Management Of Infectious Diseases Research Articles

Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis.

The increasing emergence and spread of drug-resistant pathogens resulting from inappropriate antibiotic usage have become more evident in recent years, particularly with the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections.Since joining the Organization for Economic Cooperation and Development (OECD), Costa Rica can now compare its healthcare system with other countries, and similarities have been noted with Italy regarding health indicators. Both nations have universal healthcare systems, covering their entire populations, and hold similar positions in the Human Development Index (HDI). Consequently, the goal is to compare antibiotic prescribing and consumption patterns to collaboratively develop strategies against bacterial resistance. In order to compare antibiotic consumption between regions, a standardized contrast was utilized, specifically using the defined daily dose (DDD). An Orthogonal Contrast test was performed to test the means, followed by the application of the Student's t-test on these contrasts. This analysis aimed to assess the potential influence of regions on DDD values. Antibiotic consumption data were collected between January 2021 and December 2022 from the Local Health Authority of Naples 3 South (LHANS)in Italy and IMS Health, Q Quintiles, and VIA by way of (IQVIA) reports in Costa Rica. LHANS shows a considerable disparity in gross expenditure compared to Italy's overall expenditure, while the private sector of Costa Rica exhibits even lower gross expenditure than Italy. Antibiotic consumption in Italy exceeds that of Costa Rica, with Costa Rica's consumption amounting to 47.70% of Italy's total consumption. Additionally, LHANS exhibited a 22.43% higher gross expenditure compared to the Campania region, emphasizing the variability in antibiotic usage within the same country The results indicated no statistically significant differences in antibiotic consumption between the regions, as none of the null hypotheses were rejected. The study provides valuable insights into expenditure patterns and antibiotic consumption, highlighting the need for improved prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings emphasize the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.

Physicochemical and In-Vitro Bioequivalence Analysis of Some Oral Solid-Dosage Metronidazole Formulations

Background: Metronidazole is a 5-nitroimidazole antimicrobial agent, widely used in the treatment of infections caused by Trichomonas vaginalis, such as trichomoniasis, pseudomembranous colitis, and symptomatic amoebiasis resulting from anaerobic bacteria. Aim: The study aimed to qualitatively determine the quality and in-vitrobioequivalence of selected brands of metronidazole tablet dosage forms used in the management of infectious diseases. Method: The British Pharmacopeia (BP) Standard methods were followed to conduct weight uniformity, disintegration time, hardness, and friability tests. For the Thin Layer Chromatographic (TLC) Fingerprinting, 0.1g of the brands were weighed and dissolved ins 50 ml methanol (50%). The stock solution was prepared using 50% methanol and 50% dichloromethane and was transferred into the Chamber and allowed to stand for about 45 minutes; the plates were viewed under UV-VIS Spectrophotometer at 365 nm. Result: All the brands complied with the acceptable friability limit, and disintegrated within the appropriate time of not more than 15 minutes as specified in BP, for uncoated tablets. The tablets were found to have a dissolution profile of at least 70% of the active ingredient taken at 45 minutes from the dissolution medium as stated in BP. The analysis showed the consistency of concentration of the selected tablet brands with the label claims. Conclusion: The TLC procedure used in the analysis was accurate and precise, no interference was observed from the excipients. Thus, this method can be used in the routine quality control of metronidazole solid dosage form.

COVID-19 pandemic complexities on endemic infectious disease management and diagnosis in poor countries

The persistence and frequency of prevalent infectious diseases continue to be a major problem on the African continent. Malaria, TB, and HIV/AIDS are the most common infectious diseases in Sub-Saharan Africa. Malaria and tuberculosis have had a considerable negative impact on poor nations’ health, resulting in high mortality and morbidity. Fortunately, the World Health Organization’s introduction of the RTS, S/AS01 malaria vaccine may soon put an end to the lingering difficulties in malaria eradication, barring new contagious disease outbreaks like COVID-19. The literature reviewed looked at the current condition of endemic infectious illnesses in low-income countries from 2018 to 2022. Improvements in disease management and other mitigating strategies were evaluated alongside the resurgence of malaria, and particularly tuberculosis, the deadliest infectious disease of considerable global health concern in recent decades. The study’s focus was the destructive effects of COVID-19 on the treatment and prevention of infectious illnesses. PubMed, Web of Science, and Google Scholar were used as relevant databases. The COVID-19 pandemic had a significant global impact on Africa, but not because the continent was directly impacted by the scourge and its fatal effects; rather, it did so by successfully forcing resource reallocation and diverting medical personnel to COVID-19 treatment, which in turn made TB, malaria, and HIV/AIDS-related problems worse. To halt the endemicity of these diseases and their potential intensification if a new pandemic like COVID-19 emerges in the future, enhanced efforts from all stakeholders, particularly in poorer climes, are required to be more inward looking and less reliant on foreign support.

