Antimicrobial Resistance In Hospitals Research Articles

Prevalence and antibiogram of bacterial pathogens causing urinary tract infection in a tertiary care hospital

Background: Urinary tract infection (UTI) is one of the most frequently reported bacterial infections in the community coming second to respiratory tract infections. Empirical antibiotic therapy is usually applied in the management of UTIs, which has resulted in rapidly emerging antimicrobial resistance in hospitals and the community. Objective: The objective of this study was to study the prevalence and antibiogram of bacterial pathogens causing UTI in our hospital. Materials and Methods: A cross-sectional retrospective study was done among patients visiting a tertiary care hospital in North India, for February–March 2018. Clean catch midstream urine samples were taken from patients. Urine culture was done using cystine lactose electrolyte deficient agar medium. A modified semi-quantitative technique was employed for culture (standard wire loop method). Single species count of more than 100000 organisms per ml of urine was considered as significant. Identification of the organism was done on the basis of colony morphology, motility testing, and biochemical tests using standard microbiological methods. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: Of the total 3172 samples - 341 (10.75%) were culture positive. Of these 341 culture-positive samples, the most commonly reported organism was Escherichia coli (53.9%), followed by Klebsiella spp. (24.9%). Among the Gram-positive organisms, only Enterococcus spp. was isolated in 10.8% of the total culture-positive samples. The Gramnegative isolates were found to be highly resistant to norfloxacin (nx) (56.3%) followed by cotrimoxazole (54.5%). Among Gram-positive isolates also, highest resistance was reported for nx (83.4%) and resistance to vancomycin was seen in only 5.4% of the cases. Conclusion: The study shows that Gram-negative organisms are the leading cause of UTIs among adult population and periodic monitoring needs to be done to keep their emerging resistance in check.

National disparities in the relationship between antimicrobial resistance and antimicrobial consumption in Europe: an observational study in 29 countries.

Antimicrobial resistance in invasive infections is driven mainly by human antimicrobial consumption. Limited cross-national comparative evidence exists about variation in antimicrobial consumption and effect on resistance. We examined the relationship between national community antimicrobial consumption rates (2013) and national hospital antimicrobial resistance rates (2014) across 29 countries in the European Economic Area (EEA). Consumption rates were obtained from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). Resistance data were obtained from the European Antimicrobial Resistance Surveillance Network (EARS-Net), based on 196480 invasive isolates in 2014. Data availability and consistency were good. Some countries did not report figures for each strain of resistant bacteria. National antimicrobial consumption rates (2013) varied from ≤ 13 DDD (Estonia, the Netherlands and Sweden) to ≥ 30 DDD (France, Greece and Romania) per 1000 inhabitants per day. National antimicrobial resistance rates (hospital isolates, 15 species) also varied from <6.1% (Finland, Iceland and Sweden) to > 37.2% (Bulgaria, Greece, Romania and Slovakia). National antimicrobial consumption rates (2013) showed strong to moderate correlation with national hospital antimicrobial resistance rates (2014) in 19 strains of bacteria (r = 0.84 to r = 0.39). Some countries defied the trend with high consumption and low resistance (France, Belgium and Luxembourg) or low consumption and high resistance (Bulgaria, Hungary and Latvia). We found associations between national community antimicrobial consumption and national hospital antimicrobial resistance across a wide range of bacteria. These associations were not uniform. Different mechanisms may drive resistance in hospital-based invasive infections. Future research on international variations in antimicrobial resistance should consider environmental factors, agricultural use, vaccination policies and prescribing quality.

Identifying hospital antimicrobial resistance targets via robust ranking

ABSTRACTWe develop a robust ranking procedure to uncover trends in variation in antibiotic resistance (AR) rates across hospitals for some antibiotic-bacterium pairs over several years. We illustrate how the method can be used to detect potentially dangerous trends and to direct attention to hospitals’ management practices. A robust method is indicated because some unusual reported resistance rates may be due to measurement protocol differences and not any real difference in AR rates. Our proposed method is less sensitive to outlier observations than other robust methods. The application on real AR data shows how a dangerous trend in a particular AR rate would be detected. Our results indicate the potential benefits of systematic AR rate collection and AR reporting systems across hospitals.

