Multidrug-resistant strains

The advent of multidrug resistant strains of Mycobacterium tuberculosis (MDR-TB) has led to increased fears of untreatable infections by serious pathogens. Rifampicin, streptomycin and, occasionally, the quinolones are drugs used in the treatment of mycobacterial infections and resistance to those agents is as described previously. There... 

Potential therapeutic applications of host defense peptides also include the lantibiotic nisin. Indeed, nisin has had an impressive history as a food preservative with FDA approval in 1988 for use in pasteurized, processed cheese spreads. The attractiveness of nisin as a potential therapeutic is also enhanced due to its relative resistance to proteases and broad spectrum Gram-positive antimicrobial activity including multidrug-resistant strains. Biosynexus Inc. has licensed the use of nisin for human clinical applications and Immucell Corp. has licensed the use of Mast Out, an antimastitic nisin-containing product, to Pfizer Animal Health." Indeed, nisin formulations have been used as an active agent in the topical therapies Mast Out and Wipe-Out for bovine mastitis, an inflammatory disorder of the udder that is the most persistent disease in dairy cows." ... 

The organism still thrives in many parts of the world in wild rodents. The total number of cases reported to the WHO in 1998 by various countries was almost 2500. Of further concern, a multidrug resistant strain of Y. pestis has been found. 

Since that time, artemisinin has been used successfully in many thousand malaria patients throughout the world including those infected with both cldoroquine-sensitive and chloroquine-resistant strains of P falciparum. Artemisinin has progressively estabhshed itself as one of the most potent and effective antimalarial dmg, and is primarily recommended in the treatment of multidrug-resistant strains of P. falciparum. However, the therapeutic... 

It is used in the treatment of cerebral falciparum malaria and multidrug resistant strains of cerebral malaria. It is also used along with clindamycin in the treatment of babesiosis. It is also effective in myotonia congenita and nocturnal muscle cramps. 

Capreomycin is a peptide protein synthesis inhibitor antibiotic obtained from Streptomyces capreolus. Daily injection of 1 g intramuscularly results in blood levels of 10 mcg/mL or more. Such concentrations in vitro are inhibitory for many mycobacteria, including multidrug-resistant strains of M tuberculosis. 

Artemisia annua L. A. apiacea Hance ex Walpers Qing Guo (Stinking artemisia) (aerial part) Dihydroartemisinin, artesunate, artemisinin, chloroquine, flavonoids, sesquiterpene.33-269-476 This herb is mildly toxic. A schizonticidal agent, antimalarial, treat infections of multidrug-resistant strains of Plasmodium falciparum, the cause of human malignant cerebral malaria. 

Tortoli E, Dionisio D, Fabbri C. Evaluation of moxifloxacin activity in vitro against Mycobacterium tuberculosis, including resistant and multidrug-resistant strains./. Chemother., 2004, 14, 334-336. 

Artemisinin is used here as an example of a plant sesquiterpenoid with both traditional value as well as with medicinal and social value in the twenty-first century. Research on artemisinin has also established new benchmarks for biochemical engineering and functional genomics of plant terpenoids. Artemisinin is a functionalized sesquiterpene with a unique peroxide linkage from the sweet wormwood Artemisia annua). Chinese herbalists have used it since ancient times, and it is now used for its unique efficacy to treat multidrug-resistant strains of the malaria parasite Plasmodium falciparum. Its medicinal importance has prompted studies into its biosynthesis and its biochemical engineering so that cost-effective methods for producing it in large scale and in consistent quality may be realized. 

Fosmidomycin is an antimicrobial drug that acts by inhibiting 1-deoxy-D-xylulose 5-phosphate reductoisomerase, a key enzjme of the non-mevalonate pathway of isopre-noid biosynthesis. It inhibits the synthesis of isoprenoids by Plasmodium falciparum and suppresses the growth of multidrug-resistant strains in vitro. 

In an in vitro susceptibility study of 170 clinical isolates of Mycobacterium tuberculosis to fusidic acid, 19 isolates were resistant to at least one first-Une antituberculosis drug (21). In all, 1.8% of the isolates were resistant to fusidic acid. Fusidic acid can be a potential supplementary drug for the treatment of infections due to multidrug-resistant strains of M. tuberculosis. 

Forty eight (30%) of the E. faecium isolates, two (3%) of the E. durans isolates, and six (12%) of the E. faecalis isolates exhibited multidrug resistance. Ten percent of E. faecium, 0% of E. durans, and 17% of E. faecalis strains showed simultaneous resistance to three drugs (rifampicin, erythromycin, and ciprofloxacin or nitrofurantoin). For all E. faecium, E. durans, and E. faecalis isolates, 55 (19%) multidrug resistant strains were resistant to rifampicin, 55 (19%) strains were resistant to erythromycin, nine (2%) strains were resistant to ciprofloxacin, and one (0.3%) strain was resistant to nitrofurantoin. The incidence of multiple resistance to five or more antimicrobials of enterococcal cheese isolates was confirmed by Teuber et al. (1999) and Franz et al. (2001). In this respect it may be stated that the enterococcal isolates from Bryndza cheese have simultaneous resistance to fewer antimicrobials compared to the above-mentioned cheese isolates. 

---