Oxygen poisoning in Drosophila

Fruit flies live longer at the partial pressure of oxygen found in air than at either larger or smaller partial pressures. Flies exposed to 1 atm of oxygen for 8 hr every day do not recover completely in the remaining 16 hr. In general, intermittent exposures to 1 atm of oxygen are better tolerated than continuous exposure to the same average oxygen concentration per day, but exposures to higher pressures of 2–5 atm of oxygen for as little as a half hour every two days markedly shorten the life-span. Older flies consume more oxygen per minute and are more sensitive to oxygen poisoning than young flies, and the rate of dying in 6 atm of O₂, or the reciprocal of the survival time, is a linear function of the age. The oxygen pressure-time curve can be well expressed by the general empirical equation (P_OO2)² x time = 120 where P is in atmosphere and survival time in hours. The progress of oxygen poisoning appears to be linear with time rather than exponential.     

Partial reversal by sodium ascorbate of hyperoxia-induced damage to HEp-2 cell cultures

Summary Hyperoxia induced cellular damage was used as an experimental model system for examining the ameliorative role of antioxidants. Multiplication of HEp-2 cells in monolayer culture was inhibited after exposure to 100% O₂ either hyperbarically at 3 atm absolute (atma) or normobarically at 1 atma for periods from 15 s to 4 h. The inhibition was characterized by a slower rate of replication for a period from 1 to 3 d after exposure than in unexposed cultures, and then massive cellular death. Less killing followed exposure to normobaric O₂ than to hyperbaric O₂, and the shorter the period of exposure to hyperoxia the less killing. Addition of 100 μg/ml of sodiuml-ascorbate to unexposed cultures enhanced growth (cell number at 6 d) almost twofold. When added ascorbate was present only during hyperoxic exposure (but not afterward), subsequent growth in air was enhanced 1.6-fold. However, when cells were exposed without added ascorbate, there was from 2 to 12-fold greater growth in air in the presence of the added ascorbate (as compared to exposed controls). This greater growth was always only a partial reversal of the lethal effect resulting from hyperoxia. Addition of 25 μg/ml catalase did not affect control or exposed cultures. Addition of ascorbate plus catalase was not as effective as ascorbate alone in promoting growth; the catalase moiety antagonized some of the growth enhancing influence of ascorbate. This suggests that extracellular H₂O₂ was not a factor in the lethal effect resulting from hyperoxia.     

高压氧预处理对SPS暴露大鼠学习记忆能力以及海马神经元凋亡的影响

目的:研究高压氧(HBO)预处理对SPS暴露大学学习记忆能力及其大脑海马神经元细胞凋亡的影响.方法:48只雄性Sprague-Dawley大鼠(体重220-260 g)随机分为4组(n=12):对照(sham)组,高压氧(HBO)组,SPS组以及高压氧+SPS组.高压氧组每天1小时高压氧预处理(2.5个大气压,100%O2)连续5天;SPS组采用单次延长应激模型;高压氧+SPS组每天l小时高压氧预处理连续5天于最后一次预处理后24小时,制作SPS模型.4组大鼠于SPS暴露后72小时进行TUNEL染色,第15天经行水迷宫测试.结果:水迷宫实验中大鼠逃避潜伏期及游泳路径四组之间有明显统计差异[F0.01(3,28)=4.88＞4.57,P＜0.01;F0.01(3,28)=5.31＞4.57,P＜0.01].SPS组明显长于Sham组(P＜0.01),而高压氧预处理能够逆转这种效应(P＜0.01).游泳速度四组之间无明显统计差异[F0.05(3,28)=2.23＜2.95,P＞0.05]. SPS暴露后海马神经元细胞数量和密度明显减少,给予高压氧预处理后,神经元形态明显好转,但仍不及对照组.结论:高压氧预处理可以减少海马神经元细胞凋亡从而改善SPS暴露后大鼠认知功能障碍.     

