Sample records for optimizing antibiotic usage

  1. Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.

    Broom, A; Gibson, A F; Broom, J; Kirby, E; Yarwood, T; Post, J J


    Antibiotic optimization in hospitals is an increasingly critical priority in the context of proliferating resistance. Despite the emphasis on doctors, optimizing antibiotic use within hospitals requires an understanding of how different stakeholders, including non-prescribers, influence practice and practice change. This study was designed to understand Australian hospital managers' perspectives on antimicrobial resistance, managing antibiotic governance, and negotiating clinical vis-à-vis managerial priorities. Twenty-three managers in three hospitals participated in qualitative semi-structured interviews in Australia in 2014 and 2015. Data were systematically coded and thematically analysed. The findings demonstrate, from a managerial perspective: (1) competing demands that can hinder the prioritization of antibiotic governance; (2) ineffectiveness of audit and monitoring methods that limit rationalization for change; (3) limited clinical education and feedback to doctors; and (4) management-directed change processes are constrained by the perceived absence of a 'culture of accountability' for antimicrobial use amongst doctors. Hospital managers report considerable structural and interprofessional challenges to actualizing antibiotic optimization and governance. These challenges place optimization as a lower priority vis-à-vis other issues that management are confronted with in hospital settings, and emphasize the importance of antimicrobial stewardship (AMS) programmes that engage management in understanding and addressing the barriers to change. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. [Usage of antibiotics in hospitals].

    Ternák, G; Almási, I


    The authors publish the results of a survey conducted among hospital records of patients discharged from eight inpatient's institutes between 1-31st of January 1995 to gather information on the indications and usage of antibiotics. The institutes were selected from different part of the country to represent the hospital structure as much as possible. Data from the 13,719 documents were recorded and analysed by computer program. It was found that 27.6% of the patients (3749 cases) received antibiotic treatment. 407 different diagnosis and 365 different surgical procedures (as profilaxis) were considered as indications of antibiotic treatment (total: 4450 indications for 5849 antibiotic treatment). The largest group of patients receiving antibiotics was of antibiotic profilaxis (24.56%, 1093 cases), followed by lower respiratory tract infections (19.89%, 849 cases), uroinfections (10.53%, 469 cases) and upper respiratory tract infections. Relatively large group of patients belonged to those who had fever or subfebrility without known reason (7.35%, 327 cases) and to those who did not have any proof in their document indicating the reasons of antibiotic treatment (6.4%, 285 cases). We can not consider the antibiotic indications well founded in those groups of patients (every sixth or every fifth cases). The most frequently used antibiotics were of [2-nd] generation cefalosporins. The rate of nosocomial infections were found as 6.78% average. The results are demonstrated on diagrams and table.

  3. Optimizing antibiotic usage in adults admitted with fever by a multifaceted intervention in an Indonesian governmental hospital.

    Hadi, U.; Keuter, M.; Asten, H.A.G.H. van; Broek, P. van den


    OBJECTIVE: To optimize antimicrobial treatment of patients with fever upon admission to the department of internal medicine of Dr Soetomo Hospital in Surabaya, Indonesia. METHOD: Prospective intervention study. The intervention comprised development of a consensus guideline, an official declaration

  4. Antibiotic usage pattern in selected poultry farms in Ogun state ...

    A survey was conducted from March 2011 to July 2011 on antibiotic usage pattern in selected poultry farms in Ogun State. Using a well-structured questionnaire, a total of 58 poultry farms were randomly surveyed from the four geo-political zones of Ogun State. All the 58 (100%) poultry farms used one or more antibiotics.

  5. Assessment of Antibiotic Usage in Some Selected Livestock Farms ...

    A survey to assess the use of antibiotics was conducted in 120 livestock farms across the 4 agricultural zones of Oyo state, Nigeria. Data were collected through the use of structured questionnaires on respondents characteristics; educational status, usage, adherence to prescription and withdrawal periods and were ...

  6. Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.

    Sperlich, Johannes M; Grimbacher, Bodo; Workman, Sarita; Haque, Tanzina; Seneviratne, Suranjith L; Burns, Siobhan O; Reiser, Veronika; Vach, Werner; Hurst, John R; Lowe, David M

    Patients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated. To describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations. We performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID. There were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%. Patients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  7. Making Antibiotic Choices: Formula Derivation and Usage in the ...

    formulae was demonstrated in the rational selection of antibiotics most appropriate in the empirical ... antibiotics provides a suitable means of making antibiotic choices in the empirical treatment of ... decisions are made on their choices.

  8. The analysis of animal faeces as a tool to monitor antibiotic usage

    Berendsen, B.J.A.; Wegh, R.S.; Memelink, J.; Zuidema, T.; Stolker, A.A.M.


    The analysis of antibiotics in animal faeces is important to obtain more insight in the possible formation of bacterial resistance in the animals¿ gut, to learn about the dissemination of antibiotics to the environment, to monitor trends in antibiotic usage and to detect the illegal and off-label

  9. The RESET Mindset Model applied on decreasing antibiotic usage in dairy cattle in the Netherlands.

    Lam, T J G M; Jansen, J; Wessels, R J


    Prudent use of antibiotics is important to prevent antibiotic resistance in humans and in animals. For this reason politicians demanded a decrease of total antibiotic use and of use of critically important antibiotics in animal husbandry in the Netherlands. In the dairy sector the use of antibiotics almost halved in the years 2009-2015, with a decrease of the use of critically important antibiotics to very low levels. To realize a sustainable decrease in antibiotic usage, the mindset towards the subject was considered crucial. Based on several models from social psychology, the RESET Mindset Model was used. This model contains the most important cues to change human behaviour, being Rules and regulations, Education and information, Social pressure, Economics, and Tools. To change behaviour of groups in order to reach a tipping point, it is of utmost importance to not choose among the different cues, but to use them all. In order to decrease antibiotic usage in dairy cattle in the Netherlands several actions, obliged as well as voluntary, were undertaken. An independent veterinary medicine authority was founded that became active for all animal sectors. In the dairy sector a national database on antibiotic usage called MediRund was developed, which made transparency and benchmarking on antibiotic usage at the national and the herd level possible. Several other activities are described, such as herd health and treatment plans, selective dry cow therapy, and the strong limitation on the use of critically important antibiotics. Antibiotic usage at the herd level, referred to as the 'antibiotic number', became an important and socially accepted herd level parameter. The actions undertaken worked through different cues, all part of the RESET Mindset Model. As such, different types of dairy farmers sensitive to different types of cues were motivated to change their behaviour. Antibiotic usage in dairy cattle in the Netherlands decreased significantly by intense

  10. Qualitative evaluation of antibiotic usage in pediatric patients

    Hindra Irawan Satari; Agus Firmansyah; Theresia Theresia


    Background Antibiotics are among the most commonly prescribed drug for pediatric patients. Inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistence. Antibiotic uses can be evaluated quantitatively and qualitatively. Objective To qualitatively evaluate antibiotic use in patients using Gyssens algorithm. Methods We performed a descriptive, retrospective study of matient medical records of those admitted to the pediatric ward fro...

  11. Qualitative evaluation of antibiotic usage in pediatric patients

    Hindra Irawan Satari


    Methods We performed a descriptive, retrospective study of matient medical records of those admitted to the pediatric ward from January 1 – June 30, 2009. Records were screened for patient antibiotic use, followed by qualitative evaluation using Gyssens algorithm on data from patient who received antibiotic treatment. Results We found 49.2% of subject were prescribed antibiotics. The majority of patients given antibiotics were aged 1 month - 1 year (39.3%. Antibiotic use was categorized by therapy type : empirical, prophylactic, or definitive. We found empirical therapy in 73% of cases, prophylactic in 8%, and definitive in 15%. Cefotaxime was the most common antibiotic used (25.1%, followed by ceftazidime (14% and cotrimoxazole (1%. 39.6% of subjects were given antibiotics appropriately, while 48.3% were given inappropriately. In 3.3% of patients, antibiotics were given without indication and in 8.8% there was insufficient data. Conclusions Of hospitalized patients receiving antibiotic treatment at the Departement of Child Health, Cipto Mangunkusumo Hospital, 39.6% were given antibiotic appropriately, while 48.3% were given antibiotics inappropriately. Cefotaxime was the most commonly used, as well as most inappropriately given antibiotic.

  12. [Antibiotic prescription usage and assessment in geriatric patients].

    Dinh, Aurélien; Davido, Benjamin; Salomon, Jérôme; Le Quintrec, Jean-Laurent; Teillet, Laurent


    Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Optimizing antibiotic selection in treating COPD exacerbations

    Attiya Siddiqi


    Full Text Available Attiya Siddiqi, Sanjay SethiDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Veterans Affairs Western New York Health Care System and University of Buffalo, State University of New York, Buffalo, New York, USAAbstract: Our understanding of the etiology, pathogenesis and consequences of acute exacerbations of chronic obstructive pulmonary disease (COPD has increased substantially in the last decade. Several new lines of evidence demonstrate that bacterial isolation from sputum during acute exacerbation in many instances reflects a cause-effect relationship. Placebo-controlled antibiotic trials in exacerbations of COPD demonstrate significant clinical benefits of antibiotic treatment in moderate and severe episodes. However, in the multitude of antibiotic comparison trials, the choice of antibiotics does not appear to affect the clinical outcome, which can be explained by several methodological limitations of these trials. Recently, comparison trials with nontraditional end-points have shown differences among antibiotics in the treatment of exacerbations of COPD. Observational studies that have examined clinical outcome of exacerbations have repeatedly demonstrated certain clinical characteristics to be associated with treatment failure or early relapse. Optimal antibiotic selection for exacerbations has therefore incorporated quantifying the risk for a poor outcome of the exacerbation and choosing antibiotics differently for low risk and high risk patients, reserving the broader spectrum drugs for the high risk patients. Though improved outcomes in exacerbations with antibiotic choice based on such risk stratification has not yet been demonstrated in prospective controlled trials, this approach takes into account concerns of disease heterogeneity, antibiotic resistance and judicious antibiotic use in exacerbations.Keywords: COPD, exacerbation, bronchitis, antibiotics

  14. Intestinal candidiasis and antibiotic usage in children: case study of ...

    Conclusion: The results of this study showed a high prevalence of intestinal candidiasis among children in Nsukka. Strong associations were observed between the presence of intestinal candidiasis and diarrhoea, age and use of antibiotics (p<0.001). Keywords: Intestinal candidiasis, children, antibiotic use, diarrhea ...

  15. Irrational antibiotic usage in boarding secondary school settings in ...

    Objective: To assess the prevalence of antibiotic misuse among boarding secondary school students in Dar es Salaam. Methodology: This descriptive cross-sectional study was conducted over 3-month period amongst boarding secondary school students. A randomized sample of students was recruited from at least 3 ...

  16. Veterinary antibiotic usage in the Netherlands in 2010

    Bondt, N.; Puister-Jansen, L.F.; Veen, van der H.B.; Bergevoet, R.H.M.; Douma, B.E.; Vliet, van A.L.J.; Wehling, K.W.


    The objective of this study is to obtain detailed insight into the exposure of farm animals to antibiotics, by monitoring both sales data at the national level and more specifically data per animal species. The results of the study can be used by the Ministry of Economic Affairs, Agriculture and

  17. Cost and usage patterns of antibiotics in a tertiary care neurosurgical unit

    Manish Singh Sharma


    Full Text Available Objectives: The routine use of prophylactic antibiotics in neurosurgery has been shown to significantly reduce surgical site infection rates. The documentation of non-surgical site, nosocomial infections in neurosurgical patients remains limited, despite this being a stimulus for prolific antibiotic usage. The actual quantum of antibiotic use in neurosurgery and its role in infection control remain both undocumented and controversial. The authors address this issue with a cost-effectiveness study using historical controls. Materials and Methods: Bacteriologically positive body fluid samples were used to quantify infection rates in the year 2006 and compared with those in the year 1997. Itemized drug lists obtained from dedicated neurosurgical intensive care units and wards were used to quantify antibiotic usage and calculate their costs. Results were compared using both historical and internal controls. The monetary conversion factor used was INR 40=US$1. Results: A total of 3114 consecutive elective and emergency neurosurgical procedures were performed during the study period. 329 patients (10.6% were recorded to have bacteriologically positive body fluid samples, and 100,250 units of antibiotics were consumed costing Rs. 14,378,227.5 ($359,455.7. On an average, an operated patient received 32.2 units of antibiotics valued at Rs. 4,617 ($115.4. The crude infection rates were recorded to have reduced significantly in comparison to 1997, but did not differ between mirror intra-departmental units with significantly different antibiotic usage. Conclusions: Antibiotics accounted for 31% of the per capita cost of consumables for performing a craniotomy in the year 2006. This estimate should be factored into projecting future package costs.

  18. Optimizing block-based maintenance under random machine usage

    de Jonge, Bram; Jakobsons, Edgars

    Existing studies on maintenance optimization generally assume that machines are either used continuously, or that times until failure do not depend on the actual usage. In practice, however, these assumptions are often not realistic. In this paper, we consider block-based maintenance optimization

  19. Mastitis treatment-Reduction in antibiotic usage in dairy cows.

    Krömker, V; Leimbach, S


    Animal-friendly, economical, resource-saving milk production provides the basis for sustained consumer acceptance. Bovine mastitis plays a decisive role in the dairy industry-disturbing animal health and welfare and causing considerable economic losses on the other hand. Currently, antimicrobial treatment is indispensable to keep bovine udder health, animal welfare and economic aspects in balance. On the contrary, emergence and spread of antimicrobial resistance (AMR) is an urgent matter of particular public interest, and as a consequence, antimicrobial usage (AMU) in production livestock is a critically discussed subject. In urgent need of future reduction in AMU in the dairy industry, this review article describes and discusses possible approaches promising prompt implementation, including therapeutical alternatives as well as pro- and metaphylactic concepts such as the implementation of evidence-based mastitis therapy concepts and selective dry cow treatment (sDCT), in search of the most effective and contemporary methods for decreasing AMU and AMR in dairy production. © 2017 Blackwell Verlag GmbH.

  20. The analysis of animal faeces as a tool to monitor antibiotic usage.

    Berendsen, Bjorn J A; Wegh, Robin S; Memelink, Joost; Zuidema, Tina; Stolker, Linda A M


    The analysis of antibiotics in animal faeces is important to obtain more insight in the possible formation of bacterial resistance in the animals׳ gut, to learn about the dissemination of antibiotics to the environment, to monitor trends in antibiotic usage and to detect the illegal and off-label use of antibiotics. To facilitate these studies a comprehensive method for the analysis of trace levels of 44 antibiotic compounds including tetracyclines, quinolones, macrolides and sulfonamides in animal faeces by liquid chromatography in combination with tandem mass spectrometric (LC-MS/MS) detection is reported. The method is fully validated according to European regulation and showed satisfactory quantitative performance according to the stringent criteria adopted, with the exception of some of the macrolide compounds, which can be analysed with somewhat high measurement uncertainty. A large survey was carried out monitoring swine and cattle faeces and the outcomes were striking. In 55% of the swines, originating from 80% of the swine farms and in 75% of the calves, originating from 95% of the cattle farms, antibiotics were detected. Oxytetracycline, doxycycline and sulfadiazine were the most detected antibiotics, followed by tetracycline, flumequine, lincomycin and tylosin. Over 34% of the faeces samples contained two or more different antibiotics with a maximum of eight. Possible explanations for these findings are given and the effects are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl


    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  2. Is there an improvement of antibiotic use in China? Evidence from the usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals.

    Zhou, Wen-Juan; Luo, Zhen-Ni; Tang, Chang-Min; Zou, Xiao-Xu; Zhao, Lu; Fang, Peng-Qian


    The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program (NASP), the overall usage and the prophylactic use of antibiotic for type I incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for type I incision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type I incision operations decreased by 16.22% (Pbench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.

  3. Using Chemical Reaction Kinetics to Predict Optimal Antibiotic Treatment Strategies.

    Abel Zur Wiesch, Pia; Clarelli, Fabrizio; Cohen, Ted


    Identifying optimal dosing of antibiotics has proven challenging-some antibiotics are most effective when they are administered periodically at high doses, while others work best when minimizing concentration fluctuations. Mechanistic explanations for why antibiotics differ in their optimal dosing are lacking, limiting our ability to predict optimal therapy and leading to long and costly experiments. We use mathematical models that describe both bacterial growth and intracellular antibiotic-target binding to investigate the effects of fluctuating antibiotic concentrations on individual bacterial cells and bacterial populations. We show that physicochemical parameters, e.g. the rate of drug transmembrane diffusion and the antibiotic-target complex half-life are sufficient to explain which treatment strategy is most effective. If the drug-target complex dissociates rapidly, the antibiotic must be kept constantly at a concentration that prevents bacterial replication. If antibiotics cross bacterial cell envelopes slowly to reach their target, there is a delay in the onset of action that may be reduced by increasing initial antibiotic concentration. Finally, slow drug-target dissociation and slow diffusion out of cells act to prolong antibiotic effects, thereby allowing for less frequent dosing. Our model can be used as a tool in the rational design of treatment for bacterial infections. It is easily adaptable to other biological systems, e.g. HIV, malaria and cancer, where the effects of physiological fluctuations of drug concentration are also poorly understood.

  4. Inducing optimal substitution between antibiotics under open access to the resource of antibiotic susceptibility.

    Herrmann, Markus; Nkuiya, Bruno


    This paper designs a bio-economic model to examine the use of substitute antibiotic drugs (analogs) sold by an industry that has open access to the resource of the antibiotic class's susceptibility (treatment effectiveness). Antibiotics are characterized by different expected recovery rates and production costs, which in conjunction with the class's treatment susceptibility determines their relative effectiveness. Our analysis reveals that the high-quality antibiotic drug loses its comparative advantage over time making the low-quality drug the treatment of last resort in the market equilibrium and the social optimum when antibiotic susceptibility cannot replenish. However, when antibiotic susceptibility is renewable, both antibiotics may be used in the long run, and the comparative advantage of the high-quality drug may be restored in the social optimum that allows lowering infection in the long run. We develop the optimal tax/subsidy scheme that would induce antibiotic producers under open access to behave optimally and account for the social cost of infection and value of antibiotic susceptibility. We show that the welfare loss associated with the uncorrected open-access allocation is highest; when the resource of antibiotic susceptibility is non-renewable, high morbidity costs are incurred by individuals, and low social discount rates apply. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Post-surgical infections and perioperative antibiotics usage in pediatric genitourinary procedures.

    Ellett, Justin; Prasad, Michaella M; Purves, J Todd; Stec, Andrew A


    Post-surgical infections (PSIs) are a source of preventable perioperative morbidity. No guidelines exist for the use of perioperative antibiotics in pediatric urologic procedures. This study reports the rate of PSIs in non-endoscopic pediatric genitourinary procedures at our institution. Secondary aims evaluate the association of PSI with other perioperative variables, including wound class (WC) and perioperative antibiotic administration. Data from consecutive non-endoscopic pediatric urologic procedures performed between August 2011 and April 2014 were examined retrospectively. The primary outcome was the rate of PSIs. PSIs were classified as superficial skin (SS) and deep/organ site (D/OS) according to Centers for Disease Control and Prevention guidelines, and urinary tract infection (UTI). PSIs were further stratified by WC1 and WC2 and perioperative antibiotic usage. A relative risk and chi-square analysis compared PSI rates between WC1 and WC2 procedures. A total of 1185 unique patients with 1384 surgical sites were reviewed; 1192 surgical sites had follow-up for inclusion into the study. Ten total PSIs were identified, for an overall infection rate of 0.83%. Of these, six were SS, one was D/OS, and three were UTIs. The PSI rate for WC1 (885 sites) and WC2 (307 sites) procedures was 0.34% and 2.28%, respectively, p antibiotics (0.35% vs. 0.33%). All WC2 procedures received antibiotics. Post-surgical infections are associated with significant perioperative morbidity. In some studies, PSI can double hospital costs, and contribute to hospital length of stay, admission to intensive care units, and impact patient mortality. Our study demonstrates that the rate of PSI in WC1 operations is low, irrespective of whether the patient received perioperative antibiotics (0.35%) or no antibiotics (0.33%). WC2 operations were the larger source of morbidity with an infection rate of 2.28% and a 6.7 fold higher increase in relative risk. WC1 procedures have a rate of

  6. Evaluation of antibiotic usage in swine reproduction farms in Umbria region based on the quantitative analysis of antimicrobial consumption

    Fausto Scoppetta


    Full Text Available Antibiotic use in food-producing animals has considerable impact on public health, especially with respect to the development and spread of antibiotic resistance. Pigs represent one of the main species in which antibiotics are frequently used for different purposes. Surveillance of antibiotic consumption and dose appropriateness, through novel approaches based on defined daily doses, is strongly needed to assess farms’ antibiotic risk, in terms of spread of antibiotic resistance and possibile presence of residues in meat. In this study, antibiotic consumption was monitored in 14 swine reproduction farms, together with managerial, structural, and health aspects. Most of the controlled farms (65% were classified as at medium antibiotic risk, 21% at high antibiotic risk, and 14% at low antibiotic risk. Critical aspects of antibiotic administration concerned treatments for suckling and weaner piglets, oral antibiotic administration, treatment and diagnosis of gastroenteric infections, and use of critically important antimicrobials for human medicine, especially colistin. These aspects could be considered critical aspects of antibiotic use in from-farrow-to-wean/finish swine farms in the Umbria region and must be controlled to minimize risks. Even though a small number of farms in Umbria region are at high antibiotic risk, the risk of antibiotic resistance should be minimized, and management and biosecurity of the farms should be improved by extending the use of antimicrobial susceptibility tests and optimizing the diagnostic methods for infectious diseases. Furthermore, farmers’ and veterinarians’ knowledge of antibiotic resistance should be improved and the prudent use of antibiotics encouraged to prevent the development and spread of resistant microorganisms.

  7. Antibiotic Usage Prior and During Hospitalization for Clinical Severe Pneumonia in Children under Five Years of Age in Rabat, Morocco

    Joaquim Ruiz


    Full Text Available Scarce and limited epidemiological, clinical and microbiological data are available regarding pediatric respiratory tract infections in the Kingdom of Morocco, a middle-income country in Northwestern Africa. Data on antibiotic usage for such infections are also scarce. A good understanding of pre-admission and intra-hospital usage of antibiotics in children with respiratory infections linked with an adequate surveillance of the antibiotic susceptibility from circulating pathogens could help policy makers improve their recommendations on management of respiratory infections. We hereby present data on antibiotic usage prior and during admission and antibiotic susceptibility of major circulating respiratory pathogens in children under five years of age admitted to the Hôpital d’Enfants de Rabat, Morocco, with a diagnosis of clinical severe pneumonia (using World Health Organization (WHO standardized case definitions during a period of 14 months (November 2010–December 2011, as part of a larger hospital-based surveillance study designed to understand the etiology and epidemiology of severe pneumonia cases among children.

  8. The RESET Mindset Model applied on decreasing antibiotic usage in dairy cattle in the Netherlands

    Lam, T. J. G. M.; Wessels, R. J.; Jansen, Jolanda


    BACKGROUND: Prudent use of antibiotics is important to prevent antibiotic resistance in humans and in animals. For this reason politicians demanded a decrease of total antibiotic use and of use of critically important antibiotics in animal husbandry in the Netherlands. In the dairy sector the use of antibiotics almost halved in the years 2009-2015, with a decrease of the use of critically important antibiotics to very low levels. THEORY OF BEHAVIOUR CHANGE: To realize a sustainable decrease i...

  9. Optimization and Validation of kit of detection Antibiotics on Honey

    Hamza, Malek


    According to the Codex Alimentarius and the European Commission Directive each food has a maximum residual antibiotic (MRLs) however, for honey is still no limit set. Among the main methods that guarantee the detection of antibiotic residues include the Premi Test which is a qualitative method for the detection of antibiotics in honey, but it remains a non-specific method for this matrix and long enough (three hours of incubation). Through this work, we were able to develop and optimize a new kit called Honey test. This kit is able to detect the presence of antibiotic residues in honey by a bacterial strain radio-resistant called D.ra. The duration of treatment is only 30 minutes, requiring incubation at 37 Degree C and treatment with UV at 366 nm. This work will be the subject of a national patent.

  10. The RESET Mindset Model applied on decreasing antibiotic usage in dairy cattle in the Netherlands

    Lam, T. J. G. M.; Wessels, R. J.; Jansen, Jolanda


    BACKGROUND: Prudent use of antibiotics is important to prevent antibiotic resistance in humans and in animals. For this reason politicians demanded a decrease of total antibiotic use and of use of critically important antibiotics in animal husbandry in the Netherlands. In the dairy sector the use of

  11. Insights into udder health and intramammary antibiotic usage on Irish dairy farms during 2003-2010

    More Simon J


    Full Text Available Abstract By international standards, Ireland is a relatively small dairy producer. However, the industry plays a critical role to the national economy, accounting for approximately 3% of national gross domestic product. This paper presents insights into udder health and intramammary antibiotic usage on Irish dairy farms during 2003-2010, based on data from several sources. Three data sources were used, including data on milk recording data, intramammary antibiotic sales and animal health assessment. The milk recording data included a single unadjusted herd-level somatic cell count (SCC value for each herd at each milk recording, being the arithmetic mean of cow-level SCC of each cow at that recording, weighted by cow-level yield. These data were used to calculate the percentage of herds each month where the unadjusted herd SCC exceeded 200,000 and 400,000 cells/mL. Two logistic generalised estimating-equations (GEE models were developed, the outcome variable being either the probability that the monthly SCC of a herd was greater than 400,000 cells/mL or less than or equal to 200,000 cells/mL. Spring herds had a lower probability of a high SCC (> 400,000 cells/mL during February to October compared to non-Spring herds but a higher probability between November to January. The odds of a high SCC were greater in 2005, 2006, 2009 and 2010 but less in 2007 and 2008 compared to 2004. Smaller herds had higher odds of having a high SCC compared to larger herds. We present the number of intramammary tubes and the quantity of active substance (kg sold annually in Ireland during 2003-2010. We infer an incidence of clinical mastitis of 54.0 cases per 100 cow-years at risk, assuming 4 tubes per treatment regime, one affected quarter per cow, tubes restricted to clinical cases only and 100% of treated cases considered new cases, based on data collected on sales of in-lactation intra-mammary antibiotics. With differing assumptions, this estimate varied between

  12. Antibiotic usage and resistance in different regions of the Dutch community.

    Bruinsma, N.; Filius, P.M.; Smet, P.A.G.M. de; Degener, J.E.; Endtz, P.; Bogaard, A.E. van den; Stobberingh, E.E.


    Regional differences of antibiotic use and antibiotic resistance in the fecal indicator bacteria Escherichia coli and enterococci were determined in different cities in the south, west, and north of The Netherlands. In 1999, differences in antibiotic consumption were observed between the different

  13. Antibiotic usage and resistance in different regions of the Dutch community

    Bruinsma, N; Filius, PMG; De Smet, PAGM; Degener, J; Endtz, P; Van den Bogaard, AE; Stobberingh, EE


    Regional differences of antibiotic use and antibiotic resistance in the fecal indicator bacteria Escherichia coli and enterococci were determined in different cities in the south, west, and north of The Netherlands. In 1999, differences in antibiotic consumption were observed between the different

  14. Optimizing Memory Usage in L4-Based Microkernel

    Petre Eftime; Lucian Mogoşanu; Mihai Carabaş; Răzvan Deaconescu; Laura Gheorghe; Valentin Gabriel Voiculescu


    Memory allocation is a critical aspect of any modern operating system kernel because it must run continuously for long periods of time, therefore memory leaks and inefficiency must be eliminated. This paper presents different memory management algorithms and their aplicability to an L4-based microkernel. We aim to reduce memory usage and increase the performance of allocation and deallocation of memory.

  15. The pattern of antibiotic usage in surgical in-patients of a teaching ...

    Background: Prudent use of antibiotics will curtail health care costs and potential adverse effects to the individual taking them and also diminishes the wide ecologic effects leading to selection of antibiotic resistant pathogenic Organisms. Adverse- effects to the individual taking them diminish the wide ecologic effects ...

  16. Antibiotic Usage Profile after Antibiotic Stewardship Program Implementation in Intensive Care Unit of dr. Ramelan Naval Hospital Surabaya

    Stefanie Setiawan


    Full Text Available Antibiotic Stewardship Program (ASP is mandatory to all Indonesian hospitals, in accordance to the 2015 Minister of Health Decree No. 8. Dr. Ramelan Naval Hospital Surabaya is one among the many hospitals in Indonesia that has implemented the ASP. The study objective was to describe quantitative-qualitatively the use of antibiotics, along with clinical and microbiological outcomes observed in an Intensive Care Unit (ICU after ASP implementation in dr. Ramelan Naval Hospital Surabaya. The design was a 3-month (February–May 2016 cross-sectional observational study. Quantitative description was reported using Days of Therapy (DOT/100 patient-days, the qualitative description was reviewed using Gyssens’ flowchart. Clinical outcomes observed include nosocomial infection, infection-related mortality, and average length of stay (LOS. Microbiological outcome was observed through the occurences of multi-drug resistant organism. The results showed overall antibiotic use was 151.63 DOT/100 patient-days. Quality of antibiotic use were 52.73% definitely appropriate; 8.18% inappropriate regarding dose, intervals, durations, and timing; 7.27% no indication; and no mutual agreement in 31.82% (κ=0.59; p<0.05. Hospital Acquired Pneumonias (HAPs/Ventilator Associated Pneumonias (VAPs were the most observed nosocomial infection, infection-related mortality rate was 44.68%; and average LOS were 7.17±1.9 days (p<0.05. No incidents of Methicillin-resistant Staphylococcus aureus (MRSA or Extended Spectrum Beta-Lactamase (ESBL have been found, but there were two cases of Multi Drug Resistant (MDR Acinetobacter baumannii.

  17. Anaerobic antibiotic usage for pneumonia in the medical intensive care unit.

    Kioka, Mutsumi J; DiGiovine, Bruno; Rezik, Mohamed; Jennings, Jeffrey H


    Pneumonia is a common admitting diagnosis in the intensive care unit (ICU). When aspiration is suspected, antibiotics to cover anaerobes are frequently used, but in the absence of clear risk factors, current guidelines have questioned their role. It is unknown how frequently these guidelines are followed. We conducted a single-centre observational study on practice patterns of anaerobic antibiotic use in consecutive patients admitted to the ICU with aspiration pneumonia (Asp), community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP). A total of 192 patients were studied (Asp: 20, HCAP: 107, CAP: 65). Overall, 59 patients received anaerobic antibiotics (Asp: 90%, HCAP: 28%, CAP 17%) but a significant proportion of these patients did not meet criteria to receive them. Inappropriate anaerobic antibiotic use was 12/20 for Asp, 27/107 for HCAP and 9/65 for CAP. Mortality probability model III at zero hours (MPM0) score and a diagnosis of Asp were predictors of receiving inappropriate anaerobic antibiotics. Receiving inappropriate anaerobic antibiotics was associated with a longer ICU length of stay (LOS; 7 days (interquartile range (IQR): 7-21) vs 4 days (IQR:2-9), P = 0.017). For patients in the ICU admitted with pneumonia, there is a high occurrence of inappropriately prescribed anaerobic antibiotics, the use of which was associated with a longer ICU LOS. © 2017 Asian Pacific Society of Respirology.

  18. A meta-analysis to assess usefulness of procalcitonin-guided antibiotic usage for decision making

    Nusrat Shafiq


    Interpretation & conclusions: PCT-guided therapy significantly decreased antibiotics exposure and thus treatment cost. However, the hard endpoints did not demonstrate any significant benefits, possibly due to low power to detect differences and/or the presence of comorbidities.

  19. Defining a region of optimization based on engine usage data

    Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna


    Methods and systems for engine control optimization are provided. One or more operating conditions of a vehicle engine are detected. A value for each of a plurality of engine control parameters is determined based on the detected one or more operating conditions of the vehicle engine. A range of the most commonly detected operating conditions of the vehicle engine is identified and a region of optimization is defined based on the range of the most commonly detected operating conditions of the vehicle engine. The engine control optimization routine is initiated when the one or more operating conditions of the vehicle engine are within the defined region of optimization.

  20. Optimized assessment and usage of biological waste; Optimierte Erfassung und Verwertung von Bioabfall

    Kern, Michael; Raussen, Thomas (eds.)


    The booklet on the optimized assessment and usage of biological waste includes contributions on the following issues: implementation of the bio-waste assessment in the federal states; economy and ecology of bio-waste fermentation; practice forum biogas: new bio-waste fermentation plants in Germany; effects of legal reforms on the usage and processing of bio-waste; flexible electricity input and power-to-gas.

  1. Collecting conditions usage metadata to optimize current and future ATLAS software and processing

    AUTHOR|(INSPIRE)INSPIRE-00064378; The ATLAS collaboration; Formica, Andrea; Gallas, Elizabeth; Oda, Susumu; Rinaldi, Lorenzo; Rybkin, Grigori; Verducci, Monica


    Conditions data (for example: alignment, calibration, data quality) are used extensively in the processing of real and simulated data in ATLAS. The volume and variety of the conditions data needed by different types of processing are quite diverse, so optimizing its access requires a careful understanding of conditions usage patterns. These patterns can be quantified by mining representative log files from each type of processing and gathering detailed information about conditions usage for that type of processing into a central repository.

  2. Antibiotics

    Antibiotics are powerful medicines that fight bacterial infections. Used properly, antibiotics can save lives. They either kill bacteria or ... natural defenses can usually take it from there. Antibiotics do not fight infections caused by viruses, such ...

  3. Usage of Numerical Optimization in Wind Turbine Airfoil Design

    Grasso, F. [ECN Wind Energy, Petten (Netherlands)


    One important key element in the aerodynamic design of wind turbines is the use of specially tailored airfoils to increase the ratio of energy capture to the loading and thereby to reduce the cost of energy. This work is focused on the design of a wind turbine airfoil by using numerical optimization. First, the requirements for this class of airfoils are illustrated and discussed in order to have an exhaustive outline of the complexity of the problem. Then the optimization approach is presented; a gradient-based algorithm is used, coupled with RFOIL solver and a composite Bezier geometrical parameterization. A particularly sensitive point is the choice and implementation of constraints; to formalize the design requirements in the most complete and effective way, the effects of activating specific constraints are discussed. Finally, a numerical example regarding the design of a high-efficiency airfoil for the outer part of a blade is illustrated, and the results are compared with existing wind turbine airfoils.


    Mariana Dumitrache


    Full Text Available Biocidal products are necessary in our lives in order to protect us against pathogenic microorganisms. But their use must be subject to a strict regulation because their harmful potential on human and animal health and environment is huge. Biocidal products must be authorized by a competent authority before placing them on the market and all active substances from their composition must be tested and certified to ensure they are in compliance with regulatory requirements in the field. Also biocides, with antimicrobials, may be involved in causing the phenomenon of antibiotic resistance. Their misuse can lead to the emergence of resistant organisms, through mechanisms similar to those that appear in incorrect treatment with antibiotics. We should, therefore, be aware of this aspect particularly important to prevent unwanted effects of cross resistance to antibiotics and biocides. The more so as, lately, there are pulled many alarm signals about the fact that, in a very short time, mankind is in danger of remaining without the main arsenal for fighting harmful microorganisms.

  5. Optimal usage of computing grid network in the fields of nuclear fusion computing task

    Tenev, D.


    Nowadays the nuclear power becomes the main source of energy. To make its usage more efficient, the scientists created complicated simulation models, which require powerful computers. The grid computing is the answer to powerful and accessible computing resources. The article observes, and estimates the optimal configuration of the grid environment in the fields of the complicated nuclear fusion computing tasks. (author)

  6. eCodonOpt: a systematic computational framework for optimizing codon usage in directed evolution experiments

    Moore, Gregory L.; Maranas, Costas D.


    We present a systematic computational framework, eCodonOpt, for designing parental DNA sequences for directed evolution experiments through codon usage optimization. Given a set of homologous parental proteins to be recombined at the DNA level, the optimal DNA sequences encoding these proteins are sought for a given diversity objective. We find that the free energy of annealing between the recombining DNA sequences is a much better descriptor of the extent of crossover formation than sequence...

  7. Optimization of analytical techniques to characterize antibiotics in aquatic systems

    Al Mokh, S.


    Antibiotics are considered as pollutants when they are present in aquatic ecosystems, ultimate receptacles of anthropogenic substances. These compounds are studied as their persistence in the environment or their effects on natural organisms. Numerous efforts have been made worldwide to assess the environmental quality of different water resources for the survival of aquatic species, but also for human consumption and health risk related. Towards goal, the optimization of analytical techniques for these compounds in aquatic systems remains a necessity. Our objective is to develop extraction and detection methods for 12 molecules of aminoglycosides and colistin in sewage treatment plants and hospitals waters. The lack of analytical methods for analysis of these compounds and the deficiency of studies for their detection in water is the reason for their study. Solid Phase Extraction (SPE) in classic mode (offline) or online followed by Liquid Chromatography analysis coupled with Mass Spectrometry (LC/MS/MS) is the most method commonly used for this type of analysis. The parameters are optimized and validated to ensure the best conditions for the environmental analysis. This technique was applied to real samples of wastewater treatment plants in Bordeaux and Lebanon. (author)

  8. Cross-sectional study on antibiotic usage in pigs in Germany.

    Lisa van Rennings

    Full Text Available To be able to analyze the relationship between the level of resistance and the use of antimicrobials, it is necessary to collect detailed data on antimicrobial usage. For this reason, data on antimicrobial use on 495 pig farms from entire Germany were collected and analyzed. In Germany, each application and dispensing of medicines to food-producing animals is documented in detail obligatorily by the veterinarian. This information was collected retrospectively for the year 2011. The analyses undertook separate examinations on the age groups sow, piglet, weaner and fattening pig; both the route of administration and indication per active ingredient, and active ingredient class, were evaluated. In total, 20,374 kg of antimicrobial substances were used in the study population. Tetracyclines were used in highest amounts, followed by beta-lactams, trimethoprim-sulfonamides and macrolides. Concerning the frequency of using an active substance per animal, polypeptides were most commonly administered. In all age groups, respiratory infections were the main indication for using antimicrobials, followed by intestinal diseases in piglets, weaners and fattening pigs and diseases of reproductive organs in sows. Over a period of 100 days, the median number of treatment days with one antimicrobial substance for piglets was 15 days, for weaners about 6 days, for fattening pigs about 4 days and for sows about 1 day. A multifactorial ANOVA was conducted to investigate which factors are associated with the treatment frequency. The factors "veterinarian" and "age group" were related to the treatment frequency, just as the interaction between "veterinarian" and "farm size" as well as the interaction between "veterinarian" and "age group".

  9. Codon-optimized antibiotic resistance gene improves efficiency of ...


    Oct 1, 2013 ... transient transformation and cell growth in selective culture were significantly increased by use of fgmR ... Our result shows that similarity in codon usage pattern is an important factor ... Codon adaptation index (CAI) (Sharp.

  10. Metabolomic approach to optimizing and evaluating antibiotic treatment in the axenic culture of cyanobacterium Nostoc flagelliforme.

    Han, Pei-pei; Jia, Shi-ru; Sun, Ying; Tan, Zhi-lei; Zhong, Cheng; Dai, Yu-jie; Tan, Ning; Shen, Shi-gang


    The application of antibiotic treatment with assistance of metabolomic approach in axenic isolation of cyanobacterium Nostoc flagelliforme was investigated. Seven antibiotics were tested at 1-100 mg L(-1), and order of tolerance of N. flagelliforme cells was obtained as kanamycin > ampicillin, tetracycline > chloromycetin, gentamicin > spectinomycin > streptomycin. Four antibiotics were selected based on differences in antibiotic sensitivity of N. flagelliforme and associated bacteria, and their effects on N. flagelliforme cells including the changes of metabolic activity with antibiotics and the metabolic recovery after removal were assessed by a metabolomic approach based on gas chromatography-mass spectrometry combined with multivariate analysis. The results showed that antibiotic treatment had affected cell metabolism as antibiotics treated cells were metabolically distinct from control cells, but the metabolic activity would be recovered via eliminating antibiotics and the sequence of metabolic recovery time needed was spectinomycin, gentamicin > ampicillin > kanamycin. The procedures of antibiotic treatment have been accordingly optimized as a consecutive treatment starting with spectinomycin, then gentamicin, ampicillin and lastly kanamycin, and proved to be highly effective in eliminating the bacteria as examined by agar plating method and light microscope examination. Our work presented a strategy to obtain axenic culture of N. flagelliforme and provided a method for evaluating and optimizing cyanobacteria purification process through diagnosing target species cellular state.

  11. Removal of antibiotics and antibiotic resistance genes from domestic sewage by constructed wetlands: Optimization of wetland substrates and hydraulic loading.

    Chen, Jun; Wei, Xiao-Dong; Liu, You-Sheng; Ying, Guang-Guo; Liu, Shuang-Shuang; He, Liang-Ying; Su, Hao-Chang; Hu, Li-Xin; Chen, Fan-Rong; Yang, Yong-Qiang


    This study aimed to assess removal potential of antibiotics and antibiotic resistance genes (ARGs) in raw domestic wastewater by various mesocosm-scale horizontal subsurface-flow constructed wetlands (CWs) planted Cyperus alternifolius L. with different design parameters. Twelve CWs with three hydraulic loading rates (HLR 10, 20 and 30cm/day) and four substrates (oyster shell, zeolite, medical stone and ceramic) were set up in order to select the best optimized wetland. The result showed that 7 target antibiotics compounds including erythromycin-H2O, lincomycin, monensin, ofloxacin, sulfamerazine, sulfamethazine and novobiocin were detected, and all selected 18 genes (three sulfonamide resistance genes (sul1, sul2 and sul3), four tetracycline resistance genes (tetG, tetM, tetO and tetX), two macrolide resistance genes (ermB and ermC), three quinolone resistance genes (qnrB, qnrD and qnrS) and four chloramphenicol resistance genes (cmlA, fexA, fexB and floR)) and two integrase genes (int1 and int2) were positively detected in the domestic wastewaters. The aqueous removal rates of the total antibiotics ranged from17.9 to 98.5%, while those for the total ARGs varied between 50.0 and 85.8% by the mesocosm-scale CWs. After considering their aqueous removal rates in combination with their mass removals, the CW with zeolite as the substrate and HLR of 20cm/day was selected as the best choice. Combined chemical and biological analyses indicate that both microbial degradation and physical sorption processes were responsible for the fate of antibiotics and ARGs in the wetlands. The findings from this study suggest constructed wetlands could be a promising technology for the removal of emerging contaminants such as antibiotics and ARGs in domestic wastewater. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Accepting or fighting unlicensed usage : Can firms reduce unlicensed usage by optimizing their timing and pricing strategies?

    Burmester, Alexa B.; Eggers, Felix; Clement, Michel; Prostka, Tim

    The rise of the Internet and new online services have led to the wide-scale illegal distribution of digital entertainment products, such as music, movies, games, and books. We analyze whether firms in the entertainment industry should fight unlicensed usage by providing specific offers that maximize

  13. Collecting conditions usage metadata to optimize current and future ATLAS software and processing

    Barberis, Dario; The ATLAS collaboration; Gallas, Elizabeth; Oda, Susumu


    Conditions data (for example: alignment, calibration, data quality) are used extensively in the processing of real and simulated data in ATLAS. The volume and variety of the conditions data needed by different types of processing are quite diverse, so optimizing its access requires a careful understanding of conditions usage patterns. These patterns can be quantified by mining representative log files from each type of processing and gathering detailed information about conditions usage for that type of processing into a central repository. In this presentation, we describe the systems developed to collect this conditions usage metadata per job type and describe a few specific (but very different) ways in which it has been used. For example, it can be used to cull specific conditions data into a much more compact package to be used by jobs doing similar types of processing: these customized collections can then be shipped with jobs to be executed on isolated worker nodes (such as HPC farms) that have no netwo...

  14. Removal of antibiotics from urban wastewater by constructed wetland optimization.

    Hijosa-Valsero, María; Fink, Guido; Schlüsener, Michael P; Sidrach-Cardona, Ricardo; Martín-Villacorta, Javier; Ternes, Thomas; Bécares, Eloy


    Seven mesocosm-scale constructed wetlands (CWs), differing in their design characteristics, were set up in the open air to assess their efficiency to remove antibiotics from urban raw wastewater. A conventional wastewater treatment plant (WWTP) was simultaneously monitored. The experiment took place in autumn. An analytical methodology including HPLC-MS/MS was developed to measure antibiotic concentrations in the soluble water fraction, in the suspended solids fraction and in the WWTP sludge. Considering the soluble water fraction, the only easily eliminated antibiotics in the WWTP were doxycycline (61±38%) and sulfamethoxazole (60±26%). All the studied types of CWs were efficient for the removal of sulfamethoxazole (59±30-87±41%), as found in the WWTP, and, in addition, they removed trimethoprim (65±21-96±29%). The elimination of other antibiotics in CWs was limited by the specific system-configuration: amoxicillin (45±15%) was only eliminated by a free-water (FW) subsurface flow (SSF) CW planted with Typha angustifolia; doxycycline was removed in FW systems planted with T. angustifolia (65±34-75±40%), in a Phragmites australis-floating macrophytes system (62±31%) and in conventional horizontal SSF-systems (71±39%); clarithromycin was partially eliminated by an unplanted FW-SSF system (50±18%); erythromycin could only be removed by a P. australis-horizontal SSF system (64±30%); and ampicillin was eliminated by a T. angustifolia-floating macrophytes system (29±4%). Lincomycin was not removed by any of the systems (WWTP or CWs). The presence or absence of plants, the vegetal species (T. angustifolia or P. australis), the flow type and the CW design characteristics regulated the specific removal mechanisms. Therefore, CWs are not an overall solution to remove antibiotics from urban wastewater during cold seasons. However, more studies are needed to assess their ability in warmer periods and to determine the behaviour of full-scale systems. Copyright

  15. Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the Republic of Macedonia

    Alili-Idrizi E


    Full Text Available Objective: This study sought to explore the knowledge and attitudes of parents on the use of antibiotics among children that could serve as baseline data and provide further insight in planning and developing strategies for local health education purposes. Methods: A cross-sectional survey involving 500 parents who attended community pharmacies in Tetovo, Republic of Macedonia, was conducted using a self-administered questionnaire from October 2013 to January 2014. The questionnaire included demographics, knowledge and attitude statements of parents towards antibiotics. The data collected were analyzed using SPSS program, version 19.0. Descriptive statistics was used to summarize the data. In all statistical analyses, a p-value of <0.05 was considered statistically significant. Results: Nearly 40% of the parents demonstrated a moderate level of knowledge. The highest correct response in the knowledge part was the awareness of parents in using antibiotics to treat a bacterial infection (61.2%. However, most of the parents did not know that antibiotics cannot cure viral infections (59.6%. About 48.2% of the parents were aware of the antibiotic resistance as s result of the overuse. Concerning attitudes, 60.8% reported keeping any leftover antibiotics, 77.0% agreed that taking antibiotics when having cold symptoms could help their children recover faster, while, 74.6% wrongly agreed with the statement of appropriate use of antibiotics for prophylaxis’ measure. Conclusions: This study has documented the main areas that merit attention when parental knowledge on antibiotic use for their children is the concern, reflecting in some inappropriate attitudes as well. The findings highlight the need to devise effective interventions to decrease misconceptions regarding antibiotic use and to increase parents’ awareness for the risks of inappropriate use of antibiotics in children specifically and in the community at large.

  16. Impact of an antimicrobial stewardship programme on antibiotic usage and resistance in a tertiary hospital in China.

    Zhang, Z-G; Chen, F; Ou, Y


    Antimicrobial misuse has been commonly observed in China. This phenomenon can cause antibiotic resistance. This study was designed to evaluate the impact of an antimicrobial stewardship programme implemented in a tertiary hospital in China from 2011 to 2014. The antimicrobial stewardship programme began in 2011. Data on the consumption of antibiotics and antimicrobial resistance between 2011 and 2014 were collected. Comparison of the 2011 data with those of 2014 showed that antibiotic defined daily doses/per 100 patient-days decreased from 92.5±2.8 to 35.8±1.2 (Padministrative management, especially information management, was effective in reducing antibiotic consumption and lessening antibiotic resistance. © 2017 John Wiley & Sons Ltd.

  17. Energy Hub’s Structural and Operational Optimization for Minimal Energy Usage Costs in Energy Systems

    Thanh Tung Ha


    Full Text Available The structural and optimal operation of an Energy Hub (EH has a tremendous influence on the hub’s performance and reliability. This paper envisions an innovative methodology that prominently increases the synergy between structural and operational optimization and targets system cost affordability. The generalized energy system structure is presented theoretically with all selective hub sub-modules, including electric heater (EHe and solar sources block sub-modules. To minimize energy usage cost, an energy hub is proposed that consists of 12 kinds of elements (i.e., energy resources, conversion, and storage functions and is modeled mathematically in a General Algebraic Modeling System (GAMS, which indicates the optimal hub structure’s corresponding elements with binary variables (0, 1. Simulation results contrast with 144 various scenarios established in all 144 categories of hub structures, in which for each scenario the corresponding optimal operation cost is previously calculated. These case studies demonstrate the effectiveness of the suggested model and methodology. Finally, avenues for future research are also prospected.

  18. Response Adjusted for Days of Antibiotic Risk (RADAR): evaluation of a novel method to compare strategies to optimize antibiotic use.

    Schweitzer, V A; van Smeden, M; Postma, D F; Oosterheert, J J; Bonten, M J M; van Werkhoven, C H


    The Response Adjusted for Days of Antibiotic Risk (RADAR) statistic was proposed to improve the efficiency of trials comparing antibiotic stewardship strategies to optimize antibiotic use. We studied the behaviour of RADAR in a non-inferiority trial in which a β-lactam monotherapy strategy (n = 656) was non-inferior to fluoroquinolone monotherapy (n = 888) for patients with moderately severe community-acquired pneumonia. Patients were ranked according to clinical outcome, using five or eight categories, and antibiotic use. RADAR was calculated as the probability that the β-lactam group had a more favourable ranking than the fluoroquinolone group. To investigate the sensitivity of RADAR to detrimental clinical outcome we simulated increasing rates of 90-day mortality in the β-lactam group and performed the RADAR and non-inferiority analysis. The RADAR of the β-lactam group compared with the fluoroquinolone group was 60.3% (95% CI 57.9%-62.7%) using five and 58.4% (95% CI 56.0%-60.9%) using eight clinical outcome categories, all in favour of β-lactam. Sample sizes for RADAR were 38% (250/653) and 89% (580/653) of the non-inferiority sample size calculation, using five or eight clinical outcome categories, respectively. With simulated mortality rates, loss of non-inferiority of the β-lactam group occurred at a relative risk of 1.125 in the conventional analysis, whereas using RADAR the β-lactam group lost superiority at a relative risk of mortality of 1.25 and 1.5, with eight and five clinical outcome categories, respectively. RADAR favoured β-lactam over fluoroquinolone therapy for community-acquired pneumonia. Although RADAR required fewer patients than conventional non-inferiority analysis, the statistic was less sensitive to detrimental outcomes. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Efficacy and safety profile of antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery: a meta-analysis of randomized controlled trials.

    Zhang, Yi; Dong, Jiasheng; Qiao, Yufei; He, Jinguang; Wang, Tao; Ma, Sunxiang


    There is no consensus with regard to antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery. This meta-analysis sought to assess the efficacy and safety of antibiotic prophylaxis and to determine appropriate duration of prophylaxis. An English language literature search was conducted using PubMed and the Cochrane Collaboration for randomized controlled trials (RCTs) that evaluate the use of antibiotic prophylaxis to prevent postoperative surgical site infection (SSI) in patients undergoing clean and clean-contaminated plastic and reconstructive surgery. Data from intention-to-treat analyses were used where available. For the dichotomous data, results for each study were odds ratio (OR) with 95% confidence interval (CI) and combined for meta-analysis using the Mantel-Haenszel method or the DerSimonian and Laird method. Study quality was critically appraised by 2 reviewers using established criteria. STATA version 12 was used for meta-analyses. Twelve RCTs involving 2395 patients were included, of which 8 trials were considered to be of high methodological quality. Effect of antibiotic prophylaxis in plastic and reconstructive surgery was found favorable over placebo in SSI prevention (13 studies; 2449 participants; OR, 0.53; 95% CI, 0.4-0.7; P plastic surgeries with high-risk factors and clean-contaminated plastic surgeries. Besides, a short-course administration regimen seemed to be of adequate efficacy and safety. High-quality prospective trials on larger scale are needed to further confirm these findings.

  20. Optimal usage of low temperature heat sources to supply district heating by heat pumps

    Pieper, Henrik; Ommen, Torben Schmidt; Markussen, Wiebke Brix


    This paper presents a theoretical study on the optimal usage of different low temperature heat sources to supply district heating by heat pumps. The study is based on data for the Copenhagen region. The heat sources were prioritized based on the coefficient of performance calculated for each hour...... and the covered demand of each heat source as well as required peak unit capacity. The results showed that heat pumps using different heat sources yield better performance than a heat pump based on a single one. The performance was influenced by the composition of the different heat sources. It was found that 78......% groundwater, 22% seawater and 0% air resulted in highest COP of 3.33 for the given heat demand. Furthermore, the implementation of rule based short term storage made peak units redundant. The variation in base load capacity showed that heat pumps utilizing the analyzed heat sources could perform very...

  1. Genes adopt non-optimal codon usage to generate cell cycle-dependent oscillations in protein levels

    Frenkel-Morgenstern, Milana; Danon, Tamar; Christian, Thomas


    The cell cycle is a temporal program that regulates DNA synthesis and cell division. When we compared the codon usage of cell cycle-regulated genes with that of other genes, we discovered that there is a significant preference for non-optimal codons. Moreover, genes encoding proteins that cycle a...

  2. Perioperative antibiotic usage by facial plastic surgeons: national survey results and comparison with evidence-based guidelines.

    Grunebaum, Lisa Danielle; Reiter, David


    To determine current practice for use of perioperative antibiotics among facial plastic surgeons, to determine the extent of use of literature support for preferences of facial plastic surgeons, and to compare patterns of use with nationally supported evidence-based guidelines. A link to a Web site containing a questionnaire on perioperative antibiotic use was e-mailed to more than 1000 facial plastic surgeons in the United States. Responses were archived in a dedicated database and analyzed to determine patterns of use and methods of documenting that use. Current literature was used to develop evidence-based recommendations for perioperative antibiotic use, emphasizing current nationally supported guidelines. Preferences varied significantly for medication used, dosage and regimen, time of first dose relative to incision time, setting in which medication was administered, and procedures for which perioperative antibiotic was deemed necessary. Surgical site infection in facial plastic surgery can be reduced by better conformance to currently available evidence-based guidelines. We offer specific recommendations that are supported by the current literature.

  3. Optimal Antibiotic Dosage for Chronic Kidney Disease Patient: A Pharmacological Manual for Oral Clinicians.

    Chidambaram, Ramasamy


    Chronic kidney disease, (CKD) a gradual and inevitable deterioration in renal function, is the disease with the most associations in dentistry. Dosage adjustment is one amongst the vital elements to be familiar with during their oral care. CKD patients take extended duration to filter out medications, therefore dosage must always be tailored under the supervision of nephrologist. The relished benefits from antibiotic could transform as anti-microbial resistance on their abuse and nephrotoxic when contraindicated drugs are encouraged. New patented drug belonging to oxazoliodine group has driven the researchers to handle the emerging AMR. The present communication discusses the pharmacological factors influencing in prescribing the antibiotics for CKD patient from the dentist's point of view. The formulas destined for calculating the optimal dosage of antibiotics have been documented to aid oral physicians.

  4. Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials.

