Search Results (9,549)

Background/Objectives: Clostridioides difficile infection (CDI) is the leading cause of colitis and hospital-acquired diarrhea. Patients with Chronic Obstructive Pulmonary Disease (COPD) frequently have infectious exacerbations requiring treatment with antibiotics, which may be predisposing them to CDI. This study examines the prevalence and in-hospital outcomes of CDI in patients with COPD. Methods: Data for hospitalized patients with CDI was extracted from the National Inpatient Sample database for the years 2016 through 2020. Baseline risk factors were identified using the International Classification of Diseases codes. Patients were stratified into two groups: with COPD and without COPD. The primary outcome was in-hospital mortality. The secondary outcomes were septic shock, hypovolemic shock, AKI, cardiac arrest, need for intensive care unit (ICU) level of care and length of stay. Statistical analyses were conducted using SPSS. Results: 290,172 patients were included in this study. Patients with COPD had more comorbidities overall and higher in-hospital mortality rates compared to patients without COPD (7.7% vs. 5.9%, p < 0.001). On multivariate logistic regression analysis, patients with CDI and COPD had higher risk of in-hospital mortality (OR = 1.346, p < 0.001), septic shock (OR = 1.289, p < 0.001), hypovolemic shock (OR = 1.184, p < 0.001), cardiac arrest (OR = 1.362, p < 0.001) and required more ICU level of care. Conclusions: Patients with COPD experience frequent exacerbations, often requiring hospitalizations and broad-spectrum antibiotics, steroids, proton pump inhibitors and antacids. These factors contribute to the higher prevalence of CDI in this patient population. Patients with CDI and COPD are also more likely to require ICU level of care, shedding the light on the significant burden of CDI, long hospital stays and substantial hospital charges. Recognizing mortality outcomes is essential to guide patient-specific therapies and highlights the need for closer monitoring and targeted management of CDI in patients with COPD. Full article

Background/objectives: severe mastitis is one of the leading causes of mortality in dairy cows. Its primary complication is shock, predominantly associated with systemic inflammatory response syndrome, which remains extremely challenging for practitioners to manage. The average mortality rate is estimated at approximately 25%. Many authors recommend the use of fluoroquinolones for this indication. However, these antibiotics are classified as critically important for human health, and their use requires strict compliance with specific guidelines (bacteriological analysis and antimicrobial susceptibility testing). In addition, some practitioners remain reluctant to use this class of antibiotics in field conditions. Therefore, the present study aimed to evaluate the outcomes of systematic antibiotic therapy using fluoroquinolones in cases of severe mastitis and to identify factors that may influence treatment success. Methods: a total of 323 cows with severe mastitis were enrolled by eight participating veterinary clinics located across different regions of France. The study design included: (i) clinical scoring based on a standardized grid developed by practitioners routinely managing this condition, (ii) bacteriological analysis of milk samples (with antimicrobial susceptibility testing performed when Gram-negative bacteria were isolated), and (iii) post-treatment follow-up consisting of telephone interviews conducted at 5 and 15 days after inclusion. Cows presenting with a clinical score ≥3 (scale 0–36) in association with local signs of mastitis were classified as having severe mastitis and received an injection of 10 mg/kg marbofloxacin along with 2.2 mg/kg flunixin (unless another NSAID had been administered within the previous 24 h). When the clinical score was ≥6, cows additionally received intravenous fluid therapy consisting of 3 L of 7.2% NaCl, supplemented by oral drenching if spontaneous water intake was insufficient. Results: a total of 43 cows died or were euthanized during the study period, corresponding to a mortality rate of 13.3%. The mean clinical score at inclusion was 12.6. The clinical signs most strongly associated with mortality were decubitus and hypothermia at admission. Escherichia coli was isolated in 67.0% of severe mastitis cases, either as a single pathogen (82.9%) or in mixed infections (17.1%). Overall, Gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, other Gram-negative organisms) were identified in 79.0% of cases. A total of 188 coliform isolates were tested for antimicrobial susceptibility. All isolates (100%) were susceptible to marbofloxacin, as were all tested Gram-negative strains, whereas only 79.9% of E. coli isolates were susceptible to sulfonamide/trimethoprim. Compared with previously published data, the observed mortality rate was lower despite the poor clinical condition of cows at admission. Conclusion: the timeliness of initiating effective antimicrobial therapy appears to be a critical determinant of survival in cows with severe mastitis. Full article

