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Health Policy Analysis on the Containment of Antimicrobial Resistance (AMR) in India: A Mixed Methods Study of Antimicrobial Stewardship as a Pivotal Intervention in Tackling AMR 印度遏制抗菌药物耐药性 (AMR) 的卫生政策分析:将抗菌药物管理作为应对抗菌药物耐药性的关键干预措施的混合方法研究
Q4 Medicine Pub Date : 2024-01-29 DOI: 10.2174/0122113525273938231221110816
Chetan Singh, Julia Lohmann, Anita Pandey, Lubhan Singh
This policy report aimed at two goals, that is, to report the findings of the literature review and explore the perceptions of the key stakeholders in seeking better insight into the antimicrobial stewardship program (AMSP), and to develop antimicrobial resistance (AMR) policy recommendations for the Ministry of Health and Family Welfare (MoHFW), India, based on the findings from the rapid systematic review of the literature (both published and grey) and the views of key stakeholders.A mixed method approach using literature review and qualitative interviews has been applied. A rapid systematic literature review focusing on the antimicrobial stewardship pro-gram’s key achievements and its implementation and impact, implementation challenges, gaps and barriers, and opportunities, has been carried out, which has been followed by conducting interviews of key stakeholders and reporting the findings along with the recommendations.The findings have shown significant progress towards AMSP, such as expanding to 90 secondary-level hospitals and district-level hospitals/nursing homes, and the Indian Council of Medical Research antimicrobial resistance surveillance and research network (ICMR AMRSN) program. Education, training, and microbiological testing have been found to be the current focus areas. However, there exist challenges, including a lack of leadership support, diagnostic stew-ardship, and staffing of clinical pharmacists and infectious control nurses. Key gaps and barriers identified include setting up microbiology laboratories and hiring ICN nurses and clinical phar-macists. Opportunities have also been identified. Based on these findings, we have made succinct recommendations to address the themes and issues identified.Without new medicines, India will struggle to manage antimicrobial resistance. This situation calls for national oversight. This study has demonstrated AMSP as crucial for fighting this silent pandemic. The Indian government and policymakers must swiftly address critical chal-lenges, gaps, and opportunities. These findings and recommendations might potentially strengthen the future antimicrobial resistance national action plan (AMR NAP).
本政策报告有两个目标,即报告文献综述的结果和探讨主要利益相关者的看法,以更好地了解抗菌药物管理计划(AMSP),并根据快速系统性文献综述(包括已发表和灰色文献)的结果和主要利益相关者的看法,为印度卫生和家庭福利部(MoHFW)制定抗菌药物耐药性(AMR)政策建议。研究采用了文献综述和定性访谈的混合方法。快速系统性文献综述侧重于抗菌药物管理计划的主要成就及其实施和影响、实施挑战、差距和障碍以及机遇,随后对主要利益相关者进行了访谈,并报告了研究结果和建议。研究结果表明,抗菌药物管理计划取得了重大进展,如扩展到 90 家二级医院和地区级医院/疗养院,以及印度医学研究理事会抗菌药物耐药性监测和研究网络(ICMR AMRSN)计划。教育、培训和微生物检测被认为是当前的重点领域。但也存在一些挑战,包括缺乏领导支持、诊断管理以及临床药剂师和感染控制护士的人员配备。已发现的主要差距和障碍包括建立微生物实验室以及聘用 ICN 护士和临床药剂师。同时也发现了机遇。基于这些发现,我们提出了简明扼要的建议,以解决已确定的主题和问题。这种情况要求国家进行监督。这项研究表明,AMSP 对于抗击这种无声的流行病至关重要。印度政府和决策者必须迅速应对重大挑战、差距和机遇。这些发现和建议有可能加强未来的抗菌药物耐药性国家行动计划(AMR NAP)。
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引用次数: 0
Antimicrobial and Antifungal Effects of Essential Oils from Origanum vulgare, Lavandula officinalis, and Syzygium aromaticum on Bacterial Strainsthrough Gaseous Contact 牛至、薰衣草和芳香茜草精油通过气体接触对细菌菌株的抗菌和抗真菌作用
Q4 Medicine Pub Date : 2024-01-29 DOI: 10.2174/0122113525283890240108162525
Nabila Ainseba, Nabila Loukili, Amina Soulimane, Samia Bellifa, M. A. Dib, A. Muselli
