Antibiotics-Basel最新文献

{"title":"Identifying the Molecular Fingerprint of Beta-Lactams via Raman/SERS Spectroscopy Using Unconventional Nanoparticles for Antimicrobial Stewardship.","authors":"Vinicius Pereira Anjos, Caroline Guimarães Pançardes da Silva Marangoni, Rafael Nadas, Thiago Neves Machado, Damaris Krul, Luiza Souza Rodrigues, Libera Maria Dalla-Costa, Wido Herwig Schreiner, Denise Maria Zezell, Arandi Ginane Bezerra, Rafael Eleodoro de Góes","doi":"10.3390/antibiotics13121157","DOIUrl":"https://doi.org/10.3390/antibiotics13121157","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Beta-lactam antibiotics, derived from penicillin, are the most used class of antimicrobials used for treating bacterial infections. Over the years, microorganisms have developed resistance mechanisms capable of preventing the effect of these drugs. This condition has been a significant public health concern for the 21st century, especially after predictions that antimicrobial resistance could lead to 10 million deaths annually by 2050. The challenge of developing new antimicrobials brings with it the need to ensure the efficacy of existing ones, hence the importance of developing fast and low-cost monitoring techniques. <b>Methods:</b> In this study, we present an alternative based on nanophotonics using Surface-Enhanced Raman Spectroscopy (SERS) mediated by nanoparticles for the detection of antimicrobials, with emphasis on some beta-lactam antibiotics commonly prescribed in cases of critically ill patients. It is a sensitive and accurate technique for drug monitoring, allowing for rapid and specific detection of its molecular signatures. This approach is crucial to address the challenge of antimicrobial resistance and ensure the therapeutic efficacy of existing treatments. <b>Results:</b> Our experiments demonstrate the possibility of identifying spectra with characteristic vibrations (fingerprints) of these antimicrobials via SERS. <b>Conclusions:</b> Our results point to new strategies for molecular monitoring of drugs by optical techniques using unconventional nanoparticles.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Cohort of Compassionate Use of Meropenem-Vaborbactam: No Benefit over Meropenem for <i>Pseudomonas aeruginosa</i>.","authors":"Aurélien Dinh, Alexandre Bleibtreu, Clara Duran, Frédérique Bouchand, Alexie Bosch, Jullien Crozon-Clauzel, Mariam Roncato-Saberan, Morgan Matt, André Boibieux, Annlyse Fanton, Heidi Wille, Elise Fiaux, Benoît Pilmis, Marie Lacoste, Quentin Saint-Genis, Caroline Thumerelle, Patricia Pavese, Fanny Vuotto, Eric Senneville, Anaïs Potron, Stéphane Corvec, David Boutoille, Katy Jeannot, Laurent Dortet, On Behalf Of The Meropenem-Vaborbactam French Study Group","doi":"10.3390/antibiotics13121152","DOIUrl":"https://doi.org/10.3390/antibiotics13121152","url":null,"abstract":"<p><strong>Background: </strong>Meropenem-vaborbactam (MEM-VAB) is a novel carbapenem-beta-lactamase-inhibitor combination that demonstrates activity against carbapenem-resistant (CR) Gram-negative bacteria, and more specifically KPC-producers, since vaborbactam is an effective inhibitor of KPC enzymes in vitro. This study aimed to describe the initial uses and efficacy of MEM-VAB for compassionate treatment during the first 21 months following its early access in France.</p><p><strong>Method: </strong>A national multicenter retrospective study was conducted, including all patients who received at least one dose of MEM-VAB between 20 July 2020, and 5 April 2022. Clinical characteristics and outcomes were collected using a standardized questionnaire. The minimum inhibitory concentration (MIC) of antimicrobials, and complete genome sequencing of bacteria were performed when bacterial isolates were available.</p><p><strong>Results: </strong>Ultimately, 21 patients from 15 French hospitals were included in the study. The main indication for MEM-VAB treatment was respiratory tract infections (<i>n</i> = 9). The targeted bacteria included <i>Pseudomonas aeruginosa</i> (<i>n</i> = 12), <i>Klebsiella pneumoniae</i> (<i>n</i> = 3), <i>Enterobacter spp</i> (<i>n</i> = 3), <i>Citrobacter freundii</i> (<i>n</i> = 1), <i>Escherichia coli</i> (<i>n</i> = 1), and <i>Burkholderia multivorans</i> (<i>n</i> = 1). Overall, no significant advantage of vaborbactam over meropenem alone was observed across all strains of <i>P. aeruginosa</i> in terms of in vitro susceptibility. However, MEM-VAB demonstrated a notable impact, compared to carbapenem alone, on the MIC for the two KPC-3-producing <i>K. pneumoniae</i> and <i>B. multivorans</i>.