Desenvolvimento de métodos rápidos para deteção de drogas no meio aquático

A vasta aplicação de antibióticos em sistemas de aquacultura tem conduzido ao aparecimento de espécies microbianas resistentes, devendo ser evitada ou, se possível, minimizada. A minimização implica um controlo muito rigoroso das doses aplicadas, algo que só pode ser realizado se todo o processo analítico for simples, barato e puder ser implementado no local. O presente trabalho descreve para este efeito um sistema sensor constituído por papel quimicamente modificado, cujo procedimento analítico foi semelhante à monitorização de pH através das conhecidas tiras indicadoras de pH universal. O papel foi modificado com base em reacções de monocamadas e assumiu uma coloração típica após contacto com o antibiótico. A intensidade da coloração estava também relacionada com a concentração desse antibiótico. Como prova deste conceito, o sensor proposto foi desenhado tendo em vista a monitorização de oxitetraciclina, um dos antibióticos utilizados neste contexto com elevada frequência. A modificação do papel foi baseada na alteração química das unidades de glucose na matriz sólida por reacção covalente com reagentes apropriados. Foram utilizadas duas estratégias diferentes para este efeito: uma foi baseada em reacções de tipo sol-gel e a outra em reacção de adição nucleófila. Posteriormente, o papel foi modificado com espécies metálicas capazes de mudar de cor na presença da oxitetraciclina. Estas modificações químicas foram avaliadas e optimizadas relativamente a vários parâmetros, no sentido de promover uma variação de cor intensa face à concentração de antibiótico. Procedeu-se ainda ao controlo desta modificação por técnicas de espectroscopia de infravermelho. A variação de cor foi avaliada por comparação visual, mas registada por imagem digital. Os materiais sensores preparados foram ainda caracterizados do ponto de vista do seu desempenho analítico. Incluíram-se aqui a identificação de uma relação linear entre coordenadas de cor e concentração, a atribuição de uma gama de concentrações capaz de fornecer uma resposta previsível e resposta cruzada face a outros antibióticos. Procedeu-se ainda à aplicação dos sensores numa amostra de água ambiental dopada com antibiótico. De uma forma geral, foi possível estabelecer um processo simples de modificação de papel capaz de aferir a presença e a quantidade de tetraciclinas, mais concretamente a oxitetraciclina. O processo aqui estabelecido é promissor, antevendo a concretização de uma metodologia simples, barata e local para a monitorização de anitbióticos em águas.

Desenvolvimento de sensores colorimétricos para despiste de antibióticos

introdução de drogas que assegurem o crescimento e a preservação das espécies, mas que eventualmente se espalham para o meio aquático envolvente, promovendo alterações da biodiversidade e entrar, directamente ou indirectamente, na cadeia alimentar. Quando estas drogas são agentes antimicrobianos de uso humano, tais como a amoxicilina, tetraciclina ou sulfonamidas, há um alto risco de aparecimento de espécies bacterianas resistentes, algo que constitui uma ameaça grave para a saúde pública. Esta introdução de agentes antimicrobianos no ambiente aquático através do sector das pescas pode ser reduzida através da monitorização regular ou contínua dos níveis de antibióticos no sistema de água, durante a execução, bem como antes da descarga para o meio aquático. Para isso, é necessário métodos analíticos que permitam uma frequência analítica elevada e continua, nos tanques de cultivos dos peixes. O presente trabalho descreve para este efeito, um sensor constituído por papel quimicamente modificado por reações em monocamadas, assumindo uma coloração típica após contacto com o antibiótico . A intensidade da coloração estava relacionada com a concentração desse antibiótico. A modificação do papel foi baseada na alteração química das unidades de glucose do papel por meio de uma reação covalente com reagentes apropriados. De seguida, criou-se uma camada de quitosano sobre o papel modificado onde se adsorveu a espécie metálica capaz de mudar de cor na presença de sulfadiazina. As modificações resultantes foram avaliadas em relação a vários parâmetros, com o intuito de provocar uma variação de cor intensa face à concentração de antibiótico. Os sensores preparados foram caracterizados do ponto de vista do seu desempenho analítico, efetuou-se a construção de uma gama de concentração que permitiu obter uma resposta previsível e transversal em relação a outros antibióticos, bem como a identificação de uma relação linear entre concentração e coordenadas de cor e a aplicação de sensores em amostra de água ambiental dopados com antibiótico. Generalizando, foi possível estabelecer um processo de modificação simples de papel capaz de medir a presença e quantidade de sulfadiazina

