Bakgrund: Antibiotikaresistens är ett globalt folkhälsoproblem vars ökning kan leda till att antibiotikabehandlingens verkan uteblir. Att förebygga antibiotikaresistens kan göras på många olika sätt, där utgångspunkten är att minska dagens antibiotikaanvändning för att i sin tur minska förekomsten av resistenta bakterier så framtida generationer kan behandla svåra infektioner. Sjuksköterskan är central i detta arbete till följd av omvårdnadsarbetets täta patientkontakt.  Syfte: Syftet var att beskriva sjuksköterskans kunskaper om förebyggande arbete gällande antibiotikaresistens.  Metod: Metoden var en allmän litteraturöversikt baserad på tio vetenskapliga artiklar.  Resultat: Tre teman identifierades: Sjuksköterskans kunskap om antibiotika och antibiotikaresistens, där sjuksköterskans kunskap om antibiotika generellt visades god medan kunskapen om antibiotikaresistens var något mer varierande. Sjuksköterskans förmåga och kunskap att arbeta enligt förebyggande praxis, vilket visade att sjuksköterskan till stor del hade god följsamhet att förebygga infektioner och därmed antibiotikaresistens. Desto högre utbildning och erfarenhet, desto bättre kunskap och följsamhet, vilket visade olika orsaker som ledde till bättre kunskap och följsamhet.  Slutsats: Litteraturöversikten visade att kunskap om antibiotikaresistens är nödvändigt för sjuksköterskor att ha för att de ska kunna arbeta förebyggande. Att öka kunskapen hos sjuksköterskor gällande antibiotikaresistens och hur det förebyggs i kliniskt arbete kan leda till en framtid där vi fortfarande kan behandla patienter med antibiotika. / Background: Antibiotic resistance is a global public health problem whose increase can cause antibiotic treatment to fail. Preventing antibiotic resistance can be done in many ways, where the basis is to reduce today’s antibiotic use in order to reduce the occurrence of resistant bacteria so that future generations can treat severe infections. The nurse is central in this work because of the frequent patient contact in nursing care.  Aim: The aim was to describe nurse’s knowledge of preventative work regarding antibiotic resistance.  Method: The method used was a general literature review based on ten research articles.  Results: Three themes were identified: Nurse’s knowledge regarding antibiotics and antibiotic resistance, where the nurse’s knowledge of antibiotics was generally shown to be good, while the knowledge of antibiotic resistance was somewhat more variable. Nurse’s ability and knowledge to work preventative, which showed that the nurse largely had good compliance to prevent infections and thus antibiotic resistance. The higher the education and experience, the better the knowledge and compliance, which showed different reasons that led to better knowledge and compliance.   Conclusions: This literature review showed that knowledge about antibiotic resistance is necessary for nurses to possess in order to prevent it in their profession. Increased nursing knowledge regarding antibiotic resistance and how to prevent it in clinical work results in a future where we are still able to treat patients with antibiotics.

No description available.

Abstract OBJECTIVES: The objective of the present study is to compare the effect of systemic adjunctive use of azithromycin with amoxicillin/metronidazole to scaling and root planing (SRP) in a clinical study. MATERIALS AND METHODS: Data from 60 individuals with chronic periodontitis were evaluated after full-mouth SRP. Antibiotics were given from the first day of SRP, in the test group (n = 29), azithromycin for 3 days and, in the control group (n = 31), amoxicillin/metronidazole for7 days. Probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were recorded at baseline and after 3 and 12 months. Gingival crevicular fluid was analyzed for matrix metalloprotease (MMP)-8 and interleukin (IL)-1beta levels. Subgingival plaque was taken for assessment of the major bacteria associated with periodontitis. RESULTS: In both groups, PD, AL, and BOP were significantly reduced (p < 0.001). A few significant differences between the groups were found; AL and BOP were significantly better in the test than in the control group at the end of the study (p = 0.020 and 0.009). Periodontopathogens were reduced most in the test group. CONCLUSIONS: A noninferiority of the treatment with azithromycin in comparison with amoxicillin/metronidazole can be stated. The administration of azithromycin could be an alternative to the use of amoxicillin/metronidazole adjunctive to SRP in patients with moderate or severe chronic periodontitis; however, a randomized placebo-controlled multicenter study is needed. CLINICAL RELEVANCE: Application of azithromycin as a single antibiotic for 3 days might be considered as an additional adjunctive antibiotic to SRP in selected patients.

