Antibiotics

18 pages, 2664 KiB

Open AccessArticle

Efficacy of Trichoderma spp. and Kosakonia sp. Both Independently and Combined with Fungicides against Botrytis cinerea on Strawberries

by Tom E. Schierling, Wolfgang Vogt, Ralf T. Voegele and Abbas El-Hasan

Antibiotics 2024, 13(9), 912; https://doi.org/10.3390/antibiotics13090912 - 23 Sep 2024

Viewed by 853

Abstract

Background: The ascomycete Botrytis cinerea is a major pathogen of strawberry, often causing grey mold and significant yield losses. Its management has largely relied on chemical fungicides, which, while effective, can lead to resistant pathogens and harm to non-target organisms and pose health [...] Read more.

Background: The ascomycete Botrytis cinerea is a major pathogen of strawberry, often causing grey mold and significant yield losses. Its management has largely relied on chemical fungicides, which, while effective, can lead to resistant pathogens and harm to non-target organisms and pose health risks. Objectives: This study explored a strategy for minimizing chemical usage by combining biocontrol agents (BCAs) with half-strength fungicide input. Results: In vitro results of fungicide-amended culture plates indicated that the presence of 625 µg mL⁻¹ Azoxystrobin exhibited no growth inhibition of T. atroviride T19 and T. harzianum T16 but increased conidial density of T16 by 90%. Copper (750 µg mL⁻¹) did not suppress the growth of T. virens TVSC or T16 but rather promoted it by 9.5% and 6%, respectively. Additionally, copper increased T16 sporulation by 1.4-fold. Greenhouse trials demonstrated that combining T23 with half-strength Azoxystrobin was as effective as the full dosage in suppressing flower rot. Among the antagonists assessed, Kosakonia sp. exhibited the lowest incidence of fruit rot, whereas T23 resulted in a moderate incidence. Moreover, the combination of T16 or Kosakonia sp. with half-strength copper was almost as effective as the full dosage in reducing fruit rot. Conclusions: Our findings suggest integrating these BCAs in the sustainable management of grey mold in strawberries. Full article

(This article belongs to the Special Issue Antimicrobial Resistance and Antimicrobial Activity of Natural Products and Derivatives)

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26 pages, 6687 KiB

Open AccessArticle

Insight into Romanian Wild-Grown Heracleum sphondylium: Development of a New Phytocarrier Based on Silver Nanoparticles with Antioxidant, Antimicrobial and Cytotoxicity Potential

by Adina-Elena Segneanu, Gabriela Vlase, Titus Vlase, Ludovic Everard Bejenaru, George Dan Mogoşanu, Gabriela Buema, Dumitru-Daniel Herea, Maria Viorica Ciocîlteu and Cornelia Bejenaru

Antibiotics 2024, 13(9), 911; https://doi.org/10.3390/antibiotics13090911 - 23 Sep 2024

Viewed by 942

Abstract

Background: Heracleum sphondylium, a medicinal plant used in Romanian ethnopharmacology, has been proven to have remarkable biological activity. The escalating concerns surrounding antimicrobial resistance led to a special attention being paid to new efficient antimicrobial agents based on medicinal plants and [...] Read more.

Background: Heracleum sphondylium, a medicinal plant used in Romanian ethnopharmacology, has been proven to have remarkable biological activity. The escalating concerns surrounding antimicrobial resistance led to a special attention being paid to new efficient antimicrobial agents based on medicinal plants and nanotechnology. We report the preparation of a novel, simple phytocarrier that harnesses the bioactive properties of H. sphondylium and silver nanoparticles (HS-Ag system). Methods: H. sphondylium’s low metabolic profile was determined through gas chromatography–mass spectrometry and electrospray ionization–quadrupole time-of-flight–mass spectrometry. The morphostructural properties of the innovative phytocarrier were analyzed by X-ray diffraction, Fourier-transform infrared spectroscopy, Raman spectroscopy, dynamic light scattering, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. The antioxidant activity was evaluated using total phenolic content, ferric reducing antioxidant power, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) in vitro assays. The antimicrobial activity screening against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, and Escherichia coli was conducted using the agar well diffusion method. The 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay estimated the in vitro potential cytotoxicity on normal human dermal fibroblasts (NHDF) and cervical cancer (HeLa) cells. Results: A total of 88 biomolecules were detected, such as terpenoids, flavonoids, phenolic acids, coumarins, phenylpropanoids, iridoids, amino acids, phytosterols, fatty acids. The HS-Ag phytocarrier heightened efficacy in suppressing the growth of all tested bacterial strains compared to H. sphondylium and exhibited a significant inhibition of HeLa cell viability. Conclusions: The new HS-Ag phytocarrier system holds promise for a wide range of medical applications. The data confirm the capacity to augment the pertinent theoretical understanding in the innovative field of antimicrobial agents. Full article

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28 pages, 1643 KiB

Open AccessReview

Commercial Silver-Based Dressings: In Vitro and Clinical Studies in Treatment of Chronic and Burn Wounds

by Sweta Shrestha, Bo Wang and Prabir K. Dutta

Antibiotics 2024, 13(9), 910; https://doi.org/10.3390/antibiotics13090910 - 23 Sep 2024

Viewed by 1503

Abstract

Chronic wounds are a major health problem because of delayed healing, causing hardships for the patient. The infection present in these wounds plays a role in delayed wound healing. Silver wound dressings have been used for decades, beginning in the 1960s with silver [...] Read more.

Chronic wounds are a major health problem because of delayed healing, causing hardships for the patient. The infection present in these wounds plays a role in delayed wound healing. Silver wound dressings have been used for decades, beginning in the 1960s with silver sulfadiazine for infection prevention for burn wounds. Since that time, there has been a large number of commercial silver dressings that have obtained FDA clearance. In this review, we examine the literature involving in vitro and in vivo (both animal and human clinical) studies with commercial silver dressings and attempt to glean the important characteristics of these dressings in treating infected wounds. The primary presentation of the literature is in the form of detailed tables. The narrative part of the review focuses on the different types of silver dressings, including the supporting matrix, the release characteristics of the silver into the surroundings, and their toxicity. Though there are many clinical studies of chronic and burn wounds using silver dressings that we discuss, it is difficult to compare the performances of the dressings directly because of the differences in the study protocols. We conclude that silver dressings can assist in wound healing, although it is difficult to provide general treatment guidelines. From a wound dressing point of view, future studies will need to focus on new delivery systems for silver, as well as the type of matrix in which the silver is deposited. Clearly, adding other actives to enhance the antimicrobial activity, including the disruption of mature biofilms is of interest. From a clinical point of view, the focus needs to be on the wound healing characteristics, and thus randomized control trials will provide more confidence in the results. The application of different wound dressings for specific wounds needs to be clarified, along with the application protocols. It is most likely that no single silver-based dressing can be used for all wounds. Full article

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11 pages, 2009 KiB

Open AccessArticle

Clarithromycin Modulates Neutrophilic Inflammation Induced by Prevotella intermedia in Human Airway Epithelial Cells

by Naoki Iwanaga, Ayaka Ota, Hiroki Ashizawa, Yuya Ito, Tatsuro Hirayama, Masataka Yoshida, Kazuaki Takeda, Shotaro Ide, Masato Tashiro, Naoki Hosogaya, Noriho Sakamoto, Takahiro Takazono, Kosuke Kosai, Mariko Naito, Yoshimasa Tanaka, Kazuhiro Yatera, Koichi Izumikawa, Katsunori Yanagihara and Hiroshi Mukae

Antibiotics 2024, 13(9), 909; https://doi.org/10.3390/antibiotics13090909 - 23 Sep 2024

Viewed by 833

Abstract

Objectives: In the present study, we aimed to clarify the mechanisms by which periodontal pathogens, particularly Prevotella intermedia, induce severe neutrophilic inflammation. In addition, we aimed to test the efficacy of macrolides, which has not been resolved in the neutrophilic inflammation induced [...] Read more.

