scholarly journals Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Six-Year Experience of an Oncology Center of Western China

2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cancer Patients ◽  
Nosocomial Infections ◽  
Bacterial Infections ◽  
Urinary Catheter ◽  
Multidrug Resistant ◽  
Western China ◽  
Smoking History ◽  
Resistant Bacteria ◽  
Indwelling Urinary Catheter

Abstract Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant (MDR) bacteria in cancer patients. Methods: This retrospective observational study analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the patient’s survival status after infection during hospitalization. Data were analyzed by using independent samples t-test, Chi-square test, and binary logistic regression. P -values < 0.05 were considered statistically significant. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by Acinetobacter baumannii , and Stenotrophomonas maltophilia . Smoking history, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and haemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: This study confirms that MDR bacteria caused nosocomial infections were widely prevalent in cancer patients. ESBL-PE was the most commonly MDR bacteria, and the isolated MDR strains were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Former smokers, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and anemia were associated with increased in-hospital mortality. Our findings suggest that clinicians should think highly of nosocomial infections caused by MDR in cancer patients and advise policymakers to develop a guideline.

scholarly journals Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Six-Year Experience of an Oncology Center of Western China

2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cancer Patients ◽  
Nosocomial Infections ◽  
Bacterial Infections ◽  
Urinary Catheter ◽  
Multidrug Resistant ◽  
Western China ◽  
Smoking History ◽  
Resistant Bacteria ◽  
Indwelling Urinary Catheter

Abstract Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant (MDR) bacteria in cancer patients. Methods: This retrospective observational study analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the patient’s survival status after infection during hospitalization. Data were analyzed by using independent samples t-test, Chi-square test, and binary logistic regression. P -values < 0.05 were considered statistically significant. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by Acinetobacter baumannii , and Stenotrophomonas maltophilia . Smoking history, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, length of hospitalization, and haemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, former smokers, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and anemia were independent risk factors of in-hospital mortality. Our findings suggest that clinicians should think highly of nosocomial infections caused by MDR in cancer patients and advise policymakers to develop a guideline.

scholarly journals Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Seven-Year Experience of an Oncology Center in Western China

2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Cancer Patients ◽  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
Western China ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Multidrug Resistant Bacteria ◽  
Antibiotic Resistant

Abstract Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant bacteria (MDR) in cancer patients. Methods: This retrospectively analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019 and was conducted to explore the risk factors, clinical features, outcomes, and antibiotic-resistant patterns of these infections. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by ESBL-producing Klebsiella pneumonia, and Acinetobacter baumannii. Cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, length of hospitalization, hemoglobin, and albumin were independent factors for 30-day mortality in the study population. The isolated MDR bacteria were highly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, anemia, and hypoproteinemia were independent risk factors of 30-day mortality.

scholarly journals Antibiotic-Resistant Bacteria in Clams—A Study on Mussels in the River Rhine

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 571
Author(s):  
Nicole Zacharias ◽  
Iris Löckener ◽  
Sarah M. Essert ◽  
Esther Sib ◽  
Gabriele Bierbaum ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Sewage Treatment ◽  
Sewage Treatment Plant ◽  
Treatment Plant ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
River Rhine ◽  
Antibiotic Resistant Bacteria ◽  
Surrounding Water ◽  
Antibiotic Resistant

Bacterial infections have been treated effectively by antibiotics since the discovery of penicillin in 1928. A worldwide increase in the use of antibiotics led to the emergence of antibiotic resistant strains in almost all bacterial pathogens, which complicates the treatment of infectious diseases. Antibiotic-resistant bacteria play an important role in increasing the risk associated with the usage of surface waters (e.g., irrigation, recreation) and the spread of the resistance genes. Many studies show that important pathogenic antibiotic-resistant bacteria can enter the environment by the discharge of sewage treatment plants and combined sewage overflow events. Mussels have successfully been used as bio-indicators of heavy metals, chemicals and parasites; they may also be efficient bio-indicators for viruses and bacteria. In this study an influence of the discharge of a sewage treatment plant could be shown in regard to the presence of E. coli in higher concentrations in the mussels downstream the treatment plant. Antibiotic-resistant bacteria, resistant against one or two classes of antibiotics and relevance for human health could be detected in the mussels at different sampling sites of the river Rhine. No multidrug-resistant bacteria could be isolated from the mussels, although they were found in samples of the surrounding water body.

scholarly journals Liposomes as Antibiotic Delivery Systems: A Promising Nanotechnological Strategy against Antimicrobial Resistance

