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Background/Objectives: We aimed to compare the prescribing behavior and clinical experience of urology providers when using the combined multiplex polymerase chain reaction (M-PCR)/Pooled Antibiotic Susceptibility Testing (P-AST) diagnostic test versus the standard urine culture (SUC) in the same set of patients previously reported to have improved clinical outcomes with M-PCR/P-AST. Methods: We conducted a multi-centered, prospective, observational study (clinical trial registration: NCT05091931) with Western Institutional Review Board (IRB) approval (20214705). Adult subjects were split between the M-PCR/P-AST (n = 250) and SUC arms (n = 135). Treatment details were determined by clinician and subject surveys. Differences in prescribed antibiotics were compared using the Chi-square or Fisher's exact test. Results: There was no significant difference in the overall use of "access" antibiotics (p = 1.0) or first-line drugs (p = 0.4483) between M-PCR/P-AST and SUC. Nitrofurantoin (p = 0.0172) and metronidazole (p = 0.0309) were more frequently used with M-PCR/P-AST, while amoxicillin/clavulanate (p = 0.0008), cefuroxime (p = 0.0378), and ertapenem (p = 0.0378) were more frequently used with SUC. Conclusions: The use of M-PCR/P-AST to guide complicated UTI management was not associated with the increased use of non-first-line antibiotics, such as carbapenems, compared to SUC. Combined with the prior reported evidence of improved patient outcomes in this same set of patients, this test should be considered for utilization when managing complicated UTI cases. [ABSTRACT FROM AUTHOR]

Healtcare-associated infections have increased due to the development of antimicrobial resistance (AMR) of Gram-negative pathogens (GNPs) and the development of outbreacks over the past two decades. In this work, we investigated how exposure to positive electric pulses affects the growth characteristics of Klebsiella pneumonia (K. pneumonia), a common cause of pneumonia. We explored the impact of varying exposure frequencies (0.2–2 Hz) and time (15–90 min, at resonance frequency) on bioelectric signals produced during cell division, biofilm formation, and bacterial antibiotic susceptibility. Our research found that an extremely low-frequency pulsed electric field (ELF-PEF) significantly inhibited K. pneumonia growth. Specifically, exposure to 0.8 Hz for one hour increased the antibiotic susceptibility of K. pneumonia to inhibitors of cell wall formation, proteins, β-lactamase, DNA, and other substances. We also noticed a notable decrease in K. pneumonia biofilm development exposed to ELF-PEF. Our results suggest that the interaction of K. pneumonia cells with ELF-PEF at the specified frequency and time alters cellular activity and bacterial structure. This technique may be used in the future to treat K. pneumonia infections both in vitro and in vivo. Key points: • Extremely low-frequency pulsed electric fields inhibit the growth of K. pneumonia. • ELF-PEF increases antibiotic susceptibility and reduces biofilm formation in K. pneumonia. • ELF-PEF showed potential for treating K. pneumonia infections. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is a major cause of morbidity and mortality worldwide. Understanding the bacterial profiles and antibiotic susceptibility patterns causing neonatal sepsis is crucial for guiding appropriate treatment, improving patient outcomes, and combating the emergence of antibiotic resistance. Despite its importance, data regarding neonatal sepsis in the study area is limited. Therefore, this study aimed to characterize the bacterial pathogens and identify associated factors among neonates with suspected sepsis at the University of Gondar Comprehensive Specialized Hospital, Ethiopia. Methods: A cross-sectional study was conducted by reviewing laboratory records of neonates admitted for suspected sepsis from January 2019 to December 2021. Data were checked for completeness and encoded in a spreadsheet program. Then, data were exported to STATA version 17 for analysis. Descriptive statistics such as frequency and percentage were computed. The association between neonatal sepsis and potential risk factors was assessed using Pearson's chi-square test. A p-value of < 0.05, was considered statistically significant. Results: A total of 1,236 neonates were included. Of these, 96.2% (1,190/1,236) had a fever before admission. The prevalence of culture-confirmed sepsis was 25.4% (314/1,236). Bacterial pathogens accounted for 23% (284/1,236) of these isolates, with Gram-negative bacteria being more prevalent at 75.3% (214/284) than Gram-positive bacteria at 24.7% (70/284). The most frequently isolated bacterial pathogens were K. pneumoniae 38.7% (110/284) and S. aureus 13% (37/284). The isolates demonstrated a high resistance level to commonly used antibiotics, with 61.6% exhibiting multidrug resistance. K. pneumoniae showed the highest rate of multidrug resistance (90.9%). Neonatal sepsis was associated with several factors, including fever before and after admission, hypothermia, increased respiration, suspected pneumonia, and suspected meningitis. Conclusion: This study identified a high prevalence of culture-confirmed sepsis in neonates at UoGCSH, with Gram-negative bacteria, especially K. pneumoniae, dominating the isolated pathogens. The isolated bacteria exhibited alarming resistance to commonly used antibiotics, with a high proportion demonstrating multidrug resistance. Implementing effective antibiotic stewardship programs is crucial to optimize antibiotic use, reduce unnecessary prescriptions, and curb the spread of resistant strains. [ABSTRACT FROM AUTHOR]

