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Artykuły w czasopismach na temat "MULTI- DRUG RESISTANCE (MDR)"

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Jachez, B., i F. Loor. "Atypical multi-drug resistance (MDR)". Anti-Cancer Drugs 4, nr 6 (grudzień 1993): 605–16. http://dx.doi.org/10.1097/00001813-199312000-00002.

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Putra, Pradana Maulana. "Effect of Anti-Tuberculosis Multi Drug Resistance Regimen on Hematological Lung Tuberculosis Patients Profile with Multi Drug Resistance". Berkala Kedokteran 14, nr 1 (1.03.2018): 59. http://dx.doi.org/10.20527/jbk.v14i1.4550.

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Abstract: ATD administration of tuberculosis in combination and duration often causes multi drug resistance (MDR) ATD due to discontinuation of treatment. Reported hematologic abnormal changes due to ATD. This study investigated hematological changes before and during MDR therapy of MDR TB patients in Tuberculosis MDR RSUD Ulin Banjarmasin from September to December 2017. The study population was patients treated in TB MDR Poly and selected samples with a time-limiting method. Inclusion and exclusion criteria were MDR-TB patients detected by Gene Xpert® examination, treated <30 days, between 18 and 65 years of age, HIV negative, as well as identification and laboratory data recorded in the complete medical record. 17 samples collected by hematological parameters were collected. There were significant changes in hemoglobin, hematocrit, platelets, RDW-CV, MCV, eosinophils, lymphocytes, granulocytes, and monocytes after treatment. It was concluded that MDR regimen ATD did not cause anemia and thrombocytopenia. There was also no significant change in WBC even though the count of the species changed significantly Keywords: Tubeculosis, Multi Drug Resistency (MDR), Anti Tuberculosis Drugs (ATD), profil hematologis
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Suparno, Suparno, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Mohammad Sulchan i Kusmiyati Tjahjono. "Kadar seng dan kadar malondialdehyde pada penderita multi drug resistant tuberculosis dan tuberkulosis sensitif". Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) 7, nr 1 (30.12.2018): 8–14. http://dx.doi.org/10.14710/jgi.7.1.8-14.

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Background: Zinc is the main constituent element of Superoxide Dismutase (SOD) which acts to protect cells from inflammation and the toxic effects of Reactive Oxygen Species (ROS). High ROS production induces fat peroxidation, and forms malondialdehyde (MDA) which causes oxidative stress.Objectives: This study aimed to analyze the difference of zinc and malondialdehyde levels among Multi Drug Resistant Tuberculosis and sensitive Tuberculosis.Methods: Crossectional study with 55 subjects consisted of 32 MDR-TB subjects and 23 subjects TB sensitive. Selection of subjects using consecutive sampling. Zinc and MDA serum was obtained from venous blood. Zinc and MDA concentration were assessed by quantitative colometric and Thiobarbituric Acid Reactive Substances (TBARS) respectively. Data were analized statistic by independent t-test and Mann Whitney test.Results: Zinc level of MDR-TB and TB sensitive were 74.85 (64 - 97) μg/dl and 73.03 (63 - 97) μg/dl respectively, while MDA of MDR-TB and sensitive TB were 2.262±1.055 nmol/mL and 2.66±0.992 nmol/mL. There was no significantly different in zinc level between MDR-TB and sensitive TB (p=1.000). Furthermore, there was not significantly different of MDA level between MDR-TB and sensitive Tuberculosis (p=0,147).Conclusion: There are no differences in zinc and MDA levels in patient between MDR-TB and sensitive TB.
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Tuladhar, Pranita, Dhruba Kumar Khadka, Megha Raj Banjara i Reshma Tuladhar. "Second Line Drugs Resistant Mycobacterium Tuberculosis in Multi-Drug Resistant Tuberculosis Patients". Journal of Institute of Science and Technology 22, nr 2 (9.04.2018): 168–74. http://dx.doi.org/10.3126/jist.v22i2.19609.

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With an increase in Multi-drug resistant tuberculosis (MDR-TB), there is a need of second line drug susceptibility test that helps in early diagnosis and minimize the risk of other powerful drug resistant Mycobacterium tuberculosis. The aim of this study was to determine second line drugs (ofloxacin, kanamycin, capreomycin) resistance pattern in MDR-TB isolates and to determine the prevalence of pre-Extensively drug resistant tuberculosis (pre-XDR-TB) and XDR-TB in MDR-TB patients. The study was conducted from February to September 2015 at National Tuberculosis Centre, Thimi, Bhaktapur. MDR-TB (resistant to isoniazid and rifampicin) patients’ sputum samples were processed by Modified Petroff’s method. Out of 92 samples, 57 were found culture positive. Following the species identification of culture positive MDR-TB isolates, second line drug susceptibility test was performed by conventional proportion method. Of 57 MDR-TB isolates, 22 (38.59%) showed resistance to ofloxacin (Ofx), 9 (15.79%) to capreomycin (Cm) and 9 (15.79%) to kanamycin (Km). One XDR-TB (1.8%) resistant to all drugs was detected. Of the remaining, 21(36.8%) were resistant to ofloxacin only and 8(15.4%) were resistant to two drugs i.e.29 (50.9%) were pre-XDR-TB. The prevalence of pre-XDR-TB and XDR-TB was found to be 50.88% and 1.75% respectively. The resistance pattern of second line anti-tuberculosis drugs showed higher ofloxacin resistance in MDR-TB patients. In a nutshell, MDR-TB cases need urgent and timely susceptibility report for second line anti-tuberculosis drugs to help the clinicians start proper drug combinations to treat MDR-TB patients. Journal of Institute of Science and Technology Volume 22, Issue 2, January 2018, page: 168-174
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Cho, Cheong-Weon. "Formulation strategy to overcome multi-drug resistance (MDR)". Archives of Pharmacal Research 34, nr 4 (kwiecień 2011): 511–13. http://dx.doi.org/10.1007/s12272-011-0400-0.

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Saini, Sanjeev, Manoj Kumar Dubey, Uma Bhardwaj, M. Hanif, Chopra Kk, Ashwani Khanna ., Kaushal Kumar Dwivedi i in. "RAPID DETECTION OF MULTI DRUG RESISTANCE AMONG MULTI DRUG RESISTANT TUBERCULOSIS SUSPECTS USING LINE PROBE ASSAY". Asian Journal of Pharmaceutical and Clinical Research 10, nr 1 (1.01.2016): 131. http://dx.doi.org/10.22159/ajpcr.2017.v10i1.14341.

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ABSTRACTObjective: GenoType MTBDRplus line probe assay (LPA) is developed for performing drug susceptibility testing (DST) for Rifampicin (RIF) andisoniazid in sputum specimens from smear-positive pulmonary tuberculosis (TB) patients and revised national TB control Programme (RNTCP)has endorsed LPA for the diagnosis of multi drug resistant TB (MDR-TB). This study was conducted to assess the potential utility of LPA for MDR-TBpatient management.Methods: MDR-TB suspects under RNTCP PMDT criteria C referred from different districts in Delhi state were included in the study January 2013 toDecember 2014. Sputum specimens found acid-fast bacilli positive by fluorescent microscopy were processed for LPA.Results: Out of 3062 specimens, 2055 (67.1%) MDR-TB suspects were read as positive and specimens from 1007 (32.9%) suspects were read asnegative in sputum smear microscopy. Out of 2019 specimens valid LPA results, 1427 were found to be pan-sensitive, 280 were MDR-TB, 40 were RIFmonoresistant, 183 were Isoniazid (INH) monoresistant, and 89 specimens were found negative for Mycobacterium tuberculosis.Conclusion: Routine use of LPA can substantially reduce the time to diagnosis of RIF and/or INH-resistant TB and can hence potentially enable earliercommencement of appropriate drug therapy and thereby facilitate prevention of further transmission of drug resistant strains.Keywords: Multi drug resistant tuberculosis, Line probe assay, Rifampicin, Isoniazid.
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Ghazaei, Ciamak. "Upcoming Multi-drug-Resistant and Extensively Drug-Resistant Bacteria". Research in Molecular medicine 10, nr 2 (1.05.2022): 0. http://dx.doi.org/10.32598/rmm.10.2.820.7.

