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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 張上淳(Shan-Chwen Chang) | |
dc.contributor.author | Shao-Hsuan Tsai | en |
dc.contributor.author | 蔡少軒 | zh_TW |
dc.date.accessioned | 2021-06-16T09:17:37Z | - |
dc.date.available | 2020-08-27 | |
dc.date.copyright | 2020-08-27 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-08-17 | |
dc.identifier.citation | Antibiotic resistance threats in the United States, 2019. (2019). Retrieved from https://stacks.cdc.gov/view/cdc/82532 Balouiri, M., Sadiki, M., Ibnsouda, S. K. (2016). Methods for in vitro evaluating antimicrobial activity: A review. Journal of Pharmaceutical Analysis, 6(2), 71-79. doi:https://doi.org/10.1016/j.jpha.2015.11.005 Bassolé, I. H. N., Juliani, H. R. (2012). Essential Oils in Combination and Their Antimicrobial Properties. Molecules, 17(4), 3989-4006. Retrieved from https://www.mdpi.com/1420-3049/17/4/3989 Doern, C. D. (2014). When Does 2 Plus 2 Equal 5? A Review of Antimicrobial Synergy Testing. Journal of Clinical Microbiology, 52(12), 4124. doi:10.1128/JCM.01121- 14 Durante-Mangoni, E., Signoriello, G., Andini, R., Mattei, A., De Cristoforo, M., Murino, P., . . . Utili, R. (2013). Colistin and Rifampicin Compared With Colistin Alone for the Treatment of Serious Infections Due to Extensively Drug-Resistant Acinetobacter baumannii: A Multicenter, Randomized Clinical Trial. Clinical Infectious Diseases, 57(3), 349-358. doi:10.1093/cid/cit253 Elizabeth, S. (2013). Why are there so few antibiotics in the research and development pipeline? The Pharmaceutical Journal, 291, 520. doi:10.1211/PJ.2013.11130209 Gafter-Gvili, A., Fraser, A., Paul, M., Leibovici, L. (2005). Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients. Ann Intern Med, 142(12 Pt 1), 979-995. doi:10.7326/0003-4819-142-12_part_1-200506210-00008 Kelly, P., Kahlmeier, S., Götschi, T., Orsini, N., Richards, J., Roberts, N., . . . Foster, C. (2014). Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship. The international journal of behavioral nutrition and physical activity, 11, 132-132. doi:10.1186/s12966-014-0132-x Lee, G. C., Burgess, D. S. (2012). Treatment of Klebsiella Pneumoniae Carbapenemase (KPC) infections: a review of published case series and case reports. Annals of Clinical Microbiology and Antimicrobials, 11(1), 32. doi:10.1186/1476-0711-11- 32 Lee, W., Shen, K., You, H., Lee, M. S., Lee, G. (2018, 21-25 Jan. 2018). Automatic and rapid antimicrobial susceptibility test on an integrated microfluidic device. Paper presented at the 2018 IEEE Micro Electro Mechanical Systems (MEMS). Levy, S. B., Marshall, B. (2004). Antibacterial resistance worldwide: causes, challenges and responses. Nature Medicine, 10(12), S122-S129. doi:10.1038/nm1145 25 doi:10.6342/NTU202003429 MacNair, C. R., Stokes, J. M., Carfrae, L. A., Fiebig-Comyn, A. A., Coombes, B. K., Mulvey, M. R., Brown, E. D. (2018). Overcoming mcr-1 mediated colistin resistance with colistin in combination with other antibiotics. Nature communications, 9(1), 458- 458. doi:10.1038/s41467-018-02875-z Moellering, R. C. (1983). Rationale for use of antimicrobial combinations. The American Journal of Medicine, 75(2, Part 1), 4-8. doi:https://doi.org/10.1016/0002- 9343(83)90088-8 Piddock, L. J. V. (2012). The crisis of no new antibiotics—what is the way forward? The Lancet Infectious Diseases, 12(3), 249-253. doi:https://doi.org/10.1016/S1473- 3099(11)70316-4 Piddock, L. J. V. (2016). Reflecting on the final report of the O'Neill Review on Antimicrobial Resistance. The Lancet Infectious Diseases, 16(7), 767-768. doi:https://doi.org/10.1016/S1473-3099(16)30127-X Rada, A. (2019). Ten threats to global health in 2019. Retrieved from https://www.who.int/news-room/feature-stories/ten-threats-to-global-health- in-2019 Reller, L. B., Weinstein, M., Jorgensen, J. H., Ferraro, M. J. (2009). Antimicrobial Susceptibility Testing: A Review of General Principles and Contemporary Practices. Clinical Infectious Diseases, 49(11), 1749-1755. doi:10.1086/647952 Tamma, P. D., Cosgrove, S. E., Maragakis, L. L. (2012). Combination Therapy for Treatment of Infections with Gram-Negative Bacteria. Clinical Microbiology Reviews, 25(3), 450-470. doi:10.1128/cmr.05041-11 Tyers, M., Wright, G. D. (2019). Drug combinations: a strategy to extend the life of antibiotics in the 21st century. Nature Reviews Microbiology, 17(3), 141-155. doi:10.1038/s41579-018-0141-x United Nations meeting on antimicrobial resistance. (2016). Bull World Health Organ, 94(9), 638-639. doi:10.2471/blt.16.020916 Vardakas, K. Z., Athanassaki, F., Pitiriga, V., Falagas, M. E. (2019). Clinical relevance of in vitro synergistic activity of antibiotics for multidrug-resistant Gram-negative infections: A systematic review. Journal of Global Antimicrobial Resistance, 17, 250-259. doi:https://doi.org/10.1016/j.jgar.2019.01.004 Vitale, R. G., Afeltra, J., Dannaoui, E. (2005). Antifungal combinations. Methods Mol Med, 118, 143-152. doi:10.1385/1-59259-943-5:143 Worthington, R. J., Melander, C. (2013). Combination approaches to combat multidrug-resistant bacteria. Trends in biotechnology, 31(3), 177-184. doi:10.1016/j.tibtech.2012.12.006 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/59195 | - |
