Detection of aac(3)IIc, aac(6)Ib, armA Genes Coding for Escherichia coli Resistance to Aminoglycosides in Burkina Faso

Background and Prupose: Antibiotic resistance is a major global health concern. In addition to the existing data on the prevalence of bacterial resistance to antibiotics, there are patchy data on bacterial resistance to aminoglycosides in Burkina Faso. In this study, we determined the prevalence of aminoglycoside resistance genes in E. coli, including aac(3)-IIc, aac(6)-Ib and armA in Ouagadougou, and determined which antibiotics in this class are most affected by resistance. Material and Methods: This study was conducted on 216 E. coli strains collected from the biomedical analysis laboratories of Saint Camille and Schiphra hospitals. E. coli strains were isolated from pus and urine samples collected between September 2018 and January 2019. Antibiotic susceptibility testing was performed using aminoglycosides, β-lactams, fluoroquinolones, and sulfonamides. Aminoglycoside resistance genes were detected in strains with at least one aminoglycoside resistance gene using conventional/multiplex PCR. Results: Aminoglycoside resistance was observed in 46.8% (101/216) of strains. The resistance rates were respectively 45.37% for Tobramycin, 32.40% for Gentamicin, 14.81% for Kanamycin, 2.31% for Netilmicin, 1.84% for Neomycin, and 0.46% for Amikacin. PCR showed that 86 strains (85.15%) possessed the aac(3)-IIc gene, 71 strains or 70.30%) possessed the aac(6’)-Ib gene, and nine strains (8.91%) possessed the armA gene. Conclusion: Aminoglycoside resistance in pathogenic E. coli strains is mainly due to the presence of the aac(3’)-IIc and aac(6’)-Ib genes. The presence of armA was first reported in Burkina Faso. Netilmicin, Neomycin and Amikacin are good therapeutic options for treating urinary tract and pus-forming infections.

Optimization and Comparisons for Separation, Detection and Quantification of 12 Aminoglycosides Using 2 Chromatographic Conditions by LC-MS/MS

Aminoglycosides are a family of antibiotics with important applications in veterinary medicine. Their ionic character, the similarity structures and the high polarity due to the presence of two or more amino and hydroxyl groups cause a difficulty in separation and make these compounds poorly retained on the reversed phase column. An analytical method for the separation and detection of 12 aminoglycosides has been optimized using two kinds of chromatographic conditions (HILIC, Ion pairing). In Hydrophilic Interaction, ZIC_HILIC column was used, by which the following parameters for the mobile phase were evaluated: concentration of ammonium acetate buffer, percentage of formic acid and effect of acid type. The maximum and adequate concentration of ammonium acetate for the majority of analytes was set to 30 mM. The percentage 0.1% of formic acid increases the response for the majority of analytes. On the other side, the use of 0.1% of trifluoroacetic acid improves the response when compared with the response obtained with 0.1% of formic acid except for Spectinomycin Dihydrostreptomycin and Streptomycin. For ion pairing chromatography, the concentration of pentafluoropropionic acid was tested and the greatest value appeared to be 9.2 mM. Therefore, the comparison between the two separation methods shows that the response area of the majority of analytes tested increases when using the ion pair mode. Also, the high value of S/N and the lower detection limit (5 - 15 μg m·L﹣1 for most aminoglycosides studied make the ion pairing method more preferable than HILIC interaction.

Safety in Surgery:Evaluation of Safety and Efficiency in Use of Aminoglycosides in Acute Appendicitis

Background: Aminoglycosides are used as empirical antibiotic treatment of intraabdominal infections which are caused by Gram negative bacteria and for which the treatment of choice is surgery. Aminoglycosides maintain good efficacy against these bacteria and reduce the need for prescribing fluoroquinolone, cephalosporin and carbapenem antibiotics which contribute to the development of resistant bacterial strains. In recent years, several clinical trials and international guidelines have advised against the use of aminoglycosides owing largely to doubts about their effectiveness and to the concern for their known nephrotoxicity and ototoxicity. Aim: In our study, we aimed to prove whether aminoglycosides are appropriate agents in the treatment of acute appendicitis. Methods: Retrospectively, patients with acute appendicitis we included in the trial. Demographic characteristics, comorbidities, clinical signs and symptoms, the type of antibiotic and surgical treatment were analyzed. The effect of independent variables on the occurrence of complications was calculated using Student’s T-test and Fisher’s precise test. The effect of aminoglycosides on the loss of kidney function was determined by means of a linear regression method. Results: 300 patients proved acute appendicitis were included in the study. Univariate statistical analysis showed that the risk factors for postoperative complications in treating acute appendicitis were: age over 76 years (p Conclusion: Aminoglycoside antibiotics are a safe and effective treatment of acute appendicitis;our not published data are positive of AGs use in acute cholecystitis and left colon diverticulitis which requires surgery. If used for a limited time period, they do not increase the risk for kidney injury and remain a stable low level of all over complications.

