Common Use Of Antibiotics Research Articles

KAJIAN RASIONALITAS PENGGUNAAN ANTIBIOTIK PADA ANAK DENGAN INFEKSI SALURAN KEMIH DI RSUD Dr. MOEWARDI SURAKARTA

Urinary tract infection (UTI) is the second highest infectious disease among children in Indonesia. Management of UTI requires antibiotic therapy, but the irrational use of antibiotics makes this disease one of the contributors to the high rate of antibiotic resistance. Therefore, there is a need for a study to measure the rationality of antibiotic use in children with UTI. This study is a descriptive observational study with a cross sectional design. Data were collected retrospectively using a purposive sampling technique based on medical record data of pediatric patients at Dr. Moewardi Surakarta Hospital in 2021-2023. The results showed that out of 100 medical records of pediatric patients with UTI, 68.00% were women and 32.00% were men. Based on age, the highest incidence of UTI occurred in the age range of 10-18 years as much as 52.00%. The most common antibiotic use was ampicillin 68.00%. The results of the rationality study showed 69.00% in category 0 (rational use of antibiotics). Irrationality occurred in category IIA (antibiotic use is not the right dose) 17.00%, IIIA (antibiotic use with too long duration) 1.00%, IIIB (antibiotic use with too short duration) 4.00%, IIA & IIIB (antibiotic use is not the right dose & duration is too short) 2.00%, IVA (there are other more effective antibiotic options) 4.00%, IIIB & IVA (antibiotic use is too short duration & there are other more effective antibiotic options) 3.00%. It can be concluded that the rational use of antibiotics needs to be improved.

Genomic diversity and nutritional analysis of multi-drug resistant extended spectrum β-lactamase Producing-Klebsiella pneumoniae genes isolated from mastitic cattle milk in district peshawar, Pakistan

The increasing incidence of resistance extended spectrum-beta lactamase (ESBL) producing Klebsiella pneumonia become worldwide issue. The current study aimed to determine the genomic diversity of ESBL-producing K. pneumoniae in milk samples collected from cows with mastitis as well as their antibiotic sensitivity profiles and genetic identification in Peshawar, Pakistan. The california mastitis test (CMT) was initially used to verify the presence for mastitis in 700 collected milk samples. The molecular identification of the 16SrRNA gene confirmed 120/700 (17.14 %) propagation of K. pneumonia. Out of these isolates MDR ESBL-producing isolates were 60/120 (50 %). The lactose were found (M = 3.96 ± 0.28, SD = 2.19), followed by fats (M = 3.12 ± 0.11, SD = 0.90), protein (M = 5.97 ± 0.24, SD = 1.84), sodium (M = 55.74 ± 2.07, SD = 15.81), potassium (M = 138.5 ± 1.53, SD = 11.71), chloride (M = 0.74 ± 0.03, SD = 0.24), calcium (M = 10.27 ± 0.31, SD = 2.42), and chlorine (M = 2.80 ± 0.22, SD = 1.70), respectively. Amikacin (80 %), ceftazidime (71 %), and tetracycline (71 %) were shown to be the most effective antimicrobials against all of the isolates. The occurrence of the blaSHV gene was observed at 56.00 % whereas the blaTEM gene and blaCTX-M gene were 36.00 %, and 30.00 %. The distribution of blaCTX-M subgroup genes was followed by blaCTX-M-1 (38.00 %), blaCTX-M-9 (22.20 %), and blaCTX-M-15 (61.10 %). Co-occurrence of blaCTX-M+ blaSHV was (15.00 %), blaCTX-M+ blaTEM were (6.60 %), and blaSHV + blaTEM were (10.00 %), respectively. The inappropriate, prolonged and common use of antibiotics may apply selective pressure for propagation and the occurrence of resistant isolates.

Prevalence and Associated Factors of optrA-Positive-Enterococcus faecalis in Different Reservoirs around Farms in Vietnam.

