Antibiotics-Basel最新文献

Background: The misuse of antibiotics in both humans and food-producing animals poses significant risks to human health and contributes to the rise of antibiotic resistance. Raising public awareness is crucial to managing antibiotic resistance, particularly among university students, as they represent a future force in tackling this global issue. Methods: A cross-sectional study was conducted from July 2022 to May 2024 in seven cities in Southern and Central China to assess university students' knowledge, attitude, and practice regarding antibiotic use in humans and food-producing animals. Binary logistic regression was used to identify associated factors. Results: A total of 6357 students from 72 universities participated. Less than half of the students answered the knowledge items appropriately. Only 21.47% to 29.98% had a proper understanding of basic antibiotic concepts and their use in humans and food-producing animals. Respectively, 21.49% and 28.50% students paid attention to antibiotic content in food from food-producing animals and refused to buy food containing antibiotics. Factors associated with higher knowledge, attitude, and practice total scores included being male, being of older age, having a postgraduate education, majoring in the medical science discipline, studying at a double-first-class university, having a higher family monthly income, having parents in the medical area, and using antibiotics in the past year (p < 0.001). Conclusions: Given students' insufficient knowledge-particularly in identifying antibiotics and understanding their functions-and inappropriate practices related to purchasing food from food-producing animals, targeted education programs are suggested. These programs should address the fundamental concepts of antibiotic use in both humans and food-producing animals while providing practical guidance on individual behaviors to help mitigate antibiotic resistance.

Background/Objectives: In healthcare environments with high microbial loads, effective infection control measures are critical for reducing airborne and surface contamination. One of the novel modalities in the achievement of these goals is the use of antimicrobial mists, such as droplets, in the form of dry fog. Although the usage of dry fog in the disinfection of contained healthcare microenvironments is well known, the effect of such a system in terms of a meaningful reduction in the microbial burden in an open inpatient ward is unclear. Our objective was to assess the impact of scheduled dry fogging on microbial reduction in such settings. Methods: We collected air and surface samples from rooms receiving daily, biweekly, or no fogging (controls) over six months, establishing the baseline contamination and evaluating the reduction trends in treated rooms. The "reduction effect" was measured by tracking microbial isolation trends before and after treatment, while the "degree of reduction" assessed differences across rooms with varied disinfection schedules. Results: The results indicate that scheduled dry fogging significantly reduced microbial loads in treated rooms, especially with daily disinfection (SE = 64.484, p = 0.002). The airborne contamination in treated rooms showed a strong downward trend over time (SE = 19.192, p < 0.001). Surface contamination remained challenging due to frequent recontamination; however, treated rooms exhibited a consistent reduction in microbial presence (SE = 2.002, p = 0.010), confirming dry fogging's role as a valuable adjunct to routine cleaning. Conclusions: In conclusion, this study highlights that dry fogging effectively reduces microbial loads in open, high-traffic healthcare environments, supporting its use as part of a multimodal infection control strategy.

Background: The rise in carbapenem-resistant Enterobacteriaceae (CRE) in Egypt, particularly in hospital settings, poses a significant public health challenge. This study aims to develop a combined epidemiological surveillance tool utilizing the Microreact online platform (version 269) and molecular microarray technology to track and analyze carbapenem-resistant Escherichia coli strains in Egypt. The objective is to integrate molecular diagnostics and real-time data visualization to better understand the spread and evolution of multidrug-resistant (MDR) bacteria.

Methods: The study analyzed 43 E. coli isolates collected from Egyptian hospitals between 2020 and 2023. Nanopore sequencing and microarray analysis were used to identify carbapenemase genes and other resistance markers, whereas the VITEK2 system was employed for phenotypic antibiotic susceptibility testing. Microreact was used to visualize epidemiological data, mapping the geographic and temporal distribution of resistant strains.

Results: We found that 72.09% of the isolates, predominantly from pediatric patients, carried the blaNDM-5 gene, while other carbapenemase genes, including blaOXA-48 and blaVIM, were also detected. The microarray method demonstrated 92.9% diagnostic sensitivity and 87.7% diagnostic specificity compared to whole-genome sequencing. Phenotypic resistance correlated strongly with next-generation sequencing (NGS) genotypic data, achieving 95.6% sensitivity and 95.2% specificity.

Conclusions: This method establishes the utility of combining microarray technology, NGS and real-time data visualization for the surveillance of carbapenem-resistant Enterobacteriaceae, especially E. coli. The high concordance between genotypic and phenotypic data underscores the potential of DNA microarrays as a cost-effective alternative to whole-genome sequencing, especially in resource-limited settings. This integrated approach can enhance public health responses to MDR bacteria in Egypt.

Tenacibaculosis, caused by Tenacibaculum species, is a significant disease in aquaculture, leading to high mortality and economic losses. Antibiotic treatment raises concerns about resistance, making phage therapy an interesting alternative. Analyzing phage traces in Tenacibaculum genomes is crucial for developing these bacteriophage-based strategies.

