Antibiotic Era Research Articles

A rare case of tertiary nasal syphilis: an unusual ear, nose, and throat manifestation of a rare disease

Tertiary syphilis is a rare entity in present antibiotic era. Syphilis of the nose is considered to be very rare by all authorities. It is mainly a systemic disease caused by the spirochete Treponema pallidum. The infection acquired may be congenital or acquired. Tertiary syphilis shows most marked manifestations in nose, causing superficial and deep ulcerations, and gumma. Nasal septum, especially the junction of the cartilaginous with the bony septum resulting in perforation is a usual manifestation. In cases where the bony septum is involved, existence of syphilis is unquestionable. The nasal deformity results from destruction of bony framework of nose and shrinking of fibroid tissue, thus, produces the typical saddle nose which is characteristic of syphilis. The treatment line for syphilis has remained relatively unchanged in recent years and continues to vary with stage of infection. However, local treatment consists of clearance of crusts and regular cleansing of the nasal passages by copious alkaline douches. Yellow mercury oxide ointment may be applied locally. The purpose of local treatment is to remove the discharge and crusts, kill spirochetes, promote wound healing and epithelial growth, prevent secondary infection.

The culmination of multidrug-resistant efflux pumps vs. meager antibiotic arsenal era: Urgent need for an improved new generation of EPIs.

Efflux pumps function as an advanced defense system against antimicrobials by reducing the concentration of drugs inside the bacteria and extruding the substances outside. Various extraneous substances, including antimicrobials, toxic heavy metals, dyes, and detergents, have been removed by this protective barrier composed of diverse transporter proteins found in between the cell membrane and the periplasm within the bacterial cell. In this review, multiple efflux pump families have been analytically and widely outlined, and their potential applications have been discussed in detail. Additionally, this review also discusses a variety of biological functions of efflux pumps, including their role in the formation of biofilms, quorum sensing, their survivability, and the virulence in bacteria, and the genes/proteins associated with efflux pumps have also been explored for their potential relevance to antimicrobial resistance and antibiotic residue detection. A final discussion centers around efflux pump inhibitors, particularly those derived from plants.

A Large Lung Abscess in an Electronic Cigarette User: To Drain or Not to Drain

A lung abscess is a walled necrotizing infection involving the lung parenchyma, characterized by a cavitary lesion filled with fluid. It is usually caused by microbial infection with aspiration of oropharyngeal contents being the most common mechanism for primary lung abscesses. Secondary lung abscesses occur in the presence of predisposing lung conditions like bronchial obstruction, vascular or septic emboli or impaired host defenses. Lung abscesses caused by electronic cigarette use have gained relevance in the recent years since the outbreak of EVALI, that is, e-cigarette or vaping product use-associated lung injury, in 2019. First-line therapy involves prompt initiation of antibiotics given their success rate in the treatment of lung abscess in the current potent antibiotic era. Percutaneous aspiration and catheter drainage is considered a second line approach due to concerns for potential complications including catheter blockage necessitating repeat procedures, pneumothorax, hemothorax, hemoptysis, need for surgical intervention, infection of pleural space and bronchopleural fistula. We describe a case of a 21-year-old female with a history of electronic cigarette use presenting with a large left upper lobe lung abscess (14.5 x 8.5 x 13.3 cm) treated successfully with broad-spectrum antibiotics alone resulting in clinical and radiologic improvement.

This Month in Pediatric Urology.

