Excessive Use Of Antibiotics Research Articles

Overuse of Antibiotics: Who is to Blame? A Qualitative Study.

The irrational use of antibiotics seriously threatens global health. Clinicians undoubtedly play an essential role in consuming antibiotics in hospitals and communities, and their attitudes may help the health system's optimal treatment of antibiotics. In this study, we reported clinicians' experiences with antibiotics used in Isfahan, Iran. In a qualitative study conducted from October 2020 to March 2021, the experiences of 13 clinicians with different clinical specialties were collected through one-to-one interviews. Participants were selected through purposive sampling until data saturation; data collection was conducted through semi-structured interviews. Conventional content analysis was used to analyze the transcribed interviews. The main category was recognized and subcategorized and coded by three researchers. Eight women and five men with a mean work experience of 12.54 ± 10.047 years participated in the study. All of them worried about the overuse of antibiotics and antibiotic resistance. Clinicians believe that the antimicrobial stewardship committee is not active in our country. Laboratory challenges, healthcare providers, the poor performance of the health system, and marketing and business were the main categories of the study. Subcategrories of main categories included inefficiency in the function of laboratories, harmful profit, challenges in medical education, ups and downs of disease treatment, the unacceptable performance of hospitals, failure to upgrade the health system, threats and opportunities, and jobbery. The participants of this study believed that excessive use of antibiotics is a serious challenge in our country. Physicians were concerned about antibiotic resistance and believed that the pattern of antibiotic resistance was not routinely reported. Therefore, in our region, we should make more efforts to collect data in this field and provide this information to physicians. Also, this study confirmed many obstacles to implementing the antimicrobial stewardship program, and the infrastructure needs strengthening. There is also a need for cultural changes and the views of physicians.

Characterization of the probiotic properties of Lacticaseibacillus rhamnosus LR6 isolated from the vaginas of healthy Korean women against vaginal pathogens

The human microbiome exhibits intricate populations across the body, with the vaginal tract serving as an ecosystem characterized by the prevalence of the genus Lactobacillus. Disruptions in the vaginal microbiota, which are frequently linked to variables such as sexual activity, hormonal fluctuations, and excessive use of antibiotics, can result in vaginal dysbiosis and the development of diseases such as bacterial vaginosis (BV) and candidiasis. Lactobacillus species, owing to their capacity to create an acidic environment through the production of lactic acid, have a key function within this complex microbial community: they inhibit the growth of harmful microorganisms. This study aimed to investigate the genomic characteristics of L. rhamnosus LR6, a newly discovered strain isolated from the vaginal microbiota of 20 healthy women to assess its potential as a vaginal probiotic. We performed a comparative investigation of the genetic traits of L. rhamnosus using 45 publicly available genomes from various sources. We evaluated the genetic characteristics related to carbohydrate utilization, adhesion to host cells, and the presence of bacteriocin clusters. A comprehensive study was conducted by integrating in silico evaluations with experimental techniques to authenticate the physiological characteristics of strain LR6. We further used a rat model to assess the impact of L. rhamnosus LR6 administration on the changes in the gastrointestinal tract and the vaginal microbiome. The assessments revealed a significantly high inhibitory activity against pathogens, enhanced adherence to host cells, and high lactic acid production. Rat experiments revealed changes in both the fecal and vaginal microbiota; in treated rats, Firmicutes increased in both; Lactobacillaceae increased in the fecal samples; and Enterobacteriaceae decreased but Enterococcaceae, Streptococcaceae, and Morganellaceae increased in the vaginal samples. The study results provide evidence of the genetic characteristics and probiotic properties of LR6, and suggest that oral administration of L. rhamnosus LR6 can alter both gut and vaginal microbiome. Collectively, these findings establish L. rhamnosus LR6 as a highly promising candidate for improving vaginal health.