국내 감염병 현황 대시보드 디자인 패턴 분석

In the era of the pandemic, the importance of disease data visualization has been underscored. This study critically examines the design of disease data dashboards, specifically focusing on those utilized by the infectious disease management support teams. These dashboards, primarily intended for professional use, employ detailed charts to represent extensive data sets. Our analysis reveals that while there has been a concerted effort to customize visualizations to fit region-specific data, significant enhancements from a usability perspective are required. Consequently, we argue that infectious disease dashboards should progress towards accommodating personalized and public health needs, taking into account the divergent requirements across user types. In this transformation, the synergistic collaboration of UX/UI designers and data visualization experts is deemed indispensable, with the ultimate aim to construct a system capable of providing macroscopic insights into infection statuses. This study hence contributes to the ongoing discourse by proposing vital elements for the improvement of infectious disease dashboards, anticipating its findings to serve as a valuable resource in the effective construction of future dashboards.

Expansion of the Analytical Modeling of Capacitance for 1-N-1 Multilayered CID Structures with Monotonically Increasing/Decreasing Permittivity.

Capacitive sensors that utilize the Coplanar Interdigitated (CID) electrode structure are widely employed in various technical and analytical domains, such as healthcare, infectious disease management, pharmaceuticals, metrology, and environmental monitoring. The present exigency for lab-on-a-chip contrivances and the requisite for the miniaturization of sensors have led to the widespread adoption of CID sensors featuring multiple dielectric layers (DLs), either in the form of substrates or superstrates. Previously, we derived an analytical model for the capacitance of CID capacitive sensors with four distinct 1-N-1 patterns (namely, 1-1-1, 1-3-1, 1-5-1, and 1-11-1) using partial capacitance (PC) and conformal mapping (CM) techniques. The aforementioned model has been employed in various applications wherein the permittivity of successive layers exhibits a monotonic decrease as one moves away from the electrode plane, resulting in highly satisfactory outcomes. Nevertheless, the PC technique is inadequate for structures with multiple layers where the permittivity exhibits a monotonic increase as the distance from the electrodes increases. Given these circumstances, it is necessary to adapt the initial PC method to incorporate these novel configurations. In this work, we have discussed a new approach, splitting the concept of PC into partial parallel capacitance (PPC) and partial serial capacitance (PSC), where new CM transformations are proposed for the latter case. Thus, the present study proposes a novel methodology to expand upon our prior analytical framework, which aims to incorporate scenarios where the permittivity experiences a reduction across successive layers. The outcomes are juxtaposed with the finite element simulation and analytical findings.

Knowledge of the Mpox virus and conspiracy beliefs and their association with self-confidence in managing the virus among Israeli orthopedic surgeons

ABSTRACT In 2022, the Mpox viral outbreak signaled a global public health emergency. Infectious disease management and prevention are crucial tasks for healthcare workers. In their line of work, orthopedic surgeons could come across cases of the Mpox virus. The aim of the present study was to explore orthopedic surgeons’ knowledge of the Mpox virus, their conspiracy beliefs regarding emerging viral infections, and their self-confidence in managing the Mpox virus. In this cross-sectional survey, 137 orthopedic surgeons completed an online questionnaire. The participants had low knowledge of the Mpox virus, providing on average 11.5 correct answers (SD = 2.68) of a possible 21. In addition, the participants tended to express moderate conspiracy beliefs and to have low self-confidence in managing the Mpox virus. Age 30 or older, a higher knowledge level, and lower conspiracy beliefs predicted greater self-confidence in managing the Mpox virus. In addition, a negative association was found between knowledge of the Mpox virus and conspiracy beliefs. Arab and younger orthopedic surgeons expressed stronger conspiracy beliefs. Interventions should include introduction of material regarding emerging tropical infections in medical curricula and in-service training programs. In addition, special attention should be paid to younger and Arab orthopedic surgeons, as these subgroups may endorse higher conspiracy beliefs.

SARS-CoV-2 neutralising antibody therapies: Recent advances and future challenges.

