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Cemented Calcar-Guided Short-Stem Prostheses in Geriatric Patients: Short-Term Results from a Prospective Observational Study. 老年患者的骨水泥钙引导短茎假体:一项前瞻性观察研究的短期结果。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-06 DOI: 10.3390/antibiotics13080739
Bertram Regenbrecht, Ahmed Yaseen, Gideon Wagener, Michael Wild

Both cementless and cemented stems have exhibited favorable long-term outcomes in total hip arthroplasty. Nonetheless, in elderly patients, cemented hips offer an advantage due to their reduced risk of periprosthetic fractures. This study aimed to assess the initial outcomes of 28 patients who underwent unilateral cemented total hip arthroplasty utilizing a calcar-guided A2 stem (ARTIQO GmbH, Lüdinghausen, Germany). Various types of antibiotic-loaded bone cement were employed. During follow-up, we recorded demographic data and comorbidities and employed standardized clinical assessment tools, including the Harris Hip Score. Radiographic assessments included preoperative, postoperative, and follow-up imaging to evaluate subsidence, osteolysis, and bone resorption. The results indicated that among the 28 patients, 5 withdrew consent and 2 patients passed away from unrelated causes. Additionally, one prosthesis was explanted due to the undersizing of the cement stopper, which resulted in an inadequate cement mantle. As a result, 20 patients underwent a 1-year follow-up, revealing noteworthy enhancements in clinical scores, with no instances of radiolucent lines or osteolysis. No infections were detected. In summary, our short-term experience with this particular cemented short-stem design yielded promising results, exhibiting excellent functional outcomes, no aseptic loosening attributable to the stem, and no infections. Further clinical studies and registry data are essential to corroborate these findings.

在全髋关节置换术中,无骨水泥基台和有骨水泥基台都显示出良好的长期疗效。然而,对于老年患者来说,骨水泥髋关节因可降低假体周围骨折的风险而更具优势。本研究旨在评估28名接受单侧骨水泥全髋关节置换术的患者的初步疗效,这些患者使用的是钙引导A2骨水泥柄(ARTIQO GmbH,德国吕丁豪森)。手术中使用了各种类型的抗生素骨水泥。在随访期间,我们记录了人口统计学数据和合并症,并采用了标准化临床评估工具,包括哈里斯髋关节评分。放射学评估包括术前、术后和随访成像,以评估下沉、骨溶解和骨吸收情况。结果显示,在 28 名患者中,有 5 名患者撤回同意,2 名患者因其他原因去世。此外,有一个假体因骨水泥塞尺寸过小导致骨水泥套不足而被拆除。结果,20 名患者接受了为期 1 年的随访,临床评分显著提高,没有出现放射性线或骨溶解。没有发现任何感染。总之,我们使用这种特殊的骨水泥短茎设计的短期经验取得了很好的效果,显示出极佳的功能效果,没有发生可归因于茎的无菌性松动,也没有发生感染。进一步的临床研究和登记数据对证实这些发现至关重要。
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引用次数: 0
Virulence and Antimicrobial Resistance Characterization of Glaesserella parasuis Isolates Recovered from Spanish Swine Farms. 从西班牙养猪场采集的寄生璃泽氏菌(Glaesserella parasuis)分离株的毒性和抗菌特性。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-06 DOI: 10.3390/antibiotics13080741
Alba González-Fernández, Oscar Mencía-Ares, María José García-Iglesias, Máximo Petrocchi-Rilo, Rubén Miguélez-Pérez, César Bernardo Gutiérrez-Martín, Sonia Martínez-Martínez

Glaesserella (Haemophilus) parasuis, the causative agent of Glässer's disease, is present in most pig farms as an early colonizer of the upper respiratory tract. It exhibits remarkable variability in virulence and antimicrobial resistance (AMR), with virulent strains capable of inducing respiratory or systemic disease. This study aimed to characterize the virulence and the AMR profiles in 65 G. parasuis isolates recovered from Spanish swine farms. Virulence was assessed using multiplex leader sequence (LS)-PCR targeting vtaA genes, with all isolates identified as clinical (presumed virulent). Pathotyping based on ten pangenome genes revealed the virulent HPS_22970 as the most frequent (83.1%). Diverse pathotype profiles were observed, with 29 unique gene combinations and two isolates carrying only potentially non-virulent pangenome genes. AMR phenotyping showed widespread resistance, with 63.3% classified as multidrug resistant, and high resistance to clindamycin (98.3%) and tylosin (93.3%). A very strong association was found between certain pathotype genes and AMR phenotypes, notably between the virulent HPS_22970 and tetracycline resistance (p < 0.001; Φ = 0.58). This study reveals the wide diversity and complexity of G. parasuis pathogenicity and AMR phenotype, emphasizing the need for the targeted characterization of clinical isolates to ensure appropriate antimicrobial treatments and the implementation of prophylactic measures against virulent strains.