Hospital-acquired infections, also known as nosocomial infections, affectthousands of patients worldwide. In Algeria, these infections raise significant concerns and giverise to numerous questions due to hygiene deficits and non-compliance with preventive measures.The main objective of this study was to investigate the antibacterial and antifungalproperties of Origanum vulgare, Lavandula officinalis, and Syzygium aromaticum, as well as theircombinations, to discover new antibacterial and antifungal agents to combat nosocomial infectionsrelated to hospital and medical care environments.Essential oils were obtained by a Clevenger-type apparatus and analyzedusing GC and GC/MS. The antimicrobial and antifungal activity was tested against several bacteriaresponsible for nosocomial infections in in-vitro tests using the gas contact method in sealed containers.The essential oil extracted from S. aromaticum buds was primarily composed of eugenol(59.4%), E-β-caryophyllene (16.5%), and eugenyl acetate (10.5%). The analysis of the chemicalcomposition of L. officinalis essential oil identified 1,8-cineole (22.8%), β-pinene (12.4%), andlinalool (8.5%) as the main compounds. As for O. vulgare essential oil, its major components werecarvacrol (72.6%) and thymol (10.5%). The results revealed that the essential oils of L. officinalis,O. vulgare and S. aromaticum, as well as their combinations, used at a concentration of 1/10, hada remarkable effect on the E. coli, P. aeruginosa and K. pneumoniae strains. In contrast, they hada limited effect on the Gram-positive strain, S. aureus. The antifungal effectiveness of the essentialoil of O. vulgare, as well as the combination of O. vulgare and S. aromaticum, has been remarkableagainst the C. albicans species, leading to a complete inhibition of yeast growthOur results indicate that our essential oils have a broad spectrum of antimicrobialactivity, which makes them particularly useful as disinfectants in health facilities and could beused as a valuable medicine to control nosocomial infections and avoid infections acquired duringa stay in a health facility such as respiratory tract infections and urinary tract infections.
医院获得性感染,又称院内感染,影响着全世界成千上万的病人。在阿尔及利亚,由于卫生条件差和不遵守预防措施,这些感染引起了人们的极大关注,并引发了许多问题。这项研究的主要目的是调查牛至、薰衣草和芳香茜草的抗菌和抗真菌特性,以及它们的组合,以发现新的抗菌和抗真菌剂,防治与医院和医疗环境相关的院内感染。在体外试验中,在密封容器中采用气体接触法对几种造成医院内感染的细菌进行了抗菌和抗真菌活性测试。从芳香草花蕾中提取的精油主要由丁香酚(59.4%)、E-β-石竹烯(16.5%)和乙酸丁香酯(10.5%)组成。对欧芹精油化学成分的分析表明,1,8-蒎烯(22.8%)、β-蒎烯(12.4%)和芳樟醇(8.5%)是主要的化合物。至于 O. vulgare 精油,其主要成分是香芹酚(72.6%)和百里酚(10.5%)。研究结果表明,当使用浓度为 1/10 的 L. officinalis、O. vulgare 和 S. aromaticum 精油以及它们的复方精油时,对大肠杆菌、铜绿假单胞菌和肺炎双球菌菌株有显著的抑制作用。相比之下,它们对革兰氏阳性菌株金黄色葡萄球菌的作用有限。硫黄精油以及硫黄和芳香草的复方精油对白癣菌的抗真菌效果显著,可完全清除白癣菌。我们的研究结果表明,我们的精油具有广谱的抗菌活性,这使得它们在医疗机构中作为消毒剂特别有用,并可作为一种有价值的药物来控制院内感染,避免在医疗机构逗留期间感染,如呼吸道感染和泌尿道感染。
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引用次数: 0
Cavity Disinfection with Natural Agents and their Efficacy: A Review on Recent Literature 天然制剂的龋齿消毒及其功效:最新文献综述
Q4 Medicine Pub Date : 2024-01-25 DOI: 10.2174/0122113525285948231215115207
Sreejeeta Dey, S. Deshmukh
The success of a dental restoration can be altered by the amount of residual bacteria present under the cavity which over time cause deterioration of adhesive cement by microleakage or secondary caries. Cavity disinfectant application on the cavity walls performs a cleansing ac-tion to decrease the bacterial load and improve the longevity of restorations. Although a wide variety of such chemical disinfectants have been in use, their cytotoxic effects have led to the increasing popularity of natural agents. These materials possess antimicrobial, antioxidant and anti-inflammatory properties, which effectively disinfect cavity walls while, at the same time, being cheaper, less toxic, and more patient-friendly.Some of these agents have also been proven to improve the bond strength of resin to dentin by preventing collagen degradation and MMP inhibition. Propolis, aloe vera, chitosan, green tea, liquorice etc., are derived from parts of plants or animals and have been tested to be efficacious and, in some cases, superior to chemical alternatives without any erosive effect on dentin.Although there is a lack of enough in-vivo evidence to advocate the use of these products as an adjunct in dental therapy, recent studies have yielded promising results, which increases the scope for future clinical research. This review aims to highlight the properties and effectiveness of a few of such natural agents as potential cavity disinfectants.