</p><p><strong>Conclusions: </strong>MEM-VAB seems effective as a salvage treatment in compassionate use, but vaborbactam was shown to lack benefits compared to meropenem in treating <i>P. aeruginosa</i>-related infections. Therefore, it is crucial to compare meropenem to MEM-VAB MICs, particularly for <i>P. aeruginosa</i>, before prescribing MEM-VAB.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclic Peptide MV6, an Aminoglycoside Efficacy Enhancer Against <i>Acinetobacter baumannii</i>.","authors":"Natalia Roson-Calero, Jimmy Lucas, María A Gomis-Font, Roger de Pedro-Jové, Antonio Oliver, Clara Ballesté-Delpierre, Jordi Vila","doi":"10.3390/antibiotics13121147","DOIUrl":"https://doi.org/10.3390/antibiotics13121147","url":null,"abstract":"<p><p><b>Background/Objectives</b>: <i>Acinetobacter baumannii</i> is a globally emerging pathogen with widespread antimicrobial resistance driven by multiple mechanisms, such as altered expression of efflux pumps like AdeABC, placing it as a priority for research. Driven by the lack of new treatments, alternative approaches are being explored to combat its infections, among which efficacy-enhancing adjuvants can be found. This study presents and characterizes MV6, a synthetic cyclic peptide that boosts aminoglycoside efficacy. <b>Methods</b>: MV6's activity was assessed through antimicrobial susceptibility testing in combination with different antibiotic classes against <i>A. baumannii</i> strains characterized by PCR and RT-qPCR. PAβN served as a reference efflux pump inhibitor. Synergy was evaluated using checkerboard assays, and spontaneous mutants were generated with netilmicin with/without MV6 (100 mg/L). Whole-genome sequencing and variant calling analysis were then performed. <b>Results</b>: MV6 presented low antimicrobial activity in <i>A. baumannii</i> with MICs higher than 2048 mg/L. MV6 showed a better boosting effect for aminoglycosides, especially netilmicin, exceeding that of PAβN. Checkerboard assays confirmed a strong synergy between netilmicin and MV6, and a significant correlation was found between netilmicin MIC and <i>adeB</i> overexpression, which was mitigated by the presence of MV6. MV6 reduced, by 16-fold, the mutant prevention concentration of netilmicin. Mutations in a TetR-family regulator and ABC-binding proteins were found in both groups, suggesting a direct or indirect implication of these proteins in the resistance acquisition process. <b>Conclusions</b>: MV6 lacks intrinsic antimicrobial activity, minimizing selective pressure, yet enhances netilmicin's effectiveness except for strain 210, which lacks the AdeABC efflux pump. Resistant mutants indicate specific aminoglycoside resistance mechanisms involving efflux pump mutations, suggesting synergistic interactions. Further research, including transcriptomic analysis, is essential to elucidate MV6's role in enhancing netilmicin efficacy and its resistance mechanisms.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Antibiotic Use Contribute to Biofilm Resistance in Sink Drains? A Case Study from Four German Hospital Wards.","authors":"Nicole van Leuven, Ralf Lucassen, Anna Dicks, Patrick Braß, André Lipski, Dirk P Bockmühl","doi":"10.3390/antibiotics13121148","DOIUrl":"https://doi.org/10.3390/antibiotics13121148","url":null,"abstract":"<p><p><b>Backgound</b>. As biofilms are known to harbour (multi-)resistant species, their presence in health settings must be considered critical. Although there is evidence that bacteria spread from drains to the outside, there is still a lack of research data focusing on drain biofilms from hospitals. <b>Methods</b>. We sampled biofilms from various wards of Helios Hospital Krefeld (Germany), where comprehensive antibiotic consumption data were available. Biofilms were analysed by cell counting, isolation of relevant bacterial groups and genetic and phenotypical resistance parameters. Data were correlated with the prescribed antibiotics of the respective ward. Furthermore, an ex situ biofilm model was employed to investigate the influence of sub-inhibitory antibiotics on the bacterial community and the prevalence of class 1 integrons. <b>Results</b>. Our results show that every ward harboured medically relevant bacterial species. While no significant differences were found in cell counts, the median prevalence of the resistance marker gene <i>intI1</i> correlated with the amount of prescribed antibiotics. In contrast, phenotypical resistances showed no similar tendency. In addition, melting curve analysis data and changes in <i>intI1</i> prevalence show that the composition of the bacterial community shifted depending on the biofilm and antibiotic. <b>Conclusions</b>. To the best of our knowledge, our study is the first considering possible correlations between the consumption data of hospital wards and resistances in drain biofilms the way we did. Based on our results, we conclude that sub-inhibitory concentrations of antibiotics have no general effect on biofilms in terms of bacterial community shift and occurrence of antibiotic-resistant species. Amongst other things, the effect depends on the initial composition of the bacterial community, the antibiotic used and the intrinsic bacterial resistance, e.g., prevalence of class 1 integrons.