Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2018/03/stewardship-resistance-scan-mar-30-2018
Stewardship / Resistance Scan for Mar 30, 2018
Statewide hospital stewardship; New class of synthetic antibiotics
Filed Under:
Antimicrobial Stewardship
[h=3]Statewide Colorado stewardship collaborative shows promise in UTI Rx[/h] Today in Clinical Infectious Diseases Colorado researchers report declining fluoroquinolone use after initiating a statewide stewardship collaborative to improve the diagnosis and treatment of inpatient urinary tract infections (UTIs) and skin and other soft-tissue infections (SSTIs).
Twenty-six Colorado hospitals, including nine critical access hospitals, participated in the collaborative. Collaborative outcomes were: (1) proportion of UTI diagnoses meeting criteria for symptomatic UTI, (2) exposure to fluoroquinolones (UTI only), (3) duration of therapy (UTI and SSTI), and (4) exposure to antibiotics with broad gram-negative activity (SSTI only). The investigators compared outcomes between pre-intervention and intervention periods overall and by hospital.
The team found that the proportion of diagnosed UTIs meeting symptomatic UTI criteria and the median duration of UTI therapy were unchanged, but fluoroquinolone use dropped from 49% to 41%. For SSTIs, exposure to antibiotics with broad gram-negative activity declined from 61% to 53% and the median duration of therapy dropped from 11 to 10 days, but neither change was statistically significant. Only the decline in fluoroquinolone use was significant.
The authors concluded, "Performance improvement was observed for several outcomes overall but varied substantially by hospital."
Mar 30 Clin Infect Dis abstract
[h=3]Experts report new class of synthetic antibiotics that kills MRSA in mice[/h] US scientists have identified two synthetic retinoids that represent a new class of antibiotics and can kill both growing and persistent methicillin-resistant Staphylococcus aureus (MRSA) in mice, according to a new study in Nature.
The research team developed novel ways to screen 82,000 synthetic compounds to identify potential antibiotics that would not be toxic to humans. Of 185 compounds that decreased the ability of MRSA to kill laboratory roundworms, the scientists selected 2 synthetic retinoids, called CD437 and CD1530, as the best candidates. The retinoids impair bacterial membranes.
"The molecule weakens the cell membranes of bacteria, but human cells also have membranes," said study coauthor Bill Wuest, PhD, of Emory University, in a Lifespan news release. "We found a way to tweak the molecule so that it now selectively targets bacteria."
The researchers also combined CD437 with gentamicin, which was also effective against MRSA in the mice. The bacteria did not develop any noteworthy resistance to CD437 even after 100 days of serial passaging.
Further studies will have to ensure such compounds are not toxic to people. "Despite the potential advantages of membrane-active antimicrobials such as the retinoids described here?including fast killing, low probability of developing resistance, and anti-persister activity?the major obstacle for developing retinoids as therapeutics is their potential cytotoxicity," the authors wrote.
They concluded, "With further development and optimization, synthetic retinoids have the potential to become a new class of antimicrobials for the treatment of Gram-positive bacterial infections that are currently difficult to cure."
Mar 28 Nature study
Mar 27 Lifespan news release
Stewardship / Resistance Scan for Mar 30, 2018
Statewide hospital stewardship; New class of synthetic antibiotics
Filed Under:
Antimicrobial Stewardship
[h=3]Statewide Colorado stewardship collaborative shows promise in UTI Rx[/h] Today in Clinical Infectious Diseases Colorado researchers report declining fluoroquinolone use after initiating a statewide stewardship collaborative to improve the diagnosis and treatment of inpatient urinary tract infections (UTIs) and skin and other soft-tissue infections (SSTIs).
Twenty-six Colorado hospitals, including nine critical access hospitals, participated in the collaborative. Collaborative outcomes were: (1) proportion of UTI diagnoses meeting criteria for symptomatic UTI, (2) exposure to fluoroquinolones (UTI only), (3) duration of therapy (UTI and SSTI), and (4) exposure to antibiotics with broad gram-negative activity (SSTI only). The investigators compared outcomes between pre-intervention and intervention periods overall and by hospital.
The team found that the proportion of diagnosed UTIs meeting symptomatic UTI criteria and the median duration of UTI therapy were unchanged, but fluoroquinolone use dropped from 49% to 41%. For SSTIs, exposure to antibiotics with broad gram-negative activity declined from 61% to 53% and the median duration of therapy dropped from 11 to 10 days, but neither change was statistically significant. Only the decline in fluoroquinolone use was significant.
The authors concluded, "Performance improvement was observed for several outcomes overall but varied substantially by hospital."
Mar 30 Clin Infect Dis abstract
[h=3]Experts report new class of synthetic antibiotics that kills MRSA in mice[/h] US scientists have identified two synthetic retinoids that represent a new class of antibiotics and can kill both growing and persistent methicillin-resistant Staphylococcus aureus (MRSA) in mice, according to a new study in Nature.
The research team developed novel ways to screen 82,000 synthetic compounds to identify potential antibiotics that would not be toxic to humans. Of 185 compounds that decreased the ability of MRSA to kill laboratory roundworms, the scientists selected 2 synthetic retinoids, called CD437 and CD1530, as the best candidates. The retinoids impair bacterial membranes.
"The molecule weakens the cell membranes of bacteria, but human cells also have membranes," said study coauthor Bill Wuest, PhD, of Emory University, in a Lifespan news release. "We found a way to tweak the molecule so that it now selectively targets bacteria."
The researchers also combined CD437 with gentamicin, which was also effective against MRSA in the mice. The bacteria did not develop any noteworthy resistance to CD437 even after 100 days of serial passaging.
Further studies will have to ensure such compounds are not toxic to people. "Despite the potential advantages of membrane-active antimicrobials such as the retinoids described here?including fast killing, low probability of developing resistance, and anti-persister activity?the major obstacle for developing retinoids as therapeutics is their potential cytotoxicity," the authors wrote.
They concluded, "With further development and optimization, synthetic retinoids have the potential to become a new class of antimicrobials for the treatment of Gram-positive bacterial infections that are currently difficult to cure."
Mar 28 Nature study
Mar 27 Lifespan news release