Rational Prescription Pattern of Antibiotics: A Quantitative Analysis Based on Khwaja Yunus Ali Medical College and Hospital (KYAMCH), Sirajganj, Bangladesh

Antibiotics, alternatively known as antibacterial drugs, prevent or reduce the development of germs. A decade has been added to the life expectancy of human beings since the discovery of antibiotics. Antibiotic overuse can result in resistance to a wide spectrum of diseases and bacteria. Antibiotic utility is being jeopardized by the rise of resistance. There aren't enough innovative agents to deal with the problem of resistant strains. The current study targeted to highlight the current status of antibiotic use.The study was designed as a prescription-based survey where the medicines in prescriptions were checked containing antibiotics, whether the drugs were prescribed rationally or not. The study was conducted from February to July 2018 at Khwaja Yunus Ali Medical College and Hospital, Bangladesh. Patient’s data were collected through review of patient medical records and prepared questionnaires. 100 people were interviewed, and their prescriptions were captured as photos and then checked for rationality.The antibiotics are prescribed in the group of 10 to 30 years, 31 to 50 years and more than 50 years of age.The survey demonstrated that 46% of patients know about antibiotics partially, about 74% of patients fulfill their entire course of medication and the rest of the patients stop taking medication after feeling better. Only 21% of patients knew about antibiotic resistance, whereas 37% of patients only heard about antibiotic resistance. According to the age group from low to high, 92.9%, 91.67%, 86.36% prescriptions were rational; 2.4%, 2.78%, 4.55% prescriptions were contraindicated and 4.7%, 5.56%, 9.1% prescriptions where medicines interacted with other non-antibiotic drugs, respectively. The overall rational prescription is 91%, whereas 3% of prescriptions are contraindicated and 6% of prescriptions showed interaction between antibiotics and other drugs (non-antibiotics).The study concluded that lack of knowledge and awareness of patients and inaccurate prescription data by physicians are two key factors that contribute to irrational antibiotic usage.

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Salicylate increases fitness cost associated with MarA-mediated antibiotic resistance

10.1101/454983 ◽

2018 ◽

Author(s):

T. Wang ◽

C. Kunze ◽

M. J. Dunlop

Keyword(s):

Antibiotic Resistance ◽

Wide Spectrum ◽

Environmental Chemicals ◽

Fitness Cost ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

Important Regulator ◽

Quantitative Understanding ◽

Resistant Strains ◽

The Cost

AbstractAntibiotic resistance is generally associated with a fitness deficit resulting from the burden of producing and maintaining resistance machinery. This additional cost suggests that resistant bacteria will be outcompeted by susceptible bacteria in conditions without antibiotics. However, in practice this process is slow due in part to regulation that minimizes expression of these genes in the absence of antibiotics. This suggests that if it were possible to turn on their expression, the cost would increase, thereby accelerating removal of resistant strains. Experimental and theoretical studies have shown that environmental chemicals can change the fitness cost associated with resistance and therefore have a significant impact on population dynamics. MarA (multiple antibiotic resistance activator) is a clinically important regulator in Escherichia coli which activates downstream genes to increase resistance against multiple classes of antibiotics. Salicylate is an inducer of MarA which can be found in the environment and de-represses marA’s expression. In this study, we sought to unravel the interplay between salicylate and the fitness cost of MarA-mediated antibiotic resistance. Using salicylate as a natural inducer of MarA, we found that a wide spectrum of concentrations can increase burden in resistant strains compared to susceptible strains. Induction resulted in rapid exclusion of resistant bacteria from mixed populations of antibiotic resistant and susceptible cells. A mathematical model captures the process and predicts its effect in various environmental conditions. Our work provides a quantitative understanding of salicylate exposure on the fitness of different MarA variants, and suggests that salicylate can lead to selection against MarA-mediated resistant strains. More generally, our findings show that natural inducers may serve to bias population membership and could impact antibiotic resistance and other important phenotypes.