Linezolid is an antibiotic of last resort for the treatment of infections caused by Gram-positive bacteria, including vancomycin-resistant enterococci. Enterococcus faecalis, a member of enterococci, is a significant pathogen in nosocomial infections. E. faecalis resistance to linezolid is frequently related to the presence of optrA, which is often co-carried with fex, phenicol exporter genes, and erm genes encoding macrolide resistance. Therefore, the common use of antibiotics in veterinary might promote the occurrence of optrA in livestock settings. This is a cross-sectional study aiming to investigate the prevalence of optrA positive E. faecalis (OPEfs) in 6 reservoirs in farms in Ha Nam province, Vietnam, and its associated factors and to explore genetic relationships of OPEfs isolates. Among 639 collected samples, the prevalence of OPEfs was highest in flies, 46.8% (51/109), followed by chickens 37.3% (72/193), dogs 33.3% (17/51), humans 18.7% (26/139), wastewater 16.4% (11/67) and pigs 11.3%, (14/80). The total feeding area and total livestock unit of the farm were associated with the presence of OPEfs in chickens, flies, and wastewater. Among 186 OPEfs strains, 86% were resistant to linezolid. The presence of optrA was also related to the resistant phenotype against linezolid and levofloxacin of E. faecalis isolates. Close genotypic relationships identified by Pulsed Field Gel Electrophoresis between OPEfs isolates recovered from flies and other reservoirs including chickens, pigs, dogs, and wastewater suggested the role of flies in the transmission of antibiotic-resistant pathogens. These results provided warnings of linezolid resistance although it is not used in livestock.

Drug-Induced Liver Injury with Commonly Used Antibiotics in the All of Us Research Program.

Antibiotics are a known cause of idiosyncratic drug-induced liver injury (DILI). According to the Centers for Disease Control and Prevention, the five most commonly prescribed antibiotics in the United States are azithromycin, ciprofloxacin, cephalexin, amoxicillin, and amoxicillin-clavulanate. We quantified the frequency of acute DILI for these common antibiotics in the All of Us Research Program, one of the largest electronic health record (EHR)-linked research cohorts in the United States. Retrospective analyses were conducted applying a standardized phenotyping algorithm to de-identified clinical data available in the All of Us database for 318,598 study participants. Between February 1984 and December 2022, more than 30% of All of Us participants (n = 119,812 individuals) had been exposed to at least 1 of our 5 study drugs. Initial screening identified 591 potential case patients that met our preselected laboratory-based phenotyping criteria. Because DILI is a diagnosis of exclusion, we then used phenome scanning to narrow the case counts by (i) scanning all EHRs to identify all alternative diagnostic explanations for the laboratory abnormalities, and (ii) leveraging International Classification of Disease 9th revision (ICD)-9 and ICD 10th revision (ICD)-10 codes as exclusion criteria to eliminate misclassification. Our final case counts were 30 DILI cases with amoxicillin-clavulanate, 24 cases with azithromycin, 24 cases with ciprofloxacin, 22 cases with amoxicillin alone, and < 20 cases with cephalexin. These findings demonstrate that data from EHR-linked research cohorts can be efficiently mined to identify DILI cases related to the use of common antibiotics.

A case-control study of Clostridioides difficile symptomatic infections in a pediatric cancer hospital.

The aim of this study was to analyze and identify documented infections and possible risk factors for Clostridioides difficile infections in children with cancer. This is a retrospective case-control study, carried out in a pediatric cancer hospital, covering the years 2016-2019. Matching was performed by age and underlying disease, and for each case, the number of controls varied from 1 to 3. Logistic regression models were used to assess risk factors. We analyzed 63 cases of documented infection by C. difficile and 125 controls. Diarrhea was present in all cases, accompanied by fever higher than 38°C in 52.4% of the patients. Mortality was similar among cases (n=4; 6.3%) and controls (n=6; 4.8%; p=0.7). In all, 71% of patients in the case group and 53% in the control group received broad-spectrum antibiotics prior to the infection. For previous use of vancomycin, the Odds Ratio for C. difficile infection was 5.4 (95% confidence interval [95%CI] 2.3-12.5); for meropenem, 4.41 (95%CI 2.1-9.2); and for cefepime, 2.6 (95%CI 1.3-5.1). For the antineoplastic agents, the Odds Ratio for carboplatin was 2.7 (95%CI 1.2-6.2), melphalan 9.04 (95%CI 1.9-42.3), busulfan 16.7 (95%CI 2.1-134.9), and asparaginase 8.97 (95%CI 1.9-42.9). C. difficile symptomatic infection in children with cancer was associated with previous hospitalization and the use of common antibiotics in cancer patients, such as vancomycin, meropenem, and cefepime, in the last 3 months. Chemotherapy drugs, such as carboplatin, melphalan, busulfan, and asparaginase, were also risk factors.