    Aminoshariae, Anita; Kulild, James C


    The purpose of this investigation was to identify evidence-based scientific methodologies to aid dental clinicians in establishing the indications for prescribing antibiotics for endodontic infection or pain. The authors prepared and registered a protocol on PROSPERO. They conducted electronic searches in MEDLINE, Scopus, Cochrane Library, and In addition, the authors hand searched the bibliographies of all relevant articles, the gray literature, and textbooks for randomized controlled clinical studies. The authors independently selected the relevant articles. The overall quality of the studies was fair with a low risk of bias, but 2 studies had a moderate risk of bias. The best available clinical evidence signals no indications for prescribing antibiotics preoperatively or postoperatively to prevent endodontic infection or pain unless the spread of infection is systemic, the patient is febrile, or both. Generally, an accurate diagnosis coupled with effective endodontic treatment will decrease microbial flora enough for healing to occur. To help decrease the number of drug-resistant microbes, oral health care providers should not prescribe antibiotics when they are not indicated. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  5. Multi-objective optimization of glycopeptide antibiotic production in batch and fed batch processes

    Maiti, Soumen K.; Eliasson Lantz, Anna; Bhushan, Mani


    batch operations using process model for Amycolatopsis balhimycina, a glycopeptide antibiotic producer. This resulted in a set of several pareto optimal solutions with the two objectives ranging from (0.75gl−1, 3.97g$-1) to (0.44gl−1, 5.19g$-1) for batch and from (1.5gl−1, 5.46g$-1) to (1.1gl−1, 6.34g...

  6. The Hit and Away technique: optimal usage of the ultrasonic scalpel in laparoscopic gastrectomy.

    Irino, Tomoyuki; Hiki, Naoki; Ohashi, Manabu; Nunobe, Souya; Sano, Takeshi; Yamaguchi, Toshiharu


    Thermal injury and unexpected bleeding caused by ultrasonic scalpels can lead to fatal complications in laparoscopic gastrectomy (LG), such as postoperative pancreatic fistulas (POPF). In this study, we developed the "Hit and Away" protocol for optimal usage of the ultrasonic scalpel, which in essence involves dividing tissues and vessels in batches using the tip of the scalpel to control tissue temperature. To assess the effectiveness of the technique, the surface temperature of the mesocolon of female swine after ultrasonic scalpel activations was measured, and tissue samples were collected to evaluate microscopic thermal injury to the pancreas. In parallel, we retrospectively surveyed 216 patients who had undergone LG before or after the introduction of this technique and assessed the ability of this technique to reduce POPF. The tissue temperature of the swine mesocolon reached 43 °C, a temperature at which adipose tissue melted but fibrous tissue, including vessels, remained intact. The temperature returned to baseline within 3 s of turning off the ultrasonic scalpel, demonstrating the advantage of using ultrasonic scalpel in a pulsatile manner. Tissue samples from the pancreas demonstrated that the extent of thermal injury post-procedure was limited to the capsule of the pancreas. Moreover, with respect to the clinical outcomes before and after the introduction of this technique, POPF incidence decreased significantly from 7.8 to 1.0% (p = 0.021). The "Hit and Away" technique can reduce blood loss and thermal injury to the pancreas and help to ensure the safety of lymph node dissection in LG.

  7. Simultaneous assay of multiple antibiotics in human plasma by LC-MS/MS: importance of optimizing formic acid concentration.

    Chen, Feng; Hu, Zhe-Yi; Laizure, S Casey; Hudson, Joanna Q


    Optimal dosing of antibiotics in critically ill patients is complicated by the development of resistant organisms requiring treatment with multiple antibiotics and alterations in systemic exposure due to diseases and extracorporeal drug removal. Developing guidelines for optimal antibiotic dosing is an important therapeutic goal requiring robust analytical methods to simultaneously measure multiple antibiotics. An LC-MS/MS assay using protein precipitation for cleanup followed by a 6-min gradient separation was developed to simultaneously determine five antibiotics in human plasma. The precision and accuracy were within the 15% acceptance range. The formic acid concentration was an important determinant of signal intensity, peak shape and matrix effects. The method was designed to be simple and successfully applied to a clinical pharmacokinetic study.

  8. Design, Characterization, and Optimization of Controlled Drug Delivery System Containing Antibiotic Drug/s

    Apurv Patel


    Full Text Available The objective of this work was design, characterization, and optimization of controlled drug delivery system containing antibiotic drug/s. Osmotic drug delivery system was chosen as controlled drug delivery system. The porous osmotic pump tablets were designed using Plackett-Burman and Box-Behnken factorial design to find out the best formulation. For screening of three categories of polymers, six independent variables were chosen for Plackett-Burman design. Osmotic agent sodium chloride and microcrystalline cellulose, pore forming agent sodium lauryl sulphate and sucrose, and coating agent ethyl cellulose and cellulose acetate were chosen as independent variables. Optimization of osmotic tablets was done by Box-Behnken design by selecting three independent variables. Osmotic agent sodium chloride, pore forming agent sodium lauryl sulphate, and coating agent cellulose acetate were chosen as independent variables. The result of Plackett-Burman and Box-Behnken design and ANOVA studies revealed that osmotic agent and pore former had significant effect on the drug release up to 12 hr. The observed independent variables were found to be very close to predicted values of most satisfactory formulation which demonstrates the feasibility of the optimization procedure in successful development of porous osmotic pump tablets containing antibiotic drug/s by using sodium chloride, sodium lauryl sulphate, and cellulose acetate as key excipients.

  9. Characterization and optimization of antibiotic resistant bacterial strains for polyhydroxyalkanoates (phas) production

    Rehman, S. U.; Jamil, N.; Hussain, S.


    In this investigation, sugarcane soil, sewage water and soil containing long chain hydrocarbons was screened to obtain bacterial strains that were able to synthesize poly-beta-hydroxyalkanoates (PHA). The potential to synthesize PHA was tested qualitatively by Sudan Black staining of colonies growing in glucose and sucrose. Sixteen bacterial strains were isolated, purified and characterized for Gram reaction, biochemical analysis and PHA production. Isolates showed a wide range of tolerance to different commonly used antibiotics. PHA extraction was done by solvent extraction and hypochlorite digestion method. PHA production was optimized for different nitrogen concentrations. (author)

  10. Designing the optimal robotic milking barn, Part 1: Quantifying facility usage

    Halachmi, I.; Metz, J.H.M.; Maltz, E.; Dijkhuizen, A.A.; Speelman, L.


    The aim of this paper is to explore the stochastic nature of the usage of facilities in a robotic milking barn, independent of the barn layout. It presents experimental data obtained by monitoring 10 dairy cows over a period of 18 days. To minimize restrictions to the access of cows to the

  11. Improved detection of multiple environmental antibiotics through an optimized sample extraction strategy in liquid chromatography-mass spectrometry analysis.

    Yi, Xinzhu; Bayen, Stéphane; Kelly, Barry C; Li, Xu; Zhou, Zhi


    A solid-phase extraction/liquid chromatography/electrospray ionization/multi-stage mass spectrometry (SPE-LC-ESI-MS/MS) method was optimized in this study for sensitive and simultaneous detection of multiple antibiotics in urban surface waters and soils. Among the seven classes of tested antibiotics, extraction efficiencies of macrolides, lincosamide, chloramphenicol, and polyether antibiotics were significantly improved under optimized sample extraction pH. Instead of only using acidic extraction in many existing studies, the results indicated that antibiotics with low pK a values (antibiotics with high pK a values (>7) were extracted more efficiently under neutral conditions. The effects of pH were more obvious on polar compounds than those on non-polar compounds. Optimization of extraction pH resulted in significantly improved sample recovery and better detection limits. Compared with reported values in the literature, the average reduction of minimal detection limits obtained in this study was 87.6% in surface waters (0.06-2.28 ng/L) and 67.1% in soils (0.01-18.16 ng/g dry wt). This method was subsequently applied to detect antibiotics in environmental samples in a heavily populated urban city, and macrolides, sulfonamides, and lincomycin were frequently detected. Antibiotics with highest detected concentrations were sulfamethazine (82.5 ng/L) in surface waters and erythromycin (6.6 ng/g dry wt) in soils. The optimized sample extraction strategy can be used to improve the detection of a variety of antibiotics in environmental surface waters and soils.

  12. The usage of filtration as fulfillment of acceptable indoor and optimal energy management

    Burroughs, H.E.


    The role of filtration is a significant factor in the prevention and mitigation of indoor air quality problems. ASHRAE Standard 62-89. Ventilation for Acceptable Indoor Air Quality, makes broad and non-specific references to filtration. This paper provides guidelines for the usage of filtration as a means of fulfillment of the Standard's requirements. The paper also references the specific authorities as iterated in the Standard. The discussion will include the usage of filtration in treating contaminated outside air, protection of equipment and systems, protection of occupants, reduction of ventilation air, and source control. The reduction of ventilation air through filtration has significant and positive energy management benefits. Other energy benefits accrue from clean heat exchange surfaces

  13. Combination of the Endogenous lhcsr1 Promoter and Codon Usage Optimization Boosts Protein Expression in the Moss Physcomitrella patens

    Manuel Hiss


    Full Text Available The moss Physcomitrella patens is used both as an evo-devo model and biotechnological production system for metabolites and pharmaceuticals. Strong in vivo expression of genes of interest is important for production of recombinant proteins, e.g., selectable markers, fluorescent proteins, or enzymes. In this regard, the choice of the promoter sequence as well as codon usage optimization are two important inside factors to consider in order to obtain optimum protein accumulation level. To reliably quantify fluorescence, we transfected protoplasts with promoter:GFP fusion constructs and measured fluorescence intensity of living protoplasts in a plate reader system. We used the red fluorescent protein mCherry under 2x 35S promoter control as second reporter to normalize for different transfection efficiencies. We derived a novel endogenous promoter and compared deletion variants with exogenous promoters. We used different codon-adapted green fluorescent protein (GFP genes to evaluate the influence of promoter choice and codon optimization on protein accumulation in P. patens, and show that the promoter of the gene of P. patens chlorophyll a/b binding protein lhcsr1 drives expression of GFP in protoplasts significantly (more than twofold better than the commonly used 2x 35S promoter or the rice actin1 promoter. We identified a shortened 677 bp version of the lhcsr1 promoter that retains full activity in protoplasts. The codon optimized GFP yields significantly (more than twofold stronger fluorescence signals and thus demonstrates that adjusting codon usage in P. patens can increase expression strength. In combination, new promotor and codon optimized GFP conveyed sixfold increased fluorescence signal.

  14. Using the rate of bacterial clearance determined by real-time polymerase chain reaction as a timely surrogate marker to evaluate the appropriateness of antibiotic usage in critical patients with Acinetobacter baumannii bacteremia.

    Chuang, Yu-Chung; Chang, Shan-Chwen; Wang, Wei-Kung


    Bacteremia caused by Acinetobacter baumannii is becoming more frequent among critically ill patients, and has been associated with high mortality and prolonged hospital stay. Multidrug resistance and delay in blood culture have been shown to be significant barriers to appropriate antibiotic treatment. Quantitative polymerase chain reaction assays were recently used to monitor bacterial loads; we hypothesized that the rate of bacterial clearance determined by quantitative polymerase chain reaction can be used as a timely surrogate marker to evaluate the appropriateness of antibiotic usage. Prospective observational study. University hospital and research laboratory. Patients with culture-proven A. baumannii bacteremia in the intensive care units were prospectively enrolled from April 2008 to February 2009. Plasmid Oxa-51/pCRII-TOPO, which contained a 431-bp fragment of the A. baumannii-specific Oxa-51 gene in a pCRII-TOPO vector, was used as the standard. Sequential bacterial DNA loads in the blood were measured by a quantitative polymerase chain reaction assay. We enrolled 51 patients with A. baumannii bacteremia, and examined 318 sequential whole blood samples. The initial mean bacterial load was 2.15 log copies/mL, and the rate of bacterial clearance was 0.088 log copies/mL/day. Multivariate linear regression using the generalized estimation equation approach revealed that the use of immunosuppressants was an independent predictor for slower bacterial clearance (coefficient, 1.116; pcritical patients. These findings highlight the importance of appropriate antibiotic usage and development of effective antibiotics against A. baumannii in an era of emerging antibiotic resistance. The rate of bacterial clearance could serve as a timely surrogate marker for evaluating the appropriateness of antibiotics.

  15. Optimizing the resource usage in Cloud based environments: the Synergy approach

    Zangrando, L.; Llorens, V.; Sgaravatto, M.; Verlato, M.


    Managing resource allocation in a cloud based data centre serving multiple virtual organizations is a challenging issue. In fact, while batch systems are able to allocate resources to different user groups according to specific shares imposed by the data centre administrator, without a static partitioning of such resources, this is not so straightforward in the most common cloud frameworks, e.g. OpenStack. In the current OpenStack implementation, it is only possible to grant fixed quotas to the different user groups and these resources cannot be exceeded by one group even if there are unused resources allocated to other groups. Moreover in the existing OpenStack implementation, when there aren’t resources available, new requests are simply rejected: it is then up to the client to later re-issue the request. The recently started EU-funded INDIGO-DataCloud project is addressing this issue through “Synergy”, a new advanced scheduling service targeted for OpenStack. Synergy adopts a fair-share model for resource provisioning which guarantees that resources are distributed among users following the fair-share policies defined by the administrator, taken also into account the past usage of such resources. We present the architecture of Synergy, the status of its implementation, some preliminary results and the foreseen evolution of the service.

  16. The optimization model of the logging machinery usage in forestry practice

    Jitka Janová


    Full Text Available The decision support systems commonly used in industry and economy managerial practice for optimizing the processes are based on algoritmization of the typical decision problems. In Czech forestry business, there is a lack of developed decision support systems, which could be easily used in daily practice. This stems from the fact, that the application of optimization methods is less successful in forestry decision making than in industry or economy due to inherent complexity of the forestry decision problems. There is worldwide ongoing research on optimization models applicable in forestry decision making, but the results are not globally applicable and moreover the cost of possibly arising software tools are indispensable. Especially small and medium forestry companies in Czech Republic can not afford such additional costs, although the results of optimization could positively in­fluen­ce not only the business itself but also the impact of forestry business on the environment. Hence there is a need for user friendly optimization models for forestry decision making in the area of Czech Republic, which could be easily solved in commonly available software, and whose results would be both, realistic and easily applicable in the daily decision making.The aim of this paper is to develop the optimization model for the machinery use planning in Czech logging firm in such a way, that the results can be obtained using MS EXCEL. The goal is to identify the integer number of particular machines which should be outsourced for the next period, when the total cost minimization is required. The linear programming model is designed covering the typical restrictions on available machinery and total volume of trees to be cut and transported. The model offers additional result in the form of optimal employment of particular machines. The solution procedure is described in detail and the results obtained are discussed with respect to its applicability in

  17. Optimal Multi-Interface Selection for Mobile Video Streaming in Efficient Battery Consumption and Data Usage

    Seonghoon Moon


    Full Text Available With the proliferation of high-performance, large-screen mobile devices, users’ expectations of having access to high-resolution video content in smooth network environments are steadily growing. To guarantee such stable streaming, a high cellular network bandwidth is required; yet network providers often charge high prices for even limited data plans. Moreover, the costs of smoothly streaming high-resolution videos are not merely monetary; the device’s battery life must also be accounted for. To resolve these problems, we design an optimal multi-interface selection system for streaming video over HTTP/TCP. An optimization problem including battery life and LTE data constraints is derived and then solved using binary integer programming. Additionally, the system is designed with an adoption of split-layer scalable video coding, which provides direct adaptations of video quality and prevents out-of-order packet delivery problems. The proposed system is evaluated using a prototype application in a real, iOS-based device as well as through experiments conducted in heterogeneous mobile scenarios. Results show that the system not only guarantees the highest-possible video quality, but also prevents reckless consumption of LTE data and battery life.

  18. Vancomycin-resistance enterococcal colonization in hospitalized patients in relation to antibiotic usage in a tertiary care hospital of North India

    Tuhina Banerjee


    Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

  19. The SDSS-IV MaNGA Sample: Design, Optimization, and Usage Considerations

    Wake, David A.; Bundy, Kevin; Diamond-Stanic, Aleksandar M.; Yan, Renbin; Blanton, Michael R.; Bershady, Matthew A.; Sánchez-Gallego, José R.; Drory, Niv; Jones, Amy; Kauffmann, Guinevere; Law, David R.; Li, Cheng; MacDonald, Nicholas; Masters, Karen; Thomas, Daniel; Tinker, Jeremy; Weijmans, Anne-Marie; Brownstein, Joel R.


    We describe the sample design for the SDSS-IV MaNGA survey and present the final properties of the main samples along with important considerations for using these samples for science. Our target selection criteria were developed while simultaneously optimizing the size distribution of the MaNGA integral field units (IFUs), the IFU allocation strategy, and the target density to produce a survey defined in terms of maximizing signal-to-noise ratio, spatial resolution, and sample size. Our selection strategy makes use of redshift limits that only depend on I-band absolute magnitude (M I ), or, for a small subset of our sample, M I and color (NUV - I). Such a strategy ensures that all galaxies span the same range in angular size irrespective of luminosity and are therefore covered evenly by the adopted range of IFU sizes. We define three samples: the Primary and Secondary samples are selected to have a flat number density with respect to M I and are targeted to have spectroscopic coverage to 1.5 and 2.5 effective radii (R e ), respectively. The Color-Enhanced supplement increases the number of galaxies in the low-density regions of color-magnitude space by extending the redshift limits of the Primary sample in the appropriate color bins. The samples cover the stellar mass range 5× {10}8≤slant {M}* ≤slant 3× {10}11 {M}⊙ {h}-2 and are sampled at median physical resolutions of 1.37 and 2.5 kpc for the Primary and Secondary samples, respectively. We provide weights that will statistically correct for our luminosity and color-dependent selection function and IFU allocation strategy, thus correcting the observed sample to a volume-limited sample.

  20. Optimal usage of cone beam computed tomography system with different field of views in image guided radiotherapy (IGRT

    Narayana Venkata Naga Madhusudhana Sresty


    Full Text Available Purpose: To find methods for optimal usage of XVI (X-ray volume imaging system in Elekta synergy linear accelerator with different field of views for same lesion in order to minimize patient dose due to imaging.Methods: 20 scans of 2 individual patients with ca sigmoid colon and ca lung were used in this study. Kilo voltage collimators with medium field of view were used as per the preset information. Images were reconstructed for another collimator with small field of view. The set up errors were evaluated with XVI software. Shift results of both methods were compared. Results: Variation in treatment set up errors with M20 and S20 collimators were ≤ 0.2 mm in translational and 0.30 in rotational shifts. Results showed almost equal translational and rotational shifts in both medium and small field of views with different collimators in all the scans. Visualization of target and surrounding structures were good enough and sufficient for XVI auto matching.Conclusion: Imaging with small field of view results less patient dose compared with medium or large field of views. It is Suggestible to use collimators with small field of view wherever possible. In this study, collimators with small field of view were sufficient for both patients though the preset information indicated medium field of view. But, it always depends on the area required for matching purpose. So, individual selection is important than preset information in the XVI system.

  1. Right dose, right now: using big data to optimize antibiotic dosing in the critically ill.

    Elbers, Paul W G; Girbes, Armand; Malbrain, Manu L N G; Bosman, Rob


    Antibiotics save lives and are essential for the practice of intensive care medicine. Adequate antibiotic treatment is closely related to outcome. However this is challenging in the critically ill, as their pharmacokinetic profile is markedly altered. Therefore, it is surprising that critical care physicians continue to rely on standard dosing regimens for every patient, regardless of the actual clinical situation. This review outlines the pharmacokinetic and pharmacodynamic principles that underlie the need for individualized and personalized drug dosing. At present, therapeutic drug monitoring may be of help, but has major disadvantages, remains unavailable for most antibiotics and has produced mixed results. We therefore propose the AutoKinetics concept, taking decision support for antibiotic dosing back to the bedside. By direct interaction with electronic patient records, this opens the way for the use of big data for providing the right dose at the right time in each patient.

  2. The effects of antibiotic usage in food animals on the development of antimicrobial resistance of importance for humans in Campylobacter and Escherichia coli

    Aarestrup, Frank Møller; Wegener, Henrik Caspar


    Modern food animal production depends on use of large amounts of antibiotics for disease control. This provides favourable conditions for the spread and persistence of antimicrobial-resistant zoonotic bacteria such as Campylobacter and E. coli O157. The occurrence of antimicrobial resistance...... to antimicrobials used in human therapy is increasing in human pathogenic Campylobacter and E. coli from animals. There is an urgent need to implement strategies for prudent use of antibiotics in food animal production to prevent further increases in the occurrence of antimicrobial resistance in food-borne human...

  3. [Programs for optimizing the use of antibiotics (PROA) in Spanish hospitals: GEIH-SEIMC, SEFH and SEMPSPH consensus document].

    Rodríguez-Baño, Jesús; Paño-Pardo, José Ramón; Alvarez-Rocha, Luis; Asensio, Angel; Calbo, Esther; Cercenado, Emilia; Cisneros, José Miguel; Cobo, Javier; Delgado, Olga; Garnacho-Montero, José; Grau, Santiago; Horcajada, Juan Pablo; Hornero, Ana; Murillas-Angoiti, Javier; Oliver, Antonio; Padilla, Belén; Pasquau, Juan; Pujol, Miquel; Ruiz-Garbajosa, Patricia; San Juan, Rafael; Sierra, Rafael


    The antimicrobial agents are unique drugs for several reasons. First, their efficacy is higher than other drugs in terms of reduction of morbidity and mortality. Also, antibiotics are the only group of drugs associated with ecological effects, because their administration may contribute to the emergence and spread of microbial resistance. Finally, they are used by almost all medical specialties. Appropriate use of antimicrobials is very complex because of the important advances in the management of infectious diseases and the spread of antibiotic resistance. Thus, the implementation of programs for optimizing the use of antibiotics in hospitals (called PROA in this document) is necessary. This consensus document defines the objectives of the PROA (namely, to improve the clinical results of patients with infections, to minimise the adverse events associated to the use of antimicrobials including the emergence and spread of antibiotic resistance, and to ensure the use of the most cost-efficacious treatments), and provides recommendations for the implementation of these programs in Spanish hospitals. The key aspects of the recommendations are as follows. Multidisciplinary antibiotic teams should be formed, under the auspices of the Infection Committees. The PROA need to be considered as part of institutional programs and the strategic objectives of the hospital. The PROA should include specific objectives based on measurable indicators, and activities aimed at improving the use of antimicrobials, mainly through educational activities and interventions based more on training activities directed to prescribers than just on restrictive measures. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  4. Optimization of treatment protocols to prevent de novo development of antibiotic resistance in Pseudomonas aeruginosa

    Feng, Yanfang


    The ever-increasing rate of drug resistant bacteria has been one of the most challenging problem worldwide. This thesis studied the following subjects with mostly the clinically leading pathogen, P. aeruginosa, as the model strain: de novo development of antibiotic resistance in patient during the

  5. Have the organisms that cause breast abscess changed with time?--Implications for appropriate antibiotic usage in primary and secondary care.

    Dabbas, Natalie; Chand, Manish; Pallett, Ann; Royle, Gavin T; Sainsbury, Richard


    Many patients with breast abscess are managed in primary care. Knowledge of current trends in the bacteriology is valuable in informing antibiotic choices. This study reviews bacterial cultures of a large series of breast abscesses to determine whether there has been a change in the causative organisms during the era of increasing methicillin-resistant Staphylococcus aureus (MRSA). Analysis was undertaken of all breast abscesses treated in a single unit over 2003 - 2006, including abscess type, bacterial culture, antibiotic sensitivity and resistance patterns. One hundred and ninety cultures were obtained (32.8% lactational abscess, 67.2% nonlactational). 83% yielded organisms. Staphylococcus aureus was the commonest organism isolated (51.3%). Of these, 8.6% were MRSA. Other common organisms included mixed anaerobes (13.7%), and anaerobic cocci (6.3%). Lactational abscesses were significantly more likely to be caused by S. aureus (p abscess groups. Appropriate antibiotic choices are of great importance in the community management of breast abscess. Ideally, microbial cultures should be obtained to institute targeted therapy but we recommend the continued use of flucloxacillin with or without metronidazole (or amoxicillin-clavulanate as a single preparation) as initial empirical therapy.

  6. Ribosomal Antibiotics: Contemporary Challenges

    Tamar Auerbach-Nevo


    Full Text Available Most ribosomal antibiotics obstruct distinct ribosomal functions. In selected cases, in addition to paralyzing vital ribosomal tasks, some ribosomal antibiotics are involved in cellular regulation. Owing to the global rapid increase in the appearance of multi-drug resistance in pathogenic bacterial strains, and to the extremely slow progress in developing new antibiotics worldwide, it seems that, in addition to the traditional attempts at improving current antibiotics and the intensive screening for additional natural compounds, this field should undergo substantial conceptual revision. Here, we highlight several contemporary issues, including challenging the common preference of broad-range antibiotics; the marginal attention to alterations in the microbiome population resulting from antibiotics usage, and the insufficient awareness of ecological and environmental aspects of antibiotics usage. We also highlight recent advances in the identification of species-specific structural motifs that may be exploited for the design and the creation of novel, environmental friendly, degradable, antibiotic types, with a better distinction between pathogens and useful bacterial species in the microbiome. Thus, these studies are leading towards the design of “pathogen-specific antibiotics,” in contrast to the current preference of broad range antibiotics, partially because it requires significant efforts in speeding up the discovery of the unique species motifs as well as the clinical pathogen identification.

  7. Usage Center

    Kleinaltenkamp, Michael; Plewa, Carolin; Gudergan, Siegfried


    Purpose: The purpose of this paper is to advance extant theorizing around resourceintegration by conceptualizing and delineating the notion of a usage center. Ausage center consists of a combination of interdependent actors that draw onresources across their individual usage processes to create v...

  8. Factors affecting dairy farmers' attitudes towards antimicrobial medicine usage in cattle in England and Wales.

    Jones, P J; Marier, E A; Tranter, R B; Wu, G; Watson, E; Teale, C J


    There has been growing concern about bacterial resistance to antimicrobials in the farmed livestock sector. Attention has turned to sub-optimal use of antimicrobials as a driver of resistance. Recent reviews have identified a lack of data on the pattern of antimicrobial use as an impediment to the design of measures to tackle this growing problem. This paper reports on a study that explored use of antibiotics by dairy farmers and factors influencing their decision-making around this usage. We found that respondents had either recently reduced their use of antibiotics, or planned to do so. Advice from their veterinarian was instrumental in this. Over 70% thought reducing antibiotic usage would be a good thing to do. The most influential source of information used was their own veterinarian. Some 50% were unaware of the available guidelines on use in cattle production. However, 97% thought it important to keep treatment records. The Theory of Planned Behaviour was used to identify dairy farmers' drivers and barriers to reduce use of antibiotics. Intention to reduce usage was weakly correlated with current and past practice of antibiotic use, whilst the strongest driver was respondents' belief that their social and advisory network would approve of them doing this. The higher the proportion of income from milk production and the greater the chance of remaining in milk production, the significantly higher the likelihood of farmers exhibiting positive intention to reduce antibiotic usage. Such farmers may be more commercially minded than others and thus more cost-conscious or, perhaps, more aware of possible future restrictions. Strong correlation was found between farmers' perception of their social referents' beliefs and farmers' intent to reduce antibiotic use. Policy makers should target these social referents, especially veterinarians, with information on the benefits from, and the means to, achieving reductions in antibiotic usage. Information on sub-optimal use

  9. A preliminary report on the usage of an intracorporal antibiotic cast with synthetic high purity CaSO4 for the treatment of infected penile implant.

    Swords, Kelly; Martinez, Daniel R; Lockhart, Jorge L; Carrion, Rafael


    Currently, the surgical treatment of infected penile prostheses is complete removal and either immediate salvage procedure, which carries a significant infection risk, or delayed implantation. With delayed implantation the risk of infection is lower, but the patient loses penile length and width due to corporal fibrosis. We present our experience with the use of a novel temporary synthetic high purity calcium sulfate (SHPCaSO4) component that acts as a "spacer" at the time of removal of an infected prosthesis while providing constant delivery of local antibiotic elution to the infected area. Demonstrate that the use of a novel material, SHPCaSO4, can be an innovative way to bridge the gap between removal of an infected penile implant and delayed reimplantation. Two patients (Patient A and B) presented with pain and erythema and were found to have infected malleable penile prosthesis. Both underwent removal of all infected components, and sent for tissue culture. The SHPCaSO4 was mixed with vancomycin and tobramycin, allowed to set up for 5 minutes, and then injected into the corporal space followed by closure with 2-0 Vicryl sutures. The injected SHPCaSO4 was palpable in the penile shaft both proximally and distally, as an "intracorporal casts." Patients denied pain postoperatively. Delayed implantation occurred at 6 weeks for patient A. This went uneventful and a new three-piece inflatable implant was inserted. Patient B underwent salvage placement of right malleable implant at 15 weeks, and here significant corporal fibrosis was encountered. Patients have had no infection since their delayed implantation (mean follow-up 4 months). Data in reference to SHPCaSO4 shows that this product dissolves in approximately 4-6 weeks. This may account for the difference in the ease of delayed implantation between the two patients. Further investigation is warranted. © 2013 International Society for Sexual Medicine.

  10. Antibiotic Administration and Factors Influencing the Vaginal Microbiota during Pregnancy

    Stokholm, Jakob


    cohort. In study I we described the usage of antibiotics; (1) in pregnancy as oral antibiotics subdivided into groups; urinary tract infection (UTI) antibiotics, beta-lactams and other antibiotics, and (2) during birth as intrapartum antibiotics. Furthermore we examined whether the usage of both oral...... antibiotic treatments was increased in the lower educated women. Younger women and smokers had an increased usage of UTI antibiotics and asthmatic women had an increased usage of beta-lactams. Administration of intrapartum antibiotics was increased in smokers, in women giving birth at a lower gestational age...... were associated to treatment with UTI antibiotics. Women treated in the third trimester of pregnancy were more often colonized by E. coli. This change was associated to beta-lactam treatment. We did not observe any significant changes in vaginal group B Streptococcus (GBS) following antibiotic...

  11. A Pragmatic Biomarker-Driven Algorithm to Guide Antibiotic Use in the Pediatric Intensive Care Unit: The Optimizing Antibiotic Strategies in Sepsis (OASIS) Study.

    Downes, Kevin J; Weiss, Scott L; Gerber, Jeffrey S; Klieger, Sarah B; Fitzgerald, Julie C; Balamuth, Fran; Kubis, Sherri E; Tolomeo, Pam; Bilker, Warren B; Han, Xiaoyan; Nachamkin, Irving; Garrigan, Charles; Han, Jennifer H; Lautenbach, Ebbing; Coffin, Susan E


    Biomarkers that identify critically ill children with systemic inflammatory response syndrome (SIRS) at low risk for bacterial infection may help clinicians reduce unnecessary antibiotic use. We conducted a prospective cohort study of children with SIRS and suspected infection admitted to a pediatric intensive care unit from January 5, 2012 to March 7, 2014. We enrolled patients upon initiation of new antibiotics (Time 0) and measured a panel of 8 serum biomarkers daily over 72 hours. Microbiology, imaging, and clinical data were reviewed to classify bacterial infections using Centers for Disease Control and Prevention definitions. We identified cut points of biomarker combinations to maximize the negative predictive value (NPV) and specificity for bacterial infection. Excess antibiotics were calculated as days of therapy beyond day 2 after SIRS onset in patients without bacterial infection. Infections were identified in 46 of 85 patients: bacterial (n = 22) and viral (24), whereas 39 patients had no infection identified. At Time 0, C-reactive protein (CRP) <5 mg/dL plus serum amyloid A <15.0 µg/mL had an NPV of 0.92 (95% confidence interval [CI], 0.79-1.0) and specificity of 0.54 (95% CI, 0.42-0.66) to identify patients without bacterial infection, whereas CRP <4 mg/dL plus procalcitonin <1.75 ng/mL had an NPV of 0.90 (95% CI, 0.79-1.0) and specificity of 0.43 (95% CI, 0.30-0.55). Patients without bacterial infection received a mean of 3.8 excess days of therapy. Early measurement of select biomarkers can identify children with SIRS in whom antibiotics might be safely discontinued when there is no other objective evidence of infection at 48 hours. © The Author 2016. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail:

  12. Biotherapeutics as alternatives to antibiotics

    Increasing pressure to limit antibiotic use in agriculture is heightening the need for alternative methods to reduce the adverse effects of clinical and subclinical disease on livestock performance that are currently managed by in-feed antibiotic usage. Immunomodulators have long been sought as such...

  13. Controlled Antibiotic Delivery by Gelatin Nanospheres: Optimization, Characterization and Antibacterial Evaluation

    Shahrzad Fathollahipour


    Full Text Available The present work focuses on preparation and characterization of erythromycin loaded gelatin nanoparticles through nanoprecipitation method. The procedure consists of the addition of the aqueous gelatin solution to the non-solvent phase containing Lutherol F127. Three different measures of cross-linker and polymer concentration were also examined, and the optimum concentration was found. The morphology of gelatin nanoparticles was characterized by field emission scanning electron microscope. It was shown that the optimal morphology can be achieved at the concentration of 1.25 wt % of gelatin in aqueous phase by addition of 20 mL of glutaraldehyde 5%, as the crosslinking agent. Nanoparticle wet size determination was carried out using a dynamic light scattering system and found to be approximately 100 nm. Furthermore, Erythromycin release studies proved the suitability of these particles as a drug delivery system, at least in the studied 72 hours interval. As suggested by related measurements, these nanoparticles are good candidates for antibacterial agent release in any possible related application.

  14. Sparing carbapenem usage.

    Wilson, A Peter R


    Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. To provide guidance on strategies to reduce carbapenem usage. A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report. Older agents remain active against some of the pathogens, although expectations of broad-spectrum cover for empirical treatment have risen. Education, expert advice on treatment and antimicrobial stewardship can produce significant reductions in use. More agents may need to be introduced onto the antibiotic formulary of the hospital, despite the poor quality of scientific studies in some cases. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email:

  15. An Optimal Sample Data Usage Strategy to Minimize Overfitting and Underfitting Effects in Regression Tree Models Based on Remotely-Sensed Data

    Yingxin Gu


    Full Text Available Regression tree models have been widely used for remote sensing-based ecosystem mapping. Improper use of the sample data (model training and testing data may cause overfitting and underfitting effects in the model. The goal of this study is to develop an optimal sampling data usage strategy for any dataset and identify an appropriate number of rules in the regression tree model that will improve its accuracy and robustness. Landsat 8 data and Moderate-Resolution Imaging Spectroradiometer-scaled Normalized Difference Vegetation Index (NDVI were used to develop regression tree models. A Python procedure was designed to generate random replications of model parameter options across a range of model development data sizes and rule number constraints. The mean absolute difference (MAD between the predicted and actual NDVI (scaled NDVI, value from 0–200 and its variability across the different randomized replications were calculated to assess the accuracy and stability of the models. In our case study, a six-rule regression tree model developed from 80% of the sample data had the lowest MAD (MADtraining = 2.5 and MADtesting = 2.4, which was suggested as the optimal model. This study demonstrates how the training data and rule number selections impact model accuracy and provides important guidance for future remote-sensing-based ecosystem modeling.

  16. Optimization of a data acquisition and control system for calibration of X rays detectors with usage of computational tools

    Rodrigues, Yklys Santos


    The Brazilian standard ABNT ISO/IEC 17025/2005 specifies general requirements for the competence of testing and calibration facilities. One of these requirements states that these facilities must always optimize their processes and thus, uncertainties must be estimated and lowered as much as possible. In order to achieve such goal, the Laboratorio de Calibracao de Instrumentos (LCI), a laboratory responsible for dosimeter calibration at the Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN) have acquired some equipment for the LCI's X-Ray calibration system, such as a rotating filter holder, and it has also been developing software in order to provide the best calibration results with lowest external interferences (from the operator, for instance) to diminish the possibilities of error occurrences. A semi-automated LabVIEW-based calibration software has been developed at LCI and it has been subjected to constant testing and improvements so far. The software is divided in two basic modules: one is responsible for calibration of the monitor chamber with a reference standard dosimeter, while the other is used to perform instruments calibrations using the monitor chamber as reference. Several influence quantities have been analyzed and the proper corrections have been added to the software as multiplicative correction factors. The software is not only able to acquire data from all the equipment used in the laboratory, but also it is able to calculate calibration factors and its uncertainties. A later analysis shows how this system has optimized the whole calibration process, lowering the occupational dose, reducing the mean time of calibration, uncertainties and preventing errors caused by the system's users. (author)

  17. [Optimization of cultural condition of genetic engineering strain for antibiotic peptide adenoregulin and research on its fed-batch cultivation].

    Zhou, Yu-Xun; Cao, Wei; Wei, Dong-Zhi; Luo, Qing-Ping; Wang, Jin-Zhi


    33 amino acid antibiotic peptide adenoregulin (ADR), which were firstly isolated from the skin of South America arboreal frog Phyllomedusa bicolor, forms alpha-helix amphipathic structure in apolar medium and has a wide spectrum of antimicrobial activity and high potency of lytic ability. Adr gene was cloned in pET32a and transformed into Escherichia coli BL21(DE3) . The cultural and inductive conditions of E. coli BL21(DE3)/pET32a-adr have been optimized. The effect of three factors which were time point of induction, concentration of IPTG in the culture and time of induction on the expression level of Trx-ADR was investigated. The results indicated that the expression level was affected by the time point of induction most predominantly. 9 veriaties of media in which BL21 (DE3)/pET32a-adr was cultured and induced were tested to achieve high expression level of target protein. It was found that glucose in the medium played an important role in keeping stable and high expression level of Trx-ADR. The optimal inductive condition is as follows: the culture medium is 2 x YT + 0.5% glucose, the time point of induction is OD600 = 0.9, the final concentration of IPTG in the culture is 0.1 mmol/L and the induction time is 4 h. BL21 (DE3)/pET32a-adr was cultivated according to the strategy of constant pH at early stage and exponential feeding at later stage to obtain high cell density. During the entire fed-batch phase, by controlling the feeding of glucose, the specific growth rate of the culture was controlled at about 0.15 h(-1), the accumulation of acetic acid was controlled at low level (<2 g/L), but the plasmid stability could not be maintained well. At the end of the cultivation, 40% of the bacteria in the culture lost their plasmids. As a result, the expression level of the target protein declined dramatically, but 90% of Trx-ADR was in soluble form. The expressed fusion protein showed no antibacterial activity, while the native form of ADR lysed from Trx-ADR showed

  18. Distribution and degradation of common antibiotics and linkage to antibiotic resistance genes in the environment of Shenzhen, China

    Sun, J.; Qiu, W.; Zheng, C.


    Antibiotics, as emerging contaminants, have been widely detected in environmental matrices in China and worldwide, such as wastewater treatment plants (WWTPs), hospital effluents, livestock farms, river water and sediment, soil, groundwater, and seawater. Thus, there exist significant concerns about their potential risks to human and ecosystem health. Compared to other countries, research on antibiotics in China is mainly focused on the watershed level, and there is a lack of information on emission inventory and environmental fate of antibiotics in China. In this study, we investigated the distribution of 21 frequently detected antibiotics in the five representative rivers in Shenzhen, China. Our monitoring results showed that the concentration of the 21 antibiotic contaminants in river waters and sediments ranges from 0.004ng/L to 0.378μg/L and from 0.005ng/kg to 2.089ng/kg, respectively. The data also revealed that the level of antibiotics in the five rivers exhibits strong temporal and spatial variations, and the antibiotic content in dry season is significantly higher than that in flood season. The bacterial resistance rates in sediments were found to be related to antibiotic usages, especially for those antibiotics used in the most recent period. Our degradation experiment results showed that the optimal conditions for the removal of enrofloxacin and pefloxacin were as follows: pH at 3 and the concentration of H2O2 and Fe2+ were 20mM and 0.25mM, respectively. This study can provide basic data useful for addressing the water environmental problems in Shenzhen and for dealing with national pollution control of antibiotics as emerging contaminants.

  19. Antibiotics and Antibiotic Resistance

    ... all that ails you. Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. ... Information for Consumers and Health Professionals Information by drug class Antimicrobial Resistance Animal and Veterinary Related Resources Further information ...

  20. [Proper antibiotic therapy. From penicillin to pharmacogenomic].

    Caramia, G; Ruffini, E


    Antibiotics have always been considered one of the wonder discoveries of the 20th century. The use of penicillin by Flaming, opened up the golden era of antibiotics and now is hard to imagine the practice of medicine without antibiotics. Life-threatening infections, such as meningitis, endocarditis, bacteremic pneumonia sepsis, would again prove fatal. Also aggressive chemotherapy and transplant procedures would prove impossible. Another real wonder has been the rise of antibiotic resistance soon after the clinical use of penicillin in hospitals and communities. Several study demonstrated an excessive amount of antibiotic prescribing for communities patients and inpatients and in some hospital up to 50% of antibiotic usage is inappropriate: the benefits of antibiotic treatment come with the risk of antibiotic resistance development. In hospitals, infections caused by antibiotic-resistant bacteria are associated with higher mortality, morbidity and prolonged hospital stay compared with infections caused by antibiotic-susceptible bacteria. A variety of strategies has been proposed to reduce the cost and improve the quality of medication use. Education, guidelines and evidence based recommendations are considered to be essential elements of any program designed to influence prescribing behavior and can provide a foundation of knowledge that will enhance and increase the acceptance of stewardship strategies. Evidence-based recommendations, an approach to clinical practice helping to make decisions based on clinical expertise and on intimate knowledge of the individual patient's situations, beliefs, and priorities, enhance antimicrobial stewardship, that include appropriate selection, dosing, route, and duration of antimicrobial therapy can maximize clinical cure or prevention of infection while limiting the unintended consequences, such as the emergence of resistance, adverse drug events, and cost. These evidence-based guidelines are not a substitute for clinical

  1. [Optimizing antibiotics policy in the Netherlands. VI. SWAB advice: no selective decontamination of intensive care patients on mechanical ventilation

    Bonten, M.J.; Kullberg, B.J.; Filius, P.M.


    The Working Party on Antibiotic Policy (Dutch acronym is SWAB) has issued a guideline in which the pro and cons of the routine use of selective decontamination (SD) in patients in intensive care (IC) on mechanical ventilation are compared in order to decide whether SD is indicated. The effectiveness

  2. Streptomyces thermoviolaceus SRC3 strain as a novel source of the antibiotic adjuvant streptazolin: A statistical approach toward the optimized production.

    Djinni, Ibtissem; Djoudi, Warda; Souagui, Samiha; Rabia, Farida; Rahmouni, Sihem; Mancini, Ines; Kecha, Mouloud


    Streptomyces thermoviolaceus SRC3, a newly isolated actinobacterial strain from Algerian river sediments, exhibited a broad activity against various bacterial and yeast human pathogens (Salmonella Typhi ATCC 14028, Vibrio cholerae ATCC 14035, MRSA ATCC 43300 and Candida albicans ATCC 10231). The strain SRC3 was selected from thirty nine actinobacterial isolates and identified as S. thermoviolaceus based on morphology, cultural properties, physiological analyses and 16S rRNA gene sequencing. Culture parameters for the antibiotic production were optimized by sequential statistical strategy including Plackett-Burman design (PBD) and Response Surface Methodology (RSM). In PBD experiments, KCl, K 2 HPO 4 , MgSO 4 ·7H 2 O, pH value and incubation time emerged as the most significant in affecting the output of antimicrobial activities. These factors were further optimized using Central Composite Design (CCD). The best achieved conditions were: KCl (0.01%), K 2 HPO 4 (0.1%), MgSO 4 ·7H 2 O (0.02%) and 9 days incubation for anti-S. Typhi compounds, KCl (0.051%), MgSO 4 ·7H 2 O (0.05%) and 5 days incubation for C. albicans inhibitors. The metabolite responsible for the bioactivities was purified, structurally characterized (by NMR, MS, UV and IR analyses) and identified as streptazolin, recently reported as a promising antibiotic adjuvant. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Novel approaches to developing new antibiotics for bacterial infections

    Coates, A R M; Hu, Y


    Antibiotics are an essential part of modern medicine. The emergence of antibiotic-resistant mutants among bacteria is seemingly inevitable, and results, within a few decades, in decreased efficacy and withdrawal of the antibiotic from widespread usage. The traditional answer to this problem has been to introduce new antibiotics that kill the resistant mutants. Unfortunately, after more than 50 years of success, the pharmaceutical industry is now producing too few antibiotics, particularly aga...

  4. Antibiotic residues and resistance in the environment

    Pikkemaat, M.G.; Yassin, H.; Fels-Klerkx, H.J.; Berendsen, B.J.A.


    Antibiotic usage has benefited the animal industry and helped providing affordable animal proteins to the growing human population. However, since extensive use of antibiotics results in the inhibition of susceptible organisms while selecting for the resistant ones, agricultural use is contributing

  5. Codon and amino acid usage in two major human pathogens of genus Bartonella--optimization between replicational-transcriptional selection, translational control and cost minimization.

    Das, Sabyasachi; Paul, Sandip; Chatterjee, Sanjib; Dutta, Chitra


    Intra-genomic variation in synonymous codon and amino acid usage in two human pathogens Bartonella henselae and B. quintana has been carried out through multivariate analysis. Asymmetric mutational bias, coupled with replicational-transcriptional selection, has been identified as the prime selection force behind synonymous codon selection--a characteristic of the genus Bartonella, not exhibited by any other alpha-proteobacterial genome. Distinct codon usage patterns and low synonymous divergence values between orthologous sequences of highly expressed genes from the two Bartonella species indicate that there exists a residual intra-strand synonymous codon bias in the highly expressed genes, possibly operating at the level of translation. In the case of amino acid usage, the mean hydropathy level and aromaticity are the major sources of variation, both having nearly equal impact, while strand-specific mutational pressure and gene expressivity strongly influence the inter-strand variations. In both species under study, the highly expressed gene products tend not to contain heavy and/or aromatic residues, following the cost-minimization hypothesis in spite of their intracellular lifestyle. The codon and amino acid usage in these two human pathogens are, therefore, consequences of a complex balance between replicational-transcriptional selection, translational control, protein hydropathy and cost minimization.

  6. Adverse consequences of neonatal antibiotic exposure.

    Cotten, Charles M


    Antibiotics have not only saved lives and improved outcomes, but they also influence the evolving microbiome. This review summarizes reports on neonatal infections and variation in antibiotic utilization, discusses the emergence of resistant organisms, and presents data from human neonates and animal models demonstrating the impact of antibiotics on the microbiome, and how microbiome alterations impact health. The importance of antibiotic stewardship is also discussed. Infections increase neonatal morbidity and mortality. Furthermore, the clinical presentation of infections can be subtle, prompting clinicians to empirically start antibiotics when infection is a possibility. Antibiotic-resistant infections are a growing problem. Cohort studies have identified extensive center variations in antibiotic usage and associations between antibiotic exposures and outcomes. Studies of antibiotic-induced microbiome alterations and downstream effects on the developing immune system have increased our understanding of the mechanisms underlying the associations between antibiotics and adverse outcomes. The emergence of resistant microorganisms and recent evidence linking antibiotic practice variations with health outcomes has led to the initiation of antibiotic stewardship programs. The review encourages practitioners to assess local antibiotic use with regard to local microbiology, and to adopt steps to reduce infections and use antibiotics wisely.

  7. Barriers and facilitators to the dissemination of DECISION+, a continuing medical education program for optimizing decisions about antibiotics for acute respiratory infections in primary care: A study protocol

    Gagnon Marie-Pierre


    decision making regarding the use of antibiotics in acute respiratory infections, to facilitate its dissemination in primary care on a large scale. Our results should help continuing medical educators develop a continuing medical education program in shared decision making for other clinically relevant topics. This will help optimize clinical decisions in primary care.

  8. Antibiotic Misuse among High School Students in Calabar Nigeria ...

    Five hundred and sixty high school students from five secondary schools in Calabar, Nigeria were studied for antibiotic usage. Questionnaires where administered to determine the following parameters: Knowledge of antibiotics, types of infections for which antibiotics were taken, sources of prescription and procurement of ...

  9. Collateral effects of antibiotics on mammalian gut microbiomes

    Antibiotics are an essential component of the modern lifestyle. They improve our lives by treating disease, preventing disease, and in the case of agricultural animals by improving feed efficiency. However, antibiotic usage is not without collateral effects. The development and spread of antibiot...

  10. Antibiotics, pediatric dysbiosis, and disease.

    Vangay, Pajau; Ward, Tonya; Gerber, Jeffrey S; Knights, Dan


    Antibiotics are by far the most common medications prescribed for children. Recent epidemiological data suggests an association between early antibiotic use and disease phenotypes in adulthood. Antibiotic use during infancy induces imbalances in gut microbiota, called dysbiosis. The gut microbiome's responses to antibiotics and its potential link to disease development are especially complex to study in the changing infant gut. Here, we synthesize current knowledge linking antibiotics, dysbiosis, and disease and propose a framework for studying antibiotic-related dysbiosis in children. We recommend future studies into the microbiome-mediated effects of antibiotics focused on four types of dysbiosis: loss of keystone taxa, loss of diversity, shifts in metabolic capacity, and blooms of pathogens. Establishment of a large and diverse baseline cohort to define healthy infant microbiome development is essential to advancing diagnosis, interpretation, and eventual treatment of pediatric dysbiosis. This approach will also help provide evidence-based recommendations for antibiotic usage in infancy. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Rivet usage at CMS

    Radziej, Markus; Hebbeker, Thomas; Sonnenschein, Lars [III. Phys. Inst. A, RWTH Aachen (Germany)


    In this talk an overview of Rivet and its usage at the CMS experiment is presented. Rivet stands for ''Robust Independent Validation of Experiment and Theory'' and is used for optimizing and validating Monte Carlo event generators. By using the results of published analyses, distributions of the simulation can be compared to experimental measurements (corrected for detector effects). This gives insight into the agreement on the particle-level. Starting off with an introduction to the Rivet environment, the purpose of this tool in modern particle physics is explained. Before taking a closer look at the analysis structure, the software necessary to get comparisons is outlined. Analysis implementations are discussed using code examples, showcasing the powerful framework that Rivet provides. A few selected final distributions displaying both Monte Carlo generated events and recorded data are presented, showing the potential to perform particle-level comparisons.

  12. Recent government regulations in the United States seek to ensure the effectiveness of antibiotics by limiting their agricultural use.

    Centner, Terence J


    The development of bacteria resistant to antibiotics is viewed as a medical health threat. Because thousands of people die every year due to antibiotic-resistant bacteria, efforts are underway to reduce antibiotic usage which in turn will reduce the development of antibiotic-resistant bacteria. In the United States, the use of antibiotics in the production of food animals to enhance animal growth has been identified as contributing to resistance. In 2015, a veterinary feed directive was adopted by the U.S. federal government prohibiting nontherapeutic uses of antibiotics in food animals that should reduce usage. The continued usage of antibiotics by producers for preventing disease may mean the directive is insufficient to reduce nontherapeutic antibiotic administration. This may lead some consumers to seek meat products from animals raised without antibiotics. A governmentally-sponsored labeling program could encourage reduction in antibiotic usage. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Does training family physicians in shared decision making promote optimal use of antibiotics for acute respiratory infections? Study protocol of a pilot clustered randomised controlled trial

    Côté Luc


    Full Text Available Abstract Background In North America, although it varies according to the specific type of acute respiratory infections (ARI, use of antibiotics is estimated to be well above the expected prevalence of bacterial infections. The objective of this pilot clustered randomized controlled trial (RCT is to assess the feasibility of a larger clustered RCT aiming at evaluating the impact of DECISION+, a continuing professional development (CPD program in shared decision making, on the optimal use of antibiotics in the context of ARI. Methods/design This pilot study is a cluster RCT conducted with family physicians from Family Medicine Groups (FMG in the Quebec City area, Canada. Participating FMG are randomised to an immediate DECISION+ group, a CPD program in shared decision making, (experimental group, or a delayed DECISION+ group (control group. Data collection involves recruiting five patients consulting for ARI per physician from both study groups before (Phase 1 and after (Phase 2 exposure of the experimental group to the DECISION+ program, and after exposure of the control group to the DECISION+ program (Phase 3. The primary outcome measures to assess the feasibility of a larger RCT include: 1 proportion of contacted FMG that agree to participate; 2 proportion of recruited physicians who participate in the DECISION+ program; 3 level of satisfaction of physicians regarding DECISION+; and 4 proportion of missing data in each data collection phase. Levels of agreement of the patient-physician dyad on the Decisional Conflict Scale and physicians' prescription profile for ARI are performed as secondary outcome measures. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting clustered RCT with FMG regarding training of physicians in shared decision making. Trial Registration Identifier: NCT00354315

  14. Forgotten antibiotics

    Pulcini, Céline; Bush, Karen; Craig, William A


    In view of the alarming spread of antimicrobial resistance in the absence of new antibiotics, this study aimed at assessing the availability of potentially useful older antibiotics. A survey was performed in 38 countries among experts including hospital pharmacists, microbiologists, and infectious...

  15. Use of old antibiotics now and in the future from a pharmacokinetic/pharmacodynamic perspective.

    Muller, A E; Theuretzbacher, U; Mouton, J W


    Because of the increase in bacterial resistance to commonly used antibacterial drugs, old antibiotics are being 'revived' and, once again, are attracting interest. Many of these old antibiotics were approved long ago, in an era when there was no clear process for development, and requirements for efficacy to be demonstrated in rigorous clinical trials did not exist. At the time of these approvals, pharmacokinetic and pharmacodynamic principles were largely unknown, and did not inform the dose-finding process or recommendations for optimal usage. Indeed, the task of generating basic vital information for these old antibiotics remains to be performed. In this review, we provide a brief overview of the most essential data needed for dose justification and optimization. An overview of the shortage of data for selected old antibiotics illustrates the scope of the problem. In order to prevent harming patients with clinical decisions based on inadequate evidence, a redevelopment procedure for old antibiotics is urgently needed, including a regulatory framework. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Multi-Train Energy Saving for Maximum Usage of Regenerative Energy by Dwell Time Optimization in Urban Rail Transit Using Genetic Algorithm

    Fei Lin


    Full Text Available With its large capacity, the total urban rail transit energy consumption is very high; thus, energy saving operations are quite meaningful. The effective use of regenerative braking energy is the mainstream method for improving the efficiency of energy saving. This paper examines the optimization of train dwell time and builds a multiple train operation model for energy conservation of a power supply system. By changing the dwell time, the braking energy can be absorbed and utilized by other traction trains as efficiently as possible. The application of genetic algorithms is proposed for the optimization, based on the current schedule. Next, to validate the correctness and effectiveness of the optimization, a real case is studied. Actual data from the Beijing subway Yizhuang Line are employed to perform the simulation, and the results indicate that the optimization method of the dwell time is effective.

  17. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Hong, Pei-Ying; Al-Jassim, Nada; Ansari, Mohd Ikram; Mackie, Roderick I.


    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water. PMID:27029309

  18. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Hong, Pei-Ying; Aljassim, Nada I.; Ansari, Mohd Ikram; Mackie, Roderick


    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  19. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Roderick I. Mackie


    Full Text Available Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  20. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Hong, Pei-Ying


    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  1. Antibiotic resistance

    Marianne Frieri


    Full Text Available Summary: Antimicrobial resistance in bacterial pathogens is a challenge that is associated with high morbidity and mortality. Multidrug resistance patterns in Gram-positive and -negative bacteria are difficult to treat and may even be untreatable with conventional antibiotics. There is currently a shortage of effective therapies, lack of successful prevention measures, and only a few new antibiotics, which require development of novel treatment options and alternative antimicrobial therapies. Biofilms are involved in multidrug resistance and can present challenges for infection control. Virulence, Staphylococcus aureus, Clostridium difficile infection, vancomycin-resistant enterococci, and control in the Emergency Department are also discussed. Keywords: Antibiotic resistance, Biofilms, Infections, Public health, Emergency Department

  2. Video personalization for usage environment

    Tseng, Belle L.; Lin, Ching-Yung; Smith, John R.