Objectives: In the present study, we aimed to clarify the mechanisms by which periodontal pathogens, particularly Prevotella intermedia, induce severe neutrophilic inflammation. In addition, we aimed to test the efficacy of macrolides, which has not been resolved in the neutrophilic inflammation induced by P. intermedia. Methods: NCl-H292 human airway epithelial cells were pre-incubated with clarithromycin for 2 h before incubation with P. intermedia supernatants. Then, C-X-C motif chemokine ligand 8 (CXCL8) transcription and interleukin (IL)-8 production were measured. To elucidate the signaling pathway, mitogen-activated protein kinase inhibitors were added to the cell culture, and the cells were subjected to Western blotting. Results:P. intermedia supernatants promoted CXCL8 transcription and IL-8 production, and the reactions were significantly suppressed by clarithromycin pretreatment. Only trametinib, the selective mitogen-activated extracellular signal-regulated kinase inhibitor, downregulated CXCL8 transcription and IL-8 production. Furthermore, Western blotting revealed that stimulation with P. intermedia supernatants specifically induces extracellular signal-regulated kinases (ERK) 1/2 phosphorylation, which is suppressed by clarithromycin pretreatment. Notably, the interference analysis revealed that ERK3 might be dispensable for IL-8 production under the stimulation of P. intermedia supernatants. Conclusions: Our results provide new insight into the mechanism underlying P. intermedia-induced production of IL-8 from human airway epithelial cells. Furthermore, macrolides might have therapeutic potential in regulating periodontal pathogen-induced neutrophilic inflammation in the lungs. Full article

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27 pages, 1199 KiB

Open AccessSystematic Review

Antimicrobial Effects of Metal Coatings or Physical, Chemical Modifications of Titanium Dental Implant Surfaces for Prevention of Peri-Implantitis: A Systematic Review of In Vivo Studies

by Maria Gkioka and Xiaohui Rausch-Fan

Antibiotics 2024, 13(9), 908; https://doi.org/10.3390/antibiotics13090908 - 23 Sep 2024

Cited by 1 | Viewed by 2708

Abstract

Introduction: Peri-implantitis poses a significant challenge for implant dentistry due to its association with bacterial colonization on implant surfaces and the complexity of its management. This systematic review aims to assess evidence from in vivo studies regarding the antimicrobial efficacy of titanium (Ti) [...] Read more.

Introduction: Peri-implantitis poses a significant challenge for implant dentistry due to its association with bacterial colonization on implant surfaces and the complexity of its management. This systematic review aims to assess evidence from in vivo studies regarding the antimicrobial efficacy of titanium (Ti) dental implant surfaces following physical/chemical modifications or the application of various metal element coatings in preventing bacterial growth associated with peri-implantitis. Materials and Methods: A literature review was conducted across four scientific databases (PubMed, Embase, Scopus, Web of Science), encompassing in vivo studies published between 2013 and 2024, and 18 reports were included in the systematic review. Results: The findings suggest that titanium dental implant surfaces, following physical/chemical modifications and metal element coatings, exhibit antimicrobial effects against bacteria associated with peri-implantitis in humans and various animal models. Conclusions: The reviewed studies indicated a reduction in bacterial colonization, diminished biofilm formation, and decreased signs of inflammation in the peri-implant tissues, which provides evidence that physical/chemical alterations on titanium dental implant surfaces or metal element coatings, like silver (Ag), zinc (Zn), magnesium (Mg), and copper (Cu), demonstrate antimicrobial properties in in vivo studies. However, caution is warranted when translating findings to clinical practice due to methodological disparities and high bias risks. Further larger-scale clinical trials are imperative to assess their long-term efficacy and validate their clinical applicability. Full article

(This article belongs to the Special Issue Anti-microbial Coating Innovations to Prevent Infectious Diseases)

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15 pages, 2457 KiB

Open AccessSystematic Review

Comparing the Outcomes of Cefoperazone/Sulbactam-Based and Non-Cefoperazone/Sulbactam-Based Therapeutic Regimens in Patients with Multiresistant Acinetobacter baumannii Infections—A Meta-Analysis

by Chienhsiu Huang, Lichen Lin and Sufang Kuo

Antibiotics 2024, 13(9), 907; https://doi.org/10.3390/antibiotics13090907 - 23 Sep 2024

Cited by 1 | Viewed by 1055

Abstract

The addition of sulbactam restores the complete range of cefoperazone activity against bacteria and extends its spectrum of action to include the Acinetobacter species. The effectiveness of cefoperazone/sulbactam against multiresistant Acinetobacter baumannii has not been investigated. The purpose of the current meta-analysis was [...] Read more.

The addition of sulbactam restores the complete range of cefoperazone activity against bacteria and extends its spectrum of action to include the Acinetobacter species. The effectiveness of cefoperazone/sulbactam against multiresistant Acinetobacter baumannii has not been investigated. The purpose of the current meta-analysis was to compare the efficacy of cefoperazone/sulbactam-based therapeutic regimens and non-cefoperazone/sulbactam-based therapeutic regimens in the treatment of multiresistant Acinetobacter baumannii infections. The current meta-analysis of 10 retrospective studies provides evidence that cefoperazone/sulbactam-based therapeutic regimens are superior to non-cefoperazone/sulbactam-based therapeutic regimens in terms of 30-day mortality and clinical improvement in patients with multiresistant Acinetobacter baumannii infections. The risk of mortality was reduced by 38% among multiresistant Acinetobacter baumannii infections in patients who received cefoperazone/sulbactam-based therapeutic regimens. The cefoperazone/sulbactam-based combination therapy was superior to the cefoperazone/sulbactam monotherapy in terms of 30-day mortality when both therapeutic regimens were compared to the tigecycline monotherapy in patients with multiresistant Acinetobacter baumannii infections. Full article

(This article belongs to the Special Issue Successful Antimicrobial Stewardship Approaches to Address Nosocomial Infections)

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11 pages, 953 KiB

Open AccessArticle

In Vivo Effect of Halicin on Methicillin-Resistant Staphylococcus aureus-Infected Caenorhabditis elegans and Its Clinical Potential

by Li-Ting Kao, Tsung-Ying Yang, Wei-Chun Hung, Wei-Te Yang, Pu He, Bo-Xuan Chen, Yu-Chi Wang, Shiou-Sheng Chen, Yu-Wei Lai, Hsian-Yu Wang and Sung-Pin Tseng

Antibiotics 2024, 13(9), 906; https://doi.org/10.3390/antibiotics13090906 - 23 Sep 2024

Viewed by 845

Abstract

Recently, the high proportion of methicillin-resistant Staphylococcus aureus infections worldwide has highlighted the urgent need for novel antibiotics to combat this crisis. The recent progress in computational techniques for use in health and medicine, especially artificial intelligence (AI), has created new and potential [...] Read more.

Recently, the high proportion of methicillin-resistant Staphylococcus aureus infections worldwide has highlighted the urgent need for novel antibiotics to combat this crisis. The recent progress in computational techniques for use in health and medicine, especially artificial intelligence (AI), has created new and potential approaches to combat antibiotic-resistant bacteria, such as repurposing existing drugs, optimizing current agents, and designing novel compounds. Halicin was previously used as a diabetic medication, acting as a c-Jun N-terminal protein kinase (JNK) inhibitor, and has recently demonstrated unexpected antibacterial activity. Although previous efforts have highlighted halicin’s potential as a promising antibiotic, evidence regarding its effectiveness against clinical strains remains limited, with insufficient proof of its clinical applicability. In this study, we sought to investigate the antibacterial activity of halicin against MRSA clinical strains to validate its clinical applicability, and a C. elegans model infected by MRSA was employed to evaluate the in vivo effect of halicin against MRSA. Our findings revealed the antibacterial activity of halicin against methicillin-resistant S. aureus clinical strains with MICs ranging from 2 to 4 µg/mL. Our study is also the first work to evaluate the in vivo effect of halicin against S. aureus using a C. elegans model, supporting its further development as an antibiotic. Full article

(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)

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24 pages, 1342 KiB

Open AccessReview

The Contribution of Dairy Bedding and Silage to the Dissemination of Genes Coding for Antimicrobial Resistance: A Narrative Review

by Armin Tarrah, Dong Zhang, Pariya Darvishzadeh and Gisèle LaPointe

Antibiotics 2024, 13(9), 905; https://doi.org/10.3390/antibiotics13090905 - 22 Sep 2024

Viewed by 1202

Abstract

Antimicrobial resistance (AMR) is a concern in the dairy industry. Recent studies have indicated that bedding serves as a reservoir for antimicrobial-resistant bacteria and antimicrobial-resistance genes (ARGs), while silage has been proposed as another possible source. The impact of AMR in dairy farming [...] Read more.

