Bacterial RecA promotes the development and transmission of antibiotic resistance genes by self-assembling into an ATPhydrolyzing filamentous homopolymer on single-stranded DNA. We report the design of a 29mer peptide based on the RecA N-terminal domain involved in intermonomer contact that inhibits RecA filament assembly with an IC 50 of 3 lM.Drug resistance is an ever-increasing problem for modern chemotherapy of bacterial infectious diseases. 1-3 Although the mechanisms that facilitate the de novo development, clonal spread, and horizontal transfer of resistance factors are not fully understood, the rapid rate at which antibiotic-resistant bacteria appear is largely due to mutations arising during stress-induced DNA repair 4-7 and gene transfer between organisms. 8,9 Recently, the bacterial RecA protein has emerged as a crucial player in these phenomena. 5-9 Interestingly, RecA has long been known to influence the ability of bacteria to overcome the metabolic
Available in vitro data, animal studies, and clinical studies do not clearly differentiate agents in the echinocandin class. Clinical data continue to support the use of echinocandins as a safe and well-tolerated treatment option for candidemia and invasive aspergillosis.
Bacillus Calmette-Guérin (BCG) is a live, attenuated strain of Mycobacterium bovis that is used to treat superficial bladder cancer. Although its use is typically associated with only mild, localized side effects, rare systemic complications can occur. Disseminated mycobacterium infections after BCG therapy have been reported in over 30 cases; however, central nervous system (CNS) infections do not commonly occur. We report a 74-year-old male who developed a M. bovis cerebellar abscess after receiving intravesical BCG infusion for bladder cancer for less than 1 year. This patient was successfully treated with antituberculosis therapy and corticosteroids. This patient case demonstrates that early-onset M bovis CNS infections can occur after BCG therapy. Patients presenting with altered mental status while on BCG therapy should be evaluated for disseminated infections.
Catheter-associated urinary tract infections are one of the most common sources of infection, accounting for up to 40% of health care-associated infections each year in the United States. Extended-spectrum β-lactamase-producing Enterobacteriaceae are frequent causes of urinary tract infections in health care settings. Prevalent use of carbapenems has led to the emergence of carbapenem-resistant Enterobacteriaceae infections, leaving clinicians with few treatment options. Reducing carbapenem use and investigating alternative options for low-severity extended-spectrum β-lactamase infections is imperative to prevent more cases of carbapenem-resistant Enterobacteriaceae. Although carbapenems are the antibiotics of choice for treating extended-spectrum β-lactamase-producing Enterobacteriaceae catheter-associated urinary tract infections, carbapenem-sparing regimens may be appropriate for treating hemodynamically stable patients with low inoculum levels. Moreover, frontline health care providers can initiate efforts to reduce the development of multidrug-resistant organisms by decresing inappropriate antibiotic use during the treatment of catheter-associated asymptomatic bacteruria, avoiding unnecessary catheterizations, and avoiding culturing urine in asymptomatic patients.
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