Journal Of Antimicrobial Chemotherapy Research Articles

Interest in antibiotic pharmacokinetic modelling in the context of optimising dosing and reducing resistance: bibliometric analysis.

In the era of problems with resistant bacteria strains, pharmacokinetic (PK) modelling offers ways to optimise antibiotic therapy and minimise the risk of resistance development. This bibliometric study aimed to investigate trends in PK modelling stu-dies. The goal was to provide researchers with comprehensive insight and identify future needs. We used Bibliometrix, VOSviewer, and CiteSpace to analyse Web of Science articles on antibiotic PK modelling from 1983 to March 2023. We analysed 968 papers following the inclusion criteria and built a keywords co-occurrence map and timeline. The average annual growth rate of subject-related publications was 35.56% between 1983 and 2022, maintaining a continuous upward trend. Roberts J.A., Lipman J., and Wallis S.C. are the three most productive and impactful authors (82, 57, 34 articles, and h-index of 30, 25, 15, respectively). The United States leads in this field of research (29.13% of papers). The most relevant affiliations are the University of Queensland, Royal Brisbane and Women's Hospital, and Monash University. The top three most productive and impactful journals are Antimicrobial Agents and Chemotherapy, Journal of Antimicrobial Chemotherapy, and International Journal of Antimicrobial Agents (181, 83, 47 articles and h-index of 42, 30, 18, respectively). Most articles by keyword clustered on meropenem, vancomycin, and amikacin. Moreover, therapeutic drug monitoring, resistance, antibiotic dosing, target attainment, the intensive care unit, and paediatrics are the most trending aspects. Given the results of this study, we expect to see a steady increase in interest in exploiting the potential of PK modelling for optimising antibiotic therapy.

The state of current research on COVID-19 and antibiotic use: global implications for antimicrobial resistance

BackgroundDuring the initial stages of the coronavirus disease 2019 (COVID-19) pandemic, the administration of antibiotics to patients was prevalent in numerous countries. Despite this, the rising threat of antimicrobial resistance (AMR) presents a significant public health concern. The escalation of AMR has been exacerbated by the ongoing COVID-19 pandemic. Against this backdrop, the primary aim of this study was to conduct a bibliometric and visual analysis of research pertaining to the use of antibiotics in COVID-19.MethodsThis study examined documents indexed in Scopus between 2020 and 2022. To visualize the trends and hotspots of research related to antibiotics and COVID-19, as well as collaborative networks, the researcher utilized version 1.6.18 of the VOSviewer software. Scopus data were analysed to extract information on the types of publications, annual research output, countries, institutions, funding agencies, journals, citations, and highly cited references. Microsoft Excel 2019 was used to process and organize the extracted data.ResultsThis study analysed 1137 documents related to COVID-19 and antibiotics and found that the number of publications increased from 130 in 2020 to 527 in 2022. These publications included 777 (68.34%) articles and 205 (18.03%) reviews. The top five countries in terms of scientific production were the United States (n = 231; 20.32%), the United Kingdom (n = 156; 13.72%), China (n = 101; 8.88%), India (n = 100; 8.8%), and Italy (n = 63; 5.54%), and the leading institutions were Imperial College London (n = 21; 1.85%), University of Oxford (n = 20; 1.76%), and University College London (n = 15; 1.32%). The National Natural Science Foundation of China provided funding for the highest number of articles (n = 48; 4.22%), followed by the National Institutes of Health (n = 32; 2.81%). The most productive journals were Antibiotics (n = 90; 7.92%), Journal of Antimicrobial Chemotherapy (n = 30; 2.64%), and Infection Control and Hospital Epidemiology (n = 26; 2.29%). Finally, the research hotspots identified in this study were ‘antimicrobial stewardship during the COVID-19 outbreak’ and ‘implications of the COVID-19 pandemic on the emergence of antimicrobial resistance.’ConclusionsThis is the first bibliometric analysis of COVID-19-related research on antibiotics. Research was carried out in response to global requests to increase the fight against AMR and awareness of the issue. More restrictions on the use of antibiotics are urgently needed from policy makers and authorities, more so than in the current situation.

The Next Pandemic

The Next Pandemic

Exploring determinants of antimicrobial prescribing behaviour: a qualitative study using the Theoretical Domains Framework

