Excessive Use Of Antibiotics Research Articles

Impact of a multifaceted intervention programme on antibiotic prescribing and dispensing in four patient-centred settings in five European countries. The HAPPY PATIENT project.

The primary cause of antimicrobial resistance is excessive and non-indicated antibiotic use. To evaluate the impact of a multifaceted intervention aimed at various healthcare professionals (HCPs) on antibiotic prescribing and dispensing for common infections. Before-and-after study set in general practice, out-of-hours services, nursing homes, and community pharmacies in France, Greece, Lithuania, Poland, and Spain. Following the Audit Project Odense method, HCPs from these four settings self-registered encounters with patients related to antibiotic prescribing and dispensing before and after an intervention (February-April 2022 and February-April 2023). Prior to the second registration, the HCPs undertook a multifaceted intervention, which included reviewing and discussing feedback on the first registration's results, enhancing communication skills, and providing communication tools. Indicators to identify potentially unnecessary prescriptions and non-first-line antibiotic choices were developed, and the results of the two registrations were compared. A total of 345 HCPs registered 10 744 infections in the first registration period and 10 207 infections in the second period. In general practice, participants showed a significant 9.8% reduction in unnecessary antibiotic prescriptions in the second period, whereas limited or no effect was observed in out-of-hours services and nursing homes (0.8% reduction and 4.5% increase, respectively). Pharmacies demonstrated an 18% increase in safety checks, and correct advice in pharmacies rose by 17%. External factors like COVID-19, antibiotic shortages, and a streptococcal epidemic impacted the intervention's benefits. Despite this, the intervention successfully improved antibiotic use in both settings.

Activation of Persulfate by NiFe-Layered Double Hydroxides Toward Efficient Degradation of Doxycycline in Water

In recent years, the excessive use and improper disposal of antibiotics have led to their pervasive presence in the environment, resulting in significant antibiotic pollution. To address this pressing issue, the present study synthesized nickel–iron-layered double hydroxides (NiFe-LDHs) with varying molar ratios using a hydrothermal method, employing these LDHs as catalysts for the oxidative degradation of doxycycline, with peroxymonosulfate (PMS) serving as the oxidant. X-ray diffraction analysis confirmed that the synthesized NiFe-LDHs exhibited a hexagonal crystal structure characteristic of layered double hydroxides. Experimental results demonstrated that the catalytic efficiency of NiFe-LDHs increased with both the dosage of the catalyst and the concentration of PMS, achieving a high degradation efficiency for doxycycline at a catalyst concentration of 0.5 g/L. Furthermore, the catalytic performance was notably effective across a range of pH conditions, with the highest degradation efficiency being observed at a Ni–Fe molar ratio of 3:1. The activation of PMS by NiFe-LDHs for the catalytic degradation of pollutants primarily occurs through singlet oxygen (1O2), superoxide radicals (O2−·), and sulfate radicals (SO4−·). The study also proposed three potential degradation pathways for doxycycline, indicating that the final degradation products have lower environmental toxicity. This research offers novel approaches and methodologies for the treatment of antibiotic-contaminated wastewater.

Early detection of neonatal sepsis and reduction of overall antibiotic exposure: Towards precision medicine

Infections claim the lives of over half a million newborns annually and expose survivors to the risk of lifelong disability. The challenge to clinicians is to identify newborns with invasive infections rapidly, promptly initiate antimicrobial treatment, and take measures to prevent and treat organ dysfunction. Moreover, excessive antibiotic use is a global public health problem. Despite considerable research on clinical and laboratory markers of neonatal sepsis, the effective translation into clinical practice remains limited. There is no single clinical or laboratory marker, nor any combination of markers that definitively confirms or rules out neonatal sepsis. The interpretation of these markers should take into account their diagnostic value for a given patient, along with their added value to the clinical decision-making process. The digitalization of health care systems, combined with increased computational power and advances in machine learning, offers the possibility of developing accurate predictive algorithms for early detection of neonatal sepsis.

The clinical praxis of bacteriocins as natural anti-microbial therapeutics.

