic perioperative, local irrigation, and oral immediate postoperative antimicrobials. These were considered discordant if they did not target the isolated organisms, while a breakthrough infection was defined as an infection that occurred despite concordant antimicrobial coverage.Results.Overall, 75 patients with a definite TE infection were identified. The most common organisms identified were methicillin-resistant Staphylococcus epidermidis (29%), methicillin-resistant Staphylococcus aureus (15%), and gram-negative rods (26%). The use of systemic perioperative antimicrobials was deemed discordant in 51% of the cases. Although 79% of the patients received broad-spectrum perioperative local antimicrobial irrigation, 63% developed a breakthrough infection. Even though 61% received oral postoperative prophylactic antimicrobials, 63% of the times they were deemed discordant.Conclusions.Contrary to the proven effectiveness of a single dose of perioperative antibiotics, the common use of local antimicrobial irrigation and prolonged postoperative oral antibiotics appears to be an inadequate component of our preventive armamentarium. Also, because methicillin-resistant staphylococcal and pseudomonal infections occurred approximately 60% of the time, at institutions that have observed an increase of these organisms, it may be prudent that perioperative antimicrobials target these microorganisms.
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Sotello, David, Wadih Chakkour, and Kristen Fuhrmann. "The Carbapenems Issue." Southwest Respiratory and Critical Care Chronicles 6, no. 25 (July 20, 2018): 5–7. http://dx.doi.org/10.12746/swrccc.v6i25.476.
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The development of antibiotics remains one of the great advances in medicine. Antibiotics have saved countless lives. Unfortunately, the widespread use of antimicrobials has led to the development of antimicrobial resistance. Antibiotic resistance is an important concern for public health; it is associated with poor outcomes. Carbapenems, members of the β-lactam class of antibiotics, have the broadest spectrum of antimicrobial activity. Carbapenem resistance is one of the toughest challenges in infectious diseases; it is associated with high mortality and is seen more often now due to the proliferation of multi-drug resistant bacteria. Multiple genes that cause carbapenem resistance have been identified. Resistance transmission is usually nosocomial, but community-acquired infections with resistance have been reported. Early recognition of high risk patients for multi-drug resistant infections is fundamental for adequate management. The rational use of antibiotics is required to prevent the spread of antimicrobial resistance; this requires multidisciplinary efforts among clinicians, Infection Control departments, and Antimicrobial Stewardship programs.
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Ioannou, Petros, Eirini Astrinaki, Efsevia Vitsaxaki, Emmanouil Bolikas, Despoina Christofaki, Apostolia Salvaraki, Eirini Lagoudaki, et al. "A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece." Antibiotics 11, no. 9 (September 16, 2022): 1258. http://dx.doi.org/10.3390/antibiotics11091258.
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Background: Both healthcare-associated infections (HAIs) and antimicrobial resistance are associated with an increased length of stay and hospital costs, while they have also been linked to high morbidity and mortality rates. In 2016 and 2017, the latest point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals highlighted an HAI prevalence of 6.5%, while Greece had a higher HAI prevalence of 10%. The aim of this PPS was to record the prevalence of HAIs and antimicrobial use in all eight public acute care hospitals in Crete, Greece during the COVID-19 pandemic in order to highlight the types of infections and antimicrobial practices that need to be prioritized for infection control initiatives. Methods: The PPS was conducted between 30 March and 15 April 2022, according to the ECDC standardized relevant protocol (version 5.3). Statistics were extracted using the ECDC Helics.Win.Net application (software version 4.1.0). Results: A total of 1188 patients were included. The overall point prevalence of patients with at least one HAI was 10.6%. The most frequent types of infections were pneumonia (34.3%), bloodstream infections (10.5%), systemic infections and urinary tract infections (10.5% and 9.1%, respectively). In 14 (12.4%) cases, the pathogen responsible for HAI was SARS-CoV-2 following onsite spread, accounting for almost 10% of all HAIs. Microorganisms were identified in 60.1% of HAIs. Antimicrobials were administered in 711 (59.8%) patients, with 1.59 antimicrobials used per patient. Conclusion: The prevalence of HAI and antimicrobial use among hospitalized patients in Crete, Greece was similar to the national HAI prevalence in 2016 despite the enormous pressure on public hospitals due to the COVID-19 pandemic. Nevertheless, both HAI prevalence and antimicrobial use remain high, underlining the need to implement adequate infection control and antimicrobial stewardship interventions.
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Akram, Zaid Mustafa, Khalid Burhan Khalid, Qaisar Khaleel Oraibi, and Maadh Fawzi Nassar. "Antimicrobial resistance of bacterial pathogens isolated from the infections of post maxillofacial surgery." Journal of Medicine and Life 15, no. 8 (August 2022): 944–50. http://dx.doi.org/10.25122/jml-2021-0149.
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Inappropriate antibiotic prescriptions contributed to a global issue of antimicrobial resistance. This study aimed to assess the prevalence of bacterial pathogens and antimicrobial resistance isolated from maxillofacial infections (MIs). Two hundred and twenty-two patients with different MIs were included in this study. Swab samples were taken from the site of infections. Samples were cultured, and isolated bacteria were identified using various biochemical tests. Antimicrobial resistance patterns of isolates were assessed by the disk diffusion method. The mean age of the patients was 50.8 years. The male-to-female ratio was 127/95 (P<0.05). Smoking and alcohol consumption were found in 60.36% and 37.38% of patients, respectively. Most patients had a ≤1-week infection duration (P<0.05). Abscess lesion was the most predominant infection type (P<0.05). The prevalence of aerobic bacteria among abscess, pus localization, and deep facial infections was 59.33%, 64.28%, and 46.66%, respectively. The prevalence of anaerobic bacteria among abscess, pus localization, and deep facial infections was 40.66%, 23.80%, and 53.33%, respectively. Staphylococcus aureus (10.36%) and Prevotella buccalis (8.55%) had the uppermost distribution amongst all examined samples. Isolated bacteria exhibited the uppermost resistance rate toward penicillin (65.76%), tetracycline (61.26%), gentamicin (58.10%), and ampicillin (57.65%) antimicrobials. The lowest resistance rate was obtained for linezolid (25.67%), ceftriaxone (31.08%), and azithromycin (31.08%) antimicrobials. Linezolid, ceftriaxone, and azithromycin had effective antimicrobial activities toward bacteria isolated from MIs. Therefore, cautious antibiotic prescription might decrease the prevalence of antimicrobial resistance in dental and maxillofacial infections.
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Bishop, Bryan M. "Antimicrobial Stewardship in the Emergency Department." Journal of Pharmacy Practice 29, no. 6 (July 8, 2016): 556–63. http://dx.doi.org/10.1177/0897190015585762.
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Antimicrobial resistance is a national public health concern. Misuse of antimicrobials for conditions such as upper respiratory infection, urinary tract infections, and cellulitis has led to increased resistance to antimicrobials commonly utilized to treat those infections, such as sulfamethoxazole/trimethoprim and flouroquinolones. The emergency department (ED) is a site where these infections are commonly encountered both in ambulatory patients and in patients requiring admission to a hospital. The ED is uniquely positioned to affect the antimicrobial use and resistance patterns in both ambulatory settings and inpatient settings. However, implementing antimicrobial stewardship programs in the ED is fraught with challenges including diagnostic uncertainty, distractions secondary to patient or clinician turnover, and concerns with patient satisfaction to name just a few. However, this review article highlights successful interventions that have stemmed inappropriate antimicrobial use in the ED setting and warrant further study. This article also proposes other, yet to be validated proposals. Finally, this article serves as a call to action for pharmacists working in antimicrobial stewardship programs and in emergency medicine settings. There needs to be further research on the implementation of these and other interventions to reduce inappropriate antimicrobial use to prevent patient harm and curb the development of antimicrobial resistance.
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Becker, Daniel E. "Antimicrobial Drugs." Anesthesia Progress 60, no. 3 (August 1, 2013): 111–23. http://dx.doi.org/10.2344/0003-3006-60.3.111.
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Abstract Antibiotics play a vital role in dental practice for managing orofacial infections. They are used to manage existing infection and they are also used as prophylaxis for certain medical conditions and surgical procedures. This article will review pharmacological and therapeutic considerations for the proper use of these agents for dental infections.
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Weycker, Derek, David Chandler, Rich Barron, Hairong Xu, Hongsheng Wu, John Edelsberg, and Gary H. Lyman. "Risk of infection among patients with non-metastatic solid tumors or non-Hodgkin’s lymphoma receiving myelosuppressive chemotherapy and antimicrobial prophylaxis in US clinical practice." Journal of Oncology Pharmacy Practice 23, no. 1 (July 9, 2016): 33–42. http://dx.doi.org/10.1177/1078155215614997.
