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Interrupting transmission and infection caused by multidrug-resistant organisms (MDROs) in healthcare settings can help mitigate the global antimicrobial resistance (AMR) crisis, reduce illness and death, increase patient safety, and extend [...]

Nontyphoidal Salmonella infections place a large burden on public health; an estimated 79 million cases of foodborne nontyphoidal Salmonella infection occurred in 2010 (1). Salmonella enterica subspecies enterica serovar Infantis [...]

According to the World Health Organization (WHO), antimicrobial resistance, which occurs when bacteria, viruses, fungi and parasites change and stop responding to medication, is one of the top 10 health [...]

Clostridioides difficile (formerly known as Clostridium difficile (1)) infection (CDI) is the world-leading cause of nosocomial antibiotic-associated diarrhea and pseudomembranous colitis. (2) Clostridioides difficile can cause a wide spectrum of [...], * Context.--Clostridioides difficile infection (CDI) is the world-leading cause of infectious nosocomial diarrhea and pseudomembranous colitis. Antibiotics are the first line of treatment against CDI despite the high likelihood of antibiotic failure and/or recurrence. More data are needed to correlate clinical variables with 16S rRNA microbiome profiles in CDI-infected patients. Objective.--To determine the relationship(s) between a patient's clinical factors and the stool bacteriome of CDI-positive patients and CDI-negative patients with diarrheal symptoms. Design.--This study used stool samples and clinical data from 358 patients with nosocomial diarrhea, who were divided by their CDI diagnosis (CDI-negative: n = 180; CDI-positive; n = 178). The stool bacteriome was profiled by amplicon deep sequencing of the 16S rRNA gene, followed by correlating clinical data. Results.--The stool bacteriome was significantly different by severity assessment regardless of CDI status. Phyla and species varied significantly by CDI diagnosis. Severity, defined as a serum white blood cell count greater than 15 cells/[micro]L and/or a creatinine level greater than 1.5 mg/dL, correlated significantly with dysbiosis of the stool bacteriome profile of CDI-positive patients compared to CDI-negative patients. Serum white blood cell count was significantly higher in patients with bacterial dysbiosis, and high levels of creatinine were associated with low bacteriome diversity. Conclusions.--Clinical severity of CDI influences the stool microbiome of infected patients. To date, this study has the largest data set comparing 16S rRNA microbiome profiles and clinical variables between CDI-infected and noninfected individuals. (Arch Pathol Lab Med. 2023;147:774-785; doi: 10.5858/ arpa.2021-0636-OA)

Introduction Hemp (Cannabis sativa L.) is an annual herbaceous plant found first in Central Asia, and then widely spread around the world (Izzo et al. 2020), well known for its [...], Many studies reported the diverse therapeutic potential of essential oils. They have a crucial role in cancer prevention and treatment. Antioxidant, antimutagenic, and antiproliferative are mechanisms involved. Also, essential oils may enhance immune function and surveillance, induce enzymes, enhance detoxification, and modulate multidrug resistance. Hemp oil, obtained from Cannabis sativa L. seeds, is known for its health-enhancing properties and bioactivity. Adult female Swiss albino mice were injected with viable Ehrlich ascites carcinoma cells (2.5 x [10.sub.6] cells/mouse), and then administered with hemp oil (20 mg/kg) daily for 10 consecutive days pre-, and then 10 days post-exposure to 6 Gy whole-body gamma irradiation. Hemp oil significantly increased Beclinl, VMP1, LC3, cytochrome c, and Bax. More interestingly, Hemp oil showed a significant decrease in Bcl2 and P13k either alone or in combination with [gamma] radiation. Finally, this study documented the possible role of hemp oil in inducing two cell death types, autophagy and apoptosis, as it may be applied as an adjuvant in cancer treatment. Key words: hemp oil, gamma radiation, Ehrlich ascites carcinoma, cytotoxicity, apoptosis, angiogenesis, histopathology

Streptococcus pyogenes, also known as group A Streptococcus (GAS), is a ubiquitous pathogen that produces an array of human disease, including focal infections (e.g., pharyngitis, pyoderma) with or without localized [...]