In recent decades, the excessive use of antibiotics has resulted in a rise in antimicrobial drug resistance (ADR). Annually, a significant number of human lives are lost due to resistant infectious diseases, leading to around 700,000 deaths, and it is estimated that by 2050, there could be up to 10 million casualties. Apart from their possible application as preservatives in the food sector, bacteriocins are gaining acknowledgment as potential clinical treatments. Not only this, these antimicrobial peptides have revealed in modulating the host immune system producing anti-inflammatory and anti-modulatory responses. At the same time, due to the ever-increasing global threat of antibiotic resistance, bacteriocins have gained attraction among researchers due to their potential clinical applications. Bacteriocins as antimicrobial peptides, represent one of the most important natural defense mechanisms among bacterial species, particularly lactic acid bacteria (LAB), that can fight against infection-causing pathogens. In this review, we are highlighting the potential of bacteriocins as novel therapeutics for inhibiting a wide range of clinically relevant and multi-drug-resistant pathogens (MDR). We also highlight the effectiveness and potential applications of current bacteriocin treatments in combating antimicrobial resistance (AMR), thereby promoting human health.

Copper-based photocatalysts with natural organic ligands for efficient removal of tetracycline under visible light

The excessive use of broad-spectrum antibiotics, such as tetracycline, presents a significant challenge to human survival and development. Oxygen vacancies (OVs) metal-organic framework (MOF) materials were synthesized using natural organic acids (L-malic acid, L-aspartic acid, and L-asparagine) with similar structures but different charge densities, along with copper as the metal linking agent. The presence of oxygen vacancies in the catalyst provides abundant active sites for photocatalytic reactions. The employment of flexible straight-chain organic ligands devoid of rigid polycyclic rings, combined with the incorporation of different substituents to induce variations in charge density, the resulting catalysts exhibit distinct photocatalytic activities under visible light. Density functional theory calculations confirm that L-asparagine exhibits the largest electron density difference, and the Cu-based MOF (Cu-ASU) synthesized as an organic ligand exhibits the highest photocatalytic activity under visible light excitation. The catalyst displayed remarkable photocatalytic activity against tetracycline antibiotics under identical conditions (with removal rates of 93.5 % for tetracycline, 81.4 % for terramycin, and 95.6 % for chloramphenicol hydrochloride). This provides a novel approach for the design and synthesis of photocatalysts for the removal of antibiotics from water.

Lactoferrin: a secret weapon in the war against pathogenic bacteria

The excessive use of antibiotics to treat bacterial infectious diseases in all living beings has caused a global epidemic of bacterial resistance to antibiotics, leading to the emergence of multidrug-resistant and pandrug-resistant strains. In 2019, the World Health Organization (WHO) reported that antimicrobial resistance causes at least 700,000 deaths per year worldwide. Therefore, in this global war against microorganisms, a therapeutic alternative is necessary to help us win this battle. A key in this race against the clock could be lactoferrin (Lf), a cationic glycoprotein of the mammalian innate immune system that is highly conserved among mammals. Lf is a multifunctional glycoprotein with immunomodulatory, anticarcinogenic, wound-healing, antioxidant, antimicrobial, and bone regeneration properties, in addition to improving the gut microbiota. Lf limits the growth of microorganisms through the sequestration of iron but can also interact directly with some components of the outer membrane of Gram-negative bacteria or bind to teichoic acids in Gram-positive bacteria, destabilizing the membrane and resulting in lysis. Moreover, cleavage of the Lf molecule could promote the production of lactoferricins (Lfcins) and lactoferrampin (Lfampin) from the N-terminal end, which are known to often have stronger antimicrobial effects than the native molecule, as well as analogous peptides, such as HLopt2, which have also shown enhanced antimicrobial activity. Bovine Lf (bLf) has been approved by the US Food and Drug Administration (FDA), and the European Food Safety Authority for its use as a dietary supplement in food products. Because of its effectiveness, accessibility, low cost, and nontoxicity, Lf could be a promising alternative for preventing or treating infections in animals and humans.

Addressing Challenges in Antibiotic Access: Barriers, Implications and Strategies for Solution.

