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antibiotic resistance

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81. Intestinal carriage of antibiotic resistant Acinetobacter baumannii among newborns hospitalized in Moroccan neonatal intensive care unit. Full Text available with Trip Pro

Intestinal carriage of antibiotic resistant Acinetobacter baumannii among newborns hospitalized in Moroccan neonatal intensive care unit. This study was conducted in order to assess the acquisition rate of Acinetobacter baumannii by newborn screening, on admission and during the discharge process of neonatal intensive care unit. (NICU). Furthermore, we investigated risk factors for potential colonization and molecular epidemiology of isolated resistant bacteria. This prospective study (...) g respectively. In total, 277 patients were included in the acquisition study on admission. The prevalence of multi-drug resistant (MDR) A. baumannii strain carriage was 6.5%, while the acquisition rate during the hospital recovery was 13.7%. In this study, 68 MDR A. baumannii isolates were collected. The resistance rates to different antibiotic classes including, Ceftazidime, Gentamycin and Ciprofloxacin varied between 92 and 100%. Moreover, 13% of MDR A. baumannii isolates were carbapenemase

2019 PLoS ONE

82. Resistance to Antibiotics of Uropathogen Bacteria Isolated From Urine and Blood in Pediatric Cancer Patients: A Single Center, 12-year Study. (Abstract)

Resistance to Antibiotics of Uropathogen Bacteria Isolated From Urine and Blood in Pediatric Cancer Patients: A Single Center, 12-year Study. Resistant pathogens have become a major healthcare problem in children with cancer, causing different kinds of infections such as the bloodstream ones, most common, and most frequently described and the urinary tract ones, of which less data are available. We analyzed and compared the proportions, and the trends of resistance in pathogens isolated from (...) significantly more frequently resistant to amikacin, piperacillin/tazobactam, and combination therapy piperacillin/tazobactam+amikacin, even if with a decreasing trend during the study period. These data confirm the importance of surveillance of isolated microorganism and antibiotic resistance in cancer children.

2020 Pediatric Infectious Dsease Journal

83. High throughput cultivation-based screening on porous aluminum oxide chips allows targeted isolation of antibiotic resistant human gut bacteria. Full Text available with Trip Pro

High throughput cultivation-based screening on porous aluminum oxide chips allows targeted isolation of antibiotic resistant human gut bacteria. The emergence of bacterial pathogens that are resistant to clinical antibiotics poses an increasing risk to human health. An important reservoir from which bacterial pathogens can acquire resistance is the human gut microbiota. However, thus far, a substantial fraction of the gut microbiota remains uncultivated and has been little-studied with respect (...) to its resistance reservoir-function. Here, we aimed to isolate yet uncultivated resistant gut bacteria by a targeted approach. Therefore, faecal samples from 20 intensive care patients who had received the prophylactic antibiotic treatment selective digestive decontamination (SDD), i.e. tobramycin, polymyxin E, amphotericin B and cefotaxime, were inoculated anaerobically on porous aluminium oxide chips placed on top of poor and rich agar media, including media supplemented with the SDD antibiotics

2019 PLoS ONE

84. Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic. Full Text available with Trip Pro

Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic. The prevalence of Helicobacter pylori resistance to levofloxacin and metronidazole was high in the Dominican Republic. We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutations associated with the antibiotic resistance using next (...) -generation sequencing. We revealed that all 63 strains were sensitive towards sitafloxacin, furazolidone, and rifabutin. In contrast, the prevalence of rifaximin and garenoxacin resistance were high (82.5% and 34.9%, respectively). Patients more than or equal to 60 years old had the highest risk of double-antibiotic resistance (7/9, 77.8%, OR = 31.5, P = 0.009) and garenoxacin resistances (8/9, 88.9%, OR = 45.33, P = 0.002) with an increasing risk simultaneously by age (P = 0.004, r = 0.357). Almost all

2019 PLoS ONE

85. Changing paradigm of antibiotic resistance amongst Escherichia coli isolates in Indian pediatric population. Full Text available with Trip Pro

