A.1. Statement of problem: Acinetobacter baumannii (A. baumannii) is a nosocomial, gram-negative bacterium commonly associated with pneumonia, meningitis, bacteremia, wound and urinary tract infections [1,2,25]. These bacteria are capable of preventing desiccation allowing it to thrive before prolong periods on various wet or dry surfaces. As an opportunistic human pathogen, A. baumannii may colonize a patient without causing any infections or symptoms, especially in tracheostomy sites or open wounds [26]. Historically, A. baumannii infections were clinically treated with different classes of antibiotics such as aminoglycosides, carbapenems, macrolides, and penicillins [2]. However, several studies have recently reported outbreaks of drug-resistant A. baumannii (MRAB) that were unaffected by standard clinical antibiotic treatments [2,1]. Consequently, treating patients infected with A. baumannii has become a clinical challenge and a serious public health concern [2,7].
A.2.
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B. Background
B.1. Characteristics of Acinetobacter baumannii and Infections they Cause
Acinetobacter baumannii are aerobic and non-fermentative, gram-negative bacteria [6]. This bacterium is an opportunistic pathogen found in soil and water. Also, it is commonly isolated from the hospital environment and hospitalized patients; therefore, it is known to cause nosocomial infections [6,9]. In addition, this bacterium has the ability to adhesion and forming biofilms on abiotic surfaces as well as the ability of secretion of the exopolysaccharide (EPS) a substance that allows the binding of bacterial cells to the surface, and with each other [6,9]. Further more, this bacterium capable of developing a new resistance to antibiotics by several mechanisms such as inhibiting the 30S ribosomal subunit, mutations, or Efflux
Chronic Rhinosinusitis (CRS) is an inflammatory disease of the nasal mucosa; often resulting from a Staphylococcus aureus (S. aureus), a bacterial infection in the sinus cavity (Suh JD. & Kennedy DW., 2011). S. aureus can be treated with antimicrobial mupiriocin (MUP). Nasal irrigation is employed for the current delivery of the drug, however the system lacks effectiveness. Copious amounts of solution need to be directed into the sinus cavity with majority of it pouring back out of the nose and hence decreasing the drugs efficacy. In addition to this, the planktonic bacteria in the cavity can amalgamate into biofilms; an exopolysaccharide matrix which is highly resistant to antimicrobials. These biofilms specifically require a novel drug delivery system in order to be successfully eradicated.
Adegoke AA, Tom M, Okoh AI, Jacob S (2010) Studies on multiple antibiotic resistant bacterial isolated from surgical site infection. Scient Res. Essays 5:3876-81.
Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative, rod-shaped aerobic bacterium. It is a primary cause of hospital-acquired infections. P. aeruginosa is primarily a nosocomial pathogen. It also acts as an opportunistic pathogen, which can only infect a host that is immunocompromised, due to an underlying disease or medication. Although, P. aeruginosa can cause damage to virtually any tissue in the body, it almost never affects the tissues of healthy individuals. It is a problematic pathogen in hospitals; infecting individuals with cancer, burn wound, catheters and cystic fibrosis. P. aeruginosa is most recognized for its resistance to a wide range of antibiotics. In its planktonic form, P. aeruginosa has been found to have many virulence factors. However, P. aeruginosa within biofilms have been found to have a resistance to antibiotics 1,000 times greater than that of its planktonic counterparts [4]. Infections that are caused by bacterial biofilms are very persistent and very difficult to treat.
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
Tobramycin is effective at reducing growth and reproduction of gram-negative bacteria. The bacteria P. aeruginosa, Klebsiella pneumoniae, Escherichia coli, Proteus, Serratia, Acinetobacter, Staphylococcus aureus are susceptible to Tobramycin. When treating enterococcal infections, which are part of the normal intestinal flora of humans, the addition of penicillin is needed. Tobramycin is used to treat external ocular infections, Urinary tract infection, Pseudomonas infection, Staphylococcus bacteria infection, and Respiratory Tract Infections. To reduce the creation of antibiotic-resistant bacteria, and to maintain the efficiency of Tobramycin, this ...