Patterns of Antibiotic Use in The One Hour Bundle Treatment of Sepsis

Introduction: Sepsis and septic shock are major health problems, affecting millions of people worldwide and a leading cause of death. Administration of broad-spectrum empiric antibiotics as a one hour sepsis bundle treatment is associated with antimicrobial resistance which has various adverse effects and reduces the quality of health services. The aim of this research was to determine the pattern of empiric antibiotic use in the management of one hour bundle of sepsis at Haji Adam Malik General Hospital Medan. Method: This study used a descriptive method from November 2022 to December 2022 in the Emergency Room (ER), Medical Inpatient Room, Surgical Inpatient Room, and Adult Intensive Care Unit (ICU) of Haji Adam Malik General Hospital Medan. This study used a consecutive sampling technique to recruit 42 sepsis patients who were given a one hour bundle of sepsis according to the inclusion and exclusion criteria. This descriptive analysis was used to determine the characteristics of the sample, namely age, sex, culture results, and antibiotic sensitivity test results. Results: The most common use of antibiotics in the one hour bundle sepsis strategy was ceftriaxone 1 gram in 20 patients (47.6%), Ampicillin-Sulbactam 1.5 grams in 10 patients (23.8%), Levofloxacin 750 mg in 6 patients (14.3%), Meropenem 1 gram in 4 patients (9.5%), and Ciprofloxacin 200 mg in 2 patients (4.8%). Conclusion: Antibiotic administration time is less than 1 hour in the one hour bundle strategy carried out in the ER. Most of the antibiotics given are in accordance with the antibiotic sensitivity test results, but there are still some patients who still experience resistance to the antibiotics.given so it is important to always or immediately carry out culture and sensitivity tests on patients so that the antibiotics given can be more optimal

Is There a Relationship between Antimicrobial Use and Antibiotic Resistance of the Most Common Mastitis Pathogens in Dairy Cows?

Antimicrobials have had an important impact on animal health and production performance. However, non-prudent antimicrobial use (AMU) in food producing animals is considered to contribute to the emergence of antimicrobial resistance (AMR), with a potential impact on both animal and public health. Considering the global importance of AMR, and the threats and challenges posed by mastitis and mastitis therapy in livestock production, the main objective of this study was to quantify AMU on three dairy farms in Serbia and to examine whether there is an association between AMU and the emergence of antimicrobial resistance of mastitis-associated pathogens. Antimicrobial susceptibility testing was performed by the disk diffusion method using causative agents isolated from the milk samples of 247 dairy cows. AMU data were obtained for a one-year period (May 2021 to May 2022) based on antibiotic prescriptions listed in electronic databases kept by farm veterinarians. To estimate antimicrobial drug exposure at the farm level, the veterinary drug Defined Daily Dose was calculated by multiplying the total amount of antibiotic used on the farms during the study period by the quantity of antibiotic in the administered drug and number of original drug packages used. The results on the association between the use of common antibiotics in mastitis treatment and AMR of isolated mastitis-associated pathogens confirm a pattern that could raise awareness of the importance of this aspect of good veterinary and clinical practice to combat the global threat of AMR.

Appropriate Use of Antibiotics for the Management of Respiratory Tract Infections.

