Search Results (1,314)

A chemical investigation of the soft coral Lobophytum sp. and the sponge Xestospongia sp. from the South China Sea led to the isolation of five steroids, including two new compounds (1 and 4) and one known natural product (3). Compounds 1–3 were derived from the soft coral Lobophytum sp., while 4 and 5 were obtained from the sponge Xestospongia sp. The structures of these compounds were determined by extensive spectroscopic analysis, the time-dependent density functional theory–electronic circular dichroism (TDDFT-ECD) calculation method, and comparison with the spectral data previously reported in the literature. The antibacterial and anti-inflammatory activities of isolated compounds were evaluated in vitro. Compounds 1–3, 4, and 5 exhibited weak antibacterial activity against vancomycin-resistant Enterococcus faecium G1, Streptococcus parauberis KSP28, Photobacterium damselae FP2244, Lactococcus garvieae FP5245, and Pseudomonas aeruginosa ZJ028. Moreover, compound 3 showed significant anti-inflammatory activity by inhibiting lipopolysaccharide (LPS)-induced NO production in RAW 264.7 cells, with an IC₅₀ value of 13.48 μM. Full article

Background/Objectives: The prolonged use of antibiotics is closely related to increased infections caused by Clostridioides difficile (Cdiff). Plant-origin compounds have been expanding in recent years as the best opportunity to identify new synergic therapies to combat antibiotic-associated diseases. Mexico has incredible plant biodiversity; natural compounds with antibacterial properties are an alternative treatment. The main objective of this study was to analyze the effect of medicinal plants with an antibacterial action against toxigenic clinical Cdiff strains that have a synergic effect on the antibiotics commonly used to combat this disease. Methods: The plants were selected for plants that were previously used in research, and their extracts were tested against Cdiff strains. The antibacterial activity, synergy, and antagonism between the extracts and their synergic effect with antibiotics were evaluated. Results: Our results demonstrated that some extracts have effective antimicrobial activity and synergic effects with vancomycin and metronidazole. Conclusions: This study suggests that plant extracts and plant compounds derived from these extracts could be used as synergic-antibiotic therapy to combat Cdiff infections. Full article

Background: Postoperative infection following anterior cruciate ligament reconstruction (ACLR) is a rare yet severe complication that can compromise patient outcomes, leading to prolonged recovery, graft failure, and knee dysfunction. Although infection rates are reported to be less than 2%, it remains essential to implement strategies to reduce infection risk and improve surgical outcomes. Methods: This review explores current evidence on the prevention of infections in ACLR, emphasizing the importance of timely antibiotic prophylaxis and vancomycin presoaking of grafts, which has been associated with a substantial reduction in infection rates. Results: Empirical antibiotic therapy should be started immediately after joint aspiration when infection is suspected. Treatment must prioritize culture-specific antibiotic regimens to optimize patient outcomes. Surgical intervention with arthroscopic debridement and irrigation needs to occur as soon as the diagnosis of infection is made. Often, this is performed with a focus on retaining the graft in order to preserve knee stability, if possible. Careful intraoperative management, along with the aid of infectious disease specialists, is paramount to help optimize outcomes following infection after ACLR. Conclusions: This review emphasizes the need for treatment protocols and highlights areas for future research to establish clear guidelines on infection after ACLR, especially with decisions of graft retention versus removal. Full article