Industrial modernization has generated a wide range of toxic contaminants in industrial wastewater and domestic effluents. The increasing presence of emerging contaminants and endocrine disruptors in aquatic environments poses serious threats to ecosystems and human health. Accordingly, effective strategies are urgently needed for the removal of emerging organic pollutants, including dyes and antibiotics in pharmaceutical wastewater. Photocatalysis has attracted considerable interest as a versatile and sustainable remediation approach because photocatalysts are often cost-effective, earth-abundant, and capable of utilizing solar energy. This review summarizes recent advances in ZnO-based photocatalysts, focusing on compositional tuning and heterostructure engineering to enhance pollutant degradation. The major photocatalytic degradation mechanisms are also discussed. Despite significant progress, challenges remain, including limited light absorption, poor catalytic stability, and obstacles to practical application in wastewater treatment. This review provides an updated perspective on the development of ZnO-based photocatalysts for emerging pollutant removal. Full article

Biofilm formation constitutes a major factor in antibiotic treatment failure, shielding bacteria from drugs and promoting persistence. This study demonstrates that the anti-biofilm action of clove oil enhances the efficacy of fosfomycin against Escherichia coli O157:H7 (E. coli O157). Using a luxS-eGFP reporter system, it was found that clove oil inhibited E. coli O157 biofilm formation by up to 80% via suppression of the LuxS/AI-2 quorum sensing (QS) system and bacterial motility. Crucially, this disruption was shown to correlate with a strong synergistic effect when combined with fosfomycin in vitro. In a murine peritoneal infection model, the combination therapy demonstrated superior efficacy compared to monotherapy. Specifically, bacterial loads in the liver, spleen, and small intestine were significantly reduced, and histopathological damage was alleviated. Mechanistically, these effects were linked to the downregulation of the QS. These findings indicate that clove oil acts as a potent adjuvant to fosfomycin by disrupting biofilms, offering a promising strategy against systemic infections caused by E. coli O157. Full article

Background/Objectives: Biofilms are a form of defense that enables bacteria to withstand antibiotic pressure and demonstrate antibiotic resistance. It is crucial to develop anti-biofilm strategies in order to combat chronic and persistent multidrug-resistant (MDR) infections. Methods: In this study, we developed 3D biofilms of single-, dual-, and poly-species MDR ESKAPE components, including the pathogens P. aeruginosa S. aureus and K. pneumoniae, in CF Mu3Gel. We evaluated the efficacy of using a phage, a di-hetero phage cocktail or a poly-hetero phage cocktail in combination with ciprofloxacin to eliminate mature biofilm biomass after 72 h or one week in a single treatment. Results: The phage components mostly exhibited synergistic behavior when combined with ciprofloxacin and with each other in di- and poly-hetero-cocktails. The reduction in 72-h dual- and poly-species biofilms was one log higher than that of one-week biofilms treated with the phage–antibiotic combination. The greatest reductions were observed in the 72-h single-species biofilm with combination therapy, at 1.4–3.0 log. Reductions of 2.16 and 1.6 log were observed in the dual-species P. aeruginosa and S. aureus biofilm and the poly-species biofilm, respectively. Conclusions: This study examined how a single application of phages or phage cocktails, either alone or in combination with ciprofloxacin, impacted established biofilm models, and how this affected the proportion of microcolonies of different species within each model. These insights will facilitate the development of strategies for multiple follow-up treatments, as well as the reordering of phages, phage cocktails, and combinations with antibiotics, to improve outcomes. The 3D biofilm models developed here could be used to screen phages or phage cocktails either on their own or alongside other therapies. This would facilitate the application of in vitro findings to real physiological settings. Full article

Among diverse industrial wastes, antibiotic fermentation residues containing high concentrations of nosiheptide pose significant environmental and health risks. This study demonstrates that black soldier fly larvae (BSFL) can effectively degrade the nosiheptide residues within this fermentation matrix when blended with potato peel waste. Optimal degradation efficiency was achieved at a dry weight ratio of 3:5 (antibiotic fermentation residue to potato peel waste), yielding a 40.02% material reduction, an 8.63% bioconversion rate, and a 55.74% nosiheptide degradation rate. Further optimization of the larva-to-feed ratio enhanced nosiheptide degradation to 58.21%. Following 48 h of gut emptying period, no detectable nosiheptide remained within the tissues of the treated BSFL. The harvested larvae demonstrated high nutritional value, with crude protein and crude fat contents reaching up to 35.64% and 32.65%, respectively. The larvae also contained a comprehensive profile of essential amino acids, with the glutamic acid content exceeding 3%, which enhances feed palatability. Highly concentrated antibiotic treatments significantly increased the relative abundance of Bacteroidetes within the BSFL gut microbiota, with Dysgonomonas emerging as the dominant genus. This study highlights a novel strategy for degrading residual nosiheptide and converting waste into a valuable protein source, offering an eco-friendly solution for industrial waste management. Full article