Activation of BDNF mRNA and protein after seizures in hyperbaric oxygen: implications for sensitization to seizures in re-exposures

Previous studies have demonstrated that exposure to convulsive doses of hyperbaric oxygen (HBO) increases sensitivity to seizures in re-exposures. Because brain derived neurotrophic factor (BDNF) is induced after a variety of seizures and increases cell excitability, it may contribute to the mechanism of sensitization. In this study, a fast induction in BDNF mRNA 2 hr after seizures and a temporary increase in BDNF protein 1 day after seizures induced by 100% O₂ at 5 atm (gauge pressure) were demonstrated in the rat cortex. To determine whether an elevation in BDNF protein level can modify sensitivity to the toxic effect of HBO, recombinant BDNF (12 g) was injected into cerebral ventricles 30 min prior to exposure. Administration of exogenous BDNF significantly shortened latent time to seizures in HBO exposures. We propose that upregulation of BDNF expression in the brain after seizures may contribute to sensitization to HBO toxicity.     

Growth of Chlorella sorokiniana at Hyperbaric Oxygen Pressures

The growth rate of Chlorella sorokiniana decreased in a linear fashion as the partial pressure of oxygen was increased from 711 to 1,478 mm of Hg. Under two atmospheres of oxygen pressure, growth ceased after 10 to 12 hr. This cessation of growth was not due to any permanent injury, as growth resumed when oxygen partial pressure was reduced to ambient levels. The inhibition occurred under both autotrophic and heterotrophic growth conditions and was not accompanied by an increase in cell size. The results indicated that the tolerance of Chlorella cells to elevated oxygen pressures was not an absolute immunity, and that inhibition of growth at very high oxygen pressures cannot be accounted for by an inhibition of photosynthesis alone.     

Toxic effects of zinc and iron on the routine oxygen consumption of Tilapia sparrmanii (Cichlidae)

1. The routine oxygen consumption of Tilapia sparrmanii without the addition of any toxicants over a 72 hr period showed a decrease for the first 48 hr, but stabilised thereafter.2. Addition of zinc (98 mg l⁻¹) resulted in a drastic decrease of oxygen consumption for 3 hr. The routine oxygen consumption showed a significant decrease for the first 24 hr, while the second and third 24 hr revealed significant differences with great individual variance.3. The decrease in oxygen consumption observed after exposure to zinc, could be caused by gill damage as well as the internal action of zinc.4. An increase in oxygen consumption was noted for almost 3 hr after addition of iron (88mg l⁻¹). During the first-, second- and third 24 hr the oxygen consumption increased significantly, compared to the control values.5. The increase in routine oxygen consumption of T. sparrmanii when compared to control values after exposure to iron, could be attributed to stress and possible gill changes.6. The study revealed that after acute (72 hr) exposure to sublethal concentrations of zinc and iron, the routine oxygen consumption of T. sparrmanii was altered.     

Influence of antibiotic stability on the results of in vitro testing procedures

Wick, Warren E. (The Lilly Research Laboratories, Indianapolis, Ind.). Influence of antibiotic stability on the results of in vitro testing procedures. J. Bacteriol. 87:1162-1170. 1964.-Certain antibiotics undergo at least partial degradation under the conditions of in vitro testing procedures. With cephalothin used as an example, experimental evidence is presented to indicate the necessity for re-evaluation of results obtained from in vitro sensitivity testing methods for some antibiotics. The in vitro activity of cephalothin, tetracycline, and chloramphenicol against a variety of gram-negative bacteria is described. Plate counts demonstrate changes in the viable cell population over a 48-hr period in tubes of minimal inhibitory concentration (MIC) tests, with an abrupt rise in MIC value for cephalothin between the 12th and 24th hr. Data obtained by chromatographic methods, showing the degradation of cephalothin for the same time interval, indicated that instability of the antibiotic between the 12th and 24th hr might adversely affect the results obtained from standard 20- to 24-hr in vitro antibiotic sensitivity testing methods. Because repeated administration of an antibiotic to a patient at 4- to 8-hr intervals reinforces the original concentration, a more accurate estimate of antibacterial activity of that antibiotic might preferably be related to this time interval.     