The COVID-19 pandemic represents an unparalleled global public health crisis. Despite concerted research endeavours, the repertoire of effective treatment options remains limited. However, neutralising-antibody-based therapies hold promise across an array of practices, encompassing the prophylaxis and management of acute infectious diseases. Presently, numerous investigations into COVID-19-neutralising antibodies are underway around the world, with some studies reaching clinical application stages. The advent of COVID-19-neutralising antibodies signifies the dawn of an innovative and promising strategy for treatment against SARS-CoV-2 variants. Comprehensively, our objective is to amalgamate contemporary understanding concerning antibodies targeting various regions, including receptor-binding domain (RBD), non-RBD, host cell targets, and cross-neutralising antibodies. Furthermore, we critically examine the prevailing scientific literature supporting neutralising antibody-based interventions, and also delve into the functional evaluation of antibodies, with a particular focus on in vitro (vivo) assays. Lastly, we identify and consider several pertinent challenges inherent to the realm of COVID-19-neutralising antibody-based treatments, offering insights into potential future directions for research and development.

The Implications of Using Digital Technologies in the Management of COVID-19: Comparative Study of Japan and South Korea.

Technology can assist in providing effective infectious disease management, but it can also become a source of social injustice and inequality. To control the rapidly increasing SARS-CoV-2 infections and promote effective vaccine administration, both South Korea and Japan have been using several technology-based systems and mobile apps. However, their different approaches to technology use have yielded contrasting social implications. Through comparative studies of the use of digital technologies for pandemic management and its social implications in Japan and South Korea, this study aimed to discuss whether the active and optimal use of technology for pandemic management can occur without subverting or compromising important social values, such as privacy and equality. This study compared the social implications of Japan's and South Korea's contrasting approaches to technology implementation for COVID-19 pandemic management in early 2022. Digital technologies have been actively and comprehensively used in South Korea, enabling effective COVID-19 management, but have raised serious concerns about privacy and social equality. In Japan, technologies have been more carefully implemented, thereby not causing similar social concerns, but their effectiveness in supporting COVID-19 regulations has been criticized. Potential social implications such as equality concerns, the balance between public interest and individual rights, and legal implications must be carefully assessed in conjunction with effective and optimal infectious disease control to achieve sustainable use of digital health technologies for infectious disease management in the future.

The Role and Policy of Korean Medicine Doctor for the Prevention and Management of Infectious Diseases: A Mixed-Methods Approach

Objectives: This study investigated the role of Korean medicine doctors in the national quarantine system and the status of their duties through questionnaire surveys and in-depth interviews with Korean medicine staff who participated in COVID-19 work.Methods: We developed a questionnaire survey to investigate the status and perception of Korean medicine doctors’ participation in responding to infectious diseases, and the results were derived by conducting frequency analysis and T-test using SPSS program. The measurement variables of this study were the status of COVID-19 related work participation and perception of Korean medicine doctors’ role in infectious diseases, and the maximum significance level was 0.05.Results: There were 300 respondents to the survey, and as for the COVID-19 related work, Korean medicine treatment for COVID-19 patients accounted for the most(52.7%), and various preventive and treatment tasks such as epidemiological investigations and specimen collection were conducted.Conclusion: According to this study, it was confirmed that there are sufficient legal and administrative grounds for Korean medicine doctors to perform specimen collection and epidemiological investigations. Therefore, it is necessary to prepare a policy framework to solidify the status of Korean medicine doctors in national infectious diseases in the future.

Consensus on imaging techniques and diagnostic criteria for hepatitis B virus-related early hepatocellular carcinoma

Abstract The pathological diagnostic criteria for early hepatocellular carcinoma (eHCC) were updated in 2009, but the imaging diagnostic criteria for eHCC have not yet been established in China or other countries. This consensus was formed based on the input of more than 40 experts from over 10 Chinese provinces and cities to assist doctors in diagnosing eHCC, and was endorsed by the Radiology of Infection Sub-Branch, Radiology Branch, Chinese Medical Association, together with the Committee on Radiology of Infection, Radiology Branch, Chinese Medical Doctor Association, the Radiology Committee on Infectious and Inflammatory Disease, Chinese Research Hospital Association, the Radiology of Infection Branch, Working and Treating Committee of HIV/AIDS and STD Association, the Radiology of Infectious Disease Management Sub-Branch, Infectious Disease Management Branch, Hospital Management Association in China, and the Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance.

Biogenic Nanoparticles: Synthesis, Characterization, and Biological Potential of Gold Nanoparticles Synthesized using Lasiosiphon eriocephalus Decne Plant Extract.