Molecules ◽  
2021 ◽  
Vol 26 (7) ◽  
pp. 2047
Author(s):  
Magda Ferreira ◽  
Maria Ogren ◽  
Joana N. R. Dias ◽  
Marta Silva ◽  
Solange Gil ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Private Investment ◽  
Therapeutic Index ◽  
Multidrug Resistant ◽  
Current Treatment ◽  
Delivery Systems ◽  
Resistant Bacteria ◽  
Bacterial Cells ◽  
Antimicrobial Drugs

Antimicrobial drugs are key tools to prevent and treat bacterial infections. Despite the early success of antibiotics, the current treatment of bacterial infections faces serious challenges due to the emergence and spread of resistant bacteria. Moreover, the decline of research and private investment in new antibiotics further aggravates this antibiotic crisis era. Overcoming the complexity of antimicrobial resistance must go beyond the search of new classes of antibiotics and include the development of alternative solutions. The evolution of nanomedicine has allowed the design of new drug delivery systems with improved therapeutic index for the incorporated compounds. One of the most promising strategies is their association to lipid-based delivery (nano)systems. A drug’s encapsulation in liposomes has been demonstrated to increase its accumulation at the infection site, minimizing drug toxicity and protecting the antibiotic from peripheral degradation. In addition, liposomes may be designed to fuse with bacterial cells, holding the potential to overcome antimicrobial resistance and biofilm formation and constituting a promising solution for the treatment of potential fatal multidrug-resistant bacterial infections, such as methicillin resistant Staphylococcus aureus. In this review, we aim to address the applicability of antibiotic encapsulated liposomes as an effective therapeutic strategy for bacterial infections.

scholarly journals Technologies to address antimicrobial resistance

2018 ◽  
Vol 115 (51) ◽  
pp. 12887-12895 ◽  
Author(s):  
Stephen J. Baker ◽  
David J. Payne ◽  
Rino Rappuoli ◽  
Ennio De Gregorio
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Membrane Vesicles ◽  
Multidrug Resistant ◽  
Outer Membrane Vesicles ◽  
Resistant Bacteria ◽  
Multiple Stakeholders ◽  
Global Challenge ◽  
Life Threatening ◽  
Bacterial Outer Membrane

Bacterial infections have been traditionally controlled by antibiotics and vaccines, and these approaches have greatly improved health and longevity. However, multiple stakeholders are declaring that the lack of new interventions is putting our ability to prevent and treat bacterial infections at risk. Vaccine and antibiotic approaches still have the potential to address this threat. Innovative vaccine technologies, such as reverse vaccinology, novel adjuvants, and rationally designed bacterial outer membrane vesicles, together with progress in polysaccharide conjugation and antigen design, have the potential to boost the development of vaccines targeting several classes of multidrug-resistant bacteria. Furthermore, new approaches to deliver small-molecule antibacterials into bacteria, such as hijacking active uptake pathways and potentiator approaches, along with a focus on alternative modalities, such as targeting host factors, blocking bacterial virulence factors, monoclonal antibodies, and microbiome interventions, all have potential. Both vaccines and antibacterial approaches are needed to tackle the global challenge of antimicrobial resistance (AMR), and both areas have the underpinning science to address this need. However, a concerted research agenda and rethinking of the value society puts on interventions that save lives, by preventing or treating life-threatening bacterial infections, are needed to bring these ideas to fruition.

scholarly journals Bacteriophages: the possible solution to treat infections caused by pathogenic bacteria

2017 ◽  
Vol 63 (11) ◽  
pp. 865-879 ◽  
Author(s):  
Ayman El-Shibiny ◽  
Salma El-Sahhar
Keyword(s):  
Bacterial Infections ◽  
Pathogenic Bacteria ◽  
Phage Therapy ◽  
Multidrug Resistant ◽  
Clinical Applications ◽  
Western World ◽  
Resistant Bacteria ◽  
Vaccine Production ◽  
Bacterial Populations ◽  
Antibiotic Resistant

Since their discovery in 1915, bacteriophages have been used to treat bacterial infections in animals and humans because of their unique ability to infect their specific bacterial hosts without affecting other bacterial populations. The research carried out in this field throughout the 20th century, largely in Georgia, part of USSR and Poland, led to the establishment of phage therapy protocols. However, the discovery of penicillin and sulfonamide antibiotics in the Western World during the 1930s was a setback in the advancement of phage therapy. The misuse of antibiotics has reduced their efficacy in controlling pathogens and has led to an increase in the number of antibiotic-resistant bacteria. As an alternative to antibiotics, bacteriophages have become a topic of interest with the emergence of multidrug-resistant bacteria, which are a threat to public health. Recent studies have indicated that bacteriophages can be used indirectly to detect pathogenic bacteria or directly as biocontrol agents. Moreover, they can be used to develop new molecules for clinical applications, vaccine production, drug design, and in the nanomedicine field via phage display.

scholarly journals Protein–protein interactions in bacteria: a promising and challenging avenue towards the discovery of new antibiotics