An optimization model for antibiotic use

There is a positive correlation between the intensity of use of a given antibiotic and the prevalence of resistant strains. The more you treat, more patients infected with resistant strains appears and, as a consequence, the higher the mortality due to the infection and the longer the hospitalization time. In contrast, the less you treat, the higher the mortality rates and the longer the hospitalization time of patients infected with sensitive strains that could be successfully treated. The hypothesis proposed in this paper is an attempt to solve such a conflict: there must be an optimum treatment intensity that minimizes both the additional mortality and hospitalization time due to the infection by both sensitive and resistant bacteria strains. In order to test this hypothesis we applied a simple mathematical model that allowed us to estimate the optimum proportion of patients to be treated in order to minimize the total number of deaths and hospitalization time due to the infection in a hospital setting. (C) 2007 Elsevier Inc. All rights reserved.

Development of paper-based color test-strip for drug detection in aquatic environment: Application to oxytetracycline

The wide use of antibiotics in aquaculture has led to the emergence of resistant microbial species. It should be avoided/minimized by controlling the amount of drug employed in fish farming. For this purpose, the present work proposes test-strip papers aiming at the detection/semi-quantitative determination of organic drugs by visual comparison of color changes, in a similar analytical procedure to that of pH monitoring by universal pH paper. This is done by establishing suitable chemical changes upon cellulose, attributing the paper the ability to react with the organic drug and to produce a color change. Quantitative data is also enabled by taking a picture and applying a suitable mathematical treatment to the color coordinates given by the HSL system used by windows. As proof of concept, this approach was applied to oxytetracycline (OXY), one of the antibiotics frequently used in aquaculture. A bottom-up modification of paper was established, starting by the reaction of the glucose moieties on the paper with 3-triethoxysilylpropylamine (APTES). The so-formed amine layer allowed binding to a metal ion by coordination chemistry, while the metal ion reacted after with the drug to produce a colored compound. The most suitable metals to carry out such modification were selected by bulk studies, and the several stages of the paper modification were optimized to produce an intense color change against the concentration of the drug. The paper strips were applied to the analysis of spiked environmental water, allowing a quantitative determination for OXY concentrations as low as 30 ng/mL. In general, this work provided a simple, method to screen and discriminate tetracycline drugs, in aquaculture, being a promising tool for local, quick and cheap monitoring of drugs.

Paper de l’ Haemophilus influenzae en les exacerbacions de la Malaltia Pulmonar Obstructiva Crònica (MPOC): tipificació molecular i factors de virulència

Objetivos: 1.-Identificar los factores clínicos y microbiológicos que ayuden a predecir la aparición de exacerbaciones en la EPOC. 2.-Diagnóstico y cuantificación de las especies bacterianas aisladas en esputo (fase de exacerbación y estable) .3.- Tipificación genotípica secuencial de las cepas de H. influenzae y P. aeruginosa. 4.- Impacto del tratamiento antibiótico en la aparición de resistencias en estos patógenos. 5.- Diseño: Estudio prospectivo (3 años). Ámbito del estudio: Hospital Universitario de tercer nivel. Pacientes con EPOC grave atendidos en la Consulta Monográfica de EPOC del Servicio de Neumología. Métodos microbiológicos: Cuantificación de la carga bacteriana en muestras respiratorias en fase estable y en exacerbación. Estudio de la sensibilidad “in vitro”. Tipificación molecular (PFGE y MLST) de H. influenzae y P. aeruginosa. Estudio de los genes de virulencia de H. influenzae mediante PCR. Resultados: Desde Febrero de 2010 a Julio de 2011 se han incluido 77 pacientes. Los microorganismos más frecuentemente aislados en fase de exacerbación fueron: P. aeruginosa (29.3%), H. influenzae (15.92%), M. catarrhalis (12.74%), S. pneumoniae (10.19%) y S. aureus (5.10%). En los 88 episodios por P. aeruginosa se detectaron 38 genotipos diferentes. En los 41 episodios por H. influenzae se detectaron 39 genotipos diferentes. El 10% de los episodios fueron polimicrobianos. Los episodios de EAEPOC y de fase estable tuvieron una distribución de microorganismos similar. Sin embargo, cuando se cuantificaron las cargas bacterianas fueron mayores en EAEPOC (intervalo 4x107 -2x108) que en fase estable (intervalo 2x105 -4x107). Conclusiones: El genotipo de las cepas de P. aeruginosa y H. influenzae aisladas en EAEPOC difieren de un paciente a otro, sin embargo la mayoría de los episodios de cada paciente están causados por un genotipo único.