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Purpose Guidelines generally do not recommend oral antimicrobials for prophylaxis against chemotherapy-related infections in patients with solid tumors. Evidence on antimicrobial prophylaxis use, and associated chemotherapy-related infection risk, in US clinical practice is limited. Methods A retrospective cohort design and data from two US private healthcare claims repositories (2008–2011) were employed. Study population included adults who received myelosuppressive chemotherapy for non-metastatic cancer of the breast, colon/rectum, or lung, or for non-Hodgkin’s lymphoma. For each subject, the first chemotherapy course was characterized, and within the first course, each chemotherapy cycle and chemotherapy-related infection episode was identified. Use of prophylaxis with oral antimicrobials and colony-stimulating factors in each cycle also was identified. Results A total of 7116 (22% of all) non-metastatic breast cancer, 1833 (15%) non-metastatic colorectal cancer, 1999 (15%) non-metastatic lung cancer, and 1949 (21%) non-Hodgkin’s lymphoma patients received antimicrobial prophylaxis in ≥1 cycle. Mean number of antimicrobial prophylaxis cycles during the course among these patients was typically <2, with little difference across cancers and chemotherapy regimens. Fluoroquinolones were the most commonly received class of antimicrobials, accounting for 20%–50% all antimicrobials administered. Among subjects who received first-cycle antimicrobial prophylaxis, chemotherapy-related infection risk in that cycle ranged from 3% to 6% across cancer types. Among patients who received first-cycle antimicrobial prophylaxis and developed chemotherapy-related infections, 38%–67% required inpatient care. Chemotherapy-related infection risk in subsequent cycles with antimicrobial prophylaxis was comparable. Conclusion The results of this study suggest that use of antimicrobial prophylaxis during myelosuppressive chemotherapy is far from uncommon in clinical practice. The results also suggest that an important minority of cancer chemotherapy patients receiving antimicrobial prophylaxis still develop serious infection requiring hospitalization.
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Fleming, Naomi. "AMR: effective infection prevention and control measures." Practice Nursing 30, no. 8 (August 2, 2019): 390–95. http://dx.doi.org/10.12968/pnur.2019.30.8.390.
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Antimicrobial resistance is on the rise. As more infections are becoming resistant to antibiotic treatment, it would benefit practice nurses to be aware of the effective measures they can use to prevent the spread of infection, explains Naomi Fleming When micro-organisms are exposed to an antimicrobial, more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on resistance to their offspring. The use and misuse of antimicrobials has increased the number and types of resistant organisms. As a result, standard treatments become ineffective and infections persist and may spread. Infection prevention and control (IPC) is key to reducing demand for antimicrobial use and reducing the acquisition of antimicrobial resistance. Poor IPC can increase the spread of drug-resistant infections. Interventions such as effective hand hygiene and vaccination have significant potential to limit opportunities for drug-resistant strains to emerge. Effective leadership is vital and nurses are central to promoting IPC, leading on IPC compliance and ensuring uptake of vaccination in primary care.
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Zhanel, George, Nina Clark, and Joseph Lynch. "Infections Due to Acinetobacter baumannii in the ICU: Treatment Options." Seminars in Respiratory and Critical Care Medicine 38, no. 03 (June 2017): 311–25. http://dx.doi.org/10.1055/s-0037-1599225.
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AbstractBacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that may cause nosocomial infections in critically ill or debilitated patients (particularly ventilator-associated pneumonia and infections of the bloodstream, urinary tract, and wounds). Treatment of Acinetobacter infections is difficult, as Acinetobacter spp. are intrinsically resistant to multiple antimicrobial agents, and have a remarkable ability to acquire new resistance determinants via mechanisms that include plasmids, transposons, integrons, and resistance islands. Since the 1990s, global resistance to antimicrobials has escalated dramatically among ABC. Global spread of multidrug-resistant (MDR)-A. baumannii strains reflects dissemination of a few clones between hospitals, geographic regions, and continents; excessive use of antibiotics amplifies this spread. Many isolates are resistant to all antimicrobials except colistin (polymyxin E) and tigecycline, and some infections are untreatable with existing antimicrobial agents. Antimicrobial resistance poses a serious threat to treat or prevent infections due to ABC. Strategies to curtail environmental colonization with MDR-ABD will require aggressive infection control efforts and cohorting of infected patients. Thoughtful antibiotic strategies are essential to limit the spread of MDR-ABC. Optimal therapy will likely require combination antimicrobial therapy of existing antibiotics as well as development of novel antibiotic classes.
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Kaufhold, Samantha, Reza Yaesoubi, and Virginia E. Pitzer. "Predicting the Impact of Typhoid Conjugate Vaccines on Antimicrobial Resistance." Clinical Infectious Diseases 68, Supplement_2 (March 7, 2019): S96—S104. http://dx.doi.org/10.1093/cid/ciy1108.
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Abstract Background Empiric prescribing of antimicrobials in typhoid-endemic settings has increased selective pressure on the development of antimicrobial-resistant Salmonella enterica serovar Typhi. The introduction of typhoid conjugate vaccines (TCVs) in these settings may relieve this selective pressure, thereby reducing resistant infections and improving health outcomes. Methods A deterministic transmission dynamic model was developed to simulate the impact of TCVs on the number and proportion of antimicrobial-resistant typhoid infections and chronic carriers. One-way sensitivity analyses were performed to ascertain particularly impactful model parameters influencing the proportion of antimicrobial-resistant infections and the proportion of cases averted over 10 years. Results The model simulations suggested that increasing vaccination coverage would decrease the total number of antimicrobial-resistant typhoid infections but not affect the proportion of cases that were antimicrobial resistant. In the base-case scenario with 80% vaccination coverage, 35% of all typhoid infections were antimicrobial resistant, and 44% of the total cases were averted over 10 years by vaccination. Vaccination also decreased both the total number and proportion of chronic carriers of antimicrobial-resistant infections. The prevalence of chronic carriers, recovery rates from infection, and relative fitness of resistant strains were identified as crucially important parameters. Conclusions Model predictions for the proportion of antimicrobial resistant infections and number of cases averted depended strongly on the relative fitness of the resistant strain(s), prevalence of chronic carriers, and rates of recovery without treatment. Further elucidation of these parameter values in real-world typhoid-endemic settings will improve model predictions and assist in targeting future vaccination campaigns and treatment strategies.
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Ruiz-Garbajosa, Patricia, and Rafael Cantón. "COVID-19: Impact on prescribing and antimicrobial resistance." Revista Española de Quimioterapia 34, Suppl 1 (September 30, 2021): 63–68. http://dx.doi.org/10.37201/req/s01.19.2021.
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The onset of the COVID-19 pandemic challenged healthcare systems focusing their activity on patients infected with SARS-CoV-2. Previous experience with co-infections and superinfections in patients infected with other coronaviruses (SARS-CoV and MERS), the influenza patients admitted to hospitals and prevention of the unknown led to the increased empirical use of broad-spectrum antibiotics in hospitals. The breakdown of antimicrobial stewardship and infection control programs determine an increase in infections due to multidrug-resistant bacteria, particularly in intensive care units. Most of these infections are related to high-risk carbapenemase-producing clones and occasionally with resistance to new β-lactam-β-lactamase inhibitor combinations. On the contrary, in the primary care, there has been a decrease in the use of antimicrobials during the first wave, although it would not have had a significant impact on pathogens associated with community-acquired infections. The accumulated experience reaffirms the need to maintain antimicrobial stewardship and infection control programs in future health crises.
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Gkentzi, Despoina, Christina Kortsalioudaki, Benjamin Campbell Cailes, Theoklis Zaoutis, John Kopsidas, Maria Tsolia, Nikos Spyridis, et al. "Epidemiology of infections and antimicrobial use in Greek Neonatal Units." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 3 (June 28, 2018): F293—F297. http://dx.doi.org/10.1136/archdischild-2018-315024.
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ObjectiveTo describe the epidemiology of neonatal infections and of antimicrobial use in Greek Neonatal Units (NNUs) in order to develop national, evidence-based guidelines on empiric antimicrobial use for neonatal sepsis in Greece.DesignRetrospective analysis of prospectively collected infection surveillance data from 2012 to 2015, together with a Point Prevalence Survey (PPS) on antimicrobial use and the collection of data on local empiric antimicrobial policies.Setting16 NNUs in Greece participating in the neonIN infection surveillance networkPatientsNewborns in participating NNUs who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of antibiotics.Results459 episodes were recorded in 418 infants. The overall incidence of infection was 50/1000 NNU-admissions. The majority of episodes were late-onset sepsis (LOS) (413, 90%). Coagulase-negative Staphylococci (80%) were the most common Gram-positive organisms causing LOS and Klebsiella spp (39%) the most common Gram-negative. Nearly half (45%) of the Klebsiella spp were resistant to at least one aminoglycoside. The PPS revealed that 196 of 484 (40%) neonates were on antimicrobials. The survey revealed wide variation in empiric antimicrobial policies for LOS.ConclusionsThis is the largest collection of data on the epidemiology of neonatal infections in Greece and on neonatal antimicrobial use. It provides the background for the development of national evidence-based guidelines. Continuous surveillance, the introduction of antimicrobial stewardship interventions and evidence-based guidelines are urgently required.
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Wiedermann, Christian J. "Hypoalbuminemia as Surrogate and Culprit of Infections." International Journal of Molecular Sciences 22, no. 9 (April 26, 2021): 4496. http://dx.doi.org/10.3390/ijms22094496.
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Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.
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Darouiche, R. O. "Antimicrobial Coating of Devices for Prevention of Infection: Principles and Protection." International Journal of Artificial Organs 30, no. 9 (September 2007): 820–27. http://dx.doi.org/10.1177/039139880703000912.
