Bacterial Infections ; diagnosis ; drug therapy ; etiology ; Drug Resistance, Bacterial ; Humans ; Peritonitis ; diagnosis ; drug therapy ; etiology

Formation of biofilm is a survival strategy for bacteria and fungi to adapt to their living environment, especially in the hostile environment. Under the protection of biofilm, microbial cells in biofilm become tolerant and resistant to antibiotics and the immune responses, which increases the difficulties for the clinical treatment of biofilm infections. Clinical and laboratory investigations demonstrated a perspicuous correlation between biofilm infection and medical foreign bodies or indwelling devices. Clinical observations and experimental studies indicated clearly that antibiotic treatment alone is in most cases insufficient to eradicate biofilm infections. Therefore, to effectively treat biofilm infections with currently available antibiotics and evaluate the outcomes become important and urgent for clinicians. The review summarizes the latest progress in treatment of clinical biofilm infections and scientific investigations, discusses the diagnosis and treatment of different biofilm infections and introduces the promising laboratory progress, which may contribute to prevention or cure of biofilm infections. We conclude that, an efficient treatment of biofilm infections needs a well-established multidisciplinary collaboration, which includes removal of the infected foreign bodies, selection of biofilm-active, sensitive and well-penetrating antibiotics, systemic or topical antibiotic administration in high dosage and combinations, and administration of anti-quorum sensing or biofilm dispersal agents.
Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; drug therapy ; microbiology ; Biofilms ; Drug Resistance, Bacterial ; Humans

Anti-Bacterial Agents/therapeutic use* ; Bacterial Infections/drug therapy* ; Child ; Gastroenteritis/drug therapy* ; Humans

The main factors influencing the bacterial ecology on burn wound are the selection of antibacterial agents and systemic antibiotic. Some antibacterial agents more active against P. aeruginosa were developed in 1960s, and the detection rate of P. aeruginosa on burn wound has been declined, and the detection rate of Enterobacteriaceae species and Acinetobacter SPP. has been raised since then. In 1990s, the third generation Cephalosporin was widely used in burn unit and the detection rate of staphylococcus aureus showed an increased trend. Especially, the positive rate of MRSA was increased significantly. Under the selection pressure of antibacterial agent, the resistant strains are rapidly increased and the antibiotics against opportunistic pathogen on burn wound should be selected continuously. Finally, the bacterial ecology pattern on burn wound is changing incessantly. The result is that the prevalence of infection of multi-drug resistance strains and opportunistic pathogen appears on burn wound. In order to optimize the antibiotic therapy, the bacterial ecology pattern on burn wound has to be investigated, and the dominant pathogen including invasive and currently prevailing strains in the burn unit also should always be surveyed. In addition, we also should know the mechanisms of bacterial resistance. The regular surveillance of antibiotic resistance in the clinical isolates is the most important and valuable for understanding the trend of bacterial resistance. The antibiotic therapy should be decided according to the result of susceptibility tests.
Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; drug therapy ; Burns ; drug therapy ; microbiology ; Drug Resistance, Multiple, Bacterial ; Humans

Humans ; Norepinephrine ; Bacterial Infections/drug therapy* ; Immunity, Innate

Antimicrobial resistance of bacteria has become a worldwide problem. Available data suggest that the resistance problem is comparatively more serious in Korea. In large hospitals, the proportion of methicillin-resistant Staphylococcus aureus (MRSA) has been reported at over 70%, and of penicillin-nonsusceptible Streptococcus pneumoniae at around 70%. Infection or colonization of vancomycin-resistant enterococci has started to increase. Extended-spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae has become widespread and even carbapenem-resistant Pseudomonas aeruginosa has been increasing. Community-acquired pathogens such as Salmonella, Shigella and Neisseria gonorrhoeae are often resistant to various antimicrobial agents. The prevalence of resistant bacteria can lead to erroneous empirical selection of either noneffective or expensive drugs, prolonging hospitalization and higher mortality. The emergence and spread of resistant bacteria are unavoidable unless antimicrobial agents are not used at all. The high prevalence of resistant bacteria in Korea seems to be related to antibiotic usage: 1) easy availability without prescription at drug stores, 2) injudicious use in hospitals, and 3) uncontrolled use in agriculture, animal husbandry, and fisheries. Nosocomial infection is an important factor in the spread of resistant bacteria. Antimicrobial resistance problems should be regarded as the major public health concern in Korea. It is urgently required to ban the sale of antibiotics without prescription, to use antibiotics more judiciously in hospitals by intensive teaching of the principles of the use of antibiotics, and to establish better control measures of nosocomial infections. Regulation of antimicrobials for other than human use should also be required. These issues are not easy to address and require the collective action of governments, the pharmaceutical industry, health care providers, and consumers.
Bacterial Infections/drug therapy ; Bacterial Physiology* ; Drug Resistance, Microbial/physiology* ; Enterococcus/drug effects ; Gram-Negative Bacterial Infections/drug therapy ; Human ; Korea ; Pneumococcal Infections/drug therapy ; Staphylococcal Infections/drug therapy

Bacterial Infections ; drug therapy ; Child ; Drug Resistance, Bacterial ; Humans ; Microbial Sensitivity Tests ; beta-Lactamases ; biosynthesis

OBJECTIVETo study the clinical features and antimicrobial resistance of community-acquired pneumonia caused by Klebsiella pneumoniae in infants.

METHODSThe clinical data of 65 infants with community-acquired pneumonia caused by Klebsiella pneumoniae between 2007 and 2011 were retrospectively studied.

RESULTSOf the 65 infants, 37 cases (57%) were aged ≤3 months, 17 cases (26%) over 4 months, 7 cases (11%) over 7 months and 4 cases (6%) between 13 and 24 months. There were no significant differences in clinical manifestations and chest X-ray features between the infants with community-acquired pneumonia caused by Klebsiella pneumoniae and those with other bacterial pneumonia. Forty strains (62%) of ESBLs-producing Klebsiella pneumoniae were detected. Klebsiella pneumoniae was 100% sensitive to imipenem, meropenem and amikacin but resistant to penicillins and cephalosporins. The resistance rates of ESBLs-producing strains to penicillins, cephalosporins, amoxicillin/clavulanic acid, ampicillin/sulbactam, compound sulfamethoxazole, gentamycin, ciprofloxacin and aztreonam were significantly higher than for non-ESBLs-producing strains. ESBLs-producing strains also showed multiple-drug resistance.

CONCLUSIONSCommunity-acquired pneumonia caused by Klebsiella pneumoniae is common in infants aged ≤3 months. ESBLs-producing strains are prevalent in community-acquired pneumonia caused by Klebsiella pneumoniae and demonstrate both high rates of drug resistance and multiple-drug resistance.

Community-Acquired Infections ; drug therapy ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Infant, Newborn ; Klebsiella Infections ; drug therapy ; Klebsiella pneumoniae ; drug effects ; Male ; Pneumonia, Bacterial ; drug therapy

Anti-Bacterial Agents ; pharmacology ; Bacterial Infections ; therapy ; Bacteriophages ; physiology ; Drug Resistance, Bacterial ; drug effects ; Humans ; Probiotics ; pharmacology ; therapeutic use

Anti-Bacterial Agents ; administration & dosage ; adverse effects ; therapeutic use ; Bacteria ; drug effects ; metabolism ; Bacterial Infections ; drug therapy ; Drug Resistance, Bacterial ; drug effects ; Humans ; Infant, Newborn ; Superinfection ; drug therapy