寄生嗜血杆菌(Glaesserella (Haemophilus) parasuis)是格莱塞氏病的致病菌,作为上呼吸道的早期定植菌存在于大多数养猪场。它在毒力和抗菌药耐药性(AMR)方面表现出显著的变异性,毒力强的菌株能够诱发呼吸道或全身性疾病。本研究旨在分析从西班牙养猪场分离的 65 株寄生虫的毒力和 AMR 特征。使用针对 vtaA 基因的多重前导序列 (LS)-PCR 对病毒性进行了评估,所有分离物均被鉴定为临床(假定有毒力)。基于十个泛基因组基因的病理分型显示,毒力最强的是 HPS_22970(83.1%)。观察到的病理型特征多种多样,有 29 种独特的基因组合,有两个分离物只携带潜在的非毒性泛基因组基因。AMR表型分析表明,耐药性非常普遍,63.3%的分离株具有多重耐药性,对克林霉素(98.3%)和泰乐菌素(93.3%)具有高度耐药性。研究发现,某些病原型基因与 AMR 表型之间存在很强的关联,特别是毒性 HPS_22970 与四环素耐药性之间的关联(p < 0.001;Φ = 0.58)。这项研究揭示了寄生虫致病性和AMR表型的广泛多样性和复杂性,强调有必要对临床分离株进行有针对性的特征描述,以确保对毒力强的菌株采取适当的抗菌治疗和预防措施。
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引用次数: 0
Epidemiology and Impact of Anti-Pneumococcal Vaccination and COVID-19 on Resistance of Streptococcus pneumoniae Causing Invasive Disease in Piedmont, Italy. 意大利皮埃蒙特的流行病学以及抗肺炎球菌疫苗接种和 COVID-19 对引起侵袭性疾病的肺炎链球菌耐药性的影响。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-06 DOI: 10.3390/antibiotics13080740
Alessandro Bondi, Emanuele Koumantakis, Antonio Curtoni, Anna Maria Barbui, Marco Peradotto, Daniela Lombardi, Roberto Casale, Silvia Alizzi, Elisa Zanotto, Lorena Charrier, Rossana Cavallo, Cristina Costa

Background: The international surveillance of antimicrobial resistance (AMR) reports S. pneumoniae as one of leading causes of death associated with AMR. Against invasive disease, several vaccinations are available and a reduction in AMR in S. pneumoniae has been observed. Here, we evaluated the impact of anti-pneumococcal vaccination policy and the SARS-CoV2 outbreak on AMR in S. pneumoniae causing invasive disease.

Methods: We collected all strains of S. pneumoniae causing invasive disease from 2008 in the Piedmont region (Italy). Each strain was typed in order to identify the serogroup and data about AMR were collected. The population under surveillance was classified as infants, children, adults, and the old population.

Results: We collected n = 2076 S. pneumoniae strains, with 21.9% and 40.3% being resistant to penicillin G and erythromycin, respectively. We reported an increased risk of infection with penicillin-resistant S. pneumoniae among all populations and evaluated whether the infection was caused by a serotype included in the vaccine formulation. A similar increase was observed after the SARS-CoV2 outbreak.

Conclusions: In the Piedmont region, subsequently to the introduction of anti-pneumococcal vaccination, a significant increase in the risk of penicillin G-resistant invasive pneumococcal disease among infants and old population was reported. No significant impact was found for the SARS-CoV2 outbreak.

背景:抗菌药耐药性(AMR)国际监测报告显示,肺炎双球菌是与 AMR 相关的主要死因之一。针对侵袭性疾病,目前有多种疫苗可供选择,而且已观察到肺炎球菌的 AMR 有所减少。在此,我们评估了抗肺炎球菌疫苗接种政策和 SARS-CoV2 爆发对引起侵袭性疾病的肺炎双球菌 AMR 的影响:方法:我们收集了 2008 年意大利皮埃蒙特大区所有引起侵袭性疾病的肺炎双球菌菌株。我们对每株菌株进行了分型,以确定其血清群,并收集了有关 AMR 的数据。监测人群分为婴儿、儿童、成人和老年人:我们共收集到 n = 2076 株肺炎链球菌菌株,其中 21.9% 和 40.3% 的菌株对青霉素 G 和红霉素耐药。我们报告了所有人群感染耐青霉素肺炎球菌的风险增加,并评估了感染是否由疫苗配方中的血清型引起。在 SARS-CoV2 爆发后也观察到了类似的增加:结论:在皮埃蒙特地区,在引入抗肺炎球菌疫苗接种后,婴儿和老年人感染耐青霉素 G 的侵袭性肺炎球菌疾病的风险显著增加。但对 SARS-CoV2 的爆发并无明显影响。
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引用次数: 0
Unveiling the High Diversity of Clones and Antimicrobial Resistance Genes in Escherichia coli Originating from ST10 across Different Ecological Niches. 揭示源自 ST10 大肠杆菌的克隆和抗菌基因在不同生态位中的高度多样性
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-06 DOI: 10.3390/antibiotics13080737
Maxsueli Aparecida Moura Machado, Pedro Panzenhagen, Cesar Lázaro, Miguel Rojas, Eduardo Eustáquio de Souza Figueiredo, Carlos Adam Conte-Junior