Changing paradigm of antibiotic resistance amongst Escherichia coli isolates in Indian pediatric population. Antimicrobial resistance happens when microorganisms mutates in manners that render the drugs like antibacterial, antiviral, antiparasitic and antifungal, ineffective. The normal mutation process is encouraged by the improper use of antibiotics. Mutations leading to quinolone resistance occur in a highly conserved region of the quinolone resistance-determining region (QRDR) of DNA gyrAse (...) and topoisomerase IV gene. We analyzed antibiotic resistant genes and single nucleotide polymorphism (SNP) in gyrA and parC genes in QRDR in 120 E. coli isolates (both diarrheagenic and non-pathogenic) recovered from fresh stool samples collected from children aged less than 5 years from Delhi, India. Antibiotic susceptibility testing was performed according to standard clinical and laboratory standards institute (CLSI) guidelines. Phylogenetic analysis showed the clonal diversity and phylogenetic relationships

2019 PLoS ONE

86. Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma. Full Text available with Trip Pro

Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma. The availability of antibiotics presents medical practitioners with a prescribing dilemma. On the one hand, antibiotics provide a safe and effective treatment option for patients with bacterial infections, but at a population level, over-prescription reduces their effectiveness by facilitating the evolution of bacteria that are resistant to antibiotic medication. A game (...) -theoretic investigation, including analysis of equilibrium strategies, evolutionarily stability, and replicator dynamics, reveals that rational doctors, motivated to attain the best outcomes for their own patients, will prescribe antibiotics irrespective of the level of antibiotic resistance in the population and the behavior of other doctors, although they would achieve better long-term outcomes if their prescribing were more restrained. Ever-increasing antibiotic resistance may therefore be inevitable

2019 PLoS ONE

87. Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam. Full Text available with Trip Pro

Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam. Antibiotic resistance (ABR) is an increasing burden for global health. The prevalence of ABR in Southeast Asia is among the highest worldwide, especially in relation to hospital-acquired infections (HAI) in intensive care units (ICU). However, little is known about morbidity (...) and mortality attributable to ABR in neonates.This study aimed to assess mortality and the length of hospitalization attributable to ABR in gram-negative bacteria (GNB) causing HAI in a Vietnamese neonatal ICU (NICU).We conducted a prospective cohort study (n = 296) in a NICU in Hanoi, Vietnam, from March 2016 to October 2017. Patients isolated with HAI caused by GNB were included. The exposure was resistance to multiple antibiotic classes, the two outcomes were mortality and length of hospital stay (LOS

2019 PLoS ONE

88. Evaluation of a fully automated bioinformatics tool to predict antibiotic resistance from MRSA genomes. Full Text available with Trip Pro

Evaluation of a fully automated bioinformatics tool to predict antibiotic resistance from MRSA genomes. The genetic prediction of phenotypic antibiotic resistance based on analysis of WGS data is becoming increasingly feasible, but a major barrier to its introduction into routine use is the lack of fully automated interpretation tools. Here, we report the findings of a large evaluation of the Next Gen Diagnostics (NGD) automated bioinformatics analysis tool to predict the phenotypic resistance (...) of MRSA.MRSA-positive patients were identified in a clinical microbiology laboratory in England between January and November 2018. One MRSA isolate per patient together with all blood culture isolates (total n = 778) were sequenced on the Illumina MiniSeq instrument in batches of 21 clinical MRSA isolates and three controls.The NGD system activated post-sequencing and processed the sequences to determine susceptible/resistant predictions for 11 antibiotics, taking around 11 minutes to analyse 24 isolates

2020 Journal of Antimicrobial Chemotherapy

89. Intraventricular administration of antibiotics by ommaya reservoir for patients with multidrug-resistant <i>Acinetobacter baumannii</i> central nervous system infection. (Abstract)