IntroductionFew qualitative studies have explored determinants of antimicrobial prescribing behaviour in hospitals, and none has made reference to behavioural theories. An understanding of these determinants is required for the successful development and implementation of behaviour change interventions (BCIs) in this area.AimTo explore the determinants of clinicians’ antimicrobial prescribing behaviour, using the Theoretical Domains Framework (TDF; a framework of behavioural theories).MethodsThis work was part of a multi-phase explanatory, sequential mixed methods PhD programme of research. This qualitative part involved semi-structured, online (video) interviews via a videoconferencing software programme (Zoom) with clinicians (doctors and pharmacists) based in 12 Hamad Medical Corporation hospitals in Qatar. Clinicians were sampled purposively in strata of gender, profession, years of experience and area of practice. The interview schedule was developed based on a review of published literature (1), previous findings of quantitative research (2) and the TDF to ensure comprehensive coverage of key determinants (including barriers and facilitators) related to clinicians’ antimicrobial prescribing behaviour. Interviews were conducted from December 2020 to February 2021, audio-recorded, transcribed and independently analysed by two research team members using the TDF as an initial coding framework.ResultsData saturation was achieved after interviewing eight doctors and eight pharmacists from a range of areas of practices and with a variety of experiences. A number of themes, linked to ten TDF domains, were identified as determinants of antimicrobial prescribing behaviour and these determinants were interrelated. In-depth analysis identified several barriers and facilitators that may contribute to inappropriate or appropriate antimicrobial prescribing. Main barriers identified were around hospital guidelines and electronic system deficiencies (environmental context and resources), gaps in the knowledge in relation to guidelines and appropriate prescribing (knowledge), restricted roles/responsibilities of microbiologists and pharmacists (professional role and identity), uncomfortable antimicrobial prescribing decisions (memory, attention and decision processes), as well as professional hierarchies and poor multidisciplinary teamworking/relationships (social influences). “Sometimes, the barrier would be the ego of senior doctors who refuse our evidence-based recommendation and depend on their clinical judgement or experience” (Pharmacist 470, Cardiology). Key facilitators highlighted included guidelines compliance goals and intentions, and the beliefs of consequences of appropriate or inappropriate prescribing. Further education and training sessions, and some changes to guidelines, including accessibility were also considered essential. “We need to seriously consider getting an antibiotic guidelines app which is downloaded to clinicians’ mobile phones. The mobile app is handy, you can access it anytime even at the patient’s bedside” (Doctor 514, Microbiology).ConclusionThis qualitative study, using a theoretically based approach, has identified that antimicrobial prescribing in hospitals is a complex process influenced by a broad range of behavioural determinants that described specific barriers and facilitators. The in-depth understanding of this complexity provided by this phase of the research may contribute to the design and development of theoretically based BCIs to improve clinicians’ antimicrobial prescribing. Limitations include data collected with online interviews due to the Covid-19 restrictions. This may have excluded some clinicians who did not feel comfortable with or have access to the technology required.References(1) Talkhan H, Stewart D, Mcintosh T, Ziglam H, Abdulrouf P, Al-Hail M et al. The use of theory in the development and evaluation of behaviour change interventions to improve antimicrobial prescribing: a systematic review. Journal of Antimicrobial Chemotherapy. 2020;75(9):2394-2410.(2) Talkhan H, Stewart D, McIntosh T, Ziglam H, Abdulrouf P, Al-Hail M et al. Using the Theoretical Domains Framework to investigate clinicians’ behavioural determinants of antimicrobial prescribing in Qatar. International Journal of Pharmacy Practice. 2021;29(1):i20-i22.

Plant Phyto-constituents as Antibiotic Adjuvants: A Systematic Review and Bibliometric Analysis

The advent of antibiotics in the 19th century has significantly reduced the morbidity and mortality of infectious diseases. However, irrational use of antibiotics in humans as well as in animals has driven the 21st century to the rapid emergence of MultiDrug Resistance Bacteria (MRB). Moreover, the dissemination of COVID-19 pandemic has paved the way for MRB, typically due to increased use of antibiotics to avoid secondary infections.
 The fast pace progression of bacterial resistance for the antibiotics and their combinations is making the management of MRB infections tough and increasing the cost of the treatment as well. However, use of Efflux Pump Inhibitors (EPI) as adjuvant for antibiotics has shown a ray of hope by retaining the susceptibility of the antibiotics and thereby reducing the burden of immediate requirement of new antibiotics for MRB. Accordingly, the present paper is aimed to scrutinize the predominant literature depicting the plant Phyto-constituents as an EPI and adjuvant for antibiotics in the management of MRB infections.
 The systematic review of the present paper indicates that the plant phyto-constituents belonging to the class of alkaloids, terpenoids, flavonoids can effectively be used as EPIs for antibiotics such as Ciprofloxacin, Norfloxacin, Tetracyclines and Chloramphenicol. Bibliometric analysis indicates that the Journal of Antimicrobial Chemotherapy, Antimicrobial Agents and Chemotherapy and BMC Complementary & Alternative Medicine have published impactful articles on EPI potential of plant phyto-constituents. Further, authors Kuete V, Dzotam JK, Falcao-silva VD, Gibbons S, Kuiate JR, Mbaveng AT, Tankeo SB and Voukeng IK are the major contributors and productive authors.