Antimicrobial resistance (AMR) poses a significant threat to global public health, disproportionately affecting low- and middle-income countries (LMICs). While excessive antibiotic use is often discussed, the issue of access to antibiotics demands attention. This viewpoint explores the multidimensional nature of the issue of access to antibiotics. We have examined the issue through the lens of social, economic, healthcare structures, manufacturing and supply chain, policy and practices. Inter-relatedness of these issues has also been explored. The review further discusses potential solutions involving but not limited to increased awareness, improvement in healthcare infrastructure, models for sustained manufacturing and supply chains. Additionally, enhancing antimicrobial stewardship at hospital and community levels, empowering healthcare professionals, and emphasizing infection prevention are crucial. Global initiatives that aim to address access challenges, emphasizing collaboration and innovation are important to foster for a sustained response to the issue of antibiotic access.

Dual-Responsive Antibacterial Hydrogel Patch for Chronic-Infected Wound Healing.

Bacterial infections in chronic wounds, such as bedsores and diabetic ulcers, present significant healthcare challenges. Excessive antibiotic use leads to drug resistance and lacks precision for targeted wound treatment. Our study introduces an innovative solution: a near-infrared (NIR) and pH dual-responsive hydrogel patch incorporating regenerated silk fibroin (RSF) and molybdenum dioxide (MoO2) nanoparticles (NPs), offering enhanced mechanical properties, precise drug release, and superior antibacterial efficacy. The dual-responsive hydrogel patch allows for precise control over antibiotic release triggered by NIR light and pH fluctuations, enabling tailored treatment for infected wounds. First, the pH-responsive characteristic matches the alkaline environment of the infected wound, ensuring on-demand antibiotic release. Second, NIR exposure accelerates antibiotic release, enhancing wound healing and providing additional antibacterial effects. Additionally, the patch further blocks bacterial infection, promotes wound repair, and degrades in sync with the healing process, further bolstering the efficacy against wound infections.

Antimicrobial Activity of Bacillus Coagulans Supernatant Against Human Enteric Pathogens

Background: Chronic bacterial diarrheas are common intestinal infections that have been treated with antibiotics for many years. However, the excessive use of antibiotics has led to the development of resistance in the bacteria that cause these infections. As a result, there has been growing interest in using probiotics with antibacterial effects and a greater ability to survive stomach acidity to help control antibiotic-resistant bacteria. Objectives: In the current study, the antimicrobial activity of Bacillus coagulans (a probiotic bacterium) against four different enteric pathogens (Escherichia coli, Salmonella typhi, Shigella flexneri, and Bacillus cereus), which play a significant role in the prevalence of bacterial diarrhea, has been investigated. Methods: The antimicrobial effect of the cell-free supernatant of Bacillus coagulans against pathogens (E. coli, S. typhi, Sh. flexneri, and B. cereus) was studied using agar well-diffusion, agar disc-diffusion, as well as minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. In the MIC test, the concentrations of B. coagulans cell-free supernatant examined were 100, 50, 25, 12.5, 6.25, and 3.1 µg per mL. Each bacterial strain was tested in four replicates. Results: The antimicrobial activity of B. coagulans supernatant was not observed in either the agar well-diffusion or agar disc-diffusion results. However, MIC results showed that different concentrations of B. coagulans supernatant significantly inhibit the growth of E. coli (MIC = 25 µg/mL, P < 0.0001), S. typhi (MIC = 50 μg/mL, P < 0.0001), S. flexneri (MIC = 3.1 μg/mL, P < 0.0001), and B. cereus (MIC = 100 µg/mL, P < 0.0001). Conclusions: The MBC results showed that the minimum inhibitory concentration of the supernatant had no bactericidal effects and did not completely prevent the growth of all four pathogens. Although the MIC results indicated the antibacterial activity of B. coagulans against all four pathogens, further studies are required to draw more accurate conclusions.