Background/Objectives: The growing resistance of bacteria to antibiotics is a serious problem in health care. The present study aims to assess the drug resistance of Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis and Streptococcus pneumoniae isolated from infections in a multispecialty hospital over a 6-year period. Methods: Identification and antimicrobial susceptibility testing were performed using the VITEK^®2 automated system (Biomerieux). Results and Conclusions: Based on data from the analyzed hospital, MRSA strains were the etiological factor of 18–28% of S. aureus infections. In each year from 2017 to 2022, the percentage of MSSA strains steadily exceeded the number of MRSA strains. The MRSA strains isolated show significant sensitivity to antibiotic groups other than β-lactams, such as aminoglycosides, tetracyclines, cotrimoxazole, linezolid and vancomycin. Ciprofloxacin is the antibiotic to which S. aureus displays the second-highest resistance, after methicillin. In the case of MRSA strains, almost 100% lack of sensitivity to quinolines was found. An increase in the number of infections caused by strains of the Enterococcus genus was observed. For E. faecium strains, the percentage of vancomycin-resistant strains reached as much as 41% in 2018. Among the resistant strains in E. faecalis, VREs (Vancomycin-Resistant Enterococci) slightly predominate, while GREs (Glycopeptide-Resistant Enterococci) are much more prevalent in E. faecium. The data show that the percentage of S. pneumoniae strains insensitive to ampicillin ranged from 6% to 17%. In 2017, the percentage of strains resistant to this antibiotic reached 17%, while in 2022, their share decreased to 9%. In 2021–2022, the percentage of strains resistant to erythromycin was as high as 33%. This resistance is related to the MLS (macrolides, lincosamides, streptogramines B) mechanism. An increase in S. pneumoniae resistance to 100% was observed in 2017 and 2019. In the analyzed six-year period, from 2020 (beginning of the pandemic), in some groups of antibiotics, a significant increase in consumption in DDD/100 person-days was recorded. This is most visible in the case of fluoroquinolones. The analysis carried out will increase the effectiveness of empirical therapy in the hospital and the prudent use of antibiotics to limit the selection of multidrug-resistant strains. Full article

Vancomycin-intermediate Staphylococcus aureus (VISA) is a multi-drug-resistant pathogen of significant clinical concern. Various S. aureus strains can cause infections, from skin and soft tissue infections to life-threatening conditions such as bacteremia and pneumonia. VISA infections, particularly bacteremia, are associated with high mortality rates, with 34% of patients succumbing within 30 days. This study aimed to develop predictive models for VISA (including hVISA) bacteremia outcomes using data mining techniques, potentially improving patient management and therapy selection. We focused on three endpoints in patients receiving traditional vancomycin therapy: VISA persistence in bacteremia after 7 days, after 30 days, and patient mortality. Our analysis incorporated 29 risk factors associated with VISA bacteremia. The resulting models demonstrated high predictive accuracy, with 82.0–86.6% accuracy for 7-day VISA persistence in blood cultures and 53.4–69.2% accuracy for 30-day mortality. These findings suggest that data mining techniques can effectively predict VISA bacteremia outcomes in clinical settings. The predictive models developed have the potential to be applied prospectively in hospital settings, aiding in risk stratification and informing treatment decisions. Further validation through prospective studies is warranted to confirm the clinical utility of these predictive tools in managing VISA infections. Full article

Background/Objectives: Vancomycin is a reserve antibiotic that is frequently prescribed for central venous catheter (CVC)-associated infections in hemodialysis patients. Hemodialysis patients are very fragile patients and the presence of CVCs increases the risk of sepsis. We conducted a prospective study, evaluating the needs of changes in vancomycin dosing for treatment based on the use of the new 2020 vancomycin dosing guidelines, to increase drug safety (preventing subtherapeutic or supratherapeutic doses and offering therapeutic concentrations of the drug) in a particular group of patients with sepsis caused by catheter infections and being on intermittent hemodialysis. Methods: This prospective study included patients with sepsis caused by catheter infections and being on intermittent hemodialysis, treated with vancomycin, admitted in the nephrology department and intensive care unit (ICU). Vancomycin levels were adjusted according to the 2020 vancomycin guidelines. Results: In our study, nine (45%) patients had a vancomycin AUC between 400 and 600 mcg × h/mL, five (25%) patients had a subtherapeutic AUC, and six (30%) patients had a supratherapeutic AUC. It is important to mention that in 10 (50%) of the patients included in the study, the loading and maintenance doses mentioned in the protocol were respected, but 50% of them had a supratherapeutic AUC. We observed that a supratherapeutic AUC occurred when the loading dose was 1500 mg or 2000 mg, and in one case at 1000 mg with a low BMI. Conclusions: a therapeutic level of vancomycin can often be difficult to achieve because of different reasons, mainly in hemodialysis patients. Full article