Methods: We assessed the presence of prophages in 212 Tenacibaculum genomes/assemblies available in the NCBI repository, comprising several species and global locations, using the PHASTEST program. Then, we focused on those regions classified as intact, evaluating the most common phages found using VICTOR. The protein of interest discovered in the prophages was evaluated using the ProtParam, DeepTMHMM, InterPro, and Phyre2 tools. In addition, we evaluated the presence of antiphage defense systems in those genomes with intact prophages using the DefenseFinder tool.

Results: We identified 25 phage elements in 24 out of the 212 Tenacibaculum genomes/assemblies analyzed, with 11% of the assemblies containing phage elements. These were concentrated in T. maritimum and T. mesophilum, which harbored 10 and 7 prophage regions, respectively. Of the identified elements, six were classified as intact, including four in T. maritimum, with the most common phages belonging to the Pippivirus and Siphoviridae families. Bioinformatic analysis showed that the putative endolysin is a stable protein of 432 amino acids and 49.8 kDa, with three transmembrane helices and a CHAP domain, structurally similar to the CHAP lytic domain of S. aureus bacteriophage K.

Conclusions: Key prophage elements in Tenacibaculum, especially in T. maritimum, show promise for phage therapy against tenacibaculosis, supporting sustainable, antibiotic-free treatments in aquaculture.

Over the past two decades, the global incidence of sexually transmitted infections (STIs) such as gonorrhea, chlamydia, and syphilis have increased significantly, particularly among cisgender men who have sex with men (MSM) and transgender women (TGW). This rise in STIs has spurred interest in new preventive measures, including doxycycline post-exposure prophylaxis (DoxyPEP). Clinical trials in the United States and France have demonstrated the effectiveness of DoxyPEP in reducing both chlamydia and syphilis incidence among MSM and TGW; although, its efficacy against gonorrhea remains limited, and it was further found to be ineffective among cisgender women in Kenya. Due to the promising results, the CDC and the German STI Society have incorporated DoxyPEP into their guidelines for specific high-risk groups. However, the broader implementation of DoxyPEP presents several challenges and ethical concerns. Key issues involve the potential development of antimicrobial resistance, particularly among common STI pathogens like C. trachomatis, M. genitalium, and N. gonorrhoeae, as well as other bacteria such as S. aureus and K. pneumoniae. Additionally, questions concerning equitable healthcare access, the potential impact on adherence to safer sex practices, and broader public health implications warrant careful consideration. Addressing these challenges necessitates a careful balance between the benefits and risks of DoxyPEP, as well as the implementation of strategies to mitigate negative outcomes while maximizing the impact on public health. Lastly, future research should explore the integration of DoxyPEP with other preventive strategies, such as vaccines, to enhance its effectiveness and reduce the global burden of STIs.

Genome mining has emerged as a revolutionary tool for discovering new ribosomally synthesized and post-translationally modified peptides (RiPPs) in various genomes. Recently, these approaches have been used to detect and explore unique environments as sources of RiPP-producing microorganisms, particularly focusing on endophytic microorganisms found in medicinal plants. Some endophytic actinobacteria, especially strains of Streptomyces, are notable examples of peptide producers, as specific biosynthetic clusters encode them. To uncover the genetic potential of these organisms, we analyzed the genome of the endophytic actinobacterium Embleya sp. NF3 using genome mining and bioinformatics tools. Our analysis led to the identification of a putative class I lanthipeptide. We cloned the core biosynthetic genes of this putative lanthipeptide, named embleporicin, and expressed them in vitro using a cell-free protein system (CFPS). The resulting product demonstrated antimicrobial activity against Micrococcus luteus ATCC 9341. This represents the first RiPP reported in the genus Embleya and the first actinobacterial lanthipeptide produced through cell-free technology.

Background: The objective of this study was to compare infection rates, pathogen species detection and antimicrobial susceptibility testing in patients with total hip arthroplasty (THA) and total knee arthroplasty (TKA) following post-traumatic osteoarthritis (PTOA) and primary osteoarthritis (POA). Results: Patients undergoing both THA and TKA were significantly more likely to have a PJI after PTOA than after POA (THA: 2.5% vs. 10.2%, p = 0.003; TKA: 3.2% vs. 10.3%, p = 0.028). The most frequently detected pathogen in both THA and TKA was Staphylococcus spp. Among patients with a PJI in THA, Staphylococcus spp. was detected in 47% after POA and 60% after PTOA. Among patients with a PJI in TKA, Staphylococcus spp. was isolated in 59% after POA and 80% after PTOA. The remaining pathogens were mainly Enterococcus spp., Enterobacterales and anaerobic bacteria. After THA, beta-lactam-resistant staphylococcal isolates were detected more frequently in PTOA patients than in POA patients (13% vs. 100%, p = 0.024). There was no difference in the beta-lactam staphylococcal resistance rate in patients after TKA (20% vs. 25%, p = 0.945). Furthermore, an analysis of susceptibility testing from all groups showed that significantly more pathogens were susceptible to vancomycin than to cefuroxime (76% vs. 45%, p < 0.001) or clindamycin (76% vs. 52%, p = 0.007). Methods: A retrospective analysis was performed using clinic-owned data during the period January 2016-December 2020. A total of 1485 patients following primary implantation of THA or TKA due to PTOA or POA were included. Early-onset periprosthetic joint infection (PJI), defined according to the 2018 Definition of Periprosthetic Hip and Knee Infection Criteria, was evaluated. Conclusions: Therefore, the use of vancomycin as a perioperative prophylaxis should be discussed under benefit/risk consideration in further studies.