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Multi-drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria are becoming a serious global health issue, which may soon become untreatable by clinicians. Since the invention of antibiotics, inappropriate consumption, non-prescribed drugs, overuse, and hoarding have caused the rapid emergence of MDR and XDR bacteria. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter spp.) cause many nosocomial infections and thus escape the biocidal action of the antibiotic. Gram-positive and Gram-negative bacteria have acquired self-defense tools like ESBL (extended spectrum beta-lactamase), a mutation in porin genes, biofilm production, and many more to develop multi-drug resistance. Antimicrobial resistance (AMR) endangers patients' treatment as it causes high mortality and morbidity rates, economic loss of both patient and country, and prolonged hospital stay. To combat upcoming MDR and XDR bacteria, it is essential to design novel therapeutic techniques to eradicate such resistant bacteria via burgeoning technologies like nanoparticles, CRISPER-Cas9, genetic engineering, and synthetic biology.
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Yadav, Pramod. "Challenges & Solutions for Recent Advancements in Multi-Drugs Resistance Tuberculosis: A Review". Microbiology Insights 16 (styczeń 2023): 117863612311524. http://dx.doi.org/10.1177/11786361231152438.

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In MDR-TB, mycobacterium is resistant to battlefront drugs like rifampicin and isoniazid. Now it’s an urgent global challenge for treatment & diagnosis because more than 50% of drugs are resistant. Till today's information, 5 reasons are liable for MDR: (1) Errors of physicians/patients in therapy management, (2) Complexity and poor vascularization of granulomatous lesions, which obstruct drug distribution to some sites, leading to resistance development, (3) Intrinsic drug resistance of tubercle bacilli, (4) Formation of non-replicating, drug-tolerant bacilli inside the granulomas, (5) Development of mutations in Mtb genes, which are the foremost important molecular mechanisms of resistance. the most contribution of this work is a brief & clear explanation of things chargeable for resistant development, and recent diagnostic & treatment methods for MDR-TB. This study shall help researchers & scientists to develop replacement rapid diagnostic tools, drugs, and treatment protocols.
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Neophytou, Christiana M., Ioannis P. Trougakos, Nuray Erin i Panagiotis Papageorgis. "Apoptosis Deregulation and the Development of Cancer Multi-Drug Resistance". Cancers 13, nr 17 (28.08.2021): 4363. http://dx.doi.org/10.3390/cancers13174363.

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The ability of tumor cells to evade apoptosis is established as one of the hallmarks of cancer. The deregulation of apoptotic pathways conveys a survival advantage enabling cancer cells to develop multi-drug resistance (MDR), a complex tumor phenotype referring to concurrent resistance toward agents with different function and/or structure. Proteins implicated in the intrinsic pathway of apoptosis, including the Bcl-2 superfamily and Inhibitors of Apoptosis (IAP) family members, as well as their regulator, tumor suppressor p53, have been implicated in the development of MDR in many cancer types. The PI3K/AKT pathway is pivotal in promoting survival and proliferation and is often overactive in MDR tumors. In addition, the tumor microenvironment, particularly factors secreted by cancer-associated fibroblasts, can inhibit apoptosis in cancer cells and reduce the effectiveness of different anti-cancer drugs. In this review, we describe the main alterations that occur in apoptosis-and related pathways to promote MDR. We also summarize the main therapeutic approaches against resistant tumors, including agents targeting Bcl-2 family members, small molecule inhibitors against IAPs or AKT and agents of natural origin that may be used as monotherapy or in combination with conventional therapeutics. Finally, we highlight the potential of therapeutic exploitation of epigenetic modifications to reverse the MDR phenotype.
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Gu, Liu-Qing, Peng-Fei Cui, Lei Xing, Yu-Jing He, Xin Chang, Tian-Jiao Zhou, Yu Liu, Ling Li i Hu-Lin Jiang. "An energy-blocking nanoparticle decorated with anti-VEGF antibody to reverse chemotherapeutic drug resistance". RSC Advances 9, nr 21 (2019): 12110–23. http://dx.doi.org/10.1039/c9ra01356c.

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Multi-drug resistance (MDR) of tumor has greatly hindered the therapeutic effect of chemotherapeutic drugs, resulting in chemotherapy failure, and overexpression of ATP-binding cassette (ABC) transporters in cell membrane is the main cause of MDR.
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Rozprawy doktorskie na temat "MULTI- DRUG RESISTANCE (MDR)"

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Sheth, Disha B. "Multielectrode platform for measuring oxygenation status in multicellular tumor spheroids". Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1301516012.

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Firfirey, Nousheena. "Occupational adaptation : the experiences of adult patients with MDR- TB who undergo long- term hospitalisation". University of the Western Cape, 2011. http://hdl.handle.net/11394/5300.

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Magister Scientiae (Occupational Therapy) - MSc(OT)
TB is a multi- faceted public health problem spurred on by the biological progression of the disease as well as the social issues associated with it. The treatment of TB is however primarily driven by the medical model where the focus is on the disease and not on a holistic view of the patient. Occupational therapy is a profession concerned with the use of occupation in the promotion of health and well being through the facilitation of the process of occupational adaptation. There is however a paucity of literature pertaining to the role that occupational therapy could play within the TB context. The aim of this study was to explore how adults with MDR- TB who undergo long-term hospitalisation at a hospital in the Western Cape experience occupational adaptation. The objectives of the study were to explore how the participants perceive their occupational identity, to explore the meaning and purpose the participants assign to their occupational engagement and to explore the how the participants perceive their occupational competence. The interpretive research paradigm employing a phenomenological qualitative research approach was utilized in this study. Purposive sampling was used to select four participants based on specific selection criteria. The data gathering methods utilized included diaries, semistructured interviews, participant observation and a focus group. Photographs taken by the researcher for the purpose of participant observation were used to elicit a rich, in depth response from the participants during the focus group discussion. All data was analysed through thematic content analysis. The study findings highlighted that the participants viewed themselves as occupational beings and that they valued the role that occupational engagement played in facilitating their occupational competence and ultimately their ability to adapt to long- term hospitalisation. The environmental demands and constraints that they experienced however infringed their engagement in meaningful occupation and hampered their ability to achieve occupational competence. It was recommended that the hospital adopt an integrative intervention approach to the management of MDR- TB patients that include principles of psychosocial rehabilitation and occupational enrichment to address occupational risk factors and institutionalisation.
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Alame, Ghina. "Étude de la réversion du phénotype de Multi Drug Resistance (MDR) par de nouveaux dérivés stéroïdiens, in vitro sur des lignées cellulaires humaines et murines résistantes et in vivo par xénogreffes". Phd thesis, Université Claude Bernard - Lyon I, 2009. http://tel.archives-ouvertes.fr/tel-00877481.

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La chimiorésistance des cancers est caractérisée par une résistance pléïotropique à de multiples médicaments. Ce mécanisme est en partie causé par la surexpression des transporteurs à "ATP binding cassette" (Pgp, MRP1, BCRP...). Les inhibiteurs connus de ces transporteurs comme la cyclosporine A, le vérapamil et le RU486 sont toxiques à doses élevées. Dans cette étude, de nombreux dérivés stéroïdiens synthétisés au laboratoire à base de progestérone ou d'acides biliaires ont été évalués pour leur capacité à inhiber les transporteurs ABC et plus spécifiquement les fonctions de transport par la Pgp ou la BCRP. Plusieurs de ces dérivés synthétisés se sont avérés capables de restaurer complètement la sensibilité des cellules résistantes d'une manière plus importante que la cyclosporine A in vitro. De plus, le meilleur des nos dérivés testés s'est avéré capable in vivo de diminuer significativement la progression tumorale de xénogreffe sur les souris et d'augmenter la durée de survie des souris. Cette étude a ainsi permis d'ouvrir la voie au développement de nouveaux dérivés stéroïdiens peu toxiques ayant la capacité d'inhiber le phénotype MDR et de restaurer la sensibilité des cellules cancéreuses vis-à-vis des agents chimiothérapeutiques utilisés, avec un perspective d'application clinique
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Morrison, Scott Macdonald. "Elucidation of the structure activity relationship of the multi drug resistance (Mdr) transport protein (NorA) of Escherichia coli and the putative protein (HP1181) of Helicobacter pylori". Thesis, University of Leeds, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270864.

