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Keywords = excess antibiotic use

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38 pages, 4443 KiB  
Review
The Role of Plant Growth-Promoting Bacteria in Soil Restoration: A Strategy to Promote Agricultural Sustainability
by Mario Maciel-Rodríguez, Francisco David Moreno-Valencia and Miguel Plascencia-Espinosa
Microorganisms 2025, 13(8), 1799; https://doi.org/10.3390/microorganisms13081799 - 1 Aug 2025
Viewed by 414
Abstract
Soil degradation resulting from intensive agricultural practices, the excessive use of agrochemicals, and climate-induced stresses has significantly impaired soil fertility, disrupted microbial diversity, and reduced crop productivity. Plant growth-promoting bacteria (PGPB) represent a sustainable biological approach to restoring degraded soils by modulating plant [...] Read more.
Soil degradation resulting from intensive agricultural practices, the excessive use of agrochemicals, and climate-induced stresses has significantly impaired soil fertility, disrupted microbial diversity, and reduced crop productivity. Plant growth-promoting bacteria (PGPB) represent a sustainable biological approach to restoring degraded soils by modulating plant physiology and soil function through diverse molecular mechanisms. PGPB synthesizes indole-3-acetic acid (IAA) to stimulate root development and nutrient uptake and produce ACC deaminase, which lowers ethylene accumulation under stress, mitigating growth inhibition. They also enhance nutrient availability by releasing phosphate-solubilizing enzymes and siderophores that improve iron acquisition. In parallel, PGPB activates jasmonate and salicylate pathways, priming a systemic resistance to biotic and abiotic stress. Through quorum sensing, biofilm formation, and biosynthetic gene clusters encoding antibiotics, lipopeptides, and VOCs, PGPB strengthen rhizosphere colonization and suppress pathogens. These interactions contribute to microbial community recovery, an improved soil structure, and enhanced nutrient cycling. This review synthesizes current evidence on the molecular and physiological mechanisms by which PGPB enhance soil restoration in degraded agroecosystems, highlighting their role beyond biofertilization as key agents in ecological rehabilitation. It examines advances in nutrient mobilization, stress mitigation, and signaling pathways, based on the literature retrieved from major scientific databases, focusing on studies published in the last decade. Full article
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16 pages, 306 KiB  
Article
Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population
by Israel Abebrese Sefah, Dennis Komla Bosrotsi, Kwame Ohene Buabeng, Brian Godman and Varsha Bangalee
Antibiotics 2025, 14(8), 779; https://doi.org/10.3390/antibiotics14080779 (registering DOI) - 1 Aug 2025
Viewed by 199
Abstract
Background/Objectives: Antibiotic use is common among hospitalized pediatric patients. However, inappropriate use, including excessive use of Watch antibiotics, can contribute to antimicrobial resistance, adverse events, and increased healthcare costs. Consequently, there is a need to continually assess their usage among this vulnerable [...] Read more.
Background/Objectives: Antibiotic use is common among hospitalized pediatric patients. However, inappropriate use, including excessive use of Watch antibiotics, can contribute to antimicrobial resistance, adverse events, and increased healthcare costs. Consequently, there is a need to continually assess their usage among this vulnerable population. This was the objective behind this study. Methods: The medical records of all pediatric patients (under 12 years) admitted and treated with antibiotics at a Ghanaian Teaching Hospital between January 2022 and March 2022 were extracted from the hospital’s electronic database. The prevalence and appropriateness of antibiotic use were based on antibiotic choices compared with current guidelines. Influencing factors were also assessed. Results: Of the 410 admitted patients, 319 (77.80%) received at least one antibiotic. The majority (68.65%; n = 219/319) were between 0 and 2 years, and males (54.55%; n = 174/319). Ceftriaxone was the most commonly prescribed antibiotic (20.69%; n = 66/319), and most of the systemic antibiotics used belonged to the WHO Access and Watch groups, including a combination of Access and Watch groups (42.90%; n = 136/319). Neonatal sepsis (24.14%; n = 77/319) and pneumonia (14.42%; n = 46/319) were the most common diagnoses treated with antibiotics. Antibiotic appropriateness was 42.32% (n = 135/319). Multivariate analysis revealed ceftriaxone prescriptions (aOR = 0.12; CI = 0.02–0.95; p-value = 0.044) and surgical prophylaxis (aOR = 0.07; CI = 0.01–0.42; p-value = 0.004) were associated with reduced antibiotic appropriateness, while a pneumonia diagnosis appreciably increased this (aOR = 15.38; CI = 3.30–71.62; p-value < 0.001). Conclusions: There was high and suboptimal usage of antibiotics among hospitalized pediatric patients in this leading hospital. Antibiotic appropriateness was influenced by antibiotic type, diagnosis, and surgical prophylaxis. Targeted interventions, including education, are needed to improve antibiotic utilization in this setting in Ghana and, subsequently, in ambulatory care. Full article
12 pages, 722 KiB  
Review
Bacteriophages: Potential Candidates for the Dissemination of Antibiotic Resistance Genes in the Environment
by Shahid Sher, Husnain Ahmad Khan, Zaman Khan, Muhammad Sohail Siddique, Dilara Abbas Bukhari and Abdul Rehman
Targets 2025, 3(3), 25; https://doi.org/10.3390/targets3030025 - 22 Jul 2025
Viewed by 484
Abstract
The invention of antibacterial agents (antibiotics) was a significant event in the history of the human race, and this invention changed the way in which infectious diseases were cured; as a result, many lives have been saved. Recently, antibiotic resistance has developed as [...] Read more.