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The crucial roles of the artificial information systems web in intelligent human organizations

Human Systems Management ◽

10.3233/hsm-2003-22303 ◽

2003 ◽

Vol 22 (3) ◽

pp. 115-124

Author(s):

Liang Thow Yick

Keyword(s):

Information Systems ◽

Complex Adaptive Systems ◽

Adaptive Systems ◽

Collective Intelligence ◽

Physical Structure ◽

Current Status ◽

Human Beings ◽

Intelligent Structure ◽

Complex Adaptive ◽

Human Thinking

Human organizations with human beings as interacting agents are complex adaptive systems. Such organizations continuously consume information, make decisions, and evolve with the changing environment. In this respect, all human organizations including businesses must enhance their collective intelligence in order to learn faster and compete more effectively. Thus, adopting an intelligent structure is vital to all businesses as the world moves deeper into the knowledge economy. The paradigmatic shift in thinking, structure, management and operation requires all intelligent human organizations to be designed around intelligence. An intelligent structure encompasses an orgmind, an intangible deep component, as well as a physical component. At the physical structure perspective, being able to identify, design and develop an artificial information systems network that synchronizes well with the orgmind is critical. The connectivity of the organization, and the manner in which it behaves, communicates and collaborates, depend on the effectiveness of its information systems network and its orgmind. The orgmind which is at least the collection of all the interacting human thinking systems must be fully aware of both the internal and external environments. Inevitably, in the new economy, intelligent human organizations must be equipped with a well-integrated intelligent information network which functions similarly to the nervous system in biological beings. This study examines the current status of artificial information systems and their networks in businesses with respect to the above concepts.

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Antibiotic Resistance Profile and Biofilm Production of Staphylococcus pseudintermedius Isolated from Dogs in Thailand

Pharmaceuticals ◽

10.3390/ph14060592 ◽

2021 ◽

Vol 14 (6) ◽

pp. 592

Author(s):

Pavarish Jantorn ◽

Hawaree Heemmamad ◽

Tanawan Soimala ◽

Saowakon Indoung ◽

Jongkon Saising ◽

...

Keyword(s):

Antibiotic Resistance ◽

Meca Gene ◽

Staphylococcus Pseudintermedius ◽

Methicillin Resistant ◽

Antibiotic Resistance Profile ◽

Biofilm Production ◽

Southern Thailand ◽

Life Threatening ◽

Suitable Treatment ◽

Resistant Strains

Staphylococcus pseudintermedius is a zoonotic pathogen that can cause life-threatening infections in animals and humans. The study of methicillin-resistant S. pseudintermedius (MRSP) and its ability to produce biofilms is important to select the most suitable treatment. The prevalence and characteristics of S. pseudintermedius isolated from dogs admitted at the Veterinary Teaching Hospital, Prince of Songkla University, Thailand were assessed. Results showed that 28.30% (15/53) of the isolates were MRSP. Amplification of the mecA gene was observed in 93.33% (14/15) MRSP. Methicillin-resistant strains revealed co-resistant patterns against other antibiotics, including chloramphenicol, clindamycin, tetracycline, clarithromycin, ciprofloxacin, and trimethoprim. In this study, all bacterial isolates produced biofilms, while 90.55% of S. pseudintermedius isolates were strong or moderate biofilm producers. Most (45–60%) of the resistant strains were strong biofilm producers, while the correlation between biofilm production and antibiotic resistance was not statistically significant. This is the first study in southern Thailand to investigate the drug-resistant profile of S. pseudintermedius and its ability to form biofilm. The results will contribute to a better understanding of the emergence and prevalence of antimicrobial resistance in S. pseudintermedius.

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Pheromone killing of multidrug-resistantEnterococcus faecalisV583 by native commensal strains

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1500553112 ◽

2015 ◽

Vol 112 (23) ◽

pp. 7273-7278 ◽

Cited By ~ 31

Author(s):

Michael S. Gilmore ◽

Marcus Rauch ◽

Matthew M. Ramsey ◽

Paul R. Himes ◽

Sriram Varahan ◽

...