Antimicrobial use and antimicrobial resistance trends in Canada: 2014.

There is a global concern that the emergence of antimicrobial resistance (AMR) threatens our ability to treat infectious diseases. The Canadian Antimicrobial Resistance Surveillance System (CARSS) was created in response to the Government of Canada's commitment to addressing AMR. CARSS integrates information from nine different national surveillance systems for tracking antimicrobial use (AMU) and AMR in both humans and animals to inform AMU/AMR research and policy. To provide highlights of CARSS data on antimicrobial use in humans and animals, AMR trends in human infections in both hospital and community settings and AMR bacteria found in food production animals. Information on AMU in animals and humans is purchased and additional information on AMU in animals is collected through the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). AMR data in humans focuses on first priority organisms. Data on priority organisms for hospital-based AMR is collected through Canadian Nosocomial Infection Surveillance Program (CNISP), Canadian Tuberculosis Laboratory Surveillance System (CTBLSS), Canadian Tuberculosis Laboratory Surveillance System (CTBRS), Canadian Tuberculosis Reporting System (CTBRS) and CIPARS. Data on community-based AMR is collected through CTBLSS, CTBRS, CIPARS, the Antimicrobial-resistant Neisseria gonorrhoeae Surveillance System (ARNGSS) and the National Surveillance of Invasive Streptococcal Disease (NSISD). AMR data on animals is collected through CIPARS. In terms of antibiotic usage in 2014, approximately 82% of antimicrobials were directed to food production animals, 18% to humans and less than one percent each to companion animals (e.g., pets) and crops. Over the past five years, 73% of antimicrobials distributed to food production animals belonged to the same classes as those used in human medicine. Antibiotic usage in humans has remained relatively stable. Trends in 2014 for AMR in hospitals include declining rates of hospital-acquired Clostridium difficile to 3.4 cases per 1,000 patient admissions, methicillin-resistant Staphylococcus aureus (MRSA) infections to 2.89 cases per 10,000 patient days and vancomycin-resistant Enterococci (VRE) to 0.45 cases per 10,000 patient days. Resistance to a number of antimicrobials used to treat Streptococcus pneumoniae has decreased since the introduction of pneumococcal vaccine in 2010. In contrast, trends in 2014 for AMR in the community included increasing rates of community-acquired N. gonorrhoeae - 52.4% of isolates were resistant to at least one antibiotic. Trends for carbapenem-resistant Enterobacteriaceae (CRE) were stable at 0.22 cases per 10,000 patient days. Also, between 2004 and 2014, nine percent of tuberculosis (TB) culture positive cases were resistant to at least one first line anti-tuberculosis drug and this has remained relatively stable over that time. Trends in 2014 for AMR in food production animals showed decreasing resistance of Escherichia coli and Salmonella species to third-generation cephalosporins (ceftriaxone) in poultry associated with a decrease in cephalosporin use on chicken farms, but resistance to ciprofloxacin in Campylobacter species in chicken and cattle has been increasing. Overall, antibiotic use in humans has not declined despite concerns about overuse. Although resistance rates of C. difficile, VRE, MRSA and AMR S. pneumoniae have been gradually decreasing and drug-resistant tuberculosis and CRE have remained stable, community-associated drug-resistant N. gonorrhoeae has been increasing. Although efforts to decrease antibiotic use in animals have been met with some success, AMR continues to occur in fairly high levels in food production animals.