The invention of antibacterial agents (antibiotics) was a significant event in the history of the human race, and this invention changed the way in which infectious diseases were cured; as a result, many lives have been saved. Recently, antibiotic resistance has developed as a result of excessive use of antibiotics, and it has become a major threat to world health. ARGs are spread across biomes and taxa of bacteria via lateral or horizontal gene transfer (HGT), especially via conjugation, transformation, and transduction. This review concerns transduction, whereby bacteriophages or phages facilitate gene transfer in bacteria. Bacteriophages are just as common and many times more numerous than their bacterial prey, and these phages are much more influential in controlling the population of bacteria. It is estimated that 25% of overall genes of Escherichia coli have been copied by other species of bacteria due to the HGT process. Transduction may take place via a generalized or specialized mechanism, with phages being ubiquitous in nature. Phage and virus-like particle (VLP) metagenomics have uncovered the emergence of ARGs and mobile genetic elements (MGEs) of bacterial origins. These genes, when transferred to bacteria through transduction, confer resistance to antibiotics. ARGs are spread through phage-based transduction between the environment and bacteria related to people or animals, and it is vital that we further understand and tackle this mechanism in order to combat antimicrobial resistance. Full article
(This article belongs to the Special Issue Small-Molecule Antibiotic Drug Development)
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13 pages, 788 KiB  
Article
Pediatricians’ Perspectives on Task Shifting in Pediatric Care: A Nationwide Survey in Japan
by Masatoshi Ishikawa, Ryoma Seto, Michiko Oguro and Yoshino Sato
Healthcare 2025, 13(14), 1764; https://doi.org/10.3390/healthcare13141764 - 21 Jul 2025
Viewed by 314
Abstract
Background/Objectives: In Japan, task shifting reduces the working hours of pediatricians, who face excessive workloads. The status of task shifting under the Ministry of Health, Labor, and Welfare’s reforms remains unclear. This study aimed to evaluate the current status and barriers of [...] Read more.
Background/Objectives: In Japan, task shifting reduces the working hours of pediatricians, who face excessive workloads. The status of task shifting under the Ministry of Health, Labor, and Welfare’s reforms remains unclear. This study aimed to evaluate the current status and barriers of task shifting in pediatric care in Japan. Methods: A questionnaire survey was conducted among pediatricians working in hospitals in Japan. The results were compared with those from 2020. Results: Questionnaires were sent to 835 hospitals, and valid responses were received from 815 pediatricians in 316 hospitals (response rate: 37.8%). The largest group (31.0%) was 40–49 years, and 34.4% of the participants were women. Among the items surveyed, most pediatricians indicated “shifted” in “Patient transfer (transporting between hospitals using an ambulance)” and “Intravenous injection of antibiotics.” Most physicians believed task shifting improved care quality; 10.3% felt it worsened. The most common estimate for daily working hour reduction due to task shifting was “1 to <2 h” (44.9%). Precisely 15.8% of pediatricians believed that task shifting had “not progressed at all,” with rural areas and non-university hospitals showing lower task-shifting implementation. National university hospitals had a higher likelihood of task shifting than public hospitals. No significant associations were observed for the total hospital bed count or the number of full-time pediatricians. Conclusions: Task shifting in pediatric care remains underdeveloped. While many pediatricians support the concept and report modest reductions in working hours, actual implementation remains limited. Future efforts must address systemic, institutional, and regulatory challenges to facilitate meaningful task redistribution and improve healthcare delivery. Full article
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19 pages, 2160 KiB  
Article
Genetic Diversity and Phylogenetic Analysis Among Multidrug-Resistant Pseudomonas spp. Isolated from Solid Waste Dump Sites and Dairy Farms
by Tuhina Das, Arkaprava Das, Neha Das, Rittika Mukherjee, Mousumi Saha, Dipanwita Das and Agniswar Sarkar
Acta Microbiol. Hell. 2025, 70(3), 30; https://doi.org/10.3390/amh70030030 - 16 Jul 2025
Viewed by 357
Abstract
The excessive use of antimicrobials drives the emergence of multidrug resistance (MDR) in bacterial strains, which harbor resistance genes to survive under diverse drug pressures. Such resistance can result in life-threatening infections. The predominance of MDR Pseudomonas spp. poses significant challenges to public [...] Read more.
