Frontiers in antibiotics最新文献

{"title":"Evaluation of the resistome and gut microbiome composition of hospitalized patients in a health unit of southern Brazil coming from a high animal husbandry production region.","authors":"Elisa Pires Coltro, Lucas Cafferati Beltrame, Caroline Ribeiro da Cunha, Caetana Paes Zamparette, Clarissa Feltrin, Vilmar Benetti Filho, Patrícia de Almeida Vanny, Sérgio Beduschi Filho, Taíse Costa Ribeiro Klein, Mara Cristina Scheffer, Jussara Kasuko Palmeiro, Glauber Wagner, Thaís Cristine Marques Sincero, Carlos Rodrigo Zárate-Bladés","doi":"10.3389/frabi.2024.1489356","DOIUrl":"10.3389/frabi.2024.1489356","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) poses a significant threat to global public health. The One Health approach, which integrates human, animal, and environmental health, highlights the roles of agricultural and hospital settings in the propagation of AMR. This study aimed to analyze the resistome and gut microbiome composition of individuals from a high-intensity animal husbandry area in the western region of Santa Catarina, Southern Brazil, who were subsequently admitted to the University Hospital in the city of Florianopolis, located in the eastern part of the same state.</p><p><strong>Methods: </strong>Rectal swab samples were collected upon admission and discharge. Metagenomic sequencing and resistome analysis were employed to identify antimicrobial resistance genes (ARGs) and their associated bacterial taxa. Additionally, the impact of the hospital environment on the resistome and microbiome profiles of these patients was assessed.</p><p><strong>Results: </strong>A total of 247 genetic elements related to AMR were identified, with 66.4% of these elements present in both admission and discharge samples. Aminoglycoside resistance genes were the most prevalent, followed by resistance genes for tetracyclines and lincosamides. Notably, unique resistance genes, including <i>dfrF</i> and mutations in <i>gyrB</i>, were identified at discharge. ARGs were associated with 55 bacterial species, with <i>Lactobacillus fermentum</i>, harboring the ermB gene. (MLSB), detected in both admission and discharge samples. The most prevalent bacterial families included <i>Mycobacteriaceae</i>, Enterobacteriaceae, and <i>Bacteroidaceae</i>. Among these, <i>Mycobacteriaceae</i> was the most abundant, with ARGs primarily associated with mutations in the 16S rRNA gene, RNA polymerase subunits, and gyrases.</p><p><strong>Discussion: </strong>The study revealed a high prevalence of genes related to aminoglycoside and tetracycline resistance, with a notable increase in certain resistance determinants at discharge, likely influenced by extended antimicrobial use. The presence of <i>mcr</i> genes, associated with colistin resistance, in both admission and discharge samples from a single patient highlights a concerning trend in AMR, particularly in relation to animal husbandry. These findings underscore the substantial impact of antimicrobial use on resistance development and the complex dynamics of the resistome in hospital settings. They also emphasize the influence of local factors, such as intensive animal production, on resistance patterns and advocate for ongoing surveillance and policy development to manage multidrug-resistant bacteria eVectively.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1489356"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of engineered T7 bacteriophages containing genetic sequences encoding antimicrobial peptides.","authors":"Tobias Ludwig, Daniela Volke, Andor Krizsan","doi":"10.3389/frabi.2024.1515874","DOIUrl":"https://doi.org/10.3389/frabi.2024.1515874","url":null,"abstract":"<p><p>Because of the global spread of multi- and pan-resistant bacteria, there is a need to identify, research, and develop new strategies to combat these pathogens. In a previous proof-of-concept study, we presented an innovative strategy by genetically modifying lytic T7 bacteriophages. We integrated DNA fragments encoding for derivatives of the antimicrobial peptide (AMP) apidaecin into the phage genome to induce the production and release of apidaecin within the T7 infection cycle, thereby also targeting phage-resistant <i>Escherichia coli</i> bacteria. In this follow-up study, we optimized the apidaecin encoding insert to improve the expression of the apidaecin derivative Api805 by adding the secretion signal peptide of the OmpA protein. This prevented the detrimental effects of the peptide on the producing bacterial cell after its production. The integration of two copies of the <i>OmpA</i>-Api805 insert into the phage genome resulted in T7Select-2x<i>OmpA</i>-Api805 phages, which had a partially improved activity in inhibiting phage-resistant <i>E. coli</i> compared to the T7Select phages without insert and with only one copy of the <i>OmpA</i>-Api805 insert. Additionally, we showed that the combinatorial use of the lytic bacteriophage T7Select with the highly active and lytic AMPs CRAMP (cathelicidin-related AMP) and melittin against <i>E. coli</i> made the lysis process of the phage and the peptides more effective and prevented the growth of potentially AMP- and phage-resistant <i>E. coli</i> strains. The integration of DNA sequences derived from CRAMP and melittin into the phage genome resulted in the created T7Select-(M)CRAMP and T7Select-(M)melittin phages, which showed a lysis behavior like the phage without insert and partially inhibited the growth of potentially phage-resistant <i>E. coli</i> strains after the phage-mediated lysis.