Department of Dermatology, College of Medicine, Qassim University, Buraydah 51477, Saudi Arabia. firstname.lastname@example.org.
Staphylococcus aureus is known as a common pathogen in atopic dermatitis. A methicillin-resistant S. aureus strain with reduced susceptibility to vancomycin (VISA/VRSA) is increasing worldwide. The aims of this study were to evaluate the antibiotic-susceptibility pattern of S. aureus isolated from children with atopic dermatitis and to identify the occurrence of resistance to glycopeptide antibiotics.
Swabs were collected from atopic dermatitis skin lesions of 80 children being treated at dermatology clinics whose ages ranged from 6 months to 15 years in the period from March 2009 to February 2010. Isolates were studied with an antibiogram for an antibiotic-susceptibility test. The selected antibiotics were the usually administered antimicrobials at dermatological clinics in Buraydah (Qassim, Saudi Arabia). Results were determined as minimal inhibitory concentration (MIC) using the Vitek system.
Thirty S. aureus isolates showed resistance to streptomycin (100%), benzylpenicillin and ampicillin (96.7%), and oxacillin (90%). S. aureus resistance to trimethoprim/sulfamethoxazole, tigecycline, and vancomycin was 63.3%, 83.3%, and 53.3%, respectively. Resistance to linezolid was less, at 5.7%.
Strains of MRSA with decreasing susceptibility to vancomycin were documented in the Qassim region of Saudi Arabia. Other studies will be required on VISA/VRSA strains concerning phenotypic and genotypic characterization.
Chest infections are very common at this time of year. However, a new study has found that an antibiotic commonly prescribed for some of these infections does not work, even in older patients.
The study focused on common lower respiratory tract infections (LRTI), such as bronchitis and the effect of the antibiotic, amoxicillin.
According to UK scientists, LRTIs are one of the most common acute illnesses seen by GPs. While most of these infections are thought to be caused by viruses - which antibiotics have no effect on - the use of the drugs in treating them is a topic of major debate. To date, research results have been conflicting.
The team from the University of Southampton looked at over 2,000 adults with acute, uncomplicated LRTIs from 12 European countries, including England, Wales, Germany, Sweden Spain and Poland.
The participants were randomly assigned to receive either amoxicillin or a placebo three times a day for seven days. They were monitored throughout.
The study found that there was little difference in the duration or severity of the symptoms between the two groups. This was true even for patients over the age of 60.
While more patients in the placebo group reported new or worsening symptoms, just two from that group, along with one from the antibiotic group, needed to be hospitalised because of the LRTI.
Furthermore, patients in the antibiotic group reported more side-effects, such as diarrhoea, nausea and rash, than those in the placebo group.
"Our results show that most people get better on their own. But, given that a small number of patients will benefit from antibiotics, the challenge remains to identify these individuals," commented Prof Paul Little of the University of Southampton.
He added that using amoxicillin to treat respiratory infections in patients not suspected of having pneumonia ‘is not likely to help and could be harmful', particularly if it leads to antibiotic resistance.
Details of these findings are published in the journal, The Lancet Infectious Diseases.
Turmeric has been an integral part of Indian kitchen for ages. But now, researchers from the Indian Institute of Science (IISc) suggest that people on antibiotics should avoid turmeric for fast recovery.
A study conducted by the Centre for Infectious Disease Research and Biosafety Laboratories, IISc, Bengaluru, reveals that curcumin, an active chemical substance found in turmeric, interferes with the efficacy of antibiotics like ciprofloxacin. Thus, antibiotics lose their ability to fight harmful bacteria. The IISc team tested ciprofloxacin against typhoid bacteria in the presence of curcumin.
Ciprofloxacin is the first line drug to treat typhoid.
Turmeric has gained importance in treating diseases, as a food additive and preservative. Many consume turmeric tablets as a daily dietary supplement. Some even have the spice to benefit from the curative properties of curcumin. Moreover, haldi is added in Indian dishes.
The IISc team demonstrated that curcumin inhibited the action of ciprofloxacin by not preventing the ciprofloxacin-induced cleavage of DNA.
The study was published in the latest issue of the Journal of Antimicrobial Chemotherapy.
Curcumin is a major dietary molecule among Indians and on an average, a person takes 0.03 to 0.12 gm per day.
**Editor's note: More research is needed to confirm what this article reports. It should be noted there is some criticism of it and the basis of the researchers conclusions.**
Department of General Practice, Maastricht University, , Maastricht, Limburg, The Netherlands.
