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Genomic Insights into Pediococcus pentosaceus ENM104: A Probiotic with Potential Antimicrobial and Cholesterol-Reducing Properties. 对五味子球菌 ENM104 基因组的深入研究:一种具有潜在抗菌和降低胆固醇特性的益生菌。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-27 DOI: 10.3390/antibiotics13090813
Siriwan Kompramool, Kamonnut Singkhamanan, Rattanaruji Pomwised, Nattarika Chaichana, Sirikan Suwannasin, Monwadee Wonglapsuwan, Jirayu Jitpakdee, Duangporn Kantachote, Thunchanok Yaikhan, Komwit Surachat

Pediococcus pentosaceus, which often occurs in fermented foods, is characterized by numerous positive effects on the human health, such as the presence of possible probiotic abilities, the reduction of cholesterol levels, satisfactory antimicrobial activity, and certain therapeutic functions. This study was conducted with the goal of describing the genomic content of Pediococcus pentosaceus ENM104, a strain known for its inhibitory effects against pathogenic bacteria and its remarkable probiotic potential, including the induction of significant reductions in cholesterol levels and the production of γ-aminobutyric acid (GABA). The P. pentosaceus ENM104 chromosome is circular. The chromosome is 1,734,928 bp with a GC content of 37.2%. P. pentosaceus also harbors a circular plasmid, pENM104, that is 71,811 bp with a GC content of 38.1%. Functional annotations identified numerous genes associated with probiotic traits, including those involved in stress adaptation (e.g., heat stress: htpX, dnaK, and dnaJ), bile tolerance (e.g., ppaC), vitamin biosynthesis (e.g., ribU, ribZ, ribF, and btuD), immunomodulation (e.g., dltA, dltC, and dltD), and bacteriocin production (e.g., pedA). Notably, genes responsible for lowering cholesterol levels (bile salt hydrolase, bsh) and GABA synthesis (glutamate/GABA antiporter, gadC) were also identified. The in vitro assay results using cell-free supernatants of P. pentosaceus ENM104 revealed antibacterial activity against carbapenem-resistant bacteria, such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, and the inhibition zone diameter increased progressively over time. This comprehensive study provides valuable insights into the molecular characteristics of P. pentosaceus ENM104, emphasizing its potential as a probiotic. Its notable cholesterol-lowering, GABA-producing, and antimicrobial capabilities suggest promising applications in the pharmaceutical and food industries. Future research should focus on further exploring these functional properties and assessing the strain's efficacy in clinical settings.

发酵食品中常见的五胜肽球菌对人类健康有许多积极影响,如可能具有益生能力、降低胆固醇水平、令人满意的抗菌活性和某些治疗功能。该菌株因其对病原菌的抑制作用和显著的益生潜力而闻名,包括诱导胆固醇水平显著降低和产生γ-氨基丁酸(GABA)。P. pentosaceus ENM104 染色体是环状的。染色体长 1,734,928 bp,GC 含量为 37.2%。P. pentosaceus 还携带一个环形质粒 pENM104,其长度为 71,811 bp,GC 含量为 38.1%。功能注释发现了许多与益生菌性状相关的基因,包括参与应激适应(如热应激:htpX、dnaK 和 dnaJ)、胆汁耐受(如 ppaC)、维生素生物合成(如 ribU、ribZ、ribF 和 btuD)、免疫调节(如 dltA、dltC 和 dltD)和细菌素生产(如 pedA)的基因。值得注意的是,还发现了负责降低胆固醇水平(胆盐水解酶,bsh)和 GABA 合成(谷氨酸/GABA 反转运体,gadC)的基因。使用五胜肽 ENM104 的无细胞上清液进行的体外检测结果显示,它对铜绿假单胞菌、肺炎克雷伯氏菌和鲍曼不动杆菌等耐碳青霉烯类细菌具有抗菌活性,而且随着时间的推移,抑菌区直径逐渐增大。这项全面的研究为了解五胜肽 ENM104 的分子特征提供了宝贵的信息,并强调了其作为益生菌的潜力。其显著的降胆固醇、产生 GABA 和抗菌能力表明,它在制药和食品行业的应用前景广阔。未来的研究应侧重于进一步探索这些功能特性,并评估该菌株在临床环境中的功效。
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引用次数: 0
Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-Resistant Acinetobacter baumannii Isolated from Bloodstream Infections: Mortality, Potential Virulence Factors, and Combination Therapy In Vitro. 从血流感染中分离出的高病毒性和非高病毒性耐碳青霉烯鲍曼不动杆菌的比较:死亡率、潜在毒性因素和体外联合疗法。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090807
Likang Yao, Ningjing Liu, Yingyi Guo, Chuyue Zhuo, Xu Yang, Yijing Wang, Jiong Wang, Feifeng Li, Jiahui Li, Nanhao He, Jiakang Chen, Yexin Lin, Shunian Xiao, Chao Zhuo

