UV-Based Advanced Oxidation Processes for Antibiotic Resistance Control: Efficiency, Influencing Factors, and Energy Consumption

Antibiotic resistant bacteria(ARB)with antibiotic resistance genes(ARGs)can reduce or eliminate the effectiveness of antibiotics and thus threaten human health.The United Nations Environment Programme considers antibiotic resistance the first of six emerging issues of concern.Advanced oxidation processes(AOPs)that combine ultraviolet(UV)irradiation and chemical oxidation(primarily chlorine,hydrogen peroxide,and persulfate)have attracted increasing interest as advanced water and wastewater treatment technologies.These integrated technologies have been reported to significantly elevate the efficiencies of ARB inactivation and ARG degradation compared with direct UV irradiation or chemical oxidation alone due to the generation of multiple reactive species.In this study,the performance and underlying mechanisms of UV/chlorine,UV/hydrogen peroxide,and UV/persulfate processes for controlling ARB and ARGs were reviewed based on recent studies.Factors affecting the process-specific efficiency in controlling ARB and ARGs were discussed,including biotic factors,oxidant dose,UV fluence,pH,and water matrix properties.In addition,the cost-effectiveness of the UV-based AOPs was evaluated using the concept of electrical energy per order.The UV/chlorine process exhibited a higher efficiency with lower energy consumption than other UV-based AOPs in the wastewater matrix,indicating its potential for ARB inactivation and ARG degradation in wastewater treatment.Further studies are required to address the trade-off between toxic byproduct formation and the energy efficiency of the UV/chlorine process in real wastewater to facilitate its optimization and application in the control of ARB and ARGs.

Performance Parameters:Demobilization Antibiotic Resistant Bacteria(ARB)and Carrying Genes(ARG)in Wastewater Disinfection

The UV irradiation is used for removing Antibiotic Resistant Bacteria(ARB)and Antibiotic Resistance Genes(ARG)from wastewater treatment.Bacteriophages are viruses that infect within bacteria,are recognized for bacterial control.The influence of some parameters in quantification and performance influencing of pathogen demobilization could be considered in disinfection of wastewater.The comparison of Polyvalent phage(NE1)versus Coliphage(NE4)in suppressing a bacterium Escherichia coli(NDM-1:b-lactam-resistant)with UV irradiation was observed the efficacy in reduction of cells in the disinfection and parameter process.The results with the effect of UV-C irradiation on NDM-1 infected with 1%of NE4 showed a decrease of cells from 8×10^(6)to 2×10^(5)in 60 min with UV-C dose.The NDM1(E.coli)was infected with 1%of NE4(Polyvalent Phage)under magnetic stirring for 1 h,the cells count was 8×10^(6).After 1 h in UV-C e×posure,the cells number reached 3×10^(5).The NDM1 that was e×posed in 1 h of UV-C irradiation and then was infected with 1%of NE4.Cells counting were done 24 h after this procedure.These cells were e×posed in UV-C and showed a reduction in the number of cells from 1×10^(8)to 4×10^(5)after 60 min.The results indicate that bacteriophages can mitigate bacteria species,and combined the conventional water disinfection technologies that can support the microbial safety control strategies.

Nosocomial spontaneous bacterial peritonitis antibiotic treatment in the era of multi-drug resistance pathogens: A systematic review

To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODSA literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15th of November 2016, using the following search strategy: “spontaneous” AND “peritonitis”. RESULTSThe initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies. CONCLUSIONN-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.