Streptomyces is the largest antibiotic-producing genus in the microbial world. Manumycin-type antibiotics are a small group of its metabolites. Their antibiotic activities are not very important but they show biological properties which can be potencially used e. g. to treat inflammation, cancer or Alzheimer's disease. The structure of manumycin compounds is formed by a central unit with connected upper and lower polyketide chain. The lower chain is mostly terminated by so called C5N unit. The substance U-62162 produced by the strain Streptomyces verdensis differs significantly from the other members of the manumycin-type metabolites in the structure of the lower chain which is fully saturated and lacking the C5N unit. The U-62162 biosynthetic gene cluster was sequenced and functions of identified open reading frames were deduced. Heterologous expressions of the cluster showed some genes reguired for the biosynthesis of the upper chain to be encoded on a different part of the chromosome. The insertional inactivation of the vrdER gene confirmed the enoylreductase to be responsible for the saturation of the lower chain. DSBA oxidoreductase, which gene is located at the edge of the cluster, is probably not involved in the biosynthesis. The insertion of genes for the biosynthesis of the C5N unit did...

Gradientech AB is a company that develops a new ultra-rapid system for antibiotic susceptibility testing and their product will hopefully be used in health care for more efficient diagnosis of sepsis. Today the product has difficulties with the analysis of polymicrobial tests. For our project, the task is therefore to examine the market and the demand for the ability to detect polymicrobial infections. Our project is meant to provide ideas for improvements on their current method for the feasibility to detect several types of bacteria in the same test. Through literature studies, we have received an overview of how optical methods using image analysis can work and how they could be implemented in Gradientech's product. Image analysis can make the identification of bacteria possible. Interesting objects in the image can be distinguished from each other with filters that handle, for example, size, shape and light intensity. A potential improvement in the classification of bacteria by optical methods may be to test several different angles and wavelengths. This is to get more training data for machine learning and thus more accurately detect and analyze samples. The results from literature studies and interviews with clinicians, a microbiologist, and professor in image analysis have led to a conclusion that techniques that contribute to a decrease of antimicrobial resistance will be crucial for the future. In Sweden, the development of resistant bacteria is pretty low, but in many other parts of the world, there is a different reality. The product’s greatest potential will probably be in countries with a high incidence of resistant bacteria and with educated personnel available to use the product. Ultra-rapid systems for AST can contribute to saving lives by making sure that the right type of antibiotics is given directly. Detection and identification of polymicrobial samples in sepsis are also relevant, but it will not contribute to reduced antibiotic use since the patient's health will always be prioritized as of now. Finally, we reached the conclusion that identification of polymicrobial tests is not a necessary feature for the success of the product. This is above all due to the mass spectrometry method MALDI-TOF, a technique that is already well-established in health care systems. It can quickly and cheaply identify bacteria in clinical samples.