You have accessJournal of UrologyThis Month in Pediatric Urology1 Apr 2023This Month in Pediatric Urology Julian Wan Julian WanJulian Wan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003184AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Naturally occurring substances being adapted to medicinal use is part of the lore of biomedical science. Penicillin was once just a term referring to secretion from the mold, Penicillium notatum. In 1928, Alexander Fleming fortuitously recognized the presence and importance of the bactericidal band around the mold that had contaminated a culture plate of Staphylococcus aureus.1 This finding along with the work being done on sulfonamides ushered in the antibiotic era. In a similar fashion, botulinum toxin found its way into therapeutic use. Botulism is an uncommon but potentially fatal condition resulting typically from the ingestion of botulinum toxin produced by Clostridium botulinum bacteria.2 One of the characteristic symptoms is weakness of the eye muscles with drooping eyelids. Among infants, it creates so-called floppy baby syndrome and led to a recommendation of avoiding feeding honey to infants under age 1 year due to it acting as a reservoir of C botulinum spores. This early clinical presentation in eye muscles and muscle weakness led to interest in using the purified toxin (onabotulinumtoxin A) to treat strabismus.3 Success there led to applications elsewhere including the treatment of dysfunctional bladders and has led to calls for wider use in pediatric urology.4 Franco et al (page 774) in a multi-institutional study report on the long-term safety and tolerance of repeated cystoscopic intradetrusor injections of botulinum toxin in the treatment of children with neurogenic bladder overactivity.5 They found that the injections were well tolerated and there were few serious treatment-related adverse events; notably the development of urinary tract infection was similar to the rate seen prior to injection. These findings confirm what many pediatric urologists have already known when using botulinum toxin in this manner but may serve as an important step in adding it formally to the available treatment options. The data may help garner regulatory approval, thereby broadening acceptance with third-party payers, and allow wider access and use. REFERENCES 1. . New light on the history of penicillin. Med Hist. 1982; 26(1):1-24. Crossref, Medline, Google Scholar 2. . Clostridium botulinum and the clinical laboratorian: a detailed review of botulism, including biological warfare ramifications of botulinum toxin. Arch Pathol Lab Med. 2004; 128(6):653-662. Crossref, Medline, Google Scholar 3. . Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. Ophthalmology. 1980; 87(10):1044-1049. Crossref, Medline, Google Scholar 4. . It is time to liberalize the administration of botulinum toxin in the pediatric urology clinic!. J Urol. 2022; 208(3):534-535. Link, Google Scholar 5. . Long-term safety and tolerability of repeated treatments with onabotulinumtoxinA in children with neurogenic detrusor overactivity. J Urol. 2023; 209(4):774-784. Link, Google Scholar © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue 4April 2023Page: 655-655 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julian Wan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Three Innovations of Next-Generation Antibiotics: Evolvability, Specificity, and Non-Immunogenicity

Antimicrobial resistance is a silent pandemic exacerbated by the uncontrolled use of antibiotics. Since the discovery of penicillin, we have been largely dependent on microbe-derived small molecules to treat bacterial infections. However, the golden era of antibiotics is coming to an end, as the emergence and spread of antimicrobial resistance against these antibacterial compounds are outpacing the discovery and development of new antibiotics. The current antibiotic market suffers from various shortcomings, including the absence of profitability and investment. The most important underlying issue of traditional antibiotics arises from the inherent properties of these small molecules being mostly broad-spectrum and non-programmable. As the scientific knowledge of microbes progresses, the scientific community is starting to explore entirely novel approaches to tackling antimicrobial resistance. One of the most prominent approaches is to develop next-generation antibiotics. In this review, we discuss three innovations of next-generation antibiotics compared to traditional antibiotics as specificity, evolvability, and non-immunogenicity. We present a number of potential antimicrobial agents, including bacteriophage-based therapy, CRISPR-Cas-based antimicrobials, and microbiome-derived antimicrobial agents. These alternative antimicrobial agents possess innovative properties that may overcome the inherent shortcomings of traditional antibiotics, and some of these next-generation antibiotics are not merely far-fetched ideas but are currently in clinical development. We further discuss some related issues and challenges such as infection diagnostics and regulatory frameworks that still need to be addressed to bring these next-generation antibiotics to the antibiotic market as viable products to combat antimicrobial resistance using a diversified set of strategies.

Factors to consider in the safe design of intensive care units - Part 1: historical aspects and ventilation systems.

Evidence linking the role of ventilation systems in transmission of infection to patients in intensive care units has increased in recent years. This research-based commentary set out to identify the historical aspect of intensive care unit design, current problems and some potential solutions with respect to ventilation systems. Databases and open source information was used to obtain data on the historical aspects and current guidance in ICU, and the authors experiences have been used to suggest potential solutions to ventilation problems in ICU. The authors found a number of problems with ventilation in ICU to which there has not been a cohesive response in terms of guidance to support users and designers. The resultant void permits new projects to proceed with suboptimal and designs which place patients and staff at risk. The NHS is now at the start of major new investments in healthcare facilities in England and this together with the end of the antibiotic era mandates new guidance to address these major concerns.