Pharmacodynamics of aminoglycosides and tetracycline derivatives against Japanese encephalitis virus

Objective:To explore the antiviral activity of antibiotic compounds,mainly aminoglycosides and tetracyclines against Japanese encephalitis virus(JEV) induced infection in vitro.Methods:Antiviral activity were evaluated against JEV using cytopathic effect inhibition assay,virus yield reduction assay,caspase 3 level,extracellular viral detection by antigen capture ELISA and viral RNA levels.Roults:JEV induced cytopathic effect along with reduction of viral progeny plaque formation indicated antiviral potential of the compounds suggesting that antibiotics had broad spectrum activity.Doxycycline and kanamycin administration in dose dependent manner declined viral RNA replication.Conclusions:The present study shows kanamycin and doxycyclinc can affect virion structure and alter replication causing inhibition of JEV induced pathogenesis in vitro.

Molecular Docking Studies on Streptomycin Antileishmanial Activity

Resistance to pentavalent antimonial drugs and the lack of vaccines make it urgent to find novel therapeutic options to treat Leishmaniasis, a tropical disease caused by the Leishmania protozoan parasite. The study reported here is to investigate if Streptomycin, an aminoglycoside, and Amphotericin B, the second-line treatment drug, exhibit antileishmanial activity through a similar mechanism. By using MOE (Molecular Operating Environment), we performed molecular docking studies on these drugs binding to a range of targets including ribosome targets in Leishmania and H. sapiens. Our study shows that the two drugs do not bind to the same pockets in Leishmania targets but to the same pockets in the human ribosome, with some differences in interactions. Moreover, our 2D maps indicated that Amphotericin B binds to the A-site in the human cytoplasmic ribosome, whereas streptomycin does not.

Felodipine enhances aminoglycosides efficacy against implant infections caused by methicillin-resistant Staphylococcus aureus,persisters and biofilms

Methicillin-resistant Staphylococcus aureus(MRSA),biofilms,and persisters are three major factors leading to recurrent and recalcitrant implant infections.Although antibiotics are still the primary treatment for chronic implant infections in clinical,only few drugs are effective in clearing persisters and formed biofilms.Here,felodipine,a dihydropyridine calcium channel blocker,was reported for the first time to have antibacterial effects against MRSA,biofilm,and persisters.Even after continuous exposure to sub-lethal concentrations of felodipine,bacteria are less likely to develop resistance.Besides,low doses of felodipine enhances the antibacterial activity of gentamicin by inhibiting the expression of protein associated with aminoglycoside resistance(aacA-aphD).Next,biofilm eradication test and persisters killing assay suggested felodipine has an excellent bactericidal effect against formed biofilms and persisters.Furthermore,the result of protein profiling,and quantitative metabonomics analysis indicated felodipine reduce MRSA virulence(agrABC),biofilm formation and TCA cycle.Then,molecular docking showed felodipine inhibit the growth of persisters by binding to the H pocket of ClpP protease,which could lead to substantial protein degradation.Furthermore,murine infection models suggested felodipine in combination with gentamicin alleviate bacterial burden and inflammatory response.In conclusion,low dose of felodipine might be a promising agent for biomaterial delivery to enhance aminoglycosides efficacy against implant infections caused by MRSA,biofilm,and persisters.

Design,synthesis,and bioassay of 5-epi-aminoglycosides

For the purpose of seeking new antibiotics,researchers usually modify the already-existing ones.However,this strategy has been extensively used and is close to its limits,especially in the case of aminoglycosides,and it is difficult to find a proper aminoglycoside antibiotic for novel modification.In this paper,we reported the design,synthesis,and evaluation of a series of 5-epi-neamine derivatives based on the structural information of bacterial 16S RNA A-site binding with aminoglycosides.Bioassay results showed that our design strategy was feasible.Our study offers a new way to search for structurally novel aminoglycosides.Meanwhile,our study provides valuable structure-activity relationship information,which will lead to better understanding and exploitation of the drug target,and improved development of new aminoglycoside antibiotics.

Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline

Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health problem in developing countries such as the Democratic Republic of Congo (DRC), which continues to face the emergence of MDR-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recommended the introduction of the bedaquiline regimen. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to compare the AG-based regimen and the bedaquiline-based regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB patients, performed in Kinshasa (DRC) during the period from January 2020 to January 2021. Sociodemographic, clinical, biological and audiometric data were analyzed using Stata 17. Repeated-measures analysis of variance was used to compare changes in the degree of hearing loss over time between the two groups of patients on AG and bedaquiline regimens. The double-difference method was estimated using regression with fixed-effects. A p value < 0.05 was considered the threshold for statistical significance. Results: The degree of hearing loss was similar between the two groups at the first month [AGs (28 dB) vs BDQ (30 dB);p = 0.298]. At six months, the mean degree of hearing loss was significantly greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB);p < 0.001]. The double difference was significant, with a greater increase in hearing loss in the AGs group (diff-in-diff 18.3;p < 0.001). After adjustment for age and serum albumin, the group receiving the AG-based regimen had a 2-point greater worsening than those with bedaquiline at the sixth month (diff-in-diff 19.8;p Conclusion: Hearing loss is frequent with both treatment regimens, but more marked with the Aminoglycoside-based regimen. Thus, bedaquiline should also benefit for audiometric monitoring in future MDR-TB patients.

耳蜗传出神经系统和氨基糖苷类抗生素耳中毒

耳蜗传出神经系统在正常听觉和氨基糖苷类抗生素耳中毒中发挥着重要的作用,本文复习近年来相关文献,对耳蜗传出神经系统的形态、生理、耳蜗机械特性和听觉反应的调控机制的研究近况以及氨基糖苷类抗生素对耳蜗传出神经系统的影响进行综述。

Mitochondrial DNA mutations associated with aminoglycoside induced ototoxicity

Aminoglycosides(Am An) are widely used for their great efficiency against gram-negative bacterial infections. However, they can also induce ototoxic hearing loss, which has affected millions of people around the world. As previously reported, individuals bearing mitochondrial DNA mutations in the 12 S rRNA gene, such as m.1555A>G and m.1494C>T, are more prone to Am An-induced ototoxicity. These mutations cause human mitochondrial ribosomes to more closely resemble bacterial ribosomes and enable a stronger aminoglycoside interaction. Consequently,exposure to Am An can induce or worsen hearing loss in these individuals. Furthermore, a wide range of severity and penetrance of hearing loss was observed among families carrying these mutations. Studies have revealed that these mitochondria mutations are the primary molecular mechanism of genetic susceptibility to Am An ototoxicity, though nuclear modifier genes and mitochondrial haplotypes are known to modulate the phenotypic manifestation.

The Central Cattle Breeding and Dairy Farm, Bangladesh waste contributes in emergence and spread of aminoglycoside-resistant bacteria

Aminoglycosides are one of the categories of antibiotics most frequently used in treating several cattle diseases at the Central Cattle Breeding and Dairy Farm (CCBDF), Savar,Dhaka,Bangladesh. Untreated veterinary clinical healthcare waste (VCHW) of diseased cattle at CCBDF which directly disposed to surrounding may contribute to the antibiotic resistant bacteria pollution (ARB) pollution. The investigation analyses the role of VCHW of CCBDF in spreading ARB. Here we studied:1) veterinary clinical data and antibiotics treatment history;2) total and resistant bacteria counts in fecal samples of healthy and diseased cattles as well as VCHW of CCBDF;and 3) finally, data analysis to estimate the burden of VCHW of CCBDF in the pollution of environment with aminoglycoside antibiotics resistant bacteria. The results conclusively demonstrate the spread of 3 different aminoglycoside antibiotics, namely genta- mycin, kanamycin and streptomycin resistant bacte- ria in the surrounding environment alarmingly with high significant value (p < 0.01 - 0.05). This study re- veals the risks to the cattle as well as public health posed by the random VCHW disposal at the CCBDF, Bangladesh.

Prevalence and trends of aminoglycoside resistance in Shigella worldwide, 1999-2010

Shigellosis causes diarrheal disease in humans in both developed and developing countries, and multi-drug resistance in Shigella is an emerging problem. Understanding changing resistance patterns is important in determining appropriate antibiotic treatments. This meta-analysis systematically evaluated aminoglycoside resistance in Shigella. A systematic review was constructed based on MEDLINE and EMBASE databases. Randomeffect models or fixed-effect models were used based on P value considering the possibility of heterogeneity between studies for meta-analysis. Data manipulation and statistical analyses were performed using software STATA 11.0. By means of meta-analysis, we found a lower resistance to three kinds of aminoglycosides in the Europe-America areas during the 12 year study period than that of the Asia-Africa areas. Kanamycin resistance was observed to be the most common drug resistance among Shigella isolates with a prevalence of 6.88% （95%CI： 6.36%-7.43%）. Comparison of data from Europe-America and Asia-Africa areas revealed that Shigella flexneri resistance was greater than the resistance calculated for Shigella sonnei. Importantly, Shigella sonnei has played a significant role in aminoglycoside-resistance in recent years. Similarly, data showed that resistance to these drugs in children was higher than the corresponding data of adults. In conclusion, aminoglycoside-resistant Shigella is not an unusual phenomenon worldwide. Distribution in Shigella resistance differs sharply based on geographic areas, periods of time and subtypes. The results from the present study highlight the need for con- tinuous surveillance of resistance and control of antibiotic usage.