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caught Between Stewardship and Resistance: How to Treat Acute Complicated Diverticulitis in Areas of Low Antimicrobial Susceptibility?","authors":"Octavian Enciu, Elena-Adelina Toma, Adrian Miron, Gabriela Loredana Popa, Andrei-Alexandru Muntean, Andrei Ludovic Porosnicu, Mircea Ioan Popa","doi":"10.3390/antibiotics13121150","DOIUrl":"https://doi.org/10.3390/antibiotics13121150","url":null,"abstract":"<p><p>Antimicrobial resistance is one of the main threats to public health, with multidrug-resistant (MDR) pathogens on the rise across continents. Although treatment guidelines generally recommend antimicrobial therapy for acute complicated diverticulitis, they do not specify treatment pathways according to local or national resistance profiles. There is sparse data regarding specific pathogens involved in Hinchey II-IV patients who undergo surgery. This study seeks to address these issues and determine how often and what types of MDR bacteria occur in patients undergoing emergency surgery. We prospectively enrolled patients admitted between 2020-2023 and who underwent emergency surgery for complicated acute diverticulitis. We analysed the inflammatory response parameters at admission, the type of surgery employed for source control, identified pathogens in the peritoneal samples, their antimicrobial susceptibility, the efficacy of antimicrobial empiric therapy, and mortality. Gram-negative bacteria were identified most often, with <i>Escherichia coli</i> being mostly MDR (43.9%) or extended-spectrum beta-lactamase producing (ESBL +ve) (24.4%), while most strains of <i>Klebsiella pneumoniae</i> were extended-spectrum beta-lactamase positive (ESBL +ve) (80%) and MDR (80%). Of the <i>Enterococcus</i> spp., 57.14% were vancomycin-resistant (VRE) strains. Patients with Hinchey III/IV were significantly more associated with MDR. Patients with multiple pathogens were significantly associated with ESBL+/VRE strains. Age, leucocytosis, and procalcitonin levels at admission were good indicators for mortality prediction, which occurred in four cases. In an age when antibiotic stewardship is advisable especially in emergency settings, the treatment should be tailored according to local profiles of MDR to ensure adequate outcomes for patients.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Nanoparticles Composed of Zein and Arginine-Phenylalanine-Based Surfactants for Wound Related Infections: Antioxidant and Skin-Related Anti-Enzymatic Activities and Toxicity.","authors":"Francisco Fábio Oliveira de Sousa, Zakaria Hafidi, María Teresa García, Maria Del Carmen Moran, Sergio Vazquez, Lourdes Pérez","doi":"10.3390/antibiotics13121149","DOIUrl":"https://doi.org/10.3390/antibiotics13121149","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Cationic surfactants are potential antimicrobial candidates. Even so, they are the foremost irritative and incompatible group, which limits their usage. The incorporation of surfactants in biopolymer-based nanoparticles is a feasible strategy to improve their efficacy and reduce those drawbacks. <b>Methods</b>: Surfactants with one amino acid on the polar head (lauroyl arginine methyl ester-LAM and phenylalanine dodecyl amide-PNHC₁₂) and surfactants with two amino acids on the polar heads, arginine-phenylalanine (Lauroyl phenylalanine arginine methyl esther-C₁₂PAM and phenylalanine-arginine dodecyl amide-PANHC₁₂) were loaded to zein nanoparticles. Their antimicrobial and antibiofilm activities were evaluated. Also, the inhibitory activities of the surfactants and nanoparticles over skin-related enzymes were accessed in silico and in vitro, while their cytotoxicity was determined comparatively over immortal human keratinocytes (HaCaT) and human fibroblasts (3T3). Finally, the <i>Vibrio fisheri</i> luminescence reduction test was used to detect its ecotoxicity. <b>Results</b>: The nanoparticles were obtained successfully and exhibited good biocide activity against a wide range of pathogenic bacteria and yeasts. The surfactants were found active