    A video personalization and summarization system is designed and implemented incorporating usage environment to dynamically generate a personalized video summary. The personalization system adopts the three-tier server-middleware-client architecture in order to select, adapt, and deliver rich media content to the user. The server stores the content sources along with their corresponding MPEG-7 metadata descriptions. Our semantic metadata is provided through the use of the VideoAnnEx MPEG-7 Video Annotation Tool. When the user initiates a request for content, the client communicates the MPEG-21 usage environment description along with the user query to the middleware. The middleware is powered by the personalization engine and the content adaptation engine. Our personalization engine includes the VideoSue Summarization on Usage Environment engine that selects the optimal set of desired contents according to user preferences. Afterwards, the adaptation engine performs the required transformations and compositions of the selected contents for the specific usage environment using our VideoEd Editing and Composition Tool. Finally, two personalization and summarization systems are demonstrated for the IBM Websphere Portal Server and for the pervasive PDA devices.

  3. Overexpression of antibiotic resistance genes in hospital effluents over time.

    Rowe, Will P M; Baker-Austin, Craig; Verner-Jeffreys, David W; Ryan, Jim J; Micallef, Christianne; Maskell, Duncan J; Pearce, Gareth P


    Effluents contain a diverse abundance of antibiotic resistance genes that augment the resistome of receiving aquatic environments. However, uncertainty remains regarding their temporal persistence, transcription and response to anthropogenic factors, such as antibiotic usage. We present a spatiotemporal study within a river catchment (River Cam, UK) that aims to determine the contribution of antibiotic resistance gene-containing effluents originating from sites of varying antibiotic usage to the receiving environment. Gene abundance in effluents (municipal hospital and dairy farm) was compared against background samples of the receiving aquatic environment (i.e. the catchment source) to determine the resistome contribution of effluents. We used metagenomics and metatranscriptomics to correlate DNA and RNA abundance and identified differentially regulated gene transcripts. We found that mean antibiotic resistance gene and transcript abundances were correlated for both hospital ( ρ  = 0.9, two-tailed P  hospital effluent samples. High β-lactam resistance gene transcript abundance was related to hospital antibiotic usage over time and hospital effluents contained antibiotic residues. We conclude that effluents contribute high levels of antibiotic resistance genes to the aquatic environment; these genes are expressed at significant levels and are possibly related to the level of antibiotic usage at the effluent source. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  4. Optimization of energy usage in textile finishing operations. Part I. The simulation of batch dyehouse activities with a general purpose computer model

    Beard, J.N. Jr.; Rice, W.T. Jr.


    A project to develop a mathematical model capable of simulating the activities in a typical batch dyeing process in the textile industry is described. The model could be used to study the effects of changes in dye-house operations, and to determine effective guidelines for optimal dyehouse performance. The computer model is of a hypothetical dyehouse. The appendices contain a listing of the computer program, sample computer inputs and outputs, and instructions for using the model. (MCW)

  5. Development and application of a T7 RNA polymerase-dependent expression system for antibiotic production improvement in Streptomyces.

    Wei, Junhong; Tian, Jinjin; Pan, Guoqing; Xie, Jie; Bao, Jialing; Zhou, Zeyang


    To develop a reliable and easy to use expression system for antibiotic production improvement of Streptomyces. A two-compound T7 RNA polymerase-dependent gene expression system was developed to fulfill this demand. In this system, the T7 RNA polymerase coding sequence was optimized based on the codon usage of Streptomyces coelicolor. To evaluate the functionality of this system, we constructed an activator gene overexpression strain for enhancement of actinorhodin production. By overexpression of the positive regulator actII-ORF4 with this system, the maximum actinorhodin yield of engineered strain was 15-fold higher and the fermentation time was decreased by 48 h. The modified two-compound T7 expression system improves both antibiotic production and accelerates the fermentation process in Streptomyces. This provides a general and useful strategy for strain improvement of important antibiotic producing Streptomyces strains.

  6. Differences in smartphone usage

    Gustarini, Mattia; Scipioni, Marcello Paolo; Fanourakis, Marios


    We analyze the users’ intimacy to investigate the differences in smartphone usage, considering the user’s location and number and kind of people physically around the user. With a first user study we (1) validate the intimacy concept, (2) evaluate its correlation to smartphone usage features and ...

  7. Usage Record Format Recommendation

    Nilsen, J.K.; Muller-Pfeerkorn, R


    For resources to be shared, sites must be able to exchange basic accounting and usage data in a common format. This document describes a common format which enables the exchange of basic accounting and usage data from different resources. This record format is intended to facilitate the sharing of usage information, particularly in the area of the accounting of jobs, computing, memory, storage and cloud usage but with a structure that allows an easy extension to other resources. This document describes the Usage Record components both in natural language form and annotated XML. This document does not address how these records should be used, nor does it attempt to dictate the format in which the accounting records are stored. Instead, it denes a common exchange format. Furthermore, nothing is said regarding the communication mechanisms employed to exchange the records, i.e. transport layer, framing, authentication, integrity, etc.

  8. Antibiotic Resistance

    Munck, Christian

    morbidity and mortality as well as an increase in the cost of treatment. Understanding how bacteria respond to antibiotic exposure gives the foundations for a rational approach to counteract antimicrobial resistance. In the work presented in this thesis, I explore the two fundamental sources...... of antimicrobial resistance: (1) adaptive mutations and (2) horizontal acquisition of resistance genes from antibiotic gene reservoirs. By studying the geno- and phenotypic changes of E. coli in response to single and drug-pair exposures, I uncover the evolutionary trajectories leading to adaptive resistance. I...... to rationally design drug combinations that limit the evolution of antibiotic resistance due to counteracting evolutionary trajectories. My results highlight that an in-depth knowledge about the genetic responses to the individual antimicrobial compounds enables the prediction of responses to drug combinations...

  9. Systemic antibiotic therapy in periodontics

    Anoop Kapoor


    Full Text Available Systemic antibiotics in conjunction with scaling and root planing (SRP, can offer an additional benefit over SRP alone in the treatment of periodontitis, in terms of clinical attachment loss (CAL and pocket depth change, and reduced risk of additional CAL loss. However, antibiotics are not innocuous drugs. Their use should be justified on the basis of a clearly established need and should not be substituted for adequate local treatment. The aim of this review is to discuss the rationale, proper selection, dosage and duration for antibiotic therapy so as to optimize the usefulness of drug therapy.

  10. Action and resistance mechanisms of antibiotics: A guide for clinicians

    Garima Kapoor


    Full Text Available Infections account for a major cause of death throughout the developing world. This is mainly due to the emergence of newer infectious agents and more specifically due to the appearance of antimicrobial resistance. With time, the bacteria have become smarter and along with it, massive imprudent usage of antibiotics in clinical practice has resulted in resistance of bacteria to antimicrobial agents. The antimicrobial resistance is recognized as a major problem in the treatment of microbial infections. The biochemical resistance mechanisms used by bacteria include the following: antibiotic inactivation, target modification, altered permeability, and “bypass” of metabolic pathway. Determination of bacterial resistance to antibiotics of all classes (phenotypes and mutations that are responsible for bacterial resistance to antibiotics (genetic analysis are helpful. Better understanding of the mechanisms of antibiotic resistance will help clinicians regarding usage of antibiotics in different situations. This review discusses the mechanism of action and resistance development in commonly used antimicrobials.

  11. Prevalence and antibiotic susceptibility pattern of ESBL producing ...

    Carbapenems are the best antibiotic treatment option for infections arising from these organisms although a coordinated rational usage is desired along with functional antibiotic prescription policy to avoid treatment failures. Continuous surveillance for ESBL producing Klebsiellae and resistance monitoring are necessary ...

  12. Overexpression of antibiotic resistance genes in hospital effluents over time

    Rowe, Will P. M.; Baker-Austin, Craig; Verner-Jeffreys, David W.; Ryan, Jim J.; Micallef, Christianne; Maskell, Duncan J.; Pearce, Gareth P.


    $\\textbf{Objectives}$: Effluents contain a diverse abundance of antibiotic resistance genes that augment the resistome of receiving aquatic environments. However, uncertainty remains regarding their temporal persistence, transcription and response to anthropogenic factors, such as antibiotic usage. We present a spatiotemporal study within a river catchment (River Cam, UK) that aims to determine the contribution of antibiotic resistance gene-containing effluents originating from sites of varyi...

  13. Combating Antibiotic Resistance

    ... Bacteria Phasing Out Certain Antibiotic Use in Farm Animals FDA: Cutting-Edge Technology Sheds Light on Antibiotic Resistance For More Information Antibiotics and Antibiotic Resistance Antimicrobial Resistance Information for Consumers and Health Professionals CDC: ...

  14. The Usage of E-Learning Model To Optimize Learning System In Higher Education by Using Dick and Carey Design Approach

    Anak Agung Gde Satia Utama


    Full Text Available Nowadays many universities in the world apply technology enhanced learning in order to help learning activities. Due to the potentials technology enhanced learning offers, recent education using it and universities in particular are trying to apply it. One of the subjects of this research is The Accounting Department of Airlangga University in Surabaya. The idea of this research is to investigate the students about how they know deeply about e-learning system and learning objectives as a first step to conduct e-learning model. After the model completed, the next step is to prepare database learning. Entity Relationship Diagram (ERD can help to explain the model. The purpose of this research was done by using Dick and Carey Design Model. There are nine steps to conduct e-learning model. All steps can be categorized into three steps research: first is the introduction or empirical study, the next step is the design and the last is the feedback after the implementation. The methodology used in this research is using Qualitative Exploratory, by using questionnaire and interviews as data collection techniques. The analysis of the data shows organization requires information about e-learning content, user as a learning subject and information technology infrastructures. E-learning model as one of the alternative learning can help users to optimized learning.

  15. Antibiotic Utilization in Pediatric Hospitalized Patients – A Single Center Study

    Hasime Qorraj Bytyqi


    CONCLUSION: This study demonstrates that surveillance programs on antibiotic resistance should be established and accompanied by analyses of drug utilisation data which can aid in the creation of valid cross-national studies on antibiotic usage and resistance, to motivate improvements in prescribing and guideline-directed antibiotic prescribing.

  16. Prescribing Antibiotics

    Pedersen, Inge Kryger; Jepsen, Kim Sune


    The medical professions will lose an indispensable tool in clinical practice if even simple infections cannot be cured because antibiotics have lost effectiveness. This article presents results from an exploratory enquiry into “good doctoring” in the case of antibiotic prescribing at a time when...... the knowledge base in the healthcare field is shifting. Drawing on in-depth interviews about diagnosing and prescribing, the article demonstrates how the problem of antimicrobial resistance is understood and engaged with by Danish general practitioners. When general practitioners speak of managing “non......-medical issues,” they refer to routines, clinical expertise, experiences with their patients, and decision-making based more on contextual circumstances than molecular conditions—and on the fact that such conditions can be hard to assess. This article’s contribution to knowledge about how new and global health...

  17. Researches with the 'Fertexpert' model concerning the relationships between the efficiency indexes of the fertilizers usage in optimal economic rates and the agrochemical indexes of the soil and expected yields

    Budoi, G.; Berca, M.; Borlan, Z.; Gavriluta, I.; Soare, M.; Danuso, F.; Bireescu, L.


    The 'Fertexpert' model allows undertaking researches concerning the variation of efficiency indexes for fertilizers usage in the case of many crops depending on the content of available soil nutrients (the values of soil agrochemical indexes - IA) and on the expected yield, R s , when fertilization are applied in optimal economic rates, DOE. The physical efficiency indexes calculated and researched are the following: the total physical yield increase, SFR (kg/ha), the specific average yield increase, SSp (kg/kg N, P 2 O 5 or K 2 O), the specific consumption of active substance (a.s.) from fertilizer, CSp (kg a.s./1 kg average yield increase). The economic efficiency indexes computed are: the total profit, in monetary units/ha, the specific profit, in monetary units/l monetary unit spent with fertilization, PSp, and in monetary units/kg a.s., PSpsa. The model also allows the study of DOE variation depending on R s and IA. Starting from the made calculations, there can be drown up specific graphics that can then be used in practice and for research purposes to. Refs. 6 (author)

  18. Simultaneous assessment of cytotoxic T lymphocyte responses against multiple viral infections by combined usage of optimal epitope matrices, anti- CD3 mAb T-cell expansion and "RecycleSpot"

    Wong Johnson T


    Full Text Available Abstract The assessment of cellular anti-viral immunity is often hampered by the limited availability of adequate samples, especially when attempting simultaneous, high-resolution determination of T cell responses against multiple viral infections. Thus, the development of assay systems, which optimize cell usage, while still allowing for the detailed determination of breadth and magnitude of virus-specific cytotoxic T lymphocyte (CTL responses, is urgently needed. This study provides an up-to-date listing of currently known, well-defined viral CTL epitopes for HIV, EBV, CMV, HCV and HBV and describes an approach that overcomes some of the above limitations through the use of peptide matrices of optimally defined viral CTL epitopes in combination with anti-CD3 in vitro T cell expansion and re-use of cells from negative ELISpot wells. The data show that, when compared to direct ex vivo cell preparations, antigen-unspecific in vitro T cell expansion maintains the breadth of detectable T cell responses and demonstrates that harvesting cells from negative ELISpot wells for re-use in subsequent ELISpot assays (RecycleSpot, further maximized the use of available cells. Furthermore when combining T cell expansion and RecycleSpot with the use of rationally designed peptide matrices, antiviral immunity against more than 400 different CTL epitopes from five different viruses can be reproducibly assessed from samples of less than 10 milliliters of blood without compromising information on the breadth and magnitude of these responses. Together, these data support an approach that facilitates the assessment of cellular immunity against multiple viral co-infections in settings where sample availability is severely limited.

  19. Antibiotic misuse in the community--a contributor to resistance?

    Carey, B


    The problem of antibiotic resistance is associated with the indiscriminate usage of antibiotics. Efforts have been directed at encouraging the rational use of these drugs to reduce the volume of antibiotic consumption and decrease resistance rates. There is evidence to suggest that the misuse of antibiotics by patients may also contribute to the problem. We describe a survey of a random selection of patients attending a General Practitioners\\' surgery over a six week period in an effort to estimate the level of non-compliance to antibiotic therapy in the community. The results suggest that there may be a significant level of antibiotic misuse prevalent in the local community. We discuss these results and present evidence in the literature suggesting how antibiotic misuse may affect resistance in the community. The factors affecting patient compliance to therapy are outlined along with suggested measures to improve compliance among patients.

  20. “Save Antibiotics, Save lives”: an Indian success story of infection control through persuasive diplomacy

    Ghafur A


    Full Text Available Abstract Background Carbapenem resistant Enterobacteriaceae is a worldwide threat, with increasing prevalence in many countries. Restricted usage of higher end antibiotics, especially carbapenem is of great importance in tackling these super bugs. Purpose of this retrospective study was to analyse the impact of antibiotic stewardship activities on the prevalence of carbapenem resistant Enterobacteriaceae in our hospital. Findings In the first Quarter of 2009, average usage of carbapenem group of antibiotics was 955 vials a month while in 2010, the usage dropped to 745 vials per month. Carbapenem resistant E.coli rate dropped from 3.7% in 2009 to 1.6% in 2010 and Klebsiella rate reduced from 6% in 2009 to 3.6% in 2010. Conclusions Strict antibiotic stewardship strategies in conjunction with good infection control practices are useful in restricting higher end antibiotic usage and reducing the prevalence of carbapenem resistant Enterobacteriaceae.

  1. Antibiotic usage pattern in selected poultry farms in Ogun state



    Dec 27, 2013 ... streptomycin and tylosin among poultry farms in. Ekiti State, Nigeria. ... in poultry production due to its possibility of forming residue in ... withdrawal periods are not observed before selling ... Manipulating pig production IX.

  2. French grammar and usage

    Hawkins, Roger


    Long trusted as the most comprehensive, up-to-date and user-friendly grammar available, French Grammar and Usage is a complete guide to French as it is written and spoken today. It includes clear descriptions of all the main grammatical phenomena of French, and their use, illustrated by numerous examples taken from contemporary French, and distinguishes the most common forms of usage, both formal and informal.Key features include:Comprehensive content, covering all the major structures of contemporary French User-friendly organisation offering easy-to-find sections with cross-referencing and i

  3. Occurrence, Seasonal Variation and Risk Assessment of Antibiotics in Qingcaosha Reservoir

    Yue Jiang; Cong Xu; Xiaoyu Wu; Yihan Chen; Wei Han; Karina Yew-Hoong Gin; Yiliang He


    Qingcaosha Reservoir is an important drinking water source in Shanghai. The occurrence of five groups of antibiotics was investigated in the surface water of this reservoir over a one-year period. Seventeen antibiotics were selected in this study based on their significant usage in China. Of these antibiotics, 16 were detected, while oxytetracycline was not detected in any sampling site. The detected frequency of tylosin was only 47.92% while the other 15 antibiotics were above 81.25%. The do...

  4. Antibiotic Resistance of Bacteria: A Global Challenge

    protein that functions as an elctroneutral antiport system. The .... isolates, obtained from north Bengal, and over the counter sale of the same antibiotics in and around .... biology is being applied to rapidly explore and optimize the interactions ...

  5. Vehicle usage verification system

    Scanlon, W.G.; McQuiston, Jonathan; Cotton, Simon L.


    EN)A computer-implemented system for verifying vehicle usage comprising a server capable of communication with a plurality of clients across a communications network. Each client is provided in a respective vehicle and with a respective global positioning system (GPS) by which the client can

  6. Antibiotic Resistance

    Hansen, Malene Plejdrup; Hoffmann, Tammy C; McCullough, Amanda R


    hygiene, and possibly vaccination and exercise, may be effective. Also, a large range of complementary and alternative medicines (e.g. zinc, vitamin C and probiotics) are proposed for preventing and treating ARIs, but evidence for efficacy is scarce. General practitioners' (GPs) attitudes towards...... wrong. Shared decision making might be a solution, as it enables clinician and patient to participate jointly in making a health decision, having discussed the options together with the evidence for their harms as well as benefits. Furthermore, GPs' diagnostic uncertainty - often leading...... will greatly improve the use of antibiotics for ARIs. However, used in concert, combinations are likely to enable clinicians and health care systems to implement the strategies that will reduce antimicrobial resistance in the future....

  7. Perceived driving safety and seatbelt usage.

    Svenson, O; Fischhoff, B; MacGregor, D


    Swedish and U.S. subjects judged their own driving skills and safety in relation to other drivers. As in earlier studies, most subjects showed an optimism bias: a tendency to judge oneself as safer and more skillful than the average driver, with a smaller risk of getting involved and injured in an accident. Different measures of the optimism effect were strongly correlated with one another, with driving experience and with the judged importance of human factors (as opposed to technical and chance factors) in causing accidents. Degree of optimism was positively, but weakly, correlated with reported seatbelt usage and worry about traffic accidents. Seatbelt usage was positively related to the extent to which belts are judged to be convenient and popular, and more modestly related to the belt's perceived contributions to safety. These results suggest that providing more information about the effectiveness of seatbelts may not be as efficient a way of increasing seatbelt usage as emphasizing other factors, such as comfort and social norms, which cannot be outweighed by optimism.

  8. Usage of Recycled Pet

    A. Ebru Tayyar


    Full Text Available The increasing industrialization, urbanization and the technological development have caused to increase depletion of the natural resources and environmental pollution's problem. Especially, for the countries which have not enough space recycling of the waste eliminating waste on regular basis or decreasing the amount and volume of waste have provided the important advantages. There are lots of studies and projects to develop both protect resources and prevent environmental pollution. PET bottles are commonly used in beverage industry and can be reused after physical and chemical recycling processes. Usage areas of recycled PET have been developed rapidly. Although recycled PET is used in plastic industry, composite industry also provides usage alternatives of recycled PET. Textile is a suitable sector for recycling of some plastics made of polymers too. In this study, the recycling technologies and applications of waste PET bottles have been investigated and scientific works in this area have been summarized.

  9. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows.

    Swinkels, J M; Hilkens, A; Zoche-Golob, V; Krömker, V; Buddiger, M; Jansen, J; Lam, T J G M


    farmer identifies and regularly communicates face to face, such as other farmers, the herd veterinarian, and other farm advisors, confirm the farmer's judgment on extending treatment and influences him or her toward socially accepted behavior. Society was the most negative reference group, barely influencing farmers' decision-making on treatment. The emotional gap between farmers and society is large and probably difficult to overcome. Legislation may reduce antibiotic usage, if doable and controllable. Evidence-based information on treatment efficacy or practical on-farm decision support indicating when to end treatment may be able to change social norms of "thorough" treatment, especially when communicated by a positive reference group such as veterinarians. Because prudent antibiotic use is hindered by perceived subjective norms on optimal duration of antibiotic treatment, more research is needed, particularly on the optimal duration of antibiotic treatment of specific pathogens as related to cure and recurrence of clinical mastitis. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  10. An optimized, fast-to-perform mouse lung infection model with the human pathogen Chlamydia trachomatis for in vivo screening of antibiotics, vaccine candidates and modified host-pathogen interactions.

    Dutow, Pavel; Wask, Lea; Bothe, Miriam; Fehlhaber, Beate; Laudeley, Robert; Rheinheimer, Claudia; Yang, Zhangsheng; Zhong, Guangming; Glage, Silke; Klos, Andreas


    Chlamydia trachomatis causes sexually transmitted diseases with infertility, pelvic inflammatory disease and neonatal pneumonia as complications. The duration of urogenital mouse models with the strict mouse pathogen C. muridarum addressing vaginal shedding, pathological changes of the upper genital tract or infertility is rather long. Moreover, vaginal C. trachomatis application usually does not lead to the complications feared in women. A fast-to-perform mouse model is urgently needed to analyze new antibiotics, vaccine candidates, immune responses (in gene knockout animals) or mutants of C. trachomatis. To complement the valuable urogenital model with a much faster and quantifiable screening method, we established an optimized lung infection model for the human intracellular bacterium C. trachomatis serovar D (and L2) in immunocompetent C57BL/6J mice. We demonstrated its usefulness by sensitive determination of antibiotic effects characterizing advantages and limitations achievable by early or delayed short tetracycline treatment and single-dose azithromycin application. Moreover, we achieved partial acquired protection in reinfection with serovar D indicating usability for vaccine studies, and showed a different course of disease in absence of complement factor C3. Sensitive monitoring parameters were survival rate, body weight, clinical score, bacterial load, histological score, the granulocyte marker myeloperoxidase, IFN-γ, TNF-α, MCP-1 and IL-6. © FEMS 2015. All rights reserved. For permissions, please e-mail:

  11. Demographics of antibiotic persistence

    Kollerova, Silvia; Jouvet, Lionel; Steiner, Ulrich

    Persister cells, cells that can survive antibiotic exposure but lack heritable antibiotic resistance, are assumed to play a crucial role for the evolution of antibiotic resistance. Persistence is a stage associated with reduced metabolic activity. Most previous studies have been done on batch...... even play a more prominent role for the evolution of resistance and failures of medical treatment by antibiotics as currently assumed....

  12. Prescribing antibiotics to pediatric dengue: increasing risk of bacterial resistance

    Dhanunjaya Sandopa


    Full Text Available Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country. Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India. Methods Data from case sheets of all pediatric inpatients (n=370 diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP of India Guidelines, and the Hospital Infection Society (HIS Guidelines. Results Platelet count determination (50% of the cases was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%, 2 antibiotics in 33 (8.91 % cases, and 3 antibiotics in 9 (2.43% cases. Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.

  13. Antibiotics in Canadian poultry productions and anticipated alternatives

    Moussa Sory Diarra


    Full Text Available The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics in feed (growth promoters need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can easily spread within microbial communities. In Canada, poultry production involves more than 2,600 regulated chicken producers. There are several antibiotics approved as feed additives available for poultry farmers. Feed recipes and mixtures greatly vary geographically and from one farm to another, making links between use of a specific antibiotic feed additive and production yields or selection of specific antibiotic-resistant bacteria difficult to establish. Many on-farm studies have revealed the widespread presence of antibiotic-resistant bacteria in broiler chickens. While sporadic reports linked the presence of antibiotic-resistant organisms to the use of feed supplemented with antibiotics, no recent studies could clearly demonstrate the benefit of antimicrobial growth promoters on performance and production yields. With modern biosecurity and hygienic practices, there is a genuine concern that intensive utilization of antibiotics or use of antimicrobial growth promoters in feed might no longer be useful. Public pressure and concerns about food and environmental safety (antibiotic residues, antibiotic-resistant pathogens have driven researchers to actively look for alternatives to antibiotics. Some of the alternatives include pre- and probiotics, organic acids and essential oils. We will describe here the properties of some bioactive molecules, like those found in cranberry, which have shown interesting polyvalent antibacterial and immuno

  14. [Antibiotics in the critically ill].

    Kolak, Radmila R


    Antibiotics are one the most common therapies administered in the intensive care unit setting. This review outlines the strategy for optimal use of antimicrobial agents in the critically ill. In severely ill patients, empirical antimicrobial therapy should be used when a suspected infection may impair the outcome. It is necessary to collect microbiological documentation before initiating empirical antimicrobial therapy. In addition to antimicrobial therapy, it is recommended to control a focus of infection and to modify factors that promote microbial growth or impair the host's antimicrobial defence. A judicious choice of antimicrobial therapy should be based on the host characteristics, the site of injection, the local ecology, and the pharmacokinetics/pharmacodynamics of antibiotics. This means treating empirically with broad-spectrum antimicrobials as soon as possible and narrowing the spectrum once the organism is identified (de-escalation), and limiting duration of therapy to the minimum effective period. Despite theoretical advantages, a combined antibiotic therapy is nor more effective than a mono-therapy in curing infections in most clinical trials involving intensive care patients. Nevertheless, textbooks and guidelines recommend a combination for specific pathogens and for infections commonly caused by these pathogens. Avoiding unnecessary antibiotic use and optimizing the administration of antimicrobial agents will improve patient outcomes while minimizing risks for the development of bacterial resistance. It is important to note that each intensive care unit should have a program in place which monitors antibiotic utilisation and its effectiveness. Only in this way can the impact of interventions aimed at improving antibiotic use be evaluated at the local level.

  15. Public knowledge, attitudes and practices regarding antibiotic use in Kosovo

    Zajmi, Drita; Berisha, Merita; Begolli, Ilir; Hoxha, Rina; Mehmeti, Rukije; Mulliqi-Osmani, Gjyle; Kurti, Arsim; Loku, Afrim; Raka, Lul


    Background: Antimicrobial resistance is becoming a major public health challenge worldwide, caused primarily by the misuse of antibiotics. Antibiotic use is closely related to the knowledge, attitudes and behaviour of a population. Objective: The objective of this study was to assess the level of knowledge, attitudes and practices about antibiotic use among the general public in Kosovo. Methods: A cross-sectional face-to-face survey was carried out with a sample of 811 randomly selected Kosovo residents. The methodology used for this survey was based on the European Commission Eurobarometer survey on antimicrobial resistance. Results: More than half of respondents (58.7%) have used antibiotics during the past year. A quarter of respondents consumed antibiotics without a medical prescription. The most common reasons for usage were flu (23.8%), followed by sore throat (20.2%), cold (13%) and common cold (7.6%). 42.5% of respondents think that antibiotics are effective against viral infections. Almost half of respondents (46.7%) received information about the unnecessary use of antibiotics and 32.5% of them report having changed their views and behaviours after receiving this information. Health care workers were identified as the most trustworthy source of information on antibiotic use (67.2%). Conclusion: These results provide quantitative baseline data on Kosovar knowledge, attitudes and practice regarding the use of antibiotic. These findings have potential to empower educational campaigns to promote the prudent use of antibiotics in both community and health care settings. PMID:28503216

  16. Growing natural gas usage

    Saarni, T.


    Finnish natural gas usage topped the 3.3 billion cubic metre mark last year, up 3.6 % on the 1994 figure. Growth has increased now for 12 years in a row. Thanks to offtake by large individual users, the pipeline network has been expanded from South-East Finland to the Greater Helsinki area and central southern Finland. Natural gas plays a much larger role in this region than the 10 % accounted for by natural gas nationally would indicate. The growth in the share of Finland's energy use accounted for by natural gas has served to broaden the country's energy supply base. Natural gas has replaced coal and oil, which has considerably reduced the level of emissions resulting form energy generation

  17. [Smartphone usage among adolescents].

    Körmendi, Attila


    Among our technological gadgets smartphones play the most important role, new generation devices offer other functions beyond calling (internet availability, computer games, music player, camera functions etc.) In everydays can be experienced that youth spend more and more time with their smartphones and despite the actuality of this issue there are no studies on the excessive smartphone usage in Hungary and we can find only a few international studies. Our goal is to examine smartphone usage in primary and secondary schools in Hajdu-Bihar county, Hungary and its relationship with personality traits. Our sample consist of 263 youth from primary and secondary schools. We measured the characteristics of smartphone using and attitudes with a Mobilephone Using Questionnare. Personality traits are measured with Impulsiveness, Venturesomeness, Empathy Scale. The Child Behavior Checklist gives information about peer relationships, mental state and emotions. Average phone using time is 4,48 hours per day regarding the whole sample. This mean for boys is 3,40 hour for girls 5,39 hour. Average phone using time is higher at 16 (6,35 hour per day). The most frequent used applications are calling and visiting community sites. There is no connection between phone using and grades. The smartphone using time per day shows a significant positive relationship with Impulsivity, Anxiety and Depression, Attention deficits and Somatic problems within 17-19 ages. One of the explanation of excessive smartphone using may be the frequent visiting of community sites. Mobile phones in this case raise the availability of addictive object (community site) therefore contribute to the development of community site addiction. The connection with impulsivity, somatic problems and attention deficits refer to the anxiety reducing role of smartphones within 17-19 ages.

  18. Modelling of word usage frequency dynamics using artificial neural network

    Maslennikova, Yu S; Bochkarev, V V; Voloskov, D S


    In this paper the method for modelling of word usage frequency time series is proposed. An artificial feedforward neural network was used to predict word usage frequencies. The neural network was trained using the maximum likelihood criterion. The Google Books Ngram corpus was used for the analysis. This database provides a large amount of data on frequency of specific word forms for 7 languages. Statistical modelling of word usage frequency time series allows finding optimal fitting and filtering algorithm for subsequent lexicographic analysis and verification of frequency trend models

  19. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows

    Swinkels, J M; Hilkens, A; Zoche-Golob, V; Krömker, V; Buddiger, M; Jansen, J; Lam, T J G M

    Clinical mastitis of dairy cows is a visible inflammation of the udder, which is usually caused by bacteria and treated with antibiotics. Although pressure is increasing to reduce antibiotic usage in livestock in the European Union, feedback from the field suggests that clinical mastitis treatment

  20. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows

    Swinkels, J.M.; Hilkens, A.; Zoche-Golob, V.; Krömker, V.; Buddiger, M.; Jansen, J.; Lam, T.J.G.M.


    Clinical mastitis of dairy cows is a visible inflammation of the udder, which is usually caused by bacteria and treated with antibiotics. Although pressure is increasing to reduce antibiotic usage in livestock in the European Union, feedback from the field suggests that clinical mastitis

  1. Feed additive strategies for replacement of antimicrobial growth promoters and a responsible use of antibiotics

    Hartog, den L.A.; Smits, C.H.M.; Hendriks, W.H.


    The rapid development of antimicrobial resistance (AMR) in human health care urges the need for effective strategies to reduce antibiotic use in animal production. The Netherlands and Denmark have already implemented successful strategies to reduce antibiotic usage in animal production. Part of the

  2. The antibiotic resistome.

    Wright, Gerard D


    Antibiotics are essential for the treatment of bacterial infections and are among our most important drugs. Resistance has emerged to all classes of antibiotics in clinical use. Antibiotic resistance has, proven inevitable and very often it emerges rapidly after the introduction of a drug into the clinic. There is, therefore, a great interest in understanding the origins, scope and evolution of antibiotic resistance. The review discusses the concept of the antibiotic resistome, which is the collection of all genes that directly or indirectly contribute to antibiotic resistance. The review seeks to assemble current knowledge of the resistome concept as a means of understanding the totality of resistance and not just resistance in pathogenic bacteria. The concept of the antibiotic resistome provides a framework for the study and understanding of how resistance emerges and evolves. Furthermore, the study of the resistome reveals strategies that can be applied in new antibiotic discoveries.

  3. Assessment of Antibiotics prescription in Hospitalized Patients at ...

    Objective: This study aimed to assess the pattern of antibiotics usage in medical wards at Elobeid teaching hospital, West Sudan. Patients and method: This is a descriptive hospital-based study. The data were retrospectively collected from the patient's records. Systemic random sampling was used to select 427 patient's ...

  4. Know When Antibiotics Work


    This podcast provides a brief background about antibiotics and quick tips to help prevent antibiotic resistance.  Created: 4/15/2015 by Division of Bacterial Diseases (DBD), National Center for Immunization and Respiratory Disease (NCIRD), Get Smart: Know When Antibiotics Work Program.   Date Released: 4/16/2015.

  5. Antibiotics: Miracle Drugs

    The overuse of antibiotics has led to the development of resistance among bacteria, making antibiotics ineffective in treating certain conditions. This podcast discusses the importance of talking to your healthcare professional about whether or not antibiotics will be beneficial if you've been diagnosed with an infectious disease.

  6. Degradation of ciprofloxacin antibiotic by Homogeneous Fenton oxidation: Hybrid AHP-PROMETHEE method, optimization, biodegradability improvement and identification of oxidized by-products.

    Salari, Marjan; Rakhshandehroo, Gholam Reza; Nikoo, Mohammad Reza


    The main purpose of this experimental study was to optimize Homogeneous Fenton oxidation (HFO) and identification of oxidized by-products from degradation of Ciprofloxacin (CIP) using hybrid AHP-PROMETHEE, Response Surface Methodology (RSM) and High Performance Liquid Chromatography coupled with Mass Spectrometry (HPLC-MS). At the first step, an assessment was made for performances of two catalysts (FeSO 4 ·7H 2 O and FeCl 2 ·4H 2 O) based on hybrid AHP-PROMETHEE decision making method. Then, RSM was utilized to examine and optimize the influence of different variables including initial CIP concentration, Fe 2+ concentration, [H 2 O 2 ]/[ Fe 2+ ] mole ratio and initial pH as independent variables on CIP removal, COD removal, and sludge to iron (SIR) as the response functions in a reaction time of 25 min. Weights of the mentioned responses as well as cost criteria were determined by AHP model based on pairwise comparison and then used as inputs to PROMETHEE method to develop hybrid AHP-PROMETHEE. Based on net flow results of this hybrid model, FeCl 2 ·4H 2 O was more efficient because of its less environmental stability as well as lower SIR production. Then, optimization of experiments using Central Composite Design (CCD) under RSM was performed with the FeCl 2 ·4H 2 O catalyst. Biodegradability of wastewater was determined in terms of BOD 5 /COD ratio, showing that HFO process is able to improve wastewater biodegradability from zero to 0.42. Finally, the main intermediaries of degradation and degradation pathways of CIP were investigated with (HPLC-MS). Major degradation pathways from hydroxylation of both piperazine and quinolonic rings, oxidation and cleavage of the piperazine ring, and defluorination (OH/F substitution) were suggested. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Systemic antibiotics in periodontics.

    Slots, Jørgen


    This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.

  8. Usefulness of food chain information provided by Dutch finishing pig producers to control antibiotic residues in pork.

    van Wagenberg, Coen P A; Backus, Gé B C; van der Vorst, Jack G A J; Urlings, Bert A P


    The EU prescribes that food business operators must use food chain information to assist in food safety control. This study analyses usefulness of food chain information about antibiotic usage covering the 60-day period prior to delivery of pigs to slaughter in the control of antibiotic residues in pork. A dataset with 479 test results for antibiotic residues in tissue samples of finishing pigs delivered to a Dutch slaughter company was linked to information provided by pig producers about antibiotic usage in these finishing pigs. Results show that twice as many producers reported using antibiotics in the group of 82 producers with antibiotic residues (11.0%) compared to the group without antibiotic residues (5.5%) (p=0.0686). For 89% of consignments with a finishing pig with antibiotic residues, the producer reported 'did not use antibiotics'. Food chain information about antibiotic usage provided by Dutch pig producers was no guarantee for absence of antibiotic residues in delivered finishing pigs. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Assessment of antibiotic use in farm animals in Rwanda.

    Manishimwe, Rosine; Nishimwe, Kizito; Ojok, Lonzy


    The irrational use of antibiotics in humans and animals is highly related to the emergence and increase of antibiotic-resistant bacteria worldwide. A cross-sectional survey aimed at evaluating the current level of practices regarding antibiotic use in farm animals in Rwanda was carried out countrywide. Interviews were conducted on 229 farmers rearing different types of animals. The study has revealed that almost all respondent farmers could name at least one antibiotic used in farm animals and peni-streptomycin was named by most of them (95.6%). The use of antibiotics in farm animals was observed in the majority of respondents (97.4%). It was found that 44.4 and 26.5% of respondents reported that they used antibiotics for disease prevention and growth promotion, respectively. The use of non-prescribed antibiotics in animals was also reported by more than the half of respondent farmers (55.6%). The majority of farmers had a moderate level of practices regarding antibiotic use in farm animals (73.5%), very few had a high level (26%) and only one respondent had a low level. The high level of practices in regard to antibiotic use in animals was associated with the location of the farm, the type of reared animals, and the rearing system. The results of this study give an insight into antibiotics usage practices in farm animals in Rwanda. The generated information can guide sensitizations and promotions of the prudent use of antibiotics among farmers in order to limit the increase of antibiotic resistance in the country.

  10. Prevailing practices in the use of antibiotics by dairy farmers in Eastern Haryana region of India

    Kumar, Vikash; Gupta, Jancy


    Aim: The aim of the study was to assess the antibiotic use in dairy animals and to trace its usage pattern among the small, medium, and large dairy farmers in Eastern Haryana region of India. Materials and Methods: Karnal and Kurukshetra districts from Eastern region of Haryana state were purposively selected, and four villages from each district were selected randomly. From each village, 21 farmers were selected using stratified random sampling by categorizing into small, medium, and large farmers constituting a total of 168 farmers as respondents. An antibiotic usage index (AUI) was developed to assess usage of antibiotics by dairy farmers. Results: Frequency of veterinary consultancy was high among large dairy farmers, and they mostly preferred veterinarians over para-veterinarians for treatment of dairy animals. Small farmers demanded low-cost antibiotics from veterinarians whereas large farmers rarely went for it. Antibiotics were used maximum for therapeutic purposes by all categories of farmers. Completion of treatment schedules and follow-up were strictly practiced by the majority of large farmers. AUI revealed that large farmers were more consistent on decision-making about prudent use of antibiotics. Routine use of antibiotics after parturition to prevent disease and sale of milk without adhering to withdrawal period was responsible for aggravating the antibiotic resistance. The extent of antibiotic use by small farmers depended on the severity of disease. The large farmers opted for the prophylactic use of antibiotics at the herd level. Conclusion: Antibiotic usage practices were judicious among large dairy farmers, moderately prudent by medium dairy farmers and faulty by small farmers. The frequency of veterinary consultancy promoted better veterinary-client relationship among large farmers. PMID:29657416

  11. Usage of burnable poison on research reactors

    Villarino, Eduardo Anibal


    The fuel assemblies with burnable poison are widely used on power reactors, but there are not commonly used on research reactors. This paper shows a neutronic analysis of the advantages and disadvantages of the burnable poison usage on research reactors. This paper analyses both burnable poison design used on research reactors: Boron on the lateral wall and Cadmium wires. Both designs include a parametric study on the design parameters like the amount and geometry of the burnable poison. This paper presents the design flexibility using burnable poisons, it does not find an optimal or final design, which it will strongly depend on the core characteristics and fuel management strategy. (author)

  12. Antibiotic stewardship in community-acquired pneumonia.

    Viasus, Diego; Vecino-Moreno, Milly; De La Hoz, Juan M; Carratalà, Jordi


    Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes. In this regard, antibiotic de-escalation, duration of antibiotic treatment, adherence to CAP guidelines recommendations about empirical treatment, and switching from intravenous to oral antibiotic therapy may each be relevant in this context. Antimicrobial stewardship strategies, such as prospective audit with intervention and feedback, clinical pathways, and dedicated multidisciplinary teams, that have included some of these elements have demonstrated improvements in antimicrobial use for CAP without negatively affecting clinical outcomes. Expert commentary: Although there are a limited number of randomized clinical studies addressing antimicrobial stewardship strategies in CAP, there is evidence that antibiotic stewardship initiatives can be securely applied, providing benefits to both healthcare systems and patients.

  13. Usage of Intramammary Antimicrobial Veterinary Medicinal Products in The Republic of Serbia from 2011 to 2014

    Andjelkovic Jelena


    Full Text Available Prudent use of antimicrobial medicine is an imperative in both human and veterinary medicine today. Antibiotic usage in humans and animals has increased over the years, consequently giving rise to antimicrobial resistance in pathogenic microorganisms. Mastitis is one of the most common conditions in bovine species, and intramammary antibacterial medicinal products are used in animal husbandry for mastitis treatment and prophylaxis.


    Bitterman, Roni; Raz-Pasteur, Ayelet; Azzam, Zaher S; Karban, Amir; Levy, Yishai; Hayek, Tony; Braun, Eyal; Oren, Ilana; Bar-Lavi, Yaron; Kassis, Imad; Hussein, Khetam; Paul, Mical


    Antibiotic stewardship programs (ASP) are designed to optimize antibiotic use in hospitals. Antibiotic consumption is one of the measures assessing the effects of ASPs. To evaluate the effect of an ASP on antibiotic consumption in our hospital and compare it to hospitals in Israel and worldwide. Between October 2012 and March 2013 an ASP was implemented in Rambam Hospital. The program included educational activities, publication of local guidelines for empirical antibiotic treatment, structured infectious diseases consultations, pre-authorization antibiotic restrictions and stop orders. We compared antibacterial antibiotic consumption in defined daily doses (DDD)/100 hospital days (HD) between the periods before (1/2010-3/2013) and after (4/2013-9/2014) implementing the ASP. The study was conducted in the medical departments, hematology, the intensive care unit (ICU) and all pediatric wards. Total antibiotic consumption before implementing the ASP was 96±11.2 DDD/100 HD in medical departments, 186.4±42.8 in the ICU and 185.5±59 in hematology; all values were higher than the worldwide-reported averages for these departments. Following the ASP, total antibiotic consumption decreased by 12% (p=0.008) in the medical departments and by 26% (p=0.002) in hematology, mostly due to reductions in non-restricted antibiotics. No significant changes were observed overall in the ICU and in pediatric wards. There was a significant reduction in consumption of vancomycin and carbapenems in all settings, the latter was reduced to nearly half. Amikacin use quadrupled in the medical departments. Implementation of an ASP lead to a reduction in non-restricted and restricted antibiotic consumption, especially carbapenems.

  15. Osmotic Compounds Enhance Antibiotic Efficacy against Acinetobacter baumannii Biofilm Communities.

    Falghoush, Azeza; Beyenal, Haluk; Besser, Thomas E; Omsland, Anders; Call, Douglas R


    Biofilm-associated infections are a clinical challenge, in part because a hydrated matrix protects the bacterial community from antibiotics. Herein, we evaluated how different osmotic compounds (maltodextrin, sucrose, and polyethylene glycol [PEG]) enhance antibiotic efficacy against Acinetobacter baumannii biofilm communities. Established (24-h) test tube biofilms (strain ATCC 17978) were treated with osmotic compounds in the presence or absence of 10× the MIC of different antibiotics (50 μg/ml tobramycin, 20 μg/ml ciprofloxacin, 300 μg/ml chloramphenicol, 30 μg/ml nalidixic acid, or 100 μg/ml erythromycin). Combining antibiotics with hypertonic concentrations of the osmotic compounds for 24 h reduced the number of biofilm bacteria by 5 to 7 log ( P baumannii strains were similarly treated with 400-Da PEG and tobramycin, resulting in a mean 2.7-log reduction in recoverable bacteria compared with tobramycin treatment alone. Multivariate regression models with data from different osmotic compounds and nine antibiotics demonstrated that the benefit from combining hypertonic treatments with antibiotics is a function of antibiotic mass and lipophilicity ( r 2 > 0.82; P baumannii and Escherichia coli K-12. Augmenting topical antibiotic therapies with a low-mass hypertonic treatment may enhance the efficacy of antibiotics against wound biofilms, particularly when using low-mass hydrophilic antibiotics. IMPORTANCE Biofilms form a barrier that protects bacteria from environmental insults, including exposure to antibiotics. We demonstrated that multiple osmotic compounds can enhance antibiotic efficacy against Acinetobacter baumannii biofilm communities, but viscosity is a limiting factor, and the most effective compounds have lower molecular mass. The synergism between osmotic compounds and antibiotics is also dependent on the hydrophobicity and mass of the antibiotics. The statistical models presented herein provide a basis for predicting the optimal combination of

  16. Antibiotics and Breastfeeding.

    de Sá Del Fiol, Fernando; Barberato-Filho, Silvio; de Cássia Bergamaschi, Cristiane; Lopes, Luciane Cruz; Gauthier, Timothy P


    During the breastfeeding period, bacterial infections can occur in the nursing mother, requiring the use of antibiotics. A lack of accurate information may lead health care professionals and mothers to suspend breastfeeding, which may be unnecessary. This article provides information on the main antibiotics that are appropriate for clinical use and the interference of these antibiotics with the infant to support medical decisions regarding the discontinuation of breastfeeding. We aim to provide information on the pharmacokinetic factors that interfere with the passage of antibiotics into breast milk and the toxicological implications of absorption by the infant. Publications related to the 20 most frequently employed antibiotics and their transfer into breast milk were evaluated. The results demonstrate that most antibiotics in clinical use are considered suitable during breastfeeding; however, the pharmacokinetic profile of each drug must be observed to ensure the resolution of the maternal infection and the safety of the infant. © 2016 S. Karger AG, Basel.

  17. High Antibiotic Consumption

    Malo, Sara; José Rabanaque, María; Feja, Cristina


    Heavy antibiotic users are those individuals with the highest exposure to antibiotics. They play an important role as contributors to the increasing risk of antimicrobial resistance. We applied different methods to identify and characterize the group of heavy antibiotic users in Spain as well...... as their exposure to antibiotics. Data on outpatient prescribing of antimicrobials (ATC J01) in 2010 were obtained from a prescription database covering Aragón (northeastern Spain). The antimicrobial consumption at the individual level was analysed both according to the volume of DDD and the number of packages...... purchased per year. Heavy antibiotic users were identified according to Lorenz curves and characterized by age, gender, and their antimicrobial prescription profile. Lorenz curves demonstrated substantial differences in the individual use of antimicrobials. Heavy antibiotic users (5% of individuals...

  18. Structure of polysaccharide antibiotics

    Matutano, L.


    Study of the structure of antibiotics having two or several sugars in their molecule. One may distinguish: the polysaccharide antibiotics themselves, made up of two or several sugars either with or without nitrogen, such as streptomycin, neomycins, paromomycine, kanamycin, chalcomycin; the hetero-polysaccharide antibiotics made up of one saccharide part linked to an aglycone of various type through a glucoside: macrolide, pigment, pyrimidine purine. Amongst these latter are: erythromycin, magnamycin, spiramycin, oleandomycin, cinerubin and amicetin. The sugars can either play a direct role in biochemical reactions or act as a dissolving agent, as far as the anti-microbe power of these antibiotics is concerned. (author) [fr

  19. Antibiotics: Miracle Drugs


    The overuse of antibiotics has led to the development of resistance among bacteria, making antibiotics ineffective in treating certain conditions. This podcast discusses the importance of talking to your healthcare professional about whether or not antibiotics will be beneficial if you’ve been diagnosed with an infectious disease.  Created: 4/16/2015 by Division of Bacterial Diseases (DBD), National Center for Immunization and Respiratory Disease (NCIRD), Get Smart: Know When Antibiotics Work Program.   Date Released: 4/16/2015.

  20. Variability in Antibiotic Use Across PICUs.

    Brogan, Thomas V; Thurm, Cary; Hersh, Adam L; Gerber, Jeffrey S; Smith, Michael J; Shah, Samir S; Courter, Joshua D; Patel, Sameer J; Parker, Sarah K; Kronman, Matthew P; Lee, Brian R; Newland, Jason G


    To characterize and compare antibiotic prescribing across PICUs to evaluate the degree of variability. Retrospective analysis from 2010 through 2014 of the Pediatric Health Information System. Forty-one freestanding children's hospital. Children aged 30 days to 18 years admitted to a PICU in children's hospitals contributing data to Pediatric Health Information System. To normalize for potential differences in disease severity and case mix across centers, a subanalysis was performed of children admitted with one of the 20 All Patient Refined-Diagnosis Related Groups and the seven All Patient Refined-Diagnosis Related Groups shared by all PICUs with the highest antibiotic use. The study included 3,101,201 hospital discharges from 41 institutions with 386,914 PICU patients. All antibiotic use declined during the study period. The median-adjusted antibiotic use among PICU patients was 1,043 days of therapy/1,000 patient-days (interquartile range, 977-1,147 days of therapy/1,000 patient-days) compared with 893 among non-ICU children (interquartile range, 805-968 days of therapy/1,000 patient-days). For PICU patients, the median adjusted use of broad-spectrum antibiotics was 176 days of therapy/1,000 patient-days (interquartile range, 152-217 days of therapy/1,000 patient-days) and was 302 days of therapy/1,000 patient-days (interquartile range, 220-351 days of therapy/1,000 patient-days) for antimethicillin-resistant Staphylococcus aureus agents, compared with 153 days of therapy/1,000 patient-days (interquartile range, 130-182 days of therapy/1,000 patient-days) and 244 days of therapy/1,000 patient-days (interquartile range, 203-270 days of therapy/1,000 patient-days) for non-ICU children. After adjusting for potential confounders, significant institutional variability existed in antibiotic use in PICU patients, in the 20 All Patient Refined-Diagnosis Related Groups with the highest antibiotic usage and in the seven All Patient Refined-Diagnosis Related Groups shared

  1. History Teaches Us That Confronting Antibiotic Resistance Requires Stronger Global Collective Action.

    Podolsky, Scott H; Bud, Robert; Gradmann, Christoph; Hobaek, Bård; Kirchhelle, Claas; Mitvedt, Tore; Santesmases, María Jesús; Thoms, Ulrike; Berild, Dag; Kveim Lie, Anne


    Antibiotic development and usage, and antibiotic resistance in particular, are today considered global concerns, simultaneously mandating local and global perspectives and actions. Yet such global considerations have not always been part of antibiotic policy formation, and those who attempt to formulate a globally coordinated response to antibiotic resistance will need to confront a history of heterogeneous, often uncoordinated, and at times conflicting reform efforts, whose legacies remain apparent today. Historical analysis permits us to highlight such entrenched trends and processes, helping to frame contemporary efforts to improve access, conservation and innovation. © 2015 American Society of Law, Medicine & Ethics, Inc.

  2. Mobile phone usage in rural communities in Kwara state, Nigeria ...

    The rise in mobile telephony has continued to bridge the wide disparity between urban and rural dwellers, although there are suggestions that mobile phones have not been optimally utilized by rural dwellers. In view of this, the main aim of this study was to examine mobile phone usage in rural communities of Kwara State, ...

  3. Handling Time-dependent Variables : Antibiotics and Antibiotic Resistance

    Munoz-Price, L. Silvia; Frencken, Jos F.; Tarima, Sergey; Bonten, Marc


    Elucidating quantitative associations between antibiotic exposure and antibiotic resistance development is important. In the absence of randomized trials, observational studies are the next best alternative to derive such estimates. Yet, as antibiotics are prescribed for varying time periods,

  4. Importance and implications of antibiotic resistance development in ...



    Jan 24, 2018 ... would aid in the development of surveillance systems and methods to prevent or .... and alternative production methods to industrialize and optimize food ..... Data on the sales and use of antibiotics in livestock production are ...

  5. Access to antibiotics in New Delhi, India: implications for antibiotic policy.

    Kotwani, Anita; Holloway, Kathleen


    The present survey was conducted to investigate the price and availability of a basket of 24 essential antibiotics and eight high-end antibiotics at various levels of health care in public and private sector in National Capital Territory of Delhi, India using standardized WHO/HAI methodology. DATA ON PROCUREMENT PRICE AND AVAILABILITY WAS COLLECTED FROM THREE PUBLIC HEALTHCARE PROVIDERS IN THE STATE: the federal (central) government, state government and Municipal Corporation of Delhi (MCD). Overall a total of 83 public facilities, 68 primary care, 10 secondary cares and 5 tertiary care facilities were surveyed. Data was also collected from private retail (n = 40) and chain pharmacies (n = 40) of a leading corporate house. Prices were compared to an international reference price (expressed as median price ratio-MPR). PUBLIC SECTOR: Delhi state government has its essential medicine list (Delhi state EML) and was using Delhi state EML 2007 for procurement; the other two agencies had their own procurement list. All the antibiotics procured including second and third generation antibiotics except for injections were available at primary care facilities. Antibiotic available were on the basis of supply rather than rationality or the Delhi state EML and none was 100% available. There was sub-optimal availability of some essential antibiotics while other non-essential ones were freely available. Availability of antibiotics at tertiary care facilities was also sub-optimal. Private sector: Availability of antibiotics was good. For most of the antibiotics the most expensive and popular trade names were often available. High-end antibiotics, meropenam, gemifloxacin, and moxifloxacin were commonly available. In retail pharmacies some newer generation non-essential antibiotics like gemifloxacin were priced lower than the highest-priced generic of amoxicillin + clavulanic acid, azithromycin, and cefuroxime aexitl. Inappropriate availability and pricing of newer

  6. The relationship between codon usage bias and cold resistant genes

    Barozai, M.Y.; Din, M.


    This research is based on synonymous codon usage which has been well-known as a feature that affects typical expression level of protein in an organism. Different organisms prefer different codons for same amino acid and this is called Codon Usage Bias (CUB). The codon usage directly affects the level or even direction of changes in protein expression in responses to environmental stimuli. Cold stress is a major abiotic factor that limits the agricultural productivity of plants. In the recent study CUB has been studied in Arabidopsis thaliana cold resistant and housekeeping genes and their homologs in rice (Oryza sativa) to understand the cold stress and housekeeping genes relation with CUB. Six cold resistant and three housekeeping genes in Arabidopsis thaliana and their homologs in rice, were subjected to CUB analysis. The three cold resistant genes (DREB1B, RCI and MYB15) showed more than 50% (52%, 61% and 66% respectively) similar codon usage bias for Arabidopsis thaliana and rice. On the other hand three cold resistant genes (MPK3, ICE1 and ZAT12) showed less than 50% (38%, 38% and 47% respectively) similar codon usage bias for Arabidopsis thaliana and rice. The three housekeeping genes (Actin, Tubulin and Ubiquitin) showed 76% similar codon usage bias for Arabidopsis thaliana and rice. This study will help to manage the plant gene expression through codon optimization under the cold stress. (author)

  7. [Antibiotics: present and future].

