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The emergence of multidrug-resistant bacteria constitutes a great challenge for modern medicine, recognized by leading medical experts and politicians worldwide. Rediscovery and implementation of bacteriophage therapy by Western medicine might be one solution to the problem of increasing antibiotic failure. In some Eastern European countries phage therapy is used for treating infectious diseases. However, while the European Medicines Agency (EMA) advised that the development of bacteriophage-based therapies should be expedited due to its significant potential, EMA emphasized that phages cannot be recommended for approval before efficacy and safety have been proven by appropriately designed preclinical and clinical trials. More evidence-based data is required, particularly in the areas of pharmacokinetics, repeat applications, immunological reactions to the application of phages as well as the interactions and effects on bacterial biofilms and organ-specific environments. In this brief review we summarize advantages and disadvantages of phage therapy and discuss challenges to the establishment of phage therapy as approved treatment for multidrug-resistant bacteria.

ABSTRACT BACKGROUND: The consumption of antibiotics has been widely discussed, mainly because of antibacterial resistance, which has become a worldwide concern. In Brazil, sale of antibiotics is currently ruled by Agência Nacional de Vigilância Sanitária (ANVISA) regulation RDC 20/2011, which restricts sales to those made under medical prescription. The aims of this study were to evaluate antibiotic use and associated factors among adults in the Metropolitan Region of Manaus, Amazonas, Brazil, and to assess the proportion of self-medication from this use. DESIGN AND SETTING: Population-based cross-sectional study conducted in the Metropolitan Region of Manaus between May and August 2015. METHODS: Adults aged ≥ 18 years were selected through probabilistic sampling in three stages. Trained interviewers collected data from the participants in their homes. Antibiotic consumption over the last 15 days was reported. Bivariate analysis was used to calculate the prevalence ratio (PR) of antibiotic usage, with 95% confidence interval (95% CI). A multivariate model adjusted according to significant variables at P ≤ 0.20 using Poisson regression with robust variance was constructed. RESULTS: The prevalence of antibiotic use was 3.4% (95% CI 2.8-4.0%). Adjusted analysis showed that consumption was higher among women than among men (PR 1.58; 95% CI 1.11-2.24) and among people with fair health status than among those with good health (PR 1.52; 95% CI 1.08-2.15). The prevalence of self-medication was 19.0%; amoxicillin was the most self-medicated antibiotic (10/26). CONCLUSION: Antibiotic use was associated with women and individuals with fair health status. One fifth of the antibiotics were consumed through self-medication, contrary to the current Brazilian legislation.

Arising multidrug resistance to available antibiotics is a problem of deep scientific and research concern. One organism with increasing antibiotics resistance is Klebsiella spp. that had cause several outbreaks in different locations. This study was undertaken to investigate the antibiogram and susceptibility of Klebsiella spp. isolated from clinical samples in health care centers. The study was conducted in Auchi Township in Etsako West Local Government Area, Edo State, Nigeria. Following standard procedures samples were collected and Klebsiella spp. identified using standard microbiology techniques. Antibiotic susceptibility testing was carried out using standard methods. 109 samples were collected and comprised urine (44), wound (20), high vagina swabs (17), urethral (3), sputum (9), semen (6), stool (5), endo-cervical swab (2), throat (1) and ear (1). 10 (9.17%) samples were positive to Klebsiella organism with urine consisting 50.0% and 10.0% each from sputum, stool, wound, ear and high vaginal swabs. Klebsiella isolates were completely resistance to penicillin, Amoxiclav and Chloramphenic. Amoxicillin, Floxapen, Metronidazole, Ampicillin, Cotrimoxazole, Nalidixic acid, Streptomycin, Tetracycline, Cephalexin, Genticin, Tobramycin, Nitrofurantoin, Ciprofloxacine and Cefuroxime have less than 50% potency. On the other hand, Ofloxacine, Cefotaxime, Ampisulbactam and Perflacine were 50% and above susceptible. Klesiella spp. isolated from stool sample was more multi-drug resistance (87.75%) followed by those from wound (77.55%), sputum (73.47%), high vaginal swab (69.39%), urine (65.30%) and lastly ear sample (48.98). Based on our findings, Klebsiella spp. in the study area is multidrug-resistance thus suggesting antibiotic analysis prior to treatment.