Hypervirulent carbapenem-resistant Acinetobacter baumannii (hv-CRAB) has emerged in bloodstream infections (BSI). Cases of BSI caused by hv-CRAB (hv-CRAB-BSI) had posed a significant threat to hospitalized patients. In this study, 31 CRAB strains isolated from Chinese BSI patients were analyzed, of which 24 were identified as hv-CRAB-BSI and 7 as non-hv-CRAB-BSI, using the Galleria mellonella infection model. Patients with hv-CRAB-BSI had higher rates of septic shock (79.2% vs. 14.3%, p = 0.004) and mortality (66.7% vs. 14.3%, p = 0.028). All strains were resistant to most antibiotics but sensitive to colistin. Hv-CRAB-BSI showed lower resistance to minocycline than non-hv-CRAB-BSI (54.2% vs. 100%, p = 0.03). Whole-genome sequencing revealed that the detection rates of immune modulation genes ptk and epsA in hv-CRAB-BSI were significantly higher than in non-hv-CRAB-BSI (91.7% vs. 28.6%, p = 0.002). Additionally, all ST457 hv-CRAB-BSI lacked abaR, and all ST1486 non-hv-CRAB-BSI lacked adeG. The checkerboard dilution method assessed the efficacies of various antibiotic combinations, revealing that although synergism was rarely observed, the combination of colistin and minocycline showed the best efficacy for treating CRAB-BSI, regardless of whether the infections were hv-CRAB-BSI or non-hv-CRAB-BSI. These findings highlight the importance of analyzing molecular characteristics and exploring effective treatment strategies for hv-CRAB-BSI.

对碳青霉烯类耐药的鲍曼不动杆菌(hv-CRAB)已在血液感染(BSI)中出现。由 hv-CRAB 引起的 BSI 病例(hv-CRAB-BSI)对住院患者构成了严重威胁。在这项研究中,研究人员利用灰飞虱感染模型分析了从中国 BSI 患者中分离出的 31 株 CRAB 菌株,其中 24 株被鉴定为 hv-CRAB-BSI,7 株为非 hv-CRAB-BSI。hv-CRAB-BSI 患者的脓毒性休克率(79.2% 对 14.3%,p = 0.004)和死亡率(66.7% 对 14.3%,p = 0.028)均较高。所有菌株均对大多数抗生素耐药,但对可乐定敏感。Hv-CRAB-BSI 对米诺环素的耐药性低于非 Hv-CRAB-BSI(54.2% vs. 100%,p = 0.03)。全基因组测序显示,hv-CRAB-BSI 中免疫调节基因 ptk 和 epsA 的检出率明显高于非 hv-CRAB-BSI(91.7% 对 28.6%,p = 0.002)。此外,所有 ST457 hv-CRAB-BSI 都缺乏 abaR,所有 ST1486 非 hv-CRAB-BSI 都缺乏 adeG。棋盘稀释法评估了各种抗生素组合的疗效,结果显示,虽然很少观察到协同作用,但无论感染的是 hv-CRAB-BSI 还是非 hv-CRAB-BSI,可乐定和米诺环素的组合治疗 CRAB-BSI 的疗效都是最好的。这些发现凸显了分析分子特征和探索有效治疗 hv-CRAB-BSI 策略的重要性。
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引用次数: 0
Validity and Reliability of a Questionnaire on Attitudes, Knowledge, and Perceptions of Pharmacy Students Regarding the Training Received on Antibiotics and Antimicrobial Resistance during Their University Studies. 关于药学专业学生在大学期间接受抗生素和抗菌药耐药性培训的态度、知识和看法的问卷调查的有效性和可靠性。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090811
Patricia Otero-Batán, Guillermo Lens-Perol, Olalla Vázquez-Cancela, Angel Salgado-Barreira, Juan Manuel Vazquez-Lago