Gas chromatography-mass spectrometry characterisation of the anti-Listeria components of Garcinia kola seeds

Adsorption chromatography was used to separate the bioactive constituents of the crude n-hexane extract of Garcinia kola seeds. The silica gel 60 column fractions were eluted using the solvent combination of benzene:ethanol:ammonium hydroxide (BEA) in the ratio combination of 36:4:0.4 v/v. The fractions were tested for anti-Listeria activities by determining their MIC₅₀, MIC₉₀ or MIC against 4 Listeria isolates. The fractions were labelled BEA1 to BEA5 and 3 out of the 5 fractions eluted were active against the test Listeria species with MIC’s ranging from MIC 0.157 mg/mL to MIC₅₀ 0.625 mg/mL. The most active fractions, BEA2 and BEA3, were subjected to gas chromatography coupled to mass spectrometry (GC-MS) to identify their composition. Fraction BEA2 constituted of 18 compounds mostly sterols and the BEA3 fraction contained 27 compounds with the most abundant compounds being fatty acids derivatives. The BEA2 fraction’s interactions with antibiotics proved to be 100% synergistic with ciprofloxacin and ampicillin whilst it exhibited 50% additivity and 50% synergism with penicillin G. However, all the interactions of the BEA2 fraction with each of the conventional antibiotics used were synergistic against the human listeriosis causative bacteria Listeria monocytogenes.     

Intermedilysin release by Streptococcus intermedius: effects of various antibacterial drugs at sub-MIC levels

Intermedilysin is a cytolytic toxin produced by Streptococcus intermedius, a pathogen of humans. In vitro studies showed that exposure of S. intermedius to sub-minimum inhibitory concentration (MIC) levels (1/2 MIC) of protein-inhibiting antibiotics and nucleic acid-inhibiting antibiotics decreased intermedilysin release by S. intermedius. The most potent antibiotic was clindamycin. On the other hand, exposure to cell wall-inhibiting antibiotics generally showed insignificant changes in intermedilysin release at sub-MIC concentrations. Investigations into possible mechanisms underlying this sub-MIC effect with clindamycin showed that there was selective decrease in biosynthesis and release of toxin after exposure to 1/2 MIC condition. However, no significant differences in the mRNA levels of the intermedilysin gene were observed.     

THE EFFECT OF HYDROCORTISONE ON HeLa CELL GROWTH

HeLa Chessen cells have a doubling time of 18 hr when grown in MEM containing 10% calf serum and antibiotics. When hydrocortisone (1.7 μg/ml) is added to exponentially distributed cells in log growth in this medium, a new pattern of growth begins to emerge after 10–12 hr. This pattern is characterized by a transitional state lasting for about 6 hr, and then a new doubling time of about 35 hr is maintained thereafter. Hydrocortisone removes about 5% of the cells from the proliferative pool and extends the generation time of proliferating cells to about 30 hr. The extension of the generation cycle appears to occur almost entirely in late G₁. Cells grown as clones (average 6 cells/clone) prior to the addition of hydrocortisone, undergo these changes with doses as low as 0.00017 μg/ml of medium. When the average clone size is 1.5 cells per clone, the drug concentration must be 0.017 μg/ml or higher to initiate this response. The HeLa S₃ strain continues to grow with an 18-hr doubling time in the presence of hydrocortisone after a temporary delay in growth occurring between the 12th and 16th hour.     

STUDIES ON THE POPULATION KINETICS OF THE WALKER CARCINOMA BY AUTORADIOGRAPHY AND PULSE CYTOPHOTOMETRY

The proliferation parameters of the Walker carcinoma were estimated from both in vivo and in vitro measurements. The transplantable Walker carcinoma 256 was grown in male inbred BD1 rats. During exponential growth, 5-6 days after transplantation, a PLM curve was performed, yielding estimates of Tc ? 18.0 hr, Ts ? 6.4 hr, T_G2+M? 4.1 hr. With the double labelling technique in vitro under 2.2 atm oxygen we obtained: Tc ? 18.2hr, Ts ? 8.2 hr, T_G2+M? 2.0hr. From pulse cyto-photometry DNA content histograms the fractions of cells in the cell cycle phases were calculated using a computer program: f_G1? (47.6 ± 1.1)%, f_s? (34.1 ± 1.0)%, f_G2+M? (18.3 ± 1.5)%. These fractions remained constant between the fifth and the twelfth day after transplantation. At that time the tumour growth had already slowed down appreciably. The growth fraction determined by repetitive labelling was 0.96 on the fifth and 0.93 on the seventh and eleventh day. The cell loss factor was φ? 17% during exponential tumor growth and increased to about 100% between the tenth and twelfth day. The agreement of the cell kinetic data determined by autoradiography from solid tumours in vivo (PLM, continuous labelling) and autoradiography as well as pulse cytophotometry from in vitro experiments (excised material) was satisfactory.     

