scholarly journals Microfluidics as an Emerging Platform for Tackling Antimicrobial Resistance (AMR): A Review

2020 ◽  
Vol 16 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Sammer-ul Hassan ◽  
Xunli Zhang
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Resistance ◽  
Point Of Care ◽  
Treatment Options ◽  
Cost Effective ◽  
Droplet Microfluidics ◽  
New Drugs ◽  
Testing Tools ◽  
Antibiotics Use ◽  
Increasing Demand

Background: Antimicrobial resistance (AMR) occurs when microbes become resistant to antibiotics causing complications and limited treatment options. AMR is more significant where antibiotics use is excessive or abusive and the strains of bacteria become resistant to antibiotic treatments. Current technologies for bacteria and its resistant strains identification and antimicrobial susceptibility testing (AST) are mostly central-lab based in hospitals, which normally take days to weeks to get results. These tools and procedures are expensive, laborious and skills based. There is an ever-increasing demand for developing point-of-care (POC) diagnostics tools for rapid and near patient AMR testing. Microfluidics, an important and fundamental technique to develop POC devices, has been utilized to tackle AMR in healthcare. This review mainly focuses on the current development in the field of microfluidics for rapid AMR testing. Method: Due to the limitations of conventional AMR techniques, microfluidic-based platforms have been developed for better understandings of bacterial resistance, smart AST and minimum inhibitory concentration (MIC) testing tools and development of new drugs. This review aims to summarize the recent development of AST and MIC testing tools in different formats of microfluidics technology. Results: Various microfluidics devices have been developed to combat AMR. Miniaturization and integration of different tools has been attempted to produce handheld or standalone devices for rapid AMR testing using different formats of microfluidics technology such as active microfluidics, droplet microfluidics, paper microfluidics and capillary-driven microfluidics. Conclusion: Current conventional AMR detection technologies provide time-consuming, costly, labor-intensive and central lab-based solutions, limiting their applications. Microfluidics has been developed for decades and the technology has emerged as a powerful tool for POC diagnostics of antimicrobial resistance in healthcare providing, simple, robust, cost-effective and portable diagnostics. The success has been reported in research articles; however, the potential of microfluidics technology in tackling AMR has not been fully achieved in clinical settings.

scholarly journals Recent advances in nanoplasmonic biosensors: applications and lab-on-a-chip integration

Nanophotonics ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 123-136 ◽  
Author(s):  
Gerardo A. Lopez ◽  
M.-Carmen Estevez ◽  
Maria Soler ◽  
Laura M. Lechuga
Keyword(s):  
Point Of Care ◽  
Lab On A Chip ◽  
Cost Effective ◽  
Optical Biosensor ◽  
Point Of View ◽  
Localized Surface Plasmon ◽  
Interesting Candidate ◽  
Potential Benefits ◽  
Increasing Demand ◽  
Development And Validation

AbstractMotivated by the recent progress in the nanofabrication field and the increasing demand for cost-effective, portable, and easy-to-use point-of-care platforms, localized surface plasmon resonance (LSPR) biosensors have been subjected to a great scientific interest in the last few years. The progress observed in the research of this nanoplasmonic technology is remarkable not only from a nanostructure fabrication point of view but also in the complete development and integration of operative devices and their application. The potential benefits that LSPR biosensors can offer, such as sensor miniaturization, multiplexing opportunities, and enhanced performances, have quickly positioned them as an interesting candidate in the design of lab-on-a-chip (LOC) optical biosensor platforms. This review covers specifically the most significant achievements that occurred in recent years towards the integration of this technology in compact devices, with views of obtaining LOC devices. We also discuss the most relevant examples of the use of the nanoplasmonic biosensors for real bioanalytical and clinical applications from assay development and validation to the identification of the implications, requirements, and challenges to be surpassed to achieve fully operative devices.

Resistenze antibiotiche e nuove molecole: qual è lo scenario attuale?

2018 ◽  
Vol 85 (1_suppl) ◽  
pp. S5-S13 ◽  
Author(s):  
Andrea Novelli
Keyword(s):  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Public Health Problem ◽  
New Drugs ◽  
Beta Lactam ◽  
Important Public Health Problem ◽  
Extended Spectrum Beta Lactamase ◽  
First Choice ◽  
Tract Infections