Mitochondrial DNA Mutations Associated with Aminoglycoside Ototoxicity

The mitochondrial 12S rRNA has been shown to be the hot spot for mutations associated with both aminoglycoside-induced and non-syndromic hearing loss. Of all the mutations, the homoplasmic A1555G and C1494T mutations at a highly conserved decoding region in the 12S rRNA have been associated with aminoglycoside-induced and non-syndromic hearing loss in many families worldwide. The A1555G or C1494T mutation is expected to form novel 1494C-G1555 or 1494U-A1555 base-pair at the highly conserved A-site of 12S rRNA. These transitions make the secondary structure of this RNA more closely resemble the corresponding region of bacterial 16S rRNA. Thus, the new U-A or G-C pair in 12S rRNA created by the C1494T or A1555G transition facilitates the binding of aminoglycosides, thereby accounting for the fact that the exposure to aminoglycosides can induce or worsen hearing loss in individuals carrying these mutations. Furthermore, the growth defect and impairment of mitochondrial translation were observed in cell lines carrying the A1555G or C1494T mutation in the presence of high concentration of aminoglycosides. In addition, nuclear modifier genes and mitochondrial haplotypes modulate the phenotypic manifestation of the A1555G and C1494T mutations. These observations provide the direct genetic and biochemical evidences that the A1555G or C1494T mutation is a pathogenic mtDNA mutation associated with aminoglycoside-induced and nonsyndromic hearing loss. Therefore, these data have been providing valuable information and technology to predict which individuals are at risk for ototoxicity, to improve the safety of aminoglycoside antibiotic therapy, and eventually to decrease the incidence of deafness.

Investigation on the Mechanism of Exacerbation of Myasthenia Gravis by Aminoglycoside Antibiotics in Mouse Model

To investigate the underlying mechanism of the exacerbation of myasthenia gravis by aminoglycoside antibiotics. C57/BL6 mice were immunized with acetylcholine receptor (AChR), extracted from electric organ of Narcine timilei according to Xu Haopeng's methods, in complete Fruend's adjuvant (CFA) to establish experimental autoimmune myasthenia gravis (EAMG). EAMG mice were divided randomly into 5 groups: MG group, NS group and three antibiotics groups. The clinical symptom scores of mice were evaluated on d7 after the last immunization and d14 of antibiotics treatment. Repetitive nerve stimulation (RNS) was performed and the levels of anti-AChR antibody (AChR-Ab) were tested at the same time. The mean clinical symptom grades of gentamycin group (1.312, 2.067), amikacin group (1.111, 1.889) and etimicin group (1.263, 1.632) were significantly higher than those of MG group (1.000, 1.200) (P<0.05). The positive rates of RNS of three antibiotics groups were 69.23 %, 58.82 % and 63.16 % respectively, which were significantly higher than those of MG group and NS group (40.00 %, 40.00 %, P<0.05). The AChR-Ab level in serum and the expression of AChR on neuromuscular junction (NMJ) of mice in three antibiotics groups were also higher than those of MG group. Our results indicated that aminoglycoside antibiotics could aggravate the symptom of myasthenia gravis. The exacerbation of myasthenia gravis by these antibiotics probably involves competitively restraining the release of acetylcholine from presynaptic membrane, impairing the depolarization of postsynaptic membrane, depressing the irritability of myocyte membrane around the end-plate membrane and consequently leading to the blockade of neuromuscular junction.