The initial state of the human gut microbiome determines its reshaping by antibiotics

Microbiome studies have demonstrated the high inter-individual diversity of the gut microbiota. However, how the initial composition of the microbiome affects the impact of antibiotics on microbial communities is relatively unexplored. To specifically address this question, we administered a second-generation cephalosporin, cefprozil, to healthy volunteers. Stool samples gathered before antibiotic exposure, at the end of the treatment and 3 months later were analysed using shotgun metagenomic sequencing. On average, 15 billion nucleotides were sequenced for each sample. We show that standard antibiotic treatment can alter the gut microbiome in a specific, reproducible and predictable manner. The most consistent effect of the antibiotic was the increase of Lachnoclostridium bolteae in 16 out of the 18 cefprozil-exposed participants. Strikingly, we identified a subgroup of participants who were enriched in the opportunistic pathogen Enterobacter cloacae after exposure to the antibiotic, an effect linked to lower initial microbiome diversity and to a Bacteroides enterotype. Although the resistance gene content of participants'' microbiomes was altered by the antibiotic, the impact of cefprozil remained specific to individual participants. Resistance genes that were not detectable prior to treatment were observed after a 7-day course of antibiotic administration. Specifically, point mutations in beta-lactamase bla_CfxA-6 were enriched after antibiotic treatment in several participants. This suggests that monitoring the initial composition of the microbiome before treatment could assist in the prevention of some of the adverse effects associated with antibiotics or other treatments.     

Impact of ciprofloxacin impurities on bacterial growth,antibiotic resistance development and content assays

In addition to active pharmaceutical ingredient (API), antibiotics may contain small amounts of excipients and impurities and be prone to accumulation of degradation products. There has been limited work characterizing how these substances impact bacterial growth and antibiotic resistance development. We investigated how two ciprofloxacin (CIP) impurities, fluoroquinolonic acid (FQA) and ciprofloxacin ethylenediamine analogue (CEA), impact growth and antibiotic resistance in Escherichia coli. Additionally, we investigated how these impurities impact a frequently used API content assay. Both impurities displayed modest antimicrobial activity compared to the CIP API. The effective antimicrobial activity of a medicine containing increased impurity levels may permit bacterial growth and resistance development. Our results also suggest that increasing exposure concentration and duration to CEA and FQA, independent of CIP, can promote antibiotic resistance development. However, at concentrations of 100% and below the MIC of the API, impurities had limited contributions to resistance development compared to the CIP API. From a methodological standpoint, we found that UV spectrophotometry may be inadequate to account for antibiotic impurities or degradation products. This can lead to incorrect estimations of API content and we propose additional multi-wavelength measures when using UV spectrophotometry to help identify impurities or degradation.     