Antimicrobial resistance (AMR) is a concern in the dairy industry. Recent studies have indicated that bedding serves as a reservoir for antimicrobial-resistant bacteria and antimicrobial-resistance genes (ARGs), while silage has been proposed as another possible source. The impact of AMR in dairy farming can be significant, resulting in decreased productivity and economic losses for farmers. Several studies have highlighted the safety implications of AMR bacteria and genes in bedding and silage, emphasizing the need for further research on how housing, bedding, and silage management affect AMR in farm environments. Exposure to sub-lethal concentrations of antibiotics, such as those from contaminated bedding and silage, can prompt bacteria to develop resistance mechanisms. Thus, even if antimicrobial usage is diminished, ARGs may be maintained in the dairy farm environment. By implementing proactive measures to tackle AMR in dairy farming, we can take steps to preserve the health and productivity of dairy cattle while also protecting public health. This involves addressing the prudent use of antibiotics during production and promoting animal welfare, hygiene, and management practices in bedding and farm environments to minimize the risk of AMR development and spread. This narrative review compiles the growing research, positioning the contribution of bedding and silage to the prevalence and dissemination of AMR, which can elicit insights for researchers and policymakers. Full article

(This article belongs to the Special Issue Antimicrobial Resistance in Animals and Animal Products and Its Environmental Transmission Aspects)

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32 pages, 6288 KiB

Open AccessEditor’s ChoiceReview

A Decade of Antimicrobial Resistance in Human and Animal Campylobacter spp. Isolates

by Rita Barata, Maria José Saavedra and Gonçalo Almeida

Antibiotics 2024, 13(9), 904; https://doi.org/10.3390/antibiotics13090904 - 21 Sep 2024

Cited by 1 | Viewed by 2334

Abstract

Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past [...] Read more.

Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past decade. Methods: We conducted a comprehensive review of resistance data from studies spanning ten years, analyzing profiles in resistance to key antibiotics, ciprofloxacin (CIP), tetracycline (TET), erythromycin (ERY), chloramphenicol (CHL), and gentamicin (GEN). Data were collated from various regions to assess global and regional patterns of resistance. Results: The analysis reveals a concerning trend of increasing resistance patterns, particularly to CIP and TET, across multiple regions. While resistance to CHL and GEN remains relatively low, the high prevalence of CIP resistance has significantly compromised treatment options for campylobacteriosis. Discrepancies in resistance patterns were observed between human and animal isolates, with variations across different continents and countries. Notably, resistance to ERY and CHL showed regional variability, reflecting potential differences in antimicrobial usage and management practices. Conclusions: The findings underscore the ongoing challenge of AMR in Campylobacter, highlighting the need for continued surveillance and research. The rising resistance prevalence, coupled with discrepancies in resistance patterns between human and animal isolates, emphasize the importance of a One Health approach to address AMR. Enhanced monitoring, novel treatment strategies, and global cooperation are crucial for mitigating the impact of resistance and ensuring the effective management of Campylobacter-related infections. Full article

(This article belongs to the Special Issue Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance)

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22 pages, 1450 KiB

Open AccessArticle

Opportunities for Laboratory Testing to Inform Antimicrobial Use for Bovine Respiratory Disease: Application of Information Quality Value Stream Maps in Commercial Feedlots

by Simon J. G. Otto, Colleen M. Pollock, Jo-Anne Relf-Eckstein, Lianne McLeod and Cheryl L. Waldner

Antibiotics 2024, 13(9), 903; https://doi.org/10.3390/antibiotics13090903 - 21 Sep 2024

Viewed by 839

Abstract

Background/Objectives: The implementation of information quality value stream maps (IQ-VSMs) in food animal production systems can increase our understanding of the opportunities and challenges when using laboratory testing for antimicrobial resistance (AMR) to support antimicrobial stewardship (AMS). Our objectives were to (1) explore [...] Read more.

Background/Objectives: The implementation of information quality value stream maps (IQ-VSMs) in food animal production systems can increase our understanding of the opportunities and challenges when using laboratory testing for antimicrobial resistance (AMR) to support antimicrobial stewardship (AMS). Our objectives were to (1) explore the implementation of information quality value stream mapping as a continuous improvement tool to inform decisions for bovine respiratory disease (BRD) management and AMS and (2) apply the information quality dimensions to identified Kaizen opportunities for the integration of laboratory data into BRD management systems to assess the appropriateness of BRD treatment plans in western Canadian feedlot production. Methods: A ‘Current State’ IQ-VSM outlined the processes, available information, information processing steps, and control decisions contributing to BRD management and treatment in commercial western Canadian feedlots, recognizing that laboratory BRD pathogens and AMR data are typically not part of BRD management. Results: The ‘Future State’ IQ-VSM incorporated Kaizen opportunities for improvement, including (i) the strategic collection of respiratory samples from representative samples of calves for laboratory analysis, regardless of clinical BRD status, (ii) compilation of laboratory data at the pen and feedlot levels, and (iii) analysis of pen- and feedlot-level laboratory data to inform the veterinarian’s assessment of the appropriateness of current BRD treatment plans. Conclusions: The IQ-VSMs provided a valuable framework to visualize the integration of BRD pathogen and AMR laboratory data to support AMS and address any potential future testing requirements. Full article

(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)

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11 pages, 251 KiB

Open AccessArticle

Safety of Intraoperative Cell Salvage in Two-Stage Revision of Septic Hip Arthroplasties

by Lara Krüger, André Strahl, Eva Goedecke, Maximilian M. Delsmann, Leon-Gordian Leonhardt, Frank Timo Beil and Jan Hubert

Antibiotics 2024, 13(9), 902; https://doi.org/10.3390/antibiotics13090902 - 21 Sep 2024

Viewed by 658

Abstract

(1) Background: The aim of this study was to evaluate the safety of intraoperative cell salvage (ICS) during reimplantation in the two-stage revision of septic hip arthroplasties. (2) Methods: As part of an internal quality control study, blood cultures were taken from the [...] Read more.

(1) Background: The aim of this study was to evaluate the safety of intraoperative cell salvage (ICS) during reimplantation in the two-stage revision of septic hip arthroplasties. (2) Methods: As part of an internal quality control study, blood cultures were taken from the processed ICS blood during reimplantation and examined for possible bacterial load (study group). Due to a high rate of bacterial detection with uncertain clinical significance, consecutive ICS samples were also examined from patients undergoing aseptic revision hip arthroplasty (control group). Microbiological samples, patient and surgical characteristics and the follow-up data were analyzed retrospectively. (3) Results: 9 out of 12 (75%) patients in the study group and 5 out of 8 (63%) patients in the control group had positive ICS blood cultures. There was no significant difference between the groups (p = 0.642). The initial pathogens causing the periprosthetic joint infection (PJI) were not detected, but the bacterial spectrum resembled skin flora, with a high proportion of coagulase-negative staphylococci. No complications due to possible bloodstream-associated infections were observed. In summary, the detected pathogens were interpreted as contamination without clinical significance. (4) Conclusions: ICS in the context of reimplantation was considered a safe and recommendable procedure to optimize patient blood management. Full article

(This article belongs to the Special Issue Prevention, Diagnostic and Antibiotic Treatment of Periprosthetic Joint and Fracture Related Infection, 2nd Edition)

12 pages, 527 KiB

Open AccessFeature PaperArticle

Impact of ESKAPE Pathogens on Bacteremia: A Three-Year Surveillance Study at a Major Hospital in Southern Italy

by Mariagrazia De Prisco, Roberta Manente, Biagio Santella, Enrica Serretiello, Federica Dell’Annunziata, Emanuela Santoro, Francesca F. Bernardi, Chiara D’Amore, Alessandro Perrella, Pasquale Pagliano, Giovanni Boccia, Gianluigi Franci and Veronica Folliero

Antibiotics 2024, 13(9), 901; https://doi.org/10.3390/antibiotics13090901 - 21 Sep 2024

Viewed by 1044

Abstract

Background/Objectives: ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pose a serious public health threat as they are resistant to multiple antimicrobial agents. Bloodstream infections (BSIs) caused by ESKAPE bacteria [...] Read more.