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Device-associated infections are responsible for about half of nosocomial infections and can cause major medical and economical sequelae. Despite adherence to basic infection control measures, which constitute the mainstay for preventing infection, infections associated with certain devices continue to exist at unacceptably high rates. Potentially-preventive, antimicrobial-utilizing strategies include systemic antibiotic prophylaxis and local administration of antimicrobial agents (antibiotics or antiseptics), which includes antimicrobial irrigation of the surgical field, placement of antimicrobial carriers, antiseptic cleansing of the skin, dipping of surgical implants in antimicrobial solutions, and inserting antimicrobial-coated implants. Since bacterial colonization of the indwelling device is a prelude to infection, prevention of device colonization may lead to a lower rate of clinical infection. Different approaches for antimicrobial coating of devices have been variably successful in preventing device-associated infections. Optimal characteristics of antimicrobial coating can help predict the likelihood and degree of clinical protection against infection. This review addresses the impact of device-related infection, antimicrobial-utilizing approaches for preventing infection, clinical protection afforded by different types of antimicrobial coating, characteristics that predict the ability of antimicrobial coating of devices to prevent clinical infection, and future directions of antimicrobial coating.
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Stieferman, Addison E., Patrick Mazi, and Jason P. Burnham. "Severe Skin and Soft-Tissue Infections." Seminars in Respiratory and Critical Care Medicine 43, no. 01 (February 2022): 003–9. http://dx.doi.org/10.1055/s-0041-1740974.
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AbstractSkin and soft-tissue infections (SSTIs) are a common reason for hospital admission. Severe SSTIs, particularly necrotizing infections, often require intensive care. Source control (often with surgical debridement) and broad-spectrum antimicrobials are paramount for minimizing significant morbidity and mortality. Rapid diagnostic tests may help in selection and de-escalation of antimicrobials for SSTIs. Besides early source control and early effective antimicrobial therapy, other patient-level factors such as comorbidities and immune status play a role in clinical outcomes. Intravenous immunoglobulin continues to be studied for severe SSTI, though recruitment in trials continues to be an issue. Severe SSTIs are complex to manage, due in part to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. This review includes descriptions of source control, antimicrobial therapies, intravenous immunoglobulin, and hyperbaric oxygen therapy, as well as host factors in severe SSTIs.
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Delpech, Gastón, Natalia García Allende, Sabina Lissarrague, and Mónica Sparo. "Antimicrobial Resistance of Uropathogenic Escherichia coli from Elderly Patients at a General Hospital, Argentina." Open Infectious Diseases Journal 10, no. 1 (July 19, 2018): 79–87. http://dx.doi.org/10.2174/1874279301810010079.
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Background:Urinary Tract Infection (UTI) is a common cause of morbidity and mortality in older adults.Objective:To investigate antimicrobial resistance of uropathogenicEscherichia colifrom elderly patients in a General Hospital, Argentina.Method:During the period July 2011-July 2015, patients over 70 years old with urinary tract infections, without urinary catheters and with no antimicrobial therapy the previous week before sampling, were included. Phenotypic characterization was carried out.In vitroqualitative and quantitative antimicrobial resistances were investigated. Antimicrobials assayed: ampicillin, amoxicillin-clavulanate, cefazolin, cefuroxime, cefoxitin, cefotaxime, ceftazidime, cefepime, imipenem, ertapenem, gentamicin, nalidixic acid, ciprofloxacin, trimethoprim-sulfamethoxazole (TMS) and nitrofurantoin. Patients’ medical records were produced, and risk factors were analyzed by multivariate analysis.Results:768 bacterial isolates were identified asE. coli. Resistances to ampicillin (80.5%), nalidixic acid (61.7%), ciprofloxacin (42.8%), TMS (37.6%), amoxicillin-clavulanate (28.6%), cefazolin (21.6%), cefuroxime (20.7%), gentamicin (13.8%), cefotaxime (9.7%), ceftazidime (9.7%), cefepime (8.4%), cefoxitin (3.1%) and nitrofurantoin (2.3%) were observed. Resistance to carbapenems was not expressed. Production of extended spectrum β-lactamases was detected (7.6%) in community acquired (96%) and healthcare associated (4%) isolates. The independent risk factors for urinary infections produced by multi-resistantE. coliwere: diabetes mellitus, recurrent infections, hospitalization during the last year and exposure to β-lactams in the last 3 months.Conclusion:A high prevalence of resistance to β-lactams and to other antimicrobials was observed. Detection of antimicrobial multi-resistant isolates highlights the need of antimicrobial resistance surveillance in elderly patients with urinary tract infections.
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Bennett, Noleen, Kirsty Buising, and Robyn Ingram. "A National Aged Care Infection and Antimicrobial Use Survey: A Three-Year Report." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s97—s98. http://dx.doi.org/10.1017/ice.2020.597.
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Background: Australia has ~2,700 aged-care homes and 180 multipurpose services. The annual Aged Care National Antimicrobial Prescribing Survey (AC NAPS), first pilot tested in 2015, is a surveillance tool that can be used in these facilities to monitor infections and antimicrobial use. It assists in identifying priorities for local and national infection control and antimicrobial stewardship interventions. Methods: Nurses or pharmacists collect point prevalence data using standardized data collection forms: (1) A facility form, completed by each participating facility, includes resident-level data fields (eg, number of residents present on the survey day). (2) An infection form is completed for residents with signs and/or symptoms of infection. (3) An antimicrobial form is completed for residents who are prescribed an antimicrobial. Results: Regarding prevalence,for those 31 facilities that participated annually, there was no significant change in either prevalence rate (Table 1). Regarding priority areas for improvement (2018 data only), 64.6% of prescriptions were for residents who did not have signs and/or symptoms of a suspected infection in the week prior to the antimicrobial start date. The most common clinical indications for prescriptions were skin soft-tissue and mucosal infection (18.3%), cystitis (16.0%) and pneumonia (9.4%). Cefalexin (20.3%), clotrimazole (19.0%), and chloramphenicol (7.0%) were the most commonly prescribed antimicrobials. Review or stop dates were not documented for 58.9% of prescriptions. Only 39.2% of antimicrobials were prescribed in the 7 days prior to the survey day; 28.3% were prescribed >6 months prior. Furthermore, 36.3% of all prescriptions were for topical application. In addition, 19.0% of antimicrobials were prescribed for PRN (as needed) administration; most (94.4%) of these were for topical antimicrobials, most commonly clotrimazole (65.4%). Conclusions: The AC NAPS has identified infections and consistent patterns of antimicrobial use that may adversely affect the safety of care for Australian aged-care residents. Interventions are now being developed, implemented, and evaluated to address identified ‘priority areas for improvement.’Funding: NoneDisclosures: None
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Prasad, Prithiv, Ioannis Zacharioudakis, Jordan Poles, Yanina Dubrovskaya, Dinuli Delpachitra, Eduardo Iturrate, and Sigridh Munoz-Gomez. "27. Co-infections and antimicrobial use in patients hospitalized with COVID-19." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S19—S20. http://dx.doi.org/10.1093/ofid/ofab466.027.
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Abstract Background In-hospital antimicrobial use among COVID-19 patients is widespread due to perceived bacterial and fungal co-infections. We aim to describe the incidence of these co-infections and antimicrobial use in patients hospitalized with COVID-19 to elucidate data for guiding effective antimicrobial use in this population. Methods This retrospective study included all patients admitted with COVID-19 from January 1, 2020, to February 1, 2021 at any of the three teaching hospitals of the NYU Langone Health system. Variables of interest were extracted from the health system’s de-identified clinical database. The nadir of hospital admissions between the first and second peaks of hospital admissions in the dataset was used to delineate the First Wave and Late Pandemic periods of observation. A cut-off of 48 hours after admission was used to differentiate Co-infections and Secondary infections respectively among isolates of clinically relevant bacterial or fungal pathogens in blood or sputum samples. Population statistics are presented as median with interquartile range (IQR) or total numbers with percentages. Results 663 of 7,213 (9.2%) inpatients were found to have a positive bacterial or fungal culture of the respiratory tract or blood during the entire course of their initial admission at our hospitals for COVID-19. Positive respiratory cultures were found in 437 (6.1%) patients, with 94 (1.3%) being collected within 48 hours of admission. Blood culture positivity occurred in 333 patients (4.6%), with 115 (1.6%) identified within 48 hours of admission. Infection-free survival decreased with duration of hospitalization, with rate of secondary infections steadily rising after the second week of hospitalization as seen in Figure 1. 70.2% of inpatients received antimicrobials for a median duration of 6 antimicrobial days (IQR 3.0 – 12.0) per patient. A higher proportion of patients received antimicrobials in the first wave than in the late pandemic period (82.6% vs. 51.8%). Table 1. Table 2 Figure 1 Infection free survival represented as duration of admission in days on the X-axis, and proportion of admitted patients remaining infection-free in the Y-axis. The blue line represents blood cultures and the orange line represents sputum cultures. Conclusion There was a very low incidence of co-infection with SARS-CoV-2 infection at admission. A longer duration of hospitalization was associated with an increased risk of secondary infections. Antimicrobial use far exceeded the true incidence and detection of co-infections in these patients. Disclosures All Authors: No reported disclosures
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Suchland, R. J., W. M. Geisler, and Walter E. Stamm. "Methodologies and Cell Lines Used for Antimicrobial Susceptibility Testing of Chlamydia spp." Antimicrobial Agents and Chemotherapy 47, no. 2 (February 2003): 636–42. http://dx.doi.org/10.1128/aac.47.2.636-642.2003.
