Improper Use Of Antibiotics Research Articles

Utilization Of Antibiotics In Rural Communities Of Sub- Saharan Africa: Challenges And Resistances

In the last seven decades, antibiotics have greatly influenced the remarkable advancement in world health by becoming the standard therapy for infectious diseases. Antibiotic resistance (ABR) is a significant worldwide human health issue, having notably negative effects in low- and middle-income countries (LMICs). What were once fatal illnesses are now beaten by millions of people. But since there are only so many antibiotics available, misusing them has resulted in antibiotic resistance and decreased efficacy within a few years after the release of every lifesaving antibiotic. The WHO claims that the threat of antibiotic resistance to global health and development. The Sustainable Development Goals (SDGs) must be attained urgently through multi-sectoral approach. One of the ten leading worldwide public health hazards to civilization, according to WHO, is ABR. The major causes of the emergence of infections that are resistant to antibiotics are their improper usage and excessive use. The spread of bacteria, some of which may be antibiotic-resistant, is encouraged by a lack of safe drinking water, sanitation facilities, and effective infection control and prevention measures. Antibiotic resistance is as significant a threat to international security, food and nutrition security, and industrialization, according to the WHO, as terrorist attacks and global warming. ABR has a huge cost to the economy. Long-term disease not only increases the risk of mortality and incapacity but also lengthens hospital stay, necessitates the use of more expensive medications, and puts a strain on the finances of those affected. In the absence of powerful antibiotics, contemporary medicine's ability to cure infections, including those that arise following extensive surgeries and invasive procedures, would be compromised. Due to the lack of adequate mass surveillance, it is difficult to determine the scope of the ABR issue in LMICs, although considerable progress has been made in recent years since the WHO Global Antibiotic Resistance and Use Surveillance System (GLASS) initiative was launched in 2015. One of the main factors influencing the choice of ABR in LMICs is the widespread and frequently improper use of antibiotics in people, animals, and crops. This, combined with the insufficient control of pharmacological byproducts at the centers of manufacturing, must be quickly addressed. ABR spreads more quickly in LMICs because a number of factors including poor sanitation and hygiene insufficient exposure to sufficient health facilities, and a lack of legislation. The aim is to review to predisposing factors that influence the use of antibiotics aimed at informing policy decision on antibiotics use.

Antibiotic Evaluation Use towards Diabetic Foot Ulcer Inpatient at Hospital in Surakarta

A diabetic foot ulcer is one of diabetes mellitus type 2 complications indicated by open sores. Because it contains bacteria, it is treated with antibiotics. Improper use of antibiotics could harm patients due to the length of wound healing. This study aims to determine the appropriate of antibiotics in patients with a diabetic foot ulcers. This is a non-experimental research with descriptive analysis approach. The medical records of diabetic foot ulcer patients undergoing inpatient and antibiotic prescribing are observed. The data obtained were analyzed by comparing the use of antibiotics based on the National Health Service guidelines, the Indonesian National Drug Information, and the Drug Information Handbook. The results of this study showed antibiotics used are metronidazole (4.8%), vancomycin (4.8%) and antibiotics combination are ceftriaxone-metronidazole (47.6%), ceftriaxone-metronidazole-clindamycin (4,8%), levofloxacin-azithromycin-ceftriaxone (4.8%), cotrimoxazole-ciprofloxacin (4.8%), metronidazole-meropenem (4.8%), ceftriaxone-metronidazole-gentamicin (4.8%), metronidazole-clindamycin-ciprofloxacin (4.8%), ceftriaxone-levofloxacin (4.8%), and ceftriaxone-metronidazole-ciprofloxacin (9.5%). The evaluation results according to criteria appropriate usage of antibiotics that is 100% appropriate indication, 100% for appropriate of patients, 42.3% for appropriate drug, and 61.9% for the appropriate dose.