Antimicrobial resistance (AMR) constitutes a growing global threat, facilitated by the dissemination of antibiotic resistance genes (ARGs) through wastewater treatment plants (WWTPs). This systematic review, conducted following the PRISMA guidelines, compiles the risks associated with ARGs, as well as the factors that promote horizontal gene transfer (HGT) and the technologies applied for their removal. The literature shows that WWTPs act as reservoirs, where biological treatment conditions and the presence of sub-inhibitory contaminants (antibiotics, metals, and pharmaceuticals) accelerate HGT. Although conventional methods (chlorination, ozonation, UV) are effective at eliminating antibiotic-resistant bacteria (ARB), their ability to degrade persistent genetic material is insufficient. Therefore, advanced oxidation processes (AOPs) emerge as a key solution, with the photo-Fenton process standing out due to efficiently generating hydroxyl radicals, achieving the degradation of ARGs, an essential step to mitigate the spread of AMR into the environment. Full article

Background: Debridement, antibiotics, and implant retention (DAIR) is an established treatment for early periprosthetic joint infection (PJI) following hip arthroplasty; however, reported success rates remain highly variable, particularly in patients with significant comorbidities, fracture-related arthroplasty, or resistant microorganisms. Augmentation of standard DAIR with structured local antimicrobial strategies may improve infection control but remains insufficiently standardized and evaluated. Methods: This retrospective single-center case series evaluated outcomes of a standardized multimodal DAIR-based strategy, the Mursa protocol, in 16 consecutive patients treated for early hip PJI between 2022 and 2025. PJI was diagnosed according to European Bone and Joint Infection Society criteria. The treatment included radical surgical debridement and exchange of mobile components with sequential intraoperative antiseptic microdebridement using povidone–iodine and hypochlorous/hypochlorite solution, followed by postoperative drain-based local antimicrobial irrigation and systemic antibiotic therapy. Treatment success was defined as sustained infection eradication with implant retention, absence of clinical and radiological signs of infection, no requirement for long-term suppressive antibiotics, and no infection-related mortality at a minimum one-year follow-up. Results: The cohort was clinically complex, with a predominance of arthroplasty procedures performed for fracture-related indications (11/16), a high comorbidity burden (median Charlson Comorbidity Index 5), revision arthroplasty in four patients, and a high rate of resistant or polymicrobial infections. At final follow-up, 15 of 16 patients (93.8%) achieved treatment success. One patient required implant removal due to persistent polymicrobial infection. No irrigation-related complications, wound-healing problems, or clinically relevant systemic toxicity were observed. Conclusions: In this high-risk cohort, a structured multimodal DAIR protocol incorporating sequential antiseptic microdebridement and postoperative local antimicrobial irrigation was feasible, safe, and associated with encouraging infection control. However, these findings should be interpreted as hypothesis-generating, and further prospective comparative studies are required to validate the protocol. Full article

Background/Objectives: Bleomycin is an antineoplastic antibiotic used in the management of various malignancies. Nevertheless, its benefits are constrained by the development of pulmonary fibrosis. Amentoflavone, a biflavonoid, exhibits diverse pharmacological activities, including anti-inflammatory, antiviral, antioxidant, and antitumor effects, whereas alogliptin possesses antioxidant and anti-inflammatory properties. This study aimed to assess the potential protective effects of alogliptin and/or amentoflavone in a murine model of bleomycin-induced pulmonary fibrosis and to clarify the underlying mechanisms. Methods: Fifty male C57BL/6 mice were randomly divided into 5 equal groups: control, bleomycin, bleomycin + alogliptin, bleomycin + amentoflavone, and bleomycin + alogliptin + amentoflavone. The assessed endpoints included lung weight/body weight index, lung tissue fibrotic mediators, oxidative stress parameters, proinflammatory cytokines, and pyroptotic and autophagy mediators. Also, the bronchoalveolar lavage fluid (BALF) was evaluated for total and differential leukocytic counts and lactate dehydrogenase (LDH) activity. Moreover, vascular responses to potassium chloride, phenylephrine, and carbachol, together with tracheal responses to carbachol were determined. Lung tissues were further examined histopathologically and immunohistochemically. Results: Treatment with alogliptin and/or amentoflavone significantly decreased the lung weight/body weight index and BALF LDH activity, concomitant with mitigation of lung tissue oxidative stress parameters, fibrotic mediators, apoptosis, and pyroptosis with a significant augmentation of autophagy signals, alongside marked improvement in the lung architecture and vascular and airway reactivity compared with the bleomycin group. These effects were most pronounced with animals treated with the alogliptin/amentoflavone combination. Conclusions: These findings suggest that combined alogliptin and amentoflavone may constitute a promising strategy to prevent bleomycin-induced lung fibrosis. Full article

