Hepatic encephalopathy(HE)is one of the main complications of cirrhosis,characterized by a wide spectrum of neuropsychiatric alterations that lead to an increase in mortality,morbidity and recurrent hospitalizations.D...Hepatic encephalopathy(HE)is one of the main complications of cirrhosis,characterized by a wide spectrum of neuropsychiatric alterations that lead to an increase in mortality,morbidity and recurrent hospitalizations.Due to the central role in HE pathogenesis of ammonia and other neurotoxins primarily produced by the gut microbiota,the main therapeutic approaches for the treatment of HE are based on the modulation of the gut microbiota.Rifaximin is a non-absorbable broad-spectrum antibiotic,that is effective against ammonia-producing grampositive,gram-negative,and anaerobic species,approved for the treatment of HE in secondary prophylaxis.The chronic administration of rifaximin in this setting is associated with a lower risk of HE recurrence and mortality,while the role of rifaximin for the treatment of an overt-HE episode in inpatients is still unclear.Limited data exist about the coadministration of rifaximin and broad-spectrum antibiotics commonly used to treat concomitant infections,as patients receiving or recently treated with antibiotics were frequently excluded from clinical trials.In this editorial we comment on the article by Ward et al published in the recent issue of the World Journal of Hepatology.It is a single center,retrospective,quasiexperimental,pharmacist-driven protocol,with the aim to evaluate the feasibility and safety of rifaximin discontinuation in critically ill patients with HE and chronic liver disease receiving broad-spectrum antibiotic therapies in intensive care units.The study revealed no differences between the protocol and control group in terms of primary outcome(days alive and free of delirium and coma to day 14)and secondary outcomes which include:Intensive care mortality,intensive care length of stay,intravenous vasopressor requirement changes and adverse effects rate.Therefore,rifaximin discontinuation during broad-spectrum antibiotic therapy does not appear to negatively impact the clinical status of critically ill liver patients,with a similar safety profile and significant cost savings,as compared to the coadministration of rifaximin and broad-spectrum antibiotics.In agreement with Ward et al,a recently published double-blind,randomized controlled trial provided additional evidence to support the feasibility of withholding rifaximin during broad-spectrum antibiotic therapy in critically ill cirrhotic patients.However,given the limitations of these studies,further multicentric and prospective clinical trials,enrolling a larger sample of non-critically ill patients,are needed to better establish the role of rifaximin in this setting.展开更多
Hepatic encephalopathy(HE)is a formidable complication in patients with decompensated cirrhosis,often necessitating the administration of rifaximin(RFX)for effective management.RFX,is a gut-restricted,poorly-absorbabl...Hepatic encephalopathy(HE)is a formidable complication in patients with decompensated cirrhosis,often necessitating the administration of rifaximin(RFX)for effective management.RFX,is a gut-restricted,poorly-absorbable oral rifamycin derived antibiotic that can be used in addition to lactulose for the secondary prophylaxis of HE.It has shown notable reductions in infection,hospital readmission,duration of hospital stay,and mortality.However,limited data exist about the concurrent use of RFX with broad-spectrum antibiotics,because the patients are typically excluded from studies assessing RFX efficacy in HE.A pharmacist-driven quasi-experimental pilot study was done to address this gap.They argue against the necessity of RFX in HE during broad-spectrum antibiotic treatment,particularly in critically ill patients in intensive care unit(ICU).The potential for safe RFX discontinuation without adverse effects is clearly illuminated and valuable insight into the optimization of therapeutic strategies is offered.The findings also indicate that RFX discontinuation during broadspectrum antibiotic therapy was not associated with higher rates of delirium or coma,and this result remained robust after adjustment in multivariate analysis.Furthermore,rates of other secondary clinical and safety outcomes,including ICU mortality and 48-hour changes in vasopressor requirements,were comparable.However,since the activity of RFX is mainly confined to the modulation of gut microbiota,its potential utility in patients undergoing extensive systemic antibiotic therapy is debatable,given the overlapping antibiotic activity.Further,this suggests that the action of RFX on HE is class-specific(related to its activity on gut microbiota),rather than drug-specific.A recent double-blind randomized controlled(ARiE)trial provided further evidence-based support for RFX withdrawal in critically ill cirrhotic ICU patients receiving broad-spectrum antibiotics.Both studies prompt further discussion about optimal therapeutic strategy for patients facing the dual challenge of HE and systemic infections.Despite these compelling results,both studies have limitations.A prospective,multi-center evaluation of a larger sample,with placebo control,and comprehensive neurologic evaluation of HE is warranted.It should include an exploration of longer-term outcome and the impact of this protocol in non-critically ill liver disease patients.展开更多
BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to im...BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.展开更多
[Objective] The aim of this study is to evaluate the safety and bacteriostasis of Yandureqing(AEE)and its microemulsion(AEE-ME).[Method]The acute toxicity was tested in mice by intragastric administration,and median l...[Objective] The aim of this study is to evaluate the safety and bacteriostasis of Yandureqing(AEE)and its microemulsion(AEE-ME).[Method]The acute toxicity was tested in mice by intragastric administration,and median lethal dose(LD50)as well as its 95% confidence interval was calculated by modified Karber method;the bacteriostasis was investigated by cylinder plate method.[Result]LD50 of AEE in mice was 10.937 g/kg with the 95% confidence interval of 9.309-12.850 g/kg;and LD50 of AEE-ME in mice was 5.357 g/kg with the 95% confidence interval of 4.388-6.566 g/kg.The MICs of AEE to Escherichia coli O149 from swine,Staphylococcus aureus,Salmonella pullorum and Streptococcus agalactiae were 10.00,20.00,20.00 and 10.00 mg/ml,respectively;while the MICs of AEE-ME to the 4 kinds of bacteria mentioned above were 5.00,10.00,5.00 and 5.00 mg/ml in turn,and that to Pseudomonas aeruginosa is 20.00 mg/ml.[Conclusion]AEE is an actually nontoxic drug and AEE-ME belongs to the low toxic preparation.AEE and AEE-ME have obvious bacteriostasis,in which AEE-ME is superior to AEE.展开更多
[ Objective ] The aim was to study bacteriostatic activity of the different extract from Ilex Kudingcha C. J. Tseng. [ Method ] By using test tube 2 -fold dilution method and Kirby-Baueer Disc Diffusionto,we conducted...[ Objective ] The aim was to study bacteriostatic activity of the different extract from Ilex Kudingcha C. J. Tseng. [ Method ] By using test tube 2 -fold dilution method and Kirby-Baueer Disc Diffusionto,we conducted inhibitory test on S. aureus and E, coil and determined the minimal inhibitory concentration （MIC） and minimum bactericidal concentration （MBC）and the diameter of inhibition zone. [ Result ] The extract 1 had fairly strong in vitro bacteriostasis activities and than the extract2 and extract3. The MIC and MBC was 3.91 mg/ml and 31.25 mg/ml on S. aureus and E. coil [ Conclusion] The result showed that the different extract from Ilex Kudingcha C. J. Tseng had varying amount of different bacteriostatic activities,the Ilex Kudingcha C. J. Tseng was developed new and safe bacteriostatic reagent to provide reference.展开更多
Nano selenium which has the advantages of low toxicity,strong activity and high biocompatibility has broad-spectrum antibacterial activity to bacteria,fungi,viruses and parasites,and has a broad application prospect i...Nano selenium which has the advantages of low toxicity,strong activity and high biocompatibility has broad-spectrum antibacterial activity to bacteria,fungi,viruses and parasites,and has a broad application prospect in the field of inhibiting microbial infection.This paper mainly reviews the progress in the types and mechanisms of selenium inhibition microorganisms,and prospects the development of the antibacterial activities of selenium nanoparticles.展开更多
[Objective] The paper was to explore the combined inhibitory effect of rhizoma coptidis-folium isatidis and rhizoma coptidis-flos poprli against Escherichia coli O2.[Method] Contrast test of single and associated bact...[Objective] The paper was to explore the combined inhibitory effect of rhizoma coptidis-folium isatidis and rhizoma coptidis-flos poprli against Escherichia coli O2.[Method] Contrast test of single and associated bacteriostasis against known serotype E. coli O2 was conducted using microcheckerboard method.[Result] The MIC of rhizoma coptidis, folium isatidis and flos poprli were 1/8 extracting liquid, 1/8 extracting liquid and 1/2 extracting liquid, respectively. When combined with folium isatidis or flos poprli, the MIC of rhizoma coptidis was 1/8 extracting liq-uid or 1/16 extracting liquid compared with single use. When combined with rhizoma coptidis, the MIC of folium isatidis and flos poprli were 1/8 extracting liquid and 1/16 extracting liquid.[Conclusion] When rhizoma coptidis was combined with folium isatidis or flos poprli, the FIC values were 2 and 0.625, performing independent action and additive effect, respectively.展开更多
