Combined Antibacterial Therapy Research Articles

Multi-Lasso Peptide-Based Synergistic Nanocomposite: A High-Stability, Broad-Spectrum Antimicrobial Agent with Potential for Combined Antibacterial Therapy.

Lasso peptides, natural biological microcins composed of small molecules, have demonstrated efficient bactericidal activity. However, a single lasso peptide is characterized by a narrow and targeted bactericidal spectrum. In this study, a chitosan (CN) derivative-based polymer nanomaterial incorporating three lasso peptides (MccY, MccJ25, and Klebsidin) was designed and synthesized to broaden its antimicrobial spectrum. To enhance resistance to acid and alkali conditions, arginine was appended to the terminus of conjugates, resulting in Chitosan-Lasso-Peptides-Arg (CN-LPs-Arg), and the nanomaterial biocompatibility and bactericidal activity were characterized. Chemical stability test results demonstrate that CN-LPs-Arg effectively buffered the acid-base effect of the compound. Notably, CN-LPs-Arg extended the antimicrobial spectrum of Gram-negative and Gram-positive strains including Klebsiella, Salmonella, and Staphylococcus (MIC = 0.01-1.0 μM). CN-LPs-Arg exerts its destructive effects on bacteria via a series of mechanisms; it adheres to and then penetrates the membrane, causes rupture, and leads to bacterial death. Transcriptomic data revealed that CN-LPs-Arg produced a distinct inhibitory effect on ribosomal protein subunits synthesis pathways and membrane metabolic inhibition. Furthermore, CN-LPs-Arg was nontoxic to cells and exhibited excellent biocompatibility. CN-LPs-Arg reduced bacterial burden in organs and the levels of inflammatory factors IL-6, IL-8, and TNF-α in tissues of mice with acute bacterial infections. Furthermore, it promoted the recovery of Klebsiella-infected C57BL/6 mice, demonstrating a favorable therapeutic effect in vivo. The multilasso peptide-based synergistic nanocomposite of CN-LPs-Arg exhibited high stability as a broad-spectrum antimicrobial agent with potential for combined antibacterial therapy and utilization in the fields of food, biomedicine, and public health.

Justification of Intensive care management of children with severe COVID19 (а case study)

the unprecedented COVID-19 pandemic that spread across the world and lasted for more than 3 years had significant medical and social consequences. Despite the fact that in the children's population the coronavirus infection has a milder course and a much lower risk of mortality, there are individual cases with pre-existing comorbidities that cause severe acute respiratory distress syndrome. Thus, in most cases, severe COVID-19 developed in children with pre-existing conditions, including: immunodeficiency, diabetes mellitus, bronchial asthma, etc. Therefore, comorbidities disposed children to progress to severe Covid-19 which requires treatments with more aggressive therapeutic tactics and personalised management. The article presents a clinical case of severe acute respiratory distress syndrome caused by the SARS-CoV-2 virus in an early age child. The patient was observed in the Anesthesiology and Intensive Therapy Department of the Chernivtsi Regional Children's Clinical Hospital. Due to acute respiratory infection, the child has been developing signs of respiratory failure. The available instrumental findings confirmed right lung pneumonia, complicated by pneumothorax. Laboratory tests confirmed leukocytosis, thrombocytopenia, hypertransfusion, increased procalcitonin, increased level of C-reactive protein, D-dimer and interleukin-6 as well as circulating immune complexes. The treatment regimen included respiratory protection (oxygen therapy), support of hemodynamics (infusion of glucose-saline solutions), administration of intravenous normal human immunoglobulin, a short course of parenteral glucocorticosteroids, the use of step-by-step combined antibacterial therapy and a direct-acting antiviral drug (remdesivir), and thromboembolism prophylaxis (low-molecular-weight heparin). Following intensive treatment, the child's condition was characterised by a slow positive dynamics, leading to full recovery. This case demonstrates the need for timely detection of life-threatening conditions caused by COVID-19 and requires an aggressive management of child's condition using a complex intensive therapy.