Eggerthella lenta (E. lenta) is known to cause intra-abdominal and anaerobic bloodstream infections. However, clinical insights and information on antimicrobial susceptibility in E. lenta infections are limited. This study aimed to elucidate the clinical characteristics and antimicrobial susceptibility of E. lenta infections. Patients with E. lenta isolated from various specimens who presented at Aichi Medical University Hospital between January 2018 and December 2022 were included. Patient information was retrospectively collected from electronic medical records. Logistic regression analysis was conducted to identify risk factors for bloodstream infections. The antimicrobial susceptibility of various antimicrobial agents against isolated strains was investigated. During the study period, seventy cases were classified as infection cases. The median age of patients was 69 years (range: 15-100 years), and 48 (68.6%) were males. The most common site of infection was the lower digestive tract (54.3%). In 70.4% of cases, polymicrobial infections occurred. Community-acquired infection was a significant risk factor for bloodstream infection, with an odds ratio of 4.94 (95% confidence interval: 1.02-23.9). The 30-day mortality rate was 10.0%. Univariate analysis showed lower mortality in patients who underwent surgical intervention than in those who did not (42.9% vs 57.1%, p = 0.02). The proportion of minimal inhibitory concentrations (MICs) of = 32 µg/mL for piperacillin-tazobactam was 6.3%. Additionally, the proportions of MICs of = 8 µg/mL for imipenem and meropenem were 1.4% and 0%, respectively. E. lenta should be considered when blood cultures yield gram-positive rods in community-acquired intra-abdominal infections. Effective treatment involves both antimicrobial agents and surgical interventions. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to characterize bacterial species, aetiology and antibiotic susceptibility connected to bacterial keratitis infections in Östergötland, Sweden. Methods: Retrospective cross-sectional study based on electronic health records for the period 2010–2019. Records of patients diagnosed with infectious keratitis were screened for microbiology confirmed infectious bacterial keratitis. Bacterial species and their susceptibility to antibiotics were determined from microbiology test results. Results: One-hundred and ninety patients with lab culture-confirmed infectious bacterial keratitis were included in the analysis. The most frequently found bacterial species were coagulase-negative staphylococci (39%), Staphylococcus aureus (17%) and Cutibacterium acnes (10%). Pseudomonas spp. was the most frequently found Gram-negative bacterial species (7%). Contact lens wear and severely ill/blind eye were the top two aetiologies associated with bacterial keratitis, 22% of the patients with bacterial keratitis were also diagnosed with glaucoma. Most isolates, 157 out of 173, were susceptible to fluoroquinolones, and 145 out of 155 isolates were susceptible to chloramphenicol. Conclusion: Our results revealed a positive rate of bacterial keratitis of 59% for the samples sent to the laboratory. There was a high susceptibility of the bacterial species to the recommended antibiotics. Our results indicate that it is likely that patients are receiving the correct treatment. Future studies are necessary to monitor changes in antibiotic susceptibility. [ABSTRACT FROM AUTHOR]

Birds play a critical role as a reservoir for enteric bacteria Escherichia coli and Salmonella enterica. This study aimed to investigate prevalence of E. coli and S. enterica and occurrence of their antibiotic resistance (ABR) genes in selected wild and captive bird species in Pakistan. E. coli and S. enterica were isolated from fecal samples of birds and identified by phenotypic, biochemical, and molecular characterization of ABR genes by PCR. E. coli colonies appeared circular and dark purple on EMB agar media plates while S. enterica colonies were small, circular, and red on SS agar media plates. E. coli and S. enterica isolates were found resistant to amoxicillin, ciprofloxacin, and sulfamethoxazole, while sensitive against doxycycline, gentamycin, and tetracycline. E. coli isolates showed positive results in catalase, indole, and methyl red tests while S. enterica isolates showed negative in citrate, lactose, and urease tests. E. coli and S. enterica strains were 100% and 99% identical, respectively, to previously isolated E. coli and S. enterica strains. Overall prevalence of E. coli and S. enterica was recorded as 16.55% and 2.7% respectively. Captive pigeons exhibited maximum 19.1% and 3.3% occurrence of blaTEM of E. coli and S. enterica respectively, 18.3% and 2.5% of sul3 respectively in peafowls, and 23.3% and 3.3% of qnrA respectively in captive pigeons. It has been concluded that captive birds in districts with lower elevation levels have a higher prevalence of E. coli and S. enterica at high temperatures compared to wild birds in districts with higher elevation levels. [ABSTRACT FROM AUTHOR]

CONTEXT Microbial keratitis is a potentially vision-threatening emergency that demands prompt diagnosis and treatment to ensure better vision recovery. Empirical use of broad-spectrum antimicrobial therapies is often the primary treatment modality, which is then tailored according to clinical response, cultured organisms, and their sensitivities. Since the spectrum of microbial agents associated with corneal ulcers is wide and varies from one geographical location to another, it is imperative that local microbial trends and susceptibility patterns are analyzed to enable better care in the management of these patients. AIMS The aim of the study was to report the microbiological profile and in vitro drug susceptibility patterns of bacterial isolates obtained from patients with microbial keratitis in a single tertiary center in Andhra Pradesh over 12 years. METHODS Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures from the years 2010 to 2021 were reviewed. Trends in bacterial and fungal etiology along with the antibiotic susceptibility profile of bacteria were analyzed. STATISTICAL ANALYSIS USED Frequency distribution was obtained, and percentages were calculated. RESULTS Of the 8529 microbial keratitis samples, 3581 corneal scrapings were culture positive which included Gram-positive bacteria (1054/3581, 29.4%), Gram-negative bacteria (476/3581, 13.2%), fungi (2051/3581, 57.2%), and parasites (369/3581, 10.3%). The most common fungal isolate was Fusarium species (557/1748, 31.8%) followed by Aspergillus flavus (495/1748, 28.3%). Similarly, the most common Gram-positive bacteria included Streptococcus pneumoniae (297/891, 33.3%) and Staphylococcus species (213/891, 23.9%), and the most common Gram-negative bacteria was Pseudomonas aeruginosa (294/403, 72.9%). Overall susceptibility patterns showed that Gram-positive bacteria were susceptible to vancomycin (92%), cefazolin (88%), and chloramphenicol (86%), while Gram-negative bacteria were most susceptible to gentamicin and amikacin (81%). The susceptibility to amikacin and gentamicin increased significantly from 71% in 2010 to 92% in 2021 and 74% in 2010 to 92% in 2021, respectively. In comparison, the susceptibility of fluoroquinolones for both Gram-positive and Gram-negative bacteria did not show any significant change over the study period. CONCLUSIONS The prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study reinforced that fluoroquinolones and vancomycin continue to be good empiric therapies for treating bacterial keratitis in Andhra Pradesh.

Background: Active Chronic Otitis Media is a pertinacious disease of the middle ear, capable of causing severe destructive sequelae, with the manifestations of deafness, discharge and a permanent perforation. It is one of the most common childhood diseases, more common in India. Aim of Study was to elucidate the microbial predominance and chart its antibiotic susceptibility pattern among the patients of this disease. The emergence of drug resistant strains along with changing Antibiotic susceptibility profile makes it necessary to undertake this study. Material and Methods: 138 Patients who attended the OPD & IPD of a tertiary centre in Vijayapur were included. They were diagnosed as Chronic Suppurative Otitis Media by ENT Surgeons & had not received topical and/or systemic antibiotics, minimum 5 days before sample collection. Isolation & identification of bacteria was done by standard microbiological methods & their Antibiotic Susceptibility testing (AST) was done by Kirby-Bauer disc diffusion method (CLSI guidelines). Results: Chronic Suppurative Otitis Media was found to be more common in females (55%) than males (45%), more common in age group 1-10 years (31%). Pseudomonas aeruginosa (42%) was the most common organism to be isolated followed by Staphylococcus aureus (37%). Pseudomonas aeruginosa showed maximum sensitivity to Amikacin (96%) and Piperacillin (96%). Staphyloco ccus aureus was maximum sensitive to Gentamicin (94%) & Linezolid (94%). Conclusion: Pseudomonas aeruginosa (42%) was the most common organism to be isolated and showed maximum sensitivity to Amikacin (96%) and Piperacillin (96%).

