Inhibiting Effect of Electrochemically Activated Aqueous Solutions on Growth Biofilms

In the present work, we examined intraperitoneal (3 and 6 mg/kg body weight [bw]; Rot-3-ip and Rot-6-ip, respectively) andoral (50 and 100 mg/kg bw; Rot-50-po and Rot-100-po, respectively) rotenone induced PD modeled Wistar rats to evaluatechanges in various haematological parameters. While Rot-3-ip for 21 days and Rot-50-po for 28 days caused majorParkinson’s disease (PD)-related alterations, Lewy bodies were only detected in Rot-3-ip rats. The Rot-6-ip and Rot-100-potreatments caused lethal toxicity. The ip and po rotenone doses significantly (p < 0.05) and dose dependently altered severalhaematological variables (haemoglobin [Hb], red blood cells [RBCs], white blood cells [WBCs] and packed cell volume[PCV])

Relationship between virulence factor genes in coagulase-negative Staphylococcus spp. and failure of antimicrobial treatment of subclinical mastitis in sheep / Relação entre genes de fatores de virulência em Staphylococcus spp. coagulase-negativos e a falha do tratamento antimicrobiano da mastite subclínica ovina

Coagulase-negative Staphylococcus spp. (CNS) are the main microorganisms involved in ovine mastitis. Treatment at the end of lactation can contribute towards cure and prevention of subclinical cases during the subsequent lactation. However, virulence factors and resistance mechanisms presented by CNS can decrease cure rates. The aims of the study were to identify the species of CNS in milk of mastitic ewes with and without antimicrobial treatment, and to investigate the presence of genes relating to resistance of β-lactam antimicrobials, formation of biofilms, production of enterotoxins and production of the toxic shock syndrome toxin. Cases of failure in the treatment were related with the presence/absence of the respective genes. Sixty sheep were divided into three groups: G1, without treatment; G2, animals treated via the intramammary route with 100mg of cloxacillin during drying off; and G3, sheep treated via the intramammary route with 50 mg of nanoparticulate cloxacillin. Milk samples were gathered during drying off and 15 and 30 days after the parturition of the subsequent lactation. The analyses to identify the species of CNS were carried out by means of the internal transcribe spacer technique and the investigation of the genes responsible for the virulence factors and resistance to oxacillin was performed using the polymerase chain reaction (PCR) technique. No sample was positive for the mecA gene. The only gene relating to production of enterotoxins was sec. Among the genes relating to production of biofilm, icaD was the only one identified in the three experimental groups. Staphylococcus warneri was the main species of CNS isolated during the pre and post-partum periods of the sheep. The species carrying genes relating to production of enterotoxins and biofilms were present in uncured sheep.(AU)

Staphylococus spp. coagulase-negativos (SCN) estão entre os principais micro-organismos envolvidos na mastite ovina. O tratamento ao final da lactação pode contribuir com a cura e a prevenção de casos subclínicos durante a lactação seguinte. Todavia, fatores de virulência e mecanismos de resistência apresentados por SCN podem reduzir as taxas de cura. Os objetivos desse estudo foram identificar as espécies de SCN no leite de ovelhas com mastite com e sem tratamento antimicrobiano e investigar a presença de genes relacionados com resistência a antibióticos beta lactâmicos, formação de biofilmes, produção de enterotoxinas e produção da toxina da síndrome do choque tóxico. Casos de falhas no tratamento foram relacionados com a presença/ausência dos respectivos genes. Sessenta ovelhas foram divididas em três grupos: G1, sem tratamento; G2, animais tratados via intramamária com 100mg de cloxacilina antes da secagem; e G3, ovelhas tratadas via intramamária com 50 mg de cloxacilina nanoparticulada. Amostras de leite foram obtidas durante a secagem e 15 e 30 dias depois do parto na lactação seguinte. As análises para identificar as espécies de SCN foram conduzidas por meio da técnica de Internal transcribe spacer e a investigação dos genes responsáveis pelos fatores de virulência e resistência à oxacilina foi realizada usando a técnica reação em cadeia da polimerase. Nenhuma amostra foi positiva para o gene mecA. O único gene relacionado com a produção de enterotoxinas foi o sec. Dentre os genes relacionados com a produção de biofilme, icaD foi o único identificado nos três grupos experimentais. Staphylococcus warneri foi a principal espécie de SCN isolada durante o pré e pós-parto. As espécies que apresentaram genes relacionados com a produção de enterotoxinas e biofilmes estavam presentes nas ovelhas não curadas.(AU)