THE USE OF A POLYVALENT KLEBSIELLA BACTERIOPHAGE IN INFECTION AFTER RECONSTRUCTIVE PLASTIC SURGERY ON THE SPINE IN A CHILD (A CLINICAL CASE)

The incidence of infection after reconstructive plastic surgery on the spine (in particular, spondylodesis) in children remains at a fairly high level and ranges from 0.4% to 8.7%. These complications are often caused by polyresistant bacterial pathogens; this accentuates the need for new effective therapeutic approaches. Bacteriophage preparations in combination with antibiotics can optimize existing strategies for the treatment of infectious diseases, since they are able to selectively destroy bacteria, including biofilm-forming ones. The aim of the study was to draw the attention of practitioners to modern problems of treating polyresistant infections on the example of a case of purulent complication after spinal surgery in a child. Materials and methods. On the basis of the FSBI "Federal Center for Traumatology, Orthopedics and Endoprosthetics" under the Health Ministry of the Russian Federation (the town of Cheboksary) a retrospective analysis of a clinical case of treating early infection after reconstructive plastic surgery on the spine caused by a polyresistant strain of Klebsiella pneumoniae was conducted. Research results. Patient P., 2.2 years old, with congenital pathology of the musculoskeletal system, who repeatedly received medical care in various medical organizations, underwent surgical spine stabilization. In the early postoperative period, an infectious complication developed caused by a polyresistant strain of Klebsiella pneumoniae (a producer of extended-spectrum beta-lactamases and carbapenemases). Along with surgical debridement of the postoperative wound, a combined etiotropic antibacterial therapy was performed (12 weeks). However, complete healing of the postoperative wound was achieved in combination with the administration of a polyvalent klebsiella bacteriophage (10 weeks). Conclusions. This clinical case demonstrates that the use of a polyvalent klebsiella bacteriophage can increase the effectiveness of antibacterial pharmacotherapy in surgical treatment with preservation of metal structures.

A complication during chemotherapy of recurrence of acute lymphoblastic leukemia in a child

Acute lymphoblastic leukemia (ALL) is one of the most common malignant diseases of the hematopoiesis system in childhood, characterized by uncontrolled proliferation of a tumor clone from lymphocyte progenitor cells. At the same time, as a result of total immunosuppression, the most common complications are infectious. The purpose of the work: to describe a clinical case of nosocomial pneumonia, formed against the background of chemotherapy relapse of ALL. Materials and methods. A retrospective analysis of the medical records of patient L., 6 years old, who was being treated at the Department of Pediatric Pulmonology of the UKB No. 1 of the Razumovsky SSMU with the main diagnosis: Nosocomial polysegmental pneumonia with obstructive syndrome, acute course. Complications: 1. RF III art., 2. Pulmonary edema, 3. Exudative pleurisy. Background: ALL III phenotype; late bone marrow relapse, isolated (30.12.2022). Results. At the age of 2 (2019) - he made his ALL debut, received induction courses, and achieved remission within the prescribed consolidation period. In 2022, a reinduction course was conducted, and it was removed from the D-register. Relapse of leukemia (28.12.2022) - hospitalized in the V.Ya. Shustov UCB No. 3, 1 block of anti-relapse therapy of ALL in combination with hemotransfusion, massive antibacterial (AB) therapy was performed. On the 23rd day of hospitalization in the hematology clinic, nosocomial 2-sided polysegmental pneumonia was diagnosed, complicated by pulmonary edema, exudative pleurisy, RF III art. On 23.01.2023, the patient was urgently taken to the children’s Intensive care Unit (DORIT) in extremely serious condition UKB No. 1 named after S.R. Peacemakers SSMU, where over the next 15 bed days he received: erythrocyte suspension transfusion, oxygen therapy, combined AB therapy, GCS, bronchodilator and mucolytic therapy, against which the condition improved: symptoms of intoxication, DN were stopped, the inflammatory process in the lungs was resolved. For further treatment of relapse, ALL was transferred to the hematology clinic. Conclusion: The course of chemotherapy for relapse of ALL in the patient provoked a severe infectious complication - nosocomial pneumonia with DN III art., pulmonary edema, pleurisy. Timely diagnosis of pneumonia and intensive therapy in DORIT conditions contributed to a favorable outcome of the infectious process in the lungs. Taking into account the above, the tactics of ALL management were changed - allogeneic transplantation of hematopoietic stem cells from a haploidentical donor (father) was performed, 19.07.2023 - engraftment was achieved.