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is of great concern because of the difficulties encountered in the management of infections it may cause. This study aims to identify possible difficulties in the management of K. pneumoniae infections in the current context of antibiotic resistance, particularly regarding carbapenem resistance. Methods: This is a retrospective, cross-sectional study that analyses epidemiological, clinical and bacteriological features identified in all patients with CRKP infections/colonization admitted during 2024 in an infectious diseases hospital. Results: Carbapenemase-producing K. pneumoniae isolates were co-harboring NDM+OXA-48 in 55.2% of cases. NDM+OXA-48-producing K. pneumoniae (116 isolates, 55.2%) was correlated with high resistance to aztreonam (100%, p = 0.01), ceftazidime–avibactam (100%, p < 0.01), trimethoprim–sulfamethoxazole (99.1%, p < 0.01), gentamycin (94.8%, p < 0.01), amikacin (93.8%, p < 0.01), colistin (79.8%, p < 0.01). OXA-48-producing K. pneumoniae (29 isolates, 13.8%) was correlated with lower resistance to ceftazidime–avibactam (11.5%, p < 0.01), amikacin (48.1%, p < 0.01), colistin (51.7%, p = 0.01), and gentamycin (65.5%, p < 0.01). We found in vitro synergistic effects of ceftazidime/avibactam + aztreonam for 32/32 CRKP isolates and of colistin + tigecycline for 12/14 CRKP isolates. Higher recurrence of CRKP infections was recorded in patients with urinary tract conditions (RR = 11.58, 95%CI: 1.58–81.91) and upper urinary tract devices (RR = 3.53, 95% CI: 1.72–7.22). In this study, adequate antibiotic treatment, compared to excessive antibiotic treatment in CRKP infections, was associated with shorter treatment duration (p = 0.02) and shorter length of hospitalization (p = 0.04). Conclusions: In our study, CRKP is frequently coharboring NDM+OXA-48, having limited treatment options. Implementing new treatment strategies, testing antibiotic synergies for older antibiotics in order to identify alternative treatment options and avoiding unnecessary carbapenem consumption are essential for decreasing the burden of CRKP infections. Full article

The rapid development of the aquaculture industry has led to increasing discharges of hypersaline and nutrient-enriched maricultural wastewater. Functional ceramic membranes have garnered significant advantages due to their exceptional chemical stability and high tailorability through surface and interface engineering. This research reviewed recent advances including the functionalization of ceramic membranes and hybrid systems coupled with advanced oxidation processes (AOPs) for enhancing degradations of nutrients and organics in maricultural wastewater treatment. Catalytic ceramic membranes enhanced removal of micropollutants including antibiotics and heavy metals. This review further systematically classified categorization of established functional ceramic membranes and synthesizes cutting-edge modification approaches for membrane fouling mitigation. Finally, this review evaluated the application prospects, challenges for scaled implementation, and proposed future research directions of functional ceramic membranes in the treatment of maricultural wastewater. Full article

Ofloxacin (OFL) and sulfamethoxazole (SMX) are common co-occurring antibiotic contaminants in aquatic environments, yet their long-term combined toxicity to freshwater fish remains poorly elucidated. In this study, adult mosquitofish (Gambusia affinis) were used as a model to investigate histopathological alterations, oxidative stress responses, gene expression, and gut microbiota changes after 30 days of exposure to environmentally relevant concentrations of OFL and SMX (0 ng/L, 50 ng/L, 1 μg/L, and 20 μg/L), either individually or in combination. The results showed that both single and combined exposures induced liver and intestinal damage. Oxidative stress responses exhibited clear tissue specificity, with activation of antioxidant defenses in the liver, whereas the intestine was mainly characterized by decreased SOD and GST activities, as well as reduced MDA content. Changes in gene expression were relatively limited, with significant alterations observed only in hepatic sod2 and hsp90 and intestinal hsp70 in certain treatment groups. Gut microbiota analysis showed that OFL exerted a stronger disruptive effect than SMX, as reflected by increased alpha diversity, reduced abundance of core genera, and functional remodeling, whereas combined exposure triggered weaker microbial community restructuring relative to single exposures. Overall, OFL and SMX induced tissue-specific toxicity in mosquitofish by causing tissue injury, oxidative stress imbalance, and gut microbiota dysbiosis, with OFL showing the stronger overall effect. Full article