The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events. This paper serves as a position statement of the Pediatric Pharmacy Advocacy Group (PPAG) who supports the implementation of antimicrobial stewardship programs for all pediatric patients. PPAG also believes that a pediatric pharmacy specialist should be included as part of that program and that services be covered by managed care organizations and government insurance entities. PPAG also recommends that states create legislation similar to that in existence in California and Missouri and that a federal Task Force for Combating Antibiotic-Resistant Bacteria be permanently established. PPAG also supports post-doctoral pharmacy training programs in antibiotic stewardship.

Diese Arbeit behandelt den gesetzlichen Regelungsrahmen von Novel Food (neuartige Lebensmittel), insbesondere von Probiotika. Die derzeitige Gesetzeslage in der Europäischen Union, betreffend der Zulassung neuartiger Bakterien ist langwierig und teuer für den Antragssteller. Weiteres umfasst das Europäische Regelwert einige Grauzonen, wie z.B. im Hinblick auf genetisch veränderte Mikroorganismen, substanzieller Äquivalenz von verwandten Bakterien und den Geltungsbereich des European Qualified Presumption of Safety (QPS: Qualifizierte Sicherheitsannahme) Konzepts. Diese Grauzonen werden anhand von Beispielen in dieser Arbeit diskutiert und erläutert. Antibiotika resistenten Plasmide wurden dem ursprünglichen Mutter-Stamm Lactobacillus reuteri ATCC 55730 mit Hilfe von Techniken, die als nicht genetische Manipulation von konsultierten Experten und anhand der Europäischen Gesetzeslage eingestuft werden, entfernt. Der resultierende Tochter-Stamm Lactobacillus reuteri DSM 17938 ist entsprechend dem wissenschaftlichen Wissensstand sicher für den menschlichen Gebrauch, sowie mit dem Mutter-Stamm äquivalent. Ein weiteres behandeltes Exempel stellt das probiotische und weit verbreitete Bakterium Akkermansia muciniphila dar. A. muciniphila zeigt großes Potential in der Prävention von Krankheiten und Krankheitssymptomen, sowie in der Senkung von Gesundheitskosten. Dennoch hat das Bakterium noch keinen QPS- oder "Novel Food"-Status erreicht. Zukünftige wissenschaftliche Arbeiten sollten die Funktionalität und das Potential von Akkermansia spp. untersuchen, um die Entwicklung neuer Märkte für probiotisches Produkte zu forcieren. Lactobacillus reuteri DSM 17938 und Akkermansia muciniphila fungieren als Beispiele für das noch bei weitem nicht ausgeschöpfte Repertoire von neuartigen Probiotika. ; This thesis focuses on the general regulation of novel bacteria, particularly probiotics that are intended for human consumption. Within the European Union, the regulation of novel bacteria remains challenging and expensive for applicants. The European regulatory framework contains grey zones in regards to genetically modified microorganism, substantial equivalence of related bacterial strains, and application of the European Qualified Presumption of Safety (QPS) system. Examples of these grey zones are discussed within this work. The first discussed example is Lactobacillus reuteri, strain DSM 17938, and the regulation surrounding it as a genetically modified microorganism and conventional probiotic. Antibiotic resistance plasmids were removed from the mother strain (ATCC 55730) by techniques that are not considered as genetic modification by consulted experts and European law. It is likely that the mother and the daughter strains are substantially equivalent and therefore safe. Another example of a novel bacteria is the commensal and abundant bacterium Akkermansia muciniphila. According to current scientific findings, this recently detected mucus degrader shows great potential at reducing health costs through disease prevention. The bacterium has not gained QPS or "novel food" status in terms of the Novel food Regulation (EC) No 258/97, but seems to be safe for future commercial production. Therefore, scientific work should focus on the functionality and importance of Akkermansia spp. in humans to facilitate the launch of novel probiotic formulations. Based on these examples, we can see that the repertoire and possibilities of proposed new probiotic candidates has not been exhausted. ; Stephanie Pohl ; Zsfassung in dt. Sprache ; Wien, Univ. für Bodenkultur, Masterarb., 2014 ; (VLID)1127355

History of Medicine is not a discipline destined to culturally enrich only those who work in the health sector. All historians know very well how some medical events have influenced the course of history. In particular, infectious diseases, being interconnected with political, social, economic and war issues, have an important historical significance.Microbial agents are invisible enemies ready to undermine mankind and to find prosperity in human misery.Tuberculosis, better than other, is well suited to study the epistemological path of medical thought, from its origins to the present day.From the Hippocratic and Galenic thought to the anatomo-clinical method, from the advent of microbiology to the antibiotic era up to the postantibiotic era, recognizing the timeless need to implement valid social policies and effective preventive medicine actions to achieve satisfactory results.