Background: Antimicrobial resistance is a major public health issue today. Therefore, it is essential to focus on the education of pharmacists as future dispensers. The objective of this study was to validate a questionnaire that assesses the knowledge, attitudes, and perceptions of pharmacy students regarding the education received during their university degree on the use and dispensation of antibiotics, as well as bacterial resistance.

Methods: An online questionnaire was developed and distributed via RedCap v.13.7.1 to pharmacy students at the University of Santiago de Compostela using the WhatsApp social network. The questionnaire consisted of 28 items evaluating 5 dimensions: "quality of care", "communication skills", "antibiotic resistance", "teaching methodology", and "education on antibiotics at the faculty". The questionnaire validation was conducted in 2 steps: Step 1 involved content and appearance validation, and Step 2 involved reliability analysis.

Results: A total of 61 completed questionnaires were received. The mean age was 21.82 ± 3.81 years, with 20 males (32.8%) and 41 females (67.2%). Content validation was performed through a nominal group of 5 experts, and appearance validation was conducted by a focus group of 6 university pharmacy students. The questionnaire demonstrated a Cronbach's alpha value of 0.80 and adequate item discrimination capability. Confirmatory factor analysis was performed to assess construct validity, confirming the 5 predefined dimensions.

Conclusions: A questionnaire has been developed and validated with high reliability and validity. Its use will help identify areas for improvement in the university education of pharmacy students, ultimately contributing to better use and dispensation of antibiotics and thereby improving antimicrobial resistance.

背景:抗菌药耐药性是当今重大的公共卫生问题。因此,作为未来的配药师,关注药剂师的教育至关重要。本研究的目的是验证一份问卷,评估药剂学专业学生在大学期间接受的有关抗生素使用和配药以及细菌耐药性教育方面的知识、态度和看法:我们开发了一份在线问卷,并通过 WhatsApp 社交网络以 RedCap v.13.7.1 版的形式向圣地亚哥-德孔波斯特拉大学的药剂学专业学生发放。问卷由 28 个项目组成,从 5 个方面进行评估:"护理质量"、"沟通技巧"、"抗生素耐药性"、"教学方法 "和 "学院抗生素教育"。问卷验证分两步进行:第一步是内容和外观验证,第二步是信度分析:结果:共收到 61 份填写完毕的问卷。平均年龄为 21.82±3.81 岁,其中男性 20 人(32.8%),女性 41 人(67.2%)。由 5 名专家组成的名义小组对问卷进行了内容验证,由 6 名药学专业大学生组成的焦点小组对问卷进行了外观验证。问卷的 Cronbach's alpha 值为 0.80,具有足够的项目辨别能力。为评估结构效度,还进行了确认性因子分析,确认了预定义的 5 个维度:开发并验证的问卷具有很高的信度和效度。它的使用将有助于确定大学药学专业学生教育中需要改进的地方,最终有助于更好地使用和分配抗生素,从而改善抗菌药耐药性。
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引用次数: 0
Avian Pathogenic Escherichia coli: An Overview of Infection Biology, Antimicrobial Resistance and Vaccination. 禽致病性大肠杆菌:感染生物学、抗菌药耐药性和疫苗接种概述。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090809
Amyleigh Watts, Paul Wigley