Most primary care clinical guidelines recommend restrictive antibiotic use for childhood infections. We investigated antibiotic prescription rates over time for oral and topical antibiotics for children (≤12 years) in the period 2000-2010.
DESIGN, SETTING AND PATIENTS:
Longitudinal observational study among children (≤12 years) in a large Dutch general practice database in the period 2000-2010.
MAIN OUTCOME MEASURES:
Oral and topical antibiotic prescribing rates per year and independent factors influencing antibiotic prescriptions.
We analysed 108 555 patient-years during 2000-2010. At least one chronic disease was recorded in 15.8% of patient-years, with asthma most commonly registered. In 14.8% of the patient-years at least one antibiotic was prescribed, while 26.3% of these received two or more prescriptions. Young age and chronic disease had a significant effect on antibiotic prescriptions. Prescriptions for oral and topical antibiotics increased 4.9% and 1.8%, respectively, during 2000-2005. Prescription rates for oral antibiotics decreased 3.3% during 2006-2010, while topical prescribing rates remained stable.
One in six children received at least one oral antibiotic prescription per year during 2000-2010. While topical prescription rates steadily increased during 2005-2010 and remained stable during 2006-2010, prescription rates for oral antibiotics increased significantly during the period 2000-2005 and then significantly decreased during the period 2006-2010. As clinical guidelines remained the same over this period, the effects could be contributed to the initiation of the Dutch nationwide pneumococcal vaccination campaign in 2006.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Antibiotic use and concomitant resistance are increasing. Literature reviews do not unambiguously indicate which interventions are most effective in improving antibiotic prescribing practice.
To assess the effectiveness of physician-targetedinterventions aiming to improveantibiotic prescribing for respiratorytractinfections (RTIs) in primary care, and to identify intervention features mostly contributing to intervention success.
DESIGN AND SETTING:
Analysis of a set of physician-targeted interventions in primary care.
A literature search (1990-2009) for studies describing the effectiveness of interventions aiming to optimise antibiotic prescription for RTIs by primary care physicians. Intervention features were extracted and effectiveness sizes were calculated. Association between intervention features and intervention success was analysed in multivariate regression analysis.
This study included 58 studies, describing 87 interventions of which 60% significantly improved antibioticprescribing; interventions aiming to decrease overall antibiotic prescription were more frequently effective than interventions aiming to increase first choice prescription. On average, antibiotic prescription was reduced by 11.6%, and first choice prescription increased by 9.6%. Multiple interventions containing at least 'educational material for the physician' were most often effective. No significant added value was found for interventions containing patient-directed elements. Communication skills training and near-patient testing sorted the largest intervention effects.
This review emphasises the importance of physician education in optimising antibiotic use. Further research should focus on how to provide physicians with the relevant knowledge and tools, and when to supplement education with additional intervention elements. Feasibility should be included in this process.
1] Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.  Alimentary Pharmabiotic Centre, Cork, Ireland.
Solutions are urgently required for the growing number of infections caused by antibiotic-resistant bacteria. Bacteriocins, which are antimicrobial peptides produced by certain bacteria, might warrant serious consideration as alternatives to traditional antibiotics. These molecules exhibit significant potency against other bacteria (including antibiotic-resistant strains), are stable and can have narrow or broad activity spectra. Bacteriocins can even be produced in situ in the gut by probiotic bacteria to combat intestinal infections. Although the application of specific bacteriocins might be curtailed by the development of resistance, an understanding of the mechanisms by which such resistance could emerge will enable researchers to develop strategies to minimize this potential problem.
If you want to sum up the debate over antibiotics in food animals, try this – the more we expose organisms to antibiotics in animals, the more opportunity there is for them to develop resistance to those antibiotics and, ultimately, to affect human health.
That linear thinking has been the source of decades of debate about whether or not, or to what extent, antibiotics should be used in animals. At the center of the debate is the use of low-level antibiotics for growth promotion and feed efficiency.
Here’s the rub: “While it’s plausible, there is simply no hard evidence that connects human cases of infection with a resistant bacteria and the use of antimicrobials in animals,” says Ron DeHaven, American Veterinary Medical Association (AVMA) executive vice president. “Further, there is little evidence at this point to suggest that eliminating or greatly reducing the use of antimicrobials in food animals improves human health or results in less antimicrobial resistance in humans.”
He points to Denmark as an example. That country banned the use of antibiotics for growth promotion and feed efficiency in pigs in 2000. Following the ban, Danish hog produces reported significant animal health problems, particularly in the early stages. As a result, veterinarians had to resort to greater use of therapeutic doses of antibiotics to maintain animal health and welfare.