Background/Objectives: ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pose a serious public health threat as they are resistant to multiple antimicrobial agents. Bloodstream infections (BSIs) caused by ESKAPE bacteria have high mortality rates due to the limited availability of effective antimicrobials. This study aimed to evaluate the prevalence and susceptibility of ESKAPE pathogens causing BSIs over three years in a large tertiary hospital in Salerno. Methods: Conducted at the Clinical Microbiology Laboratory of San Giovanni di Dio e ‘‘Ruggi D’Aragona’’ Hospital from January 2020 to December 2022, blood culture samples from different departments were incubated in the BD BACTEC™ system for 5 days. Species identification was performed using MALDI-TOF MS, and antimicrobial resistance patterns were determined by the VITEK2 system. Results: Out of 3197 species isolated from positive blood cultures, 38.7% were ESKAPE bacteria. Of these, 59.9% were found in blood culture samples taken from men, and the most affected age group was those aged >60 years. (70.6%). Staphylococcus aureus was the main BSI pathogen (26.3%), followed by Klebsiella pneumoniae (15.8%). Significant resistance rates were found, including 35% of Staphylococcus aureus being resistant to oxacillin and over 90% of Acinetobacter baumannii being resistant to carbapenems. Conclusions: These results highlight the urgent need for antimicrobial stewardship programs to prevent incurable infections. Full article

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2 pages, 164 KiB

Open AccessEditorial

Antibiotic Use and Antimicrobial Resistance: A Global Public Health Crisis

by Ana Estany-Gestal, Angel Salgado-Barreira and Juan Manuel Vazquez-Lago

Antibiotics 2024, 13(9), 900; https://doi.org/10.3390/antibiotics13090900 - 21 Sep 2024

Viewed by 2876

Abstract

The discovery of antibiotics revolutionized modern medicine, effectively treating bacterial infections that were once fatal [...] Full article

(This article belongs to the Special Issue Antimicrobial Prescribing, Population Use and Resistance, Impact in Global Health)

12 pages, 3111 KiB

Open AccessArticle

Antibacterial and Antibiofilm Potential of Chlorophyllin Against Streptococcus mutans In Vitro and In Silico

by Seemrose Khan, Ihtisham Ul Haq, Imran Ali, Abdul Rehman, Mazen Almehmadi, Meshari A. Alsuwat, Tariq Zaman and Muhammad Qasim

Antibiotics 2024, 13(9), 899; https://doi.org/10.3390/antibiotics13090899 - 20 Sep 2024

Viewed by 1288

Abstract

Background: Streptococcus mutans is a leading causative agent of dental caries and exerts pathogenicity by forming biofilms. Dental caries continues to be a significant public health issue worldwide, affecting an estimated 2.5 billion people, showing a 14.6% increase over the past decade. Herein, [...] Read more.

Background: Streptococcus mutans is a leading causative agent of dental caries and exerts pathogenicity by forming biofilms. Dental caries continues to be a significant public health issue worldwide, affecting an estimated 2.5 billion people, showing a 14.6% increase over the past decade. Herein, the antibacterial potential of Chlorophyllin extracted from Spinacia oleracea was evaluated against biofilm-forming S. mutans via in vitro and in silico studies. Methodology: The antimicrobial activity of chlorophyllin extract against S. mutans isolates was tested using the agar well diffusion method. Chlorophyllin extract was also tested against biofilm-forming isolates of S. mutans. Chlorophyllin was docked with the antigen I/II (AgI/II) protein of S. mutans to evaluate its antimicrobial mechanism. The chemical structure and canonical SMILES format of Chlorophyllin were obtained from PubChem. Additionally, adsorption, distribution, metabolism, excretion, and toxicity (ADMET) analyses of Chlorophyllin were performed using ADMETlab 2.0 to assess its pharmacokinetic properties. Results: An agar well diffusion assay revealed that all S. mutans isolates were susceptible to Chlorophyllin extract and showed a variety of inhibition zones ranging from 32 to 41 mm. Chlorophyllin reduces the biofilm strength of four isolates from strong to moderate and six from strong to weak. The antibiofilm potential of Chlorophyllin was measured by a reduction in the number of functional groups observed in the Fourier Transform Infrared Spectrometer (FTIR) spectra of the extracellular polymeric substance (EPS) samples. Chlorophyllin showed binding with AgI/II proteins of S. mutans, which are involved in adherence to the tooth surface and initiating biofilm formation. The ADMET analysis revealed that the safety of Chlorophyllin exhibited favorable pharmacokinetic properties. Conclusions: Chlorophyllin stands out as a promising antibacterial and antibiofilm agent against biofilm-forming S. mutans, and its safety profile highlights its potential suitability for further investigation as a therapeutic agent. Full article

(This article belongs to the Special Issue The Search for Antimicrobial Agents from Natural Products)

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13 pages, 2540 KiB

Open AccessArticle

Antimicrobial and Phylogenomic Characterization of Bacillus cereus Group Strains Isolated from Different Food Sources in Italy

by Donatella Farina, Angelica Bianco, Viviana Manzulli, Stefano Castellana, Antonio Parisi, Marta Caruso, Rosa Fraccalvieri, Luigina Serrecchia, Valeria Rondinone, Lorenzo Pace, Antonio Fasanella, Valerio Vetritto, Laura Maria Difato, Dora Cipolletta, Michela Iatarola and Domenico Galante

Antibiotics 2024, 13(9), 898; https://doi.org/10.3390/antibiotics13090898 - 20 Sep 2024

Viewed by 1108

Abstract

Background: Bacillus cereus is a widespread environmental Gram-positive bacterium which is especially common in soil and dust. It produces two types of toxins that cause vomiting and diarrhea. At present, foodborne outbreaks due to Bacillus cereus group bacteria (especially Bacillus cereus sensu [...] Read more.

Background: Bacillus cereus is a widespread environmental Gram-positive bacterium which is especially common in soil and dust. It produces two types of toxins that cause vomiting and diarrhea. At present, foodborne outbreaks due to Bacillus cereus group bacteria (especially Bacillus cereus sensu stricto) are rising, representing a serious problem in the agri-food supply chain. Methods: In this work, we analyzed 118 strains belonging to the Bacillus cereus group, isolated from several food sources, for which in vitro and in silico antibiotic resistance assessments were performed. Results: Many strains showed intermediate susceptibility to clindamycin, erythromycin, and tetracycline, suggesting an evolving acquisition of resistance against these antibiotics. Moreover, one strain showed intermediate resistance to meropenem, an antibiotic currently used to treat infections caused by Bacillus cereus. In addition to the phenotypic antimicrobial resistance profile, all strains were screened for the presence/absence of antimicrobial genes via whole-genome sequencing. There was inconsistency between the in vitro and in silico analyses, such as in the case of vancomycin, for which different isolates harbored resistance genes but, phenotypically, the same strains were sensitive. Conclusions: This would suggest that antibiotic resistance is a complex phenomenon due to a variety of genetic, epigenetic, and biochemical mechanisms. Full article

(This article belongs to the Special Issue Exploring Antimicrobial Resistance in Foodborne Pathogens: Microbiological Perspectives)

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16 pages, 5378 KiB

Open AccessEditor’s ChoiceArticle

Alkyl Pyridinol Compounds Exhibit Antimicrobial Effects against Gram-Positive Bacteria

by Juan Canchola, Gracious Yoofi Boafo Donkor, Patrick Ofori Tawiah, Ayoola Fasawe, Emmanuel Ayim, Martin F. Engelke and Jan-Ulrik Dahl

Antibiotics 2024, 13(9), 897; https://doi.org/10.3390/antibiotics13090897 - 20 Sep 2024

Viewed by 770

Abstract

Background/Objectives. The rise of antibiotic-resistant pathogens represents a significant global challenge in infectious disease control, which is amplified by the decline in the discovery of novel antibiotics. Staphylococcus aureus continues to be a highly significant pathogen, causing infections in multiple organs and tissues [...] Read more.