    Bérdy, János


    The author discuss the up to date interpretation of the concept of antibiotics and antibiotic research, as well as the present role of various natural, semisynthetic and synthetic antibiotic compounds in various areas of the human therapy. The origin and the total number of all antibiotics and applied antibiotics in the practice, as well as the bioactive microbial metabolites (antibiotics) in other therapeutical, non-antibiotic fields (including agriculture) are also reviewed. The author discusses main problems, such as increasing (poly)resistance, virulence of pathogens and the non-scientific factors (such as a decline of research efforts and their sociological, economic, financial and regulatory reasons). A short summary of the history of Hungarian antibiotic research is also provided. The author briefly discusses the prospects in the future and the general advantages of the natural products over synthetic compounds. It is concluded that new approaches for the investigation of the unlimited possibilities of the living world are necessary. The discovery of new types or simply neglected (micro)organisms and their biosynthetic capabilities, the introduction of new biotechnological and genetic methods (genomics, metagenom, genome mining) are absolutely required in the future.

  8. The future of antibiotics


    Antibiotic resistance continues to spread even as society is experiencing a market failure of new antibiotic research and development (R&D). Scientific, economic, and regulatory barriers all contribute to the antibiotic market failure. Scientific solutions to rekindle R&D include finding new screening strategies to identify novel antibiotic scaffolds and transforming the way we think about treating infections, such that the goal is to disarm the pathogen without killing it or modulate the host response to the organism without targeting the organism for destruction. Future economic strategies are likely to focus on ‘push’ incentives offered by public-private partnerships as well as increasing pricing by focusing development on areas of high unmet need. Such strategies can also help protect new antibiotics from overuse after marketing. Regulatory reform is needed to re-establish feasible and meaningful traditional antibiotic pathways, to create novel limited-use pathways that focus on highly resistant infections, and to harmonize regulatory standards across nations. We need new antibiotics with which to treat our patients. But we also need to protect those new antibiotics from misuse when they become available. If we want to break the cycle of resistance and change the current landscape, disruptive approaches that challenge long-standing dogma will be needed. PMID:25043962

  9. Complex Codon Usage Pattern and Compositional Features of Retroviruses

    Sourav RoyChoudhury


    Full Text Available Retroviruses infect a wide range of organisms including humans. Among them, HIV-1, which causes AIDS, has now become a major threat for world health. Some of these viruses are also potential gene transfer vectors. In this study, the patterns of synonymous codon usage in retroviruses have been studied through multivariate statistical methods on ORFs sequences from the available 56 retroviruses. The principal determinant for evolution of the codon usage pattern in retroviruses seemed to be the compositional constraints, while selection for translation of the viral genes plays a secondary role. This was further supported by multivariate analysis on relative synonymous codon usage. Thus, it seems that mutational bias might have dominated role over translational selection in shaping the codon usage of retroviruses. Codon adaptation index was used to identify translationally optimal codons among genes from retroviruses. The comparative analysis of the preferred and optimal codons among different retroviral groups revealed that four codons GAA, AAA, AGA, and GGA were significantly more frequent in most of the retroviral genes inspite of some differences. Cluster analysis also revealed that phylogenetically related groups of retroviruses have probably evolved their codon usage in a concerted manner under the influence of their nucleotide composition.

  10. History of Antibiotics Research.

    Mohr, Kathrin I


    For thousands of years people were delivered helplessly to various kinds of infections, which often reached epidemic proportions and have cost the lives of millions of people. This is precisely the age since mankind has been thinking of infectious diseases and the question of their causes. However, due to a lack of knowledge, the search for strategies to fight, heal, and prevent the spread of communicable diseases was unsuccessful for a long time. It was not until the discovery of the healing effects of (antibiotic producing) molds, the first microscopic observations of microorganisms in the seventeenth century, the refutation of the abiogenesis theory, and the dissolution of the question "What is the nature of infectious diseases?" that the first milestones within the history of antibiotics research were set. Then new discoveries accelerated rapidly: Bacteria could be isolated and cultured and were identified as possible agents of diseases as well as producers of bioactive metabolites. At the same time the first synthetic antibiotics were developed and shortly thereafter, thousands of synthetic substances as well as millions of soil borne bacteria and fungi were screened for bioactivity within numerous microbial laboratories of pharmaceutical companies. New antibiotic classes with different targets were discovered as on assembly line production. With the beginning of the twentieth century, many of the diseases which reached epidemic proportions at the time-e.g., cholera, syphilis, plague, tuberculosis, or typhoid fever, just to name a few, could be combatted with new discovered antibiotics. It should be considered that hundred years ago the market launch of new antibiotics was significantly faster and less complicated than today (where it takes 10-12 years in average between the discovery of a new antibiotic until the launch). After the first euphoria it was quickly realized that bacteria are able to develop, acquire, and spread numerous resistance mechanisms

  11. Release of antibiotics from collagen dressing.

    Grzybowski, J; Antos-Bielska, M; Ołdak, E; Trafny, E A


    Our new collagen dressing has been developed recently. Three types (A, B, and C) of the dressing were prepared in this study. Each type contained bacitracin, neomycin or colistin. The antibiotic was input into: i. collagen sponge (CS)--type A, ii. layer of limited hydrophobicity (LLH)--type B, and iii. into both CS and LLH layers--type C. The final concentration of the antibiotic that resulted from the loading level was 2 mg/cm2 for the dressings of type A and B and 4 mg/cm2 for the dressing of type C. The antibiotics were then extracted from the pieces of dressings for two days through dialysis membrane. Susceptibility of 54 bacterial strains (S. aureus, P. aeruginosa, and Acinetobacter) isolated from burn wounds were tested to the three antibiotics used for preparation of the dressings. The results of the study evidenced that efficiency of released of antibiotics into the extracts depended on the kind of antibiotic and on the type of dressing. The concentration of the antibiotics proved to be much higher than MIC90 values of the bacterial isolates tested in respect to their susceptibility. The dressing containing mixture of the three antibiotics in two layers--CS and LLH is now considered as potentially effective for care of infected wounds. It may be useful for the treatment of infected wounds or for profilaxis of contaminated wounds, ensuring: i. sufficient antimicrobial activity in wound, and ii. optimal wound environment for the presence of collagenic biomaterial on the damaged tissue.

  12. A population model evaluating the consequences of the evolution of double-resistance and tradeoffs on the benefits of two-drug antibiotic treatments.

    Campbell, Ellsworth M; Chao, Lin


    The evolution of antibiotic resistance in microbes poses one of the greatest challenges to the management of human health. Because addressing the problem experimentally has been difficult, research on strategies to slow the evolution of resistance through the rational use of antibiotics has resorted to mathematical and computational models. However, despite many advances, several questions remain unsettled. Here we present a population model for rational antibiotic usage by adding three key features that have been overlooked: 1) the maximization of the frequency of uninfected patients in the human population rather than the minimization of antibiotic resistance in the bacterial population, 2) the use of cocktails containing antibiotic pairs, and 3) the imposition of tradeoff constraints on bacterial resistance to multiple drugs. Because of tradeoffs, bacterial resistance does not evolve directionally and the system reaches an equilibrium state. When considering the equilibrium frequency of uninfected patients, both cycling and mixing improve upon single-drug treatment strategies. Mixing outperforms optimal cycling regimens. Cocktails further improve upon aforementioned strategies. Moreover, conditions that increase the population frequency of uninfected patients also increase the recovery rate of infected individual patients. Thus, a rational strategy does not necessarily result in a tragedy of the commons because benefits to the individual patient and general public are not in conflict. Our identification of cocktails as the best strategy when tradeoffs between multiple-resistance are operating could also be extended to other host-pathogen systems. Cocktails or other multiple-drug treatments are additionally attractive because they allow re-using antibiotics whose utility has been negated by the evolution of single resistance.

  13. Increasing transmission of antibiotic resistance from animals to humans

    Aarestrup, Frank Møller; Frimodt-Møller, Niels


    The importance of the animal reservoir for emergence of antimicrobial resistance in bacteria in humans is difficult to estimate. In this article we give our estimate of the importance and also highlight on which points we have become wiser during recent years. We conclude that it still is the human...... usage of antibiotics which contributes most to resistance observed in humans, but also that the contribution from animals is large and larger than estimated just a few years ago. This indicates the need to implement restriction on antimicrobial usage for both humans and animals....

  14. Increasing transmission of antibiotic resistance from animals to humans

    Aarestrup, Frank Møller; Frimodt-Møller, Niels


    usage of antibiotics which contributes most to resistance observed in humans, but also that the contribution from animals is large and larger than estimated just a few years ago. This indicates the need to implement restriction on antimicrobial usage for both humans and animals.......The importance of the animal reservoir for emergence of antimicrobial resistance in bacteria in humans is difficult to estimate. In this article we give our estimate of the importance and also highlight on which points we have become wiser during recent years. We conclude that it still is the human...

  15. Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery.

    Khan, Sohail Ahmad; Rodrigues, Gabrial; Kumar, Pramod; Rao, Padma G M


    To study the impact of guidelines on surgical antibiotic prophylaxis in clinical practice, barriers involved in adherence to guidelines and how to overcome the same. Literature pertaining to prophylactic antibiotic usage was searched. Medscape, Medline, Cochrane, Surgical Infection Prevention (SIP) project databases were reviewed. Recent articles from relevant journals, texts, and standard guidelines were also studied. Local guidelines seem more likely to be accepted and followed than those developed nationally. Major barriers involved in adherence to guidelines include lack of awareness about the guidelines, general perception of guideline as a bureaucratic rather than educational tool. Some practitioners perceive guidelines as "cookbook medicine" that does not permit them to make their own medical decisions. Other barriers are complex, multi-step systems that create confusion, decrease accountability. Methods for guideline adherence include surveillance and data analysis, new systems to facilitate documentation and improving workflow, education regarding current evidence-based guidelines and promoting the development of local guidelines or protocol, development and implementation of reminders to facilitate adherence to the local guidelines. A multidisciplinary steering team of surgeons, infectious disease specialists, pharmacists, anesthesiologists, microbiologists and nurses should develop local guidelines suitable to their institution and methods for adherence to prevent the surgical site infections. The gap between evidence-based guidelines and practice must be addressed in order to achieve optimal practice in this domain.

  16. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions

    Leibovici, Leonard; Paul, Mical; Garner, Paul; Sinclair, David J; Afshari, Arash; Pace, Nathan Leon; Cullum, Nicky; Williams, Hywel C; Smyth, Alan; Skoetz, Nicole; Del Mar, Chris; Schilder, Anne G M; Yahav, Dafna; Tovey, David

    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies. This

  17. Manufacturer Usage Description Specification Implementation

    Srinivasan, Kaushik


    Manufacturer Usage Description Specification (MUDS) is aframework under RFC development that aims to automate Internet access control rules for IoT devices . These access controls prevent malicious IoT devices from attacking other devices and also protect the IoT devices from being attacked by other devices.We are implementing this framework and trying to improve its security.


    Anjan Adhikari


    Full Text Available Antibiotics are most commonly prescribed drugs in tertiary care hospitals; more than 30% of the hospitalised patients were treated with antibiotics. Rational use of antibiotics is very important to ensure the optimum treatment outcomes and to limit the emergence of bacterial resistance. Present study is a hospital based cross-sectional study carried out for a period of three months in different clinical departments of a tertiary care hospital to find out the antibiotics prescribing pattern. Out of total 551 evaluated prescriptions, an antibiotic was prescribed in 45.5% cases. The most commonly prescribed antibiotics were Moxifloxacin 19.5%, Metronidazole 10.4% and Amoxicillin+Cloxacillin 10.2%, broad spectrum antibiotics usage was higher & 87.7% of the antibiotics were prescribed by brand names. The appropriate use of antibiotic is a greatest need of the current situation all over the world. The rising antibiotic resistance is a global problem which is directly related with the irrational prescription of antibiotics.

  19. Fighting antibiotic resistance in the intensive care unit using antibiotics.

    Plantinga, Nienke L; Wittekamp, Bastiaan H J; van Duijn, Pleun J; Bonten, Marc J M


    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to classical infection prevention protocols and surveillance programs, counterintuitive interventions, such as selective decontamination with antibiotics and antibiotic rotation have been applied and investigated to control the emergence of antibiotic resistance. This review provides an overview of selective oropharyngeal and digestive tract decontamination, decolonization of methicillin-resistant Staphylococcus aureus and antibiotic rotation as strategies to modulate antibiotic resistance in the intensive care unit.

  20. Selection of antibiotic resistance at very low antibiotic concentrations

    Sandegren, Linus


    Human use of antibiotics has driven the selective enrichment of pathogenic bacteria resistant to clinically used drugs. Traditionally, the selection of resistance has been considered to occur mainly at high, therapeutic levels of antibiotics, but we are now beginning to understand better the importance of selection of resistance at low levels of antibiotics. The concentration of an antibiotic varies in different body compartments during treatment, and low concentrations of antibiotics are fou...

  1. Antibiotic alternatives: the substitution of antibiotics in animal husbandry?

    Cheng, Guyue; Hao, Haihong; Xie, Shuyu; Wang, Xu; Dai, Menghong; Huang, Lingli; Yuan, Zonghui


    It is a common practice for decades to use of sub-therapeutic dose of antibiotics in food-animal feeds to prevent animals from diseases and to improve production performance in modern animal husbandry. In the meantime, concerns over the increasing emergence of antibiotic-resistant bacteria due to the unreasonable use of antibiotics and an appearance of less novelty antibiotics have prompted efforts to develop so-called alternatives to antibiotics. Whether or not the alternatives could really ...

  2. IceProd 2 Usage Experience

    Delventhal, D.; Schultz, D.; Diaz Velez, J. C.


    IceProd is a data processing and management framework developed by the IceCube Neutrino Observatory for processing of Monte Carlo simulations, detector data, and data driven analysis. It runs as a separate layer on top of grid and batch systems. This is accomplished by a set of daemons which process job workflow, maintaining configuration and status information on the job before, during, and after processing. IceProd can also manage complex workflow DAGs across distributed computing grids in order to optimize usage of resources. IceProd has recently been rewritten to increase its scaling capabilities, handle user analysis workflows together with simulation production, and facilitate the integration with 3rd party scheduling tools. IceProd 2, the second generation of IceProd, has been running in production for several months now. We share our experience setting up the system and things we’ve learned along the way.

  3. Antibiotic-Resistant Gonorrhea

    ... Search Form Controls Cancel Submit Search the CDC Gonorrhea Note: Javascript is disabled or is not supported ... on Facebook Sexually Transmitted Diseases (STDs) Antibiotic-Resistant Gonorrhea Recommend on Facebook Tweet Share Compartir Low Resolution ...

  4. Glycopeptide antibiotic biosynthesis.

    Yim, Grace; Thaker, Maulik N; Koteva, Kalinka; Wright, Gerard


    Glycopeptides such as vancomycin, teicoplanin and telavancin are essential for treating infections caused by Gram-positive bacteria. Unfortunately, the dwindled pipeline of new antibiotics into the market and the emergence of glycopeptide-resistant enterococci and other resistant bacteria are increasingly making effective antibiotic treatment difficult. We have now learned a great deal about how bacteria produce antibiotics. This information can be exploited to develop the next generation of antimicrobials. The biosynthesis of glycopeptides via nonribosomal peptide assembly and unusual amino acid synthesis, crosslinking and tailoring enzymes gives rise to intricate chemical structures that target the bacterial cell wall. This review seeks to describe recent advances in our understanding of both biosynthesis and resistance of these important antibiotics.

  5. Antibiotics for uncomplicated diverticulitis

    Shabanzadeh, Daniel M; Wille-Jørgensen, Peer


    Diverticulitis is an inflammatory complication to the very common condition diverticulosis. Uncomplicated diverticulitis has traditionally been treated with antibiotics with reference to the microbiology, extrapolation from trials on complicated intra-abdominal infections and clinical experience....

  6. Urinary Tract Infection in Children: Management in the Era of Antibiotic Resistance-A Pediatric Urologist's View.

    Kutasy, Balazs; Coyle, David; Fossum, Magdalena


    Antibiotic resistance to uropathogens has grown significantly worldwide. Today, pediatric urologist experience a situation that needs appropriate action because urinary tract infections are one of the most common bacterial infections in children. In this overview we aimed at presenting the clinical aspects of antibiotic usage in pediatric urology. Our intention was to take part of the important debate regarding future management of bacterial resistance against antibiotics. We searched PubMed for the terms: [UTI in children], [Recurrent UTI in children], and [Antibiotic resistance in UTI]. When using these terms, we found a numerous amount (3875) of published clinical articles related to the topic. By means of an overview, we chose not to focus on a specific condition but to an overall understanding of the problems related to pediatric urology in general. We found that usage of antibiotics has had an unquestionable benefit to reduce the morbidity and mortality related to urinary tract infections in childhood. However, recent studies suggest that early exposure to antibiotics in childhood might have negative systemic effects related to neurocognitive function, body metabolism, and fat distribution. In addition to increased resistance to common antimicrobial agents, it has resulted in increased costs and inadequate effect in severe infections. This calls for changes in the clinical management of urinary pathogens in pediatric urology. As the prevalence of antibiotic resistance grows, pediatric urologists have a key role in managing its consequences and its prevention. In this overview we looked at the consequences of antibiotic usage treating urinary tract infections in childhood. We found that the prevalence of antibiotic resistance has grown. We concluded that decision-makers must know about the short- and long-term effects of antibiotic usage in children. When we understand the development of antibiotic resistance better, we can build up prevention strategies

  7. Antibiotics for sore throat.

    Spinks, Anneliese; Glasziou, Paul P; Del Mar, Chris B


    Sore throat is a common reason for people to present for medical care. Although it remits spontaneously, primary care doctors commonly prescribe antibiotics for it. To assess the benefits of antibiotics for sore throat for patients in primary care settings. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to July week 1, 2013) and EMBASE (January 1990 to July 2013). Randomised controlled trials (RCTs) or quasi-RCTs of antibiotics versus control assessing typical sore throat symptoms or complications. Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. We contacted trial authors from three studies for additional information. We included 27 trials with 12,835 cases of sore throat. We did not identify any new trials in this 2013 update. 1. Symptoms Throat soreness and fever were reduced by about half by using antibiotics. The greatest difference was seen at day three. The number needed to treat to benefit (NNTB) to prevent one sore throat at day three was less than six; at week one it was 21. 2. Non-suppurative complications The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure. Several studies found antibiotics reduced acute rheumatic fever by more than two-thirds within one month (risk ratio (RR) 0.27; 95% confidence interval (CI) 0.12 to 0.60). 3. Suppurative complications Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0.30; 95% CI 0.15 to 0.58); acute sinusitis within 14 days (RR 0.48; 95% CI 0.08 to 2.76); and quinsy within two months (RR 0.15; 95% CI 0.05 to 0.47) compared to those taking placebo. 4. Subgroup analyses of symptom reduction Antibiotics were more effective against symptoms at day three (RR 0.58; 95% CI 0.48 to 0.71) if throat swabs were positive for Streptococcus, compared to RR 0.78; 95% CI 0.63 to 0.97 if negative. Similarly at week one the RR was 0.29 (95% CI 0.12 to 0

  8. Phenotypic Resistance to Antibiotics

    Jose L. Martinez


    Full Text Available The development of antibiotic resistance is usually associated with genetic changes, either to the acquisition of resistance genes, or to mutations in elements relevant for the activity of the antibiotic. However, in some situations resistance can be achieved without any genetic alteration; this is called phenotypic resistance. Non-inherited resistance is associated to specific processes such as growth in biofilms, a stationary growth phase or persistence. These situations might occur during infection but they are not usually considered in classical susceptibility tests at the clinical microbiology laboratories. Recent work has also shown that the susceptibility to antibiotics is highly dependent on the bacterial metabolism and that global metabolic regulators can modulate this phenotype. This modulation includes situations in which bacteria can be more resistant or more susceptible to antibiotics. Understanding these processes will thus help in establishing novel therapeutic approaches based on the actual susceptibility shown by bacteria during infection, which might differ from that determined in the laboratory. In this review, we discuss different examples of phenotypic resistance and the mechanisms that regulate the crosstalk between bacterial metabolism and the susceptibility to antibiotics. Finally, information on strategies currently under development for diminishing the phenotypic resistance to antibiotics of bacterial pathogens is presented.

  9. Antibiotics produced by Streptomyces.

    Procópio, Rudi Emerson de Lima; Silva, Ingrid Reis da; Martins, Mayra Kassawara; Azevedo, João Lúcio de; Araújo, Janete Magali de


    Streptomyces is a genus of Gram-positive bacteria that grows in various environments, and its shape resembles filamentous fungi. The morphological differentiation of Streptomyces involves the formation of a layer of hyphae that can differentiate into a chain of spores. The most interesting property of Streptomyces is the ability to produce bioactive secondary metabolites, such as antifungals, antivirals, antitumorals, anti-hypertensives, immunosuppressants, and especially antibiotics. The production of most antibiotics is species specific, and these secondary metabolites are important for Streptomyces species in order to compete with other microorganisms that come in contact, even within the same genre. Despite the success of the discovery of antibiotics, and advances in the techniques of their production, infectious diseases still remain the second leading cause of death worldwide, and bacterial infections cause approximately 17 million deaths annually, affecting mainly children and the elderly. Self-medication and overuse of antibiotics is another important factor that contributes to resistance, reducing the lifetime of the antibiotic, thus causing the constant need for research and development of new antibiotics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  10. [Antibiotic treatment for prevention of infectious complications in joint replacement].

    Jahoda, D; Nyc, O; Pokorný, D; Landor, I; Sosna, A


    Prophylactic antibiotic treatment is mandatory in every operation involving an orthopedic implant. Carefully selected and correctly administered antibiotics can provide effective protection of the implant from bacterial colonization. The prevention of deep wound infection in joint replacement includes several procedures and measures which constitute three basic groups: 1) Promotion of patient's ability to resist infection (careful pre-operative preparation, elimination of potential infectious loci, good nutritional status, etc). 2) Optimal conditions for the operative wound (surgical technique, prophylactic antibiotics). 3) Reduction of the number of bacteria brought in the wound (control measures, super-sterile operating theatres). Clear rules for the system of prophylactic antibiotic treatment should be adopted. A program in which responsibility for antibiotic administration was shifted from the nursing staff to the anesthesiologist in the operating theatre showed improved outcomes and reduced costs. Poor timing of prophylactic antibiotic administration is one of the basic mistakes. If the wound happened to be contaminated during surgery, the first three post-operative hours would be most decisive for the development of infection. An effective bactericidal concentration of antibiotic should be present in tissues and serum immediately after surgery has begun. Therefore the appropriate time for antibiotic application is before a skin incision is made, and not after the operation has started; the highest serum and bone tissue levels appear 20 to 30 min. after intravenous antibiotic injection. To allow antibiotics to reach target tissues, they should be introduced at least 10 min. before tourniquet application. For long surgical procedures or when blood loss is high, an additional dose of antibiotics is recommended during the operation. If a sample for bacterial cultivation is required, antibiotic administration is postponed until during surgery. However, this is

  11. Strategies to Minimize Antibiotic Resistance

    Sang Hee Lee


    Full Text Available Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs and various data such as pharmacokinetic (PK and pharmacodynamic (PD properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST, clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care, the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing. The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

  12. Analysis of Usage Patterns in Large Multimedia Websites

    Singh, Rahul; Bhattarai, Bibek

    User behavior in a website is a critical indicator of the web site's usability and success. Therefore an understanding of usage patterns is essential to website design optimization. In this context, large multimedia websites pose a significant challenge for comprehension of the complex and diverse user behaviors they sustain. This is due to the complexity of analyzing and understanding user-data interactions in media-rich contexts. In this chapter we present a novel multi-perspective approach for usability analysis of large media rich websites. Our research combines multimedia web content analysis with elements of web-log analysis and visualization/visual mining of web usage metadata. Multimedia content analysis allows direct estimation of the information-cues presented to a user by the web content. Analysis of web logs and usage-metadata, such as location, type, and frequency of interactions provides a complimentary perspective on the site's usage. The entire set of information is leveraged through powerful visualization and interactive querying techniques to provide analysis of usage patterns, measure of design quality, as well as the ability to rapidly identify problems in the web-site design. Experiments on media rich sites including the SkyServer - a large multimedia web-based astronomy information repository demonstrate the efficacy and promise of the proposed approach.

  13. Antibiotic use and resistance in animals: Belgian initiatives.

    Daeseleire, Els; De Graef, Evelyne; Rasschaert, Geertrui; De Mulder, Thijs; Van den Meersche, Tina; Van Coillie, Els; Dewulf, Jeroen; Heyndrickx, Marc


    The widespread use of antibiotics in animals is causing concerns about the growing risk for development and the spread of antibiotic-resistant bacteria. Antibiotic consumption is higher in animals than in humans as reported in a joint publication of EFSA (European Food Safety Agency), ECDC (European Centre for Disease Prevention and Control), and EMA (European Medicines Agency) using data from 2011 and 2012. Both in humans and animals, positive associations between the consumption of antibiotics and resistant bacteria are observed. Responsible use of antibiotics in humans and animals should therefore be promoted. In this paper some general aspects of antibiotic resistance such as microbiological versus clinical resistance, intrinsic versus acquired resistance, resistance mechanisms, and transfer of resistance are briefly introduced. In 2012, the Belgian Center of Expertise on Antimicrobial Consumption and Resistance in Animals (AMCRA) was founded. Its mission is to collect and analyze all data related to antibiotic use and resistance in animals in Belgium and to communicate these findings in a neutral and objective manner. One of AMCRA's 10 objectives is a 50% reduction in antibiotic consumption in veterinary medicine in Belgium by 2020. The aim of this paper is to report on the achievements of this national project. The Institute for Agricultural and Fisheries Research (ILVO, Merelbeke-Melle), in collaboration with Ghent University, is currently working on three nationally funded projects on antibiotic resistance in animal husbandry. In the first project, an in vitro model is used to study the influence of low antibiotic concentrations due to carry-over after production and usage of medicated feed on the development of resistance in the pig gut. Part of that project is to develop a quantitative risk assessment model. A second project focuses on tracking excreted antibiotics used in pig rearing and their influence on the development of antibiotic resistance in pig

  14. Student Empowerment Through Internet Usage

    Purushothaman, Aparna


    in a University in Southern India to empower the female students through Internet usage. The study was done to find out the problems the woman students faced in gaining access and using Internet and how they can be empowered through Internet usage. Future workshop was conducted to find out the problems...... and reflecting. The paper will explore the various cultural issues and explicate how the social context plays a major role in the use of Internet even if there is sufficient access. These issues will be addressed from an empowerment perspective. The paper ends by recommending the methods to be adopted for more......Information and Communication Technology (ICT) has been widely recognized as a tool for human development (UNDP 2001). The rate at which ICT are growing is changing the way knowledge is developed, acquired and delivered. (Tongia, et al. 2005) Internet is one of the Information & Communication...

  15. Understanding Mobile Social Media Usage

    Gan, Chunmei; Tan, Chee-Wee


    Despite the increasing popularity and growing trend of mobile social media in China, factors affecting users’ continued usage behavior remains unclear and deserves further scholarly attention. Synthesizing theories of expectation confirmation as well as uses and gratification, we advance a uses...... and gratification expectancy model that depicts how confirmation, perceived usability and gratification affect users’ continuance intention towards mobile social media. Empirical findings from an online survey of 247 respondents reveal that continuance intention is determined by a range of gratifications, including...... information sharing, media appeal and perceived enjoyment. In addition, confirmation of expectations and perceptions of usefulness gleaned through prior usage of mobile social media have significant effects on gratifications of information sharing, perceived enjoyment, social interaction, passing time...

  16. Game-Theoretic Models for Usage-based Maintenance Contract

    Husniah, H.; Wangsaputra, R.; Cakravastia, A.; Iskandar, B. P.


    A usage-based maintenance contracts with coordination and non coordination between two parties is studied in this paper. The contract is applied to a dump truck operated in a mining industry. The situation under study is that an agent offers service contract to the owner of the truck after warranty ends. This contract has only a time limit but no usage limit. If the total usage per period exceeds the maximum usage allowed in the contract, then the owner will be charged an additional cost. In general, the agent (Original Equipment Manufacturer/OEM) provides a full coverage of maintenance, which includes PM and CM under the lease contract. The decision problem for the owner is to select the best option offered that fits to its requirement, and the decision problem for the agent is to find the optimal maintenance efforts for a given price of the service option offered. We first find the optimal decisions using coordination scheme and then with non coordination scheme for both parties.

  17. The Selective Advantage of Synonymous Codon Usage Bias in Salmonella.

    Gerrit Brandis


    Full Text Available The genetic code in mRNA is redundant, with 61 sense codons translated into 20 different amino acids. Individual amino acids are encoded by up to six different codons but within codon families some are used more frequently than others. This phenomenon is referred to as synonymous codon usage bias. The genomes of free-living unicellular organisms such as bacteria have an extreme codon usage bias and the degree of bias differs between genes within the same genome. The strong positive correlation between codon usage bias and gene expression levels in many microorganisms is attributed to selection for translational efficiency. However, this putative selective advantage has never been measured in bacteria and theoretical estimates vary widely. By systematically exchanging optimal codons for synonymous codons in the tuf genes we quantified the selective advantage of biased codon usage in highly expressed genes to be in the range 0.2-4.2 x 10-4 per codon per generation. These data quantify for the first time the potential for selection on synonymous codon choice to drive genome-wide sequence evolution in bacteria, and in particular to optimize the sequences of highly expressed genes. This quantification may have predictive applications in the design of synthetic genes and for heterologous gene expression in biotechnology.

  18. Formation of Linear Gradient of Antibiotics on Microfluidic Chips for High-throughput Antibiotic Susceptibility Testing

    Kim, Seunggyu; Lee, Seokhun; Jeon, Jessie S.


    To determine the most effective antimicrobial treatments of infectious pathogen, high-throughput antibiotic susceptibility test (AST) is critically required. However, the conventional AST requires at least 16 hours to reach the minimum observable population. Therefore, we developed a microfluidic system that allows maintenance of linear antibiotic concentration and measurement of local bacterial density. Based on the Stokes-Einstein equation, the flow rate in the microchannel was optimized so that linearization was achieved within 10 minutes, taking into account the diffusion coefficient of each antibiotic in the agar gel. As a result, the minimum inhibitory concentration (MIC) of each antibiotic against P. aeruginosa could be immediately determined 6 hours after treatment of the linear antibiotic concentration. In conclusion, our system proved the efficacy of a high-throughput AST platform through MIC comparison with Clinical and Laboratory Standards Institute (CLSI) range of antibiotics. This work was supported by the Climate Change Research Hub (Grant No. N11170060) of the KAIST and by the Brain Korea 21 Plus project.

  19. Opportunistic resource usage in CMS

    Kreuzer, Peter; Hufnagel, Dirk; Dykstra, D; Gutsche, O; Tadel, M; Sfiligoi, I; Letts, J; Wuerthwein, F; McCrea, A; Bockelman, B; Fajardo, E; Linares, L; Wagner, R; Konstantinov, P; Blumenfeld, B; Bradley, D


    CMS is using a tiered setup of dedicated computing resources provided by sites distributed over the world and organized in WLCG. These sites pledge resources to CMS and are preparing them especially for CMS to run the experiment's applications. But there are more resources available opportunistically both on the GRID and in local university and research clusters which can be used for CMS applications. We will present CMS' strategy to use opportunistic resources and prepare them dynamically to run CMS applications. CMS is able to run its applications on resources that can be reached through the GRID, through EC2 compliant cloud interfaces. Even resources that can be used through ssh login nodes can be harnessed. All of these usage modes are integrated transparently into the GlideIn WMS submission infrastructure, which is the basis of CMS' opportunistic resource usage strategy. Technologies like Parrot to mount the software distribution via CVMFS and xrootd for access to data and simulation samples via the WAN are used and will be described. We will summarize the experience with opportunistic resource usage and give an outlook for the restart of LHC data taking in 2015.

  20. Reversing bacterial resistance to antibiotics by phage-mediated delivery of dominant sensitive genes.

    Edgar, Rotem; Friedman, Nir; Molshanski-Mor, Shahar; Qimron, Udi


    Pathogen resistance to antibiotics is a rapidly growing problem, leading to an urgent need for novel antimicrobial agents. Unfortunately, development of new antibiotics faces numerous obstacles, and a method that resensitizes pathogens to approved antibiotics therefore holds key advantages. We present a proof of principle for a system that restores antibiotic efficiency by reversing pathogen resistance. This system uses temperate phages to introduce, by lysogenization, the genes rpsL and gyrA conferring sensitivity in a dominant fashion to two antibiotics, streptomycin and nalidixic acid, respectively. Unique selective pressure is generated to enrich for bacteria that harbor the phages carrying the sensitizing constructs. This selection pressure is based on a toxic compound, tellurite, and therefore does not forfeit any antibiotic for the sensitization procedure. We further demonstrate a possible way of reducing undesirable recombination events by synthesizing dominant sensitive genes with major barriers to homologous recombination. Such synthesis does not significantly reduce the gene's sensitization ability. Unlike conventional bacteriophage therapy, the system does not rely on the phage's ability to kill pathogens in the infected host, but instead, on its ability to deliver genetic constructs into the bacteria and thus render them sensitive to antibiotics prior to host infection. We believe that transfer of the sensitizing cassette by the constructed phage will significantly enrich for antibiotic-treatable pathogens on hospital surfaces. Broad usage of the proposed system, in contrast to antibiotics and phage therapy, will potentially change the nature of nosocomial infections toward being more susceptible to antibiotics rather than more resistant.

  1. Antibiotic use during the intracoelomic implantation of electronic tags into fish

    Mulcahy, D.M.


    The use of antibiotics, in particular, the use of a single dose of antibiotics during electronic tag implantation is of unproven value, and carries with it the potential for the development of antibiotic resistance in bacteria and the alteration of the immune response of the fish. Antibiotic use during electronic tag implantation must conform to relevant drug laws and regulations in the country where work is being done, including the requirements for withdrawal times before human consumption is a possibility. Currently, the choice of antibiotics (most often tetracycline or oxytetracycline) and the use of a single dose of the drug are decisions made without knowledge of the basic need for antibiotic usage and of the bacteria involved in infections that occur following electronic tag implantation. Correct perioperative use of an antibiotic is to apply the drug to the animal before surgery begins, to assure serum and tissue levels of the drug are adequate before the incision is made. However, the most common perioperative application of antibiotics during implantation of an electronic tag is to delay the administration of the drug, injecting it into the coelom after the electronic tag is inserted, just prior to closure of the incision. There is little empirical evidence that the present application of antibiotics in fish being implanted with electronic tags is of value. Improvements should first be made to surgical techniques, especially the use of aseptic techniques and sterilized instruments and electronic tags, before resorting to antibiotics. ?? 2010 Springer Science+Business Media B.V.(outside the USA).

  2. Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

    Bosco, Joseph A; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett


    Infection is a rare, serious complication following total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  3. Antibiotic prophylaxis and complications following prostate biopsies - a systematic review

    Klemann, Nina; Helgstrand, John Thomas; Brasso, Klaus


    of the first dose of antibiotic, one study found that administration 24 h before biopsy versus administration immediately before reduced the relative risk of post-biopsy infection by 55%. Seven studies compared different durations of antibiotic prophylaxis. None showed any benefit from continuing prophylaxis......INTRODUCTION: Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and mortality; however, no international consensus exists on the timing and duration of antibiotics, including the optimal...... drug strategy. We reviewed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies. METHODS: This review was drafted in accordance with the Prisma Guidelines. The PubMed, Embase and Cochrane databases were searched. RESULTS: A total...

  4. Antibiotics for acute bronchitis.

    Smith, Susan M; Fahey, Tom; Smucny, John; Becker, Lorne A


    The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. To assess the effects of antibiotics in improving outcomes and to assess adverse effects of antibiotic therapy for people with a clinical diagnosis of acute bronchitis. We searched CENTRAL 2016, Issue 11 (accessed 13 January 2017), MEDLINE (1966 to January week 1, 2017), Embase (1974 to 13 January 2017), and LILACS (1982 to 13 January 2017). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and on 5 April 2017. Randomised controlled trials comparing any antibiotic therapy with placebo or no treatment in acute bronchitis or acute productive cough, in people without underlying pulmonary disease. At least two review authors extracted data and assessed trial quality. We did not identify any new trials for inclusion in this 2017 update. We included 17 trials with 5099 participants in the primary analysis. The quality of trials was generally good. At follow-up there was no difference in participants described as being clinically improved between the antibiotic and placebo groups (11 studies with 3841 participants, risk ratio (RR) 1.07, 95% confidence interval (CI) 0.99 to 1.15). Participants given antibiotics were less likely to have a cough (4 studies with 275 participants, RR 0.64, 95% CI 0.49 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) 6) and a night cough (4 studies with 538 participants, RR 0.67, 95% CI 0.54 to 0.83; NNTB 7). Participants given antibiotics had a shorter mean cough duration (7 studies with 2776 participants, mean difference (MD) -0.46 days, 95% CI -0.87 to -0.04). The differences in presence of a productive cough at follow-up and MD of productive cough did not reach statistical significance.Antibiotic-treated participants were more likely to be improved according to clinician's global assessment (6 studies

  5. Facebook usage by students in higher education

    Wesseling, N.F.; de la Poza, Elena; Dormènech, Jozep; Lloret, Jaime; Vincent Vela, M. Cinta; Zuriaga Agustí, Elena


    In this paper I measure first year student Facebook usage as part of a broader PhD study into the influence of social media usage on the success of students in higher education. A total of 906 students were asked to complete 3 surveys on Facebook usage with their peers, for two consecutive years

  6. Managing time-substitutable electricity usage using dynamic controls

    Ghosh, Soumyadip; Hosking, Jonathan R.; Natarajan, Ramesh; Subramaniam, Shivaram; Zhang, Xiaoxuan


    A predictive-control approach allows an electricity provider to monitor and proactively manage peak and off-peak residential intra-day electricity usage in an emerging smart energy grid using time-dependent dynamic pricing incentives. The daily load is modeled as time-shifted, but cost-differentiated and substitutable, copies of the continuously-consumed electricity resource, and a consumer-choice prediction model is constructed to forecast the corresponding intra-day shares of total daily load according to this model. This is embedded within an optimization framework for managing the daily electricity usage. A series of transformations are employed, including the reformulation-linearization technique (RLT) to obtain a Mixed-Integer Programming (MIP) model representation of the resulting nonlinear optimization problem. In addition, various regulatory and pricing constraints are incorporated in conjunction with the specified profit and capacity utilization objectives.

  7. Managing time-substitutable electricity usage using dynamic controls

    Ghosh, Soumyadip; Hosking, Jonathan R.; Natarajan, Ramesh; Subramaniam, Shivaram; Zhang, Xiaoxuan


    A predictive-control approach allows an electricity provider to monitor and proactively manage peak and off-peak residential intra-day electricity usage in an emerging smart energy grid using time-dependent dynamic pricing incentives. The daily load is modeled as time-shifted, but cost-differentiated and substitutable, copies of the continuously-consumed electricity resource, and a consumer-choice prediction model is constructed to forecast the corresponding intra-day shares of total daily load according to this model. This is embedded within an optimization framework for managing the daily electricity usage. A series of transformations are employed, including the reformulation-linearization technique (RLT) to obtain a Mixed-Integer Programming (MIP) model representation of the resulting nonlinear optimization problem. In addition, various regulatory and pricing constraints are incorporated in conjunction with the specified profit and capacity utilization objectives.

  8. Control of fire blight (Erwinia amylovora on apple trees with trunk-injected plant resistance inducers and antibiotics and assessment of induction of pathogenesis-related protein genes

    Srđan G. Aćimović


    Full Text Available Management of fire blight is complicated by limitations on use of antibiotics in agriculture, antibiotic resistance development, and limited efficacy of alternative control agents. Even though successful in control, preventive antibiotic sprays also affect non-target bacteria, aiding the selection for resistance which could ultimately be transferred to the pathogen Erwinia amylovora. Trunk injection is a target-precise pesticide delivery method that utilizes tree xylem to distribute injected compounds. Trunk injection could decrease antibiotic usage in the open environment and increase the effectiveness of compounds in fire blight control. In field experiments, after 1-2 apple tree injections of either streptomycin, potassium phosphites (PH or acibenzolar-S-methyl (ASM, significant reduction of blossom and shoot blight symptoms was observed compared to water- or non-injected control trees. Overall disease suppression with streptomycin was lower than typically observed following spray applications to flowers. Trunk injection of oxytetracycline resulted in excellent control of shoot blight severity, suggesting that injection is a superior delivery method for this antibiotic. Injection of both ASM and PH resulted in the significant induction of PR-1, PR-2 and PR-8 protein genes in apple leaves indicating induction of systemic acquired resistance (SAR under field conditions. The time separating SAR induction and fire blight symptom suppression indicated that various defensive compounds within the SAR response were synthesized and accumulated in the canopy. ASM and PH suppressed fire blight even after cessation of induced gene expression. With the development of injectable formulations and optimization of doses and injection schedules, the injection of protective compounds could serve as an effective option for fire blight control.

  9. The multifaceted roles of antibiotics and antibiotic resistance in nature

    Saswati eSengupta


    Full Text Available Antibiotics are chemotherapeutic agents, which have been a very powerful tool in the clinical management of bacterial diseases since the 1940s. However, benefits offered by these magic bullets have been substantially lost in subsequent days following the widespread emergence and dissemination of antibiotic resistant strains. While it is obvious that excessive and imprudent use of antibiotics significantly contributes to the emergence of resistant strains, antibiotic-resistance is also observed in natural bacteria of remote places unlikely to be impacted by human intervention. Both antibiotic biosynthetic genes and resistance-conferring genes have been known to evolve billions of years ago, long before clinical use of antibiotics. Hence it appears that antibiotics and antibiotics resistance determinants have some other roles in nature, which often elude our attention because of overemphasis on the therapeutic importance of antibiotics and the crisis imposed by the antibiotic-resistance in pathogens. In the natural milieu, antibiotics are often found to be present in subinhibitory concentrations acting as signalling molecules supporting quorum sensing and biofilm formation. They also play an important role in the production of virulence factors and influence host-parasite interactions (e.g., phagocytosis, adherence to the target cell and so on. The evolutionary and ecological aspects of antibiotics and antibiotic-resistance in the naturally occurring microbial community are little understood. Therefore, the actual role of antibiotics in nature warrants in-depth investigations. Studies on such an intriguing behaviour of the microorganisms promise insight into the intricacies of the microbial physiology and are likely to provide some lead in controlling the emergence and subsequent dissemination of antibiotic resistance. This article highlights some of the recent findings on the role of antibiotics and genes that confer resistance to antibiotics in

  10. Antibiotics and antibiotic resistance in agroecosystems: State of the science

    We propose a simple causal model depicting relationships involved in dissemination of antibiotics and antibiotic resistance in agroecosystems and potential effects on human health, functioning of natural ecosystems, and agricultural productivity. Available evidence for each causal link is briefly su...

  11. Overdosing on Antibiotics


    Du, a Beijing resident in her 60s, believes that an antibiotic is a panacea for the maladies of her now 6-year-old grand- daughter Guoguo. Du began to take care of her granddaugh- ter since the child was merely 2 months old, for the gid's parents were busy. She is comfortable with her caretaker duties except when the girl runs high fevers. Then, the anxious grandma will feed the girl antibiotics or take her to a private child clinic nearby for intravenous infusion.

  12. Antibiotics in Animal Products

    Falcão, Amílcar C.

    The administration of antibiotics to animals to prevent or treat diseases led us to be concerned about the impact of these antibiotics on human health. In fact, animal products could be a potential vehicle to transfer drugs to humans. Using appropri ated mathematical and statistical models, one can predict the kinetic profile of drugs and their metabolites and, consequently, develop preventive procedures regarding drug transmission (i.e., determination of appropriate withdrawal periods). Nevertheless, in the present chapter the mathematical and statistical concepts for data interpretation are strictly given to allow understanding of some basic pharma-cokinetic principles and to illustrate the determination of withdrawal periods

  13. Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.

    Pollack, Loria A; Srinivasan, Arjun


    The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  14. Prophylactic antibiotics in pediatric shunt surgery.

    Biyani, N; Grisaru-Soen, G; Steinbok, P; Sgouros, S; Constantini, S


    The optimal antibiotic prophylaxis for pediatric shunt-related procedures is not clear. There is much inconsistency among different medical centers. This paper summarizes and analyzes the various prophylactic antibiotic regiments used for shunt-related surgeries at different pediatric neurosurgery centers in the world. A survey questionnaire was distributed through the Pediatric Neurosurgery list-server (an e-mail-based special interest group in pediatric neurosurgery). Forty-five completed questionnaires were received, one per medical center, primarily from pediatric neurosurgeons with the following geographic breakdown: 25 from North America, 13 from Europe, and 7 from Asia and other countries. All centers routinely administered prophylactic antibiotics for shunt-related procedures. The drugs of choice were first-generation cephalosporins (23), second-generation cephalosporins (10), naficillin/oxacillin (4), vancomycin (3), clindamycin (1), amoxicillin (1), and mixed protocols in three centers. The initial drug administration ("first dose") was: in the department before transfer to operating room (5), upon arrival to operating room (11), at induction of anesthesia (13), and at initial skin incision (16). The duration of antibiotic dosage also varied: single dose (13), 24-h administration (26), 48-h administration (2), and longer than 48 h in four centers. Two general tendencies were noted, common to the majority of participating centers. There was a general trend to modify antibiotic treatment protocol in "high-risk" populations. The second common theme noted in more than half of responding centers was the use of long-term antibiotic treatment for externalized devices (such as externalized shunts, external ventricular drains or lumbar drains), usually till the device was in place.


    D. M. Antioushenya


    Full Text Available It has been determined that sustainable and safety operation of a transport system and also efficient functioning of transport infrastructure depend on introduction of modern systems and technologies of passenger and load transportation  with usage of logistic approaches. The paper cites results of marketing investigations testifying to availability of the potential for formation of a transport and logistic system in the Republic. A conclusion has been made that realization of the mentioned key ideas shall allow efficiently to integrate in the world economic system.

  16. Risk-adjusted antibiotic consumption in 34 public acute hospitals in Ireland, 2006 to 2014

    Oza, Ajay; Donohue, Fionnuala; Johnson, Howard; Cunney, Robert


    As antibiotic consumption rates between hospitals can vary depending on the characteristics of the patients treated, risk-adjustment that compensates for the patient-based variation is required to assess the impact of any stewardship measures. The aim of this study was to investigate the usefulness of patient-based administrative data variables for adjusting aggregate hospital antibiotic consumption rates. Data on total inpatient antibiotics and six broad subclasses were sourced from 34 acute hospitals from 2006 to 2014. Aggregate annual patient administration data were divided into explanatory variables, including major diagnostic categories, for each hospital. Multivariable regression models were used to identify factors affecting antibiotic consumption. Coefficient of variation of the root mean squared errors (CV-RMSE) for the total antibiotic usage model was very good (11%), however, the value for two of the models was poor (> 30%). The overall inpatient antibiotic consumption increased from 82.5 defined daily doses (DDD)/100 bed-days used in 2006 to 89.2 DDD/100 bed-days used in 2014; the increase was not significant after risk-adjustment. During the same period, consumption of carbapenems increased significantly, while usage of fluoroquinolones decreased. In conclusion, patient-based administrative data variables are useful for adjusting hospital antibiotic consumption rates, although additional variables should also be employed. PMID:27541730

  17. Patterns of medication use and factors associated with antibiotic use among adult fever patients at Singapore primary care clinics

    Zaw Myo Tun


    Full Text Available Abstract Background Antimicrobial resistance is a public health problem of global importance. In Singapore, much focus has been given to antibiotic usage patterns in hospital settings. Data on antibiotic use in primary care is lacking. We describe antibiotic usage patterns and assess factors contributing to antibiotic usage among adults presenting with acute febrile illness (AFI in primary care settings in Singapore. Methods We analyzed data from the Early Dengue infection and outcome study. Adults with AFI presenting at 5 Singapore polyclinics were included. We used multivariable logistic regression to assess demographic, clinical and laboratory factors associated with antibiotic usage among adults with AFI. Results Between December 2007 and February 2013, 1884 adult AFI patients were enrolled. Overall, 16% of adult AFI patients reported antibiotic use. We observed a rise in the use of over-the-counter medications in late 2009 and a decrease in antibiotic use during 2010, possibly related to the outbreak of pandemic influenza A H1N1 virus. After adjusting for age, gender, polyclinic and year of enrolment, the following factors were associated with higher odds of antibiotic use: living in landed property (compared to public housing (OR = 1.73; 95% CI: 1.06–2.80; body mass index (BMI <18.5 (OR = 1.87; 95% CI: 1.19–2.93; elevated white blood cell (WBC count (OR = 1.98; 95% CI: 1.42–2.78; and persistence of initial symptoms at 2–3 days follow-up with OR (95% CI for categories of 1, 2, 3, and ≥4 persisting symptoms being 2.00 (1.38–2.92, 2.67 (1.80–3.97, 4.26 (2.73–6.64, and 2.79 (1.84–4.24 respectively. Conclusions Our study provides insights on antibiotic usage among adult patients presenting to primary care clinics with febrile illness, and suggests that high socio-economic status, and risk factors of a severe illness, that is, low BMI and persistence of initial symptoms, are associated with higher antibiotic use

  18. Improving antibiotic use in daily hospital practice : The antibiotic checklist

    van Daalen, F.V.


    Better use of current antibiotic agents is necessary to help control antimicrobial resistance (AMR). Antibiotic stewardship programs (ASPs) are introduced to coordinate activities to measure and improve appropriate antibiotic use in daily hospital practice. This thesis shows how the introduction of

  19. Impact of over-the-counter restrictions on antibiotic consumption in Brazil and Mexico.

    Yared Santa-Ana-Tellez

    Full Text Available BACKGROUND: In Latin American countries over-the-counter (OTC dispensing of antibiotics is common. In 2010, both Mexico and Brazil implemented policies to enforce existing laws of restricting consumption of antibiotics only to patients presenting a prescription. The objective of the present study is therefore to evaluate the impact of OTC restrictions (2010 on antibiotics consumption in Brazil and Mexico. METHODS AND FINDINGS: Retail quarterly sales data in kilograms of oral and injectable antibiotics between January 2007 and June 2012 for Brazil and Mexico were obtained from IMS Health. The unit of analysis for antibiotics consumption was the defined daily dose per 1,000 inhabitants per day (DDD/TID according to the WHO ATC classification system. Interrupted time series analysis was conducted using antihypertensives as reference group to account for changes occurring independently of the OTC restrictions directed at antibiotics. To reduce the effect of (a seasonality and (b autocorrelation, dummy variables and Prais-Winsten regression were used respectively. Between 2007 and 2012 total antibiotic usage increased in Brazil (from 5.7 to 8.5 DDD/TID, +49.3% and decreased in Mexico (10.5 to 7.5 DDD/TID, -29.2%. Interrupted time series analysis showed a change in level of consumption of -1.35 DDD/TID (p<0.01 for Brazil and -1.17 DDD/TID (p<0.00 for Mexico. In Brazil the penicillins, sulfonamides and macrolides consumption had a decrease in level after the intervention of 0.64 DDD/TID (p = 0.02, 0.41 (p = 0.02 and 0.47 (p = 0.01 respectively. While in Mexico it was found that only penicillins and sulfonamides had significant changes in level of -0.86 DDD/TID (p<0.00 and -0.17 DDD/TID (p = 0.07. CONCLUSIONS: Despite different overall usage patterns of antibiotics in Brazil and Mexico, the effect of the OTC restrictions on antibiotics usage was similar. In Brazil the trend of increased usage of antibiotics was tempered after the OTC restrictions; in

  20. Food and human gut as reservoirs of transferable antibiotic resistance encoding genes

    Jean-Marc eRolain


    Full Text Available The increase and spread of antibiotic resistance (AR over the past decade in human pathogens has become a worldwide health concern. Recent genomic and metagenomic studies in humans, animals, in food and in the environment have led to the discovery of a huge reservoir of AR genes called the resistome that could be mobilized and transferred from these sources to human pathogens. AR is a natural phenomenon developed by bacteria to protect antibiotic-producing bacteria from their own products and also to increase their survival in highly competitive microbial environments. Although antibiotics are used extensively in humans and animals, there is also considerable usage of antibiotics in agriculture, especially in animal feeds and aquaculture. The aim of this review is to give an overview of the sources of AR and the use of antibiotics in these reservoirs as selectors for emergence of AR bacteria in humans via the food chain.

  1. Bacterial cheating limits antibiotic resistance

    Xiao Chao, Hui; Yurtsev, Eugene; Datta, Manoshi; Artemova, Tanya; Gore, Jeff


    The widespread use of antibiotics has led to the evolution of resistance in bacteria. Bacteria can gain resistance to the antibiotic ampicillin by acquiring a plasmid carrying the gene beta-lactamase, which inactivates the antibiotic. This inactivation may represent a cooperative behavior, as the entire bacterial population benefits from removing the antibiotic. The cooperative nature of this growth suggests that a cheater strain---which does not contribute to breaking down the antibiotic---may be able to take advantage of cells cooperatively inactivating the antibiotic. Here we find experimentally that a ``sensitive'' bacterial strain lacking the plasmid conferring resistance can invade a population of resistant bacteria, even in antibiotic concentrations that should kill the sensitive strain. We observe stable coexistence between the two strains and find that a simple model successfully explains the behavior as a function of antibiotic concentration and cell density. We anticipate that our results will provide insight into the evolutionary origin of phenotypic diversity and cooperative behaviors.


    pneumonia, typhoid fever, plaque, tuberculosis, typhus, syphilis, etc. were rampant.1 ... the bacteria to resist the effect of antibiotic for which they were initially ... research and development of new antibiotics, vaccines, diagnostic and other tools.

  3. Assessment of attitudes and practices of young Malaysian adults about antibiotics use: a cross-sectional study

    Hassali MA


    Full Text Available Objective: The present study was aimed to evaluate the practices and attitudes of young Malaysian adults towards the use of antibiotics, and to determine the socioeconomic factors associated with the antibiotic use. Methods: A survey was carried in Cheras community by approaching a conveniently selected sample of 480 participants. A pre-tested questionnaire was used for data collection. Result: Of 480 participants approached, 400 agreed to participate in this study, giving a response rate of 83.3%. The study results showed that 42.75% of the participants exhibited poor attitudes towards antibiotic usage. Chinese race and high income were significantly associated with the positive attitudes towards antibiotic usage. It is shown that the practice of the participants towards antibiotics was relatively poor. The majority of participants agreed that they do not consult a doctor for minor illnesses (64%. The main reason for not consulting a doctor was the high fees of consultation (34.25% and the inconvenience of visit (29.25%. However, a large proportion of respondents (77.5% agreed that there is a need to enhance antibiotic education among public. Conclusion: The study results identified some crucial gaps in the attitudes and practices of Cheras community about the use of antibiotics. Thus, improving the public knowledge and changing their attitude towards antibiotic use along with proper interventions to regulate the ease of their availability would play a significant role for the effective use of antibiotics in the community.

  4. A survey of awareness related to the use of antibiotics for dental issues among non-medical female university students in Riyadh, Saudi Arabia.

    Abu-Mostafa, Nedal A; Al-Mejlad, Najmah J; Al-Yami, Amal S; Al-Sakhin, Fatimah Z; Al-Mudhi, Shahad A

    Inappropriate use of antibiotics may lead to adverse side effects. This cross-sectional survey aimed to investigate the knowledge and attitude of female non-medical students regarding the medical and dental use of antibiotics. Four hundred validated self-administered questionnaires were distributed in Princess Norah Bint-Abdurrahman University, Riyadh, Saudi Arabia. The questionnaire included questions about accessibility, attitude toward usage, efficacy, side effects, resistance, and usage for dental issues. Knowledge was estimated for every respondent by counting the correct answers, which were considered as points. The scores were categorized as poor, moderate, and high. Of the respondents, 77.8% answered they get antibiotics according to a doctor's prescription; however, 31% stops taking antibiotics when they feel well. Only 38.8% of respondents knew that antibiotics may cause allergic reactions while 59.8% believed the human body can be resistant to antibiotics. The percentages of answers related to dental issues were: antibiotics relieve dental pain (68.8%), antibiotics can be harmful for children's teeth (27.3%), antibiotics are best avoided in pregnancy (56.7%) and no need for antibiotics after scaling (33.8%), root canal treatment (16%), or simple extraction (40.3%). Of respondents, 68% had poor scores about antibiotics efficacy, side effects, and resistance while 86.8% had poor scores related to dental problems. This study noticed a bad attitude related to antibiotics usage, with many misconceptions and poor knowledge. Moreover, the necessity of antibiotics for treatment of dental disease or after dental procedures was totally unclear for the respondents. Community campaigns are recommended every university semester to educate students about the indications, efficacy, and side effects of antibiotics. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population.