2018 ◽  
Vol 14 ◽  
pp. 2881-2896 ◽  
Author(s):  
Laura Carro
Keyword(s):  
Protein Interactions ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Protein Protein Interactions ◽  
Lead Discovery ◽  
Antibiotic Development ◽  
Cellular Processes ◽  
Ppi Networks ◽  
New Antibiotics

Antibiotics are potent pharmacological weapons against bacterial infections; however, the growing antibiotic resistance of microorganisms is compromising the efficacy of the currently available pharmacotherapies. Even though antimicrobial resistance is not a new problem, antibiotic development has failed to match the growth of resistant pathogens and hence, it is highly critical to discover new anti-infective drugs with novel mechanisms of action which will help reducing the burden of multidrug-resistant microorganisms. Protein–protein interactions (PPIs) are involved in a myriad of vital cellular processes and have become an attractive target to treat diseases. Therefore, targeting PPI networks in bacteria may offer a new and unconventional point of intervention to develop novel anti-infective drugs which can combat the ever-increasing rate of multidrug-resistant bacteria. This review describes the progress achieved towards the discovery of molecules that disrupt PPI systems in bacteria for which inhibitors have been identified and whose targets could represent an alternative lead discovery strategy to obtain new anti-infective molecules.

scholarly journals Antibiotics in Food Chain: The Consequences for Antibiotic Resistance

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 688
Author(s):  
Shashi B. Kumar ◽  
Shanvanth R. Arnipalli ◽  
Ouliana Ziouzenkova
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Food Chain ◽  
Bacterial Infections ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Alternative Strategies ◽  
Antibiotic Resistant ◽  
Continuous Use

Antibiotics have been used as essential therapeutics for nearly 100 years and, increasingly, as a preventive agent in the agricultural and animal industry. Continuous use and misuse of antibiotics have provoked the development of antibiotic resistant bacteria that progressively increased mortality from multidrug-resistant bacterial infections, thereby posing a tremendous threat to public health. The goal of our review is to advance the understanding of mechanisms of dissemination and the development of antibiotic resistance genes in the context of nutrition and related clinical, agricultural, veterinary, and environmental settings. We conclude with an overview of alternative strategies, including probiotics, essential oils, vaccines, and antibodies, as primary or adjunct preventive antimicrobial measures or therapies against multidrug-resistant bacterial infections. The solution for antibiotic resistance will require comprehensive and incessant efforts of policymakers in agriculture along with the development of alternative therapeutics by experts in diverse fields of microbiology, biochemistry, clinical research, genetic, and computational engineering.

scholarly journals Engineered Lysins With Customized Lytic Activities Against Enterococci and Staphylococci

2020 ◽  
Vol 11 ◽  
Author(s):  
Hana Sakina Binte Muhammad Jai ◽  
Linh Chi Dam ◽  
Lowella Servito Tay ◽  
Jodi Jia Wei Koh ◽  
Hooi Linn Loo ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Catalytic Domain ◽  
Therapeutic Potential ◽  
Multidrug Resistant ◽  
Species Specificity ◽  
Resistant Bacteria ◽  
Modular Architecture ◽  
Narrow Spectrum ◽  
Cell Wall Binding ◽  
Peptidoglycan Hydrolysis

The emergence of multidrug-resistant bacteria has made minor bacterial infections incurable with many existing antibiotics. Lysins are phage-encoded peptidoglycan hydrolases that have demonstrated therapeutic potential as a novel class of antimicrobials. The modular architecture of lysins enables the functional domains – catalytic domain (CD) and cell wall binding domain (CBD) – to be shuffled to create novel lysins. The CD is classically thought to be only involved in peptidoglycan hydrolysis whereas the CBD dictates the lytic spectrum of a lysin. While there are many studies that extended the lytic spectrum of a lysin by domain swapping, few have managed to introduce species specificity in a chimeric lysin. In this work, we constructed two chimeric lysins by swapping the CBDs of two parent lysins with different lytic spectra against enterococci and staphylococci. We showed that these chimeric lysins exhibited customized lytic spectra distinct from the parent lysins. Notably, the chimeric lysin P10N-V12C, which comprises a narrow-spectrum CD fused with a broad-spectrum CBD, displayed species specificity not lysing Enterococcus faecium while targeting Enterococcus faecalis and staphylococci. Such species specificity can be attributed to the narrow-spectrum CD of the chimeric lysin. Using flow cytometry and confocal microscopy, we found that the E. faecium cells that were treated with P10N-V12C are less viable with compromised membranes yet remained morphologically intact. Our results suggest that while the CBD is a major determinant of the lytic spectrum of a lysin, the CD is also responsible in the composition of the final lytic spectrum, especially when it pertains to species-specificity.

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