Frontiers in antibiotics最新文献

The worldwide increasing frequency and severity of multidrug-resistant gastrointestinal (MDR-GI) infections not only raises awareness of the debilities of conventional antibiotic treatments but also highlights the demand for alternative interventions. One of these alternatives is probiotics, harmless bacteria that compete with pathogenic species, which have been considered beneficial due to their therapeutic potential since they strengthen the mucosal barrier and modulate the host immune response. Other natural compounds (e.g., polyphenols, flavonoids, and essential oils) present diverse antimicrobial mechanisms, which are promising alternatives to mitigate resistant pathogens. Finally, bacteriophages, viruses that target specific bacteria, constitute a precise approach in which MDR bacteria are lysed or disrupted by the biofilms formed during colonization without compromising the normal gut microbiome. Therefore, the present manuscript provides an integrated perspective on alternative non-antibiotic therapies to manage MDR-GI infections; for this purpose, it covers aspects such as their action mechanisms, current clinical applications, and the challenges that limit their broader application in clinical practice. The potential of combining these approaches or personalizing infection treatments adjusted to patients' microbiome profiles is also discussed, aiming to enhance efficacy and reduce resistance risks. Finally, the importance of continued research and development to optimize these alternatives is also debated, addressing aspects such as the need to surpass regulatory barriers and conducting large-scale clinical trials to establish the safety and efficacy of these non-antibiotic alternatives. This overview of the current knowledge contributes to the ongoing efforts to develop sustainable strategies to combat MDR-GI infections and reduce the global burden of antibiotic resistance.

In the evolving and interdisciplinary landscape of health and disease research, data transparency and reproducibility are increasingly recognised as essential for maintaining scientific integrity and trust. This article invites early-career researchers (ECRs) to engage critically with these principles while navigating the pressures of academic progression, publication demands, and career development. It examines the challenges ECRs face in maintaining reproducible practices and underscores the need for institutional support, inclusive training, and mentorship across all stages of the research career. Drawing on global initiatives and case studies, the article advocates for a more collaborative, diverse, and mentally healthy research culture. It also highlights alternative career pathways beyond academia, empowering ECRs to explore opportunities in industry, government, and non-governmental organisations. By integrating transparency with values such as team science, responsible metrics, and researcher wellbeing, this article reflects the ethos of the new generation of scientists and offers a timely call for systemic change and collective action to strengthen the future of research culture.

Introduction: Indiscriminate use of veterinary antibiotics significantly contributes to the current antibiotic resistance in the world. The primary objective of this study was to explore the factors that could influence knowledge, attitudes and practices of antibiotic use in commercial layer farms.

Methods: A cross-sectional study was conducted to evaluate antibiotic use patterns and their associated factors among layer chicken farmers in Tanzania. The study surveyed 205 farmers randomly selected from three regions: Unguja, Morogoro, and Dar es Salaam. Data were analysed using descriptive statistics, while negative binomial and multiple linear regression models were employed to identify factors influencing antibiotic usage patterns.

Results: A widespread use of antibiotics was revealed, with 97.1% of farmers using antibiotics for treatment, prophylaxis and/or increasing egg productivity. The most commonly used antibiotics were oxytetracycline (63%), doxycline-tylosin combination (29.8%) and enrofloxacin (22.4%). Notably, 95.6% of farmers reported that they do not observe withdrawal periods. Assessment of farmers' knowledge, attitudes, and practices yielded mean scores of 55.5%, 69.1% and 50.9% respectively. Furthermore, older adults and individuals with primary education were more likely to have higher attitude scores. Geographic location and flock size are among other factors that are likely to influence knowledge and attitudes towards antibiotic use. Higher frequency of antibiotic use was significantly associated with young adults, medium-scale farm operators, and farmers in Morogoro region (compared to the other two regions).

Conclusion: The frequency, knowledge, attitude and practices related to the use of antibiotics were affected by scale of production, location, age, and education. These findings provide insights into antibiotic stewardship among layer farmers that could suggest future multifaceted interventions to promote prudent use of antibiotics, hence mitigating risk of antibiotic resistance.

Introduction: Antimicrobial resistance (AMR) poses a significant threat to global public health. The One Health approach, which integrates human, animal, and environmental health, highlights the roles of agricultural and hospital settings in the propagation of AMR. This study aimed to analyze the resistome and gut microbiome composition of individuals from a high-intensity animal husbandry area in the western region of Santa Catarina, Southern Brazil, who were subsequently admitted to the University Hospital in the city of Florianopolis, located in the eastern part of the same state.