Identification of a Novel β-Defensin Gene in Gilthead Seabream (Sparus aurata)

The excessive use of antibiotics in aquaculture favors the natural selection of multidrug-resistant bacteria, and antimicrobial peptides (AMPs) could be a promising alternative to this problem. The most studied AMPs in teleost fish are piscidins, hepcidins, and β-defensins. In this work, we have found a new gene (defb2) encoding a type 2 β-defensin in the genome of gilthead seabream, a species chosen for its economic interest in aquaculture. Its open reading frame (192 bp) encodes a protein (71 amino acids) that undergoes proteolytic cleavage to obtain the functional mature peptide (42 amino acids). The genetic structure in three exons and two introns and the six characteristic cysteines are conserved as the main signature of this protein family. In the evolutionary analysis, synteny shows a preservation of chromosomal localization and the phylogenetic tree constructed exposes the differences between both types of β-defensin as well as the similarities between seabream and European seabass. In relation to its basal expression, β-defensin 2 is mostly expressed in the intestine, thymus, skin, and gonads of the gilthead seabream (Sparus aurata). In head kidney leucoytes (HKLs), the expression was very low and did not change significantly when stimulated with various immunocompetent agents. However, the expression was significantly down-regulated in the liver, head–kidney, and blood 4 h post-injection with the fish pathogen Vibrio harveyi. When infected with nodavirus, the expression was downregulated in brain at 7 days post-infection. These results denote a possible complementarity between the expression patterns of β-defensins and hepcidins. Further studies are needed to analyze gene duplications and expression patterns of β-defensins and describe their mechanism of action in seabream and other teleost fish.

Light‐Activated Nanocatalyst for Precise In‐Situ Antimicrobial Synthesis via Photoredox‐Catalytic Click Reaction

AbstractThe excessive and prolonged use of antibiotics contributes to the emergence of drug‐resistant S. aureus strains and potential dysbacteriosis‐related diseases, necessitating the exploration of alternative therapeutic approaches. Herein, we present a light‐activated nanocatalyst for synthesizing in situ antimicrobials through photoredox‐catalytic click reaction, achieving precise, site‐directed elimination of S. aureus skin infections. Methylene blue (MB), a commercially available photosensitizer, was encapsulated within the CuII‐based metal–organic framework, MOF‐199, and further enveloped with Pluronic F‐127 to create the light‐responsive nanocatalyst MB@PMOF. Upon exposure to red light, MB participates in a photoredox‐catalytic cycle, driven by the 1,3,5‐benzenetricarboxylic carboxylate salts (BTC−) ligand presented in the structure of MOF‐199. This light‐activated MB then catalyzes the reduction of CuII to CuI through a single‐electron transfer (SET) process, efficiently initiating the click reaction to form active antimicrobial agents under physiological conditions. Both in vitro and in vivo results demonstrated the effectiveness of MB@PMOF‐catalyzed drug synthesis in inhibiting S. aureus, including their methicillin‐resistant strains, thereby accelerating skin healing in severe bacterial infections. This study introduces a novel design paradigm for controlled, on‐site drug synthesis, offering a promising alternative to realize precise treatment of bacterial infections without undesirable side effects.

Light-Activated Nanocatalyst for Precise In-Situ Antimicrobial Synthesis via Photoredox-Catalytic Click Reaction.

The excessive and prolonged use of antibiotics contributes to the emergence of drug-resistant S. aureus strains and potential dysbacteriosis-related diseases, necessitating the exploration of alternative therapeutic approaches. Herein, we present a light-activated nanocatalyst for synthesizing in situ antimicrobials through photoredox-catalytic click reaction, achieving precise, site-directed elimination of S. aureus skin infections. Methylene blue (MB), a commercially available photosensitizer, was encapsulated within the CuII-based metal-organic framework, MOF-199, and further enveloped with Pluronic F-127 to create the light-responsive nanocatalyst MB@PMOF. Upon exposure to red light, MB participates in a photoredox-catalytic cycle, driven by the 1,3,5-benzenetricarboxylic carboxylate salts (BTC-) ligand presented in the structure of MOF-199. This light-activated MB then catalyzes the reduction of CuII to CuI through a single-electron transfer (SET) process, efficiently initiating the click reaction to form active antimicrobial agents under physiological conditions. Both in vitro and in vivo results demonstrated the effectiveness of MB@PMOF-catalyzed drug synthesis in inhibiting S. aureus, including their methicillin-resistant strains, thereby accelerating skin healing in severe bacterial infections. This study introduces a novel design paradigm for controlled, on-site drug synthesis, offering a promising alternative to realize precise treatment of bacterial infections without undesirable side effects.