Antibiotic prophylaxis to prevent local infection in oral surgery: use or abuse?

Antibiotics have a well-documented efficacy in the treatment of established infections and as prophylactic agents in medically compromised patients. However, the systematic administration of antibiotics to prevent local infections in fit patients is much more controversial. The aim of this paper is to reflect on the justification for prophylactic usage of antibiotics to prevent wound infection and to reason out the most appropriate antibiotic guidelines taking into account available scientific data and studies by other authors. Numerous clinical trials question the efficacy of antibiotics in preventing wound infection. While some studies establish that antibiotics reduce the incidence of postoperative infections, others compare their efficacy to that of placebo. Thus, scientific literature suggests that every oral surgical intervention is not tributary of systematic antibiotic prophylaxis to prevent local infections. Intrinsic surgical risk factors and the patient"s individual circumstances must be taken into account. Even though the efficacy of other antibiotics cannot be ruled out due to our limited comprehension of the bacteriologic interrelations intervening in the pathogenesis of postextraction local infection, the amoxicillin-clavulanic acid combination theoretically covers the complete odontogenic bacterial spectrum in Spain. When the prophylactic use of antibiotics is indicated, this should be performed preoperatively, at high doses, and its extent should not exceed 24 hours. Special attention should be paid to antiinfectious local measures that can minimize infection risk during the wound"s healing period

Multiple Antibiotic Resistances of Vibrio Isolates from Coastal and Brackish Water Areas

An experiment was designed to assess the occurrence of multiple antibiotic resistances in Vibrio sp from different (brackish and marine) environments. Water samples front nine marine landing sites and two coastal inland aquaculture farms were screened for the Vibrio spp and assessed their resistance to twenty-two different antibiotics, which arc commonly encountered in the aquatic ecosystem. Tissue samples (shrimp, mussel and sepia) were tested from the sampling site with highest antibiotic resistance. Of' the total 119 Vibrio isolates, 16. 8% were susceptible to all antibiotics. Of the resistant (83.19%) Vibrio strains, 30.3% were resistant against three antibiotics, 55.5% were resistant against 4-10 antibiotics, 14.14% were resistant against more than 10 antibiotics and 54% have shown multiple antibiotics resistance (MAR). Antibiotic resistance index was higher in Coastal 3, 6, Aqua farm 2 in isolates from water samples and all the tissues tested. Interestingly, incidence of antibiotic resistance in isolates from water samples was comparatively lower in aquaculture farms than that observed in coastal areas. Highest incidence of antibiotic resistance was evident against Amoxycillin, Ampicillin, Carbencillin and Cefuroxime followed by Rilanipicin and Streptomycin and lowest against Chloramphenicol, Tetracycline, Chlortetracycline, Furazolidone, Nalidixic acid, Gentamycin Sulphafurazole, Trimcthoprinr, Neomycin and Amikacin irrespective of the sampling sites. Results from various tissue samples collected from the sites of highest antibiotic resistance indicated that antibiotic resistance Vibrio spp collected from fish and tissue samples were higher than that of water samples. Overall results indicated that persistent use of antibiotics against diseases in human beings and other life forms may pollute the aquatic system and their impact on developing antibiotic resistant Vibrio sp may be a serious threat in addition to the use of antibiotics in aquaculture farms.

Multiple Antibiotic Resistances of Vibrio Isolates from Coastal and Brackish Water Areas

An experiment was designed to assess the occurrence of multiple antibiotic resistances in Vibrio sp from different (brackish and marine) environments. Water samples front nine marine landing sites and two coastal inland aquaculture farms were screened for the Vihrio spp and assessed their resistance to twenty-two different antibiotics, which arc commonly encountered in the aquatic ecosystem. Tissue samples (shrimp, mussel and sepia) were tested from the sampling site with highest antibiotic resistance. Of' the total 119 Vihrio isolates, 16. 8'7(, were susceptible to all antibiotics. Of the resistant (83.19%) Vibrio strains, 30.3% were resistant against three antibiotics, 55.5% were resistant against 4-10 antibiotics, 14.14% were resistant against more than 10 antibiotics and 54% have shown multiple antibiotics resistance (MAR). Antibiotic resistance index was higher in Coastal 3, 6, Aqua farm 2 in isolates from water samples and all the tissues tested. Interestingly, incidence of antibiotic resistance in isolates from water samples was comparatively lower in aquaculture farms than that observed in coastal areas. Highest incidence of antibiotic resistance was evident against Amoxycillin, Ampicillin, Carbencillin and Cefuroxime followed by Rilanipicin and Streptomycin and lowest against Chloramphenicol, Tetracycline, Chlortetracycline, Furazolidone, Nalidixic acid, Gentamycin Sulphafurazole, Trimcthoprinr, Neomycin and Amikacin irrespective of the sampling sites. Results from various tissue samples collected from the sites of highest antibiotic resistance indicated that antibiotic resistance Vibrio spp collected from fish and tissue samples were higher than that of water samples. Overall results indicated that persistent use of antibiotics against diseases in human beings and other life forms may pollute the aquatic system and their impact on developing antibiotic resistant Vibrio sp may be a serious threat in addition to the use of antibiotics in aquaculture farms.