Abstract Background The aim of this study was to characterize bacterial species, aetiology and antibiotic susceptibility connected to bacterial keratitis infections in Östergötland, Sweden. Methods Retrospective cross-sectional study based on electronic health records for the period 2010–2019. Records of patients diagnosed with infectious keratitis were screened for microbiology confirmed infectious bacterial keratitis. Bacterial species and their susceptibility to antibiotics were determined from microbiology test results. Results One-hundred and ninety patients with lab culture-confirmed infectious bacterial keratitis were included in the analysis. The most frequently found bacterial species were coagulase-negative staphylococci (39%), Staphylococcus aureus (17%) and Cutibacterium acnes (10%). Pseudomonas spp. was the most frequently found Gram-negative bacterial species (7%). Contact lens wear and severely ill/blind eye were the top two aetiologies associated with bacterial keratitis, 22% of the patients with bacterial keratitis were also diagnosed with glaucoma. Most isolates, 157 out of 173, were susceptible to fluoroquinolones, and 145 out of 155 isolates were susceptible to chloramphenicol. Conclusion Our results revealed a positive rate of bacterial keratitis of 59% for the samples sent to the laboratory. There was a high susceptibility of the bacterial species to the recommended antibiotics. Our results indicate that it is likely that patients are receiving the correct treatment. Future studies are necessary to monitor changes in antibiotic susceptibility.

Milk remains vulnerable to microbial contamination due to favorable microenvironmental conditions. The objective of this study was to assess the antimicrobial susceptibility profiles of bacterial isolates from raw cow milk obtained from four distinct bulk collection centers in Oyo, Southwest Nigeria. A total of 80 samples of raw cow milk were collected in aseptic conditions. A total of 20 samples were collected from each of the four bulk collection centers (Iseyin, Maya, Fashola, and Alaga) at different time intervals. Total viable bacteria count, isolation, and identification of bacteria, as well as antibiotic susceptibility testing by disc diffusion method, were performed. The findings revealed the presence of bacteria from five different genera, namely Staphylococcus, Enterococcus, Bacillus, Salmonella, and Escherichia in the raw cow milk samples. Antibiotic susceptibility testing demonstrated high sensitivity of the bacterial isolates to ciprofloxacin, gentamicin, and pefloxacin. This study provides additional evidence that raw cow milk serves as a conducive medium for the growth of various bacterial pathogens of medical significance. It is strongly recommended that proper aseptic techniques be implemented at the bulk collection centers to minimize the risk of bacterial contamination.

Objectives: In response to the growing global concerns regarding antibiotic resistance, we conducted a meta-analysis to assess the prevalence of antibiotic resistance in hypervirulent Klebsiella pneumoniae (hvKp) strains. Methods: We conducted a meta-analysis of antibiotic resistance in the hvKp strains. Eligible studies published in English until April 10, 2023, were identified through a systematic search of various databases. After removing duplicates, two authors independently assessed and analysed the relevant publications, and a third author resolved any discrepancies. Data extraction included publication details and key information on antibiotic resistance. Data synthesis employed a random-effects model to account for heterogeneity, and various statistical analyses were conducted using R and the metafor package. Results: This meta-analysis of 77 studies from 17 countries revealed the prevalence of antibiotic resistance in hvKp strains. A high resistance rates have been observed against various classes of antibiotics. Ampicillin-sulbactam faced 45.3% resistance, respectively, rendering them largely ineffective. The first-generation cephalosporin cefazolin exhibited a resistance rate of 38.1%, whereas second-generation cefuroxime displayed 26.7% resistance. Third-generation cephalosporins, cefotaxime (65.8%) and ceftazidime (57.1%), and fourth-generation cephalosporins, cefepime (51.3%), showed substantial resistance. The last resort carbapenems, imipenem (45.7%), meropenem (51.0%) and ertapenem (40.6%), were not spared. Conclusion: This study emphasizes the growing issue of antibiotic resistance in hvKp strains, with notable resistance to both older and newer antibiotics, increasing resistance over time, regional disparities and methodological variations. Effective responses should involve international cooperation, standardized testing and tailored regional interventions.

Abstract Biofilm formation and toxin production are some of the virulence factors of Clostridioides difficile (C. difficile), which causes hospital-acquired C. difficile infection (HA-CDI). This work investigated the prevalence and distribution of different strains recovered from HA-CDI patients hospitalized in 4 medical centres across Israel, and characterized strains' virulence factors and antibiotic susceptibility. One-hundred and eighty-eight faecal samples were collected. C. difficile 's toxins were detected by the CerTest Clostridium difficile GDH + Toxin A + B combo card test kit. Toxin loci PaLoc and PaCdt were detected by whole-genome sequencing (WGS). Multi-locus sequence typing (MLST) was performed to classify strains. Biofilm production was assessed by crystal violet. Antibiotic susceptibility was determined using Etest. Fidaxomicin susceptibility was tested via agar dilution. Sequence type (ST) 42 was the most (13.8%) common strain. All strains harboured the 2 toxins genes; 6.9% had the binary toxin. Most isolates were susceptible to metronidazole (98.9%) and vancomycin (99.5%). Eleven (5.85%) isolates were fidaxomicin-resistant. Biofilm production capacity was associated with ST (p

Using probiotics represents a potential solution to post-weaning diarrheal diseases in piglets on commercial farms. The gastrointestinal tract of wild boars serves as a promising reservoir of novel lactic acid bacteria with suitable probiotic characteristics. In this study, we isolated eight bacterial strains from the intestinal content of wild boars identified as representatives of the species Bifidobacterium apri, Lactobacillus amylovorus, and Ligilactobacillus salivarius. These isolates underwent in vitro analysis and characterisation to assess their biological safety and probiotic properties. Analysis of their full genome sequences revealed the absence of horizontally transferrable genes for antibiotic resistance. However, seven out of eight isolates harboured genes encoding various types of bacteriocins in their genomes, and bacteriocin production was further confirmed by mass spectrometry analysis. Most of the tested strains demonstrated the ability to inhibit the growth of selected pathogenic bacteria, produce exopolysaccharides, and stimulate the expression of interleukin-10 in porcine macrophages. These characteristics deem the isolates characterised in this study as potential candidates for use as probiotics for piglets during the post-weaning period.