Photothermal antibacterial MoS2 composited chitosan hydrogel for infectious wound healing

Pathological bacterial infection poses a serious threat to public health security. The excessive use of antibiotics has resulted in a serious decline in treatment effect and bacterial resistance. For the treatment of infected wounds, we compounded dopamine-assisted exfoliated molybdenum disulfide (MoS2@PDA) into lipoic acid modified chitosan (LAMC) to obtain a composite hydrogel dressing (LAMC-MoS2@PDA). LAMC-MoS2@PDA hydrogels exhibited excellent photothermal conversion ability and the LAMC-MoS2@PDA2 group (0.3 wt%) has a photothermal conversion efficiency of 26.29 %. Meanwhile, they showed good biocompatibility and ROS scavenging activity in vitro. Photothermal therapy usually utilizes photothermal agents to convert near-infrared light into heat energy for bacterial cell membrane destruction and bacterial protein inactivation. Under the near-infrared light irradiation, the antibacterial ratio of LAMC-MoS2@PDA hydrogels against Staphylococcus aureus and Escherichia coli reached nearly 100 %, and the morphology of the bacteria showed obvious contraction and cleavage. The hydrogels also showed an excellent antibacterial effect and wound healing promotion in the infected wound of rats. In particular, the LAMC-MoS2@PDA2 (+) group (with NIR) showed almost complete wound closure after 14 days, indicating that the LAMC-MoS2@PDA hydrogels have great potential in clinical anti-infected treatment.

Solanum lycopersicum heme-binding protein 2 as a potent antimicrobial weapon against plant pathogens

The rise in antibiotic-resistant bacteria caused by the excessive use of antibiotics has led to the urgent exploration of alternative antimicrobial solutions. Among these alternatives, antimicrobial proteins, and peptides (Apps) have garnered attention due to their wide-ranging antimicrobial effects. This study focuses on evaluating the antimicrobial properties of Solanum lycopersicum heme-binding protein 2 (SlHBP2), an apoplastic protein extracted from tomato plants treated with 1-Methyl tryptophan (1-MT), against Pseudomonas syringae pv. tomato DC3000 (Pst). Computational studies indicate that SlHBP2 is annotated as a SOUL heme-binding family protein. Remarkably, recombinant SlHBP2 demonstrated significant efficacy in inhibiting the growth of Pst within a concentration range of 3–25 μg/mL. Moreover, SlHBP2 exhibited potent antimicrobial effects against other microorganisms, including Xanthomonas vesicatoria (Xv), Clavibacter michiganensis subsp. michiganensis (Cmm), and Botrytis cinerea. To understand the mechanism of action employed by SlHBP2 against Pst, various techniques such as microscopy and fluorescence assays were employed. The results revealed that SlHBP2 disrupts the bacterial cell wall and causes leakage of intracellular contents. To summarize, the findings suggest that SlHBP2 has significant antimicrobial properties, making it a potential antimicrobial agent against a wide range of pathogens. Although further studies are warranted to explore the full potential of SlHBP2 and its suitability in various applications.

Chicken feedlot revisited: Co-dispersal of antibiotic and metal resistome under banning in-feed veterinary antibiotics

Intensive livestock farming has been implicated as a notorious hotspot for antibiotic resistance genes (ARGs) due to the excessive or inappropriate use of in-feed antibiotics over the past few decades. Since China implemented a ban on the use of antibiotics in animal feed since 2020, the dissemination of ARGs in the vicinity of feedlots has remained unclear. This study presents a case study that aims to investigate the dispersal of antibiotics and ARGs from a chicken feedlot (established in 2020) to the adjacent aquatic and soil environments. Comparing the sample collected from upstream area, the water and sediment samples from midstream and downstream areas showed an increase in total antibiotic residues and metal content (Cu and Zn) by 4.2–5.3 fold and 1.3–22.6 fold, respectively. The downstream water samples exhibited a 2.49–2.93-fold increase in the abundance of ARGs and a 1.48–1.75-fold increase in the abundance of metal resistance genes (MRGs). The results of Pearson correlation and metagenome-assembled genome revealed a tendency for the co-occurrence of ARGs and MRGs. The dissemination of ARGs and MRGs is primarily driven by tetracycline, tylosin, Cu, and, Mn, with mobile genetic elements playing a more significant role than bacterial communities. These findings shed light on the overlooked co-dispersal pattern of ARGs and MRGs in the environment surrounding feedlots, particularly in the context of banning in-feed veterinary antibiotics.