Fighting against antimicrobial resistance: focus on improving the efficiency of treatment of respiratory infections in outpatient settings

Increasing antimicrobial resistance, including improper antibiotic use, is a global threat to public health. Reducing prophylactic antibacterial (AB) prescriptions in acute respiratory viral infection (ARVI) and reducing the incidence of bacterial complications in patients at risk of severe ARVI is an urgent medical task. For this purpose, Rafamin can be used, which has antiviral and antibacterial effects. The article provides the preliminary results of a large-scale observational study on Rafamin efficacy and safety in treating acute respiratory viral infections in routine outpatient practice. Rafamin was shown to be effective irrespective of the timing of treatment initiation with early and delayed treatment initiation. The AB prescription rate was low (0.8%) and did not increase in patients who started taking Rafamin a few days after the onset of the first disease symptoms. The data obtained are promising for treating patients at risk of severe respiratory infection. Rafamin may reduce the rate of improper AB prescribing and antibiotic resistance rate.

One-step preparation of titanium sharkskin bionic antibacterial surface

In recently, titanium and its alloys have been used in a large number of medical implants due to their excellent biological qualities. However, infections brought on by their biological inertness have emerged as a challenging issue for clinicians across a range of specialties. On the other hand, improper use of antibiotics has increased bacterial resistance, which has made the issue of infections brought on by titanium implants worse. The preparation of implants with antimicrobial capabilities has emerged as a key research area in the effort to address this issue at its source. However, present techniques for preparing antimicrobial surfaces are pricy, ineffective, and harmful to the environment, thus cannot be used extensively in industrial manufacturing. In this study, the bionic shark skin's antibacterial rhombic surface was prepared in a single step using the WEDM processing. The samples were then described, and the outcomes were examined using XRD, FE-SEM, and EDS. By using the plate coating method and SBF immersion assays, the samples' bioactivity and antibacterial capacity were assessed. Due to the high temperature produced during the WEDM process, which enables the tool electrode to melt and metallurgically link with the titanium alloy substrate surface, the primary crystalline phase of the antibacterial surface is CuTi2. After 1 h of incubation on the sample surface, the samples' antibacterial rate was 93%. The antibacterial property of the sample also attained an ideal 98.4% when acid etching was carried out using a 20%wt HNO3 solution. The Ti on the sample surface had no discernible impact on the effectiveness of the antibacterial. Additionally, the simulated liquid immersion findings demonstrated that the sample pieces made using this approach exhibited good bioactivity.

Antibiogram Analysis of Escherichia coli Isolates Recovered from Dog Faeces

Antimicrobial resistance is a global problem affecting animals and humans. Improper use of antibiotics by humans, inefficient prevention and control of infections, poor hygiene and sanitation, are causes for the emergence and distribution of antibiotic resistant bacteria. The role of pets is quite significant as disseminators of antimicrobial-resistant bacteria. This study was planned to analyze the antibiotic susceptibility profile of Escherichia coli isolated from dog faeces. The dog faecal samples (n=5) collected from Veterinary Clinical Complex, College of Veterinary and Animal Science, Navania were subjected to bacteriological examination for the isolation and identification of Escherichia coli. The isolates were confirmed by PCR to detect the species specific uspA gene. Antimicrobial susceptibility testing was done to determine the antibiotic susceptibility pattern of the isolates. In the present study, it was revealed that out of 5 dog faecal samples analyzed, E coli was isolated from 4 samples. The PCR analysis revealed a specific amplification of 884 bp product of the uspA gene among the isolates. Further on analyzing the antibiogram, it was found that chloramphenicol, oxytetracycline, azithromycin, ampicillin, co-trimoxazole and ceftriaxone were effective against E. coli. While, the isolates were resistant to amoxicillin and trimethoprim. Therefore, it was concluded that the screening of cultures by antimicrobial susceptibility testing will not only help in deciding the right antibiotic for treatment but also identify the shifting trends of antimicrobial resistance.