Partial budget analysis of prepartum antimicrobial therapy and Escherichia coli J5 vaccination of dairy heifers and their effect on milk production and milk quality parameters / Análise econômica da terapia antimicrobiana no pré-parto e da vacinação com Escherichia coli J5 em novilhas leiteiras e seu efeito sobre a produção e qualidade de leite

This study aimed to determine whether prepartum antimicrobial and/or Escherichia coli J5 vaccination in dairy heifers influence the milk production, milk quality, and estimate their economic benefit. Thus, 33 dairy heifers were enrolled in four groups using a split-splot design. Groups were: (G1) prepartum antimicrobial infusion and vaccination with an E. coli J5 bacterin, (G2) prepartum antimicrobial infusion, (G3) vaccination with an E. coli J5 bacterin, and (G4) control heifers. Composite milk samples for somatic cell count, total bacteria count and milk composition were collected 15 days after calving and every 15 days until the end of the experiment. Bacteriological analysis was carried out at the end of study. The milk production and the incidence of clinical cases of mastitis, as well as the costs associated with them were recorded. The results demonstrate a reduction on clinical mastitis rates by preventive strategies, which implicated in lower volume of discarded milk (0.99, 1.01, 1.04 and 3.98% for G1, G2, G3 and G4, respectively) and higher economic benefit. Thus, in well-managed dairy herds the prevention of heifer mastitis by vaccination or antimicrobial therapy can reduce the amount of antimicrobials needed to treat clinical mastitis cases and the days of discarded milk.

O presente estudo objetivou realizar uma análise econômica do tratamento antimicrobiano no pré-parto e/ou da vacinação com Escherihia coli J5 em novilhas leiteiras, e seu efeito sobre a produção e qualidade de leite. Portanto, utilizou-se o delineamento split-splot em esquema fatorial, no qual 33 novilhas da raça Holandesa foram divididas aleatoriamente em quatro grupos: (G1) antimicroianoterapia no pré-parto e vacinação com E. coli J5, (G2) antimicrobianoterapia no pré-parto, (G3) vacinação com E. coli J5 e (G4) controle. Amostras compostas de leite foram coletadas para contagem de células somáticas, contagem bacteriana total e composição do leite 15 dias após o parto, e a cada 15 dias até o término do experimento. A análise bacteriológica do leite foi realizada ao término do experimento. A produção de leite e a incidência dos casos clínicos de mastite, assim como, os custos associados à antimicrobianoterapia no pré-parto e/ou vacinação com E. coli J5 foram registrados. Os resultados demonstraram redução dos casos clínicos de mastite com a implementação das medidas preventivas resultando no menor volume de leite descartado (0,99, 1,01, 1,04 e 3,98% para os animais dos grupos G1, G2, G3 e G4, respectivemente) e maior benefício econômico. Desta forma, em rebanhos bem manejados, a implementação da antimicrobianoterapia no pré-parto e vacinação com E. coli J5 e novilhas pode reduzir a quantidade de antimicrobianos necessário para o tratamento de casos de mastite clínica durante a lactação, resultando em menor número de dias em que o leite é descartado.

Terapia antimicrobiana utilizada de forma empírica y prudente en los pacientes con enfermedades vasculares periféricas / The empiric and prudent anti-microbial therapy used in the patients with vascular peripheral disease