Intraventricular administration of antibiotics by ommaya reservoir for patients with multidrug-resistant Acinetobacter baumannii central nervous system infection. To investigate whether the Ommaya reservoir can be used to treat multiple drug-resistant Acinetobacter baumannii (MDR-AB) infections in the central nervous system (CNS).Retrospectively analyzed the clinical records and data of 15 MDR-AB CNS infection patients who were treated in our neuro-ICU. Four patients with MDR-AB CNS (...) infection were involved in this study.We report the successful treatment of MDR-AB CNS infection by Ommaya reservoirs and intraventricular antibiotic (IVA) administration. Ommaya reservoirs allow serial CSF sampling and IVA injection. Furthermore, debridement can be performed during the operation to insert the Ommaya.Ommaya reservoirs can be used as an effective treatment approach of MDR-AB or other multidrug-resistant Gram-negative bacteria CNS infections.

2020 British Journal of Neurosurgery

90. Efficacy of Antibiotic Combinations against Multidrug-Resistant Pseudomonas aeruginosa in Automated Time-Lapse Microscopy and Static Time-Kill Experiments. Full Text available with Trip Pro

Efficacy of Antibiotic Combinations against Multidrug-Resistant Pseudomonas aeruginosa in Automated Time-Lapse Microscopy and Static Time-Kill Experiments. Antibiotic combination therapy is used for severe infections caused by multidrug-resistant (MDR) Gram-negative bacteria, yet data regarding which combinations are most effective are lacking. This study aimed to evaluate the in vitro efficacy of polymyxin B in combination with 13 other antibiotics against four clinical strains of MDR (...) , and trimethoprim. Time-kill experiments showed additive or synergistic activity with 27 of the 39 tested polymyxin B combinations, most frequently with aztreonam, cefepime, and meropenem. Positive interactions were frequently found with the tested combinations, against strains that harbored several resistance mechanisms to the single drugs, and with antibiotics that are normally not active against P. aeruginosa Further study is needed to explore the clinical utility of these combinations.Copyright © 2020

2020 Antimicrobial Agents and Chemotherapy

91. Complex Response of the CpxAR Two-Component System to β-Lactams on Antibiotic Resistance and Envelope Homeostasis in <i>Enterobacteriaceae</i>. (Abstract)

Complex Response of the CpxAR Two-Component System to β-Lactams on Antibiotic Resistance and Envelope Homeostasis in Enterobacteriaceae. The Cpx stress response is widespread among Enterobacteriaceae We previously reported a mutation in cpxA in a multidrug-resistant strain of Klebsiella aerogenes isolated from a patient treated with imipenem. This mutation yields a single-amino-acid substitution (Y144N) located in the periplasmic sensor domain of CpxA. In this work, we sought (...) to characterize this mutation in Escherichia coli by using genetic and biochemical approaches. Here, we show that cpxAY144N is an activated allele that confers resistance to β-lactams and aminoglycosides in a CpxR-dependent manner, by regulating the expression of the OmpF porin and the AcrD efflux pump, respectively. We also demonstrate the effect of the intimate interconnection between the Cpx system and peptidoglycan integrity on the expression of an exogenous AmpC β-lactamase by using imipenem as a cell

2020 Antimicrobial Agents and Chemotherapy

92. Scarless Removal of Large Resistance Island AbaR Results in Antibiotic Susceptibility and Increased Natural Transformability in Acinetobacter baumannii. Full Text available with Trip Pro

Scarless Removal of Large Resistance Island AbaR Results in Antibiotic Susceptibility and Increased Natural Transformability in Acinetobacter baumannii. With a great diversity in gene composition, including multiple putative antibiotic resistance genes, AbaR islands are potential contributors to multidrug resistance in Acinetobacter baumannii However, the effective contribution of AbaR to antibiotic resistance and bacterial physiology remains elusive. To address this, we sought to accurately (...) of the open reading frame (ORF) of this island, the antibiotic resistance profiles were identical between the wild type and the AbaR11-cured AB5075 strains. In contrast, AbaR1 carries 25 ORFs, with predicted resistance to several classes of antibiotics, and the AYE AbaR1-cured derivative showed restored susceptibility to multiple classes of antibiotics. Moreover, curing of AbaRs restored high levels of natural transformability. Indeed, most AbaR islands are inserted into the comM gene involved in natural

