Antimicrobial use in European acute care hospitals: results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016-17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2-31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials

Urinary tract infections in women

Symptoms suggestive of acute urinary tract infections (UTIs) are common reasons why women consult a health professional. Antimicrobial agents are usually prescribed for the treatment of symptomatic UTIs seen in clinical practice. However, the extensive use of antimicrobial agents for community-acquired UTIs has resulted in the emergence of antimicrobial resistance. Increasing concern about the association between the use of antimicrobial agents and acquired antimicrobial resistance has highlighted the need for rational pharmacotherapy when treating UTIs. This article discusses currently recommended antimicrobial therapy for uncomplicated UTIs in women, UTIs during pregnancy and recurrent UTIs.Keywords: urinary tract infection, cystitis, pyelonephritis, antimicrobial agents, resistanc

Rapid method for determination of antimicrobial susceptibilities pattern of urinary bacteria

Method determines bacterial sensitivity to antimicrobial agents by measuring level of adenosine triphosphate remaining in the bacteria. Light emitted during reaction of sample with a mixture of luciferase and luciferin is measured

ZraP is a periplasmic molecular chaperone and a repressor of the zinc-responsive two-component regulator ZraSR

The bacterial envelope is the interface with the surrounding environment and is consequently subjected to a barrage of noxious agents including a range of compounds with antimicrobial activity. The ESR (envelope stress response) pathways of enteric bacteria are critical for maintenance of the envelope against these antimicrobial agents. In the present study, we demonstrate that the periplasmic protein ZraP contributes to envelope homoeostasis and assign both chaperone and regulatory function to ZraP from Salmonella Typhimurium. The ZraP chaperone mechanism is catalytic and independent of ATP; the chaperone activity is dependent on the presence of zinc, which is shown to be responsible for the stabilization of an oligomeric ZraP complex. Furthermore, ZraP can act to repress the two-component regulatory system ZraSR, which itself is responsive to zinc concentrations. Through structural homology, ZraP is a member of the bacterial CpxP family of periplasmic proteins, which also consists of CpxP and Spy. We demonstrate environmental co-expression of the CpxP family and identify an important role for these proteins in Salmonella's defence against the cationic antimicrobial peptide polymyxin B

Isolation of a Novel Phage with Activity against Streptococcus mutans Biofilms

peer-reviewedStreptococcus mutans is one of the principal agents of caries formation mainly, because of its ability to form biofilms at the tooth surface. Bacteriophages (phages) are promising antimicrobial agents that could be used to prevent or treat caries formation by S. mutans. The aim of this study was to isolate new S. mutans phages and to characterize their antimicrobial properties. A new phage, ɸAPCM01, was isolated from a human saliva sample. Its genome was closely related to the only two other available S. mutans phage genomes, M102 and M102AD. ɸAPCM01 inhibited the growth of S. mutans strain DPC6143 within hours in broth and in artificial saliva at multiplicity of infections as low as 2.5x10-5. In the presence of phage ɸAPCM01 the metabolic activity of a S. mutans biofilm was reduced after 24 h of contact and did not increased again after 48 h, and the live cells in the biofilm decreased by at least 5 log cfu/ml. Despite its narrow host range, this newly isolated S. mutans phage exhibits promising antimicrobial properties

The Design and Synthesis of Novel Antimicrobial Agents for Use in the Battle Against Bacterial Resistance

There is an ever increasing need to develop new antimicrobial agents with novel mechanisms of action. These new agents will help to combat the steady rise of antibiotic-resistant bacteria which are becoming more and more difficult to treat due to the dwindling number of antibiotics available to treat such organisms. This body of work brings to light the many ways in which medicinal chemistry plays a vital role in the discovery of novel antimicrobial agents. Chapter 1 is an introduction into antimicrobial agents. It provides a brief history of the discovery of antimicrobial agents, and delves into reasons why new agents are urgently needed. It also examines the recent antimicrobial agents approved by the Food and Drug Administration for use in the United States, and looks into the current antimicrobial drug pipeline. Chapter 2 explores the current therapy regime for combating tuberculosis and expresses the need for novel agents in this arena. It also shows how current medicinal chemistry techniques are being utilized to develop a novel class of potential anti-tuberculosis agents with novel mechanisms of action. Chapter 3 discusses the treatment of gram-negative bacterial infections with novel hybrid antimicrobial agents. These agents afford current antimicrobial agents, which have difficulty penetrating the gram-negative cell wall, a way into the gram-negative cell in order to exert their intended mechanism of action. This chapter explores the rationale and design behind the making of such agents. Chapter 4 provides an overview of the work detailed in the dissertation; as well as future directions that will help further the scope of these projects

Non-thermal plasma technology for the development of antimicrobial surfaces: a review