Environment-triggered nanoagent with programmed gas release performance for accelerating diabetic infected wound healing

The treatment of diabetic infected wound still faces severe challenges, including drug-resistant bacterial infections, exaggerated inflammatory reactions, and dysangiogenesis. To address these issues, a programmed gas release nanoparticle (PB-SNP@SiO2, PSS NPs) were developed to effectively remove drug-resistant pathogens and remodel the microenvironment of diabetic wounds using NO and H2S, respectively. During hydrothermal synthesis, NO donor (sodium nitroprusside) was doped into Prussian blue (PB) NPs. Then bis[3-(triethoxysilyl)propyl]tetrasulfid as glutathione (GSH)-responsive H2S donor was incorporated into the silica outer layer of the PB NPs for anti-inflammatory and pro-angiogenesis applications. After receiving PSS NPs treatment, the bacteria and even bacterial biofilm could be effectively eliminated by using NO/photothermal combined antibacterial therapy upon irradiated with 808 nm laser. Simultaneously, under the triggering of endogenous GSH, the H2S gas released from PSS NPs could ameliorate the detrimental diabetic wound microenvironment by inhibiting the excessive inflammatory response (e.g., inhibiting the expression of inflammatory factors and promoting the transformation of M1 type into M2 type macrophage) and facilitating revascularization, further expediting wounds healing. Using this gas-programmed release strategies, different therapeutic gases can be release precisely for diabetic treatment, which provides a novel reference for gases combined therapy.

Особливості лікувальної тактики за неонатального сепсису залежно від запальної відповіді організму

Purpose - to conduct a comparative analysis of the effectiveness of etiotropic treatment and supporting therapy of infants with neonatal sepsis with an alternative content of C-reactive protein in the blood serum to improve individualized therapy of generalized infectious and inflammatory diseases in the newborn period. Materials and methods. A comprehensive examination of 56 newborns suffering from neonatal sepsis the 1st, 3rd and 7th days of the disease. The Group I included 25 patients with neonatal sepsis with a serum C-reactive protein level <20 mg/l, and the Group II included 31 newborns with sepsis with a serum C-reactive protein level >20 mg/l. Determination of the content of C-reactive protein in blood serum (mg/l) was carried out by the method of immunoenzymatic analysis on the «StatFax 303 / Plus» device. The obtained results were analyzed by methods of descriptive statistics, biostatistics and clinical epidemiology. Fisher’s exact test (Pφ) and Student’s test were used for statistical processing; the results were significant at p<0.05 with a tendency to significance - at p=0.05-0.1. Results. It was established that in 20.0% of newborns of the Group I and in 11.4% of patients of the Group II (Рφ>0.05), etiotropic treatment was changed due to insufficient effectiveness of the previous two courses. Patients of the Group I had a higher risk of needing to re-review the composition of antibiotic therapy: odds ratio (OR) = 1.9 (95% confidence interval (95% CI): 0.8-4.3), attributive risk (AR) = 16.0%. Practically all patients of the Group I were on oxygen support, the risk of this event was significantly higher for them compared to children of the Group II: OR=2.7 (95% CI: 1.2-6.6). Newborns of the Group II compared to babies of the Group I received inpatient treatment for less time, their chances of being discharged from the hospital before the 20th day were probably higher: OR=5.7 (95% CI: 1.85-17.32). The better effectiveness of the standard treatment of sepsis of newborns in the Group II in terms of the frequency of discharge from the hospital up to 20 days is demonstrated by a decrease in the AR of event realization, which is 15.4%. Conclusions. Patients of the Group I twice as often received the third course of antibiotic therapy. Infants of the Group II more often needed combined antibacterial therapy with a slightly shorter course and also recovered faster with discharge of every fifth baby by the 20th day. Against the background of a relatively higher content of C-reactive protein in blood serum, the standard treatment of newborns is more effective and allows for a 79.3% increase in the relative risk of rapid recovery at the same time, the minimum number of treated patients - 1.3. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. The informed consent of the children's parents was obtained for the conducting the studies. No conflict of interests was declared by the authors.