dc.description.abstract | 細菌抗藥性是影響全球醫療體系的一大流行,目前臨床上常使用的療法包含 了抗生素組合,尤其是在治療多重抗藥性細菌上。然而,關於抗生素組合的療效是 有爭議的,近年來文獻上有支持的數據也有相反的,如此不一致的結論使「個人化」 抗生素組合顯的重要,要達到這個目標,在投藥前的評估即要做的完善。 在日本、台灣、和法國,我們透過拜訪微生物實驗室、檢驗室與感染科醫師來 了解當地如何去評估抗生素組合的效用,由於不同國家皆有自己習慣的一套判定 方式,由此得出一個結論—全球並沒有一個臨床評估抗生素組合效用的「黃金準 則」。僅有研究用的 E 測試法、棋盤格殺菌試驗、殺菌時間曲線試驗供參考用,而 此些實驗方法不單人力成本高,繁瑣的實驗流程更使其操作時間長,是此,這些研 究用的實驗方法始終無法完整被應用於臨床檢驗室。 為了解決此一痛點,我與三位共同創辦人們一起創立了醫流體股份有限公司, 以微流體的技術為核心去建造一抗生素篩選平台,不單能自動化的進行微量的抗 生素稀釋以及不同抗生素的混合、更能於 6 小時內給出抗生素敏感性結果。利用 在台大感染科實驗室實習的機會,以十例的臨床菌株驗證此微流體技術是否有辦 法準確的評估抗生素組合效用。 | zh_TW |
dc.description.abstract | Antimicrobial resistance (AMR) is a well-known pandemic threating the modern medicine. To fight with AMR, antibiotic combination therapy (ACT) is commonly used in clinical practice, especially for treating multi-drug resistance bacteria. However, some recent studies demonstrated ACT has controversial results that some are supportive and some are not. This fact strengthens the importance that the use of ACT should be more individualized, and thus spotlights evaluating ACT effect before the actual prescription. In Japan, Taiwan, and France, we investigated how different countries evaluate ACT effect through laboratory practice, corporate visit, and consulting with infectious disease specialists. We confirmed that no gold standard methods have been established globally for the evaluation of ACT effect but for research use only, including the Etest methods, the checkerboard array, and the time-kill assay. It is the high labor cost and time- consuming procedure that make them cumbersome to adapt to the clinical labs. Aiming to tackle this issue, I cofounded MedFluid with my teammates and used microfluidic chip to build an antibiotic screening platform. The microfluidic chip can rapidly combine different antibiotics in multiple concentrations automatically and provide results within 6 hours. During my internship in the infectious disease laboratory at National Taiwan University Hospital, I validated the microfluidic chip with 10 clinical isolated bacteria to learn its functionality to evaluate the ACT effect. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T09:17:37Z (GMT). No. of bitstreams: 1 U0001-1408202015253800.pdf: 1420951 bytes, checksum: 9598b4a1df320915f795c85681343ff0 (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | 誌謝 i 中文摘要 iii Abstract iv 圖目錄 vii 表目錄 viii Chapter 1 Introduction 2 1.1 Antimicrobial resistance 2 1.2 Limited new antibiotics 2 1.3 Antibiotic Combination therapy 3 1.3.1 Types of combination 3 1.3.2 Evaluation of combination 4 1.4 Challenging issues for empirical combination therapy 4 1.4.1 Controversial results of empirical antibiotic combination therapy 4 1.4.2 Problems to conduct in vitro synergy testing 5 1.5 “MedFluid fAST” designed as the potential product for rapid in vitro synergy testing 5 Chapter 2 Learning achievement 7 2.1 Study 1 7 2.1.1 Objectives 7 2.1.2 Methods 7 2.1.3 Results 7 2.1.4 Discussion 9 2.2 Study 2 10 2.2.1 Objectives 10 2.2.2 Methods 10 2.2.3 Results 10 2.2.4 Discussion 16 2.3 Study 3 16 2.3.1 Objectives 16 2.3.2 Methods 16 2.3.3 Results 17 2.3.4 Discussion 20 2.3.4.1 Low reproductivity of checkerboard array. 20 2.3.4.2 Limited chambers to test different conditions 21 2.3.4.3 Low yield rate of microfluidic chips production 21 Chapter 3 Conclusion and a way forward 22 Chapter 4 References 25 | |
dc.language.iso | en | |
dc.title | 全球對抗生素組合效用的評估困境 | zh_TW |
dc.title | The Global Challenge of Evaluating Antibiotic Combination Therapy Effect | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 盛望徽(Wang-Huei Sheng),森川一也(Kazuya Morikawa) | |
dc.subject.keyword | 抗藥性,抗生素組合,協同性測試, | zh_TW |
dc.subject.keyword | antimicrobial resistance,antibiotic combination therapy,in vitro synergy test, | en |
dc.relation.page | 26 | |
dc.identifier.doi | 10.6342/NTU202003429 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2020-08-18 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 國際三校農業生技與健康醫療碩士學位學程 | zh_TW |
顯示於系所單位: | 國際三校農業生技與健康醫療碩士學位學程 |
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