Species Distribution of the Aerobic Bacterial Profile in Pyoderma with Special Reference to Antibiotic Susceptibility Pattern of the Isolates at a Tertiary Care Hospital of West Bengal, India

Introduction: Pyoderma is a common health problem characterised by pyogenic infections of the skin and its appendages. Though easily treatable, the condition is known for its chronicity, recurrence and other complications. Therefore, timely recognition and prompt bacterial diagnosis with antimicrobial sensitivity is imperative for the effective management and treatment of pyoderma. It is a common bacterial skin infection accounting for nearly 25% of patients attending Dermatology Outpatient Department (OPD) in India and other tropical countries. Aim: To determine the incidence of pyoderma in relation to age, sex and socio-economic status, to isolate and identify the common aerobic microbial pathogens associated with pyoderma prevalent in the community and antibiotic susceptibility pattern. Materials and Methods: An institutional based crosssectional observational study was conducted on 148 cases in Department of Microbiology, Rampurhat Government Medical College and Hospital, Burdwan, West Bengal, India, clinical features of suspected pyoderma for a period of 12 months from March 2021 to February 2022. Lesion swabs were collected and isolates were identified; antibiotic susceptibility testing was also performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines using antibiotic discs. Descriptive data was presented as count and percentages. Results: Out of 148 samples collected 144 (97.3%) were culture positive while, rest 04 (2.7%) were culture negative. Overcrowding and low socio-economic group were closely related with pyoderma patients. Primary pyoderma (72.2%) cases were detected more than the secondary (27.8%) cases. Impetigo contagiosa (54%) were detected more among the primary pyoderma patients. High numbers (66.7%) of pyoderma were detected among children (0 to 10 years). The culture positive samples were more in male patients (68.7%) than in female patients (31.3%) and mostly detected from OPD. Out of 144 isolates, 89 (61.8%) were Staphylococcus aureus, 23 (15.9%) isolates were Coagulase Negative Staphylococci (CoNS) and 04 (2.8%) were Streptococcus pyogens. Further 06 (4.2%) isolates of Pseudomonas aeruginosa, 10 (6.9%) isolates of Escherichia coli and 08 (5.5%) isolates of Klebsiella pneumonia were found. Conclusion: The present study results suggest that the era of antibiotics has ushered in an unprecedented predominance of Staphylococcal rather than Streptococcal infections and other gram negative infections for pyoderma cases. Increasing incidence of methicillin, quinolones and amikacin resistance in Staphylococci and other gram negative isolates have limited treatment options. For this, a single infection like pyoderma is challenging in all the healthcare facility.

A comparative study on incidence of surgical site infections in elective abdominal surgeries with and without antibiotic prophylaxis

Background: Surgical site infection (SSI) is one of the most common nosocomial infection encountered in post-operative surgical ward. It has become a significant problem for surgeons and results in increased antibiotic usage, associated costs, and prolonged hospital stay. The antibiotic era revolutionized the treatment of surgical infection, but the wide spread use of antibiotics has frequently resulted in over dependence and emergence of resistant strains. Aims and Objectives: The aim of the study was to determine the incidence of SSI in elective abdominal surgeries with and without antibiotic prophylaxis. Materials and Methods: The materials for this study on clean and clean contaminated surgeries were collected from 200 cases admitted for elective surgeries in department of general, VIMSAR, Burla, who were divided into groups of 100 each; Group A was given prophylactic antibiotic and Group B was not given prophylactic antibiotic. They were followed up for any signs and symptoms of wound infection and if present treated accordingly. Results: Out of 100 patients in Group A, 57 were clean surgeries and 43 were clean contaminated surgeries and none developed SSI. In group B who were not given prophylactic antibiotic, 10 patients developed SSI, four clean surgeries, and six clean contaminated surgeries. The patients in Group B who had more than one risk factor had increased incidence rate for SSI. Conclusion: For clean surgeries and clean contaminated surgeries, prophylactic antibiotic administration is recommended as there is statistical significance. Meticulous surgical techniques and proper patient preparation before surgery helps to reduce the incidence of SSI.

Filamentous temperature sensitive mutant Z: a putative target to combat antibacterial resistance.