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1515874"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians', pharmacists', and nurses' education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review.","authors":"Lavinia Bianca Balea, Ragnhild J A Gulestø, Hongxuan Xu, Stinne Glasdam","doi":"10.3389/frabi.2024.1507868","DOIUrl":"10.3389/frabi.2024.1507868","url":null,"abstract":"<p><strong>Background: </strong>Patients' adherence to antibiotic treatment and related prevention of AMR is significant. Understanding healthcare professionals' strategies for advising and educating patients in primary care settings is crucial.</p><p><strong>Aim: </strong>From the perspectives of professionals and patients, to explore how physicians, pharmacists, and nurses educate patients about antibiotic use and antimicrobial resistance in primary care settings.</p><p><strong>Methods: </strong>A qualitative systematic literature review was conducted in MEDLINE, EMBASE, CINAHL Complete, Eric, SocINDEX, PsycInfo, Web of Science and Scopus. The study included 102 publications, followed PRISMA recommendations and was registered in PROSPERO (reg.no. CRD4202455761). The studies were screened and selected based on specific inclusion and exclusion criteria using Covidence. Quality appraisal followed the Critical Appraisal Skills Program (CASP) qualitative study checklist. Data were extracted, and the analysis consisted of a descriptive numerical summary analysis and a qualitative thematic analysis.</p><p><strong>Results: </strong>The analyzed studies spanned multiple countries and settings and included perspectives of primary care physicians, pharmacists, nurses and patients. Two main themes emerged: (1) Relationships between professionals and patients influenced educational strategies, showing that trust and rapport between healthcare professionals and patients played a crucial role in shaping educational strategies around antibiotic use; (2) The organizational structures challenged professionals in guiding and educating patients, highlighting how limited resources, time constraints, and system-level pressures hindered healthcare professionals' ability to provide consistent and effective education. Often, structural challenges led to not educating the patients on the risks of antibiotic misuse and antimicrobial resistance. The use of delayed prescriptions emerged as a strategy for improved AMR stewardship and to meet patients' expectations for antibiotic treatment, though it raised concerns about undermining professional responsibility and authority in ensuring appropriate antibiotic use.</p><p><strong>Conclusion: </strong>Healthcare professionals' role in educating patients about antibiotic use and AMR in primary care settings was complex, with different challenges faced by nurses, pharmacists and primary care physicians. These challenges extended beyond the clinical level, including relational, social and structural factors. Power dynamics, trust issues, and time pressures often hindered effective education on antibiotic use. Addressing gaps in education on antibiotic use and AMR requires acknowledging these multifaceted challenges, with future efforts focusing on better supporting healthcare professionals in this context.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD4202455761.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1507868"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Escherichia coli</i> as a sentinel in the assessment of antimicrobial resistance in the tilapia production chain: from production environment to the final product.","authors":"Sthéfany Da Cunha Dias, Letícia Roberta Martins Costa, Ana Beatriz Garcez Buiatte, Marcus Vinícius Coutinho Cossi, Luís Augusto Nero, Ricardo Seiti Yamatogi, Luciano Dos Santos Bersot, Juliano Gonçalves Pereira","doi":"10.3389/frabi.2024.1461662","DOIUrl":"10.3389/frabi.2024.1461662","url":null,"abstract":"<p><strong>Introduction: </strong>The intensification of tilapia production has increased animal density in tanks, leading to more frequent exposure to pathogenic agents and compromising the quality of fish products. Antimicrobial resistance is a global concern that affects human treatment, and sentinel microorganisms like <i>Escherichia coli</i> are crucial for monitoring production chains, especially in aquaculture, where research is still limited. The aim of this study was to identify the presence of <i>E. coli</i> and investigate its antimicrobial resistance profiles throughout the entire tilapia production chain.