Methods: Rectal swab samples were collected upon admission and discharge. Metagenomic sequencing and resistome analysis were employed to identify antimicrobial resistance genes (ARGs) and their associated bacterial taxa. Additionally, the impact of the hospital environment on the resistome and microbiome profiles of these patients was assessed.

Results: A total of 247 genetic elements related to AMR were identified, with 66.4% of these elements present in both admission and discharge samples. Aminoglycoside resistance genes were the most prevalent, followed by resistance genes for tetracyclines and lincosamides. Notably, unique resistance genes, including dfrF and mutations in gyrB, were identified at discharge. ARGs were associated with 55 bacterial species, with Lactobacillus fermentum, harboring the ermB gene. (MLSB), detected in both admission and discharge samples. The most prevalent bacterial families included Mycobacteriaceae, Enterobacteriaceae, and Bacteroidaceae. Among these, Mycobacteriaceae was the most abundant, with ARGs primarily associated with mutations in the 16S rRNA gene, RNA polymerase subunits, and gyrases.

Discussion: The study revealed a high prevalence of genes related to aminoglycoside and tetracycline resistance, with a notable increase in certain resistance determinants at discharge, likely influenced by extended antimicrobial use. The presence of mcr genes, associated with colistin resistance, in both admission and discharge samples from a single patient highlights a concerning trend in AMR, particularly in relation to animal husbandry. These findings underscore the substantial impact of antimicrobial use on resistance development and the complex dynamics of the resistome in hospital settings. They also emphasize the influence of local factors, such as intensive animal production, on resistance patterns and advocate for ongoing surveillance and policy development to manage multidrug-resistant bacteria eVectively.

Because of the global spread of multi- and pan-resistant bacteria, there is a need to identify, research, and develop new strategies to combat these pathogens. In a previous proof-of-concept study, we presented an innovative strategy by genetically modifying lytic T7 bacteriophages. We integrated DNA fragments encoding for derivatives of the antimicrobial peptide (AMP) apidaecin into the phage genome to induce the production and release of apidaecin within the T7 infection cycle, thereby also targeting phage-resistant Escherichia coli bacteria. In this follow-up study, we optimized the apidaecin encoding insert to improve the expression of the apidaecin derivative Api805 by adding the secretion signal peptide of the OmpA protein. This prevented the detrimental effects of the peptide on the producing bacterial cell after its production. The integration of two copies of the OmpA-Api805 insert into the phage genome resulted in T7Select-2xOmpA-Api805 phages, which had a partially improved activity in inhibiting phage-resistant E. coli compared to the T7Select phages without insert and with only one copy of the OmpA-Api805 insert. Additionally, we showed that the combinatorial use of the lytic bacteriophage T7Select with the highly active and lytic AMPs CRAMP (cathelicidin-related AMP) and melittin against E. coli made the lysis process of the phage and the peptides more effective and prevented the growth of potentially AMP- and phage-resistant E. coli strains. The integration of DNA sequences derived from CRAMP and melittin into the phage genome resulted in the created T7Select-(M)CRAMP and T7Select-(M)melittin phages, which showed a lysis behavior like the phage without insert and partially inhibited the growth of potentially phage-resistant E. coli strains after the phage-mediated lysis.

Background: Patients' adherence to antibiotic treatment and related prevention of AMR is significant. Understanding healthcare professionals' strategies for advising and educating patients in primary care settings is crucial.

Aim: From the perspectives of professionals and patients, to explore how physicians, pharmacists, and nurses educate patients about antibiotic use and antimicrobial resistance in primary care settings.

Methods: A qualitative systematic literature review was conducted in MEDLINE, EMBASE, CINAHL Complete, Eric, SocINDEX, PsycInfo, Web of Science and Scopus. The study included 102 publications, followed PRISMA recommendations and was registered in PROSPERO (reg.no. CRD4202455761). The studies were screened and selected based on specific inclusion and exclusion criteria using Covidence. Quality appraisal followed the Critical Appraisal Skills Program (CASP) qualitative study checklist. Data were extracted, and the analysis consisted of a descriptive numerical summary analysis and a qualitative thematic analysis.

Results: The analyzed studies spanned multiple countries and settings and included perspectives of primary care physicians, pharmacists, nurses and patients. Two main themes emerged: (1) Relationships between professionals and patients influenced educational strategies, showing that trust and rapport between healthcare professionals and patients played a crucial role in shaping educational strategies around antibiotic use; (2) The organizational structures challenged professionals in guiding and educating patients, highlighting how limited resources, time constraints, and system-level pressures hindered healthcare professionals' ability to provide consistent and effective education. Often, structural challenges led to not educating the patients on the risks of antibiotic misuse and antimicrobial resistance. The use of delayed prescriptions emerged as a strategy for improved AMR stewardship and to meet patients' expectations for antibiotic treatment, though it raised concerns about undermining professional responsibility and authority in ensuring appropriate antibiotic use.