PREVALENCE OF PLASMID MEDIATED QNRA, QNRB AND QNRS AMONG CLINICAL ESCHERICHIA COLI ISOLATED FROM URINARY TRACT INFECTIONS IN DUHOK, KURDISTAN REGION OF IRAQ

Excessive use of antibiotics (such as fluoroquinolone) and inadequate infection control practices have turned antibiotics resistance (AMR) into a global, public health peril. The current study emphasizes on the prevalence of qnrA, qnrB, and qnrS plasmid in fluroquinolone (FQ) resistant Escherichia coli (E. coli) isolates from urinary tract samples and their correlation with the burden of resistance in these isolates. In this research, several E. coli strains were isolated from outpatients having urinary tract infections (UTIs) from Duhok province, Kurdistan Region of Iraq. Biochemical and Molecular confirmations were performed to confirm the isolates. Antibiotics susceptibility test was performed to detect the isolates antibiogram. Furthermore, polymerase chain reaction (PCR) amplification was used to detect the qnrA, B and S genes. Bioinformatics tools were used to perform the analysis of the results and data visualization. Forty isolates (out of 55) have been confirmed as E. coli. Antibiograms revealed that 70%, 65% and 63% of the isolates were resistant to Ciprofloxacin, Enrofloxacin and Levofloxacin, respectively. While there was variation in resistance to other antibiotics tested. The FQ resistant genes were detected in 17 (42.5%) isolates, with some isolates carrying more than one gene. The variant qnrS was the most predominant, as it has been detected in 14 isolates. The increasing rates of multidrug resistance E. coli isolates from UTIs, including FQ antibiotics, emphasizes the importance of carefully monitoring their use for UTI treatment.

Molecular Investigation of gyrA Mutations in Clinical Isolates of Methicillin-Resistant Staphylococcus aureus Derived from Diverse Sources

Background: Fluoroquinolones are the most effective antibiotics against Staphylococcus aureus isolates. In hospitals, excessive use of antibiotics has led to the emergence of highly resistant strains of S. aureus isolates. Objective: The aim of this study was to detect the mutations that occur in the gyrA gene encoding for DNA gyrase, which is one of the targets for fluoroquinolone resistance. Methods: Fifty clinical isolates were diagnosed as S. aureus according to molecular and bacteriological methods. The susceptibility tests were performed on all bacterial isolates by the disc diffusion method using methicillin and six fluoroquinolone antibiotics. Results: Out of fifty isolates, twelve were resistant to methicillin and all six antibiotics (nalidixic acid, lomefloxacin, ciprofloxacin, norfloxacin, ofloxacin, and levofloxacin). From the fifty isolates, 12 were resistant, 3 were intermediate, and 38 were sensitive to three or more tested antibiotics. The resistance of S. aureus isolates was also confirmed by the minimum inhibitory concentration test. The main sources of isolates were burns (10%), nose (16) wounds (8%), operation room (10%), ear (20%), urine (8%), skin (6%), and throat (22%). Twelve resistant isolates were used to examine the mutations in the gyrA gene. A direct sequence analysis found eight mutations in the gyrA gene; these mutations included 2 (25% missense mutations), 1 (12.5%) deletion mutation, and 5 (62.5%) silent mutations at various sites. Conclusion: gyrA mutations resulting from the excessive use of antibiotics may be one of the mechanisms leading to fluoroquinolone resistance.

A Review on Advanced Nanomaterials for Antibacterial Applications

Abstract: The management of infectious diseases is one of the major public health challenges of the 21st century. Mutation of the microbes, biofilm formation, and other structural-morphological behaviors have resulted in pathogens acquiring multi-drug resistance. The development of advanced materials that can provide long-lasting and effective protection against harmful microbes is becoming a need of the hour. Biocompatibility, efficient microbial inactivation, thermal and chemical stability of nanomaterials help to reduce the excessive use of antibiotics and, thus, to overcome antimicrobial resistance. Metal and metal oxide nanostructures, graphene, carbon dots, and other two-dimensional materials exhibit excellent antimicrobial properties. This review provides a comprehensive overview of antibacterial mechanisms and factors that help to inactivate the bacteria by nanomaterials. It also points out the enhanced antibacterial behaviors of the modified nanomaterials for future research concerns. Abstract: The management of infectious diseases is one of the major public health challenges of the 21st century. Mutation of the microbes, biofilm formation, and other structural-morphological behaviors have resulted in pathogens acquiring multi-drug resistance. The development of advanced materials that can provide long-lasting and effective protection against harmful microbes is becoming a need of the hour. Biocompatibility, efficient microbial inactivation, thermal and chemical stability of nanomaterials help to reduce the excessive use of antibiotics and, thus, to overcome antimicrobial resistance. Metal and metal oxide nanostructures, graphene, carbon dots, and other two-dimensional materials exhibit excellent antimicrobial properties. This review provides a comprehensive overview of antibacterial mechanisms and factors that help to inactivate the bacteria by nanomaterials. It also points out the enhanced antibacterial behaviors of the modified nanomaterials for future research concerns.