Healthcare-associated infections (HAIs) significantly increase morbidity, mortality, length of hospital stays, and costs, particularly among ICU patients. Despite standard interventions, catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) remain major HAI contributors. This study evaluated the efficacy of daily 2% chlorhexidine gluconate (CHG) bathing in reducing HAI incidence, specifically CAUTI, CLABSI, and multidrug-resistant organisms (MDROs), in a 20-bed ICU at a regional hospital. Using a prospective, uncontrolled before-and-after design, we compared traditional soap-water bathing (pre-intervention period) with CHG bathing over a one-year intervention and one-year post-intervention follow-up. The total number of patients and patient days admitted to the ICU per year were around 1330–1412 patients and 6702–6927 patient days, respectively, during 2018–2020. Results showed a significant reduction in HAI incidence rates from 3.43‰ to 0.58‰ (p < 0.05) during the intervention and sustained benefits post-intervention. Incidences of CAUTI and CLABSI decreased markedly (p < 0.05), with reduced MDRO isolates, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, carbapenem-resistant Acinetobacter baumannii, and Pseudomonas aeruginosa. Our findings support the implementation of daily CHG bathing as an effective strategy to reduce HAI and MDROs in ICU settings. Full article

Objective: This study aimed to investigate the etiology, pathogens, antibiotic susceptibility, treatments, and factors influencing the visual prognosis of pediatric post-traumatic endophthalmitis (PTE) to provide valuable insights for clinical diagnosis and treatment. Results: A total of 301 children were included, with 142 (47.2%) cultures yielding positive results. Gram-positive cocci were the predominant pathogens (71.1%), with high sensitivity to vancomycin (95.4%). Pars plana vitrectomy (PPV) was performed in 216 eyes (71.8%), with emergency or immediate vitrectomy within 24 h of hospitalization performed on 171 eyes (56.8%). The first intravitreal antibiotic injection, consisting of ceftazidime and norvancomycin, was administered to 248 patients (82.4%). The absence of retinal detachment (OR, 0.191; 95% CI, 0.065–0.560; p = 0.002), normal intraocular pressure (OR, 1.894; 95% CI, 1.151–3.117; p = 0.012), and no lens extraction (OR, 0.187; 95% CI, 0.069–0.504; p < 0.001) were found to be independent factors associated with better visual outcomes (BCVA) in pediatric PTE patients. Methods: A retrospective analysis was conducted on pediatric PTE patients treated between January 2012 and June 2022. Data were collected on clinical characteristics, causative pathogens, antibiotic sensitivity, treatments, and visual outcomes. Conclusions: Gram-positive cocci are the most common pathogens in pediatric PTE, with early vitrectomy and intravitreal ceftazidime and norvancomycin being the most effective treatments. Favorable visual outcomes are strongly associated with the absence of retinal detachment, normal intraocular pressure, and no lens extraction. These findings highlight the need for timely surgical and antimicrobial interventions tailored to each patient to improve visual prognosis. Full article

Background/Objectives: Antimicrobial resistance (AMR) in Enterococcus species from poultry production represents a significant public health threat due to the potential transmission of AMR through the food chain. This study aimed to examine the relative prevalence, resistance patterns, and mannitol fermentation capacity of Enterococcus isolates from various poultry production systems in Spain over a seven-year period (2017–2023). Methods: A total of 215 Enterococcus isolates were analyzed. Phenotypic assessments were conducted to determine resistance rates and metabolic capacities, while genotypic characterization focused on detecting vancomycin-resistance genes (vanA, vanB, vanC, and vanD). Results: Enterococcus faecalis (62.3%) and Enterococcus faecium (29.77%) were the predominant species, primarily isolated from broilers (74.88%), with the highest frequency observed in one-week-old chicks (31.16%). High resistance rates to tetracyclines and streptogramins were identified, while resistance to vancomycin (0.47%) and tigecycline (3.03%) was low. Interestingly, a significant reduction in tetracyclines resistance was shown in this period for Enterococcus faecalis (from 100% to 70% (2017–2023) and Enterococcus faecium (from 100% to 40% (2018–2023)). Multidrug resistance (MDR) was detected in 26.98% of isolates. Mannitol fermentation tests revealed high metabolic capacity in Enterococcus faecalis (99.25%) and Enterococcus faecium (96.88%), associated with adaptability and virulence potential. Genotypic analysis showed a very low prevalence of vanB and vanC genes. Conclusions: These findings highlight the critical need for targeted surveillance and intervention strategies in poultry production to mitigate the risks posed by MDR Enterococcus to public health. Full article