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ABSTRACT In vitro susceptibility testing was performed on strains of Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci under various conditions, including the cell line utilized, the time between infection and the addition of an antimicrobial, the concentration of inoculum, and the effect of multiple passage on the minimal chlamydicidal concentrations for the antibiotics doxycycline, azithromycin, erythromycin, ofloxacin, and tetracycline. With macrolides, the MIC varied depending upon the cell line utilized. With all antimicrobials, the MIC was related to the time at which the antimicrobial was added after infection. By an optimized cell culture passage method, all strains of chlamydia tested demonstrated survival after exposure to high levels (>100 times the MIC) of antimicrobials. Furthermore, upon retest, these surviving organisms did not demonstrate increased MICs. Thus, this phenomenon does not reflect selection of antimicrobial-resistant mutants but rather survival of some organisms in high antimicrobial concentrations (heterotypic survival). An additional 44 clinical isolates of C. trachomatis from patients with single-incident infections were tested against those from patients with recurrent or persistent infections, and heterotypic survival was seen in all isolates tested; hence, in vitro resistance did not correlate with the patient's apparent clinical outcome.
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Sheng, Tianchen, Gaya B. Wijayaratne, Thushani M. Dabrera, Ajith Nagahawatte, Champica K. Bodinayake, Ruvini Kurukulasooriya, Kristin J. Nagaro, et al. "436. Skin and Soft-tissue Infections Are a Common Reason for Potentially Inappropriate Antimicrobial Use among Inpatients in Sri Lanka." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S216—S217. http://dx.doi.org/10.1093/ofid/ofz360.509.
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Abstract Background Skin and soft-tissue infections (SSTI) are a common reason for antimicrobial use in the outpatient and inpatient settings. Inappropriate antimicrobial use for SSTI is common. We determined the prevalence of SSTI and associated inappropriate antimicrobial use among inpatients in Sri Lanka. Methods A point-prevalence study of antimicrobial use was conducted using one-day cross-sectional surveys at five public hospitals in Southern Province, Sri Lanka from Jun-August 2017. Inpatients’ medical records were reviewed for clinical data including antimicrobials prescribed. Inappropriate antimicrobial use was identified as (1) antimicrobial use discordant with guidelines by the Sri Lanka College of Microbiologists (SLCM), and (2) redundant combinations of antimicrobials. Results Of 1,709 surveyed patients, 935 (54.7%) received antimicrobials, of whom 779 (83.3%) had a specified or inferred indication for antimicrobial use. Among patients with an indication for antimicrobial use, SSTI was the second leading indication (181 patients, 23.2%) after lower respiratory tract infection (194, 24.9%). One-third (62, 34.2%) of patients with SSTI had a history of diabetes. Commonly used antimicrobials for SSTI included amoxicillin and clavulanic acid (40.3%), extended-spectrum penicillins (24.9%), and metronidazole (22.1%). inappropriate antimicrobial use was observed in 53.0% of SSTI patients, with redundant antibiotic therapy in 35.9% and antimicrobials discordant with SLCM guidelines in 32.6%. Conclusion SSTI was a common reason for antimicrobial use among inpatients in Sri Lanka, with more than half of patients receiving potentially inappropriate antimicrobial therapy. We identified targets for future antimicrobial stewardship efforts. Disclosures All authors: No reported disclosures.
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Gkartziou, Foteini, Nikolaos Giormezis, Iris Spiliopoulou, and Sophia G. Antimisiaris. "Nanobiosystems for Antimicrobial Drug-Resistant Infections." Nanomaterials 11, no. 5 (April 22, 2021): 1075. http://dx.doi.org/10.3390/nano11051075.
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The worldwide increased bacterial resistance toward antimicrobial therapeutics has led investigators to search for new therapeutic options. Some of the options currently exploited to treat drug-resistant infections include drug-associated nanosystems. Additionally, the use of bacteriophages alone or in combination with drugs has been recently revisited; some studies utilizing nanosystems for bacteriophage delivery have been already reported. In this review article, we focus on nine pathogens that are the leading antimicrobial drug-resistant organisms, causing difficult-to-treat infections. For each organism, the bacteriophages and nanosystems developed or used in the last 20 years as potential treatments of pathogen-related infections are discussed. Summarizing conclusions and future perspectives related with the potential of such nano-antimicrobials for the treatment of persistent infections are finally highlighted.
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Lupia, Tommaso, Ilaria De Benedetto, Giacomo Stroffolini, Stefano Di Bella, Simone Mornese Pinna, Verena Zerbato, Barbara Rizzello, et al. "Temocillin: Applications in Antimicrobial Stewardship as a Potential Carbapenem-Sparing Antibiotic." Antibiotics 11, no. 4 (April 7, 2022): 493. http://dx.doi.org/10.3390/antibiotics11040493.
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Temocillin is an old antibiotic, but given its particular characteristics, it may be a suitable alternative to carbapenems for treating infections due to ESBL-producing Enterobacterales and uncomplicated UTI due to KPC-producers. In this narrative review, the main research question was to summarize current evidence on temocillin and its uses in infectious diseases. A search was run on PubMed using the terms (‘Temocillin’ [Mesh]) AND (‘Infection’ [Mesh]). Current knowledge regarding temocillin in urinary tract infection, blood-stream infections, pneumonia, intra-abdominal infections, central nervous system infections, skin and soft tissues infections, surgical sites infections and osteoarticular Infections were summarized. Temocillin retain a favourable profile on microbiota and risk of Clostridioides difficile infections and could be an option for treating outpatients. Temocillin may be a valuable tool to treat susceptible pathogens and for which a carbapenem could be spared. Other advantages in temocillin use are that it is well-tolerated; it is associated with a low rate of C. difficile infections; it is active against ESBL, AmpC, and KPC-producing Enterobacterales; and it can be used in the OPAT clinical setting.
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Hussain, Muhammad Shahbaz, Zafar Majeed, and Mazhar Hussain. "ANTIMICROBIAL SUSCEPTIBILITY." Professional Medical Journal 23, no. 12 (December 12, 2016): 1581–86. http://dx.doi.org/10.29309/tpmj/2016.23.12.1820.
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Infections occurring more than 48 hours after admission in hospital are usuallyconsidered as nosocomial infections. Patients in ICUs are at a higher risk of acquiring thisinfection than those in non-critical areas. The total length of stay increased from three days tonineteen days for clinical procedures. Increased antimicrobial resistance in such cases makesincrease in mortality and morbidity. The ICU infection rates is five to ten times higher than HAIs inward patients. ICU acquired infections are major health problem globally, in developing countrieslike Pakistan. The microorganisms that are frequently isolated from intensive care units areAcinetobacter spp, P. aeruginosa, Klebsiella pneumoniae, Streptococcus spp, Staphylococcusspp, Enterococci and Enterobacteriaceae i.e E. coli, Proteus mirabilis and Serratia marcescens.Aims: The present study was aimed at to determine the frequency of causative organismsin intensive care unit (ICU) patients and antimicrobial susceptibility pattern of the isolates.Study Design: A cross-sectional study. Place and Duration of Study: Microbiology section ofPathology department Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Four months(September to December 2015). Materials and Methods: Clinical samples from patientshaving signs and syptoms of site-specific infections or fever in ICU were collected. The sampleswere cultured on suitable culture media and bacterial isolates were identified by Gram stain andstandard biochemical methods. Antimicrobial susceptibility testing to conventional and newerantibiotics was performed on Mueller Hinton agar using disc diffusion method. Frequencypercentages of all isolates were determined. Results: Out of 100 samples only 30 samples werepositive for growth and 70 samples showed no growth. The most frequent isolates were E. coli(40%), K. pneumoniae (10%) P. aeruginosa (10%) Proteus spp. (20%) Acinetobacter (17%) andS.aureus (3%). S.aureus (Gram positive bacteria) were more sensitive to imipenem, cefoxitinand resistant to ceftriaxone, nitrofurantoin azithromycin, Tetracycline, Cefotaxime and amoxicillinclavulanic acid. Other Gram negative bacteria i.e E.coli, K. Pneumoniae, P.aeruginosa, Proteusspp. and Acinetobacter spp. were sensitive to imipenem, sulzone, ceftriaxone, Ciprofloxacin,Gentamicin, Nitrofurantoin and resistant to amoxicillin clavulanic acid. Conclusion: Bacteriawere isolated from 30% clinical samples taken from patients admitted in ICU. The most frequentsite of infection was the respiratory tract followed by urinary tract and blood stream infections.E. coli, P. aeruginosa, K. pneumonia, Proteus spp., Acinetibacter and S. aureus were isolated.The high frequency of Health associated infections and elevated bacterial resistance rate in ICUpatients suggest that more strict measures regarding infection control practices can be done.
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Garg, Aakriti, Balraj Singh, Ruchika Sharma, Arti Singh, and Anoop Kumar. "Selective Estrogen Receptor Modulators (SERMs): Mechanistic Insights Against Microbial Infections." Current Molecular Medicine 20, no. 2 (January 14, 2020): 102–15. http://dx.doi.org/10.2174/1566524019666191014112133.
