scholarly journals Bacteriophage to Combat Biofilms in Hospital Drains

2019 ◽  
Author(s):  
Jenny Yijian Huang
Keyword(s):  
Nosocomial Infections ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Environment Modeling ◽  
Water Control ◽  
E Coli ◽  
Area Of Concern ◽  
Chemical Disinfectant ◽  
Health Organization

AbstractBackgroundAccording to the World Health Organization, nearly 15% of all hospitalized patients worldwide acquire nosocomial infections. A particular area of concern for bacterial build up in hospitals is sink drains. The moist, microbiologically active environment of drains promotes the formation of biofilms that are difficult to target with standard chemical disinfectants. Bacteriophages, however, show potential to be used as disinfecting agents in hospital drains. Not only do bacteriophages increase in titer as they infect, spreading to hard-to-reach surfaces, phages have been shown to degrade the extracellular matrix of biofilms and gain access to underlying bacteria. This research explores the potential of bacteriophages to eradicate biofilms in an environment modeling a sink drain by comparing the efficacy, range, and durability of bacteriophage to a chemical disinfectant.MethodsE. coli biofilms were grown in M9 minimal media placed in sink P-traps assigned one of three treatments: chemical disinfectant, bacteriophage, or deionized water (control). Biofilms were quantified at five time points -- 1, 12, 24, 36, and 48 hours -- using the crystal violet assay.ResultsBoth chemical disinfectant and bacteriophage significantly decreased the optical densities of biofilms (p < 0.001***). P-traps treated with bacteriophages showed more uniform destruction of biofilm across P-trap compared to chemical disinfectant (p < 0.01**). A trend may suggest that over time bacteriophage became more effective at reducing biofilm than chemical disinfectant.ConclusionThis work highlights the potential of bacteriophage as an alternative to conventional chemical disinfectants for biofilm control in settings such as hospital drains.ImportanceNosocomial infections prolong hospital stay, costing the U.S. healthcare system $5-10 billion annually. An increasing number of reports demonstrate that sink drains -- reservoirs for multidrug resistant bacteria -- may be a source of hospital-related outbreaks. Recent studies have elucidated the mechanism of dispersal of bacteria from contaminated sinks to patients, but limited data are available identifying disinfecting methods for hospital drains. Not only did this study demonstrate that bacteriophages could reduce biofilms on sink drains just as effectively as a commercial disinfectant, it showed that phages tended to spread more thoroughly across P-traps and may work for longer. With hand-washing an imperative activity for disease prevention, hospital sinks should remain clean. This work explores an alternative disinfecting method for hospital sink drains.

scholarly journals Gold Nanoparticles: Can They Be the Next Magic Bullet for Multidrug-Resistant Bacteria?

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 312
Author(s):  
Mohammad Okkeh ◽  
Nora Bloise ◽  
Elisa Restivo ◽  
Lorenzo De Vita ◽  
Piersandro Pallavicini ◽  
...  
Keyword(s):  
Gold Nanoparticles ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Magic Bullet ◽  
Global Challenge ◽  
Gold Silver ◽  
Inorganic Nanomaterials ◽  
Health Organization

In 2017 the World Health Organization (WHO) announced a list of the 12 multidrug-resistant (MDR) families of bacteria that pose the greatest threat to human health, and recommended that new measures should be taken to promote the development of new therapies against these superbugs. Few antibiotics have been developed in the last two decades. Part of this slow progression can be attributed to the surge in the resistance acquired by bacteria, which is holding back pharma companies from taking the risk to invest in new antibiotic entities. With limited antibiotic options and an escalating bacterial resistance there is an urgent need to explore alternative ways of meeting this global challenge. The field of medical nanotechnology has emerged as an innovative and a powerful tool for treating some of the most complicated health conditions. Different inorganic nanomaterials including gold, silver, and others have showed potential antibacterial efficacies. Interestingly, gold nanoparticles (AuNPs) have gained specific attention, due to their biocompatibility, ease of surface functionalization, and their optical properties. In this review, we will focus on the latest research, done in the field of antibacterial gold nanoparticles; by discussing the mechanisms of action, antibacterial efficacies, and future implementations of these innovative antibacterial systems.