The multiple antibiotic resistance (mar) locus and its significance

Chromosomally encoded systems involved in low level resistance of bacteria to different classes of antibiotics (mainly beta-lactams, chloramphenicol, quinolones and tetracycline), disinfectants and in resistance to organic solvents have been the focus of considerable interest in recent years. The multiple antibiotic resistance (mar) locus of Escherichia coli and Salmonella is perhaps the best described system involved in this type of resistance which is induced by MarA, the activator protein encoded by the marRAB locus. The mar-locus is reported to mediate resistance primarily by up-regulating efflux of some antibiotics, disinfectants and organic solvents via the AcrAB-TolC efflux pump and down regulating influx through Outer Membrane Protein F (OmpF). Whilst the level of antibiotic resistance conferred by marRAB is only low level, there are increasing data to suggest that marRAB and related systems are important in clinical antibiotic resistance, possibly as a 'stepping stone' to higher levels of resistance. Other related systems include up-regulation of RobA, SoxS and AcrAB which give rise to a similar resistance phenotype to that conferred by up-regulation of MarA. The aim of this paper is to review the function and significance of the mar-locus and related systems with a particular focus on its implications in veterinary medicine. (C) 2002 Published by Elsevier Science Ltd.

Polymeric electro-mechanic devices applied to antibiotic-controlled release

Polymeric electroactive blends formed by electropolymerized aniline inside a non-conductive polyacrylamide porous matrix were already shown as suitable materials for the electrocontrolled release of model compounds like safranin. In this paper the intermolecular interactions between the two components of the blend are put in evidence by Raman spectroscopy measurements. Also, in situ optical microscopy was used to follow changes occurring in the polyaniline/polyacrylamide blend during pyrocathecol violet release tests. These two sets of experiments show the possibility of controlling electrochemically the release of both, safranin (a cation) and pyrocathecol violet (an anion) and allow to infer a release mechanism based on the electromechanical properties of the blends explaining the dependence of the release kinetics on the applied potential. Tetracycline release curves for different potentials and pHs are shown and the obtained profiles are in agreement with those expected for a device acting as an electrochemically driven pump due to the artificial muscle properties of the conducting phase of the blends. (c) 2007 Elsevier B.V. All rights reserved.

Calcium hydroxide and a corticosteroid-antibiotic association as dressings in cases of biopulpectomy. A comparative study in dogs' teeth.

The subject of this paper was to study the behavior of the periapical tissues of dogs' teeth after biopulpectomy and dressing with calcium hydroxide or a corticosteroid-antibiotic association, before root canal filling with zinc oxide eugenol (ZOE) or Sealapex sealers. The teeth were overinstrumented and dressed for 7 days before the root canal filling. The animals were sacrificed 180 days after treatment and the specimens were prepared for morphological analysis. Specimens treated with Sealapex presented a higher number of cases with biological closure than ZOE. When the root canals were filled with ZOE, better results were observed with the use of the Ca(OH)2 dressing.

Antibiotic prophylaxis for third molar extraction in healthy patients: current scientific evidence

Third molar extraction is one of the most frequently performed procedures in the dental clinic, and it is associated with innumerable trans- and postoperative complications, such as pain, trismus, edema, localized alveolar osteitis, and surgical site infection. Some authors advocate the use of local or systemic antibiotics to reduce the incidence of these postoperative complications. However, several studies have revealed an insignificant gain after using antibiotics. Despite the risks of allergic reactions, toxicity, and the development of resistant microorganisms, about 50% of dentists routinely prescribe the use of prophylactic antibiotics for this purpose. The goal of this paper is to evaluate the scientific evidence that justifies antibiotic prescription to healthy patients undergoing third molar extraction.