Antibiotics Misuse in Children KAP Survey of Parents at Benghazi-Libya 2021

Introduction: Children are known to receive antibiotics more often than any other type of drug, as they are frequent subjects of infections of various etiologies. The improper use of antibiotics is the most important cause of the modern expansion of antibiotic resistance. The development of antibiotic resistance, with its clinical and economic consequences. Increased bacterial resistance is threatening the therapeutic effectiveness of antibiotics. High level of antibiotic use is probably the main factor driving the emergence of resistant. Objectives of the Study: To determine the level of awareness of antibiotic use in Benghazi 2021 among parents of children and to identify factors associated with parent’s decision regarding use of antibiotics. Materials and Methods: A convenient sample of 2000 questionnaires was distributed among parents of their children aged from 6moths to 6 years. By direct an interview to the parents at Benghazi city during the period from September to December –2021 who agreed for an interview survey. The questionnaire was developed by the researcher, and the data collected by well- trained interviewer team (the researcher and his colleagues, including doctors, medical students and pharmacists). The questionnaire contains were focused on the knowledge and attitude and practice of parents including the general knowledge on antibiotics, side effects of antibiotics use, the ideal mechanism of action of antibiotics and if antibiotics can cause allergy. If the parents use antibiotics to their children without a doctor's prescription, the reasons for use antibiotics without doctor's prescription. A score technique was chosen as suitable method to identify the level of awareness among parents regarding antibiotics use. A Scoring for questions knowledge five questions, every question gives 2 marks. We Categorize Score as: Deficient (poor), intermediate (average), Optimum (good) marks. The participants responded to the questionnaire without any .......

A novel pentavalent vaccine candidate completely protects against Acinetobacter baumannii in a mouse model of peritonitis

Acinetobacter baumannii is considered as one of the most virulent and infectious organisms that have an increased ability to both evade host immune response and resist various classes of antibiotics, leading to life-threatening infections. Multiple virulence factors have been implicated in the high prevalence rate of A. baumannii in hospitalized and immunocompromised patients. Moreover, improper use of antibiotics has led to the emergence of extensive drug-resistant strains that urgently require alternative strategies to control this superbug. Unfortunately, the availability of a licensed vaccine against A. baumannii infections is still challenged by the vast diversity among A. baumannii strains. Here, we report the development of a novel pentavalent vaccine candidate composed of two recombinant proteins (Wza and YiaD) and a pool of capsular polysaccharides isolated from 3 clinical isolates. We tested this new vaccine in vivo in a mouse model of peritonitis against the standard strain ATCC 19606 in addition to 3 clinical isolates of A. baumannii. Immunization with this vaccine completely protected the challenged mice with 100% survival rate in the case of all the tested bacteria. Further clinical studies are urgently needed to evaluate the efficacy and safety of this proprietary vaccine to protect patients from A. baumannii lethal infections.Key points• Recombinant proteins pool (Wza and YiaD) immunization led to a synergistic immune response.• Capsular polysaccharides pool induced up to 90% protection of tested clinical isolates.• The pentavalent pool showed superiority with 100% survival of immunized mice.

Antibacterial effects of oak bark (Quercus robur) and heather herb (Calluna vulgaris L.) extracts against the causative bacteria of bovine mastitis.