Background: High-dose dual therapy (HDDT) using proton-pump inhibitors (PPI) and amoxicillin attracted attention for its simplicity and lower adverse event profile. Besides, vonoprazan is not available worldwide. This real-world study aims to compare the efficacy of esomeprazole-based and rabeprazole-based HDDT regimens and to identify clinical factors influencing outcomes. Methods: A retrospective study enrolled 346 Helicobacter pylori-infected naïve patients from January 2016 to August 2023. Patients were assigned to either a 14-day esomeprazole-based HDDT (EA-14; esomeprazole 40 mg t.i.d. and amoxicillin 750 mg q.i.d. for 14 days, n = 173) or a 14-day rabeprazole-based HDDT (RA-14; rabeprazole 20 mg and amoxicillin 750 mg q.i.d. for 14 days, n = 173). Results: Five patients from the EA-14 group and 10 from the RA-14 group were lost to follow-up, resulting in 168 and 163 patients for the per-protocol (PP) analysis, respectively. Eradication rates for the EA-14 and RA-14 groups were 90.2% and 80.9% (P = 0.014) in intention-to-treat (ITT) analysis; and 92.9% and 85.9% (P = 0.039) in PP analysis. Adverse event rates were similar between the two groups (11.9% vs 11.7%, P = 0.944). In multiple logistic regression analysis, age≧60 was associated with eradication failure (P = 0.046) and a trend of significance for smoking (P = 0.060) in the EA-14 group but not in the RA-14 group. A trend of significance was also observed for eradication regimens (EA-14 vs RA-14) (P = 0.071).The antibiotic resistance rates were amoxicillin (2.3%), clarithromycin (14.7%), metronidazole (40.3%), and dual resistance to clarithromycin and metronidazole (7.0%). Conclusions: Esomeprazole-based HDDT achieved over 90% eradication rates but rabeprazole-based HDDT, which failed.

Biofilm formation and toxin production are some of the virulence factors of Clostridioides difficile (C. difficile), which causes hospital-acquired C. difficile infection (HA-CDI). This work investigated the prevalence and distribution of different strains recovered from HA-CDI patients hospitalized in 4 medical centres across Israel, and characterized strains' virulence factors and antibiotic susceptibility. One-hundred and eighty-eight faecal samples were collected. C. difficile 's toxins were detected by the CerTest Clostridium difficile GDH + Toxin A + B combo card test kit. Toxin loci PaLoc and PaCdt were detected by whole-genome sequencing (WGS). Multi-locus sequence typing (MLST) was performed to classify strains. Biofilm production was assessed by crystal violet. Antibiotic susceptibility was determined using Etest. Fidaxomicin susceptibility was tested via agar dilution. Sequence type (ST) 42 was the most (13.8%) common strain. All strains harboured the 2 toxins genes; 6.9% had the binary toxin. Most isolates were susceptible to metronidazole (98.9%) and vancomycin (99.5%). Eleven (5.85%) isolates were fidaxomicin-resistant. Biofilm production capacity was associated with ST (p < 0.001). In conclusion, a broad variety of C. difficile strains circulate in Israel's medical centres. Further studies are needed to explore the differences and their contribution to HA-CDI epidemiology. [ABSTRACT FROM AUTHOR]

CONTEXT: Microbial keratitis is a potentially vision-threatening emergency that demands prompt diagnosis and treatment to ensure better vision recovery. Empirical use of broad-spectrum antimicrobial therapies is often the primary treatment modality, which is then tailored according to clinical response, cultured organisms, and their sensitivities. Since the spectrum of microbial agents associated with corneal ulcers is wide and varies from one geographical location to another, it is imperative that local microbial trends and susceptibility patterns are analyzed to enable better care in the management of these patients. AIMS: The aim of the study was to report the microbiological profile and in vitro drug susceptibility patterns of bacterial isolates obtained from patients with microbial keratitis in a single tertiary center in Andhra Pradesh over 12 years. METHODS: Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures from the years 2010 to 2021 were reviewed. Trends in bacterial and fungal etiology along with the antibiotic susceptibility profile of bacteria were analyzed. STATISTICAL ANALYSIS USED: Frequency distribution was obtained, and percentages were calculated. RESULTS: Of the 8529 microbial keratitis samples, 3581 corneal scrapings were culture positive which included Gram-positive bacteria (1054/3581, 29.4%), Gram-negative bacteria (476/3581, 13.2%), fungi (2051/3581, 57.2%), and parasites (369/3581, 10.3%). The most common fungal isolate was Fusarium species (557/1748, 31.8%) followed by Aspergillus flavus (495/1748, 28.3%). Similarly, the most common Gram-positive bacteria included Streptococcus pneumoniae (297/891, 33.3%) and Staphylococcus species (213/891, 23.9%), and the most common Gram-negative bacteria was Pseudomonas aeruginosa (294/403, 72.9%). Overall susceptibility patterns showed that Gram-positive bacteria were susceptible to vancomycin (92%), cefazolin (88%), and chloramphenicol (86%), while Gram-negative bacteria were most susceptible to gentamicin and amikacin (81%). The susceptibility to amikacin and gentamicin increased significantly from 71% in 2010 to 92% in 2021 and 74% in 2010 to 92% in 2021, respectively. In comparison, the susceptibility of fluoroquinolones for both Gram-positive and Gram-negative bacteria did not show any significant change over the study period. CONCLUSIONS: The prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study reinforced that fluoroquinolones and vancomycin continue to be good empiric therapies for treating bacterial keratitis in Andhra Pradesh. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa (P. aeruginosa) is a major pathogen that causes infectious diseases. It has high tendency to form biofilms, resulting in the failure of traditional antibiotic therapies. Inspired by the phenomenon that co-culture of Escherichia coli (E. coli) and P. aeruginosa leads to a biofilm reduction, we reveal that E. coli exopolysaccharides (EPS) can disrupt P. aeruginosa biofilm and increase its antibiotic susceptibility. The results show that E. coli EPS effectively inhibit biofilm formation and disrupt mature biofilms in P. aeruginosa, Staphylococcus aureus , and E. coli itself. The maximal inhibition and disruption rates against P. aeruginosa biofilm are 40 % and 47 %, respectively. Based on the biofilm-disrupting ability of E. coli EPS, we develop an E. coli EPS/antibiotic combining strategy for the treatment of P. aeruginosa biofilms. The combination with E. coli EPS increases the antibacterial efficiency of tobramycin against P. aeruginosa biofilms in vitro and in vivo. This study provides a promising strategy for treating biofilm infections. Biofilm formation is a leading cause of chronic infections. It blocks antibiotics, increases antibiotic-tolerance, and aids in immune evasion, thus representing a great challenge in clinic. This study proposes a promising approach to combat pathogenic Pseudomonas aeruginosa (P. aeruginosa) biofilms by combining Escherichia coli exopolysaccharides with antibiotics. This strategy shows high efficiency in different P. aeruginosa stains, including two laboratory strains, PAO1 and ATCC 10145, as well as a clinically acquired carbapenem-resistant strain. In addition, in vivo experiments have shown that this approach is effective against implanted P. aeruginosa biofilms and can prevent systemic inflammation in mice. This strategy offers new possibilities to address the clinical failure of conventional antibiotic therapies for microbial biofilms. [Display omitted] [ABSTRACT FROM AUTHOR]