Near-IR-Regulated Composite Hydrogel with Real-Time Infection Monitoring and a Combined Antibacterial Effect for Efficient Wound Management.

Chronic wounds induced by bacterial infection have seriously affected the health of people in the world. So, it is meaningful to develop a novel strategy with real-time infection monitoring and excellent antibacterial performance for enhancing wound management. Herein, we constructed a composite hydrogel by loading the pH indicator bromothymol blue (BTB) and gold nanocages containing 2,2'-azobis[2-(2-imidazolin-2-yl)propane] dihydrochloride (Au NCs@AIPH) into a polyacrylamide-co-poly(acrylic anhydride-modified oxidized sodium alginate) (PAM-co-PAOSA) hydrogel. In vitro and in vivo experimental results demonstrated that the composite hydrogel could effectively detect bacteria and diagnose the infection status of a wound in real time by showing visible color changes. In addition, the composite hydrogel containing Au NCs@AIPH possessed an excellent photothermal effect under near-IR (NIR) laser irradiation. The photothermal effect further activated AIPH to generate toxic free radicals to form combined antibacterial therapy for accelerating wound healing. Moreover, the composite hydrogel showed great biocompatibility. Therefore, the multifunctional hydrogel provided a novel wound management strategy for bacterial infection diagnosis and combined therapy in an infected wound.

Rapid sterilisation and diabetic cutaneous regeneration using cascade bio-heterojunctions through glucose oxidase-primed therapy.

The cutaneous wound in diabetic patients frequently encounters intractable pathogenic infections due to the hyperglycemia micromilieu which is conducive to bacterial growth and multiplication. Despite the extensive clinical use of antibiotics to treat bacterial infections, the emergence of drug-resistant and super pathogens as well as the potential side effects of antibiotics have elicited alarming challenges to public health. To address this daunting concern, we devise and develop a photo-activated cascade bio-heterojunctions (C-bio-HJs) for rapid sterilization and diabetic cutaneous regeneration. In the designed C-bio-HJs, photo-generated electron-hole pairs of graphite-phase carbon nitride (g-C3N4) are effectively separated with the marriage of molybdenum disulfide (MoS2), which achieves the augmented photodynamic antibacterial effect. Moreover, glucose oxidase (GOx) tethered on the bio-HJs catalyzes glucose into hydrogen peroxide (H2O2) in diabetic wounds for starvation therapy. Furthermore, Mo4+ enables the catalysis of H2O2 into a highly effective hydroxyl radical (·OH) for chemodynamic-photothermal combined antibacterial therapy. Both in vitro and in vivo results authenticate the cascading antibacterial properties and skin regeneration-promoting effects of the C-bio-HJs, which provide a facile strategy to combat diabetic wound healing through the synergistic GOx-primed dynamic therapies.

Synergistic antibacterial effect of multifunctional TiO2−X-based nanoplatform loading arginine and polydopamine for promoting infected wounds healing

The gas therapy of some endogenous signaling molecules to treat diseases has caused extensive research, among which NO gas has shown great potential in fighting infection with various pathogens, promoting wound healing, etc. Here, we propose a photothermal/photodynamic/NO synergistic antibacterial nanoplatform by loading L-arginine (LA) on mesoporous TiO2 and then encapsulating it with polydopamine. The obtained TiO2−x-LA@PDA nanocomposite possesses both the excellent photothermal effect and ROS generation ability of mesoporous TiO2, and the release of nitric oxide (NO) from L-arginine under near-infrared (NIR) light irradiation, while the sealing layer of PDA could induce NIR-triggered NO controlled release. In vitro antibacterial experiments confirmed that the synergistic effect of TiO2−x-LA@PDA nanocomposites has excellent antibacterial effects against Gram-negative and Gram-positive bacteria, while in vivo experiments showed that it has lower toxicity. It is worth noting that compared with the pure photothermal effect and ROS, the generated NO showed a better bactericidal effect, and NO had a better ability to promote wound healing. In conclusion, the developed TiO2−x-LA@PDA nanoplatform can be used as a nanoantibacterial agent, which can be further explored in the related biomedical field of photothermal activation of multimodal combined antibacterial therapy.