Avian Pathogenic Escherichia coli (APEC) is an extraintestinal pathotype of E. coli that leads to a range of clinical manifestations, including respiratory, systemic and reproductive infections of chickens in both egg and meat production. Unlike most E. coli pathotypes, APEC is not defined by specific virulence genes but rather is a collection of several distinct genotypes that can act as both primary and secondary pathogens leading to colibacillosis. Recent measures to reduce antimicrobials both as growth promoters and as flock-level therapeutics are considered to have led to increased numbers of animals affected. Nevertheless, antimicrobial resistance is a considerable problem in APEC, with resistance to third and fourth-generation cephalosporins via extended-spectrum beta-lactamases (ESBLs), fluoroquinolones and colistin seen as a particular concern. The need to control APEC without antimicrobial use at the flock level has seen an increased focus on vaccination. Currently, a few commercial vaccines are already available, and a range of approaches are being applied to develop new vaccines, and other controls, such as bacteriophage or probiotics, are attracting interest. The lack of a single defined APEC genotype presents challenges to these approaches.

禽致病性大肠杆菌(APEC)是大肠杆菌的一种肠外病原型,可导致一系列临床表现,包括蛋鸡和肉鸡的呼吸道感染、全身感染和生殖感染。与大多数大肠杆菌病型不同,APEC 并不是由特定的毒力基因定义的,而是由几种不同基因型组成的集合体,这些基因型既可作为主要病原体,也可作为次要病原体,导致大肠杆菌病。最近采取的减少作为生长促进剂和鸡群级治疗药物的抗菌药物的措施被认为导致了患病动物数量的增加。尽管如此,抗菌药耐药性仍是亚太经合组织面临的一个严重问题,通过广谱β-内酰胺酶(ESBLs)对第三代和第四代头孢菌素、氟喹诺酮类药物和大肠杆菌素产生的耐药性尤其令人担忧。由于需要在不使用抗菌素的情况下控制羊群中的 APEC,因此疫苗接种越来越受到重视。目前,一些商业疫苗已经上市,一系列方法正被用于开发新疫苗,噬菌体或益生菌等其他控制方法也引起了人们的兴趣。亚太经合组织缺乏单一确定的基因型,这给这些方法带来了挑战。
{"title":"Avian Pathogenic <i>Escherichia coli</i>: An Overview of Infection Biology, Antimicrobial Resistance and Vaccination.","authors":"Amyleigh Watts, Paul Wigley","doi":"10.3390/antibiotics13090809","DOIUrl":"https://doi.org/10.3390/antibiotics13090809","url":null,"abstract":"<p><p>Avian Pathogenic <i>Escherichia coli</i> (APEC) is an extraintestinal pathotype of <i>E. coli</i> that leads to a range of clinical manifestations, including respiratory, systemic and reproductive infections of chickens in both egg and meat production. Unlike most <i>E. coli</i> pathotypes, APEC is not defined by specific virulence genes but rather is a collection of several distinct genotypes that can act as both primary and secondary pathogens leading to colibacillosis. Recent measures to reduce antimicrobials both as growth promoters and as flock-level therapeutics are considered to have led to increased numbers of animals affected. Nevertheless, antimicrobial resistance is a considerable problem in APEC, with resistance to third and fourth-generation cephalosporins via extended-spectrum beta-lactamases (ESBLs), fluoroquinolones and colistin seen as a particular concern. The need to control APEC without antimicrobial use at the flock level has seen an increased focus on vaccination. Currently, a few commercial vaccines are already available, and a range of approaches are being applied to develop new vaccines, and other controls, such as bacteriophage or probiotics, are attracting interest. The lack of a single defined APEC genotype presents challenges to these approaches.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11429189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drinking Water and Biofilm as Sources of Antimicrobial Resistance in Free-Range Organic Broiler Farms. 饮用水和生物膜是散养有机肉鸡农场中抗菌剂耐药性的来源。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090808
Alessandra Piccirillo, Roberta Tolosi, Lapo Mughini-Gras, Jannigje G Kers, Andrea Laconi