The present study evaluated the Salmonella isolates obtained from various origins in Iran. Salmonella strains previously recovered and stored in the veterinary microbiology laboratory were serotyped and subjected to antibiotic susceptibility test, detection of the virulence and resistance genes by polymerase chain reaction (PCR), and genotyping by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). All Salmonella isolates showed resistance to erythromycin and the most resistance rates were detected for trimethoprim (86.66%), ampicillin (75.00%), and sulfamethoxazole-trimethoprim (63.33%), respectively. In total, 86.33% of the isolates were known as multi-drug resistant and none of the isolates showed resistance to cefepime, nalidixic acid, imipenem, ceftriaxone, and polymyxin B. The virulence genes, invA, sdiA, and hilA besides the tetA resistance gene were identified in all 60 Salmonella strains. The most prevalent resistance genes were respectively tetC (70.00%), sul2 (58.33%), and ereA (55.00%). Statistical analysis revealed a significant difference between Salmonella serotypes associated with the sul1 resistance gene. In ERICPCR analysis, 14 distinct clusters were obtained. Statistically, there were significant relationships between the source and ERIC's genomic pattern and between the serotype of Salmonella isolates and genotypic pattern of ERIC. According to the results, Salmonella serotypes from non-human sources had considerable resistance to different antibiotics and carried significant virulence determinants and resistance genes. In addition, ERIC-PCR showed relevant results in discriminating Salmonella serotypes from other sources. [ABSTRACT FROM AUTHOR]

Pasteurella multocida is a Gram-negative bacterium causing economically significant diseases in cattle. This study aimed to determine P. multocida susceptibility to different antibiotics and antibiotic alternatives. In this study, 246 samples (180 nasal swabs and 66 lung tissue specimens) were collected from cattle showing respiratory manifestations in Egypt. Suspected P. multocida colonies following culture were subjected to polymerase chain reaction (PCR) for molecular confirmation of the isolates. A multiplex PCR was employed to identify P. multocida capsular groups. Susceptibility of the isolated P. multocida to different antibiotics and nanoparticles as antibiotic alternatives including silver (AgNPs), chitosan (CNPs) and curcumin (CurNPs) were tested using broth microdilution method. Thirty-two P. multocida isolates were obtained, kmt1 gene was detected in these isolates, and molecular capsular types classification revealed that all isolates were belonged to the capsular type A. Based on broth microdilution method findings, 20 (62.50%) isolates were considered as multi-drug resistant (MDR); the isolates were most sensitive to danofloxacin and kanamycin, whereas they were most resistant to doxycycline and tilmicosin. Antibiotic alternatives showed high anti-microbial activity against tested isolates with minimum inhibitory concentrations ranging from 1.56 - 6.25 µg mL-1, 156 - 625 µg mL-1, and 128 - 512 µg mL-1 for AgNPs, CNPs and CurNPs, respectively. Our finding demonstrated that MDR P. multocida was evident in cattle in Egypt. Although antibiotic alternatives showed promising in vitro anti-microbial effects against MDR isolates, additional studies are required to be actually applicable in veterinary practices. [ABSTRACT FROM AUTHOR]

Due to the increasing resistance of aerobic and facultative anaerobic Gram-negative rods, ceftazidime-avibactam and ceftolozane-tazobactam have been launched in the market in the last few years. In this study, we analyzed the susceptibility pattern of the major aerobic and facultative anaerobic Gram-negative rods in Hong Kong for ceftazidime-avibactam, ceftolozane-tazobactam, four other broad-spectrum antibiotics commonly used in Hong Kong and colistin. For 300 isolates collected from January to December 2021, non-ESBL-producing Enterobacterales, ESBL-producing Enterobacterales and Pseudomonas aeruginosa were highly susceptible to ceftazidime-avibactam (all 100%) and ceftolozane-tazobactam (98.7%, 99.7% and 94.3%). For 32 archived ESBL-producing Klebsiella pneumoniae isolates collected between January 2014 and March 2023, all were susceptible to ceftazidime-avibactam and ceftolozane-tazobactam. For 101 archived carbapenemase-producing Enterobacterales, their susceptibilities to ceftazidime-avibactam and ceftolozane-tazobactam varied depending on the type of carbapenemase produced. Both had high activities against OXA-producing strains (97.1% and 76.5%, respectively) but were 100% resistant for NDM-producing and NDM+OXA-producing strains. All KPC-producing strains were susceptible to ceftazidime-avibactam but resistant to ceftolozane-tazobactam. Ceftazidime-avibactam and ceftolozane-tazobactam are good alternatives for the management of infections caused by ESBL-producing Enterobacterales and selective strains of carbapenemase-producing Enterobacterales in Hong Kong. [ABSTRACT FROM AUTHOR]

The fruit and vegetable industry in post-harvest processing plants is characterized by a substantial consumption of water resources. Wash waters may serve as an environment for the periodic or permanent habitation of microorganisms, particularly if biofilm forms on the inner walls of tanks and flushing channels. Despite the implementation of integrated food safety monitoring systems in numerous countries, foodborne pathogens remain a global public health and food safety concern, particularly for minimally processed food products such as vegetables and fruits. This necessitates the importance of studies that will explore wash water quality to safeguard minimally processed food against foodborne pathogen contamination. Therefore, the current study aimed to isolate and identify bacteria contaminating the wash waters of four fresh-cut processing plants (Poland) and to evaluate the phenotypic antibiotic resistance profiles in selected species. Bacteria were isolated using membrane filtration and identified through mass spectrometry, followed by antibiotic susceptibility testing according to EUCAST guidelines. The results revealed that the level of contamination with total aerobic bacteria in the water ranged from 1.30 × 106 cfu/mL to 2.54 × 108 cfu/mL. Among the isolates, opportunistic pathogens including Enterococcus faecalis, Pseudomonas aeruginosa, Klebsiella oxytoca, Klebsiella pneumoniae, Serratia marcescens, and Proteus vulgaris strains were identified. An especially noteworthy result was the identification of cefepime-resistant K. oxytoca isolates. These findings highlight the importance of monitoring the microbial microflora in minimally processed foods and the need for appropriate sanitary control procedures to minimize the risk of pathogen contamination, ensuring that products remain safe and of high quality throughout the supply chain. [ABSTRACT FROM AUTHOR]