</p><p><strong>Methods: </strong>A total of 240 samples were collected from various points in the production process: carcasses before scaling (Ca), scaling wastewater (Sw), filleting wastewater (Fw), fillet washing wastewater (Tw), fillet handling surfaces (Su), and pre-packaged fillets (Pf). The samples were collected during 10 visits, each corresponding to animals from different farms. <i>E. coli</i> isolates were identified using MacConkey agar and biochemical tests. Phenotypic resistance profiles were determined using nine classes of antimicrobials. Extended- spectrum b-lactamase (ESBL) production was identified with ceftazidime and cefotaxime and confirmed by a double-disc synergy test. Isolates were classified as sensitive or resistant based on the inhibition zone. Multidrug-resistant (MDR) was defined as resistance to at least one agent in three or more antimicrobial categories, while extensively drug-resistant (XDR) was defined as resistance to at least one agent in all but two or fewer categories.</p><p><strong>Results: </strong>Overall, 50.8% of the samples (122/240) tested positive for <i>E. coli</i>, with 403 isolates identified. Of these, 33% (133/403) were resistant to at least two antimicrobials, and 20% (48/240) of the samples had MDR isolates, with the highest frequency found at the filleting point (Fw), which also had the only XDR profile. Resistance was most commonly observed against amoxicillin (35.73%), tetracycline (30.77%), and ciprofloxacin (26.30%).</p><p><strong>Discussion: </strong>These findings emphasize the importance of <i>E. coli</i> as an indicator of antimicrobial resistance throughout tilapia processing and highlight the need for good production practices and qualified technical support to mitigate risks to public health, animal health, and the environment.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1461662"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial stewardship: from theory to reality in a resource-limited setting (and beyond).","authors":"Eric Ochoa-Hein, Arturo Galindo-Fraga","doi":"10.3389/frabi.2024.1492319","DOIUrl":"10.3389/frabi.2024.1492319","url":null,"abstract":"<p><p>Correct use of antibiotics is paramount to present global health. Among other actions, antimicrobial stewardship emphasizes de-escalation and suspension whenever possible. Nonetheless, roadblocks can be encountered (e.g., lack of culture results or availability of specific antibiotic classes). Furthermore, in an ever-increasing interconnected world, global success relies on local success. In this perspective, a particular case study in a resource-limited setting is an example of the many difficulties encountered in the fight against antimicrobial resistance that could hamper global advancements.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1492319"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defense mechanisms of <i>Salmonella</i> against antibiotics: a review.","authors":"Anuradha Jeewantha Punchihewage-Don, Priyanka Nilmini Ranaweera, Salina Parveen","doi":"10.3389/frabi.2024.1448796","DOIUrl":"10.3389/frabi.2024.1448796","url":null,"abstract":"<p><p><i>Salmonella</i> is a foodborne pathogenic bacterium that causes salmonellosis worldwide. Also, <i>Salmonella</i> is considered a serious problem for food safety and public health. Several antimicrobial classes including aminoglycosides, tetracyclines, phenols, and β-Lactams are used to treat <i>Salmonella</i> infections. Antibiotics have been prescribed for decades to treat infections caused by bacteria in human and animal healthcare. However, intensive use of antibiotics resulted in antibiotic resistance (AR) among several foodborne bacteria including <i>Salmonella</i>. Furthermore, multi-drug resistance (MDR) of <i>Salmonella</i> has increased dramatically. In addition to MDR <i>Salmonella</i>, extensively drug resistant (XDR) as well as pan drug resistant (PDR) <i>Salmonella</i> were reported globally. Therefore, increasing AR is becoming a serious universal public health crisis. <i>Salmonella</i> developed many mechanisms to ensure its survival against antimicrobials. The most prominent defense mechanisms against these antibiotics include enzymatic inactivation, expelling drugs from the cell through efflux pumps, altering the structure of drugs, and changing or protecting the targets of drugs. Additionally, the formation of biofilms and plasmid-mediated AR by <i>Salmonella</i>, enhancing its resistance to various antibiotics, making it a challenging pathogen in both healthcare and food industry settings. This review focuses exclusively on providing a detailed overview of the mechanisms of AR in <i>Salmonella</i>.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1448796"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective review of the common childhood illnesses and the indications for antibiotic prescription at community hospital in Malawi.","authors":"Adriano Focus Lubanga, Chana Khuluza, Jamillah Muhyuddin, Reuben Simfukwe, Frank Kaphesi, Yeo Hwan Yeum, Joshua J Yoon, Changwoo Kim, Seunghyun Kim, Si Yeon Kim, Ji An Lee, Jooheon Park, David Kim, Akim Nelson Bwanali, Lee Woohyung, Thomas Nyirenda","doi":"10.3389/frabi.2024.1447435","DOIUrl":"10.3389/frabi.2024.1447435","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childhood remains a vulnerable period and a key determiner for adult health. Various illnesses experienced by children in their early years determine future performance and contribution to society. Acute and chronic infectious diseases, undernutrition, and