    El Zowalaty, Mohamed E; Belkina, Tatiana; Bahashwan, Saleh A; El Zowalaty, Ahmed E; Tebbens, Jurjen Duintjer; Abdel-Salam, Hassan A; Khalil, Adel I; Daghriry, Safaa I; Gahtani, Mona A; Madkhaly, Fatimah M; Nohi, Nahed I; Khodari, Rafaa H; Sharahili, Reem M; Dagreery, Khlood A; Khormi, Mayisah; Habibah, Sarah Abuo; Medrba, Bayan A; Gahtani, Amal A; Hifthi, Rasha Y; Zaid, Jameelah M; Amshan, Arwa W; Alneami, Alqasim A; Noreddin, Ayman; Vlček, Jiří


    Background Inappropriate use of antibiotics is a public health problem of great concern. Objective To evaluate knowledge of antibiotics, race, gender and age as independent risk factors for self-medication. Setting Residents and population from different regions of Saudi Arabia. Methods We conducted a cross sectional survey study among residents. Data were collected between June 2014 to May, 2015 from 1310 participants and data were recorded anonymously. The questionnaire was randomly distributed by interview of participants and included sociodemographic characteristics, antibiotics knowledge, attitudes and behavior with respect to antibiotics usage. Main outcome measure Population aggregate scores on questions and data were analyzed using univariate logistic regression to evaluate the influence of variables on self-prescription of antibiotics. Results The response rate was 87.7 %. A cumulative 63.6 % of participants reported to have purchased antibiotics without a prescription from pharmacies; 71.1 % reported that they did not finish the antibiotic course as they felt better. The availability of antibiotics without prescription was found to be positively associated with self-medication (OR 0.238, 95 % CI 0.17-0.33). Of those who used prescribed or non-prescribed antibiotics, 44.7 % reported that they kept left-over antibiotics from the incomplete course of treatment for future need. Interestingly, 62 % of respondents who used drugs without prescription agreed with the statement that antibiotics should be access-controlled prescribed by a physician. We also found significant association between storage, knowledge/attitudes and education. Conclusions The overall level of awareness on antibiotics use among residents in Saudi Arabia is low. This mandates public health awareness intervention programs to be implemented on the use of antibiotics.

  6. Antibiotic resistance reservoirs

    Versluis, Dennis


    One of the major threats to human health in the 21st century is the emergence of pathogenic bacteria that are resistant to multiple antibiotics, thereby limiting treatment options. An important route through which pathogens become resistant is via acquisition of resistance genes from

  7. Mechanisms of Antibiotic Resistance

    Munita, Jose M.; Arias, Cesar A.


    Emergence of resistance among the most important bacterial pathogens is recognized as a major public health threat affecting humans worldwide. Multidrug-resistant organisms have emerged not only in the hospital environment but are now often identified in community settings, suggesting that reservoirs of antibiotic-resistant bacteria are present outside the hospital. The bacterial response to the antibiotic “attack” is the prime example of bacterial adaptation and the pinnacle of evolution. “Survival of the fittest” is a consequence of an immense genetic plasticity of bacterial pathogens that trigger specific responses that result in mutational adaptations, acquisition of genetic material or alteration of gene expression producing resistance to virtually all antibiotics currently available in clinical practice. Therefore, understanding the biochemical and genetic basis of resistance is of paramount importance to design strategies to curtail the emergence and spread of resistance and devise innovative therapeutic approaches against multidrug-resistant organisms. In this chapter, we will describe in detail the major mechanisms of antibiotic resistance encountered in clinical practice providing specific examples in relevant bacterial pathogens. PMID:27227291

  8. Antibiotic resistance in Salmonella

    Vo, A.T.T.


    Immediately after their introduction in the beginning of the fourties of the previous century, the agents used to combat infectious diseases caused by bacteria were regarded with suspicion, but not long thereafter antibiotics had the status of miracle drugs. For decades mankind has lived under the

  9. Antibiotic Resistance in Foodborne Pathogens

    Walsh, Ciara; Duffy, Geraldine


    Wide-spread antibiotic resistance among bacterial pathogens is now a serious public health issue and multi-antibiotic resistance has been reported in many foodborne pathogens including Salmonella and E. coli. A study to determine antibiotic resistance profiles of a range of Salmonella and Verocytotoxigenic E.coli (VTEC) isolated from Irish foods revealed significant levels of antibiotic resistance in the strains. S. typhimurium DT104 were multiantibiotic resistant with 97% resistant to 7 anti...

  10. When and How to Take Antibiotics

    ... bacterial balance, it may cause stomach upsets, diarrhea, vaginal infections, or other problems. If you take antibiotics unnecessarily ... before taking antibiotics? Antibiotics often lead to a vaginal yeast infection. Because antibiotics kill the normal bacteria in the ...

  11. Codon usage and amino acid usage influence genes expression level.

    Paul, Prosenjit; Malakar, Arup Kumar; Chakraborty, Supriyo


    Highly expressed genes in any species differ in the usage frequency of synonymous codons. The relative recurrence of an event of the favored codon pair (amino acid pairs) varies between gene and genomes due to varying gene expression and different base composition. Here we propose a new measure for predicting the gene expression level, i.e., codon plus amino bias index (CABI). Our approach is based on the relative bias of the favored codon pair inclination among the genes, illustrated by analyzing the CABI score of the Medicago truncatula genes. CABI showed strong correlation with all other widely used measures (CAI, RCBS, SCUO) for gene expression analysis. Surprisingly, CABI outperforms all other measures by showing better correlation with the wet-lab data. This emphasizes the importance of the neighboring codons of the favored codon in a synonymous group while estimating the expression level of a gene.

  12. Perioperative antibiotics in the setting of microvascular free tissue transfer: current practices

    Reiffel, Alyssa J.; Kamdar, Mehul R.; Kadouch, Daniel J. M.; Rohde, Christine H.; Spector, Jason A.


    Microvascular free tissue transfer is a ubiquitous and routine method of restoring anatomic defects. There is a paucity of data regarding the role of perioperative antibiotics in free tissue transfer. We designed a survey to explore usage patterns among microvascular surgeons and thereby define a

  13. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions

    Leibovici, Leonard; Paul, Mical; Garner, Paul


    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies....... This omission creates a skewed view, which emphasizes short-term efficacy and ignores the long-term consequences to the patient and other people. We offer a framework for addressing antibiotic resistance in systematic reviews. We suggest that the data on background resistance in the original trials should...... controlled trials or systematic reviews....

  14. Occurrence, Distribution, and Risk Assessment of Antibiotics in a Subtropical River-Reservoir System

    Yihan Chen


    Full Text Available Antibiotic pollutions in the aquatic environment have attracted widespread attention due to their ubiquitous distribution and antibacterial properties. The occurrence, distribution, and ecological risk assessment of 17 common antibiotics in this study were preformed in a vital drinking water source represented as a river-reservoir system in South China. In general, 15 antibiotics were detected at least once in the watershed, with the total concentrations of antibiotics in the water samples ranging from 193.6 to 863.3 ng/L and 115.1 to 278.2 μg/kg in the sediment samples. For the water samples, higher rain runoff may contribute to the levels of total concentration in the river system, while perennial anthropic activity associated with the usage pattern of antibiotics may be an important factor determining similar sources and release mechanisms of antibiotics in the riparian environment. Meanwhile, the reservoir system could act as a stable reactor to influence the level and composition of antibiotics exported from the river system. For the sediment samples, hydrological factor in the reservoir may influence the antibiotic distributions along with seasonal variation. Ecological risk assessment revealed that tetracycline and ciprofloxacin could pose high risks in the aquatic environment. Taken together, further investigations should be performed to elaborate the environmental behaviors of antibiotics in the river-reservoir system, especially in drinking water sources.

  15. Assessing the construct validity and reliability of the Parental Perception on Antibiotics (PAPA) scales.

    Alumran, Arwa; Hou, Xiang-Yu; Sun, Jiandong; Yousef, Abdullah A; Hurst, Cameron


    The overuse of antibiotics is becoming an increasing concern. Antibiotic resistance, which increases both the burden of disease, and the cost of health services, is perhaps the most profound impact of antibiotics overuse. Attempts have been made to develop instruments to measure the psychosocial constructs underlying antibiotics use, however, none of these instruments have undergone thorough psychometric validation. This study evaluates the psychometric properties of the Parental Perceptions on Antibiotics (PAPA) scales. The PAPA scales attempt to measure the factors influencing parental use of antibiotics in children. 1111 parents of children younger than 12 years old were recruited from primary schools' parental meetings in the Eastern Province of Saudi Arabia from September 2012 to January 2013. The structure of the PAPA instrument was validated using Confirmatory Factor Analysis (CFA) with measurement model fit evaluated using the raw and scaled χ2, Goodness of Fit Index, and Root Mean Square Error of Approximation. A five-factor model was confirmed with the model showing good fit. Constructs in the model include: Knowledge and Beliefs, Behaviors, Sources of information, Adherence, and Awareness about antibiotics resistance. The instrument was shown to have good internal consistency, and good discriminant and convergent validity. The availability of an instrument able to measure the psychosocial factors underlying antibiotics usage allows the risk factors underlying antibiotic use and overuse to now be investigated.

  16. The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery.

    Koullouros, Michalis; Khan, Nadir; Aly, Emad H


    Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics. The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery. The secondary aim was to explore any potential benefit in the use of mechanical bowel preparation (MBP) in relation to SSI in elective colorectal surgery. Medline, Embase and the Cochrane Library were searched. Any randomised controlled trials (RCTs) or cohort studies after 1980, which investigated the effectiveness of oral antibiotic prophylaxis and/or MBP in preventing SSIs in elective colorectal surgery were included. Twenty-three RCTs and eight cohorts were included. The results indicate a statistically significant advantage in preventing SSIs with the combined usage of oral and systemic antibiotic prophylaxis. Furthermore, our analysis of the cohort studies shows no benefits in the use of MBP in prevention of SSIs. The addition of oral antibiotics to systemic antibiotics could potentially reduce the risk of SSIs in elective colorectal surgery. Additionally, MBP does not seem to provide a clear benefit with regard to SSI prevention.

  17. Rational use of antibiotics: a quality improvement initiative in hospital setting

    Nausheen, S.; Hammad, R.; Khan, A.


    Objectives: To minimise irrational use of antibiotics by implementing guidelines for antibiotic usage in obstetrics and Gynaecology. Methods: The observational study was conducted from January to December 2010 at the maternity unit of Aga Khan Hospital for Women and children, Kharadar, a secondary care facility in Karachi, Pakistan. Data was collected from medical records related to the study period. Prophylactic antibiotics were given according to the American College of Obstetricians and Gynaecologists recommendation 2009. Surveillance was done by surgical site infection rates and infectious morbidity. Data was analysed on SPSS 13. Results: Therapeutic antibiotic use was rationalized, reducing the use of therapeutic antibiotics from 97% (n= 160/165) in January 2010 to 8% (n=10/125) in December 2010. Surgical site infection rates were less than 5%. Cost of antibiotics per patient decreased by 90%. Decrease in the length of stay and workload on nursing staff was also observed. Conclusion: Implementing guidelines for antibiotic use in obstetrics and gynaecology and translating it into our protocols was effective in decreasing the irrational antibiotic consumption and increasing the rational use of antibiotics in the hospital. (author)

  18. Antibiotics in Crab Ponds of Lake Guchenghu Basin, China: Occurrence, Temporal Variations, and Ecological Risks

    Wenxia Wang


    Full Text Available Antibiotics are widely used in aquaculture, however, this often results in undesirable ecological effects. To evaluate the occurrence, temporal variations, and ecological risk of antibiotics in five crab ponds of Lake Guchenghu Basin, China, 44 antibiotics from nine classes were analyzed by rapid resolution liquid chromatography-tandem mass spectrometry (RRLC-MS/MS. Twelve antibiotics belonging to six classes were detected in the aqueous phase of five crab ponds, among which sulfonamides and macrolides were the predominant classes, and six compounds (sulfamonomethoxine, sulfadiazine, trimethoprim, erythromycin-H2O, monensin, and florfenicol were frequently detected at high concentrations. In general, the antibiotic levels varied between different crab ponds, with the average concentrations ranging from 122 to 1440 ng/L. The antibiotic concentrations in crab ponds exhibited obvious seasonal variations, with the highest concentration and detection frequency detected in summer. Multivariate analysis showed that antibiotic concentrations were significantly correlated with environmental variables, such as total organic carbon, phosphate, ammonia nitrogen, and pH. Sulfadiazine, clarithromycin, erythromycin-H2O, and ciprofloxacin posed a high risk to algae, while the mixture of antibiotics could pose a high risk to aquatic organisms in the crab ponds. Overall, the usage of antibiotics in farming ponds should be comprehensively investigated and controlled to preserve a healthy aquaculture ecosystem.

  19. Bacteriocins from lactic acid bacteria as an alternative to antibiotics

    Aleksandra Ołdak


    Full Text Available Bacteriocins are ribosomally synthesized, proteinaceous substances that inhibit the growth of closely related species through numerous mechanisms. The classification system used in this review divided bacteriocins into four sub-groups based on their size. Currently, there is extensive research focused on bacteriocins and their usage as a food preservative.The increasing incidence of multidrug resistant bacterial pathogens is one of the most pressing medical problems in recent years. Recently, the potential clinical application of LAB (Lactic Acid Bacteria bacteriocin has been the subject of investigations by many scientists.Bacteriocins can be considered in a sense as antibiotic, although they differ from conventional antibiotics in numerous aspects. The gene-encoded nature of bacteriocins makes them easily amenable through bioengineering to either increase their activity or specify target microorganism. Owing to this feature of bacteriocins, antibiotic therapy would become less damaging to the natural gut microflora, which is a common drawback of conventional antibiotic use. Bacteriocins from lactic acid bacteria represent one of the most studied microbial defense systems and the idea of subjecting them to bioengineering to either increase antimicrobial activity or further specify their target microorganism is now a rapidly expanding field. This review aimed to present bacteriocins as a possible alternative to conventional antibiotics basic on latest scientific data.

  20. Selection of antibiotic resistance at very low antibiotic concentrations.

    Sandegren, Linus


    Human use of antibiotics has driven the selective enrichment of pathogenic bacteria resistant to clinically used drugs. Traditionally, the selection of resistance has been considered to occur mainly at high, therapeutic levels of antibiotics, but we are now beginning to understand better the importance of selection of resistance at low levels of antibiotics. The concentration of an antibiotic varies in different body compartments during treatment, and low concentrations of antibiotics are found in sewage water, soils, and many water environments due to natural production and contamination from human activities. Selection of resistance at non-lethal antibiotic concentrations (below the wild-type minimum inhibitory concentration) occurs due to differences in growth rate at the particular antibiotic concentration between cells with different tolerance levels to the antibiotic. The minimum selective concentration for a particular antibiotic is reached when its reducing effect on growth of the susceptible strain balances the reducing effect (fitness cost) of the resistance determinant in the resistant strain. Recent studies have shown that resistant bacteria can be selected at concentrations several hundred-fold below the lethal concentrations for susceptible cells. Resistant mutants selected at low antibiotic concentrations are generally more fit than those selected at high concentrations but can still be highly resistant. The characteristics of selection at low antibiotic concentrations, the potential clinical problems of this mode of selection, and potential solutions will be discussed.

  1. Environmental pollution by antibiotics and by antibiotic resistance determinants

    Martinez, Jose Luis


    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  2. Environmental pollution by antibiotics and by antibiotic resistance determinants

    Martinez, Jose Luis, E-mail: jlmtnez@cnb.csic.e [Departamento de Biotecnologia Microbiana, Centro Nacional de Biotecnologia, Consejo Superior de Investigaciones Cientificas, Darwin 3, Cantoblanco, 28049 Madrid, and CIBERESP (Spain)


    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  3. Reducing antibiotic prescribing in Australian general practice: time for a national strategy.

    Del Mar, Christopher B; Scott, Anna Mae; Glasziou, Paul P; Hoffmann, Tammy; van Driel, Mieke L; Beller, Elaine; Phillips, Susan M; Dartnell, Jonathan


    In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult. Categories of interventions that may support general practitioners to reduce prescribing antibiotics are: regulatory (eg, changing the default to "no repeats" in electronic prescribing, changing the packaging of antibiotics to facilitate tailored amounts of antibiotics for the right indication and restricting access to prescribing selected antibiotics to conserve them), externally administered (eg, academic detailing and audit and feedback on total antibiotic use for individual GPs), interventions that GPs can individually implement (eg, delayed prescribing, shared decision making, public declarations in the practice about conserving antibiotics, and self-administered audit), supporting GPs' access to near-patient diagnostic testing, and public awareness campaigns. Many unanswered clinical research questions remain, including research into optimal implementation methods. Reducing antibiotic use in Australian general practice will require a range of approaches (with various intervention categories), a sustained effort over many years and a commitment of appropriate resources and support.

  4. Usage of marketing in politics

    Marić Ivana


    Full Text Available Multi-party political system led to competition between political parties which caused the need for marketing in politics that improves political reputation. Politics, based on rich experience of political practice, used existing, developed methods and techniques of commercial marketing. Political marketing openly admits that politics and politicians are simply goods that are being sold on a political market. Political marketing is a whole way of operation by political parties which ask these questions: how do the voters choose; what affects their preference and how that preference can be influenced. Usage of political marketing in Bosnia and Herzegovina is still not on a satisfactory level but the knowledge about the importance of political marketing is increasing.

  5. Transmission usage cost allocation schemes

    Abou El Ela, A.A.; El-Sehiemy, R.A.


    This paper presents different suggested transmission usage cost allocation (TCA) schemes to the system individuals. Different independent system operator (ISO) visions are presented using the proportional rata and flow-based TCA methods. There are two proposed flow-based TCA schemes (FTCA). The first FTCA scheme generalizes the equivalent bilateral exchanges (EBE) concepts for lossy networks through two-stage procedure. The second FTCA scheme is based on the modified sensitivity factors (MSF). These factors are developed from the actual measurements of power flows in transmission lines and the power injections at different buses. The proposed schemes exhibit desirable apportioning properties and are easy to implement and understand. Case studies for different loading conditions are carried out to show the capability of the proposed schemes for solving the TCA problem. (author)

  6. Generic antibiotics in Japan.

    Fujimura, Shigeru; Watanabe, Akira


    Generic drugs have been used extensively in many developed countries, although their use in Japan has been limited. Generic drugs reduce drug expenses and thereby national medical expenditure. Because generic drugs provide advantages for both public administration and consumers, it is expected that they will be more widely used in the future. However, the diffusion rate of generic drugs in Japan is quite low compared with that of other developed countries. An investigation on generic drugs conducted by the Ministry of Health, Labour and Welfare in Japan revealed that 17.2 % of doctors and 37.2 % of patients had not used generic drugs. The major reasons for this low use rate included distrust of off-patent products and lower drug price margin compared with the brand name drug. The generic drugs available in the market include external drugs such as wet packs, antihypertensive agents, analgesics, anticancer drugs, and antibiotics. Among them, antibiotics are frequently used in cases of acute infectious diseases. When the treatment of these infections is delayed, the infection might be aggravated rapidly. The pharmacokinetics-pharmacodynamics (PK-PD) theory has been adopted in recent chemotherapy, and in many cases, the most appropriate dosage and administration of antibiotics are determined for individual patients considering renal function; high-dosage antibiotics are used preferably for a short duration. Therefore, a highly detailed antimicrobial agent is necessary. However, some of the generic antibiotics have less antibacterial potency or solubility than the brand name products. We showed that the potency of the generic products of vancomycin and teicoplanin is lower than that of the branded drugs by 14.6 % and 17.3 %, respectively. Furthermore, we confirmed that a generic meropenem drug for injection required about 82 s to solubilize in saline, whereas the brand product required only about 21 s. It was thought that the cause may be the difference in size of bulk

  7. Codon Usage Bias and Determining Forces in Taenia solium Genome.

    Yang, Xing; Ma, Xusheng; Luo, Xuenong; Ling, Houjun; Zhang, Xichen; Cai, Xuepeng


    The tapeworm Taenia solium is an important human zoonotic parasite that causes great economic loss and also endangers public health. At present, an effective vaccine that will prevent infection and chemotherapy without any side effect remains to be developed. In this study, codon usage patterns in the T. solium genome were examined through 8,484 protein-coding genes. Neutrality analysis showed that T. solium had a narrow GC distribution, and a significant correlation was observed between GC12 and GC3. Examination of an NC (ENC vs GC3s)-plot showed a few genes on or close to the expected curve, but the majority of points with low-ENC (the effective number of codons) values were detected below the expected curve, suggesting that mutational bias plays a major role in shaping codon usage. The Parity Rule 2 plot (PR2) analysis showed that GC and AT were not used proportionally. We also identified 26 optimal codons in the T. solium genome, all of which ended with either a G or C residue. These optimal codons in the T. solium genome are likely consistent with tRNAs that are highly expressed in the cell, suggesting that mutational and translational selection forces are probably driving factors of codon usage bias in the T. solium genome.

  8. Discovering More Accurate Frequent Web Usage Patterns

    Bayir, Murat Ali; Toroslu, Ismail Hakki; Cosar, Ahmet; Fidan, Guven


    Web usage mining is a type of web mining, which exploits data mining techniques to discover valuable information from navigation behavior of World Wide Web users. As in classical data mining, data preparation and pattern discovery are the main issues in web usage mining. The first phase of web usage mining is the data processing phase, which includes the session reconstruction operation from server logs. Session reconstruction success directly affects the quality of the frequent patterns disc...

  9. The Scope of Usage-based Theory

    Paul eIbbotson


    Usage-based approaches typically draw on a relatively small set of cognitive processes, such as categorization, analogy, and chunking to explain language structure and function. The goal of this paper is to first review the extent to which the “cognitive commitment” of usage-based theory has had success in explaining empirical findings across domains, including language acquisition, processing, and typology. We then look at the overall strengths and weaknesses of usage-based theory and highli...

  10. Antibiotic use and microbiome function.

    Ferrer, Manuel; Méndez-García, Celia; Rojo, David; Barbas, Coral; Moya, Andrés


    Our microbiome should be understood as one of the most complex components of the human body. The use of β-lactam antibiotics is one of the microbiome covariates that influence its composition. The extent to which our microbiota changes after an antibiotic intervention depends not only on the chemical nature of the antibiotic or cocktail of antibiotics used to treat specific infections, but also on the type of administration, duration and dose, as well as the level of resistance that each microbiota develops. We have begun to appreciate that not all bacteria within our microbiota are vulnerable or reactive to different antibiotic interventions, and that their influence on both microbial composition and metabolism may differ. Antibiotics are being used worldwide on a huge scale and the prescription of antibiotics is continuing to rise; however, their effects on our microbiota have been reported for only a limited number of them. This article presents a critical review of the antibiotics or antibiotic cocktails whose use in humans has been linked to changes in the composition of our microbial communities, with a particular focus on the gut, oral, respiratory, skin and vaginal microbiota, and on their molecular agents (genes, proteins and metabolites). We review the state of the art as of June 2016, and cover a total of circa 68 different antibiotics. The data herein are the first to compile information about the bacteria, fungi, archaea and viruses most influenced by the main antibiotic treatments prescribed nowadays. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Prescribing antibiotics in general practice:

    Sydenham, Rikke Vognbjerg; Pedersen, Line Bjørnskov; Plejdrup Hansen, Malene

    Objectives The majority of antibiotics are prescribed from general practice. The use of broad-spectrum antibiotics increases the risk of development of bacteria resistant to antibiotic treatment. In spite of guidelines aiming to minimize the use of broad-spectrum antibiotics we see an increase...... in the use of these agents. The overall aim of the project is to explore factors influencing the decision process and the prescribing behaviour of the GPs when prescribing antibiotics. We will study the impact of microbiological testing on the choice of antibiotic. Furthermore the project will explore how...... the GPs’ prescribing behaviour is influenced by selected factors. Method The study consists of a register-based study and a questionnaire study. The register-based study is based on data from the Register of Medicinal Product Statistics (prescribed antibiotics), Statistics Denmark (socio-demographic data...

  12. Antibiotics and oral contraceptives.

    DeRossi, Scott S; Hersh, Elliot V


    With the exception of rifampin-like drugs, there is a lack of scientific evidence supporting the ability of commonly prescribed antibiotics, including all those routinely employed in outpatient dentistry, to either reduce blood levels and/or the effectiveness of oral contraceptives. To date, all clinical trials studying the effects of concomitant antibiotic therapy (with the exception of rifampin and rifabutin) have failed to demonstrate an interaction. Like all drugs, oral contraceptives are not 100% effective with the failure rate in the typical United States population reported to be as high as 3%. It is thus possible that the case reports of unintended pregnancies during antibiotic therapy may simply represent the normal failure rate of these drugs. Considering that both drug classes are prescribed frequently to women of childbearing potential, one would expect a much higher rate of oral contraceptive failure in this group of patients if a true drug:drug interaction existed. On the other hand, if the interaction does exist but is a relatively rare event, occurring in, say, 1 in 5000 women, clinical studies such as those described in this article would not detect the interaction. The pharmacokinetic studies of simultaneous antibiotic and oral contraceptive ingestion, and the retrospective studies of pregnancy rates among oral contraceptive users exposed to antibiotics, all suffer from one potential common weakness, i.e., their relatively small sample size. Sample sizes in the pharmacokinetic trials ranged from 7 to 24 participants, whereas the largest retrospective study of pregnancy rates still evaluated less than 800 total contraceptive users. Still, the incidence of such a rare interaction would not differ from the accepted normal failure rate of oral contraceptive therapy. The medico-legal ramifications of what looks like at best a rare interaction remains somewhat "murky." On one hand, we have medico-legal experts advising the profession to exercise caution

  13. Nebulized antibiotics in mechanically ventilated patients: roadmap and challenges.

    Poulakou, G; Siakallis, G; Tsiodras, S; Arfaras-Melainis, A; Dimopoulos, G


    Nebulized antibiotics use has become common practice in the therapeutics of pneumonia in cystic fibrosis patients. There is an increasing interest in their use for respiratory infections in mechanically ventilated (MV) patients in order to a) overcome pharmacokinetic issues in the lung compartment with traditional systemic antibiotic use and b) prevent the emergence of multi-drug-resistant (MDR) pathogens. Areas covered: The beneficial effects of antibiotic nebulization in MV patients e.g. increasing efficacy, reduced toxicity and prevention of resistance are described. Physicochemical parameters of optimal lung deposition, characteristics of currently available nebulizers, practical aspects of the procedure, including drug preparation and adjustments of ventilator and circuit parameter are presented. Antibiotics used in nebulized route, along with efficacy in various clinical indications and safety issues are reviewed. Expert commentary: The safety of nebulization of antibiotics has been proven in numerous studies; efficacy as adjunctive treatment to intravenous regimens or as monotherapy has been demonstrated in ventilator-associated pneumonia or ventilator-associated tracheobronchitis due to MDR or susceptible pathogens. However, due to the heterogeneity of studies, multiple meta-analyses fail to demonstrate a clear effect. Clarification of indications, standardization of technique and implementation of clinical practice guidelines, based on new large-scale trials will lead to the optimal use of nebulized antibiotics.

  14. Surveillance of antibiotic resistance

    Johnson, Alan P.


    Surveillance involves the collection and analysis of data for the detection and monitoring of threats to public health. Surveillance should also inform as to the epidemiology of the threat and its burden in the population. A further key component of surveillance is the timely feedback of data to stakeholders with a view to generating action aimed at reducing or preventing the public health threat being monitored. Surveillance of antibiotic resistance involves the collection of antibiotic susceptibility test results undertaken by microbiology laboratories on bacteria isolated from clinical samples sent for investigation. Correlation of these data with demographic and clinical data for the patient populations from whom the pathogens were isolated gives insight into the underlying epidemiology and facilitates the formulation of rational interventions aimed at reducing the burden of resistance. This article describes a range of surveillance activities that have been undertaken in the UK over a number of years, together with current interventions being implemented. These activities are not only of national importance but form part of the international response to the global threat posed by antibiotic resistance. PMID:25918439

  15. Antibiotic Desensitization Therapy in Secondary Syphilis and Listeria Infection: Case Reports and Review of Desensitization Therapy

    Magpantay, Gil; Madar, Cristian S; Hsue, Gunther; Belnap, Conrad


    Two adult cases, one of secondary syphilis and one of Listeria monocytogenes bacteremia, in which antibiotic desensitization therapy was utilized to assist treatment of active infection in the face of severe penicillin allergy. Clinical considerations are discussed that led to the decision to employ a formal desensitization procedure. Antibiotic desensitization protocols can facilitate optimal and safe antibiotic therapy in the appropriate clinical setting. PMID:22187514

  16. Optimal usage of FujiFilm's supply chain

    Belhaj, Z.


    The following report presents the results of the logistics design project carried out in FujiFilm B.V. in the plant of PS-plates (P3) in Tilburg. The project was conducted from September 2008 to July 2009. FujiP3, one of the most important production units of FujiFilm, manufactures and sells

  17. On Optimizing Radio Resource Usage in Cellular Networks

    Bogdan Ciobanu


    Full Text Available The control of the interference between mobile terminals and radio access points inside the network represented since always a challenge for all mobile telecommunications service providers. The present paper represents a study regarding the optimum utilization of radio resources in order to obtain a system with as high a capacity as possible for a certain available bandwidth.

  18. Optimized usage of NExBTL renewable diesel fuel - OPTIBIO

    Nylund, N.-O. [VTT Technical Research Centre of Finland, Espoo (Finland); TEC TransEnergy Consulting Oy, Espoo (Finland)], email:, email:


    Buses are the backbone of many public transport systems, and typically have a long lifespan. Considering the need for switching to non-fossil fuels, municipalities increasingly want to raise the share of renewable fuels - also for their bus fleets - to reduce greenhouse gas emissions and fossil fuel imports. It is important for local decision-makers to understand which options are available and what the range of limitations and benefits of each. As the service life of buses is quite long, measures which can help improve the environmental performance of existing vehicles are important. When using conventional biodiesel there are technical limitations on how much fatty acid methyl ester (FAME) can be added to standard diesel fuel - in most cases replacement is below 10%. Further to this, some alternative fuels require new dedicated vehicles. The OPTIBIO project needed to explore how to optimise fuels that can be used in both existing and new vehicles, using high quality paraffinic renewable diesel (HVO) as fossil fuel replacement of up to 100%. The value, in addition to fuel replacement, would be the reduction of harmful emissions which are most crucial for urban air quality, namely nitrogen oxides and particulates.

  19. Landsat Data Continuity Mission (LDCM) - Optimizing X-Band Usage

    Garon, H. M.; Gal-Edd, J. S.; Dearth, K. W.; Sank, V. I.


    The NASA version of the low-density parity check (LDPC) 7/8-rate code, shortened to the dimensions of (8160, 7136), has been implemented as the forward error correction (FEC) schema for the Landsat Data Continuity Mission (LDCM). This is the first flight application of this code. In order to place a 440 Msps link within the 375 MHz wide X band we found it necessary to heavily bandpass filter the satellite transmitter output . Despite the significant amplitude and phase distortions that accompanied the spectral truncation, the mission required BER is maintained at LDPC code and the amplitude and phase compensation provided in the receiver. Similar results were obtained with receivers from several vendors.

  20. An approach towards optimal usage of immobilized sensor chips in ...



    Nov 9, 2011 ... protein interaction was developed and compared with common regeneration methods. .... Analysis of variance for all analyt-ligand complexes .... achieved therefore two main components comprising higher Re from first ...

  1. Optimizing Battery Usage and Management for Long Life

    Smith, Kandler; Shi, Ying; Wood, Eric; Pesaran, Ahmad


    This presentation discusses the impact of system design factors on battery aging and end of life. Topics include sizing of the state-of-charge operating window, cell balancing, and thermal management systems and their value in reducing pack degradation rates and cell imbalance growth over lifetime.

  2. Optimizing Battery Usage and Management for Long Life

    Smith, Kandler; Shi, Ying; Wood, Eric; Pesaran, Ahmad


    This presentation discusses the impact of system design factors on battery aging and end of life. Topics include sizing of the SOC operating window, cell balancing and thermal management systems and their value in reducing pack degradation rates and cell imbalance growth over lifetime.

  3. A systems integration approach to the optimum operation and scheduling of biocide usage and discharge for seawater cooling systems

    Mahfouz, Abdullah Bin; Atilhan, Selma; Batchelor, Bill; Linke, Patrick; Wahab, Ahmed Abdel; Halwagi, Mahmoud M. El


    The objective of this work is to develop a systematic approach to the optimal design and integration of seawater cooling systems in industrial facilities along with the usage and discharge of biocides. Specifically, the paper will address

  4. Occurrence, fate and interrelation of selected antibiotics in sewage treatment plants and their receiving surface water.

    Wu, Ming-Hong; Que, Chen-Jing; Xu, Gang; Sun, Yan-Feng; Ma, Jing; Xu, Hui; Sun, Rui; Tang, Liang


    The occurrence and fate of 12 commonly used antibiotics, two fluoroquinolones (FQs), three sulfonamides (SAs), three macrolides (MLs), two β-lactams and two tetracyclines (TCs), were studied in four sewage treatment plants (STPs) and their receiving water, the Huangpu River, Shanghai. The levels of selected antibiotics in the STPs ranged from ngL(-1) to μgL(-1), while ofloxacin (OFL) was predominant (reach up to 2936.94ngL(-1)). The highest and lowest proportions were of FQs (STP 1, STP 2 and STP 3) and TCs (in four STPs) respectively in both influents and effluents. And the second-highest proportion was of FQs in STP 4 (only 2% lower than the highest). What could be inferred was that the usage of TCs were extremely low while the usage of FQs were larger than other antibiotics in our study area. The elimination of antibiotics through these STPs was incomplete and a wide range of removal efficiencies (-442.8% to 100%) during the treatment was observed. Based on the mass loadings as well as the per-capita mass loadings of target antibiotics in four STPs, OFL was considered the primary contaminant herein. In the Huangpu River, 3 antibiotics were not detected in any water samples, while the detection frequencies of 4 antibiotics were 100%. The highest concentration detected in the river was 53.91ngL(-1) of sulfapyridine (SD). The Spearman correlation analysis of antibiotics in STPs and the nearby water samples suggests that the antibiotics discharged from some STPs might influence the receiving water to some extent. Moreover, most of the hazard quotient (HQ) values in STP effluents were one order magnitude higher than those in their receiving water. However, there is no imminent significant ecotoxicological risk caused by any single compound in the effluents and receiving waters. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Pattern of antimicrobial usage in livestock animals in south-western Nigeria: The need for alternative plans

    Hezekiah K. Adesokan


    Full Text Available Resistance to antibiotics has continued to increase, placing future animal and human disease management in real danger. The developing countries characterised by widespread indiscriminate antibiotic use and in which ‘third-generation’ antibiotics are not readily available or affordable are the worst affected. A 3-year (2010–2012 retrospective survey of antibiotic usage in livestock production in three selected states of south-western Nigeria was conducted. Data obtained from eight purposively selected licensed veterinary pharmaceutical sales establishments in the area, based on keeping detailed sales records for the study period, were analysed using Stata Version 12. Results showed that tetracyclines (33.6%, fluoroquinolones (26.5% and beta-lactams/aminoglycosides (20.4% constituted the majority of the antibiotics used over the 3 years. The differences in the quantities of antibiotic types used within each antimicrobial class were statistically significant for tetracyclines (F = 59.87; p < 0.0001 and fluoroquinolones (F = 43.97; p < 0.0001 but not for beta-lactams/aminoglycosides (F = 3.21; p = 0.148. Furthermore, antibiotic consumption increased by 40.4% between 2010 and 2012. Although statistically insignificant (F = 0.277; p = 0.762, the increasing trend across the years was at rates of 23.5% between 2010 and 2011 and 13.8% between 2011 and 2012. In addition, the findings show a significantly higher consumption rate (t = 15.21; df = 5; p < 0.0001 during the rainy (52.5% than the dry (47.5% seasons. The current increasing trend in antibiotic usage holds a serious danger for the future and therefore calls for alternative plans to safeguard future livestock production, food security and human health. This becomes more imperative considering emerging resistance against tetracyclines and fluoroquinolones, the foremost remedies for livestock diseases in most developing countries.

  6. MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years

    Scheinfeld, Meir H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Emergency Radiology, Bronx, NY (United States); Moon, Jee-Young; Wang, Dan [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States); Fagan, Michele J. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pediatrics, Division of Emergency Medicine, Bronx, NY (United States); Davoudzadeh, Reubin [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Taragin, Benjamin H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Pediatric Radiology, Bronx, NY (United States)


    Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend. Institutional Review Board exemption was obtained. Emergency department patient visit and exam data were obtained from the hospital database for the 2011-2015 time period. MRI usage data were normalized using emergency department patient visit data to determine usage rates. The z-test was used to compare MRI use by gender. The chi-square test was used to test for trends in MRI usage during the study period and in patient age. MRI usage for each hour and each weekday were tabulated to determine peak and trough usage times. MRI usage rate per emergency department patient visit was 0.36%. Headache, pain and rule-out appendicitis were the most common indications for neuroradiology, musculoskeletal and trunk exams, respectively. Usage in female patients was significantly greater than in males (0.42% vs. 0.29%, respectively, P<0.001). Usage significantly increased during the 5-year period (P<0.001). Use significantly increased from age 3 to 17 (0.011% to 1.1%, respectively, P<0.001). Sixty percent of exams were performed after-hours, the highest volume during the 10 p.m. hour and lowest between 4 a.m. and 9 a.m. MRI use was highest on Thursdays and lowest on Sundays (MRI on 0.45% and 0.22% of patients, respectively). MRI use in children increased during the study period, most notably in females, on weekdays and after-hours. (orig.)

  7. Analysis of transcriptome data reveals multifactor constraint on codon usage in Taenia multiceps.

    Huang, Xing; Xu, Jing; Chen, Lin; Wang, Yu; Gu, Xiaobin; Peng, Xuerong; Yang, Guangyou


    Codon usage bias (CUB) is an important evolutionary feature in genomes that has been widely observed in many organisms. However, the synonymous codon usage pattern in the genome of T. multiceps remains to be clarified. In this study, we analyzed the codon usage of T. multiceps based on the transcriptome data to reveal the constraint factors and to gain an improved understanding of the mechanisms that shape synonymous CUB. Analysis of a total of 8,620 annotated mRNA sequences from T. multiceps indicated only a weak codon bias, with mean GC and GC3 content values of 49.29% and 51.43%, respectively. Our analysis indicated that nucleotide composition, mutational pressure, natural selection, gene expression level, amino acids with grand average of hydropathicity (GRAVY) and aromaticity (Aromo) and the effective selection of amino-acids all contributed to the codon usage in T. multiceps. Among these factors, natural selection was implicated as the major factor affecting the codon usage variation in T. multiceps. The codon usage of ribosome genes was affected mainly by mutations, while the essential genes were affected mainly by selection. In addition, 21codons were identified as "optimal codons". Overall, the optimal codons were GC-rich (GC:AU, 41:22), and ended with G or C (except CGU). Furthermore, different degrees of variation in codon usage were found between T. multiceps and Escherichia coli, yeast, Homo sapiens. However, little difference was found between T. multiceps and Taenia pisiformis. In this study, the codon usage pattern of T. multiceps was analyzed systematically and factors affected CUB were also identified. This is the first study of codon biology in T. multiceps. Understanding the codon usage pattern in T. multiceps can be helpful for the discovery of new genes, molecular genetic engineering and evolutionary studies.

  8. Problematic Internet Usage of ICT Teachers

    Gunduz, Semseddin


    Information and communication technologies (ICT) have affected all area in a society. Human can learn quickly and accurately from the internet. The aim of this study was to investigate what the problematic internet usage of ICT teachers. Therefore, the present study investigated the problematic internet usage, who worked as an ICT teacher in…

  9. Neurotic Anxiety, Pronoun Usage, and Stress

    Alban, Lewis Sigmund; Groman, William D.


    Attempts to clarify the function of a particular aspect of verbal communication, pronoun usage, by (a) using a Gestalt Therapy theory conceptual framework and (b) experimentally focusing on the relationship of pronoun usage to neurotic anxiety and emotional stress. (Author/RK)

  10. Library training to promote electronic resource usage

    Frandsen, Tove Faber; Tibyampansha, Dativa; Ibrahim, Glory


    Purpose: Increasing the usage of electronic resources is an issue of concern for many libraries all over the world. Several studies stress the importance of information literacy and instruction in order to increase the usage. Design/methodology/approach: The present article presents the results...

  11. Definite Article Usage across Varieties of English

    Wahid, Ridwan


    This paper seeks to explore the extent of definite article usage variation in several varieties of English based on a classification of its usage types. An annotation scheme based on Hawkins and Prince was developed for this purpose. Using matching corpus data representing Inner Circle varieties and Outer Circle varieties, analysis was made on…

  12. Receptor-based screening assays for the detection of antibiotics residues - A review.

    Ahmed, Saeed; Ning, Jianan; Cheng, Guyue; Ahmad, Ijaz; Li, Jun; Mingyue, Liu; Qu, Wei; Iqbal, Mujahid; Shabbir, M A B; Yuan, Zonghui


    Consumer and regulatory agencies have a high concern to antibiotic residues in food producing animals, so appropriate screening assays of fast, sensitive, low cost, and easy sample preparation for the identification of these residues are essential for the food-safety insurance. Great efforts in the development of a high-throughput antibiotic screening assay have been made in recent years. Concerning the screening of antibiotic residue, this review elaborate an overview on the availability, advancement and applicability of antibiotic receptor based screening assays for the safety assessment of antibiotics usage (i.e. radio receptor assay, enzyme labeling assays, colloidal gold receptor assay, enzyme colorimetry assay and biosensor assay). This manuscript also tries to shed a light on the selection, preparation and future perspective of receptor protein for antibiotic residue detection. These assays have been introduced for the screening of numerous food samples. Receptor based screening technology for antibiotic detection has high accuracy. It has been concluded that at the same time, it can detect a class of drugs for certain receptor, and realize the multi-residue detection. These assays offer fast, easy and precise detection of antibiotics. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Daily antibiotic cost of nosocomial infections in a Turkish university hospital

    Yalcin Ata


    Full Text Available Abstract Background Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. Methods All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. Results Among the 8460 study patients, 817 (16.6% developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7% presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was $99.02 for pneumonia, $94.32 for bloodstream infection, $94.31 for surgical site infection, $52.37 for urinary tract infection, and $162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. Conclusions Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

  14. Interactive publications: creation and usage

    Thoma, George R.; Ford, Glenn; Chung, Michael; Vasudevan, Kirankumar; Antani, Sameer


    As envisioned here, an "interactive publication" has similarities to multimedia documents that have been in existence for a decade or more, but possesses specific differentiating characteristics. In common usage, the latter refers to online entities that, in addition to text, consist of files of images and video clips residing separately in databases, rarely providing immediate context to the document text. While an interactive publication has many media objects as does the "traditional" multimedia document, it is a self-contained document, either as a single file with media files embedded within it, or as a "folder" containing tightly linked media files. The main characteristic that differentiates an interactive publication from a traditional multimedia document is that the reader would be able to reuse the media content for analysis and presentation, and to check the underlying data and possibly derive alternative conclusions leading, for example, to more in-depth peer reviews. We have created prototype publications containing paginated text and several media types encountered in the biomedical literature: 3D animations of anatomic structures; graphs, charts and tabular data; cell development images (video sequences); and clinical images such as CT, MRI and ultrasound in the DICOM format. This paper presents developments to date including: a tool to convert static tables or graphs into interactive entities, authoring procedures followed to create prototypes, and advantages and drawbacks of each of these platforms. It also outlines future work including meeting the challenge of network distribution for these large files.

  15. MESUR metrics from scholarly usage of resources

    CERN. Geneva; Van de Sompel, Herbert


    Usage data is increasingly regarded as a valuable resource in the assessment of scholarly communication items. However, the development of quantitative, usage-based indicators of scholarly impact is still in its infancy. The Digital Library Research & Prototyping Team at the Los Alamos National Laboratory's Research library has therefore started a program to expand the set of usage-based tools for the assessment of scholarly communication items. The two-year MESUR project, funded by the Andrew W. Mellon Foundation, aims to define and validate a range of usage-based impact metrics, and issue guidelines with regards to their characteristics and proper application. The MESUR project is constructing a large-scale semantic model of the scholarly community that seamlessly integrates a wide range of bibliographic, citation and usage data. Functioning as a reference data set, this model is analyzed to characterize the intricate networks of typed relationships that exist in the scholarly community. The resulting c...

  16. Cycling empirical antibiotic therapy in hospitals: meta-analysis and models.

    Pia Abel zur Wiesch


    Full Text Available The rise of resistance together with the shortage of new broad-spectrum antibiotics underlines the urgency of optimizing the use of available drugs to minimize disease burden. Theoretical studies suggest that coordinating empirical usage of antibiotics in a hospital ward can contain the spread of resistance. However, theoretical and clinical studies came to different conclusions regarding the usefulness of rotating first-line therapy (cycling. Here, we performed a quantitative pathogen-specific meta-analysis of clinical studies comparing cycling to standard practice. We searched PubMed and Google Scholar and identified 46 clinical studies addressing the effect of cycling on nosocomial infections, of which 11 met our selection criteria. We employed a method for multivariate meta-analysis using incidence rates as endpoints and find that cycling reduced the incidence rate/1000 patient days of both total infections by 4.95 [9.43-0.48] and resistant infections by 7.2 [14.00-0.44]. This positive effect was observed in most pathogens despite a large variance between individual species. Our findings remain robust in uni- and multivariate metaregressions. We used theoretical models that reflect various infections and hospital settings to compare cycling to random assignment to different drugs (mixing. We make the realistic assumption that therapy is changed when first line treatment is ineffective, which we call "adjustable cycling/mixing". In concordance with earlier theoretical studies, we find that in strict regimens, cycling is detrimental. However, in adjustable regimens single resistance is suppressed and cycling is successful in most settings. Both a meta-regression and our theoretical model indicate that "adjustable cycling" is especially useful to suppress emergence of multiple resistance. While our model predicts that cycling periods of one month perform well, we expect that too long cycling periods are detrimental. Our results suggest that

  17. Development of a novel and automated fluorescent immunoassay for the analysis of beta-lactam antibiotics

    Benito-Pena, E.; Moreno-Bondi, M.C.; Orellana, G.; Maquieira, K.; Amerongen, van A.


    An automated immunosensor for the rapid and sensitive analysis of penicillin type -lactam antibiotics has been developed and optimized. An immunogen was prepared by coupling the common structure of the penicillanic -lactam antibiotics, i.e., 6-aminopenicillanic acid to keyhole limpet hemocyanin.

  18. Infusional β-lactam antibiotics in febrile neutropenia: has the time come?

    Abbott, Iain J; Roberts, Jason A


    Febrile neutropenia presents a clinical challenge in which timely and appropriate antibiotic exposure is crucial. In the context of altered pharmacokinetics and rising bacterial resistance, standard antibiotic doses are unlikely to be sufficient. This review explores the potential utility of altered dosing approaches of β-lactam antibiotics to optimize treatment in febrile neutropenia. There is a dynamic relationship between the antibiotic, the infecting pathogen, and the host. Great advancements have been made in the understanding of the pharmacokinetic changes in critical illness and the pharmacodynamic relationships of antibiotics in these settings. Antibiotic treatment in febrile neutropenia is becoming increasingly difficult. Patients are of higher acuity, receive more intensive chemotherapy regimens leading to prolonged neutropenia, and are often exposed to multiple antibiotic courses. These patients display significant variability in antibiotic clearances and increases in volume of distribution compared with standard ward-based patients. Rising antibiotic resistance and a lack of new antibiotics in production have prompted alternative dosing strategies based on pharmacokinetic/pharmacodynamic data, such as extended or continuous infusions of β-lactam antibiotics, to maximize the likelihood of treatment success. A definitive study that describes a mortality benefit of such dosing regimens remains elusive and the theoretical advantages require testing in well designed clinical trials.

  19. Multiple Evolutionary Selections Involved in Synonymous Codon Usages in the Streptococcus agalactiae Genome.

    Ma, Yan-Ping; Ke, Hao; Liang, Zhi-Ling; Liu, Zhen-Xing; Hao, Le; Ma, Jiang-Yao; Li, Yu-Gu


    Streptococcus agalactiae is an important human and animal pathogen. To better understand the genetic features and evolution of S. agalactiae, multiple factors influencing synonymous codon usage patterns in S. agalactiae were analyzed in this study. A- and U-ending rich codons were used in S. agalactiae function genes through the overall codon usage analysis, indicating that Adenine (A)/Thymine (T) compositional constraints might contribute an important role to the synonymous codon usage pattern. The GC3% against the effective number of codon (ENC) value suggested that translational selection was the important factor for codon bias in the microorganism. Principal component analysis (PCA) showed that (i) mutational pressure was the most important factor in shaping codon usage of all open reading frames (ORFs) in the S. agalactiae genome; (ii) strand specific mutational bias was not capable of influencing the codon usage bias in the leading and lagging strands; and (iii) gene length was not the important factor in synonymous codon usage pattern in this organism. Additionally, the high correlation between tRNA adaptation index (tAI) value and codon adaptation index (CAI), frequency of optimal codons (Fop) value, reinforced the role of natural selection for efficient translation in S. agalactiae. Comparison of synonymous codon usage pattern between S. agalactiae and susceptible hosts (human and tilapia) showed that synonymous codon usage of S. agalactiae was independent of the synonymous codon usage of susceptible hosts. The study of codon usage in S. agalactiae may provide evidence about the molecular evolution of the bacterium and a greater understanding of evolutionary relationships between S. agalactiae and its hosts.

  20. A study of antibiotic prescribing

    Jaruseviciene, L.; Radzeviciene-Jurgute, R.; Jurgutis, A.


    Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated...... clinically or pharmacologically. Methods. 22 Lithuanian and 29 Russian GPs participated in five focus group discussions. Thematic analysis was used to analyse the data. Results. We identified four main thematic categories: patients' faith in antibiotics as medication for upper respiratory tract infections......; patient potential to influence a GP's decision to prescribe antibiotics for upper respiratory tract infections; impediments perceived by GPs in advocating clinically grounded antibiotic prescribing with their patients, and strategies applied in physician-patient negotiation about antibiotic prescribing...

  1. Antibiotics in late clinical development.

    Fernandes, Prabhavathi; Martens, Evan


    Most pharmaceutical companies have stopped or have severely limited investments to discover and develop new antibiotics to treat the increasing prevalence of infections caused by multi-drug resistant bacteria, because the return on investment has been mostly negative for antibiotics that received marketing approved in the last few decades. In contrast, a few small companies have taken on this challenge and are developing new antibiotics. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund discovery of new antibiotics are described. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Antibiotic prevention of postcataract endophthalmitis

    Kessel, Line; Flesner, Per; Andresen, Jens


    Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL......, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one...... with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one...

  3. Antibiotics for acute pyelonephritis in children.

    Strohmeier, Yvonne; Hodson, Elisabeth M; Willis, Narelle S; Webster, Angela C; Craig, Jonathan C


    comparisons. No significant differences were found in duration of fever (2 studies, 808 children: MD 2.05 hours, 95% CI -0.84 to 4.94), persistent UTI at 72 hours after commencing therapy (2 studies, 542 children: RR 1.10, 95% CI 0.07 to 17.41) or persistent kidney damage at six to 12 months (4 studies, 943 children: RR 0.82, 95% CI 0.59 to 1.12) between oral antibiotic therapy (10 to 14 days) and intravenous (IV) therapy (3 days) followed by oral therapy (10 days). Similarly, no significant differences in persistent bacteriuria at the end of treatment (4 studies, 305 children: RR 0.78, 95% CI 0.24 to 2.55) or persistent kidney damage (4 studies, 726 children: RR 1.01, 95% CI 0.80 to 1.29) were found between IV therapy (three to four days) followed by oral therapy and IV therapy (seven to 14 days). No significant differences in efficacy were found between daily and thrice daily administration of aminoglycosides (1 study, 179 children, persistent clinical symptoms at three days: RR 1.98, 95% CI 0.37 to 10.53). Adverse events were mild and uncommon and rarely resulted in discontinuation of treatment. This updated review increases the body of evidence that oral antibiotics alone are as effective as a short course (three to four days) of IV antibiotics followed by oral therapy for a total treatment duration of 10 to 14 days for the treatment of acute pyelonephritis in children. When IV antibiotics are given, a short course (two to four days) of IV therapy followed by oral therapy is as effective as a longer course (seven to 10 days) of IV therapy. If IV therapy with aminoglycosides is chosen, single daily dosing is safe and effective. Insufficient data are available to extrapolate these findings to children aged less than one month of age or to children with dilating vesicoureteric reflux (grades III-V). Further studies are required to determine the optimal total duration of antibiotic therapy required for acute pyelonephritis.

  4. Antibiotics from predatory bacteria

    Juliane Korp


    Full Text Available Bacteria, which prey on other microorganisms, are commonly found in the environment. While some of these organisms act as solitary hunters, others band together in large consortia before they attack their prey. Anecdotal reports suggest that bacteria practicing such a wolfpack strategy utilize antibiotics as predatory weapons. Consistent with this hypothesis, genome sequencing revealed that these micropredators possess impressive capacities for natural product biosynthesis. Here, we will present the results from recent chemical investigations of this bacterial group, compare the biosynthetic potential with that of non-predatory bacteria and discuss the link between predation and secondary metabolism.

  5. Profile of antibiotic consumption, sensitivity and resistance in an urban area of Andhra Pradesh, India.

    Peripi, Sunita Bhargavi; Thadepalli, Venu Gopala Rao; Khagga, Mukkanti; Tripuraribhatla, Prasanna Krishna; Bharadwaj, Dinesh Kumar


    Antibiotics are an important category of drugs in which indiscriminate use can affect the susceptibility patterns among infectious organisms, resulting in antibiotic resistance. Data on antibiotic usage and susceptibility patterns were collected from public and private health centres in Vijayawada, Andhra Pradesh, India, through the use of questionnaires. The data collected were then coded, tabulated, computed and evaluated using statistical analysis. The consumption profile of the different categories of drugs used in public and private hospitals was as follows: nutrition and metabolism products 19.0%; gastrointestinal disorder-related drugs 18.5%; antibiotics 16.8%; anti-pyretics and anti-analgesics 20.6%. These drugs were found to be in high demand. Among the antibiotics, aminoglycosides (amikacin), quinolones (ofloxacin, ciprofloxacin), tetracyclines (doxycycline), penicillin (ampicillin) and sulphonamides (co-trimoxazole) were the most commonly prescribed drugs for antibiotic therapy. 46% of the culture laboratory reports were positive with the following organism profile: Escherichia coli (36%), Klebsiella pneumoniae (16%), Staphylococcus aureus (29%), Enterococcus faecalis (9%) and Pseudomonas aeruginosa (10%). In terms of the sensitivity profile of antibacterials, amikacin (66.9%) was the only antibiotic showing sensitivity patterns, while the majority of antibiotics, such as cotrimoxazole, nalidixic acid, amoxicillin, gentamycin and norfloxacin, had acquired a resistance rate of 55.1%-80.6%. The results of this study suggest that indiscriminate prescription and consumption of new broad-spectrum antibiotics against sensitive organisms results in the development of antimicrobial resistance. Therefore, there is an urgent need to curb the excessive use of antibiotics in local hospitals in order to control the trend of increasing antimicrobial resistance to antibiotics.

