DSpace Community:http://repository.usmf.md:80/handle/20.500.12710/146032026-04-10T01:55:10Z2026-04-10T01:55:10ZNanotechnology approaches for fungal diseasesBurduniuc, Olgahttp://repository.usmf.md:80/handle/20.500.12710/183552021-11-24T11:09:30Z2021-01-01T00:00:00ZTitle: Nanotechnology approaches for fungal diseases
Authors: Burduniuc, Olga
Abstract: Introduction. Diseases caused by fungi affect millions of people every year worldwide
and most of these infections requiring hospitalization and advanced treatment. Therefore, well-timed and appropriate laboratory diagnostic, treatment of invasive fungal
infections (IFIs) are major importance in the management of these diseases. The analyzed scientific studies highlighted that despite the drug availability on the market
aimed to treat these infections, their efficiency is arguable, while their side effects cannot be significant. As for the drawbacks of the available drugs, these are related to their
physical-chemical properties Antifungal medicine is usually of hydrophobic character
meaning they have poor solubility in water. Both issues lead to limitations in terms of
their efficacy and efficiency within the clinical settings. Therefore, scientific studies on
development of new antifungal compounds are urgently required. The purpose of the
study was to carry out an analysis of the specialized literature related to nanotechnology
approaches for fungal diseases, a new emerging novelty in treatment of IFIs.
Material and methods. The study is based on 45 literature sources written by foreign
authors (from USA, Italy, Germany, Canada, Spain, Romania etc.). Most publications
come from highly developed countries. The bibliographic search was performed on the
evidence-based sources, on the mostly relevant databases – such as PubMed, HINARI,
Google Scholar. The filter for the publication date has been set for the last 10 years.
Results. Over the recent decades, a specific scientific interest was given to nanotechnology, which has become an extremely well-known and researched domain. The high incidence of fungal infections has become a worrisome public health issue. The major issue
among these is the resistance to antifungals, an increasing hazard for the effective
treatment of IFI, which make therapy difficult sometimes even impossible. Late diagnosis and delayed treatment are the top causes for the high morbidity and mortality rates
of IFIs. A number of studies reported challenges in using antifungals including but not
limited to diminished efficacy of medication, limited drug penetration through tissue,
low solubility in water, decreased bioavailability, and poor drug pharmacokinetic properties. Apart from the physical-chemical limitations, the low number of available antifungal agents is also accompanied by their toxicity and high resistance.
Currently, the treatment approach for IFIs is rather limited and includes three main
classes of drugs, such as polyenes, azoles, and echinocandins.
Considering that there is a stringent need for alternatives in treatment of invasive fungal
infections, it is believed that nanostructured systems are the solution, since they could
be excellent carriers for antifungal drugs. Studies that investigated the innovative therapeutic techniques via nanotechnology and medically important fungi have established
that there are compelling enhancements in the antifungal properties, such as bioavailability, toxicity, and target tissue for some antifungal drugs.
Conclusions. In conclusion, there is an obvious requirement for new therapeutic alternatives for IFIs due to the low number of drugs and their high resistance to antifungal
agents, mainly in medically relevant fungi. The well-timed and adequate pathogen detection is decisive for disease management and prevention of drug resistance, thus aiding in
the prevention of therapeutic failures and death in case of invasive fungal infections.
There is an urgent need for cutting-edge and cost-effective nanotechnologies providing
management of fungal diseases, which are considered challenging issues facing today’s
health systems.
Description: National Agency for Public Health, Republic of Moldova, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova2021-01-01T00:00:00ZClostridioides difficile infection: laboratory diagnosis and control strategiesMahroom, Taima Mohamadhttp://repository.usmf.md:80/handle/20.500.12710/183542021-11-05T12:43:36Z2021-01-01T00:00:00ZTitle: Clostridioides difficile infection: laboratory diagnosis and control strategies
Authors: Mahroom, Taima Mohamad
Abstract: Introduction. Clostridioides (previously Clostridium) difficile has received much attention
in the past decades due to its rapid spread and rising virulence. The reclassification of
Clostridium difficile to Clostridioides difficile in 2016 was based on phenotypic, chemotaxonomic and phylogenetic analyses. The bacterium is an anaerobic, spore-forming, Grampositive bacillus that that causes infectious diarrhea by producing two toxins - toxin A (an
enterotoxin) and toxin B (a cytotoxin). C. difficile is spread via the oral-fecal route and in
hospitalized patients may be acquired through the ingestion of spores from other patients, healthcare personnel’s hands, or from environmental surfaces. The incidence and
the severity of C. difficile infection (CDI) have been significantly increased globally during
the last 20 years. CDI is a leading cause of antibiotic-associated diarrhea and one of the
most common healthcare-associated infections resulting with high levels of morbidity
and mortality.