Bovine mastitis has a negative impact on animals, and improper antibiotic use has caused an increase in bacterial resistance. Therefore, medicinal plants could serve as an alternative treatment for this condition. Polyphenols have potential as antibiotic agents. Oak bark has long been used as a medicine and has shown antibacterial effects. Moreover, research on heather plant demonstrated that it has antibacterial properties. This study aimed to assess the antibacterial effects of oak (Quercus robur) bark and heather (Calluna vulgaris L.) herb extracts against common bovine mastitis pathogens. Dried oak bark and heather herb were used to prepare extracts using 30%, 50%, and 70% ethanol and acetone as solvents. Their polyphenol content was determined using the Folin-Ciocalteu method. Bovine mastitis-inducing clinical isolates of Escherichia coli, Streptococcus agalactiae, Streptococcus uberis, Serratia liquefaciens, Staphylococcus aureus, and reference cultures of S. aureus and E. coli were used for antibacterial tests. All extracts were screened through a disk diffusion test to ascertain their antibacterial effects, and the minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined for the most effective extracts. Oak bark extracts had variable antibacterial effects against S. aureus and Streptococcus strains, but no statistically significant difference was observed in activity against E. coli. The disk diffusion test showed that the oak bark extracts obtained using acetone and ethanol at 30% yielded the best results. However, the 70% acetone oak extract alone affected all types of bacteria. Further antibacterial tests of 70% acetone and 30% ethanol oak extracts revealed that the lowest MIC and MBC scores were against S. aureus strains and E. coli reference cultures. Conversely, the heather herb extracts exhibited broader activity against all types of bacteria, although better results were observed against Gram-positive bacteria. There was also a negative correlation between solvent concentration and antibacterial effect (p < 0.05, r = -0.507). The highest inhibition zone scores and broadest spectrum were observed in samples prepared in 30% ethanol. There was no statistically significant correlation between the phenolic content of plants and their antibacterial effects. Oak bark and heather extracts could be used as potential antibacterial agents against bovine mastitis pathogens.

Prevalence, Antibiotics Resistance and Plasmid Profiling of Vibrio spp. Isolated from Cultured Shrimp in Peninsular Malaysia.

Vibrio is the most common bacterium associated with diseases in crustaceans. Outbreaks of vibriosis pose a serious threat to shrimp production. Therefore, antibiotics are commonly used as preventative and therapeutic measures. Unfortunately, improper use of antibiotics leads to antibiotic resistance. Nevertheless, information on the occurrence of Vibrio spp. and antibiotic use in shrimp, particularly in Malaysia, is minimal. This study aimed to provide information on the occurrence of Vibrio spp., its status of antibiotic resistance and the plasmid profiles of Vibrio spp. isolated from cultured shrimp in Peninsular Malaysia. Shrimp were sampled from seven farms that were located in different geographical regions of Peninsular Malaysia. According to the observations, 85% of the shrimp were healthy, whereas 15% were unhealthy. Subsequently, 225 presumptive Vibrio isolates were subjected to biochemical tests and molecular detection using the pyrH gene. The isolates were also tested for antibiotic susceptibility against 16 antibiotics and were subjected to plasmid profiling. Eventually, 13 different Vibrio spp. were successfully isolated and characterized using the pyrH gene. They were the following: V. parahaemolyticus (55%), V. communis (9%), V. campbellii (8%), V. owensii (7%), V. rotiferianus (5%), Vibrio spp. (4%), V. alginolyticus (3%), V. brasiliensis (2%), V. natriegens (2%), V. xuii (1%), V. harveyi (1%), V. hepatarius (0.4%) and P. damselae (3%). Antibiotic susceptibility profiles revealed that all isolates were resistant to penicillin G (100%), but susceptible to norfloxacin (96%). Furthermore, 16% of the isolates revealed MAR of less than 0.2, while 84% were greater than 0.2. A total of 125 isolates harbored plasmids with molecular weights between 1.0 and above 10 kb, detected among the resistant isolates. The resistant isolates were mediated by both chromosomal and plasmid factors. These findings support the use of surveillance data on the emerging patterns of antimicrobial-resistance and plasmid profiles of Vibrio spp. in shrimp farms. The findings from this study can be used to develop a better disease management strategy for shrimp farming.

Multidrug-Resistant Bacteria in Children and Adolescents with Cystic Fibrosis.