Nanomaterial-based fluorescent biosensors for the detection of antibiotics in foodstuffs: A review.

Antibiotics are widely used as bacteriostatic or bactericidal agents against various microbial infections in humans and animals. The excessive use of antibiotics has led to an accumulation of their residues in food products, which ultimately poses a threat to human health. In light of the shortcomings of conventional methods for antibiotic detection (primarily cost, proficiency, and time-consuming procedures), the development of robust, accurate, on-site, and sensitive technologies for antibiotic detection in foodstuffs is important. Nanomaterials with amazing optical properties are promising materials for developing the next generation of fluorescent sensors. In this article, advances in detecting antibiotics in food products are discussed with respect to their sensing applications, with a focus on fluorescent nanomaterials such as metallic nanoparticles, upconversion nanoparticles, quantum dots, carbon-based nanomaterials, and metal-organic frameworks. Furthermore, their performance is evaluated to promote the continuation of technical advances.

A new supramolecular fluorescent probe based on cucurbit[8]uril for visual determination of norfloxacin: Multi-color, quantitative detection, and practical applications

In recent years, the excessive use of antibiotics in agricultural by-products and aquaculture has attracted great attention due to its impact on human health and damage to ecosystems. Therefore, it is of great significance to detect antibiotics with sensitive and intuitive. In this paper, we report a novel fluorescence probe based on multiple chromaticity response for the rapid and sensitive detection of norfloxacin, in which the fluorescence probe was assembled through host–guest coordination between cucurbit[8]uril (Q[8]) and dibromoxanthen-9-one phenylpyridine cationic derivative (DBXPY), named DBXPY@Q[8]. With the addition of norfloxacin, the probe DBXPY@Q[8] provides a continuous fluorescence color change from yellow to blue, and even white fluorescence appears. In the presence of amino acids, pesticides, and other antibiotics, the probe remains unaffected in the detection of norfloxacin with a low detection limit (1.08 × 10−7 M). Interestingly, combined with smart phone RGB analysis, the probe DBXPY@Q[8] enables visual and quantitative detection of norfloxacin without any precision instrument and can be applied to the detection of norfloxacin in food and water. In contrast to traditional NOF detection methods, which are time-consuming, costly, and complex to operate, the use of fluorescent probes allows for the visual analysis and detection of NOF in water and food. It’s simple to operate, responsive, and can be monitored in real time, offering a significant improvement over conventional methods and has great application potential in field and quantitative analysis.

One Health strategies for addressing antimicrobial resistance: an exclusive emphasis on Bulgaria

Abstract Antimicrobial resistance (AMR) is a public health challenge, primarily driven by the excessive use of antibiotics (ABs). While the European Union (EU) has successfully reduced ABs consumption since 2009, Bulgaria (BG) reports an increase in ABs use in both community and hospital settings. According to the 2021 Eurobarometer, the consumption rate of ABs among Bulgarians is twice as high as that in Germany, with a significant number taking ABs without a prescription. Moreover, only 41% of Bulgarians are aware that ABs do not kill viruses, and 30% took ABs for COVID-19 (as compared to 1% in Finland). This highlights an urgent need for interventions to tackle AMR in BG, using One Health (OH) approaches that consider the complex interplay between human, animal, and environmental health. The data presented aims to alert a wide range of stakeholders that AMR is not just a clinical or national issue but it has cross-border implications. It emphasizes the role that everyone must play in preserving the efficacy of ABs. Strategies for sustainable OH solutions: Researchers and educators should incorporate AMR and OH in their core responsibilities, providing relevant training and raising community awareness regarding prudent ABs use. Encouraging integrative medicine approaches, including traditional practices such as phytotherapy, can help delay the ABs prescriptions. Research is also necessary to support OH legislative changes that restrict ABs sales. Particularly, Bulgaria is among the few EU countries that have not approved an OH Action Plan against AMR or an inter-sectoral OH mechanism between veterinary, food, and health authorities. OH remains relatively unfamiliar in BG. Despite this, there is a political will to develop national OH policies, as demonstrated in the recently adopted National Health Strategy 2030. Urgent actions are needed to address AMR in BG. Using EU's AMR activities as a model, this analysis is a step towards a regional OH project. Key messages • AMR is a pressing public health problem in Bulgaria with cross-border implications. One Health strategies are needed urgently to address it. EU's AMR activities can be a model. • Bulgarian researchers, educators, and policymakers must make AMR their central responsibility. OH Action Plan against AMR and an inter-sectoral collaboration are the keys to success.