Dual-Mechanism Glycolipidpeptide with High Antimicrobial Activity, Immunomodulatory Activity, and Potential Application for Combined Antibacterial Therapy.

Bacterial drug resistance is becoming increasingly serious, and it is urgent to develop effective antibacterial drugs. Antimicrobial peptides (AMPs), as potential candidates against bacteria, have a broad prospect for development. Herein, a series of AMPs with biological characteristics (net positive charge, amphiphilicity, and α-helix), an AXA motif recognized by membrane bound serine protease type I signal peptidases (SPase I), an FLPII motif to reduce hemolysis, and a monosaccharide motif to improve the stability and activity were designed and synthesized, and among which, the glycolipidpeptide GLP6 (glycosylated LP6 lipopeptide) had excellent antibacterial and immunomodulatory activity, good stability and biocompatibility, and excellent biofilm eradication and membrane penetrating activity. The positively charged spherical aggregates formed by self-assembly of GLP6 could encapsulate tetracycline (TC) to form GLP6@TC with a sustained-release effect, which could enhance the sensitivity of bacteria to the antibiotic and realize combined sterilization. The results of acute peritonitis and bacterial keratitis showed that GLP6@TC had a good combined antibacterial effect and the ability to inhibit interleukin-2 (IL-2), which could significantly reduce the inflammatory response while treating bacterial infection, and it had great potential for application. The results of computer molecular docking showed the AXA motif could effectively bind to SPase I, which was consistent with the results of biological experiments. In general, the study could provide a perspective for the design of AMPs and combined antibacterial therapy.

Analysis of combined antibacterial therapy in young children

The aim of the work was to study the rationality and safety of combined antibiotic therapy in young children with bronchopneumonia. Methods: retrospective, descriptive study.

Silver nanoparticle-decorated 2D Co-TCPP MOF nanosheets for synergistic photodynamic and silver ion antibacterial

Two-dimensional (2D) metal organic framework (MOF) nanosheets have been demonstrated to be promising templates for preparing functional 2D composites. Herein, we report the preparation of silver nanoparticle (Ag NP)-decorated 2D porphyrinic MOF nanosheets (denoted as Ag/Co-TCPP NSs) with a high efficiency for combined antibacterial therapy. The as-prepared Ag/Co-TCPP NSs feature both the advantages of Co-TCPP NSs and Ag NPs, which exhibit excellent antibacterial properties against both Gram-positive (S. aureus) and Gram-negative (E. coli) bacteria. Under a 660 nm laser irradiation, Ag/Co-TCPP NSs locally generated singlet oxygen (1O2) and promoted Ag NPs to be partly degraded for sustained release of toxic Ag+, achieving a synergistic sterilization effect. This effective strategy for achieving 2D MOF nanosheets with in situ loaded metal nanoparticles provides a guideline to broaden the diverse applications of MOFs and contributes to the development of new intelligent metal-based antibacterial nanomaterials.

Silver Mesoporous Silica Nanoparticles: Fabrication to Combination Therapies for Cancer and Infection.

The integration of silver nanoparticles (Ag NPs) with mesoporous silica nanoparticles (MSNs) protects the former from aggregation and promotes the controlled release of silver ions, resulting in therapeutic significance on cancer and infection. The unique size, shape, pore structure and silver distribution of silver mesoporous silica nanoparticles (Ag-MSNs) embellish them with the potential to perform combined imaging and therapeutic actions via modulating optical and drug release properties. Here, we comprehensively review the recent progress in the fabrication and application of Ag-MSNs for combination therapies for cancer and infection. We first elaborate on the fabrication of star-shaped structure, core-shell structure, and Janus structure Ag-MSNs. We then highlight Ag-MSNs as a multifunctional nanoplatform to surface-enhanced Raman scattering-based detection, non-photo-based cancer theranostics and photo-based cancer theranostics. In addition, we detail Ag-MSNs for combined antibacterial therapy via drug delivery and phototherapy. Overall, we summarize the challenges and future perspectives of Ag-MSNs that make them promising for diagnosis and therapy of cancer and infection.

White light-induced AIEgen polyurethane films containing Schiff base copper(ii) complexes for synergistic chemo/photodynamic antibacterial therapy

Polyurethane films containing AIEgens and copper complexes can act as a potential antibacterial agent for multi-mode combined antibacterial therapy.