Lower Respiratory Tract Infections (LRTIs) and Upper Respiratory Tract Infections (URTIs) cause high morbidity and mortality worldwide. Lower respiratory tract infections are generally more serious than upper infections. Antibiotics are often inappropriately prescribed for patients with RTI. Inappropriate utilization of antibiotics, specifically the broad spectrum in respiratory tract infection, results in resistance to antibiotics. The common use of antibiotics is the prime reason for the spread of drug-resistant bacterial strains, which not only results in expensive treatments but also causes a high rate of morbidity and mortality due to undesired adverse effects of the drug. A literature survey was performed using PubMed, Science Direct, and Web of Science search engines. One hundred forty-five papers were retrieved, and more than 100 were included in this review. This article describes the overview and diagnosis of respiratory tract infections and the plethora of antibiotics that have been used in the management of RTIs.

E. coli chromosomal-driven expression of NADK2 from A. thaliana: A preferable alternative to plasmid-driven expression for challenging proteins

The expression and purification of large recombinant proteins or protein complexes is problematic for some biotechnology laboratories. Indeed, it is often difficult to obtain enough active proteins to perform biological characterization or reach commercialization, when large proteins or protein complexes are expressed in E. coli via the popular T7-based plasmid-driven expression system.There is also an industrial demand to decrease our dependence on plasmid-driven expression, because of its drawbacks, such as: i) the common use of antibiotics to maintain the plasmid, ii) the issue of plasmid copy number, and iii) the risk of overloading the expression system. Despite all these issues, alternative solutions, such as gene integration in the bacterial chromosome, are rarely employed and their advantages are still a matter of debate.Plant plastidial NAD kinases (NADK; ATP:NAD 2′-phosphotransferase, EC 2.7.1.23) are a classic example of proteins with high molecular weight, that are difficult to express and purify with traditional T7-based technology. We therefore compared plasmid-driven and chromosomal-driven expression of the Arabidopsis thaliana NADK2 protein, using a proprietary counter-selection tool, COLIBELT®, that allows scar-free and marker-free chromosomal modifications.Here we show that chromosomal-driven expression allowed recovery of more active NADK2 protein than classic T7 expression systems, as well as better production, thus confirming that expression from one single chromosomal copy is preferable to plasmid-driven expression and might be appealing for both basic and applied research.

The public health issue of antibiotic residues in food and feed: Causes, consequences, and potential solutions.

Antibiotics are among the essential veterinary medicine compounds associated with animal feed and food animal production. The use of antibiotics for the treatment of bacterial infections is almost unavoidable, with less need to demonstrate their importance. Although banned as a growth factor for a few years, their use in animals can add residues in foodstuffs, presenting several environmental, technological, animal health, and consumer health risks. With regard to human health risks, antibiotic residues induce and accelerate antibiotic resistance development, promote the transfer of antibiotic-resistant bacteria to humans, cause allergies (penicillin), and induce other severe pathologies, such as cancers (sulfamethazine, oxytetracycline, and furazolidone), anaphylactic shock, nephropathy (gentamicin), bone marrow toxicity, mutagenic effects, and reproductive disorders (chloramphenicol). Antibiotic resistance, which has excessively increased over the years, is one of the adverse consequences of this phenomenon, constituting a severe public health issue, thus requiring the regulation of antibiotics in all areas, including animal breeding. This review discusses the common use of antibiotics in agriculture and antibiotic residues in food/feed. In-depth, we discussed the detection techniques of antibiotic residues, potential consequences on the environment and animal health, the technological transformation processes and impacts on consumer health, and recommendations to mitigate this situation.

Chitosan‐capped silver nanoparticles: A comprehensive study of polymer molecular weight effect on the reaction kinetic, physicochemical properties, and synergetic antibacterial potential

AbstractThe search for novel efficient antibacterial agents is attracting a great attention due to the unregulated use of common antibiotics and development of multidrug‐resistant bacteria strains. This paper proposes an eco‐friendly approach to obtain stable chitosan‐capped silver nanoparticles with controlled physicochemical and biological properties using reducing and stabilizing capacity of chitosan. The study of the influence of chitosan characteristics on the kinetic of Ag+ reduction showed that an increase in polysaccharide molecular weight led to a decrease in their reducing ability. The synthesized silver nanoparticles were characterized by UV and FTIR spectroscopy, TEM, XRD, DLS. The relationships between physicochemical characteristics of the formed silver nanoparticles and the type of used chitosan, as well as synthesis temperature, were determined. It has been demonstrated that spherically‐shaped (13–27 nm) and positively‐charged (zeta‐potential 26.1–29.5 mV) silver nanoparticles with a single symmetric SPR band at 408–418 nm are stable during 6 months in a colloidal form, and can be produced with the assistance of low‐molecular weight chitosan (20–30 kDa) at 95°C. The synthesized silver nanoparticles enhanced the antibacterial activity of kanamycin and ampicillin against both gram‐negative and gram‐positive bacteria. These results revealed the prospects for the application of chitosan‐capped silver nanoparticles to create new effective antibacterial systems (gels, films, etc).