Response of rat lung tissue to short-term hyperoxia: a proteomic approach

An inspiratory oxygen fraction of 1.0 is often required to avoid hypoxia both in many pre- and in-hospital situations. On the other hand, hyperoxia may lead to deleterious consequences (cell growth inhibition, inflammation, and apoptosis) for numerous tissues including the lung. Whereas clinical effects of hyperoxic lung injury are well known, its impact on the expression of lung proteins has not yet been evaluated sufficiently. The aim of this study was to analyze time-dependent alterations of protein expression in rat lung tissue after short-term normobaric hyperoxia (NH). After approval of the local ethics committee for animal research, N = 36 Wistar rats were randomized into six different groups: three groups with NH with exposure to 100 % oxygen for 3 h and three groups with normobaric normoxia (NN) with exposure to room air (21 % oxygen). After the end of the experiments, lungs were removed immediately (NH₀ and NN₀), after 3 days (NH₃ and NN₃) and after 7 days (NH₇ and NN₇). Lung lysates were analyzed by two-dimensional gel electrophoresis (2D-GE) followed by peptide mass fingerprinting using mass spectrometry. Statistical analysis was performed with Delta 2D (DECODON GmbH, Greifswald, Germany; ANOVA, Bonferroni correction, p < 0.01). Biological functions of differential regulated proteins were studied using functional network analysis (Ingenuity Pathways Analysis, IPA). pO₂ was significantly higher in NH-groups compared to NN-groups (581 ± 28 vs. 98 ± 12 mmHg; p < 0.01), all other physiological parameters did not differ. Expression of 14 proteins were significantly altered: two proteins were up-regulated and 12 proteins were down-regulated. Even though NH was comparatively short termed, significant alterations in lung protein expression could be demonstrated up to 7 days after hyperoxia. The identified proteins indicate an association with cell growth inhibition, regulation of apoptosis, and approval of structural cell integrity.     

Inhibition of growth and decreased survival of B104 rat neuroblastoma cells after exposure to hyperbaric oxygen

Summary The toxic effects of hyperbaric oxygen (HBO) on growth and survival of B104 rat neuroblastoma cells were investigated. Cells in log phase growth were incubated at 37°C with 10 atm O₂ for 1 to 4 h. After exposure to HBO, cells were monitored for their subsequent growth and survival. Two hours of exposure caused a slowing of growth, which returned to normaly by the end of the 7th d of the postexposure period. Exposures to O₂ of 3 h or longer caused a complete cessation of growth for 4 d after the exposure and very litle or no recovery after this period. Increased hydrostatic pressure for 6 h using helium as the inert gas had no effect on growth. A colony formation assay was used to quantitative the degree of cell death induced by HBO. The resulting survival curve was of the exponential type with a broad shoulder between 0 to 2.5 h of exposure to 10 atm O₂. The curve fell off sharply at 2.5 h with an exponential decrease in survival when the exposure to HBO was extended to 4 h. At 2 h about 50% of cells were killed, but at 4 h only 2% survived the treatment. These results show that the depression of the growth rate by HBO is related to the number of cells that are killed by the exposure. This system provides a model in which the molecular and cellular effects of HBO can be investigated. This work was supported by the National Institutes of Health, Bethesda, MD, Grants AM-21423 and CA-14489, and by grants from the W. W. Smith Foundation and the Philadelphia Foundation. The studies presented here are part of a dissertation submitted by G. J. Gendimenico in partial fulfillment of the requirements for the degree of Ph.D. in pharmacology from the University of Pennsylvania.     

Study of the sensitivity of the L-forms of group A Streptococcus to antibiotics in artificial nutrient media and in human cell cultures

Sensitivity of L-forms of group A streptococci to 5 antibiotics such as erythromycin, lincomycin, tetracycline, gentamicin and chloramphenicol was studied in an artificial nutrient medium and cell cultures i.e. human fibroblast diploid cells and transplantable human heart cells (Girardi). In vitro investigation of the antibiotic effect on the streptococcal L-forms revealed their sensitivity to erythromycin (MIC, 0.4 micrograms/ml), lincomycin (MIC, 0.08 microgram/ml) and tetracycline (MIC, 2 micrograms/ml). The streptococcal L-forms were slightly sensitive to gentamicin (MIC, 6 micrograms/ml) and chloramphenicol (MIC, 30 micrograms/ml). Complete inhibition of the growth of the L-forms in the Girardi cells on the 1st day of the experiment after the antibiotics administration in single doses was induced by lincomycin, 5 micrograms/ml, erythromycin, 10 micrograms/ml, and tetracycline, 100 micrograms/ml. In the diploid cells, the respective figures were 50, 100 and 200 micrograms/ml. Chloramphenicol and gentamicin had an inhibitory effect on the growth of the L-forms but produced no sanative effect.     