Antimicrobial coatings are in high demand in many fields including the biomaterials and healthcare sectors. Within recent progress in nanoscience and engineering at the nanoscale, preparation of nanocomposite films containing metal nanoparticles ( such as silver nanoparticles, copper nanoparticles, zinc oxide nanoparticles) is becoming an important step in manufacturing biomaterials with high antimicrobial activity. Controlled release of antibiotic agents and eliminating free nanoparticles are of equal importance for engineering antimicrobial nanocomposite materials. Compared to traditional chemical 'wet' methods, plasma deposition and plasma polymerization are promising approaches for the fabrication of nanocomposite films with the advantages of gas phase dry processes, effective use of chemicals and applicability to various substrates. In this article, we present a short overview of state-of-the-art engineering of antimicrobial materials based on the use of non-thermal plasmas at low and atmospheric pressure

Investigation of the Influence of Antimicrobial Preparations on the Shelf Life of Broccoli Cabbage

Studies of the effect of antimicrobial agents on the conservation of broccoli cabbage have been conducted. The late hybrids of broccoli Ironman F1, Agassi F1, Beaumont F1, grown under the conditions of the Forest-Steppe of Ukraine were studied. The content of the main components of the chemical composition (dry substances, dry soluble substances, sugars, vitamin C) of broccoli cabbage is analyzed depending on the characteristics of the hybrid. The effect of antimicrobial treatment on the natural loss of cabbage, microbiological lesions during storage has been studied. Antimicrobial preparations Baikal EM-1 (dilution of working solution in water 1: 500), 0.5 % solution of citric, 0.2 % benzoic, 0.05 % sorbic acid, and also 0.5:0.5 % solution of vitamins C and P (ascorutin), water for the preparation of solutions had a temperature of 23 ... 25 °C.The processing of fruit and vegetable products with various chemicals is aimed at prolonging the shelf life, increasing the shelf life and increasing the yield of commercial products at the end of storage.It is established that the natural loss of broccoli cabbage during storage depends on the characteristics of the hybrid and the type of antimicrobial preparation. Treatment with preparations increases the shelf life of broccoli cabbage to 30 - 50 days with a natural weight loss of up to 6.1 %, and ensures minimal disease burden.Treatment with antimicrobial agents reduces the loss of dry substances, dry soluble substances, sugars, vitamin C. The most effective is the treatment of broccoli with acids. It has been established that ascorbic acid is contained in broccoli cabbage, with hydrolysis from which ascorbic acid is split off, the content of which is increased.The maximum effective storage of broccoli cabbage at a temperature of 0 ± 1 oС and relative humidity of 90-95 %, pretreatment with preparations of antimicrobial action.The proposed method of processing broccoli cabbage with antimicrobial preparations before storage allows the use of vegetable raw materials for post-harvest treatment. In the development of new, low-cost, environmentally friendly and affordable storage technologies, this is an important technique

Results of A Local Combination Therapy Antibiogram For \u3cem\u3ePseudomonas Aeruginosa\u3c/em\u3e Isolates: Is Double Worth The Trouble?

Purpose: To determine the frequency at which fluoroquinolones and aminoglycosides demonstrate in vitro activity against non-urinary, non-skin/skin structure Pseudomonas aeruginosa isolates exhibiting decreased susceptibilities to one or more β-lactam agents. Methods: β-lactam-non-susceptible P. aeruginosa isolates recovered from blood, bone, lower respiratory tract, pleural fluid, cerebrospinal fluid, or peritoneal fluid cultures between October 2010 and October 2014 were reviewed from four community hospitals within a single health-system. Only the first isolate per patient was included for analysis. The likelihood that each isolate was susceptible to a non-β-lactam antimicrobial was then determined and summarized within a combination antibiogram. Results: In total, 179 P. aeruginosa isolates with decreased susceptibilities to one or more β-lactam agents were assessed. Because no appreciable differences in antimicrobial susceptibility profile were observed between hospitals, the isolates were evaluated in aggregate. Susceptibility rates for β-lactam monotherapy ranged from 34% to 75%. Aminoglycosides possessed increased antibacterial activity compared to fluoroquinolones. Tobramycin was the non-β-lactam most likely to expand antimicrobial coverage against β-lactam-non-susceptible P. aeruginosa with activity against 64%, 66%, and 65% of cefepime-, piperacillin-tazobactam-, and meropenem-non-susceptible isolates, respectively (p \u3c 0.001 for all). Conclusions: The results of this study support the use of aminoglycosides over fluoroquinolones for achieving optimal, empiric antimicrobial combination therapy for P. aeruginosa when dual antimicrobial therapy is clinically necessary. Future efforts aimed at optimizing combination therapy for P. aeruginosa should focus on systemic interventions that limit the selection of fluoroquinolones in combination with β-lactams to expand coverage based on local susceptibility rates