Pub Date : 2020-07-08DOI: 10.1097/MRM.0000000000000216
Rasoul Mirzaei, M. Abdi, H. Gholami
The interplay of biofilm with host leads to a range of physiological reactions of the interacting members aimed at an adaptation to the novel position. These reactions include metabolic shifts in the influenced host cell, which is most apparent when the biofilm-forming bacteria replicates surround host cells. Whilst the bacteria try to deprive micronutrients of the host, the host cell, in turn, takes many metabolic countermeasures toward the micronutrient steal. During these conflicting interplays, the bacteria stimulate metabolic host cell reactions by means of common cell envelope ingredients and particular factors mediated to virulence. Hence, there is a crucial need for cellular models that more closely reflect the in-vivo infection conditions. The profound comprehension of the metabolic host cell reactions can provide novel interesting concepts for antibacterial treatments. In this review, a summarize of the metabolic changes of the host cells after bacterial biofilm formation is presented.
{"title":"The host metabolism following bacterial biofilm: what is the mechanism of action?","authors":"Rasoul Mirzaei, M. Abdi, H. Gholami","doi":"10.1097/MRM.0000000000000216","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000216","url":null,"abstract":"The interplay of biofilm with host leads to a range of physiological reactions of the interacting members aimed at an adaptation to the novel position. These reactions include metabolic shifts in the influenced host cell, which is most apparent when the biofilm-forming bacteria replicates surround host cells. Whilst the bacteria try to deprive micronutrients of the host, the host cell, in turn, takes many metabolic countermeasures toward the micronutrient steal. During these conflicting interplays, the bacteria stimulate metabolic host cell reactions by means of common cell envelope ingredients and particular factors mediated to virulence. Hence, there is a crucial need for cellular models that more closely reflect the in-vivo infection conditions. The profound comprehension of the metabolic host cell reactions can provide novel interesting concepts for antibacterial treatments. In this review, a summarize of the metabolic changes of the host cells after bacterial biofilm formation is presented.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"18 1","pages":"175 - 182"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80847792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-08DOI: 10.1097/MRM.0000000000000229
Parisa Agahi, Masoumeh Mahdavi-Ourtakand, F. Noorbakhsh
Background: Acinetobacter baumannii infections have become a major cause of hospital-acquired infections worldwide and can rapidly develop resistance to antibiotics. There are various mechanisms for multidrug resistance in the A. baumannii and efflux pumps is the most important among those. The purpose of this study is to evaluate the synergistic effect of Zataria multiflora and Lavandula stoechas essential oils on phenotype detection of efflux pump against multidrug-resistant A. baumannii isolates. Methods: A total of 55 A. baumannii strains were collected from clinical specimens and those with multidrug resistant (MDR) has been isolated by using the Kirby-Bauer disk diffusion method. Z. multiflora and L. stoechas essential oils were extracted and analyzed by gas chromatography–mass spectrometry. The minimum inhibitory concentration for antimicrobial activity of essential oils against MDR A. baumannii strains and fractional inhibitory concentration index was evaluated to determine their synergistic effect. The activity of efflux pumps of MDR strains was investigated by the ethidium bromide-agar cartwheel method and the inhibitory effect of essential oils on the efflux pumps activity was evaluated. Results: The results of this study showed that Z. multiflora and L. stoechas essential oils had additive antibacterial effects against MDR A. baumannii strains. The study of efflux pumps by cartwheel method showed that 10% of the strains had active efflux pump, after the effect of 1/2 minimum inhibitory concentration synergistic of Z. multiflora and L. stoechas essential oils, the activity of efflux pumps was inhibited. Conclusion: The combination of Z. multiflora and L. stoechas essential oils against MDR A. baumannii strains were additive antibacterial effects. It was also found that these compounds, as inhibitors of efflux pumps, could also be used to suppress MDR A. baumannii isolated.
