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European Journal of Microbiology and Immunology
Authors: Julia Münch, Ralf Matthias Hagen, Martin Müller, Viktor Kellert, Dorothea Franziska Wiemer, Rebecca Hinz, Norbert Georg Schwarz and Hagen Frickmann

) 16. Buke C , Armand-Lefevre L , Lolom I , Guerinot W , Deblangy C , Ruimy R , Andremont A , Lucet JC : Epidemiology of multidrug-resistant bacteria in patients

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European Journal of Microbiology and Immunology
Authors: Hagen Frickmann, Thomas Köller, Ralf Matthias Hagen, Klaus-Peter Ebert, Martin Müller, Werner Wenzel, Renate Gatzer, Ulrich Schotte, Alfred Binder, Romy Skusa, Philipp Warnke, Andreas Podbielski, Christian Rückert and Bernd Kreikemeyer

Introduction Colonization or infection with multidrug-resistant bacteria is a frequent phenomenon in traumatized patients from war and crisis zones. In a recent assessment of 21 male Ukrainian patients who were treated at 4 Bundeswehr

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The progressive rise in multidrug-resistant (MDR) bacterial strains poses serious problems in the treatment of infectious diseases. While the number of newly developed antimicrobial compounds has greatly fallen, the resistance of pathogens against commonly prescribed drugs is further increasing. This rise in resistance illustrates the need for developing novel therapeutic and preventive antimicrobial options. The medicinal herb Nigella sativa and its derivatives constitute promising candidates. In a comprehensive literature survey (using the PubMed data base), we searched for publications on the antimicrobial effects of N. sativa particularly directed against MDR bacterial strains. In vitro studies published between 2000 and 2015 revealed that N. sativa exerted potent antibacterial effects against both Gram-positive and Gram-negative species including resistant strains. For instance, N. sativa inhibited the growth of bacteria causing significant gastrointestinal morbidity such as Salmonella, Helicobacter pylori, and Escherichia coli. However, Listeria monocytogenes and Pseudomonas aeruginosa displayed resistance against black cumin seed extracts. In conclusion, our literature survey revealed potent antimicrobial properties of N. sativa against MDR strains in vitro that should be further investigated in order to develop novel therapeutic perspectives for combating infectious diseases particularly caused by MDR strains.

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Hematológia–Transzfuziológia
Authors: Dávid Sipos, Adrienn Nyul, Krisztina Kovács, Hussain Alizadeh and Zoltán Péterfi

National Center for Epidemiology. Prevention of bacterial infections caused by multidrug-resistant bacteria guideline. [Módszertani levél a multirezisztens kórokozók által okozott fertőzések megelőzéséről] 2016

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Hematológia–Transzfuziológia
Authors: Réka Ráhel Bicskó, Renáta Nyilas, Judit Szabó, Ádám Jóna, Ferenc Magyari, Mariann Szarvas, Árpád Illés and Lajos Gergely

National Center of Epidemiology Methodological Letter about the prevention of multidrug resistant bacteria associated infections. [Módszertani levél a multirezisztens kórokozók által okozott fertőzések

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Nowadays, multidrug-resistant bacteria are considered as an increasing serious threat to public health worldwide. Global and local surveillance data are helpful in the application of the most efficient antimicrobial agent in bacterial infections. In the current study, we aimed to analyze the activity of the previously cleared agent ceftolozane/tazobactam (C/T) in African and European multidrug-resistant Gram-negative bacteria. Susceptibility testing was performed on 147 extended-spectrum β-lactamase (107 Escherichia coli and 40 Klebsiella pneumoniae) and 103 carbapenemase-producing Gram-negative bacteria using Etest according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints. Among the extended-spectrum β-lactamase producing isolates, 91 Escherichia coli isolates (85%) and 23 Klebsiella pneumoniae isolates (57.5%) were susceptible towards C/T whereas out of the 103 carbapenemase-producing isolates 102 (99.0%) were C/T-resistant. C/T should be included in susceptibility testing to fairly administer this antimicrobial agent in infections caused by multidrug-resistant bacteria. It may be considered as a therapy option for infections caused by extended-spectrum β-lactamase-producing bacteria once susceptibility to this antimicrobial combination has been confirmed.

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In recent years rapidly growing antibiotic resistance has increased interest toward natural products, especially essential oils because of their various effects. The aim of this study was to identify the chemical composition of the commercial Origanum onites essential oil (EO) and to investigate the antimicrobial activity by disc diffusion and dilution methods, against ten different ATCC strains, including eight bacteria, two yeasts and seventy-nine clinical nosocomial Escherichia coli isolates that produce extended spectrum beta lactamase (ESBL). The chemical composition of EO was analyzed by GC and GC-MS. The major compounds of the EO were determined as carvacrol (51.4%) followed by linalool (11.2%), p-cymene (8.9%) and γ-terpinene (6.7%). O. onites EO had antimicrobial activity against all standard strains and inhibited microbial growth of ESBL positive E. coli isolates. According to our results, O. onites EO may be an alternative to synthetic drug, used in combination with other antibiotics for treatment of infection caused by multidrug resistant bacteria after testing toxic effects and irritation at preferred doses on human.