The study investigates the antibiotic resistance (AR) profiles and genetic determinants in three strains of guaiacol-producing Alicyclobacillus spp. isolated from orchard soil and pears. Their phenotypic characteristics, such as spore formation; resistance to different factors, including drugs or disinfectants; or production of off-flavor compounds, can affect the taste and aroma of spoiled products. Food and beverages are potential vectors for the transfer of antibiotic resistance genes, which is a growing health concern; thus, microorganisms in food and beverages should not be a potential source of drug resistance to consumers. Whole-genome sequencing (WGS) was utilized to identify antibiotic resistance genes, metabolic pathways, and elements associated with guaiacol and halophenol production. Minimum inhibitory concentration (MIC) testing revealed that all strains were susceptible to eight out of nine tested antibiotics (ampicillin, gentamycin, kanamycin, streptomycin, clindamycin, tetracycline, chloramphenicol, and vancomycin) but exhibited high resistance to erythromycin. Analysis indicated that the erythromycin resistance gene, ribosomal RNA small subunit methyltransferase A (RsmA), was intrinsic and likely acquired through horizontal gene transfer (HGT). The comprehensive genomic analysis provides insights into the molecular mechanisms of antibiotic resistance in Alicyclobacillus spp., highlighting the potential risk of these bacteria as vectors for antibiotic resistance genes in the food chain. This study expands the understanding of the genetic makeup of these spoilage bacteria and their role in antimicrobial resistance dissemination. [ABSTRACT FROM AUTHOR]

Using probiotics represents a potential solution to post-weaning diarrheal diseases in piglets on commercial farms. The gastrointestinal tract of wild boars serves as a promising reservoir of novel lactic acid bacteria with suitable probiotic characteristics. In this study, we isolated eight bacterial strains from the intestinal content of wild boars identified as representatives of the species Bifidobacterium apri, Lactobacillus amylovorus, and Ligilactobacillus salivarius. These isolates underwent in vitro analysis and characterisation to assess their biological safety and probiotic properties. Analysis of their full genome sequences revealed the absence of horizontally transferrable genes for antibiotic resistance. However, seven out of eight isolates harboured genes encoding various types of bacteriocins in their genomes, and bacteriocin production was further confirmed by mass spectrometry analysis. Most of the tested strains demonstrated the ability to inhibit the growth of selected pathogenic bacteria, produce exopolysaccharides, and stimulate the expression of interleukin-10 in porcine macrophages. These characteristics deem the isolates characterised in this study as potential candidates for use as probiotics for piglets during the post-weaning period. [ABSTRACT FROM AUTHOR]

Background: Acute Infectious Diarrhea (AID) and the short- and long-term complications associated with it are major causes of hospitalization worldwide. In Italy, due to a lack of robust surveillance programs, only limited data has been collected on their prevalence and circulation. This study aims to evaluate the resistance pattern of enteric pathogens and their epidemiological trends over a six-year period. Methods: This cross-sectional retrospective study was conducted from January 2018 to December 2023. Stool samples were analyzed during routine diagnosis with culture methods, syndromic molecular tests, and enzyme immunoassay. Results: Bacteria were the most isolated enteric pathogens (62.2%), followed by fungi (29.0%), viruses (8.2%), and parasites (0.6%). Most bacteria were isolated from outpatients (29.5%) and from patients in the Oncology ward (26.2%). The most prevalent target was EPEC (11.1%), followed by C. difficile toxin A/B-producing strains (8.3%), C. jejuni (2.5%), and S. enterica, (1%.). Norovirus and Candida spp. were the most prevalent in pediatric patients (6.5% and 39.6%, respectively). In the last years, enteric pathogens have been a frequent cause of infections characterized by a problematic resistance to common antimicrobials. In our study, S. enterica showed resistance to amikacin, gentamicin, ampicillin, levofloxacin, and ciprofloxacin. C. jejuni was susceptible to all tested drugs. Conclusion: Timely notification of gastroenteric infections is crucial in identifying potential outbreak sources and ensuring strict adherence to food safety and hygiene practices, so as to protect the most vulnerable populations. The present study offers insights into the epidemiological characteristics and the antibiotic susceptibility of the main enteric AID pathogens in order to implement infection control measures in health care settings. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) in children are among the most frequent bacterial infections they may suffer, causing a considerable degree of morbidity. The emergence of uropathogens resistant to antimicrobial agents is making treatment and management more difficult. Aims and Objectives: The aims and objectives of study are to evaluate the patterns of antimicrobial susceptibilities and resistance among common uropathogens in pediatric UTIs. Materials and Methods: This is one-year cross-sectional study at MES Medical College, Perinthalmanna, on patients undergoing laparoscopic cholecystectomy for symptomatic gallstones. Fifty-four children had a culture-confirmed UTI; their urine samples were studied. All pathogens were tested for antibiotic susceptibility using the Kirby-Bauer disk diffusion method. Results: Escherichia coli was the most common pathogen isolated, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. There was a low sensitivity for cephalexin and cefepime (12.03-26.75%), whereas piperacillin-tazobactam (100%) and amikacin had high sensitivity (88.89%). Conclusion: The present study showed high antimicrobial resistance among common uropathogens causing pediatric UTIs. Optimal treatment aims to reduce the spread of resistant strains, necessitating continued monitoring of resistance patterns and the conservative use of antibiotics. [ABSTRACT FROM AUTHOR]