The excessive use of antimicrobials drives the emergence of multidrug resistance (MDR) in bacterial strains, which harbor resistance genes to survive under diverse drug pressures. Such resistance can result in life-threatening infections. The predominance of MDR Pseudomonas spp. poses significant challenges to public health and environmental sustainability, particularly in ecosystems affected by human activities. Characterizing MDR Pseudomonas spp. is crucial for developing effective diagnostic tools and biosecurity protocols, with broader implications for managing other pathogenic bacteria. Strains were diagnosed through 16S rRNA PCR and sequencing, complemented by phylogenetic analysis to evaluate local and global evolutionary connections. Antibiotic susceptibility tests revealed extensive resistance across multiple classes, with MIC values surpassing clinical breakpoints. This study examined the genetic diversity, resistance potential, and phylogenetic relationships among Pseudomonas aeruginosa strain DG2 and Pseudomonas fluorescens strain FM3, which were isolated from solid waste dump sites (n = 30) and dairy farms (n = 22) in West Bengal, India. Phylogenetic analysis reveals distinct clusters that highlight significant geographic linkages and genetic variability among the strains. Significant biofilm production under antibiotic exposure markedly increased resistance levels. RAPD-PCR profiling revealed substantial genetic diversity among the isolates, indicating variations in their genetic makeup. In contrast, SDS-PAGE analysis provided insights into the protein expression patterns that are activated by stress, which are closely linked to MDR. This dual approach offers a clearer perspective on their adaptive responses to environmental stressors. This study underscores the need for vigilant monitoring of MDR Pseudomonas spp. in anthropogenically impacted environments to mitigate risks to human and animal health. Surveillance strategies combining phenotypic and molecular approaches are essential to assess the risks posed by resilient pathogens. Solid waste and dairy farm ecosystems emerge as critical reservoirs for the evolution and dissemination of MDR Pseudomonas spp. Full article
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12 pages, 1374 KiB  
Review
Ethanol-Producing Micro-Organisms of Human Gut: A Biological Phenomenon or a Disease?
by Aladin Abu Issa, Yftach Shoval and Fabio Pace
Appl. Biosci. 2025, 4(3), 36; https://doi.org/10.3390/applbiosci4030036 - 15 Jul 2025
Viewed by 359
Abstract
The discovery that human beings may endogenously produce ethanol is not new and dates back at the end of the 19th century; recently, however, it has become clear that through the proliferation of gut microorganisms that produce ethanol from sugars or other substrates, [...] Read more.