{"title":"Synergistic effect of Zataria multiflora and Lavandula stoechas essential oils on phenotype detection of efflux pump against multidrug-resistant Acinetobacter baumannii isolates","authors":"Parisa Agahi, Masoumeh Mahdavi-Ourtakand, F. Noorbakhsh","doi":"10.1097/MRM.0000000000000229","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000229","url":null,"abstract":"Background: Acinetobacter baumannii infections have become a major cause of hospital-acquired infections worldwide and can rapidly develop resistance to antibiotics. There are various mechanisms for multidrug resistance in the A. baumannii and efflux pumps is the most important among those. The purpose of this study is to evaluate the synergistic effect of Zataria multiflora and Lavandula stoechas essential oils on phenotype detection of efflux pump against multidrug-resistant A. baumannii isolates. Methods: A total of 55 A. baumannii strains were collected from clinical specimens and those with multidrug resistant (MDR) has been isolated by using the Kirby-Bauer disk diffusion method. Z. multiflora and L. stoechas essential oils were extracted and analyzed by gas chromatography–mass spectrometry. The minimum inhibitory concentration for antimicrobial activity of essential oils against MDR A. baumannii strains and fractional inhibitory concentration index was evaluated to determine their synergistic effect. The activity of efflux pumps of MDR strains was investigated by the ethidium bromide-agar cartwheel method and the inhibitory effect of essential oils on the efflux pumps activity was evaluated. Results: The results of this study showed that Z. multiflora and L. stoechas essential oils had additive antibacterial effects against MDR A. baumannii strains. The study of efflux pumps by cartwheel method showed that 10% of the strains had active efflux pump, after the effect of 1/2 minimum inhibitory concentration synergistic of Z. multiflora and L. stoechas essential oils, the activity of efflux pumps was inhibited. Conclusion: The combination of Z. multiflora and L. stoechas essential oils against MDR A. baumannii strains were additive antibacterial effects. It was also found that these compounds, as inhibitors of efflux pumps, could also be used to suppress MDR A. baumannii isolated.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"69 1","pages":"39 - 44"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89103878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-08DOI: 10.1097/MRM.0000000000000226
H. Özçelik, Tuba Yıldırım, S. Marakli, Ö. İdil
Acinetobacter baumannii, one of the most important infectious agents spread in hospitals, is an opportunistic, Gram-negative, aerobic and nonfermentative pathogen causing outbreaks often in ICUs and difficulties in treatments due to multiple antibiotic resistance characteristics. Carbapenem resistance in A. baumannii is a growing public health concern and most often mediated by oxacillinases carbapenemases. Carbapenems are significant representatives of the group β-lactamases that are used in the treatment of A. baumannii. OXA-23, OXA-24, OXA-51 and OXA-58 are the most common type of OXA gene family members which are responsible for carbapenem resistance. This study aimed to identify the carbapenem resistant A. baumannii isolates in ICU and analyse OXA-23, OXA-24, OXA-51 and OXA-58 genes’ expressions by using reverse transcritptase-PCR. In this study, A. baumannii isolates collected from the respiratory tract samples obtained from the patients receiving treatment between June 2017 and January 2018 at the ICU in Amasya University Sabuncuoğlu Serefeddin Education and Research Hospital. Collected samples identified by VITEK-2 device. Resistance profiles of carbapenem-resistant strains against to cefepime, ceftazidime, ciprofloxacin, levofloxacin, amikacin, gentamicin, tetracycline, tigecycline and colistin antibiotics were determined by disk diffusion and minimum inhibition concentration tests. Moreover, OXA-23, OXA-24, OXA-51 and OXA-58 genes were investigated by reverse transcritptase-PCR. Identified 50 A. baumannii isolates were found to be 100% resistant to imipenem, meropenem, cefepime, ceftazidime and ciprofloxacin, 94% for levofloxacin, 68% for amikacin, 78% for gentamicin, 88% for tetracycline and 6% for tigecycline. It was detected that all samples are susceptible to colistin and showed multiple antibiotic resistance. As a result of molecular analyses, it was also determined that the expressions of only OXA-23 and OXA-51 genes in all isolates. This study is one of the first reports to analyse A. baumannii isolated from respiratory tract samples in terms of microbiological and molecular analyses.