Traditionally, antibiotics are included in animal feed at subtherapeutic levels for growth promotion and disease prevention. However, recent links between in-feed antibiotics and a rise in antibiotic-resistant pathogens have led to a ban of all antibiotics in livestock production by the European Union in January 2006 and a removal of medically important antibiotics in animal feeds in the United States in January 2017. An urgent need arises for antibiotic alternatives capable of maintaining animal health and productivity without triggering antimicrobial resistance. Host defense peptides (HDP) are a critical component of the animal innate immune system with direct antimicrobial and immunomodulatory activities. While in-feed supplementation of recombinant or synthetic HDP appears to be effective in maintaining animal performance and alleviating clinical symptoms in the context of disease, dietary modulation of the synthesis of endogenous host defense peptides has emerged as a cost-effective, antibiotic-alternative approach to disease control and prevention. Several different classes of small-molecule compounds have been found capable of promoting HDP synthesis. Among the most efficacious compounds are butyrate and vitamin D. Moreover, butyrate and vitamin D synergize with each other in enhancing HDP synthesis. This review will focus on the regulation of HDP synthesis by butyrate and vitamin D in humans, chickens, pigs, and cattle and argue for potential application of HDP-inducing compounds in antibiotic-free livestock production.

Background Antimicrobial resistance may result from inappropriate use of antibiotics in health care. Turkey is one of the countries with the highest antibiotic consumption in the world. Considering the role of transnational ties between Turkish migrants and their social contacts in Turkey, the attitudes and behaviors relating to rational antibiotic use in Turkey can also affect the use of antibiotics by Turkish migrants residing abroad. This study explores physicians' and pharmacists' experiences and perspectives on rational antibiotic use among Turkish adults in Turkey and among Turkish migrants in Germany, Sweden, and the Netherlands, three European countries with large populations of Turkish migrants. Methods Following a qualitative study design using convenience and snowball sampling, in-depth interviews with 21 family physicians and 24 pharmacists were conducted in the aforementioned countries. We transcribed all interviews verbatim and performed content analysis separately in the countries, followed by translation, pooling and joint interpretation of the findings. Results Physicians and pharmacists encountered irrational use of antibiotics among their patients in Turkey. Physicians interviewed in the three European countries explained that Turkish migrants differ from non-migrants with respect to their attitudes towards antibiotics, for example by more often expecting to be prescribed antibiotics. All physicians and pharmacists in the selected countries reported to inform their patients on how to use antibiotics upon prescription; however, Turkish migrants' poor language proficiency was considered as a substantial communication barrier by the physicians and pharmacists interviewed in the European countries. Conclusions The study illustrated some aspects of irrational antibiotic use among the population in Turkey and Turkish migrants in selected European countries. It emphasized the need for closer community participation, adequate information campaigns, as well as in-service training of health care providers in Turkey. The strategies and interventions on rational antibiotic use should also be supported and encouraged by health care providers, who need to reach out to people with various cultural backgrounds.