Distribution and drug resistance of pathogenic bacteria isolated from cancer hospital in 2013

Objective： To understand distribution and drug resistance of pathogenic bacteria from a specialized cancer hospital in 2013 in order to provide a basis for rational clinical antimicrobial agents. Methods： Pathogenic bacteria identification and drug sensitivity tests were performed with a VITEK 2 compact automatic identification system and data were analyzed using WHONET5.6 software.Results： Of the 1,378 strains tested, 980 were Gram-negative bacilli, accounting for 71.1%, in which Klebsiella pneumonia, Escherichia coli and Pseudomonas aeruginosa were the dominant strains. We found 328 Gram-positive coccus, accounting for 23.8%, in which the amount of Staphylococcus aureus was the highest. We identified 46 fungi, accounting for 4.1%. According to the departmental distribution within the hospital, the surgical departments isolated the major strains, accounting for 49.7%. According to disease types, lung cancer, intestinal cancer and esophagus cancer were the top three, accounting for 20.9%, 17.3% and 14.2%, respectively. No strains were resistant to imipenem, ertapenem or vancomycin.Conclusions： Pathogenic bacteria isolated from the specialized cancer hospital have different resistance rates compared to commonly used antimicrobial agents; therefore antimicrobial agents to reduce the morbidity and mortality of infections should be used.

Seafood as a Reservoir of Gram-negative Bacteria Carrying Integrons and Antimicrobial Resistance Genes in Japan

PCR and DNA sequencing were used to screen and characterize integrons and resistance genes in Gram-negative bacteria isolated from seafood products in Japan.A total of 215 Gram-negative bacteria were isolated from local and imported seafood samples collected from retail markets in Hiroshima Prefecture.Class 1 integrons containing gene cassettes encoding resistance to trimethoprim

Direct and Residual Microbicidal Efficacy of Various Antiseptics against Multi-Drug Resistant Bacteria

Background: Infections in ICU’s patients are known to often originate from the colonization of wounds by the patient’s endogenous microbiota, and to eventually lead to secondary sepsis. Aim: to compare in vitro the direct and residual effects after different exposure times of 4% chlorhexidine, and of 0.1% and 0.04% polyhexanide (in gel and solution forms), on ATCC-microorganisms, and too, on bacterial strains obtained from ICU patients. Methods: We used wild multi-drug resistant strains recently obtained from the wounds of patients hospitalized at ICU and reference strains from the American Type Culture Collection (ATCC). Chlorhexidine 4% was studied as a reference solution. The direct and residual effects of the 0.1% and 0.04% polyhexanide, in gel and solution forms, were analyzed using cotton germ carriers. To evaluate the direct effect, we exposed the strains to the antiseptic. To assess the residual effect, the germ-carriers were impregnated with antiseptic and were allowed to dry before we contaminated them. We inoculated the germ carriers in a culture medium with an inhibitor of antiseptic effect to count the number of surviving microorganisms. Findings: 0.1% Polyhexanide solution proved a direct and residual efficacy after 24 hours equivalent to 4% chlorhexidine. Is very important to highlight that this great efficacy did not change according to whether they were ATCC or multidrug-resistant strains. Conclusions: 0.1% polyhexanide demonstrated a great direct and residual efficacy (like 4% chlorhexidine), against multi-drug resistant strains isolated from ICU’s patients. Moreover, due to its few cytotoxicity against keratinocytes and fibroblasts can be an optimal antiseptic for burns, wounds or ulcers.

Bacterial infection after liver transplantation

Infectious complications are major causes of morbidity and mortality after liver transplantation,despite recent advances in the transplant field.Bacteria,fungi,viruses and parasites can cause infection before and after transplantation.Among them,bacterial infections are predominant during the first two months posttransplantation and affect patient and graft survival.They might cause surgical site infections,including deep intra-abdominal infections,bacteremia,pneumonia,catheter-related infections and urinary tract infections.The risk factors for bacterial infections differ between the periods after transplant,and between centers.Recently,the emergence of multi-drug resistant bacteria is great concern in liver transplant(LT)patients.The instructive data about effects of infections with extended-spectrum beta lactamase producing bacteria,carbapenem-resistant gram-negative bacteria,and glycopeptide-resistant gram-positive bacteria were reported on a center-by-center basis.To prevent posttransplant bacterial infections,proper strategies need to be established based upon center-specific data and evidence from well-controlled studies.This article reviewed the recent epidemiological data,risk factors for each type of infections and important clinical issues in bacterial infection after LT.

Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease patients.SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable source.Several mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune responses.Historically,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic choice.However,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been seen.Recently,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of cases.Consequently,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor outcomes.Theaim of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic strategies.An appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development.

Biogeochemical cyclic activity of bacterial arsB in arsenic-contaminated mines

Biogeochemical cyclic activity of the ars (arsenic resistance system) operon is arsB influx/effux encoded by the ecological of Pseudomonas putida.This suggests that studying arsenite-oxidizing bacteria may lead to a better understanding of molecular geomicrobiology,which can be applied to the bioremediation of arsenic-contaminated mines.This is the first report in which multiple arsB-binding mechanisms have been used on indigenous bacteria.In ArsB (strains OS-5; ABB83931; OS-19; ABB04282 and RW-28; ABB88574...

Synthesis and antibacterial activity of 4″-O-carbamoyl analogs of clarithromycin

A series of novel 4'-O-carbamoyl analogs of clarithromycin were synthesized and evaluated for their in vitro antibacterial activity. All of the desired compounds showed excellent activity against erythromycin-susceptible S.pneumoniae.Particularly,4-fluorobenzyl carbamate 7a demonstrated potent activity against erythromycin-resistant S.pneumoniae encoded by the mef gene,and remarkably improved activity against erythromycin-resistant S.pneumoniae encoded by the erm gene,and the erm and mef genes.

Analysis of Influencing Factors and Predictive Models of Multidrug-resistant Bacterial Infection in Severe Patients

Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.

Impact of Antibacterial Activity of Physical Storage Extracts on Pathogenic Bacteria

The overuse of antibiotics can lead to resistance among pathogenic bacteria. A new antibiotic that is effective against new and resistant bacterial strains is needed. Plants and marine organisms may offer such novel treatments. In this study, extracts of the seaweed U. lactuca, and the plant seeds N. sativa were tested against strains of Gram-positive cocci and Gram-negative bacilli S. aureus, and P. aeruginosa. The results of the bacterial inhibitor showed high activity in both extracts with inhibition of S. aureus growth up to 30 mm and 20 mm and P. aeruginosa growth inhibition was up to 12 mm and 15 mm, after the treated with 100 μl U. lactuca and N. sativa extracts, respectively. The MICs and MBCs were reflected with the growth inhibitor with values of 2 μl, 8 μl and 4 μl, 8 μl for S. aureus and P. aeruginosa after treated with N. sativa respectively. Kill-time increases as concentrations of U. lactuca and N. sativa extracts increase. Moreover, extracts stored in the transparent bottle decreased in effectiveness after one month of storage with percentage of 58.85%. After three months, heating the extracts of U. lactuca and N. sativa to 90°C increased their antibacterial activity.

A New Evaluation Method for Antibiotic-Resistant Bacterial Groups in Environment

In the present manuscript it was presented whether spreading of antibiotic resistant bacterial groups in environment could be monitored by our newly developed method by enumerating antibiotic resistant bacterial groups in various biological wastes and composts. Although the numbers were not so high, diverse kinds of colistin resistant bacteria (25 mg·L-1) were included in row cattle feces (1.78 × 104 MPN g-1) and cattle feces manure (>3.84 × 104 MPN g-1). Compost originated from leftover food (>44.8 × 104 MPN g-1) and shochu lee (>320 × 104 MPN g-1) included higher numbers of chlortetracycline resistant Pseudomonas sp., (25 mg·L-1), and row cattle feces included higher numbers of chlortetracycline resistant Enterobacteriacea (15.7 × 104 MPN g-1), which mostly consisted from Pantoea sp. or Xenorhobdus doucetiae. Numbers of multi drug resistant bacteria, resistant to 25 mg·L-1 of ciprofloxacin, streptomycin, chloramphenicol, and ampicillin, were the highest in row cattle feces (>143.6 × 104 MPN g-1), followed by cattle feces manure (4.19 × 104 MPN g-1), and shochu lee (0.36 × 104 MPN g-1), which included diverse kinds of bacterial group. The present results indicated that higher numbers of multi drug resistant bacteria were typically found in row cattle feces, and the method was found suitable to enumerate and identify them. These results suggested that the method might become their environmental risk evaluation method.