{"title":"Investigation of oxacillinases type beta-lactamases in carbapenems resistant Acinetobacter baumannii clinical isolates","authors":"H. Özçelik, Tuba Yıldırım, S. Marakli, Ö. İdil","doi":"10.1097/MRM.0000000000000226","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000226","url":null,"abstract":"Acinetobacter baumannii, one of the most important infectious agents spread in hospitals, is an opportunistic, Gram-negative, aerobic and nonfermentative pathogen causing outbreaks often in ICUs and difficulties in treatments due to multiple antibiotic resistance characteristics. Carbapenem resistance in A. baumannii is a growing public health concern and most often mediated by oxacillinases carbapenemases. Carbapenems are significant representatives of the group β-lactamases that are used in the treatment of A. baumannii. OXA-23, OXA-24, OXA-51 and OXA-58 are the most common type of OXA gene family members which are responsible for carbapenem resistance. This study aimed to identify the carbapenem resistant A. baumannii isolates in ICU and analyse OXA-23, OXA-24, OXA-51 and OXA-58 genes’ expressions by using reverse transcritptase-PCR. In this study, A. baumannii isolates collected from the respiratory tract samples obtained from the patients receiving treatment between June 2017 and January 2018 at the ICU in Amasya University Sabuncuoğlu Serefeddin Education and Research Hospital. Collected samples identified by VITEK-2 device. Resistance profiles of carbapenem-resistant strains against to cefepime, ceftazidime, ciprofloxacin, levofloxacin, amikacin, gentamicin, tetracycline, tigecycline and colistin antibiotics were determined by disk diffusion and minimum inhibition concentration tests. Moreover, OXA-23, OXA-24, OXA-51 and OXA-58 genes were investigated by reverse transcritptase-PCR. Identified 50 A. baumannii isolates were found to be 100% resistant to imipenem, meropenem, cefepime, ceftazidime and ciprofloxacin, 94% for levofloxacin, 68% for amikacin, 78% for gentamicin, 88% for tetracycline and 6% for tigecycline. It was detected that all samples are susceptible to colistin and showed multiple antibiotic resistance. As a result of molecular analyses, it was also determined that the expressions of only OXA-23 and OXA-51 genes in all isolates. This study is one of the first reports to analyse A. baumannii isolated from respiratory tract samples in terms of microbiological and molecular analyses.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"36 1","pages":"209 - 214"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81971913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000209
A. Varghese
Method: A regimented search in the online databases such as PubMed, EMBASE, Google scholar, scopus and so on was done to identify relevant studies according to search strategies. Other search engines were also used, but could not extract relevant articles or studies form those electronic data bases. From the electronic search, 125 articles were identified, after title and abstract review, 96 articles were retained as eligible. A full-text evaluation resulted in 23 studies to be included for review.
{"title":"Acne vulgaris and antimicrobial resistance: a review","authors":"A. Varghese","doi":"10.1097/MRM.0000000000000209","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000209","url":null,"abstract":"Method: A regimented search in the online databases such as PubMed, EMBASE, Google scholar, scopus and so on was done to identify relevant studies according to search strategies. Other search engines were also used, but could not extract relevant articles or studies form those electronic data bases. From the electronic search, 125 articles were identified, after title and abstract review, 96 articles were retained as eligible. A full-text evaluation resulted in 23 studies to be included for review.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76718336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000181
Yaqdhan Alnomani, A. Ghasemian, M. Memariani, M. Eslami, Abdolreza Sabokrouh, A. F. Abbas, M. Shafiei
ISSN The role of efflux pumps in antibiotic resistance development among Escherichia coli may have been underappreciated. The objective of this study was assessment the association of AcrAB-TolCeffluxpumps and qepAgenes with resistance tocommonantibiotics among E. coli isolates. A total of 200 E. coli isolates were obtained from diverse samples of inpatients. Minimum inhibitory concentrations and Kirby–Bauer disk diffusion tests were determined for ceftazidime, cefotaxime, imipenem, gentamicin, and tetracycline. The Acr-AB-TolC and qepA genes were amplified using PCR technique and their association with antibiotics was also evaluated using Chi-square test. A majority of isolates (64%) were retrieved from gastrointestinal samples, followedby urinary tract infections (33%), and bloodstream (3%). All the isolates were resistant to ampicillin (100%), followed by cefazolin (59%), and cefoxitin (58%). However, 100% of the isolates showed susceptibility to fosfomycin. The prevalence of acrA, acrB, and qepA genes was 94% (n1⁄4188), 86% (n1⁄4172), and 8% (n1⁄416), respectively. The acrA and acrB were significantly associated with resistance to cefoxitin and cefazolin (P<0.01), ceftazidime (P<0.01), carbapenems (P1⁄40.022), and tetracycline (P1⁄40.0112). In addition, qepA gene was significantly associated with tetracycline resistance (P1⁄40.032). None of the patients had death outcome. A majority of E. coli isolates harbored the AcrAB genes, but qepA was observed among lower number of the isolates. It is notable that three strains lacked the extended spectrum beta-lactamase and carbapenemases and none of multidrug resistant strains carried tet and aminoglycoside modifying enzymes genes. Over-expression of efflux pumps has been increasingly is associated with clinically relevant antibiotic resistance. For this reason, the expression and functionality of efflux pumps should be more investigated profoundly and be compared between drug-resistant and drug-susceptible isolates. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.