The strategy of combating the development of antibiotic resistance is a global challenge for the scientific community for the sake of life and health of the population. An analysis of the relationship between the levels of antimicrobial drug consumption and the development of antibiotic resistance is one of the tools to contain the resistance. An increase in the consumption of antimicrobial drugs may not significantly reduce the possibility of treating infectious diseases.According to reports from the European Surveillance of Antimicrobial Consumption Network, β-lactam antimicrobial drugs are the most consumed antibiotic group in Europe among other. The consumption level of β-lactams in Ukraine is significantly lower than in the Europe. Such data require a detailed assessment of the level of consumption of β-lactam antimicrobial drugs, for individual INN and analysis of the balance of their use.The aim of the work is to analyze the market and consumption of antimicrobial drugs of the β-lactam group in Ukraine for 2013-2018 with the help of the ATC / DDD methodology, as well as comparison of the obtained consumption volumes with similar results in the European Union.Results. The total amount of AMP of the β-lactam group presented in the Ukrainian market in 2018 is 343 trade names (TN), of which 92 are domestic and 251 are foreign manufactured, which indicates the high saturation of the Ukrainian pharmaceuticals by imported drugsIn Ukraine, in 2017, penicillins consumed 4.48 times less than the EU average, while cephalosporins and carbapenems are almost the same.The most commonly used INNs from the penicillin group – Amoxicillin and Amoxicillin with β-lactamase inhibitors, and the leaders in terms of consumption among cephalosporins are medicines for CITIs Ceftriaxone and Cefuroxime.Conclusions. Antimicrobials of the β-lactam group are well-studied and widely used in medical practice. They are widely represented in the Ukrainian market (343 TN), but only less than a third of them (92 TN) of domestic production, which indicates the high saturation of the Ukrainian pharmaceutical market with imported drugs. The volume of antimicrobial drugs used in the β-lactam group in Ukraine is almost 4.5 times lower than in the EU.The most commonly used drugs are Amoxicillin, from a group of penicillins with extended spectrum. Cefriaxone and Cefuroxime are most commonly used drugs among cephalosporins ; Стратегія боротьби проти розвитку антибіотикорезистентності – глобальний виклик для наукової спільноти задля життя і здоров'я населення. Аналіз взаємозв'язку між рівнями споживання антимікробних препаратів та розвитком антибіотикорезистентності – один з інструментів стримування останньої. Збільшення споживання антимікробних препаратів знижує можливості лікування інфекційних захворювань.Антимікробні препарати групи β-лактамів, за даними звітів Європейської мережі нагляду за споживанням антимікробних засобів, є одними з найбільш споживаних серед інших груп антибіотиків у Європі. В Україні рівень споживання β-лактамів значно нижчий середньоєвропейського. Такі дані вимагають детальної оцінки рівня споживання β-лактамних антимікробних препаратів, за окремими МНН, аналізу балансу їх застосування.Метою роботи є аналіз ринку та споживання АМП групи β-лактамів в Україні за 2013-2018 роки за допомогою ATC/DDD-методології, а також порівняння отриманих об'ємів споживання з аналогічними результатами в Європейському Союзі.Результати. Загальна кількість АМП групи β-лактамів представлених на ринку України у 2018 році становить 343 торгових найменування (ТН), з них – 92 пропозиції вітчизняних і 251 – іноземних фірм-виробників, що свідчить про високу насиченість українського фармацевтичного ринку імпортними препаратамиВ Україні у 2017 році пеніцилінів спожито у 4,48 разу менше ніж у середньому по ЄС, а цефалоспоринів та карбапенемів майже стільки ж.Найбільше було спожито препаратів МНН з групи пеніцилінів – Амоксициліну та Амоксициліну з інгібіторами β-лактамаз, а лідерами за об'ємами споживання серед цефалоспоринів є лікарські засоби за МНН Цефтріаксону і Цефуроксиму.Висновки. Антимікробні препарати групи β-лактамів добре вивчені та широко використовуються у медичній практиці, в асортименті представлені на ринку України (343 ТН), але тільки менше третини з них (92 ТН) – вітчизняного виробництва, що свідчить про високу насиченість українського фармацевтичного ринку імпортними препаратами. Об'єм споживання антимікробних препаратів групи β-лактамів в Україні майже в 4,5 рази менший, ніж у країнах ЄС.