龋洞下残留的细菌数量会改变牙齿修复的成功率,随着时间的推移,微渗漏或二次龋坏会导致粘接剂变质。在龋洞壁上涂抹龋洞消毒剂可以起到清洁作用,减少细菌负荷,延长修复体的寿命。虽然这类化学消毒剂种类繁多,但由于其细胞毒性作用,天然制剂越来越受欢迎。这些材料具有抗菌、抗氧化和消炎的特性,可以有效地消毒龋洞壁,同时成本更低、毒性更小、对患者更友好。其中一些制剂还被证明可以通过防止胶原降解和抑制 MMP 来提高树脂与牙本质的粘结强度。蜂胶、芦荟、壳聚糖、绿茶、甘草等提取自植物或动物的部分,经测试具有良好的疗效,在某些情况下优于化学替代品,且不会对牙本质产生任何侵蚀作用。本综述旨在强调几种此类天然制剂作为潜在龋齿消毒剂的特性和有效性。
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引用次数: 0
Prevalence and Antibiogram of Escherichia coli Isolated from Children Under Five Years of Age Presented with Acute Diarrhoea: Cross Sectional Study from a Tertiary Care Centre in South India 从五岁以下急性腹泻儿童中分离出的大肠埃希菌的流行率和抗生素图谱:印度南部一家三级医疗中心的横断面研究
Q4 Medicine Pub Date : 2024-01-25 DOI: 10.2174/0122113525274118231203153143
Santhosh J. Thattil, Thekkuttuparambil A. Ajith
The study aimed to analyze the prevalence and antibiogram of E. coli isolated from stool sample cultures collected from children below five years of age who were presented with acute diarrhoea in a tertiary care centre.Multidrug-resistant strains of diarrheagenic E. coliremain a major public health concern for greater morbidity and mortality. Antibiotic resistance and susceptibility patterns of E. coli were found to vary with geographical location.To determine the prevalence and antibiogram of E. coli isolated from cultures of diarrhoea stool samples collected from children below five years of age from laboratory records.A cross-sectional study was designed to analyze the report on stool culture of children (aged below five years) presented with acute diarrhea during the period between 2017 and 2020. The prevalence of E. coli and its antibiogram were analyzed. The data were subjected to statis-tical analysis.A total of 245 diarrhoea stool samples results were analyzed. E. coli was confirmed in 176 samples (72%). More number of isolates (51/176, 28.9%) were found in children below one year of age with male dominance. Amoxicillin resistance was found in all the E. coli strains isolated with no significant difference (p=0.2233) between genders and age groups below and above one year. A significant difference (p=0.0001) was found between male and female chil-dren of age below and above one year for cefotaxime and ciprofloxacin resistance. Polymyxin B (72%) followed by imipenem (69%) sensitivity was exhibited by the isolated E. coli strains.E. coli isolates were more sensitive to polymyxin B and imipenem while they were most resistant to amoxicillin. Effective antibiotic treatment strategies should be developed to control E. coli infections in children.