Incidence, risk factors and mortality of nosocomial pneumonia in Intensive Care Units: A prospective study

Background

Increasing antimicrobial resistance among the key pathogens responsible for community-acquired respiratory tract infections has the potential to limit the effectiveness of antibiotics available to treat these infections. Since there are regional differences in the susceptibility patterns observed and treatment is frequently empirical, the selection of antibiotic therapy may be challenging. PROTEKT, a global, longitudinal multicentre surveillance study, tracks the activity of telithromycin and comparator antibacterial agents against key respiratory tract pathogens.

Methods

In this analysis, we examine the prevalence of antibacterial resistance in 1,336 bacterial pathogens, isolated from adult and paediatric patients clinically diagnosed with acute bacterial sinusitis (ABS).

Results and discussion

In total, 58.0%, 66.1%, and 55.8% of S. pneumoniae isolates were susceptible to penicillin, cefuroxime, and clarithromycin respectively. Combined macrolide resistance and reduced susceptibility to penicillin was present in 200/640 (31.3 %) of S. pneumoniae isolates (128 isolates were resistant to penicillin [MIC >= 2 mg/L], 72 intermediate [MIC 0.12–1 mg/L]) while 99.5% and 95.5% of isolates were susceptible to telithromycin and amoxicillin-clavulanate, respectively. In total, 88.2%, 87.5%, 99.4%, 100%, and 100% of H. influenzae isolates were susceptible to ampicillin, clarithromycin, cefuroxime, telithromycin, and amoxicillin-clavulanate, respectively. In vitro, telithromycin demonstrated the highest activity against M. catarrhalis (MIC₅₀ = 0.06 mg/L, MIC₉₀ = 0.12 mg/L).

Conclusion

The high in vitro activity of against pathogens commonly isolated in ABS, together with a once daily dosing regimen and clinical efficacy with 5-day course of therapy, suggest that telithromycin may play a role in the empiric treatment of ABS.     

Augmentation of mitochondrial oxidative metabolism in lung tissue during recovery of animals from acute ozone exposure

After O₃-mediated lung injury in rats (3 ppm O₃ exposure for 4 hr) recovery was studied in terms of alteration in lung mitochondrial oxidative metabolism. As judged from O₂ consumption, succinate oxidation in lung homogenate exhibited a 20% (P < 0.05) decrease at 0 hr but attained the control rate (0.6 μmole O₂/min/lung) within 12 hr and the peak rate (55% over control, P < 0.001) within 48 hr of recovery. Thereafter, the rate plateaued and at about the fifth day began to decline, exhibiting only a 15% (P < 0.05) increase over control after 21 days. The half-life for duration of this augmentation appeared to be 10 days. During recovery, the yield of isolated mitochondria was increasingly greater for exposed lungs relative to control (viz., 25–30% increase after 96 hr) as viewed from mitochondrial packed volume and protein content. Mitochondria from exposed lungs exhibited a 17–24% (P < 0.05) increase in activity (per mg of protein) for oxidation of 2-oxoglutarate, succinate, glycerol-1-phosphate, and ascorbate-Wurster's blue. The over-all augmentation of O₂ consumption observed in exposed rat lungs, therefore, would be attributable primarily to increase in population of mitochondria. Enhanced mitochondrial metabolism might serve as an index for assessing the repair process of injured lung.     

Effect of Exposure to Hyperoxic, Hypobaric, and Hyperbaric Environments on Concentrations of Selected Aerobic and Anaerobic Fecal Flora of Mice