Antibiotic awareness and preventing further antimicrobial resistance

Journal of Prescribing PracticeVol. 1, No. 12 NewsAntibiotic awareness and preventing further antimicrobial resistanceAysha MendesAysha MendesE-mail Address: [email protected]Freelance journalist, specialising in healthcare and psychologySearch for more papers by this authorAysha MendesPublished Online:13 Dec 2019https://doi.org/10.12968/jprp.2019.1.12.580AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References Appelbaum P. 2012 and beyond: potential for the start of a second pre-antibiotic era?. Journal of Antimicrobial Chemotherapy. 2012;67(9):2062-2068. https://doi.org/10.1093/jac/dks213 Google ScholarAshiru-Oredope D. Providing self-care advice for cold and flu keeps antibiotics working. 2019. https://www.pharmaceutical-journal.com/20206996.article?utm_campaign=2483_PJ_weekly_roundup&utm_medium=email&utm_source=Pharmaceutical%2Journal&firstPass=false (accessed 20 November 2019) Google ScholarCenters for Disease Control and Prevention. Antibiotic prescribing and use in doctor's offfices. 2017. https://www.cdc.gov/antibiotic-use/community/index.html (accessed 20 November, 2019) Google ScholarMolteni M. The Post-Antibiotic Era Is Here. Now What? 2017. https://www.wired.com/story/the-post-antibiotic-era-is-here-now-what/ (accessed 25 November 2019) Google ScholarNHS. World Antibiotic Awareness Week, 18-22 November. 2019. https://www.england.nhs.uk/2019/10/world-antibiotic-awareness-week-18-22-november/ (accessed 20 November 2019) Google ScholarPharamaceutical Technlogy. Innovation could prevent a return to a pre-antibiotic era. 2019. https://www.pharmaceutical-technology.com/comment/innovation-prevent-return-pre-antibiotic-era/ (accessed 25 November 2019) Google ScholarRaymond B, Powell N. We must follow these five rules to avert an antimicrobial resistance crisis. 2019. https://www.pharmaceutical-journal.com/news-and-analysis/opinion/insight/we-must-follow-these-five-rules-to-avert-an-antimicrobial-resistance-crisis/20207265.fullarticle (accessed 20 November 2019) Google ScholarRaymond B and Powell N. We Must Follow These Five Rules to Avert an Antimicrobial Resistance Crisis. Pharmaceutical Journal. 2013. www.pharmaceutical-journal.com/20207265.article?utm_campaign=2483_PJ_weekly_roundup&utm_medium=email&utm_source=Pharmaceutical%20Journal (accessed 22 November 2019. Google ScholarReview on Antimicrobial Resistance. Tackling drug-resistant infections globally. 2016. https://amr-review.org/ (accessed 20 November 2019) Google ScholarSprenger M. How to stop antibiotic resistance? Here's a WHO prescription. 2015. https://www.who.int/mediacentre/commentaries/stop-antibiotic-resistance/en/ (accessed 20 November 2019) Google ScholarThe Pharmaceutical Journal. Little progress made to develop incentives for new antibiotics, vaccines and diagnostics, AMR review concludes. 2019. https://www.pharmaceutical-journal.com/20207177.article?utm_campaign=2482_PJ_daily_alert&utm_medium=email&utm_source=Pharmaceutical%20Journal&firstPass=false (accessed 20 November 2019) Google Scholar FiguresReferencesRelatedDetails 2 December 2019Volume 1Issue 12ISSN (print): 2631-8385ISSN (online): 2631-8393 Metrics History Published online 13 December 2019 Published in print 2 December 2019 Information© MA Healthcare LimitedPDF download