Accurate detection and monitoring of antimicrobial resistance (AMR) in Helicobacter pylori mainly rely on phenotypic methods and culture, which can sometimes fail when bacterial load is low or after recent treatment. We investigated whether gastric biopsies classified as H. pylori-negative by standard diagnostic techniques still contain detectable bacterial DNA, including regions linked to AMR, and assessed whether selected DNA fragments can mediate allelic exchange in vitro. Gastric biopsies from 46 dyspeptic patients in the Democratic Republic of the Congo (including 23 phenotypically positive and 23 phenotypically negative individuals) were analyzed using long-read amplicon sequencing of seven resistance-associated loci, selective whole-genome amplification (sWGA) followed by long-read sequencing of H. pylori-enriched reads, and a proof-of-concept natural transformation assay. Phenotypically negative biopsies exhibited significantly lower sequencing depth across multiple loci (including 23S rRNA, gyrA, gyrB, and pbp1A; p = 0.003–0.014), indicating a reduced H. pylori DNA burden. However, AMR-associated mutations linked to various antibiotic classes were found in both groups. sWGA enabled recovery of fragmentary H. pylori sequence data from phenotypically negative samples, including reads that map to resistance- and virulence-associated genes. In vitro, 23S rRNA A2143G amplicons from both phenotypically positive and negative biopsies produced clarithromycin-resistant transformants in strain 26695. These findings indicate that phenotypically negative gastric biopsies might contain low-abundance and fragmentary H. pylori DNA. Although certain DNA fragments can mediate allelic exchange under controlled in vitro conditions, these results do not confirm bacterial viability, active infection, or clinically relevant in vivo resistance transfer. Therefore, they should be interpreted with caution in molecular AMR surveillance and detection contexts. Full article

Water pollution caused by antibiotics is a growing problem. Therefore, photodegradation by efficient catalysts is an environmentally friendly technology that can effectively degrade organic pollutants in water. In this work, a method was innovatively used to prepare a ternary heterostructure of plasmon-enhanced Ag-CuO/TiO₂. The composite was synthesized through a facile stepwise strategy involving the formation of CuO nanorods, TiO₂ coating, and subsequent deposition of Ag nanoparticles on their surface using AgNO₃, enabling intimate interfacial contact among the different components. The prepared samples were characterized by XRD, HRTEM, XPS, and UV-Vis. The chemical composition of the composite Ag-CuO/TiO₂ showed a Cu/Ti atomic ratio of 2.58, as well as a Ag/Cu ratio of 0.91. The UV-Vis spectrum reveals the largest absorption peak at 550 nm for the composite Ag-CuO/TiO₂. The prepared Ag-CuO/TiO₂ composites were applied to the visible-light degradation of tetracycline hydrochloride, with the photocatalytic degradation rate reaching 80.7% under the optimal conditions within 60 min, which is significantly better than CuO and CuO/TiO₂ without silver nanoparticles. Capture experiments indicated that h⁺ are involved during the course of the photodegradation and that h⁺ are the main active substances. Furthermore, the proposed mechanism for the photodegradation of the Ag-CuO/TiO₂ composites is given. It has potential applications in the treatment of organic pollutants in water. Full article

Background/Objectives: Skin and soft tissue infections (SSTIs) represent a significant clinical challenge, largely due to the high prevalence of antibiotic-resistant Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA). Treatment is further complicated by biofilm formation, which reduces antibiotic efficacy. The limitations of conventional therapies highlight the need for alternative approaches. Phage therapy has emerged as a promising biological strategy; however, its effectiveness may be constrained by factors such as phage instability and biofilm regrowth. This study aimed to enhance phage-based treatment by combining a newly isolated phage, vB_Sau-E, with lactoferrin (Lf), a multifunctional protein of the innate immune system. Methods: Phage vB_Sau-E was characterized in terms of its infection dynamics and lytic activity. Biocompatibility was further examined using human skin cell lines. The potential effect of Lf was assessed by evaluating its impact on phage infectivity and stability under a range of environmental conditions and by checkerboard assay. Results: Phage vB_Sau-E belongs to the Silviavirus genus in the Herelleviridae family. It was shown to infect 12 out of 22 tested clinical MRSA isolates, with 10 strains identified as good hosts. The phage has a ~30 min life cycle, and ~50 progeny virions are released after bacterial cell lysis. We have also observed that Lf increased plating efficiency and enhanced phage stability at a pH of 5.5 and at −20° C. It also proved to have an additive antibacterial effect, though this was observed to be strain-dependent. Conclusions: Lactoferrin functions as a stabilizing adjuvant for phage vB_Sau-E. Its additive effect supports the development of more effective, biofilm-targeting therapies for staphylococcal SSTIs. Full article