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Aguilar, Mónica Alejandra Pavez. "Análise molecular da expressão do fenótipo multi-droga resistente (MDR) em enterobactérias isoladas de amostras clínicas após exposição in vitro ao Imipenem". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/9/9136/tde-22062015-153149/.

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Após o surgimento e disseminação das β-lactamases de amplo espectro em membros da família Enterobacteriaceae, os antibióticos carbapenêmicos (imipenem, meropenemeertapenem) têm sido considerados a terapia de escolha devido à estabilidade apresentada contra estas enzimas. A desvantagem destes antibióticos é a sua capacidade de induzir resistência aos β-lactâmicos e a outros antibióticos quimicamente não relacionados. O imipenem tem favorecido a indução de cefalosporinases cromossômicas (AmpC) e também tem sido relacionado, in vivo, com a seleção de mecanismos intrínsecos de resistência, contribuindo com o perfil multi -droga resistente (MDR). Esse perfil é freqüentemente associado à diminuição da permeabilidade por alteração na síntese de porinas em conjunto com um aumento da atividade de bombas de efluxo, as quais não permitem o estabelecimento de uma concentração ativa do antibiótico no interior da célula bacteriana. O presente trabalho teve como objetivo avaliar o estabelecimento do perfil MDR em enterobactérias provenientes de isolados clínicos em função da exposição a diferentes concentrações de imipenemin vitro. A seleção do grupo das amostras estudadas foi feito por meio da determinação do perfil de sensibilidade dos isolados, tipagem molecular e ensaio de hidrólise de Imipenem. Nos isolados selecionados para a indução foi realizada numa etapa inicial (etapa basal) a análise de porinas de membrana externa por SDS-PAGE e o estudo de genes codificadores de β-lactamases pela técnica de PCR. O estudo do estabelecimento do perfil MDR foi feito por meio de passagens sucessivas das amostras em meio contendo concentrações sub-inibitórias de imipenem seguido de análise fenotípica (CIM e acúmulo do antibiótico intracelular e SDS-PAGE), e a análise da expressão gênica de genes associados a permeabilidade de membrana (ompC, ompF eAcrA) e genes reguladores(marA e ompR). Após a indução com o imipenem, 77% dos isolados induzidos aumentaram a CIM para os carbapenêmicos, mudando assim o perfil de resistência observado na etapa basal Também foi afetado o perfil de resistência para outros antibióticos não relacionados a β-lactámicos, porém numa percentagem menor. Com relação à alteração da permeabilidade, a perda de porina foi observada apenas para um isolado, no entanto a diminuição na expressão gênica de Omp36 foi significativa desde o começo da indução. A expressão da bomba de efluxoAcrAB foi afetada pela indução com imipenem, aumentando significativamente a expressão de AcrA, enquanto os reguladores estudados, MarA e OmpR tiveram a sua expressão induzida pelo imipenem. Foi possível observar também associação do nível de expressão gênica do regulador MarA com a expressão de AcrA,porém não foi possível observar uma associação estatisticamente significativa deste regulador com o perfil de expressão de OMPs. A indução de OmpR foi associado com um aumento da expressão de RNAm de Omp35, já para Omp36 foi possível observar apenas uma tendência na repressão deste gene. O estudo da resposta destes genes reguladores e determinantes de resistência, em resposta à exposição ao com o imipenem in vitro, permitiu reportar o comportamento molecular da bactéria numa resposta adaptativa no estagio inicial do estabelecimento do fenótipo MDR. A utilização de isolados clínicos com diversos determinantes de resistência permitiu observar a variabilidade nas respostas adaptativas das enterobacterias, o que é fundamental para a compreensão dos mecanismos de adaptação da bactéria e sua contribuição na falha terapêutica.
After emergence and broad dissemination of extended spectrum β-lactamases into the Enterobacteriaceae family, the carbapenemic antibiotics (imipenem, meropenem and ertapenem) have been considered the chosen therapy in the treatment of nosocomial infections by the stability that these antibiotics show to these enzymes. The disadvantage of carbapenems is theirs capacity to induce resistance against β-lactamics and to other chemically unrelated antibiotics. The imipenem has been shown to induce chromosomal cephalosporinases (AmpC) and it was also related, in vivo, with the selection of intrinsic mechanism leading to multi-drug resistance profile (MDR). This profile is usually associated with membrane impermeability due to reduced outer membrane porin synthesis with an incremented activity of efflux pumps, which results in a reduced concentration of antibiotics inside the bacteria. This study aimed to evaluate the establishment of the MDR profile in Enterobacteriaceae from clinical isolates by exposure to different concentrations of imipenem in vitro. The selection of the study group was performed by determination of antibiotic susceptibility profile,molecular typing and hydrolysis assay of imipenem. In the selected isolates submitted to induction, in an initial step (baseline), was performed the outer membrane porin analysis by SDS-PAGE and the gene-specific amplification of B-lactamase enzymes by PCR. The study of the establishment of MDR was performed by progressive passages with subclinical concentrations of imipenem, followed each one by the evaluation of phenotypic profile (MIC, accumulation antibiotic in celland SDS-PAGE) and gene expression analysisof genes related to membrane permeability (ompC, ompF and acrA) and regulatory genes(MarA and ompR). After induction with imipenem, 77 % of the isolates increased the MIC for the carbapenems, changing the resistance profile at the baseline. In a lesser percentage, the resistance profile to other β-lactams-unrelated antibiotics was also affected. Loss of porin was observed only for an isolated, however a significantly decreased Omp36 mRNA expression was observed from the start of induction. The expression of the efflux pump AcrAB ,was also affected by the imipenem induction, significantly increasing the AcrA gene expression, whereas the studied regulatory genes,MarA and OmpR,were induced by the imipenem. It was also possible to observe an association between the expression of the regulator MarA and the expression of AcrA, nevertheless no association was observed between this regulator and OMPs . OmpR induction was associated with an increased Omp35mRNA expression, however only a trend for the repression of Omp36was observed. The study of the response of these regulatory genes and genetic determinants of resistance, in response to the imipenem exposure in vitro, allowed to report the molecular behavior of the bacteria in an adaptive response in the initial stage of the establishment of a MDR phenotype. The use of clinical isolates with diverse resistance determinants allowed observing the variability in adaptive responses in enterobacteria, which is important to understand the adaptive mechanisms of bacteria to this antibiotic, the involvement in the emergence of the MDR profile and its contribution to the treatment failure.
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Liu, Miaomiao. "Actinomycetes Sourced From Unique Environments as a Promising Source of New TB-Active Natural Products". Thesis, Griffith University, 2017. http://hdl.handle.net/10072/366523.

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Tuberculosis (TB) is the leading cause of death from infectious diseases in the world, affecting more than ten million patients each year. However, multi-drug resistance (MDR-TB) threatens progress achieved in TB care and control, and there are few drugs available to treat MDR-TB. Our overall aim was to identify anti-TB natural products from microbes sourced from unique environments. This thesis presents efforts to achieve an effective approach to identify anti-TB microbial natural products with the combination of one strain many compounds (OSMAC) strategy, NMR fingerprint and principal component analysis. The thesis begins with an introduction of TB and the current anti-TB drugs and candidates. It also covers a review on anti-TB natural products from marine microbe and endophyte origin and analysis of their physicochemical properties using Lipinski’s rule of five as well as the ChemGPS tool. As part of a research program aiming to identify anti-TB microbial constituents, a cell-based screening assay was developed to screen 2562 crude extracts. Among the active hits, 46 actinomyces isolated from marine, desert or Traditional Chinese Medicines were selected for further chemical investigation according to their chemical profiles or anti-TB activities. The results are presented in chapters 2 to 7.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Natural Sciences
Science, Environment, Engineering and Technology
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AMBIKA, KM. "ROLE OF LACTOSMART AS A NOVEL THERAPEUTIC AGENT IN ANTIMICROBIAL DEFENSE". Thesis, DELHI TECHNOLOGICAL UNIVERSITY, 2021. http://dspace.dtu.ac.in:8080/jspui/handle/repository/18433.