Background/Objectives. The rise of antibiotic-resistant pathogens represents a significant global challenge in infectious disease control, which is amplified by the decline in the discovery of novel antibiotics. Staphylococcus aureus continues to be a highly significant pathogen, causing infections in multiple organs and tissues in both healthcare institutions and community settings. The bacterium has become increasingly resistant to all available antibiotics. Consequently, there is an urgent need for novel small molecules that inhibit the growth or impair the survival of bacterial pathogens. Given their large structural and chemical diversity, as well as often unique mechanisms of action, natural products represent an excellent avenue for the discovery and development of novel antimicrobial treatments. Anaephene A and B are two such naturally occurring compounds with significant antimicrobial activity against Gram-positive bacteria. Here, we report the rapid syntheses and biological characterization of five novel anaephene derivatives, which display low cytotoxicity against mammalian cells but potent antibacterial activity against various S. aureus strains, including methicillin-resistant S. aureus (MRSA) and the multi-drug-resistant community-acquired strain USA300LAC. Methods. A Sonogashira cross-coupling reaction served as the key step for the synthesis of the alkyl pyridinol products. Results/Conclusions. Using the compound JC-01-074, which displays bactericidal activity already at low concentrations (MIC: 16 μg/mL), we provide evidence that alkyl pyridinols target actively growing and biofilm-forming cells and show that these compounds cause disruption and deformation of the staphylococcal membrane, indicating a membrane-associated mechanism of action. Full article

(This article belongs to the Special Issue Recent Advances in Antimicrobial Drug Discovery, 2nd Edition)

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15 pages, 264 KiB

Open AccessReview

Preventing and Controlling Healthcare-Associated Infections: The First Principle of Every Antimicrobial Stewardship Program in Hospital Settings

by Massimo Sartelli, Corrado P. Marini, John McNelis, Federico Coccolini, Caterina Rizzo, Francesco M. Labricciosa and Patrizio Petrone

Antibiotics 2024, 13(9), 896; https://doi.org/10.3390/antibiotics13090896 - 20 Sep 2024

Viewed by 3621

Abstract

Antimicrobial resistance (AMR) is one of the main public health global burdens of the 21st century, responsible for over a million deaths every year. Hospital programs aimed at improving antibiotic use, referred to as antimicrobial stewardship programs (ASPs), can both optimize the treatment [...] Read more.

Antimicrobial resistance (AMR) is one of the main public health global burdens of the 21st century, responsible for over a million deaths every year. Hospital programs aimed at improving antibiotic use, referred to as antimicrobial stewardship programs (ASPs), can both optimize the treatment of infections and minimize adverse antibiotics events including the development and spread of AMR. The challenge of AMR is closely linked to the development and spread of healthcare-associated infection (HAIs). In fact, the management of patients with HAIs frequently requires the administration of broader-spectrum antibiotic regimens due to the higher risk of acquiring multidrug-resistant organisms, which, in turn, promotes resistance. For this reason, even before using antibiotics correctly, it is necessary to prevent and control the spread of HAIs in our hospitals. In this narrative review, we present seven measures that healthcare workers, even if not directly involved in the tasks of infection prevention and control, must know, support, and embrace. We hope that this review may raise awareness among all healthcare professionals about the issues with the increasing rate of AMR and the ongoing efforts towards minimizing its rise. Full article

(This article belongs to the Special Issue Successful Antimicrobial Stewardship Approaches to Address Nosocomial Infections)

15 pages, 1668 KiB

Open AccessReview

Carbapenem-Resistant Enterobacterales in the Western Balkans: Addressing Gaps in European AMR Surveillance Map

by Snezana Brkic and Ivana Cirkovic

Antibiotics 2024, 13(9), 895; https://doi.org/10.3390/antibiotics13090895 - 19 Sep 2024

Viewed by 1265

Abstract

In the context of global efforts to combat antimicrobial resistance (AMR), the importance of comprehensive AMR data is more crucial than ever. AMR surveillance networks, such as the European Antimicrobial Resistance Surveillance Network (EARS-Net) and the Central Asian and European Surveillance of Antimicrobial [...] Read more.

In the context of global efforts to combat antimicrobial resistance (AMR), the importance of comprehensive AMR data is more crucial than ever. AMR surveillance networks, such as the European Antimicrobial Resistance Surveillance Network (EARS-Net) and the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), support member states in obtaining high-quality AMR data. Nevertheless, data gaps persist in some countries, including those in the Western Balkans (WBs), a region with high AMR rates. This review analyzed existing research on carbapenem-resistant Enterobacterales (CRE) to better understand the AMR landscape in the WB countries. The most prevalent CRE was Klebsiella pneumoniae, followed by Escherichia coli, Enterobacter cloacae, and Proteus mirabilis, with sporadic cases of Morganella morganii, Providencia spp., Klebsiella oxytoca, and Citrobacter sedlakii. Carbapenemase production was identified as the most common mechanism of carbapenem resistance, but other resistance mechanisms were not investigated. An increasing trend in carbapenem resistance has been observed over the last decade, alongside a shift in carbapenemase epidemiology from the NDM type in 2013–2014 to the OXA-48 type in recent years. Few studies have applied whole-genome sequencing for CRE analysis, which has demonstrated the spread of resistance determinants across different niches and over time, emphasizing the importance of molecular-based research. The overall low number of studies in the WB countries can be attributed to limited resources, highlighting the need for enhanced support in education, training, technology, and equipment to improve data collection and evaluation. Full article

(This article belongs to the Special Issue Molecular Epidemiology and Mechanisms of Carbapenem Resistance in Clinical Gram-Negative Bacteria)

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14 pages, 940 KiB

Open AccessReview

Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review

by Josep M. Badia, Sara Amador, Carmen González-Sánchez, Inés Rubio-Pérez, Alba Manuel-Vázquez, Montserrat Juvany, Estela Membrilla, José M. Balibrea and Xavier Guirao

Antibiotics 2024, 13(9), 894; https://doi.org/10.3390/antibiotics13090894 - 18 Sep 2024

Viewed by 1344

Abstract

Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. Methods: A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data [...] Read more.

Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. Methods: A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narrative synthesis was performed. Results: The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN management; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition. Conclusions: Early antibiotic therapy is essential for the treatment of IPN, but prophylactic antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management. Full article

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18 pages, 962 KiB

Open AccessReview

ST105 Lineage of MRSA: An Emerging Implication for Bloodstream Infection in the American and European Continents

by Alice Slotfeldt Viana, Laís Pires do Valle Tótola and Agnes Marie Sá Figueiredo

Antibiotics 2024, 13(9), 893; https://doi.org/10.3390/antibiotics13090893 - 18 Sep 2024

Viewed by 1135

Abstract

Sequence-type 5 (ST5) of methicillin-resistant Staphylococcus aureus (MRSA), harboring the staphylococcal chromosomal cassette mec type IV (SCCmecIV), was first detected in Portugal. It emerged as a significant cause of healthcare-associated (HA) infection in pediatric units and was hence named the pediatric [...] Read more.