Recent advancements in biomedicine have revolutionized nanomedicine as a therapeutic moderator in the management of both infectious and noninfectious diseases. In the current study we demonstrated biosynthesis of gold nanoparticles using aqueous leaf extract of Lasiosiphon eriocephalus as a capping and reducing agent and evaluation of their antioxidant, antibacterial, and anticancer properties. The biosynthesized LE-AuNPs were characterized by UV-Vis spectrophotometry, SEM, TEM, XRD, FTIR, DLS, and Zeta potential analysis. The antibacterial activity was checked by a minimum inhibitory concentration assay. The anticancer potential of biogenic LE-AuNPs was checked by cytotoxicity and genotoxicity assay against HeLa and HCT-15 cells. The characteristic surface plasmon resonance peak of the colloidal solution at 538 nm by UV-Vis spectrum confirmed the formation of LE-AuNPs in the solution. The SEM, TEM, and XRD revealed 20-60 sized hexagonal and crystalline LE-AuNPs. The LE-AuNPs displayed significant inhibition potential against DPPH and ABTS radicals in vitro. The LE-AuNPs demonstrated significant antibacterial potential. The results of cytotoxicity interpreted that biogenic gold nanoparticles exhibited strong dose and time-dependent cytotoxicity effect against selected cancer cell lines where IC50 of LE-AuNPs required to inhibit the growth of HeLa cells after 24 h and 48 h exposure were 5.65± 0.69 μg/mL and 4.37±0.23 μg/mL respectively and that of HCT- 15 cells was 6.46 ± 0.69 μg/mL and 5.27 ± 0.34 μg/mL, 24h and 48h post-exposure respectively. Findings from this study revealed that gold nanoparticles synthesized using L. eriocephalus, showed remarkable antioxidant, antimicrobial, and extensive cytotoxicity and genotoxicity activities.

The Current Policy Debate around the Regulation of LDTs: What It Means for Infectious Disease Testing and Where It May Be Headed

The debate over federal regulation of diagnostic tests is not new, but scientific advances, societal developments, and global events over the past decade have accelerated efforts by the Food and Drug Administration (FDA) and members of Congress to revise the regulatory oversight of these devices, including laboratory-developed tests (LDTs). Despite years of congressional hearings and public meetings, legislation in the House and Senate, draft guidance from the FDA, and debate in the stakeholder community, LDT regulation remains unchanged, and the path forward remains unclear. LDTs play an essential role in infectious disease (ID) management and treatment, and changes in their regulation will have far-reaching implications for diagnostic laboratories. LDTs are widely used by clinical microbiology laboratories for the diagnosis and monitoring of a myriad infectious diseases, and until three years ago, such testing was conducted largely out of the spotlight. The COVID-19 pandemic changed this by bringing ID tests into the forefront. As the 118th Congress gets under way, the regulation and oversight of diagnostic tests, including LDTs, remains at the forefront of health care policy discussions on Capitol Hill and with the FDA. Change is coming, and it is important that clinical microbiologists, ID physicians, and other laboratorians have a seat at the table when such changes are being discussed.

Stress, COVID-19 related knowledge, attitude, and infection control performance of nurses at long-term care hospitals.

This study aimed to identify the stress level, knowledge, attitude, and infection control performance of nurses at long-term care hospitals (LTCHs) designated for infectious disease management and to investigate factors contributing to infection control performance. A total of 178 nurses who had worked for at least 1 month at seven LTCHs designated for infectious disease management and provided care for patients confirmed with COVID-19 were enrolled in the study. Data were collected from February to March 2022 using written and online self-report questionnaires. COVID-19 infection control performance was higher among married than among single participants (t = -3.71, p < 0.001), among those aged 40-49 versus 30-39 years (F = 4.10, p = 0.003), and those with 1-2, 3-4, or ≥5 sessions versus no prior education (F = 6.41, p < 0.001). COVID-19 infection control performance was negatively correlated with stress (r = 0.26, p < 0.001) and positively correlated with knowledge (r = 0.40, p < 0.001) and attitude toward COVID-19 (r = -0.36, p < 0.001). Stress (β = -0.17, p = 0.012), knowledge of COVID-19 (β = 0.28, p < 0.001), attitude toward COVID-19 (β = 0.20, p = 0.004), and marital status (β = 0.18, p = 0.009) were identified as predictors of COVID-19 infection control performance.