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The emergence of multi – drug resistance (MDR ) in microorganisms against antibiotics has become a global problem [1,2,3]. Various conventional drugs with promised efficacy and specificity are unable to withstand the threat of antibiotic drug resistance [4,5,6]. The rising crisis of MDR bacteria has led to the channelization of relevant research in the direction of antimicrobial molecules from natural sources as potential novel antibiotics. The spectrum of innate immune proteins and their potent fragments herald a promising approach to fight the problem of drug resistance. Among the natural antimicrobial proteins, Lactoferrin (LF) has been identified as a potent host defense system based on its wide spectrum bactericidal and bacteriostatic activities [7,8,9,10,11,12,13] . In the past , several studies have demonstrated the antibacterial and antifungal effects of LF and its derivative peptides, for instance, lactoferricin B [14,15,16,17,18,19] and lactoferrampin [20,21]. Structurally, LF consists of two iron bound lobes, N -lobe (1-333) and C -lobe (345-692) [22,23,24,25]. Amongst the two lobes , the highly cationic properties of N- lobe are responsible for membrane disruption by interacting with anionic components present on bacterial surface [26,27]. It has been established that the lipid A component of the LPS is a known drug target for antimicrobial therapeutics [ 28,29]. One of the mechanisms by which Lf acts as an antimicrobial agent is through binding to pathogen associated molecular patterns (PAMP) such as Lipopolysaccharide (LPS), thereby disrupting the bacterial membrane integrity and activating the chemical signaling pathway[30- 32]. This leads to the secretion of pro- inflammatory responses which down regulates the release of cytokine production [33,34]. In the past, it had been reported that LF binds to LPS with its hexameric sequence present in the 18 - loop region of the lactoferricin [35-37] . In the present study , we have performed the partial digestion of LF with trypsin which generates a potent antimicrobial molecule of the size of about 21kDa (85-281). We have proposed its name as Lactosmart due to its higher potency against pathogens when compared to native LF as a whole protein . The lactosmart has been tested for antibacterial and antifungal properties along with its inhibitory potential of biofilm formation by Pseudomonas aeruginosa through established assays [41]. Our primary focus was on the comparison of LPS binding properties of lactosmart with native LF using surface plasmon resonance technique . The docking and molecular dynamics simulations (MD) studies with LPS have also been performed to further substantiate our claims. Through our studies , we have demonstrated that LF sequesters LPS through two binding sites which are situated on the N- lobe.
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Firfirey, Nousheena. "The evaluation of the integrated client-centred intervention programme (ICIP) for clients with MDR-TB at DP Marais Hospital in the Western Cape". University of Western Cape, 2020. http://hdl.handle.net/11394/7687.

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Philosophiae Doctor - PhD
Although TB is a curable communicable disease, poor adherence to TB treatment is a major barrier to TB control in South Africa as it increases the risks of morbidity, mortality and drug resistance at individual and community level. As a result, multi-drug-resistant TB (MDR-TB) has become a serious public health issue. Underpinning this study was the assumption that a client-centred approach to treatment of MDR-TB clients, with a hospital programme which adopts an integrated multidisciplinary approach that is client-centred and is not purely biomedically driven, would improve treatment outcomes of MDR-TB clients.
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Greeff, Wildine Marion. "Ototoxicity Monitoring using Automated Extended High-Frequency Audiometry and the Sensitive Range of Ototoxicity in Patients with MDR-TB". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32696.

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Background: Disabling hearing loss is a global burden. This burden is worsened by the emergence of multi-drug resistant tuberculosis (MDR-TB). Some of the medications used to treat MDR-TB are damaging to the cochlea and auditory nerve (ototoxic) and can lead to permanent hearing loss and/or balance disorders. Ototoxicity monitoring aims to reduce this burden by preventing or minimising the damage caused by ototoxic treatment as it can progress and worsen speech perception difficulties. However, the proposed test battery for ototoxicity monitoring is lengthy and demands active participation which is not ideal for ill patients (such as those on MDR-TB treatment). The Sensitive Range of Ototoxicity (SRO) technique is recommended to shorten the test time. The SRO consists of seven consecutive relatively high frequencies determined from the highest frequency the participant responded to. The SRO technique is time efficient. Although the SRO technique provides the prospect of a shortened test battery, there is still a global lack of audiologists. Automated audiometry is a vital application for testing especially when audiologists are not available to physically do the test. Automated audiometry has been previously validated. Clinically, automated audiometry is objective and allows for standardisation. Even though automated audiometry helps improve access to monitoring more patients, patient preference is an important factor when using automated audiometry to ensure patient-centred care is not compromised. Aims and Objectives: This study aimed to investigate the specificity and sensitivity of the SRO technique with automated audiometry compared to the gold standard (manual audiometry). This comparison was made by firstly, determining the testing time efficiency and the correlation of thresholds obtained with the different test methods and, secondly, testing the diagnostic value of automated audiometry using the SRO technique. The incidence of an ototoxicity-induced hearing loss was described by determining the time interval between starting ototoxic MDR-TB treatment and the onset of a significant threshold shift (STS) according to ASHA's criteria. Lastly, the test method preference of the participants with MDR-TB was described and compared using a short exit survey. Study Design: A prospective repeated-measures study design was used. Participants were chosen based on a risk factor (i.e. exposure to ototoxic medication) for an outcome of interest (i.e. the presence or absence of an STS). With a repeated measures study, multiple tests using different test methods can be compared with the same sample. Participants: Twenty-seven in-patients at Brooklyn Chest Hospital and DP Marais TB Hospital with normal hearing and on MDR-TB medication were included in the study. Their age range was from 19 to 51 years old with an average age of 33 years old. Non-probability convenience sampling was used as it was cost-effective, reduced data collection time and was relatively easy to execute. Data collection materials and procedures: The procedure for data collection included weekly follow-up testing for a maximum of four weeks. The test battery was as follows: an auditory symptom questionnaire, otoscopy examination, and manual and automated audiometry using the SRO technique with a fifteen-minute break in between. Participants were tested with the KUDUwave ™ in a non-sound treated room. The frequency range was determined with the SRO technique. If an STS was obtained, the patient was discharged from the study after completing an exit survey. Statistics: Analysis included descriptive statistics and inferential statistics. A Bonferroni corrected p-value (initially p ≤ 0.05) was used. Manual and automated audiometry thresholds were compared using the Pearson's Correlation Coefficient test. Manual and automated audiometry testing time and threshold means were compared using paired sample's t-tests. The diagnostic value of automated audiometry with the SRO technique was assessed with Receiver Operating Characteristics (ROC) Curves. Results: Manual audiometry was statistically more time-efficient compared to automated audiometry by an average of one minute and ten seconds (t (94) = -5.44; p< 0.003). There was a strong positive correlation for both left and right ears between the thresholds' obtained from manual and automated audiometry at 8kHz to 16 kHz (df> 28 = r > 0.70, p< 0.003). Automated audiometry was found to be a fair diagnostic test (area under the curve was 0.75; p= 0.002). Also, the ROC curve revealed that automated audiometry had a sensitivity of 61% and specificity of 90% when compared to manual audiometry (gold standard). Only participants that started data collection within 31 days after starting their MDR-TB treatment were included in the analysis of determining the incidence of an ototoxicity-induced hearing loss (n= 24 ears). This study found that 41.67% of ears (n= 10) had an ototoxicity-induced hearing loss. A box and whisker plot revealed that data was skewed to the right (i.e. more variation in data between the median and the maximum values) and that the median number of days for an ototoxicity-induced hearing loss to appear was 33 days. Secondly, 55.55% of participants (n=15 out of 27) reported auditory symptoms before data collection commencement. Aural fullness was the most reported symptom (n= eight out of 15). Ten out of 15 (66.66%) participants that reported auditory symptoms obtained an ototoxicity-induced hearing loss. Lastly, most participants (i.e. 13 out of 19; 68.42%) that completed the exit survey had no preference between manual or automated audiometry. The common rationale among these participants was “No difference noted.” Conclusion: This research study has revealed that manual audiometry was more time-efficient compared to automated audiometry in patients with MDR-TB. Also, automated audiometry was a fair diagnostic test. It may aid in reducing the disproportionate audiologist to patient ratio, especially in a developing country. However, manual audiometry (with the SRO technique) is more clinically appropriate in patients that are difficult-to-test. Secondly, audiometric settings can be changed to accommodate testing frequencies in 1/6 octaves so that the SRO technique can be clinically adopted. An ototoxicity-induced hearing loss seems to appear 33 days after ototoxic MDR-TB treatment commencement. Aural fullness was a commonly reported symptom among participants with MDRTB. Aural fullness is omnipresent in peripheral auditory pathologies. Therefore, auditory symptoms reported by patients' needs a comprehensive audiological investigation. Lastly, more research is needed on how patients (and clinicians) experience the advances in technology innovation especially in audiology where technology innovation is continuously evolving.
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Vallie, Razia. "Assessing and comparing the effectiveness of treatment for multidrug resistant tuberculosis between specialized TB hospital in-patient and general outpatient clinic settings within the Western Cape Province, South Africa". University of the Western Cape, 2016. http://hdl.handle.net/11394/5600.