“That ban has been in place for quite some time and yet there has been no improvement in terms of the increased frequency of antimicrobial resistance seen in humans,” DeHaven says. “Indeed, some evidence suggests there’s been an increasing prevalence of antimicrobial-resistant infections in people since the ban.”
A Closer Look: Is Solving The Antibiotic Resistance Dilemma Possible?
That suggests a number of things, he says, not the least of which is that there may be a therapeutic response to subtherapeutic use of antibiotics.
Nonetheless, U.S. politicians and regulators are forging ahead, seeking to limit the use of antibiotics in food animal production.
DeHaven says the FDA Center for Veterinary Medicine, the regulatory body over antibiotic use, recognizes and supports the importance of antibiotics in animals for control and prevention of disease. “Long term, they would like to see a phase in of greater veterinary oversight and a phase out of growth promotion and feed efficiency use,” he says. “In the meantime, we need data to see if, in fact, the benefit we’re seeing in terms of growth promotion and feed efficiency is because we’re seeing a therapeutic benefit from the use of antibiotics given in low doses to large numbers of animals.”
So what’s ahead? Likely, it’s more veterinary oversight on all antibiotic use and an eventual reduction in flexibility, if not an outright ban, of low-level antibiotics in feed and water. While AVMA supports more veterinary oversight of antibiotic use, DeHaven says the group does have some workforce concerns.
Another Perspective: Overcoming Antibiotic Resistance Is A Tough Task
Those concerns revolve largely around limitations in the number of rural veterinarians to carry out the needs of greater veterinary oversight. If you have to wait on your veterinarian to write a prescription for an antibiotic before you head to the feed store, the delay could result in greater animal suffering and increased disease incidence as the bugs spread through your herd.
DeHaven says FDA will likely use the existing Veterinary Feed Directive as the vehicle to impose more regulations on antibiotic use in food animals. The directive essentially calls for a veterinarian’s prescription to use antibiotics in feed and water. “We do have workforce concerns, hence the need for more flexibility in how we apply the Veterinary Feed Directive,” he says.
Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Via Commenda 9, 20122 Milano , Italy +39 02 55032498 ; +39 02 50320206 ; email@example.com.
The management of pneumococcal diseases still places a significant burden on medical and economic resources. The subjects at greatest risk of pneumococcal infections are children. Areas covered: The aim of this review is to analyse the best current therapeutic approach to pneumococcal resistance, taking into account the level of susceptibility of Streptococcus pneumoniae, and the pharmacokinetics and pharmacodynamics of different antibiotics in the various pneumococcal diseases. Expert opinion: Antibiotic treatment of a number of pneumococcal diseases remains difficult or impossible due to the presence of strains resistant to commonly used antibiotics. In children the problem is significantly more important than in adults due to the reduced number of licenced drugs for subjects in the first years of life. The new conjugate pneumococcal vaccines containing 10 (PCV10) and 13 serotypes (PCV13), which include most of the recently emerging strains, might reduce the incidence of pneumococcal infections and the circulation of resistant pathogens. However, it is likely that optimal results will only be reached after the development of effective vaccines based on conserved proteins that are capable of preventing all pneumococcal infections, regardless of the serotype of the causative organism.
The detection of the pollution level of antibiotics in Daliao River system is a meaningful work. Sixteen antibiotics (6 sulfonamides, 5 fluoroquinolones, 3 tetracyclines and 2 chloramphenicols) were simultaneously quantified with solid-phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). In the SPE procedure, methanol and 2% (v/v) ammonia/methanol were used as the elution solvents in sequence to reduce the elution volume and improve the recovery. The results showed that this method have good sensitivity and enrichment effect for the target antibiotics in aqueous water, the recoveries ranged from 69.5% to 122.6%, the detection limits ranged from 0.05 ng/L to 0.32 ng/L. Thirteen antibiotics were found in the river water of Daliao River water system. Sulfa antibiotics were widely distributed, in which sulfamethoxazole was detected in all the sampling sites. The concentration of fluoroquinolones was relatively high in some sampling sites. The highest detection concentration of enoxacin was 41.3 ng/L. The frequencies and concentrations of tetracyclines and chloramphenicols were lower. In the upper reaches of the river, the concentrations of the 4 types ofantibiotics appeared lower, but around the large cities such as Shenyang City, Benxi City, Liaoyang City, the concentrations showed higher levels. The study indicated that the Daliao River water system suffered from the pollution of antibiotics to a certain extent.
Department of Urology, Kantonsspital Graubünden, Chur, Switzerland.