Material and methods. The objective of the study was to carry out an analysis of the
literature related etiology, epidemiology diagnostic methods and prevention measures of
CDI. The bibliographic search was made using internet search medical databases as Medline (PubMed) and Scopus, as well as through the other relevant.
Results. After several decades the epidemiology of CDI noted a marked increase in incidence and severity, occurring at a disproportionately higher frequency in older patients.
C. difficile exists in two forms: the vegetative form highly sensitive to oxygen and the heatstable spore form, which is able to survive a variety of harsh conditions. The clinical picture is diverse and ranges from asymptomatic carrier status, through various degrees of
diarrhea, to the most severe, life threatening colitis resulting with death (liquid diarrhea,
dehydration, fever, appetite loss, and abdominal pain, which are often severe). The diagnostic methods have considerably progressed over the years. Multistep algorithms combining two or three assays can increase diagnostic accuracy of C. difficile infection and are
recommended, especially when there are no institutional criteria for patient stool submission. The best performing diagnostic algorithm may differ in each institution, depending on test volume, patient population, laboratory work flow, and cost.
According CDC, the core strategies for the prevention of CDI in acute care facilities include: isolate and initiate contact precautions for suspected or confirmed CDI; confirm
CDI in patients; perform environmental cleaning to prevent CDI; develop infrastructure to
support cdi prevention; engage the facility antibiotic stewardship program.
Conclusions. Since the last decade, C. difficile has remained a major cause of attention in
hospitals and also an important topic for research worldwide. Diagnosis is based on direct detection of C. difficile toxins in feces, and studies recommend multistep algorithms
combining two or three assays. Appropriate use of antibiotics and contact precautions, for
example, using gloves, hand washing, and environmental disinfection, along with integrated surveillance programs can be effective for the control of CDI outbreaks.
Description: Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova2021-01-01T00:00:00ZBotulism: life-threatening illnessAbo Arkia, Adan Raedhttp://repository.usmf.md:80/handle/20.500.12710/183532021-11-05T12:34:46Z2021-01-01T00:00:00ZTitle: Botulism: life-threatening illness
Authors: Abo Arkia, Adan Raed
Abstract: Introduction. Botulism is a potentially fatal syndrome of diffuse, flaccid paralysis caused
by botulinum neurotoxin (BoNT), produced by the bacterium Clostridium botulinum. The
toxin is produced as the bacteria multiply; the bacteria multiply under anaerobic and
mildly acidic conditions. The neurotoxin BoNT is considered the deadliest toxin known
due to its high potency and lethality. Based on the different serotypes known today, a classification of serotype variants termed subtypes has been proposed according to sequence
diversity and immunological properties. Authors described seven types of botulinum toxins (A–G), but human botulism is primarily caused by types A, B, E, while types C, D and E
cause illness in other mammals, birds and fish. Most studies demonstrated that antitoxin
should be administered as soon as possible after a clinical diagnosis. There is no vaccination to protect people against botulism. The effective prevention measures of foodborne
botulism are based on good practice of food products preparation and compliance with
basic hygiene rules.
Material and methods. The purpose of the study was to find relevant publications on the
etiology, epidemiology, diagnostic methods and prevention measures of botulism, critically analyze them and describe the research findings. Therefore, a bibliographic review
was performed using online databases as PubMed, Scopus, Web of Science, and Google
Scholar as well as the following keywords C. botulinum, botulism, botulinum neurotoxin
for identifying the evidence published both in the country and abroad.
Results. When analyzing the existing evidence, there was noticed that botulism is a severe
neurological disease caused by the complex family of botulinum neurotoxins that can be
acquired through exposure to the pre-formed toxin via improperly-stored food, iatrogenic
injection, and bioterrorism. Moreover, in infants and wound botulism cases it can be the
result of a systemic release of the toxin in vivo. Most studies have shown that botulism is
an intoxication usually caused by ingestion of potent neurotoxins, the botulinum toxins,
formed in contaminated foods. Person to person transmission of botulism does not occur.