{"title":"The association of acetylacetate (Acr AB-Tol C) and QepA genes with multiple antibiotic resistance among Escherichia coli clinical isolates","authors":"Yaqdhan Alnomani, A. Ghasemian, M. Memariani, M. Eslami, Abdolreza Sabokrouh, A. F. Abbas, M. Shafiei","doi":"10.1097/MRM.0000000000000181","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000181","url":null,"abstract":"ISSN The role of efflux pumps in antibiotic resistance development among Escherichia coli may have been underappreciated. The objective of this study was assessment the association of AcrAB-TolCeffluxpumps and qepAgenes with resistance tocommonantibiotics among E. coli isolates. A total of 200 E. coli isolates were obtained from diverse samples of inpatients. Minimum inhibitory concentrations and Kirby–Bauer disk diffusion tests were determined for ceftazidime, cefotaxime, imipenem, gentamicin, and tetracycline. The Acr-AB-TolC and qepA genes were amplified using PCR technique and their association with antibiotics was also evaluated using Chi-square test. A majority of isolates (64%) were retrieved from gastrointestinal samples, followedby urinary tract infections (33%), and bloodstream (3%). All the isolates were resistant to ampicillin (100%), followed by cefazolin (59%), and cefoxitin (58%). However, 100% of the isolates showed susceptibility to fosfomycin. The prevalence of acrA, acrB, and qepA genes was 94% (n1⁄4188), 86% (n1⁄4172), and 8% (n1⁄416), respectively. The acrA and acrB were significantly associated with resistance to cefoxitin and cefazolin (P<0.01), ceftazidime (P<0.01), carbapenems (P1⁄40.022), and tetracycline (P1⁄40.0112). In addition, qepA gene was significantly associated with tetracycline resistance (P1⁄40.032). None of the patients had death outcome. A majority of E. coli isolates harbored the AcrAB genes, but qepA was observed among lower number of the isolates. It is notable that three strains lacked the extended spectrum beta-lactamase and carbapenemases and none of multidrug resistant strains carried tet and aminoglycoside modifying enzymes genes. Over-expression of efflux pumps has been increasingly is associated with clinically relevant antibiotic resistance. For this reason, the expression and functionality of efflux pumps should be more investigated profoundly and be compared between drug-resistant and drug-susceptible isolates. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84050292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000212
H. Mirzanejad-asl
Results: The most important risk factors were excessive consumption of wild vegetables and the use of spring water. Keeping the dog in the yard was the third risk factor. Results were analyzed using logistic regression and SPSS 21 software. From 2453 serum samples, 21 samples were positive for alveolar echinococcosis 0.79% with Em2þ Ag. The prevalence was higher in men than women (1.24 vs. 0.6%). People within the age range of 40–59 years had the highest infection rates. About cystic echinococcosis, for Ag-5 and Ag-B, 172 (6.4%) and 178 (6.7%) serum samples were positive, respectively. Cystic echinococcosis was higher in women than men (8.52 vs. 5.6%). The age range 40–59 years presented the highest infection rates.