Importance of antibiotic class to the development of Clostridium difficile infection (CDI) in adults: A systematic review

C. difficile causes gastrointestinal infections in humans, including severe diarrhea. It is implicated in 20%-30% of cases of antibiotic-associated diarrhea, in 50%-70% of cases of antibiotic-associated colitis, and in >90% of cases of antibiotic-associated pseudomembranous colitis. Exposure to antimicrobial agent, hospitalization and age are some of the risk factors that predispose to CDI. Virtually all hospitalized patients with nosocomially-acquired CDI have a history of treatment with antimicrobials or neoplastic agent within the previous 2 months. The development of CDI usually occurs during treatment with antibiotics or some weeks after completing the course of the antibiotics. ^ After exposure to the organism (often in a hospital), the median incubation period is less than 1 week, with a median time of onset of 2days. The difference in the time between the use of antibiotic and the development of the disease relate to the timing of exogenous acquisition of C. difficile. ^ This paper reviewed the literature for studies on different classes of antibiotics in association with the rates of primary CDI and RCDI from the year 1984 to 2012. The databases searched in this systematic review were: PubMed (National Library of Medicine) and Medline (R) (Ovid). RefWorks was used to store bibliographic data. ^ The search strategy yielded 733 studies, 692 articles from Ovid Medline (R) and 41 articles from PubMed after removing all duplicates. Only 11 studies were included as high quality studies. Out of the 11 studies reviewed, 6 studies described the development of CDI in non-CDI patients taking antibiotics for other purposes and 5 studies identified the risk factors associated with the development of recurrent CDI after exposure to antibiotics. ^ The risk of developing CDI in non-CDI patients receiving beta lactam antibiotics was 2.35%, while fluoroquinolones, clindamycin/macrolides and other antibiotics were associated with 2.64%, 2.54% and 2.35% respectively. Of those who received beta lactam antibiotic, 26.7% developed RCDI, while 36.8% of those who received any fluoroquinolone developed RCDI, 26.5% of those who received either clindamycin or macrolides developed RCDI and 29.1% of those who received other antibiotics developed RCDI. Continued use of non-C. difficile antibiotics especially fluoroquinolones was identified as an important risk factor for primary CDI and recurrent CDI. ^

Antibiotic treatment for intermittent bladder catheterisation with once daily prophylaxis (the AnTIC study) : Study protocol for a randomised controlled trial

Funder statement This article/paper/report presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the UK Government’s Department of Health. Acknowledgements We would like to acknowledge Dr Graeme MacLennan, Mr Simon Skene, Mr Julian Shah and Dr Nadine Dougall (past member) for their valuable contribution to the study as DMC members. We would like to thank Professor Chris Butler, Dr Emma Hall, Mr Roland Morley, Mr Dan Wood, Ms Jane Laws and Ms Sarah Bittlestone for their oversight of the AnTIC study as members of the TSC, and we would like to thank Ms Heather Armstrong for her contributions as a patient group representative. We thank all Principal Investigators and site staff for their commitment in recruitment for the AnTIC study. Finally, we would like to thank Hazel Wilde for secretarial support. The trial is funded by the NIHR Health Technology Assessment Programme (project reference: 11-72-01) and will be published in full in the Health Technology Assessment journal series. The authors also acknowledge the support of the National Institute for Health Research through the Comprehensive Clinical Research Network.

Predictors of an antibiotic prescription by GPs for respiratory tract infections: a pilot

Background. Antibiotics are over-prescribed for respiratory tract infections in Australia. Objectives. The aim of this study was to describe the clinical predictors of GPs' prescribing of antibiotics. Methods. We used Clinical Judgment Analysis to study the responses of GPs to hypothetical paper-based vignettes of a 20-year-old with a respiratory tract infection. The nature of four symptoms and signs (colour of nasal mucous discharge; soreness of the throat; presence of fever; and whether any cough was productive of sputum) was varied and their effect on prescribing measured using logistic regression. Results. Twenty GPs participated. The nature of each symptom and sign significantly predicted prescribing of an antibiotic. Cough productive of yellow sputum; presence of sore throat; fever; and coloured nasal mucus increased the probability of an antibiotic being prescribed. Conclusions. GPs are influenced by clinical signs and symptoms to use antibiotics for respiratory infections for which there is poor evidence of efficacy from the literature.