Isolation and Characterization of Potential Salmonella Phages Targeting Multidrug-Resistant and Major Serovars of Salmonella Derived From Broiler Production Chain in Thailand.

Salmonella is a major foodborne pathogen that causes foodborne disease in humans through consumption of contaminated foods, especially those of animal origin. Multiple Salmonella strains are antibiotic-resistant due to the common use of antibiotics in farm animals, including broiler farms. In this study, an alternative strategy using phage-based treatment was evaluated against Salmonella isolated from the broiler production. The prevalence of Salmonella spp. showed up to 46.2 and 44.4% in bedding samples from the broiler farms located in eastern and southern Thailand, respectively. Overall, 21 samples (36.2%) were positive for Salmonella and eight serovars were recovered from cloacal swabs, bedding materials (rice husk), and boot swabs collected from five farms. Up to 20 Salmonella phages were isolated from seven water samples from wastewater treatment ponds, a river, and a natural reservoir in Songkhla province. Isolated phages were investigated, as well as their lysis ability on eight target Salmonella serovars derived from broiler farms, five foodborne outbreak-related serovars, and 10 multidrug-resistant (MDR) serovars. All phages showed a strong lytic ability against five serovars of Salmonella derived from broiler farms including Kentucky, Saintpaul, Schwarzengrund, Corvalis, and Typhimurium; three foodborne outbreak serovars including Enteritidis, Typhimurium, and Virchow; and eight MDR serovars including Agona, Albany, Give, Kentucky, Typhimurium, Schwarzengrund, Singapore, and Weltevreden. Three phages with the highest lysis potential including vB_SenS_WP109, vB_SenS_WP110, and vB_SenP_WP128 were selected for a phage cocktail preparation. Overall, a phage cocktail could reduce Salmonella counts by 2.2–2.8 log units at 6 h of treatment. Moreover, Salmonella did not develop a resistant pattern after being treated with a phage cocktail. Findings here suggest that a phage cocktail is an effective biocontrol to combat Salmonella derived from broiler production chain, other serovars linked to foodborne outbreaks, and MDR serovars.

Antibiotic resistance pattern in Shigella species isolated from children with acute diarrhea in Tabriz city, Iran

Background and aim: Shigella is one of the leading causes of acute diarrhea in children worldwide. Antibiotic resistance in this bacterium has increased due to the indiscriminate use of common antibiotics. Therefore, the aim of this study was to investigate the prevalence and pattern of antibiotic resistance in Shigella species isolated from children with acute diarrhea in Tabriz hospitals.&#x0D; Materials and methods: In this descriptive cross-sectional study, 321 samples suspected of Shigella were collected from children's diarrhea stool samples and identified using standard microbiological and biochemical tests. Antibiotic resistance was also determined using disk diffusion by the Kirby-Bauer method.&#x0D; Results: A total of 84 samples were positive for Shigella. Among them, S. flexneri species with 83.3% had the highest frequency and S. boydii with 13.1%, S. sonnei with 2.4% and S. dysanteriae with 1.2% had the lowest frequency. The highest resistance was related to the antibiotics cotrimoxazole (92.85%), tetracycline and ampicillin (67.86%) and the lowest resistance was related to imipenem antibiotics (2.38%) and ceftizoxime (9.52%). &#x0D; Conclusion: The present study showed that Shigella flexneri is the predominant species isolated from children with Shigellosis in hospitals in Tabriz city. Our results also indicate an increase in resistance to common antibiotics. Therefore, it is recommended that antimicrobial susceptibility testing be performed in the study area prior to antibiotic administration.