In the pre-antibiotic era, common bacterial infections accounted for high mortality and morbidity. Moreover, the discovery of penicillin in 1928 marked the beginning of an antibiotic revolution, and this antibiotic era witnessed the discovery of many novel antibiotics, a golden era. However, the misuse or overuse of these antibiotics, natural resistance that existed even before the antibiotics were discovered, genetic variations in bacteria, natural selection, and acquisition of resistance from one species to another consistently increased the resistance to the existing antibacterial targets. Antibacterial resistance (ABR) is now becoming an ever-increasing concern jeopardizing global health. Henceforth, there is an urgent unmet need to discover novel compounds to combat ABR, which act through untapped pathways/mechanisms. Filamentous Temperature Sensitive mutant Z (FtsZ) is one such unique target, a tubulin homolog involved in developing a cytoskeletal framework for the cytokinetic ring. Additionally, its pivotal role in bacterial cell division and the lack of homologous structural protein in mammals makes it a potential antibacterial target for developing novel molecules. Approximately 2176 X-crystal structures of FtsZ were available, which initiated the research efforts to develop novel antibacterial agents. The literature has reported several natural, semisynthetic, peptides, and synthetic molecules as FtsZ inhibitors. This review provides valuable insights into the basic crystal structure of FtsZ, its inhibitors, and their inhibitory activities. This review also describes the available in vitro detection and quantification methods of FtsZ-drug complexes and the various approaches for determining drugs targeting FtsZ polymerization.

Dietary fiber and animal health: A mini review

This mini review describes dietary fibers, their source and compositions. It explores the importance of fiber in the animal diet, health benefit and how fiber contributes to the production of healthy animals in post antibiotics era. The review also discusses fiber fermentation, role in nutrient digestion, enzyme production and how the gut microbiota responds to a selection of fibers. And the components of fiber that increases microbiota which are commensal to the mucus and epithelium of gut. Lastly, recommendations are made on how dietary fiber could be used to achieve maximum advantages in terms of nutrient utilization, performance, and gut health in both monogastric and ruminant animals.

Antibacterial Activity of Imported Honey against Methicillin Resistant Staphylococcus aureus (MRSA) Isolated from Infected Wounds

The use of traditional and herbal medicine to treat infections has been in practice since the origin of mankind, and it was the only option for treatment before the era of antibiotics. This research work was aimed at evaluating the antibacterial activity of imported honey against methicillin resistant Staphylococcus aureus isolated from different wound infections.152Samples from different wounds were obtained from patients with infected wounds attending Murtala Muhammad Specialist Hospital and Muhammadu Abdullahi Wase Specialist Hospital, Kano. The isolates were identified and confirmed using biochemical tests. The antibacterial activity of the honey and minimum inhibitory concentration (MIC) against the isolates were determined using agar well diffusion and two-fold dilution method respectively. The results to detect MRSA revealed its incidence as 24.9%. The result of the antibacterial activity of honey revealed activity at all the concentrations with the diameter of zones of inhibition ranging from 8-34mm.The two imported honey used in the study showed varied bacteriostatic activities, and none of the isolates was resistant to the tested honeys. Therefore, the antibacterial activity of honey even at lower strength justify their efficacy in the treatment of wound infection.

The role of clinical models in understanding the etiology of pneumonia

The etiology of pneumonia has changed since the beginning of the antibiotic era. Clinical and etiological classifications and protocols recommend immediate empiric antibiotic treatment after diagnosing. However, recommendations for antibiotic treatment, on the one hand, and clinical misunderstanding of the etiology, on the other, gave rise to this review, reflecting the significance of clinical radiological and laboratory epidemiological models in detecting the etiology of pneumonia. We conducted a systematic review of domestic and English-language literature on the etiology of pneumonia. We reviewed articles on the etiology of various forms of pneumonia. We have studied many cases as well as the works that are cited and found as a result of the search.

652. Ceftazidime-avibactam Alone or as Combination Therapy? Multicenter Retrospective Cohort Analysis of Clinical Outcomes in Patients with Carbapenem-resistant Gram-negative Infection