The discovery that human beings may endogenously produce ethanol is not new and dates back at the end of the 19th century; recently, however, it has become clear that through the proliferation of gut microorganisms that produce ethanol from sugars or other substrates, blood alcohol level may be greater than 0, despite Homo sapiens sapiens lacking the enzymatic pathways to produce it. Very rarely this can lead to symptoms and/or to a disease, named gut fermentation syndrome or auto-brewery syndrome (ABS). The list of microorganisms (mostly bacteria and fungi) is very long and contains almost 100 different strains, and many metabolic pathways are involved. Endogenous ethanol production is a neglected entity, but it may be suspected in patients in whom ethanol consumption may be firmly excluded. Nevertheless, due to the growing prevalence of NAFLD (now renamed as MAFLD) worldwide, an ethanol-producing microorganism responsible for endogenous ethanol production such as Klebsiella pneumoniae or Saccharomices cerevisiae is increasingly sought in NAFLD patients, or in patients with metabolic diseases such as diabetes mellitus, obesity, or metabolic syndrome, at least in selected instances. In the absence of standard diagnostic and therapeutic guidelines, ABS requires a detailed patient history, including dietary habits, alcohol consumption, and gastrointestinal symptoms, and a comprehensive physical examination to detect unexplained ethanol intoxication. It has been proposed to start the diagnostic protocol with a standardized carbohydrate challenge test, followed, if positive, by the use of antifungal agents or antibiotics; indeed, fecal microbiota transplantation might be the only way to cure a patient with refractory ABS. Scientific societies should produce internationally agreed recommendations for ABS and other conditions linked to excessive endogenous ethanol production. Full article
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19 pages, 2255 KiB  
Article
In Vitro Characterization and Safety Assessment of Streptococcus salivarius, Levilactobacillus brevis and Pediococcus pentosaceus Isolated from the Small Intestine of Broiler Breeders
by Nwabisa Happiness Kokwe, Freedom Tshabuse and Feroz Mahomed Swalaha
Microorganisms 2025, 13(6), 1231; https://doi.org/10.3390/microorganisms13061231 - 27 May 2025
Viewed by 408
Abstract
In poultry production, antibiotics have been excessively used as growth promoters to support well-being and decrease mortality caused by pathogenic microorganisms. The overuse of antibiotics has led to the emergence of antibiotic-resistant bacteria and the presence of antibiotic residues in poultry products. To [...] Read more.
In poultry production, antibiotics have been excessively used as growth promoters to support well-being and decrease mortality caused by pathogenic microorganisms. The overuse of antibiotics has led to the emergence of antibiotic-resistant bacteria and the presence of antibiotic residues in poultry products. To counteract this problem, probiotics could be used as adjuncts or as substitutes for preserving a diverse and balanced microflora to prevent the colonization and multiplication of pathogenic bacteria in the GI tract. This study aimed to isolate and characterize the potential probiotic properties of lactic acid bacteria from the small intestine of 23-week-old broiler breeders, with the goal of identifying potential probiotic candidates. Four phenotypically healthy broiler breeders were selected, and intestinal contents were aseptically collected and cultured on MRS agar. From the initial pool of 39 colonies, six isolates were identified based on Gram-positive and catalase-negative characteristics and further classified using 16S rRNA sequencing as Levilactobacillus brevis (n = 3), Pediococcus pentosaceus (n = 2), and Streptococcus salivarius (n = 1). These strains were further evaluated for probiotic properties such as transit resistance to simulated upper gastrointestinal conditions, antagonist activity, haemolytic activity, and cell surface properties such as autoaggregation, co-aggregation and hydrophobicity, in vitro. L. brevis NKFS8 showed good tolerance to pH 3, while P. pentosaceus NKSF10 exhibited good tolerance to pH 4 acidic conditions. All isolates demonstrated good survivability in bile salt concentration of 3% (w/v), with P. pentosaceus NKSF10 exhibiting the highest tolerance. The isolates showed a wide range of antagonistic activity against the test pathogens Pseudomonas aeruginosa (ATCC 27853), Salmonella typhimurium, Salmonella enterica (ATCC 13314), Staphylococcus aureus (ATCC 29213), and Listeria monocytogenes (ATCC 7644). Furthermore, these strains exhibited good auto-aggregation, co-aggregation, and hydrophobicity properties. In conclusion, lactic acid bacteria from the small intestine of broiler breeders present a valuable prospect for the development of effective probiotics. These probiotics can be utilized as a supplementary inclusion in poultry feed, obviating the need for antibiotics as growth promoters. Nevertheless, additional in vivo studies are required to closely monitor and assess the effects of probiotics on the gastrointestinal system of chickens. Full article
(This article belongs to the Section Microbial Biotechnology)
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11 pages, 1029 KiB  
Article
Public Awareness and Perceptions of Antibiotic Use in Human and Veterinary Medicine in Serbia
by Gordana Belamarić, Dejana Vuković, Zoran Bukumirić, Rada Sandić Spaho and Gordana Marković
Antibiotics 2025, 14(5), 523; https://doi.org/10.3390/antibiotics14050523 - 19 May 2025
Viewed by 644
Abstract
Background/Objectives: Antimicrobial resistance (AMR) is a growing global health threat, requiring an approach that integrates human, animal, and environmental health. Public awareness and responsible antibiotic use are key to combating AMR. This study examines the knowledge, attitudes, and practices related to antibiotic [...] Read more.