In this pioneering in silico study in Peru, we aimed to analyze Escherichia coli (E. coli) genomes for antimicrobial resistance genes (ARGs) diversity and virulence and for its mobilome. For this purpose, 469 assemblies from human, domestic, and wild animal hosts were investigated. Of these genomes, three were E. coli strains (pv05, pv06, and sf25) isolated from chickens in our previous study, characterized for antimicrobial susceptibility profile, and sequenced in this study. Three other genomes were included in our repertoire for having rare cgMLSTs. The phenotypic analysis for antimicrobial resistance revealed that pv05, pv06, and sf25 strains presented multidrug resistance to antibiotics belonging to at least three classes. Our in silico analysis indicated that many Peruvian genomes included resistance genes, mainly to the aminoglycoside class, ESBL-producing E. coli, sulfonamides, and tetracyclines. In addition, through Multi-locus Sequence Typing, we found more than 180 different STs, with ST10 being the most prevalent among the genomes. Pan-genome mapping revealed that, with new lineages, the repertoire of accessory genes in E. coli increased, especially genes related to resistance and persistence, which may be carried by plasmids. The results also demonstrated several genes related to adhesion, virulence, and pathogenesis, especially genes belonging to the high pathogenicity island (HPI) from Yersinia pestis, with a prevalence of 42.2% among the genomes. The complexity of the genetic profiles of resistance and virulence in our study highlights the adaptability of the pathogen to different environments and hosts. Therefore, our in silico analysis through genome sequencing enables tracking the epidemiology of E. coli from Peru and the future development of strategies to mitigate its survival.

在秘鲁进行的这项开创性的硅学研究中,我们旨在分析大肠埃希菌(E. coli)基因组的抗菌药耐药性基因(ARGs)多样性和毒力及其移动组。为此,我们研究了来自人类、家畜和野生动物宿主的 469 个基因组。在这些基因组中,有三个是我们之前研究中从鸡体内分离出的大肠杆菌菌株(pv05、pv06 和 sf25),它们对抗菌药敏感,并在本研究中进行了测序。另外三个基因组因具有罕见的 cgMLSTs 而被纳入我们的研究范围。抗菌药耐药性表型分析表明,pv05、pv06 和 sf25 菌株对至少三类抗生素具有多重耐药性。我们的硅学分析表明,秘鲁的许多基因组都包含耐药基因,主要是对氨基糖苷类、产ESBL大肠杆菌、磺胺类和四环素类的耐药基因。此外,通过多焦点序列分型,我们发现了 180 多种不同的 ST,其中 ST10 在基因组中最为普遍。泛基因组图谱显示,随着新品系的出现,大肠杆菌中的附属基因也在增加,特别是与抗性和持久性有关的基因,这些基因可能由质粒携带。研究结果还发现了一些与粘附性、毒性和致病性有关的基因,尤其是属于鼠疫耶尔森菌高致病性岛(HPI)的基因,在基因组中的流行率高达 42.2%。在我们的研究中,抗性和毒力基因谱的复杂性凸显了病原体对不同环境和宿主的适应性。因此,我们通过基因组测序进行的硅学分析能够追踪秘鲁大肠杆菌的流行病学,并在未来制定策略以减少其生存。
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引用次数: 0
Detection of Pharmaceutical Contamination in Amphipods of Lake Baikal by the HPLC-MS Method. 用高效液相色谱-质谱法检测贝加尔湖片脚类动物体内的药物污染
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-06 DOI: 10.3390/antibiotics13080738
Tamara Y Telnova, Maria M Morgunova, Sophie S Shashkina, Anfisa A Vlasova, Maria E Dmitrieva, Victoria N Shelkovnikova, Ekaterina V Malygina, Natalia A Imidoeva, Alexander Y Belyshenko, Alexander S Konovalov, Evgenia A Misharina, Denis V Axenov-Gribanov

Pollution by active ingredients is one of the most significant and widespread forms of pollution on Earth. Medicines can have a negative impact on ecosystems, and contamination can have unpredictable consequences. An urgent and unexplored task is to study the Lake Baikal ecosystem and its organisms for the presence of trace concentrations of active pharmaceutical ingredients. Our study aimed to conduct a qualitative analysis of active pharmaceutical ingredients, and quantitative analysis of ibuprofen in endemic amphipods of Lake Baikal, using methods of high-performance liquid chromatography and mass spectrometry (HPLC-MS). Acetylsalicylic acid (aspirin), ibuprofen, acetaminophen, azithromycin, dimetridazole, metronidazole, amikacin, spiramycin, and some tetracycline antibiotics were detected in the studied littoral amphipods. We also detected different annual loads of active pharmaceutical ingredients on amphipods. Using the multiple reaction monitoring (MRM) mode mentioned in GOST International Technical Standards, we detected molecules, fragmented as amikacin, chlortetracycline, doxycycline, oxytetracycline, dimetridazole, metronidazole and spiramycin. Thus, we first revealed that invertebrates of Lake Baikal can uptake pharmaceutical contaminants in the environment.

