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antibiotic resistance

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141. Hospital surveillance predicts community pneumococcal antibiotic resistance in Vietnam. (Abstract)

Hospital surveillance predicts community pneumococcal antibiotic resistance in Vietnam. In Vietnam, Streptococcus pneumoniae is a leading cause of disease, including meningitis. Antibiotics are available without physician prescription at community pharmacies and rates of antibiotic non-susceptibility are high. Appropriate treatment and antibiotic stewardship need to be informed by surveillance data.To report community-based pneumococcal antibiotic susceptibility testing data from children (...) enrolled in a pneumococcal conjugate vaccine trial in Ho Chi Minh City [the Vietnam Pneumococcal Project (ViPP)] and compare these with published hospital-based data from the nationwide Survey of Antibiotic Resistance (SOAR) to determine whether hospital surveillance data provide an informative estimate of circulating pneumococcal resistance.Pneumococcal isolates from 234 nasopharyngeal swabs collected from ViPP participants at 12 months of age underwent antibiotic susceptibility testing using CLSI

2020 Journal of Antimicrobial Chemotherapy

142. Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010-20. Full Text available with Trip Pro

Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010-20. Carbapenemase-producing Enterobacteriaceae (CPE) cause resistant healthcare-associated infections that jeopardize healthcare systems and patient safety worldwide. The number of CPE episodes has been increasing in France since 2009, but the dynamics are still poorly understood.To use time-series (...) of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

2020 Journal of Antimicrobial Chemotherapy

143. Detection of mobile genetic elements associated with antibiotic resistance in Salmonella enterica using a newly developed web tool: MobileElementFinder. Full Text available with Trip Pro

Detection of mobile genetic elements associated with antibiotic resistance in Salmonella enterica using a newly developed web tool: MobileElementFinder. Antimicrobial resistance (AMR) in clinically relevant bacteria is a growing threat to public health globally. In these bacteria, antimicrobial resistance genes are often associated with mobile genetic elements (MGEs), which promote their mobility, enabling them to rapidly spread throughout a bacterial community.The tool MobileElementFinder (...) was developed to enable rapid detection of MGEs and their genetic context in assembled sequence data. MGEs are detected based on sequence similarity to a database of 4452 known elements augmented with annotation of resistance genes, virulence factors and detection of plasmids.MobileElementFinder was applied to analyse the mobilome of 1725 sequenced Salmonella enterica isolates of animal origin from Denmark, Germany and the USA. We found that the MGEs were seemingly conserved according to multilocus ST

2020 Journal of Antimicrobial Chemotherapy

144. High prevalence and risk factors of multiple antibiotic resistance in patients who fail first-line Helicobacter pylori therapy in southern China: a municipality-wide, multicentre, prospective cohort study. (Abstract)

of doctors/10 000 population (aOR = 1.59; 95% CI = 1.07-2.39). A higher human development index was of borderline significance (aOR = 2.79; 95% CI = 0.97-8.70).The rates of secondary resistance of H. pylori to multiple antibiotics were high in southern China. Certain population-level risk factors were associated with levofloxacin + metronidazole resistance.© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved (...) High prevalence and risk factors of multiple antibiotic resistance in patients who fail first-line Helicobacter pylori therapy in southern China: a municipality-wide, multicentre, prospective cohort study. We aimed to study the prevalence of secondary antibiotic resistance of Helicobacter pylori in southern China and its risk factors, particularly geographical and socio-economic factors.This was a municipality-wide, multicentre, prospective cohort study involving five major hospitals. Patients

2020 Journal of Antimicrobial Chemotherapy

145. Revealing antibiotic cross-resistance patterns in hospitalized patients through Bayesian network modellingty. Full Text available with Trip Pro

Revealing antibiotic cross-resistance patterns in hospitalized patients through Bayesian network modellingty. Microbial resistance exhibits dependency patterns between different antibiotics, termed cross-resistance and collateral sensitivity. These patterns differ between experimental and clinical settings. It is unclear whether the differences result from biological reasons or from confounding, biasing results found in clinical settings. We set out to elucidate the underlying dependency (...) patterns between resistance to different antibiotics from clinical data, while accounting for patient characteristics and previous antibiotic usage.Additive Bayesian network modelling was employed to simultaneously estimate relationships between variables in a dataset of bacterial cultures derived from hospitalized patients and tested for resistance to multiple antibiotics. Data contained resistance results, patient demographics and previous antibiotic usage, for five bacterial species: Escherichia

2020 Journal of Antimicrobial Chemotherapy

146. Antibiotic multi-drug-resistance of Escherichia coli causing device- and procedure-related infections in the United States reported to the National Healthcare Safety Network (NHSN), 2013-2017. Full Text available with Trip Pro