Drinking water distribution systems (DWDSs) represent an ideal environment for biofilm formation, which can harbor pathogenic and antimicrobial-resistant bacteria. This study aimed to assess longitudinally the microbial community composition and antimicrobial resistance (AMR), as determined by 16S rRNA NGS and qPCR, respectively, in drinking water (DW) and biofilm from DWDSs, as well as faeces, of free-range organic broiler farms. The role of DWDSs in AMR gene (ARG) dissemination within the farm environment and transmission to animals, was also assessed. DW and biofilm microbial communities differed from those of faecal samples. Moreover, potentially pathogenic and opportunistic bacteria (e.g., Staphylococcaceae) were identified in water and biofilms. High prevalence and abundance of ARGs conferring resistance to carbapenems (i.e., blaNDM), 3rd and 4th generation cephalosporins (i.e., blaCMY-2), (fluoro)quinolones (i.e., qnrS), and polymyxins (i.e., mcr-3 and mcr-5) were detected in DW, biofilm, and faecal samples, which is of concern for both animal and human health. Although other factors (e.g., feed, pests, and wildlife) may contribute to the dissemination of AMR in free-range organic poultry farms, this study indicates that DWDSs can also play a role.

饮用水输配系统(DWDS)是生物膜形成的理想环境,生物膜可滋生致病菌和抗菌药耐药菌。本研究旨在通过 16S rRNA NGS 和 qPCR 分别测定散养有机肉鸡养殖场饮用水(DW)和 DWDSs 生物膜以及粪便中的微生物群落组成和抗菌药物耐药性(AMR),并对其进行纵向评估。此外,还评估了 DWDS 在农场环境中传播 AMR 基因(ARG)以及将其传播给动物的作用。粪便和生物膜微生物群落与粪便样本不同。此外,在水和生物膜中还发现了潜在的致病菌和机会性细菌(如葡萄球菌)。在 DW、生物膜和粪便样本中检测到对碳青霉烯类(即 blaNDM)、第三代和第四代头孢菌素(即 blaCMY-2)、(氟)喹诺酮类(即 qnrS)和多粘菌素(即 mcr-3 和 mcr-5)具有耐药性的 ARGs 的高流行率和高丰度,这对动物和人类健康都是一个问题。虽然其他因素(如饲料、害虫和野生动物)可能会导致 AMR 在散养有机家禽农场中的传播,但本研究表明,DWDS 也可能起到一定作用。
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引用次数: 0
Synergistic Effects of Artesunate in Combination with Amphotericin B and Miltefosine against Leishmania infantum: Potential for Dose Reduction and Enhanced Therapeutic Strategies. 青蒿琥酯与两性霉素 B 和米替福新联合治疗婴儿利什曼病的协同效应:减少剂量和加强治疗策略的潜力。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090806
Nuchpicha Intakhan, Atiporn Saeung, Sonia M Rodrigues Oliveira, Maria de Lourdes Pereira, Wetpisit Chanmol

Leishmaniasis is a tropical infectious disease caused by Leishmania parasites. The disease can be spread by the bite of an infected sand fly. Currently, five chemotherapeutic drugs are available in leishmaniasis treatment. However, these drugs exhibit toxicity and serious adverse effects on infected individuals, necessitating alternative treatment strategies. One such strategy involves using combinations of existing antileishmanial drugs. In this study, we evaluated the interaction between artesunate (AS) and three antileishmanial drugs-amphotericin B (AmB), miltefosine (MF), and paromomycin (PM) against Leishmania infantum. This evaluation marks the first time such an assessment has been conducted. The Chou-Talalay combination index method was employed to analyze the drug interaction. The findings revealed that the interaction between AS and AmB ranged from antagonistic to synergistic, while the interaction between AS and MF showed moderate to strong synergism. In contrast, the interaction between AS and PM resulted in an antagonistic interaction, which differs from the combinations with AmB or MF. This study provides valuable insights for developing novel drug regimens for leishmaniasis treatment, emphasizing the potential of AS and its combination with existing antileishmanial drugs. Further research is necessary to optimize drug combinations and minimize adverse effects, leading to more effective therapeutic outcomes.