scholarly journals Multidrug-Resistant Bacteria Isolated from Different Aquatic Environments in the North of Spain and South of France

2020 ◽  
Vol 8 (9) ◽  
pp. 1425
Author(s):  
Lara Pérez-Etayo ◽  
David González ◽  
José Leiva ◽  
Ana Isabel Vitas
Keyword(s):  
Wastewater Treatment Plants ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Aquatic Environments ◽  
Multidrug Resistant Bacteria ◽  
Antibiotic Resistant ◽  
The North ◽  
New Antibiotics ◽  
Health Organization

Due to the global progress of antimicrobial resistance, the World Health Organization (WHO) published the list of the antibiotic-resistant “priority pathogens” in order to promote research and development of new antibiotics to the families of bacteria that cause severe and often deadly infections. In the framework of the One Health approach, the surveillance of these pathogens in different environments should be implemented in order to analyze their spread and the potential risk of transmission of antibiotic resistances by food and water. Therefore, the objective of this work was to determine the presence of high and critical priority pathogens included in the aforementioned list in different aquatic environments in the POCTEFA area (North Spain–South France). In addition to these pathogens, detection of colistin-resistant Enterobacteriaceae was included due its relevance as being the antibiotic of choice to treat infections caused by multidrug resistant bacteria (MDR). From the total of 80 analyzed samples, 100% of the wastewater treatment plants (WWTPs) and collectors (from hospitals and slaughterhouses) and 96.4% of the rivers, carried antibiotic resistant bacteria (ARB) against the tested antibiotics. Fifty-five (17.7%) of the isolates were identified as target microorganisms (high and critical priority pathogens of WHO list) and 58.2% (n = 32) of them came from WWTPs and collectors. Phenotypic and genotypic characterization showed that 96.4% were MDR and resistance to penicillins/cephalosporins was the most widespread. The presence of bla genes, KPC-type carbapenemases, mcr-1 and vanB genes has been confirmed. In summary, the presence of clinically relevant MDR bacteria in the studied aquatic environments demonstrates the need to improve surveillance and treatments of wastewaters from slaughterhouses, hospitals and WWTPs, in order to minimize the dispersion of resistance through the effluents of these areas.

scholarly journals Holistic Herbs – A Natural Aresnal for Contention between Bugs and Drugs

2018 ◽  
pp. 1-4
Keyword(s):  
Nosocomial Infections ◽  
Therapeutic Option ◽  
Developed Countries ◽  
Chemotherapeutic Agents ◽  
World Health ◽  
Economic Losses ◽  
Resistant Bacteria ◽  
Causes Of Disease ◽  
Health Care Associated Infections ◽  
Health Organization

Nosocomial infections are one of the major causes of disease globally, leading to the most frequent adverse events in healthcare setups worldwide [1]. Millions of patients are affected by nosocomial infections each year globally, bringing about significant mortality and economic losses in healthcare systems. At any given time, the prevalence of health care-associated infections in developed countries varies between 3% to 15% [2]. Moreover, nosocomial infections are becoming even more complicated to treat as antibiotic resistance surfaces up. Recent reports from Centre for Disease Control (CDC) and World Health Organization (WHO) have indicated that nosocomial infections accounts for approximately 2 million infections and 90,000 deaths per year, out of which nearly 23% deaths are attributed to reemerging antibiotic resistant pathogens [3]. Antibiotics comprising bactericidal or bacteriostatic chemotherapeutic agents are presently the only available therapeutic option for the management and deterrence of infectious diseases. However, several drug resistant microbes are emerging as a result of continuous mutations, there by restraining the efficacy of such pharmaceuticals [4]. Over use of antibiotics imposes selective pressure on a specific population of bacteria, thereby allowing the resistant bacteria to thrive and the susceptible bacteria to die off[5].

scholarly journals Emergence and Spread of Cephalosporinases in Wildlife: A Review