Keyword(s):

Antibiotic Resistance ◽

Cross Talk ◽

Metabolic Pathways ◽

Multidrug Resistant ◽

Mobile Elements ◽

Competitive Growth ◽

Gi Tract ◽

Subsequent Infection ◽

Native Flora ◽

Resistant Strains

Multidrug-resistantEnterococcus faecalispossess numerous mobile elements that encode virulence and antibiotic resistance traits as well as new metabolic pathways, often constituting over one-quarter of the genome. It was of interest to determine how this large accretion of mobile elements affects competitive growth in the gastrointestinal (GI) tract consortium. We unexpectedly observed that the prototype clinical isolate strain V583 was actively killed by GI tract flora, whereas commensal enterococci flourished. It was found that killing of V583 resulted from lethal cross-talk between accumulated mobile elements and that this cross-talk was induced by a heptapeptide pheromone produced by nativeE. faecalispresent in the fecal consortium. These results highlight two important aspects of the evolution of multidrug-resistant enterococci: (i) the accretion of mobile elements inE. faecalisV583 renders it incompatible with commensal strains, and (ii) because of this incompatibility, multidrug-resistant strains sharing features found in V583 cannot coexist with commensal strains. The accumulation of mobile elements in hospital isolates of enterococci can include those that are inherently incompatible with native flora, highlighting the importance of maintaining commensal populations as means of preventing colonization and subsequent infection by multidrug-resistant strains.

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Changing patterns and widening of antibiotic resistance inShigellaspp. over a decade (2000–2011), Andaman Islands, India

Epidemiology and Infection ◽

10.1017/s0950268814000958 ◽

2014 ◽

Vol 143 (3) ◽

pp. 470-477 ◽

Cited By ~ 12

Author(s):

D. BHATTACHARYA ◽

H. BHATTACHARYA ◽

D. S. SAYI ◽

A. P. BHARADWAJ ◽

M. SINGHANIA ◽

...

Keyword(s):

Drug Resistance ◽

Antibiotic Resistance ◽

Wide Spectrum ◽

Resistance Pattern ◽

Third Generation ◽

Isolation And Identification ◽

Antimicrobial Drugs ◽

Drug Resistance Pattern ◽

Resistance Patterns ◽

Third Generation Cephalosporins

SUMMARYThis study is a part of the surveillance study on childhood diarrhoea in the Andaman and Nicobar Islands; here we report the drug resistance pattern of recent isolates ofShigellaspp. (2006–2011) obtained as part of that study and compare it with that ofShigellaisolates obtained earlier during 2000–2005. During 2006–2011, stool samples from paediatric diarrhoea patients were collected and processed for isolation and identification ofShigellaspp. Susceptibility to 22 antimicrobial drugs was tested and minimum inhibitory concentrations were determined for third-generation cephalosporins, quinolones, amoxicillin-clavulanic acid combinations and gentamicin. A wide spectrum of antibiotic resistance was observed in theShigellastrains obtained during 2006–2011. The proportions of resistant strains showed an increase from 2000–2005 to 2006–2011 in 20/22 antibiotics tested. The number of drug resistance patterns increased from 13 in 2000–2005 to 43 in 2006–2011. Resistance to newer generation fluoroquinolones, third-generation cephalosporins and augmentin, which was not observed during 2000–2005, appeared during 2006–2011. The frequency of resistance inShigellaisolates has increased substantially between 2000–2006 and 2006–2011, with a wide spectrum of resistance. At present, the option for antimicrobial therapy in shigellosis in Andaman is limited to a small number of drugs.

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Evidence of Another Anthropic Impact on Iguana delicatissima from the Lesser Antilles: The Presence of Antibiotic Resistant Enterobacteria

Antibiotics ◽

10.3390/antibiotics10080885 ◽

2021 ◽

Vol 10 (8) ◽

pp. 885

Author(s):

Gustavo Di Lallo ◽

Marco Maria D’Andrea ◽

Samanta Sennati ◽

Maria Cristina Thaller ◽

Luciana Migliore ◽

...