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Background: Infections are one of the leading causes of death worldwide and currently available treatments remain unsatisfactory due to rise in the cases of antimicrobial resistance. Thus, there is a need for the development of new drugs with different mechanisms of action. However, the development of new antimicrobials agents is a long and expensive process. Hence, most of the pharmaceutical companies are Methodology: The data related to SERMs and microbial infection has been extracted from Pub Med (from January 1997 to December 2018). A total of 101 studies have been published from 1997 -2018 regarding SERMs and microbial infections. Results: On the basis of inclusion and exclusion criteria, 25 studies have been included for the analysis of level of evidence regarding antimicrobial effects of SERMs. Emerging reports have indicated the antimicrobial property of selective estrogen receptor modulators (SERMs) against normal and resistant strains under in vitro and in vivo conditions against wide variety of microorganisms through different mechanisms of action. Conclusion: In conclusion, SERMs could be developed as a broad spectrum antimicrobial agent alone or in combination with existing antimicrobial agents.
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Rahman, Md Mominur, Mst Afroza Alam Tumpa, Mehrukh Zehravi, Md Taslim Sarker, Md Yamin, Md Rezaul Islam, Md Harun-Or-Rashid, et al. "An Overview of Antimicrobial Stewardship Optimization: The Use of Antibiotics in Humans and Animals to Prevent Resistance." Antibiotics 11, no. 5 (May 16, 2022): 667. http://dx.doi.org/10.3390/antibiotics11050667.
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Antimicrobials are a type of agent widely used to prevent various microbial infections in humans and animals. Antimicrobial resistance is a major cause of clinical antimicrobial therapy failure, and it has become a major public health concern around the world. Increasing the development of multiple antimicrobials has become available for humans and animals with no appropriate guidance. As a result, inappropriate use of antimicrobials has significantly produced antimicrobial resistance. However, an increasing number of infections such as sepsis are untreatable due to this antimicrobial resistance. In either case, life-saving drugs are rendered ineffective in most cases. The actual causes of antimicrobial resistance are complex and versatile. A lack of adequate health services, unoptimized use of antimicrobials in humans and animals, poor water and sanitation systems, wide gaps in access and research and development in healthcare technologies, and environmental pollution have vital impacts on antimicrobial resistance. This current review will highlight the natural history and basics of the development of antimicrobials, the relationship between antimicrobial use in humans and antimicrobial use in animals, the simplistic pathways, and mechanisms of antimicrobial resistance, and how to control the spread of this resistance.
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Bateman, Emily, Sara Mansour, Euchariachristy Okafor, Kedzie Arrington, Bo-Young Hong, and Jorge Cervantes. "Examining the Efficacy of Antimicrobial Therapy in Preventing the Development of Postinfectious Glomerulonephritis: A Systematic Review and Meta-Analysis." Infectious Disease Reports 14, no. 2 (March 7, 2022): 176–83. http://dx.doi.org/10.3390/idr14020022.
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Postinfectious glomerulonephritis (PIGN) is an immune-mediated acute glomerulonephritis classically seen weeks after infection with Streptococcus pyogenes, although other infectious etiologies have emerged. While it has become increasingly rare in industrialized regions, it continues to affect children in developing countries. There has been debate as to why incidence rates are declining, including the possibility of improved initial treatment of bacterial infections. The ability of antimicrobial therapy in preventing PIGN as infectious sequelae, however, has not been comprehensively assessed. As varying evidence from published studies exists, the objective of this meta-analysis is to determine if antimicrobial therapy utilized to treat an initial infection has an effect in reducing the development of PIGN in humans. EMBASE, MEDLINE, and CENTRAL were searched using a comprehensive terminology strategy. From an initial search that returned 337 publications, 9 articles were included for analysis. Eight studies showed an incidence of PIGN after antimicrobial use ranging from 0.05% to 10% with a mean standardized difference (MSD) of 0.03 (0.01–0.06). Three studies showed an occurrence of PIGN without antibiotic use ranging from 1% to 13% with an MSD of 0.06 (−0.09–0.21). Our findings suggest that antimicrobial treatment for the initial infection may help diminish the development of PIGN. Although Streptococcus pyogenes infections are generally treated aggressively to prevent rheumatic fever, these findings may help further support the early treatment of bacterial infections to prevent postinfectious sequelae, especially as we consider other infectious etiologies of PIGN antimicrobial resistance.
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Oyardi, Ozlem, Paul B. Savage, and Cagla Bozkurt Guzel. "Effects of Ceragenins and Antimicrobial Peptides on the A549 Cell Line and an In Vitro Co-Culture Model of A549 Cells and Pseudomonas aeruginosa." Pathogens 11, no. 9 (September 14, 2022): 1044. http://dx.doi.org/10.3390/pathogens11091044.
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Pseudomonas aeruginosa is an important pathogen that can adhere to host tissues and epithelial surfaces, especially during chronic infections such as cystic fibrosis (CF) lung infections. The effect of ceragenins and antimicrobial peptides (AMP) on this colonization was investigated in a co-culture infection model. After determining the antimicrobial effects of the substances on P. aeruginosa planktonic cells, their cytotoxicity on the A549 cell line was also determined. After the A549 cell line was infected with P. aeruginosa, the effect of antimicrobials on intracellular bacteria as well as the effects in inhibiting the adhesion of P. aeruginosa were investigated. In addition, LDH release from cells was determined by performing an LDH experiment to understand the cytotoxicity of bacterial infection and antimicrobial treatment on cells. CSA-131 was determined as the antimicrobial agent with the highest antimicrobial activity, while the antimicrobial effects of AMPs were found to be much lower than those of ceragenins. The antimicrobial with the lowest IC50 value was determined as the combination of CSA-131 with Pluronic F127. CSA-13 has been determined to be the most effective antimicrobial with its effectiveness to both intracellular bacteria and bacterial adhesion. Nevertheless, further safety, efficacy, toxicity, and pharmacological studies of ceragenins are needed to evaluate clinical utility.
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Fernandes, Ariane Martins, Alessandra Tammy Hayakawa Ito de Sousa, Luciana Auxiliadora Viebrantz da Conceição, Felipe Gomes da Silva, Mayara Aparecida Araújo Cayuela, Adriane Jorge Mendonça, Arleana do Bom Parto Ferreira de Almeida, Valéria Dutra, and Valeria Régia Franco Sousa. "Urinary infection in dogs with chronic kidney disease: aetiology and resistance." Semina: Ciências Agrárias 40, no. 6Supl3 (October 16, 2019): 3741. http://dx.doi.org/10.5433/1679-0359.2019v40n6supl3p3741.
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Infections of the genitourinary system are among the most frequent in the clinical routine of small animals. Treatment with the most appropriate antimicrobial therapy, according to the uropathogen susceptibility test, can avoid the spread of bacterial resistance to antimicrobials. A clinical study was performed in 32 canines, of both sexes and differing ages, who attended the Veterinary Teaching Hospital. Urine samples underwent culture, with the objective of evaluating urinary tract infection in dogs with renal disease, identifying the associated bacterial pathogens, and verifying their antimicrobial susceptibility in vitro. Urine culture was positive in 10 dogs, mostly males, with no predisposition for breed, and a mean age of 8.28 years. Most of the urinary tract infections (UTIs) were monobacterial, with the most common microorganisms being Pseudomonas sp. and Staphylococcus sp. The antimicrobials imipenem and meropenem had the best overall sensitivity profile, and ampicillin showed the highest resistance. The variation in epidemiological profiles, and susceptibility to uropathogens, reinforces the importance of the veterinarian in the prevention and control of infection, in addition to the need for further research to identify new antimicrobial agents.
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Ankrah, Daniel, Helena Owusu, Asiwome Aggor, Anthony Osei, Agneta Ampomah, Mark Harrison, Frempomaa Nelson, et al. "Point Prevalence Survey of Antimicrobial Utilization in Ghana’s Premier Hospital: Implications for Antimicrobial Stewardship." Antibiotics 10, no. 12 (December 14, 2021): 1528. http://dx.doi.org/10.3390/antibiotics10121528.
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The first comprehensive point prevalence survey at the Korle Bu Teaching Hospital (KBTH) was performed as part of the 2019 Global Point Prevalence Survey (Global-PPS) on antimicrobials. The aim was to establish a PPS baseline for the whole hospital and to identify required stewardship interventions. The PPS was conducted over three days in June 2019 using the GLOBAL-PPS standardized method for surveillance of antimicrobial utilization in hospitals to evaluate antimicrobial prescribing. In all, 988 patients were admitted to 69 wards. Overall antimicrobial prevalence was 53.3%. More community-acquired infections (CAI) were treated empirically compared to health-care associated infections (94.0% vs. 86.1% respectively, p = 0.002). Main indications for prescribing antimicrobials were pneumonia (18.4%), skin and soft tissue infections (11.4%) and sepsis (11.1%). Among antimicrobials, systemic antibiotics accounted for 83.5%, of which amoxicillin with beta-lactam inhibitor (17.5%), metronidazole (11.8%) and ceftriaxone (11.5%) dominated. Guideline compliance was 89.0%. Stop/review dates were completed in 33.4% and documented reason was recorded in 53.0% of all prescriptions. If the findings in this PPS can be addressed antimicrobial stewardship at the KBTH stands to improve significantly.