文摘Hepatic encephalopathy(HE)is one of the main complications of cirrhosis,characterized by a wide spectrum of neuropsychiatric alterations that lead to an increase in mortality,morbidity and recurrent hospitalizations.Due to the central role in HE pathogenesis of ammonia and other neurotoxins primarily produced by the gut microbiota,the main therapeutic approaches for the treatment of HE are based on the modulation of the gut microbiota.Rifaximin is a non-absorbable broad-spectrum antibiotic,that is effective against ammonia-producing grampositive,gram-negative,and anaerobic species,approved for the treatment of HE in secondary prophylaxis.The chronic administration of rifaximin in this setting is associated with a lower risk of HE recurrence and mortality,while the role of rifaximin for the treatment of an overt-HE episode in inpatients is still unclear.Limited data exist about the coadministration of rifaximin and broad-spectrum antibiotics commonly used to treat concomitant infections,as patients receiving or recently treated with antibiotics were frequently excluded from clinical trials.In this editorial we comment on the article by Ward et al published in the recent issue of the World Journal of Hepatology.It is a single center,retrospective,quasiexperimental,pharmacist-driven protocol,with the aim to evaluate the feasibility and safety of rifaximin discontinuation in critically ill patients with HE and chronic liver disease receiving broad-spectrum antibiotic therapies in intensive care units.The study revealed no differences between the protocol and control group in terms of primary outcome(days alive and free of delirium and coma to day 14)and secondary outcomes which include:Intensive care mortality,intensive care length of stay,intravenous vasopressor requirement changes and adverse effects rate.Therefore,rifaximin discontinuation during broad-spectrum antibiotic therapy does not appear to negatively impact the clinical status of critically ill liver patients,with a similar safety profile and significant cost savings,as compared to the coadministration of rifaximin and broad-spectrum antibiotics.In agreement with Ward et al,a recently published double-blind,randomized controlled trial provided additional evidence to support the feasibility of withholding rifaximin during broad-spectrum antibiotic therapy in critically ill cirrhotic patients.However,given the limitations of these studies,further multicentric and prospective clinical trials,enrolling a larger sample of non-critically ill patients,are needed to better establish the role of rifaximin in this setting.
基金Supported by the Chang Gung Medical Research Project,No.CMRPG3M1931-1932the National Science and Technology Council,No.MOST 110-2314-B-182A-093-and No.NMRPG3L0331.
文摘Hepatic encephalopathy(HE)is a formidable complication in patients with decompensated cirrhosis,often necessitating the administration of rifaximin(RFX)for effective management.RFX,is a gut-restricted,poorly-absorbable oral rifamycin derived antibiotic that can be used in addition to lactulose for the secondary prophylaxis of HE.It has shown notable reductions in infection,hospital readmission,duration of hospital stay,and mortality.However,limited data exist about the concurrent use of RFX with broad-spectrum antibiotics,because the patients are typically excluded from studies assessing RFX efficacy in HE.A pharmacist-driven quasi-experimental pilot study was done to address this gap.They argue against the necessity of RFX in HE during broad-spectrum antibiotic treatment,particularly in critically ill patients in intensive care unit(ICU).The potential for safe RFX discontinuation without adverse effects is clearly illuminated and valuable insight into the optimization of therapeutic strategies is offered.The findings also indicate that RFX discontinuation during broadspectrum antibiotic therapy was not associated with higher rates of delirium or coma,and this result remained robust after adjustment in multivariate analysis.Furthermore,rates of other secondary clinical and safety outcomes,including ICU mortality and 48-hour changes in vasopressor requirements,were comparable.However,since the activity of RFX is mainly confined to the modulation of gut microbiota,its potential utility in patients undergoing extensive systemic antibiotic therapy is debatable,given the overlapping antibiotic activity.Further,this suggests that the action of RFX on HE is class-specific(related to its activity on gut microbiota),rather than drug-specific.A recent double-blind randomized controlled(ARiE)trial provided further evidence-based support for RFX withdrawal in critically ill cirrhotic ICU patients receiving broad-spectrum antibiotics.Both studies prompt further discussion about optimal therapeutic strategy for patients facing the dual challenge of HE and systemic infections.Despite these compelling results,both studies have limitations.A prospective,multi-center evaluation of a larger sample,with placebo control,and comprehensive neurologic evaluation of HE is warranted.It should include an exploration of longer-term outcome and the impact of this protocol in non-critically ill liver disease patients.