A smart pathogen detector engineered from intracellular hydrogelation of DNA-decorated macrophages

Bacterial infection is a major threat to global public health, which urgently requires useful tools to rapidly analyze pathogens in the early stages of infection. Herein, we develop a smart macrophage (Mø)-based bacteria detector, which can recognize, capture, enrich and detect different bacteria and their secreted exotoxins. We transform the fragile native Møs into robust gelated cell particles (GMøs) using photo-activated crosslinking chemistry, which retains membrane integrity and recognition capacity for different microbes. Meanwhile, these GMøs equipped with magnetic nanoparticles and DNA sensing elements can not only respond to an external magnet for facile bacteria collection, but allow the detection of multiple types of bacteria in a single assay. Additionally, we design a propidium iodide-based staining assay to rapidly detect pathogen-associated exotoxins at ultralow concentrations. Overall, these nanoengineered cell particles have broad applicability in the analysis of bacteria, and could potentially be used for the management and diagnosis of infectious diseases.

Development of Infectious Disease Emergency Response Competencies for Nurses in China: A Delphi Study and an Analytic Hierarchy Process

Aim. To develop a set of infectious disease emergency response competencies specific to frontline nurses in China. Background. Nurses play an important role in the infectious disease emergency response. Competency-based training is the cornerstone of the professionalization of disaster rescue, including the infectious disease emergency response. Accordingly, reaching a consensus on a set of core competencies is essential. However, information regarding the competencies needed for nurses in the infectious disease emergency response is limited. Methods. A literature review and in-depth expert interviews were conducted to establish a draft of competencies, which consisted of 53 items, including 3 first-level index items, 12 second-level index items, and 38 third-level index items. Eighteen experts with the knowledge of infectious disease management and experience with infectious disease emergency rescue from different regions in China were recruited for Delphi consultation. A two-round Delphi survey was conducted via email. Consensus was defined as a mean importance value &gt;4.5 and the coefficient of variation &lt;0.25 among the experts. Finally, the analytic hierarchy process was used to determine the weight of each index on which consensus had been reached. Results. An index system of infectious disease emergency response competencies for nurses was constructed, including 3 first-level indices (knowledge, attitudes, and skills), 10 second-level indices, and 32 third-level indices. The response rates of the two rounds of the Delphi survey were both 100%, and the authority coefficient of the 18 experts was 0.903. The weighted value of each index was established with a consistency ratio &lt;0.1, demonstrating that skill (0.5396) ranked first among the three first-level indices, followed by knowledge (0.2970) and attitudes (0.1634). Conclusion. The study developed a consensus on infectious disease emergency response competencies required for nurses in China, which provides guidance for the assessment and training of nurses on infectious disease emergency response. Implications for Nursing Management. According to the competency index system, nursing managers could develop effective training programs of infectious disease emergency response competency for nurses and select competent nurses for emergency response to infectious diseases.

팬데믹의 일상화에 따른 손실보상

The transition from Pandemic to Endemic requires a new task for compensation for loss after police restriction for public order. The government recognizes loss compensation for small business owners and small and medium-sized business operators who have been closed or suspended due to collective bans or restrictions caused by COVID-19 through the Infectious Disease Prevention and Management Act and the Small Business Protection and Support Act. In this regard, major previous researches have been conducted on whether to apply traditional discussions on property rights guarantees to new situations. We study whether the current loss compensation due to the pandemic can be understood as public compensation or support for socialization of responsibility under the Disaster law from a different perspective from previous studies discussed mainly on German property rights guarantee and loss compensation. In addition, we reviewed the French Constitution, related laws, and Constitutional Court decisions, which were rare to discuss in Korea, and considered the possibility of interpreting the meaning of loss compensation(SON-SIL-BO-SANG) from a perspective other than boundary/separation theory on property rights.

A Public Health Laboratory Information System in Support of Health Emergencies: The Nebraska Public Health Laboratory COVID-19 Experience.