Objectives: The main aim of this study was to describe the epidemiology of infected non-unions (INUs) managed at an Infectious Disease (ID) referral centre and to investigate the factors associated with treatment failure. Methods: This was an observational retrospective study on adult patients with INUs managed between 2012 and 2018 at the ID Unit of the IRCCS Azienda Ospedaliero-Universitaria di Bologna, an Italian ID referral centre for bone and joint infections. Patients were observed for at least 24 months. Those who achieved clinical success were compared with those who experienced clinical failure; to identify factors associated with treatment failure, we performed a univariate and multivariate logistic regression analysis. Results: Overall, 78 patients were included. A total of 57/78 (73%) were males; their median age was 43 (IQR 34-56) years; their median Charlson index was 0 (IQR 0-2); 32/78 (41%) reported a history of an open fracture; the non-union most frequently involved the leg. Polymicrobial infection was found in 23/78 cases (29%); the most common microorganisms were coagulase-negative staphylococci (n = 47) and Staphylococcus aureus (n = 35). At 24-month follow-up from index surgery, 16/78 patients had experienced clinical failure: 13 (16.6%) presented with persistence of local signs of infection and 3 (3.8%) had undergone amputation. Logistic regression analysis of risk factors for clinical failure identified body mass index (BMI) (aOR 1.15; 95% CI 1.03-1.28, p = 0.01) and MRSA infection (aOR 5.35; 95% CI 1.06-26.92, p = 0.04) as factors associated with clinical failure. Conclusions: Given that a standardized management of antibiotic therapy is initiated by an expert ID consultant team, BMI and MRSA infection are associated with worse outcomes among patients with INUs.

Background/Objectives: Although chronic infection by Pseudomonas aeruginosa among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with P. aeruginosa coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. Methods: This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients' backgrounds. Results: In total, 4943 patients with bacterial pneumonia and 1914 patients with exacerbation of bronchiectasis were included in this study. The in-hospital mortality rate did not differ between patients who did and did not receive antipseudomonal agents among patients with bacterial pneumonia (9.0% [185/2045] vs. 7.4% [151/2045]; p = 0.053) and those with exacerbation of bronchiectasis (5.2% [42/803] vs. 4.1% [33/803] group; p = 0.287). Conclusions: The use of antibiotics covering P. aeruginosa does not apparently improve prognosis in patients with bacterial pneumonia or exacerbation of bronchiectasis. A prospective study focusing on the impact of antibiotics covering P. aeruginosa among patients with bronchiectasis in whom P. aeruginosa is isolated is required.

Background/Objectives: Antimicrobial resistance (AMR) is a global public health threat, with antimicrobial use (AMU) in livestock recognized as a significant driver. This study examines farm-level AMU and AMR as well as the relationship between AMU and AMR on broiler farms in Indonesia. Methods: Data were collected from 19 farms in West Java between 2019 and 2021 to examine AMU in depth across four to five successive production cycles. The correlation between AMU and AMR in commensal Escherichia coli (E. coli) was investigated. AMU was recorded as treatment days per 30-day production cycle, and antimicrobial susceptibility was assessed using epidemiological cut-off (ECOFF) values to differentiate wildtype (WT) and non-wildtype (NWT) E. coli. Results: The average AMU was 12 treatment days per 30-day production cycle, with a wide range of 4 to 22 days. On average, E. coli isolates from each farm exhibited NWT phenotypes, reflecting AMR levels, for 6 out of 14 antimicrobials tested. This included notable levels for the highest priority critically important antimicrobials (HPCIAs) ciprofloxacin (93%) and nalidixic acid (64%). A significant correlation (Spearman ρ = 0.67, p < 0.05) was observed between the total farm-level AMU and the number of antimicrobials for which NWT E. coli isolates were found. However, no significant correlation was found between AMU and AMR for the five most frequently used antimicrobials, likely due to a high baseline prevalence of NWT E. coli isolates and relatively few independent observations. Conclusions: These findings highlight the urgent need to reduce AMU in general, specifically the use of (HP)CIAs, to mitigate AMR on Indonesian broiler farms.