DUAL MRSA COVERAGE FOR NECROTIZING PNEUMONIA IN A CRITICAL CARE PATIENT

SESSION TITLE: Monday Fellow Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the common causes of health care-associated pneumonia. Choice of antibacterial therapy can affect outcome. Vancomycin continues to remain the drug of choice for MRSA. Persistent MRSA (pMRSA) pneumonia has been described however the role of dual antimicrobial coverage for MRSA is not well known. Here, we present a case of pMRSA pneumonia that failed initial treatment with vancomycin followed by linezolid but improved with dual treatment consisting of vancomycin and ceftaroline. CASE PRESENTATION: 52-year-old male with PMHx of chronic back pain with recent lumbar spine surgery and history of opioid dependence presented with altered mental status, acute hypoxemic respiratory failure and shock. Initial Labs showed a wbc 9 with 80% left shift. CXR was consistent with pneumonia with a dense right basilar opacity. He was empirically started on vancomycin and zosyn given recent health care exposure. Respiratory culture (RC) grew MRSA and pan sensitive enterobacter; despite appropriate weight based dosing, vancomycin levels remained slightly subtherapeutic so antibiotics were switched to linezolid and ceftriaxone. He improved clinically and was extubated. 3 days after completion of 2 weeks of appropriate antibiotic therapy, he again decompensated requiring intubation and vasopressors. Meropenem and vancomycin were empirically administered. Repeat RC again grew MRSA, vancomycin minimum inhibitory concentration (MIC) DISCUSSION: MRSA is defined as an oxallicin MIC ≥4 mcg/ml. In the United States, about 7% of patients are colonized with MRSA. Vancomycin is the mainstream treatment for MRSA pneumonia. PMRSA pneumonia has not been well described and the role of dual antimicrobial coverage is not well known. In vitro synergy between vancomycin and ceftaroline has been reported in some studies but clinical experience with this therapy is limited. Our patient failed vancomycin followed by linezolid therapy. He improved rapidly with combination therapy. CONCLUSIONS: Further study is needed for the role of dual antimicrobial coverage for pMRSA. Reference #1: Gritsenko, Diana, et al. “Combination Therapy With Vancomycin and Ceftaroline for Refractory Methicillin-Resistant Staphylococcus Aureus Bacteremia: A Case Series.” Clinical Therapeutics, vol. 39, no. 1, 2017, pp. 212–218., https://doi.org/10.1016/j.clinthera.2016.12.005. Reference #2: Katie E. Barber, Michael J. Rybak, George Sakoulas; Vancomycin plus ceftaroline shows potent in vitrosynergy and was successfully utilized to clear persistent daptomycin-non-susceptible MRSA bacteraemia, Journal of Antimicrobial Chemotherapy, Volume 70, Issue 1, 1 January 2015, Pages 311–313 Reference #3: Choo, Eun Ju and Henry F Chambers. “Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia” Infection & chemotherapy vol. 48,4 (2016): 267-273. DISCLOSURES: No relevant relationships by Obed Adarkwah, source=Web Response No relevant relationships by Mona Alipour, source=Web Response No relevant relationships by Louis Gerolemou, source=Web Response No relevant relationships by Nabil Mesiha, source=Web Response Speaker/Speaker's Bureau relationship with Allergan Please note: $20001 - $100000 Added 03/18/2019 by Joshua Rosenberg, source=Web Response, value=Honoraria No relevant relationships by jad sargi, source=Web Response

DOXYCYCLINE AND DRUG INJURY: RARE SIDE EFFECTS IN A COMMONLY PRESCRIBED MEDICATION

SESSION TITLE: Wednesday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM INTRODUCTION: Tetracyclines were first discovered in the 1940s, and like penicillins, are found in nature. Tetracycline itself was one of the first semi-synthetic antibiotics made, and after further development, doxycycline was developed as a more stable pharmacological compound. In studies of pharmacokinetics and metabolism, doxycycline concentrations are highest in the liver, kidney, and digestive tract. Though there is no significant metabolism or generation of metabolites discovered yet, its co-administration with liver metabolized medications indicate that it may have some hepatic metabolism. Literature suggests that liver injury associated with doxycycline may be immunoallergic in nature, as it can happen after multiple administrations with no prior injuries. For its role in causing acute pancreatitis, doxycycline has been implicated in prior case reports, though the absolute occurrence of this adverse drug event is difficult to assess. Estimates range from 0.1% to 5.3%. CASE PRESENTATION: Our patient was transferred from an outside hospital to our intensive care unit (ICU) for evaluation of elevated transaminitis and pancreatitis. After initial evaluation for autoimmune hepatitis, choledocolithiasis, cholethiasis and alternative liver or biliary duct pathology, it was determined that he had doxycycline induced liver injury as well as pancreatitis likely due to its use. On review of the patient’s history, he had a history of recurrent doxycycline use for chronic osteomyelitis that was diagnosed in childhood and was recently on a course of doxycycline for that reason. His course of pancreatitis and liver injury was sufficient to warrant admission to the ICU for closer monitoring. DISCUSSION: Doxycycline is a commonly used medication in the inpatient and ambulatory setting. There is known liver toxicity associated with doxycycline and documented instances of acute pancreatitis, though the role of impaired liver function as an independent risk factor for pancreatitis is not established in literature. In patients with prior history of doxycycline use who are found to have liver and pancreatic injury of otherwise undetermined etiology, consideration must be made for doxycycline as an etiology. With withdrawal of the drug, our patient had normalization of his liver function tests as well as improvement of his pancreatitis. He is a patient who should avoid doxycycline use when alternatives are available given its immunoallergic nature. CONCLUSIONS: As more reports are published regarding doxycycline induced pancreatitis and liver injury, a better assessment can be made of the incidence and possible concurrence of these adverse events. In patients with no alternative organic cause for pancreatitis or liver injury, consideration should be made for doxycycline as the underlying etiology, and a specific history of its use can be ascertained from patients. Reference #1: Kenneth N. Agwuh, Alasdair MacGowan; Pharmacokinetics and pharmacodynamics of the tetracyclines including glycylcyclines, Journal of Antimicrobial Chemotherapy, Volume 58, Issue 2, 1 August 2006, Pages 256–265, https://doi.org/10.1093/jac/dkl224 Reference #2: Rawla P, Raj JP. Doxycycline-Induced Acute Pancreatitis: A Rare Adverse Event. Gastroenterology Res. 2017;10(4):244-246. Reference #3: Wachira JK, Jensen CH, Rhone K. Doxycycline-induced pancreatitis: a rare finding. S D Med. 2013;66(6):227-9. DISCLOSURES: No relevant relationships by Tania Kohal, source=Web Response

Therapeutic drug monitoring in the past 40 years of the Journal of Antimicrobial Chemotherapy.