该研究旨在分析从一家三级护理中心收集的五岁以下急性腹泻儿童粪便样本培养物中分离出的大肠杆菌的流行率和抗生素分布图。为了确定从实验室记录中收集的五岁以下儿童腹泻粪便样本培养物中分离出的大肠杆菌的流行率和抗生素图谱,我们设计了一项横断面研究,分析2017年至2020年间急性腹泻儿童(五岁以下)的粪便培养报告。研究分析了大肠杆菌的流行率及其抗生素图谱。共分析了 245 份腹泻粪便样本结果。共有 245 份腹泻粪便样本结果得到分析,其中 176 份样本(72%)确诊为大肠杆菌。更多分离菌株(51/176,28.9%)在一岁以下儿童中发现,且以男性居多。在所有分离出的大肠杆菌菌株中都发现了阿莫西林耐药性,但一岁以下和一岁以上的性别和年龄组之间无明显差异(p=0.2233)。一岁以下和一岁以上的男女儿童对头孢他啶和环丙沙星的耐药性有明显差异(p=0.0001)。分离出的大肠杆菌菌株对多粘菌素 B(72%)和亚胺培南(69%)的敏感性较高,而对阿莫西林的耐药性最强。应制定有效的抗生素治疗策略来控制儿童的大肠杆菌感染。
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引用次数: 0
Potential of TPC and TFC as Free Radical Scavengers and Microbial Growth Inhibitors in Himalayan Endemic Artemisia sieversiana Ehrhl Ex Willd. (Asteraceae) Plant from Northeastern, Pakistan TPC 和 TFC 作为自由基清除剂和微生物生长抑制剂在巴基斯坦东北部喜马拉雅特有的蒿属植物(菊科)中的应用潜力
Q4 Medicine Pub Date : 2024-01-25 DOI: 10.2174/0122113525281671231220035432
A. Hussain, Hassam Rasheed, Muhammad A. Khan, Syed A.I. Bokhari
In various microorganisms, various defense mechanisms have evolved against the commercially available antimicrobial agents with increased resistance. Natural antimi-crobial agents of plant origin are better alternatives when an infectious disease arises due to resistant microbial strains. Here, we have evaluated the efficacy of total phenolics and total flavonoids with antioxidant and antimicrobial potential of Artemisia sieversiana Ehrhl Ex Willd. plant extracted with methanol, ethyl acetate, ethanol, n-hexane, and chloroform using soxhlet proceduresThe evaluation of TPC was achieved with Folin-Ciocalteu’s reagent method and quanti-tative estimation of TFC was done with the aluminum chloride colorimetric method. The antioxi-dant activities were estimated using FRSA-DPPH and TAC methods. The inhibitory activities of five solvent extracts of A. sieversiana against 2 gram-positive and 2 gram-negative pathogenic bac-terial strains (B. subtilis, P. aerogenosa, S. aureus, and E. coli) were evaluated using the well dif-fusion technique.The highest percentage yields of A. sieversiana extracts were obtained in ethanol (4.8 g, 12.1%) and methanol (4.01 g, 10%), while minimum extract yield was obtained in n-hexane (0.53 g, 1.34%). Both phenolics and flavonoids were higher in ethanol, methanol, and ethyl acetate ex-tracts while minimal in n-hexane extracts. Ethanol extract has shown maximum (69%) DPPH ac-tivity with a lower IC50 value (181 μg/ml), while the highest IC50 values of 330 and 325μg/ml were recorded for n-hexane and ethyl acetate extracts. The ethyl acetate and chloroform extracts dis-played overall highest TAC values. All the tested extracts of A. sieversiana exhibited variable in-hibitory effects in a dose-dependent manner against the tested bacterial strains with minimum 9.08 ± 0.23 to maximum 21.23 ± 7.04 mm inhibition zones. Methanol and ethyl acetate extracts at 2 to 4 mg/ml showed greater MIC results against P. aeruginosa in comparison to the B. subtilis strain.The extracts of A. sieversiana have been found to be rich in TPC and TFC with re-markable antibacterial and antioxidant efficacies, and the plant extracts could be employed as pos-sible alternatives to synthetic drugs in various nutraceutical and pharmaceutical industries.