Data supporting the widespread use of antibiotics in patients with chronic scrotal pain syndrome (CSPS) are not available. Therefore, the aim of this study was to investigate the presence of bacteria in the genitourinary tract in patients presenting with CSPS. From July 2005 to July 2007 we prospectively enrolled patients presenting with CSPS in our outpatient clinic. The evaluation consisted of a detailed patient's history, physical examination and ultrasound examination of the scrotum. A blood and urinalysis, a Meares-Stamey four-glass test for bacterial cultures and PCR testing for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis and Neisseria gonorrhoeae as well as a semen culture were performed. We assessed the symptom severity with the chronic epididymitis symptom index (CESI) score according to Nickel et al. (J Urol 2002, 167:1701; based on the NIH-CPSI). A total of 55 eligible men (median age 34 years) with CSPS were enrolled in the study. The median CESI score was 17 (range 4-26). The majority of patients (n = 39; 71%) were seen by a general practitioner or an urologist before. Of these, 25 patients (64%) were treated with antibiotics and 26 (67%) with non-steroidal anti-inflammatory drugs, respectively. A significant bacterial colony count in at least one specimen was detected in 21 of 55 patients (38%). The predominantly detected microorganisms were an Alpha-haemolytic Streptococcus (11 patients) and coagulase-negative staphylococci (10 patients). Thus, only in 12 of 55 (22%) patients isolated bacteria were considered to be of clinical relevance. No factor or condition predictive for a bacterial aetiology for CSPS could be identified. In our microbiological assessment of patients presenting with CSPS we found no evidence for the widely held belief that CSPS is predominantly the result of a chronic bacterial infection. We therefore conclude that the widespread use of antibiotic agents in the treatment of patients with CSPS is not justified.
Department of Plastic Surgery, Guy's and St Thomas's Hospital, Westminster Bridge Road, London SE1 7EH, UK.
Traumatic injuries cause 5.8 million deaths per year globally. Before the advent of antibiotics, sepsis was considered almost inevitable after injury. Today infection continues to be a common complication after traumatic injury and is associated with increases in morbidity and mortality and longer hospital stays. Research into the prevention of post-traumatic infection has predominantly focused on thoracic and abdominal injuries. In addition, because research on sepsis following musculoskeletal injuries has predominantly been on open fractures. There is a paucity of research into the prevention of soft tissue infections following traumatic injuries. This review analyses the evidence for the role of prophylactic antibiotics in the management of soft tissue injuries. Emphasis is placed on assessing the strength of the presented evidence according to the Oxford Level of Evidence scale.
Antibiotics work by killing bacteria or by stopping bacteria from multiplying. Each type of antibiotics affects different bacteria in different ways, although broad-spectrum antibiotics are used to treat a wide range of infections. Antibiotics quickly make you feel better because the drug kills the majority of the targeted bacteria very quickly.
However antibiotics also kill beneficial bacteria and induce negative side effects — most commonly diarrhea, upset stomach, and vaginal yeast infection. For instance, antibiotics cause about one out of three people to get diarrhea by disrupting the balance of the intestinal flora, a collection of bacteria and other microorganisms in the digestive tract. This can result in an overgrowth of the Clostridium difficile bacteria that causes diarrhea. Similarly, antibiotics can disrupt the vaginal flora and cause an overgrowth of Candidayeasts to cause a yeast infection.
Probiotics are live bacteria, yeasts and other microbes intended to maintain or restore the supply of beneficial bacteria in the body, particularly the stomach and intestines. Probiotics are found naturally in certain foods, including yogurt, aged cheeses, kefir, miso, tempeh, and fermented cabbage. Dietary supplements are another common source of probiotics.
Although probiotics have been widely promoted as a way to keep your body in balance, scientific evidence for these claims have been weakened by the small size of most research studies. However, the use of probiotics to reduce antibiotic-induced side effects is now becoming more widely accepted by the medical profession.
In a recent study published in the Journal of the American Medical Association supports taking probiotics with antibiotics. A team of researchers from southern California combined and analyzed the results of 63 randomized controlled trials of probiotics for the prevention or treatment of antibiotic-associated diarrhea. The 11811 men and women included in this large combined study took a placebo or probiotics supplement along with their antibiotics. The people who took the probiotics were 42% less likely to develop diarrhea than those taking the placebo. This pooled evidence strongly suggests that probiotics can help populations of beneficial bacteria recover and more quickly restore balance in the intestines.
However, further research is needed to determine which probiotics are the most effective at preventing and treating antibiotic-associated side effects, as well as determine the optimal dose of the probiotics. Research is also needed to identify which antibiotics are most likely to induce adverse effects. Hopefully these further studies are underway.