Staphylococcus aureus is a bacteria that is abundant in many places. It can even be found in some of our bodies. These bacteria are harmless as long as none of them are Methicillin resistant Staphylococcus aureus (MRSA). Methicillin is the name of a family of antibiotics that includes penicillin. This MRSA is the deadly superbug that has developed resistant to antibiotics. Statistics show that MRSA contributes to more US deaths than does HIV. It has become a huge threat to every country as the outbreaks can be a surprising one. This threat is caused by the evolution of the bacteria. These superbugs have evolved a resistance of antibiotics which makes them extremely difficult to treat. One article states, “In the early 1940s, when penicillin was first used to treat bacterial infections, penicillin-resistant strains of S. aureus were unknown — but by the 1950s, they were common in hospitals. Methicillin was introduced in 1961 to treat these resistant strains, and within one year, doctors had encountered methicillin-resistant S. aureus. Today, we have strains of MRSA that simultaneously resist a laundry list of different antibiotics, including vancomycin — often considered our last line of antibacterial defense.” [1]
Another campaign developed by the CDC is the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR). This task force focused on urgent antimicrobial resistance issues and appropriate therapeutic use of antimicrobial drugs in the medical and veterinary communities. Also, prevention of both healthcare- and community-associated drug-resistant infections, and strategies for improving the pipeline of new antimicrobial drugs()
S. aureus is a formidable pathogen that infects nearly every tissue of the human body. S. aureus infections include mild skin and soft tissue infections, as well as serious diseases like sepsis and toxic shock syndrome, which can result in death. The evolution of S. aureus has been seen since it was identified. Initially, S. aureus was treated by the typical antibiotic, penicillin. When penicillin resistant strains were identified in 1959, methicillin was introduced to treat these infections. In 1961 there were reports from the United Kingdom of S. aureus isolates that had acquired resistance to methicillin (methicillin-resistant S. aureus, MRSA) [1], and MRSA isolates were soon recovered from other European countries, and later from Japan, Australia, and the United States. MRSA is now a problem in hospitals worldwide and is increasingly recovered from nursing homes and the community [2, 3]. The methicillin resistance gene (mecA) encodes a methicillin-resistant penicillin-binding protein that is not present in susceptible strains and is believed to have been acquired from a distantly related species [4]. Many MRSA isolates are resistant to multiple antibiotics and are susceptible only to glycopeptide antibiotics such as vancomycin and investigational
Brusselaers, N., Vogelaers, D., Blot, S. (2011). The rising problem of antimicrobial resistance in the intensive care unit.Annals of Intensive Care, (1)47. Doi:10.1186/2110-5820-1-47
aureus can cause infections such as boils and abscesses as well as impetigo, a highly contagious, crunchy skin infection that is frequently found of newborn babies and small children. [3] It causes superficial stys and furuncles, in worst case scenarios is can cause serious issues such as meningitis, pneumonia, osteomyelitis, septic phlebitis, some urinary tract infections and/or endocarditis. S. aureus is one of the main causes of hospital acquired (nosocomial) infection where the bacterium attaches itself to medical devices where operated by surgical wounds or infections [4]. The best way to prevent the spread of this organism is by proper personal hygiene by applying alcohol-based hand rubs before and after each patients and accurately autoclaving reusable objects and being sure to cover open wounds and cuts. Remember to wash hands religiously as
In the documentary, Hunting the Nightmare Bacteria, reporter David Hoffman investigates this new untreatable infection along two individuals and a bacterial virus within a hospital. The first individual Hoffman investigates is Addie Rerecich of Arizona, she was treated for a staph infection with antibiotics, but other complications arise. Addie had a lung transplant, she was given several different antibiotics, but her body became pan-bacteria, non-resistance to the bacteria. Addie’s life was on the edge, she had to be on life support, and finally she received new lungs. The transplant helped Addie but it would take years before could go back to normal before the infection. The second individual is David Ricci; he had his leg amputated in India after a train accident. The antibiotic treatment he received became toxic to his body increasing problems. While in India, he underwent surgery almost every day because of infections he was developing. Back in Seattle, doctors found the NDM-1 resistance gene in his body; NDM-1 gene is resistance to almost all antib...
Since antibiotics, such as penicillin, became widely available in the 1940s, they have been called miracle drugs. They have been able to eliminate bacteria without significantly harming the other cells of the host. Now with each passing year, bacteria that are immune to antibiotics have become more and more common. This turn of events presents us with an alarming problem. Strains of bacteria that are resistant to all prescribed antibiotics are beginning to appear. As a result, diseases such as tuberculosis and penicillin-resistant gonorrhea are reemerging on a worldwide scale (1).
Antibiotics have been vitally important for many years in treating infectious diseases in both, humans and animals. Their discovery was described as the miracle of the 20th century [1]. However the overuse of antibiotics caused the emergence of a new problem, antibiotic resistance.
The cause of acute, persistent, or relapsing clinical infections is often due to multidrug resistance and/or antibiotic tolerance. Pseudomonas aeruginosa is a widespread, opportunistic, gram-negative, bacterial pathogen that readily develops multidrug resistance and is responsible for causing acute and persistent infections (Starkey et al, 2014). P. aeruginosa thrives in moist environments, primarily as waterborne and soil-borne organisms (Chen, 2015). It is found on medical equipment including catheters, which can cause cross-infections in hospitals and lead to nosocomial infections. If P. aeruginosa is found in the lungs, the urinary tract, or the kidneys, the results can be fatal (Chen, 2015). In addition to causing life-threatening diseases,
Antibiotic resistance occurs in bacteria when the use of antibiotics manages to kill off every bacteria except for a lone few. The lone few then live to pass on their DNA every time they undergo binary fission and the antibiotic resistance bacteria spread. This antibiotic resistance has given rise to numerous problems in the medical world as the bacteria they used to handle with a prescription of antibiotics now thrive without barriers. Currently, the main six bacteria that present problems with antibiotic resistance are Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., collectively known as the ESKAPE pathogens. Collectively these ESKAPE pathogens claim