基金Zhangjiakou Science and Technology Tackling Program,No.2021099D.
文摘BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.
基金Supported by Specific Program Funded by Basic Scientific Research Operating Expenses of Central Public Scientific Research Institutes(BRF060403)Key Project of Scientific and Technical Supporting Pro-grams of Gansu Province(0804NKCA074)~~
文摘[Objective] The aim of this study is to evaluate the safety and bacteriostasis of Yandureqing(AEE)and its microemulsion(AEE-ME).[Method]The acute toxicity was tested in mice by intragastric administration,and median lethal dose(LD50)as well as its 95% confidence interval was calculated by modified Karber method;the bacteriostasis was investigated by cylinder plate method.[Result]LD50 of AEE in mice was 10.937 g/kg with the 95% confidence interval of 9.309-12.850 g/kg;and LD50 of AEE-ME in mice was 5.357 g/kg with the 95% confidence interval of 4.388-6.566 g/kg.The MICs of AEE to Escherichia coli O149 from swine,Staphylococcus aureus,Salmonella pullorum and Streptococcus agalactiae were 10.00,20.00,20.00 and 10.00 mg/ml,respectively;while the MICs of AEE-ME to the 4 kinds of bacteria mentioned above were 5.00,10.00,5.00 and 5.00 mg/ml in turn,and that to Pseudomonas aeruginosa is 20.00 mg/ml.[Conclusion]AEE is an actually nontoxic drug and AEE-ME belongs to the low toxic preparation.AEE and AEE-ME have obvious bacteriostasis,in which AEE-ME is superior to AEE.
基金Supported by the Key Project in Natural Science Foundation ofGuangxi Province(0719004-3H)~~
文摘[ Objective ] The aim was to study bacteriostatic activity of the different extract from Ilex Kudingcha C. J. Tseng. [ Method ] By using test tube 2 -fold dilution method and Kirby-Baueer Disc Diffusionto,we conducted inhibitory test on S. aureus and E, coil and determined the minimal inhibitory concentration （MIC） and minimum bactericidal concentration （MBC）and the diameter of inhibition zone. [ Result ] The extract 1 had fairly strong in vitro bacteriostasis activities and than the extract2 and extract3. The MIC and MBC was 3.91 mg/ml and 31.25 mg/ml on S. aureus and E. coil [ Conclusion] The result showed that the different extract from Ilex Kudingcha C. J. Tseng had varying amount of different bacteriostatic activities,the Ilex Kudingcha C. J. Tseng was developed new and safe bacteriostatic reagent to provide reference.
基金Special Fund for Technological Innovation Guidance of Shaanxi Provincial Department of Science and Technology(2017CG-003)Key R&D Projects in Shaanxi Province(2018NY-043).
文摘Nano selenium which has the advantages of low toxicity,strong activity and high biocompatibility has broad-spectrum antibacterial activity to bacteria,fungi,viruses and parasites,and has a broad application prospect in the field of inhibiting microbial infection.This paper mainly reviews the progress in the types and mechanisms of selenium inhibition microorganisms,and prospects the development of the antibacterial activities of selenium nanoparticles.
基金Supported by Natural Science Foundation of Shandong Province(ZR2014CQ012)
文摘[Objective] The paper was to explore the combined inhibitory effect of rhizoma coptidis-folium isatidis and rhizoma coptidis-flos poprli against Escherichia coli O2.[Method] Contrast test of single and associated bacteriostasis against known serotype E. coli O2 was conducted using microcheckerboard method.[Result] The MIC of rhizoma coptidis, folium isatidis and flos poprli were 1/8 extracting liquid, 1/8 extracting liquid and 1/2 extracting liquid, respectively. When combined with folium isatidis or flos poprli, the MIC of rhizoma coptidis was 1/8 extracting liq-uid or 1/16 extracting liquid compared with single use. When combined with rhizoma coptidis, the MIC of folium isatidis and flos poprli were 1/8 extracting liquid and 1/16 extracting liquid.[Conclusion] When rhizoma coptidis was combined with folium isatidis or flos poprli, the FIC values were 2 and 0.625, performing independent action and additive effect, respectively.