Antibiotic multi-drug-resistance of Escherichia coli causing device- and procedure-related infections in the United States reported to the National Healthcare Safety Network (NHSN), 2013-2017. Escherichia coli is one of the most common causes of healthcare-associated infections (HAI); multidrug resistance reduces available options for antibiotic treatment. We examined factors associated with the spread of multidrug-resistant E. coli phenotypes responsible for device- and procedure-related HAI (...) from acute care hospitals, long term acute care hospitals and inpatient rehabilitation facilities, using isolate and antimicrobial susceptibility data reported to the National Healthcare Safety Network (NHSN) from 2013-2017.We used multivariable logistic regression to examine associations between co-resistant phenotypes, patient and healthcare facility characteristics, and time. We also examined the geographic distributione of co-resistant phenotypes each year by state and by hospital referral

2020 Clinical Infectious Diseases

147. Do Inpatient Antimicrobial Stewardship Programs help us in the Battle against Antimicrobial Resistance? (Abstract)

Do Inpatient Antimicrobial Stewardship Programs help us in the Battle against Antimicrobial Resistance? Antibiotic stewardship programs (ASPs) have demonstrated success at reducing costs, yet there is limited quality evidence of their effectiveness to reduce infections of high-profile drug-resistant organisms.This retrospective cohort study included all Kaiser Permanente Southern California (KPSC) members hospitalized in 9 KPSC hospitals aged ≥18 years from January 1, 2008 to December 31, 2016 (...) . We measured the impact of staggered ASP implementation on consumption of 18 ASP-targeted antibiotics using generalized linear mixed effects models. We used multivariable generalized linear mixed effects models to estimate the adjusted effect of ASP on rates of infection with drug-resistant organisms. Analyses were adjusted for confounding by time, cluster effects, and patient-level and hospital-level characteristics.We included 765,111 hospitalizations (288,257 pre-ASP, 476,854 post-ASP

2020 Clinical Infectious Diseases

148. Equations To Predict Antimicrobial MICs in Neisseria gonorrhoeae Using Molecular Antimicrobial Resistance Determinants. Full Text available with Trip Pro

Equations To Predict Antimicrobial MICs in Neisseria gonorrhoeae Using Molecular Antimicrobial Resistance Determinants. The emergence of Neisseria gonorrhoeae strains that are resistant to azithromycin and extended-spectrum cephalosporins represents a public health threat, that of untreatable gonorrhea infections. Multivariate regression modeling was used to determine the contributions of molecular antimicrobial resistance determinants to the overall antimicrobial MICs for ceftriaxone, cefixime (...) comparison studies. The ability to acquire detailed antimicrobial resistance information directly from molecular data will facilitate the transition to whole-genome sequencing analysis from phenotypic testing and can fill the surveillance gap in an era of increased reliance on nucleic acid assay testing (NAAT) diagnostics to better monitor the dynamics of N. gonorrhoeae.© Crown copyright 2020.

2020 Antimicrobial Agents and Chemotherapy

149. BceAB-Type Antibiotic Resistance Transporters Appear To Act by Target Protection of Cell Wall Synthesis. Full Text available with Trip Pro

BceAB-Type Antibiotic Resistance Transporters Appear To Act by Target Protection of Cell Wall Synthesis. Resistance against cell wall-active antimicrobial peptides in bacteria is often mediated by transporters. In low-GC-content Gram-positive bacteria, a common type of such transporters is BceAB-like systems, which frequently provide high-level resistance against peptide antibiotics that target intermediates of the lipid II cycle of cell wall synthesis. How a transporter can offer protection (...) bacitracin. Moreover, we present evidence that the critical factor driving transport activity is not the drug itself but instead the concentration of drug-target complexes in the cell. Our results, together with previously reported findings, lead us to propose that BceAB-type transporters act by transiently freeing lipid II cycle intermediates from the inhibitory grip of antimicrobial peptides and thus provide resistance through target protection of cell wall synthesis. Target protection has so far only

2020 Antimicrobial Agents and Chemotherapy

150. Suppression of β-Lactam Resistance by Aspergillomarasmine A Is Influenced by both the Metallo-β-Lactamase Target and the Antibiotic Partner. Full Text available with Trip Pro