Найбільш споживаними є препарати Амоксициліну – групи пеніцилінів широкого спектру дії та серед цефалоспоринів – препарати Цефтріаксону та Цефуроксиму ; Стратегия борьбы против развития антибиотикорезистентности - глобальный вызов научному сообществу ради жизни и здоровья населения. Анализ взаимосвязи между уровнями потребления антимикробных препаратов и развитием антибиотикорезистентности – один из инструментов сдерживания последней. Увеличение потребления антимикробных препаратов существенно снижает возможности лечения инфекционных заболеваний.Антимикробные препараты группы β-лактамов, по данным отчетов Европейской сети наблюдения за потреблением антимикробных средств, являются одними из наиболее потребляемых среди других групп антибиотиков в Европе. В Украине уровень потребления β-лактамов значительно ниже среднеевропейского. Такие данные требуют детальной оценки уровня потребления β-лактамных антимикробных препаратов, по отдельным МНН, анализа баланса их применения.Целью работы является анализ рынка и потребления АМП группы β-лактамов в Украине за 2013-2018 годы с помощью ATC/DDD-методологии, а также сравнение полученных объёмов потребления с аналогичными результатами в Европейском Союзе.Результаты. Общее количество АМП группы β-лактамов, представленных на рынке Украины в 2018 году, составляет 343 торговых наименования (ТН), из них – 92 предложения отечественных и 251 – иностранных фирм-производителей, что свидетельствует о высокой насыщенности украинского фармацевтического рынка импортными препаратами. В Украине в 2017 году пенициллина потреблено в 4,48 раза меньше, чем в среднем по ЕС, а цефалоспоринов и карбапенемов – почти столько же. Более всего было потреблено препаратов МНН из группы пенициллина - Амоксициллина и Амоксициллина с ингибиторами β-лактамаз, а лидерами по объемам потребления среди цефалоспоринов являются лекарственные средства по МНН Цефтриаксон и Цефуроксима.Выводы. Антимикробные препараты группы β-лактамов хорошо изучены и широко используются в медицинской практике. Они широко представлены на рынке Украины (343 ТН), но только менее трети из них (92 ТН) отечественного производства, что свидетельствует о высокой насыщенности украинского фармацевтического рынка импортными препаратами. Объём потребления антимикробных препаратов группы β-лактамов в Украине почти в 4,5 раза меньше, чем в странах ЕС. Наиболее потребляемыми являются препараты Амоксициллина - группы пенициллина широкого спектра действия и среди цефалоспоринов - препараты Цефтриаксон и Цефуроксима

The strategy of combating the development of antibiotic resistance is a global challenge for the scientific community for the sake of life and health of the population. An analysis of the relationship between the levels of antimicrobial drug consumption and the development of antibiotic resistance is one of the tools to contain the resistance. An increase in the consumption of antimicrobial drugs may not significantly reduce the possibility of treating infectious diseases.According to reports from the European Surveillance of Antimicrobial Consumption Network, β-lactam antimicrobial drugs are the most consumed antibiotic group in Europe among other. The consumption level of β-lactams in Ukraine is significantly lower than in the Europe. Such data require a detailed assessment of the level of consumption of β-lactam antimicrobial drugs, for individual INN and analysis of the balance of their use.The aim of the work is to analyze the market and consumption of antimicrobial drugs of the β-lactam group in Ukraine for 2013-2018 with the help of the ATC / DDD methodology, as well as comparison of the obtained consumption volumes with similar results in the European Union.Results. The total amount of AMP of the β-lactam group presented in the Ukrainian market in 2018 is 343 trade names (TN), of which 92 are domestic and 251 are foreign manufactured, which indicates the high saturation of the Ukrainian pharmaceuticals by imported drugsIn Ukraine, in 2017, penicillins consumed 4.48 times less than the EU average, while cephalosporins and carbapenems are almost the same.The most commonly used INNs from the penicillin group – Amoxicillin and Amoxicillin with β-lactamase inhibitors, and the leaders in terms of consumption among cephalosporins are medicines for CITIs Ceftriaxone and Cefuroxime.Conclusions. Antimicrobials of the