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Magister Public Health - MPH
Background: Multidrug resistant tuberculosis (MDR TB) is a growing threat globally. The large increase in the incidence and prevalence of MDR TB in South Africa in recent years has impacted on the way in which MDR TB is managed within the health services. It became logistically difficult to manage MDR TB by treating all patients as in-patients in a specialized tuberculosis (TB) hospital. The clinics, which are run by nurses and/or general medical officers, are then required to manage this more complex form of TB, with limited resources, less experience and assumingly with less MDR TB knowledge. Of particular concern is that shifting of the patient management from specialized TB hospitals to Primary Health Care clinics which might worsen the already poor MDR TB treatment outcomes. There has been minimal assessment of the management of MDR TB at clinic level and hence the comparison of treatment outcomes for those patients initiated on treatment in clinics compared to in-patients in specialized TB hospitals is urgently needed. Aim: To compare the treatment outcomes and the effectiveness of medication regimens provided to MDR TB patients initiated on treatment in specialized TB hospitals as inpatients, to that of MDR TB patients initiated on treatment as outpatients at community clinics within the Western Cape Province, South Africa. Methodology Study Design: A retrospective cohort study was undertaken, as the length of treatment for a MDR TB patient can be for 24 months or longer and this study was based on treatment outcome data. Study Population and sample: The study population was uncomplicated MDR TB patients initiated on treatment in hospitals and clinics from January 2010 to December 2012. The sample comprised of 568 participants that were laboratory confirmed to have MDR TB and had the outcomes of their treatment recorded in an electronic database or a paper register. Data Collection: The researcher collected MDR TB information from standardized MDR TB registers as well as an electronic MDR TB database. Analysis: Data was analyzed comparing the exposed (clinic initiated) and unexposed (hospital initiated) cohorts incidence of 4 key treatment outcomes, namely: successfully treated, failed treatment, died and defaulted treatment. Bivariate analysis (relative and absolute) was done to determine the cumulative incidence ratio and cumulative incidence difference and multivariate logistic regression analysis for the adjusted odds ratio to control for confounders and effect modifiers. Ethics: Permission to conduct this research was obtained from the relevant authorities. The confidentiality of the participants as per the Department of Health policy and in adherence to general ethical guidelines was strictly maintained. The study proposal received ethical clearance and approval from the University of the Western Cape Research Committee. Results: All participants within this study received the appropriate treatment as per the MDR TB guidelines. The incidence rate for the main outcomes of this study indicated that successfully treated for the clinic initiated participants was 41% and 31% for the hospital initiated participants. ‘Defaulted’ treatment was 39% and 41%, ‘failed’ treatment 7% and 13% and ‘died’ was 14% and 16%, respectively. The clinic initiated participants appeared to have better treatment outcomes on bivariate analysis, however on multivariate analysis, there was no difference in the treatment outcomes of the clinic initiated participants compared to the hospital initiated participants, and therefore the clinic initiated treatment is seen as effective. The time to treatment initiation for clinic and hospital initiated participants is excessively long for both cohorts, with a median of 29 days, and 37 days respectively. The key findings of note in the multivariate analysis is that the Human Immunodeficiency Virus positive (HIV+) participants provided with antiretrovirals therapy (ART) were, based on adjusted cumulative incidence ratios, 6.6 times more likely to have a successfully treated outcome (95% CI 1.48-29.84), and were 0.2 times less likely to die (95% CI 0.08-0.53). Having a previous cured history of TB and no previous history of TB were 2.9 times more likely to have a successfully treated outcome (95% CI 1.48-5.56) and were 0.1 times (0.04-0.38) less likely to fail treatment. An interesting finding was that participants living in the rural districts were 2.6 times more likely to die. Conclusion: Clinic initiated treatment for uncomplicated MDR TB is as effective as hospital initiated treatment. Also, those provided with ART and those without previous TB or who had a previous bout of TB cured, had better outcomes. Main Recommendations: The Western Cape health department should continue with the decentralization of MDR TB services to the clinics and could safely consider expanding the decentralization to include uncomplicated Preextensively drug-resistant TB and Extensively drug-resistant TB patients. Offering ART to HIV+ patients should be mandatory. The delays in the time to treatment initiation of MDR TB need to be further investigated.
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Książki na temat "MULTI- DRUG RESISTANCE (MDR)"

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Zhou, Jun, red. Multi-Drug Resistance in Cancer. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-416-6.

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Multi-drug resistance in cancer. Totowa, N.J: Humana, 2010.

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Vinšová, Jarmila. Development of new MDR-tuberculosis drugs. Hauppauge, N.Y: Nova Science Publisher, 2010.

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C, Mahajan R., Therwath Amu i Indian National Science Academy, red. Multi-drug resistance in emerging and re-emerging diseases. New Delhi: Indian National Science Academy, 2000.

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Hopkins, Tanne Janice, red. Timebomb: The global epidemic of multi-drug-resistant tuberculosis. New York: McGraw-Hill, 2002.

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Society of Critical Care Medicine, red. ICU infection in an era of multi resistance: Selected proceedings from the 8th Summer Conference in Intensive Care Medicine. Mount Prospect, IL: Society of Critical Care Medicine, 2009.

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Kaushik, Sanket, i Nagendra Singh, red. Current Developments in the Detection and Control of Multi Drug Resistance. BENTHAM SCIENCE PUBLISHERS, 2022. http://dx.doi.org/10.2174/97898150498791220101.

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The rise in the incidence of infections is caused by multi drug resistant (MDR) bacteria, it is essential to elucidate the basic mechanism of antibiotic resistance to discover effective methods for diagnosis and treatment of infections. The use of pathogen-specific probes offers a faster alternative for pathogen detection and could improve the diagnosis of infection. High resolution melting analysis techniques are useful for the detection of multi drug resistant pathogens. Rational Structural Based Drug Design is a common method to identify a lead compound and take it forward for further developments. This book provides information about recent strategies involved in the diagnosis and treatment of infections caused by MDR bacteria. The volume covers the use of molecular probes for the quantification of pathogenic bacteria, along with other techniques mentioned above. Chapters also cover the use of identification of novel drug targets from the Lipid A biosynthesis and also from quorum sensing mediated biofilm formation in MDR bacteria. Chapters also cover herbal alternatives for the treatment of MDR bacteria like the use of Cassia aungustifolia in treatment of various diseases. The reference is suitable for biomedical students, cellular and molecular biologists.
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Multi-Drug Resistance in Cancer. Humana, 2012.

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Reichman, Lee B., i Janice Hopkins Tanne. Timebomb:The Global Epidemic of Multi-Drug Resistant Tuberculosis. McGraw-Hill Companies, 2001.