The current study was conducted to determine the occurrence of Listeria species in live chicken and some chicken products (fillets, burger and luncheon). In addition, determine the antibiogram profile of Listeria strains and detection of some virulence genes of Listeria monocytogenes which recovered from the examined samples. The study included 100 samples including cloacal swabs from broiler chicken (n =25) from 5 different broiler chicken farms beside as well as chicken products (25 samples each of chicken fillets, burger and luncheon) that were randomly purchased from supermarkets. Isolation and identification of Listeria was performed according to the standard protocol provided by ISO (2017). It was recorded that the recovery rate of Listeria species from the examined samples was 24, 20, 8 and 16%, in cloacal swabs, chicken fillets, burger and luncheon, respectively with an overall incidence of 17%. In addition, biochemical identification of the recovered Listeria isolates revealed the presence of L. monocytogenes, L. innocua, L. ivanovii, L. seeligeri and L. grayi with various rates where L. monocytogenes scored the highest rate 29.4% (5 isolates). Antimicrobial susceptibility of Listeria strains (n=17) clarified that the highest antibiotic resistance was recorded when using streptomycin (82.4%) followed by Neomycin (76.5%) then Doxycycline and Cefotaxime (52.9%) while the lowest resistance was noticed when using Amikacin (11.8%) then Ciprofloxacin (35.3%). Finally, molecular detection of virulence genes in the identified L. monocytogenesstrains (n= 5) clarified the detection of iap and actA genes in the five isolates while hylA gene was detected in three isolates only. At the end, results obtained by this study emphasize a significant occurrence of resistant Listeria in chicken and chicken products including processed animal-originated foods commonly purchased by the public in including; chicken fillets, burger and luncheon. Seriously, the presence of such resistant bacteria endangers human health by making routine antibiotic courses useless in the treatment of such infections. Finally, data proved that retail foods of animal origin pose a risk to human health so it is advisable to examine chicken and chicken products routinely for presence of antibiotic resistant bacteria as well as antibiotic residues. [ABSTRACT FROM AUTHOR]

The occurrence of high levels of heavy metals in drinking water is a significant health concern due to the accompanying health concerns. Hence, the objective of this study was to evaluate the bacterial species and concentration of heavy metals in certain drinking water sources in Ikwo, Ebonyi State. Nigeria. The analysis of metal concentration revealed that the levels of lead, iron, and mercury in the water exceeded the established limits for drinking water quality set by the World Health Organisation (WHO) and Nigeria standard for drinking water quality (NSDWQ). However, the concentrations of copper, zinc, calcium, and sodium in the water were not statistically significant (P >0.05). The bacteriological count results indicated that the average Total Bacterial Count (TBC) in water samples collected from ponds, rivers, and wells were 5.10 x 10-4, 6.10 x 10-3, and 4.10 x 10-4, respectively. During the experiment, there was a notable disparity (p <0.05) in the bacterial quantities seen in all of the samples. Escherichia coli was the predominant strain, representing 70% of all isolates, as indicated by prevalence surveys. Salmonella and Klebsiella species accounted for 25% and 39% of isolates, respectively. Research on antibiotics discovered that Salmonella, Klebsiella species, and E. coli exhibited significant resistance to popular antibiotics, albeit showing some vulnerability to some ones. The presence of antibiotic resistant microbes in drinking water samples from the research region is a significant public health concern due to the high probability of contracting waterborne illnesses and the associated health hazards. This is particularly worrisome for the immune-compromised residents of the area. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has made antibiotic resistance (AMR) and healthcare-acquired infections (HAIs) increasingly serious problems. Point-prevalence Surveys (PPS) and other surveillance techniques are essential for antimicrobial management and prevention. Methods: In a hematology department of an Italian hospital, the prevalence of HAI, microbiology, and AMR were examined in this retrospective study in two different periods, namely 2019 and 2021 (pre-pandemic and during the pandemic, respectively). Comparisons were made between patient demographics, hospitalization duration, surveillance swabs, and HAIs. Findings: There was no discernible variation in the prevalence of HAI between 2019 and 2021. Higher rates of HAI were connected with longer hospital stays. Variations in antimicrobial susceptibility and species distribution were found by microbiological analysis. Discussion: The incidence of HAI stayed constant during the epidemic. Nevertheless, shifts in antibiotic susceptibility and microbiological profiles highlight the necessity of continuous monitoring and care. Conclusions: Despite the difficulties of COVID-19, ongoing surveillance and infection control initiatives are crucial for halting HAIs and battling antimicrobial resistance (AMR) in healthcare environments. To fully understand the pandemic's long-term impact on the spread of infectious diseases and antibiotic resistance, more research is required. [ABSTRACT FROM AUTHOR]

Bacillus cereus endophthalmitis is a severe vision-threatening disease. This study aimed to analyze the clinical characteristics, antibiotic susceptibility, and risk factors for poor final visual acuity (VA) and enucleation or evisceration (ENEV) outcomes of B. cereus endophthalmitis patients. We retrospectively reviewed 52 cases (52 eyes) of culture-proven B. cereus endophthalmitis at Zhongshan Ophthalmic Center from January 2013 to December 2023. The mean age of the patients was 38.1 ± 20.1 years, and males composed the majority (90.4%) of the sample size; laborers (32.7%) and farmers (19.2%) were the primary occupations of the patients. All cases were caused by ocular trauma. Forty-one of 51 eyes (80.4%) had a final VA worse than the ability to count fingers (CFs), and 15 of the 52 total eyes (28.8%) underwent ENEV. Binary logistic forward (LR) regression analysis demonstrated that red eye (odds ratio [OR], 13.13; 95% confidence interval [CI], 1.58–108.80; p = 0.017), eye pain (OR, 22.87; 95% CI, 1.00–522.72; p = 0.050), and corneal edema/ulcer (OR, 13.13; 95% CI, 1.58–108.80; p = 0.017) were significant risk factors for poor VA outcomes. Conjunctival sac purulent discharge (OR, 10.08; 95% CI, 2.11–48.12, p = 0.004) and white blood cell (WBC) count (OR, 1.35; 95% CI, 1.06–1.72, p = 0.016) were significant risk factors for ENEV outcomes. B. cereus showed susceptibility rates of 100.0% to vancomycin and ofloxacin; 98.0% to levofloxacin; 93.3% to ciprofloxacin; 87.5% to imipenem; and 78.9% to tobramycin. The susceptibility to azithromycin and clindamycin was 66.7% and 50.0%, respectively. In contrast, B. cereus was resistant to penicillin (susceptibility at 3.8%), cefuroxime (5.6%), and cefoxitin (37.1%). [ABSTRACT FROM AUTHOR]