early childhood non-communicable diseases have greatly been linked to intellectual disability, poor childhood development, increased morbidity, and household and healthcare economic costs. In most developing countries, infections contribute to a larger burden of disease. Despite this being the case, most developing countries have a limited range of diagnostic capacity and access to a wide range spectrum of WHO Access, Watch and Reserve antibiotics. This leads to overuse and misuse of the available antibiotics and a wide range spread of resistance strains. In this study, we evaluated common childhood presentations and indications for antibiotic prescriptions at a community hospital in Malawi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study analyzed common childhood Clinical Presentations and antibiotic prescription patterns at the pediatric outpatient department (OPD) at St. Gabriel Community Mission Hospital in Malawi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective search of all outpatient routinely corrected data from St. Gabriel Community Mission Hospital between January to December 2022 was carried out. Manual screening was done on all appropriate routines under 14 medical records, and prespecified variables were extracted. Data collected consisted of total OPD patient number, age, sex, diagnosis and prescription.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2711 children under 15 years of age were included, with 53.9% being males. The majority of them were below the age of 5 (59.5%). 30% of the cases seen in the department were attributable to respiratory presentation, representing the majority of the cases seen. Sepsis and enteric diseases also constituted the majority of the cases seen and contributed 18% and 7% respectively. 68% per cent of the children seen during the period of the study had an antibiotic prescription, with the majority having only one antibiotic prescribed (31.7%). Overall, amoxicillin constituted the most commonly prescribed antibiotic for the whole system, while metronidazole was the most commonly prescribed antibiotic among enteric illnesses. Being under five was associated with a higher likelihood of antibiotic prescription (p &lt;0.001). There were no significant differences in antibiotic prescription by gender and prescribing quarter of the year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings suggest that there could be overuse and misuse of antibiotics within community hospitals. Overuse and misuse of antibiotics at the community level is closely linked to limited cytobacteriological testing, and limited access to all categories of antibiotics. Amid limited resources, more research is needed to understand the barriers and facilitators t","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1447435"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices, strategies, and challenges in antibiotic treatment and prevention of antimicrobial resistance from the perspectives of Romanian community pharmacists and general practitioners: a Goffman-inspired qualitative interview study.","authors":"Lavinia Bianca Balea, Stinne Glasdam","doi":"10.3389/frabi.2024.1439688","DOIUrl":"10.3389/frabi.2024.1439688","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) represents a persistent and ascensive global threat influenced by antibiotic misuse and overuse. In the Romanian context, patterns of antibiotic consumption and resistance within the healthcare system are marked in the red scenario on the European map. General practitioners and pharmacists, among others, play a major role in stewardship towards AMR.</p><p><strong>Aim: </strong>To explore the practices, strategies, and challenges in antibiotic treatment and prevention of antimicrobial resistance from the perspectives of Romanian community pharmacists and general practitioners.</p><p><strong>Method and materials: </strong>Semi-structured interviews were conducted with six general practitioners and five community pharmacists in Romania from January to March 2024. An inductive, Goffman theory-inspired thematic analysis was conducted, inspired by Braun and Clarke's thematic analysis method, consisting of familiarization with the data, iterative coding guided by theoretically inspired questions, and identification and refinement of (sub)themes. Goffman's theory of social interaction, focusing on the concepts of front stage, backstage, and roles, guided the analytical questions.</p><p><strong>Results: </strong>The results were presented in three overarching themes: 'Knowledge acquired backstage to support challenges and performance on front stage', 'Adapting roles and performances on the front stage: A mix of structured and twisted acts', and 'Interprofessional Collaboration: A latent part in the play's roles and performances'. Professionals prepared their understandings of AMR and antibiotics backstage, with an awareness of the challenges rooted in the Romanian context. The front stage scenario evolved from structured antibiotic performances led by AMR strategies with compliant actors to challenging performances influenced by actors which changed the course of performances and intended AMR strategies. The revealed competition between general practitioners and pharmacists further complicated antibiotic use and AMR-related performances.