In patients with cystic fibrosis (CF), multidrug-resistant (MDR) bacteria can predispose to exacerbations, limit the effectiveness of antibiotic treatments and promote the progression of lung disease. The aim of this retrospective study was to compare pulmonary exacerbations (Pex), hospitalizations, lung function and nutritional status in a group of children and adolescents with CF colonized by MDR bacteria and in a noncolonized control group. Overall, 7/54 pediatric patients (12.9%) were colonized by MDR bacteria and enrolled (3 with Achromobacter xyloxidans, 3 with Stenotrophomonas maltophilia and 1 with Burkholderia cepacia). The control group included 14 sex- and age-matched CF patients (8/14 colonized by Staphylococcus aureus, 2/14 by Pseudomonas aeruginosa, 2/14 by both microorganisms and 2/14 germ free). At the time of enrollment and 12 months before the first detection of the MDR microorganism, children colonized by MDR bacteria showed lower body mass index (BMI) and lower FEV1/FVC compared to the control group. Over the previous year before the first detection, children colonized with MDR had more Pex compared to control group; those colonized by S. maltophilia experienced the highest number of Pex. In the 12 months following the first detection of MDR bacteria, all seven patients colonized by MDR had at least one Pex and patients colonized by S. maltophilia had the highest number (mean ± SD: 6 ± 2.6 vs. 1.7 ± 2.3). Our study suggests that CF pediatric patients infected by MDR bacteria have lower BMI, more obstructive disease and experience more exacerbations than patients without MDR bacteria. These differences are present even before being infected, suggesting that children and adolescents with more severe disease are predisposed to be colonized by MDR bacteria. S. maltophilia appeared to be the most aggressive pathogen. Further studies and the implementation of antimicrobial stewardship programs are necessary to clarify when and how to treat patients with CF and MDR bacteria in order to avoid the improper use of antibiotics and the development of antibiotic resistance.

Prevalence of Antibiotic Resistant Bacteria among the Clinical Samples from Different Hospitals of Peshawar, Pakistan

Background: Majority of the microorganisms are responsible for causing diseases which can be fatal if left untreated. In Pakistan this might be very critical because of the misuse and/or improper use of antibiotics. Objective: The current study was designed to point out the challenges of antibiotic resistance in Peshawar Pakistan. Methods: A total of 100 samples, 25 each from blood, pus, skin, urine were collected from four different hospitals of Peshawar, Pakistan. The samples were grown on culture media after collection. Results: Out 100 samples, 46 samples showed growth on culture medium. Four main isolates namely Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa. S. aureus and E. coli were found in all tested samples blood, pus, skin, urine. P. aeruginosa was found in pus and K. pneumonia in urine only. The identified strains were subjected to sensitivity testing against 7 different antibiotics i.e., ampicillin, piperacillin tazobactam, doxycycline, aztreonam, ciprofloxacin, levofloxacin and teicoplanin. Conclusion: All of the bacterial species were found resistant against the applied antibiotics except aztreonam. Keywords: Prevalence, antibiotics sensitivity, S. aureus, E. coli, K. pneumonia, P. aeruginosa

Characteristics of Antibiotic-Resistant Bacteria in Libya Based on Different Source of Infections

AbstractIn recent years and for decades, antimicrobial resistance (AMR) has expanded into a major clinical issue. Infections were no longer a life-threatening issue for clinicians after the discovery of antibiotics. The misuse or overuse of antibiotics, however, contributes to global AMR, and numerous mobile genetic elements and relevant resistant genes worsen the spread of resistance. As antibiotics lose their effectiveness, a growing number of infections such as pneumonia, tuberculosis, and gonorrhea are getting harder and sometimes impossible to treat. Infections that are resistant to antibiotics are correlated with antibiotic misuse. The majority of the antibiotic resistance in microbes is caused by improper use of antibiotics. Because there are a few antibiotics available to treat multidrug-resistant bacterial infections, there is a high rate of morbidity and mortality. Libya has a high burden of antibiotic resistance, and antimicrobial malpractice has frequently been reported. Providing information on the current state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Therefore, this review highlights the current situation of bacterial profile and their antimicrobial resistance in Libya based on the source of infection. Articles related to the topic were searched using databases and search engines such as PubMed, Google Scholar, and ResearchGate websites. These articles were selected if they were conducted in Libya and provided information on bacterial pathogens and AMR. Required data were extracted for the purpose of this review report, and then further verified for identifying the prevalence and number of susceptible and resistant pathogens in each source of infection.

Performance of PCR-based syndromic testing compared to bacterial culture in patients with suspected pneumonia applying microscopy for quality assessment.

