Metronidazole resistance and virulence factors in Helicobacter pylori as markers for treatment failure in a paediatric population

The eradication rate obtained using the classical triple therapy containing metronidazole, amoxicillin and bismuth citrate, was determined in 57 paediatric patients with digestive disorders, according to the susceptibility to metronidazole of the Helicobacter pylori strains (determined by agar dilution) and the cagA and vacA status (determined by PCR). Eradication was obtained in 38 out of 43 patients (88.3%) infected by H. pylori with metronidazole MIC < or = 2 mg l(-1), in 3 out of 6 patients (50%) when MIC was 4-8 mg l(-1) and in 4 out of 8 patients (50%) when MIC was > 8 mg l(-1). Among patients infected with cagA+ and cagA- strains an eradication rate of 75% (6/8) and 75% (18/24) was found, and 50% (3/6) and 80% (21/26) among vacA s1- and vacA s2-infected subjects (P > 0.05). H. pylori eradication depends on the susceptibility of the strain to metronidazole, being higher in patients infected with susceptible H. pylori. However, according to our data the cagA or vacA status was not an important factor in treatment failure in the eradication of H. pylori.     

Follow-up of drug permeation through excised human skin with confocal Raman microspectroscopy

Skin is a multilayered organ which covers and protects the surface of human body by providing a barrier function against exogenous agents. Meanwhile, the efficacy of several topically applicated drugs is directly related to their penetration through the skin barrier. Several techniques are commonly used to evaluate the rate, the speed and the depth of penetration of these drugs, but few of them can provide real-time results. Therefore, the use of nondestructive and structurally informative techniques permits a real breakthrough in the investigations on skin penetration at a microscopic scale. Confocal Raman microspectroscopy is a nondestructive and rapid technique which allows information to be obtained from deep layers under the skin surface, giving the possibility of a real-time tracking of the drug in the skin layers. The specific Raman signature of the drug enables its identification in the skin. In this study, we try to follow the penetration of Metronidazole, a drug produced by Galderma as a therapeutic agent for Rosacea treatment, through the skin. The first step was the spectral characterization of Metronidazole in the skin. Then micro-axial profiles were conducted to follow the penetration of the drug in the superficial layers, on excised human skin specimens. For more accurate information, transverse sections were cut from the skin and spectral images were conducted, giving information down to several millimeters deep. Moreover, the collected spectra permit us to follow the structural modifications, induced by the Metronidazole on the skin, by studying the changes in the spectral signature of the skin constituents. Presented at the joint biannual meeting of the SFB-GEIMM-GRIP, Anglet France, 14–19 October, 2006.     

Rapid and selective high-performance liquid chromatographic method for the determination of metronidazole and its active metabolite in human plasma, saliva and gastric juice

A rapid and selective HPLC method has been developed for the separation and quantitation of metronidazole and its hydroxylated metabolite in human plasma, saliva and gastric juice. The assay requires a simple protein precipitation step prior to analysis and is selective, sensitive and reproducible. The limits of quantitation (0/5-ml sample) were at least 0.25 μg/ml for metronidazole and 0.20 μg/ml for its hydroxy metabolite. A Hypersil ODS 5 μm (150×4.6 mm I.D.) column was used with a mobile phase of acetonitrile-aqueous 0.05 M potassium phosphate buffer (pH 7) containing 0.1% triethylamine (10:90) delivered at a flow-rate of 1.0 ml/min.     

The interaction of metronidazole with electron carriers of the Azotobacter vinelandii respiratory particle fraction

Abstract Metronidazole, menadione bisulfite, and oxygen oxidized NADH- and dithionite-reduced flavin of the Azotobacter vinelandii respiratory particle fraction. The oxidation of NADH-reduced flavin by metronidazole was slow compared to the oxidations by menadione bisulfite and oxygen. Metronidazole caused spectral changes characteristic of cytochrome d oxidation, but the changes in NADH-reduced particles were slow.     

Tritrichomonas foetus: Stable anaerobic resistance to metronidazole in vitro

Stable anaerobic resistance of Tritrichomonas foetus to metronidazole was induced in vitro by cultivation of trichomonads in the Diamond's TYM medium with metronidazole in concentrations sublethal to the parasites. Nine metronidazole-resistant strains were derived from four drug-susceptible clones of the T. foetus strain KV-1. Subculturing the parasites at both increasing and constant pressure of the drug resulted in development of resistance if the medium contained at least 3 μg ml^?1 of metronidazole and the organisms were exposed to the drug for 3 to 8 months. The development of resistance was gradual and in all clones investigated proceeded through similar sequence of stages: (1) Survival without growth and subsequent reproduction at low metronidazole concentrations (1 to 5 μg ml^?1. (2) Survival and reproduction at moderate concentrations of the drug (10 to 15 μg ml^?1. (3) Resistance to 100 μg ml^?1 metronidazole, unstable in absence of selective pressure of the drug. (4) Resistance to high concentrations of metronidazole, stable when the organisms were maintained under nonselective conditions. The trichomonads with fully developed resistance were able to grow in anaerobic culture at 100 μg ml^?1 metronidazole and could be maintained indefinitely under these conditions. The minimal lethal concentrations for metronidazole obtained with these strains in an anaerobic in vitro assay were, at 48 h, 500 to 1000 μg ml^?1. This is 100 to 400 times higher than those obtained with the parent clones. The fully developed resistance was stable in organisms maintained in the absence of the drug over 2 years. The substrains with unstable resistance regained the susceptibility to high concentrations of metronidazole after 80 to 100 transfers in drug-free media. These strains, however, retained their resistance to moderate doses of metronidazole and full resistance could be restored by subculture in the presence of 10 μ ml^?1 metronidazole.     