Since the Journal of Antimicrobial Chemotherapy was first published in 1975, papers addressing therapeutic drug monitoring (TDM) have been a regular feature. Initially they focused on laboratory aspects of drug concentration measurement then they changed more to the application of TDM in a clinical setting. Over its history, the Journal has provided its readership with the latest technological and scientific advances in TDM and has helped to drive changes in TDM that have directly impacted on patient care. These have varied from improvement in the quality of antimicrobial measurements through better identification of dosage regimens and TDM targets that help predict outcome and adverse events. Despite these advances in our understanding of the science and practice of TDM, there remain many areas of uncertainty. As we move into the next 40 years, it is clear that the Journal will continue to provide the readership with the latest science and opinion in this important area.

Contribution of JAC to antimicrobial stewardship.

Antimicrobial stewardship programmes are increasingly being used to improve the quality of antimicrobial prescribing, with the dual aim of optimizing clinical outcomes and minimizing the emergence and spread of antimicrobial resistance. The Journal of Antimicrobial Chemotherapy (JAC) is celebrating its 40th anniversary and, as part of activities to commemorate this event, this article highlights the contribution of JAC to antimicrobial stewardship. Papers published in JAC have contributed to the evidence base for stewardship, have highlighted educational and behavioural change initiatives aimed at improving antibiotic prescribing practice, and have actively sought to foster the practice of antimicrobial stewardship amongst its readers.

40 years of veterinary papers in JAC - what have we learnt?

This review, for the occasion of the 40th anniversary of the Journal of Antimicrobial Chemotherapy (JAC), gives an overview of the manuscripts related to veterinary bacteriology published in the journal in the past 40 years with a focus on 'One Health' aspects. From 1975 to 2000 the number of manuscripts related to veterinary medicine was limited, but thereafter, the number steadily increased. Most manuscripts published were related to food-producing animals, but companion animals and minor species were also covered. Subjects included antimicrobial usage in animals and the consequences for human medicine, new resistance genes and mechanisms, the prevalence and epidemiology of antimicrobial resistance, and the emergence of resistant bacteria in animals with zoonotic potential such as livestock-associated MRSA (LA-MRSA), methicillin-resistant Staphylococcus pseudintermedius (MRSP) and ESBL-producing Enterobacteriaceae. These manuscripts have added to our knowledge on the risks of transmission of resistant bacteria from animals to humans and the importance of the prudent use of antimicrobial agents in veterinary medicine.

EFSA's assistance for the 2015 Codex Committee on Residues of Veterinary Drugs in Food (CCRVDF) in relation to rBST

EFSA's assistance for the 2015 Codex Committee on Residues of Veterinary Drugs in Food (CCRVDF) in relation to rBST

Preparatory work for the pest categorisation of three bacteria listed in the annexes of the Council directive 2000/29/EC Erwinia amylovora Winslow et al. Xylophilus ampelinus (Panagopoulos) Willems et al. Clavibacter michiganensis subsp. insidiosus(McCulloch) Davis et al

Preparatory work for the pest categorisation of three bacteria listed in the annexes of the Council directive 2000/29/EC Erwinia amylovora Winslow et al. Xylophilus ampelinus (Panagopoulos) Willems et al. Clavibacter michiganensis subsp. insidiosus(McCulloch) Davis et al

Patients Infected with HIV Type 1 Subtype CRF01_AE and Failing First-Line Nevirapine- and Efavirenz-Based Regimens Demonstrate Considerable Cross-Resistance to Etravirine