  6. The antibiotic resistome: what's new?

    Perry, Julie Ann; Westman, Erin Louise; Wright, Gerard D


    The antibiotic resistome is dynamic and ever expanding, yet its foundations were laid long before the introduction of antibiotics into clinical practice. Here, we revisit our theoretical framework for the resistome concept and consider the many factors that influence the evolution of novel resistance genes, the spread of mobile resistance elements, and the ramifications of these processes for clinical practice. Observing the trends and prevalence of genes within the antibiotic resistome is key to maintaining the efficacy of antibiotics in the clinic. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Coil Optimization for HTS Machines

    Mijatovic, Nenad; Jensen, Bogi Bech; Abrahamsen, Asger Bech

    An optimization approach of HTS coils in HTS synchronous machines (SM) is presented. The optimization is aimed at high power SM suitable for direct driven wind turbines applications. The optimization process was applied to a general radial flux machine with a peak air gap flux density of ~3T...... is suitable for which coil segment is presented. Thus, the performed study gives valuable input for the coil design of HTS machines ensuring optimal usage of HTS tapes....

  8. Challenges for future energy usage

    Rebhan, E.


    In the last 2000 years the world's population and the worldwide total energy consumption have been continuously increasing, at a rate even greater than exponential. By now a situation has been reached in which energy resources are running short, which for a long time have been treated as though they were almost inexhaustible. The ongoing growth of the world's population and a growing hunger for energy in underdeveloped and emerging countries imply that the yearly overall energy consumption will continue to grow, by about 1.6 percent every year so that it would have doubled by 2050. This massive energy consumption has led to and is progressively leading to severe changes in our environment and is threatening a climatic state that, for the last 10 000 years, has been unusually benign. The coincidence of the shortage of conventional energy resources with the hazards of an impending climate change is a dangerous threat to the well-being of all, but it is also a challenging opportunity for improvements in our energy usage. On a global scale, conventional methods such as the burning of coal, gas and oil or the use of nuclear fission will still dominate for some time. In their case, the challenge consists in making them more efficient and environmentally benign, and using them only where and when it is unavoidable. Alternative energies must be expanded and economically improved. Among these, promising techniques such as solar thermal and geothermal energy production should be promoted from a shadow existence and further advanced. New technologies, for instance nuclear fusion or transmutation of radioactive nuclear waste, are also quite promising. Finally, a careful analysis of the national and global energy flow systems and intelligent energy management, with emphasis on efficiency, overall effectiveness and sustainability, will acquire increasing importance. Thereby, economic viability, political and legal issues as well as moral aspects such as fairness to disadvantaged

  9. Fighting antibiotic resistance in the intensive care unit using antibiotics

    Plantinga, Nienke L.; Wittekamp, Bastiaan H J; Van Duijn, Pleun J.; Bonten, Marc J M


    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to

  10. Antibiotic resistance in animals.

    Barton, Mary D; Pratt, Rachael; Hart, Wendy S


    There is currently no systematic surveillance or monitoring of antibiotic resistance in Australian animals. Registration of antibiotics for use in animals is tightly controlled and has been very conservative. Fluoroquinolones have not been registered for use in food producing animals and other products have been removed from the market because of human health concerns. In the late 1970s, the Animal Health Committee coordinated a survey of resistance in Salmonella and Escherichia coli isolates from cattle, pigs and poultry and in bovine Staphylococcus aureus. Some additional information is available from published case reports. In samples collected prior to the withdrawal of avoparcin from the market, no vancomycin resistant Enterococcus faecium or Enterococcus faecalis were detected in samples collected from pigs, whereas some vanA enterococci, including E. faecium and E. faecalis, were found in chickens. No vanB enterococci were detected in either species. Virginiamycin resistance was common in both pig and poultry isolates. Multiple resistance was common in E. coli and salmonellae isolates. No fluoroquinolone resistance was found in salmonellae, E. coli or Campylobacter. Beta-lactamase production is common in isolates from bovine mastitis, but no methicillin resistance has been detected. However, methicillin resistance has been reported in canine isolates of Staphylococcus intermedius and extended spectrum beta-lactamase producing E. coli has been found in dogs.

  11. Translational selection on codon usage in the genus Aspergillus.

    Iriarte, Andrés; Sanguinetti, Manuel; Fernández-Calero, Tamara; Naya, Hugo; Ramón, Ana; Musto, Héctor


    Aspergillus is a genus of mold fungi that includes more than 200 described species. Many members of the group are relevant pathogens and other species are economically important. Only one species has been analyzed for codon usage, and this was performed with a small number of genes. In this paper, we report the codon usage patterns of eight completely sequenced genomes which belong to this genus. The results suggest that selection for translational efficiency and accuracy are the major factors shaping codon usage in all of the species studied so far, and therefore they were active in the last common ancestor of the group. Composition and molecular distances analyses show that highly expressed genes evolve slower at synonymous sites. We identified a conserved core of translationally optimal codons and study the tRNA gene pool in each genome. We found that the great majority of preferred triplets match the respective cognate tRNA with more copies in the respective genome. We discuss the possible scenarios that can explain the observed differences among the species analyzed. Finally we highlight the biotechnological application of this research regarding heterologous protein expression. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Prevalence of internet and social media usage in orthopedic surgery.

    Curry, Emily; Li, Xinning; Nguyen, Joseph; Matzkin, Elizabeth


    Prior studies in other specialties have shown that social networking and Internet usage has become an increasingly important means of patient communication and referral. The purpose of this study is to evaluate the prevalence of Internet or social media usage in new patients referred to a major academic orthopedics center and to identify new avenues to optimize patient recruitment and communication. New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed. Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (Psocial media. Patients that travelled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment. We conclude that orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day's travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals.

  13. Multifaceted antibiotic treatment analysis of methicillin-sensitive Staphylococcus aureus bloodstream infections.

    Weber, Zhanni; Ariano, Robert; Lagacé-Wiens, Philippe; Zelenitsky, Sheryl


    Given the overall prevalence and poor prognosis of Staphylococcus aureus bloodstream infections (BSIs), the study of treatment strategies to improve patient outcomes is important. The aim of this study was to conduct a multifaceted antibiotic treatment analysis of methicillin-sensitive S. aureus (MSSA) BSI and to characterise optimal early antibiotic therapy (within the first 7 days of drawing the index blood culture) for this serious infection. Antibiotic selection was categorised as optimal targeted (intravenous cloxacillin or cefazolin), optimal broad (piperacillin/tazobactam or meropenem), adequate (vancomycin) or inadequate (other antibiotics or oral therapy). A TSE (timing, selection, exposure) score was developed to comprehensively characterise early antibiotic therapy, where higher points corresponded to prompt initiation, optimal antibiotic selection and longer exposure (duration). Amongst 71 cases of complicated MSSA-BSI, end-of-treatment (EOT) response (i.e. clinical cure) was improved when at least adequate antibiotic therapy was initiated within 24 h [71.7% (33/46) vs. 48.0% (12/25); P = 0.047]. Clinical cure was also more likely when therapy included ≥4 days of optimal targeted antibiotics within the first 7 days [74.4% (29/39) vs. 50.0% (16/32); P = 0.03]. The TSE score was an informative index of early antibiotic therapy, with EOT cure documented in 72.0% (36/50) compared with 42.9% (9/21) of cases with scores above and below 15.2, respectively (P = 0.02). In multivariable analysis, lower Charlson comorbidity index, presence of BSI on admission, and optimising early antibiotic therapy, as described above, were associated with clinical cure in patients with MSSA-BSI. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  14. Prevalence and antibiotic resistance of coagulase-negative Staphylococci isolated from poultry farms in three regions of Ghana

    Boamah, Vivian Etsiapa; Agyare, Christian; Odoi, Hayford


    The use of antibiotics in animal production has been associated with the development and spread of antibiotic-resistant organisms including commensals. Coagulase-negative Staphylococcus (CoNS) species, which were until recently considered non-pathogenic, have been associated with opportunistic...... usage in both animal production and in humans....... infections and high resistance to several antibiotics. This study sought to determine the prevalence, identity, and phenotypic resistance of coagulase-negative Staphylococcus spp. isolated from some selected poultry farms and farm workers in the Ashanti, Brong Ahafo, and Greater Accra regions of Ghana...

  15. Immersion Suit Usage Within the RAAF



  16. Towards the just and sustainable use of antibiotics.

    Merrett, Gemma L Buckland; Bloom, Gerald; Wilkinson, Annie; MacGregor, Hayley


    The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. It highlights the main areas of intervention that could provide the key to addressing the sustainable long term use and availability of antibiotics. A focus on the synergies between interventions addressing access strategies, antibiotic quality, diagnostics for low-resource settings, measures to encourage just and sustainable decision making and help seeking optimal therapeutic and dosing strategies are key levers for the sustainable future of antibiotic use. Successful integration of such strategies will be dependent on effective governance mechanisms, effective partnerships and coalition building and accurate evaluation systems at national, regional and global levels.

  17. Surgical site infection and timing of prophylactic antibiotics for appendectomy.

    Wu, Wan-Ting; Tai, Feng-Chuan; Wang, Pa-Chun; Tsai, Ming-Lin


    Pre-operative prophylactic antibiotics may decrease the frequency of surgical site infection after appendectomy. However, the optimal timing for administration of pre-operative prophylactic antibiotics is unknown. The purpose of this study was to evaluate the effect of timing of prophylactic antibiotics on the frequency of surgical site infection after appendectomy. Medical records were reviewed retrospectively for 577 consecutive patients who had appendectomy for acute appendicitis from 2006 to 2009. Quality assurance guidelines for timing of prophylactic antibiotics before the skin incision were changed from 0 to 30 min before the skin incision (before June 2008) to 30 to 60 min before the skin incision (after June 2008). Surgical site infection occurred in 28 patients (4.9%). There was no difference in frequency of surgical site infection with different timing of pre-operative prophylactic antibiotic (pre-operative time 0 to 30 min: 9 infections [3.6%]; 31 to 60 min: 13 infections [5.4%]; 61 to 120 min: 5 infections [7.0%]; >120 min: 1 infection [6.6%]). Multivariable analysis showed that surgical site infection was associated significantly with medical comorbidity but not perforated appendicitis. The frequency of surgical site infection was independent of timing of preoperative prophylactic antibiotics but was associated with the presence of medical comorbidity.

  18. Inhaled Antibiotics for Gram-Negative Respiratory Infections

    Fraidenburg, Dustin R.; Scardina, Tonya


    SUMMARY Gram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects, in vitro and microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena. PMID:27226088

  19. Positive selection for unpreferred codon usage in eukaryotic genomes

    Galagan James E


    Full Text Available Abstract Background Natural selection has traditionally been understood as a force responsible for pushing genes to states of higher translational efficiency, whereas lower translational efficiency has been explained by neutral mutation and genetic drift. We looked for evidence of directional selection resulting in increased unpreferred codon usage (and presumably reduced translational efficiency in three divergent clusters of eukaryotic genomes using a simple optimal-codon-based metric (Kp/Ku. Results Here we show that for some genes natural selection is indeed responsible for causing accelerated unpreferred codon substitution, and document the scope of this selection. In Cryptococcus and to a lesser extent Drosophila, we find many genes showing a statistically significant signal of selection for unpreferred codon usage in one or more lineages. We did not find evidence for this type of selection in Saccharomyces. The signal of positive selection observed from unpreferred synonymous codon substitutions is coincident in Cryptococcus and Drosophila with the distribution of upstream open reading frames (uORFs, another genic feature known to reduce translational efficiency. Functional enrichment analysis of genes exhibiting low Kp/Ku ratios reveals that genes in regulatory roles are particularly subject to this type of selection. Conclusion Through genome-wide scans, we find recent selection for unpreferred codon usage at approximately 1% of genetic loci in a Cryptococcus and several genes in Drosophila. Unpreferred codons can impede translation efficiency, and we find that genes with translation-impeding uORFs are enriched for this selection signal. We find that regulatory genes are particularly likely to be subject to selection for unpreferred codon usage. Given that expression noise can propagate through regulatory cascades, and that low translational efficiency can reduce expression noise, this finding supports the hypothesis that translational

  20. Antibiotic prophylaxis for patients undergoing elective endoscopic ...

    Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. M Brand, D Bisoz. Abstract. Background. Antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is controversial. We set out to assess the current antibiotic prescribing practice among ...

  1. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard


    with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support......Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality...... assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  2. Antibiotic tolerance and microbial biofilms

    Folkesson, Anders

    Increased tolerance to antimicrobial agents is thought to be an important feature of microbes growing in biofilms. We study the dynamics of antibiotic action within hydrodynamic flow chamber biofilms of Escherichia coli and Pseudomonas aeruginosa using isogenic mutants and fluorescent gene...... expression reporters and we address the question of how biofilm organization affects antibiotic susceptibility. The dynamics of microbial killing is monitored by viable count determination, and confocal laser microscopy. Our work shows that the apparent increased antibiotic tolerance is due to the formation...... of antibiotic tolerant subpopulations within the biofilm. The formation of these subpopulations is highly variable and dependent on the antibiotic used, the biofilm structural organization and the induction of specific tolerance mechanisms....

  3. The Prehistory of Antibiotic Resistance.

    Perry, Julie; Waglechner, Nicholas; Wright, Gerard


    Antibiotic resistance is a global problem that is reaching crisis levels. The global collection of resistance genes in clinical and environmental samples is the antibiotic "resistome," and is subject to the selective pressure of human activity. The origin of many modern resistance genes in pathogens is likely environmental bacteria, including antibiotic producing organisms that have existed for millennia. Recent work has uncovered resistance in ancient permafrost, isolated caves, and in human specimens preserved for hundreds of years. Together with bioinformatic analyses on modern-day sequences, these studies predict an ancient origin of resistance that long precedes the use of antibiotics in the clinic. Understanding the history of antibiotic resistance is important in predicting its future evolution. Copyright © 2016 Cold Spring Harbor Laboratory Press; all rights reserved.

  4. Antibiotics for acute maxillary sinusitis

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina


    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... are the most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...

  5. Antibiotic prescribing for acute bronchitis

    Llor, Carl; Bjerrum, Lars


    INTRODUCTION: Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses. AREAS COVERED: Antibiotics for acute bronchitis have been associated with an approximately half......-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review...... discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. EXPERT COMMENTARY: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed...

  6. Problems of Usage Labelling in English Lexicography*

    ancies in the contextual usage labelling in the dictionaries were established and are discussed. ..... Likewise, the noun vagrant meaning 'a person who has no job .... tions: Proceedings of the 36th Conference of the American Translators ...

  7. College Student Credit Card Usage and Debt.

    Rybka, Kathryn M.


    Provides an overview of the concerns related to credit card usage by college students. Offers information student affairs professionals can use to help college students make responsible choices. (Contains 26 references.) (GCP)

  8. Internet Usage and Academic Performance of Undergraduate ...

    Internet Usage and Academic Performance of Undergraduate Students in University of Ilorin, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ... This study adopted descriptive survey method. Six faculties ...

  9. Usage Notes in the Oxford American Dictionary.

    Berner, R. Thomas


    Compares the "Oxford American Dictionary" with the "American Heritage Dictionary." Examines the dictionaries' differences in philosophies of language, introductory essays, and usage notes. Concludes that the "Oxford American Dictionary" is too conservative, paternalistic, and dogmatic for the 1980s. (DMM)

  10. Antibiotic use in dentistry: A cross-sectional survey from a developing country

    Sivaramakrishnan Gowri


    Full Text Available Introduction: Antimicrobial resistance is a well-known entity and the most common factor leading to this is the irrational use of antibiotics. Several studies from the West have substantiated the irrational use of antibiotics in dentistry. Aims: The aim was to assess the knowledge, attitude, and practice (KAP of antimicrobial drug use among dental fraternity in a tertiary care teaching dental college and hospital. Materials and methods: A cross-sectional survey of various dental fraternities using a structured validated questionnaire. The study was initiated following approval from Institutional Ethics Committee and interns, junior residents and faculty members of various departments in dentistry were enrolled after obtaining written informed consent. A structured validated questionnaire was developed to assess the above-mentioned objectives. Statistical analysis: Descriptive statistics was used for representing each category of response and kappa statistics were used to assess the reliability in the initial cohort. Chi-square test for independence was used to evaluate the difference in proportion between different professional cadres. Results: A total of 120 participants were recruited out of which 81.6% (98/120 of the participants accepted their frequent antibiotic usage. The most common dental indication of antibiotics among dentists was post dental extraction, attributing to 30.8% (37/120, followed by dental abscess 21.6% (26/120 and 60% (72/120 prescribed antibiotics after most minor surgical procedures. Surprisingly, 37.5% (45/120 of the participants opined that they use antibiotics against viral infection. Regarding the spectrum of antibiotic usage, 74.1% (89/120 preferred broad spectrum instead of narrow spectrum 25.8% (31/120. The commonly prescribed antibiotics were amoxicillin 71.7% (86/120, metronidazole 33.3% (40/120, amoxicillin with clavulanic acid 26.6% (32/120. A total of (43/120 35.8% opted generic name for mentioning the

  11. Global shortage of neonatal and paediatric antibiotic trials: rapid review.

    Thompson, Georgina; Barker, Charlotte I; Folgori, Laura; Bielicki, Julia A; Bradley, John S; Lutsar, Irja; Sharland, Mike


    There have been few clinical trials (CTs) on antibiotics that inform neonatal and paediatric drug labelling. The rate of unlicensed and off-label prescribing in paediatrics remains high. It is unclear whether the current neonatal and paediatric antibiotic research pipeline is adequate to inform optimal drug dosing. Using the registry, this review aims to establish the current global status of antibiotic CTs in children up to 18 years of age. Studies were identified using key word searches of the registry and were manually filtered using prespecified inclusion/exclusion criteria. 76 registered open CTs of antibiotics in children were identified globally; 23 (30%) were recruiting newborns (only 8 (11%) included preterm neonates), 52 (68%) infants and toddlers, 58 (76%) children and 54 (71%) adolescents. The majority of registered trials were late phase (10 (15%) phase 3 and 23 (35%) phase 4/pharmacovigilance). Two-thirds were sponsored by non-profit organisations, compared with pharmaceutical companies (50 (66%) vs 26 (34%), respectively). A greater proportion of non-profit funded trials were efficacy-based strategic trials (n=34, 68%), in comparison with industry-led trials, which were most often focused on safety or pharmacokinetic data (n=17, 65%). Only 2 of the 37 antibiotics listed on the May 2016 Pew Charitable Trusts antibiotic development pipeline, currently being studied in adults, appear to be currently recruiting in open paediatric CTs. This review highlights that very few paediatric antibiotic CTs are being conducted globally, especially in neonates. There is a striking disparity noted between antibiotic drug development programmes in adults and children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. CloudMonitor: Profiling Power Usage

    Smith, James William; Khajeh-Hosseini, Ali; Ward, Jonathan Stuart; Sommerville, Ian


    In Cloud Computing platforms the addition of hardware monitoring devices to gather power usage data can be impractical or uneconomical due to the large number of machines to be metered. CloudMonitor, a monitoring tool that can generate power models for software-based power estimation, can provide insights to the energy costs of deployments without additional hardware. Accurate power usage data leads to the possibility of Cloud providers creating a separate tariff for power and therefore incen...

  13. Tattoo inks in general usage contain nanoparticles

    Høgsberg, T; Löschner, Katrin; Löf, D


    the particle sizes in tattoo inks in general usage. Methods The particle size was measured by laser diffraction, electron microscopy and X-ray diffraction. Results The size of the pigments could be divided into three main classes. The black pigments were the smallest, the white pigments the largest...... in general usage is new and may contribute to the understanding of tattoo ink kinetics. How the body responds to NP tattoo pigments should be examined further....

  14. Enteropathogens and antibiotics.

    González-Torralba, Ana; García-Esteban, Coral; Alós, Juan-Ignacio


    Infectious gastroenteritis remains a public health problem. The most severe cases are of bacterial origin. In Spain, Campylobacter and Salmonella are the most prevalent bacterial genus, while Yersinia and Shigella are much less frequent. Most cases are usually self-limiting and antibiotic therapy is not generally indicated, unless patients have risk factors for severe infection and shigellosis. Ciprofloxacin, third generation cephalosporins, azithromycin, ampicillin, cotrimoxazole and doxycycline are the most recommended drugs. The susceptibility pattern of the different bacteria determines the choice of the most appropriate treatment. The aim of this review is to analyse the current situation, developments, and evolution of resistance and multidrug resistance in these 4 enteric pathogens. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Occurrence, Seasonal Variation and Risk Assessment of Antibiotics in Qingcaosha Reservoir

    Yue Jiang


    Full Text Available Qingcaosha Reservoir is an important drinking water source in Shanghai. The occurrence of five groups of antibiotics was investigated in the surface water of this reservoir over a one-year period. Seventeen antibiotics were selected in this study based on their significant usage in China. Of these antibiotics, 16 were detected, while oxytetracycline was not detected in any sampling site. The detected frequency of tylosin was only 47.92% while the other 15 antibiotics were above 81.25%. The dominant antibiotic was different in four seasons: norfloxacin was dominant in spring, and penicillinV was dominant in summer, autumn and winter, with medium concentrations of 124.10 ng/L, 89.91 ng/L, 180.28 ng/L, and 216.43 ng/L, respectively. The concentrations and detection frequencies of antibiotics were notably higher in winter than in other seasons, demonstrating that low temperature and low flow may result in the persistence of antibiotics in the aquatic environment. Risk assessment suggested that norfloxacin, ciprofloxacin, penicillinV, and doxycycline in the surface water presented high ecological risks.

  16. Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?

    Nightingale, K; Patel, NN; Salib, RJ


    Introduction The current mainstream practice in otolaryngology departments relating to the use of prophylactic antibiotics in epistaxis patients requiring nasal packing is highly variable. This is due primarily to the lack of any validated guidelines. As such, we introduced a new treatment algorithm resulting in significant reduction of use in the systemic antibiotics, with emphasis instead on the use of topical antibiotics. The results were validated through a complete audit cycle. Methods A total of 57 patients undergoing nasal packing for spontaneous epistaxis were studied. Reaudit occurred after the implementation of new guidelines. Telephone surveys were conducted six weeks after hospital discharge, assessing infective nasal symptoms as well as rebleeding and readmission rates. Results Systemic antibiotic prescribing in anterior nasal packing fell by 58.2% between audit cycles with no statistically significant associated increase in infective nasal symptoms, rebleeding or readmission rates six weeks following hospital discharge. Conclusions Systemic prophylactic antibiotics are unnecessary in the majority of epistaxis patients with nasal packs. The use of topical antibiotics such as Naseptin® may be more appropriate, cheaper and as effective. Implementation of this treatment algorithm will help standardise systemic antibiotic usage in epistaxis patients with nasal packing and should reduce costs associated with unnecessary use of such medication. PMID:23317726

  17. Antibiotic misuse in children by the primary care physicians--an Indian experience.

    Basu, S; Chatterjee, M; Chandra, P Kumar; Basu, S


    To determine the misuse of antibiotics in the Pediatric outpatients department' (OPD) of a busy teaching hospital and to ascertain the probable reasons behind it. Over a 6 months period, new cases primarily treated with antibiotics by Medical Officers (first contact physicians in Peadiatric Medicine and Surgery OPD) were recruited in the study after obtaining written consent from the parents. Various errors of antibiotic usage were noted. All Medical Officers were asked to fill up a preformed questionnaire and the parents/guardians were interviewed on their ideas about antibiotics. Data were analyzed by the statistical software SPSS 10. Antibiotics were prescribed in 2427 (84.9%) new patients. Misuse of antibiotics was documented in 36.8% patients (no indication in 35.3%, improper selection in 17.9% and incorrect dosage in 7.7%). All medical officers were aware that they overuse antibiotics. The various reasons sited were demand of the parents, reluctance to counsel due to patient overload, free supply of medicines from OPD and sympathetic grounds as follow up visits were uncertain. Majority of the parents/attendants belonged to poor socioeconomic status and did not have any idea regarding antibiotics. All parents wanted quick relief without hospitalization and only 2.3% were willing to revisit the OPD for the same illness. Both medical officers and parents felt that base line investigations were unnecessary. Antibiotic misuse is quite common in this part of the world. Irrational use was mostly seen in over-prescribing and improper selection of antibiotic. Poor socio-economic status and overcrowding of patients in OPD were the main responsible factors.

  18. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review


    Background Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. Objectives To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. Methods A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing) OR (clinical decision support) AND (antibiotic or antibacterial or antimicrobial) AND (hospital or secondary care or inpatient). Studies were evaluated for quality using a 10-point rating scale. Results Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]). Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]). CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted. Conclusions CDS has the potential to improve the adequacy of antibiotic

  19. Duration of antibiotic therapy for ventilator-associated pneumonia in burn patients.

    Wahl, Wendy L; Taddonio, Michael A; Arbabi, Saman; Hemmila, Mark R


    Shorter compared with longer courses of antibiotic therapy for ventilator-associated pneumonia (VAP) in mixed medical-surgical intensive care units (ICUs) have been reported to produce equivalent outcomes. There have been few studies on the duration of antibiotic therapy for VAP in the burn population. We hypothesized that a shorter duration of antibiotic therapy for VAP would produce similar outcomes in our burn ICU. All burn patients from July 2001 to December 2006 admitted to the burn ICU requiring mechanical ventilation were studied. VAP was diagnosed prospectively by our Infection Control Liaison using bronchoalveolar lavage for cultures. Patients were cohorted into two groups: before July 1, 2004, antibiotic therapy duration was directed by the discretion of the attending physician (preprotocol), and after, the goal was 8 days of appropriate therapy or longer based on physician discretion (postprotocol). There were 98 patients treated for VAP with similar rates of inhalation injury, %TBSA burn size, age, and need for mechanical ventilation between the groups. The incidence of recurrent VAP was the same: 17% for the preprotocol and 15% for the postprotocol periods. The overall duration of antibiotic therapy did not change from 11 +/- 4 to 12 +/- 6 days. For patients treated longer than the target of 8 days, 66% had positive respiratory cultures at 4 days after initiation of antibiotic therapy. For the majority of patients with aspiration-type organisms or nonvirulent strains, there were fewer antibiotic days overall at 10 +/- 5 days (P VAP with the same bacteria. Despite a focused effort to decrease antibiotic usage for VAP in burn patients, the overall duration of therapy did not change. The majority of patients with virulent organisms such as methicillin-resistant Staphylococcus aureus or nonfermenting Gram-negative rods still had clinical signs of pneumonia and positive cultures, leading clinicians to continue antibiotics. In patients without virulent

  20. Occurrence of antibiotics and their impacts to primary productivity in fishponds around Tai Lake, China.

    Song, Chao; Zhang, Cong; Fan, Limin; Qiu, Liping; Wu, Wei; Meng, Shunlong; Hu, Gengdong; Kamira, Barry; Chen, Jiazhang


    Antibiotics are widely used to improve the health and yields of farmed animals, including fish, but their use is accompanied by undesirable ecological effects. Relatively little is known about the water-body burden of antibiotics and their influence on primary productivity in aquaculture ecosystem. In this study, antibiotics usage within 24 fishponds, covering 4 areas, sampled 5 times, and having 5 fish species, was investigated surrounding Tai Lake in China. The study analyzed 15 antibiotics (including 5 sulfonamides, 2 quinolones, 3 β-lactams, 3 tetracyclines, 1 amphenicol, and 1 macrolide), and all of them were detected in water samples, with a detection frequency of 2-60%. Sulfonamides were the most prevalent, and concentrations of sulfamethoxazole, sulfamonomethoxine, and florfenicol being over 2000 ng L(-1) in some samples, while the other antibiotics levels ranged from ND (no detection) to 551.18 ng L(-1). Significant differences were observed in antibiotic burden among different regions for total antibiotics, sulfonamides, quinolones, and amphenicols; among time points for quinolones, β-lactams, and tetracyclines; and among species for quinolones and macrolides. Furthermore, basing on the risk quotient (RQ) method, the assessment revealed that florfenicol was of highest risk to algae with RQ values exceeding 0.1, while macrolide erythromycin posed the second highest risk. The partial correlation coefficient between total antibiotics and chlorophyll (a) was -0.035 that clearly indicated total antibiotics were detrimental to green algae growth, while the nutrient input and other physical - chemical factors were much more beneficial. Overall, holistic far-reaching measures of antibiotics control are recommended to preserve aquaculture ecosystem health. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.

    Christopher E Curtis

    Full Text Available Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR. Health information technology (HIT in the form of Computerised Decision Support (CDS represents an option for improving antimicrobial prescribing and containing AMR.To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings.A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing OR (clinical decision support AND (antibiotic or antibacterial or antimicrobial AND (hospital or secondary care or inpatient. Studies were evaluated for quality using a 10-point rating scale.Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]. Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]. CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted.CDS has the potential to improve the adequacy of antibiotic coverage and marginally decrease mortality in

  2. Feature Usage Explorer: Usage Monitoring and Visualization Tool in HTML5 Based Applications

    Sarunas Marciuska


    Full Text Available Feature Usage Explorer is a JavaScript library, which automatically detects features in HTML5 based applications and monitors their usage. The collected information can be visualized in a Feature Usage Diagram, which is automatically generated from an input json file. Currently, the users of Feature Usage Explorer have to design their own tool in order to generate the json file from collected usage information. This option remains viable when using the library in order not to constraint the user’s choice of preferred data storage. Feature Usage Explorer can be reused in any HTML5 based applications where an understanding of how users interact with the system is required (i.e. user experience and usability studies, human computer interaction field, or requirement prioritization area.

  3. Analysis of codon usage patterns in Morus notabilis based on genome and transcriptome data.

    Wen, Yan; Zou, Ziliang; Li, Hongshun; Xiang, Zhonghuai; He, Ningjia


    Codons play important roles in regulating gene expression levels and mRNA half-lives. However, codon usage and related studies in multicellular organisms still lag far behind those in unicellular organisms. In this study, we describe for the first time genome-wide patterns of codon bias in Morus notabilis (mulberry tree), and analyze genome-wide codon usage in 12 other species within the order Rosales. The codon usage of M. notabilis was affected by nucleotide composition, mutation pressure, nature selection, and gene expression level. Translational selection optimal codons were identified and highly expressed genes of M. notabilis tended to use the optimal codons. Genes with higher expression levels have shorter coding region and lower amino acid complexity. Housekeeping genes showed stronger translational selection, which, notably, was not caused by the large differences between the expression level of housekeeping genes and other genes.

  4. A Survey of Anti-biotic Usage and its Effects in Port Harcourt City in ...

    Michael Horsfall

    with a view of measuring the existing practices in the consumer use of antibacterial drugs. This will serve .... prescriptions and peers, but only became familiar with the name but not ... Manilla, The Phillipines: Inappropriate choices and doses.

  5. Infectious diseases and the use of antibiotics in outpatients at the emergency department of the University Hospital of Leon, Nicaragua

    den Engelsen, C.; van der Werf, C.; Matute, A. J.; Delgado, E.; Schurink, C. A. M.; Hoepelman, A. I. M.

    Background: In order to develop guidelines for the use of antimicrobial agents, it is necessary to obtain detailed information on the prevalence of infectious diseases and antibiotic usage. Methods: A retrospective study was conducted among outpatients with acute infections visiting the emergency

  6. Dissemination of antibiotic resistance genes from antibiotic producers to pathogens

    Jiang, Xinglin; Ellabaan, Mostafa M Hashim; Charusanti, Pep


    It has been hypothesized that some antibiotic resistance genes (ARGs) found in pathogenic bacteria derive from antibiotic-producing actinobacteria. Here we provide bioinformatic and experimental evidence supporting this hypothesis. We identify genes in proteobacteria, including some pathogens...... and experimentally test a 'carry-back' mechanism for the transfer, involving conjugative transfer of a carrier sequence from proteobacteria to actinobacteria, recombination of the carrier sequence with the actinobacterial ARG, followed by natural transformation of proteobacteria with the carrier-sandwiched ARG. Our...... results support the existence of ancient and, possibly, recent transfers of ARGs from antibiotic-producing actinobacteria to proteobacteria, and provide evidence for a defined mechanism....

  7. Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns

    Soo-Hyun Paik; Hyun Cho; Ji-Won Chun; Jo-Eun Jeong; Dai-Jin Kim


    Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smart...

  8. Effects of over-the-counter sales restriction of antibiotics on substitution with medicines for symptoms relief of cold in Mexico and Brazil: time series analysis.

    Santa-Ana-Tellez, Yared; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; Wirtz, Veronika J


    We evaluated changes in the use of non-steroidal anti-inflammatory drugs (NSAIDs), non-opioid analgesics and cough and cold medicines and its relation with the use of antibiotics after the over-the-counter (OTC) antibiotic sales restrictions in Mexico and Brazil. IMS Health provided retail quarterly data from the private sectors in Mexico and Brazil from the first quarter of 2007 to the first quarter of 2013. Data of each active substance of antibiotics, easily accessible medicines perceived as antibiotics substitutes (cough and cold medicines, analgesics and NSAIDs-the latter two being combined in the analyses), and medicines to control for external factors that can affect the medicines usage trend (antihypertensives) were converted from kilograms to defined daily doses per 1000 inhabitants days (DDD/TID). Interrupted time series were used to estimate changes in level of medicines use at the intervention point and slope after the regulation. The Gregory-Hansen cointegration test was used to explore the relation between the use of antibiotics and perceived substitutes. After the regulation in Mexico NSAIDs-analgesics usage level increased by 1.1 DDD/TID with a slope increase of 0.2 DDD/TID per quarter and the cough and cold medicines usage level increased by 0.4 DDD/TID. In Brazil NSAIDs-analgesics usage level increased by 1.9 DDD/TID, and cough and cold medicines did not change. In the two countries, NSAIDs-analgesics usage changes were related with antibiotic usage changes; in Mexico cough and cold medicines usage changes had a relation with the antibiotics usage changes. These results showed a substitution effect on the use of other medicines, especially NSAIDs and analgesics, after reinforcement of OTC antibiotics sales restrictions. These regulations aimed to improve the antibiotics use and as a consequence reduce antimicrobial resistance; however, this type of policies should be comprehensive and take into account the potential substitution effects on the use

  9. Characterisation of antimicrobial usage in cats and dogs attending UK primary care companion animal veterinary practices.

    Buckland, E L; O'Neill, D; Summers, J; Mateus, A; Church, D; Redmond, L; Brodbelt, D


    There is scant evidence describing antimicrobial (AM) usage in companion animal primary care veterinary practices in the UK. The use of AMs in dogs and cats was quantified using data extracted from 374 veterinary practices participating in VetCompass. The frequency and quantity of systemic antibiotic usage was described.Overall, 25 per cent of 963,463 dogs and 21 per cent of 594,812 cats seen at veterinary practices received at least one AM over a two-year period (2012-2014) and 42 per cent of these animals were given repeated AMs. The main agents used were aminopenicillin types and cephalosporins. Of the AM events, 60 per cent in dogs and 81 per cent in cats were AMs classified as critically important (CIAs) to human health by the World Health Organisation. CIAs of highest importance (fluoroquinolones, macrolides, third-generation cephalosporins) accounted for just over 6 per cent and 34 per cent of AMs in dogs and cats, respectively. The total quantity of AMs used within the study population was estimated to be 1473 kg for dogs and 58 kg for cats.This study has identified a high frequency of AM usage in companion animal practice and for certain agents classified as of critical importance in human medicine. The study highlights the usefulness of veterinary practice electronic health records for studying AM usage. British Veterinary Association.

  10. Antibiotics and inflammatory bowel diseases.

    Scribano, Maria Lia; Prantera, Cosimo


    Inflammatory bowel diseases are characterized by an altered composition of gut microbiota (dysbiosis) that may contribute to their development. Antibiotics can alter the bacterial flora, and a link between antibiotic use and onset of Crohn's disease (CD), but not ulcerative colitis, has been reported. The hypothesis that Mycobacterium avium subspecies paratuberculosis (MAP) could be an etiologic agent of CD has not been confirmed by a large study on patients treated by an association of antibiotics active against MAP. The observations supporting a role of intestinal microbiota in CD pathogenesis provide the rationale for a therapeutic manipulation of the intestinal flora through the employment of antibiotics. However, current data do not strongly support a therapeutic benefit from antibiotics, and there is still controversy regarding their use as primary therapy for treatment of acute flares of CD, and for postoperative recurrence prevention. Nevertheless, clinical practice and some studies suggest that a subgroup of patients with colonic involvement, early disease, and abnormal laboratory test of inflammation may respond better to antibiotic treatment. Since their long-term use is frequently complicated by a high rate of side effects, the use of antibiotics that work locally appears to be promising.

  11. Necrotising enterocolitis in preterm infants: epidemiology and antibiotic consumption in the Polish neonatology network neonatal intensive care units in 2009.

    Jadwiga Wójkowska-Mach

    Full Text Available The aim of this study was to describe the epidemiology of necrotising enterocolitis (NEC, antibiotic consumption and the usefulness of microbiological tests in very low birth weight (VLBW Polish newborns.Prospective surveillance was performed in the year 2009 by local infection control teams. The study covered 910 infants hospitalized in six Polish neonatal intensive care units. Two kinds of indicators were used for the description of antibiotic usage: the duration of treatment (days of treatment, DOTs and the defined daily dose (DDD.NEC incidence was 8.7% and fatality rate was 19%. Chorioamnionitis, late gestational age and low birth weight were identified as risk factors for NEC. Catheterization, mechanical ventilation and other selected procedures were used considerably longer in newborns with NEC than in the remaining neonates. Total usage of antibiotics reached 2.9 DDDs or 1.437 days; the average use of drugs per case of NEC amounted to 0.47 DDD or 23.2 DOTs. The level of antibiotic usage was analysed with correlation to microbiological tests performed and it was non-significantly greater in the group of children with NEC in whom the tests were performed.A high risk of developing NEC is closely associated with VLBW and with inflammation of the amnion during labour. We observed no relationship between the consumption of antibiotics in neonates with NEC and positive results of microbiological testing indicating sepsis accompanying NEC or gut colonization with pathogens.

  12. Macrolide antibiotics for bronchiectasis.

    Kelly, Carol; Chalmers, James D; Crossingham, Iain; Relph, Nicola; Felix, Lambert M; Evans, David J; Milan, Stephen J; Spencer, Sally


    Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance. To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis. We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial registries and reference lists of primary studies. We conducted all searches on 18 January 2018. We included randomised controlled trials (RCTs) of at least four weeks' duration that compared macrolide antibiotics with placebo or no intervention for the long-term management of stable bronchiectasis in adults or children with a diagnosis of bronchiectasis by bronchography, plain film chest radiograph, or high-resolution computed tomography. We excluded studies in which participants had received continuous or high-dose antibiotics immediately before enrolment or before a diagnosis of cystic fibrosis, sarcoidosis, or allergic bronchopulmonary aspergillosis. Our primary outcomes were exacerbation, hospitalisation, and serious adverse events. Two review authors independently screened the titles and abstracts of 103 records. We independently screened the full text of 40 study reports and included 15 trials from 30 reports. Two review authors independently extracted outcome data and assessed risk of bias for each study. We analysed

  13. Maximum likelihood estimation of ancestral codon usage bias parameters in Drosophila

    Nielsen, Rasmus; Bauer DuMont, Vanessa L; Hubisz, Melissa J


    : the selection coefficient for optimal codon usage (S), allowing joint maximum likelihood estimation of S and the dN/dS ratio. We apply the method to previously published data from Drosophila melanogaster, Drosophila simulans, and Drosophila yakuba and show, in accordance with previous results, that the D...

  14. Antibiotic Sensitivity of Micrococcus radiodurans

    Hawiger, J.; Jeljaszewicz, J.


    A wild-type strain of Micrococcus radiodurans and its nonpigmented mutant W1 were tested for sensitivity to 10 antibiotics selected from the standpoint of their mechanism of action. Representatives of groups of antibiotics inhibiting deoxyribonucleic acid (DNA) synthesis, DNA-dependent ribonucleic acid synthesis, protein synthesis, and cell wall synthesis were selected. M. radiodurans and its mutant exhibited full susceptibility to all antibiotics tested (mitomycin C, actinomycin D, chloramphenicol, dihydrostreptomycin, erythromycin, neomycin, kanamycin, benzylpenicillin, bacitracin, and vancomycin), the degree of susceptibility being of the same order as that of a standard strain of Staphylococcus aureus 209 P, with the exception of dihydrostreptomycin. PMID:4166078

  15. Antibiotics as CECs: An Overview of the Hazards Posed by Antibiotics and Antibiotic Resistance

    Geoffrey Ivan Scott


    Full Text Available ABSTRACTMonitoring programs have traditionally monitored legacy contaminants but are shifting focus to Contaminants of Emerging Concern (CECs. CECs present many challenges for monitoring and assessment, because measurement methods don't always exist nor have toxicological studies been fully conducted to place results in proper context. Also some CECs affect metabolic pathways to produce adverse outcomes that are not assessed through traditional toxicological evaluations. Antibiotics are CECs that pose significant environmental risks including development of both toxic effects at high doses and antibiotic resistance at doses well below the Minimum Inhibitory Concentration (MIC which kill bacteria and have been found in nearly half of all sites monitored in the US. Antimicrobial resistance has generally been attributed to the use of antibiotics in medicine for humans and livestock as well as aquaculture operations. The objective of this study was to assess the extent and magnitude of antibiotics in the environment and estimate their potential hazards in the environment. Antibiotics concentrations were measured in a number of monitoring studies which included Waste Water Treatment Plants (WWTP effluent, surface waters, sediments and biota. A number of studies reported levels of Antibiotic Resistant Microbes (ARM in surface waters and some studies found specific ARM genes (e.g. the blaM-1 gene in E. coli which may pose additional environmental risk. High levels of this gene were found to survive WWTP disinfection and accumulated in sediment at levels 100-1000 times higher than in the sewerage effluent, posing potential risks for gene transfer to other aquatic and marine ecosystems. Antibiotic risk assessment approaches were developed based on the use of MICs and MIC Ratios [High (Antibiotic Resistant/Low (Antibiotic Sensitive MIC] for each antibiotic indicating the range of bacterial adaptability to each antibiotic to help define the No

  16. Prophylactic antibiotics versus post- operative antibiotics in herniorraphy

    Abedulla Khan Kayamkani


    Full Text Available Postoperative surgical site infections are a major source of illness.  Infection results in longer hospital stay and higher costs.  Uses of preoperative antibiotics have been standardized and are being used routinely in most clinical surgeries and include controversial areas like breast surgery and herniorraphy. Objective of the study is to find out the benefit of prophylactic use of antibiotics in the management of herniorraphy.This project was carried out in a multispeciality tertiary care teaching hospital from 1st-30th April in 2002. Group 1 patients were treated prophylactically half an hour before surgery with single dose of I.V. antibiotics (injection.  Ampicillin 1gm + injection.  Gentamicin 80mg. Group 2 patients were treated post surgery with capsule. Ampicillin 500mg 4 times a day for 7 days and injection. Gentamicin twice a day for first 4 days. In case of group 1 patients only one out of 20 patients (5% was infected.  Whereas in-group 2 patients 5 out of 20 patients (25% were infected. The cost of prophylactic antibiotic treatment was Rs. 25.56 per patient.  The postoperative antibiotic treatment cost was Rs. 220.4 per patient.  That means postoperative treatment is around 8.62 times costlier than prophylactic treatment.             From this study it is evident that prophylactic (preoperative treatment is better than postoperative treatment with antibiotics.

  17. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions.

    Leibovici, Leonard; Paul, Mical; Garner, Paul; Sinclair, David J; Afshari, Arash; Pace, Nathan Leon; Cullum, Nicky; Williams, Hywel C; Smyth, Alan; Skoetz, Nicole; Del Mar, Chris; Schilder, Anne G M; Yahav, Dafna; Tovey, David


    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies. This omission creates a skewed view, which emphasizes short-term efficacy and ignores the long-term consequences to the patient and other people. We offer a framework for addressing antibiotic resistance in systematic reviews. We suggest that the data on background resistance in the original trials should be reported and taken into account when interpreting results. Data on emergence of resistance (whether in the body reservoirs or in the bacteria causing infection) are important outcomes. Emergence of resistance should be taken into account when interpreting the evidence on antibiotic treatment in randomized controlled trials or systematic reviews. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail:

  18. What do I need to know about penicillin antibiotics?

    Barker, Charlotte I; Germovsek, Eva; Sharland, Mike


    The penicillins remain the class of antibiotics most commonly prescribed to children worldwide. In an era when the risks posed by antimicrobial resistance are growing, an understanding of antibiotic pharmacology and how to apply these principles in clinical practice is increasingly important. This paper provides an overview of the pharmacology of penicillins, focusing on those aspects of pharmacokinetics, pharmacodynamics and toxicity that are clinically relevant in paediatric prescribing. Penicillin allergy is frequently reported but a detailed history of suspected adverse reactions is essential to identify whether a clinically relevant hypersensitivity reaction is likely or not. The importance of additional factors such as antibiotic palatability, concordance and stewardship are also discussed, highlighting their relevance to optimal prescribing of the penicillins for children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  19. An Antibiotic Selection System For Protein Overproducing Bacteria

    Rennig, Maja; Nørholm, Morten


    Introduction: Protein overproduction is a major bottleneck for analyses of membrane proteins and for the construction of cell factories. Screening for optimized protein production can be very time consuming. In this study we show that the coupling of antibiotic resistance to poorly produced...... membrane proteins of Escherichia coli can be used as a fast and simple selection system for protein overproduction.Methods: We designed an expression plasmid encoding the gene of interest and an additional, inducible antibiotic resistance marker. Both genes were linked by a hairpin structure...... that translationally couples the genes. Consequently, high expressing gene variants also allow for higher production of the coupled antibiotic resistance marker. Therefore, high expressing gene variants in a library can be determined either by plating the expression library on selection plates or by growing...

  20. Antibiotic managment in renal failure.

    Winter, R E


    This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

  1. Antibiotic prophylaxis in obstetric procedures.

    van Schalkwyk, Julie; Van Eyk, Nancy


    To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June 2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. SUMMARY STATEMENTS: 1. Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following operative vaginal delivery. (II-1) 2. There is insufficient evidence to argue for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta. (III) 3. There is insufficient evidence to argue for or against the use of

  2. Use of antibiotics in children

    Pottegård, Anton; Broe, A.; Aabenhus, R.


    Background: We aimed to describe the use of systemic antibiotics among children in Denmark. Methods: National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0 to 11 years from January 1, 2000...... to December 31, 2012. Results: We obtained data on 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children. The most used single substances were phenoxymethylpenicillin (45%), amoxicillin (34%) and erythromycin (6%). The highest incidence rate of antibiotic treatment episodes......-1. There was little evidence of heavy users. Conclusion: Prescribing rate of antibiotics to children in Denmark remained stable at a high level from 2000 to 2012. An increase in the use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adhered well to National guidelines...

  3. Fuzzy usage pattern in customizing public transport fleet and its maintenance options

    Husniah, H.; Herdiani, L.; Kusmaya; Supriatna, A. K.


    In this paper we study a two-dimensional maintenance contract for a fleet of public transport, such as buses, shuttle etc. The buses are sold with a two-dimensional warranty. The warranty and the maintenance contract are characterized by two parameters – age and usage – which define a two-dimensional region. However, we use one dimensional approach to model these age and usage of the buses. The under-laying maintenance service contracts is the one which offers policy limit cost to protect a service provider (an agent) from over claim and to pursue the owner to do maintenance under specified cost in house. This in turn gives benefit for both the owner of the buses and the agent of service contract. The decision problem for an agent is to determine the optimal price for each option offered, and for the owner is to select the best contract option. We use a Nash game theory formulation in order to obtain a win-win solution – i.e. the optimal price for the agent and the optimal option for the owner. We further assume that there will be three different usage pattern of the buses, i.e. low, medium, and high pattern of the usage rate. In many situations it is often that we face a blur boundary between the adjacent patterns. In this paper we look for the optimal price for the agent and the optimal option for the owner, which minimizes the expected total cost while considering the fuzziness of the usage rate pattern.

  4. The determinants of the antibiotic resistance process.

    Franco, Beatriz Espinosa; Altagracia Martínez, Marina; Sánchez Rodríguez, Martha A; Wertheimer, Albert I


    The use of antibiotic drugs triggers a complex interaction involving many biological, sociological, and psychological determinants. Resistance to antibiotics is a serious worldwide problem which is increasing and has implications for morbidity, mortality, and health care both in hospitals and in the community. To analyze current research on the determinants of antibiotic resistance and comprehensively review the main factors in the process of resistance in order to aid our understanding and assessment of this problem. We conducted a MedLine search using the key words "determinants", "antibiotic", and "antibiotic resistance" to identify publications between 1995 and 2007 on the determinants of antibiotic resistance. Publications that did not address the determinants of antibiotic resistance were excluded. The process and determinants of antibiotic resistance are described, beginning with the development of antibiotics, resistance and the mechanisms of resistance, sociocultural determinants of resistance, the consequences of antibiotic resistance, and alternative measures proposed to combat antibiotic resistance. Analysis of the published literature identified the main determinants of antibiotic resistance as irrational use of antibiotics in humans and animal species, insufficient patient education when antibiotics are prescribed, lack of guidelines for treatment and control of infections, lack of scientific information for physicians on the rational use of antibiotics, and lack of official government policy on the rational use of antibiotics in public and private hospitals.

  5. [Self-medication with antibiotics in Poland

    Olczak, A.; Grzesiowski, P.; Hryniewicz, W.; Haaijer-Ruskamp, F.M.


    Antibiotic resistance, the important public health threat, depends on antibiotic overuse/misuse. Self-medication with antibiotics is of serious medical concern. The aim of the study, as a part of SAR project (Self-medication with antibiotic in Europe) was to survey the incidence of this phenomenon.

  6. ICT in University Education: Usage and Challenges among ...

    This study was a survey which explored ICT usage and challenges among academic staff. Thus, the main purpose of this study was to determine the areas of ICT usage among academic staff; identify the obstacles to their ICT usage and identify their areas of training need in ICT usage. Five research questions were posed ...

  7. When the Most Potent Combination of Antibiotics Selects for the Greatest Bacterial Load: The Smile-Frown Transition

    Pena-Miller, Rafael; Laehnemann, David; Jansen, Gunther; Fuentes-Hernandez, Ayari; Rosenstiel, Philip; Schulenburg, Hinrich; Beardmore, Robert


    Conventional wisdom holds that the best way to treat infection with antibiotics is to 'hit early and hit hard'. A favoured strategy is to deploy two antibiotics that produce a stronger effect in combination than if either drug were used alone. But are such synergistic combinations necessarily optimal? We combine mathematical modelling, evolution experiments, whole genome sequencing and genetic manipulation of a resistance mechanism to demonstrate that deploying synergistic antibiotics can, in...

  8. [Clinical effect of different sequences of debridement-antibiotic therapy in treatment of severe chronic periodontitis].

    Li, Yi; Xu, Li; Lu, Rui-fang; An, Yue-bang; Wang, Xian-e; Song, Wen-li; Meng, Huan-xi


    To evaluate the feasibility of full-mouth debridement (subgingival scaling and root planning, SRP) by 2 times within 1 week and compare the clinical effects of different sequences of debridement-antibiotic usage in patients with severe chronic periodontitis (CP). A double-blinded, placebo-controlled, randomized clinical trial was conducted in 30 severe CP patients (14 males and 16 females, 40.5 ± 8.4 years old on average from 35 to 60) receiving 3 different sequences of debridement-antibiotictherapy: Group A, antibiotic usage (metronidazole, MTZ, 0.2 g, tid, 7 d; amoxicillin, AMX 0.5 g, tid, 7 d) was started together with SRP (completed by 2 times in 7 d); Group B, antibiotic usage (MTZ 0.2 g, tid, 7 d; AMX 0.5 g, tid, 7 d) was started 1 d after SRP(completed by 2 times in 7 d); Group C, SRP alone[probing depth (PD), bleeding index (BI) and tooth mobility] was examined. The average full-mouth probing depth, the average full-mouth proximal probing depth (pPD), the percentage of sites with PD>5 mm (PD>5 mm%), the percentage of sites with proximal PD>5 mm (pPD>5 mm%), the average bleeding index (BI) and the percentage of sites with bleeding on probing (BOP%) were calculated. Clinical examinations were performed at baseline and 2 months post therapy. (1) Compared with baseline conditions, all the subjects showed clinical improvements in all the parameters evaluated 2 months post therapy, Pantibiotic usage at the same time comparing with patients using antibiotics after SRP or SRP alone.

  9. Antibiotic prophylaxis in orthognathic surgery: A complex systematic review

    Hultin, Margareta; Klinge, Anna; Klinge, Björn; Tranæus, Sofia; Lund, Bodil


    Objective In orthognathic surgery, antibiotics are prescribed to reduce the risk of postoperative infection. However, there is lack of consensus over the appropriate drug, the dose and duration of administration. The aim of this complex systematic review was to assess the effect of antibiotics on postoperative infections in orthognathic surgery. Methods Both systematic reviews and primary studies were assessed. Medline (OVID), The Cochrane Library (Wiley) and EMBASE (, PubMed (non-indexed articles) and Health Technology Assessment (HTA) publications were searched. The primary studies were assessed using GRADE and the systematic reviews by AMSTAR. Results Screening of abstracts yielded 6 systematic reviews and 36 primary studies warranting full text scrutiny. In total,14 primary studies were assessed for risk of bias. Assessment of the included systematic reviews identified two studies with a moderate risk of bias, due to inclusion in the meta-analyses of primary studies with a high risk of bias. Quality assessment of the primary studies disclosed one with a moderate risk of bias and one with a low risk. The former compared a single dose of antibiotic with 24 hour prophylaxis using the same antibiotic; the latter compared oral and intravenous administration of antibiotics. Given the limited number of acceptable studies, no statistical analysis was undertaken, as it was unlikely to contribute any relevant information. Conclusion With respect to antibiotic prophylaxis in orthognathic surgery, most of the studies to date have been poorly conducted and reported. Thus scientific uncertainty remains as to the preferred antibiotic and the optimal duration of administration. PMID:29385159

  10. Universality and Shannon entropy of codon usage

    Frappat, L; Sciarrino, A; Sorba, Paul


    The distribution functions of the codon usage probabilities, computed over all the available GenBank data, for 40 eukaryotic biological species and 5 chloroplasts, do not follow a Zipf law, but are best fitted by the sum of a constant, an exponential and a linear function in the rank of usage. For mitochondriae the analysis is not conclusive. A quantum-mechanics-inspired model is proposed to describe the observed behaviour. These functions are characterized by parameters that strongly depend on the total GC content of the coding regions of biological species. It is predicted that the codon usage is the same in all exonic genes with the same GC content. The Shannon entropy for codons, also strongly depending on the exonic GC content, is computed.