Photothermally activated multifunctional MoS2 bactericidal nanoplatform for combined chemo/photothermal/photodynamic triple-mode therapy of bacterial and biofilm infections

Combined therapy can improve the curative effect and reduce side effect, so it has a broad application prospect in the treatment of bacterial infections especially bacterial biofilm infections. Herein, we propose a photothermal-activated multifunctional nano-antibacterial platform that is constructed by Introducing indocyanine green (ICG) photosensitizers and silver nanoparticles (AgNPs) onto Molybdenum disulfide (MoS2) nanosheets surface. The constructed nanoplatform (MoS2/ICG/Ag) has the combined chemo/photothermal/photodynamic triple-mode antibacterial capability under a single 808 nm laser irradiation. Briefly, the photonic hyperthermia generated by MoS2 nanosheets can not only directly kill bacteria, but also accelerate the release of ICG and silver ions, and the latter is a commonly used chemical antibacterial reagent. The released ICG can catalyze the conversion of oxygen into singlet oxygen with the help of 808 nm light, achieving the photodynamic sterilization. Encouragingly, the loaded ICG and AgNPs can in turn enhance the heat, which is a mutually reinforcing effect that can produce a combined or even synergistic therapeutic effect. In vitro experiments demonstrate that the MoS2/ICG/Ag with triple bactericidal modalities has good broad-spectrum antibacterial performance. Importantly, it can remarkably inhibit the S. aureus biofilms formation and effectively eradicate the bacteria deep in the biofilms. In addition, the MoS2/ICG/Ag is successfully used for treating S. aureus biofilms-infected wound in vivo with minimal toxicity. Taken together, the developed MoS2/ICG/Ag nanoplatform may serve as a potential nano-antibacterial agent for photothermally activated multimodal combined antibacterial and antibiofilm therapy.

Стартовая антибактериальная терапия при внебольничной пневмонии у детей: результаты многоцентрового исследования

Community-acquired pneumonia (CAP) is one of the leading reasons for background prescribing antibacterial therapy (ABT) in pediatric practice. In 2015, the Russian Pediatric Respiratory Society published a guideline on CAP in children. Objective. To assess compliance with the recommendations of starting ABT for CAP of pediatric inpatients in various regions of the Russia. Materials and methods. We reviewed the medical records of pediatric patients with CAP who were hospitalized in 2017–2018. The study was in 6 regions of the Russia. A total of 793 cases of CAP were studied in children aged 1 month to 16 years. We analyzed data from patients, such as demographic indicators, severity of the disease, the presence and nature of complications, and starting ABT. Results. The patient’s age ranged from 1 month to 16 years (average – 4.33 years). The amount of cases of severe CAP was 5.55%, in the remaining 94.45% of cases there was a moderate CAP. Complications were present among 3.91% of patients. The overwhelming majority of patients received parenteral ABT (more than 89%). In the majority of cases, third-generation cephalosporins (65.2%) were used as starting therapy. Amoxicillin was prescribed in only 4.04% of patients. The combination therapy was used in 13.27% of cases (beta-lactam with macrolides or aminoglycosides used most often). We found a significant discrepancy between the actual practice of the recommendations: excessive use of parenteral and combined ABT, private prescription of 3rd generation cephalosporins and rare prescription of amoxicillin, the use of aminoglycosides (including as monotherapy). Conclusion. The use of antibiotics for CAP in children in Russia is often incorrect, which can reduce the effectiveness of treatment and contribute to an increase in antimicrobial resistance. Increased education of pediatricians in ABT and the introduction of antibiotic control is required to address this problem. Key words: children, community-acquired pneumonia, antibiotic therapy

Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: a case report

BackgroundListeria monocytogenes (L. monocytogenes) is a facultative intracellular bacterial pathogen which can invade different mammalian cells and reach to the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), the traditional test often reports negative owing to the antibiotic treatment or a low number of bacteria in the cerebrospinal fluid. To date, timely diagnosis and accurate treatment remains a challenge for patients with listeria infections.Case presentationWe present the case of a 66-year-old woman whose clinical manifestations were suspected as tuberculous meningoencephalitis, but the case was finally properly diagnosed as LMM by next-generation sequencing (NGS). The patient was successfully treated using a combined antibacterial therapy, comprising ampicillin and trimethoprim-sulfamethoxazole.ConclusionTo improve the sensitivity of LMM diagnosis, we used NGS for the detection of L. monocytogenes. Hence, the clinical utility of this approach can be very helpful since it provides quickly and trust results.

