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19 ANTIBIOTIC RESISTANCE & STEWARDSHIP Breastfeeding linked to less antibiotic-resistant bacteria in infants, study finds By Harrison Cook B reastfeeding may help infants de- velop gut bacteria that is resistant to antibiotics, according to a study published in Nature Communications. Here are four things to know: 1. For the study, researchers from the University of Helsinki in Finland se- quenced the bacterial DNA found in the milk and fecal matter of 16 mother and infant pairs in which infants were born vaginally at full term and did not receive antibiotics during the first six months of life. Eight mothers received penicillin or cephalothin during labor, while 10 took probiotic supplements containing various bacterium two months before and after delivery. 2. Researchers found infants who were breastfed for at least six months had a smaller number of resistant bacteria in their gut than babies who were breastfed for a short time or never breastfed. 3. Infants whose mothers took an an- tibiotic treatment during delivery had a larger amount of antibiotic-resistant bacteria in their guts. 4. Researchers found breast milk samples contained bacteria resistant to antibiot- ics, which mothers were more likely to pass on to the babies through their milk. However, researchers concluded breast- feeding still proves beneficial for infants, as the sugars in breast milk help good bacteria thrive in infants' guts. "As a general rule, it could be said that all breastfeeding is for the better," study author Katariina Pärnänen, a microbi- ologist and PhD student at University of Helsinki, told Science Daily. n How Case Western researchers are eliminating drug-resistant infections without antibiotics By Mackenzie Bean M olecules designed to inhibit toxin formation in bacte- ria could prove an effective alternative to antibiotics, according to a study published in Scientific Reports. For the study, researchers from Cleveland-based Case West- ern Reserve University conducted various mouse models to assess the therapeutic molecules' ability to eliminate antibi- otic-resistant bacteria. The molecules attach to a protein responsible for making toxins in all Gram-positive bacterial species. "Without the toxins, the bacteria become harmless. And since they don't need the toxins to survive, there is less pressure to develop resistance," senior study author Men- achem Shoham, PhD, associate professor of biochemistry at Case Western Reserve University School of Medicine, said in a press release. In one model, septic mice infected with methicillin-resis- tant Staphylococcus aureus demonstrated a 100 percent survival rate when treated with the molecules. In contrast, 70 percent of the untreated mice died. Researchers found the molecules offered similar efficacy to current antibiotics used to treat S. aureus. "We have proven efficacy not only against MRSA but also against Staphylococcus epidermidis, which is notorious for clogging catheters, Streptococcus pyogenes that causes strep throat, Streptococcus pneumoniae and other pathogens," Dr. Shoham said in the press release. n Early antibiotic stewardship intervention lowers costs By Anuja Vaidya A study in International Journal of Infectious Dis- eases examined the effects of earlier intervention by an antimicrobial stewardship team on various factors, including antimicrobial use and cost. Researchers conducted a retrospective study at a hospi- tal in Japan between April 2013 and March 2016. They compared three study periods: • SP1: Patients receiving anti-methicillin-resistant Staphylococcus aureus agents and carbapenems for more than 14 days • SP2: Patients receiving specific antimicrobials for more than 14 days • SP3: Patients receiving specific antimicrobials re- gardless of the treatment duration Here are four study findings: 1. The timing of the antimicrobial stewardship team's intervention reduced from an average of 15.5 days after administration in SP1 to 4.2 days in SP3. 2. The antimicrobial use density of carbapenems and piperacillin-tazobactam decreased significantly from SP2 to SP3. 3. The cost of specific antimicrobials decreased from $1.08 million in SP1 to $944,000 in SP2 and $763,000 in SP3. 4. The mortality rate and length of stay did not change during the study periods. n