β-lactam group are well-studied and widely used in medical practice. They are widely represented in the Ukrainian market (343 TN), but only less than a third of them (92 TN) of domestic production, which indicates the high saturation of the Ukrainian pharmaceutical market with imported drugs. The volume of antimicrobial drugs used in the β-lactam group in Ukraine is almost 4.5 times lower than in the EU.The most commonly used drugs are Amoxicillin, from a group of penicillins with extended spectrum. Cefriaxone and Cefuroxime are most commonly used drugs among cephalosporins ; Стратегія боротьби проти розвитку антибіотикорезистентності – глобальний виклик для наукової спільноти задля життя і здоров'я населення. Аналіз взаємозв'язку між рівнями споживання антимікробних препаратів та розвитком антибіотикорезистентності – один з інструментів стримування останньої. Збільшення споживання антимікробних препаратів знижує можливості лікування інфекційних захворювань.Антимікробні препарати групи β-лактамів, за даними звітів Європейської мережі нагляду за споживанням антимікробних засобів, є одними з найбільш споживаних серед інших груп антибіотиків у Європі. В Україні рівень споживання β-лактамів значно нижчий середньоєвропейського. Такі дані вимагають детальної оцінки рівня споживання β-лактамних антимікробних препаратів, за окремими МНН, аналізу балансу їх застосування.Метою роботи є аналіз ринку та споживання АМП групи β-лактамів в Україні за 2013-2018 роки за допомогою ATC/DDD-методології, а також порівняння отриманих об'ємів споживання з аналогічними результатами в Європейському Союзі.Результати. Загальна кількість АМП групи β-лактамів представлених на ринку України у 2018 році становить 343 торгових найменування (ТН), з них – 92 пропозиції вітчизняних і 251 – іноземних фірм-виробників, що свідчить про високу насиченість українського фармацевтичного ринку імпортними препаратамиВ Україні у 2017 році пеніцилінів спожито у 4,48 разу менше ніж у середньому по ЄС, а цефалоспоринів та карбапенемів майже стільки ж.Найбільше було спожито препаратів МНН з групи пеніцилінів – Амоксициліну та Амоксициліну з інгібіторами β-лактамаз, а лідерами за об'ємами споживання серед цефалоспоринів є лікарські засоби за МНН Цефтріаксону і Цефуроксиму.Висновки. Антимікробні препарати групи β-лактамів добре вивчені та широко використовуються у медичній практиці, в асортименті представлені на ринку України (343 ТН), але тільки менше третини з них (92 ТН) – вітчизняного виробництва, що свідчить про високу насиченість українського фармацевтичного ринку імпортними препаратами. Об'єм споживання антимікробних препаратів групи β-лактамів в Україні майже в 4,5 рази менший, ніж у країнах ЄС.Найбільш споживаними є препарати Амоксициліну – групи пеніцилінів широкого спектру дії та серед цефалоспоринів – препарати Цефтріаксону та Цефуроксиму ; Стратегия борьбы против развития антибиотикорезистентности - глобальный вызов научному сообществу ради жизни и здоровья населения. Анализ взаимосвязи между уровнями потребления антимикробных препаратов и развитием антибиотикорезистентности – один из инструментов сдерживания последней. Увеличение потребления антимикробных препаратов существенно снижает возможности лечения инфекционных заболеваний.Антимикробные препараты группы β-лактамов, по данным отчетов Европейской сети наблюдения за потреблением антимикробных средств, являются одними из наиболее потребляемых среди других групп антибиотиков в Европе. В Украине уровень потребления β-лактамов значительно ниже среднеевропейского. Такие данные требуют детальной оценки уровня потребления β-лактамных антимикробных препаратов, по отдельным МНН, анализа баланса их применения.Целью работы является анализ рынка и потребления АМП группы β-лактамов в Украине за 2013-2018 годы с помощью ATC/DDD-методологии, а также сравнение полученных объёмов потребления с аналогичными результатами в Европейском Союзе.Результаты. Общее количество АМП группы β-лактамов, представленных на рынке Украины в 2018 году, составляет 343 торговых наименования (ТН), из них – 92 предложения отечественных и 251 – иностранных фирм-производителей, что свидетельствует о высокой насыщенности украинского фармацевтического рынка импортными препаратами. В Украине в 2017 году пенициллина потреблено в 4,48 раза меньше, чем в среднем по ЕС, а цефалоспоринов и карбапенемов – почти столько же. Более всего было потреблено препаратов МНН из группы пенициллина - Амоксициллина и Амоксициллина с ингибиторами β-лактамаз, а лидерами по объемам потребления среди цефалоспоринов являются лекарственные средства по МНН Цефтриаксон и Цефуроксима.