活性成分污染是地球上最重要、最普遍的污染形式之一。药物会对生态系统产生负面影响,而污染会带来不可预知的后果。研究贝加尔湖生态系统及其生物体中是否存在痕量浓度的活性药物成分是一项紧迫而尚未探索的任务。我们的研究旨在采用高效液相色谱法和质谱法(HPLC-MS),对贝加尔湖特有片脚类动物体内的活性药物成分进行定性分析,并对布洛芬进行定量分析。在所研究的沿岸片脚类动物体内检测到了乙酰水杨酸(阿司匹林)、布洛芬、对乙酰氨基酚、阿奇霉素、二甲硝咪唑、甲硝唑、阿米卡星、螺旋霉素和一些四环素类抗生素。我们还在片脚类动物身上检测到了不同年负荷量的活性药物成分。利用 GOST 国际技术标准中提到的多反应监测(MRM)模式,我们检测到了阿米卡星、金霉素、强力霉素、土霉素、二甲硝咪唑、甲硝唑和螺旋霉素等分子碎片。因此,我们首次发现贝加尔湖的无脊椎动物可以吸收环境中的药物污染物。
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引用次数: 0
Impact of Combined Pollution of Ciprofloxacin and Copper on the Diversity of Archaeal Communities and Antibiotic-Resistance Genes. 环丙沙星和铜的联合污染对古细菌群落多样性和抗生素耐药基因的影响
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-05 DOI: 10.3390/antibiotics13080734
Meijuan Chen, Weiying Li, Haibo Teng, Wenxin Hu, Zhiqiang Dong, Dawei Zhang, Tianyi Liu, Quan Zheng

This study aimed to explore the response of archaeal communities and antibiotic-resistance genes (ARGs) to ciprofloxacin (CIP, 0.05-40 mg/L) and copper (Cu, 3 mg/L) combined pollution during stress- and post-effect periods in an activated sludge system. With the increase in the CIP concentration, the diversity of archaea decreased, but the richness increased under the stress of 10 mg/L CIP. Under stress and post effects, the change in unknown archaeal community structure was more significant than that of the known archaea. The relative abundance of unknown archaea was significantly reduced with the increase in CIP concentration. Meanwhile, there were certain archaea that belonged to abundant and rare taxa with different resistance and recovery characteristics. Among them, Methanosaeta (49.15-83.66%), Methanoculleus (0.11-0.45%), and Nitrososphaera (0.03-0.36%) were the typical resistant archaea to combined pollution. And the resistance of the abundant taxa to combined pollution was significantly higher than that of the rare taxa. Symbiotic and competitive relationships were observed between the known and the unknown archaea. The interactions of abundant known taxa were mainly symbiotic relationships. While the rare unknown taxa were mainly competitive relationships in the post-effect period. Rare archaea showed an important ecological niche under the stress-effect. Some archaea displayed positive correlation with ARGs and played important roles as potential hosts of ARGs during stress- and post-periods. Methanospirillum, Methanosphaerula, Nitrososphaera and some rare unknown archaea also significantly co-occurred with a large number of ARGs. Overall, this study points out the importance of interactions among known and unknown archaeal communities and ARGs in a wastewater treatment system under the stress of antibiotics and heavy metal combined pollution.

本研究旨在探讨活性污泥系统中的古细菌群落和抗生素耐药基因(ARGs)对环丙沙星(CIP,0.05-40 mg/L)和铜(Cu,3 mg/L)联合污染在胁迫期和后效应期的响应。随着 CIP 浓度的增加,古细菌的多样性降低,但在 10 mg/L CIP 的压力下,古细菌的丰富度有所增加。在压力和后效应下,未知古细菌群落结构的变化比已知古细菌群落结构的变化更为显著。随着 CIP 浓度的增加,未知古菌的相对丰度明显降低。同时,某些古细菌属于丰富类群和稀有类群,具有不同的抗性和恢复特性。其中,Methanosaeta(49.15%-83.66%)、Methanoculleus(0.11%-0.45%)和 Nitrososphaera(0.03%-0.36%)是对联合污染具有典型抵抗力的古细菌。丰富类群对联合污染的抗性明显高于稀有类群。已知和未知古细菌之间存在共生和竞争关系。丰富的已知类群的相互作用主要是共生关系。而稀有的未知类群在后效应期主要是竞争关系。稀有古细菌在胁迫效应下显示出重要的生态位。一些古细菌与ARGs呈正相关,在胁迫期和胁迫后作为ARGs的潜在宿主发挥了重要作用。Methanospirillum、Methanosphaerula、Nitrososphaera和一些罕见的未知古菌也与大量ARGs显著共存。总之,本研究指出了在抗生素和重金属联合污染的压力下,污水处理系统中已知和未知古菌群落与 ARGs 之间相互作用的重要性。
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引用次数: 0
Genetic Characterization of Antibiotic-Resistant Staphylococcus spp. and Mammaliicoccus sciuri from Healthy Humans and Poultry in Nigeria. 尼日利亚健康人和家禽中的抗生素耐药葡萄球菌属和 Mammaliicoccus sciuri 的遗传特征。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-05 DOI: 10.3390/antibiotics13080733
Christiana Jesumirhewe, Tolulope Oluwadamilola Odufuye, Juliana Ukinebo Ariri, Amdallat Arike Adebiyi, Amina Tanko Sanusi, Anna Stöger, Beatriz Daza-Prieto, Franz Allerberger, Adriana Cabal-Rosel, Werner Ruppitsch

Staphylococcus spp. poses a significant threat to human and animal health due to their capacity to cause a wide range of infections in both. In this study, resistance genes conferring antibiotic resistance in Staphylococcus spp. and Mammaliicoccus sciuri isolates from humans and poultry in Edo state, Nigeria, were investigated. In April 2017, 61 Staphylococcus spp. isolates were obtained from urine, wounds, nasal and chicken fecal samples. Species identification was carried out by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method for 16 antibiotics. Whole-genome sequencing was used for characterization of the isolates. The 61 investigated isolates included Staphylococcus aureus, S. arlettae, M. sciuri, S. haemolyticus, and S. epidermidis. A total of 47 isolates (77%) belonged to human samples and 14 (23%) isolates were collected from poultry samples. All were phenotypically resistant to at least three antimicrobial(s). Multiple resistance determinants were detected in the human and poultry isolates analyzed. Phylogenetic analysis revealed close relatedness among the isolates within each species for S. arlettae, M. sciuri, and S. haemolyticus, respectively. This study delivered comprehensive genomic insights into antibiotic-resistant Staphylococcus species and M. sciuri isolates from human and poultry sources in Edo state, Nigeria, from a One Health perspective.

