Antimicrobial Mechanisms of <i>Escherichia coli</i>

Increasing antimicrobial resistance in strains of Escherichia coli is having a major impact on the healthcare industry worldwide. The appearance of extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) strains has caused clinicians to worry that these strains might become as deadly as methicillin-resistant Staphylococcus aureus (MRSA) strains. It is vital that physicians have resources available to help keep them updated on these bacteria and the potential impact on healthcare. This chapter reviews the major strains of E. coli (intestinal and urinary), along with a review of the virulence factors, main diseases caused, and pertinent pathogenesis. The chapter then discusses antimicrobial therapy, what drugs are effective against these E. coli strains, and the development of resistance to these specific drug classes. Lastly, the molecular aspects of antimicrobial resistance mechanisms in this organism are discussed. This information will be especially helpful for physicians in providing them with a concise review of E. coli and an understanding of what is involved in antimicrobial resistance. Hopefully this information can be used to improve the outcomes for patients with E. coli infections

Antibiotic optimization in the difficult-to-treat patient with complicated intra-abdominal or complicated skin and skin structure infections: focus on tigecycline

Complicated intra-abdominal and skin and skin structure infections are widely varied in presentation. These infections very often lead to an increase in length of hospital stay, with a resulting increase in costs and mortality. In addition, these infections may be caused by a wide variety of bacteria and are often polymicrobial with the possibility of the presence of antimicrobial-resistant strains, such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum β-lactamase strains (Escherichia coli, Klebsiella pneumoniae), and K. pneumoniae carbapenemase-producing strains. In combination with patients’ immunosuppression or comorbidities, the treatment and management options for initial therapy success are few. Tigecycline, a new glycylcyline antimicrobial from the tetracycline drug class, represents a viable option for the successful treatment of these infections. It has been shown to have activity against a wide variety of bacteria, including the antimicrobial-resistant strains. As with all tetracycline drugs, it is not recommended for pregnant or nursing women. The potential side effects are those typical of tetracycline drugs: nausea, vomiting, and headaches. Drug–drug interactions are not expected, and renal function monitoring is not necessary

An Overview of the Genetic Causes of Frontotemporal Degeneration

Many neurodegenerative diseases (NDDs) have been thought to be caused mainly by conditions that were not controlled by genetic inheritance. Extensive research into these diseases has recently discovered that perhaps a majority of them have genetic inheritance components. Once thought to be a rare form of NDD, frontotemporal degeneration (FTD) is now considered to be the main cause of early onset NDD, and the information on genetic causes and inheritance has increased dramatically over the last 10 years. The main genes that have been found to be involved in frontotemporal degeneration, MAPT, TARDBP, GRN C9orf72, VCP, FUS, and CHMP2B, have also been found in related diseases such as Alzheimer’s disease, Amyotrophic Lateral Sclerosis, and Parkinson’s disease. This paper is intended as an updated review of the genetic causes of FTD. This information should aid physicians and scientists in understanding the current concepts, and encourage even more genetic testing so that a full knowledge of genetic inheritance in FTD will be soon be forthcoming

Higher incidence of perineal community acquired MRSA infections among toddlers

<p>Abstract</p> <p>Background</p> <p>A six-fold increase in pediatric MRSA infections, prompted us to examine the clinical profile of children with MRSA infections seen at Mercy Children's Hospital, Toledo, Ohio and to characterize the responsible strains.</p> <p>Methods</p> <p>Records were reviewed of pediatric patients who cultured positive for MRSA from June 1 to December 31, 2007. Strain typing by pulsed field gel electrophoresis (PFT) and DiversiLab, SCC<it>mec </it>typing, and PCR-based <it>lukSF-PV </it>gene (encodes Panton-Valentine leukocidin), arginine catabolic mobile element (ACME) and <it>cap</it>5 gene detection was performed.</p> <p>Results</p> <p>Chart review of 63 patients with MRSA infections revealed that 58(92%) were community acquired MRSA (CAMRSA). All CAMRSA were skin and soft tissue infections (SSTI). Twenty five (43%) patients were aged < 3 yrs, 19(33%) aged 4-12 and 14(24%) aged 13-18. Nineteen (76%) of those aged < 3 yrs had higher incidence of perineal infections compared to only 2(11%) of the 4-12 yrs and none of the 13-18 yrs of age. Infections in the extremities were more common in the older youth compared to the youngest children. Overall, there was a significant association between site of the infection and age group (Fisher's Exact p-value < 0.001). All CAMRSA were USA300 PFT, clindamycin susceptible, SCC<it>mec </it>type IVa and <it>lukSF-PV gene </it>positive. Nearly all contained ACME and about 80% were <it>cap</it>5 positive. Of the 58 USA300 strains by PFT, 55(95%) were also identified as USA300 via the automated repetitive sequence-based PCR method from DiversiLab.</p> <p>Conclusions</p> <p>CAMRSA SSTI of the perineum was significantly more common among toddlers and that of the extremities in older children. The infecting strains were all USA300 PFT. Further studies are needed to identify the unique virulence and colonization characteristics of USA300 strains in these infections.</p

A call for action to the biomaterial community to tackle antimicrobial resistance

The global surge of antimicrobial resistance (AMR) is a major concern for public health and proving to be a key challenge in modern disease treatment, requiring action plans at all levels. Microorganisms regularly and rapidly acquire resistance to antibiotic treatments and new drugs are continuously required. However, the inherent cost and risk to develop such molecules has resulted in a drying of the pipeline with very few compounds currently in development. Over the last two decades, efforts have been made to tackle the main sources of AMR. Nevertheless, these require the involvement of large governmental bodies, further increasing the complexity of the problem. As a group with a long innovation history, the biomaterials community is perfectly situated to push forward novel antimicrobial technologies to combat AMR. Although this involvement has been felt, it is necessary to ensure that the field offers a united front with special focus in areas that will facilitate the development and implementation of such systems. This paper reviews state of the art biomaterials strategies striving to limit AMR. Promising broad-spectrum antimicrobials and device modifications are showcased through two case studies for different applications, namely topical and implantables, demonstrating the potential for a highly efficacious physical and chemical approach. Finally, a critical review on barriers and limitations of these methods has been developed to provide a list of short and long-term focus areas in order to ensure the full potential of the biomaterials community is directed to helping tackle the AMR pandemic

An Update on the Health Benefits of Green Tea

Green tea, which is produced from the leaves of the Camellia sinensis plant, is one of the most popular beverages worldwide. Over the past 30 years or more, scientists have studied this plant in respect to potential health benefits. Research has shown that the main components of green tea that are associated with health benefits are the catechins. The four main catechins found in green tea are: (−)-epicatechin (EC), (−)-epicatechin-3-gallate (ECG), (−)-epigallocatechin (EGC), and (−)-epigallocatechin-3-gallate (EGCG). Of these four, EGCG is present in the largest quantity, and so has been used in much of the research. Among the health benefits of green tea are: anticarcinogenic, anti-inflammatory, antimicrobial, and antioxidant properties, and benefits in cardiovascular disease and oral health. Research has been carried out using various animal models and cells lines, and is now more and more being carried out in humans. This type of research will help us to better understand the direct benefits of green tea. This review will focus primarily on research conducted using human subjects to investigate the health benefits of green tea