over the enzymes assayed: elastase > tyrosinase > collagenase > lipoxygenase, while the inhibitory activity was superior when nanoencapsulated over the enzymes tyrosinase and lipoxygenase. The surfactants and their corresponding nanoparticles presented acceptable cytotoxic levels, except for PNHC₁₂ in both forms, while their ecotoxicity was limited and acceptable. <b>Conclusions</b>: Accordingly, the nanoencapsulation of the arginine-phenylalanine surfactants loaded to zein nanoparticles was found to be a smart strategy to enhance the antimicrobial activity and improve their selectivity over representative skin and connective tissues cell lines. These biological properties render the arginine-phenylalanine surfactant nanoparticles as promising candidates for antimicrobial and tissue repairing applications in wound treatments.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Antibiotic-Impregnated Cement Spacer for Diabetic Osteomyelitis of the Foot.","authors":"Farouk Khury, Ihab Karkabi, Elias Mazzawi, Doron Norman, Eyal A Melamed, Eli Peled","doi":"10.3390/antibiotics13121153","DOIUrl":"https://doi.org/10.3390/antibiotics13121153","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the rising global awareness and improvement of socioeconomic and living standards, the prevalence of diabetic osteomyelitis (DOM) and its complications has been increasing rapidly. This study aims to investigate the long-term prognosis of DOM of the foot treated using antibiotic-impregnated cement spacer (ACS) and the contributing risk factors for reoperation.</p><p><strong>Methods and materials: </strong>We retrospectively reviewed the data of 55 diabetic patients with Meggitt-Wagner Grade IIB wounds diagnosed with osteomyelitis of the foot, treated in our institution with excessive debridement, excision of the infected tissue, and implantation of antibiotic-impregnated cement spacer fixed with a Kirschner wire. Descriptive statistics, including patient demographics, were analyzed. Statistical analysis was performed using point-biserial correlation and a Chi-square test with Cramer's V effect-size estimation to determine the relationship between reoperation and various parameters.</p><p><strong>Results: </strong>55 patients (36 (65.45%) males and 19 (34.55%) females) with a median age of 64 (39-84) years were thoroughly analyzed throughout a median follow-up of 884 days (2-4671 days). Of the entire cohort, 29 (52.72%) patients achieved primary successful infection eradication without any further intervention, and 8 (14.54%) patients were successfully treated using a secondary procedure. More than half of the reoperated patients underwent the secondary intervention within less than a month after the primary ACS. When assessing correlation, age (r = 0.28, <i>p</i> = 0.04), gender (r = 0.31, <i>p</i> = 0.02), <i>Staphylococcus aureus</i> (r = -0.10, <i>p</i> = 0.04), and the use of gentamicin-only antibiotic cement spacer (r = 0.34, <i>p</i> = 0.01) demonstrated statistically significant correlation to reoperation. 89.18% of the patients who achieved infection eradication did not undergo cement removal.</p><p><strong>Conclusions: </strong>ACS has shown excellent results in eradicating bone infection with up to 7.23 years of follow-up, acting as a structural stabilizer, preventing soft tissue contractures, and delivering highly concentrated local antibiotic treatment both to soft tissue and bone. Regardless, specific factors should be thoroughly evaluated prior to surgery, as advancing age, gender, and the use of gentamicin-only antibiotics appear to be positively associated with a higher likelihood of reoperation. Conversely, infections caused by cultured <i>Staphylococcus aureus</i> seem to be inversely related to reoperation.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention and Modern Strategies for Managing Methicillin-Resistant Staphylococcal Infections in Prosthetic Joint Infections (PJIs).","authors":"Karolina Kraus, Paweł Mikziński, Jarosław Widelski, Emil Paluch","doi":"10.3390/antibiotics13121151","DOIUrl":"https://doi.org/10.3390/antibiotics13121151","url":null,"abstract":"<p><p>Periprosthetic joint infections (PJIs) are a dangerous complication of joint replacement surgeries which have become much more common in recent years (mostly hip and knee replacement surgeries). Such a condition can lead to many health issues and often requires reoperation. Staphylococci is a bacterial group most common in terms of the pathogens causing PJIs. <i>S. aureus</i> and coagulase-negative staphylococci are found in around two-thirds of PJI cases. Recently, the numbers of staphylococci that cause such infections and that are methicillin-resistant are increasing. This trend leads to difficulties in the treatment and prevention of such infections. That is why MRSA and MRSE groups require extraordinary attention when dealing with PJIs in order to successfully treat them. Controlling carriage, using optimal prosthetic materials, and implementing perioperative antimicrobial prophylaxis are crucial strategies in infection prevention and are as essential as quick diagnosis and effective targeted treatment. The comprehensive professional procedures presented in this review show how to deal with such cases.