Simple and sensitive method for determination of metronidazole in human serum by high-performance liquid chromatography

A simple and sensitive HPLC method for determination of metronidazole in human plasma has been developed. A step of freezing the protein precipitate allowed an efficient separation of aqueous and organic phases minimizing the noise level and improved therefore the limit of quantitation (10 ng ml⁻¹ using 1 ml of plasma sample). The separation of compounds was performed on a RP 18 column with acetonitrile–aqueous 0.01 M phosphate solution (15:85, v/v) as mobile phase. Detection was performed by UV absorbance at 318 nm. Metronidazole was well resolved from the plasma constituents and internal standard. An excellent linearity was observed between peak-height ratios plasma concentrations over a concentration range of 0.01 to 10 μg ml⁻¹. Within-day and between-day precision (expressed by relative standard deviation) and accuracy (mean error in per cent) did not exceed 4% between 1 and 10 μg ml⁻¹ and 8.3 and 7.2% respectively for the limit of quantitation. The method is suitable for bioavailability and pharmacokinetic studies in humans.     

甲硝哒唑对脆弱类杆菌作用机理的研究

采用同位素标记前体体外掺入技术和透射电镜观察方法从DNA. RNA及蛋白质水平上进行了甲硝哒唑对脆弱类杆菌作用机理研究。实验表明:甲硝哒唑几乎能完全抑制~3H-TdR掺入脆弱类杆菌,对~3H-亮氨酸的掺入也具明显的抑制作用,未观察到对RNA合成的影响。透射电镜下观察到,随着甲硝哒唑浓度增加,菌体形态发生明显的改变。     

地塞米松与甲硝唑在防治根管治疗期间急症中的联合应用

目的:观察联合应用地塞米松与甲硝唑行根管治疗期间急症处理的效果。方法:对66例根管治疗期间急症发作的病例分别采用联合应用地塞米松与甲硝唑、单独使用地塞米松和单独使用甲醛甲酚的方法治疗,观察各组的差异。结果:地塞米松与甲硝唑联合应用组的治疗效果优于其他组,差异显著。结论:联合应用地塞米松与甲硝唑可有效治疗根管治疗期间急症。     

Hydrogenosomes of Laboratory‐Induced Metronidazole‐Resistant Trichomonas vaginalis Lines are Downsized While Those from Clinically Metronidazole‐Resistant Isolates Are Not

ABSTRACT. Trichomonas vaginalis is the most common sexually transmitted protozoan in the world and its resistance to metronidazole is increasing. The purpose of this study was to demonstrate that clinical metronidazole resistance in T. vaginalis does not occur via the same mechanism as laboratory‐induced metronidazole resistance—that is, via hydrogenosome down sizing. Ultrathin sections of this parasite were examined using transmission electron microscopy and the size and area of the cell and hydrogenosomes were compared between drug‐resistant laboratory lines and clinically resistant isolates. Clinical metronidazole‐resistant T. vaginalis had similar‐sized hydrogenosomes as a metronidazole‐sensitive isolate. Inducing metronidazole resistance in both of these isolates caused down sizing of hydrogenosomes. Inducing toyocamycin resistance did not cause any ultrastructural changes to the cell or to the hydrogenosome. No correlation between hydrogenosome number and the drug‐resistant status of T. vaginalis isolates and lines was observed. This report demonstrates that clinical metronidazole resistance is not associated with down‐sized hydrogenosomes, thus indicating that an alternative resistance mechanism is used by T. vaginalis.     

Development of an obligate anaerobe specific biocide

Summary Anaerobic bacteria, such as sulfate-reducing bacteria and clostridia, are capable of generating H₂S and organic acids which corrode metallurgy resulting in millions of dollars of damage to industry annually. The bacteria are obligate anaerobes which grow typically on equipment surfaces under deposits such as biofilms. A successful method of penetrating biofilm and killing the anaerobic bacteria specifically has not been previously presented. We have investigated whether a blend of 1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole (metronidazole) and a biodispersant would killDesulfovibrio, Desulfotomaculum, andClostridium species grown in the laboratory and in field applications. We found the blend significantly reduced the anaerobes in laboratory cultures. However, in a bioreactor designed to induced a high level of biofilm production and enhance underdeposit growth of anaerobic bacteria, a 40–58% increase in the antibiotic-biodispersant blend concentration was required. The metronidazole blend killed obligate anaerobic bacteria specifically but was non-toxic to aerobic bacteria and fungi. These results were confirmed in cooling tower field trial studies.