Pathogenic bacteria and their antibiotic sensitivity in ophthalmia neonatorum.

CONTEXT:Emergence of coagulase-negative staphylococci as pathogens in ophthalmia neonatorum.AIMS:To analyze the bacteriological spectrum of ophthalmia neonatorum and its associated risk factors.SETTINGS AND DESIGN:Retrospective analysis in a tertiary care hospital in India.SUBJECTS AND METHODS:A retrospective review was performed in a tertiary care center in India on 139 neonates presenting with conjunctivitis over a period of 3 years. All the neonates presenting to the out-patient department, those admitted in the Neonatal Intensive care Unit and in-patient wards were included in our study. The neonates were clinically examined and followed-up by a single experienced ophthalmologist. Details including demographic data, age of the infant, type of delivery, investigations, and treatment outcomes were analyzed.STATISTICAL ANALYSIS USED:Frequency calculation using Microsoft Excel for windows 10.RESULTS:In the 92 samples with growth (66.2%), the most common organisms isolated were coagulase-negative Staphylococci (35.9%), Klebsiella pneumoniae (16.3%), and Acinetobacter species (16.3%). Others were Staphylococcus aureus (14.1%), Pseudomonas aeruginosa (8.7%), and Escherichia coli (8.7%). Ophthalmia neonatorum was significantly higher in preterm infants born out of lower-segment cesarean section and those requiring ventilatory support.CONCLUSIONS:Unlike gonococcus, which is implicated in ophthalmia neonatorum, our study shows varied microbiological spectrum and sensitivity patterns with coagulase-negative staphylococci as the key pathogen. The role of coagulase-negative staphylococci as a disease-causing pathogen becomes increasingly important with an imperative need for prudent use of common antibiotics in treating these pathogenic bacteria.

A single center study on antimicrobial use and bacterial resistance in burn ward

Objective: To investigate the effect of antibiotics on bacterial resistance through analyzing the use of common antibiotics and the bacterial prevalence in single-center burn ward. Methods: The epidemiological data of pathogenic bacteria and the use of common antibiotics in burn ward of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College was investigated in the past 9 years. Bacteria samples were collected from the wounds, catheters, blood, feces, urine and sputum of inpatients in the unit from January 2010 to December 2018. The antibiotics use density was calculated by defined daily doses (DDDs)/(1 000 patient-days). Results: (1) In the proportion of bacteria detected, Staphylococcus aureus was the first and sensitive to glycopeptide antibiotics. Klebsiella pneumonia (19.8%), Pseudomonas aeruginosa (11.9%) and Acinetobacter baumannii (11.5%) were the top three Gram-negative bacteria in 2018; the proportion of Klebsiella pneumoniae was significantly increased (R(2)=0.861, P<0.001). (2) The Pseudomonas aeruginosa resistance rate to ceftazidime (R(2)=0.447, P=0.049) and ciprofloxacin (R(2)=0.663, P=0.008) increased significantly. The Klebsiella pneumoniae resistance rate to piperacillin (R(2)=0.999, P=0.018), meropenem (R(2)=0.999, P=0.023), ciprofloxacin (R(2)=1.000, P=0.010) increased significantly. There was no significant trend in the Acinetobacter baumannii resistance rate. (3) The use density of meropenem increased significantly (R(2)=0.492, P=0.035), and that of ciprofloxacin decreased significantly (R(2)=0.572, P=0.018). (4) Carbapenems use density was positively correlated with resistance rate of Klebsiella pneumoniae to cefoperazone sulbactam (r=0.733, P=0.025), piperacillin tazobactam (r=0.684, P=0.042), cefuroxime (r=0.821, P=0.023), ceftazidime (r=0.741, P=0.022), imipenem (r=0.718, P=0.029), meropenem (r=0.690, P=0.040), amikacin (r=0.750, P=0.020). (5) Ciprofloxacin use density was negatively correlated with the Pseudomonas aeruginosa resistance rate to ceftazidime (r=-0.751, P=0.020), Ciprofloxacin (r=-0.873, P=0.002) and with the Klebsiella pneumoniae resistance rate to cefuroxime (r=-0.767, P=0.044), ceftazidime (r=-0.712, P=0.031), imipenem (r=-0.780, P=0.013), meropenem (r=-0.793, P=0.011), ciprofloxacin (r=-0.871, P=0.002), Sulfamethoxazole/trimethoprim (r=-0.793, P=0.011). Conclusion: Carbapenems can induce Klebsiella pneumoniae to be multiple drug resistance; through the relationship between ciprofloxacin use intensity and drug resistance, the strategy of only restricting a certain antimicrobial agent may not restore the bacterial sensitivity.

