The role of the phosphopantetheinyltransferase enzyme, PswP, in the biosynthesis of antimicrobial secondary metabolites by <em>Serratia marcescens </em>Db10

Phosphopantetheinyltransferase (PPTase) enzymes fulfil essential roles in primary and secondary metabolism in prokaryotes, archaea and eukaryotes. PPTase enzymes catalyse the essential modification of the carrier protein domain of fatty acid synthases, polyketide synthases (PKSs) and non-ribosomal peptide synthetases (NRPSs). In bacteria and fungi, NRPS and PKS enzymes are often responsible for the biosynthesis of secondary metabolites with clinically relevant properties; these secondary metabolites include a variety of antimicrobial peptides. We have previously shown that in the Gram-negative bacterium Serratia marcescens Db10, the PPTase enzyme PswP is essential for the biosynthesis of an NRPS-PKS dependent antibiotic called althiomycin. In this work we utilize bioinformatic analyses to classify PswP as belonging to the F/KES subfamily of Sfp type PPTases and to putatively identify additional NRPS substrates of PswP, in addition to the althiomycin NRPS-PKS, in Ser. marcescens Db10. We show that PswP is required for the production of three diffusible metabolites by this organism, each possessing antimicrobial activity against Staphylococcus aureus. Genetic analyses identify the three metabolites as althiomycin, serrawettin W2 and an as-yet-uncharacterized siderophore, which may be related to enterobactin. Our results highlight the use of an individual PPTase enzyme in multiple biosynthetic pathways, each contributing to the ability of Ser. marcescens to inhibit competitor bacteria by the production of antimicrobial secondary metabolites

Patientinformationens betydelse för en säker läkemedelshantering

Bristande information angående läkemedelshantering kan vara en orsak till att patienter läggs in på sjukhus med läkemedelsrelaterade problem. En välinformerad och kunnig patient minskar risken för fel i läkemedelshanteringen. Patientinformation bör ses som en viktig del i patientens omvårdnad. Syftet med studien är att belysa betydelsen av sjuksköterskans roll i informationen till patienten för att få en säker läkemedelshantering. Metoden utgörs av litteraturstudier och vetenskapliga artiklar söktes i databaserna CINAHL, PubMed och ELIN under perioden september och oktober 2007. Resultatet visar att sjuksköterskors förhållande till patientinformation angående läkemedelshantering är ganska begränsad. Brist på information är ett stort problem för många patienter, vilket leder till ett stort antal läkemedelsrelaterade problem. Utbildningsprogram i läkemedelshantering ökar kunskaperna och leder till en effektiv patientinformation. Sjuksköterskor, läkare och farmaceuter bör samarbeta för att minska andelen läkemedelsrelaterade problem. Sammanfattningsvis så har sjuksköterskan en viktig roll att identifiera läkemedelsrelaterade problem. Genom att förse patienten med relevant information angående läkemedelshanteringen så kan oro över de läkemedel som patienten tar reduceras.Lack of information regarding the medication use process could be a reason for admission in hospitals with drug related problems. A well informed patient with a good knowledge can reduce risks for mismanagement in the medication use process. Patient education should be seen as an important component in patient care. The aim of this study was to highlight the importance of nurse’s role in patient information regarding safe medication use process. The research was based upon literature reviews and scientific articles witch can be found on the databases CINAHL, PubMed and ELIN during the period of Septem-ber and October 2007. Findings indicate that the nurses’ contribution to medication educa-tion is commonly limited. Lack of information is a key concern for many patients leading to a wide range of medication related problems. Medication programmes increase knowl-edge of medication and contribute to an effective patient education. Nurses, physicians and pharmacists should work collaboratively to reduce medication mismanagement. Conclu-sions show that nurses play an important role in identifying drug related problems. Provid-ing patients with relevant individual information about their medication use process may help to reduce anxiety about the prescription medication they are taking