Prevalence of Antibiotic Resistant Bacteria on Tomato Surfaces and Effectiveness of Disinfectants in Reducing the Microbial Load

This study was conducted to isolate and identify antibiotic resistant bacteria in fresh tomato sold in three different local markets of Dhaka city. On an average 〉 5.0 log CFU/g of natural microbial populations and coliform bacteria was present in the samples. Prevalence of Salmonella spp., E. coli, Listeria spp., and Yersinia spp., were recorded through cultivation dependent assay of tomato samples of different markets. Almost all of the isolates were uniformly resistant to rifampicin, erythromycin, clindamycin and oxacillin （100%）, vancomycin （93%）, amoxicillin （87%）, whereas 60% of the isolates were found to be resistant to ampicillin and cephalexin. Antibiotic sensitivity test of the presumptive E. coli and Salmonella spp. and corresponding plasmid profiling indicated a correlation of plasmid mediated multidrug resistance （MDR） of these environmental bacteria. Washing with sanitizing agents such as acidified sodium chlorite （ASC） and 200 ppm chlorinated water was able to reduce _〈 2.0 log CFU/g of natural microflora and coliform bacteria. In contrast, ASC was able to reduce 〈 2.0 log CFU/g of other food borne pathogens and, chlorinated water was able to reduce up to undetectable level. Therefore, washing of tomato with 200 ppm chlorinated water could be useful in reducing the pathogen populations on tomatoes.

Ventilator-associated pneumonia in patients with cancer: Impact of multidrug resistant bacteria

BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of MDRB.METHODS A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 h.They were classified as those who developed VAP versus those who did not;pathogens isolated,including MDRB.Clinical evolution at 60-d was assessed.Descriptive analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs non-MDRB.RESULTS Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid tumors.There were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 ventilation-days.The most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was identified.In multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with MDRB.CONCLUSION This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these pathogens.In this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days.

Analysis of Clinical Symptoms Improvement in Treatment of Severe Pneumonia Caused by Multi-drug Resistant Bacterial Infection by Bronchoscopy Alveolar Lavage

Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.

Metagenomic insights into microorganisms and antibiotic resistance genes of waste antibiotic fermentation residues along production,storage and treatment processes

Antibiotic fermentation residue(AFR)is nutrient-rich solid waste generated from fermentative antibiotic production process.It is demonstrated that AFR contains high-concentration of remaining antibiotics,and thus may promote antibiotic resistance development in receiving environment or feeding farmed animals.However,the dominate microorganisms and antibiotic resistance genes(ARGs)in AFRs have not been adequately explored,hampering understanding on the potential antibiotic resistance risk development caused by AFRs.Herein,seven kinds of representative AFRs along their production,storage,and treatment processes were collected,and multiple methods including amplicon sequencing,metagenomic sequencing,and bioinformatic approaches were adopted to explore the biological characteristics of AFRs.As expected,antibiotic fermentation producer was found as the predominant species in raw AFRs,which were collected at the outlet of fermentation tanks.However,except for producer species,more environment-derived species persisted in stored AFRs,which were temporarily stored at a semi-open space.Lactobacillus genus,classified as Firmicutes phylum and Bacilli class,became predominant bacterial taxa in stored AFRs,which might attribute to its tolerance to high concentration of antibiotics.Results from metagenomic sequencing together with assembly and binning approaches showed that these newly-colonizing species(e.g.,Lactobacillus genus)tended to carry ARGs conferring resistance to the remaining antibiotic.However,after thermal treatment,remaining antibiotic could be efficiently removed from AFRs,and microorganisms together with DNA could be strongly destroyed.In sum,the main risk from the AFRs was the remaining antibiotic,while environment-derived bacteria which tolerate extreme environment,survived in ARFs with high content antibiotics,and may carry ARGs.Thus,hydrothermal or other harmless treatment technologies are recommended to remove antibiotic content and inactivate bacteria before recycling of AFRs in pharmaceutical industry.