Introducción: el uso inadecuado de los antimicrobianos ha traído un incremento de la resistencia de los microorganismos, aumento de los costos hospitalarios y calidad deficiente en los servicios brindados. Objetivo: orientar una política terapéutica racional de los antimicrobianos sobre todo cuando son utilizados de forma empírica. Fuente de datos: revisión bibliográfica realizada entre 2000-2014 en las bases de datos MedLine, Hinari, Cochrane, PubMed, de revistas líderes en la publicación de artículos de interés. Las palabras claves fueron: antibióticos, resistencia bacteriana, tratamiento antimicrobiano. Se consultaron estudios de cohorte prospectivos, retrospectivos, clínicos, epidemiológicos, revisiones bibliográficas y ensayos clínicos. Síntesis de los datos: aportamos información que puede ser útil en la práctica médica y procederes y métodos creados por diferentes equipos de especialistas en el tema y de consensos internacionales. Siempre que sea posible, debe tenerse en cuenta la toma de un exudado para cultivo y antibiograma que muestre los posibles antimicrobianos a los que el germen es sensible y seleccionar el apropiado según su efectividad con el espectro más estrecho posible, menos efectos indeseables y el más económico para utilizarlo en la dosis adecuada y durante el tiempo necesario según el peso, la talla, la edad y afecciones renales o hepáticas del paciente, para ajuste de las dosis; además, aplicarlo por la vía de administración más sencilla y menos riesgosa, para alcanzar el efecto terapéutico durante el tiempo más corto posible. Conclusiones: se sugiere una terapia antimicrobiana racional y prudente, sobre todo cuando es utilizada de forma empírica. Su efecto es elevar la eficacia de los fármacos empleados en pacientes con afecciones infecciosas frecuentes en angiología(AU)

Introduction: inadequate use of the antimicrobial drugs has brought about increase microorganism resistance, the rise of hospital costs and poor quality of the rendered services. Objective: to advise on the rational therapeutic policy for the use of antimicrobials, mainly when used empirically. Data source: literature review conducted from 2000 to 2014 MedLine, Hinari, Cochrane PubMed databases and in leading journals that publish articles of interest. The following keywords were used: antibiotics, bacterial resistance and antimicrobial treatment. Prospective, retrospective, clinical, epidemiological cohort studies as well as literature reviews and clinical assays were all consulted. Data synthesis: this paper provided some useful information in medical practice, as well as some procedures and methods created by teams of experts on this topic and international consensus on the theme. One must take into account whenever possible exudates for culturing and antibiogram that show the likely antimicrobials to which the microorganism is sensitive, and select the most appropriate based on its narrowest spectrum effectiveness, less adverse effects and the most economic to be used at the right dosage and for the required time depending on weight, size, age and renal or liver conditions of the patient. Additionally, the antimicrobial should be applied through the simplest and less risky way of administration in order to achieve the best results of treatment at the shortest term. Conclusions: It is suggested that rational and prudent antimicrobial therapy should be used in patients, mainly if it is empirically applied. Its effect is to increase efficacy of drugs for patients suffering frequent vascular infections(AU)

Survey on de-escalation of empiric broad-spectrum antibiotics treatment for patients in intensive care unit / 中华临床感染病杂志

Objective To investigate de-escalation of empiric broad-spectrum antibiotics treatment for patients in intensive care unit (ICU).Methods Data of the patients discharged from ICU in the Second Affiliated Hospital of Zhejiang University from July 1 to December 31 of 2012 and from July 1 to December 31 of 2013 were retrospectively reviewed.Patients with initial use of empirical broad-spectrum antibiotics within 3 d after ICU admission were included in the study.Clinical data including status of infection,the initial empiric antimicrobial therapy,pathogens culture and adjustment of antibiotics in 5 days were analyzed.Results A total of 841 patients were discharged from ICU during the study periods and antibiotics were used in 786 (93.5％) patients.Among 786 patients,389 (49.5％) were treated empirically with broad-spectrum antibiotics,but only 269 (69.2％) had evidences of bacterial infections.Of the 389 patients with empiric antibiotics use,de-escalation of antibiotics was applied only in 6 (1.54％) patients within 5 days after the initiation of treatment.In 269 patients with evidence of infection,specimen sampling and culture were performed in 248 (92.2％) patients within 3 days,among which 165 samples were positive,and the clinical isolates were mainly multi-drug resistant gram negative bacilli and colonized bacteria in oropharyngeal cavity.De-escalation was applied only in 4 (1.49％,4/269) patients with evidences of bacterial infections.Conclusion Broad-spectrum antibiotics as initial empiric therapy is common for patients in ICU,however de-escalation of empiric therapy is rarely applied even in patients with positive results in pathogen isolation and culture.