Alterations in selected aerobic and anaerobic fecal microflora of the mouse were determined during exposure to hyperoxic and normoxic hypo- and hyperbaric environments. Examination of fecal cultures obtained during exposure for 6 weeks to either 60 or 77% oxygen concentration at 1 atmosphere absolute revealed little alteration in the aerobic or anaerobic flora. There appeared to be only a retardation in the reduction of the Klebsiella-Enterobacter flora which normally occurs after weaning. During exposure to hypobaric environments (100% O₂, 0.2 atmosphere absolute), significant alterations in concentrations of Escherichia coli, slow lactose fermenters, Klebsiella-Enterobacter, and enterococci were found in some instances. All alterations were toward increased concentrations. Variations in concentrations of different colony types of obligately anaerobic gram-positive (anGPR) and gram-negative (anGNR) rods cultured during the same experiments also occurred. One colony type of anGPR appeared to decrease while a second type increased in numbers. Concentrations of three colony types of anGNR were generally, but not always, increased. During hyperbaric exposure (2.8% O₂, 7.5 atmospheres absolute), increased concentrations of Klebsiella-Enterobacter, E. coli, slow lactose fermenters and enterococci were also noted. Changes in numbers of both colony types of anGPR, when occurring, were in the direction of lower numbers. Alteration in numbers of anGNR were in both directions but were more frequent in the direction of higher numbers. After return to normal air for 4 weeks of either hypo- or hyperbaric exposure, fecal concentrations of all organisms tended to revert toward control values with the exception of the anGPR which remained in lower concentrations after termination of the hyperbaric exposure. These observations indicate that, despite the great variation in the fecal flora among individual mice, it is possible to discover the effects induced by altered gaseous environments.     

Assessment of antibiotic resistance in <Emphasis Type="Italic">Klebsiella pneumoniae</Emphasis> exposed to sequential in vitro antibiotic treatments

Background

Bacteria treated with different classes of antibiotics exhibit changes in susceptibility to successive antibiotic treatments. This study was designed to evaluate the influence of sequential antibiotic treatments on the development of antibiotic resistance in Klebsiella pneumoniae associated with β-lactamase and efflux pump activities.

Methods

The antibiotic susceptibility, β-lactamase activity, and efflux activity were determined in K. pneumoniae grown at 37 °C by adding initial (0 h) and second antibiotics (8 or 12 h). Treatments include control (CON; no first and second antibiotic addition), no initial antibiotic addition followed by 1 MIC ciprofloxacin addition (CON-CIP), no initial antibiotic addition followed by 1 MIC meropenem addition (CON-MER), initial 1/4 MIC ciprofloxacin addition followed by no antibiotic addition (1/4CIP-CON), initial 1/4 MIC ciprofloxacin addition followed by 1 MIC ciprofloxacin addition (1/4CIP-CIP), and initial 1/4 MIC ciprofloxacin addition followed by 1 MIC meropenem addition (1/4CIP-MER).

Results

Compared to the CON, the initial addition of 1/4 MIC ciprofloxacin inhibited the growth of K. pneumoniae throughout the incubation period. The ciprofloxacin treatments (CON-CIP and 1/4CIP-CIP) showed significant reduction in the number of K. pneumoniae cells compared to meropenem (CON-MER and 1/4CIP-MER). The 1/4CIP-CIP achieved a further 1 log reduction of K. pneumoniae, when compared to the 1/4CIP-CON and 1/CIP-MER. The increase in sensitivity of K. pneumoniae to cefotaxime, kanamycin, levofloxacin, nalidixic acid was observed for CON-CIP. Noticeable cross-resistance pattern was observed at the 1/4CIP-CIP, showing the increased resistance of K. pneumoniae to chloramphenicol, ciprofloxacin, kanamycin, levofloxacin, nalidixic acid norfloxacin, sulphamethoxazole/trimethoprim, and tetracycline. The levels of β-lactamase activities were estimated to be 8.4 μmol/min/ml for CON, 7.7 μmol/min/ml for 1/4CIP-CON and as low as 2.9 μmol/min/ml for CON-CIP. Compared to the absence of phenylalanine-arginine-β-naphthylamide (PAβN), the fluorescence intensity of EtBr was increased in K. pneumoniae cells treated at the CON, CON-CIP, and CON-MER in the presence of PAβN. However, the efflux pump activity remained in K. pneumoniae cells treated at the 1/CIP, 1/CIP–CIP, and 1/CIP-MER in the presence of PAβN.

Conclusion

The results suggest that the pre-exposed antibiotic history, treatment order, and concentrations influenced the development of multiple antibiotic resistant associated with β-lactamase and efflux pump activities. This study highlights the importance of antibiotic treatment conditions, which would be taken into consideration when new antibiotic strategy is designed to prevent antibiotic resistance.