利什曼病是一种由利什曼寄生虫引起的热带传染病。该病可通过被感染的沙蝇叮咬传播。目前,治疗利什曼病的化疗药物有五种。然而,这些药物对受感染者有毒性和严重的不良影响,因此需要采取其他治疗策略。其中一种策略就是将现有的抗利什曼病药物组合使用。在这项研究中,我们评估了青蒿琥酯(AS)与三种抗利什曼病药--两性霉素 B(AmB)、米替福星(MF)和副黏菌素(PM)--在抗婴儿利什曼病方面的相互作用。这是首次进行此类评估。采用 Chou-Talalay 组合指数法分析了药物相互作用。结果显示,AS 与 AmB 之间的相互作用从拮抗到协同不等,而 AS 与 MF 之间的相互作用则表现出中等到强的协同作用。与此相反,AS 与 PM 的相互作用为拮抗作用,这与与 AmB 或 MF 的组合不同。这项研究为开发治疗利什曼病的新型药物方案提供了有价值的见解,强调了 AS 及其与现有抗利什曼病药物组合的潜力。有必要开展进一步研究,以优化药物组合,尽量减少不良反应,从而取得更有效的治疗效果。
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引用次数: 0
Murepavadin Enhances the Killing Efficacy of Ciprofloxacin against Pseudomonas aeruginosa by Inhibiting Drug Efflux. Murepavadin 通过抑制药物外流增强环丙沙星对铜绿假单胞菌的杀灭效力
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.3390/antibiotics13090810
Xiaoya Wei, Dandan Zhou, Congjuan Xu, Ping Chen, Shuiping Chen, Zhihui Cheng, Yongxin Jin, Shouguang Jin, Weihui Wu

Pseudomonas aeruginosa is a multidrug-resistant Gram-negative pathogen and one of the leading causes of ventilator-associated pneumonia and infections in patients with chronic obstructive pulmonary disease and cystic fibrosis. Murepavadin is a peptidomimetic that specifically targets outer-membrane lipopolysaccharide transport protein LptD of P. aeruginosa. In this study, we find that murepavadin enhances the bactericidal efficacy of ciprofloxacin. We further demonstrate that murepavadin increases intracellular accumulation of ciprofloxacin by suppressing drug efflux. In addition, the murepavadin-ciprofloxacin combination exhibits a synergistic bactericidal effect in an acute murine pneumonia model. In conclusion, our results identify an effective drug combination for the treatment of P. aeruginosa infections.

铜绿假单胞菌是一种具有多重耐药性的革兰氏阴性病原体,是呼吸机相关性肺炎和慢性阻塞性肺病及囊性纤维化患者感染的主要病因之一。Murepavadin 是一种肽模拟物,专门针对铜绿假单胞菌的外膜脂多糖转运蛋白 LptD。在这项研究中,我们发现金刚烷胺能增强环丙沙星的杀菌效果。我们进一步证明,金葡菌胺通过抑制药物外流增加了环丙沙星在细胞内的蓄积。此外,在急性小鼠肺炎模型中,murepavadin-环丙沙星复方制剂具有协同杀菌作用。总之,我们的研究结果确定了一种治疗铜绿假单胞菌感染的有效联合用药。
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引用次数: 0
Rapid Molecular Diagnostics of Pneumonia Caused by Gram-Negative Bacteria: A Clinician's Review. 革兰氏阴性细菌引起的肺炎的快速分子诊断:临床医生综述》。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-25 DOI: 10.3390/antibiotics13090805
Ionela-Anca Pintea-Simon, Ligia Bancu, Anca Delia Mare, Cristina Nicoleta Ciurea, Felicia Toma, Adrian Man