Candida species at the workplace: microbiota component, opportunistic pathogen and zoonotic agent

Candida spp. isolated from both humans and animals have a similar genotype. Properties of Candida spp. specific for different host species have not been isolated, followed by studies indicating that animals can be a reservoir of these fungi for humans. Occupational exposure concerns workers who have direct contact with farm animals, i.e., farmers, breeders, veterinarians, farm technicians. Hand dermatitis and fungal infection may be caused by prolonged exposure to water and occlusive gloves. The risk of fungal infection is estimated to be high for seafood workers, florists, hairdressers, bakers and cooks, gastronomy workers and healthcare workers. Even though Candida spp. are effective as saprophytic, in the event of a weakening of the function or disturbance of homeostasis, the risk of developing an additional form of candidiasis is increasing due to the intensification of animal production, environmental changes and the excessive use of antibiotics to treat infections in humans and animals. Employers and workers should adopt appropriate strategies to reduce factors conductive to Candida spp. infection at professional work. Med Pr Work Health Saf. 2023;74(5):425-33.

The Change in Antimicrobial Resistance During the COVID-19 Pandemic in Türkiye

Antimicrobial resistance (AMR) is one of the most important problems threatening human health worldwide. The impact of the Coronavirus disease-2019 (COVID-19) pandemic on AMR continues to be discussed. Some researchers argue that the pandemic will increase AMR rates, while others suggest the opposite. The aim of this study was to investigate the change in AMR of Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus strains in three cross-sectional periods in Türkiye, the first one before the COVID-19 pandemic, the second and the third one during the pandemic. The change in antibiotic susceptibility in Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus strains isolated from urine, blood, and lower respiratory tract samples of patients hospitalized in intensive care units and wards of hospitals before (November 2019) and during the COVID-19 pandemic (November 2020 and July 2021) was investigated in this study. A total of 17 voluntary hospitals, members of the Antibiotic Susceptibility Surveillance Study Group (ADSI) of the Society for Clinical Microbiology Specialists (KLIMUD), participated in the study. Identification of bacteria was performed with automated bacterial identification systems (VITEK2, bioMérieux, France or Phoenix, BD, USA). Antibiotic susceptibility tests were performed in one center with the Kirby-Bauer disc diffusion method and in other centers with automated antibiotic susceptibility test systems (VITEK2, bioMérieux, France or Phoenix, BD, USA), and the results were evaluated according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Antibiotic susceptibility ratios were statistically analyzed using either the chi-square or Fisher's exact test. A p-value of < 0.05 was considered statistically significant. Antibiotic susceptibility test results of a total of 4030 strains; 1152, 1139, and 1739 belonging to November 2019, November 2020, and July 2021, respectively; were examined. While cefotaxime and ceftazidime susceptibility rates in E.coli strains increased during the pandemic period compared to previous period (p= 0.04, p= 0.001, respectively); nitrofurantoin sensitivity (p= 0.02) and extended-spectrum beta-lactamase (ESBL) ratios (p< 0.001) were found to be decreased. It was determined that the susceptibility rates of all other examined antimicrobials did not change statistically. It was observed that the susceptibility rates of all antibiotics in K.pneumoniae isolates decreased during the pandemic period, but the ESBL rates increased between 2019-2020 (p= 0.01) and decreased between 2020-2021 (p= 0.02). It was found that ESBL rates increased before and after the pandemic. It was observed that the susceptibility to ciprofloxacin (p= 0.0001), levofloxacin (p= 0.003), and gentamicin (p= 0.005) in S.aureus strains increased during the pandemic period. No significant changes were observed in other antibiotic susceptibility rates. Methicillin resistance of S.aureus (MRSA) strains decreased between 2019-2020 (p= 0.03) and increased again in 2021 (p= 0.04) and returned to the pre-pandemic rate. Our study results suggest that the measures taken to reduce the spread of COVID-19 with the pandemic (such as quarantine practices, increased hand hygiene, mask use, and national/international travel restriction) may reduce the spread of bacteria such as ESBL-producing E.coli and the rate of MRSA, which is considered as a hand hygiene indicator. The increase in the later stages of the pandemic recalls the relaxation in compliance with hand hygiene rules. The decrease in the susceptibility rate of K.pneumoniae isolates to antibiotics and the increase in the ESBL rate may be due to inappropriate and excessive use of antibiotics during the pandemic period. However, we believe that these data should be supported by studies to be conducted nowadays when all the rules and measures are back as if the pandemic has ended.