葡萄球菌可引起多种感染,对人类和动物健康构成严重威胁。本研究调查了尼日利亚埃多州从人类和家禽中分离出的葡萄球菌属和Mammaliicoccus sciuri中赋予抗生素耐药性的耐药基因。2017 年 4 月,从尿液、伤口、鼻腔和鸡粪便样本中获得了 61 株葡萄球菌属分离物。通过基质辅助激光解吸电离飞行时间质谱法进行了菌种鉴定。采用柯比-鲍尔法对 16 种抗生素进行了抗菌药敏感性测试。全基因组测序用于鉴定分离物的特征。调查的 61 个分离菌株包括金黄色葡萄球菌、阿雷泰葡萄球菌、M. sciuri 葡萄球菌、溶血性葡萄球菌和表皮葡萄球菌。共有 47 个分离菌株(77%)来自人类样本,14 个分离菌株(23%)来自家禽样本。所有分离物均对至少三种抗菌药具有表型耐药性。在分析的人类和家禽分离物中检测到多种耐药性决定因子。系统发育分析表明,在每个物种中,阿雷特氏菌、苏合香杆菌和溶血性链球菌分离物之间的亲缘关系很近。这项研究从 "一体健康 "的角度,对尼日利亚埃多州从人类和家禽中分离出的耐抗生素葡萄球菌和M.sciuri进行了全面的基因组研究。
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引用次数: 0
Measuring Temporal Trends and Patterns of Inpatient Antibiotic Use in Northwest China's Hospitals: Data from the Center for Antibacterial Surveillance, 2012-2022. 衡量中国西北地区医院住院患者抗生素使用的时间趋势和模式:2012-2022年抗菌药物监测中心的数据。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-05 DOI: 10.3390/antibiotics13080732
Aizezijiang Aierken, Xiaochen Zhu, Ningning Wang, Jiangtao Zhang, Weibin Li, Haishaerjiang Wushouer, Kaisaier Abudukeremu

Background: The challenge of emerging antimicrobial resistance and variation in antibiotic use across provinces in China call for knowledge on antibiotic utilization at the regional level. This study aims to evaluate the long-term trends and patterns of antibiotic usage in Xinjiang Province, the largest provincial-level division located in the northwest of China, aiming to provide evidence in enhancing provincial antimicrobial stewardship (AMS) and developing policy measures to optimize regional antimicrobial use.

Methods: This was an ecological study with temporal trend analysis on inpatient antibiotic utilization, with antibiotic use data from 92 public hospitals covered by Xinjiang's Center for Antibacterial Surveillance from 2012 to 2022. Antibiotic use was measured by the number of daily defined doses per 100 patient days (DDDs/100 pds). Patterns of antibiotic use were described by Anatomical Therapeutic Chemical (ATC) subgroups and the Access, Watch, Reserve (AWaRe) classification. The Average Annual Percent Change (AAPC) of antibiotic use and the corresponding 95% confidence intervals (CIs) were calculated to describe the trend of antibiotic use over time. Joinpoint regression was performed using the Weighted Bayesian Information Criteria (WBIC) model with a parametric method. A pairwise comparison between secondary and tertiary hospitals was conducted to explore disparities in antibiotic use across hospital levels. The most commonly used antibiotics were also analyzed.

Results: The total inpatient antibiotic use in Xinjiang was 27.6 DDDs/100 patient days in 2022, with a significant decreasing trend during 2012-2022 (AAPC, -2.0%; 95% CI, -3.6% to -0.4%). The Watch group antibiotics were the most used AWaRe category, with the Access-to-Watch ratio decreasing significantly from 46.4% to 24.4% (AAPC, -6.8%; 95% CI, -8.4% to -5.1%). No significant difference was found in the trend of total antibiotic use between secondary and tertiary hospitals, but there were disparities across hospital levels in subgroups. Third-generation cephalosporins, second-generation cephalosporins, and fluoroquinolones remained the top three antibiotic class throughout the study period. The number of antibiotics accounting for 90% of the total antibiotic use decreased from 34 antibiotics in 2012 to 18 antibiotics in 2022.

Conclusions: The decreasing trend of inpatient antibiotic use in Xinjiang's public hospitals reflects the effects of continuous AMS implementation. Patterns of antibiotic use underscore the need for further efforts on evidence-based antibiotic selection and for analyses on the appropriateness of antibiotic use.