Risk Factors Influencing Tolerance and Clinical Features of Food Protein-induced Allergic Proctocolitis.

Continued progress in our understanding of the food protein-induced allergic proctocolitis (FPIAP) will provide the development of diagnostic tests and treatments. We aimed to identify precisely the clinical features and natural course of the disease in a large group of patients. Also, we investigated the predicting risk factors for persistent course since influencing parameters has not yet been established. Infants who were admitted with rectal bleeding and had a diagnosis of food protein-induced allergic proctocolitis in 5 different allergy or gastroenterology outpatient clinics were enrolled. Clinical features, laboratory tests, and prognosis were evaluated. Risk factors for persistent course were determined by logistic regression analyses. Among the 257 infants, 50.2% (n = 129) were girls and cow's milk (99.2%) was the most common trigger. Twenty-four percent of the patients had multiple food allergies and had more common antibiotic use (41.9% vs 11.8%), atopic dermatitis (21% vs 10.2%), wheezing (11.3% vs 1.5%), colic (33.8% vs 11.2%), and IgE sensitization (50% vs 13.5%) compared to the single-food allergic group (P < 0.001, P = 0.025, P = 0.003, P < 0.001, respectively). In multivariate logistic regression analysis, presence of colic (odds ratio [OR]: 5.128, 95% confidence interval [CI]: 1.926-13.655, P = 0.001), IgE sensitization (OR: 3.964, 95% CI: 1.424-11.034, P = 0.008), and having allergy to multiple foods (OR: 3.679, 95% CI: 1.278-10.593, P = 0.001] were found to be risk factors for continuing disease after 1 year of age. Although most children achieve tolerance at 1 year of age, IgE sensitization, allergy to multiple foods, and presence of colic were risk factors for persistent course and late tolerance. In this context, these children may require more close and extended follow-up.

Removal of Ciprofloxacin with Aluminum-Pillared Kaolin Sodium Alginate Beads (CA-Al-KABs): Kinetics, Isotherms, and BBD Model

In recent years, the problem of water pollution caused by antibiotics has attracted wide attention. The common use of antibiotics represents a threat to both human health and environmental safety. The modification of kaolin clay is promising due to its high efficiency, easy operation, and low cost. In this study, a novel material, aluminum-pillared kaolin sodium alginate beads (CA-Al-KABs), was synthesized by gelling and solidification processes. The structure and chemical properties were characterized by various analytical methods. The influencing factors (such as adsorbent dosage, contacting time, pH, ion strength, temperature, and initial concentration) and adsorption mechanism of ciprofloxacin (CIP) were studied. Furthermore, adsorption kinetics, adsorption isotherms, and a Box–Behnken design (BBD) model were conducted. Moreover, CA-Al-KABs’ adsorption efficiency towards other antibiotics were also evaluated. The adsorption experiments showed that the acidic environment (pH = 4) was more favorable for the adsorption of ciprofloxacin. The adsorption kinetics of ciprofloxacin by CA-Al-KABs microspheres were confirmed to be more suitable with the pseudo-first-order kinetics model. The Langmuir isotherm model showed that the maximum adsorption capacity of CA-Al-KABs microspheres to ciprofloxacin was 68.36 mg/g at 308.15 K. The adsorption driving force of CIP near CA-Al-KABs may be the electrostatic attraction. Further, CIP could also form complexes with Ca2+ and Al—Al—OH on CA-Al-KABs, and thus CIP was attracted to the adsorbent. Adsorption thermodynamics showed that the adsorption process was exothermic, feasible, and spontaneous. In addition, the adsorption performance on other antibiotics indicated CA-Al-KABs’ broad application in the treatment of antibiotic wastewater.