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Yan, Marie, Marion Elligsen, Andrew E. Simor, and Nick Daneman. "Patient Characteristics and Outcomes of Outpatient Parenteral Antimicrobial Therapy: A Retrospective Study." Canadian Journal of Infectious Diseases and Medical Microbiology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/8435257.
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Outpatient parenteral antimicrobial therapy (OPAT) is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years) were discharged home with parenteral antimicrobials. The most commonly treated syndromes included surgical site infections (33%), osteoarticular infections (28%), and bacteremia (21%). The most frequently prescribed antimicrobials were ceftriaxone (21%) and cefazolin (20%). Only 56% of the patients received follow-up care from an infectious diseases specialist. In the 60 days following discharge, 43% of the patients returned to the emergency department, while 26% required readmission. Forty-eight percent of the return visits were due to infection relapse or treatment failure, and 23% could be attributed to OPAT-related complications. These results suggest that many OPAT patients have unplanned health care encounters because of issues related to their infection or treatment, and the creation of a formal OPAT clinic may help improve outcomes.
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Khan, Inam Danish, and Ajay Kumar Sahni. "Bacterial infections and emerging resistance in renal transplant recipients." Bangladesh Journal of Medical Science 14, no. 1 (November 19, 2014): 14–21. http://dx.doi.org/10.3329/bjms.v14i1.16306.
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Objective: Renal transplantation is frequently complicated by bacterial infections in the scenario of immunosuppression, altered metabolism and interventions resulting in prolonged morbidity. Subdued clinical presentation, antimicrobial resistance and toxicity question the outcome of transplantation. This retrospective study conducted at tertiary care apex transplant centre highlights colonization, clinical infection and antimicrobial resistance patterns in Renal Transplant Recipients (RTR). Materials and methods: Infection and antimicrobial resistance patterns in 130 RTR were studied. Clinico-demographic and transplant parameters were noted. Infection screening in the post transplant period along with antimicrobial susceptibility were used to analyze data in a post transplant time frame. Results and discussion: Culture positivity timeline was dominated by post surgical infections in the first week post transplant. Urinary infections followed by blood stream infections were noted. Infection profile included simultaneous polymicrobial, prolonged and widespread infections. Multi-resistant organisms producing beta lactamases and extended spectrum beta lactamases were isolated. Conclusion: Transplant recipients remain prone to bacterial infections with multi-resistant organisms which may persist due to immunosuppression, altered metabolism and toxicity, and contribute to nosocomial hazard. Infection control may be targeted at avoidance of donor derived infections, surgical complications, epidemiologic exposures, strengthening antimicrobial prophylaxis and anti-infection engineering. Antimicrobial stewardship, outbreak and epidemic preparedness should be ensured. DOI: http://dx.doi.org/10.3329/bjms.v14i1.16306 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.14-21
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Lynch, Joseph P., Nina M. Clark, and George G. Zhanel. "Infections Due to Acinetobacter baumannii–calcoaceticus Complex: Escalation of Antimicrobial Resistance and Evolving Treatment Options." Seminars in Respiratory and Critical Care Medicine 43, no. 01 (February 2022): 097–124. http://dx.doi.org/10.1055/s-0041-1741019.
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AbstractBacteria within the genus Acinetobacter (principally A. baumannii–calcoaceticus complex [ABC]) are gram-negative coccobacilli that most often cause infections in nosocomial settings. Community-acquired infections are rare, but may occur in patients with comorbidities, advanced age, diabetes mellitus, chronic lung or renal disease, malignancy, or impaired immunity. Most common sites of infections include blood stream, skin/soft-tissue/surgical wounds, ventilator-associated pneumonia, orthopaedic or neurosurgical procedures, and urinary tract. Acinetobacter species are intrinsically resistant to multiple antimicrobials, and have a remarkable ability to acquire new resistance determinants via plasmids, transposons, integrons, and resistance islands. Since the 1990s, antimicrobial resistance (AMR) has escalated dramatically among ABC. Global spread of multidrug-resistant (MDR)-ABC strains reflects dissemination of a few clones between hospitals, geographic regions, and continents; excessive antibiotic use amplifies this spread. Many isolates are resistant to all antimicrobials except colistimethate sodium and tetracyclines (minocycline or tigecycline); some infections are untreatable with existing antimicrobial agents. AMR poses a serious threat to effectively treat or prevent ABC infections. Strategies to curtail environmental colonization with MDR-ABC require aggressive infection-control efforts and cohorting of infected patients. Thoughtful antibiotic strategies are essential to limit the spread of MDR-ABC. Optimal therapy will likely require combination antimicrobial therapy with existing antibiotics as well as development of novel antibiotic classes.
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Cesaro, Angela, Rosa Gaglione, Marco Chino, Maria De Luca, Rocco Di Girolamo, Angelina Lombardi, Rosanna Filosa, and Angela Arciello. "Novel Retro-Inverso Peptide Antibiotic Efficiently Released by a Responsive Hydrogel-Based System." Biomedicines 10, no. 6 (June 2, 2022): 1301. http://dx.doi.org/10.3390/biomedicines10061301.
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Topical antimicrobial treatments are often ineffective on recalcitrant and resistant skin infections. This necessitates the design of antimicrobials that are less susceptible to resistance mechanisms, as well as the development of appropriate delivery systems. These two issues represent a great challenge for researchers in pharmaceutical and drug discovery fields. Here, we defined the therapeutic properties of a novel peptidomimetic inspired by an antimicrobial sequence encrypted in human apolipoprotein B. The peptidomimetic was found to exhibit antimicrobial and anti-biofilm properties at concentration values ranging from 2.5 to 20 µmol L−1, to be biocompatible toward human skin cell lines, and to protect human keratinocytes from bacterial infections being able to induce a reduction of bacterial units by two or even four orders of magnitude with respect to untreated samples. Based on these promising results, a hyaluronic-acid-based hydrogel was devised to encapsulate and to specifically deliver the selected antimicrobial agent to the site of infection. The developed hydrogel-based system represents a promising, effective therapeutic option by combining the mechanical properties of the hyaluronic acid polymer with the anti-infective activity of the antimicrobial peptidomimetic, thus opening novel perspectives in the treatment of skin infections.
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Calfee, David P. "Recent advances in the understanding and management of Klebsiella pneumoniae." F1000Research 6 (September 27, 2017): 1760. http://dx.doi.org/10.12688/f1000research.11532.1.
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Klebsiella pneumoniae, a gram-negative bacillus of the Enterobacteriaceae family, is a component of the normal human microbiota and a common cause of community- and healthcare-associated infections. The increasing prevalence of antimicrobial resistance among K. pneumoniae isolates, particularly among those causing healthcare-associated infections, is an important public health concern. Infections caused by these multidrug-resistant organisms, for which safe and effective antimicrobial therapy options are extremely limited, are associated with poor outcomes for patients. The optimal approach to the treatment of infections caused by these multidrug-resistant strains remains undefined, and treatment decisions for an individual patient should be based on a number of organism- (for example, minimum inhibitory concentration) and patient-specific (for example, site of infection) factors. The emergence of pandrug-resistant strains of K. pneumoniae highlights the critical need for consistent implementation of effective strategies for prevention of transmission and infection and for the development of new antimicrobials with activity against these emerging pathogens.
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Bassetti, Matteo, and Elda Righi. "Multidrug-resistant bacteria: what is the threat?" Hematology 2013, no. 1 (December 6, 2013): 428–32. http://dx.doi.org/10.1182/asheducation-2013.1.428.
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Abstract Despite big advances in antimicrobial therapies and infection strategies, the emergence of antibiotic resistance represents an emergency situation, especially in immunocompromised hosts. Specifically, infections due to multidrug resistant, gram-negative pathogens are responsible for high mortality rates and may leave few effective antimicrobial options. Furthermore, although new compounds are available for severe methicillin-resistant staphylococcal infections, there is a paucity of novel classes of antimicrobials to target resistant gram-negatives. A careful assessment of the clinical conditions and underlying comorbidities, along with knowledge about the previous history of colonization or infections due to multidrug-resistant bacteria, represent key points in approaching the hematological patient with signs of infection. A de-escalation therapy with initial use of wide-spectrum antimicrobials followed by a reassessment after 72 hours of treatment may represent a good option in severe infections if a resistant pathogen is suspected. Prompt empiric or targeted therapy using combination regimens (ie, antipseudomonal beta-lactam plus an aminoglycoside or a quinolone) with the addition of colistin, along with increased dosage and therapeutic drug monitoring, represent options for these life-threatening infections. Continuous epidemiological surveillance of local bacteremias is necessary, along with stringent enforcement of antibiotic stewardship programs in cancer patients.
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Porto, Ana Paula Matos, Icaro Boszczowski, Ann Versporten, Ines Pauwels, Thais THAIS, Evelyne Girão, Patricia Esteves, et al. "Point Prevalence Surveys and Customized Interventions Are Good Strategies to Improve Antimicrobial Use: The Brazilian Experience." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s523. http://dx.doi.org/10.1017/ice.2020.1207.