</p><p><strong>Conclusion: </strong>The Romanian socio-political system influenced the course of antibiotic treatment and the professionals' intended antibiotic related practices and AMR strategies. The study showed a theory-practice gap in health professionals' practices, leading to limited strategy integration towards AMR and increased antibiotic use. The study underscores the need for context-specific policies and interventions to minimize identified gaps.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1439688"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Acinetobacter</i> spp. in neonatal sepsis: an urgent global threat.","authors":"Kamla Pillay, Anirban Ray-Chaudhuri, Seamus O'Brien, Paul Heath, Mike Sharland","doi":"10.3389/frabi.2024.1448071","DOIUrl":"10.3389/frabi.2024.1448071","url":null,"abstract":"<p><p>Neonatal sepsis causes substantial morbidity and mortality, the burden of which is carried by low-income countries (LICs). The emergence of multidrug-resistant pathogens in vulnerable neonatal populations poses an urgent threat to infant survival. <i>Acinetobacter</i> spp. are increasingly responsible for severe disease in neonates globally. The cause of this escalation remains unclear, but host, pathogen and environmental factors are all likely to contribute. <i>Acinetobacter</i> spp. strains are frequently resistant to the first line empirical treatment for neonatal sepsis as recommended by the World Health Organization (WHO), ampicillin and gentamicin, rendering these antibiotics ineffectual in many critically ill neonates. The resultant escalation to broader spectrum antibiotic regimens in neonatal intensive care units (NICUs) worldwide has led to the emergence of more resistant strains, including carbapenem-resistant <i>Acinetobacter baumanii</i> (CRAB), resulting in infections that are ever more difficult to treat. While some existing antimicrobial agents are under consideration for treatment of <i>Acinetobacter</i> spp. infections, the majority remain a long way from clinical use in neonates. Further research into the clinical phenotype of these infections, transmission dynamics and preventative measures are urgently needed to reduce neonatal deaths. This review aims to summarise the role of <i>Acinetobacter</i> spp. in neonatal sepsis, including host, pathogen and environmental factors, the global epidemiology and clinical features of the disease, the treatment options, and future research priorities.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"3 ","pages":"1448071"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro antimicrobial susceptibility of clinical isolates from adult and paediatric patients in Jordan: Antimicrobial Testing Leadership and Surveillance (ATLAS) 2010–2021","authors":"Dima Al Jammal, Julia Bachir, Jihane A. Moussa, Jamal Wadi Al Ramahi","doi":"10.3389/frabi.2024.1375980","DOIUrl":"https://doi.org/10.3389/frabi.2024.1375980","url":null,"abstract":"To evaluate the in vitro antimicrobial susceptibilities of Gram-positive and Gram-negative isolates from patients in Jordan between 2010 and 2021, through the Antimicrobial Testing Leadership and Surveillance (ATLAS) programme.Medical centres in Jordan collected bacterial isolates from hospitalised patients with defined infection sources between 2010 and 2021 (no isolates collected in 2014). Antimicrobial susceptibility was interpreted using CLSI standards. FDA-approved breakpoints were applied for tigecycline. The identification of β-lactamase genes was performed for a proportion of isolates using multiplex PCR assays.More than 92% of Acinetobacter baumannii collected were multidrug-resistant (MDR) and/or carbapenem-resistant (CR), and > 50% susceptibility was reported only to minocycline (62.2% among both MDR and CR isolates). Rates of MDR and CR Pseudomonas aeruginosa were 14.3% and 20.5%, respectively, and among all P. aeruginosa collected from adults, susceptibility to ceftazidime/avibactam was 95.3% and to ceftolozane/tazobactam was 88.4%. For Escherichia coli from adults and MDR E. coli, susceptibility to ceftazidime/avibactam, ceftolozane/tazobactam, imipenem, meropenem and meropenem/vaborbactam was 92.1%–98.7%. Susceptibility to tigecycline was > 94% among Klebsiella pneumoniae from adult, paediatric, and ICU patients (all ages). CTX-M-15 was the most frequently identified β-lactamase gene among E. coli and K. pneumoniae. Susceptibility to most antimicrobial agents was < 50% among K. pneumoniae carrying CTX-M-15, CTX-M-9-type, NDM-5, and/or OXA-48 β-lactamase genes. All S. aureus collected were susceptible to teicoplanin, vancomycin, daptomycin, linezolid and tigecycline, with 96.1% of S. aureus from adults were susceptible to ceftaroline. Overall, 58.8% of Staphylococcus aureus were MRSA.This study provides valuable information regarding antimicrobial susceptibility in Jordan between 2010 and 2021. Continued monitoring of in vitro antimicrobial susceptibility is critical in the fight against antimicrobial resistance.","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":"30 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}