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AcrAB Efflux Pump Plays a Crucial Role in Bile Salts Resistance and Pathogenesis of <i>Klebsiella pneumoniae</i>.","authors":"Rundong Shu, Ge Liu, Yunyu Xu, Bojun Liu, Zhi Huang, Hui Wang","doi":"10.3390/antibiotics13121146","DOIUrl":"https://doi.org/10.3390/antibiotics13121146","url":null,"abstract":"<p><p>Bile salts possess innate antibacterial properties and can cause significant damage to bacteria. To survive in the mammalian gut, <i>Klebsiella pneumoniae</i> has developed mechanisms to tolerate bile salts; however, the specific mechanisms remain unclear. Transposon library screening revealed that the efflux pump AcrAB is involved in bile salt resistance. <i>acrA</i> and <i>acrB</i> mutants exhibited high sensitivity not only to bile salts but also to SDS and various antibiotics, with a switch-loop, comprising residues G615, F616, A617, and G618, proving to be crucial in this process. A colonization defect of <i>acrA</i> and <i>acrB</i> mutants was demonstrated to be located in the mouse small intestine, where the bile salt concentration is higher compared to the large intestine. Additionally, both <i>acrA</i> and <i>acrB</i> mutants displayed reduced virulence in the <i>Galleria mellonella</i> model. In conclusion, our results suggest that the Resistance-Nodulation-Cell Division efflux pump serves as a critical determinant in the pathogenesis of <i>K. pneumoniae</i> through various aspects.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Stewardship Intervention for the Family Caregiver Attending Primary Health Care Setting: A Quasi-Experimental Study.","authors":"Ammena Y Binsaleh, Mahmoud S Abdallah, Basma Mohamed Osman, Mostafa M Bahaa, Nawal Alsubaie, Thanaa A Elmasry, Mohamed Yasser, Mamdouh Eldesoqui, Abdel-Naser Abdel-Atty Gadallah, Manal A Hamouda, Nashwa Eltantawy, Fatma A Mokhtar, Ramy M El Sabaa","doi":"10.3390/antibiotics13121145","DOIUrl":"https://doi.org/10.3390/antibiotics13121145","url":null,"abstract":"<p><p><b>Background:</b> Antimicrobial resistance (AMR) has been identified as one of the top ten public health threats facing humanity. <b>Aim:</b> The purpose of this study was to assess the effect of an antimicrobial stewardship educational intervention on family caregivers' knowledge and practices in primary healthcare settings in Egypt. <b>Methods:</b> A quasi-experimental, one-group pretest-posttest design involving a sample of 300 family caregivers attending family health centers. The data were collected using questionnaires that assessed caregiver knowledge and self-reported practices regarding AMR before and after the intervention (primary outcomes). The intervention combined tailored knowledge and practice components that carefully evaluated participants' knowledge regarding AMR, health risk, antibiotic usage, and prevention of infection. Furthermore, their practice of using antibiotics, including previous antibiotic exposure, their antibiotic use during the past year, reasons for taking antibiotics, ways of obtaining antibiotics, and reasons for discontinuing of antibiotic therapy were also recorded. <b>Results:</b> The pre-intervention assessment revealed poor knowledge and practice regarding antibiotic use. Post-intervention, mean knowledge scores increased significantly from 18.36 to 23.28 (t = 19.5, <i>p</i> < 0.0001), while mean practice scores improved from 9.83 to 12.37 (t = 6.4, <i>p</i> < 0.0001). <b>Conclusions:</b> The intervention successfully improved caregivers' knowledge and practices regarding AMR. However, there are some limitations that could affect the generalization, and the impact of the results such as the relatively small sample size recruited from a single center, lack of a control group, reliance on self-reported data, and lack of long-term follow-up. Future studies should aim to address these constraints in order to assess the intervention's effectiveness.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"13 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}