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Background: Although antimicrobial stewardship is recommended by Brazilian government, data regarding prescription practices in the country are scarce. Objective: To describe the impact of 2 point-prevalence surveys and customized interventions on antimicrobial consumption among 8 hospitals in 3 regions of Brazil. Method: In 2017 and 2018, 8 tertiary-care Brazilian hospitals conducted the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS). All enrolled hospitals were provided the 2017 results. The group discussed intervention strategies by WhatsApp and e-mail. Hospitals customized interventions, including feedback to prescribers, discussion with pharmacists, and antimicrobial use data in accreditation process. A web-based program was used for data entry, validation, and reporting of details on AMC prescriptions. The Global-PPS was developed by the University of Antwerp and was funded by bioMérieux. The 1-day prevalences in 2017 and 2018 are presented as risk ratios. The main outcomes are whole antimicrobial use in hospitals and intensive care units (ICUs). Prevalence of infections caused by multidrug-resistant organisms (MDROs) were reported. Results: Overall, 1,716 patients were evaluated, of whom 420 (52.5%) and 429 (46.8%) were using antimicrobials in 2017 and 2018, respectively (P = .02). In 33 ICUs, 170 patients (61.4%) and 204 patients (56.8%) were on antimicrobials, in 2017 and 2018, respectively (P = .20). Significant decreases of overall use were observed for vancomycin (from 11% to 7%; P =.01), meropenem (from 12% to 9%; P = .04), and linezolid (from 1.5% to 0.33%; P =.01). There was no significant increase in any singular drug or class of drugs. Within ICUs, vancomycin use decreased significantly (from 19% to 11%; P = .005), linezolid use decreased significantly (from 2.9% to 0.3%; P = .01), colistin use decreased significantly (from 4.3% to 1.7%; P = .05), and metronidazole use decreased significantly (from 6.5% to 2.8%; P = .03). We observed a nonsignificant decrease of infections caused by MDROs across the whole hospital (from 8.7% to 6.6%; P = .10) and in the ICUs (from 15.2% to 12.3%; P = .30). The most frequent infectious diagnoses were pneumonia (27%), intra-abdominal sepsis (14%), skin and soft-tissue infection (SSTI) (9.4%), urinary tract infection (9.1%), and sepsis and septic shock with no identified focus (SSNIF) (7.4%). There was a significant increase in SST (from 7.6% to 11.4%; P = .03) and a decrease in SSNIF (from 10.7% to 4.1%; P = .00002). In 2018, there were significantly fewer antimicrobial prescriptions for healthcare-acquired infections (from 52.6% to 43.6%; P = .0007) and more antimicrobial prescriptions for community-acquired infections (from 27.4% to 34.6%; P = .003). We detected no difference for medical or surgical prophylaxis. Conclusions: Feedback of prescription practices might have had an impact on local policies of antimicrobial use, as demonstrated by an overall decrease is antimicrobial use and a decrease in the ICU.Funding: This study was supported by Biomérieux.Disclosures: None
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Colilla, Montserrat, and María Vallet-Regí. "Targeted Stimuli-Responsive Mesoporous Silica Nanoparticles for Bacterial Infection Treatment." International Journal of Molecular Sciences 21, no. 22 (November 15, 2020): 8605. http://dx.doi.org/10.3390/ijms21228605.
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The rise of antibiotic resistance and the growing number of biofilm-related infections make bacterial infections a serious threat for global human health. Nanomedicine has entered into this scenario by bringing new alternatives to design and develop effective antimicrobial nanoweapons to fight against bacterial infection. Among them, mesoporous silica nanoparticles (MSNs) exhibit unique characteristics that make them ideal nanocarriers to load, protect and transport antimicrobial cargoes to the target bacteria and/or biofilm, and release them in response to certain stimuli. The combination of infection-targeting and stimuli-responsive drug delivery capabilities aims to increase the specificity and efficacy of antimicrobial treatment and prevent undesirable side effects, becoming a ground-breaking alternative to conventional antibiotic treatments. This review focuses on the scientific advances developed to date in MSNs for infection-targeted stimuli-responsive antimicrobials delivery. The targeting strategies for specific recognition of bacteria are detailed. Moreover, the possibility of incorporating anti-biofilm agents with MSNs aimed at promoting biofilm penetrability is overviewed. Finally, a comprehensive description of the different scientific approaches for the design and development of smart MSNs able to release the antimicrobial payloads at the infection site in response to internal or external stimuli is provided.
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Nicolle, L. E., L. J. Strausbaugh, and R. A. Garibaldi. "Infections and antibiotic resistance in nursing homes." Clinical Microbiology Reviews 9, no. 1 (January 1996): 1–17. http://dx.doi.org/10.1128/cmr.9.1.1.
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Infections occur frequently in nursing home residents. The most common infections are pneumonia, urinary tract infection, and skin and soft tissue infection. Aging-associated physiologic and pathologic changes, functional disability, institutionalization, and invasive devices all contribute to the high occurrence of infection. Antimicrobial agent use in nursing homes is intense and usually empiric. All of these factors contribute to the increasing frequency of antimicrobial agent-resistant organisms in nursing homes. Programs that will limit the emergence and impact of antimicrobial resistance and infections in nursing homes need to be developed.
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Nair, Arya, Rashmi Mallya, Vasanti Suvarna, Tabassum Asif Khan, Munira Momin, and Abdelwahab Omri. "Nanoparticles—Attractive Carriers of Antimicrobial Essential Oils." Antibiotics 11, no. 1 (January 14, 2022): 108. http://dx.doi.org/10.3390/antibiotics11010108.
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Microbial pathogens are the most prevalent cause of chronic infections and fatalities around the world. Antimicrobial agents including antibiotics have been frequently utilized in the treatment of infections due to their exceptional outcomes. However, their widespread use has resulted in the emergence of multidrug-resistant strains of bacteria, fungi, viruses, and parasites. Furthermore, due to inherent resistance to antimicrobial drugs and the host defence system, the advent of new infectious diseases, chronic infections, and the occurrence of biofilms pose a tougher challenge to the current treatment line. Essential oils (EOs) and their biologically and structurally diverse constituents provide a distinctive, inexhaustible, and novel source of antibacterial, antiviral, antifungal, and antiparasitic agents. However, due to their volatile nature, chemical susceptibility, and poor solubility, their development as antimicrobials is limited. Nanoparticles composed of biodegradable polymeric and inorganic materials have been studied extensively to overcome these limitations. Nanoparticles are being investigated as nanocarriers for antimicrobial delivery, antimicrobial coatings for food products, implantable devices, and medicinal materials in dressings and packaging materials due to their intrinsic capacity to overcome microbial resistance. Essential oil-loaded nanoparticles may offer the potential benefits of synergism in antimicrobial activity, high loading capacity, increased solubility, decreased volatility, chemical stability, and enhancement of the bioavailability and shelf life of EOs and their constituents. This review focuses on the potentiation of the antimicrobial activity of essential oils and their constituents in nanoparticulate delivery systems for a wide range of applications, such as food preservation, packaging, and alternative treatments for infectious diseases.
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Tailor, Sandra A. N., Elaine M. Bailey, and Michael J. Rybak. "Enterococcus, an Emerging Pathogen." Annals of Pharmacotherapy 27, no. 10 (October 1993): 1231–42. http://dx.doi.org/10.1177/106002809302701014.
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OBJECTIVE: To review the bacterial genus Enterococcus with respect to its epidemiology, specific infections in humans, mechanisms of resistance and tolerance, and antimicrobial treatment. DATA SOURCES: A MEDLINE search of English-language journal articles published from 1977 to 1992 was completed. Articles published prior to 1977 were identified through Index Medicus and from references appearing in the bibliographies of other journal articles. Information also was acquired from abstracts, personal communication with infectious disease specialists with active research in the area of enterococcal infection, and conference proceedings. STUDY SELECTION: In vitro data; animal models of enterococcal infection; case reports; and case-controlled, cohort, and randomized controlled trials in humans were evaluated for relevant information. DATA EXTRACTION: Studies were evaluated by their methodologic strength (e.g., randomized controlled trial), reporting of clinically relevant outcomes (e.g., clinical response to antimicrobial therapy), statistical analyses, and accountability of all patients who entered the study. DATA SYNTHESIS: The incidence of enterococcal infections has increased in recent years and enterococci are now the second most frequently reported nosocomial pathogens. Enterococcus faecalis is the pathogen responsible for most enterococcal infections seen today; it has been implicated as an important cause of endocarditis, bacteremia, urinary tract infections, and intraabdominal infections. CONCLUSIONS: Enterococcal infection is of particular concern clinically because of its resistance to several antibiotics. Controlled comparative clinical trials of antimicrobial therapy in humans are lacking for several enterococcal infections. Therefore, the recommendations for antimicrobial therapy presented in this review are guidelines that reflect our current understanding of antibiotics used for enterococcal infection.
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Lastinger, Allison, Nathanael McLeod, Matthew J. Dietz, John Guilfoose, and Arif R. Sarwari. "Clinical Experience with Tigecycline in the Treatment of Prosthetic Joint Infections." Journal of Bone and Joint Infection 4, no. 3 (May 21, 2019): 126–32. http://dx.doi.org/10.7150/jbji.34866.