Introduktion: Antibiotikaresistens är ett ökande globalt problem som på sikt påverkar möjligheterna till effektiv sjukvård. Insatser mot ökad antibiotikaresistens genomförs på flera håll i världen men sjuksköterskor har inte i någon större utsträckning varit involverade. På senare år har deras roll dock börjat diskuteras allt mer. Syfte: Att undersöka sjuksköterskors skattade kunskap om antibiotika och mikrobiologi samt upplevda hinder för ökad delaktighet i arbetet med rationell antibiotikaanvändning inom slutenvården. Metod: En enkät skickades till omkring 700 sjuksköterskor på slutenvårdsavdelningar i Region Halland. De ombads att skatta sin kunskap om antibiotika och mikrobiologiska odlingar, att besvara frågor om egna erfarenheter kring dessa områden samt ange vilka hinder de såg för ökad delaktighet. Resultat: 171 sjuksköterskor (24 procent) besvarade enkäten. Majoriteten av sjuksköterskorna skattade sin kunskap om antibiotika och mikrobiologiska odlingar som god. Flest sjuksköterskor bedömde sin kunskap som låg rörande laboratoriets olika hantering av odlingar och läkemedelshantering gällande antibiotika. Otillräcklig kunskap hos sjuksköterskor och hög arbetsbelastning var de hinder för ökad delaktighet som flest uppgav. Slutsats: Än högre kunskap hos sjuksköterskorna kan påverka deras möjligheter att vara delaktiga i patientens antibiotikabehandling då högre kunskap visade sig påverka samarbetet mellan läkare och sjuksköterskor positivt. De sjuksköterskor som skattade sin kunskap om antibiotika som låg ansåg dessutom i högre utsträckning att otillräcklig kunskap var ett hinder för ökad delaktighet. Mer utbildade och delaktiga sjuksköterskor kan vara nyckeln till en smartare antibiotikabehandling och kan innebära att riskerna för onödigt bred eller lång behandling minskar och därmed minskar riskerna för negativa konsekvenser för patienten.

<p style="text-align: justify;">Jedno od najvećih dostignuća u dvadesetom veku je bio pronalazak antibiotika i njihova primena u humanoj medicini. Međutim, vremenom se pokazalo da su izazivači bolesti mikroorganizmi koji &ldquo;uče&rdquo; i imaju sposobnost da se &ldquo;menjaju&rdquo;, &scaron;to neminovno dovodi do pojave antibiotske rezistencije, a čemu ide u prilog &scaron;iroko rasprostranjena upotreba antibiotika u lečenju pacijenata i primena humanih antimikrobnih lekova u veterini i fitofarmaciji. Razvoj novih i unapređenje postojećih farmaceutika zahteva ogromna ulaganja koja se mogu ali i ne moraju vratiti godinama. Prvi korak u razvoju novog farmaceutika je identifikacija ciljanog antibiotskog delovanja metabolita izabranog proizvodnog mikroorganizma, nakon čega sledi optimizacija uslova biosinteze u smislu sastava medijuma za proizvodnju.<br />Osnovni cilj ove doktorske disertacije je optimizacija formulacije medijuma za kultivaciju prirodnog izolata Streptomyces hygroscopicus u pogledu izvora makronutrijenata i njihovih količina, kako bi se metabolička aktivnost primenjenog proizvodnog mikroorganizma, u definisanim proizvodnim uslovima, usmerila ka sintezi antibiotika sa ciljanim delovanjem.<br />Optimizacijom formulacije medijuma za kultivaciju prirodnog izolata <em>Streptomyces hygroscopicus</em>, u primenjenim eksperimentalnim uslovima, odabrani su najpogodniji izvori makronutrijenata i definisane su njihove optimalne koncentracije za proizvodnju antibiotika sa ciljanim delovanjem. Utvrđeno je da je biosinteza baktericida efikasnih protiv <em>B. cereus</em> ATCC 10876, <em>S. aureus</em> ATCC 11632 i P. <em>aeruginosa</em> ATCC 27853 najizraženija u medijumu sa fruktozom, sojinim bra&scaron;nom i fosfatnim solima, dok je za dobijanje fungicida koji deluju na <em>C. albicans</em> ATCC 10231 i <em>A. niger</em> ATCC 16404 najadekvatnije primeniti medijum sa glukozom kao izvorom ugljenika i već pomenutim izvorima azota i fosfora pri čemu je odnos navedenih sastojaka medijuma specifičan za svaki test mikroorganizam. Sa tehnolo&scaron;kog aspekta, rezultati ovih istraživanja predstavljaju pouzdan izvor informacija za unapređenje proizvodnih karakteristika primenjenog biokatalizatora, izbor tehnike kultivacije, definisanje toka i optimizaciju postupka proizvodnje baktericida i fungicida sa krajnjim ciljem uvećanja razmera posmatranog bioprocesa.</p> / <p>One of the greatest achievements in the twentieth century was the invention of antibiotics and their application in human medicine. However, over time, it has been proven that disease susceptors are &quot;learning&quot; microorganisms and have the ability to &quot;change&quot;, which inevitably leads to the emergence of antibiotic resistance, which is in favor of widespread use of antibiotics in the treatment of patients and the application of human antibiotics in veterinary medicine and phytopharmacy. The development of new and the advancement of existing pharmaceuticals requires huge investments that may or may not be back for years. The first step in the development of a new pharmaceutical is the identification of the target antibiotic activity of the metabolite of the selected production microorganism, followed by the optimization of the conditions of biosynthesis in terms of composition of the production medium.<br />The main goal of this PhD thesis is the optimization of the formulation of the medium for the cultivation of the natural isolate Streptomyces hygroscopicus in terms of the source of macronutrients and their amounts, in order to direct the metabolic activity of the applied production microorganism, in the defined production conditions, towards the synthesis of antibiotics with targeted action. By optimizing the formulation of the medium for the culture of the natural isolate Streptomyces hygroscopicus, in the applied experimental conditions, the most suitable sources of macronutrients were selected and their optimal concentrations for the production of antibiotics with targeted action were defined. The biosynthesis of bactericides was found to be effective against B. cereus ATCC 10876, S. aureus ATCC 11632 and P. aeruginosa ATCC 27853 most pronounced in the medium with fructose, soy flour and phosphate salts, while for the production of fungicides acting on C. albicans ATCC 10231 and A. niger ATCC 16404 most appropriately apply a glucose medium as carbon source and already mentioned sources of nitrogen and phosphorus wherein the ratio of said ingredients to the medium is specific to each test microorganism. From a technological point of view, the results of these studies represent a reliable source of information for improving the production characteristics of the applied biocatalyst, a selection of cultivation techniques, defining the flow and optimizing the production of bactericides and fungicides with the ultimate goal of increasing the size of the observed bioprocess.</p>