各种微生物针对市售抗菌剂进化出了各种防御机制,抗药性不断增强。当抗药性微生物菌株引起传染病时,植物来源的天然抗微生物剂是更好的替代品。在这里,我们用索氏提取法评估了用甲醇、乙酸乙酯、乙醇、正己烷和氯仿提取的蒿属植物总酚类和总黄酮的抗氧化和抗菌潜力。抗氧化剂活性采用 FRSA-DPPH 和 TAC 法进行评估。采用井扩散技术评估了 A. sieversiana 的五种溶剂提取物对 2 种革兰氏阳性和 2 种革兰氏阴性病原菌菌株(枯草杆菌、绿脓杆菌、金黄色葡萄球菌和大肠杆菌)的抑制活性。在乙醇(4.8 克,12.1%)和甲醇(4.01 克,10%)中,A. sieversiana 提取物的得率最高,而在正己烷(0.53 克,1.34%)中,提取物得率最低。乙醇、甲醇和乙酸乙酯提取物中的酚类和类黄酮含量较高,而正己烷提取物中的酚类和类黄酮含量最低。乙醇提取物的 DPPH 活性最高(69%),IC50 值较低(181 μg/ml),而正己烷和乙酸乙酯提取物的 IC50 值最高,分别为 330 和 325 μg/ml。乙酸乙酯和氯仿提取物的 TAC 值最高。所有测试的 A. sieversiana 提取物都以剂量依赖的方式对测试的细菌菌株表现出不同的抑制作用,抑制区最小为 9.08 ± 0.23 mm,最大为 21.23 ± 7.04 mm。研究发现,A. sieversiana 的提取物富含 TPC 和 TFC,具有显著的抗菌和抗氧化功效。
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引用次数: 0
Effect of Toll-like Receptor-3 Antagonist on Viral Asthma Exacerbations Via a TLR3/dsRNA Complex Pathway 通过 TLR3/dsRNA 复合物途径,Toll 样受体-3 拮抗剂对病毒性哮喘恶化的影响
Q4 Medicine Pub Date : 2024-01-19 DOI: 10.2174/0122113525282849231228125935
Swamita Arora, Mohit Agrawal, K. Sahu, Sanjar Alam, Wasim Akram, Mohammad Khalid, Shivendra Kumar, S. Saha, Kuldeep Singh, Hema Chaudhary
The Toll-like receptor-3 (TLR3) ligand Poly(I:C) has been shown to induce a viral aggravation of severe asthma by identifying double-stranded RNA (dsRNA). This study aimed to evaluate the therapeutic role of the TLR3/dsRNA complex inhibitor-calbiochem compound in the treatment of Poly(I:C)-induced viral asthma exacerbations through the ovalbu-min-induced asthma model in Swiss albino mice.Poly(I:C) and Ovalbumin drugs were injected in mice to sensitize (i.p. on 0, 7, and 14th day) and challenge (i.n. on the 21st and 22nd days). In contrast, the treatment drug TLR3/dsRNA complex inhibitor-calbiochem was given on the 21st and 22nd days intraperitoneally within the study period. In-vivo measurements were carried out in BALF and serum for pro-inflammatory cytokines, inflammatory leukocyte counts, lactate dehydrogenase (LDH) and nitrite levels, lungs/body weight index, and lung tissue histopathology using H and E staining in mice airways.High levels of cytokines (NF-κB, IL-1β, IL-5, RANTES, MIP-2, and MCP-1) are seen in groups exposed to OVA and Poly (I:C). Further, inflammatory leukocyte cell counts, lung-body weight (LW/BW) index, airway hyperresponsiveness (AHR), and lung tissue damage sug-gest exacerbations in mice airways. On the other hand, TLR3/dsRNA complex inhibitor-calbio-chem and dexamethasone significantly reversed these changes toward normal levels.These results suggest that the novel compound TLR3/dsRNA complex inhibitor-calbiochem has a better therapeutic role than dexamethasone for managing inflammatory char-acteristics in asthmatic mice lungs and is a potent target for viral asthma exacerbations
已证明Toll样受体-3(TLR3)配体Poly(I:C)可通过识别双链RNA(dsRNA)诱导病毒性重症哮喘加重。本研究旨在通过卵清蛋白诱导的瑞士白化小鼠哮喘模型,评估TLR3/dsRNA复合物抑制剂-生化化合物在治疗Poly(I:C)诱导的病毒性哮喘加重中的治疗作用。Poly(I:C)和卵清蛋白药物分别在小鼠体内注射致敏(第0、7和14天静注)和挑战(第21和22天静注)。而治疗药物 TLR3/dsRNA 复合物抑制剂-calbiochem 则在研究期间的第 21 和 22 天腹腔注射。对小鼠气道中的促炎细胞因子、炎性白细胞计数、乳酸脱氢酶(LDH)和亚硝酸盐水平、肺/体重指数以及肺组织病理学(使用 H 和 E 染色)进行了活体测量,结果显示,暴露于 OVA 和保利(I:C)组的细胞因子(NF-κB、IL-1β、IL-5、RANTES、MIP-2 和 MCP-1)水平较高。此外,炎性白细胞计数、肺-体重(LW/BW)指数、气道高反应性(AHR)和肺组织损伤表明小鼠气道恶化。这些结果表明,与地塞米松相比,新型化合物 TLR3/dsRNA 复合物抑制剂albiochem 在控制哮喘小鼠肺部炎症特征方面具有更好的治疗作用,是治疗病毒性哮喘恶化的有效靶点。
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引用次数: 0
Development of Phytoconstituents from Spathodea campanulata Flowers as Potential Antimalarial Agents 开发从石蒜花(Spathodea campanulata)中提取的植物成分,作为潜在的抗疟药物
Q4 Medicine Pub Date : 2024-01-19 DOI: 10.2174/0122113525275435231205111538
Abin V. Geevarghese, Maida Engels S.E., Ida Christi V. E., Poovarasan K. P., Sarulatha Sarulatha M. S., Thirumal P.