Выводы. Антимикробные препараты группы β-лактамов хорошо изучены и широко используются в медицинской практике. Они широко представлены на рынке Украины (343 ТН), но только менее трети из них (92 ТН) отечественного производства, что свидетельствует о высокой насыщенности украинского фармацевтического рынка импортными препаратами. Объём потребления антимикробных препаратов группы β-лактамов в Украине почти в 4,5 раза меньше, чем в странах ЕС. Наиболее потребляемыми являются препараты Амоксициллина - группы пенициллина широкого спектра действия и среди цефалоспоринов - препараты Цефтриаксон и Цефуроксима

Salmonella enterica serovar Infantis (Salmonella Infantis) is consistently isolated from broiler chickens, pigs, and humans worldwide. This study investigated 93 epidemiologically unrelated Salmonella Infantis strains isolated in Germany between 2005 and 2008 in respect to their transmission along the food chain. Various phenotypic and genotypic methods were applied, and the pathogenicity and resistance gene repertoire was determined. Phenotypically, 66% of the strains were susceptible to all 17 antimicrobials tested, while the others were almost all multidrug-resistant (two or more antimicrobial resistances), with different resistance profiles and preferentially isolated from broiler chickens. A number of phage types (PTs) were shared by strains from pigs, broiler chickens, and humans (predominated by PT 29). One, PT 1, was only detected in strains from pigs/pork and humans. Pulsed-field gel electrophoresis (PFGE) subdivided strains in seven different clusters, named A-G, consisting of 35 various XbaI profiles with coefficient of similarity values of 0.73-0.97. The majority of XbaI profiles were assigned to clusters A and C, and two predominant XbaI profiles were common in strains isolated from all sources investigated. Multi-locus sequence typing (MLST) analysis of selected strains representing the seven PFGE clusters revealed that they all belonged to ST32. The pathogenicity gene repertoire of 37 representative Salmonella Infantis strains analyzed by microarray was also identical. The resistance gene repertoire correlated perfectly with the phenotypic antimicrobial resistance profiles, and multidrug-resistant strains were associated with class 1 integrons. Overall, this study showed that two major closely related genotypes of Salmonella Infantis can transmit in Germany to humans through contaminated broiler meat or pork, and consequently presents a hazard for human health. -® Copyright 2012, Mary Ann Liebert, Inc. 2012

Background: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses' can be supported in ASPs by means of an eHealth intervention that targets their information needs. Methods: We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital. Results: To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application's functionality, content, and structure to nurse work practice and tasks. Conclusions: By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses') and top-down legislations (medical protocols). Second, it enabled us to fragmentise and ...

The emergence of multidrug-resistant bacteria constitutes a great challenge for modern medicine, recognized by leading medical experts and politicians worldwide. Rediscovery and implementation of bacteriophage therapy by Western medicine might be one solution to the problem of increasing antibiotic failure. In some Eastern European countries phage therapy is used for treating infectious diseases. However, while the European Medicines Agency (EMA) advised that the development of bacteriophage-based therapies should be expedited due to its significant potential, EMA emphasized that phages cannot be recommended for approval before efficacy and safety have been proven by appropriately designed preclinical and clinical trials. More evidence-based data is required, particularly in the areas of pharmacokinetics, repeat applications, immunological reactions to the application of phages as well as the interactions and effects on bacterial biofilms and organ-specific environments. In this brief review we summarize advantages and disadvantages of phage therapy and discuss challenges to the establishment of phage therapy as approved treatment for multidrug-resistant bacteria.