AIDS Research and Human RetrovirusesVol. 26, No. 6 Letter to the EditorPatients Infected with HIV Type 1 Subtype CRF01_AE and Failing First-Line Nevirapine- and Efavirenz-Based Regimens Demonstrate Considerable Cross-Resistance to EtravirineWeerawat Manosuthi, David M. Butler, Wasun Chantratita, Chonlaphat Sukasem, Douglas D. Richman, and Davey M. SmithWeerawat ManosuthiBamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand.Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.Search for more papers by this author, David M. ButlerUniversity of California San Diego, La Jolla, California.Search for more papers by this author, Wasun ChantratitaFaculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.Search for more papers by this author, Chonlaphat SukasemFaculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.Search for more papers by this author, Douglas D. RichmanUniversity of California San Diego, La Jolla, California.Veterans Affairs San Diego Healthcare System, San Diego, California.Search for more papers by this author, and Davey M. SmithUniversity of California San Diego, La Jolla, California.Veterans Affairs San Diego Healthcare System, San Diego, California.Search for more papers by this authorPublished Online:20 Jun 2010https://doi.org/10.1089/aid.2009.0107AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited ByGlobal Comparison of Drug Resistance Mutations After First-Line Antiretroviral Therapy Across Human Immunodeficiency Virus-1 Subtypes3 November 2015 | Open Forum Infectious Diseases, Vol. 3, No. 2High prevalence of PI resistance in patients failing second-line ART in Vietnam11 December 2015 | Journal of Antimicrobial Chemotherapy, Vol. 71, No. 3A simian-human immunodeficiency virus carrying the rt gene from Chinese CRF01_AE strain of HIV is sensitive to nucleoside reverse transcriptase inhibitors and has a highly genetic stability in vivoMicrobes and Infection, Vol. 16, No. 6Extensive Drug Resistance in HIV-Infected Cambodian Children Who Are Undetected as Failing First-Line Antiretroviral Therapy by WHO 2010 Guidelines Mia Coetzer, Benjamin Westley, Allison DeLong, Chhraing Tray, Dim Sophearin, Eric Nerrienet, Leeann Schreier, and Rami Kantor13 June 2013 | AIDS Research and Human Retroviruses, Vol. 29, No. 7The Potential Cost and Benefits of Raltegravir in Simplified Second-Line Therapy among HIV Infected Patients in Nigeria and South Africa15 February 2013 | PLoS ONE, Vol. 8, No. 2High Plasma Efavirenz Concentration and CYP2B6 Polymorphisms in Thai HIV-1 InfectionsDrug Metabolism and Pharmacokinetics, Vol. 28, No. 5Unusual Insertion and Deletion at Codon 67 and 69 of HIV Type 1 Subtype C Reverse Transcriptase Among First-Line Highly Active Antiretroviral Treatment-Failing South Indian Patients: Association with Other Resistance Mutations Shanmugam Saravanan, Vidya Madhavan, Rami Kantor, Sathasivam Sivamalar, Selvamurthi Gomathi, Sunil S. Solomon, Nagalingeswaran Kumarasamy, Davey M. Smith, Robert T. Schooley, Suniti Solomon, and Pachamuthu Balakrishnan21 November 2012 | AIDS Research and Human Retroviruses, Vol. 28, No. 12Antiviral Drug Resistance and the Need for Development of New HIV-1 Reverse Transcriptase InhibitorsAntimicrobial Agents and Chemotherapy, Vol. 56, No. 10The Need for Development of New HIV-1 Reverse Transcriptase and Integrase Inhibitors in the Aftermath of Antiviral Drug ResistanceScientifica, Vol. 2012Short Communication Prevalence of Susceptibility to Etravirine by Genotype and Phenotype in Samples Received for Routine HIV Type 1 Resistance Testing in the United States Gaston Picchio, Johan Vingerhoets, Lotke Tambuyzer, Eoin Coakley, Mojgan Haddad, and James Witek29 November 2011 | AIDS Research and Human Retroviruses, Vol. 27, No. 12Genotypic Impact of Prolonged Detectable HIV Type 1 RNA Viral Load after HAART Failure in a CRF01_AE-Infected Cohort Maria Zolfo, Jonathan M. Schapiro, Vichet Phan, Olivier Koole, Sopheak Thai, Marc Vekemans, Katrien Fransen, and Lutgarde Lynen27 June 2011 | AIDS Research and Human Retroviruses, Vol. 27, No. 7Selection of nonnucleoside reverse transcriptase inhibitor-associated mutations in HIV-1 subtype C: evidence of etravirine cross-resistanceAIDS, Vol. 25, No. 8Reverse transcriptase mutation K65N confers a decreased replication capacity to HIV-1 in comparison to K65R due to a decreased RT processivityVirology, Vol. 414, No. 1Assessments of HIV Drug Resistance Mutations in Resource-Limited Settings15 April 2011 | Clinical Infectious Diseases, Vol. 52, No. 8Characterization of the E138K Resistance Mutation in HIV-1 Reverse Transcriptase Conferring Susceptibility to Etravirine in B and Non-B HIV-1 SubtypesAntimicrobial Agents and Chemotherapy, Vol. 55, No. 2 Volume 26Issue 6Jun 2010 InformationCopyright 2010, Mary Ann Liebert, Inc.To cite this article:Weerawat Manosuthi, David M. Butler, Wasun Chantratita, Chonlaphat Sukasem, Douglas D. Richman, and Davey M. Smith.Patients Infected with HIV Type 1 Subtype CRF01_AE and Failing First-Line Nevirapine- and Efavirenz-Based Regimens Demonstrate Considerable Cross-Resistance to Etravirine.AIDS Research and Human Retroviruses.Jun 2010.609-611.http://doi.org/10.1089/aid.2009.0107Published in Volume: 26 Issue 6: June 20, 2010Online Ahead of Print:May 27, 2010PDF download