The Master thesis dealt with changes in cytoplasmatic membrane of model strain Streptomyces nodosus subsp. asukaensis. This strain produces polyketide antibiotic called asukamycin. Changes of cytoplasmatic membrane were observed as a response to the age of bacterial culture (exponential and stationary growth phase) and addition of produced antibiotic precursor (cyclohexanecarboxylic acid) to incubation medium. Observed parametres were the composition of membrane fatty acids and the membrane fluidity.

The work deals with the monitoring of selected indicators of milk quality including residues of inhibitory substances (RIS) in the milk of cows treated with selected groups of antibiotics. It contains an analysis of selected factors that act on these indicators. The theoretical part deals with the inhibitory substances, their effects on the human body and the processing technology. The paper describes the application of antibiotics to treat mastitis and drying off cows including factors that affect the excretion of antibiotics in milk. The legislative regulations relating to this issue are also a part of the theoretical section. The practical part is divided into three parts. The first part focuses on the characteristics observed in cows treated within selected businesses and farms. The second part is focused on the assessment of the quality parameters studied samples (fat, protein and somatic cell count) and the third part is devoted to factors that influence the presence of RIS in milk samples. In determining the quality indicators monitored in milk treated cows, it was confirmed that the protein content and static cell count (SCC) are in these cows due to disease increased and the mean value of the SCC did not correspond to a given limit legislation. When monitoring factors affecting presence RIS, it was found that the method of drug administration group and used antibiotics have influenced the presence RIS after the withdrawal period.