结果:过量食用野菜和饮用泉水是最重要的危险因素。把狗养在院子里是第三个风险因素。采用logistic回归和SPSS 21软件对结果进行分析。2453份血清标本中，肺泡棘球蚴病阳性21份，阳性率0.79%。男性的患病率高于女性(1.24比0.6%)。40-59岁的人群感染率最高。囊性包虫病血清中Ag-5阳性172例(6.4%)，Ag-B阳性178例(6.7%)。囊性包虫病女性高于男性(8.52% vs. 5.6%)。40 ~ 59岁年龄组感染率最高。
{"title":"Survey of human alveolar and cystic echinococcosis rates based on ELISA and portable ultrasound in Moghan, northwestern Iran","authors":"H. Mirzanejad-asl","doi":"10.1097/MRM.0000000000000212","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000212","url":null,"abstract":"Results: The most important risk factors were excessive consumption of wild vegetables and the use of spring water. Keeping the dog in the yard was the third risk factor. Results were analyzed using logistic regression and SPSS 21 software. From 2453 serum samples, 21 samples were positive for alveolar echinococcosis 0.79% with Em2þ Ag. The prevalence was higher in men than women (1.24 vs. 0.6%). People within the age range of 40–59 years had the highest infection rates. About cystic echinococcosis, for Ag-5 and Ag-B, 172 (6.4%) and 178 (6.7%) serum samples were positive, respectively. Cystic echinococcosis was higher in women than men (8.52 vs. 5.6%). The age range 40–59 years presented the highest infection rates.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90185281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000204
A. Al-Marzoqi, S. Kareem, S. AlHuchaimi, N. Hindi, A. Ghasemian
ISSN Vancomycin is among last-resort drugs for the elimination of serious methicillinresistant Staphylococcus aureus (MRSA) infections. Suboptimal or prolonged exposure to vancomycin is a major cause of decreased vancomycin susceptibility being a great concern toward the eradication of related infections. This arises from genetic and metabolic alterations leading to cell wall thickness and mitigation of autolysis. Therefore, the study on the major mechanisms contributing to the development of heterogeneous vancomycin-intermediate S. aureus (hVISA) and VISA strains and development of novel and efficient therapeutic approaches is essential. This nonsusceptibility imposes a fitness burden on bacterial cells through adaptive changes not verified entirely. Cell wall thickening and expression of various cell wall-related enzymes are major mechanisms with this regard. Metabolic changes permit growth of VISA in the presence of vancomycin. Prolonged vancomycin consumption, previous MRSA colonization, hemodialysis dependence, residence in an ICU and use of indwelling devices account for major risk factors for VISA emergence, hence care should be taken to hinder their development. Inhibitors of amino sugar and purine biosynthesis have exhibited synergistic properties to kill VISA, postulating the efficiency of combination therapies. In addition, combination of vancomycin with each of metabolic inhibitors, b-lactams (mostly such as fosfomycin, cefazolin, cefepime, ceftaroline, nafcillin, meropenem and piperacillin-tazobactam) have been effective against VISA and hVISA. Combination therapy of MRSA and hVISA with vancomycin and non-b-lactams has exerted lower effects compared to b-lactams combination therapies. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.
{"title":"Decreased vancomycin susceptibility among Staphylococcus aureus clinical isolates and postulated platforms to explore rational drugs","authors":"A. Al-Marzoqi, S. Kareem, S. AlHuchaimi, N. Hindi, A. Ghasemian","doi":"10.1097/MRM.0000000000000204","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000204","url":null,"abstract":"ISSN Vancomycin is among last-resort drugs for the elimination of serious methicillinresistant Staphylococcus aureus (MRSA) infections. Suboptimal or prolonged exposure to vancomycin is a major cause of decreased vancomycin susceptibility being a great concern toward the eradication of related infections. This arises from genetic and metabolic alterations leading to cell wall thickness and mitigation of autolysis. Therefore, the study on the major mechanisms contributing to the development of heterogeneous vancomycin-intermediate S. aureus (hVISA) and VISA strains and development of novel and efficient therapeutic approaches is essential. This nonsusceptibility imposes a fitness burden on bacterial cells through adaptive changes not verified entirely. Cell wall thickening and expression of various cell wall-related enzymes are major mechanisms with this regard. Metabolic changes permit growth of VISA in the presence of vancomycin. Prolonged vancomycin consumption, previous MRSA colonization, hemodialysis dependence, residence in an ICU and use of indwelling devices account for major risk factors for VISA emergence, hence care should be taken to hinder their development. Inhibitors of amino sugar and purine biosynthesis have exhibited synergistic properties to kill VISA, postulating the efficiency of combination therapies. In addition, combination of vancomycin with each of metabolic inhibitors, b-lactams (mostly such as fosfomycin, cefazolin, cefepime, ceftaroline, nafcillin, meropenem and piperacillin-tazobactam) have been effective against VISA and hVISA. Combination therapy of MRSA and hVISA with vancomycin and non-b-lactams has exerted lower effects compared to b-lactams combination therapies. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74406184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000208
A. K. Erenler, A. Baydın, M. Ay, G. Doğan, A. C. Yastı
ISSN Sepsis is the leading cause of morbidity and mortality in patients with burn injury and emerges as a clinical challenge for both emergency specialists and critical care staff. Since early diagnosis and appropriate treatment are known to be the milestones of sepsis management, use of biomarkers in diagnosis is highly recommended in the initial stage of sepsis. Although currently used Procalcitonin, as a traditional marker, may accurately indicate the presence of a systemic inflammation in burn patients, there is a need for more accurate markers of sepsis in burn patients. For now, use of a combination of markers may be suggested for a more accurate diagnosis. In the near future, gene therapy may make not only early prediction, but also appropriate treatment of sepsis in burn patients possible. In this article, we aimed to clarify roles of current biomarkers in early diagnosis of sepsis in burn patients and make future reflections in this growing field. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.