Burden of Salmonella Typhi Isolated from Bloodstream Infection from 2015 to 2020: A Systematic Review and Meta-analysis

Background: Bangladesh is a major contributor to the global problem of typhoid fever, which is predominantly caused by Salmonella typhi. This is due to Bangladesh’s subpar healthcare standards, inadequate cleanliness standards, and inappropriate and excessive use of antibiotics. Objective: Salmonella typhi antibiotic resistance and the current situation of typhoid fever in Bangladesh were the subjects of this systematic review. Methodology: Finding publications about Salmonella typhi in Bangladesh published between 2015 and 2020 required searching Google Scholar, PubMed, and Bangladesh Journals Online with pertinent keywords. A predetermined set of criteria determined who would be included or excluded. Results: Initially,50 articles were retrieved. Using PRISMA flow chart 5 were selected for the study. Through forest plot, the overall effect size is found 0.28 which is represented by a diamond with confidence interval of 0.06 – 0.50. Since the confidence interval does not cross the threshold of no impact, the p value is 0.00. We can conclude that the overall effect is statistically significant. Microsoft excel was used to figure out the trend of antibiotic resistance. The effect size of an article was 0.08 (95%CI 0.05 – 0.11) and weighted 20.44%. Another study was reported with the effect size of 0.07 (95%CI 0.00 – 0.14) and weighted 20.07%. Conclusions: S. typhi was shown to be quite prevalent, and there were also significant surveillance and data gaps in the research’ methodological data. Bangladesh Journal of Infectious Diseases, June 2023;10(1):3-10

Two–step pulsed laser ablation for preparation NiO@ZnO core-shell nanostructure and evaluation of their antibacterial activity

The excessive use of antibiotics led to the appearance of many strains of resistant bacteria, so it became necessary to use new antibacterial techniques. The aim of this work is the synthesis of novel core–shell NPs (NiO@ZnO) for antibacterial applications. A novel NiO@ZnO core–shell nanomaterial with a nanosize and uniform shape has been synthesised using the two-step pulsed laser ablation in liquid (PLAL) method. The first step is the laser ablation of the nickel target and the production of NiO NPs (core) colloidal, followed by the second step, the ablation of ZnO (shell) inside NiO NPs colloidal. The transmission electron microscopy results approve the formation of NiO@ZnO core–shell NPs with an average particle size of 54.4 nm for NiO particles and 60.7 nm for the NiO@ZnO core–shell. The antibacterial activity was examined against the pathogenic bacterial strains E. coli and S. aureus. We found that in the case of NiO, the inhibition rates were 62.4 and 59.2% for E. coli and S. aureus, respectively. While with NiO@ZnO NPs, this result was improved to 74.8% for E. coli and 71.2% for S. aureus. So, it was found that using the core–shell NPs increased the antibacterial activity of NPs, and the use of NiO NPs and core approved their effect as antibacterial agents due to their special properties. This behaviour is primarily because of the accumulation of the NiO@ZnO NPs on the surface of the bacteria, which leads to cytotoxic bacteria and a relatively increased ZnO, causing cell death. Furthermore, the use of a NiO@ZnO core–shell material will inhibit the bacteria from nourishing themselves on the culture medium. Therefore, core shelling metal oxides with another metal oxide or other material improves their antibacterial activity compared with using them alone.