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Reichman, Lee B., i Janice Hopkins Tanne. Timebomb:The Global Epidemic of Multi-Drug Resistant Tuberculosis. McGraw-Hill Companies, 2001.

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Części książek na temat "MULTI- DRUG RESISTANCE (MDR)"

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Singh, Amit, Anil Kumar Gupta i Sarman Singh. "Molecular Mechanisms of Drug Resistance in Mycobacterium tuberculosis: Role of Nanoparticles Against Multi-drug-Resistant Tuberculosis (MDR-TB)". W NanoBioMedicine, 285–314. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-32-9898-9_12.

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Gilbert, Gwendolyn L., i Ian Kerridge. "Hospital Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS): Dual Strategies to Reduce Antibiotic Resistance (ABR) in Hospitals". W Ethics and Drug Resistance: Collective Responsibility for Global Public Health, 89–108. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-27874-8_6.

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Abstract In this chapter we review the development of hospital infection prevention and control (IPC) since the nineteenth century and its increasingly important role in reducing the spread of antibiotic resistance (ABR). Excessive rates of hospital-acquired infection (HAI) fell dramatically, towards the end of the nineteenth century, because of improved hygiene and surgical antisepsis, but treatment remained rudimentary until effective antibiotics became widely available in the mid-twentieth century. While antibiotics had profound clinical benefits, their widespread appropriate and inappropriate use in humans and animals inevitably led to the emergence of antibiotic resistance (ABR). Within 50 years, this could no longer be offset by a reliable supply of new drugs, which slowed to a trickle in the 1980s. In hospitals, particularly, high rates of (often unnecessary) antibiotic use and ABR are exacerbated by person-to-person transmission of multi-drug resistant organisms (MDRO), which have, so far, largely resisted the introduction of antimicrobial stewardship (AMS) programs and repeated campaigns to improve infection prevention and control (IPC). Despite clear evidence of efficacy in research settings, both AMS and IPC programs are often ineffective, in practice, because of, inter alia, insufficient resourcing, poor implementation, lack of ongoing evaluation and failure to consult frontline staff. In this chapter we review reasons for the relatively low priority given to preventive programs despite the ethical obligation of healthcare organisations to protect current and future patients from preventable harm. The imminent threat of untreatable infections may provide an impetus for a shared organisational and professional commitment to promoting the cultural and behavioural changes needed to successfully reduce the burdens of ABR and drug-resistant HAIs.
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Schneider, C. G., S. B. Hosch, A. Reymann, G. Fröschle, J. H. Bräsen i J. R. Izbicki. "Expression der Multi-Drug-Resistance-Gene mdr1 und mrp in kolorektalen Karzinomen". W Deutsche Gesellschaft für Chirurgie, 49–51. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-642-56698-1_13.

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Davey, Ross, i Mary Davey. "The extended-MDR phenotype". W Multiple Drug Resistance in Cancer 2, 237–47. Dordrecht: Springer Netherlands, 1998. http://dx.doi.org/10.1007/978-94-017-2374-9_15.

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Belvedere, G., i E. Dolfini. "Studies on low-level MDR cells". W Multiple Drug Resistance in Cancer, 257–64. Dordrecht: Springer Netherlands, 1994. http://dx.doi.org/10.1007/978-94-011-0826-3_12.

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Scotto, Kathleen W., i David A. Egan. "Transcriptional regulation of MDR genes". W Multiple Drug Resistance in Cancer 2, 257–69. Dordrecht: Springer Netherlands, 1998. http://dx.doi.org/10.1007/978-94-017-2374-9_17.

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Nooter, K., i P. Sonneveld. "Multidrug resistance (MDR) genes in haematological malignancies". W Multiple Drug Resistance in Cancer, 213–30. Dordrecht: Springer Netherlands, 1994. http://dx.doi.org/10.1007/978-94-011-0826-3_10.

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Szakács, Gergely, Kenneth Kin Wah, Orsolya Polgár, Robert W. Robey i Susan E. Bates. "Multidrug Resistance Mediated by MDR-ABC Transporters". W Drug Resistance in Cancer Cells, 1–20. New York, NY: Springer US, 2009. http://dx.doi.org/10.1007/978-0-387-89445-4_1.

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Larkin, Annemarie, Elizabeth Moran, Denis Alexander i Martin Clynes. "Preliminary Immunocytochemical Studies of MDR-1 and MDR-3 Pgp Expression in B-Cell Leukaemias". W Drug Resistance in Leukemia and Lymphoma III, 65–70. Boston, MA: Springer US, 1999. http://dx.doi.org/10.1007/978-1-4615-4811-9_8.

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Kohler, Verena, Ankita Vaishampayan i Elisabeth Grohmann. "Problematic Groups of Multidrug-Resistant Bacteria and Their Resistance Mechanisms". W Antibacterial Drug Discovery to Combat MDR, 25–69. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-9871-1_2.

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Streszczenia konferencji na temat "MULTI- DRUG RESISTANCE (MDR)"

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Teo, Ka Yaw, i Bumsoo Han. "Freezing-Assisted Intracellular Drug Delivery to Multi-Drug Resistant Cancer Cells". W ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192373.

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The efficacy of chemotherapy is significantly impaired by multi-drug resistance (MDR) of cancer cells. The mechanism of MDR is associated with the overexpression of certain ATP-binding cassette protein transporters in plasma membranes. These transporters actively keep intracellular drug concentration below the cell-killing threshold by extruding cytotoxic drugs. Various strategies to overcome MDR have been proposed and have shown promising results at the laboratory level. However, pharmacokinetic alteration of co-administered anticancer agents reduces their clinical effectiveness. This leads to increased toxicity and undesirable side effects at effective concentrations [1]. Hence, a clinically feasible strategy to overcome the phenomenon of MDR is highly desired.
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Madhav, Bhumika, Aparna Iyer i T. K. Jayalakshmi. "Side effect profile of 2ndline drugs in multi drug resistant (MDR) and extensively drug resistant (XDR) tuberculosis". W Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa2708.

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ankale, Padmaraj, Girija Nair, Abhay Uppe, Aleena Mathew i Ria shah. "Socioeconomic Conditions Contributing to Multi Drug Resistant (MDR) and Extremely Drug Resistant(XDR) Tuberculosis". W ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa2727.

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Kapo, Naida, Jasmin Omeragić, Faruk Tandir, Indira Mujezinović, Ahmed Smajlović i Ermin Šaljić. "Anthelmintic Resistance in Gastrointestinal Nematodes of Ru-minants". W Socratic Lectures 7. University of Lubljana Press, 2022. http://dx.doi.org/10.55295/psl.2022.d9.

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Gastrointestinal nematode (GIN) infections remain one of the most prevalent and important issue affecting ruminants worldwide. Until date, the majority of GIN control has relied on the administra-tion of chemical anthelmintic medications on a regular basis, in recent years, the problem of anthel-mintic resistance has reached new heights where it can no longer be ignored as a major issue in the control of parasites of livestock. Anthelmintics are generally used at farmers' discretion, with no restrictions to access to commercially available drugs and without any assistance from veterinarians. Thus, inadequate use of anthelmintics is not rare, animals are often treated excessively, interfering with production, accelerating selection of resistant parasites, and posing significant problems for the ruminant industry. The unusually high frequency of multi-drug resistance (MDR) in sheep and goat nematodes threatens the sustainability of small-ruminant enterprises in several parts of the world. Although resistance in horses and cattle nematodes has not yet reached the levels reported in small ruminants, data shows that resistance issues, particularly MDR worms, are rising in these hosts. Both innovative non-chemical parasite control methods and molecular tests capable of detecting resistant worms are urgently needed. Keywords: Anthelmintics; Multidrug resistance; Gastrointestinal nematodes; Ruminants; Preva-lence
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Widyasrini, Elisabeth Ria, Ari N. Probandari i Reviono. "FACTORS AFFECTING THE SUCCESS OF MULTI DRUG RESISTANCE (MDR-TB) TUBERCULOSIS TREATMENT IN RESIDENTIAL SURAKARTA". W THE 2ND INTERNATIONAL CONFERENCE ON PUBLIC HEALTH. Masters Program in Public Health, Graduate School, Sebelas Maret University Jl. Ir Sutami 36A, Surakarta 57126. Telp/Fax: (0271) 632 450 ext.208 First website:http//: pasca.uns.ac.id/s2ikm Second website: www.theicph.com. Email: theicph2017@gmail.com, 2017. http://dx.doi.org/10.26911/theicph.2017.007.