Background/Objectives: Antimicrobial resistance (AMR) is a growing global health threat, requiring an approach that integrates human, animal, and environmental health. Public awareness and responsible antibiotic use are key to combating AMR. This study examines the knowledge, attitudes, and practices related to antibiotic use among the general population in Serbia, exploring their impact on antimicrobial stewardship efforts. Methods: A cross-sectional study was conducted in December 2022 using a three-stage stratified random sample of the Serbian population. The Eurobarometer questionnaire was utilized with permission from the European Commission. Statistical analyses included multivariate ordinal logistic regression to identify predictors of desirable attitudes and behaviors related to antibiotic use. Results: Almost two-thirds of respondents (61.6%) reported not receiving any advice on rational antibiotic use, underscoring the need for education of the general population and raising awareness. A Higher Antibiotic Knowledge Score was associated with a 60% greater likelihood of favorable attitudes and a 21% greater likelihood of rational antibiotic use. Pharmacists were identified as the primary source of antibiotic-related information for the general population in Serbia, but there is limited public interest and awareness of antibiotic use in animals, as well as of the bans on using antibiotics to stimulate growth in farm animals within the EU. Conclusions: Through targeted educational interventions, strengthening interdisciplinary collaboration and AMR control measures is necessary for human and veterinary medicine. Although pharmacists are the primary source of information about antibiotics for the population in Serbia, collaboration with physicians and their empowerment should be introduced to strengthen antimicrobial stewardship further. Full article
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16 pages, 4625 KiB  
Article
Lactobacillus Re-Engineers Gut Microbiota to Overcome E. coli Colonization Resistance in Mice
by Jianlei Jia, Pengjia Bao, Qinran Yu, Ning Li, Hao Ren, Qian Chen and Ping Yan
Vet. Sci. 2025, 12(5), 484; https://doi.org/10.3390/vetsci12050484 - 16 May 2025
Cited by 1 | Viewed by 664
Abstract
The intestinal health and functionality of animals play pivotal roles in nutrient digestion and absorption, as well as in maintaining defense against pathogenic invasions. These biological processes are modulated by various determinants, including husbandry conditions, dietary composition, and gut microbial ecology. The excessive [...] Read more.
The intestinal health and functionality of animals play pivotal roles in nutrient digestion and absorption, as well as in maintaining defense against pathogenic invasions. These biological processes are modulated by various determinants, including husbandry conditions, dietary composition, and gut microbial ecology. The excessive use of anthropogenic antibiotics may disrupt intestinal microbiota composition, potentially leading to dysbiosis that directly compromises host homeostasis. While Lactobacillus species are recognized for their immunomodulatory properties, their precise mechanisms in regulating host anti-inflammatory gene expression and influencing mucosal layer maturation, particularly regarding E. coli colonization resistance, require further elucidation. To investigate the regulatory mechanisms of Lactobacillus in relation to intestinal architecture and function during E. coli infection, we established a colonic infection model using Bal b/c mice, conducting systematic analyses of intestinal morphology, inflammatory mediator profiles, and microbial community dynamics. Our results demonstrate that Lactobacillus supplementation (Pediococcus acidilactici) effectively mitigated E. coli O78-induced enteritis, with co-administration during infection facilitating the restoration of physiological parameters, including body mass, intestinal histoarchitecture, and microbial metabolic functions. Microbiome profiling revealed that the Lactobacillus intervention significantly elevated Lactococcus abundance while reducing Weissella populations (p < 0.05), concurrently enhancing metabolic pathways related to nutrient assimilation and environmental signal processing (including translation mechanisms, ribosomal biogenesis, amino acid transport metabolism, and energy transduction systems; p < 0.05). Mechanistically, Lactobacillus administration attenuated E. coli-induced intestinal pathology through multiple pathways: downregulating pro-inflammatory cytokine expression (IL-1β, IL-1α, and TNF-α), upregulating epithelial junctional complexes (Occludin, Claudin-1, and ZO-1), and stimulating mucin biosynthesis (MUC1 and MUC2; p < 0.05). These modifications collectively enhanced mucosal barrier integrity and promoted epithelial maturation. This investigation advances our comprehension of microbiota–host crosstalk during enteropathogenic infections under probiotic intervention, offering valuable insights for developing novel nutritional strategies and microbial management protocols in animal husbandry. Full article
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9 pages, 763 KiB  
Article
Epidemiological Profile and Antibiotic Resistance in Urinary Tract Infections Among Elderly Women
by Francisco José Barbas Rodrigues, Patrícia Coelho, Sónia Mateus, João Metello and Miguel Castelo-Branco
Women 2025, 5(2), 16; https://doi.org/10.3390/women5020016 - 14 May 2025
Viewed by 465
Abstract
Urinary tract infections (UTIs) are among the most prevalent infectious diseases in older women, especially those over 65 years of age. Physiological changes related to aging, comorbidities, and frequent use of medical devices such as urinary catheters increase susceptibility. Increasing antimicrobial resistance further [...] Read more.