Suppression of β-Lactam Resistance by Aspergillomarasmine A Is Influenced by both the Metallo-β-Lactamase Target and the Antibiotic Partner. The rise of Gram-negative pathogens expressing metallo-β-lactamases (MBLs) is a growing concern, threatening the efficacy of β-lactam antibiotics, in particular, the carbapenems. There are no inhibitors of MBLs in current clinical use. Aspergillomarasmine A (AMA) is an MBL inhibitor isolated from Aspergillus versicolor with the ability to rescue meropenem (...) activity in MBL-producing bacteria both in vitro and in vivo Here, we systematically explored the pairing of AMA with six β-lactam antibiotic partners against 19 MBLs from three subclasses (B1, B2, and B3). Cell-based assays performed with Escherichia coli and Klebsiella pneumoniae showed that bacteria producing NDM-1 and VIM-2 of subclass B1 were the most susceptible to AMA inhibition, whereas bacteria producing CphA2 and AIM-1 of subclasses B2 and B3, respectively, were the least sensitive

2020 Antimicrobial Agents and Chemotherapy

151. Antibiotic Resistance and Epigenetics: More to It than Meets the Eye. Full Text available with Trip Pro

Antibiotic Resistance and Epigenetics: More to It than Meets the Eye. The discovery of antibiotics in the last century is considered one of the most important achievements in the history of medicine. Antibiotic usage has significantly reduced morbidity and mortality associated with bacterial infections. However, inappropriate use of antibiotics has led to emergence of antibiotic resistance at an alarming rate. Antibiotic resistance is regarded as a major health care challenge of this century (...) . Despite extensive research, well-documented biochemical mechanisms and genetic changes fail to fully explain mechanisms underlying antibiotic resistance. Several recent reports suggest a key role for epigenetics in the development of antibiotic resistance in bacteria. The intrinsic heterogeneity as well as transient nature of epigenetic inheritance provides a plausible backdrop for high-paced emergence of drug resistance in bacteria. The methylation of adenines and cytosines can influence mutation

2020 Antimicrobial Agents and Chemotherapy

152. Determining the Development of Persisters in Extensively Drug-Resistant Acinetobacter baumannii upon Exposure to Polymyxin B-Based Antibiotic Combinations Using Flow Cytometry. Full Text available with Trip Pro

Determining the Development of Persisters in Extensively Drug-Resistant Acinetobacter baumannii upon Exposure to Polymyxin B-Based Antibiotic Combinations Using Flow Cytometry. Polymyxin B-based combinations are increasingly prescribed as a last-line option against extensively drug-resistant (XDR) Acinetobacter baumannii It is unknown if such combinations can result in the development of nondividing persister cells in XDR A. baumannii We investigated persister development upon exposure of XDR (...) A. baumannii to polymyxin B-based antibiotic combinations using flow cytometry. Time-kill studies (TKSs) were conducted in three nonclonal XDR A. baumannii strains with 5 log10 CFU/ml bacteria against polymyxin B alone and polymyxin B-based two-drug combinations over 24 h. At different time points, samples were obtained and enumerated by viable plating and flow cytometry. Propidium iodide and carboxyfluorescein succinimidyl ester dyes were used to differentiate between live and dead cells and between

2020 Antimicrobial Agents and Chemotherapy

153. Ability of Bicarbonate Supplementation To Sensitize Selected Methicillin-Resistant <i>Staphylococcus aureus</i> Strains to β-Lactam Antibiotics in an <i>Ex Vivo</i> Simulated Endocardial Vegetation Model. Full Text available with Trip Pro

Ability of Bicarbonate Supplementation To Sensitize Selected Methicillin-Resistant Staphylococcus aureus Strains to β-Lactam Antibiotics in an Ex Vivo Simulated Endocardial Vegetation Model. Supplementation of standard growth media (cation-adjusted Mueller-Hinton Broth [CAMHB]) with bicarbonate (NaHCO3) increases β-lactam susceptibility of selected methicillin-resistant Staphylococcus aureus (MRSA) strains ("NaHCO3 responsive"). This "sensitization" phenomenon translated (...) % for both CFZ and OXA in the responsive MRSA strains. Also, in media containing RPMI plus 10% Luria-Bertani broth (proposed as a more host-mimicking microenvironment and containing 25 mM NaHCO3), both CFZ and OXA exhibited enhanced bactericidal activity against NaHCO3-responsive strains in the SEV model. Neither CFZ nor OXA exposures selected for emergence of high-level β-lactam-resistant mutants within SEVs. Thus, in this ex vivo model of endocarditis, in the presence of NaHCO3 supplementation, both

2020 Antimicrobial Agents and Chemotherapy

154. Using Genetic Distance from Archived Samples for the Prediction of Antibiotic Resistance in <i>Escherichia coli</i>. Full Text available with Trip Pro

Using Genetic Distance from Archived Samples for the Prediction of Antibiotic Resistance in Escherichia coli. The rising rates of antibiotic resistance increasingly compromise empirical treatment. Knowing the antibiotic susceptibility of a pathogen's close genetic relative(s) may improve empirical antibiotic selection. Using genomic and phenotypic data for Escherichia coli isolates from three separate clinically derived databases, we evaluated multiple genomic methods and statistical (...) of every 3 patients while maintaining high treatment adequacy (∼90%). Methods based on genetic relatedness to archived samples of E. coli could be used to predict antibiotic resistance and improve antibiotic selection.Copyright © 2020 MacFadden et al.