Pediatric orbital subperiosteal abscess outbreak in Iran: characteristics and causes.

To evaluate demographics, characteristics, and management of pediatric patients with subperiosteal abscesses (SPA) secondary to orbital cellulitis and discuss the etiology of a dramatic rise in SPA. Data were gathered by retrospective chart review of patients admitted to a tertiary referral eye hospital (Farabi Eye Hospital) diagnosed with orbital cellulitis with subperiosteal abscess from October 2022 to March 2023 (six months). Data on demographic information, clinical examination, radiographic evidence of sinusitis, orbital cellulitis, SPA, surgical and non-surgical management taken, isolated bacteria, and duration of hospital stay were gathered. 24 patients were admitted during these six months, with a diagnosis of orbital SPA secondary to paranasal sinusitis, confirmed by an orbital Computed Tomography (CT) scan. The age range was 11 months to 16 years. 75% of patients were male. All patients had a history of flu-like illness before developing orbital cellulitis. All patients had concurrent sinusitis, and 18 underwent initial surgical abscess drainage. The ethmoid sinus was the most involved, and most patients had a medially located SPA. Abscess volume ranged from 0.78 to 7.81 cm3 (mean: 3.52 cm3). One patient had concurrent central retinal artery occlusion due to orbital cellulitis. In this study, we report a dramatic increase in the incidence of SPA referred to our hospital. Larger abscess volumes and an increased number of cases that needed initial surgical drainage are also of note. An influenza outbreak in the autumn and winter, undiagnosed Corona Virus Disease 2019 (COVID-19) infection, increased antimicrobial resistance due to excessive off-label use of antibiotics during the COVID-19 pandemic, and more virulent bacterial infections are the most probable hypotheses to justify this observation.

Electromembrane extraction – capillary zone electrophoresis for the quantitative determination of β-lactam antibiotics in milk samples

Three penicillin-based β-lactam antibiotics (benzylpenicillin, amoxicillin, and ampicillin) were extracted by electromembrane extraction (EME) and determined in the resulting extracts by capillary zone electrophoresis (CZE) with UV–Vis detection. The EME was optimized for the simultaneous clean-up of complex samples and preconcentration of the three antibiotics and employed 1-octanol as the organic phase interface (impregnated in the pores of a hollow fiber), acidified donor solution (pH 3), and phosphate buffer (pH 5.6) as the acceptor solution. The EMEs were carried out for 20 min at 300 V and constant stirring (750 rpm) of the donor solution. At the optimized EME-CZE conditions, the sensitivity of the analytical method was sufficient for the determination of the three β-lactam antibiotics in undiluted cow's milk at concentrations below the EU maximum residue limits (4 μg/L) in foodstuffs. The method was simple, rapid, and convenient and offered extraction recoveries of 13.5 – 87.3 %, enrichment factors of 23.6 – 152.8, repeatability (RSD values) better than 7.6 %, linear analytical response in the 1 – 100 μg/L (3 – 100 μg/L for benzylpenicillin) concentration range with correlation coefficients ≥ 0.9997, and limits of detection from 0.2 to 1.2 μg/L. The proposed analytical concept was used for the rapid control of milk quality (i.e. assessment of excessive use of antibiotics in dairy animals), moreover, it was further extended to the trace determination of β-lactam antibiotics in other complex samples, such as in wastewater.

A Comparative Assessment of High-Throughput Quantitative Polymerase Chain Reaction versus Shotgun Metagenomic Sequencing in Sediment Resistome Profiling