Antibiotic resistance and new drugs in urologic setting: what we need to know? Urinary tract infections (UTIs) are among the most frequent infectious diseases, and represent an important public health problem with a substantial economic burden. In recent years the chemoresistance of the main uropathogens has significantly increased worldwide. Extended spectrum beta-lactamase (ESBL) production and multi-drug resistant (MDR) clones of Escherichia coli and Klebsiella pneumoniae are limiting available treatment options. Carbapenems and aminoglycosides are still effective in complicated UTI. New beta-lactam combinations such as ceftolozane-tazobactam and ceftazidime-avibactam may be highly useful in treating severe infections while contributing to the carbapenem sparing strategy. For uncomplicated UTI, within older antibiotics, fosfomycin trometamol may be considered a first-choice drug since it is still retaining a good activity against MDR uropathogens. On the other hand, there are extensive data showing that the administration of antimicrobials according to pharmacokinetic/pharmacodynamic (PK/PD) parameters improves the possibility of a positive clinical outcome, particularly in severely ill patients. Evidence is growing that when PK/PD parameters are used to target not only clinical cure. This article discusses the PK/PD characteristics of antimicrobial agents for the treatment of UTIs, and the pharmacological and therapeutic strategies for limiting or preventing bacterial resistance.

d-Amino acids in antimicrobial peptides: a potential approach to treat and combat antimicrobial resistance

2020 ◽  
pp. 1-19
Author(s):  
Shikha Kapil ◽  
Vipasha Sharma
Keyword(s):  
Amino Acids ◽  
Antimicrobial Resistance ◽  
Antimicrobial Peptides ◽  
De Novo ◽  
Wide Spectrum ◽  
New Drugs ◽  
Novel Treatments ◽  
Gram Positive Bacteria ◽  
Increasing Demand ◽  
Bacteria And Fungi

Antimicrobial resistance is one of the leading challenges in the human healthcare segment. Advances in antimicrobial resistance have triggered exploration of natural alternatives to stabilize its seriousness. Antimicrobial peptides are small, positively charged oligopeptides that are as potent as commercially available antibiotics against a wide spectrum of organisms, such as Gram-positive bacteria, Gram-negative bacteria, viruses, and fungal strains. In addition to their antibiotic capabilities, these peptides possess anticancer activity, activate the immune response, and regulate inflammation. Peptides have distinct modes of action and fall into various categories due to their amino acid composition. Although antimicrobial peptides specifically target the bacterial cytoplasmic membrane, they can also target the cell nucleus and protein synthesis. Owing to the increasing demand for novel treatments against the threat of antimicrobial resistance, naturally synthesized peptides are a beneficial development concept. Antimicrobial peptides are pervasive and can easily be modified using de-novo synthesis technology. Antimicrobial peptides can be isolated from natural resources such as humans, plants, bacteria, and fungi. This review gives a brief overview of antimicrobial peptides and their diastereomeric composition. Other current trends, the future scope of antimicrobial peptides, and the role of d-amino acids are also discussed, with a specific emphasis on the design and development of new drugs.

scholarly journals Economic considerations support C-reactive protein testing alongside malaria rapid diagnostic tests to guide antimicrobial therapy for patients with febrile illness in settings with low malaria endemicity

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Yoel Lubell ◽  
Arjun Chandna ◽  
Frank Smithuis ◽  
Lisa White ◽  
Heiman F. L. Wertheim ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Therapy ◽  
Diagnostic Tests ◽  
Distribution Systems ◽  
Point Of Care ◽  
Febrile Illness ◽  
Cost Effective ◽  
Rapid Diagnostic Tests ◽  
C Reactive Protein ◽  
Reactive Protein

AbstractMalaria is no longer a common cause of febrile illness in many regions of the tropics. In part, this success is a result of improved access to accurate diagnosis and effective anti-malarial treatment, including in many hard-to-reach rural areas. However, in these settings, management of other causes of febrile illness remains challenging. Health systems are often weak and other than malaria rapid tests no other diagnostics are available. With millions of deaths occurring annually due to treatable bacterial infections and the ever increasing spread of antimicrobial resistance, improvement in the management of febrile illness is a global public health priority. Whilst numerous promising point-of-care diagnostics are in the pipeline, substantial progress can be made in the interim with existing tools: C-reactive protein (CRP) is a highly sensitive and moderately specific biomarker of bacterial infection and has been in clinical use for these purposes for decades, with dozens of low-cost devices commercially available. This paper takes a health-economics approach to consider the possible advantages of CRP point-of-care tests alongside rapid diagnostic tests for malaria, potentially in a single multiplex device, to guide antimicrobial therapy for patients with febrile illness. Three rudimentary assessments of the costs and benefits of this approach all indicate that this is likely to be cost-effective when considering the incremental costs of the CRP tests as compared with either (i) the improved health outcomes for patients with bacterial illnesses; (ii) the costs of antimicrobial resistance averted; or (iii) the economic benefits of better management of remaining malaria cases and shorter malaria elimination campaigns in areas of low transmission. While CRP-guided antibiotic therapy alone cannot resolve all challenges associated with management of febrile illness in remote tropical settings, in the short-term a multiplexed CRP and malaria RDT could be highly cost-effective and utilize the well-established funding and distribution systems already in place for malaria RDTs. These findings should spark further interest amongst industry, academics and policy-makers in the development and deployment of such diagnostics, and discussion on their geographically appropriate use.