Public health laboratories (PHLs) are essential components of US Public Health Service operations. The health information technology that supports PHLs is central to effective and efficient laboratory operations and overall public health response to infectious disease management. This analysis presents key information on how the Nebraska Public Health Laboratory (NPHL) information technology system evolved to meet the demands of the COVID-19 pandemic. COVID-19 presented numerous, unforeseen information technology system challenges. The most notable challenges requiring changes to NPHL software systems and capability were improving efficiency of the laboratory operation due to high-volume testing, responding daily to demands for timely data for analysis by partner systems, interfacing with multiple testing (equipment) platforms, and supporting community-based specimen collection programs. Improvements to the NPHL information technology system enabled NPHL to perform >121 000 SARS-CoV-2 polymerase chain reaction tests from March 2020 through January 2022 at a sustainable rate of 2000 SARS-CoV-2 tests per day, with no increase in laboratory staffing. Electronic reporting of 62 000 rapid antigen tests eliminated paper reporting and extended testing services throughout the state. Collection of COVID-19 symptom data before specimen collection enabled NPHL to make data-driven decisions to perform pool testing and conserve testing kits when supplies were low. NPHL information technology applications proved essential for managing health care provider workload, prioritizing the use of scarce testing supplies, and managing Nebraska's overall pandemic response. The NPHL experience provides useful examples of a highly capable information technology system and suggests areas for additional attention in the PHL environment, including a focus on end users, collaboration with various partners, and investment in information technology.

Immunotherapies against human bacterial and fungal infectious diseases: A review.

Nations' ongoing struggles with a number of novel and reemerging infectious diseases, including the ongoing global health issue, the SARS-Co-V2 (severe acute respiratory syndrome coronavirus 2) outbreak, serve as proof that infectious diseases constitute a serious threat to the global public health. Moreover, the fatality rate in humans is rising as a result of the development of severe infectious diseases brought about by multiple drug-tolerant pathogenic microorganisms. The widespread use of traditional antimicrobial drugs, immunosuppressive medications, and other related factors led to the establishment of such drug resistant pathogenic microbial species. To overcome the difficulties commonly encountered by current infectious disease management and control processes, like inadequate effectiveness, toxicities, and the evolution of drug tolerance, new treatment solutions are required. Fortunately, immunotherapies already hold great potential for reducing these restrictions while simultaneously expanding the boundaries of healthcare and medicine, as shown by the latest discoveries and the success of drugs including monoclonal antibodies (MAbs), vaccinations, etc. Immunotherapies comprise methods for treating diseases that specifically target or affect the body's immune system and such immunological procedures/therapies strengthen the host's defenses to fight those infections. The immunotherapy-based treatments control the host's innate and adaptive immune responses, which are effective in treating different pathogenic microbial infections. As a result, diverse immunotherapeutic strategies are being researched more and more as alternative treatments for infectious diseases, leading to substantial improvements in our comprehension of the associations between pathogens and host immune system. In this review we will explore different immunotherapies and their usage for the assistance of a broad spectrum of infectious ailments caused by various human bacterial and fungal pathogenic microbes. We will discuss about the recent developments in the therapeutics against the growing human pathogenic microbial diseases and focus on the present and future of using immunotherapies to overcome these diseases. Graphical AbstractThe graphical abstract shows the therapeutic potential of different types of immunotherapies like vaccines, monoclonal antibodies-based therapies, etc., against different kinds of human Bacterial and Fungal microbial infections.

RNA molecule signature diagnosis could revolutionize personalized medicine

RNA molecule signature diagnosis could revolutionize personalized medicine Professor Michael Levin from Imperial College London argues that in the DIAMONDS project, there has been a breakthrough response in personalized medicine via RNA molecular signature diagnosis. Correct treatment of patients requires first that their illness is accurately diagnosed. Although doctors aim to deliver the right treatment to each patient, current medical diagnosis is often far from precise, and a high proportion of patients are treated based on a doctor’s “best guess” rather than on a definite diagnosis. Nowhere is this more evident, than in the management of infectious and inflammatory diseases, which are among the most common conditions for which patients seek medical care.

Collateral sensitivity profiling in drug-resistant Escherichia coli identifies natural products suppressing cephalosporin resistance

The rapid emergence of antimicrobial resistance presents serious health challenges to the management of infectious diseases, a problem that is further exacerbated by slowing rates of antimicrobial drug discovery in recent years. The phenomenon of collateral sensitivity (CS), whereby resistance to one drug is accompanied by increased sensitivity to another, provides new opportunities to address both these challenges. Here, we present a high-throughput screening platform termed Collateral Sensitivity Profiling (CSP) to map the difference in bioactivity of large chemical libraries across 29 drug-resistant strains of E. coli. CSP screening of 80 commercial antimicrobials demonstrated multiple CS interactions. Further screening of a 6195-member natural product library revealed extensive CS relationships in nature. In particular, we report the isolation of known and new analogues of borrelidin A with potent CS activities against cephalosporin-resistant strains. Co-dosing ceftazidime with borrelidin A slows broader cephalosporin resistance with no recognizable resistance to borrelidin A itself.