The current study systematically reviewed, summarized and meta-analyzed the clinical features of the vaccines in clinical trials to provide a better estimate of their efficacy, side effects and immunogenicity. All relevant publications were systematically searched and collected from major databases up to 12 March 2021. A total of 25 RCTs (123 datasets), 58,889 cases that received the COVID-19 vaccine and 46,638 controls who received placebo were included in the meta-analysis. In total, mRNA-based and adenovirus-vectored COVID-19 vaccines had 94.6% (95% CI 0.936–0.954) and 80.2% (95% CI 0.56–0.93) efficacy in phase II/III RCTs, respectively. Efficacy of the adenovirus-vectored vaccine after the first (97.6%; 95% CI 0.939–0.997) and second (98.2%; 95% CI 0.980–0.984) doses was the highest against receptor-binding domain (RBD) antigen after 3 weeks of injections. The mRNA-based vaccines had the highest level of side effects reported except for diarrhea and arthralgia. Aluminum-adjuvanted vaccines had the lowest systemic and local side effects between vaccines’ adjuvant or without adjuvant, except for injection site redness. The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after first and second doses, respectively. The mRNA-based vaccines had higher side effects. Remarkably few experienced extreme adverse effects and all stimulated robust immune responses.
Wounds continue to be a serious medical concern due to their increasing incidence from injuries, surgery, burns and chronic diseases such as diabetes. Delays in the healing process are influenced by infectious microbes, especially when they are in the biofilm form, which leads to a persistent infection. Biofilms are well known for their increased antibiotic resistance. Therefore, the development of novel wound dressing drug formulations and materials with combined antibacterial, antibiofilm and wound healing properties are required. Nanomaterials (NM) have unique properties due to their size and very large surface area that leads to a wide range of applications. Several NMs have antimicrobial activity combined with wound regeneration features thus give them promising applicability to a variety of wound types. The idea of NM-based antibiotics has been around for a decade at least and there are many recent reviews of the use of nanomaterials as antimicrobials. However, far less attention has been given to exploring if these NMs actually improve wound healing outcomes. In this review, we present an overview of different types of nanomaterials explored specifically for wound healing properties combined with infection control.
Introduction: One of the global concerns is the increasing trend toward antimicrobial resistance and the consequent lack of efficient antimicrobials. Nosocomial infections present a big threat for patients all over the world and treatment with broad-spectrum antibiotics leads to outgrowth of hospital-associated resistant Enterococci clones that are very important in bloodstream infections. We surveyed the frequency and time trend of antibiotic resistance in Enterococci blood isolates from hospitalized patients in different regions of the world. Methods: Literature from January 1, 2000 to May 20, 2018 was searched systematically using Medline (via PubMed), Embase, and Cochrane Library and all original publications on the antibiotic resistance prevalence in blood-isolated Enterococci strains with standard laboratory tests were included. Quality of the included studies was assessed with the modified Critical Appraisal Checklist recommended by the Joanna Briggs Institute. Depending on the heterogeneity test, we used either random or fixed effect models to assess the appropriateness of the pooled prevalence of drug resistance. Results: A total of 291 studies were enrolled in the meta-analysis. Between all antibiotics, based on the WHO original offices, American countries showed the lowest prevalence of resistance for linezolid in Enterococcus faecalis. Regarding the prevalence of vancomycin resistance, Western Pacific, European, and American countries had the lowest level of resistance and South-East Asia and Eastern Mediterranean countries showed the highest level of resistance. Moreover, our findings for Enterococcus faecium indicated that America and South-East Asia had the lowest and the highest levels of resistance for linezolid, respectively. Conclusion: Based on our findings, the prevalence of vancomycin-resistant E. faecium in bloodstream infections is significantly high, especially in Eastern Mediterranean countries, which is a massive warning signal for resistance to this broad-spectrum antibiotic. Therefore, the establishment of appropriate antibiotic usage guidelines should be essential in these countries.