scholarly journals Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Marianne Harris ◽  
Bohdan Nosyk ◽  
Richard Harrigan ◽  
Viviane Dias Lima ◽  
Calvin Cohen ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Treatment Options ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Antiretroviral Drugs ◽  
Early Years ◽  
New Drugs ◽  
Multiple Drug ◽  
Highly Active

In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.

scholarly journals Assessment of Brazilian pharmacists’ knowledge about antimicrobial resistance

2015 ◽  
Vol 9 (03) ◽  
pp. 239-243 ◽  
Author(s):  
Fernando de Sa Del Fiol ◽  
Silvio Barberato-Filho ◽  
Luciane Cruz Lopes ◽  
Cristiane da Cassia Bergamaschi ◽  
Rodrigo Boscariol
Keyword(s):  
Antimicrobial Resistance ◽  
Health Professionals ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
New Drugs ◽  
Community Pharmacies ◽  
Level Of Knowledge ◽  
Scientific Meetings ◽  
Educational Campaigns

Introduction: Antimicrobial resistance (AR) is a multifaceted problem of global significance. In addition to developing new drugs and using antimicrobial guidelines, it is essential that health professionals understand all aspects of the problem and the most effective ways to handle it. This study evaluated pharmacists’ level of knowledge about bacterial resistance and antibiotic use in Brazil. Methodology: The study was conducted using a survey provided electronically to pharmacists in São Paulo State, Brazil. Results: In total, 754 pharmacists completed the survey. The majority of the pharmacists were young (under 30 years of age), female, and worked in community pharmacies. Pharmacists who worked in hospital or community pharmacies reported a greater AR interference in their work than did pharmacists working in other locations (p < 0.05). With respect to factors that contribute to AR, pharmacists placed little weight on the role of inadequate hand washing or lack of immunization campaigns. The pharmacists also believed that vaccination was of limited value in combating AR and instead placed the highest value on educational campaigns. The study showed that pharmacists who used package inserts and advertising material as their source for updated information had a poorer understanding of the appropriate use of antibiotics than did those who obtained their information from scientific journals, textbooks, or scientific meetings. Conclusions: The results highlight the need for adequate information regarding AR to reach health professionals such as pharmacists. Governments should promote campaigns for integrated actions to combat the serious global problem presented by AR.

scholarly journals Design & development of customizable web API for interoperability of antimicrobial resistance data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jasleen Kaur ◽  
Jasmine Kaur ◽  
Shruti Kapoor ◽  
Harpreet Singh
Keyword(s):  
Antimicrobial Resistance ◽  
Clinical Data ◽  
Data Exchange ◽  
Cost Effective ◽  
New Drugs ◽  
Data Repository ◽  
Design Development ◽  
Surveillance Network ◽  
Modeling And Analysis ◽  
Analysis System

AbstractAntimicrobial resistance (AMR) is a global health emergency. Complementary to developing new drugs, AMR can be monitored and controlled through cost-effective active surveillance of resistance. As an initiative to monitor resistance, countries all across the globe are collecting data using a variety of surveillance tools. Moreover, hospitals routinely collect the AMR data for treatment which is being stored in their Laboratory and Hospital Information systems (LIS-HIS). The generated clinical data is collected & stored in various formats, making it very difficult to analyze and generate national reports. To integrate the stored clinical data for predictive modeling and analysis, there is an immediate need for a one-stop data repository capable of importing and exporting data in simple data exchange formats (CSV/Excel). The paper highlights the design & development of i-DIA, a python-based web API to facilitate the interoperability of AMR data by automatically importing the bulk of medical data from CSV files into generic data management and analysis system. The i-DIA has been integrated and tested with the ICMR’s AMR surveillance network on in-house developed software, i-AMRSS. The i-AMRSS is presently collecting data from 31 laboratories across India and i-DIA has been used to import data generated from LIS & HIS of a few hospitals directly into the system. The paper also proposes the complete web-based framework (an extension of i-DIA) integrated with peer-to-peer system architecture.