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Prasad, R., SK Verma, SK Verma, A. Jain i RC Ahuja. "Long Term Treatment Outcome in Multi Drug Resistant Tuberculosis (MDR-TB)." W American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a4087.

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Perez, Javier, Eva Polverino, Antonio Alvares, Patricia Chang, Letizia Traversi, Ariadna Rando, Daniel Romero i Maria Teresa Martin. "Prevalence of relevant multi-drug resistant (MDR) pathogens in a bronchiectasis (BE) cohort". W ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa4580.

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Syarifah, E. Mutiara i S. N. Lubis. "SMS Reminder Program to Improve Drug Adherence of Multi-drug Resistant Tubeculosis (MDR-TB) Patients in Medan". W International Conference of Science, Technology, Engineering, Environmental and Ramification Researches. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0010082714791485.

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"The bactericidal activity of Magnetic water on Multi Drug Resistance [ MDR] Pseudomonas aeruginosa Resistance Colistin from clinical and environmental sources and effect on Biofilm". W المؤتمر الدولي الاول للعلوم والاداب. شبكة المؤتمرات العربية, 2017. http://dx.doi.org/10.24897/acn.64.68.31.

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Yasmirullah, Septia Devi Prihastuti, Bambang Widjanarko Otok, Jerry Dwi Trijoyo Purnomo i Dedy Dwi Prastyo. "Multivariate adaptive regression spline (MARS) methods with application to multi drug-resistant tuberculosis (MDR-TB) prevalence". W INTERNATIONAL CONFERENCE ON MATHEMATICS, COMPUTATIONAL SCIENCES AND STATISTICS 2020. AIP Publishing, 2021. http://dx.doi.org/10.1063/5.0042145.

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Raporty organizacyjne na temat "MULTI- DRUG RESISTANCE (MDR)"

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Larson, S. M., i R. D. Finn. Improving cancer treatment with cyclotron produced radionuclides. [Multiple Drug Resistance (MDR)]. Office of Scientific and Technical Information (OSTI), październik 1990. http://dx.doi.org/10.2172/6253141.

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Willis, C., F. Jorgensen, S. A. Cawthraw, H. Aird, S. Lai, M. Chattaway, I. Lock, E. Quill i G. Raykova. A survey of Salmonella, Escherichia coli (E. coli) and antimicrobial resistance in frozen, part-cooked, breaded or battered poultry products on retail sale in the United Kingdom. Food Standards Agency, maj 2022. http://dx.doi.org/10.46756/sci.fsa.xvu389.

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Frozen, breaded, ready-to-cook chicken products have been implicated in outbreaks of salmonellosis. Some of these outbreaks can be large. For example, one outbreak of Salmonella Enteritidis involved 193 people in nine countries between 2018 and 2020, of which 122 cases were in the UK. These ready-to-cook products have a browned, cooked external appearance, which may be perceived as ready-to-eat, leading to mishandling or undercooking by consumers. Continuing concerns about these products led FSA to initiate a short-term (four month), cross-sectional surveillance study undertaken in 2021 to determine the prevalence of Salmonella spp., Escherichia coli and antimicrobial resistance (AMR) in frozen, breaded or battered chicken products on retail sale in the UK. This study sought to obtain data on AMR levels in Salmonella and E. coli in these products, in line with a number of other FSA instigated studies of the incidence and nature of AMR in the UK food chain, for example, the systematic review (2016). Between the beginning of April and the end of July 2021, 310 samples of frozen, breaded or battered chicken products containing either raw or partly cooked chicken, were collected using representative sampling of retailers in England, Wales, Scotland and Northern Ireland based on market share data. Samples included domestically produced and imported chicken products and were tested for E. coli (including extended-spectrum beta-lactamase (ESBL)-producing, colistin-resistant and carbapenem-resistant E. coli) and Salmonella spp. One isolate of each bacterial type from each contaminated sample was randomly selected for additional AMR testing to determine the minimum inhibitory concentration (MIC) for a range of antimicrobials. More detailed analysis based on Whole Genome Sequencing (WGS) data was used to further characterise Salmonella spp. isolates and allow the identification of potential links with human isolates. Salmonella spp. were detected in 5 (1.6%) of the 310 samples and identified as Salmonella Infantis (in three samples) and S. Java (in two samples). One of the S. Infantis isolates fell into the same genetic cluster as S. Infantis isolates from three recent human cases of infection; the second fell into another cluster containing two recent cases of infection. Countries of origin recorded on the packaging of the five Salmonella contaminated samples were Hungary (n=1), Ireland (n=2) and the UK (n=2). One S. Infantis isolate was multi-drug resistant (i.e. resistant to three different classes of antimicrobials), while the other Salmonella isolates were each resistant to at least one of the classes of antimicrobials tested. E. coli was detected in 113 samples (36.4%), with counts ranging from <3 to >1100 MPN (Most Probable Number)/g. Almost half of the E. coli isolates (44.5%) were susceptible to all antimicrobials tested. Multi-drug resistance was detected in 20.0% of E. coli isolates. E. coli isolates demonstrating the ESBL (but not AmpC) phenotype were detected in 15 of the 310 samples (4.8%) and the AmpC phenotype alone was detected in two of the 310 samples (0.6%) of chicken samples. Polymerase Chain Reaction (PCR) testing showed that five of the 15 (33.3%) ESBL-producing E. coli carried blaCTX-M genes (CTX-M-1, CTX-M-55 or CTX-M-15), which confer resistance to third generation cephalosporin antimicrobials. One E. coli isolate demonstrated resistance to colistin and was found to possess the mcr-1 gene. The five Salmonella-positive samples recovered from this study, and 20 similar Salmonella-positive samples from a previous UKHSA (2020/2021) study (which had been stored frozen), were subjected to the cooking procedures described on the sample product packaging for fan assisted ovens. No Salmonella were detected in any of these 25 samples after cooking. The current survey provides evidence of the presence of Salmonella in frozen, breaded and battered chicken products in the UK food chain, although at a considerably lower incidence than reported in an earlier (2020/2021) study carried out by PHE/UKHSA as part of an outbreak investigation where Salmonella prevalence was found to be 8.8%. The current survey also provides data on the prevalence of specified AMR bacteria found in the tested chicken products on retail sale in the UK. It will contribute to monitoring trends in AMR prevalence over time within the UK, support comparisons with data from other countries, and provide a baseline against which to monitor the impact of future interventions. While AMR activity was observed in some of the E. coli and Salmonella spp. examined in this study, the risk of acquiring AMR bacteria from consumption of these processed chicken products is low if the products are cooked thoroughly and handled hygienically.
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Jorgensen, Frieda, Andre Charlett, Craig Swift, Anais Painset i Nicolae Corcionivoschi. A survey of the levels of Campylobacter spp. contamination and prevalence of selected antimicrobial resistance determinants in fresh whole UK-produced chilled chickens at retail sale (non-major retailers). Food Standards Agency, czerwiec 2021. http://dx.doi.org/10.46756/sci.fsa.xls618.

