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.
Aerosolized antibiotic used in this study that are proven to be effective are: amikacin, colistin, ceftazidime, gentamicin, tobramycin, sisomycin, and yancomycin. However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
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.
Bacillus anthracis (anthrax) is a bacterium that infects organisms through sporulation. Bacillus anthracis is can be aerobic (needs oxygen) or, facultative anaerobic (does not require oxygen). It is also a gram positive bacterium that can be found in the soil of humid and damp climates (Hicks, 2012). The bacterium is part of the species Bacillus Cereus (Koehler, 2009). It is known to infect life forms four different ways. Infection can be caused through digestion, eating food that is contaminated with the bacteria. Another way is through inhaling; which occurs through breathing in the spores. The third way of becoming infected is through the skin, known as cutaneous; this infection occurs through open wounds. The newest form discovered of infection is through injection; the use of needles (Hicks, 2012). Though it is not common to be found in wealthy countries; there have been numerous outbreaks in Europe and the United States. It is also being considered for bioterrorism (Sweeney, 2011). Symptoms of the early stages of anthrax can be misunderstood for less lethal conditions (Hicks, 2012). For patients with a possible anthrax infection can be determined by gram positive staining. It can also be diagnosed by confirmatory testing, such as PCR (Polymerase Chain Reaction) (Sweeney, 2011). PCR focuses on certain DNA strands for replication and identifying what the organism is (Genetic, 2014). Anthrax toxin antagonists can be considered for healing; but antibiotic therapy is the most common use of treatment (Sweeney, 2011).
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 ...
Antibiotic resistance is one of the most important issues facing health care today, with wide reaching future implications if abuse continues. In the United States alone, antibiotic resistance is responsible for over two million illnesses and 23,000 deaths per year. Providers need to be judicious in the disbursement of these life saving pharmacological agents, while being informative of why antibiotics are not always the answer (Talkington, Cairns, Dolen, & Mothershed, 2014). In the case listed below, several issues need to be addressed including perception, knowledge deficit, and the caregiver’s role. This paper will focus on whether a prescription for antibiotics is appropriate and other courses of action that may be taken instead.
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]
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.
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).
Multiplication of attached organisms leads to confluent growth and biofilm formation. Adherent bacteria synthesise extracellular polymers.
Biofilms are formed by a six step process. First is a reversible process, when an organic monolayer(made of polysaccharides or glycoproteins) absorbs to the surface, altering the chemical and physical properties of the surface. This makes the surface more conditioned and increase the chance that planktonic bacteria will attach. Secondly, also a reversible step, is when the free-floating or planktonic bacteria encounter the conditioned surface, and some attachment of the bacteria may occur. The third step is when the bacteria is left attached too long, then an irreversible attachment occurs. F...
Viral meningitis, the most common form of the disease, often resolves itself without treatment within a few days. However, bacterial meningitis, somewhat rare in the United States but rampant in West Africa, requires immediate attention in order to prevent fatality. The bacteria that cause meningitis include Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, and Listeria monocytogenes. The severity of the body’...
Knowledge is power when discussing the classes you have taken in college and how it affects your everyday life. Microbiology is one of those important classes where although for a majority of majors you do not have to take it and therefore will not learn the information discussed in it, other majors such as biology and nursing require you to take it. They will require you to take it because you will encounter some of the information being taught in it in the work field. As a nurse practitioner I have worked in the field with many patients who were diagnosed with Leprosy, Escherichia coli, Salmonella and other bacterial diseases. All of these diseases that I have encountered in patients were ones I was familiar with due to learning about them as a student in microbiology at CSUB. My children plan on