RESUMO
Antibiotic-resistant bacteria are currently an important public health concern posing a serious threat due to their resistance to the current arsenal of antibiotics. Uropathogens Escherichia coli (UPEC), Proteus mirabilis, Klebsiella pneumoniae and Enterococcus faecalis, antibiotic-resistant gram-negative bacteria, cause serious cases of prolonged UTIs, increasing healthcare costs and potentially even leading to the death of an affected patient. This review discusses current knowledge about the increasing resistance to currently recommended antibiotics for UTI therapy, as well as novel therapeutic options. Traditional antibiotics are still a part of the therapy guidelines for UTIs, although they are often not effective and have serious side effects. Hence, novel drugs are being developed, such as combinations of ß-lactam antibiotics with cephalosporins and carbapenems. Siderophoric cephalosporins, such as cefiderocol, have shown potential in the treatment of individuals with significant gram-negative bacterial infections, as well as aminoglycosides, fluoroquinolones and tetracyclines that are also undergoing clinical trials. The use of cranberry and probiotics is another potential curative and preventive method that has shown antimicrobial and anti-inflammatory effects. However, further studies are needed to assess the efficacy and safety of probiotics containing cranberry extract for UTI prevention and treatment. An emerging novel approach for UTI treatment is the use of immuno-prophylactic vaccines, as well as different nanotechnology solutions such as nanoparticles (Nanoparticles). Nanoparticles have the potential to be used as delivery systems for drugs to specific targets. Furthermore, nanotechnology could enable the development of nano antibiotics with improved features by the application of different Nanoparticles in their structure, such as gold and copper Nanoparticles. However, further high-quality research is required for the synthesis and testing of these novel molecules, such as safety evaluation and pharmacovigilance.
RESUMO
The aims of this study were to compare predictive values of hsTroponin I assay with contemporary assays and its usefulness in diagnosis of acute coronary syndrome (ACS). We also aimed to determine reference values of the assay and the possibility of fast ACS diagnosis using hsTnI. The study included 26 patients with ongoing chest pains and suspected ACS. ACS diagnosis was determined using electrocardiographic changes and international guidelines. Biochemical parameters were measured using standard tests which included Troponin I, hsTroponin I, CK, CK-MB and CRP. 10 (38.5 %) patients out of 26 were diagnosed with ACS. Median age was 63.92 years. Comparison of predictive values showed that hsTnI and TnI had an advantage before CK, CK-MB and CRP. hsTnI showed no significant improvements over TnI. With an perfect negative predictive value at admission, hsTnI is recommended for use as a rule-out method for ACS in patients with chest pain and suspected ACS on admission. hsTnI was superior to contemporary TnI assays only as a rule-out method for suspected ACS patients at admission.