Frequency of isolated antibiotic resistant bacterial strains from nursing staff (Azzahra Hospital, Iran)

Nursing staff have important roles to play in nosocomial infections. Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic; it evolves naturally via natural selection through random mutation, but it could also be engineered. The purpose of this study was to survey the relative frequency of antibiotic resistant strains in isolated bacteria from nursing staff. The present study was performed at one of the tertiary care hospitals in Isfahan, Iran, during a 24 month period (2007 to 2009). Eighty bacterial isolates from nursing staff were studied. Samples were collected with finger print method. Standard microbiological methods were performed for the detection of bacterial species. Bacterial antibiogram pattern according to Clinical and Laboratory Standards Institute (CLSI) 2010, were used by disk diffusion method. The result showed that Staphylococcus spp. 28 (53%), Bacillus spp. 48 (60%) andEnterobacteriaceae 4 (5%) were constituents of the isolated bacteria from nursing staff. According to the antibiogram pattern, 17.5, 59.5, 69.5, 41, 70.5, 50, 78, 97.5 and 64% ofStaphylococcus spp.; 28, 30.5, 59, 65, 65, 77.5, 98, 93.5 and 100% of Bacillus spp. and 25, 73, 6, 75, 65, 50%, 64, 15 and 95% of Enterobacteriaceae were sensitive to Penicillin, Cephotaxime, Clindamycin, Co-trimoxazol, Ampicillin, Erythromycin, Tetracycline, Vancomycin and Gentamicin respectively. The results showed a high frequency of antibiotic resistant strains on nursing staff. Establishing systems for monitoring antimicrobial resistance in hospitals and the community and linking these findings to resistance and disease surveillance data is fundamental to develop treatment guidelines accurately and to assess the effectiveness of interventions appropriately. Key words: Antibiotic resistance, nosocomial infection, nursing staff.

Antibiogram Pattern in Escherichia coli Strains isolated of Community Acquired Urinary Tract Infection in Iranian Girl Children's

Most urinary tract includes (UTIs) in children are monomicrobic, often caused by Escherichia coli. Evidence on risk factors for UTI in children is limited. UTIs were associated with constipation, encopresis, bladder instability, and infrequent voiding in some studies but not in a cohort of febrile children younger than two years. In this study we evaluated antibiogram pattern E. coli isolated from urinary tract infection in Iranian girl children’s.Materials and MethodsThe search was laboratory and performed in DEY laboratory in 2010 year in Isfahan, a total 702 urinary children samples, cultured and study with microbiological methods.Antibiotic susceptibility was performed with antibiotic susceptibility standard disc diffusion agar.ResultsAccording to result of antibiogram test, respectively 40(90.90%), 32(66.66%),16 (38.095%), 34(70.069%),10 (22.72%),18 (37.5%),19 (42.22%), 8(16.32%) and 26 (61.90%) of Escherichia coli strains Isolated was resistant to Nitrofurantoion, Ceftizoxime,Cephalothin,Ciprofloxacin,Tetracycline,Co-Trimoxazole,Nalidixic Acid, Amoxycillin and Gentamicin.DiscussionOral antibiotics are as effective as parenteral therapy in randomized trials.The optimal duration of antibiotic therapy has not been established,but one-day therapies have been shown to be inferior to longer treatment courses. Undiagnosed or untreated UTIs can lead to kidney damage,especially in kids younger than six year. Establish systems for monitoring antimicrobial resistance in hospitals and the community and link these findings to resistance and disease surveillance data is fundamental to developing treatment guidelines accurately and to assessing the effectiveness of interventions appropriately.

English

Hospital surfaces play an important role in nosocomial infection (NI), in that the health-care environment contains a diverse population of microorganisms. Antibiotic resistance is the ability of a micro-organism to withstand the effects of an antibiotic, which is a specific type of drug resistance. Antibiotic resistance evolves naturally from a natural selection through random mutation, but could also be engineered by other selections. The research was performed with laboratory method in Esfahan City and the study as a whole comprised 194 strains obtained from hospital surfaces&rsquo; samples. These strains were randomly selected from different wards of the hospital with sterile swab and NB medium. According to the results,&nbsp;Staphylococcus&nbsp;spp. (54.7%),&nbsp;Bacillus&nbsp;spp. (25%) and Enterobacteriaceae (10.7%) consist of isolated bacteria. The results of this study show high frequency of antibiotic resistant strain on hospital surfaces. Establishing systems for monitoring antimicrobial resistance in hospitals and the community, and linking these findings to resistance and disease surveillance data is fundamental to developing treatment guidelines accurately and to assessing the effectiveness of interventions appropriately. &nbsp; Key words:&nbsp;Antibiotic resistance, nosocomial infection, hospital surfaces.