Considering the majority of pharmaceutical firms focus on using herbalremedies as an alternative source of essential components, herbal remedies are extremely significantto pharmacological researchers. Spathodea campanulata is one of the members of the Bignoniaceaefamily. It is popular for its curative propertiesThis research aimed to assess the possibility of bioactive elements and antioxidant impacts ofthe methanol fraction of Spathodea campanulata flowers.The objective of this research was to assess the achievable bioactive elements and antioxidant impacts of the methanol fraction of Spathodea campanulata flowers.GC-MS was adopted to identify the phytoconstituents present in the extract. In the presentstudy, we utilized computational modelling with the Schrödinger Maestro 11.2 edition to make benefit of interactions among 42 bio-active components and anti-malarial targets (1LDG and 2ANL).In the methanol extract of the Spathodea campanulata flowers, phytochemical research revealed the presence of terpenoids, glycosides, carbohydrates, steroids, and flavonoids. Forty-twophytoconstituents, notably methyl-beta-d-galactopyranoside, 4-hydroxybenzoic acid, and 1,2-ethanediol monobenzoate, were determined through GC-MS analysis. Docking analysis of 42 bioactive compounds demonstrated that 1,2-ethanediol mono benzoate, 4-hydroxy benzoic acid, and methyl.beta.-d-galactopyranoside had higher G-Scores with 1LDG and 2ANL.In this work, multiple phytoconstituents discovered in a methanol extract of the S. campanulata flower were determined. As a result of this research, four phytoconstituents from the flowerextracts may be created as an exciting new therapy for malaria.
考虑到大多数制药公司都专注于使用草药作为基本成分的替代来源,草药对药理学研究人员来说意义重大。Spathodea campanulata 是 Bignoniacea 家族的成员之一。本研究的目的是评估 Spathodea campanulata 花甲醇提取物的生物活性成分和抗氧化作用。在本研究中,我们利用 Schrödinger Maestro 11.2 版进行了计算建模,以了解 42 种生物活性成分与抗疟疾靶标(1LDG 和 2ANL)之间的相互作用。通过气相色谱-质谱分析,确定了 42 种植物成分,特别是甲基-beta-d-吡喃半乳糖苷、4-羟基苯甲酸和 1,2-乙二醇单苯甲酸酯。对 42 种生物活性化合物的 Docking 分析表明,1,2-乙二醇单苯甲酸酯、4-羟基苯甲酸和甲基.beta.-d-吡喃半乳糖苷与 1LDG 和 2ANL 的 G 值较高。这项研究的结果是,花提取物中的四种植物成分可能会成为一种令人兴奋的疟疾新疗法。
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引用次数: 0
ANTIMICROBIAL STEWARDSHIP: SMART APPROACH TO COMBAT ANTIBIOTIC RESISTANCE 抗菌管理:对抗抗生素耐药性的明智方法
Q4 Medicine Pub Date : 2024-01-18 DOI: 10.2174/0122113525274628231220062819
Manoj S. Dikkatwar, Sharad Chand, Treesa P. Varghese, Shrishti Shandily, Jeetu Biswas, Supriya Roy, Jitendra Vagashiya, Rakesh Kumar Singh
Antimicrobial resistance (AMR) is a major public health concern worldwide. It raises morbidity and mortality and is connected with substantial/significant economic costs. Effective prevention and treatment of an increasing number of diseases caused by pathogens that can no longer be treated with conventional drugs are threatened by antimicrobial re-sistance. AMS programme helps to encourage the appropriate use of antimicrobials. The rise and spread of antibiotic resistance and strategies to combat it are the main topics of this review. Antimicrobial stewardship programme is a healthcare strategy that optimizes the use of anti-biotics and promotes the appropriate use of antimicrobials through the adoption of evidence-based interventions. AMS programme helps to encourage the right use of antimicrobials. This coordinated approach enhances patient outcomes, reduces microbial resistance, and slows the spread of diseases brought on by multidrug-resistant organisms. The growth of antibiotic re-sistance and the strategies for battling it have been the main topics of this review.