背景:新出现的抗菌药物耐药性和中国各省抗生素使用的差异所带来的挑战要求了解区域层面的抗生素使用情况。本研究旨在评估中国西北地区最大的省级行政区--新疆省抗生素使用的长期趋势和模式,旨在为加强省级抗菌药物管理(AMS)和制定优化区域抗菌药物使用的政策措施提供证据:这是一项对住院患者抗生素使用情况进行时间趋势分析的生态学研究,研究数据来自新疆抗菌药物监测中心2012年至2022年覆盖的92家公立医院的抗生素使用情况。抗生素使用量以每100个患者日的日定义剂量数(DDDs/100 pds)来衡量。抗生素使用模式按解剖治疗化学物(ATC)亚组和使用、观察、储备(AWaRe)分类进行描述。计算抗生素使用的年均百分比变化(AAPC)和相应的 95% 置信区间(CI),以描述抗生素使用随时间变化的趋势。采用加权贝叶斯信息标准(WBIC)模型和参数法进行了连接点回归。对二级医院和三级医院进行了配对比较,以探讨不同级别医院在抗生素使用方面的差异。此外,还对最常用的抗生素进行了分析:结果:2022年,新疆住院患者抗生素总使用量为27.6DDDs/100个住院日,2012-2022年间呈显著下降趋势(AAPC,-2.0%;95% CI,-3.6%至-0.4%)。观察组抗生素是使用最多的 AWaRe 类别,使用观察组抗生素的比例从 46.4% 显著下降至 24.4%(AAPC,-6.8%;95% CI,-8.4% 至-5.1%)。二级医院和三级医院的抗生素总使用趋势没有明显差异,但不同级别医院的亚组存在差异。在整个研究期间,第三代头孢菌素、第二代头孢菌素和氟喹诺酮类药物仍然是抗生素种类的前三名。占抗生素使用总量90%的抗生素数量从2012年的34种减少到2022年的18种:结论:新疆公立医院住院患者抗生素使用量的下降趋势反映了持续实施AMS的效果。抗生素的使用模式凸显了进一步开展循证抗生素选择和分析抗生素使用合理性的必要性。
{"title":"Measuring Temporal Trends and Patterns of Inpatient Antibiotic Use in Northwest China's Hospitals: Data from the Center for Antibacterial Surveillance, 2012-2022.","authors":"Aizezijiang Aierken, Xiaochen Zhu, Ningning Wang, Jiangtao Zhang, Weibin Li, Haishaerjiang Wushouer, Kaisaier Abudukeremu","doi":"10.3390/antibiotics13080732","DOIUrl":"https://doi.org/10.3390/antibiotics13080732","url":null,"abstract":"<p><strong>Background: </strong>The challenge of emerging antimicrobial resistance and variation in antibiotic use across provinces in China call for knowledge on antibiotic utilization at the regional level. This study aims to evaluate the long-term trends and patterns of antibiotic usage in Xinjiang Province, the largest provincial-level division located in the northwest of China, aiming to provide evidence in enhancing provincial antimicrobial stewardship (AMS) and developing policy measures to optimize regional antimicrobial use.</p><p><strong>Methods: </strong>This was an ecological study with temporal trend analysis on inpatient antibiotic utilization, with antibiotic use data from 92 public hospitals covered by Xinjiang's Center for Antibacterial Surveillance from 2012 to 2022. Antibiotic use was measured by the number of daily defined doses per 100 patient days (DDDs/100 pds). Patterns of antibiotic use were described by Anatomical Therapeutic Chemical (ATC) subgroups and the Access, Watch, Reserve (AWaRe) classification. The Average Annual Percent Change (AAPC) of antibiotic use and the corresponding 95% confidence intervals (CIs) were calculated to describe the trend of antibiotic use over time. Joinpoint regression was performed using the Weighted Bayesian Information Criteria (WBIC) model with a parametric method. A pairwise comparison between secondary and tertiary hospitals was conducted to explore disparities in antibiotic use across hospital levels. The most commonly used antibiotics were also analyzed.</p><p><strong>Results: </strong>The total inpatient antibiotic use in Xinjiang was 27.6 DDDs/100 patient days in 2022, with a significant decreasing trend during 2012-2022 (AAPC, -2.0%; 95% CI, -3.6% to -0.4%). The Watch group antibiotics were the most used AWaRe category, with the Access-to-Watch ratio decreasing significantly from 46.4% to 24.4% (AAPC, -6.8%; 95% CI, -8.4% to -5.1%). No significant difference was found in the trend of total antibiotic use between secondary and tertiary hospitals, but there were disparities across hospital levels in subgroups. Third-generation cephalosporins, second-generation cephalosporins, and fluoroquinolones remained the top three antibiotic class throughout the study period. The number of antibiotics accounting for 90% of the total antibiotic use decreased from 34 antibiotics in 2012 to 18 antibiotics in 2022.</p><p><strong>Conclusions: </strong>The decreasing trend of inpatient antibiotic use in Xinjiang's public hospitals reflects the effects of continuous AMS implementation. Patterns of antibiotic use underscore the need for further efforts on evidence-based antibiotic selection and for analyses on the appropriateness of antibiotic use.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094204","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
Guided Plasma Application in Dentistry-An Alternative to Antibiotic Therapy. 引导等离子体在牙科中的应用--抗生素疗法的替代疗法。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-05 DOI: 10.3390/antibiotics13080735
Tara Gross, Loic Alain Ledernez, Laurent Birrer, Michael Eckhard Bergmann, Markus Jörg Altenburger