  11. Review of Bison Usage in VERA

    Gardner, Russell [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pawlowski, Roger P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Clarno, Kevin T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Stimpson, Shane G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)


    Bison is being used in VERA in a variety of ways; this milestone will document an independent review of the current usage of Bison and provide guidance that will improve the accuracy, performance, and consistency in the ways that Bison is used. This task will entail running a suite of small, single and multi-cycle problems with VERA-CS, followed by Bison, and Tiamat (inline) and evaluating the usage. It will also entail performing several detailed ramp to full power solutions to compare the one-way coupled solver with the fully-coupled Tiamat. This will include at least one iteration with the PHI team to incorporate some of the feedback and improve the usage. This work will also be completed in conjunction with an FMC task to evaluate the ability of Bison to model load-follow in a PWR

  12. Synthetic membrane-targeted antibiotics.

    Vooturi, S K; Firestine, S M


    Antimicrobial resistance continues to evolve and presents serious challenges in the therapy of both nosocomial and community-acquired infections. The rise of resistant strains like methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Staphylococcus aureus (VRSA) and vancomycin-resistant enterococci (VRE) suggests that antimicrobial resistance is an inevitable evolutionary response to antimicrobial use. This highlights the tremendous need for antibiotics against new bacterial targets. Agents that target the integrity of bacterial membrane are relatively novel in the clinical armamentarium. Daptomycin, a lipopeptide is a classical example of membrane-bound antibiotic. Nature has also utilized this tactic. Antimicrobial peptides (AMPs), which are found in all kingdoms, function primarily by permeabilizing the bacterial membrane. AMPs have several advantages over existing antibiotics including a broad spectrum of activity, rapid bactericidal activity, no cross-resistance with the existing antibiotics and a low probability for developing resistance. Currently, a small number of peptides have been developed for clinical use but therapeutic applications are limited because of poor bioavailability and high manufacturing cost. However, their broad specificity, potent activity and lower probability for resistance have spurred the search for synthetic mimetics of antimicrobial peptides as membrane-active antibiotics. In this review, we will discuss the different classes of synthetic membrane-bound antibiotics published since 2004.

  13. Expedient antibiotics production: Final report

    Bienkowski, P.R.; Byers, C.H.; Lee, D.D.


    The literature on the manufacture, separation and purification, and clinical uses of antibiotics was reviewed, and a bibliography of the pertinent material was completed. Five antimicrobial drugs, penicillin V and G, (and amoxicillin with clavulanic acid), Cephalexin (a cephalosporin), tetracycline and oxytetracycline, Bacitracin (topical), and sulfonamide (chemically produced) were identified for emergency production. Plants that manufacture antibiotics in the continental United States, Mexico, and Puerto Rico have been identified along with potential alternate sites such as those where SCP, enzyme, and fermentation ethanol are produced. Detailed process flow sheets and process descriptions have been derived from the literature and documented. This investigation revealed that a typical antibiotic-manufacturing facility is composed of two main sections: (1) a highly specialized, but generic, fermentation unit and (2) a multistep, complex separation and purification unit which is specific to a particular antibiotic product. The fermentation section requires specialized equipment for operation in a sterile environment which is not usually available in other industries. The emergency production of antibiotics under austere conditions will be feasible only if a substantial reduction in the complexity and degree of separation and purity normally required can be realized. Detailed instructions were developed to assist state and federal officials who would be directing the resumption of antibiotic production after a nuclear attack. 182 refs., 54 figs., 26 tabs.

  14. An alternative for antibiotic se in poultry: probiotics

    FW Edens


    Full Text Available Over the past 50 years, there has been increasing amounts of antibiotics used prophylactically and as growth promoters. Today, there is a consumer and governmental outcry to eliminate that practice from poultry and livestock production. Evidence has been accumulated to show that there is a link between risk of zoonotic disease and growth promoting antibiotic usage in livestock and poultry. Therefore, alternatives to the use of growth promoting antibiotics must be found to promote growth or production at or near the genetic potential of the modern day broiler, turkey, and egg producer. The use of probiotics has many potential benefits and include modified host metabolism, immuno-stimulation, anti-inflammatory reactions, exclusion and killing of pathogens in the intestinal tract, reduced bacterial contamination on processed broiler carcasses, enhanced nutrient absorption and performance, and ultimately decreased human health risk. The development of these factors generally can be ascribed to the ability of most probiotic products to balance and maintain the intestinal microflora in poultry species.

  15. The impact of the increased use of piperacillin/tazobactam on the selection of antibiotic resistance among invasive Escherichia coli and Klebsiella pneumoniae isolates.

    Lee, Jina; Oh, Chi Eun; Choi, Eun Hwa; Lee, Hoan Jong


    Increasing antimicrobial resistance is related to the selective pressure exerted by antibiotic usage. This study evaluated the impact of the increased use of piperacillin/tazobactam (TZP) on the selection of antibiotic resistance. From 1999 to 2010, Escherichia coli and Klebsiella pneumoniae invasive isolates obtained from hospitalized Korean children were analyzed in antibiotic susceptibility tests and subjected to characterization of the β-lactamase types. Antibiotic consumption data were also analyzed. Between January 1999 and December 2010, 409 invasive isolates of E. coli (n=170) and K. pneumoniae (n=239) were obtained. A rebound of extended-spectrum β-lactamase (ESBL) prevalence with an increase in total antibiotics was noted. Non-susceptibility to TZP was determined in 7.6% of E. coli isolates and 20.9% of K. pneumoniae isolates. Despite the increase in TZP usage, the overall prevalence of TZP resistance did not significantly increase over time, especially in E. coli. The mechanisms for TZP resistance included the presence of AmpC producers, possible TEM-1 hyperproducers, and multiple β-lactamases in individual organisms of a given isolate. Replacement of only the antibiotic class appears to be insufficient to control antibiotic resistance, and continued efforts to decrease overall antibiotic pressure are needed, especially in highly endemic situations. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Resistant gram-negative bacilli and antibiotic consumption in zarqa, jordan

    Bataineh, H.A.; Alrashed, K.M.


    To investigate the prevalence of antibiotic resistance among gram-negative bacteria in relation to antibiotic use in Prince Hashem Hospital (PHH), Jordan. One hundred consecutive gram-negative bacterial isolates from different sites were collected from patients admitted to the ICU at PHH. The susceptibilities of the strains to 12 antibiotics were performed and interpreted. The quantities and the numbers of the patients discharged on antibiotics and the quantities consumed were obtained from the hospital pharmacy records. The most common isolate was P. aeruginosa (n=21) The most common site of isolation was the respiratory tract (65%), The highest susceptibility was to piperacillin/ tazobactam(78%), and the lowest was to cefuroxime(34%). The aminoglycosides gentamicin and amikacin were active against 71% and 73% of the isolates respectively, Ciprofloxacin was active against 75% of the isolates. The most frequently used antibiotics were the third-generation cephalosporins ceftriaxone and ceftazidime, followed by imipenem and amikacin. Antibiotic resistance surveillance programs associated with registration of antibiotic consumption are necessary to promote optimal use of antibiotics. Rational prescribing of antibiotics should be encouraged through educational programs, surveillance and audit. Proper infection control measures should be practiced to prevent horizontal transfer of drug-resistant organisms. (author)

  17. Characterization of the Antibiotic Compound No. 70 Produced by Streptomyces sp. IMV-70

    Trenozhnikova, Lyudmila P.; Khasenova, Almagul K.; Balgimbaeva, Assya S.; Fedorova, Galina B.; Katrukha, Genrikh S.; Tokareva, Nina L.; Kwa, Boo H.; Azizan, Azliyati


    We describe the actinomycete strain IMV-70 isolated from the soils of Kazakhstan, which produces potent antibiotics with high levels of antibacterial activity. After the research of its morphological, chemotaxonomic, and cultural characteristics, the strain with potential to be developed further as a novel class of antibiotics with chemotherapeutics potential was identified as Streptomyces sp. IMV-70. In the process of fermentation, the strain Streptomyces spp. IMV-70 produces the antibiotic no. 70, which was isolated from the culture broth by extraction with organic solvents. Antibiotic compound no. 70 was purified and separated into individual components by HPLC, TLC, and column chromatography methods. The main component of the compound is the antibiotic 70-A, which was found to be identical to the peptolide etamycin A. Two other antibiotics 70-B and 70-C have never been described and therefore are new antibiotics. The physical-chemical and biological characteristics of these preparations were described and further researched. Determination of the optimal growth conditions to cultivate actinomycete-producer strain IMV-70 and development of methods to isolate, purify, and accumulate preparations of the new antibiotic no. 70 enable us to research further the potential of this new class of antibiotics. PMID:22536145

  18. Characterization of the Antibiotic Compound No. 70 Produced by Streptomyces sp. IMV-70

    Lyudmila P. Trenozhnikova


    Full Text Available We describe the actinomycete strain IMV-70 isolated from the soils of Kazakhstan, which produces potent antibiotics with high levels of antibacterial activity. After the research of its morphological, chemotaxonomic, and cultural characteristics, the strain with potential to be developed further as a novel class of antibiotics with chemotherapeutics potential was identified as Streptomyces sp. IMV-70. In the process of fermentation, the strain Streptomyces spp. IMV-70 produces the antibiotic no. 70, which was isolated from the culture broth by extraction with organic solvents. Antibiotic compound no. 70 was purified and separated into individual components by HPLC, TLC, and column chromatography methods. The main component of the compound is the antibiotic 70-A, which was found to be identical to the peptolide etamycin A. Two other antibiotics 70-B and 70-C have never been described and therefore are new antibiotics. The physical-chemical and biological characteristics of these preparations were described and further researched. Determination of the optimal growth conditions to cultivate actinomycete-producer strain IMV-70 and development of methods to isolate, purify, and accumulate preparations of the new antibiotic no. 70 enable us to research further the potential of this new class of antibiotics.


    Abdul Jabbar


    Full Text Available Microbiological tests are widely used to detect antibiotic residues in the meat, milk and eggs for better care of the quality and health safety. In the present study microbiological inhibition test i.e. Swab Test on Animal Food (STAF was developed indigenously for screening of animal foods for presence of antibiotic residues. In this test local isolated culture of Bacillus subtilis was used as a test microorganism due to its high sensitivity to detect a wide range of antibiotics commonly used in animal disorders. The concentration of spore suspension of Bacillus subtilis JS2004 used in the formation of STAF plate was optimized at 2x107 spores/ ml. At this concentration, inhibition zone around Neomycin control disc was 10-16 mm. Nutrient agar was used as a medium in spore suspension and 0.4% dextrose was added as a constituent of medium. Zones of inhibition around swab samples and Neomycin control disc were observed and the diameter was measured. All swab samples showing a minimum of 2 mm wide inhibition zone around them were considered as positive for presence of antibiotic residues. The swab samples showing no zone of inhibition or a zone measuring less than 2 mm were considered as negative. Results of application of STAF test was on animal food samples revealed the high incidence of antibiotic residues.

  20. Motivations and usage patterns of Weibo.

    Zhang, Lixuan; Pentina, Iryna


    Referred to as "Weibo," microblogging in China has witnessed an exponential growth. In addition to the Twitter-like functionality, Weibo allows rich media uploads into user feeds, provides threaded comments, and offers applications, games, and Weibo medals. This expanded functionality, as well as the observed differences in trending content, suggests potentially different user motivations to join Weibo and their usage patterns compared to Twitter. This pioneering study identifies dominant Weibo user motivations and their effects on usage patterns. We discuss the findings of an online survey of 234 Weibo users and suggest managerial implications and future research directions.

  1. Power factor regulation for household usage

    Daud, Nik Ghazali Nik; Hashim, Fakroul Ridzuan; Tarmizi, Muhammad Haziq Ahmad


    Power factor regulator technology has recently drawn attention to the consumer and to power generation company in order for consumers to use electricity efficiently. Controlling of power factor for efficient usage can reduce the production of power in fulfilment demands hence reducing the greenhouse effect. This paper presents the design method of power factor controller for household usage. There are several methods to improve the power factor. The power factor controller used by this method is by using capacitors. Total harmonic distortion also has become a major problem for the reliability of the electrical appliances and techniques to control it will be discussed.


    Gitten Kristiansen


    Full Text Available The usage-based conception of language is a major tenet in Cognitive Linguistics, but cognitive phonology has not yet been developed sufficiently in this direction. Often, phonemic analysis is carried out at the high level of abstraction of `a language´, disregarding rich patterns of languageinternal variation. This paper first argues that cognitive phonology must aim at a higher degree of descriptive refinement, especially in the direction of social variation. Then it goes on to examine the implications of a usage-based and multi-faceted model for a theoretical discussion of the phoneme as a prototype category.

  3. Dielectrophoretic assay of bacterial resistance to antibiotics

    Johari, Juliana; Huebner, Yvonne; Hull, Judith C; Dale, Jeremy W; Hughes, Michael P


    The dielectrophoretic collection spectra of antibiotic-sensitive and antibiotic-resistant strains of Staphylococcus epidermidis have been determined. These indicate that in the absence of antibiotic treatment there is a strong similarity between the dielectric properties of sensitive and resistant strains, and that there is a significant difference between the sensitive strains before and after treatment with the antibiotic streptomycin after 24 h exposure. This method offers possibilities for the assessment of bacterial resistance to antibiotics. (note)

  4. Macrolide antibiotics and the airway: antibiotic or non-antibiotic effects?

    Murphy, D M


    The macrolides are a class of antibiotics widely prescribed in infectious disease. More recently, there has been considerable interest in potential indications for these agents, in addition to their simple antibacterial indications, in a number of lung pathophysiologies.

  5. Codon usage regulates protein structure and function by affecting translation elongation speed in Drosophila cells.

    Zhao, Fangzhou; Yu, Chien-Hung; Liu, Yi


    Codon usage biases are found in all eukaryotic and prokaryotic genomes and have been proposed to regulate different aspects of translation process. Codon optimality has been shown to regulate translation elongation speed in fungal systems, but its effect on translation elongation speed in animal systems is not clear. In this study, we used a Drosophila cell-free translation system to directly compare the velocity of mRNA translation elongation. Our results demonstrate that optimal synonymous codons speed up translation elongation while non-optimal codons slow down translation. In addition, codon usage regulates ribosome movement and stalling on mRNA during translation. Finally, we show that codon usage affects protein structure and function in vitro and in Drosophila cells. Together, these results suggest that the effect of codon usage on translation elongation speed is a conserved mechanism from fungi to animals that can affect protein folding in eukaryotic organisms. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  6. Determination of antibiotics consumption in buali-sina pediatric hospital, sari 2010-2011.

    Salehifar, Ebrahim; Nasehi, Mohammadmehdi; Eslami, Gohar; Sahraei, Sima; Alizadeh Navaei, Reza


    The increasing prevalence of antibiotic-resistant bacteria is a major health-care problem worldwide. WHO recommends DID (daily defined dose per 100 Inhabitant per day) as a standard tool for measurement of antibiotic consumption. Since there was not any information regarding the antibiotics usage pattern in the north of Iran, the aim of this study was determine this in our centre. This cross-sectional study was performed in Buali Sina hospital. Using the health information system (HIS) database, records of patients hospitalized during 22 Sep 2010 - 21 Sep 2011. Data of different wards including Neonatal, NICU, PICU, Pediatrics and Pediatric surgery were separately extracted and analyzed. Drug consumption data were expressed as DID. SPSS 16 software was used for statistical analysis. Independent samples t-test was used to compare the quantitative variables. A total of 4619 in-patients records during 1 year of study including 2494 patients in fall and winter and 2125 patients in spring and summer were evaluated. The most hospitalized patients were in Pediatric ward (43.9 %). The highest DID value were obtained for ceftriaxone (21.7), ampicillin (6.05) and vancomycin (4.7), while the lowest value was for gentamicin (0.01). In both cold and warm seasons, Ceftriaxone was the most frequent prescribed antibiotic. The rate of antibiotics consumption especially Ceftriaxone in our setting was significantly higher than the other centers. Strategies for more justified administration of antibiotics especially broad -spectrum ones are necessary.

  7. Selection of antibiotics in detection procedure of Escherichia coli O157:H7 in vegetables

    Hoang, Hoang A.; Nhung, Nguyen T. T.


    Detection of Escherichia coli O157:H7 in ready-to-eat fresh vegetables is important since this bacteria is considered as one of the most important pathogens in relation to public health. However, it could be a big challenge for detection of initial low concentrations of E. coli O157:H7 in the samples. In this study, selection of antibiotics that suppress growth of background bacteria to enable detection of E. coli O157:H7 in ready-to-eat fresh vegetables was investigated. Firstly, different combinations of two antibiotics, i.e. novobiocin (N) and vancomycin (V), in BHI broth were conducted. The three antibiotic combinations were preliminary examined their effect on the growth of E. coli O157:H7 and Bacillus spp. in broth based on OD600nm measurement. The combination of both the antibiotics was selected to examine their possibility to support detection of E. coli O157:H7 in vegetables. It was successful when two antibiotics showed their support in detection of E. coli O157:H7 at very low concentration of 2 CFU per one gram of lettuce. Usage of these antibiotics is simple and cheap in the detection procedure and could be applied to other types of ready-to-eat fresh vegetables popular in Vietnam.

  8. Antibiotic Resistome: Improving Detection and Quantification Accuracy for Comparative Metagenomics.

    Elbehery, Ali H A; Aziz, Ramy K; Siam, Rania


    The unprecedented rise of life-threatening antibiotic resistance (AR), combined with the unparalleled advances in DNA sequencing of genomes and metagenomes, has pushed the need for in silico detection of the resistance potential of clinical and environmental metagenomic samples through the quantification of AR genes (i.e., genes conferring antibiotic resistance). Therefore, determining an optimal methodology to quantitatively and accurately assess AR genes in a given environment is pivotal. Here, we optimized and improved existing AR detection methodologies from metagenomic datasets to properly consider AR-generating mutations in antibiotic target genes. Through comparative metagenomic analysis of previously published AR gene abundance in three publicly available metagenomes, we illustrate how mutation-generated resistance genes are either falsely assigned or neglected, which alters the detection and quantitation of the antibiotic resistome. In addition, we inspected factors influencing the outcome of AR gene quantification using metagenome simulation experiments, and identified that genome size, AR gene length, total number of metagenomics reads and selected sequencing platforms had pronounced effects on the level of detected AR. In conclusion, our proposed improvements in the current methodologies for accurate AR detection and resistome assessment show reliable results when tested on real and simulated metagenomic datasets.

  9. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  10. Antibody-Based Agents in the Management of Antibiotic-Resistant Staphylococcus aureus Diseases

    Speziale, Pietro; Rindi, Simonetta


    Staphylococcus aureus is a human pathogen that can cause a wide spectrum of diseases, including sepsis, pneumonia, arthritis, and endocarditis. Ineffective treatment of a number of staphylococcal infections with antibiotics is due to the development and spread of antibiotic-resistant strains following decades of antibiotic usage. This has generated renewed interest within the scientific community in alternative therapeutic agents, such as anti-S. aureus antibodies. Although the role of antibodies in the management of S. aureus diseases is controversial, the success of this pathogen in neutralizing humoral immunity clearly indicates that antibodies offer the host extensive protection. In this review, we report an update on efforts to develop antibody-based agents, particularly monoclonal antibodies, and their therapeutic potential in the passive immunization approach to the treatment and prevention of S. aureus infections. PMID:29533985

  11. Distribution, fate and risk assessment of antibiotics in sewage treatment plants in Hong Kong, South China.

    Leung, H W; Minh, T B; Murphy, M B; Lam, James C W; So, M K; Martin, Michael; Lam, Paul K S; Richardson, B J


    Occurrence, removal, consumption and environmental risks of sixteen antibiotics were investigated in several sewage treatment plants (STPs) featuring different treatment levels in Hong Kong, China. Cefalexin, ofloxacin and erythromycin-H(2)O were predominant with concentrations of 1020-5640, 142-7900 and 243-4740 ng/L in influent, respectively; their mass loads were comparable to levels reported in urban regions in China and were at the high end of the range reported for western countries. The target antibiotics behaved differently depending on the treatment level employed at the STPs and relatively higher removal efficiencies (>70%) were observed for cefalexin, cefotaxime, amoxicillin, sulfamethoxazole and chloramphenicol during secondary treatment. ß-lactams were especially susceptible to removal via the activated sludge process while macrolides were recalcitrant (antibiotic consumption in Hong Kong was back-calculated based on influent mass flows and compared with available prescription and usage data. This model was verified by a good approximation of 82% and 141% to the predicted consumption of total ofloxacin, but a less accurate estimate was obtained for erythromycin usage. Risk assessment indicated that algae are susceptible to the environmental concentrations of amoxicillin as well as the mixture of the nine detected antibiotics in receiving surface waters. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Production, Usage, and Comprehension in Animal Vocalizations

    Seyfarth, Robert M.; Cheney, Dorothy L.


    In this review, we place equal emphasis on production, usage, and comprehension because these components of communication may exhibit different developmental trajectories and be affected by different neural mechanisms. In the animal kingdom generally, learned, flexible vocal production is rare, appearing in only a few orders of birds and few…

  13. Statistical Measures for Usage-Based Linguistics

    Gries, Stefan Th.; Ellis, Nick C.


    The advent of usage-/exemplar-based approaches has resulted in a major change in the theoretical landscape of linguistics, but also in the range of methodologies that are brought to bear on the study of language acquisition/learning, structure, and use. In particular, methods from corpus linguistics are now frequently used to study distributional…

  14. Twitter Usage of Universities in Turkey

    Yolcu, Ozgu


    Universities are among the users of the most popular social media networks. Usage of social media by especially students and many other people and institutions, which constitutes the target audience for universities, encourages the universities to effectively use this environment. Twitter is among these social media networks which facilitate the…

  15. Student Time Usage during Fall Reading Week

    Cramer, Ken; Pschibul, Rebecca


    The present study investigated the time usage and levels of perceived stress, academic workload, and recreation time for 177 students at the University of Windsor before, during, and after Fall Reading Week (FRW). Over a three-week span (at various times of the day), students received a message to their smartphone to complete a 20-second survey…

  16. College Student Performance and Credit Card Usage.

    Pinto, Mary Beth; Parente, Diane H.; Palmer, Todd Starr


    Examines the relationship between credit card usage, employment, and academic performance among a group of college students with credit cards. Results reveal that the students differed significantly in the level of anxiety felt from carrying debt, perceived need to work, and perceived impact of employment on academic performance. (Contains 57…

  17. Decay-usage scheduling in multiprocessors

    Epema, D.H.J.


    Decay-usage scheduling is a priority-aging time-sharing scheduling policy capable of dealing with a workload of both interactive and batch jobs by decreasing the priority of a job when it acquires CPU time, and by increasing its priority when it does not use the (a) CPU. In this article we deal with

  18. MESUR: metrics from scholarly usage of resources

    CERN. Geneva


    The MESUR project is constructing a large-scale semantic model of the scholarly community that seamlessly integrates a wide range of bibliographic, citation and usage data. Functioning as a reference data set, this model is analyzed to characterize the intricate networks of typed relationships that exist in the scholarly community. The resulting ...

  19. Aspiration Curettage and its Outpatient Usage

    Aspiration Curettage and its Outpatient Usage. D. A. G. BARFORD, M, NOTELOVITZ. SUMMARY ... its use on a number of outpatients without anaesthesia is discussed. S. Afr. Med. l., 48, 22 (1974). In order to ... plastic aspiration chamber and suction is applied centrally at the base of the chamber, a cylindrical filter within the.

  20. An Empirical Investigation of Campus Portal Usage

    Saghapour, Mohsen; Iranmanesh, Mohammad; Zailani, Suhaiza; Goh, Gerald Guan Gan


    This study has determined the determinants of the perceived ease of use and perceived usefulness and their influence on campus portal usage. A quantitative approach was employed, using a five-point Likert scale questionnaire, adapted from previous studies. Data were gathered through a survey conducted with 341 staff working in the University of…

  1. Slang Usage of French by Young Americans.

    Ensz, Kathleen Y.


    Describes reactions of native French speakers to usage of French slang by young American students. French-speaking participants rated 30 tape-recorded slang expressions. Their reactions were evaluated in relation to the sex, profession, age, and residence of the respondents. Results show attitudes critical of the use of slang in general. (SED)

  2. Notational usage modulates attention networks in binumerates

    Atesh eKoul


    Full Text Available Multicultural environments require learning multiple number notations wherein some are encountered more frequently than others. This leads to differences in exposure and consequently differences in usage between notations. We find that differential notational usage imposes a significant neurocognitive load on number processing. Despite simultaneous acquisition, forty-two adult binumerate populations, familiar with two positional writing systems namely Hindu Nagari digits and Hindu Arabic digits, reported significantly lower preference and usage for Nagari as compared to Arabic. Twenty-four participants showed significantly increased reaction times and reduced accuracy while performing magnitude comparison tasks in Nagari with respect to Arabic. Functional magnetic resonance imaging revealed that processing Nagari elicited significantly greater activity in number processing and attention networks. A direct subtraction of networks for Nagari and Arabic notations revealed a neural circuit comprising of bilateral intra-parietal sulcus, inferior and mid frontal gyri, fusiform gyrus and the anterior cingulate cortex (FDR p<0.005. Additionally, whole brain correlation analysis showed that activity in the left inferior parietal region was modulated by task performance in Nagari. We attribute the increased activation in Ng to increased task difficulty due to infrequent exposure and usage. Our results reiterate the role of the left intra-parietal sulcus in modulating performance in numeric tasks and highlight that of the attention network for monitoring symbolic notation mode in binumerates.

  3. Usage of cell nomenclature in biomedical literature

    Kafkas, Senay; Sarntivijai, Sirarat; Hoehndorf, Robert


    large scale for understanding the level of uptake of cell nomenclature in literature by scientists. In this study, we analyse the usage of cell nomenclature, both in Vivo, and in Vitro in biomedical literature by using text mining methods and present our

  4. Sporforming probiotics and their usage in children

    Marushko RV


    Full Text Available The data of literature about spore-forming probiotics, as well as their usage in the pathology of the gastrointestinal tract in children were sumerised. Analysis of the data allows us to recommend the preparation «Biosporin-Biopharma» for preventive measures and treatment of gastrointestinal tract diseases at all levels of children health care, including infants.

  5. Mobile Device Usage in Higher Education

    Delcker, Jan; Honal, Andrea; Ifenthaler, Dirk


    This paper focuses on mobile device usage of students in higher education. While more and more students embrace mobile devices in their daily life, institutions attempt to profit from those devices for educational purposes. It is therefore crucial for institutional development to identify students' needs and how mobile devices may facilitate these…

  6. Google Scholar Usage: An Academic Library's Experience

    Wang, Ya; Howard, Pamela


    Google Scholar is a free service that provides a simple way to broadly search for scholarly works and to connect patrons with the resources libraries provide. The researchers in this study analyzed Google Scholar usage data from 2006 for three library tools at San Francisco State University: SFX link resolver, Web Access Management proxy server,…

  7. The Scope of Usage-based Theory

    Paul eIbbotson


    Full Text Available Usage-based approaches typically draw on a relatively small set of cognitive processes, such as categorization, analogy and chunking to explain language structure and function. The goal of this paper is to first review the extent to which the ‘cognitive commitment’ of usage-based theory has had success in explaining empirical findings across domains, including language acquisition, processing and typology. We then look at the overall strengths and weaknesses of usage-based theory and highlight where there are significant debates. Finally, we draw special attention to a set of culturally generated structural patterns that seem to lie beyond the explanation of core usage-based cognitive processes. In this context we draw a distinction between cognition permitting language structure versus cognition entailing language structure. As well as addressing the need for greater clarity on the mechanisms of generalizations and the fundamental units of grammar, we suggest that integrating culturally generated structures within existing cognitive models of use will generate tighter predictions about how language works.

  8. High-throughput hydrophilic interaction chromatography coupled to tandem mass spectrometry for the optimized quantification of the anti-Gram-negatives antibiotic colistin A/B and its pro-drug colistimethate.

    Mercier, Thomas; Tissot, Fréderic; Gardiol, Céline; Corti, Natascia; Wehrli, Stéphane; Guidi, Monia; Csajka, Chantal; Buclin, Thierry; Couet, William; Marchetti, Oscar; Decosterd, Laurent A


    Colistin is a last resort's antibacterial treatment in critically ill patients with multi-drug resistant Gram-negative infections. As appropriate colistin exposure is the key for maximizing efficacy while minimizing toxicity, individualized dosing optimization guided by therapeutic drug monitoring is a top clinical priority. Objective of the present work was to develop a rapid and robust HPLC-MS/MS assay for quantification of colistin plasma concentrations. This novel methodology validated according to international standards simultaneously quantifies the microbiologically active compounds colistin A and B, plus the pro-drug colistin methanesulfonate (colistimethate, CMS). 96-well micro-Elution SPE on Oasis Hydrophilic-Lipophilic-Balanced (HLB) followed by direct analysis by Hydrophilic Interaction Liquid Chromatography (HILIC) with Ethylene Bridged Hybrid--BEH--Amide phase column coupled to tandem mass spectrometry allows a high-throughput with no significant matrix effect. The technique is highly sensitive (limit of quantification 0.014 and 0.006 μg/mL for colistin A and B), precise (intra-/inter-assay CV 0.6-8.4%) and accurate (intra-/inter-assay deviation from nominal concentrations -4.4 to +6.3%) over the clinically relevant analytical range 0.05-20 μg/mL. Colistin A and B in plasma and whole blood samples are reliably quantified over 48 h at room temperature and at +4°C (<6% deviation from nominal values) and after three freeze-thaw cycles. Colistimethate acidic hydrolysis (1M H2SO4) to colistin A and B in plasma was completed in vitro after 15 min of sonication while the pro-drug hydrolyzed spontaneously in plasma ex vivo after 4 h at room temperature: this information is of utmost importance for interpretation of analytical results. Quantification is precise and accurate when using serum, citrated or EDTA plasma as biological matrix, while use of heparin plasma is not appropriate. This new analytical technique providing optimized quantification in real

  9. [Antibiotic resistance: A global crisis].

    Alós, Juan-Ignacio


    The introduction of antibiotics into clinical practice represented one of the most important interventions for the control of infectious diseases. Antibiotics have saved millions of lives and have also brought a revolution in medicine. However, an increasing threat has deteriorated the effectiveness of these drugs, that of bacterial resistance to antibiotics, which is defined here as the ability of bacteria to survive in antibiotic concentrations that inhibit/kill others of the same species. In this review some recent and important examples of resistance in pathogens of concern for mankind are mentioned. It is explained, according to present knowledge, the process that led to the current situation in a short time, evolutionarily speaking. It begins with the resistance genes, continues with clones and genetic elements involved in the maintenance and dissemination, and ends with other factors that contribute to its spread. Possible responses to the problem are also reviewed, with special reference to the development of new antibiotics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  10. Consumer attitudes and use of antibiotics.

    Vanden Eng, Jodi; Marcus, Ruthanne; Hadler, James L; Imhoff, Beth; Vugia, Duc J; Cieslak, Paul R; Zell, Elizabeth; Deneen, Valerie; McCombs, Katherine Gibbs; Zansky, Shelley M; Hawkins, Marguerite A; Besser, Richard E


    Recent antibiotic use is a risk factor for infection or colonization with resistant bacterial pathogens. Demand for antibiotics can be affected by consumers' knowledge, attitudes, and practices. In 1998-1999, the Foodborne Diseases Active Surveillance Network (FoodNet( conducted a population-based, random-digit dialing telephone survey, including questions regarding respondents' knowledge, attitudes, and practices of antibiotic use. Twelve percent had recently taken antibiotics; 27% believed that taking antibiotics when they had a cold made them better more quickly, 32% believed that taking antibiotics when they had a cold prevented more serious illness, and 48% expected a prescription for antibiotics when they were ill enough from a cold to seek medical attention. These misguided beliefs and expectations were associated with a lack of awareness of the dangers of antibiotic use; 58% of patients were not aware of the possible health dangers. National educational efforts are needed to address these issues if patient demand for antibiotics is to be reduced.

  11. [Utilization of antibiotics according to most frequent indications at Hungarian hospitals and results of surveys].

    Ternák, G; Almási, I


    Antibiotic utilisation of 8 Hungarian hospitals was analyzed examining the case histories of patients who were discharged between January 1 and 31, 1995. Usage of antibiotics in the most frequent indications is reported in this paper. Majority of the prescriptions for the treatment of upper and lower respiratory tract infections were broad spectrum beta lactams. Higher rate of penicillin usage was found only in tonsillitis cases. Besides II. generation cephalosporins (22.7% of 730 prescriptions), beta-lactamase inhibitor + aminopenicillin combinations (13.4%) and III. generation cephalosporins (9.5%) considerable quantity of aminoglycosides (14.9%) and quinolones (9.5%) were found in pneumonia. Relatively high rate of aminoglycosides in the treatment of lower respiratory infections is inconsistent with therapeutic guidelines in force. Co-trimoxazol and quinolones were most frequently prescribed for the treatment of lower urinary tract infections. Traditional urodesinficients were on the first place only at one hospital. Treatment of frequently occurring nosocomial infections was compared with those of community acquired at the same site. There was not significant difference in the utilisation rates of the most of antibiotic groups regarding place of disease acquisition. 44% of the 1373 prescriptions for perioperative profilaxis was indicated for clean operations where benefit of antibiotic administration is questionable. Duration of antibiotic profilaxis was more than 48 hours in 59% of prescriptions. Drugs most frequently used for perioperative profilaxis were II. generation cephalosporins (23.7%), metronidazol (16.7%), aminoglycosides (9.6%) and III. generation cephalosporines (9.6%). The authors compare their results to the literature. They suggest the setting up of "infection control committees" to organise the antibiotic policies in hospitals.

  12. [Antibiotic therapy of hospital-acquired pneumonia and its pharmacoeconomics].

    Kolář, Milan; Htoutou Sedláková, Miroslava; Urbánek, Karel; Uvízl, Radomír; Adamus, Milan; Imwensi, O P


    Important hospital-acquired infections include pneumonia, mainly because of the increasing resistance of bacterial pathogens to antimicrobials and the associated potential failure of antibiotic therapy. The present study aimed at determining the most frequent etiological agents of hospital-acquired pneumonia (HAP) and assessing the relationship between 30-day mortality and adequacy of antibiotic therapy. Based on the obtained information, optimal patterns of antibiotic therapy were to be defined, including a pharmacoeconomic perspective. In patients with clinically confirmed HAP, bacterial etiological agents were identified, their susceptibility to antimicrobials was determined and statistical methods were used to assess the relationship between adequacy of antibiotic therapy and 30-day mortality. The study comprised 68 patients with clinically confirmed HAP. The most common etiological agents were strains of Pseudomonas aeruginosa (30.8 %), Klebsiella pneumoniae (23.1 %) and Burkholderia cepacia complex (15.4 %). Gram-negative bacteria accounted for 86.5 % of all bacterial pathogens. The overall mortality reached 42.5 %. In the subgroup of patients with inadequate antibiotic therapy, 30-day mortality was significantly higher (83.3 %) than in the subgroup with adequate therapy (30.0 %; p = 0.002). The risk for 30-day mortality was 2.78 times higher in case of inadequate antibiotic therapy (95%CI: 1.52-5.07). The proportion of Pseudomonas aeruginosa strains was significantly higher in the subgroup of patients with inadequate antibiotic therapy than in those with adequate therapy (67 % vs. 27 %; p = 0.032). Results of the present study suggest a significant relationship between mortality of patients with HAP and ineffective antibiotic therapy due to resistance of the bacterial pathogen. Thus, it is clear that initial antibiotic therapy must be based on qualified assumption of sufficient activity against the most common bacterial pathogens and results of surveillance

  13. Plant Growth, Antibiotic Uptake, and Prevalence of Antibiotic Resistance in an Endophytic System of Pakchoi under Antibiotic Exposure

    Hao Zhang


    Full Text Available Antibiotic contamination in agroecosystems may cause serious problems, such as the proliferation of various antibiotic resistant bacteria and the spreading of antibiotic resistance genes (ARGs in the environment or even to human beings. However, it is unclear whether environmental antibiotics, antibiotic resistant bacteria, and ARGs can directly enter into, or occur in, the endophytic systems of plants exposed to pollutants. In this study, a hydroponic experiment exposing pakchoi (Brassica chinensis L. to tetracycline, cephalexin, and sulfamethoxazole at 50% minimum inhibitory concentration (MIC levels and MIC levels, respectively, was conducted to explore plant growth, antibiotic uptake, and the development of antibiotic resistance in endophytic systems. The three antibiotics promoted pakchoi growth at 50% MIC values. Target antibiotics at concentrations ranging from 6.9 to 48.1 µg·kg−1 were detected in the treated vegetables. Additionally, the rates of antibiotic-resistant endophytic bacteria to total cultivable endophytic bacteria significantly increased as the antibiotics accumulated in the plants. The detection and quantification of ARGs indicated that four types, tetX, blaCTX-M, and sul1 and sul2, which correspond to tetracycline, cephalexin, and sulfamethoxazole resistance, respectively, were present in the pakchoi endophytic system and increased with the antibiotic concentrations. The results highlight a potential risk of the development and spread of antibiotic resistance in vegetable endophytic systems.

  14. Plant Growth, Antibiotic Uptake, and Prevalence of Antibiotic Resistance in an Endophytic System of Pakchoi under Antibiotic Exposure.

    Zhang, Hao; Li, Xunan; Yang, Qingxiang; Sun, Linlin; Yang, Xinxin; Zhou, Mingming; Deng, Rongzhen; Bi, Linqian


    Antibiotic contamination in agroecosystems may cause serious problems, such as the proliferation of various antibiotic resistant bacteria and the spreading of antibiotic resistance genes (ARGs) in the environment or even to human beings. However, it is unclear whether environmental antibiotics, antibiotic resistant bacteria, and ARGs can directly enter into, or occur in, the endophytic systems of plants exposed to pollutants. In this study, a hydroponic experiment exposing pakchoi ( Brassica chinensis L.) to tetracycline, cephalexin, and sulfamethoxazole at 50% minimum inhibitory concentration (MIC) levels and MIC levels, respectively, was conducted to explore plant growth, antibiotic uptake, and the development of antibiotic resistance in endophytic systems. The three antibiotics promoted pakchoi growth at 50% MIC values. Target antibiotics at concentrations ranging from 6.9 to 48.1 µg·kg -1 were detected in the treated vegetables. Additionally, the rates of antibiotic-resistant endophytic bacteria to total cultivable endophytic bacteria significantly increased as the antibiotics accumulated in the plants. The detection and quantification of ARGs indicated that four types, tet X, bla CTX-M , and sul 1 and sul 2, which correspond to tetracycline, cephalexin, and sulfamethoxazole resistance, respectively, were present in the pakchoi endophytic system and increased with the antibiotic concentrations. The results highlight a potential risk of the development and spread of antibiotic resistance in vegetable endophytic systems.

  15. Experimental investigation review of biodiesel usage in bus diesel engine

    Kegl Breda


    Full Text Available This paper assembles and analyses extensive experimental research work conducted for several years in relation to biodiesel usage in a MAN bus Diesel engine with M injection system. At first the most important properties of the actually used neat rapeseed biodiesel fuel and its blends with mineral diesel are discussed and compared to that of mineral diesel. Then the injection, fuel spray, and engine characteristics for various considered fuel blends are compared at various ambient conditions, with special emphasis on the influence of low temperature on fueling. Furthermore, for each tested fuel the optimal injection pump timing is determined. The obtained optimal injection pump timings for individual fuels are then used to determine and discuss the most important injection and combustion characteristics, engine performance, as well as the emission, economy, and tribology characteristics of the engine at all modes of emission test cycles test. The results show that for each tested fuel it is possible to find the optimized injection pump timing, which enables acceptable engine characteristics at all modes of the emission test cycles test.

  16. Forces shaping the antibiotic resistome.

    Perry, Julie A; Wright, Gerard D


    Antibiotic resistance has become a problem of global scale. Resistance arises through mutation or through the acquisition of resistance gene(s) from other bacteria in a process called horizontal gene transfer (HGT). While HGT is recognized as an important factor in the dissemination of resistance genes in clinical pathogens, its role in the environment has been called into question by a recent study published in Nature. The authors found little evidence of HGT in soil using a culture-independent functional metagenomics approach, which is in contrast to previous work from the same lab showing HGT between the environment and human microbiome. While surprising at face value, these results may be explained by the lack of selective pressure in the environment studied. Importantly, this work suggests the need for careful monitoring of environmental antibiotic pollution and stringent antibiotic stewardship in the fight against resistance. © 2014 WILEY Periodicals, Inc.

  17. Peptide Antibiotics for ESKAPE Pathogens

    Thomsen, Thomas Thyge

    is considered poor compared to medicines for lifestyle diseases. According to the WHO we could be moving towards a post-antibiotic era in which previously treatable infections become fatal. Of special importance are multidrug resistant bacteria from the ESKAPE group (Enterococcus faecium, Staphylococcus aureus......Multi-drug resistance to antibiotics represents a global health challenge that results in increased morbidity and mortality rates. The annual death-toll is >700.000 people world-wide, rising to ~10 million by 2050. New antibiotics are lacking, and few are under development as return on investment......, Klebsiella pneumoniae, Acinetobacter, Pseudomonas aeruginosa and Enterobacter). As a consequence of widespread multi-drug resistance, researchers have sought for alternative sources of antimicrobials. Antimicrobial peptides are produced by almost all living organisms as part of their defense or innate immune...

  18. Benchmarking antibiotic use in Finnish acute care hospitals using patient case-mix adjustment.

    Kanerva, Mari; Ollgren, Jukka; Lyytikäinen, Outi


    It is difficult to draw conclusions about the prudence of antibiotic use in different hospitals by directly comparing usage figures. We present a patient case-mix adjustment model of antibiotic use to rank hospitals while taking patient characteristics into account. Data on antibiotic use were collected during the national healthcare-associated infection (HAI) prevalence survey in 2005 in Finland in all 5 tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals. The use of antibiotics was measured using use-days/100 patient-days during a 7day period and the prevalence of patients receiving at least two antimicrobials during the study day. Case-mix-adjusted antibiotic use was calculated by using multivariate models and an indirect standardization method. Parameters in the model included age, sex, severity of underlying diseases, intensive care, haematology, preceding surgery, respirator, central venous and urinary catheters, community-associated infection, HAI and contact isolation due to methicillin-resistant Staphylococcus aureus. The ranking order changed one position in 12 (40%) hospitals and more than two positions in 13 (43%) hospitals when the case-mix-adjusted figures were compared with those observed. In 24 hospitals (80%), the antibiotic use density observed was lower than expected by the case-mix-adjusted use density. The patient case-mix adjustment of antibiotic use ranked the hospitals differently from the ranking according to observed use, and may be a useful tool for benchmarking hospital antibiotic use. However, the best set of easily and widely available parameters that would describe both patient material and hospital activities remains to be determined.

  19. Antibiotic Policies in the Intensive Care Unit

    Nese Saltoglu


    Full Text Available The antimicrobial management of patients in the Intensive Care Units are complex. Antimicrobial resistance is an increasing problem. Effective strategies for the prevention of antimicrobial resistance in ICUs have focused on limiting the unnecessary use of antibiotics and increasing compliance with infection control practices. Antibiotic policies have been implemented to modify antibiotic use, including national or regional formulary manipulations, antibiotic restriction forms, care plans, antibiotic cycling and computer assigned antimicrobial therapy. Moreover, infectious diseases consultation is a simple way to limit antibiotic use in ICU units. To improve rational antimicrobial using a multidisiplinary approach is suggested. [Archives Medical Review Journal 2003; 12(4.000: 299-309

  20. Nucleoside antibiotics: biosynthesis, regulation, and biotechnology.

    Niu, Guoqing; Tan, Huarong


    The alarming rise in antibiotic-resistant pathogens has coincided with a decline in the supply of new antibiotics. It is therefore of great importance to find and create new antibiotics. Nucleoside antibiotics are a large family of natural products with diverse biological functions. Their biosynthesis is a complex process through multistep enzymatic reactions and is subject to hierarchical regulation. Genetic and biochemical studies of the biosynthetic machinery have provided the basis for pathway engineering and combinatorial biosynthesis to create new or hybrid nucleoside antibiotics. Dissection of regulatory mechanisms is leading to strategies to increase the titer of bioactive nucleoside antibiotics. Copyright © 2014. Published by Elsevier Ltd.

  1. Surgical excision versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children: a multicenter, randomized, controlled trial

    Lindeboom, Jerome A.; Kuijper, Ed J.; van Coppenraet, Elisabeth S. Bruijnesteijn; Lindeboom, Robert; Prins, Jan M.


    BACKGROUND: The optimal treatment of nontuberculosis mycobacterial cervical lymphadenitis in children has not been established. Until recently, surgical excision was the standard treatment, but the number of reports of successful antibiotic treatment is increasing, which questions whether surgery is

  2. Codon usage bias and the evolution of influenza A viruses. Codon Usage Biases of Influenza Virus

    Wong Emily HM


    Full Text Available Abstract Background The influenza A virus is an important infectious cause of morbidity and mortality in humans and was responsible for 3 pandemics in the 20th century. As the replication of the influenza virus is based on its host's machinery, codon usage of its viral genes might be subject to host selection pressures, especially after interspecies transmission. A better understanding of viral evolution and host adaptive responses might help control this disease. Results Relative Synonymous Codon Usage (RSCU values of the genes from segment 1 to segment 6 of avian and human influenza viruses, including pandemic H1N1, were studied via Correspondence Analysis (CA. The codon usage patterns of seasonal human influenza viruses were distinct among their subtypes and different from those of avian viruses. Newly isolated viruses could be added to the CA results, creating a tool to investigate the host origin and evolution of viral genes. It was found that the 1918 pandemic H1N1 virus contained genes with mammalian-like viral codon usage patterns, indicating that the introduction of this virus to humans was not through in toto transfer of an avian influenza virus. Many human viral genes had directional changes in codon usage over time of viral isolation, indicating the effect of host selection pressures. These changes reduced the overall GC content and the usage of G at the third codon position in the viral genome. Limited evidence of translational selection pressure was found in a few viral genes. Conclusions Codon usage patterns from CA allowed identification of host origin and evolutionary trends in influenza viruses, providing an alternative method and a tool to understand the evolution of influenza viruses. Human influenza viruses are subject to selection pressure on codon usage which might assist in understanding the characteristics of newly emerging viruses.

  3. Adsorption of antibiotics on microplastics.

    Li, Jia; Zhang, Kaina; Zhang, Hua


    Microplastics and antibiotics are two classes of emerging contaminants with proposed negative impacts to aqueous ecosystems. Adsorption of antibiotics on microplastics may result in their long-range transport and may cause compound combination effects. In this study, we investigated the adsorption of 5 antibiotics [sulfadiazine (SDZ), amoxicillin (AMX), tetracycline (TC), ciprofloxacin (CIP), and trimethoprim (TMP)] on 5 types of microplastics [polyethylene (PE), polystyrene (PS), polypropylene (PP), polyamide (PA), and polyvinyl chloride (PVC)] in the freshwater and seawater systems. Scanning Electron Microscope (SEM) and X-ray diffractometer (XRD) analysis revealed that microplastics have different surface characterizes and various degrees of crystalline. Adsorption isotherms demonstrated that PA had the strongest adsorption capacity for antibiotics with distribution coefficient (K d ) values ranged from 7.36 ± 0.257 to 756 ± 48.0 L kg -1 in the freshwater system, which can be attributed to its porous structure and hydrogen bonding. Relatively low adsorption capacity was observed on other four microplastics. The adsorption amounts of 5 antibiotics on PS, PE, PP, and PVC decreased in the order of CIP > AMX > TMP > SDZ > TC with K f correlated positively with octanol-water partition coefficients (Log K ow ). Comparing to freshwater system, adsorption capacity in seawater decreased significantly and no adsorption was observed for CIP and AMX. Our results indicated that commonly observed polyamide particles can serve as a carrier of antibiotics in the aquatic environment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Antibiotics for whooping cough (pertussis).

    Altunaiji, S; Kukuruzovic, R; Curtis, N; Massie, J


    Whooping cough is a highly contagious disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis, but is of uncertain benefit. To study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 1, 2007); MEDLINE (January 1966 to March 2007); EMBASE (January 1974 to March 2007). All randomised and quasi-randomised controlled trials of antibiotics for treatment of, and contact prophylaxis against, whooping cough. Three to four review authors independently extracted data and assessed the quality of each trial. Thirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; 2 investigated prophylaxis regimens. The quality of the trials was variable.Short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) in eradicating Bordetella pertussis (B. pertussis) from the nasopharynx (relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05), but had fewer side effects (RR 0.66, 95% CI 0.52 to 0.83). Trimethoprim/sulfamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. Contact prophylaxis of contacts older than six months of age with antibiotics did not significantly improve clinical symptoms or the number of cases developing culture-positive B. pertussis. Although antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.

  5. Antimicrobial biocides in the healthcare environment: efficacy, usage, policies, and perceived problems.

    Maillard, Jean-Yves


    Biocides are heavily used in the healthcare environment, mainly for the disinfection of surfaces, water, equipment, and antisepsis, but also for the sterilization of medical devices and preservation of pharmaceutical and medicinal products. The number of biocidal products for such usage continuously increases along with the number of applications, although some are prone to controversies. There are hundreds of products containing low concentrations of biocides, including various fabrics such as linen, curtains, mattresses, and mops that claim to help control infection, although evidence has not been evaluated in practice. Concurrently, the incidence of hospital-associated infections (HAIs) caused notably by bacterial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) remains high. The intensive use of biocides is the subject of current debate. Some professionals would like to see an increase in their use throughout hospitals, whereas others call for a restriction in their usage to where the risk of pathogen transmission to patients is high. In addition, the possible linkage between biocide and antibiotic resistance in bacteria and the role of biocides in the emergence of such resistance has provided more controversies in their extensive and indiscriminate usage. When used appropriately, biocidal products have a very important role to play in the control of HAIs. This paper discusses the benefits and problems associated with the use of biocides in the healthcare environment and provides a constructive view on their overall usefulness in the hospital setting.

  6. Recent updates of carbapenem antibiotics.

    El-Gamal, Mohammed I; Brahim, Imen; Hisham, Noorhan; Aladdin, Rand; Mohammed, Haneen; Bahaaeldin, Amany


    Carbapenems are among the most commonly used and the most efficient antibiotics since they are relatively resistant to hydrolysis by most β-lactamases, they target penicillin-binding proteins, and generally have broad-spectrum antibacterial effect. In this review, we described the initial discovery and development of carbapenems, chemical characteristics, in vitro/in vivo activities, resistance studies, and clinical investigations for traditional carbapenem antibiotics in the market; imipenem-cilastatin, meropenem, ertapenem, doripenem, biapenem, panipenem/betamipron in addition to newer carbapenems such as razupenem, tebipenem, tomopenem, and sanfetrinem. We focused on the literature published from 2010 to 2016. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Antibiotics and the resistant microbiome

    Sommer, Morten; Dantas, Gautam


    . Less appreciated are the concomitant changes in the human microbiome in response to these assaults and their contribution to clinical resistance problems. Studies have shown that pervasive changes to the human microbiota result from antibiotic treatment and that resistant strains can persist for years....... Additionally, culture-independent functional characterization of the resistance genes from the microbiome has demonstrated a close evolutionary relationship between resistance genes in the microbiome and in pathogens. Application of these techniques and novel cultivation methods are expected to significantly...... expand our understanding of the interplay between antibiotics and the microbiome....

  8. The Pharmacodynamics of Antibiotic Treatment

    Imran Mudassar


    Full Text Available We derive models of the effects of periodic, discrete dosing or constant dosing of antibiotics on a bacterial population whose growth is checked by nutrient-limitation and possibly by host defenses. Mathematically rigorous results providing sufficient conditions for treatment success, i.e. the elimination of the bacteria, as well as for treatment failure, are obtained. Our models can exhibit bi-stability where the infection-free state and an infection-state are locally stable when antibiotic dosing is marginal. In this case, treatment success may occur only for sub-threshold level infections.

  9. Antibiotic concentrations in intestinal mucosa.

    Malmborg, A S


    The concentrations in the intestinal mucosa after the initial dose of cefoxitin, piperacillin and clindamycin have been studied. The antibiotics were given at the induction of anesthesia as prophylaxis to patients undergoing elective colorectal surgery. The concentrations of the antibiotics in serum and intestinal mucosa taken during the operation were determined by the microbiological agar diffusion method. Therapeutic concentrations in intestinal mucosa were maintained during the major part of the operation period. The mean mucosa/serum concentration ratios were for cefoxitin 0.4, for piperacillin 0.5 and for clindamycin 1.2.

  10. Dose optimisation of antibiotics in children: application of pharmacokinetics/pharmacodynamics in paediatrics

    Downes, Kevin J.; Hahn, Andrea; Wiles, Jason; Courter, Joshua D.; Vinks, Alexander A.


    The judicious use of antibiotics to combat infections in children relies upon appropriate selection of an agent, dose and duration to maximise efficacy and to minimise toxicity. Critical to dose optimisation is an understanding of the pharmacokinetics and pharmacodynamics of available drugs. Optimal dosing strategies may take advantage of pharmacokinetic/pharmacodynamic (PK/PD) principles so that antibiotic dosing can be individualised to assure effective bacterial killing in patients who hav...

  11. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015

    Van Boeckel, Thomas P.; Martinez, Elena M.; Pant, Suraj; Gandra, Sumanth; Levin, Simon A.; Goossens, Herman


    Tracking antibiotic consumption patterns over time and across countries could inform policies to optimize antibiotic prescribing and minimize antibiotic resistance, such as setting and enforcing per capita consumption targets or aiding investments in alternatives to antibiotics. In this study, we analyzed the trends and drivers of antibiotic consumption from 2000 to 2015 in 76 countries and projected total global antibiotic consumption through 2030. Between 2000 and 2015, antibiotic consumption, expressed in defined daily doses (DDD), increased 65% (21.1–34.8 billion DDDs), and the antibiotic consumption rate increased 39% (11.3–15.7 DDDs per 1,000 inhabitants per day). The increase was driven by low- and middle-income countries (LMICs), where rising consumption was correlated with gross domestic product per capita (GDPPC) growth (P = 0.004). In high-income countries (HICs), although overall consumption increased modestly, DDDs per 1,000 inhabitants per day fell 4%, and there was no correlation with GDPPC. Of particular concern was the rapid increase in the use of last-resort compounds, both in HICs and LMICs, such as glycylcyclines, oxazolidinones, carbapenems, and polymyxins. Projections of global antibiotic consumption in 2030, assuming no policy changes, were up to 200% higher than the 42 billion DDDs estimated in 2015. Although antibiotic consumption rates in most LMICs remain lower than in HICs despite higher bacterial disease burden, consumption in LMICs is rapidly converging to rates similar to HICs. Reducing global consumption is critical for reducing the threat of antibiotic resistance, but reduction efforts must balance access limitations in LMICs and take account of local and global resistance patterns. PMID:29581252

  12. Antibiotics prescription in Nigerian dental healthcare services.

    Azodo, C C; Ojehanon, P I


    Inappropriate antibiotics prescription in dental healthcare delivery that may result in the emergence of antibiotic-resistant bacteria, is a worldwide concern. The objective of the study was to determine the antibiotics knowledge and prescription patterns among dentists in Nigeria. A total of 160 questionnaires were distributed to dentists attending continuing education courses organized by two organizations in Southern and Northern parts of Nigeria. Data analysis was done using SPSS version 17.0. A total of 146 questionnaires were returned, properly filled, out of 160 questionnaires, giving an overall response rate 91.3%. The clinical factors predominantly influenced the choice of therapeutic antibiotics among the respondents. In this study, the most commonly prescribed antibiotics among the respondents was a combination of amoxicillin and metronidazole. Of the respondents, 136 (93.2%) of them considered antibiotic resistance as a major problem in Nigeria and 102 (69.9%) have experienced antibiotics resistance in dental practice. The major reported conditions for prophylactic antibiotics among the respondents were diabetic mellitus, HIV/AIDS, history of rheumatic fever, other heart anomalies presenting with heart murmur and presence of prosthetic hip. The knowledge of adverse effects of antibiotics was greatest for tooth discoloration which is related to tetracycline. Data from this study revealed the most commonly prescribed antibiotics as a combination of amoxicillin and metronidazole. There existed gaps in prophylactic antibiotic prescription, consideration in the choice of therapeutic antibiotics and knowledge of adverse effects of antibiotics among the studied dentists.