Prolonged and excessive use of antibiotics has resulted in the development of antimicrobial resistance (AMR), which is considered an emerging global challenge that warrants a deeper understanding of the antibiotic-resistant gene elements (ARGEs/resistomes) involved in its rapid dissemination. Currently, advanced molecular methods such as high-throughput quantitative polymerase chain reaction (HT-qPCR) and shotgun metagenomic sequencing (SMS) are commonly applied for the surveillance and monitoring of AMR in the environment. Although both methods are considered complementary to each other, there are some appreciable differences that we wish to highlight in this communication. We compared both these approaches to map the ARGEs in the coastal sediments of Kuwait. The study area represents an excellent model as it receives recurrent emergency waste and other anthropogenic contaminants. The HT-qPCR identified about 100 ARGs, 5 integrons, and 18 MGEs (total—122). These ARGs coded for resistance against the drug classes of beta-lactams &gt; aminoglycoside &gt; tetracycline, macrolide lincosamide streptogramin B (MLSB) &gt; phenicol &gt; trimethoprim, quinolone, and sulfonamide. The SMS picked a greater number of ARGs (402), plasmid sequences (1567), and integrons (168). Based on the evidence, we feel the SMS is a better method to undertake ARG assessment to fulfil the WHO mandate of “One Health Approach.” This manuscript is a useful resource for environmental scientists involved in AMR monitoring.

Antimicrobial stewardship and clinical pharmacist interventions in an Indian tertiary care hospital

AbstractObjectiveComprehensive antimicrobial stewardship programs (ASPs) are needed in Indian healthcare settings due to high rates of communicable diseases and excessive antibiotic use. However, the implementation of both ASPs and clinical pharmacists (CPs) into the system is still in its nascent stages in India. Therefore, our study aims to evaluate the type and acceptance rates of CP interventions in the implementation of ASPs and its impact on antimicrobial utilization.MethodsA single‐center quasi‐experimental study was conducted at Jehangir Hospital, India, wherein prescribed antimicrobials were subjected to evaluation by CPs using the prospective audit and feedback approach. The antimicrobials were reviewed for loading dose, dosages as per creatinine clearance (CrCl), weight, suitability with site of infection, drug interactions, de‐escalations, and therapeutic duplications. Impact on antimicrobial utilization in pre‐intervention (April 2021 to March 2022) and intervention (April 2022 to March 2023) periods were compared using daily defined dose (DDD) per 1000 in‐patient days, following World Health Organization (WHO) guidelines.ResultsDuring the intervention period, 485 out of 609 proposed interventions (79.6%) were implemented. Of these, 417 (85.9%) pertained to intravenous (IV) antimicrobials, while the remaining 68 (14.1%) involved oral formulations. Notably, interventions proposing antibiotic de‐escalations showed higher acceptance rates on Days 3, 5, 7, and 10 compared with other days (p = 0.027). Dosing based on CrCl yielded the highest acceptance rate (50/56, 89.2%). Significant reductions were observed in the DDDs of polymyxins by 58% (3.48–1.29), carbapenems by 7% (57.09–52.85), and glycopeptides by 10% (47.44–42.73). The reduction in these three classes combined was statistically significant (p = 0.04, 95% confidence interval [CI] = 0.3–7.0).ConclusionThis study highlights the vital role of CP interventions within the healthcare team in optimizing antimicrobial pharmacotherapy. The noteworthy reduction in DDDs of restricted antimicrobials provides compelling evidence of the impact CPs can have on antimicrobial consumption and the fight against antimicrobial resistance.

Label-free and highly sensitive immunosensor based on L-cysteine capped vanadium disulfide quantum dots for amoxicillin detection

Excess and unmonitored use of antibiotics across globe is rapidly leading to antibiotics resistance. Thus, early-stage detection of antibiotics resistance has become necessary to monitor and control their use to reduce the side effects. Amoxicillin (Amoxi) is a type of beta-lactam antibiotic that is often used to treat bacterial infections. Herein, L-cysteine capped vanadium disulphide quantum dots (L-CYST-VS2QDs) were synthesized via hydrothermal method and used to construct an electrochemical immunosensor for Amoxi detection. To prepare Ab-Amoxi/L-CYST-VS2QDs/ indium tin oxide coated glass (ITO) immunoelectrode, monoclonal antibodies against Amoxi were immobilized on the L-CYST-VS2QDs/ITO followed by blocking uncovered sites with BSA. This BSA/Ab-Amoxi/L-CYST-VS2/ITO bioelectrode was revealed selective and specific interaction towards Amoxi among various other antibiotics. The immunoelectrode showed linearity within 1 pM to 100 µM range, with sensitivity of 4.827 µA nM−1 cm2, and detection limit of 0.5 pM, with better results than chitosan–TGA-VS2QDs based immunosensor. The applicability in real sample testing was proved by monitoring the response in spiked fish samples, which yielded positive outcomes.