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1765
Author(s):  
Josman D. Palmeira ◽  
Mónica V. Cunha ◽  
João Carvalho ◽  
Helena Ferreira ◽  
Carlos Fonseca ◽  
...  
Keyword(s):  
Anthropogenic Activities ◽  
Acquired Resistance ◽  
World Health ◽  
Mitigation Measures ◽  
Resistant Bacteria ◽  
Wild Animals ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Health Organization

In the last decade, detection of antibiotic resistant bacteria from wildlife has received increasing interest, due to the potential risk posed by those bacteria to wild animals, livestock or humans at the interface with wildlife, and due to the ensuing contamination of the environment. According to World Health Organization, cephalosporins are critically important antibiotics to human health. However, acquired resistance to β-lactams is widely distributed and is mainly mediated by extended-spectrum beta-lactamase and AmpC beta-lactamases, such as cephalosporinases. This work thus aimed to compile and analyse the information available on the emergence and dissemination of cephalosporinases in wildlife worldwide. Results suggest a serious scenario, with reporting of cephalosporinases in 46 countries from all continents (52% in Europe), across 188 host species, mainly birds and mammals, especially gulls and ungulates. The most widely reported cephalosporinases, CTX-M-1, CTX-M-14, CTX-M-15 and CMY-2, were also the most common in wild animals, in agreement with their ubiquity in human settings, including their association to high-risk clones of Escherichia coli (E. coli), such as the worldwide distributed CTX-M-15/ST131 E. coli. Altogether, our findings show that anthropogenic activities affect the whole ecosystem and that public policies promoting animal and environmental surveillance, as well as mitigation measures to avoid antimicrobial misuse and AMR spread, are urgently needed to be out in practise.

scholarly journals Evaluation of Emerging Antimicrobials Resistance in nosocomial infections caused by E. coli: The comparison results of observed cases and compartmental model

2021 ◽  
Author(s):  
mohammad kogani ◽  
babak eshrati ◽  
hamid reza baradaran ◽  
leila janani ◽  
mahshid nasehii
Keyword(s):  
Nosocomial Infections ◽  
Compartmental Model ◽  
Study Data ◽  
World Health ◽  
E Coli ◽  
Time Period ◽  
Comparison Results ◽  
Number Of Patients ◽  
Health Organization ◽  
The University

Abstract Background Early detection of Antimicrobials Resistance outbreaks is one of the most important goals of the World Health Organization. In this study, by comparing the observed cases of resistance with its expected cases, the outbreak of these resistances was investigated. It should be noted that this subject was not done in the country until the time of the study. Methods This study is a hospital-based study. Data related to all the university general of Iran (57 hospitals) were used. In these hospitals, all the patients who were infected by E.coli in time period of March 21 2017 to March 20 2018 were enrolled in the study. Then, using an index called the SIR; the observed cases of resistant E.coli were compared with the expected ones. This index is achieved from dividing the observed cases by its expected cases. If the obtained number is greater than one, it indicates the greater observed cases rather than the expected cases, which can represent Emerging. In order to compute SIR index, we divided the number of observed cases of Antimicrobials Resistance E.coli by the number of expected cases of each Antimicrobials Resistance E coli. To predict the expected cases of each Antimicrobials Resistance E coli, we developed one compartmental model. In this model, the number of patients is estimated using equations. Berkeley Madonna version 8.3.23 software was used to manipulate these equations. Results The SIR index for E.coli resistant to Ampicillin, Ceftazidime and Colistin were 1.2(1.1–1.3), 1.1(1.02–1.2) and 1.7(1.02–2.3) respectively. This index for E.coli resistant to Meropenem was .8 (.6-.9). In other cases, the calculated index was not statistically significant. Conclusions Ampicillin-resistant E.coli and Ceftazidime-resistant E.coli observed cases among nosocomial infections were greater than the expected cases. Hence it is necessary to reconsider using such type of antibiotics in treatment of nosocomial infections caused by E.coli. The results of this study could be important for health policy makers. In the future, outbreaks of this type of infection can be investigated with the help of the results of this study.

scholarly journals Multidrug resistant E. coli recovered from household reared female budgerigar pet bird (Melopsittacus undulatus) in Ibadan, Oyo State Nigeria: a case report