2020 Antimicrobial Agents and Chemotherapy

93. Ribosome-mediated attenuation of <i>vga(A</i>) expression is shaped by the antibiotic resistance specificity of Vga(A) protein variants. (Abstract)

Ribosome-mediated attenuation of vga(A) expression is shaped by the antibiotic resistance specificity of Vga(A) protein variants. Vga(A) protein variants confer different levels of resistance to lincosamides, streptogramins A and pleuromutilins (LSAP) by displacing antibiotics from the ribosome. Here we show that expression of vga(A) variants from Staphylococcus haemolyticus is regulated by cis-regulatory RNA in response to the LSAP antibiotics by the mechanism of ribosome-mediated (...) attenuation. The specificity of induction depends on the Vga(A)-mediated resistance rather than on the sequence of the riboregulator. Fine-tuning between Vga(A) activity and its expression in response to the antibiotics may contribute to the selection of more potent Vga(A) variants because newly acquired mutation can be immediately phenotypically manifested.Copyright © 2020 American Society for Microbiology.

2020 Antimicrobial Agents and Chemotherapy

94. Epidemiological, and Clinical Characteristics of International Travelers with Enteric Fever and Antibiotic Resistance Profiles of their Isolates: A GeoSentinel Analysis. (Abstract)

Epidemiological, and Clinical Characteristics of International Travelers with Enteric Fever and Antibiotic Resistance Profiles of their Isolates: A GeoSentinel Analysis. Background. Enteric fever, caused by Salmonella enterica serovar Typhi (S. Typhi) and Paratyphi (S. Paratyphi), is a common travel-related illness. Limited data are available on their antimicrobial resistance (AMR) patterns among travelers. Methods. Records with a culture-confirmed diagnosis seen during or after travel from (...) January 2007 to December 2018 were obtained from GeoSentinel. Traveler demographics and antimicrobial susceptibility data were analyzed. Isolates were classified as 'non-susceptible' if intermediate or resistant, or 'susceptible' in accordance with participating site's national guidelines. Results. A total of 889 travelers (S. Typhi, n=474; S. Paratyphi, n=414; co-infection, n=1) were included; 114 (13%) were children <18 years. Most (41%) traveled to visit friends and relatives (VFRs) and acquired

2020 Antimicrobial Agents and Chemotherapy

95. Genomic Analysis Reveals Antibiotic-Susceptible Clones and Emerging Resistance in Neisseria gonorrhoeae in Saskatchewan, Canada. (Abstract)

Genomic Analysis Reveals Antibiotic-Susceptible Clones and Emerging Resistance in Neisseria gonorrhoeae in Saskatchewan, Canada. Whole-genome sequencing was used to identify mutations in antibiotic resistance-conferring genes to compare susceptibility predictions with MICs and to ascertain strain types in 99 isolates of Neisseria gonorrhoeae Genotypes associated with susceptibility, as well as MIC creep or emerging resistance, were noted. Phylogenomic analysis revealed three distinctive clades (...) and putative gonococcal transmission linkages involving a tetracycline-resistant N. gonorrhoeae outbreak and the clonal spread of susceptible isolates in men.Copyright © 2020 American Society for Microbiology.

2020 Antimicrobial Agents and Chemotherapy

96. Bacteriophage-Antibiotic Combination Strategy: an Alternative against Methicillin-Resistant Phenotypes of Staphylococcus aureus. (Abstract)

Bacteriophage-Antibiotic Combination Strategy: an Alternative against Methicillin-Resistant Phenotypes of Staphylococcus aureus. Comparative time-kill experiments with Staphylococcus aureus bacteriophage (phage) Sb-1 alone and phage-antibiotic combinations (PACs) against two methicillin-resistant S. aureus (MRSA) strains have shown synergy with both daptomycin-phage and vancomycin-phage combinations. PACs prevented development of phage resistance and demonstrated bactericidal activity for all