抗菌药耐药性(AMR)是全球关注的一个重大公共卫生问题。它提高了发病率和死亡率,并造成了巨大的经济损失。越来越多的疾病是由病原体引起的,传统药物已无法治疗这些疾病,而抗菌素的耐药性则威胁着这些疾病的有效预防和治疗。AMS 计划有助于鼓励合理使用抗菌药物。抗生素耐药性的增加和蔓延以及应对策略是本综述的主要议题。抗菌药物管理计划是一项医疗保健战略,旨在优化抗生素的使用,并通过采取循证干预措施促进抗菌药物的合理使用。抗菌药物管理计划有助于鼓励正确使用抗菌药物。这种协调的方法可提高患者的治疗效果,减少微生物的耐药性,并减缓耐多药生物带来的疾病传播。抗生素耐药性的增长和应对策略是本综述的主要议题。
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引用次数: 0
Use of Pharmacophore Modeling, 3D-atom-based QSAR, ADMET, Dock-ing, and Molecular Dynamics Studies for the Development of Psoralen-based Derivatives as Antifungal Agents 利用药效学建模、基于三维原子的 QSAR、ADMET、Dock-ing 和分子动力学研究开发作为抗真菌剂的补骨脂素基衍生物
Q4 Medicine Pub Date : 2024-01-17 DOI: 10.2174/0122113525279683231228130206
Kalyani D. Asgaonkar, Shital M. Patil, Trupti S Chitre, Arati Prabhu, Krishna S. Shevate, Ashwini K. Sagar, Akshata P. Naik
The mortality and morbidity rates in patients caused by fungi are ex-tremely high. 3-4 % of species of fungi like Candida and Aspergillus are responsible for >99% of invasive fungal infections.The goal of the current work was to use several In-silico methods, such as Pharmacophore modeling and 3D-QSAR, to design New chemical entities (NCEs) that have antifungal activity.A dataset of 40 Psoralen derivatives was taken from available literature, and then, the pharmacophore hypothesis and 3D-QSAR model development were generated using Schrodinger 2023-1 software. After designing a library of 36 compounds, they were sub-jected to ADMET prediction. Screened compounds from the ADMET study were docked with 14 alpha demethylase CYP51 (PDB ID: 3LD6) using Schrödinger software. Molecular dynam-ics (MD) simulation studies were performed on PDB-3LD6 using Desmond-v7.2.The top-ranked hypothesis, AHRRR_1, was taken into consideration when designing the library of potential NCEs.In order to check the drug likeliness of the com-pounds, all 36 designed NCEs were subjected to ADMET prediction using the QikProp tool. The majority of compounds have a good partition coefficient index (less than five). Qplog HERG value was found to be less, making them safer and less toxic. C- 4, 6, 9, 13, 15, 22, 24, 27, 31, and 33 have shown compliance with Lipinski’s rule with zero violations. Compounds C-9, C-13, C-22, C-24, and C-27 have shown better docking scores than the standard Ketocon-azole. Compounds C-9, 24, and 27 have shown a greater number of hydrophobic and hydrogen bond interactions in comparison with the other compounds. Compounds 9, 24, and 27 showed good stability after 100ns molecular simulation simulations.In the current work, the application of insilico methods such as pharmacophore hypothesis, 3D QSAR, ADMET study, docking, and simulation studies have helped to optimize Psoralen pharmacophore for potential antifungal activity. Therefore, the outcomes of the present study could provide insights into the discovery of new potential alpha demethylase inhibitors with improved selectivity and activity against fungal infections.