Status report on carbapenemases: challenges and prospects

Antimicrobial resistance in hospital and community-onset bacterial infections is a significant source of patient morbidity and mortality. In the past decade, we have witnessed the increasing recovery of carbapenem-resistant Gram-negative bacteria. For many isolates, carbapenem resistance is due to the production of carbapenemases, β-lactamases that can inactivate carbapenems and frequently other β-lactam antibiotics. Currently, these enzymes are mainly found in three different β-lactamase classes (class A, B and D). Regardless of the molecular classification, there are few antimicrobials available to treat infections with these organisms and data regarding agents in development are limited to in vitro studies. This article focuses on the epidemiology of carbapenemase-producing Gram-negative bacteria. We also review available agents and those in development with potential activity against this evolving threat.

Prevalence and risk factors for colonisation with extended spectrum β-lactamase producing enterobacteriacae vis-à-vis usage of antimicrobials

Purpose: A point prevalence study was carried out in a teaching hospital in Assam to determine the prevalence, sensitivity profile and risk factors for acquisition of extended spectrum β-lactamase (ESBL) producing enterobacteriacae vis-à-vis amount and pattern of antibiotic use. Materials and Methods: ESBL was detected by double disc synergy method. Defined daily dose and bed-days were calculated. Result: Colonisation rate of ESBL producing enterobacteriacae ranged from 14% (n=73) in medicine to the highest 41% (n=29) in orthopaedic with an intermediate 23% (n=80) in surgery. Presence of ESBL was found to be strongly associated with resistance to specific classes of antimicrobials. Exposure to cefotaxime and gentamicin, and surgery were risk factors for acquiring ESBL producing enterobacteriacae. Non-ESBL producing community isolates were found to be considerably more sensitive to different antibiotics with no resistance detected to trimethoprim, co-trimoxazole, ciprofloxacin and aminoglycosides. Conclusion: The study confirms the role of certain ‘high risk’ antimicrobials in acquisition of ESBL producing Enterobacteriaceae and shows that periodic cohort studies could be an effective strategy in surveillance of antimicrobial resistance in hospitals of resource poor countries to inform antibiotic policy and treatment guidelines.

Antimicrobial resistance in hospitals: How concerned should we be?

The emergence of antibiotic-resistant organisms is a major public health concern, particularly in hospitals and other health care settings.[1][1],[2][2] Antibiotic-resistant organisms appear to be biologically fit and are capable of causing serious, life-threatening infections that are difficult to

Bugs versus drugs: Addressing the pharmacist’s challenge

To address how the high endemic levels of antimicrobial resistance and multidrug resistance in hospitals have challenged clinicians to select appropriate therapy for effectively treating bacterial infections among seriously ill patients. Among gram-positive bacterial infections, differentiating between healthcare-associated and community-associated methicillin-resistant Staphylococcus aureus infections is becoming more difficult and can seriously impact therapeutic strategies and hence outcomes. Furthermore, the rising prevalence of multidrug-resistant gram-negative bacterial infections is increasing the pressure on proper antimicrobial selection given the dearth of new antimicrobial agents under development. Optimized dosing strategies will be instrumental in minimizing emergence of resistance and preserving the utility of currently available agents. Antimicrobial stewardship programs in conjunction with stringent infection control policies will be critical in improving the appropriate use of antimicrobials while reducing the spread of nosocomial pathogens. Addressing the challenges of antimicrobial resistance in hospitals will require a multidisciplinary approach, with clinical pharmacists taking a proactive role in ensuring the appropriate use of antimicrobials.