Structural Analysis and Design of Chionodracine-Derived Peptides Using Circular Dichroism and Molecular Dynamics Simulations.

Antimicrobial peptides have been identified as one of the alternatives to the extensive use of common antibiotics as they show a broad spectrum of activity against human pathogens. Among these is Chionodracine (Cnd), a host-defense peptide isolated from the Antarctic icefish Chionodraco hamatus, which belongs to the family of Piscidins. Previously, we demonstrated that Cnd and its analogs display high antimicrobial activity against ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species). Herein, we investigate the interactions with lipid membranes of Cnd and two analogs, Cnd-m3 and Cnd-m3a, showing enhanced potency. Using a combination of Circular Dichroism, fluorescence spectroscopy, and all-atom Molecular Dynamics (MD) simulations, we determined the structural basis for the different activity among these peptides. We show that all peptides are predominantly unstructured in water and fold, preferentially as α-helices, in the presence of lipid vesicles of various compositions. Through a series of MD simulations of 400 ns time scale, we show the effect of mutations on the structure and lipid interactions of Cnd and its analogs. By explaining the structural basis for the activity of these analogs, our findings provide structural templates to design minimalistic peptides for therapeutics.

Antibiotics in early life associate with specific gut microbiota signatures in a prospective longitudinal infant cohort.

The effects of antibiotics on infant gut microbiota are unclear. We hypothesized that the use of common antibiotics results in long-term aberration in gut microbiota. Antibiotic-naive infants were prospectively recruited when hospitalized because of a respiratory syncytial virus infection. Composition of fecal microbiota was compared between those receiving antibiotics during follow-up (prescribed at clinicians' discretion because of complications such as otitis media) and those with no antibiotic exposure. Fecal sampling started on day 1, then continued at 2-day intervals during the hospital stay, and at 1, 3 and 6 months at home. One hundred and sixty-three fecal samples from 40 patients (median age 2.3 months at baseline; 22 exposed to antibiotics) were available for microbiota analyses. A single course of amoxicillin or macrolide resulted in aberration of infant microbiota characterized by variation in the abundance of bifidobacteria, enterobacteria and clostridia, lasting for several months. Recovery from the antibiotics was associated with an increase in clostridia. Occasionally, antibiotic use resulted in microbiota profiles associated with inflammatory conditions. Antibiotic use in infants modifies especially bifidobacterial levels. Further studies are warranted whether administration of bifidobacteria will provide health benefits by normalizing the microbiota in infants receiving antibiotics.

The Regulation of Host Intestinal Microbiota by Polyphenols in the Development and Prevention of Chronic Kidney Disease.

Polyphenols are essential antioxidants in our regular diet, and have shown potential antibacterial effects. Other important biological effects, such as anticancer or antibacterial activities, have been demonstrated by some polyphenols. In recent years, the benefits of polyphenols to human health have attracted increasing attention from the scientific community. Recent studies have shown that polyphenols such as anthocyanin, catechin, chlorogenic acid, and resveratrol can inhibit pathogenic bacteria such as Escherichia coli and Salmonella to help regulate intestinal microflora. An imbalance of intestinal microflora and the destruction of intestinal barrier function have been found to have a potential relationship with the occurrence of chronic kidney disease (CKD). Specifically, they can aberrantly trigger the immune system to cause inflammation, increase the production of uremic toxins, and further worsen the condition of CKD. Therefore, the maintenance of intestinal microflora and the intestinal tract in a stable and healthy state may be able to “immunize” patients against CKD, and treat pre-existing disease. The use of common antibiotics may lead to drug resistance in pathogens, and thus beneficial polyphenols may be suitable natural substitutes for antibiotics. Herein we review the ability of different polyphenols, such as anthocyanin, catechin, chlorogenic acid, and resveratrol, to regulate intestinal microorganisms, inhibit pathogenic bacteria, and improve inflammation. In addition, we review the ability of different polyphenols to reduce kidney injury, as described in recent studies.