An Antibiotic-Degrading Engineered Biofilm Platform to Combat Environmental Antibiotic Resistance.

The presence of antibiotics in natural water bodies is a growing problem regarding the occurrence of antibiotic resistance among various species. This is mainly caused by the excessive use of medical and veterinary antibiotics as well as the lack of effective treatment processes for eliminating residual antibiotics from wastewaters. In this study, we introduce a genetically engineered biomaterial as a solution for the effective degradation of one of the dominantly found antibiotics in natural water bodies. Our biomaterial harnesses laccase-type enzymes, which are known to attack specific types of antibiotics, i.e., fluoroquinolone-type synthetic antibiotics, and as a result degradation occurs. The engineered biomaterial is built using Escherichia coli biofilm protein CsgA as a scaffold, which is fused separately to two different laccase enzymes with the SpyTag-SpyCatcher peptide-protein duo. The designed biofilm materials were successful in degrading ciprofloxacin, as demonstrated with the data obtained from mass spectrometry analysis and cell viability assays.

C-reactive protein compared to procalcitonin in guiding of anti-microbial stoppage in patients with septic shock

BackgroundOne of the greatest and most effective strategies to decrease the likelihood of discovering antibiotic-resistant bacteria in patients receiving critical care is to shorten the duration of antibiotic therapy.ObjectivesTo assess the utility of procalcitonin compared to traditional inflammation markers like C-reactive protein in an antimicrobial stoppage in patients with septic shock.MethodsThis was a comparative, prospective, randomized, observer-blind clinical experiment conducted on 60 septic patients hospitalized in intensive care units at Benha University hospitals between May 2021 and May 2022. Groups for PCT and CRP patients were separated. The full clinical history, co-morbidities that were related, and patient history were recorded. The baseline PCT and CRP values were determined on days 4, 7, 10, and 14. They were contrasted with sepsis ratings obtained from the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sepsis-related Organ Failure Assessment (SOFA). Days 4, 7, and 10 were used to evaluate the antibiotic's efficacy.ResultsThere was no correlation between CRP levels and APACHE II and SOFA scores on days 1, 4, and 7, but on days 7 and 10, PCT levels were strongly linked with both (P < 0.05). PCT was linked to lower antibacterial exposure (23.3% of PCT participants ceased taking antibiotics on day 4, compared to 6.6% of CRP participants; P = 0.07). After 10 days, 30% of the PCT group and 70% of the CRP group kept up their antimicrobial regimen (P = 0.0001).ConclusionProcalcitonin dramatically reduced the duration of antimicrobial treatment. Procalcitonin use has reduced hospital expenses, complications of extended hospital stay, side effects of excessive antibiotic use, and hence, the mortality rate in septic patients.

Positive assessment of an autogenous vaccine against pathogenic Escherichia coli in broiler breeders and their progeny in Morocco

Excessive use of antibiotics to control colibacillosis on poultry farms in Morocco contributes to the development of multiresistant avian pathogenic Escherichia coli. Autogenous vaccines are an alternative to antibiotic usage. The main goal of this study was to assess the efficacy of this approach to control recurrent outbreaks of colibacillosis in a large broiler production flow. A tetravalent autogenous vaccine (serotypes O78, O88, O91, and O185) was produced from multiresistant E. coli strains isolated from clinical lesions in breeding hens and used on two farms (65,000 breeding hens in total). On each farm, contemporaneous groups were included: groups vaccinated twice (12 and 18 weeks of age) and unvaccinated control groups. The performances of these flocks, as well as the performances of broilers hatched from these breeders (12 farms, over 600,000 broilers in total), were recorded. A significant reduction in lesion scores, mortality rate and a significant increase in the number of sellable day-old chicks were observed among vaccinated hens. In broilers, body weight at slaughter, lesion scores, feed conversion ratio, mortality, and condemnation rates were significantly improved. This is the first field observation of a lasting effect of breeder hen’s immunization with an autogenous vaccine against E. coli on their offspring.

Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan

Background &amp; objective: The prevalence of antibiotic resistance has increased with the excessive use of antibiotics in our country. We aimed to examine the patterns of antibiotic resistance in different organisms found in patients admitted to our Medical Intensive Care Unit (MICU). Additionally, the study sought to determine the relationship between the pathogen causing the infection and the outcome of the patients. Methodology: This retrospective observational cross-sectional study was conducted in the MICU of Farooq Hospital affiliated with Akhtar Saeed Medical College, Rawalpindi, Pakistan, from January 01, 2024 to March 31, 2024. The data was collected from the medical records of adult patients (aged 12-79 y) who were admitted to the MICU during the study period. SPSS 29 was used for data analysis. Analyzed data included information on demographics, culture results, and antibiotic resistance patterns. We included culture results of blood, urine, and Foley catheter tip. The final disposal of the patients was noted and linked to the pathogen responsible for the disease. Results: The study involved 104 patients admitted to the MICU. The average duration of stay was 5.36 days, the average age was 51.17 ± 18.47 y, and 61.53% of the patients were male. The primary diagnoses were urinary tract infection (18.22%) and sepsis (15.76%). Pre-existing conditions included diabetes mellitus (24.15%) and hypertension (23.59%). Klebsiella pneumoniae was the predominant organism, followed by E. coli. Overall, 58.52% of the isolates showed resistance to the tested antibiotics. Specific drugs, such as ceftazidime and amoxicillin-clavulanic acid, demonstrated absolute resistance (100%), while vancomycin and tigecycline showed no resistance. In this study, patients with infections caused by Enterobacter, Enterococcus faecalis, Proteus, and Salmonella spp. had discharge rates of 100%. In contrast, infections caused by Candida, Acinetobacter species, and Klebsiella pneumoniae were associated with 100%, 75%, and 48.5% mortality rates, respectively. Conclusion: The study revealed a significant prevalence of antibiotic resistance among microorganisms in our Medical Intensive Care Unit. Klebsiella pneumoniae was the predominant organism, and distinct bacterial infections were linked to diverse patient outcomes. Abbreviations: MDR - multidrug resistance; MICU - Medical Intensive Care Unit; MRSA - methylene resistant S. aureus XDR - extensively drug resistant Keywords: Antibiotic, Resistance, Pakistan, Intensive Care Units. Citation: Bacha MF, Sayed TM, Maqsood J, Noaman M, Aslam M, Noureen F, Ikram N. Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan. Anaesth. pain intensive care 2024;28(4):727−731; DOI: 10.35975/apic.v28i4.2521 Received: June 10, 2024; Reviewed: June 21, 2024; Accepted: July 15,2024

Challenges in designing a randomized, double-blind noninferiority trial for treatment of acne: The SD-ACNE trial.

Excessive use of antibiotics has led to development of antibiotic resistance and other antibiotic-associated complications. Dermatologists prescribe more antibiotics per clinician than any other major specialty, with much of this use for acne. Alternative acne treatments are available but are used much less often than antibiotics, at least partially because dermatologists feel that they are less effective. Spironolactone, a hormonal therapy with antiandrogen effects that can address the hormonal pathogenesis of acne, may represent a therapeutic alternative to oral antibiotics for women with acne. However, the comparative effects of spironolactone and oral antibiotics in the treatment of acne have not been definitively studied. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation (SD-ACNE) trial aims to answer whether spironolactone, in addition to standard topical therapy, is noninferior to doxycycline (an oral antibiotic) for women with acne. Several interesting challenges arose in the development of this study, including determining acceptability of the comparative regimens to participating dermatologists, identifying data to support a noninferiority margin, and establishing a process for unblinding participants after they completed the study while maintaining the blind for study investigators. We present the scientific and clinical rationale for the decisions made in the design of the trial, including input from key stakeholders through a Delphi consensus process. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial (NCT04582383) is being conducted at a range of community and academic sites in the United States. To maximize external validity and inform clinical practice, the study is designed with broad eligibility criteria and no prohibition of use of topical medications. Participants in the trial will be randomized to receive either spironolactone 100 mg/day or doxycycline hyclate 100 mg/day for 16 weeks. The primary outcome is the absolute decrease in inflammatory lesion count, and we have established a noninferiority margin of four inflammatory lesions. Secondary outcomes include the percentage of participants achieving Investigator Global Assessment success, change in quality of life, and microbiome changes and diversity. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial will have substantial implications for the treatment of acne and antibiotic stewardship. In addition, this study will provide important information on the effect of these systemic agents on the development of changes to the microbiome and antibiotic resistance in a healthy population of patients.