Urinary tract infections (UTIs) are among the most prevalent infectious diseases in older women, especially those over 65 years of age. Physiological changes related to aging, comorbidities, and frequent use of medical devices such as urinary catheters increase susceptibility. Increasing antimicrobial resistance further complicates treatment strategies. This study aims to describe the epidemiological profile of UTI in women over 65 years of age, focusing on the characterization of etiological agents, observed antimicrobial resistance patterns, and commonly reported risk factors. We conducted a retrospective analysis of microbiological and clinical data from elderly women diagnosed with UTIs. Bacterial isolates were identified and antimicrobial susceptibility profiles were evaluated over a specified period. A statistical analysis was performed to determine the prevalence of different pathogens and antibiotic resistance trends. Escherichia coli was the predominant uropathogen, consistent across different clinical scenarios and patient conditions. The four most common bacterial strains—E. coli, Klebsiella pneumoniae, Proteus mirabilis, and Enterococcus faecalis—aligned with global epidemiological data. In Escherichia coli a significant increase in resistance to nitrofurantoin was observed, possibly indicating excessive empirical use, while resistance to other antibiotics, such as amoxicillin/clavulanic acid and ertapenem, remained stable or decreased. Institutional antibiotic stewardship programs likely contributed to this trend. The study highlights E. coli as the main etiological agent in elderly women with UTIs. The observed resistance patterns emphasize the need for localized antimicrobial surveillance and personalized therapeutic approaches. Continuous microbiological monitoring and rational use of antibiotics are crucial to optimize treatment outcomes and control the development of resistance. Full article
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24 pages, 4838 KiB  
Article
Genetically Modified Mesenchymal Stromal/Stem Cells as a Delivery Platform for SE-33, a Cathelicidin LL-37 Analogue: Preclinical Pharmacokinetics and Tissue Distribution in C57BL/6 Mice
by Vagif Ali oglu Gasanov, Dmitry Alexandrovich Kashirskikh, Victoria Alexandrovna Khotina, Arthur Anatolievich Lee, Sofya Yurievna Nikitochkina, Daria Mikhailovna Kuzmina, Irina Vasilievna Mukhina, Ekaterina Andreevna Vorotelyak and Andrey Valentinovich Vasiliev
Antibiotics 2025, 14(5), 429; https://doi.org/10.3390/antibiotics14050429 - 24 Apr 2025
Viewed by 599
Abstract
Background: The genetic modification of mesenchymal stromal/stem cells (MSCs) to express antimicrobial peptides may provide a promising strategy for developing advanced cell-based therapies for bacterial infections, including those caused or complicated by antibiotic-resistant bacteria. We have previously demonstrated that genetically modified Wharton’s jelly-derived [...] Read more.
Background: The genetic modification of mesenchymal stromal/stem cells (MSCs) to express antimicrobial peptides may provide a promising strategy for developing advanced cell-based therapies for bacterial infections, including those caused or complicated by antibiotic-resistant bacteria. We have previously demonstrated that genetically modified Wharton’s jelly-derived MSCs expressing an antimicrobial peptide SE-33 (WJ-MSC-SE33) effectively reduce bacterial load, inflammation, and mortality in a mouse model of Staphylococcus aureus-induced pneumonia compared with native WJ-MSCs. The present study aimed to evaluate the pharmacokinetics and tissue distribution of the SE-33 peptide expressed by WJ-MSC-SE33 following administration to animals. Methods: WJ-MSC-SE33 were administered to C57BL/6 mice at therapeutic and excess doses. The biodistribution and pharmacokinetics of the SE-33 peptide were analyzed in serum, lungs, liver, and spleen using chromatographic methods after single and repeated administrations. Results: The SE-33 peptide exhibited dose-dependent pharmacokinetics. The highest levels of SE-33 peptide were detected in the liver and lungs, with persistence in tissues for up to 48 h at medium and high doses of administered WJ-MSC-SE33. A repeated administration of WJ-MSC-SE33 increased SE-33 levels in target organs. Conclusions: The SE-33 peptide expressed by genetically modified WJ-MSCs demonstrated predictable pharmacokinetics and effective biodistribution. These findings, together with the previously established safety profile of WJ-MSC-SE33, support its potential as a promising cell-based therapy for bacterial infections, particularly those associated with antibiotic resistance. Full article
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13 pages, 1280 KiB  
Article
Antimicrobial Therapies for Early-Onset Group B Streptococcal Sepsis: Insights from an Italian Multicenter Study