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Abstract

The study of the bacteriological profile, the association of complement C3, interleukin-1beta, and zinc therapy of diabetic foot ulcers (type two) was investigated. Twenty diabetics without foot ulcers (group I), 50 diabetics with foot ulcers (group II), and 10 matched normal controls (group III) were enrolled in this study. Diabetic foot ulcers were mostly of grade 2. The most frequent organisms were Clostridium spp., Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, respectively. Vancomycin, Imipenem, and Meropenem were the most effective against Gram-positive and Gram-negative aerobes, while Imipenem, Meropenem and Chloramphenicol for Gram-positive anaerobes. Group II had abnormal levels of C3 (72%). A significant higher concentration of C3 was found in group II. Group II had abnormal levels of IL-1β (60%). A significant higher concentration of IL-1β was found in group II. Zinc therapy (25 mg/day/oral) induced a highly significant decrease in the frequency of Gram-positive anaerobes and levels of IL-1β. Significantly increases all mineral concentrations in serum level except Mn+2. The study highlights the prevalence of antibiotic multidrug resistant bacteria causing foot infections in diabetics which require combined antimicrobial therapy. Altered levels of serum complement C3 and IL-1β might be responsible for depressed immune response which might be causes for delayed wound healing and repeated infections. Zinc supplementation may help in healing the wounds by enhancing the immune response.

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Antimicrobial multidrug-resistance (MDR) constitutes an emerging threat to global health and makes the effective prevention and treatment of many, particularly severe infections challenging, if not impossible. Many antibiotic classes have lost antimicrobial efficacy against a plethora of infectious agents including bacterial species due to microbial acquisition of distinct resistance genes. Hence, the development of novel anti-infectious intervention strategies including antibiotic-independent approaches is urgently needed. Vitamins such as vitamin D and vitamin D derivates might be such promising molecular candidates to combat infections caused by bacteria including MDR strains. Using the Pubmed database, we therefore performed an in-depth literature survey, searching for publications on the antimicrobial effect of vitamin D directed against bacteria including MDR strains. In vitro and clinical studies between 2009 and 2019 revealed that vitamin D does, in fact, possess antimicrobial properties against both Gram-positive and Gram-negative bacterial species, whereas conflicting results could be obtained from in vivo studies. Taken together, the potential anti-infectious effects for the antibiotic-independent application of vitamin D and/or an adjunct therapy in combination with antibiotic compounds directed against infectious diseases such as tuberculosis, H. pylori infections, or skin diseases, for instance, should be considered and further investigated in more detail.

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Absztrakt:

Bevezetés: Hematológiai és őssejt-transzplantált betegek véráram-infekcióiról kevés adat áll rendelkezésre. Epidemiológiájuk naprakész ismerete ugyanakkor elengedhetetlen a hatékony terápia megválasztásához. Célkitűzés: Jelen kutatás célja a véráram-infekciók gyakoriságának, a kórokozók megoszlásának és rezisztenciájának elemzése, a 7 és 30 napos halálozás, illetve az ezt befolyásoló rizikófaktorok vizsgálata volt. Módszer: 2016. január és 2017. július között a Hematológiai és Őssejt-transzplantációs Osztályon ápolt betegek véráram-infekcióira vonatkozó adatok kerültek feldolgozásra. Az adatokat, az intézményi adatbázisokból gyűjtöttük össze és retrospektív módon elemeztük, leíró statisztikai módszerek alkalmazásával. A rezisztenciára vonatkozó adatokat összevetettük az Országos Epidemiológiai Központ 2016-os adataival. Eredmények: Összesen 362 beteg 624 pozitív vérmintájából 216 kontaminációnak bizonyult. A 408 nem kontamináns izolátumhoz kapcsolódó epizódok száma 353 volt. A monomikrobás (N = 320) epizódok hátterében 149 (47%) esetben Gram-pozitív, 166 (52%) esetben Gram-negatív, 5-ben (2%) pedig gomba kórokozó igazolódott. Gram-pozitív speciesek: koaguláz-negatív staphylococcusok (49%), Staphylococcus aureus (16%), Streptococcus species (15%). Gram-negatív speciesek: Escherichia coli (46%), Klebsiella species (19%) és Pseudomonas aeruginosa (17%). A Staphylococcus aureusok 19%-a, a Staphylococcus epidermidis törzsek 73%-a methicillinrezisztens, az enterococcusok 20%-a vancomycinrezisztens, az Acinetobacter baumannii és Pseudomonas aeruginosa törzsek 40% illetve 11%-a multirezisztens, a Gram-negatívok 27%-a fluorokinolonrezisztens, az Enterobacteriales 14%-a kiterjedt spektrumú béta-laktamáz-termelő volt. A 7 és 30 napos halálozás 12% és 21% volt. Halálozás szempontjából szignifikánsan magasabb kockázatot jelentett a fungaemia (p = 0,007) és a myeloma multiplex mint alapbetegség (p = 0,045). Következtetések: Kutatásunkban a Gram-negatív baktériumok enyhe túlsúlyát és az országos átlagnál kedvezőbb rezisztenciát figyeltünk meg. Halálozás szempontjából kiemelt figyelmet érdemelnek a myeloma multiplexes betegek és a gombainfekciók.

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