Parth Solanki
LightNews LightNews
banner
2yellowducks.bsky.social
Parth Solanki
@2yellowducks.bsky.social
790 followers 63 following 0 posts
Infectious Diseases Physician
🧳 🍜 ⚽ 🇭🇲
Posts Replies Media Videos
Reposted by Parth Solanki
germhuntermd.bsky.social
#IDSky #MedSky required reading:

Multidrug-resistant Gram-negative bacterial infections

Nenad Macesic, Anne-Catrin Uhlemann, Anton Peleg

Review in @thelancet.bsky.social

doi.org/10.1016/S014...
Figure 1 Mechanisms of action of key antibiotics for the treatment of multidrug-resistant Gram-negative bacterial infections Several classes of antibiotics are available for the treatment of multidrug-resistant Gram-negative bacterial infections. Their mechanisms of action focus on key aspects of bacterial cell function, such as inhibiting cell wall synthesis (ie, β-lactams and fosfomycin) and function (ie, polymyxins), protein synthesis (ie, aminoglycosides and tetracyclines), folic acid synthesis (ie, trimethoprim and sulphonamides), and DNA replication (ie, fluoroquinolones). Because of increasing antimicrobial resistance, novel antibiotics have been developed to overcome some of these mechanisms; for example, by inhibiting antibiotic modification (ie, β-lactamase inhibitors) or by altering entry pathways (ie, cefiderocol, which enters via iron transporters). DHF=dihydrofolic acid. PABA=para-aminobenzoic acid. THF=tetrahydrofolate. Figure 2 Diagnostic testing of multidrug-resistant Gram-negative bacteria Diagnosis of multidrug-resistant Gram-negative bacterial infections involves both species identification and antibiotic susceptibility testing. Although clinical microbiology laboratories have undergone automation of these processes and have seen the introduction of proteomic methods, such as MALDI-TOF, delays in turnaround time remain and might affect patient outcomes. New biochemical, molecular (eg, PCR), automated microscopy, and hybridisation-based rapid diagnostics now allow faster detection of antimicrobial resistance, including by testing clinical samples directly. Emerging technologies are seeking to improve both the speed of testing and provide more detailed information regarding the underlying mechanisms of antimicrobial resistance. MALDI-TOF=matrix-assisted laser desorption/ionisation time-of-flight. Figure 3 Summary of new antibiotic agents for the treatment of multidrug-resistant Gram-negative bacterial infections Green=antibiotic is reliably active in vitro and guideline recommended. Yellow=variable activity; antibiotic might be effective if in vitro susceptibility is shown, clinical data might be lacking to support routine use. Red=not recommended, likely absence of in vitro susceptibility. IV=intravenously. *Administered simultaneously via Y-site administration. †Administration was studied in combination with imipenem–cilastatin. Figure 4 Summary of IDSA and ESCMID guidelines for the treatment of multidrug-resistant Gram-negative bacterial infections 3GCephR-E=third-generation cephalosporin-resistant Enterobacterales. AmpC-E=β-lactamase producing Enterobacterales. CRAB=carbapenem-resistant Acinetobacter baumannii. CRE=carbapenem-resistant Enterobacterales. DTR-P aeruginosa=difficult-to-treat resistant-Pseudomonas aeruginosa. ESBL-E=extended-spectrum β-lactamase-producing Enterobacterales. ESCMID=European Society for Clinical Microbiology and Infectious Diseases. IDSA=Infectious Diseases Society of America. MBL=metallo-β-lactamase. UTI=urinary tract infection.
January 17, 2025 at 2:21 PM
Reposted by Parth Solanki
drneilstone.bsky.social
Optimist: The cup is half full
Pessimist: The cup is half empty
ID Doctor : I want to know all about this cup. Right from the start. Where was it made. Where has it been. Who has drunk from it. What was in it.
boghuma.bsky.social BK. Titanji @boghuma.bsky.social · Nov 23
Optimist: The cup is half full.
Pessimist: The cup is half empty.
ID Doctor: Is the cup clean, and what’s growing in it?
chanda.blacksky.app Chanda Prescod-Weinstein 🌌 @chanda.blacksky.app · Nov 23
Optimist: The cup is half full
Pessimist: The cup is half empty
Cosmologist: The cup is dusty or full of gravitational waves
November 23, 2024 at 9:39 PM
Reposted by Parth Solanki
absteward.bsky.social
The most anticipated trial in infectious diseases #idsky #BALANCE
November 20, 2024 at 2:28 PM