Conclusion: Healthcare professionals' role in educating patients about antibiotic use and AMR in primary care settings was complex, with different challenges faced by nurses, pharmacists and primary care physicians. These challenges extended beyond the clinical level, including relational, social and structural factors. Power dynamics, trust issues, and time pressures often hindered effective education on antibiotic use. Addressing gaps in education on antibiotic use and AMR requires acknowledging these multifaceted challenges, with future efforts focusing on better supporting healthcare professionals in this context.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD4202455761.

Introduction: The intensification of tilapia production has increased animal density in tanks, leading to more frequent exposure to pathogenic agents and compromising the quality of fish products. Antimicrobial resistance is a global concern that affects human treatment, and sentinel microorganisms like Escherichia coli are crucial for monitoring production chains, especially in aquaculture, where research is still limited. The aim of this study was to identify the presence of E. coli and investigate its antimicrobial resistance profiles throughout the entire tilapia production chain.

Methods: A total of 240 samples were collected from various points in the production process: carcasses before scaling (Ca), scaling wastewater (Sw), filleting wastewater (Fw), fillet washing wastewater (Tw), fillet handling surfaces (Su), and pre-packaged fillets (Pf). The samples were collected during 10 visits, each corresponding to animals from different farms. E. coli isolates were identified using MacConkey agar and biochemical tests. Phenotypic resistance profiles were determined using nine classes of antimicrobials. Extended- spectrum b-lactamase (ESBL) production was identified with ceftazidime and cefotaxime and confirmed by a double-disc synergy test. Isolates were classified as sensitive or resistant based on the inhibition zone. Multidrug-resistant (MDR) was defined as resistance to at least one agent in three or more antimicrobial categories, while extensively drug-resistant (XDR) was defined as resistance to at least one agent in all but two or fewer categories.

Results: Overall, 50.8% of the samples (122/240) tested positive for E. coli, with 403 isolates identified. Of these, 33% (133/403) were resistant to at least two antimicrobials, and 20% (48/240) of the samples had MDR isolates, with the highest frequency found at the filleting point (Fw), which also had the only XDR profile. Resistance was most commonly observed against amoxicillin (35.73%), tetracycline (30.77%), and ciprofloxacin (26.30%).

Discussion: These findings emphasize the importance of E. coli as an indicator of antimicrobial resistance throughout tilapia processing and highlight the need for good production practices and qualified technical support to mitigate risks to public health, animal health, and the environment.

Correct use of antibiotics is paramount to present global health. Among other actions, antimicrobial stewardship emphasizes de-escalation and suspension whenever possible. Nonetheless, roadblocks can be encountered (e.g., lack of culture results or availability of specific antibiotic classes). Furthermore, in an ever-increasing interconnected world, global success relies on local success. In this perspective, a particular case study in a resource-limited setting is an example of the many difficulties encountered in the fight against antimicrobial resistance that could hamper global advancements.

Salmonella is a foodborne pathogenic bacterium that causes salmonellosis worldwide. Also, Salmonella is considered a serious problem for food safety and public health. Several antimicrobial classes including aminoglycosides, tetracyclines, phenols, and β-Lactams are used to treat Salmonella infections. Antibiotics have been prescribed for decades to treat infections caused by bacteria in human and animal healthcare. However, intensive use of antibiotics resulted in antibiotic resistance (AR) among several foodborne bacteria including Salmonella. Furthermore, multi-drug resistance (MDR) of Salmonella has increased dramatically. In addition to MDR Salmonella, extensively drug resistant (XDR) as well as pan drug resistant (PDR) Salmonella were reported globally. Therefore, increasing AR is becoming a serious universal public health crisis. Salmonella developed many mechanisms to ensure its survival against antimicrobials. The most prominent defense mechanisms against these antibiotics include enzymatic inactivation, expelling drugs from the cell through efflux pumps, altering the structure of drugs, and changing or protecting the targets of drugs. Additionally, the formation of biofilms and plasmid-mediated AR by Salmonella, enhancing its resistance to various antibiotics, making it a challenging pathogen in both healthcare and food industry settings. This review focuses exclusively on providing a detailed overview of the mechanisms of AR in Salmonella.