Infection-responsive polysaccharide-based drug-loaded nano-assembly for dual-modal treatment against drug-resistant bacterial lung infection

The escalating issue of lung infections induced by multi-drug resistant(MDR)bacteria is threatening human health.Thus,the development of efficient drug delivery systems is essential to eliminate MDR bacterial lung infections effectively.Herein,we designed inhalable drug-loaded nano-assemblies by the electrostatic interaction between negatively charged sodium alginate and a positively charged antibacterial polymer,quaternized polyethyleneimine(QPEI-C_(6)),as well as a kind of typical antibiotic for therapy of lung infection,azithromycin(AZT).By adjusting the feed ratios,we optimized the size of the nano-assembly to approximately 200 nm(STQ_(12)),which was beneficial for penetration through the mucus layer and biofilm.In the slightly acidic environment of the infected site,the nano-assembly could dissemble responsively and release AZT and QPEI-C_(6).Because of the combined bactericidal effect,STQ_(12)exhibited high bactericidal efficiency against MDR bacteria.In animal experiments,STQ_(12)showed notable efficacy against MDR bacterial lung infection.Gene transcriptomic results showed that the main effects of STQ_(12)against bacteria were through influencing the bacterial cell components and metabolic processes,and affecting their growth and reproduction.This work provides a promising strategy to treat MDR bacterium-induced lower respiratory tract infections.

Prevention and control strategies for antibiotic resistance:from species to community level

Antibiotic resistance genes(ARGs)and antibiotic resistant bacteria(ARB)in the environment pose serious threats to environmental security and public health.There is an urgent need for methods to specifically and effectively control environmental pollution or pathogen infection associated with ARGs and ARB.This review aims to provide an overview of methods abating the prevalence and spread of ARGs and ARB from species to community level.At the species level,species-specific technologies,such as nanoparticle-,photosensitizer-,CRISPR-Cas-,and phage-related technology can be utilized to clear a particular class of ARGs or ARB,and in combination with low-dose antibiotics,a higher removal efficiency can be achieved.Moreover,the combination of antibiotics can be used to reverse microbial resistance and treat recurrent antibiotic resistant pathogen infections.At the community level,community-specific strategies,such as biochar,hyperthermophilic compost,and fecal microbiota transplantation can eradicate most types of ARGs or ARB in one shot,reducing the probability of resistance development.Though some progress has been made to eliminate ARGs and ARB in disease treatment or decontamination scenarios,further research is still needed to elucidate their mechanisms of action and scopes of application,and efforts should be made to explore novel strategies to counter the prevalence of antibiotic resistance.

Genomic analyses of metal resistance genes in three plant growth promoting bacteria of legume plants in Northwest mine tailings, China

To better understand the diversity of metal resistance genetic determinant from microbes that survived at metal tailings in northwest of China, a highly elevated level of heavy metal containing region, genomic analyses was conducted using genome sequence of three native metal-resistant plant growth promoting bacteria（PGPB）. It shows that： Mesorhizobium amorphae CCNWGS0123 contains metal transporters from P-type ATPase, CDF（Cation Diffusion Facilitator）, Hup E/Ure J and CHR（chromate ion transporter） family involved in copper, zinc, nickel as well as chromate resistance and homeostasis. Meanwhile, the putative Cop A/Cue O system is expected to mediate copper resistance in Sinorhizobium meliloti CCNWSX0020 while Znt A transporter, assisted with putative Czc D, determines zinc tolerance in Agrobacterium tumefaciens CCNWGS0286. The greenhouse experiment provides the consistent evidence of the plant growth promoting effects of these microbes on their hosts by nitrogen fixation and/or indoleacetic acid（IAA） secretion,indicating a potential in-site phytoremediation usage in the mining tailing regions of China.