Background: Necrotizing pancreatitis is a life-threatening presentation of acute pancreatitis. The mortality of 20–80% initially depends on the persistence of organ failure and systemic inflammatory response syndrome (SIRS) and, in the later course of the disease, on secondary infection of the necrosis. The questions whether prophylactic antibiotics aiming to prevent this infection should be administered and which antibiotic is the best to use, as well as the problem of fungal infection under antibiotic treatment are still intriguing and insufficiently solved. Methods: A search of the literature using PubMed was carried out, supplemented by a review of the programmes of the Digestive Disease Week (DDW) and the United European Gastroenterology Week (UEGW). Results: Despite the widely practised prophylactic antibiotic administration in severe pancreatitis, no evidence for the benefit of this strategy exists. One of the drawbacks might be a tendency for disastrous fungal infection under prophylactic antibiotics. Bacterial translocation from the gut in the second week after the onset of symptoms is the major source for infection of pancreatic necrosis and provides a clear indication for antibiotic treatment. However, routine fine-needle aspiration for a calculated antibiotic therapy cannot be recommended, and all other tests offer only indirect signs. Important factors such as enteral versus parenteral feeding and the method of necrosectomy are mostly neglected in the trials but seem to be essential for the outcome of the patient. Conclusions: Even though most meta-analyses including the newer double-blind, placebo-controlled trials on prophylactic antibiotics showed no beneficial effects in the prevention of infection of necrosis and/or outcome of the patients, this strategy is still widely used in clinical routine. Since nearly all trials published so far show systematic problems (i.e. inaccurate definition of the severity of the disease, poor statistical testing, and neglect of differences in the route of nutrition), there is a need for randomized controlled prospective trials with exact definitions of the disease. / Hintergrund: Die nekrotisierende Pankreatitis weist eine Mortalität von 20–80% auf. Initial ist vor allem das Ausmaß des Organversagens entscheidend für die Prognose des Patienten. In der zweiten Krankheitswoche stellt dann die sekundäre Infektion der Nekrosen durch die Translokation von Darmkeimen das entscheidende Problem dar. Zur Vermeidung einer solchen Infektion werden klinisch sehr häufig Breitspektrumantibioktika prophylaktisch eingesetzt. Dies wird aber zunehmend kritisch diskutiert, und es existieren kontroverse Empfehlungen. Methoden: Eine Literaturrecherche unter Einbeziehung von PubMed und der Programme der Digestive Disease Week (DDW) und der United European Gastroenterology Week (UEGW) wurde durchgeführt. Ergebnisse: Die meisten Studien können den prophylaktischen Einsatz von Antibiotika bei der schweren Pankreatitis nicht rechtfertigen. Einige Studien belegen vielmehr eine Selektion resistenter Keime und vor allem auch eine erhöhte Rate von schwer therapierbaren Pilzinfektionen unter einer solchen Therapie. Daher sollte erst nach dem Nachweis einer Nekroseinfektion mit einer Antibiotikatherapie begonnen werden, wobei keine Routine-Feinnadelpunktion der Nekrose zum Keimnachweis durchgeführt werden sollte. Es stehen daher nur indirekte, meist bildgebende Verfahren für den Infektionsnachweis zur Verfügung. Entscheidende Faktoren wie die enterale Ernährung und die Methode der Nekrosektomie wurden bisher bei den meisten Studien vernachlässigt, scheinen aber essenziell für das Behandlungsergebnis des Patienten zu sein. Schlussfolgerungen: Die meisten publizierten Studien weisen eine sehr heterogene Definition der Erkrankung, uneinheitliche Behandlungsprotokolle und Ungenauigkeiten bei der statistischen Testung auf. Gerade entscheidende Faktoren wie die enterale Ernährung werden größtenteils komplett vernachlässigt. Es besteht daher ein Bedarf für randomisierte placebokontrollierte Studien, die diese Probleme berücksichtigen und suffiziente Schlussfolgerungen zur Antibiotikatherapie der schweren Pankreatitis zulassen.