Cold atmospheric plasma (CAP) is a promising alternative to antibiotics and chemical substances in dentistry that can reduce the risk of unwanted side effects and bacterial resistance. AmbiJet is a device that can ignite and deliver plasma directly to the site of action for maximum effectiveness. The aim of the study was to investigate its antimicrobial efficacy and the possible development of bacterial resistance. The antimicrobial effect of the plasma was tested under aerobic and anaerobic conditions on bacteria (five aerobic, three anaerobic (Gram +/-)) that are relevant in dentistry. The application times varied from 1 to 7 min. Possible bacterial resistance was evaluated by repeated plasma applications (10 times in 50 days). A possible increase in temperature was measured. Plasma effectively killed 106 seeded aerobic and anaerobic bacteria after an application time of 1 min per 10 mm2. Neither the development of resistance nor an increase in temperature above 40 °C was observed, so patient discomfort can be ruled out. The plasma treatment proved to be effective under anaerobic conditions, so the influence of ROS can be questioned. Our results show that AmbiJet efficiently eliminates pathogenic oral bacteria. Therefore, it can be advocated for clinical therapeutic use.

在牙科治疗中,冷等离子体(CAP)是抗生素和化学物质的一种很有前途的替代品,可以减少不必要的副作用和细菌耐药性的风险。AmbiJet 是一种可以点燃等离子体并将其直接输送到作用部位以发挥最大功效的设备。这项研究的目的是调查其抗菌效果和细菌耐药性的可能发展。在有氧和厌氧条件下,对牙科相关细菌(五种需氧菌、三种厌氧菌(革兰氏+/-))进行了等离子体抗菌效果测试。使用时间从 1 分钟到 7 分钟不等。通过反复使用等离子体(50 天内使用 10 次),对细菌可能产生的抗药性进行了评估。还测量了温度可能升高的情况。每 10 平方毫米施用等离子体 1 分钟后,可有效杀死 106 个需氧和厌氧细菌。既没有观察到耐药性的产生,也没有观察到温度升高超过 40 °C,因此可以排除病人不适的可能性。在厌氧条件下,等离子体治疗被证明是有效的,因此可以质疑 ROS 的影响。我们的研究结果表明,AmbiJet 能有效清除口腔致病细菌。因此,可以将其用于临床治疗。
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引用次数: 0
Randomized, Double-Blind, Placebo-Controlled Study of Anti-Mycobacterial Therapy (RHB-104) in Active Crohn's Disease. 抗霉菌疗法(RHB-104)治疗活动性克罗恩病的随机、双盲、安慰剂对照研究。
IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-07-25 DOI: 10.3390/antibiotics13080694
David Y Graham, Saleh A Naser, Thomas Borody, Zbigniew Hebzda, Harry Sarles, Scott Levenson, Robert Hardi, Tomasz Arłukowicz, Petar Svorcan, Reza Fathi, Aida Bibliowicz, Patricia Anderson, Patrick McLean, Clara Fehrmann, M Scott Harris, Shuhong Zhao, Ira N Kalfus

This study, conducted between 4 October 2013, and 30 November 2018, tested the hypothesis that triple antimicrobial therapy, targeting Mycobacterium avium subspecies paratuberculosis (MAP), long considered a putative cause, would favorably affect Crohn's disease. A double-blind multicenter study of adults with active Crohn's disease, (i.e., Crohn's Disease Activity Index [CDAI] 220-450 plus C-reactive protein ≥ 1.0 mg/dL, fecal calprotectin (FCP) >162.9 µg/g stool, or recent endoscopic or radiographic confirmation of active disease) receiving concomitant standard-of-care Crohn's disease treatment (Clinicaltrials.gov: NCT01951326) were stratified by anti-tumor necrosis factor use and randomized (1:1) to anti-MAP RHB-104 (clarithromycin 95 mg, rifabutin 45 mg, and clofazimine 10 mg per capsule) (n = 166), resulting in clarithromycin 950 mg/day, rifabutin 450 mg/day, and clofazimine 100 mg/day, or placebo (n = 165) for up to 52 weeks. A greater proportion of RHB-104 versus placebo-treated patients met the primary endpoint-remission (i.e., CDAI < 150)-at week 26 (36.7% [61/166] vs. 22.4% [37/165], respectively; 95% CI for difference: 4.6, 24.0, p = 0.0048; chi-square test). Clinical response (reduction of CDAI by ≥100 points from baseline) at week 26 (first secondary endpoint) was also higher among the patients treated with RHB-104 (73/166 [44.0%]) compared with placebo (50/165 [30.3%]; 95% CI for difference: 3.4, 24.0, p = 0.0116), and it remained higher at week 52 among the patients treated with RHB-104 (59/166 [35.5%] vs. (35/165 [21.2%] for placebo; 95% CI for difference: 4.7, 23.9, p = 0.0042). A statistically significantly greater decline in FCP (another prospective efficacy endpoint) was also observed in RHB-104-treated patients, compared with placebo, at weeks 12, 26, and 52. The rates of serious adverse events were similar between groups (RHB-104: 18.7%; placebo: 18.8%). No patient died during the study. Antimicrobial therapy directed against MAP resulted in significantly greater improvement in clinical and laboratory (FCP) measures of active Crohn's disease.