Abstract Background Ceftazidime-avibactam (caz-avi), a novel β-lactam/β-lactamase inhibitor, is commonly utilized for carbapenem-resistant gram-negative infections (CR-GNI). However, the benefits vs risks of combining caz-avi with other agents are unclear. Methods In this retrospective cohort study, inpatients with CR-GNI treated with caz-avi were identified at 9 U.S. hospitals. The impact of caz-avi monotherapy (MT) or combination therapy (CT; i.e., any concomitant use of gram-negative-active antibiotics) was studied using logistic regression, controlling for baseline patient and hospital factors. The primary outcome was in-hospital mortality or discharge to hospice (death), and secondary outcomes were length of stay (LOS), resolution of infectious signs and symptoms (clinical response), 90-day recurrent infection and future caz-avi–resistant organism. An adjusted odds ratio (aOR) with 95% confidence interval (CI) was used to assess the primary and secondary outcomes. Results 328/499 (65.7%) patients received caz-avi as targeted therapy for a CR-GNI. Overall patients treated with MT and CT were similar at baseline and had comparable baseline demographics although patients treated with CT were more likely to be in the ICU and receive a concomitant empiric in vitro-concordant antibiotic (table 1). The most common organism was Klebsiella spp. (44.6%) followed by Pseudomonas aeruginosa (27.7%) (table 2). Concomitant gram-negative agents are shown in table 3. Overall, 92 (28.1%) patients died and CT (vs MT) displayed similar adjusted mortality risk (27.7% vs 28.7%; aOR [95%CI]: 0.67 [0.34-1.33]) and LOS (19 [9, 37] and 20 [9, 42.5] days). CT (vs MT) was associated with greater odds of clinical response (aOR: 2.25 [95%CI:1.15-4.41]). Among survivors, similar rates of 90-day recurrent infection (50/154 (32.5%) were observed in CT vs 18/82 (22.0%) in MT group (p=0.09) and 5 (2.19%) patients had future infection with a caz-avi–resistant pathogen (3 in CT and 2 in MT group). Conclusion Compared to patients with CR-GNI treated with caz-avi alone, those who received CT including caz-avy had similar survival and LOS but higher clinical response. The role of CT in the era of novel antibiotics warrants additional study. Disclosures Helen W. Boucher, MD, American Society of Microbiology: Honoraria|Elsevier: Honoraria|Sanford Guide: Honoraria.

Case Report: Ludwig's angina - 'The Dangerous Space'

Background: Ludwig's angina is a potentially life-threatening disease characterized by diffuse bilateral cellulitis with an odontogenic origin. This unique infection is now rare owing to the antibiotic era. Case: This patient presented to the emergency room with trismus, jaw and neck swelling, mild respiratory distress with tachypnea, hyperthermia, and panic. Clinical examination and radiographic evaluation confirmed the diagnosis of Ludwig's angina. As it is a quickly spreading infection, the patient was taken up for immediate surgical decompression leading to pus drainage, removal of the offending tooth, bacterial culture and sensitivity, and administration of empirical antibiotics. As we had operated promptly, there was no need for emergency airway intervention, and the patient had immediate relief from airway distress. Conclusions: Early accurate diagnosis with conservative surgical decompression, thereby negating the need for airway intervention, was vital to avoiding mortality which is always possible in such an expeditious infection.

Host defense against the infection of Klebsiella pneumoniae: New strategy to kill the bacterium in the era of antibiotics?

Klebsiella pneumoniae (K. pneumoniae) is a typical gram-negative iatrogenic bacterium that often causes bacteremia, pneumonia and urinary tract infection particularly among those with low immunity. Although antibiotics is the cornerstone of anti-infections, the clinical efficacy of β-lactamase and carbapenems drugs has been weakened due to the emergence of drug-resistant K. pneumoniae. Recent studies have demonstrated that host defense plays a critical role in killing K. pneumoniae. Here, we summarize our current understanding of host immunity mechanisms against K. pneumoniae, including mechanical barrier, innate immune cells, cellular immunity and humoral immunity, providing a theoretical basis and the new strategy for the clinical treatment of K. pneumoniae through improving host immunity.

Naringenin and Its Derivatives-Health-Promoting Phytobiotic against Resistant Bacteria and Fungi in Humans.

Naringenin is a trihydroxyflavanone present in large amount in different citrus fruits, e.g., oranges, pomelos, grapefruits, but also in tomatoes, fenugreek and coffee. It has a wide range of pharmacological and biological effects beneficial to human health. Its antioxidant, anti-cancer, anti-inflammatory, antifungal and antimicrobial activity is frequently reported in scientific literature. In this review we presented the current state of knowledge on the antimicrobial activity of naringenin and its natural and synthetic derivatives as a phytobiotic against resistant Gram-positive and Gram-negative bacteria as well as fungi in humans. Most of the data reported here have been obtained from in vitro or in vivo studies. Over the past few years, due to the overuse of antibiotics, the occurrence of bacteria resistant to all available antibiotics has been growing. Therefore, the main focus here is on antibiotic resistant strains, which are a significant, worldwide problem in the treatment of infectious diseases. The situation is so alarming that the WHO has listed microbial resistance to drugs on the list of the 10 most important health problems facing humanity. In addition, based on scientific reports from recent years, we described the potential molecular mechanism of action of these bioflavonoids against pathogenic strains of microorganisms. As plant-derived substances have been pushed out of use with the beginning of the antibiotic era, we hope that this review will contribute to their return as alternative methods of preventing and treating infections in the epoch of drug resistance.

