Antibiotics

Background/Objectives: Postoperative pneumonia and other infectious complications after robotic-assisted minimally invasive esophagectomy still contribute to morbidity and mortality. Selective oral decontamination of the esophagus prior to surgery might reduce the rate of infectious complications. However, its impact on the esophageal microbiota is unknown. Therefore, this study aimed to analyze whether selective oral decontamination of the esophagus prior to surgery reduces postoperative pneumonia rates and alters the esophageal microbiome. Methods: We conducted a proof-of-principle study including 22 patients who underwent robotic-assisted minimally invasive esophagectomy. Thirteen patients were treated with 50 mg amphotericin B, 8 mg tobramycin, and 10 mg colistin orally 7 days prior to surgery, intraoperatively, and 5 days postoperatively. The remaining nine patients received standard-of-care treatment (no oral decontamination). The esophageal microbiome was assessed using 16S rRNA gene amplicon libraries which were annotated using the Ribosomal Data Project. The incidence of postoperative (at discharge from hospital or 30 days, whichever was later) infectious complications was assessed. Results: Selective oral decontamination was associated with reduced overall rates of infectious complications (7.7% vs. 55.5%, p = 0.008) and postoperative pneumonia (0% vs. 33.3%, p = 0.007). Alterations in the esophageal microbiome depending on selective oral decontamination were detectable. The microbiomes of patients with infectious complications showed higher abundances of Neisseria and lower abundances of Streptococcus than samples without infectious complications. Conclusions: Selective oral decontamination reduced the rate of postoperative complications, postoperative pneumonia in particular, after robot-assisted esophagectomy. Alterations in the microbiome were also evident following decontamination. Further studies with larger sample sizes are necessary to confirm these data.

Environmental dissemination of antibiotics is a pressing global challenge, driving ecological imbalances and the proliferation of antibiotic resistance genes (ARGs). Conventional treatment technologies often fail to fully eliminate these micropollutants or are cost-prohibitive for widespread use. In this context, phytoremediation—using plants and their associated microbiota to remove, transform, or immobilize contaminants—has emerged as an effective and promising, low-impact, and nature-based approach for mitigating antibiotic pollution in aquatic and terrestrial environments. This review provides a comprehensive synthesis of the physiological, biochemical, and ecological mechanisms by which plants interact with antibiotics, including phytoextraction, phytodegradation, rhizodegradation, and phytostabilization. This review prioritizes phytoremediation goals, with attention to high-performing aquatic (e.g., Lemna minor, Eichhornia crassipes, Phragmites australis) and terrestrial plants (e.g., Brassica juncea, Zea mays) and their ability to remediate major classes of antibiotics. This study highlights the role of rhizosphere microbes and engineered systems in phytoremediation, while noting challenges such as variable efficiency, phytotoxicity risks, limited knowledge of by-products, and environmental concerns with antibiotic degradation. Future perspectives include the integration of genetic engineering, microbiome optimization, and smart monitoring technologies to enhance system performance and scalability. Plant-based solutions thus represent a vital component of next-generation remediation strategies aimed at reducing antibiotic burdens in the environment and curbing the rise in antimicrobial resistance.

Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-E. coli) are widespread in the food chain, but nationwide surveillance in Indonesian broiler production is limited. This study investigated the occurrence, antimicrobial resistance, phylogenetic diversity, and molecular characteristics of ESBL-E. coli from broilers in Indonesia. A total of 2182 E. coli isolates from broiler cecal samples across three regions during the period 2018–2020 were analyzed. Antimicrobial susceptibility testing and ESBL phenotyping were performed following the CLSI guidelines. ESBL resistance genes and phylogenetic groups were detected using multiplex/quadruplex PCR. ESBL-E. coli (9.9%) was most frequently observed in the western (15.2%) region, followed by the central (8.0%) and eastern (7.2%) regions. A total of 85 resistance patterns were identified, with 98.5% exhibiting multidrug resistance. The bla_CTX-M gene was detected in 97.5% of isolates, predominantly bla_CTX-M-1 (97.5%), while bla_CTX-M-9 was found in 2.5%. The bla_TEM gene was present in 33.0% of ESBL isolates; however, bla_SHV and bla_OXA-1 were absent. Phylogenetic group A predominated (42.0%), followed by E (22.5%), B1 (20.5%), F (10.5%), C (2.5%), and D (2.0%). This study demonstrates a significant occurrence of ESBL-E. coli in Indonesian broilers with regional variation and bla_CTX-M predominance. The high rate of multidrug resistance poses a serious public health concern, emphasizing the urgent need for antimicrobial stewardship and enhanced surveillance programs.