With approximately half a billion events per year, lower respiratory tract infections (LRTIs) represent a major challenge for the global public health. Among LRTI cases, those caused by Gram-negative bacteria (GNB) are associated with a poorer prognostic. Standard-of-care etiologic diagnostics is lengthy and difficult to establish, with more than half of cases remaining microbiologically undocumented. Recently, syndromic molecular diagnostic panels became available, enabling simultaneous detection of tens of pathogen-related and antimicrobial-resistance genetic markers within a few hours. In this narrative review, we summarize the available data on the performance of molecular diagnostics in GNB pneumonia, highlighting the main strengths and limitations of these assays, as well as the main factors influencing their clinical utility. We searched MEDLINE and Web of Science databases for relevant English-language articles. Molecular assays have higher analytical sensitivity than cultural methods, and show good agreement with standard-of-care diagnostics regarding detection of respiratory pathogens, including GNB, and identification of frequent patterns of resistance to antibiotics. Clinical trials reported encouraging results on the usefulness of molecular assays in antibiotic stewardship. By providing early information on the presence of pathogens and their probable resistance phenotypes, these assays assist in the choice of targeted therapy, in shortening the time from sample collection to appropriate antimicrobial treatment, and in reducing unnecessary antibiotic use.

下呼吸道感染(LRTI)每年约有 5 亿例,是全球公共卫生面临的一大挑战。在下呼吸道感染病例中,由革兰氏阴性菌(GNB)引起的病例预后较差。标准病原学诊断耗时长且难以确定,半数以上的病例仍无微生物学记录。最近,综合征分子诊断面板问世,可在数小时内同时检测数十种病原体相关基因标记和抗菌药耐药性基因标记。在这篇叙述性综述中,我们总结了有关 GNB 肺炎分子诊断性能的现有数据,强调了这些检测方法的主要优势和局限性,以及影响其临床实用性的主要因素。我们在 MEDLINE 和 Web of Science 数据库中检索了相关的英文文章。分子检测法的分析灵敏度高于培养法,在检测呼吸道病原体(包括 GNB)和识别抗生素耐药性的常见模式方面与常规诊断法有很好的一致性。临床试验报告显示,分子检测在抗生素管理中的作用令人鼓舞。通过提供病原体存在及其可能耐药表型的早期信息,这些检测有助于选择有针对性的治疗方法,缩短从样本采集到适当抗菌治疗的时间,并减少不必要的抗生素使用。
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引用次数: 0
Days of Antibiotic Spectrum Coverage (DASC) as a Metric for Evaluating the Impact of Prospective Audit and Feedback (PAF) against Long-Term Broad-Spectrum Antibiotic Use. 将抗生素谱覆盖天数 (DASC) 作为评估前瞻性审核和反馈 (PAF) 对长期广谱抗生素使用影响的指标。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-25 DOI: 10.3390/antibiotics13090804
Yuichi Shibata, Jun Hirai, Nobuaki Mori, Nobuhiro Asai, Mao Hagihara, Hiroshige Mikamo

The present study aimed to evaluate the impact of prospective audit and feedback (PAF) on the use of inpatient broad-spectrum antibiotics for more than 10 days using days of therapy (DOT) and a novel metric called days of antibiotic spectrum coverage (DASC) to assess whether the antimicrobial spectrum was narrowed. Conducted at Aichi Medical University Hospital in Japan, the study compared a six-month baseline period (April to September 2022) with a six-month intervention period (April to September 2023). The primary outcome measures were changes in DOT/patient and DASC/patient for broad-spectrum antibiotics. Propensity score matching was performed between two periods and a total of 172 patients were included in the study (pre-intervention, n = 86; intervention, n = 86). The DASC/patient of broad-spectrum antibiotics was statistically decreased in the intervention period compared to that in the baseline period (153.3 vs. 122.7, p < 0.05). Additionally, our PAF intervention led to a switch to narrow-spectrum antimicrobial therapy without increasing all-cause 30-day mortality (5.8% vs. 5.8%, p = 1.0). However, the DOT/patient, DASC/patient, and DASC/DOT of all antimicrobials were not significantly changed. Our study concluded that we should reconsider the timing of PAF intervention by evaluating the effort of PAF by using DOT and DASC.