Neutrophil Extracellular Traps-Inspired Bismuth-Based Polypeptide Nanonets for Synergetic Treatment of Bacterial Infections.

Excessive use of antibiotics and the formation of bacterial biofilms can lead to persistent infections caused by drug-resistant bacteria, rendering ineffective immune responses and even life-threatening. There is an urgent need to explore synergistic antibacterial therapies across all stages of infection. Drawing inspiration from the antibacterial properties of neutrophil extracellular traps (NETs) and integrating the bacterial biofilm dispersal mechanism involving boronic acid-catechol interaction, the multifunctional bismuth-based polypeptide nanonets (PLBA-Bi-Fe-TA) are developed. These nanonets are designed to capture bacteria through a coordination complex involving cationic polypeptides (PLBA) with boronic acid-functionalized side chains, alongside metal ions (bismuth (Bi) and iron (Fe)), and tannic acid (TA). Leveraging the nanoconfinement-enhanced high-contact network-driven multiple efficiency, PLBA-Bi-Fe-TA demonstrates the excellent ability to swiftly capture bacteria and their extracellular polysaccharides. This interaction culminates in the formation of a highly hydrophilic complex, effectively enabling the rapid inhibition and dispersion of antibiotic-resistant bacterial biofilms, while Fe-TA shows mild photothermal ability to further assist fluffy mature biofilm. In addition, Bi is beneficial to regulate the polarization of macrophages to pro-inflammatory phenotype to further kill escaping biofilm bacteria. In summary, this novel approach offers a promising bionic optimization strategy for treating bacterial-associated infections at all stages through synergetic treatment.

Innovations in combating antimicrobial resistance: Unveiling nanotechnology, gene technology, and molecular diagnostics

Antimicrobial resistance (AMR) presents a substantial global menace, diminishing the effectiveness of antibiotics and posing challenges to combat bacterial infections. The excessive use of antibiotics accelerates the emergence of drug-resistant pathogens, resulting in prolonged illnesses, elevated mortality rates, and escalated healthcare expenditures. Consequently, there is a drive to explore novel solutions to address this pressing concerns. Nanotechnology, gene technology, and molecular diagnostics are being developed as innovative strategies to tackle AMR. These approaches enable precise drug delivery, genetic modifications, and rapid detection of drug-resistant strains. This review examines these advanced technologies, highlighting their potential in AMR management and advocating for a comprehensive approach.

Livestock and poultry breeding farms as a fixed and underestimated source of antibiotic resistance genes.

The excessive use of antibiotics, disinfectants, and drugs in livestock and poultry breeding has resulted in a rise in the presence of antibiotic resistance genes (ARGs). Antibiotic-resistant bacteria (ARB) and ARGs have been widely found in animal feces, farm wastewater, and farm air. ARGs can not only spread across media through adsorption and migration, but also transfer resistance across bacterial genera through horizontal gene transfer. Livestock breeding has become a fixed and unavoidable source of ARGs in the environment. Existing technologies for controlling ARGs, such as composting, disinfection, and sewage treatment, are not efficient in removing ARB and ARGs from waste. Furthermore, the remaining ARGs still possess a strong capacity for dissemination. At present, antibiotics used in animal husbandry are difficult to replace in a short period of time. The growth and potential risks of resistance genes in livestock and poultry breeding sources in the receiving environment are not yet clear. In this paper, we summarize the current situation of ARGs in the livestock and poultry breeding environment. We also explain the key environmental processes, main influencing factors, and corresponding ecological risks associated with ARGs in this environment. The advantages and disadvantages of current technologies for the removal of ARGs are primarily discussed. There is a particular emphasis on clarifying the spatiotemporal evolution patterns and environmental process mechanisms of ARGs, as well as highlighting the importance and urgency of developing efficient pollution control technologies.