2020 Antimicrobial Agents and Chemotherapy

155. 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

156. Comparative Evaluation of the <i>In Vitro</i> Activities of WCK 5222 (Cefepime-Zidebactam) and Combination Antibiotic Therapies against Carbapenem-Resistant <i>Pseudomonas aeruginosa</i>. Full Text available with Trip Pro

Comparative Evaluation of the In Vitro Activities of WCK 5222 (Cefepime-Zidebactam) and Combination Antibiotic Therapies against Carbapenem-Resistant Pseudomonas aeruginosa. The in vitro activity of WCK 5222 (cefepime-zidebactam) was compared to that of several available combination therapies among 30 clinical carbapenem-resistant Pseudomonas aeruginosa (CRP) strains using gradient diffusion strips. The combinations included nonsusceptible β-lactams (cefepime, ceftolozane

2020 Antimicrobial Agents and Chemotherapy

157. Assessment of the Potential of Vaccination to Combat Antibiotic Resistance in Gonorrhea: A Modeling Analysis to Determine Preferred Product Characteristics. Full Text available with Trip Pro

Assessment of the Potential of Vaccination to Combat Antibiotic Resistance in Gonorrhea: A Modeling Analysis to Determine Preferred Product Characteristics. Gonorrhea incidence is increasing rapidly in many countries, whilst antibiotic resistance is making treatment more difficult. Combined with evidence that MeNZB and Bexsero meningococcal vaccines are likely partially-protective against gonorrhea, this has renewed interest in a gonococcal vaccine, and several candidates are in development (...) health clinics receive a vaccine offering ≥52% protection for ≥6 years. A vaccine conferring 31% protection (as estimated for MeNZB) for 2-4 years, could reduce incidence in 2030 by 45% in the worst-case scenario, and by 75% if >70% of resistant gonorrhea remains treatable.Even a partially-protective vaccine, delivered through a realistic targeting strategy, could substantially reduce gonorrhea incidence, despite antibiotic resistance.© The Author(s) 2020. Published by Oxford University Press

2020 Clinical Infectious Diseases

158. Rising Pneumococcal Antibiotic Resistance in the Post 13-valent Pneumococcal Conjugate Vaccine Era in Pediatric Isolates from a Primary Care Setting. (Abstract)

Rising Pneumococcal Antibiotic Resistance in the Post 13-valent Pneumococcal Conjugate Vaccine Era in Pediatric Isolates from a Primary Care Setting. Antibiotic-resistant S. pneumoniae strains may cause infections that fail to respond to antimicrobial-therapy. Results reported from hospitalized patients with invasive, bacteremic infections may not be the same as those observed in a primary-care setting where young children receive care for non-invasive infections. Young children experience (...) , the most recent isolates show reduced susceptibility to third generation cephalosporins, fluoroquinolones and carbapenems, antibiotics commonly used to treat life-threatening, invasive pneumococcal diseases.In recent years, pneumococcal nasopharyngeal and AOM isolates from children exhibit reduced susceptibility to penicillin, third generation cephalosporin, fluoroquinolone and carbapenem antibiotics. The new strains have a different profile of resistance compared to the pre-PCV-13 era.© The Author(s

2020 Clinical Infectious Diseases

159. Acquisition of antibiotic-resistant Gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial. Full Text available with Trip Pro

Acquisition of antibiotic-resistant Gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial. The Benefits of Universal Gloves and Gowns cluster randomized trial found varying effects on MRSA and VRE and no increase in adverse events. The aim of this study was to assess whether the intervention decreases the acquisition of antibiotic-resistant Gram-negative bacteria.Secondary analysis of 20 hospital intensive care unit, randomized trial (...) . The intervention consisted of healthcare workers wearing gloves and gowns when entering any patient room compared to standard care. The primary composite outcome was acquisition of any antibiotic-resistant Gram-negative bacteria based on surveillance cultures.A total of 40,492 admission and discharge perianal swabs from 20,246 individual patient admissions were included in the primary outcome. For the primary outcome of acquisition of any antibiotic-resistant Gram-negative bacteria, the intervention had a RR

2020 Clinical Infectious Diseases

160. Bacteriophage-Antibiotic Combination Strategy: an Alternative against Methicillin-Resistant Phenotypes of Staphylococcus aureus. Full Text available with Trip Pro

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

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