本研究旨在评估前瞻性审核和反馈(PAF)对住院病人使用广谱抗生素超过 10 天的影响,采用治疗天数(DOT)和一种称为抗菌谱覆盖天数(DASC)的新指标来评估抗菌谱是否缩小。该研究在日本爱知医科大学医院进行,比较了六个月基线期(2022 年 4 月至 9 月)和六个月干预期(2023 年 4 月至 9 月)。主要结果指标是广谱抗生素 DOT/患者和 DASC/患者的变化。在两个时期之间进行倾向得分匹配,共有 172 名患者被纳入研究(干预前,n = 86;干预,n = 86)。与基线期相比,干预期广谱抗生素的DASC/患者数出现了统计学上的下降(153.3 对 122.7,P < 0.05)。此外,我们的 PAF 干预措施导致患者转用窄谱抗菌药治疗,但并未增加全因 30 天死亡率(5.8% vs. 5.8%,p = 1.0)。但是,所有抗菌药物的 DOT/患者、DASC/患者和 DASC/DOT 均无显著变化。我们的研究得出结论,我们应该通过使用 DOT 和 DASC 评估 PAF 的努力程度,重新考虑 PAF 干预的时机。
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引用次数: 0
Novel Antimicrobial Agents Based on Zinc-Doped Hydroxyapatite Loaded with Tetracycline. 基于负载四环素的掺锌羟基磷灰石的新型抗菌剂。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-25 DOI: 10.3390/antibiotics13090803
Simona Liliana Iconaru, Daniela Predoi, Carmen Steluta Ciobanu, Catalin Constantin Negrila, Roxana Trusca, Steinar Raaen, Krzysztof Rokosz, Liliana Ghegoiu, Monica Luminita Badea, Carmen Cimpeanu

In this paper, we present for the first time the development of zinc-doped hydroxyapatite enriched with tetracycline (ZnHApTe) powders and provide a comprehensive evaluation of their physico-chemical and biological properties. Various techniques such as X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR) were used for the sample's complex evaluation. Moreover, the biocompatibility of zinc-doped hydroxyapatite (ZnHAp) and ZnHApTe nanoparticles was evaluated with the aid of human fetal osteoblastic cells (hFOB 1.19 cell line). The results of the biological assays suggested that these nanoparticles hold great promise as potential candidates for the future development of novel biocompatible and antimicrobial agents for biomedical applications. The antimicrobial properties of the ZnHAp and ZnHApTe nanoparticles were assessed using the standard reference microbial strains Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Candida albicans ATCC 10231. The results of the in vitro antimicrobial assay demonstrated that both tested materials exhibited good antimicrobial activity. Additionally, these data also indicated that the antimicrobial effects of the ZnHAp nanoparticles were intensified by the presence of tetracycline (Te). Furthermore, the results also suggested that the antimicrobial activity of the samples increased with the incubation time.

本文首次介绍了富含四环素的锌掺杂羟基磷灰石(ZnHApTe)粉末的开发情况,并对其物理化学和生物特性进行了全面评估。样品的复杂性评估采用了多种技术,如 X 射线衍射 (XRD)、X 射线光电子能谱 (XPS)、扫描电子显微镜 (SEM) 和傅立叶变换红外光谱 (FTIR)。此外,还利用人体胎儿成骨细胞(hFOB 1.19 细胞系)评估了掺锌羟基磷灰石(ZnHAp)和 ZnHApTe 纳米粒子的生物相容性。生物检测结果表明,这些纳米粒子很有希望成为未来开发生物医学应用领域新型生物相容性和抗菌剂的潜在候选材料。使用标准参考微生物菌株金黄色葡萄球菌 ATCC 25923、大肠杆菌 ATCC 25922 和白色念珠菌 ATCC 10231 评估了 ZnHAp 和 ZnHApTe 纳米粒子的抗菌特性。体外抗菌试验结果表明,两种受试材料都具有良好的抗菌活性。此外,这些数据还表明,四环素(Te)的存在增强了 ZnHAp 纳米粒子的抗菌效果。此外,结果还表明,样品的抗菌活性随着培养时间的延长而增强。
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引用次数: 0
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