2020 Antimicrobial Agents and Chemotherapy

97. Strong Environment-Genotype Interactions Determine the Fitness Costs of Antibiotic Resistance <i>In Vitro</i> and in an Insect Model of Infection. (Abstract)

Strong Environment-Genotype Interactions Determine the Fitness Costs of Antibiotic Resistance In Vitro and in an Insect Model of Infection. The acquisition of antibiotic resistance commonly imposes fitness costs, a reduction in the fitness of bacteria in the absence of drugs. These costs have been quantified primarily using in vitro experiments and a small number of in vivo studies in mice, and it is commonly assumed that these diverse methods are consistent. Here, we used an insect (...) model of infection to compare the fitness costs of antibiotic resistance in vivo to those in vitro Experiments explored diverse mechanisms of resistance in a Gram-positive pathogen, Bacillus thuringiensis, and a Gram-negative intestinal symbiont, Enterobacter cloacae Rifampin resistance in B. thuringiensis showed fitness costs that were typically elevated in vivo, although these were modulated by genotype-environment interactions. In contrast, resistance to cefotaxime via derepression of AmpC β

2020 Antimicrobial Agents and Chemotherapy

98. Radial Expansion Facilitates the Maintenance of Double Antibiotic Resistances. (Abstract)

Radial Expansion Facilitates the Maintenance of Double Antibiotic Resistances. Most microbes live in spatially confined subpopulations. Under spatial structure conditions, the efficacy of natural selection is often reduced (relative to homogeneous conditions) due to the increased importance of genetic drift and local competition. Additionally, under spatial structure conditions, the fittest genotype may not always be the one with better access to the heterogeneous distribution of nutrients (...) . The effect of radial expansion may be particularly relevant for the elimination of antibiotic resistance mutations, as their dynamics within bacterial populations are strongly dependent on their growth rate. Here, we use Escherichia coli to systematically compare the allele frequency of streptomycin, rifampin, and fluoroquinolone single and double resistance mutants after 24 h of coexistence with a susceptible strain under radial expansion (local competition) and homogeneous (global competition

2020 Antimicrobial Agents and Chemotherapy

99. Application of combined genomic and transfer analyses to identify factors mediating regional spread of antibiotic resistant bacterial lineages. Full Text available with Trip Pro

Application of combined genomic and transfer analyses to identify factors mediating regional spread of antibiotic resistant bacterial lineages. Patients entering nursing facilities (NFs) are frequently colonized with antibiotic resistant organisms (AROs). To understand the determinants of ARO colonization on NF admission we applied whole-genome sequencing to track the spread of four ARO species across regional NFs and evaluated patient-level characteristics and transfer acute-care hospitals (...) (ACHs) as risk factors for colonization.584 patients from six NFs were surveyed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecalis/faecium (VREfc/VREfm) and ciprofloxacin-resistant Escherichia coli (CipREc) colonization. Genomic analysis was performed to quantify ARO spread between NFs and compared to patient-transfer networks. The association between admission colonization and patient-level variables and recent ACH exposures was examined using

2020 Clinical Infectious Diseases

100. Assessment of data supporting the efficacy of new antibiotics for treating infections caused by multidrug resistant bacteria. (Abstract)

Assessment of data supporting the efficacy of new antibiotics for treating infections caused by multidrug resistant bacteria. Infections caused by multidrug resistant (MDR) bacteria are major public health threat. We aimed to assess the data supporting US Food and Drug (FDA) approval of new agents aimed to treat MDR bacterial infections, and the data provided by post-marketing studies.We identified all drugs with in-vitro activity against MDR bacteria initially approved by FDA between January (...) 2010- December 2018. Characteristics of trials supporting approval and regulatory pathways were collected from Drugs@FDA. Characteristics of post-marketing studies were extracted from drug labels and ClinicalTrials.gov entries effective on June 1, 2019.Initial approval of 11 newly approved antibiotics with anti-MDR activity was supported by 20 trials, all with non-inferiority design. All initially approved indications were for common infections, mostly acute bacterial skin and skin-structure

2020 Clinical Infectious Diseases

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