Sequence-type 5 (ST5) of methicillin-resistant Staphylococcus aureus (MRSA), harboring the staphylococcal chromosomal cassette mec type IV (SCCmecIV), was first detected in Portugal. It emerged as a significant cause of healthcare-associated (HA) infection in pediatric units and was hence named the pediatric clone. Another ST5 lineage, which carries SCCmecII, also prevailed in the USA and Japan for multiple years. More recently, another MRSA lineage, ST105-SCCmecII, part of the evolution of clonal complex 5 (CC5) MRSA, has emerged as the cause of hospital-acquired bloodstream infection outbreaks in countries including Portugal, the USA, and Brazil. This article reviews studies on the epidemiology and evolution of these newly emerging pathogens. To this end, a search of PUBMED from inception to 2024 was performed to find articles reporting the occurrence of ST105 MRSA in epidemiologic studies. A second search was performed to find studies on MRSA, CC5, ST5, and SCCmecII. A search of PUBMED from 1999 to 2024 was also performed to identify studies on the genomics and evolution of ST5, CC5, and ST105 MRSA. Further studies were identified by analyzing the references of the previously selected articles from PUBMED. Most articles on ST105 MRSA were included in this review. Only articles written in English were included. Furthermore, only studies that used a reliable genotyping method (e.g., whole genome sequencing, or MLST) to classify the CC5 lineages were selected. The quality and selection of articles were based on the consensus assessment of the three authors in independent evaluations. In conclusion, ST105-SCCmecII is an emerging MRSA in several countries, being the second/third most important CC5 lineage, with a relatively high frequency in bloodstream infections. Of concern is the increased mortality from BSI in patients older than 15 years and the higher prevalence of ST105-SCCmecII in the blood of patients older than 60 years reported in some studies. Full article

(This article belongs to the Special Issue Epidemiology of Clinically Relevant Bacteria and Antimicrobial Resistance)

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25 pages, 6961 KiB

Open AccessArticle

Nail Lacquer Containing Origanum vulgare and Rosmarinus officinalis Essential Oils and Biogenic Silver Nanoparticles for Onychomycosis: Development, Characterization, and Evaluation of Antifungal Efficacy

by Sara Scandorieiro, Natalia Rodrigues de Oliveira, Monique de Souza, Lidiane Vizioli de Castro-Hoshino, Mauro Luciano Baesso, Gerson Nakazato, Renata Katsuko Takayama Kobayashi, Luciano Aparecido Panagio and Audrey Alesandra Stinghen Garcia Lonni

Antibiotics 2024, 13(9), 892; https://doi.org/10.3390/antibiotics13090892 - 17 Sep 2024

Cited by 1 | Viewed by 1036

Abstract

Onychomycosis is a common fungal nail infection for which new antifungals are needed to overcome antimicrobial resistance and the limitations of conventional treatments. This study reports the development of antifungal nail lacquers containing oregano essential oil (OEO), rosemary essential oil (REO), and biogenic [...] Read more.

Onychomycosis is a common fungal nail infection for which new antifungals are needed to overcome antimicrobial resistance and the limitations of conventional treatments. This study reports the development of antifungal nail lacquers containing oregano essential oil (OEO), rosemary essential oil (REO), and biogenic silver nanoparticles (bioAgNPs). The formulations (F) were tested against dermatophytes using agar diffusion, ex vivo nail infection, and scanning electron microscopy techniques. They were evaluated for their pharmacotechnical characteristics and by FTIR-PAS to assess permeation across the nail. F-OEO and F-OEO/bioAgNPs were promising candidates for the final nail lacquer formulation, as they permeated through the nail and showed antifungal efficacy against dermatophytes-contaminated nails after 5 days of treatment. Treated nails exhibited decreased hyphae and spores compared to the untreated control; the hyphae were atypically flattened, indicating loss of cytoplasmic content due to damage to the cytoplasmic membrane. The formulations were stable after centrifugation and thermal stress, maintaining organoleptic and physicochemical characteristics. Both F-OEO and F-OEO/bioAgNPs had pH compatible with the nail and drying times (59–90 s) within the reference for nail lacquer. For the first time, OEO and bioAgNPs were incorporated into nail lacquer, resulting in a natural and nanotechnological product for onychomycosis that could combat microbial resistance. Full article

(This article belongs to the Special Issue Antimicrobials Agents: Latest Advances and Prospects)

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15 pages, 612 KiB

Open AccessArticle

Acute Diarrhea in a Tertiary Emergency Department: From Readmission Determinants to Antibiotic Prescription

by Marcello Covino, Antonella Gallo, Fiammetta Maria Rognoni, Maria Caterina Parlangeli, Benedetta Simeoni, Francesco Franceschi, Francesco Landi and Massimo Montalto

Antibiotics 2024, 13(9), 891; https://doi.org/10.3390/antibiotics13090891 - 16 Sep 2024

Viewed by 831

Abstract

Acute diarrhea represents a major public health issue, and the management of adult patients admitted to the emergency department (ED) for this problem is still challenging. In a retrospective analysis on more than 20,000 patients visiting a tertiary ED for acute diarrhea and [...] Read more.

Acute diarrhea represents a major public health issue, and the management of adult patients admitted to the emergency department (ED) for this problem is still challenging. In a retrospective analysis on more than 20,000 patients visiting a tertiary ED for acute diarrhea and then being discharged home, we found that age > 65 years, onset of symptoms > 24 h since ED admission, refusal of hospitalization, and a history of chronic renal and liver diseases were independently associated with ED readmission for abdominal symptoms within 7 days. In the younger group, the presence of comorbidities significantly impacted on ED readmission, while fever and alteration of serum creatinine were the main determinants in the older group. Antibiotics were prescribed in about 25% of patients, although diarrhea etiology (viral or bacterial) was usually not available. According to international guidelines, fluoroquinolones were the most prescribed class, showing an inverse correlation to ED readmission. However, β-lactams and probiotics were also commonly prescribed; the latter were independently correlated to ED readmission in the elderly group. A comprehensive, guideline-based approach, including a detailed clinical history and laboratory and comorbidity assessment, should be encouraged to support physicians in the management of different age subgroups of adults admitted to the ED for acute diarrhea. Full article

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9 pages, 219 KiB

Open AccessCommunication

Recurrent Cystitis in Women—A Real-World Analysis of Bacteria Spectrum and Resistance Situation for Calculated Therapy

by Philipp J. Spachmann, Maximilian Radlmaier, Stefan Denzinger, Maximilian Burger, Johannes Breyer, Wolfgang Otto, Marco J. Schnabel and Daniel Vergho

Antibiotics 2024, 13(9), 890; https://doi.org/10.3390/antibiotics13090890 - 16 Sep 2024

Viewed by 867

Abstract

Recurrent cystitis in women represents an everyday challenge; however, little to no data regarding this population are available. This study aimed to evaluate this collective with respect to a rational calculated antibiotic therapy. Urine cultures and antibiograms from a urological office were retrospectively [...] Read more.

Recurrent cystitis in women represents an everyday challenge; however, little to no data regarding this population are available. This study aimed to evaluate this collective with respect to a rational calculated antibiotic therapy. Urine cultures and antibiograms from a urological office were retrospectively evaluated from patient data collected between January 2017 and June 2019. The evaluation was conducted using SPSS ©. In total, 84 female patients, who were aged between 18 and 87 years old (median 60 years), suffered from recurrent cystitis. Escherichia coli was found in 53.9% of cases, Staphylococcus aureus and enterococci were each found in 6.7%, and Proteus spp. and Streptococcus agalactiae were each found in 5.6%. The resistance levels to ciprofloxacin (CIP), trimethoprim–sulfamethoxazole (TRS), nitrofurantoin (NIT), and nitroxoline (NOX) were 18.2%, 30.7%, 16.1%, and 12.5% in the tested cases, respectively. Regarding E. coli, resistance to CIP, TRS, and NIT was found in 17.8%, 25%, and 4.2% of the tested cases, and no resistance to NOX was found. The resistance level to CIP was in a tolerable range of <20% in the overall cohort and the E. coli subgroup. More than a quarter of the bacteria were resistant to TRS. The low resistance rates for NIT and NOX are remarkable, promoting the use of these substances if they are not yet used. Full article

(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)

17 pages, 4188 KiB

Open AccessArticle

Three in One with Dual-Functional Hydrogel of Lactoferrin/NZ2114/LMSH Promoting Staphylococcus aureus-Infected Wound Healing

by Kun Zhang, Xuanxuan Ma, Da Teng, Ruoyu Mao, Na Yang, Ya Hao and Jianhua Wang

Antibiotics 2024, 13(9), 889; https://doi.org/10.3390/antibiotics13090889 - 15 Sep 2024

Viewed by 1323

Abstract

Wound infections caused by Staphylococcus aureus often result in localized suppurative lesions that severely impede the healing process, so it is urgent to develop a dress with efficient antimicrobial and pro-healing functions. In this study, the bifunctional injectable hydrogel lactoferrin (Lf)/NZ2114/lithium magnesium silicate [...] Read more.