Manejo de la infección del tracto urinario en lactantes febriles: experiencia de tratamiento antimicrobiano intravenoso ambulatorio / Treatment of urinary tract infections in febrile infants: experience of outpatient intravenous antibiotic treatment

Objective: To describe the feasibility, effectiveness and safety of intravenous (iv) outpatient treatment in 2 to 24 month-old children with febrile urinary tract infection (UTI). Method: Children presenting to the ER, between April 2003-2005, with fever and no identifiable focus who had a diagnosis of UTI were randomized to receive iv antibiotic in the hospital or in an outpatient facility. Children were started on amikacin or ceftriaxona according to physician criteria followed by antimicrobial adjustment based on uriñe culture result and a later switch to an oral antimicrobial. Uriñe cultures were performed during and after completing the antimicrobial course. Adherence and effectiveness of antimicrobial treatment and treatment-associated complications were analyzed. Results: The study included 112 patients, 58 inpatient children and 54 outpatient children, with an average age of 7.7 months. Duration of iv treatment didnot differ among groups (2.8 days (SD 1.2) 2.7 +0.91 days ininpatients vs 2.9 + 1.9 days in outpatients (p = 0.22). In 100 percent of outpatient children and 100 percent of inpatient children (overall 101/101) uriñe cultures were negative on day 5. None of the children had a treatment-associated complication. Cost analysis yielded 73 percent of saving money (overall cost for inpatient treatment US 9,815 vs outpatient treatment US 2,650). Conclusions: Outpatient iv treatment in patients between 2 and 24 months with UTI and fever was effective, safe and of lower cost.

Objetivo: Describir la factibilidad, efectividad y seguridad del tratamiento intravenoso (iv) ambulatorio en niños de 2 meses a 2 años con infección del tracto urinario (ITU) y fiebre. Método: Entre abril 2003 y abril 2005 se realizó un estudio prospectivo en pacientes con fiebre sin foco derivados de Emergencia Infantil, finalmente diagnosticados como ITU, estableciéndose dos grupos con tratamiento iv: uno hospitalizado y otro ambulatorio. Se administró amikacina o ceftriaxona según criterio del médico de turno, hasta obtener resultado del urocultivo, y posteriormente se cambió a tratamiento oral. Se controló urocultivo intra y post tratamiento registrándose adherencia, efectividad y complicaciones. Resultados: Se incluyeron 112 pacientes (58 hospitalizados y 54 ambulatorios), con edad promedio de 7,8 meses. El promedio de días de tratamiento iv fue 2,8 días (SD 1,2) sin diferencias significativas entre ambos grupos 2,7 +0,91 días en los internados vs 2,9 + 1,9 días en los ambulatorios (p = 0,22). En 100 por ciento de ambos grupos de pacientes (en globo 101/101) el urocultivo obtenido al día 5 fue estéril. No hubo complicaciones del tratamiento o sobre la vía venosa. El análisis de costos concluyó que en globo, el manejo ambulatorio representó un 73 por ciento de ahorro económico (1.430.000 pesos chilenos vs 5.300.000 pesos en el sólo rubro de día-cama Conclusiones: El tratamiento iv ambulatorio en pacientes con ITU febril entre 2 y 24 meses fue efectivo, seguro y a un menor costo.

Antimicrobial Treatment of Bacterial Infections of the Central Nervous System

Advances in the antimicrobials lower the mortality rate in most infectious diseases. But bacterial infections of the CNS is still one of the life-threatening infections. Untreated acute bacterial meningitis is fatal in 70% to 100% of patients. With appropriate antibacterial therapy, the case-fatality rate had been greatly reduced with death occurring principally in the very young the very old, or those with potentially lethal underlying diseases. Early recognition and antimicrobial therapy is mostly desirable. The causes of acute bacterial meningitis vary with age and the clinical setting under which the infection occurs. Empirical antibiotic treatment was started immediately on suspicion of the bacterial meningitis prior to etiologic diagnosis. The most effective and least toxic bactericidal drugs should be selected on the basis of known or predicted susceptibility of the bacterial cause of the disease. After the identification of the specific organism and determination of susceptibilities, effective antimicrobial was administered parenterally at maximum dose. The third-generation cephalosporins(cefotaxime, ceftriaxone, and ceftzidime) offer new advantages in the treatment of meningitis because they are active at the CSF concentraions obtainable. Newer antimicrobials(monobactam and newer quinolones) with improved access and an appropriately focused spectrum for CNS infections will become available.