Introduction Optimizing the use of antibiotics is a key objective of the WHO Global action plan on antimicrobial resistance. (1) However, the lack of comprehensive evidence-based guidance for common infections [...], Guidance on the appropriate use of antibiotics for common infections is lacking in many settings. The World Health Organization (WHO) has recently released The WHO AWaRe (Access, Watch, Reserve) antibiotic book which complements the WHO Model list of essential medicines and WHO Model list of essential medicines for children. The book gives specific guidance on the empiric use of antibiotics in the model lists with a strong emphasis on the AWaRe framework, which is centred around the risk of antimicrobial resistance development associated with the use of different antibiotics. Recommendations in the book cover 34 common infections in primary and hospital care both for children and adults. The book also includes a section on the use of the last-resort Reserve antibiotics, whose use should be restricted to very selected cases when an infection is confirmed or suspected to be caused by multidrug-resistant pathogens. The book highlights the use of first-line Access antibiotics or no antibiotic care if this is the safest approach for the patient. Here we present the background behind the development of the AWaRe book and the evidence behind its recommendations. We also outline how the book could be used in different settings to help reach the WHO target of increasing the proportion of global consumption of Access antibiotics to at least 60% of total consumption. The guidance in the book will also more broadly contribute to improving universal health coverage. De nombreuses regions manquent d'encadrement relatif a l'usage d'antibiotiques pour des infections courantes. LOrganisation mondiale de la Sante (OMS) a recemment publie le Livre sur les antibiotiques AWaRe (Access, Watch, Reserve) de l'OMS, qui complete la Liste modele des medicaments essentiels ainsi que la Liste modele des medicaments essentiels destines a l'enfant, toutes deux etablies par l'OMS. Ce livre fournit des indications specifiques concernant l'usage empirique des antibiotiques dans les listes modeles en insistant sur le cadre AWaRe, qui se concentre sur le risque d'apparition d'une resistance aux antimicrobiens en lien avec le recours a differents antibiotiques. Les recommandations du livre portent sur 34 infections courantes dans les soins primaires et hospitaliers, tant chez les adultes que chez les enfants. Cet ouvrage inclut en outre une section dediee a l'utilisation en dernier recours des antibiotiques appartenant a la categorie Reserve, a employer uniquement dans des cas tres precis ou des pathogenes multiresistants constituent la cause suspectee ou averee de l'infection. Il privilegie l'emploi d'antibiotiques de premiere intention appartenant a la categorie Access, voire l'absence de recours aux antibiotiques s'il s'agit de l'approche la plus sure pour le patient. Dans le present document, nous definissons le contexte dans lequel le livre AWaRe a ete redige, ainsi que les preuves a l'origine des recommandations formulees. Nous exposons egalement dans les grandes lignes la maniere dont ce livre peut etre utilise a divers endroits pour contribuer a la realisation de l'objectif fixe par l'OMS: accroitre le pourcentage global de consommation des antibiotiques de la categorie Access afin qu'il represente au moins 60% de la consommation totale. Enfin, les conseils prodigues par l'ouvrage aideront plus generalement a ameliorer la couverture sanitaire universelle. Muchas poblaciones carecen de orientaciones sobre el uso adecuado de antibioticos para tratar las infecciones mas comunes. La Organizacion Mundial de la Salud (OMS) ha publicado recientemente El libro de antibioticos AWaRe (Access, Watch, Reserve) de la OMS, que complementa la Lista modelo de medicamentos esenciales de la OMS y la Lista modelo de medicamentos pediatricos esenciales de la OMS. El libro ofrece orientaciones especificas sobre el uso empirico de antibioticos en las listas modelo, destacando el marco AWaRe, que se centra en el riesgo de desarrollo de resistencia a los antimicrobianos asociada al uso de diferentes antibioticos. Las recomendaciones del libro abordan 34 infecciones comunes en atencion primaria y hospitalaria, tanto en ninos como en adultos. El libro tambien incluye una seccion sobre el uso de los antibioticos en la categoria Reserve (reserva) de ultimo recurso, cuyo uso se debe restringir a casos muy seleccionados cuando se confirma o se sospecha que una infeccion esta causada por patogenos multirresistentes. El libro destaca el uso de antibioticos en la categoria Access (acceso) de primera linea o la no administracion de antibioticos si este es el enfoque mas seguro para el paciente. En el presente documento, exponemos el contexto en el que se ha desarrollado el libro AWaRe y las evidencias en las que se basan sus recomendaciones. Tambien describimos como se podria utilizar el libro en diferentes contextos para ayudar a alcanzar el objetivo de la OMS de aumentar el porcentaje de consumo global de antibioticos en la categoria Access hasta al menos el 60% del consumo total. Por ultimo, las orientaciones incluidas en el libro contribuiran a mejorar la cobertura sanitaria universal de manera mas general.

Author(s): Alev Yilmaz [sup.1] [sup.2] , Alberto Caldas Afonso [sup.3] , Ipek Akil [sup.4] , Bagdagul Aksu [sup.2] [sup.1] , Harika Alpay [sup.5] , Bahriye Atmis [sup.6] [sup.7] , Ozlem [...], Background The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. Methods A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Results Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p 48 ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Conclusions Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

WHO published its first-ever guidance on wastewater and solid waste management for antibiotic manufacturing. The guidance sheds light on the important but neglected challenge of antibiotic pollution ahead of the [...]