Wound infections caused by Staphylococcus aureus often result in localized suppurative lesions that severely impede the healing process, so it is urgent to develop a dress with efficient antimicrobial and pro-healing functions. In this study, the bifunctional injectable hydrogel lactoferrin (Lf)/NZ2114/lithium magnesium silicate hydrogel (LMSH) was first successfully prepared through the electrostatic interaction method. The physical, biological, and efficacy properties are systematically analyzed with good shear-thinning capacity and biocompatibility. More importantly, it inhibits infection and promotes wound healing in a mouse wound infection model after 14 d treatment, and the bactericidal rate and healing rate were over 99.92% and nearly 100%, respectively. Meanwhile, the massive reduction of inflammatory cells, restoration of tissue structure, and angiogenesis in mice showed the anti-inflammatory and pro-healing properties of the hydrogel. The healed wounds showed thickening with more hair follicles and glands, suggesting that the hydrogel Lf/NZ2114/LMSH (Three in One) could be a better dressing candidate for the treatment of S. aureus-induced wound infections. Full article

(This article belongs to the Special Issue Anti-microbial Coating Innovations to Prevent Infectious Diseases)

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12 pages, 2864 KiB

Open AccessArticle

Two Novel Hydrate Salts of Norfloxacin with Phenolic Acids and Their Physicochemical Properties

by Di Liang, Fei Li, Jingzhong Duan, Wei Sun and Xiaoyan Yu

Antibiotics 2024, 13(9), 888; https://doi.org/10.3390/antibiotics13090888 - 14 Sep 2024

Viewed by 845

Abstract

Norfloxacin (NORF) is a broad-spectrum quinolone that is widely utilized for the treatment of various bacterial infections and is considered one of the most commonly used fluoroquinolone antibiotics. However, NORF’s clinical utility is limited by its poor water solubility and relatively low oral [...] Read more.

Norfloxacin (NORF) is a broad-spectrum quinolone that is widely utilized for the treatment of various bacterial infections and is considered one of the most commonly used fluoroquinolone antibiotics. However, NORF’s clinical utility is limited by its poor water solubility and relatively low oral bioavailability. This study presents an optimization and synergistic enhancement approach through salt/co-crystal, aiming to maximize the biopharmaceutical properties of NORF with the use of phenolic acid. Following this strategy, two new hydrate salts of NORF with phenolic acid, namely, NORF—3,5-DBA hydrate (salt 1) and NORF—VA hydrate (salt 2), were prepared and systematically confirmed. Two hydrate salts were produced by means of the slow evaporation crystallization method, and the structures were determined through single-crystal X-ray diffraction (SCXRD). Additionally, powder X-ray diffraction (PXRD), Fourier-transform infrared (FT-IR) spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and high-performance liquid chromatography (HPLC) were applied to analyze the features of the two salts. The experimental results indicated that the formation of the two salts could enhance the solubility and improve the release behavior of NORF. Interestingly, the physicochemical properties of NORF were significantly improved as a result, leading to an enhancement in its antibacterial activity. This was demonstrated by the enhanced inhibition of bacterial strains and the lower minimum inhibitory concentration values. Full article

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18 pages, 1731 KiB

Open AccessConference Report

Towards Sustainable Antibiotic Use in Aquaculture and Antimicrobial Resistance: Participatory Experts’ Overview and Recommendations

by Daniela R. Farías, Rolando Ibarra, Rodrigo A. Estévez, Michael F. Tlusty, Oskar Nyberg, Max Troell, Ruben Avendaño-Herrera and Wendy Norden

Antibiotics 2024, 13(9), 887; https://doi.org/10.3390/antibiotics13090887 - 14 Sep 2024

Viewed by 1655

Abstract

Notably, 56 worldwide experts gathered for the Antimicrobial Assessment on Global Aquaculture Production (AGAP) series of workshops to (1) evaluate the current state of knowledge on antimicrobial use and identify existing gaps; (2) formulate strategies to identify ecologically relevant impact indicators and establish [...] Read more.

Notably, 56 worldwide experts gathered for the Antimicrobial Assessment on Global Aquaculture Production (AGAP) series of workshops to (1) evaluate the current state of knowledge on antimicrobial use and identify existing gaps; (2) formulate strategies to identify ecologically relevant impact indicators and establish thresholds for assessment; (3) identify pivotal socioeconomic factors and effective governance mechanisms essential for implementing monitoring practices in aquaculture and extending them across sectors and countries for aquaculture sustainability; (4) develop pathways to enhance our comprehension between antibiotic use in aquaculture and antimicrobial resistance; and (5) explore potential antibiotic monitoring tools that can be universally adapted and implemented across region and sectors. The main outcomes were a roadmap for establishing investigation priorities on the relevant topics regarding antibiotic use in aquaculture, socioeconomic drivers for using antibiotics and behaviors that need more robust and transparent regulatory frameworks to guide farmers, training on antimicrobial use, and access to veterinarians and extension services agents for education. Overall, the workshop evidenced the power of collaboration in addressing complex global challenges to achieve sustainable aquaculture. Despite diligent efforts, some constraints may have inadvertently narrowed the possibility of having more experts and left some pertinent topics unaddressed, but they are needed in the discussion. Full article

(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)

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12 pages, 931 KiB

Open AccessArticle

Establishment of an Antimicrobial Stewardship Program to Spare the Use of Oral Fluoroquinolones for Acute Uncomplicated Cystitis in Outpatients

by Tomoyuki Kato, Masayuki Nagasawa, Ippei Tanaka, Yuka Seyama, Reiko Sekikawa, Shiori Yamada, Eriko Ishikawa and Kento Kitajima

Antibiotics 2024, 13(9), 886; https://doi.org/10.3390/antibiotics13090886 - 14 Sep 2024

Viewed by 812

Abstract

The increase in fluoroquinolone (FQ)-resistant Escherichia coli (EC) is a serious global problem. In addition, much of acute uncomplicated cystitis (AUC) cases are caused by EC. FQs have been selected for the treatment of cystitis in outpatients, and there is concern about treatment [...] Read more.