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Adelekan Oluseyi Okunlade ◽  
Oluwaseun Olanrewaju Esan ◽  
Akinlabi Oladele Ogunleye
Keyword(s):  
Public Health ◽  
Disease Transmission ◽  
Multidrug Resistant ◽  
World Health ◽  
Health Concern ◽  
Microbial Culture ◽  
Melopsittacus Undulatus ◽  
E Coli ◽  
Pet Birds ◽  
Health Organization

Abstract Background Pet birds are housed and reared exclusively for ornamental use. These include psittaciformes (parrots, parakeets, budgerigars, love birds) and passeriformes (e.g. canaries, finches, sparrows, also called songbirds). E. coli is a Gram negative bacterium. In birds, it is called Avian Pathogenic E. coli and is a causative agent of avian colibacillosis. Antimicrobial resistance is the process through which bacteria evade the activity of antibiotics. According to WHO (World Health Organization), antibiotic resistance is the result of indiscriminate use of these drugs which are used both in Veterinary and human medicine. Case presentation A one and half year old yellow female budgerigar pet bird (Melopsittacus undulatus) with patches of black and white on wings and back, kept as companion (one out of four) was presented dead at the avian clinic section of the Veterinary Teaching Hospital, University of Ibadan, Nigeria. It was reported to have presented signs of anorexia and diarrhea for two days before death. Provisional diagnosis was colibacillosis. Intestinal samples were sent for microbial culture and sensitivity. The samples yielded growth of E. coli. Antimicrobial susceptibility revealed that the organism showed resistance to all tested antibiotics. Conclusions Multidrug-resistant Escherichia coli constitutes a major public health concern. The constant interaction between household companion birds and humans gives room for disease transmission. Wild birds kept as pets or companions harbor pathogenic and zoonotic pathogens, hence a threat to public health.

Prevalence of Carbapenemase Genes, qacE, qacEΔ1 and cepA in Multidrug-Resistant Gram-Negative Bacteria with Different Susceptibility to Chlorhexidine

2020 ◽  
Vol 19 (5) ◽  
pp. 49-60
Author(s):  
K. G. Kosyakova ◽  
N. B. Esaulenko ◽  
O. A. Kameneva ◽  
S. P. Kazakov ◽  
A. Y. Dubinina ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Multidrug Resistant ◽  
World Health ◽  
Dynamic Monitoring ◽  
Resistant Bacteria ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Health Organization

Relevance The World Health Organization has provided a list of resistant bacteria that pose the greatest threat to society. Among them, the most important (critically high priority level) are Pseudomonas aeruginosa and Acinetobacter baumannii strains resistant to carbapenems, as well as enterobacteriaceae producing extended spectrum beta-lactamases and carbapenemases.Aim. To conduct a comparative analysis of the sensitivity to chlorhexidine of multiply-resistant gram-negative bacteria, the causative agents of infectious conditions in patients of various medical organizations, and to study the relationship between the presence of resistance genes and the minimum inhibitory concentration of chlorhexidine.Materials & methods. The study included 138 Gram-negative multidrug-resistant strains isolated during 2018–2019 from various clinical specimens. Susceptibility of the isolates to antibiotics were determined using Vitek-2 compact and Phoenix М50, susceptibility to chlorhexidine were determined by agar dilution method. The resistance genes were detected by the real-time PCR method.Results. The lowest level of resistance to chlorhexidine was determined in E. coli strains (MIC90 16 mg/l), other strains were highly resistant: MIC90 of P. aeruginosa and A. baumannii – 128 mg/l, K. pneumoniae, E. cloacae и P. mirabilis – 256 mg/l. The highest frequency of detection of carbapenemase genes observed in K. pneumoniae strains – 56.0% and P. aeruginosa – 48.1%. High prevalence of cepA gene was found out (the strains of enterobacteria – 47.8%, A. baumannii – 42.9%), genes qacE, qacEΔ1 were more often detected in non-fermenting Gram-negative bacteria then in enterobacteria. Conclusion. According to the results of our study, we did not reveal a significant correlation between the presence or absence of resistance genes and MIC of chlorhexidine in Gram-negative bacteria. However, taking into account complex mechanism of the adaptive response of bacteria to the effects of chlorhexidine, and to implement the concept of preventing health care-associated infections, it is proposed to continue dynamic monitoring of the resistance of microorganisms to antiseptics, disinfectants and antibiotics.