Syndromic testing for lower respiratory tract infections with BioFire® FilmArray® Pneumonia Panel Plus (BF) detects 27 pathogens with a turn-around-time of one hour. We compared the performance of BF with culture. Samples from 298 hospitalized patients with suspected pneumonia routinely sent for culture were also analyzed using BF. Retrospectively, patients were clinically categorized as having "pneumonia" or "no pneumonia." BF and culture were compared by analytical performance, which was evaluated by pathogen concordance, and by clinical performance by comparing pathogen detections in patients with and without pneumonia. The BF results for viruses and atypical bacteria were not included in the performance analysis. In 298 patient samples, BF and culture detected 285 and 142 potential pathogens, respectively. Positive percent agreement (PPA) was 88% (125/142). In patients with community-acquired pneumonia (CAP), clinical sensitivity was 70% and 51%, and specificity was 43% and 71% for BF and culture, respectively. In patients with hospital-acquired pneumonia, the corresponding numbers were 55% and 23%, and 47% and 68%. There was no significant improvement of performance, when only high-quality sputum samples were considered. Efficacy of both BF and culture was low. Both tests are best used in CAP patients for whom the diagnosis has already been clinically established. Indiscriminate use may be clinically misleading and a cause of improper use of antibiotics.

Antibacterial Effects of Artemisia afra Leaf Crude Extract Against Some Selected Multi-Antibiotic Resistant Clinical Pathogens.

Due to improper use of antibiotics, some pathogenic bacteria that cause serious and deadly infections have become resistant to commonly used broad spectrum antibiotics. This antibiotic resistance has become major global healthcare problem. Therefore, there is an urgent need to develop novel antibacterial agents; hence, much attention has been made on medicinal plants such as Artemisia afra. Thus, the current study was aimed to evaluate the antibacterial activity of ethanolic, methanolic and n-hexane extracts of this plant leaf against four multi-antibiotic resistant clinical pathogens. Crude extracts from A.afra leaf were prepared using ethanol, methanol and n-hexane and the antibacterial effect of each extract was tested against Escherichia coli, Streptococcus pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. In addition, minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) were evaluated. Among the crude extracts, the highest zone of inhibition (25.33±0.58mm) was recorded against E. coli when methanolic extract was applied. On the other hand, the lowest inhibition was exhibited when n-hexane extract was applied against S.aureus (5.67±1.56 mm). Concerning MIC values of the different extracts, varied results were obtained. MIC value of 6.25mg/mL was recorded when methanolic extract was applied against all clinical pathogens. Moreover, both methanolic and ethanolic extracts showed MBC value of 12.5mg/mL against the four clinical pathogens. However, the methanolic extract gave MBC value of 6.25mg/mL against E. coli. From this study, it can be concluded that it is possible to develop and formulate of new, efficacious, less toxic and inexpensive herbal medicine from A.afra leaf extract that act against multi-antibiotic resistant clinical pathogens.

Evaluation of Attitudes and Practices of mothers on Antibiotic Use in Children under five years old Referred to Shahid Sadoughi Hospital in Yazd, 2019-2020

Introduction: Microbial resistance due to antibiotics overuse can endanger the general health of society. Various factors play a role in mothers' overuse of antibiotics for their children. This study aimed to investigate mothers' attitude and behavior about the use of antibiotics in children under five years old in Yazd City.&#x0D; Methods: In this cross-sectional descriptive study, 302 mothers with children under five years old were included in 2019-2020; a questionnaire of mothers' attitudes and practices regarding antibiotic use was completed. Then, the obtained data were analyzed by SPSS software version 16 and P-value less than 0.05 was considered statistically significant.&#x0D; Results: The mothers' attitude level was poor, moderate, and good in 60 (20%), 180 (59.5%), and 62 patients (20.5%), respectively. Furthermore, mothers' practice level was poor in 55 (18.2%), moderate in 210 (69.5%) and good in 37 (12.3%). The level of attitude (P = 0.000) and practice (P = 0.007) in mothers with a higher level of education was significantly higher. With increasing the number of children, mothers' attitude (P = 0.03) and practice (P = 0.02) were significantly lower.&#x0D; Conclusion: The study results showed that most mothers have a moderate level of attitude and practice in using antibiotics in their children. A significant number of them also mentioned antibiotic use without a prescription. Therefore, to reduce the improper use of antibiotics, it is recommended to pay attention to educational programs with proper planning by the public media. It makes sense to train physicians, monitor their performance and closely monitor the sale of antibiotics in pharmacies to reduce their use without a doctor's prescription.