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Abstract. Purpose: The purpose of this study was to examine the use of tigecycline in the treatment of prosthetic joint infection (PJI).Methods: This is a retrospective review performed from 2008 to 2017, examining adult patients with PJI at a tertiary medical referral center who received tigecycline for 75% or greater of the treatment course. Failure was defined as need to return to the operating room for an infectious complication or persistent drainage from the joint.Results: A total of 37 patients met inclusion criteria. The median age was 65 years, and 65% of patients were female. The most common reasons for tigecycline use were culture negative infection, polymicrobial infection, and renal failure, but other reasons included antimicrobial allergies and resistant organisms. The mean duration of tigecycline therapy was 40 days (range 28-52 days). Treatment success was documented in 16 cases (43%).Conclusions: Tigecycline is a glycylcycline approved for treatment of a variety of infections including skin and soft tissue infections, but little is known about its use in the treatment of PJI. We found that tigecycline is well-tolerated for prolonged durations. Our success rate was 43%, but the majority of patients in this study had complicated infectious surgical histories and had received prior prolonged courses of antimicrobial therapy which likely affected treatment outcome. We concluded that tigecycline should be reserved as an alternative when other antimicrobials for PJI have been exhausted. More studies are needed to assess tigecycline's use in the treatment of PJI.
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Sharma, Rashi. "Antimicrobial Resistance in Staphylococcus Aureus and the Immunocompromised Child." International Journal for Research in Applied Science and Engineering Technology 10, no. 8 (August 31, 2022): 507–13. http://dx.doi.org/10.22214/ijraset.2022.46182.
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Abstract: Staphylococcus aureus is a gram-positive bacterium. Many antibiotics are tried in opposition to S. aureus infection but in the end they all fail because of the multidrug resistance in this bacterium. Staphylococcus aureus are also responsible for many infections like skin and shock syndrome. From that point forward Methicillin-safe Staphylococcus aureus strains (MRSAMethicillin-resistant Staphylococcus aureus) were extremely normal which causes nosocomial diseases. Microorganisms for the need of the endurance goes through mutational changes either in their chromosomal DNA/RNA which gives the obstruction. One of the popular models is the obstruction against methicillin in Staphylococcus aureus. Due to high morbidness and death rate antimicrobial resistance becomes very challenging. Antimicrobial resistance (AMR) takes place when microscopic organisms like bacteria, virus, parasites swap over some period of time and they have no response to any medicines. This disease is difficult to treat and it causes the risk of death, different illnesses and also major infections. In this review paper, the difference between antimicrobial resistance and multidrug resistance, antibiotic resistance drugs, classification of multidrug resistance, mechanism of penicillin and methicillin in Staphylococcus aureus are going to be discussed. Due to their frequent contact with the healthcare system, requirement for empiric antimicrobials, and immunological dysfunction, children with immunocompromising diseases represent a special category for the acquisition of antimicrobial resistant infections. These infections are made more difficult by the relative dearth of information on the clinical characteristics and treatment of Staphylococcus aureus infections in children with impaired immune systems. Review of the literature that is currently accessible on the clinical characteristics, antimicrobial susceptibility, and treatment of S. aureus infections in immunocompromised children. Children with HIV are more likely to develop S. aureus infections, which are linked to higher HIV viral loads and more severe CD4 T-cell suppression. Additionally, children with HIV frequently develop staphylococcal infections that show a multidrug resistant phenotype.
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Pempek, Jessica, Martey Masterson, Rafael Portillo-Gonzalez, Kate Creutzinger, Ting-Yu Cheng, and Greg Habing. "The Impact of Antimicrobial Stewardship Training on Calf Producers’ Knowledge, Treatment Behaviors and Quantified Antimicrobial Use." Microorganisms 10, no. 8 (July 27, 2022): 1525. http://dx.doi.org/10.3390/microorganisms10081525.
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The judicious use of antimicrobials on farms is necessary to mitigate the development of antimicrobial-resistant pathogens that compromise human and animal health. On livestock farms, veterinarians prescribe and dispense antimicrobials, but producers use rapid judgements of disease severity to make routine decisions on the initiation of empirical antimicrobial therapy. Therefore, the knowledge and skills required to accurately diagnose treatable bacterial infections is necessary for optimal antimicrobial stewardship. Veal calves often undergo stressors and environmental exposures that increase calves’ risk of bacterial infections, and antimicrobials are sometimes necessary to ensure their health. The objective of this trial was to measure the impact of antimicrobial stewardship training on calf producers’ knowledge of antimicrobial stewardship, accuracy of identifying calves for treatment, and quantified antimicrobial use. Eight farms were evenly allocated into either intervention or control groups. Training resulted in both higher scores on assessments and higher sensitivity for detecting cases that required antimicrobial therapy relative to a veterinarian. Importantly, there was a 50% reduction in the antimicrobial dosing rate among intervention farms relative to control farms. Antimicrobial stewardship training among calf producers was effective at changing producers’ behaviors and reducing antimicrobial use.
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Gheorghiţă, Valeriu, and Aida Răşcanu. "Procalcitonin: friend or foe in the setting of antimicrobial therapy?" Romanian Journal of Infectious Diseases 18, no. 1 (March 31, 2015): 13–19. http://dx.doi.org/10.37897/rjid.2015.1.2.
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According to WHO, infectious diseases remain in the top 10 of the most common causes of death worldwide, leading to an excessive consumption of antibiotics, often unnecessarily. Antibiotic stewardship policy aims to identify an useful surrogate marker for the differential diagnosis of the bacterial infections from viral or fungal infections. The aims of this strategy is to restrict the prescriptions of antibiotics in order to reduce morbidity associated with excessive antibiotic treatment, decrease of bacterial resistance and optimize the costs of patient care. Procalcitonin (PCT) has emerged in the early ‘90s as a specific biomarker for bacterial infections. Many clinical studies have shown a correlation between the use of PCT as a diagnostic marker of bacterial sepsis and decrease antibiotic consumption, without a secondary increase in mortality. However, the PCT has a number of limitations regarding sensitivity and specificity. Thus, it may be increased in non-infectious diseases or it may remain at low levels in bacterial infections. Also, PCT cannot replace clinical evaluation and bacteriological tests in facing a patient with suspected infectious disease. This review aims to summarize the available informations so far about pathophysiological mechanisms, biological role and clinical utility of PCT in the diagnostic and treatment algorithm of bacterial infections.
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Coburn, Bryan, Baldwin Toye, Prasad Rawte, Frances B. Jamieson, David J. Farrell, and Samir N. Patel. "Antimicrobial Susceptibilities of Clinical Isolates of HACEK Organisms." Antimicrobial Agents and Chemotherapy 57, no. 4 (February 12, 2013): 1989–91. http://dx.doi.org/10.1128/aac.00111-13.
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ABSTRACTThe “HACEK” organisms are a group of fastidious Gram-negative bacteria that cause a variety of infections, including infective endocarditis. Antimicrobial susceptibility testing is not universally available, and therapy for these infections is often empirical. We report the antimicrobial susceptibilities of 70 clinical HACEK isolates to 18 antimicrobials. All isolates were susceptible to ceftriaxone and levofloxacin, indicating that these agents remain appropriate empirical choices for the treatment of infections with this group of organisms.
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Stephen, Jerusha, Manjusha Lekshmi, Parvathi Ammini, Sanath H. Kumar, and Manuel F. Varela. "Membrane Efflux Pumps of Pathogenic Vibrio Species: Role in Antimicrobial Resistance and Virulence." Microorganisms 10, no. 2 (February 7, 2022): 382. http://dx.doi.org/10.3390/microorganisms10020382.
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Infectious diseases caused by bacterial species of the Vibrio genus have had considerable significance upon human health for centuries. V. cholerae is the causative microbial agent of cholera, a severe ailment characterized by profuse watery diarrhea, a condition associated with epidemics, and seven great historical pandemics. V. parahaemolyticus causes wound infection and watery diarrhea, while V. vulnificus can cause wound infections and septicemia. Species of the Vibrio genus with resistance to multiple antimicrobials have been a significant health concern for several decades. Mechanisms of antimicrobial resistance machinery in Vibrio spp. include biofilm formation, drug inactivation, target protection, antimicrobial permeability reduction, and active antimicrobial efflux. Integral membrane-bound active antimicrobial efflux pump systems include primary and secondary transporters, members of which belong to closely related protein superfamilies. The RND (resistance-nodulation-division) pumps, the MFS (major facilitator superfamily) transporters, and the ABC superfamily of efflux pumps constitute significant drug transporters for investigation. In this review, we explore these antimicrobial transport systems in the context of Vibrio spp. pathogenesis and virulence.
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Owoicho, Oloche, Kesego Tapela, Alexandra Lindsey Djomkam Zune, Nora Nganyewo Nghochuzie, Abiola Isawumi, and Lydia Mosi. "Suboptimal antimicrobial stewardship in the COVID-19 era: is humanity staring at a postantibiotic future?" Future Microbiology 16, no. 12 (August 2021): 919–25. http://dx.doi.org/10.2217/fmb-2021-0008.
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In the absence of potent antimicrobial agents, it is estimated that bacterial infections could cause millions of deaths. The emergence of COVID-19, its complex pathophysiology and the high propensity of patients to coinfections has resulted in therapeutic regimes that use a cocktail of antibiotics for disease management. Suboptimal antimicrobial stewardship in this era and the slow pace of drug discovery could result in large-scale drug resistance, narrowing future antimicrobial therapeutics. Thus, judicious use of current antimicrobials is imperative to keep up with existing and emerging infectious pathogens. Here, we provide insights into the potential implications of suboptimal antimicrobial stewardship, resulting from the emergence of COVID-19, on the spread of antimicrobial resistance.