Microorganisms, including pathogens that cause skin, respiratory, and urinary tract infections, are widespread in our environment. Despite routine cleaning with bleach and disinfectants, the transmission of pathogens still occurs, leading to potential infectious diseases. This study aimed to determine the antibacterial effect of two coating formulas against common environmental pathogens like Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, Salmonella sp., vancomycin-resistant Enterococcus faecium, and Klebsiella pneumoniae. The antibacterial coatings exhibited efficacy against these pathogens, with a bacterial reduction rate (R) greater than two, even after prolonged bleach cleaning. However, UV exposure may affect the efficacy of such coatings. The antibacterial coatings can eliminate the need for repetitive consumption of toxic detergents and reduce cleaning manpower, making them an environmentally friendly product for safety control and infection prevention. Full article

Brain abscesses are invasive infections of the central nervous system with a high level of treatment complexity especially in pediatric patients. Here, we describe a 3-month-old infant with multiple brain abscesses caused by methicillin-susceptible Staphylococcus aureus (MSSA). The patient was initially treated with empirical antibiotics (ceftriaxone, metronidazole, vancomycin). Upon MSSA identification, therapy was optimized by switching vancomycin to linezolid to improve tissue penetration. Therapeutic drug monitoring (TDM) was performed to check linezolid levels in the plasma and pus of the abscess, confirming drug penetration into brain tissue. A two-stage surgical drainage approach, consisting of repeated pus aspiration through an intracystic catheter, was then performed to achieve a significant reduction in abscess size. After nine weeks of antibiotic therapy, the patient was discharged in good clinical condition. This case highlights the role of linezolid for the treatment of complicated CNS infections and the importance of a multidisciplinary approach, combining TDM-based antibiotic therapy with timely and eventually repeated surgery, in order to effectively treat brain abscesses. Full article

Background/Objectives: Endophthalmitis is an intraocular microbial infection that can lead to permanent blindness, even with prompt anti-microbial therapy. Multi-drug-resistant organisms are on the rise, potentially limiting the efficacy of current empiric antibiotic therapies of intravitreal ceftazidime and vancomycin. Cefiderocol is a recent FDA- and EMA-approved antibiotic for multi-drug-resistant Gram-negative bacteria. Methods: To better understand its potential utility in the treatment of ocular infections, the MIC of cefiderocol was compared to ceftazidime and amikacin in endophthalmitis bacterial isolates using Epsilometer testing. Because vancomycin is commonly given concomitantly as part of empiric endophthalmitis treatment, possible synergistic and antagonistic effects of concomitant vancomycin and cefiderocol were also evaluated. Results: Cefiderocol was found to have lower MIC values compared to ceftazidime for Pseudomonadales or Enterobacterales species. When comparing the MICs of cefiderocol and vancomycin, there appeared to be no antagonism between the two antibiotics. Conclusions: This is the first report exploring the use of cefiderocol in endophthalmitis strains. The results of this study show this is a promising antibiotic for multi-drug-resistant Gram-negative organisms but further research is needed to investigate its intraocular safety profile. Full article