The standard method for rapid diagnosis is positive laboratory findings (detection of
toxin in the patient's serum, feces, gastric, intestinal contents, wound swabs and tissues),
however the clinical manifestations and patient history are also very important. Laboratory rapid diagnosis of botulism is required for successful therapy, considering that it is a
life-threatening condition. This disease can be fatal if left untreated, but most people who
receive a prompt diagnosis and treatment can fully recover from the illness.
Conclusions. The results of many scientific papers have demonstrated that botulism is a
rare but serious condition caused by toxins from bacteria called Clostridium botulinum.
The authors described the principle of diagnosis and showed that it is usually based on
anamnesis and clinical findings followed by laboratory investigations: the presence of
BoNT in serum, stool or food, or a culture of C. botulinum. Also, each case of botulism is
considered a public health emergency and requires immediate report of the suspected
case to the ministry of health or national agency of public health.
Description: Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova2021-01-01T00:00:00ZThe burden of multi-drug resistant uropathogensZaid, Smaa Ahmadhttp://repository.usmf.md:80/handle/20.500.12710/183512021-11-05T12:25:20Z2021-01-01T00:00:00ZTitle: The burden of multi-drug resistant uropathogens
Authors: Zaid, Smaa Ahmad
Abstract: Introduction. Urinary tract infections (UTIs) are among the most frequent infectious diseases affecting humans, thus representing an important public health problem with a substantial economic impact. The reviewed literature highlighted that the causative agents
are gram-negative organisms from the family Enterobacterales. In recent decades the
emerging threat of resistant Gram-negative bacteria to beta-lactams, aminoglycosides,
sulfonamides, and fluoroquinolones in urology became a major global concern. The results of many scientific papers have demonstrated that the knowledge of local and regional antimicrobial susceptibility patterns is one of the ways to improve antibiotic prescription.
Material and methods. A bibliographic review was conducted to identify the published
studies between 2010 and 2020. This present paper used the literature search strategy,
including PubMed, Scopus, Web of Science, Springer open and Google Scholar databases
of the relevant publications on multi-drug resistant uropathogens. Thereby, searching
was performed using the keywords on multi-drug resistant uropathogens and urinary
tract infections to identify evidence published at international and national level.
Results. UTIs caused by resistant gram-negative bacteria are becoming increasingly prevalent and now constitute a serious threat to public health worldwide due treatment difficulties associated with high morbidity and mortality rate. Authors demonstrated that Enterobacterales are frequently isolated from samples of patients with UTIs. Also, studies
demonstrated that E. coli remains the most common causative agent followed by K. pneumoniae, P. mirabilis, E. faecalis, S. saprophyticus. Due to a widespread and/or inappropriate use of antibiotics, the antimicrobial resistance is growing at an alarming rate, which
develops in pathogens commonly causing UTIs. In clinical practice, it is not uncommon to
encounter organisms that are resistant to multiple antibiotics, or even to all the antimicrobial agents available. The development of multidrug-resistant (MDR) strains, which
are resistant to three or more classes of antimicrobials, or extensively drug-resistant
(XDR) strains, which are resistant to all but one or two classes of antimicrobials, is a cause
of major concern. The culture-based diagnosis of UTIs presents several challenges to clinical microbiologists, physicians and health care system. Bacteriological tests are necessary to make the diagnosis and provide specific information regarding the identity and
the antimicrobial susceptibility pattern of pathogens. Most of the reviewed studies indicated that the culture technique aids to identify uropathogens, selection of antimicrobial
preparation for treatment but the accurate interpretation of the results requires clinical
information that is usually available only to the clinician. When analyzing the relevant
data, there was noticed that Gram-negative resistance to UTIs is associated with severe
and serious consequences such as recurrence, pyelonephritis followed by sepsis, renal
damage etc. Therefore, the monitoring of pathogen resistance patterns is very important
and help clinicians to develop guidelines for establishing a proper empirical therapy for
UTIs while awaiting culture sensitivity reports.
Conclusions. UTIs caused by Gram-negative pathogens that are resistant to many and, in
some cases, to all available antimicrobial agents, are becoming increasingly common and
difficult to treat. Consequently, UTIs caused by multi-drug resistance bacteria require a
multifaceted approach such as the rationale use of current antimicrobials, improved diagnostics and surveillance, better adherence to basic measures of infection prevention, development of new antibiotics.
Description: Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova2021-01-01T00:00:00Z