Keyword(s):

Antibiotic Resistance ◽

Animal Species ◽

Susceptibility Testing ◽

Acquired Resistance ◽

Climatic Conditions ◽

Antibiotic Resistant ◽

Associated Bacteria ◽

Improper Use ◽

Resistant Strains ◽

Drug Resistant Strains

The improper use of antibiotics by humans may promote the dissemination of resistance in wildlife. The persistence and spread of acquired antibiotic resistance and human-associated bacteria in the environment, while representing a threat to wildlife, can also be exploited as a tool to monitor the extent of human impact, particularly on endangered animal species. Hence, we investigated both the associated enterobacterial species and the presence of acquired resistance traits in the cloacal microbiota of the critically endangered lesser Antillean iguana (Iguana delicatissima), by comparing two separate populations living in similar climatic conditions but exposed to different anthropic pressures. A combination of techniques, including direct plating, DNA sequencing and antimicrobial susceptibility testing allowed us to characterize the dominant enterobacterial populations, the antibiotic resistant strains and their profiles. A higher frequency of Escherichia coli was found in the samples from the more anthropized site, where multi-drug resistant strains were also isolated. These results confirm how human-associated bacteria as well as their antibiotic-resistance determinants may be transferred to wildlife, which, in turn, may act as a reservoir of antibiotic resistance.

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Vulnerability and Importance of Arctic Wetlands as large-scale nature-based solutions for Sustainability in a Changing Climate

10.5194/egusphere-egu21-3148 ◽

2021 ◽

Author(s):

Elisie Kåresdotter ◽

Zahra Kalantari

Keyword(s):

Ecosystem Services ◽

High Resolution ◽

Large Scale ◽

Natural Capital ◽

Environmental Benefits ◽

Indigenous Populations ◽

The Arctic ◽

Current Status ◽

Human Beings ◽

Arctic Wetlands

<p>Wetlands as large-scale nature-based solutions (NBS) provide multiple ecosystem services of local, regional, and global importance. Knowledge concerning location and vulnerability of wetlands, specifically in the Arctic, is vital to understand and assess the current status and future potential changes in the Arctic. Using available high-resolution wetland databases together with datasets on soil wetness and soil types, we created the first high-resolution map with full coverage of Arctic wetlands. Arctic wetlands' vulnerability is assessed for the years 2050, 2075, and 2100 by utilizing datasets of permafrost extent and projected mean annual average temperature from HadGEM2-ES climate model outputs for three change scenarios (RCP2.6, 4.5, and 8.5). With approximately 25% of Arctic landmass covered with wetlands and 99% being in permafrost areas, Arctic wetlands are highly vulnerable to changes in all scenarios, apart from RCP2.6 where wetlands remain largely stable. Climate change threatens Arctic wetlands and can impact wetland functions and services. These changes can adversely affect the multiple services this sort of NBS can provide in terms of great social, economic, and environmental benefits to human beings. Consequently, negative changes in Arctic wetland ecosystems can escalate land-use conflicts resulting from natural capital exploitation when new areas become more accessible for use. Limiting changes to Arctic wetlands can help maintain their ecosystem services and limit societal challenges arising from thawing permafrost wetlands, especially for indigenous populations dependent on their ecosystem services. This study highlights areas subject to changes and provides useful information to better plan for a sustainable and social-ecological resilient Arctic.</p><p>Keywords: Arctic wetlands, permafrost thaw, regime shift vulnerability, climate projection</p>

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Species diversity and antibiotic resistance of Staphylococci isolated in children of the first month of life in children’s hospitals in Nizhny Novgorod

Russian Clinical Laboratory Diagnostics ◽

10.18821/0869-2084-2021-66-1-42-44 ◽

2021 ◽

Vol 66 (1) ◽

pp. 42-44

Author(s):

N. A. Gordinskaya ◽

E. V. Boriskina ◽

D. V. Kryazhev

Keyword(s):