LOWER DOSE OF AMINOGLYCOSIDE OTOTOXIC EXPOSURE CAUSES PRESYNAPTIC ALTERATIONS ASSOICATED WITH HEARING LOSS

Objective To study presynaptic alternations of cochlear ribbons arising from aminoglycoside ototoxic stimuli in C57BL/6J mice. Methods Animals were injected with low dose gentamicin (100 mg/kg/day) for 14 days, From the 14th to 28th days, the mice were maintained free of gentamicin treatment. Immunohisto-chemistry labeling was employed to trace RIBEYE, a major presynaptic componment of ribbon synapses. RIBEYE/CtBP2 expression levels were assessed and compared with hearing threshold shifts. Auditory func-tion was assessed by auditory brainstem responses. The stereocilia of outer hair cells (OHCs) and IHCs was examined by scanning electron microscopy (SEM). Results Hearing thresholds were elevated with peak hearing loss observed on the 7th day after gentamicin exposure, followed by improvement after the 7th day. RIBEYE/CtBP2 expression directly correlated with observed hearing threshold shifts. Strikingly, we did not see any obvious changes in stereocilia in both OHCs and IHCs until the 28th day. Mild changes in stereocil-ia were only observed in OHCs on the 28th day. Conclusions These findings indicate that presynapse co-chlear ribbons, rather than stereocilia, may be sensitive to aminoglycoside ototoxic exposure in mice cochle-ae. A pattern of RIBEYE/CtBP2 expression changes seems to parallel hearing threshold shifts and suggests presynaptic response properties to lower dosage of aminoglycoside ototoxic stimuli.

Resonance Light Scattering Method for Determination of Amikacin with Potassium Ferrioxalate as a Probe

In a weak acid medium, potassium ferrioxalate（PF） can react with some aminoglycoside（AGs） antibiotics, such as amikacin（AMK）, kanamycin（KANA）, tobramycin（TOB） and gentamicin（GEN）, to form ion-association complexes. It results in the enhancement of resonance light scattering（RLS） in different degrees. The maximum scattering peaks are all located at 345 nm. Among them, the relative scattering intensity（AIRLs） of AMK system is much higher than that of KANA, TOB or GEN. Therefore the method is more propitious to the determination of trace amounts of AMK. The optimum reaction conditions, influencing factors, and the relationship between scattering intensity and concentration of antibiotics were investigated by means of the proposed method. The enhancement of RLS signals is directly proportional to the concentration of antibiotics in a certain range of concentration. A new resonance light scattering method for the determination of AMK and other aminoglycoside antibiotics with [Fe（C2O4）3]^3- as a probe is thus established based on it. The method exhibits high sensitivity and good selectivity. The detection limit（3σ） for AMK is 1.8 ng/mL. The method can be applied to the determination of AMK in clinical serum samples. The reaction mechanism and the reasons for RLS enhancement are discussed in this paper.

《细胞》杂志刊发贾旭博士所在团队学习揭示抗生素耐药新机制

2013年1月17日，成都医学院贾旭博士在复旦大学导师AIaStairMurchie指导下，作为并列第一作者，在《细胞》杂志发表研究论文（XUJia，Jing Zhang，Wenxia Sun, Weizhi He, Hengyi Jiang, Dongrong Chen, Alastair Murchie. Riboswitch control of aminoglycoside antibiotic resistance. Cell. 2013, 152 （1- 2）：68-81）,揭示了氨基糖苷类抗生素（aminoglycosides）耐药的新机制。

Clino-Pathological Features of Urinary Tract Infection in Rural India

The study was aimed to understand the clino-pathological characteristics of urinary tract infection along with the techniques used in diagnosis and treatment of the presenting infection. The study takes into consideration the various risk factors such as age, sex, and diabetes mellitus which can precipitate a urinary tract infection. The study was conducted at the Global Baroda Hospital, Vadodara and Narhari Hospital, Vadodara in the duration from January to March 2012, under the supervision of Dr. Hiten Kareliya. A questionnaire was prepared in accordance to evaluate risk factors of urinary tract infection. The patients under study were chosen according to specific inclusion criteria. The uropathogens were isolated with the help of biochemical testing. E. coli (38%) was found to be the most prevalent organism followed by Klebsiella and Candida albicans (both 10%), Pseudomonas aeruginosa (9%), Staphylococcus (7%).

Injury and protection of spiral ganglion neurons

Cochlear spiral ganglion neurons(SGNs)are bipolar ganglion cells and are the first neurons in the auditory transduction pathway.They transmit complex acoustic information from hair cells to second-order sensory neurons in the cochlear nucleus for sound processing.Injury to SGNs causes largely irreversible hearing impairment because these neurons are highly differentiated cells and cannot regenerate,making treatment of sensorineural hearing loss(SNHL)arising from SGN injury difficult.When exposed to ototoxic drugs or damaging levels of noise or when there is loss of neurotrophic factors(NTFs),aging,and presence of other factors,SGNs can be irreversibly damaged,resulting in SNHL.It has been found that NTFs and stem cells can induce regeneration among dead spiral ganglion cells.In this paper,we summarized the present knowledge regarding injury,protection,and regeneration of SGNs.