Breaking down the cell wall: Still an attractive antibacterial strategy.

Since the advent of penicillin, humans have known about and explored the phenomenon of bacterial inhibition via antibiotics. However, with changes in the global environment and the abuse of antibiotics, resistance mechanisms have been selected in bacteria, presenting huge threats and challenges to the global medical and health system. Thus, the study and development of new antimicrobials is of unprecedented urgency and difficulty. Bacteria surround themselves with a cell wall to maintain cell rigidity and protect against environmental insults. Humans have taken advantage of antibiotics to target the bacterial cell wall, yielding some of the most widely used antibiotics to date. The cell wall is essential for bacterial growth and virulence but is absent from humans, remaining a high-priority target for antibiotic screening throughout the antibiotic era. Here, we review the extensively studied targets, i.e., MurA, MurB, MurC, MurD, MurE, MurF, Alr, Ddl, MurI, MurG, lipid A, and BamA in the cell wall, starting from the very beginning to the latest developments to elucidate antimicrobial screening. Furthermore, recent advances, including MraY and MsbA in peptidoglycan and lipopolysaccharide, and tagO, LtaS, LspA, Lgt, Lnt, Tol-Pal, MntC, and OspA in teichoic acid and lipoprotein, have also been profoundly discussed. The review further highlights that the application of new methods such as macromolecular labeling, compound libraries construction, and structure-based drug design will inspire researchers to screen ideal antibiotics.

Medicinal Chemistry of Inhibitors Targeting Resistant Bacteria.

The discovery of antibiotics was a revolutionary feat that provided countless health benefits. The identification of penicillin by Alexander Fleming initiated the era of antibiotics, represented by constant discoveries that enabled effective treatments for the different classes of diseases caused by bacteria. However, the indiscriminate use of these drugs allowed the emergence of resistance mechanisms of these microorganisms against the available drugs. In addition, the constant discoveries in the 20th century generated a shortage of new molecules, worrying health agencies and professionals about the appearance of multidrug-resistant strains against available drugs. In this context, the advances of recent years in molecular biology and microbiology have allowed new perspectives in drug design and development, using the findings related to the mechanisms of bacterial resistance to generate new drugs that are not affected by such mechanisms and supply new molecules to be used to treat resistant bacterial infections. Besides, a promising strategy against bacterial resistance is the combination of drugs through adjuvants, providing new expectations in designing new antibiotics and new antimicrobial therapies. Thus, this manuscript will address the main mechanisms of bacterial resistance under the understanding of medicinal chemistry, showing the main active compounds against efflux mechanisms, and also the application of the use of drug delivery systems, and finally, the main potential natural products as adjuvants or with promising activity against resistant strains.

Wars and sweets: microbes, medicines and other moderns in and beyond the(ir) antibiotic era

Once upon a time, many of us moderns dreamt that our future was bright, squeaky clean, germ-free. Now, we increasingly fear that bacterial resistance movements and hordes of viruses are...

To the 80th Anniversary of Gramicidin C Сreation: From the Study of the Asymmetry of Bacterial Molecules to the Discovery of Antimicrobial Peptides

In 1942, G. F. Gause and M. G. Brazhnikova created one of the first antibiotics in the Soviet Union — gramicidin C. In the same year, its successful use started in front-line hospitals in the treatment of complications of wound infections. Thanks to it, the lives of hundreds of thousands of soldiers and officers were saved. Gramicidin C has passed the test of time, and today this antibiotic is effectively used in the treatment of infectious and inflammatory diseases, as well as purulent wounds. In this regard, the 80th anniversary is a good reason to recall the history of the creation of this peptide antibiotic possessing bactericidal action based on the presence of the D-isomer of the amino acid phenylalanine in the producing bacteria. However, the study of ways to overcome the spreading antibiotic resistance in bacteria, as well as the search for alternative antimicrobial strategies are currently on the agenda. For this reason, it is appropriate to recall that the study of the molecular structure of gramicidin C gave impetus not only to the discovery of a whole family of cyclic peptide antibiotics, but also to the discovery of the ability of various organisms to nonribosomal synthesis of biologically active peptides containing D-amino acids with a pronounced antimicrobial effect. Their development is already a vital task today, and the use of peptides is considered a real and promising alternative to traditional antibiotics. Thus, gramicidin C, obtained at the dawn of the era of antibiotics, became a harbinger of the birth of a fundamentally new and promising antimicrobial strategy.