Antibiotic Resistance ◽

Species Diversity ◽

Meca Gene ◽

Coagulase Negative Staphylococci ◽

Children's Hospitals ◽

Children’S Hospitals ◽

Minimum Number ◽

Resistant Strains

1235 strains of Staphylococci isolated in a multidisciplinary children’s clinic were analyzed. The species and antibiotic resistance of Golden and coagulase-negative Staphylococci were studied. The most frequently identified species were: S. aureus-36.06%, S. epidermidis-23.05%, S. haemolyticus-19.7%, S. hominis-14.03%. Phenotype methicillinsensitive strains had 48.9% of the allocated staphylococci, while metitillinrezistentnykh S. aureus was identified in 25.6%, and coagulase-negative staphylococci methicillinresistant- 63.2 per cent. The frequency of associated resistance to aminoglycosides, fluoroquinolones, macrolides and tetracyclines have metitillinresictant strains 92,7%, 78,3%, 83,4% and 52,05% respectively, resistant Staphylococcus and coagulase-negative staphylococci were similar. The minimum number of resistant strains was found in relation to daptomycin, no strains resistant to vancomycin and linezolid were found. Antibiotic resistance of staphylococci in children’s hospitals is determined by the presence of the mecA gene or sensitivity to cefoxitin and does not depend on the type of strain.

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Culture and Susceptibility of Levofloxacin Resistant H.pylori

QJM ◽

10.1093/qjmed/hcab100.021 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Sameh Mohamed Fahiem Ghaly ◽

Hany Ali Hussien Abd El-Rahman ◽

Mohamed Osama Aly Aly ◽

Ahmed Medhat Youssef Ibrahim Youssef

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Proper Time ◽

Wide Spectrum ◽

Signs And Symptoms ◽

Line Treatment ◽

Clarithromycin Resistance ◽

Prior Use ◽

H Pylori ◽

Main Factor

Abstract Background Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Prevalence of H.pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim is to investigate H.pylori resistant patients toward Levofloxacin and detect the most effective antibiotic in eradication of H.pylori. Objective To investigate H.pylori resistant patients toward Levofloxacin including regimens and to detect the most effective antibiotic in H.pylori eradication. Patients and Methods The present study aimed to investigate the Susceptibility of Levofloxacin Resistant H.pylori in patients who had been diagnosed and received any regimen including Levofloxacin and still signs and symptoms of H.pylori infection not releaved and after proper time of stoppage of PPI and antibiotics H.pylori Ag in stool still positive at the period from January 2019 to February 2020. Results In the present study we found a wide spectrum of resistance to rates of H. pylori, from nearly negligible rates of Rifampicin (0%), Imipenem (0%), Cefotaxime (2%), Tetracycline (6%), Doxycycline(10%), and Amoxicillin(38%). To high rates resistance to Metronidazole (100%), Erythromycin (72%), Clarithromycin (68%), Azithromycin (60%), Ciprofloxacin (52%), and Levofloxacin (48%). Conclusion Helicobacter pylori is the most common chronic bacterial infection in humans. Antibiotic resistance is a major issue nowadays. Prior use of macrolide antibiotics or metronidazole appears to increase the risk of H. pylori resistance. Clarithromycin resistance appears to be an "absolute" condition that can not be overcome by increasing the macrolide dose. Levofloxacin resistance seems to be increasing. Culture and susceptibility should be done before starting second line treatment.

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Radiation therapy for hepatocellular carcinoma: current status and perspectives from our experience

Oncology Reviews ◽

10.4081/oncol.2009.101 ◽

2011 ◽

pp. 257-264

Author(s):

Wei Jiang ◽

Zhao-chong Zeng

Keyword(s):

Hepatocellular Carcinoma ◽

Radiation Therapy ◽

Wide Spectrum ◽

Distant Metastases ◽

Current Status ◽

Radiation Technology ◽

Tumor Thrombosis ◽

Liver Cancers ◽

Advanced Stages ◽

Promising Treatment

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and is accompanied by a poor prognosis. We had reported that radiation therapy has great potential, in a wide spectrum of primary liver cancers, fromlocal advanced stage of the disease to the more advanced stages, with regional nodal metastases, tumor thrombosis, and for palliation of distant metastases. Following the initial observation that HCC is radiosensitive and with the development of radiation technology, radiotherapy has become a feasible and promising treatment modality for HCC, particularly for advanced forms of the disease. Here, we review the substantial amount of available data on radiotherapy for HCC, report on the current status of this application of radiotherapy, and propose future avenues of research.

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