这项研究在 2013 年 10 月 4 日至 2018 年 11 月 30 日期间进行,检验了针对长期以来被认为是假定病因的副结核分枝杆菌(MAP)的三联抗菌疗法会对克罗恩病产生有利影响的假设。一项针对患有活动性克罗恩病(即:克罗恩病指数)的成人的双盲多中心研究发现,MAP 对克罗恩病的治疗效果很好、克罗恩病活动指数[CDAI] 220-450 加 C 反应蛋白≥ 1.0 mg/dL,粪便钙蛋白 (FCP) >162.9 µg/g 大便,或最近经内窥镜或放射学检查确认为活动性疾病),同时接受克罗恩病标准治疗(Clinicaltrials.gov:NCT01951326)的患者按使用抗肿瘤坏死因子的情况进行分层,并随机(1:1)使用抗 MAP RHB-104(克拉霉素 95 毫克、利福布汀 45 毫克、氯法齐明 10 毫克/粒)(n = 166),结果克拉霉素 950 毫克/天、利福布汀 450 毫克/天、氯法齐明 100 毫克/天,或安慰剂(n = 165),疗程长达 52 周。与安慰剂相比,RHB-104治疗的患者在第26周达到主要终点-缓解(即CDAI<150)的比例更高(分别为36.7% [61/166] vs. 22.4% [37/165]; 95% CI for difference:4.6,24.0,P = 0.0048;卡方检验)。与安慰剂(50/165 [30.3%];95% CI 差异:3.4,24.0,p = 0.0116),并且在第 52 周时,接受 RHB-104 治疗的患者的血压仍较高(59/166 [35.5%] vs. (安慰剂为 35/165 [21.2%];95% CI 差异:4.7,23.9,p = 0.0042)。与安慰剂相比,在第12、26和52周,RHB-104治疗患者的FCP(另一个前瞻性疗效终点)下降幅度也有统计学意义上的明显增加。两组患者的严重不良事件发生率相似(RHB-104:18.7%;安慰剂:18.8%)。研究期间没有患者死亡。针对 MAP 的抗菌疗法明显改善了活动性克罗恩病的临床和实验室(FCP)指标。
{"title":"Randomized, Double-Blind, Placebo-Controlled Study of Anti-Mycobacterial Therapy (RHB-104) in Active Crohn's Disease.","authors":"David Y Graham, Saleh A Naser, Thomas Borody, Zbigniew Hebzda, Harry Sarles, Scott Levenson, Robert Hardi, Tomasz Arłukowicz, Petar Svorcan, Reza Fathi, Aida Bibliowicz, Patricia Anderson, Patrick McLean, Clara Fehrmann, M Scott Harris, Shuhong Zhao, Ira N Kalfus","doi":"10.3390/antibiotics13080694","DOIUrl":"https://doi.org/10.3390/antibiotics13080694","url":null,"abstract":"<p><p>This study, conducted between 4 October 2013, and 30 November 2018, tested the hypothesis that triple antimicrobial therapy, targeting <i>Mycobacterium avium</i> subspecies <i>paratuberculosis</i> (MAP), long considered a putative cause, would favorably affect Crohn's disease. A double-blind multicenter study of adults with active Crohn's disease, (i.e., Crohn's Disease Activity Index [CDAI] 220-450 plus C-reactive protein ≥ 1.0 mg/dL, fecal calprotectin (FCP) >162.9 µg/g stool, or recent endoscopic or radiographic confirmation of active disease) receiving concomitant standard-of-care Crohn's disease treatment (Clinicaltrials.gov: NCT01951326) were stratified by anti-tumor necrosis factor use and randomized (1:1) to anti-MAP RHB-104 (clarithromycin 95 mg, rifabutin 45 mg, and clofazimine 10 mg per capsule) (n = 166), resulting in clarithromycin 950 mg/day, rifabutin 450 mg/day, and clofazimine 100 mg/day, or placebo (n = 165) for up to 52 weeks. A greater proportion of RHB-104 versus placebo-treated patients met the primary endpoint-remission (i.e., CDAI < 150)-at week 26 (36.7% [61/166] vs. 22.4% [37/165], respectively; 95% CI for difference: 4.6, 24.0, <i>p</i> = 0.0048; chi-square test). Clinical response (reduction of CDAI by ≥100 points from baseline) at week 26 (first secondary endpoint) was also higher among the patients treated with RHB-104 (73/166 [44.0%]) compared with placebo (50/165 [30.3%]; 95% CI for difference: 3.4, 24.0, <i>p</i> = 0.0116), and it remained higher at week 52 among the patients treated with RHB-104 (59/166 [35.5%] vs. (35/165 [21.2%] for placebo; 95% CI for difference: 4.7, 23.9, <i>p</i> = 0.0042). A statistically significantly greater decline in FCP (another prospective efficacy endpoint) was also observed in RHB-104-treated patients, compared with placebo, at weeks 12, 26, and 52. The rates of serious adverse events were similar between groups (RHB-104: 18.7%; placebo: 18.8%). No patient died during the study. Antimicrobial therapy directed against MAP resulted in significantly greater improvement in clinical and laboratory (FCP) measures of active Crohn's disease.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094210","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
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