Photosensitizer doped zeolitic imidazolate framework-8 nanocomposites for combined antibacterial therapy to overcome methicillin-resistant Staphylococcus aureus (MRSA)

Antibiotics have played an important role in the treatment of bacteria related infections. However, the rapid emergence of multidrug-resistant bacteria and limited number of antibiotics available is a great challenge to humankind. To address this problem, we are proposing a photosensitizer-modified biodegradable zeolitic imidazolate framework-8 nanocomposite that can kill not only Gram-positive bacteria Staphylococcus aureus, but also methicillin-resistant Staphylococcus aureus (MRSA) with high efficacy. In vivo testing revealed that these nanocomposites are highly effective for in vivo wound disinfection with minimal side-effects. In conclusion, this photosensitizer-modified biodegradable nanocomposite could be very promising for a synergistic antibacterial therapy to overcome MRSA.

Pseudomonas aeruginosa bloodstream infections in children: a 9-year retrospective study.

P. aeruginosa bloodstream infection (BSI) is associated with high hospital mortality. Empirical combination therapy is commonly used, but its benefit remains debated. The purpose of this study was to describe in a paediatric population, demographical characteristics and outcome of children treated for P. aeruginosa BSI receiving either a combined or single antibacterial therapy. We performed a retrospective, single-centre, cohort study of hospitalized children with P. aeruginosa BSI from 2007 to 2015. A total of 118 bloodstream infections (BSI) were analysed (102 (86.4%) hospital-acquired, including 52 (44.1%) hospitalized in intensive care unit). In immunocompromised children, 52% of BSI episodes were recorded. Recent medical history revealed that 68% were hospitalized, 31% underwent surgery and 67% had a prior antibiotic therapy within the last 3months. In-hospital mortality was similar for patients receiving single or combined anti-Pseudomonas therapy (p = 0.78). In multivariate analysis, independent risk factors for in-hospital mortality were neutropenia (OR = 6.23 [1.94-20.01], hospitalization in ICU (OR = 5.24 [2.04-13.49]) and urinary tract infection (OR = 4.40 [1.02-19.25]).Conclusion: P. aeruginosa BSI mainly occurred in immunocompromised children. Most infections were hospital-acquired and associated with high mortality. Combination therapy did not improve survival. What is Known: • P. aeruginosa bloodstream infection (BSI) is associated with high hospital mortality. Empirical combination therapy is commonly used but its benefit remains debated. What is New: • This is the largest cohort of Pseudomonas aeruginosa bacteraemia in children ever published. P. aeruginosa Bloodstream mainly occurred in immunocompromised children. Most infections were hospital-acquired and associated with high mortality. Combination therapy did not improve survival.

Двусторонний острый гнойно-деструктивный пиелонефрит после выполнения контактной уретеролитотрипсии

The problem of urinary stone disease and acute destructive pyelonephritis remains to be relevant in the current urologic practice. The acute pyelonephritis is the most common infectious and inflammatory complication after retrograde ureteroscopy. According to data of leading urologists in Russian Federation and worldwide, the incidence of acute purulent pyelonephritis ranges from 0.1 to 0.2%. Infectious and inflammatory complications of retrograde ureteroscopy often require urgent interventions. Acute pyelonephritis can result in destructive changes in the renal parenchyma. In case of ineffective conservative measures, pyelonephritis can progress into sepsis with the development of multiple organ failure. Therefore, infectious and inflammatory complications require to start combined antibacterial, anti-inflammatory and detoxification therapy, as well as to resolve any upper urinary tract obstruction. If acute pyelonephritis leads to destructive phase with a formation of a carbuncle or an abscess in the kidney, an open surgery is indicated. Despite being minimally-invasive, retrograde ureteroscopy can lead to serious complications requiring an open surgical intervention. In some cases, the severity of the patients condition may require nephrectomy.