The increase in fluoroquinolone (FQ)-resistant Escherichia coli (EC) is a serious global problem. In addition, much of acute uncomplicated cystitis (AUC) cases are caused by EC. FQs have been selected for the treatment of cystitis in outpatients, and there is concern about treatment failure. It is therefore necessary to select appropriate antimicrobials to spare FQs. However, there are few reported effective antimicrobial stewardship programs (ASPs) for outpatients. We aimed to establish the effective ASP for outpatients diagnosed with AUC caused by EC, to spare the use of FQs, and to explore optimal oral antimicrobials for AUC. The study subjects were outpatients treated for AUC caused by extended-spectrum β-lactamase-non-producing EC (non-ESBL-EC). Based on the antibiogram results, we recommended cefaclor (CCL) as the initial treatment for AUC, and educated clinical pharmacists who also worked together to advocate for CCL or cephalexin (CEX) prescriptions. FQ usages decreased, and cephalosporin (Ceph) prescriptions increased in all medical departments. The Ceph group (n = 114; CCL = 60, CEX = 54) in the non-FQ group had fewer treatment failures than the FQ group (n = 86) (12.3% vs. 31.4%). Cephs, including CCL and CEX, were effective treatments for AUC caused by non-ESBL-EC. Antimicrobial selection based on antibiogram results and the practice of an ASP in collaboration with clinical pharmacists were useful for optimizing antimicrobial therapy in outpatients. Full article

(This article belongs to the Special Issue Antimicrobial Stewardship Intervention: Importance for Clinical Practice and Health Policy)

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9 pages, 622 KiB

Open AccessArticle

Evaluation of T2 Magnetic Resonance (T2MR^®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients

by Celestino Bonura, Domenico Graceffa, Salvatore Distefano, Simona De Grazia, Oscar Guzman, Brian Bohn, Mariachiara Ippolito, Salvatore Campanella, Angelica Ancona, Marta Caputo, Pietro Mirasola, Cesira Palmeri, Santi Maurizio Raineri, Antonino Giarratano, Giovanni Maurizio Giammanco and Andrea Cortegiani

Antibiotics 2024, 13(9), 885; https://doi.org/10.3390/antibiotics13090885 - 14 Sep 2024

Viewed by 909

Abstract

Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR^®) technology may enable fast and sensitive detection [...] Read more.

Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR^®) technology may enable fast and sensitive detection of ESKAPEc pathogens directly from whole-blood samples. We aimed to evaluate concordance between the T2Bacteria^® Panel and standard blood culture and its impact on antibiotic therapy decisions. We conducted a single-centre retrospective study on patients with sepsis-induced hypotension or septic shock admitted to general, post-operative/neurosurgical, and cardiothoracic Intensive Care Units who were tested with the T2Bacteria^® Panel from January 2021 to December 2022. Eighty-five consecutively admitted patients were included, for a total of 85 paired tests. A total of 48 ESKAPEc pathogens were identified by the T2Bacteria^® Panel. The concordance rate between the T2Bacteria^® Panel and blood cultures was 81% (69/85), with 20 concordant-positive and 49 concordant-negative cases. For the 25 microorganisms grown from accompanying blood cultures, blood pathogen coverage by the T2Bacteria^® Panel was 88%. In this cohort of severely ill septic patients, the T2Bacteria^® Panel was highly concordant and was able to detect more ESKAPEc pathogens, with a significantly shorter turn-around time compared to conventional blood cultures. The T2Bacteria^® Panel also significantly impacted decisions on antibiotic therapy. Full article

(This article belongs to the Special Issue Infections and Sepsis in the Intensive Care Unit)

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21 pages, 5445 KiB

Open AccessEditor’s ChoiceArticle

Characterization of Two Novel Endolysins from Bacteriophage PEF1 and Evaluation of Their Combined Effects on the Control of Enterococcus faecalis Planktonic and Biofilm Cells

by Chen Wang, Junxin Zhao, Yunzhi Lin, Su Zar Chi Lwin, Mohamed El-Telbany, Yoshimitsu Masuda, Ken-ichi Honjoh and Takahisa Miyamoto

Antibiotics 2024, 13(9), 884; https://doi.org/10.3390/antibiotics13090884 - 13 Sep 2024

Viewed by 1046

Abstract

Endolysin, a bacteriophage-derived lytic enzyme, has emerged as a promising alternative antimicrobial agent against rising multidrug-resistant bacterial infections. Two novel endolysins LysPEF1-1 and LysPEF1-2 derived from Enterococcus phage PEF1 were cloned and overexpressed in Escherichia coli to test their antimicrobial efficacy against multidrug-resistant [...] Read more.

Endolysin, a bacteriophage-derived lytic enzyme, has emerged as a promising alternative antimicrobial agent against rising multidrug-resistant bacterial infections. Two novel endolysins LysPEF1-1 and LysPEF1-2 derived from Enterococcus phage PEF1 were cloned and overexpressed in Escherichia coli to test their antimicrobial efficacy against multidrug-resistant E. faecalis strains and their biofilms. LysPEF1-1 comprises an enzymatically active domain and a cell-wall-binding domain originating from the NLPC-P60 and SH3 superfamilies, while LysPEF1-2 contains a putative peptidoglycan recognition domain that belongs to the PGRP superfamily. LysPEF1-1 was active against 89.86% (62/69) of Enterococcus spp. tested, displaying a wider antibacterial spectrum than phage PEF1. Moreover, two endolysins demonstrated lytic activity against additional gram-positive and gram-negative species pretreated with chloroform. LysPEF1-1 showed higher activity against multidrug-resistant E. faecalis strain E5 than LysPEF1-2. The combination of two endolysins effectively reduced planktonic cells of E5 in broth and was more efficient at inhibiting biofilm formation and removing biofilm cells of E. faecalis JCM 7783^T than used individually. Especially at 4 °C, they reduced viable biofilm cells by 4.5 log after 2 h of treatment on glass slide surfaces. The results suggest that two novel endolysins could be alternative antimicrobial agents for controlling E. faecalis infections. Full article

(This article belongs to the Special Issue Phage Applications from Diagnostics to Treatment of Bacterial Infections in a One Health World)

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13 pages, 1322 KiB

Open AccessArticle

Identification of Antimicrobial-Resistant Zoonotic Bacteria in Swine Production: Implications from the One Health Perspective

by Maria Paz Ventero, Clara Marin, Lourdes Migura-Garcia, Carla Tort-Miro, Noemi Giler, Inmaculada Gomez, Isabel Escribano, Ana Marco-Fuertes, Laura Montoro-Dasi, Laura Lorenzo-Rebenaque, Santiago Vega, Maria Teresa Pérez-Gracia and Juan Carlos Rodríguez

Antibiotics 2024, 13(9), 883; https://doi.org/10.3390/antibiotics13090883 - 13 Sep 2024

Viewed by 1991

Abstract

Antimicrobial resistance poses a major threat to global health and food security and is primarily driven by antimicrobial use in human and veterinary medicine. Understanding its epidemiology at farm level is crucial for effective control measures. Despite the significant reduction in antibiotic use [...] Read more.

Antimicrobial resistance poses a major threat to global health and food security and is primarily driven by antimicrobial use in human and veterinary medicine. Understanding its epidemiology at farm level is crucial for effective control measures. Despite the significant reduction in antibiotic use in conventional livestock production, the swine sector traditionally has a higher level of antibiotic use in veterinary medicine. Consequently, multidrug resistance (MDR) among microbial isolates of swine origin has been relatively frequent. The aim of this study was to assess the presence of multidrug-resistant (MDR) bacteria, enteric pathogens and resistance genes to the main antibiotics used in clinical practice, both within the environment and in animals across pig farms characterized by varying degrees of sanitary status. A total of 274 samples were collected. Of these, 34 samples were collected from the environment (wall swabs, slat swabs and slurry pit), and 240 samples were collected from animals (sows’ and piglets’ rectal faeces). All samples were analysed for MDR bacteria and enteric pathogens. The study revealed a high frequency of extended-spectrum beta-lactamases (ESBL)-producing Enterobacterales and Campylobacter spp., with ESBL-producing Enterobacterales predominating in high health status farms (environment and animals) and Campylobacter spp. in both high health status and low health status environments. Additionally, a high percentage of methicillin-resistant Staphylococcus aureus (MRSA) was found, mainly in environmental samples from high health status farms, and Clostridioides difficile was distributed ubiquitously among farms and samples. Furthermore, though less frequently, vancomycin-resistant Enterococcus faecium (VRE) was isolated only in high health status farms, and Gram-negative bacilli resistant to carbapenems were isolated only in environmental samples of high health status and low health status farms. This study underscores the importance of surveillance for MDR bacteria in farm animals and their environment, including their waste. Such ecosystems serve as crucial reservoirs of bacteria, requiring national-level surveillance to promote responsible antibiotic use and pandemic control. Full article

(This article belongs to the Special Issue Antibiotics and Environment − Research and Development toward the One Health Approach)

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Antibiotics, Volume 13, Issue 9 (September 2024) – 122 articles

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