scholarly journals Evaluation of Emerging Antimicrobials Resistance in Nosocomial Infections Caused by E. Coli: The Comparison Results of Observed Cases and Compartmental Model

2021 ◽  
Author(s):  
Mahshid Nasehi ◽  
Babak Eshrati ◽  
Hamidreza Baradaran ◽  
Leila Janani ◽  
Sasan Ghorbani-Kalkhajeh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
World Health Organization ◽  
Nosocomial Infections ◽  
World Health ◽  
Antibiotic Resistant ◽  
Microbial Resistance ◽  
E Coli ◽  
The World ◽  
Health Organization

Abstract Background: The World Health Organization repeatedly emphasizes the spread and association of nosocomial infections with microbial resistance. In a 2014 report, the World Health Organization cited microbial resistance as a global threat. In recent years, the world has seen the rapid growth of antibiotic-resistant E. coli in most areas, which poses a serious threat to public health. A high percentage of bacteria that cause nosocomial infections have been resistant to treatment. The most common bacterial agent among these nosocomial infections is E. coli. This bacterium is one of the main causes of nosocomial infections among hospitalized patients. One of the most important goals of the Global Antimicrobial Resistance and Use Surveillance System (GLASS) is timely identification and transmission of Emerging Antimicrobial Resistance (EAR) or outbreak of antibiotic resistance. One of the main ways to identify this "emerging" at the national or local level is to identify deviations from the expected resistance in drug compounds. As a result, if the observed cases of a drug-resistant pathogen are significantly higher than expected, it could indicate "emerging".Purpose: This study aimed to identify and transmit EAR or outbreak of antibiotic resistance among antibiotics used in the treatment of nosocomial infections caused by E. coli. This was done by comparing the observed cases of resistant E. coli with the predicted cases of resistant E. coli, which were predicted by the compartment model.Methods: This is a hospital-based study that used data from the nosocomial infection survelliance system to investigate observed cases of antibiotic resistance. In this study, the results of 12,954 antibiogram tests related to 57 hospitals located in 31 provinces of Iran were divided into two parts (results related to the first half of 2017 and results related to the second half of 2017). The model was developed in the second half of the year to predict expected cases. Before developeing model to predict the expected cases of resistant E. coli, the validity of the model was evaluated by implementing the model in the first half of the year. Finally, the predicted cases of resistant E. coli were compared with those observed in 2017. If the difference between the two was statistically significant, it indicated the outbreak of E.coli. This model evaluated 11 antibiotics recommended by the World Health Organization that are used to treat nosocomial infections caused by E. coli.Results: The results of this study showed that the outbreak of E. coli resistant to ampicillin and ceftazidime occurred in 2017 in hospitals of Iran. This means that resistance to ampicillin and ceftazidime antibiotics in nosocomial infections caused by E. coli is higher than expected and has become "emerging".Conclusion: This study showed how the outbreak of antibiotic resistance in the country's hospitals can be investigated. Using the method of this study, we can investigate the outbreak of antibiotic-resistant E. coli in the coming years and in different substrates. The results of this study showed that the administration and use of antibiotics should be reconsidered.

scholarly journals Evaluation of Emerging Antimicrobials Resistance in Nosocomial Infections Caused by E. Coli: the Comparison Results of Observed Cases and Compartmental Model

2021 ◽  
Author(s):  
Mahshid Nasehi ◽  
Babak Eshrati ◽  
Hamid Reza Baradaran ◽  
Leila Janani ◽  
Sasan Ghorbani Kalkhajeh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
World Health Organization ◽  
Nosocomial Infections ◽  
World Health ◽  
Antibiotic Resistant ◽  
Microbial Resistance ◽  
E Coli ◽  
The World ◽  
Health Organization