Of course it is also important to limit your use of antibiotics, using them only for bacterial infections when necessary. Common cold and flu viruses don’t respond to antibiotics anyway.
Long-term exposure to antibiotics from agricultural run off may encourage the evolution of soil bacteria that break down and consume the antibacterial agents.
Soil microbes exposed to antibiotics over a long period evolve the ability to detoxify the compounds, and may even derive nutritional benefit in the process, according to a report out last week (December 6) in the Journal of Environmental Quality.
Antibiotics administered to promote the growth and health of livestock find their way into agricultural soils through the manure of the treated animals, which is used as fertilizer. To see how long-term exposure to these medicines affect bacteria in the soil, researchers set up an experiment more than a decade ago in which plots of land were dosed every year with a mixture of three common veterinary antibiotics—sulfamethazine, tylosin, and chlortetracycline.
Ten years on, the team found that sulfamethazine and tylosin were degraded much more rapidly in soils with a history of antibiotic exposure than in untreated soils, suggesting that antibiotic-degrading microbes are selected for over time. They also found that residues of sulfamethazine were quickly mineralized to carbon dioxide in exposed soils, but not in controls, and subsequently isolated from the treated soil a new strain of Microbacterium, a microbe that uses sulfamethazine as source of carbon and nitrogen.
The findings led the team to propose that under the selective pressure of long-term exposure to antibiotics, microbes may evolve to not only break down the compounds, but also to use them to fuel its own growth. “I think it’s kind of a game changer in terms of how we think about our environment and antibiotic resistance,” lead study author Edward Topp of Agriculture and Agri-Food Canada in London, Ontario, said in a press release.
And although the evolution of antibiotic-eating bacteria means that drugs from agricultural wastes will not linger in the soil for long, the researchers warn that the trait could be transferred to a pathogenic microbe. “A reservoir of antibiotic resistance genes in the environment that is made larger through contamination with agricultural wastes may represent an enhanced threat to human health,” the authors wrote.
Biochemistry Laboratory, Experimental Sciences Faculty, University of Huelva, Huelva 27071, Spain. firstname.lastname@example.org.
The lack of highly active endogenous promoters to drive the expression of transgenes is one of the main drawbacks to achieving efficient transformation of many microalgal species. Using the model chlorophyte Chlamydomonas reinhardtii and the paromomycin resistance APHVIII gene from Streptomyces rimosus as a marker, we have demonstrated that random insertion of the promoterless marker gene and subsequent isolation of the most robust transformants allows for the identification of novel strong promoter sequences in microalgae. Digestion of the genomic DNA with an enzyme that has a unique restriction site inside the marker gene and a high number of target sites in the genome of the microalga, followed by inverse PCR, allows for easy determination of the genomic region, which precedes the APHVIII marker gene. In most of the transformants analyzed, the marker gene is inserted in intragenic regions and its expression relies on its adequate insertion in frame with native genes. As an example, one of the new promoters identified was used to direct the expression of the APHVIII marker gene in C. reinhardtii, showing high transformation efficiencies.
Case Comprehensive Hernia Center, Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106-5047, USA.
Prosthetic mesh infection is one of the most challenging complications after hernia repair. We evaluate the efficacy of soaking mesh in antibiotics to prevent prosthetic infection in an animal model of clean-contaminated ventral hernia repair (VHR).
MATERIAL AND METHODS:
Rats underwent an acute VHR with one of four synthetic meshes (composite multifilament polyester (Parietex PCO), multifilament polyester (Parietex TET), composite monofilament polypropylene (Ventralight), or monofilament polypropylene (SoftMesh)). Prior to implantation, mesh was soaked in saline or 10 mg/ml of vancomycin for 15 min. Following implantation, meshes were contaminated with 10(4) CFU of methicillin-resistant Staphylococcus aureus (MRSA) bacteria. Thirty days after implantation, mesh samples were cultured and evaluated under scanning electron microscope for biofilm formation.
Presoaking meshes significantly improves bacterial clearance in composite meshes and multifilament polyester mesh. MRSA clearance was as follows for all meshes (saline-soaked vs. vanco-soaked): Parietex PCO (0 vs. 56 %, p = 0.006), Parietex TET (0 vs. 50 %, p = 0.01), Ventralight (20 vs. 78 %, p = 0.012), and SoftMesh (70 vs. 80 %, p = 0.6). MRSA biofilm formation was consistent with bacterial growth.
Presoaking multifilament and composite mesh in vancomycin solution reduces MRSA bacterial growth. Its implementation may reduce the risk of mesh infection in clean-contaminated cases, although further investigation with human trials should be performed.