{"title":"Early biochemical predictors of sepsis in patients with burn injury: current status and future perspectives","authors":"A. K. Erenler, A. Baydın, M. Ay, G. Doğan, A. C. Yastı","doi":"10.1097/MRM.0000000000000208","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000208","url":null,"abstract":"ISSN Sepsis is the leading cause of morbidity and mortality in patients with burn injury and emerges as a clinical challenge for both emergency specialists and critical care staff. Since early diagnosis and appropriate treatment are known to be the milestones of sepsis management, use of biomarkers in diagnosis is highly recommended in the initial stage of sepsis. Although currently used Procalcitonin, as a traditional marker, may accurately indicate the presence of a systemic inflammation in burn patients, there is a need for more accurate markers of sepsis in burn patients. For now, use of a combination of markers may be suggested for a more accurate diagnosis. In the near future, gene therapy may make not only early prediction, but also appropriate treatment of sepsis in burn patients possible. In this article, we aimed to clarify roles of current biomarkers in early diagnosis of sepsis in burn patients and make future reflections in this growing field. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79531203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000213
M. Keikha, M. Eslami, B. Yousefi, M. Karbalaei
ISSN To date, tuberculosis (TB) infection, is the most threatening infectious disease in all humans around the world. Mycobacterium tuberculosis is a facultative intracellular bacterium, possesses an exclusive life-cycle inside the macrophages, as one of the most important cells in the innate immune system. As soon as entrance in the lungs, bacteria actively replicate, but intracellular conditions such as hypoxia and nutrient starvation, lead to low replication of bacteria, or nonreplicating state. While Bacillus Calmette-Guerin vaccine is the most usable vaccine, especially in children and against active form, but this vaccine has no more protection in infected adults to latent forms of disease. Among the new generation of vaccines, fusion multistage subunit vaccines have prodigious effect on immune responses. By virtue of simultaneous presence of both expressed antigens from active and latent forms of TB in the structure of these recombinant subunit vaccines, they can strongly induce immune responses against all stages of the disease. The findings suggest subunit vaccines are the best candidates for immunization against TB, by virtue of their high safety, ease of production, specificity, and utilization of mycobacterial immunodominant antigens. Fusion multistage subunit vaccines, as novel subunit vaccines are the most ideal target for proper prevention against TB infection. Due to simultaneous use of both expressed antigens in active and latent forms of TB, these vaccines are able to induce strong immune responses versus all of TB stages. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.