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Campylobacter spp. are the most common bacterial cause of foodborne illness in the UK, with chicken considered to be the most important vehicle for this organism. The UK Food Standards Agency (FSA) agreed with industry to reduce Campylobacter spp. contamination in raw chicken and issued a target to reduce the prevalence of the most contaminated chickens (those with more than 1000 cfu per g chicken neck skin) to below 10 % at the end of the slaughter process, initially by 2016. To help monitor progress, a series of UK-wide surveys were undertaken to determine the levels of Campylobacter spp. on whole UK-produced, fresh chicken at retail sale in the UK. The data obtained for the first four years was reported in FSA projects FS241044 (2014/15) and FS102121 (2015 to 2018). The FSA has indicated that the retail proxy target for the percentage of highly contaminated raw whole retail chickens should be less than 7% and while continued monitoring has demonstrated a sustained decline for chickens from major retailer stores, chicken on sale in other stores have yet to meet this target. This report presents results from testing chickens from non-major retailer stores (only) in a fifth survey year from 2018 to 2019. In line with previous practise, samples were collected from stores distributed throughout the UK (in proportion to the population size of each country). Testing was performed by two laboratories - a Public Health England (PHE) laboratory or the Agri-Food & Biosciences Institute (AFBI), Belfast. Enumeration of Campylobacter spp. was performed using the ISO 10272-2 standard enumeration method applied with a detection limit of 10 colony forming units (cfu) per gram (g) of neck skin. Antimicrobial resistance (AMR) to selected antimicrobials in accordance with those advised in the EU harmonised monitoring protocol was predicted from genome sequence data in Campylobacter jejuni and Campylobacter coli isolates The percentage (10.8%) of fresh, whole chicken at retail sale in stores of smaller chains (for example, Iceland, McColl’s, Budgens, Nisa, Costcutter, One Stop), independents and butchers (collectively referred to as non-major retailer stores in this report) in the UK that are highly contaminated (at more than 1000 cfu per g) with Campylobacter spp. has decreased since the previous survey year but is still higher than that found in samples from major retailers. 8 whole fresh raw chickens from non-major retailer stores were collected from August 2018 to July 2019 (n = 1009). Campylobacter spp. were detected in 55.8% of the chicken skin samples obtained from non-major retailer shops, and 10.8% of the samples had counts above 1000 cfu per g chicken skin. Comparison among production plant approval codes showed significant differences of the percentages of chicken samples with more than 1000 cfu per g, ranging from 0% to 28.1%. The percentage of samples with more than 1000 cfu of Campylobacter spp. per g was significantly higher in the period May, June and July than in the period November to April. The percentage of highly contaminated samples was significantly higher for samples taken from larger compared to smaller chickens. There was no statistical difference in the percentage of highly contaminated samples between those obtained from chicken reared with access to range (for example, free-range and organic birds) and those reared under standard regime (for example, no access to range) but the small sample size for organic and to a lesser extent free-range chickens, may have limited the ability to detect important differences should they exist. Campylobacter species was determined for isolates from 93.4% of the positive samples. C. jejuni was isolated from the majority (72.6%) of samples while C. coli was identified in 22.1% of samples. A combination of both species was found in 5.3% of samples. C. coli was more frequently isolated from samples obtained from chicken reared with access to range in comparison to those reared as standard birds. C. jejuni was less prevalent during the summer months of June, July and August compared to the remaining months of the year. Resistance to ciprofloxacin (fluoroquinolone), erythromycin (macrolide), tetracycline, (tetracyclines), gentamicin and streptomycin (aminoglycosides) was predicted from WGS data by the detection of known antimicrobial resistance determinants. Resistance to ciprofloxacin was detected in 185 (51.7%) isolates of C. jejuni and 49 (42.1%) isolates of C. coli; while 220 (61.1%) isolates of C. jejuni and 73 (62.9%) isolates of C. coli isolates were resistant to tetracycline. Three C. coli (2.6%) but none of the C. jejuni isolates harboured 23S mutations predicting reduced susceptibility to erythromycin. Multidrug resistance (MDR), defined as harbouring genetic determinants for resistance to at least three unrelated antimicrobial classes, was found in 10 (8.6%) C. coli isolates but not in any C. jejuni isolates. Co-resistance to ciprofloxacin and erythromycin was predicted in 1.7% of C. coli isolates. 9 Overall, the percentages of isolates with genetic AMR determinants found in this study were similar to those reported in the previous survey year (August 2016 to July 2017) where testing was based on phenotypic break-point testing. Multi-drug resistance was similar to that found in the previous survey years. It is recommended that trends in AMR in Campylobacter spp. isolates from retail chickens continue to be monitored to realise any increasing resistance of concern, particulary to erythromycin (macrolide). Considering that the percentage of fresh, whole chicken from non-major retailer stores in the UK that are highly contaminated (at more than 1000 cfu per g) with Campylobacter spp. continues to be above that in samples from major retailers more action including consideration of interventions such as improved biosecurity and slaughterhouse measures is needed to achieve better control of Campylobacter spp. for this section of the industry. The FSA has indicated that the retail proxy target for the percentage of highly contaminated retail chickens should be less than 7% and while continued monitoring has demonstrated a sustained decline for chickens from major retailer stores, chicken on sale in other stores have yet to meet this target.
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Cytryn, Eddie, Mark R. Liles i Omer Frenkel. Mining multidrug-resistant desert soil bacteria for biocontrol activity and biologically-active compounds. United States Department of Agriculture, styczeń 2014. http://dx.doi.org/10.32747/2014.7598174.bard.

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Control of agro-associated pathogens is becoming increasingly difficult due to increased resistance and mounting restrictions on chemical pesticides and antibiotics. Likewise, in veterinary and human environments, there is increasing resistance of pathogens to currently available antibiotics requiring discovery of novel antibiotic compounds. These drawbacks necessitate discovery and application of microorganisms that can be used as biocontrol agents (BCAs) and the isolation of novel biologically-active compounds. This highly-synergistic one year project implemented an innovative pipeline aimed at detecting BCAs and associated biologically-active compounds, which included: (A) isolation of multidrug-resistant desert soil bacteria and root-associated bacteria from medicinal plants; (B) invitro screening of bacterial isolates against known plant, animal and human pathogens; (C) nextgeneration sequencing of isolates that displayed antagonistic activity against at least one of the model pathogens and (D) in-planta screening of promising BCAs in a model bean-Sclerotiumrolfsii system. The BCA genome data were examined for presence of: i) secondary metabolite encoding genes potentially linked to the anti-pathogenic activity of the isolates; and ii) rhizosphere competence-associated genes, associated with the capacity of microorganisms to successfully inhabit plant roots, and a prerequisite for the success of a soil amended BCA. Altogether, 56 phylogenetically-diverse isolates with bioactivity against bacterial, oomycete and fungal plant pathogens were identified. These strains were sent to Auburn University where bioassays against a panel of animal and human pathogens (including multi-drug resistant pathogenic strains such as A. baumannii 3806) were conducted. Nineteen isolates that showed substantial antagonistic activity against at least one of the screened pathogens were sequenced, assembled and subjected to bioinformatics analyses aimed at identifying secondary metabolite-encoding and rhizosphere competence-associated genes. The genome size of the bacteria ranged from 3.77 to 9.85 Mbp. All of the genomes were characterized by a plethora of secondary metabolite encoding genes including non-ribosomal peptide synthase, polyketidesynthases, lantipeptides, bacteriocins, terpenes and siderophores. While some of these genes were highly similar to documented genes, many were unique and therefore may encode for novel antagonistic compounds. Comparative genomic analysis of root-associated isolates with similar strains not isolated from root environments revealed genes encoding for several rhizospherecompetence- associated traits including urea utilization, chitin degradation, plant cell polymerdegradation, biofilm formation, mechanisms for iron, phosphorus and sulfur acquisition and antibiotic resistance. Our labs are currently writing a continuation of this feasibility study that proposes a unique pipeline for the detection of BCAs and biopesticides that can be used against phytopathogens. It will combine i) metabolomic screening of strains from our collection that contain unique secondary metabolite-encoding genes, in order to isolate novel antimicrobial compounds; ii) model plant-based experiments to assess the antagonistic capacities of selected BCAs toward selected phytopathogens; and iii) an innovative next-generation-sequencing based method to monitor the relative abundance and distribution of selected BCAs in field experiments in order to assess their persistence in natural agro-environments. We believe that this integrated approach will enable development of novel strains and compounds that can be used in large-scale operations.
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Drug treatment of GUTB - short course DOTS and multi-drug resistance management. BJUI Knowledge, kwiecień 2017. http://dx.doi.org/10.18591/bjuik.0564.

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