Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 28 - 28

Published: Jan. 3, 2025

Background/Objectives: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection encountered in intensive care unit (ICU) and associated with prolonged hospitalization increased mortality. We evaluated causative pathogens involved their resistance to major classes of antibiotics patients VAP assessed differences between without coronavirus disease 2019 (COVID-19). Materials Methods: This study was a single-center, cross-sectional, retrospective analysis involving 122 who were hospitalized ICU Târgu Mureș County Clinical Hospital from 1 April 2021, 2023. compares COVID-19 non-COVID-19 groups, examining clinical progression, duration ventilation hospitalization, mortality, pathogen distribution, emergence multidrug-resistant strains. Results: A length stay exceeding 11.5 days development (MDR) infections (AUC: 0.708, p < 0.001). Similarly, MV 196 h MDR acquisition 0.695, = 0.002). Additionally, Pulmonary Infection Score (CPIS) greater than 5 0.854, 0.001) whole group patients. The commonly isolated strains Acinetobacter spp., Pseudomonas Klebsiella Staphylococcus aureus. Among patients, there notably higher frequency baumannii. bacterial carbapenems found spp. (51.6%), (22.6%), (25.8%). Conclusions: experienced longer ventilation, an risk developing MDR. Carbapenem universal pneumoniae, whereas aeruginosa more prevalent among strongly correlates both patient groups.

Language: Английский

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Potential Antibiotic Resurgence: Consecutive Silver Nanoparticle Applications Gradually Increase Bacterial Susceptibility to Antibiotics

ACS Omega, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 30, 2025

The increasing prevalence of resistant bacteria has emerged as a critical public health concern due to their ability resist multiple antibiotics. This study aimed investigate whether repeated treatments with silver nanoparticles (AgNPs) could gradually decrease bacterial resistance methodology involved three consecutive applications AgNPs on six strains, followed by assessing susceptibility 38 different To our knowledge, the following phenomena were observed for first time. (1) During AgNP applications, it was revealed that all studied became more susceptible antibiotics; end treatments, had doubled five and tripled Klebsiella pneumoniae compared before application. (2) Three led 27–47% restoration antibiotics, which already completely lost activity initial (3) Unlike previous studies, we discovered novel effect: increased Salmonella enteritidis Staphylococcus aureus themselves. Obtained results suggest may offer new promising strategy combat antibiotic resistance.

Language: Английский

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Antimicrobial Resistance Patterns and Biofilm Analysis via Sonication in Intensive Care Unit Patients at a County Emergency Hospital in Romania

Pharmaceuticals, Journal Year: 2025, Volume and Issue: 18(2), P. 161 - 161

Published: Jan. 25, 2025

Background/Objectives: Ventilator-associated pneumonia (VAP) remains a critical challenge in ICU settings, often driven by the biofilm-mediated bacterial colonization of endotracheal tubes (ETTs). This study investigates antimicrobial resistance patterns and biofilm dynamics patients, focusing on microbial trends tracheal aspirates tube biofilms at county emergency hospital Romania. Methods: We conducted longitudinal analysis patients requiring mechanical ventilation for more than 48 h. Tracheal ETT were collected three key time points: T1 (baseline), T2 (48 h post-intubation with replacement), T3 (92–100 post-T2); these analyzed using sonication microbiological techniques to assess patterns. Results: In total 30 bacteria from ESKAPEE group (e.g., Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus) dominated microbiota, increasing their prevalence over time. Resistance carbapenems, colistin, vancomycin was notably observed, particularly among K. pneumoniae A. baumannii. Biofilm revealed high persistence rates emergence multidrug-resistant strains, underscoring role ETTs as reservoirs resistant pathogens. The replacement correlated shift composition reduced biofilm-associated contamination. Conclusions: highlights temporal evolution limited number (30 patients). findings support implementing routine management strategies, including scheduled replacements advanced biofilm-disruption techniques, mitigate VAP risk improve patient outcomes.

Language: Английский

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New Agents Are Coming, and So Is the Resistance

Antibiotics, Journal Year: 2024, Volume and Issue: 13(7), P. 648 - 648

Published: July 13, 2024

Antimicrobial resistance is a global threat that requires urgent attention to slow the spread of resistant pathogens. The United States Centers for Disease Control and Prevention (CDC) has emphasized clinician-driven antimicrobial stewardship approaches including reporting proper documentation usage resistance. Additional efforts have targeted development new agents, but narrow profit margins hindered manufacturers from investing in novel antimicrobials clinical use therefore production antibiotics decreased. In order combat this, both drug discovery processes healthcare reimbursement programs must be improved. Without action, this poses high probability culminate deadly post-antibiotic era. This review will highlight some health challenges faced today future. Furthermore, Infectious Diseases Society America (IDSA) guidelines Gram-negative pathogens discussed. includes agents which gained or are likely gain FDA approval. Emphasis placed on human each these cover, as well how could utilized practice.

Language: Английский

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Convergence of multidrug resistance and efflux-mediated biocide tolerance in klebsiella pneumoniae ST307: implications for nosocomial infection control in Iranian hospitals

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: June 3, 2025

The relentless evolution of K. pneumoniae ST307 into a "superbug" with dual resistance to last-line antibiotics and hospital disinfectants poses an existential threat infection control. This study characterizes the molecular epidemiology, profiles, biocide tolerance isolates from Iranian hospitals, highlighting its role in nosocomial outbreaks. A multicenter cross-sectional analysis 500 (2022-2024) utilized CLSI-compliant disk diffusion, broth microdilution, PCR for genes (blaCTX-M-15, blaNDM-1,cepA, qacED1). Biocide MICs were correlated genetic markers. accounted 30% (150/500) isolates, predominantly ICUs. Resistance rates included meropenem (60.0%; MIC₅₀ >32 µg/mL), ciprofloxacin (75.3%), gentamicin (45.3%). Colistin retained efficacy (85.3% susceptibility). Elevated (chlorhexidine ≥ 0.5% [70.0%]; benzalkonium chloride 0.1% [65.3%]) cepA (65.3%) qacED1 (70.0%) positivity (p < 0.01). Carbapenemase blaOXA-48 (22.0%) blaNDM-1 (10.0%) co-occurred ESBLs. ST307's convergence mechanisms represents catastrophic failure current control frameworks. Without immediate interventions-such as ICU closures deep disinfection, restricted colistin/tigecycline use, genomic surveillance mandates-this clone will dominate hospitals within 3-5 years.

Language: Английский

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Antibiotic residues and antibiotic resistance genes in African water systems: Implications for safe drinking water, aquatic ecosystems, and Sustainable Development Goals

Journal of Water Process Engineering, Journal Year: 2024, Volume and Issue: 69, P. 106636 - 106636

Published: Nov. 30, 2024

Language: Английский

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