Microarray Technology for the Detection of Antimicrobial Resistance Genes Present in Hospital and Community Acquired Methicillin Resistant S.aureus Strains

2017 ◽  
Vol 68 (11) ◽  
pp. 2546-2550
Author(s):  
Monica Licker ◽  
Andrei Anghel ◽  
Roxana Moldovan ◽  
Elena Hogea ◽  
Delia Muntean ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Dna Microarray ◽  
Bacterial Resistance ◽  
Meca Gene ◽  
Modern Medicine ◽  
Microarray Technology ◽  
Methicillin Resistant ◽  
Antimicrobial Sensitivity ◽  
Antimicrobial Resistance Genes ◽  
Mrsa Strains

Antimicrobial resistance (AMR) represents a real burden for the modern medicine. One of the most frecvently isolated hospital acquired (HA) pathogens wordlwide, is Methicillin resistant Staphylococcus aureus (MRSA). Recently not only HA, but also community-acquired MRSA (CA-MRSA) infections have been reported. A prospective study was performed between February 2009 and October 2010, with the aim to investigate bacterial resistance of CA-MRSA and HA-MRSA. DNA microarray technology has been used for the detection of 4 AMR genes for the studied MRSA strains. A number of 218 HA- S.aureus strains have been isolated, from which 89 (40. 82%) were MRSA. In the community, 1.553 S.aureus strains were isolated, out of which, 356 (22. 92%) were MRSA. From these, a number of 17 HA and 12 CA �MRSA strains have been analyzed by DNA microarray technology. From 100% phenotypically described HA- MRSA, we identified mecA gene in 10 strains (58. 83%). Other 6 strains (35. 29%) have been erm(A) positive and 4 (23. 53%) - tet(O) positive. 83. 33% (10 strains) from the CA strains had mecA gene, only one (8. 33%) was erm(A) positive and 4 (33. 33%) were erm(C) positive. DNA microarray is a method allowing the concomitant scan of multiple genes and can be done within a few hours. That type of rapid and reliable methods for antimicrobial sensitivity tests are important to start an appropriate therapy.

Recent Advances in Drug Repurposing for Parkinson’s Disease

2019 ◽  
Vol 26 (28) ◽  
pp. 5340-5362 ◽  
Author(s):  
Xin Chen ◽  
Giuseppe Gumina ◽  
Kristopher G. Virga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Discovery ◽  
De Novo ◽  
Drug Repositioning ◽  
Drug Repurposing ◽  
Cost Effective ◽  
New Drugs ◽  
Recent Advances ◽  
Clinical Drugs

:As a long-term degenerative disorder of the central nervous system that mostly affects older people, Parkinson’s disease is a growing health threat to our ever-aging population. Despite remarkable advances in our understanding of this disease, all therapeutics currently available only act to improve symptoms but cannot stop the disease progression. Therefore, it is essential that more effective drug discovery methods and approaches are developed, validated, and used for the discovery of disease-modifying treatments for Parkinson’s disease. Drug repurposing, also known as drug repositioning, or the process of finding new uses for existing or abandoned pharmaceuticals, has been recognized as a cost-effective and timeefficient way to develop new drugs, being equally promising as de novo drug discovery in the field of neurodegeneration and, more specifically for Parkinson’s disease. The availability of several established libraries of clinical drugs and fast evolvement in disease biology, genomics and bioinformatics has stimulated the momentums of both in silico and activity-based drug repurposing. With the successful clinical introduction of several repurposed drugs for Parkinson’s disease, drug repurposing has now become a robust alternative approach to the discovery and development of novel drugs for this disease. In this review, recent advances in drug repurposing for Parkinson’s disease will be discussed.

scholarly journals Evaluation of the effects of acetylcholinesterase inhibitors in the zebrafish touch-evoked response: quantitative vs. qualitative assessment

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Laura Guzman ◽  
Gisela Besa ◽  
Daniela Linares ◽  
Lara González ◽  
Caterina Pont ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Acetylcholinesterase Inhibitors ◽  
Cost Effective ◽  
Evoked Response ◽  
New Drugs ◽  
Screening Tools ◽  
Qualitative Assessment ◽  
Toxicity Screening ◽  
Novel Treatments ◽  
Ache Inhibitors

Abstract Background The difficulty of finding new treatments for neurological diseases with great impact in our society like Alzheimer’s disease can be ascribed in part to the complexity of the nervous system and the lack of quick and cost-effective screening tools. Such tools could not only help to identify potential novel treatments, but could also be used to test environmental contaminants for their potential to cause neurotoxicity. It has been estimated that 5–10% of the anthropogenic chemicals are developmental neurotoxic (DNT) and exposure to DNT compounds has been linked to several neurological diseases. Within this study we were testing the applicability of a quick and cost-effective behavioural test using zebrafish embryos: the touch-evoked response assay, in this case, an assay evaluating the swimming response to a tap in the tail. Two acetylcholinesterase (AChE) inhibitors positive controls (paraoxon and huprine Y), as well as 10 huprine-derivative compounds were tested and the results were evaluated using 2 different methods, a quantitative and a qualitative one. Results We could show that the methodology presented is able to detect behavioural effects of AChE inhibitors. A good correlation between the results obtained with the quantitative and the qualitative method was obtained (R2 = 0.84). Conclusions Our proposed method enables combination of screening for new drugs with toxicity screening in a whole embryo model alternative to animal experimentation, thereby merging 2 drug development steps into one.

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