by Valeria Capone, Martina Buttera, Francesca Miselli, Serena Truocchio, Mattia Iaccheri, Cinzia Auriti, Roberta Creti, Lorenza Baroni, Luca Bedetti, Belinda Benenati, Giacomo Biasucci, Jenny Bua, Lidia Decembrino, Luisa Di Luca, Silvia Fanaro, Alessandra Foglianese, Lucia Gambini, Nicola Laforgia, Giuseppe Latorre, Sabrina Loprieno, Gianfranco Maffei, Lucia Marrozzini, Francesca Nanni, Giangiacomo Nicolini, Irene Papa, Barbara Perrone, Giancarlo Piccinini, Maria Rita Pulvirenti, Maria Paola Ronchetti, Enrico Rosati, Daniele Santori, Maria Eleonora Scapillati, Davide Scarponi, Sofia Spinedi, Tzialla Chryssoula, Caterina Vocale, Licia Lugli and Alberto Berardiadd Show full author list remove Hide full author list
Antibiotics 2025, 14(4), 410; https://doi.org/10.3390/antibiotics14040410 - 16 Apr 2025
Cited by 1 | Viewed by 735
Abstract
Background: Antimicrobial therapies used for treating group B streptococcus (GBS) early-onset sepsis (EOS) provide insight into clinicians’ adherence to antimicrobial stewardship (AMS) guidelines. Methods: We reviewed antimicrobial therapies given to treat newborns with GBS-EOS. Data were obtained from an Italian surveillance [...] Read more.
Background: Antimicrobial therapies used for treating group B streptococcus (GBS) early-onset sepsis (EOS) provide insight into clinicians’ adherence to antimicrobial stewardship (AMS) guidelines. Methods: We reviewed antimicrobial therapies given to treat newborns with GBS-EOS. Data were obtained from an Italian surveillance network (including 35 birthing centers) and were prospectively collected from 1 January 2003 to 31 December 2024. Empiric and definitive therapies were classified as adequate and inadequate. Results: There were 967,054 live births and 200 cases of GBS-EOS, of which 43 (21.5%) were preterm and 157 (78.5%) were full-term; 35 (17.5%) out of 200 showed no signs of illness. Fourteen (7.0%) died (one full-term and thirteen preterm newborns under 34 weeks of gestation). Based on the available information, antibiotics were adequate in 106/137 (77.4%) empiric and 48/119 (40.3%) definitive therapies. The duration of antibiotic courses did not differ between severe (median 10 days, IQR 8.0–14.0) and non-severe cases (median: 10 days; IQR: 10.0–12.5; p = 0.68). Antibiotic treatments lasted ≥ 15 days in 34 (20.1%) out of 169 cases with available information. Conclusions: In this large Italian multicenter study, deviations from international recommendations in antimicrobial therapies for GBS-EOS were critical. Our findings underscore the importance of timely antimicrobial de-escalation and the need to avoid excessively prolonged courses of antimicrobials. Full article
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11 pages, 191 KiB  
Article
Factors Influencing Community Pharmacists’ Participation in Antimicrobial Stewardship: A Qualitative Inquiry
by Tasneem Rizvi, Syed Tabish R. Zaidi, Mackenzie Williams, Angus Thompson and Gregory M. Peterson
Pharmacy 2025, 13(2), 56; https://doi.org/10.3390/pharmacy13020056 - 14 Apr 2025
Viewed by 836
Abstract
Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed [...] Read more.
Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed to explore the perceived barriers and enablers of community pharmacists’ participation in AMS. One-on-one semi-structured telephone interviews were conducted with a sample of community pharmacists from across Australia. Interviews were transcribed verbatim and analysed using the Framework Analysis method. Twenty community pharmacists (70% female), representing urban, regional, and remote areas of Australia participated in the study. Pharmacists identified a discord between clinical needs of patients and practice policies as the primary source of excessive prescribing and dispensing of antibiotics. The fragmented nature of the primary healthcare system in Australia was seen as limiting information exchange between community pharmacists and general practitioners about antibiotic use, that was encouraging inappropriate and, at times, unsupervised use of antibiotics. The existing community pharmacy funding model in Australia, where individual pharmacists do not benefit from any financial incentives associated with clinical interventions, was also discouraging their participation in AMS. Pharmacists suggested restricting default antibiotic repeat supplies, reducing legal validity of antibiotic prescriptions to less than the current 12 months, and adopting a treatment duration-based approach to antibiotic prescribing instead of the ‘quantity-based’ approach, where the quantity prescribed is linked to the available pack size of the antibiotic. Structural changes in the way antibiotics are prescribed, dispensed, and funded in the Australian primary care setting are urgently needed to discourage their misuse by the public. Modifications to the current funding model for pharmacist-led cognitive services are needed to motivate pharmacists to participate in AMS initiatives. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
33 pages, 3548 KiB  
Article
Analysis of ESAC-Net/EARS-Net Data from 29 EEA Countries for Spatiotemporal Associations Between Antimicrobial Use and Resistance—Implications for Antimicrobial Stewardship?