Abstract Background: The World Health Organization repeatedly emphasizes the spread and association of nosocomial infections with microbial resistance. In a 2014 report, the World Health Organization cited microbial resistance as a global threat. In recent years, the world has seen the rapid growth of antibiotic-resistant E. coli in most areas, which poses a serious threat to public health. A high percentage of bacteria that cause nosocomial infections have been resistant to treatment. The most common bacterial agent among these nosocomial infections is E. coli. This bacterium is one of the main causes of nosocomial infections among hospitalized patients. One of the most important goals of the Global Antimicrobial Resistance and Use Surveillance System (GLASS) is timely identification and transmission of Emerging Antimicrobial Resistance (EAR) or outbreak of antibiotic resistance. One of the main ways to identify this "emerging" at the national or local level is to identify deviations from the expected resistance in drug compounds. As a result, if the observed cases of a drug-resistant pathogen are significantly higher than expected, it could indicate "emerging".Purpose: This study aimed to identify and transmit EAR or outbreak of antibiotic resistance among antibiotics used in the treatment of nosocomial infections caused by E. coli. This was done by comparing the observed cases of resistant E. coli with the predicted cases of resistant E. coli, which were predicted by the compartment model.Methods: This is a hospital-based study that used data from the nosocomial infection survelliance system to investigate observed cases of antibiotic resistance. In this study, the results of 12,954 antibiogram tests related to 57 hospitals located in 31 provinces of Iran were divided into two parts (results related to the first half of 2017 and results related to the second half of 2017). The model was developed in the second half of the year to predict expected cases. Before developeing model to predict the expected cases of resistant E. coli, the validity of the model was evaluated by implementing the model in the first half of the year. Finally, the predicted cases of resistant E. coli were compared with those observed in 2017. If the difference between the two was statistically significant, it indicated the outbreak of E.coli. This model evaluated 11 antibiotics recommended by the World Health Organization that are used to treat nosocomial infections caused by E. coli.Results: The results of this study showed that the outbreak of E. coli resistant to ampicillin and ceftazidime occurred in 2017 in hospitals of Iran. This means that resistance to ampicillin and ceftazidime antibiotics in nosocomial infections caused by E. coli is higher than expected and has become "emerging".Conclusion: This study showed how the outbreak of antibiotic resistance in the country's hospitals can be investigated. Using the method of this study, we can investigate the outbreak of antibiotic-resistant E. coli in the coming years and in different substrates. The results of this study showed that the administration and use of antibiotics should be reconsidered.

scholarly journals Fight Against Antimicrobial Resistance: We Always Need New Antibacterials but for Right Bacteria

Molecules ◽  
2019 ◽  
Vol 24 (17) ◽  
pp. 3152 ◽  
Author(s):  
Raphaël E. Duval ◽  
Marion Grare ◽  
Béatrice Demoré
Keyword(s):  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Infectious Agents ◽  
Different Types ◽  
Long Time ◽  
Vancomycin Resistant ◽  
Health Organization

Antimicrobial resistance in bacteria is frightening, especially resistance in Gram-negative Bacteria (GNB). In 2017, the World Health Organization (WHO) published a list of 12 bacteria that represent a threat to human health, and among these, a majority of GNB. Antibiotic resistance is a complex and relatively old phenomenon that is the consequence of several factors. The first factor is the vertiginous drop in research and development of new antibacterials. In fact, many companies simply stop this R&D activity. The finding is simple: there are enough antibiotics to treat the different types of infection that clinicians face. The second factor is the appearance and spread of resistant or even multidrug-resistant bacteria. For a long time, this situation remained rather confidential, almost anecdotal. It was not until the end of the 1980s that awareness emerged. It was the time of Vancomycin-Resistance Enterococci (VRE), and the threat of Vancomycin-Resistant MRSA (Methicillin-Resistant Staphylococcus aureus). After this, there has been renewed interest but only in anti-Gram positive antibacterials. Today, the threat is GNB, and we have no new molecules with innovative mechanism of action to fight effectively against these bugs. However, the war against antimicrobial resistance is not lost. We must continue the fight, which requires a better knowledge of the mechanisms of action of anti-infectious agents and concomitantly the mechanisms of resistance of infectious agents.

Sign in / Sign up

Export Citation Format

Share Document