由真菌引起的患者死亡率和发病率都非常高。从现有文献中提取了 40 种补骨脂素衍生物的数据集,然后使用 Schrodinger 2023-1 软件生成了药效假设和 3D-QSAR 模型。设计出 36 个化合物库后,对其进行 ADMET 预测。使用薛定谔软件将 ADMET 研究中筛选出的化合物与 14 α 去甲基化酶 CYP51(PDB ID:3LD6)进行对接。在设计潜在 NCEs 库时,考虑了排名第一的假说 AHRRR_1。为了检查化合物的药物相似性,使用 QikProp 工具对所有 36 个设计的 NCEs 进行了 ADMET 预测。大多数化合物具有良好的分配系数指数(小于 5)。Qplog HERG 值较低,因此更安全、毒性更低。C-4、6、9、13、15、22、24、27、31 和 33 符合利平斯基规则,零违规。化合物 C-9、C-13、C-22、C-24 和 C-27 显示出比标准 Ketocon-azole 更好的对接得分。与其他化合物相比,化合物 C-9、24 和 27 显示出更多的疏水和氢键相互作用。在目前的工作中,应用药效假说、三维 QSAR、ADMET 研究、对接和模拟研究等内测方法有助于优化补骨脂素的药效结构,从而提高其潜在的抗真菌活性。因此,本研究的成果可以为发现具有更好选择性和抗真菌感染活性的新α去甲基化酶抑制剂提供启示。
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引用次数: 0
β-lactamase and Plasmid-mediated Quinolone Resistance Determinants Among Proteus spp. Isolates at a Tertiary-care Hospital in Kolkata, India 印度加尔各答一家三级医院中变形杆菌属分离菌株的β-内酰胺酶和质粒介导的喹诺酮耐药性决定因素
Q4 Medicine Pub Date : 2024-01-17 DOI: 10.2174/0122113525279277231223035547
Abhinandan Mallick, Mili Barik, Soma Sarkar, Surojit Das
Emerging antibiotic resistance (ABR) in Proteus spp., especially to third-generation cephalosporins (3GCc), carbapenems, and fluoroquinolones, challenges the treatment outcome and infection prevention. Limited studies pose a knowledge gap between them and ABR.We investigated the in vitro efficacy of therapeutic options and prevalence of β-lac-tamase and plasmid-mediated quinolone resistance (PMQR) traits in 3GC- and/or fluoroquino-lone-nonsusceptible Proteus (P.) spp. (n=27) in Kolkata, India, during 2021–2022. P. mirabilis was commonly isolated (>80%) from superficial and urine samples. The majority of the isolates (48-78%) remained susceptible to piperacillin-tazobactam, meropenem, amikacin, cefoperazone-sulbactam, and cefepime.All isolates showed >0.2 multiple-antibiotic resistance index, with >65% being multi-drug and >30% being extensively drug-resistant. blaTEM (n=9), blaNDM (n=9), and qnrA (n=6) were commonly noted with the co-production of β-lactamases and PMQR in ten (37%) isolates. More than 50% of the isolates were devoid of the tested acquired genes.The study concludes that superbugs dominate, with limited occurrence of plasmid-borne markers in this geographic location.
变形杆菌中新出现的抗生素耐药性(ABR),尤其是对第三代头孢菌素(3GCc)、碳青霉烯类和氟喹诺酮类药物的耐药性,给治疗效果和感染预防带来了挑战。2021-2022 年间,我们在印度加尔各答调查了治疗方案的体外疗效以及对 3GC 和/或氟喹诺酮类药物不敏感的变形杆菌(P. )属(n=27)的β-lac-amase 和质粒介导的喹诺酮类药物耐药性(PMQR)特征的流行情况。奇异变形杆菌通常(>80%)从表皮和尿液样本中分离出来。大多数分离株(48-78%)对哌拉西林-他唑巴坦、美罗培南、阿米卡星、头孢哌酮-舒巴坦和头孢吡肟仍然敏感。blaTEM(9 个)、blaNDM(9 个)和 qnrA(6 个)是常见的耐药菌,其中 10 个(37%)分离菌同时产生了 β-内酰胺酶和 PMQR。该研究得出结论:在这一地理位置,超级细菌占主导地位,质粒携带的标记出现有限。
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Anti-Infective Agents
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