Background: This study investigates bacterial etiology and antibiotic resistance in pediatric leukemia patients to determine the impact of chronic pathology on treatment efficacy. Methods: Thirty cases of children aged 1–16 years (18 boys, 12 girls) were analyzed, identifying 13 pathogens, including 8 Gram-positive and 5 Gram-negative bacteria. Results: Among the patients, 11 girls presented with acute lymphoblastic leukemia (ALL) type B, while one boy and one girl had acute myeloid leukemia, and, as for boys, three had ALL type T and two had pre-B ALL. The most common pathogens were methicillin-resistant Staphylococcus aureus (MRSA, 11 patients), methicillin-sensitive Staphylococcus aureus (MSSA, 6 patients), Klebsiella spp., and Staphylococcus epidermidis. Due to the patients’ compromised health, most required intensive care and strong antibiotic regimens, including linezolid, vancomycin, and ertapenem, which showed limited resistance. Conclusions: These findings highlight the critical importance of understanding bacterial resistance patterns to guide effective treatments in vulnerable populations. Knowing specific resistance profiles can be lifesaving, allowing for tailored therapies that improve survival rates in children with leukemia facing serious bacterial infections. Focusing on the dual aspects of pediatric patients and multidrug-resistant bacterial infections, this study aims to highlight the importance of addressing these factors together to enhance therapeutic approaches in vulnerable populations. Full article

Green propolis, particularly from the unique flora of the Brazilian Caatinga biome, has gained significant interest due to its diverse chemical composition and biological activities. This study focuses on the chemical characterization and antimicrobial evaluation of Caatinga green propolis. Twelve compounds were isolated through different chromatographic techniques, including flavanones (naringenin, 7-O-methyleriodictyol, sakuranetin), flavones (hispidulin, cirsimaritin), flavonols (quercetin, quercetin-3-methyl ether, kaempferol, 6-methoxykaempferol, viscosine, penduletin), and one chalcone (kukulkanin B). Using liquid chromatography–quadrupole time-of-flight tandem mass spectrometry (LC-QToF-MS), a total of 55 compounds excluding reference standards were tentatively identified, which include flavonoids, phenolic acids derivatives, and alkaloids, with flavonols, flavanones, and flavones being predominant. Antimicrobial testing against pathogens revealed that the crude extract exhibited low inhibitory activity, against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) (IC₅₀: 148.4 and 120.98 µg/mL, respectively). Although the isolated compounds showed limited individual activity, a fraction containing sakuranetin and penduletin (Fraction 8) exhibited moderated activity against Cryptococcus neoformans (IC₅₀: 47.86 µg/mL), while a fraction containing quercetin and hispidulin showed moderated activity against VRE (IC₅₀: 16.99 µg/mL). These findings highlight the potential application of Caatinga green propolis as an antimicrobial agent, particularly against resistant bacterial strains, and underscore the importance of synergistic interactions between compounds in enhancing biological effects. Full article

This cross-sectional study assessed the prevalence, bacterial distribution, antimicrobial susceptibility, and potential risk factors associated with subclinical mastitis (SCM) in small-holder dairy herds in Gansu Province, Northwest China. Forty small-holder cow farms were randomly selected from eight cities/counties in six districts of Gansu Province, and a total of n = 530 lactating cows were included in this study. SCM prevalence was noted at 38.87% and 9.72% at the cow and quarter levels, respectively, based on the California Mastitis Test (CMT). The prevalence of the recovered bacterial species was noted as follows: S. agalactiae (36.02%), S. aureus (19.43%), coagulase-negative staphylococci (CNS) (16.11%), S. dysgalactiae (12.80%), E. coli (9.00%), and S. uberis (6.64%). All isolated bacteria were 100% multi-drug-resistant (MDR) except S. aureus (87.8% MDR). Antimicrobial susceptibility profiles revealed the increased resistance (>85%) of these pathogens to penicillin, streptomycin, trimethoprim–sulfamethoxazole, vancomycin, and erythromycin. However, these pathogens showed increased susceptibility to ampicillin, amoxicillin–sulbactam, ceftazidime, neomycin, kanamycin, spectinomycin, norfloxacin, ciprofloxacin, and doxycycline. The multivariate regression analysis demonstrated that old age, high parity, late lactation, lesions on teats, previous history of clinical mastitis, higher milk yield, and milking training were found to be potential risk factors (p < 0.001) associated with developing SCM in small-holder dairy cows in Gansu Province, China. These findings highlight the need for routine surveillance, antimicrobial stewardship, and effective preventive strategies to mitigate SCM in small-holder dairy production and their possible impacts, i.e., increased antimicrobial resistance and infection, on public health. Full article