Registries and Selection Bias

Outcomes researchers share a strong interest in determining what is being achieved in practice. In the quest to reveal what is actually being done in medicine, we are often in a position to use existing data about clinical practice and patient experience to answer relevant questions, rather than having to generate data de novo. Patient registries, with their size, scope, and focus on patients who represent those seen in clinical practice, have become an increasingly common source of data for outcomes researchers. There is much to like about patient registries. These organized collections of data about clinical practice are a vehicle by which we can assemble massive amounts of information about patients and use it to assess quality of care, identify patterns of care, facilitate real-world research, and improve performance. In cardiovascular medicine, registries capture information about patients with acute coronary syndromes and heart failure as well as those who undergo procedures related to cardiac catheterization, percutaneous coronary intervention, carotid stents, and internal cardioverter defibrillators. Federal agencies are turning to registries to provide information about quality and produce insights about how to best practice medicine through an emphasis on comparative effectiveness research. Outcomes research articles based on registry data are numerous, including those from NRMI, CRUSADE, GWTG-HF, …

Description of an unusual class 2 integron in Shigella sonnei isolates in Senegal (sub-Saharan Africa)

Description of an unusual class 2 integron in Shigella sonnei isolates in Senegal (sub-Saharan Africa)

Evidence for chromosomal and plasmid location of CMY-2 cephalosporinase gene in Salmonella serotype Typhimurium

Sir, Resistance to extended-spectrum cephalosporins has emerged among non-typhoid salmonellae (NTS) worldwide due to acquisition of plasmid-mediated b-lactamases including CMY-2. The isolation frequency of CMY-2-producing NTS in the USA has gradually increased since 1996 reflecting the widespread transmission of CMY-2-positive NTS among food animal reservoirs. The blaCMY-2 gene has been disseminated by plasmids to various Salmonella serotypes including Typhimurium. – 4 We report here on a human isolate of Salmonella serotype Typhimurium harbouring a CMY-2-encoding plasmid as well as a chromosomally located copy of blaCMY-2. Salmonella serovar Typhimurium AM19083 was submitted to the National Antimicrobial Resistance Monitoring System in 2003 from Massachusetts. Antimicrobial susceptibility was assessed by broth microdilution (Sensititre, Westlake, OH, USA). The isolate met the phenotypic criteria indicative of class C cephalosporinase production (i.e. resistance or decreased susceptibility to cefoxitin, ceftiofur and ceftriaxone). It was also resistant to ampicillin, amoxicillin/clavulanate and cefalotin, but susceptible to non-b-lactam drugs including streptomycin, sulphonamides, chloramphenicol, tetracycline, nalidixic acid and ciprofloxacin. AM19083 was positive in PCR assays with blaCMY-specific primers, and the sequence of the amplicon (369 bp) was homologous to an internal fragment of blaCMY-2 (from nt 271 to nt 639, in GenBank accession no. X91840). Isoelectric focusing of sonicated cell extracts in polyacrylamide gels containing ampholines showed production of a b-lactamase species with an isoelectric point of .8.4 corresponding to CMY-2. b-Lactam resistance was readily transferred by conjugation in broth cultures to a susceptible Escherichia coli host. The plasmid content analysis indicated transfer of an ~90 kb plasmid (designated p19083) that was positive in hybridization with a blaCMY-2 probe prepared as described previously. 5 Plasmid p19083 belonged to the incompatibility Group I1 (IncI1), as found by a PCR-based Inc/rep typing method. Furthermore, the PstI restriction profile of p19083 resembled restriction type B of the IncI1, CMY-2-encoding plasmids previously described in Salmonella Typhimurium and Salmonella Thompson isolates from the USA. A plasmid DNA preparation from AM19083 was electrophoresed through agarose gels (0.8%). DNA was then transferred to Hybond-N nylon membranes (Amersham Biosciences, Buckingham, UK) and hybridized with a digoxigenin-labelled blaCMY-2 probe. 5 These experiments showed not only the expected hybridization with plasmid p19083, but also a strong signal with the chromosomal material. This was not observed with preparations from two control strains of serotype Typhimurium, one of which (AM18447) also carried two CMY-2-encoding plasmids, p18447-S and p18447-L (~140 and 300 kb, respectively). To clarify this issue, an I-CeuI genomic analysis of isolates AM19083 and AM18447 was performed. The digested fragments were separated by PFGE (6.0 V/cm for 8 h/16 h with a pulsing time linearly ramped from 5 to 20 s/20 to 70 s) (Figure 1a). The blaCMY-2 probe was hybridized with a 16SrRNA-positive I-CeuI fragment of ~500 kb from isolate AM19083. Positive signals probably corresponding to the blaCMY-2-carrying plasmids were also seen (Figure 1b). Subsequent hybridization with Inc/rep probes showed that p19083 and p18447-S belonged to IncI1, whereas the blaCMY-2-carrying putative plasmid p18447-L and the 500 kb fragment from AM 19083 were not reactive (Figure 1c). In an attempt to rule out the existence of blaCMY-2-positive plasmids of high molecular weight in AM19083 and, also, to corroborate the plasmidic nature of p18447-L, the plasmid contents of AM19083 and AM18447 were analysed by PFGE after treatment of total DNA with S1 nuclease. The respective electrophoretic profiles indicated the absence of blaCMY-2-carrying ‘megaplasmids’ in AM19083, whereas a band of ~300 kb likely representing the linear form of p18447-L was observed in the preparations from AM18447 (data not shown). Finally, to further strengthen our hypothesis for the chromosomal acquisition of blaCMY-2 in AM19083, the relevant I-CeuI fragment was purified by electroelution. The resulting preparation contained blaCMY-2 as confirmed by PCR and sequencing. It was also negative in PCR assays designed for replicon typing of plasmids including IncI1 and IncA/C. Nevertheless, the possibility that plasmid segments including rep could have been removed during I-CeuI treatment cannot be excluded. Production of CMY-2 has been described in a wide variety of NTS serotypes in the USA. The plasmidic location of blaCMY-2 is critical for spread of this resistant determinant. The present findings confirm the prominent role of IncI1 plasmids in this process. Additionally, the likely chromosomal carriage of blaCMY-2 underscores the operation of efficient mobilization mechanisms commonly involving ISEcp1 and/or IS26. Multiple copies of a resistance gene may increase the antimicrobial resistance levels and provide more of a selective advantage. Expression of the chromosomal CMY-2 and its possible contribution to b-lactam resistance levels were not studied. b-Lactam MICs for Salmonella Typhimurium AM19083, however, were comparable with those observed for other Salmonella strains carrying only plasmidic blaCMY-2, such as AM18447, but, for many of Journal of Antimicrobial Chemotherapy (2008) 61, 1389–1399 doi:10.1093/jac/dkn116 Advance Access publication 18 March 2008