Development and Validation of Measures to Assess Prevention and Control of AMR in Hospitals

The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

Relationship of Antimicrobial Control Policies and Hospital and Infection Control Characteristics to Antimicrobial Resistance Rates

Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices, and systems-level indicators of implementation of the hand hygiene guideline of the Centers for Disease Control and Prevention. An on-site survey of intensive care unit staff and infection control directors of 33 hospitals in the United States was conducted. The following data were collected: antimicrobial control policies; rates during the previous 12 months of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and ceftazidime-resistant Klebsiella pneumoniae; an implementation score of systems-level efforts to implement the guideline; staff attitudes toward practice guidelines; and observations of staff hand hygiene. Variables associated with resistance rates were examined for independent effects by using logistic regression. Resistance rates for S aureus, enterococci, and K pneumoniae were 52.5%, 18.2%, and 16.0%, respectively. Ten (30.3%) hospitals had an antibiotic control policy. No statistically significant correlation was observed between staff attitudes toward practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046). Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance.

Dutch Guideline for Preventing Nosocomial Transmission of Highly Resistant Microorganisms (HRMO)

Hospitals are faced with the increasingly rapid emergence and dissemination of antimicrobial-resistant microorganisms. US and European guidelines on the prevention of antimicrobial resistance in hospitals were, until recently, mainly directed at methicillin-resistant Staphylococcus aureus (MRSA). In 2004, the Dutch Working Party on Infection Prevention issued a guideline on the prevention of nosocomial transmission of highly resistant microorganisms (HRMO), in order to fulfill the growing need for additional guidance on the control of other pathogens with acquired resistance and the potential to spread within hospitals (such as glycopeptide-resistant Enterococcus faecium, penicillin-resistant Streptococcus pneumoniae, extendedspectrum beta-lactamase producing Enterobacteriaceae, and other (multi)drug-resistant gram-negatives). In addition to providing criteria for defining HRMO, the Dutch guideline provides recommendations on isolation of patients, active surveillance, and contact tracing. The guideline will enable the comparison of HRMO rates between hospitals, and may be used to evaluate the efficacy of programs to control antibiotic use and/or nosocomial transmission of resistant pathogens. The eventual success of nationwide implementation of this guideline remains to be established in the coming years.

Mise en place d'un outil informatisé de surveillance de la résistance bactérienne et de la consommation antibiotique dans un centre hospitalier universitaire

After half a century of antibiotic use, the increasing problem of the emergence and spread of antimicrobial-resistant pathogens has created a problem of public health. The causes of this problem are multifactorial, but the excessive and inappropriate use of antimicrobials is the principal cause. The current guidelines for the control of antimicrobial resistance in hospitals recommend the implementation of a surveillance system of antimicrobial use and antimicrobial resistance data. Aim of the study. – The objective of our project was to develop a computerised tool to survey the antibiotic consumption data and the antimicrobial resistance. Materials et methods. – We have collected antimicrobial resistance data from the software of the bacteriology laboratory, antibiotic use data from the pharmacy and demographical data from the hospital's admission department. These data were integrated in a database server and available with a web application. Antimicrobial resistance data of 15 major microorganisms were extracted and expressed as a frequency with elimination of repeats by using time criteria (7, 14 or 28 days). Antibiotic use data were converted into defined daily doses (DDD) and expressed per 1000 patient-days. Results. – Data are available for consultation in the form of tables or graphs per unit, type of units (medicine, surgery, pediatrics, intensive care units) or in the whole hospital. The system allows the confrontation on the same graph of antimicrobial resistance and antibiotic use data. Conclusion. – Our surveillance system constitutes a needed prerequisite to the implementation of a global strategy of antibiotic use improvement in our hospital.

Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals

To examine the extent to which the strategies recommended by the National Foundation for Infectious Diseases (NFID)-Centers for Disease Control and Prevention (CDC) co-sponsored workshop, Antimicrobial Resistance in Hospitals: Strategies to Improve Antimicrobial Use and Prevent Nosocomial Transmission of Antimicrobial-Resistant Microorganisms, have been implemented and the relationship between the degree of implementation and hospital culture, leadership, and organizational factors. Survey. A representative sample of U.S. hospitals stratified by teaching status, bed size, and geographic region. Infection control professionals. Surveyed hospitals had implemented strategies to optimize the use of antimicrobials and to detect, report, and prevent transmission of antimicrobial-resistant microorganisms. Multivariate analyses found that hospitals with a greater degree of implementation of the NFID-CDC strategic goals were more likely to have management support, education of staff, and interdisciplinary groups specifically to address these issues; they were also more likely to engage in benchmarking on broader quality of care indicators. Most surveyed hospitals had implemented some measures to address the NFID-CDC recommendations; however, hospitals need to do much more to improve antimicrobial use and to increase their efforts to detect, report, and control the spread of antimicrobial resistance. A supportive hospital administration must foster a culture of ongoing support, education, and interdisciplinary work groups focused on this important issue to successfully accomplish these goals.

Ecological theory suggests that antimicrobial cycling will not reduce antimicrobial resistance in hospitals.

Hospital-acquired infections caused by antibiotic-resistant bacteria pose a grave and growing threat to public health. Antimicrobial cycling, in which two or more antibiotic classes are alternated on a time scale of months to years, seems to be a leading candidate in the search for treatment strategies that can slow the evolution and spread of antibiotic resistance in hospitals. We develop a mathematical model of antimicrobial cycling in a hospital setting and use this model to explore the efficacy of cycling programs. We find that cycling is unlikely to reduce either the evolution or the spread of antibiotic resistance. Alternative drug-use strategies such as mixing, in which each treated patient receives one of several drug classes used simultaneously in the hospital, are predicted to be more effective. A simple ecological explanation underlies these results. Heterogeneous antibiotic use slows the spread of resistance. However, at the scale relevant to bacterial populations, mixing imposes greater heterogeneity than does cycling. As a consequence, cycling is unlikely to be effective and may even hinder resistance control. These results may explain the limited success reported thus far from clinical trials of antimicrobial cycling.

Challenges in antimicrobial drug discovery and the potential of nucleoside antibiotics.

Antimicrobial resistance in hospital and community settings is growing at an alarming rate and has been attributed to such organisms as methicillin-resistant staphylococcus aureus, staphylococci with decreased susceptibility to vancomycin, vancomycin-resistant enterococci, multi-drug resistant pseudomonas spp., klebsiella spp., enterobacter spp, and acinetobacter spp., as well as Streptococcus pneumoniae with decreased susceptibility to penicillin and other antibacterials. To address the need for new therapies to combat resistant organisms, drug companies are refocusing their discovery efforts on developing novel agents with new mechanisms of action. The hope is that rapidly emerging technologies including combinatorial chemistry, high throughput screening, proteomics and microbial genomics will have a positive impact on antimicrobial drug discovery. These technologies should aid in the identification of novel drug targets and compounds with unique mechanisms of action other than those currently provided by the traditional antibiotics. Nucleosides are one class of compounds worthy of further investigation as antibacterials since some derivatives have shown moderate to good activity against specific bacterial strains. For example, 5'-peptidyl nucleoside derivatives can inhibit peptide deformylase, an enzyme essential for bacterial survival that is not vital to human cells. This review also includes a list of miscellaneous nucleosides that have been synthesized as potential antibacterials. More detailed investigations on structure, as it relates to the antimicrobial activity of the various classes of nucleosides, need to be conducted in order to maximize the potential of developing a potent nucleoside for the treatment of bacterial infections. This review begins with an introduction to terms followed by discussions regarding the general background and relevance for developing novel antimicrobial agents. Challenges facing the antimicrobial drug discovery process are discussed along with relevant drug targets. An overview of nucleoside chemistry as it relates to antimicrobial activity is presented, followed by a discussion of the evidence which supports the potential of this class of compounds to yield the novel antimicrobial therapies needed in the new millennium.

CDC Campaign Targets Antimicrobial Resistance in Hospitals

CDC Campaign Targets Antimicrobial Resistance in Hospitals

CDC Campaign Targets Antimicrobial Resistance in Hospitals

CDC Campaign Targets Antimicrobial Resistance in Hospitals