17 p.-9 fig.-1 tab. ; Plasmid conjugation plays a significant role in the dissemination of antibiotic resistance and pathogenicity determinants. Understanding how conjugation is regulated is important to gain insights into these features. Little is known about regulation of conjugation systems present on plasmids from Gram-positive bacteria. pLS20 is a native conjugative plasmid from the Gram-positive bacterium Bacillus subtilis. Recently the key players that repress and activate pLS20 conjugation have been identified. Here we studied in detail the molecular mechanism regulating the pLS20 conjugation genes using both in vivo and in vitro approaches. Our results show that conjugation is subject to the control of a complex genetic switch where at least three levels of regulation are integrated. The first of the three layers involves overlapping divergent promoters of different strengths regulating expression of the conjugation genes and the key transcriptional regulator RcoLS20. The second layer involves a triple function of RcoLS20 being a repressor of the main conjugation promoter and an activator and repressor of its own promoter at low and high concentrations, respectively. The third level of regulation concerns formation of a DNA loop mediated by simultaneous binding of tetrameric RcoLS20 to two operators, one of which overlaps with the divergent promoters. The combination of these three layers of regulation in the same switch allows the main conjugation promoter to be tightly repressed during conditions unfavorable to conjugation while maintaining the sensitivity to accurately switch on the conjugation genes when appropriate conditions occur. The implications of the regulatory switch and comparison with other genetic switches involving DNA looping are discussed. ; Work in the Meijer lab was funded by grants BFU2008-04034/BMC from the Ministry of Science and Innovation, and Bio2013-41489-P of the Ministry of Economy and Competitiveness of the Spanish Government. Work in the Newcastle lab was funded by the Wellcome Trust Investigator Award 098374/Z/12/Z. JRLO and CA were supported by grant BIO2011-28941-CO3 of the Ministry of Science and Innovation to CA. LY and FR were supported by grant BFU2012-32797 of the Spanish Ministry of Economy and Competitiveness to FR. PKS is holder of a JaePre fellowship from the Spanish Research Council (CSIC). ; Peer reviewed

Intro -- Preface -- Contents -- Chapter 1: Salmonella in Poultry Meat Production -- 1.1 Salmonella: A Major Foodborne Pathogen in Poultry -- 1.2 Salmonella in Poultry Production -- 1.2.1 S. Pullorum and S. Gallinarum -- 1.2.2 Non-typhoidal Salmonella -- 1.2.3 S. Enteritidis: A Major Serovar -- 1.2.4 Antibiotic-Resistant Salmonella -- 1.2.5 Salmonella Serotypes in Poultry Meat Products -- 1.3 Salmonella in Vertically Integrated Production Systems -- 1.3.1 Breeders -- 1.3.2 Hatchery -- 1.3.3 Farmed and Wild Animals, Rodents, and Other Vectors -- 1.3.4 Human Traffic and Related Activities -- 1.3.5 Feed, Litter, and Water -- 1.3.6 Aerosols -- 1.3.7 Processing Environment -- 1.3.7.1 Scalding -- 1.3.7.2 Defeathering -- 1.3.7.3 Evisceration -- 1.3.7.4 Chilling -- 1.4 Conclusions -- References -- Chapter 2: Reducing Foodborne Pathogens in Organic Poultry: Challenges and Opportunities -- 2.1 Introduction -- 2.2 Challenges for Organic Poultry Producers -- 2.2.1 Animal Health and Food Safety Implications -- 2.2.2 Access to Outdoors -- 2.2.3 Slaughter and Processing Issues -- 2.3 Reducing the Prevalence of Pathogens in Organic Chickens -- 2.3.1 Plant Extracts as Safe and Effective Treatments for Organic Poultry -- 2.3.2 Postharvest Utilization of Plant-Derived Compounds -- 2.3.3 Organic Acids -- 2.3.4 Probiotics and Prebiotics -- 2.4 Other Challenges for Organic Poultry Producers -- 2.4.1 Availability of Organically Certified Feed Ingredients -- 2.4.2 Manure Management and Water -- 2.5 Conclusions -- References -- Chapter 3: Antibiotic Usage in Poultry Production and Antimicrobial-Resistant Salmonella in Poultry -- 3.1 Introduction -- 3.2 Antibiotic Use in Poultry Production -- 3.3 Impact of Antibiotic Use on Poultry, Human, and Environmental Health -- 3.4 Recent Case of Transferrable Colistin Resistance and Poultry.