  13. Probiotic approach to prevent antibiotic resistance.

    Ouwehand, Arthur C; Forssten, Sofia; Hibberd, Ashley A; Lyra, Anna; Stahl, Buffy


    Probiotics are live microorganisms, mainly belonging to the genera Lactobacillus and Bifidobacterium, although also strain of other species are commercialized, that have a beneficial effect on the host. From the perspective of antibiotic use, probiotics have been observed to reduce the risk of certain infectious disease such as certain types of diarrhea and respiratory tract infection. This may be accompanied with a reduced need of antibiotics for secondary infections. Antibiotics tend to be effective against most common diseases, but increasingly resistance is being observed among pathogens. Probiotics are specifically selected to not contribute to the spread of antibiotic resistance and not carry transferable antibiotic resistance. Concomitant use of probiotics with antibiotics has been observed to reduce the incidence, duration and/or severity of antibiotic-associated diarrhea. This contributes to better adherence to the antibiotic prescription and thereby reduces the evolution of resistance. To what extent probiotics directly reduce the spread of antibiotic resistance is still much under investigation; but maintaining a balanced microbiota during antibiotic use may certainly provide opportunities for reducing the spread of resistances. Key messages Probiotics may reduce the risk for certain infectious diseases and thereby reduce the need for antibiotics. Probiotics may reduce the risk for antibiotic-associated diarrhea Probiotics do not contribute to the spread of antibiotic resistance and may even reduce it.

  14. Fuel cell usage in motor vehicles

    Vellone, R.


    Much interest has been aroused by fuel cell usage in motor vehicles, since this technology seems to overcome the conventional limits by other kinds of drive, i.e. the high environmental impact of internal-combustion engines and the drawbacks of electric battery vehicles in terms of maximum operating range and battery recharge time. After 2010 its costs are expected to fall in competitive levels with internal-combustion engines [it

  15. Radionuclide usage survey 1979-80

    Woods, M.J.


    Details of a survey by the Life Sciences Working Group of the International Committee for Radionuclide Metrology (ICRM) on radionuclide usage by medical physicists in 11 countries are presented. The results indicate that the radionuclide which will be of most significance in the future will be F-18, Fe-52, Ga-67, Ga-68, Kr-81m, Tc-99m, In-111, I-123, Xe-127 and Tl-201, (U.K.)

  16. Usage of Wifi Technology for PLC Programming

    Jaromír ŠKUTA


    Full Text Available This contribution describes usage of WIFI technology for programming and parameterization of application in PLC. INSYS WLAN unit from the Microelectronics INSYS Corporation is the base of application. Software access point with using USB WIFI component WL167 is running in industrial PC. Particular PC clients are connecting into network infrastructure PLC by the help of this access point and INSYS WLAN unit. This connection allows configuring and uploading program into this PLC.

  17. Correlation matrix for quartet codon usage

    Frappat, L; Sorba, Paul


    It has been argued that the sum of usage probabilities for codons, belonging to quartets, that have as third nucleotide C or A, is independent of the biological species for vertebrates. The comparison between the theoretical correlation matrix derived from these sum rules and the experimentally computed matrix for 26 species shows a satisfactory agreement. The Shannon entropy, weakly depending on the biological species, gives further support. Suppression of codons containing the dinucleotides CG or AU is put in evidence.

  18. Problematic Internet Usage and Immune Function

    Reed, P.; Vile, R.; Osborne, L.A.; Romano, M.; Truzoli, R.


    Problematic internet use has been associated with a variety of psychological comorbidities, but it relationship with physical illness has not received the same degree of investigation. The current study surveyed 505 participants online, and asked about their levels of problematic internet usage (Internet Addiction Test), depression and anxiety (Hospital Anxiety and Depression Scales), social isolation (UCLA Loneliness Questionnaire), sleep problems (Pittsburgh Sleep Quality Index), and their ...

  19. Porflow Capabilities, Usage, History, and Testing

    Collard, L.B.


    To support closure of the Savannah River Site High Level Waste tanks, the PORFLOW computer program is being applied to predict long term movement of residual contaminants from the tanks. The PORFLOW program has greater capabilities than simpler programs that have been used previously, and PORFLOW results have been accepted by state and federal regulators throughout the United States. This document briefly discusses the PORFLOW capabilities and presents lists of reports showing PORFLOW's usage history and testing

  20. LHCb Computing Resource usage in 2017

    Bozzi, Concezio


    This document reports the usage of computing resources by the LHCb collaboration during the period January 1st – December 31st 2017. The data in the following sections have been compiled from the EGI Accounting portal: For LHCb specific information, the data is taken from the DIRAC Accounting at the LHCb DIRAC Web portal:

  1. Cost Focussed Firms and Internet Usage

    Joanne Loundes


    This paper looks at Internet usage by Australian firms that have a cost focussed competitive strategy. The data source for this analysis is the Melbourne Institute Business Survey, conducted by the Melbourne Institute of Applied Economic and Social Research. The survey was conducted in late 2001, and targeted large Australian firms. Instrumental variables estimation found that cost-focussed organizations utilised the Internet more intensively for both internal organizational activities and ex...

  2. The effect of antibiotics on diatom communities

    DeCosta, P.M.; Anil, A.C.

    Effect of antibiotics (penicillin (P), streptomycin (S) and chloramphenicol (C)) on benthic diatom communities was evaluated using a modified extinction–dilution method. The high antibiotic combinations (2PSC and PSC) reduced diatoms by 99...

  3. Assessment of antibiotic susceptibilities, genotypic characteristics ...



    Sep 28, 2011 ... Staphylococcus aureus and Salmonella Typhimurium ... This study was designed to evaluate the antibiotic susceptibilities, genotypic characteristics and ..... Distribution of reference and virulence genes among antibiotic-sensitive S. aureus (SAS), .... environmental factors such as temperature, water activity,.

  4. Antibiotic and Antimicrobial Resistance: Threat Report 2013

    ... Form Controls Cancel Submit Search The CDC Antibiotic / Antimicrobial Resistance Note: Javascript is disabled or is not ... please visit this page: About . Antibiotic / Antimicrobial Resistance About Antimicrobial Resistance Biggest Threats Emerging Drug ...

  5. Original Paper Multicenter study on antibiotic susceptibility ...

    Multicenter study on antibiotic susceptibility/resistance trends in the western region of Cameroon ... antibiotic era, IDs used to be serious threats because of lack or insufficient ...... antimicrobial use in livestock; AMR. Control., 116-122. Vandini ...

  6. What Can Be Done about Antibiotic Resistance?

    ... Us General Background: What can be done about Antibiotic Resistance? What can I do? Are antibacterial agents, such as antibacterial soaps, a solution? Are antibiotics regulated? Is there any international action on the ...

  7. Antibiotic Prescription in Danish General Practice

    Sydenham, Rikke Vognbjerg; Plejdrup Hansen, Malene; Pedersen, Line Bjørnskov


    1. Background & Aim The overall aim of the project is to describe antibiotic consumption in Danish general practice with emphasis on specific types of antibiotics. The project will shed light on the impact of microbiological diagnostic methods (MDM) on the choice of antibiotic and the project...... will explore how the GPs prescription behaviour is influenced by selected factors. Antibiotics are essential when treating potentially lethal infections. An increasing development of resistant bacteria is considered one of the primary threats to public health. The majority of antibiotics (90%) are prescribed...... from general practice. The prescription of broad-spectrum antibiotics can cause unnecessary side effects for the individual and increases the risk of development of bacteria resistant to antibiotic treatment. Both the prescription of broad-spectrum antibiotics and the level of resistant bacteria...

  8. Antibiotic Resistance in Human Chronic Periodontitis Microbiota

    Rams, Thomas E.; Degener, John E.; van Winkelhoff, Arie J.

    Background: Patients with chronic periodontitis (CP) may yield multiple species of putative periodontal bacterial pathogens that vary in their antibiotic drug susceptibility. This study determines the occurrence of in vitro antibiotic resistance among selected subgingival periodontal pathogens in

  9. Usage of the cyclotron facility local area network

    Heinzmann, H.; Peters, J.; Thow, T.J.


    Local area network of controllers at the Karlsruhe cyclotyron is shown. Experience after two years of usage is described. The system is applied controlling, data acquisition, management, databases usage

  10. Antibiotic treatment of biofilm infections

    Ciofu, Oana; Rojo-Molinero, Estrella; Macià, María D.


    Bacterial biofilms are associated with a wide range of infections, from those related to exogenous devices, such as catheters or prosthetic joints, to chronic tissue infections such as those occurring in the lungs of cystic fibrosis patients. Biofilms are recalcitrant to antibiotic treatment due ...

  11. EAMJ Antibiotic May 2010.indd


    May 1, 2010 ... ANTIBIOTIC RESISTANT SALMONELLA AND ESCHERICHIA COLI ISOLATED FROM INDIGENOUS GALLUS. DOMESTICUS IN ... in line of resistance was Amp 32.86%, followed by Aug (11.43%), low or moderate ... Salmonellaentericashould be done to identify infected flocks as a regulatory procedure.


    9 mars 2015 ... strategy to prevent the spread of this resistance. Keywords: Staphylococci; Staphylococcus aureus; Oxacillin; Antibiotic resistance; Disc diffusion. Author Correspondence, e-mail: ICID: 1142924. Journal of Fundamental and Applied Sciences. ISSN 1112-9867. Available online at.

  13. Prophylactic Antibiotics and Wound Infection

    Elbur, Abubaker Ibrahim; M.A., Yousif; El-Sayed, Ahmed S.A.; Abdel-Rahman, Manar E.


    Introduction: Surgical site infections account for 14%-25% of all nosocomial infections. The main aims of this study were to audit the use of prophylactic antibiotic, to quantify the rate of post-operative wound infection, and to identify risk factors for its occurrence in general surgery.

  14. Endophytes as sources of antibiotics.

    Martinez-Klimova, Elena; Rodríguez-Peña, Karol; Sánchez, Sergio


    Until a viable alternative can be accessible, the emergence of resistance to antimicrobials requires the constant development of new antibiotics. Recent scientific efforts have been aimed at the bioprospecting of microorganisms' secondary metabolites, with special emphasis on the search for antimicrobial natural products derived from endophytes. Endophytes are microorganisms that inhabit the internal tissues of plants without causing apparent harm to the plant. The present review article compiles recent (2006-2016) literature to provide an update on endophyte research aimed at finding metabolites with antibiotic activities. We have included exclusively information on endophytes that produce metabolites capable of inhibiting the growth of bacterial, fungal and protozoan pathogens of humans, animals and plants. Where available, the identified metabolites have been listed. In this review, we have also compiled a list of the bacterial and fungal phyla that have been isolated as endophytes as well as the plant families from which the endophytes were isolated. The majority of endophytes that produce antibiotic metabolites belong to either phylum Ascomycota (kingdom Fungi) or to phylum Actinobacteria (superkingdom Bacteria). Endophytes that produce antibiotic metabolites were predominant, but certainly not exclusively, from the plant families Fabaceae, Lamiaceae, Asteraceae and Araceae, suggesting that endophytes that produce antimicrobial metabolites are not restricted to a reduced number of plant families. The locations where plants (and inhabiting endophytes) were collected from, according to the literature, have been mapped, showing that endophytes that produce bioactive compounds have been collected globally. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Abiotic degradation of antibiotic ionophores

    Bohn, Pernille; Bak, Søren A; Björklund, Erland


    Hydrolytic and photolytic degradation were investigated for the ionophore antibiotics lasalocid, monensin, salinomycin, and narasin. The hydrolysis study was carried out by dissolving the ionophores in solutions of pH 4, 7, and 9, followed by incubation at three temperatures of 6, 22, and 28 °C f...... because they absorb light of environmentally irrelevant wavelengths....

  16. Evaluation of the understanding of antibiotic resistance among Malaysian pharmacy students at public universities: An exploratory study

    Kingston Rajiah


    Full Text Available Summary: Background: Infectious diseases are a great threat to humankind, and antibiotics are a viable proposition to numerous pathologies. However, antibiotic resistance is a global concern. Therefore, the aims of this survey were to explore the understanding and attitudes of pharmacy students regarding antibiotic use and resistance. Methods: This is a cross-sectional study conducted on final-year undergraduate pharmacy students from 5 public universities. A validated, self-administered questionnaire written in English was used to collect data. It was made up of six domains and forty-five questions. Raosoft software was used to determine the minimum required sample size. Descriptive and inferential data analyses were carried out using SPSS version 20 software. Results: Out of 346 students, only 59.5% showed a strong understanding of antibiotic usage, while 84.4% of students demonstrated a good level of understanding regarding the issue of antibiotic resistance. However, only 34.1% of students demonstrated a positive attitude toward this issue. Conclusion: This survey reveals that final-year pharmacy students at Malaysian public universities have a relatively good understanding of antibiotic resistance. However, their attitudes did not strongly correlate to their knowledge. Keywords: Antibiotic resistance, Pharmacy students, Malaysian public universities

  17. Temporal relationship between antibiotic use and respiratory virus activities in the Republic of Korea: a time-series analysis.

    Ryu, Sukhyun; Kim, Sojung; Kim, Bryan I; Klein, Eili Y; Yoon, Young Kyung; Chun, Byung Chul


    Inappropriate use of antibiotics increases resistance and reduces their effectiveness. Despite evidence-based guidelines, antibiotics are still commonly used to treat infections likely caused by respiratory viruses. In this study, we examined the temporal relationships between antibiotic usage and respiratory infections in the Republic of Korea. The number of monthly antibiotic prescriptions and the incidence of acute respiratory tract infections between 2010 and 2015 at all primary care clinics were obtained from the Korean Health Insurance Review and Assessment Service. The monthly detection rates of respiratory viruses, including adenovirus, respiratory syncytial virus, influenza virus, human coronavirus, and human rhinovirus, were collected from Korea Centers for Disease Control and Prevention. Cross-correlation analysis was conducted to quantify the temporal relationship between antibiotic use and respiratory virus activities as well as respiratory infections in primary clinics. The monthly use of different classes of antibiotic, including penicillins, other beta-lactam antibacterials, macrolides and quinolones, was significantly correlated with influenza virus activity. These correlations peaked at the 0-month lag with cross-correlation coefficients of 0.45 ( p  < 0.01), 0.46 ( p  < 0.01), 0.40 ( p  < 0.01), and 0.35 (< 0.01), respectively. Furthermore, a significant correlation was found between acute bronchitis and antibiotics, including penicillin (0.73, p  < 0.01), macrolides (0.74, p  < 0.01), and quinolones (0.45, p  < 0.01), at the 0-month lag. Our findings suggest that there is a significant temporal relationship between influenza virus activity and antibiotic use in primary clinics. This relationship indicates that interventions aimed at reducing influenza cases in addition to effort to discourage the prescription of antibiotics by physicians may help to decrease unnecessary antibiotic consumption.

  18. The determinants of the antibiotic resistance process

    Beatriz Espinosa Franco


    Full Text Available Beatriz Espinosa Franco1, Marina Altagracia Martínez2, Martha A Sánchez Rodríguez1, Albert I Wertheimer31Facultad de Estudios Superiores Zaragoza (UNAM, Mexico; 2Universidad Autónoma Metropolitana Unidad Xochimilco, Mexico; 3Temple University, Philadelphia, Pennsylvania, USABackground: The use of antibiotic drugs triggers a complex interaction involving many biological, sociological, and psychological determinants. Resistance to antibiotics is a serious worldwide problem which is increasing and has implications for morbidity, mortality, and health care both in hospitals and in the community.Objectives: To analyze current research on the determinants of antibiotic resistance and comprehensively review the main factors in the process of resistance in order to aid our understanding and assessment of this problem.Methods: We conducted a MedLine search using the key words “determinants”, “antibiotic”, and “antibiotic resistance” to identify publications between 1995 and 2007 on the determinants of antibiotic resistance. Publications that did not address the determinants of antibiotic resistance were excluded.Results: The process and determinants of antibiotic resistance are described, beginning with the development of antibiotics, resistance and the mechanisms of resistance, sociocultural determinants of resistance, the consequences of antibiotic resistance, and alternative measures proposed to combat antibiotic resistance.Conclusions: Analysis of the published literature identified the main determinants of antibiotic resistance as irrational use of antibiotics in humans and animal species, insufficient patient education when antibiotics are prescribed, lack of guidelines for treatment and control of infections, lack of scientific information for physicians on the rational use of antibiotics, and lack of official government policy on the rational use of antibiotics in public and private hospitals.Keywords: antibiotic drug resistance

  19. Antibiotics: Use and misuse in pediatric dentistry

    F C Peedikayil


    Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Most often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains. Dentists want to make their patients well and to prevent unpleasant complications. These desires, coupled with the belief that many oral problems are infectious, stimulate the prescribing of antibiotics. Good knowledge about the indications of antibiotics is the need of the hour in prescr...

  20. Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.

    Daneman, Nick; Campitelli, Michael A; Giannakeas, Vasily; Morris, Andrew M; Bell, Chaim M; Maxwell, Colleen J; Jeffs, Lianne; Austin, Peter C; Bronskill, Susan E


    Understanding the extent to which current antibiotic prescribing behaviour is influenced by clinicians' historical patterns of practice will help target interventions to optimize antibiotic use in long-term care. Our objective was to evaluate whether clinicians' historical prescribing behaviours influence the start, prolongation and class selection for treatment with antibiotics in residents of long-term care facilities. We conducted a retrospective cohort study of all physicians who prescribed to residents in long-term care facilities in Ontario between Jan. 1 and Dec. 31, 2014. We examined variability in antibiotic prescribing among physicians for 3 measures: start of treatment with antibiotics, use of prolonged durations exceeding 7 days and selection of fluoroquinolones. Funnel plots with control limits were used to determine the extent of variation and characterize physicians as extreme low, low, average, high and extreme high prescribers for each tendency. Multivariable logistic regression was used to assess whether a clinician's prescribing tendency in the previous year predicted current prescribing patterns, after accounting for residents' demographics, comorbidity, functional status and indwelling devices. Among 1695 long-term care physicians, who prescribed for 93 132 residents, there was wide variability in the start of antibiotic treatment (median 45% of patients, interquartile range [IQR] 32%-55%), use of prolonged treatment durations (median 30% of antibiotic prescriptions, IQR 19%-46%) and selection of fluoroquinolones (median 27% of antibiotic prescriptions, IQR 18%-37%). Prescribing tendencies for antibiotics by physicians in 2014 correlated strongly with tendencies in the previous year. After controlling for individual resident characteristics, prior prescribing tendency was a significant predictor of current practice. Physicians prescribing antibiotics exhibited individual, measurable and historical tendencies toward start of antibiotic treatment

  1. Empiric antibiotic prescription among febrile under-five Children in ...

    limiting viral infection and therefore, would not require antibiotics. Over prescription of antibiotics increases antibiotics exposure and development of resistance among patients. There is need to evaluate empiric antibiotic prescription in order to limit ...

  2. Trends in Antibiotic Prescribing in Adults in Dutch General Practice

    M.B. Haeseker (Michiel); N.H.T.M. Dukers-Muijrers (Nicole); C.J.P.A. Hoebe (Christian); C.A. Bruggeman (Cathrien); J.W.L. Cals (Jochen); A. Verbon (Annelies)


    textabstractBackground: Antibiotic consumption is associated with adverse drug events (ADE) and increasing antibiotic resistance. Detailed information of antibiotic prescribing in different age categories is scarce, but necessary to develop strategies for prudent antibiotic use. The aim of this

  3. Implementation of an antibiotic checklist increased appropriate antibiotic use in the hospital on Aruba

    van Daalen, Frederike Vera; Lagerburg, Anouk; de Kort, Jaclyn; Sànchez Rivas, Elena; Geerlings, Suzanne Eugenie


    No interventions have yet been implemented to improve antibiotic use on Aruba. In the Netherlands, the introduction of an antibiotic checklist resulted in more appropriate antibiotic use in nine hospitals. The aim of this study was to introduce the antibiotic checklist on Aruba, test its

  4. Shift in antibiotic prescribing patterns in relation to antibiotic expenditure in paediatrics

    Kimpen, JLL; van Houten, M.A.

    In paediatrics, antibiotics are among the most commonly prescribed drugs. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use is of growing concern and strict antibiotic policies

  5. ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

    Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A


    Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

  6. Do topical antibiotics help corneal epithelial trauma?

    King, J. W.; Brison, R. J.


    Topical antibiotics are routinely used in emergency rooms to treat corneal trauma, although no published evidence supports this treatment. In a noncomparative clinical trial, 351 patients with corneal epithelial injuries were treated without antibiotics. The infection rate was 0.7%, suggesting that such injuries can be safely and effectively managed without antibiotics. A comparative clinical trial is neither warranted nor feasible.

  7. [Antibiotic therapy in patients with renal insufficiency].

    Luckhaupt, H; Rose, K G


    For the otolaryngologist (ENT specialist), too, antibiotics are among the most frequently prescribed drugs. This article gives the essential fundamentals for the antibiotic treatment of patients with restricted kidney functions, as well as advice for antibiotic therapy in clinics and in medical practice.

  8. Overcoming the current deadlock in antibiotic research.

    Schäberle, Till F; Hack, Ingrid M


    Antibiotic-resistant bacteria are on the rise, making it harder to treat bacterial infections. The situation is aggravated by the shrinking of the antibiotic development pipeline. To finance urgently needed incentives for antibiotic research, creative financing solutions are needed. Public-private partnerships (PPPs) are a successful model for moving forward. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Antibiotic susceptibility profiles of oral pathogens

    Veloo, A. C. M.; Seme, K.; Raangs, Gerwin; Rurenga, P.; Singadji, Z.; Wekema - Mulder, G.; van Winkelhoff, A. J.


    Periodontitis is a bacterial disease that can be treated with systemic antibiotics. The aim of this study was to establish the antibiotic susceptibility profiles of five periodontal pathogens to six commonly used antibiotics in periodontics. A total of 247 periodontal bacterial isolates were tested

  10. New business models for antibiotic innovation.

    So, Anthony D; Shah, Tejen A


    The increase in antibiotic resistance and the dearth of novel antibiotics have become a growing concern among policy-makers. A combination of financial, scientific, and regulatory challenges poses barriers to antibiotic innovation. However, each of these three challenges provides an opportunity to develop pathways for new business models to bring novel antibiotics to market. Pull-incentives that pay for the outputs of research and development (R&D) and push-incentives that pay for the inputs of R&D can be used to increase innovation for antibiotics. Financial incentives might be structured to promote delinkage of a company's return on investment from revenues of antibiotics. This delinkage strategy might not only increase innovation, but also reinforce rational use of antibiotics. Regulatory approval, however, should not and need not compromise safety and efficacy standards to bring antibiotics with novel mechanisms of action to market. Instead regulatory agencies could encourage development of companion diagnostics, test antibiotic combinations in parallel, and pool and make transparent clinical trial data to lower R&D costs. A tax on non-human use of antibiotics might also create a disincentive for non-therapeutic use of these drugs. Finally, the new business model for antibiotic innovation should apply the 3Rs strategy for encouraging collaborative approaches to R&D in innovating novel antibiotics: sharing resources, risks, and rewards.

  11. [Potentialization of antibiotics by lytic enzymes].

    Brisou, J; Babin, P; Babin, R


    Few lytic enzymes, specially papaine and lysozyme, acting on the membrane and cell wall structures facilitate effects of bacitracine, streptomycine and other antibiotics. Streptomycino resistant strains became sensibles to this antibiotic after contact with papaine and lysozyme. The results of tests in physiological suspensions concern only the lytic activity of enzymes. The results on nutrient medium concern together lytic, and antibiotic activities.

  12. Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training

    Tomson, Tanja; Zary, Nabil


    Introduction. Antimicrobial resistance is a global health issue. Studies have shown that improved antibiotic prescription education among healthcare professionals reduces mistakes during the antibiotic prescription process. The aim of this study was to investigate novel educational approaches that through the use of Augmented Reality technology could make use of the real physical context and thereby enrich the educational process of antibiotics prescription. The objective is to investigate which type of information related to antibiotics could be used in an augmented reality application for antibiotics education. Methods. This study followed the Design-Based Research Methodology composed of the following main steps: problem analysis, investigation of information that should be visualized for the training session, and finally the involvement of the end users the development and evaluation processes of the prototype. Results. Two of the most important aspects in the antibiotic prescription process, to represent in an augmented reality application, are the antibiotic guidelines and the side effects. Moreover, this study showed how this information could be visualized from a mobile device using an Augmented Reality scanner and antibiotic drug boxes as markers. Discussion. In this study we investigated the usage of objects from a real physical context such as drug boxes and how they could be used as educational resources. The logical next steps are to examine how this approach of combining physical and virtual contexts through Augmented Reality applications could contribute to the improvement of competencies among healthcare professionals and its impact on the decrease of antibiotics resistance. PMID:25548733

  13. Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training

    Sokratis Nifakos


    Full Text Available Introduction. Antimicrobial resistance is a global health issue. Studies have shown that improved antibiotic prescription education among healthcare professionals reduces mistakes during the antibiotic prescription process. The aim of this study was to investigate novel educational approaches that through the use of Augmented Reality technology could make use of the real physical context and thereby enrich the educational process of antibiotics prescription. The objective is to investigate which type of information related to antibiotics could be used in an augmented reality application for antibiotics education.Methods. This study followed the Design-Based Research Methodology composed of the following main steps: problem analysis, investigation of information that should be visualized for the training session, and finally the involvement of the end users the development and evaluation processes of the prototype.Results. Two of the most important aspects in the antibiotic prescription process, to represent in an augmented reality application, are the antibiotic guidelines and the side effects. Moreover, this study showed how this information could be visualized from a mobile device using an Augmented Reality scanner and antibiotic drug boxes as markers.Discussion. In this study we investigated the usage of objects from a real physical context such as drug boxes and how they could be used as educational resources. The logical next steps are to examine how this approach of combining physical and virtual contexts through Augmented Reality applications could contribute to the improvement of competencies among healthcare professionals and its impact on the decrease of antibiotics resistance.

  14. Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training.

    Nifakos, Sokratis; Tomson, Tanja; Zary, Nabil


    Introduction. Antimicrobial resistance is a global health issue. Studies have shown that improved antibiotic prescription education among healthcare professionals reduces mistakes during the antibiotic prescription process. The aim of this study was to investigate novel educational approaches that through the use of Augmented Reality technology could make use of the real physical context and thereby enrich the educational process of antibiotics prescription. The objective is to investigate which type of information related to antibiotics could be used in an augmented reality application for antibiotics education. Methods. This study followed the Design-Based Research Methodology composed of the following main steps: problem analysis, investigation of information that should be visualized for the training session, and finally the involvement of the end users the development and evaluation processes of the prototype. Results. Two of the most important aspects in the antibiotic prescription process, to represent in an augmented reality application, are the antibiotic guidelines and the side effects. Moreover, this study showed how this information could be visualized from a mobile device using an Augmented Reality scanner and antibiotic drug boxes as markers. Discussion. In this study we investigated the usage of objects from a real physical context such as drug boxes and how they could be used as educational resources. The logical next steps are to examine how this approach of combining physical and virtual contexts through Augmented Reality applications could contribute to the improvement of competencies among healthcare professionals and its impact on the decrease of antibiotics resistance.

  15. Burnout and Humor Usage among Community College Nursing Faculty Members.

    Talbot, Laura A.


    Assesses the correlation of burnout among community college nursing faculty members and their use of humor to mediate academic stress related to burnout. Differences in burnout between high versus low humor usage respondents showed a higher sense of personal accomplishment with high humor usage. Of those with low humor usage, workload was related…

  16. Antibiotic prescription practices in six primary health centers in South Sumatra

    Sjamsuir Munaf


    Full Text Available Drug utilization study, especially antibiotic usage in therapy of mild acute upper respiratory infections and acute diarrheas has been conducted in six Primary Health Center (PHC in urban, suburban and rural area in the Province of South Sumatra.  We conducted systematic random sampling during which 15% of patients in each PHC were taken. We collected information about drug utilization from medical record of out patient in each PHC for three months period (January to March 1997. We recorded the characteristics of patients, the diagnosis, the number and type of drug (including injection used. The number of cases studied was 1781, with the average number of drug per prescription being 2.7; the percentage of cases receiving an injection was 43%, and the percentage of cases receiving antibiotic was 48%. Sixty-four percent of 1277 acute respiratory tract infections (common cold, and 79% of 140 cases of acute diarrhea received antibiotic. This study showed that there is overuse or inappropriate use of drugs, especially antibiotic for acute nonspecific diarrhea and mild acute respiratory tract infections. (Med J Indones 2005; 14: 44-9Keywords: drug utilization study, antibiotic use, acute upper respiratory infection, acute diarrhea

  17. August 2014 Phoenix pulmonary journal club: the use of macrolide antibiotics in chronic respiratory disease

    Robbins RA


    Full Text Available No abstract available. Article truncated after 150 words. This month's journal club reviewed the role of macrolide antibiotics in chronic respiratory disease. Macrolide usage was suggested from observational studies in Japan in diffuse panbroncholitis, a disorder associated with chronic respiratory infection, usually Pseudomonas aeruginosa (1. Clinical improvement was noted despite doses of antibiotics well below the minimal inhibitory concentration (MIC of the antibiotic. This suggested the antibiotic was likely working by an anti-inflammatory effect. These observations were extended to cystic fibrosis (CF where prophylactic macrolide therapy in CF patients infected with Pseudomonas has become standard therapy (2. More recently, low dose macrolide therapy has been applied to non-CF lung diseases such as chronic obstructive pulmonary disease (COPD, bronchiectasis and asthma. Time did not permit a review of all studies so a representative sample was discussed. In patients with COPD, the four randomized, placebo-controlled trials reviewed all suggested that chronic therapy with macrolide antibiotics reduced COPD exacerbations (3-5. This ...

  18. Calculation of heat-kernel coefficients and usage of computer algebra

    Bel'kov, A.A.; Lanev, A.V.; Schaale, A.


    The calculation of heat-kernel coefficients with the classical De Witt algorithm has been discussed. We present the explicit form of the coefficients up to h 5 in the general case and up to h 7 min for the minimal parts. The results are compared with the expressions in other papers. A method to optimize the usage of memory for working with large expressions on universal computer algebra systems has been proposed. 20 refs

  19. Antibiotics from bacillus subtilis AECL90 - effect of trace elements and carbohydrates on antibiotic production

    Malik, M.A.; Shaukat, G.A.; Ahmed, M.S.


    Three types of antibiotics S, X and F characteristically bioactive against staphylococcic, xanthomonas and fungi are elaborated by Bacillus Subtilis AECL 69 when grown in molasses peptone malt extract sucrose. No antibiotic production was observed when molasses was omitted from the growth medium. A mineral salt mixture was devised that could replace molasses and restore the production of antibiotics. Influence of various carbohydrates on the production of antibiotics was also studied. Mannose and mannitol had inhibitory effect on the antibiotic production. (author)

  20. Intraventricular antibiotics for bacterial meningitis in neonates.

    Shah, Sachin S; Ohlsson, Arne; Shah, Vibhuti S


    Neonatal meningitis may be caused by bacteria, especially gram-negative bacteria, which are difficult to eradicate from the cerebrospinal fluid (CSF) using safe doses of antibiotics. In theory, intraventricular administration of antibiotics would produce higher antibiotic concentrations in the CSF than intravenous administration alone, and eliminate the bacteria more quickly. However, ventricular taps may cause harm. To assess the effectiveness and safety of intraventricular antibiotics (with or without intravenous antibiotics) in neonates with meningitis (with or without ventriculitis) as compared to treatment with intravenous antibiotics alone. The Cochrane Library, Issue 2, 2007; MEDLINE; EMBASE; CINAHL and Science Citation Index were searched in June 2007. The Oxford Database of Perinatal Trials was searched in June 2004. Pediatric Research (abstracts of proceedings) were searched (1990 to April 2007) as were reference lists of identified trials and personal files. No language restrictions were applied.This search was updated in May 2011. Selection criteria for study inclusion were: randomised or quasi-randomised controlled trials in which intraventricular antibiotics with or without intravenous antibiotics were compared with intravenous antibiotics alone in neonates (antibiotics compared to the group receiving intravenous antibiotics alone (RR 3.43; 95% CI 1.09 to 10.74; RD 0.30; 95% CI 0.08 to 0.53); NNTH 3; 95% CI 2 to 13). Duration of CSF culture positivity did not differ significantly (MD -1.20 days; 95% CI -2.67 to 0.27). In one trial that enrolled infants with gram-negative meningitis and ventriculitis, the use of intraventricular antibiotics in addition to intravenous antibiotics resulted in a three-fold increased RR for mortality compared to standard treatment with intravenous antibiotics alone. Based on this result, intraventricular antibiotics as tested in this trial should be avoided. Further trials comparing these interventions are not justified in

  1. Antibiotics and common antibacterial biocides stimulate horizontal transfer of resistance at low concentrations.

    Jutkina, J; Marathe, N P; Flach, C-F; Larsson, D G J


    There is a rising concern that antibiotics, and possibly other antimicrobial agents, can promote horizontal transfer of antibiotic resistance genes. For most types of antimicrobials their ability to induce conjugation below minimal inhibitory concentrations (MICs) is still unknown. Our aim was therefore to explore the potential of commonly used antibiotics and antibacterial biocides to induce horizontal transfer of antibiotic resistance. Effects of a wide range of sub-MIC concentrations of the antibiotics cefotaxime, ciprofloxacin, gentamicin, erythromycin, sulfamethoxazole, trimethoprim and the antibacterial biocides chlorhexidine digluconate, hexadecyltrimethylammoniumchloride and triclosan were investigated using a previously optimized culture-based assay with a complex bacterial community as a donor of mobile resistance elements and a traceable Escherichia coli strain as a recipient. Chlorhexidine (24.4μg/L), triclosan (0.1mg/L), gentamicin (0.1mg/L) and sulfamethoxazole (1mg/L) significantly increased the frequencies of transfer of antibiotic resistance whereas similar effects were not observed for any other tested antimicrobial compounds. This corresponds to 200 times below the MIC of the recipient for chlorhexidine, 1/20 of the MIC for triclosan, 1/16 of the MIC for sulfamethoxazole and right below the MIC for gentamicin. To our best knowledge, this is the first study showing that triclosan and chlorhexidine could stimulate the horizontal transfer of antibiotic resistance. Together with recent research showing that tetracycline is a potent inducer of conjugation, our results indicate that several antimicrobials including both common antibiotics and antibacterial biocides at low concentrations could contribute to antibiotic resistance development by facilitating the spread of antibiotic resistance between bacteria. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Risks and benefits associated with antibiotic use for acute respiratory infections: a cohort study.

    Meropol, Sharon B; Localio, A Russell; Metlay, Joshua P


    Antibiotics are frequently prescribed for acute nonspecific respiratory infections (ARIs), presumably to avoid small risks of progression to serious bacterial illness. However, even low risks of associated adverse drug events could result in many such events at the population level. Our objective was to assess the risks and benefits of antibiotic use in a cohort of patients with ARIs, comparing outcomes of patients who were prescribed antibiotics with outcomes of patients not receiving antibiotics. We used a June 1986 to August 2006 cohort of adult patients with ARI visits from a UK primary care database. Exposure was an antibiotic prescribed with the visit. Primary outcomes were hospitalization within 15 days for (1) severe adverse drug events (hypersensitivity, diarrhea, seizure, arrhythmia, hepatic or renal failure), and (2) community-acquired pneumonia. The cohort included 1,531,019 visits with an ARI diagnosis; prescriptions for antibiotics were given in 65% of cases. The adjusted risk difference for treated vs untreated patients per 100,000 visits was 1.07 fewer adverse events (95% CI, -4.52 to 2.38; P = .54) and 8.16 fewer pneumonia hospitalizations (95% CI, -13.24 to -3.08; P = .002). The number needed to treat to prevent 1 hospitalization for pneumonia was 12,255. Compared with patients with ARI who were not treated with antibiotics, patients who were treated with antibiotics were not at increased risk of severe adverse drug events and had a small decreased risk of pneumonia hospitalization. This small benefit from antibiotics for a common ambulatory diagnosis creates persistent tension; at the societal level, physicians are compelled to reduce antibiotic prescribing, thus minimizing future resistance, whereas at the encounter level, they are compelled to optimize the benefit-risk balance for that patient.

  3. Evaluation of antibiotic prescription in the Lebanese community: a pilot study

    Nadine Saleh


    Full Text Available Background: Antibiotics are considered among the most commonly prescribed drug classes in developing countries. Inappropriate prescription of antibiotics is a major public health concern and is related to the development of antimicrobial resistance. Objective: This study aimed at assessing the appropriateness of antibiotic prescription by non-infectious disease physicians in a community setting in Lebanon. Methods: A pilot cross-sectional study was undertaken on community pharmacy patients presenting with antibiotic prescription. It was performed over a period of 4 months in different regions of Lebanon. Participants answered a questionnaire inquiring about socio-demographic characteristics, medical conditions, symptoms that required medical attention, the doctor's diagnosis, the prescribed antibiotic, and whether laboratory tests were ordered to identify the causative organism or not. Data were analyzed using SPSS 17. Results: We studied 270 patients (49.3% males and 50.7% females. This study showed that the most-prescribed antibiotics were the cephalosporins (82% and that almost half of the illnesses for which antibiotics were prescribed were respiratory tract infections (41%. The study also showed that the choice of the prescribed antibiotic was appropriate in 61.5% of the studied cases, while the prescribed dose and the duration of the treatment were inaccurate in 52 and 64% of the cases, respectively. In addition, fever seemed to be a factor that influenced the physician's prescriptions, since the choice of drug conformity to guidelines increased from 53.7% (1 day of fever to 88.9% (1 week of fever, and the dose prescription compliance to guidelines was higher (55.9% for patients suffering from fever compared to those with no fever (38.1%. Conclusion: This study showed a high prevalence of inappropriate antibiotic prescriptions in Lebanon. Therefore, actions should be taken to optimize antibiotic prescription.

  4. Effects of Antibiotics on the Growth and Physiology of Chlorophytes, Cyanobacteria, and a Diatom.

    Guo, Jiahua; Selby, Katherine; Boxall, Alistair B A


    The occurrence of antibiotics in surface waters has been reported worldwide with concentrations ranging from ng L -1 to low µg L -1 levels. During environmental risk assessments, effects of antibiotics on algal species are assessed using standard test protocols (e.g., the OECD 201 guideline), where the cell number endpoint is used as a surrogate for growth. However, the use of photosynthetic related endpoints, such as oxygen evolution rate, and the assessment of effects on algal pigments could help to inform our understanding of the impacts of antibiotics on algal species. This study explored the effects of three major usage antibiotics (tylosin, lincomycin, and trimethoprim) on the growth and physiology of two chlorophytes (Desmodesmus subspicatus and Pseudokirchneriella subcapitata), a cyanobacteria (Anabaena flos-aquae), and a diatom (Navicula pelliculosa) using a battery of parameters, including cell density, oxygen evolution rate, total chlorophyll content, carotenoids, and the irradiance-photosynthesis relationship. The results indicated that photosynthesis of chlorophytes was a more sensitive endpoint than growth (i.e., EC 50 derived based on the effects of tylosin on the growth of D. subspicatus was 38.27 µmol L -1 compared with an EC 50 of 17.6 µmol L -1 based on photosynthetic rate), but the situation was reversed when testing cyanobacteria and the diatom (i.e., EC 50 derived based on the effects of tylosin on the growth of A. flos-aquae was 0.06 µmol L -1 ; EC 50 0.33 µmol L -1 based on photosynthetic rate). The pigment contents of algal cells were affected by the three antibiotics for D. subspicatus. However, in some cases, pigment content was stimulated for P. subcapitata, N. pelliculosa, and A. flos-aquae. The light utilization efficiency of chlorophytes and diatom was decreased markedly in the presence of antibiotics. The results demonstrated that the integration of these additional endpoints into existing standardised protocols could provide

  5. Use patterns, excretion masses and contamination profiles of antibiotics in a typical swine farm, south China.

    Zhou, Li-Jun; Ying, Guang-Guo; Zhang, Rui-Quan; Liu, Shan; Lai, Hua-Jie; Chen, Zhi-Feng; Yang, Bin; Zhao, Jian-Liang


    The objective of this study was to screen the occurrence of 50 antibiotics in a typical swine farm in southern China, which includes animal feeds, waste collection and treatment systems (lagoons and anaerobic digesters), and receiving environments (vegetable fields, streams, and private wells). Nine antibiotics were found in the feeds for different stages of the development of pigs in the swine farm, at concentrations ranging from 2.37 ± 0.16 ng g(-1) (sulfamethazine) to 61 500 ± 11 900 ng g(-1) (bacitracin). 11, 17 and 15 target compounds were detected in feces, flush water, and suspended particles in the swine farm, respectively. Based on the survey of feeds and animal waste from the farm, chlortetracycline, tetracycline, bacitracin and florfenicol in the feces, flush water and suspended particles mainly originated from the feeds, while most sulfonamides, including doxycycline, oxytetracycline, fluoroquinolones, macrolides and trimethoprim, were mainly from injection and other oral routes. The daily excretion masses of antibiotics per pig calculated based on animal waste had the following order: sows (48.3 mg per day per pig), piglets (18.9 mg per day per pig), growing pigs (7.01 mg per day per pig) and finishing pigs (1.47 mg per day per pig), indicating that the usage of antibiotics (type and dosage) and excretion masses are related to the growth stage of pigs. Chlortetracycline and bacitracin are the main contributors to the total excretion mass of antibiotics from pigs at different stages of development in the farm. The waste treatment system (lagoons and anaerobic digesters) was found to be ineffective in the elimination of antibiotics. The detection of some antibiotics in the surrounding environments of the farm (the well water, stream water and vegetable field soil) was a reflection of pollution from the swine farm.

  6. Antibiotic effectiveness: balancing conservation against innovation.

    Laxminarayan, Ramanan


    Antibiotic effectiveness is a natural societal resource that is diminished by antibiotic use. As with other such assets, keeping it available requires both conservation and innovation. Conservation encompasses making the best use of current antibiotic effectiveness by reducing demand through vaccination, infection control, diagnostics, public education, incentives for clinicians to prescribe fewer antibiotics, and restrictions on access to newer, last-resort antibiotics. Innovation includes improving the efficacy of current drugs and replenishing effectiveness by developing new drugs. In this paper, I assess the relative benefits and costs of these two approaches to maintaining our ability to treat infections. Copyright © 2014, American Association for the Advancement of Science.

  7. Cloud-Based Automated Design and Additive Manufacturing: A Usage Data-Enabled Paradigm Shift.

    Lehmhus, Dirk; Wuest, Thorsten; Wellsandt, Stefan; Bosse, Stefan; Kaihara, Toshiya; Thoben, Klaus-Dieter; Busse, Matthias


    Integration of sensors into various kinds of products and machines provides access to in-depth usage information as basis for product optimization. Presently, this large potential for more user-friendly and efficient products is not being realized because (a) sensor integration and thus usage information is not available on a large scale and (b) product optimization requires considerable efforts in terms of manpower and adaptation of production equipment. However, with the advent of cloud-based services and highly flexible additive manufacturing techniques, these obstacles are currently crumbling away at rapid pace. The present study explores the state of the art in gathering and evaluating product usage and life cycle data, additive manufacturing and sensor integration, automated design and cloud-based services in manufacturing. By joining and extrapolating development trends in these areas, it delimits the foundations of a manufacturing concept that will allow continuous and economically viable product optimization on a general, user group or individual user level. This projection is checked against three different application scenarios, each of which stresses different aspects of the underlying holistic concept. The following discussion identifies critical issues and research needs by adopting the relevant stakeholder perspectives.

  8. Cloud-Based Automated Design and Additive Manufacturing: A Usage Data-Enabled Paradigm Shift

    Lehmhus, Dirk; Wuest, Thorsten; Wellsandt, Stefan; Bosse, Stefan; Kaihara, Toshiya; Thoben, Klaus-Dieter; Busse, Matthias


    Integration of sensors into various kinds of products and machines provides access to in-depth usage information as basis for product optimization. Presently, this large potential for more user-friendly and efficient products is not being realized because (a) sensor integration and thus usage information is not available on a large scale and (b) product optimization requires considerable efforts in terms of manpower and adaptation of production equipment. However, with the advent of cloud-based services and highly flexible additive manufacturing techniques, these obstacles are currently crumbling away at rapid pace. The present study explores the state of the art in gathering and evaluating product usage and life cycle data, additive manufacturing and sensor integration, automated design and cloud-based services in manufacturing. By joining and extrapolating development trends in these areas, it delimits the foundations of a manufacturing concept that will allow continuous and economically viable product optimization on a general, user group or individual user level. This projection is checked against three different application scenarios, each of which stresses different aspects of the underlying holistic concept. The following discussion identifies critical issues and research needs by adopting the relevant stakeholder perspectives. PMID:26703606

  9. Comparative evolutionary genomics of Corynebacterium with special reference to codon and amino acid usage diversities.

    Pal, Shilpee; Sarkar, Indrani; Roy, Ayan; Mohapatra, Pradeep K Das; Mondal, Keshab C; Sen, Arnab


    The present study has been aimed to the comparative analysis of high GC composition containing Corynebacterium genomes and their evolutionary study by exploring codon and amino acid usage patterns. Phylogenetic study by MLSA approach, indel analysis and BLAST matrix differentiated Corynebacterium species in pathogenic and non-pathogenic clusters. Correspondence analysis on synonymous codon usage reveals that, gene length, optimal codon frequencies and tRNA abundance affect the gene expression of Corynebacterium. Most of the optimal codons as well as translationally optimal codons are C ending i.e. RNY (R-purine, N-any nucleotide base, and Y-pyrimidine) and reveal translational selection pressure on codon bias of Corynebacterium. Amino acid usage is affected by hydrophobicity, aromaticity, protein energy cost, etc. Highly expressed genes followed the cost minimization hypothesis and are less diverged at their synonymous positions of codons. Functional analysis of core genes shows significant difference in pathogenic and non-pathogenic Corynebacterium. The study reveals close relationship between non-pathogenic and opportunistic pathogenic Corynebaterium as well as between molecular evolution and survival niches of the organism.

  10. Antibiotic prophylaxis in COPD: Why, when, and for whom?

    Miravitlles, Marc; Anzueto, Antonio


    One of the main goals of treatment of chronic obstructive pulmonary disease (COPD) is the prevention of exacerbations. Bronchodilators and anti-inflammatories are the first line therapy for treatment of COPD; however, these drugs are not effective in suppressing all infective exacerbations. In fact, the use of inhaled corticosteroids in patients with COPD and chronic bronchial infection may even increase the bacterial load in the airways and increase the risk of pneumonia. In this context, the use of long-term or intermittent antibiotic treatment has shown to prevent COPD exacerbations and hospitalizations. These effects may be achieved by reducing bacterial load in the airways in stable state and/or bronchial inflammation. The drugs more extensively studied are macrolides, followed by quinolones. The long-term use of antibiotics is associated with an increased risk of potentially serious adverse events and development of bacterial resistance. Therefore, the indication of long-term antibiotic therapy must be determined on a case by case basis taking into account the potential risks and benefits. In general, this treatment may be indicated in patients with severe or very severe COPD with frequent or severe exacerbations despite optimal pharmacological and non pharmacological treatment. These patients should be carefully monitored based on clinical and microbiological assessments. The most appropriate drug and regime administration, as well as the optimal duration of therapy are issues that still require further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Possible hepatotoxicity of chronic marijuana usage

    Paulo Borini

    Full Text Available CONTEXT: Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE: To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY: transversal study SETTING: Hospital Espírita de Marília, Marília, São Paulo, Brazil PARTICIPANTS: The study was made among 123 patients interned in the Hospital Espírita de Marília from October 1996 to December 1998, divided into 3 groups: 26 (21% using only marijuana, 83 (67.5% using marijuana and crack, and 14 (11.4% consuming marijuana and alcohol. PROCEDURES AND MAIN MEASUREMENTS: Patients were examined clinically with special emphasis on types of drugs used, drug intake route, age when consumption began, length and pattern of usage, presence of tattooing, jaundice, hepatomegaly and splenomegaly. Serum determinations of total proteins, albumin, globulin, total and fractions of bilirubin, aspartate (AST and alanine (ALT aminotransferases, alkaline phosphatase (AP, gamma-glutamyltransferase and prothrombin activity were performed. RESULTS: Among users of only marijuana, hepatomegaly was observed in 57.7% and splenomegaly in 73.1%, and slightly elevated AST (42.3%, ALT (34.6% and AP (53.8%. The three groups did not differ significantly in the prevalence of hepatomegaly, splenomegaly and hepatosplenomegaly. The group using both marijuana and alcohol showed the highest prevalence of alterations and highest levels of aminotransferases. Mean AP levels were above normal in all groups. CONCLUSIONS: Chronic marijuana usage, on its own or in association with other drugs, was associated with hepatic morphologic and enzymatic alterations. This indicates that cannabinoids are possible hepatotoxic substances.

  12. Antibiotic prescribing in dental practice in Belgium.

    Mainjot, A; D'Hoore, W; Vanheusden, A; Van Nieuwenhuysen, J-P


    To assess the types and frequency of antibiotic prescriptions by Belgian dentists, the indications for antibiotic prescription, and dentists' knowledge about recommended practice in antibiotic use. In this cross-sectional survey, dental practitioners were asked to record information about all antibiotics prescribed to their patients during a 2-week period. The dental practitioners were also asked to complete a self-administered questionnaire regarding demographic data, prescribing practices, and knowledge about antibiotic use. A random sample of 268 Belgian dentists participated in the survey. During the 2-week period, 24 421 patient encounters were recorded; 1033 patients were prescribed an antibiotic (4.2%). The median number of prescriptions per dentist for the 2 weeks was 3. Broad spectrum antibiotics were most commonly prescribed: 82% of all prescriptions were for amoxycillin, amoxycillin-clavulanic acid and clindamycin. Antibiotics were often prescribed in the absence of fever (92.2%) and without any local treatment (54.2%). The most frequent diagnosis for which antibiotics were prescribed was periapical abscess (51.9%). Antibiotics were prescribed to 63.3% of patients with periapical abscess and 4.3% of patients with pulpitis. Patterns of prescriptions were confirmed by the data from the self-reported practice. Discrepancies between observed and recommended practice support the need for educational initiatives to promote rational use of antibiotics in dentistry in Belgium.

  13. Risk assessment of antimicrobial usage in Danish pig production on the human exposure to antimicrobial resistant bacteria from pork

    Struve, Tina

    to antimicrobials are influenced by the use of antimicrobial agents, and the prudence of antimicrobial use have been emphasized since the Swann report in 1969 recommended that antibiotics used in human medicine should not be used as growth promoters in food-producing animals. In 2007, the World Health Organisation...... the human exposure to cephalosporin resistance from pork purchased in retail shops was assessed using different scenarios for the amount of antimicrobial used in the primary production. Also, farm-related factors affecting the antimicrobial usage were investigated as a part of this thesis. The thesis...... producing E. coli through the purchase of pork chops Objective 3: Identification of management factors in the Danish finishing pig production important for antimicrobial usage In Objective 1, the occurrence (presence/non-presence) of ESC producing E. coli in samples from healthy pigs at slaughter...

  14. Roflumilast Usage from 2010 to 2016

    Salvesen, Øyvind Nicolay Ulland; Davidsen, Jesper Rømhild; Pottegård, Anton


    Roflumilast, a phosphodiesterase-4-inhibitor, is marketed as add-on treatment to inhaled bronchodilators and corticosteroids in COPD patients with frequent exacerbations. Although marketed since 2010, usage pattern of roflumilast for an entire nation has not previously been explored. This study...... (OR 0.62; 95% CI 0.49-0.80). The decreasing incidence and high level of early roflumilast discontinuation could be due to lack of benefit, a low awareness of romiflulast's indication among physicians, secondary to a challenging prescribing procedure, or to adverse effects. This article is protected...

  15. An assessment of worldwide supercomputer usage

    Wasserman, H.J.; Simmons, M.L.; Hayes, A.H.


    This report provides a comparative study of advanced supercomputing usage in Japan and the United States as of Spring 1994. It is based on the findings of a group of US scientists whose careers have centered on programming, evaluating, and designing high-performance supercomputers for over ten years. The report is a follow-on to an assessment of supercomputing technology in Europe and Japan that was published in 1993. Whereas the previous study focused on supercomputer manufacturing capabilities, the primary focus of the current work was to compare where and how supercomputers are used. Research for this report was conducted through both literature studies and field research in Japan.

  16. Possible hepatotoxicity of chronic marijuana usage

    Borini, Paulo; Guimarães, Romeu Cardoso; Borini, Sabrina Bicalho


    CONTEXT: Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. OBJECTIVE: To study the occurrence of clinical and laboratory hepatic alterations in chronic marijuana users, from the use of marijuana on its own or in association with other legal or illicit drugs. TYPE OF STUDY: transversal study SETTING: Hospital Espírita de Marília, Marília, São Paulo, Braz...

  17. LSF usage for batch at CERN

    Schwickerath, Ulrich


    Contributed poster to the CHEP07. Original abstract: LSF 7, the latest version of Platform's batch workload management system, addresses many issues which limited the ability of LSF 6.1 to support large scale batch farms, such as the lxbatch service at CERN. In this paper we will present the status of the evaluation and deployment of LSF 7 at CERN, including issues concerning the integration of LSF 7 with the gLite grid middleware suite and, in particular, the steps taken to endure an efficient reporting of the local batch system status and usage to the Grid Information System

  18. Optimal Placement Algorithms for Virtual Machines

    Bellur, Umesh; Rao, Chetan S; SD, Madhu Kumar


    Cloud computing provides a computing platform for the users to meet their demands in an efficient, cost-effective way. Virtualization technologies are used in the clouds to aid the efficient usage of hardware. Virtual machines (VMs) are utilized to satisfy the user needs and are placed on physical machines (PMs) of the cloud for effective usage of hardware resources and electricity in the cloud. Optimizing the number of PMs used helps in cutting down the power consumption by a substantial amo...

  19. [Prophylactic antibiotics for immunocompromised children].

    Poirée, M; Picard, C; Aguilar, C; Haas, H


    Infections are the most common cause of morbidity and mortality in pediatric immunocompromised children. The emergence of pan-drug resistant bacteria is particularly concerning for these patients. The risk of infection can be reduced by educational rules, immunizing these patients and sometimes antibiotic prophylaxis. But the individual level of risk is very difficult to assess. Using antibiotics may lead to adverse effects such as allergic reactions, cross-reactions with other drugs, development of super-infections, pseudomembranous colitis and overall development of antibioticresistant bacterial strains. Recommendations for preventing infections in these patients exist for specific case such as inherited disorder or stem cell transplantation. In others cases it depends on physicians' habits: the increase of bacterial resistance could lead to reduce the prescriptions non evidence based and not included in official guidelines. Pneumococcal and meningococcal vaccinations might change guidelines and habits. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Bacterial biofilms and antibiotic resistance

    Liliana Caldas-Arias


    Full Text Available Biofilms give to bacteria micro-environmental benefits; confers protection against antimicrobials. Bacteria have antibiotic resistance by conventional and unusual mechanisms leading to delayed wound healing, to increase recurrent chronic infections and nosocomial contamination of medical devices. Objective: This narrative review aims to introduce the characteristics of Bacteria-biofilms, antimicrobial resistance mechanisms and potential alternatives for prevention and control of its formation. Methods: Search strategy was performed on records: PubMed / Medline, Lilacs, Redalyc; with suppliers such as EBSCO and thesaurus MeSH and DeCS. Conclusions: Knowledge and research performance of biofilm bacteria are relevant in the search of technology for detection and measuring sensitivity to antibiotics. The identification of Bacterial-biofilms needs no-traditional microbiological diagnosis.