Microbiological profile with Antibiotic Sensitivity Pattern for Chronic Suppurative Otitis Media in A Tertiary Hospital, Indonesia

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation in the middle ear and mastoid space that repeatedly secretes through the perforated membrane of tympanic disease over three months. This disease is a critical cause of hearing in developing countries. The prevalence of CSOM in Indonesia is 3.8%. Improper use of antibiotics leads to germicidal incidence. Understanding the pattern of germs and their antibiotic sensitivity will lead to a rational choice of antibiotics to prevent the emergence of resistance. Aim: to report the microbiological profile and sensitivity patterns in CSOM patients in our department. Materials and Methods: This is a retrospective descriptive study conducted on 45 patients from September 2019 - March 2020 at the ENT-KL Department of Dr Soetomo Surabaya Indonesia. Forty-five samples were collected from CSOM patients who underwent mastoidectomy. Specimens were collected from these patients, examination, isolation, examination and isolation antibiogram were carried out according to standard procedures. Results: A total of 45 samples were obtained from this study, and all (57.77%) of the patients were identified as CSOM cases with cholesteatoma. The number of women is 62.3% more than men, and the age group 12 to 16 (20.0%) is the most reported. There were 75.6% perforations in the tympanic membrane, and a central perforation was primarily found (35.6%). Most of the Schuller mastoid X-ray results showed sclerotic features in 29 patients (59.2%). Of the 45 ear swabs, about 68.89% of the surgical materials gave positive culture results, the remaining 31.11%. There was no microbial growth, where most of the growth of monomicrobial bacteria (57.8%). Of the isolates that grew, 70.58% were identified as the group of gram-negative bacteria, with Pseudomonas Aerogenosa isolates being the most common (44.11%). Conclusion: The sensitivity test showed the most sensitivity to Meropenam, Amikacin, Piperacillin-Tazobactam, Ceftasidim and Cefoperazone-Sulbactam Cefotaxime and Ceftriaxone showed lower sensitivity.

Comparative Proteomic Analysis of Membrane Vesicles from Clinical C. acnes Isolates with Differential Antibiotic Resistance.

PurposeCutibacterium acnes (C. acnes) is closely associated with the pathogenesis of acne, and antibiotics targeting C. acnes have been widely used for decades. However, antibiotic resistance has been increasing rapidly. Membrane vesicles (MVs) have been found to play important roles in antibiotic resistance in some bacteria. We aimed to explore the mechanism of antibiotic resistance and the virulence components within C. acnes-derived MVs.Materials and MethodsWe isolated clinical C. acnes strains from the lesions of acne patients who were sensitive or resistant to the antibiotics erythromycin and clindamycin. We analyzed the proteome of MVs from four sensitive C. acnes isolates and three resistant isolates by LC-MS/MS.ResultsWe identified 543 proteins within the MVs of clinical C. acnes strains. Several lipases, NlpC/P60, CAMP factor, and Hta domain protein were detected as virulence factors in the C. acnes-derived MVs. The levels of two lipases and FtsZ were significantly higher in resistant C. acnes-derived MVs compared with sensitive strains (p < 0.05).ConclusionAccording to the implications of this study, improper antibiotic use might not only increase antibiotic resistance in C. acnes but could also further alter the cutaneous lipid composition and aggravate host inflammation, thus resulting in worse clinical manifestations in acne patients. This study re-emphasizes that the improper use of antibiotics should be treated more seriously in clinical practice. Furthermore, to combat multidrug resistance in C. acnes, this study suggests that FtsZ inhibitors could be useful.