Randomized controlled trials in the Journal of Antimicrobial Chemotherapy

The Journal of Antimicrobial Chemotherapy welcomes submissions of well-reported randomized controlled trials (RCTs) with solid methodology based on the CONSORT statement (http://www.consort-statement.org). The Journal would be especially happy to publish RCTs in the area of antimicrobial chemotherapy if they address significant problems and look at measurable outcomes that matter to patients.

Aminoglycoside/ -lactam combinations in clinical practice

Randomized controlled trials failed to show an advantage of the addition of aminoglycosides to broad-spectrum beta-lactams. In the present issue of the Journal of Antimicrobial Chemotherapy, an analysis of a large series of bacteraemic patients from Denmark, treated either with a narrow-spectrum beta-lactam or with a combination of a beta-lactam and an aminoglycoside, shows comparable outcomes in the two groups. In locations where broad-spectrum beta-lactams are in common use, the addition of an aminoglycoside does not improve efficacy and adds side effects. In countries where the resistance is low enough to use 'old' beta-lactams, and there is an unwillingness to use broad-spectrum beta-lactams, evidence for the efficacy of combination treatment and for its role in keeping the resistance at a low level is wanting.

Antiviral Briefs

AIDS Patient Care and STDsVol. 21, No. 9 Antiviral BriefsPublished Online:5 Oct 2007https://doi.org/10.1089/apc.2007.9970AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byLogistic Regression Classifiers in the Analysis of HIV-1 Use of CCR5 and CXCR4 Coreceptors4 June 2019Journal of Natural Medicines, Vol. 71, No. 4Increased CXCR4 Use of HIV-1 Subtype C Identified by Population Sequencing in Patients Failing Antiretroviral Treatment Compared with Treatment-Naive Patients in Botswana Lotta Pramanik Sollerkvist, Simani Gaseitsiwe, Madisa Mine, Gaseene Sebetso, Thongbotho Mphoyakgosi, Thabo Diphoko, Max Essex, and Anneka Ehrnst2 May 2014 | AIDS Research and Human Retroviruses, Vol. 30, No. 5Determination of HIV tropism and its use in the clinical practice10 January 2014 | Expert Review of Anti-infective Therapy, Vol. 11, No. 12When and how to use maraviroc in HIV-infected patientsAIDS, Vol. 23, No. 18HIV Type-1 Latency: Targeted Induction of Proviral Reservoirs1 April 2009 | Antiviral Chemistry and Chemotherapy, Vol. 19, No. 5Design and validation of new genotypic tools for easy and reliable estimation of HIV tropism before using CCR5 antagonists5 March 2009 | Journal of Antimicrobial Chemotherapy, Vol. 63, No. 5Optimal use of maraviroc in clinical practiceAIDS, Vol. 22, No. 17Maraviroc: farmacocinética, interacciones y mecanismo de acciónEnfermedades Infecciosas y Microbiología Clínica, Vol. 26Métodos de determinación del tropismo viral: tests genotípicos y fenotípicosEnfermedades Infecciosas y Microbiología Clínica, Vol. 26A sensitive HPLC–MS–MS method for the determination of raltegravir in human plasmaJournal of Chromatography B, Vol. 867, No. 2 Volume 21Issue 9Sep 2007 InformationMary Ann Liebert, Inc.To cite this article:Antiviral Briefs.AIDS Patient Care and STDs.Sep 2007.702-705.http://doi.org/10.1089/apc.2007.9970Published in Volume: 21 Issue 9: October 5, 2007PDF download