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mayo 14, 2021

Inhaled antibiotics during mechanical ventilation-why it will work

Inhaled antibiotics are a common therapy among patients suffering recurrent or chronic pulmonary infections. Their use is less frequent in acutely ill patients despite a strong theoretical rationale and growing evidence of their efficiency, safety and beneficial effect on reducing bacterial resistance emergence. Clinical trials of inhaled antibiotics have shown contradictory results among mechanically ventilated patients. The optimal nebulization setup, not always implemented in all trials, the…

Embelin-loaded chitosan gold nanoparticles interact synergistically with ciprofloxacin by inhibiting efflux pumps in multidrug-resistant Pseudomonas aeruginosa and Escherichia coli

A global upsurge in emergence and spread of antibiotic resistance (ABR) in bacterial populations is a serious threat for human health. Unfortunately, ABR is no longer confined to nosocomial environments and is frequently reported from community microbes as well. The ABR is resulting in shrinking potent antibiotics pool and thus necessitating novel and alternative therapies and therapeutics. Current investigation was aimed to assess the synergistic potential of a synthesized,…

Fast cycle H2O2 nebulisationagainst frequent healthcare-associated microorganisms: efficacy assessment

CONCLUSION: The very high disinfection efficacy of the fast cycle was found to be similar to that of the standard cycle. Moreover, a similar efficacy was also demonstrated when comparing between multidrug-resistant and multidrug-susceptible strains. This study provides support for a wider implementation of the technology, with the expected advantages of reducing room turnover time, costs and indirect infection transmission. Further assessment of the efficacy of this faster cycle against other…

Reducing antibiotic treatment duration for ventilator-associated pneumonia (REGARD-VAP): a trial protocol for a randomised clinical trial

INTRODUCTION: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). Using short-course antibiotics to treat VAP caused by Gram-negative non-fermenting bacteria has been reported to be associated with excess pneumonia recurrences. The «REducinG Antibiotic tReatment Duration for Ventilator-Associated Pneumonia» (REGARD-VAP) trial aims to provide evidence for using a set of reproducible clinical criteria to shorten antibiotic duration for…

A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: a prospective observational study

CONCLUSION: VAP remains a considerable source of morbidity and mortality in modern intensive care units. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS had the greatest comparative diagnostic accuracy, whereas the sensitivity of the CDC/NHSN was only marginally better than a positive TAC plus serum procalcitonin > 0.5 ng/ml. Algorithm accuracy was improved by adding serum procalcitonin > 0.5 ng/ml, but not positive quantitative TAC.

Management of peritoneal dialysis <em>Mycobacterium abscessus</em> exit-site infection: A case report and literature review

Peritoneal dialysis associated infections are common and associated with high morbidity and mortality, if not treated in a timely manner. Mycobacterium abscessus is an uncommon pathogen in peritoneal dialysis associated infections, but is resistant to standard antimicrobial therapies used. Here we present a case of a 56 year-old male with end stage kidney disease on peritoneal dialysis for 7 years who developed a Mycobacterium abscessus exit-site infection. Peritonitis and peritoneal dialysis…

Structural basis of KdpD histidine kinase binding to the second messenger c-di-AMP

The KdpDE two-component system (TCS) regulates potassium homeostasis and virulence in various bacterial species. The KdpD histidine kinases of this system contain a universal stress protein (USP) domain which binds to the second messenger cyclic-di-adenosine monophosphate (c-di-AMP) for regulating transcriptional output from this TCS in Firmicutes such as Staphylococcus aureus. However, the structural basis of c-di-AMP specificity within the KdpD-USP domain is not well understood. Here, we…