{"title":"Overview of multistage subunit tuberculosis vaccines: advantages and challenges","authors":"M. Keikha, M. Eslami, B. Yousefi, M. Karbalaei","doi":"10.1097/MRM.0000000000000213","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000213","url":null,"abstract":"ISSN To date, tuberculosis (TB) infection, is the most threatening infectious disease in all humans around the world. Mycobacterium tuberculosis is a facultative intracellular bacterium, possesses an exclusive life-cycle inside the macrophages, as one of the most important cells in the innate immune system. As soon as entrance in the lungs, bacteria actively replicate, but intracellular conditions such as hypoxia and nutrient starvation, lead to low replication of bacteria, or nonreplicating state. While Bacillus Calmette-Guerin vaccine is the most usable vaccine, especially in children and against active form, but this vaccine has no more protection in infected adults to latent forms of disease. Among the new generation of vaccines, fusion multistage subunit vaccines have prodigious effect on immune responses. By virtue of simultaneous presence of both expressed antigens from active and latent forms of TB in the structure of these recombinant subunit vaccines, they can strongly induce immune responses against all stages of the disease. The findings suggest subunit vaccines are the best candidates for immunization against TB, by virtue of their high safety, ease of production, specificity, and utilization of mycobacterial immunodominant antigens. Fusion multistage subunit vaccines, as novel subunit vaccines are the most ideal target for proper prevention against TB infection. Due to simultaneous use of both expressed antigens in active and latent forms of TB, these vaccines are able to induce strong immune responses versus all of TB stages. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73077569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/MRM.0000000000000210
Azar Najafi, Nahid Mahdian, B. Yousefi, M. Karbalaei, A. Kermanjani, Behrouz Ezatpour, M. Eslami
ISSN Tuberculosis (TB) is accounted for as one of the most important destructive infectious diseases for humans, which is caused by Mycobacterium tuberculosis. Studies have shown the severe effects of tuberculosis in patients, especially sensitive groups. Emergence and distribution of both multidrug-resistant (MDR) and extensively drugresistant (XDR) strains have caused failure in the infection eradication. At present, BCG vaccine is the only most effective vaccine for the prevention of TB in childhood but its protection level in pulmonary TB in adult is very variable. Therefore, the need for an appropriate alternative vaccine instead of BCG is urgent. On the basis of the studies, cell-mediated immune (CMI) is known as the best immune response against TB infection. For this purpose, a desirable CMI response should be along with a balance between Th1, Th17, and T-reg cells. Several vaccine candidates have been evaluated in vitro and in vivo examinations, such as recombinant BCG (rBCG), DNA vaccines, and subunit vaccines. Factors, such as applicability of vaccine candidates in all individuals, cost-effectiveness, long-term immunity and stimulation of a wide range of responses are important factors. Now, most of these vaccines have entered in the phases of clinical trial (even IIB and III); however, these trials are complex, need a large number of individuals and need a long time. Funding for TB vaccine trials is an important issue, especially in poor countries. With preclinical safety precision studies, it is likely that at least one of these vaccines will develop into early clinical trials in the next few years. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.
{"title":"New vaccine candidates as a scientific solution against the dream of tuberculosis vaccine","authors":"Azar Najafi, Nahid Mahdian, B. Yousefi, M. Karbalaei, A. Kermanjani, Behrouz Ezatpour, M. Eslami","doi":"10.1097/MRM.0000000000000210","DOIUrl":"https://doi.org/10.1097/MRM.0000000000000210","url":null,"abstract":"ISSN Tuberculosis (TB) is accounted for as one of the most important destructive infectious diseases for humans, which is caused by Mycobacterium tuberculosis. Studies have shown the severe effects of tuberculosis in patients, especially sensitive groups. Emergence and distribution of both multidrug-resistant (MDR) and extensively drugresistant (XDR) strains have caused failure in the infection eradication. At present, BCG vaccine is the only most effective vaccine for the prevention of TB in childhood but its protection level in pulmonary TB in adult is very variable. Therefore, the need for an appropriate alternative vaccine instead of BCG is urgent. On the basis of the studies, cell-mediated immune (CMI) is known as the best immune response against TB infection. For this purpose, a desirable CMI response should be along with a balance between Th1, Th17, and T-reg cells. Several vaccine candidates have been evaluated in vitro and in vivo examinations, such as recombinant BCG (rBCG), DNA vaccines, and subunit vaccines. Factors, such as applicability of vaccine candidates in all individuals, cost-effectiveness, long-term immunity and stimulation of a wide range of responses are important factors. Now, most of these vaccines have entered in the phases of clinical trial (even IIB and III); however, these trials are complex, need a large number of individuals and need a long time. Funding for TB vaccine trials is an important issue, especially in poor countries. With preclinical safety precision studies, it is likely that at least one of these vaccines will develop into early clinical trials in the next few years. Copyright 2020 Wolters Kluwer Health, Inc. All rights reserved.","PeriodicalId":49625,"journal":{"name":"Reviews in Medical Microbiology","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/MRM.0000000000000210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72408658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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