Multidrug-Resistant Infections in the Developing World

Singh, Prachi; Holmen, Jenna

doi:10.1016/j.pcl.2021.09.003

Cited by 8 publications

(10 citation statements)

References 65 publications

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“…In two cases, MDR-GNB colonization may have affected the escalation of the antibiotic therapy with carbapenems, even though MDROs were not detected in any respiratory specimen. The evolving proportion of MDRO in pediatric patients complicates antibiotic therapies in an increasing number of cases [ 54 , 55 ]. Attending physicians tend to “err on the side of caution” in patients colonized with MDR bacteria and primarily use broad-spectrum antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Lower Respiratory Tract Infections in Pediatric Patients with Severe Neurological Impairments: Clinical Observations and Perspectives in a Palliative Care Unit

et al. 2022

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Pediatric palliative care (PPC) patients with a severe neurologic impairment (SNI) suffer considerable morbidity and increased mortality from lower respiratory tract infections (LRTIs). The indication and choice of antibiotic therapy for bacterial LRTIs are often challenging given the lack of evidence-based treatment recommendations for this vulnerable patient population. We conducted an observational study before the SARS-CoV-2 pandemic in an eight-bed pediatric palliative care inpatient unit. During two years of surveillance, we diagnosed and treated 33 cases of a bacterial LRTI in patients with an SNI; 5 patients were hospitalized with an LRTI more than once. Two patients died from complications due to LRTIs during hospitalization. Three patients (15%) were colonized with multidrug-resistant organisms. An initial antibiotic treatment failed in one-third of the cases; a successful therapy of the LRTI was achieved with broad-spectrum and extended-spectrum penicillins (n = 13; in combination with β-lactamase inhibitors for n = 5 cases), cephalosporins (n = 13: n = 4 second-generation and n = 9 third-generation cephalosporins; in combination with other substances for n = 5 cases), ciprofloxacin (n = 3), and meropenem plus vancomycin (n = 2) or meropenem (n = 1). A respiratory specimen was obtained in 66.7% of cases with P. aeruginosa, E. coli, and K. pneumoniae accounting for the majority of the detected species. In most cases, there was no definite confirmation that the LRTI was caused by the species detected. The diagnostics and treatment of bacterial LRTIs in PPC patients with an SNI are challenging. The lack of controlled studies and the heterogeneity of this population often necessitate an individual approach. This lack of controlled studies may partly be compensated by a set of diagnostic and antibiotic stewardship criteria.

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Section: Discussionmentioning

confidence: 99%

Lower Respiratory Tract Infections in Pediatric Patients with Severe Neurological Impairments: Clinical Observations and Perspectives in a Palliative Care Unit

et al. 2022

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“…in different human and environmental samples. The prevalence of diarrheagenic bacteria is high among children in Bangladesh 3 , 13 – 15 . Multidrug resistance bacterial pathogens in children can contribute to prolonged hospitalization and treatment failure 13 – 15 .…”

Section: Introductionmentioning

confidence: 99%

Multidrug resistance pattern and molecular epidemiology of pathogens among children with diarrhea in Bangladesh, 2019–2021

Sharif,

Ahmed,

Khandaker

et al. 2023

Sci Rep

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Antimicrobial and multidrug resistance (MDR) pathogens are becoming one of the major health threats among children. Integrated studies on the molecular epidemiology and prevalence of AMR and MDR diarrheal pathogens are lacking. A total of 404 fecal specimens were collected from children with diarrhea in Bangladesh from January 2019 to December 2021. We used conventional bacteriologic and molecular sequence analysis methods. Phenotypic and genotypic resistance were determined by disk diffusion and molecular sequencing methods. Fisher’s exact tests with 95% confidence intervals (CIs) was performed. Prevalence of bacterial infection was 63% (251 of 404) among children with diarrhea. E. coli (29%) was the most prevalent. E. coli, Shigella spp., V. cholerae, and Salmonella spp., showed the highest frequency of resistance against ceftriaxone (75–85%), and erythromycin (70–75%%). About 10–20% isolates of E. coli, V. cholerae and Shigella spp. showed MDR against cephem, macrolides, and quinolones. Significant association (p value < 0.05) was found between the phenotypic and genotypic resistance. The risk of diarrhea was the highest among the patients co-infected with E. coli and rotavirus [OR 3.6 (95% CI 1.1–5.4) (p = 0.001)] followed by Shigella spp. and rotavirus [OR 3.5 (95% CI 0.5–5.3) (p = 0.001)]. This study will provide an integrated insight of molecular epidemiology and antimicrobial resistance profiling of bacterial pathogens among children with diarrhea in Bangladesh.

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“…Antimicrobial resistance has been a growing concern worldwide [1]. It has been defined as a global pandemic for the twenty-first century in [2], Recently, World Health Organization (WHO) has released a list (12 bacteria names from bacterial families) of the drug-resistant bacteria that pose a big sanitary challenges to human health [4,5], such problem is due to the lack of effective surveillance measures and widespread overuse, In the 1990s a sharp reduction in development of new drug classes coupled with emergence of strains of human pathogens resistant with a great concern are multi-drug-resistant strains., now antimibrobial resistance causes 700,000 or more deaths each year which number could grow to 10 million by 2050 [4,6],with a loss of up to USD100 trillion to the global economy [7].…”

Section: Introductionmentioning

confidence: 99%

Biological Activity of Propolis: An Update

Benhanifia¹,

SOLTANI²

2022

Preprint

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Antibiotic resistance was described soon discovery of penicillin by Fleming. In recent years, there has been increasing research interest in the development of alternatives to address this problem. Natural products, mainly, have long been considered as sources of drugs, and a great part of pharmaceuticals available in modern medicine are directly or indirectly derived from natural sources. propolis been used to treat human diseases since ancient times, propolis, is a natural resinous mixture produced by honeybees (Apis mellifera) from collected parts of plants, he is increasingly recognized by their wide range of biological and pharmacological properties, As anti- infective agent, combination synergy with standard antibiotics could be very promising alternative strategy

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Multidrug-Resistant Infections in the Developing World

Cited by 8 publications

References 65 publications

Lower Respiratory Tract Infections in Pediatric Patients with Severe Neurological Impairments: Clinical Observations and Perspectives in a Palliative Care Unit

Lower Respiratory Tract Infections in Pediatric Patients with Severe Neurological Impairments: Clinical Observations and Perspectives in a Palliative Care Unit

Multidrug resistance pattern and molecular epidemiology of pathogens among children with diarrhea in Bangladesh, 2019–2021

Biological Activity of Propolis: An Update

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