Isolation of Klebsiella pneumoniae Phage vB_KpnS_MK54 and Pathological Assessment of Endolysin in the Treatment of Pneumonia Mice Model.

With the improper use of antibiotics, an increasing number of multidrug-resistant bacteria have been reported worldwide, posing challenges for disease treatment. Klebsiella pneumoniae is an important zoonotic pathogen that colonises the respiratory tract. Endolysin therapy has emerged with the development of phages. In this study, a lytic phage vB_KpnS_MK54 was isolated from the drinking water of a forest musk deer (FMD) farm in Sichuan Province. It was the first reported phage obtained from FMD. The primary biological characteristics were determined, and whole-genome sequencing analysis was performed. The phage which belongs to the family Siphoviridae is highly specific for lytic host bacteria and is moderately adaptable to different environments. Whole-genome sequencing results showed that the phage genome size was 46,218 bp. There were 80 coding DNA sequences (CDSs) in total, 32 of which had known functions. The last CDS is the phage endolysin LysG24. A new peptide-modified endolysin (LysCA) was constituted by connecting the cecropin A peptide residues with LysG24 to investigate the antibacterial activities of both LysG24 and LysCA. The results showed that the lytic profile of LysG24 and LysCA was wider than that of phage MK54. For in vitro tests, both endolysins destroyed 99% of the host bacteria within 6 h. The lysing ability and environmental adaptability of LysCA were significantly stronger than those of LysG24. For in vivo tests, LysG24 and LysCA exhibited therapeutic effects in a mouse model of pneumonia wherewith the mice were infected with K. pneumoniae (LPKP), wherein both LysG24 and LysCA can effectively reduce the pulmonary inflammatory response. The LPKP bacterial load in the treatment group was significantly lower than that in the bacterial group, among which LysCA displayed a more obvious therapeutic effect. Furthermore, the safety test showed that the endolysins had no toxic effects on mice. In general, both LysG24 and LysCA showed excellent antibacterial activity in vivo and in vitro, with high safety and strong adaptability to the environment, manifesting their latent potential as new antimicrobial agents.

Azithromycin Has Been Flying Off the Shelves: The Italian Lesson Learnt from Improper Use of Antibiotics against COVID-19.

The warning by the Italian Medicines Agency on the high shortage of azithromycin in the country in January 2022 represents a paradigmatic lesson learnt from improper use of antibiotics during COVID-19 pandemic.

The Effectiveness of MOFs for the Removal of Pharmaceuticals from Aquatic Environments: A Review Focused on Antibiotics Removal.

There is an increasing level of various pollutants and their persistence in aquatic environments. The improper use of antibiotics and their inefficient metabolism in organisms result in their release into aquatic environments. Antibiotic abuse has led to hazardous effects on human health. Thereby, efficient removal of pharmaceuticals, particularly antibiotics, from wastewater and contaminated water bodies is greatly interested in international research communities. Metal-organic framework (MOF) materials, as a hybrid group of material containing metallic center and organic linkers, offer a porous structure that is highly efficient for removing different pollutants from contaminated water and wastewater streams. This article aims to review the recent advancement in using MOF-based adsorbents and catalysts for the removal of pharmaceuticals, especially antibiotics, from polluted water. Applying MOFs-based structures for removing antibiotics using photocatalytic removal and adsorptive removal techniques will be discussed and evaluated in this review paper. Various MOF-based materials such as functionalized MOFs, MOF-based composites, magnetic MOF-based composites, MOFs templated-metal oxide catalysts for removing pharmaceuticals, personal care products, and antibiotics from contaminated aqueous media are discussed. Furthermore, effective operational parameters on the adsorption, adsorption mechanisms, adsorption isotherms, and thermodynamic parameters are explained and discussed. Finally, in the concluding remarks, the challenges and future outlooks of using MOFs-based adsorbents and catalysts for removing antibiotics are summarized.