by James C. McSorley
Antibiotics 2025, 14(4), 399; https://doi.org/10.3390/antibiotics14040399 - 13 Apr 2025
Viewed by 1333
Abstract
Background/Objectives: Antimicrobial resistance is one of the foremost global health concerns of today, and it could offset much of the progress accrued in healthcare over the last century. Excessive antibiotic use accelerates this problem, but it is recognised that specific agents differ in [...] Read more.
Background/Objectives: Antimicrobial resistance is one of the foremost global health concerns of today, and it could offset much of the progress accrued in healthcare over the last century. Excessive antibiotic use accelerates this problem, but it is recognised that specific agents differ in their capacity to promote resistance, a concept recently promoted by the World Health Organisation in the form of its Access, Watch, Reserve (AWaRe) schema. Which, if any, agents should be construed as having a high proclivity for selection of resistance has been contested. The European Antimicrobial Resistance Surveillance Network (EARS-NET) and European Surveillance of Antimicrobial Consumption Network (ESAC-NET) curate population level data over time and throughout the European Economic Area (EEA). EARS-NET monitors resistance to antimicrobials amongst invasive isolates of sentinel pathogens whereas ESAC-NET tracks usage of systemic antimicrobials. Together, data from these networks were interrogated to delineate correlations between antimicrobial consumption and resistance. Methods: Using univariate and multivariate regression analyses, spatiotemporal associations between the use of specific antimicrobial classes and 14 key resistance phenotypes in five sentinel pathogens were assessed methodically for 29 EEA countries. Results: Use of second and third generation cephalosporins, extended spectrum penicillin/β-lactamase inhibitor combinations, carbapenems, fluoroquinolones, nitroimidazoles and macrolides strongly correlated with key resistance phenotypes, as did overall antimicrobial consumption. Conclusions: The data obtained mostly support the WHO AWaRe schema with critical caveats. They have the potential to inform antimicrobial stewardship initiatives in the EEA, highlighting obstacles and shortcomings which may be modified in future to minimise positive selection for problematic resistance. Full article
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
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19 pages, 2035 KiB  
Review
Chitin, Chitosan and Its Derivatives: Antimicrobials and/or Mitigators of Water
by Eva Scarcelli, Alessia Catalano, Domenico Iacopetta, Jessica Ceramella, Maria Stefania Sinicropi and Francesca Aiello
Macromol 2025, 5(2), 15; https://doi.org/10.3390/macromol5020015 - 8 Apr 2025
Viewed by 2667
Abstract
Antimicrobial resistance (AMR) is a major global health problem, exacerbated by the excessive and inappropriate use of antibiotics in human medicine, animal care and agriculture. Therefore, new strategies and compounds are needed to overcome this issue. In this view, it may be appropriate [...] Read more.
Antimicrobial resistance (AMR) is a major global health problem, exacerbated by the excessive and inappropriate use of antibiotics in human medicine, animal care and agriculture. Therefore, new strategies and compounds are needed to overcome this issue. In this view, it may be appropriate to reconsider existing biomaterials to alleviate antibiotic overuse. Chitin, a naturally abundant amino mucopolysaccharide, is a poly-β-1, 4-N-acetylglucosamine (GlcNAc). It is a white, hard, inelastic, nitrogenous polysaccharide and the major source of surface pollution in coastal areas. Chitosan derives from the partial N-deacetylation of chitin and originates from the shells of crustaceans and the fungi cell walls. It is a nontoxic natural antimicrobial polymer approved by GRAS (Generally Recognized as Safe by the United States Food and Drug Administration). Chitin and chitosan, as non-toxic biopolymers, are useful compounds for wastewater treatment to remove pollutants, such as pharmaceuticals, heavy metals and dyes. The described features make these biopolymers intriguing compounds to be investigated for their application as antibacterials. Full article
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