Background: Diabetic foot osteomyelitis (DFO) commonly occurs secondary to ulcerations of the skin. Empirical antibiotic agents are a key element of treatment and their use is dependent on local knowledge of the microbial spectrum of diabetic foot infections. This study aimed to retrospectively analyze the local microbiological profile, including bacterial culture/sensitivity results of DFO, and compare findings with literature. This study also aimed to review the concordance of microbiology results with national guidelines for the future treatment of DFO. Methods: A retrospective review of clinical records was performed on patients who presented to the high-risk foot clinic, Townsville University Hospital, between 2018 and 2022. All patients older than 18 years and diagnosed with DFO were included. Our exclusion criteria included all other foot presentations, including trauma, vasculitis, and neoplasms. Results: On the basis of the inclusion and exclusion criteria, 124 patients with DFO were selected. Most patients in the cohort were males (70.2%), non-Indigenous (68.5%), aged 50-69 years (55.6%), and with elevated HbA1c levels (>8.6). Chronic kidney disease (39.5%) and ischemic heart disease (41.9%) were common comorbidities. Of the pertinent microbial results, Staphylococcus aureus (~76%) was the most commonly isolated Gram-positive organism. Gram-positive bacteria were significantly increased in the elderly population with DFO (P <.05). All methicillin-resistant S aureus isolates were vancomycin- and cotrimoxazole-sensitive. Pseudomonas aeruginosa was the predominant Gram-negative organism isolated (39.3%). P aeruginosa exhibited low sensitivity to ciprofloxacin. Conclusion: This study has enhanced our understanding of the various microbial species underlying DFO at our center and may be generalizable. Level of Evidence: Level IV, retrospective case series. [ABSTRACT FROM AUTHOR]

BackgroundStreptococcus pneumoniae is a transmitted respiratory pathogen that causes high morbidity and mortality in children, especially those under 5 years of age. During the implementation of population control measures for COVID-19 in mainland China, the Streptococcus pneumoniae detection rate in pediatric patients decreased. However, with the second wave of the COVID-19 pandemic (2022), the incidence of pneumococcal disease (PD) and even invasive pneumococcal disease (IPD) began to rise again.MethodsThis study was conducted from August 2022 to September 2023 at a national regional medical center based mainly in West China Second University Hospital, Sichuan University. The demographic and clinical characteristics of S. pneumoniae-infected pediatric patients were analyzed. All S. pneumoniae isolates were subjected to standardized clinical sample inoculation, culture, subculture, and identification procedures. Next-generation sequencing and analysis were used to determine serotypes and sequence types (STs) and evaluate antibiotic resistance- and virulence-related genes. Antimicrobial susceptibility was determined in AST dishes via the broth microdilution method.ResultsThe prevalent serotypes in the IPD patients were 14, 6A, and 23F, and the prevalent serotypes in the NIPD patients were 19F and 6A. A significant difference in the proportion of patients with serotype 14 was noted between the two groups. A total of 23 STs were identified and classified into 13 different GPSC lineages, including 4 novel STs (ST18449, ST18451, ST18464 and ST18466) and 1 novel allele (ddl1209). According to the interpretation breakpoints for non-meningitis infections, the resistance/nonsusceptibility rates of invasive isolates were as follows: penicillin (0.0%/8.3%), amoxicillin (0.0%/0.0%), cefotaxime (8.3%/16.6%), ceftriaxone (8.3%/8.3%), and cefepime (0.0%/8.3%). The resistance/nonsusceptibility rates of invasive isolates according to the meningitis breakpoints were as follows: penicillin (100.0%), cefotaxime (16.7%/33.4%), ceftriaxone (8.3%/50.0%), and cefepime (8.3%/66.7%). All the isolates were susceptible to rifampicin, levofloxacin, moxifloxacin, linezolid and vancomycin. In addition, the characteristics of the antibiotic resistance-related genes and virulence genes of serotype 19F were significantly different from those of the other serotypes.ConclusionThese data provide valuable information for understanding pediatric pneumococcal disease during the second outbreak of COVID-19 in Southwest China and will contribute to the prevention and treatment of S. pneumoniae infection.

BackgroundNeonatal sepsis is a major cause of morbidity and mortality worldwide. Understanding the bacterial profiles and antibiotic susceptibility patterns causing neonatal sepsis is crucial for guiding appropriate treatment, improving patient outcomes, and combating the emergence of antibiotic resistance. Despite its importance, data regarding neonatal sepsis in the study area is limited. Therefore, this study aimed to characterize the bacterial pathogens and identify associated factors among neonates with suspected sepsis at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.MethodsA cross-sectional study was conducted by reviewing laboratory records of neonates admitted for suspected sepsis from January 2019 to December 2021. Data were checked for completeness and encoded in a spreadsheet program. Then, data were exported to STATA version 17 for analysis. Descriptive statistics such as frequency and percentage were computed. The association between neonatal sepsis and potential risk factors was assessed using Pearson’s chi-square test. A p-value of < 0.05, was considered statistically significant.ResultsA total of 1,236 neonates were included. Of these, 96.2% (1,190/1,236) had a fever before admission. The prevalence of culture-confirmed sepsis was 25.4% (314/1,236). Bacterial pathogens accounted for 23% (284/1,236) of these isolates, with Gram-negative bacteria being more prevalent at 75.3% (214/284) than Gram-positive bacteria at 24.7% (70/284). The most frequently isolated bacterial pathogens were K. pneumoniae 38.7% (110/284) and S. aureus 13% (37/284). The isolates demonstrated a high resistance level to commonly used antibiotics, with 61.6% exhibiting multidrug resistance. K. pneumoniae showed the highest rate of multidrug resistance (90.9%). Neonatal sepsis was associated with several factors, including fever before and after admission, hypothermia, increased respiration, suspected pneumonia, and suspected meningitis.ConclusionThis study identified a high prevalence of culture-confirmed sepsis in neonates at UoGCSH, with Gram-negative bacteria, especially K. pneumoniae, dominating the isolated pathogens. The isolated bacteria exhibited alarming resistance to commonly used antibiotics, with a high proportion demonstrating multidrug resistance. Implementing effective antibiotic stewardship programs is crucial to optimize antibiotic use, reduce unnecessary prescriptions, and curb the spread of resistant strains.

We report a case of Legionnaires’ disease caused by Legionella bozemanae, which is the first time that L. bozemanae has been isolated from a bronchoalveolar lavage fluid sample from an immunocompromised patient in China. The findings highlight the susceptibility of immunocompromised patients to infections caused by the rare but highly pathogenic L. bozemanae.

Background: The adhesion of bacteria to biotic and abiotic surfaces reflects their ability to cause infectious diseases. The distinction between the ability of Pseudomonas aeruginosa bacteria to adhere to biotic and abiotic surfaces is not clear in the literature. Objectives: The current study aims to shed light on the extent of similarities and differences between P. aeruginosa in terms of their ability to adhere to different biotic and abiotic surfaces. Materials and Methods: ten isolates of P. aeruginosa were isolated from 100 wound and burn swabs. The isolates were identified using biochemical and phenotypic tests in addition to VITIK-II technology. The susceptibility to antibiotics was estimated using the disc diffusion method. The microtiter-spectrophotometric was used to measure the biofilm formation on polystyrene microtiter plates. The Human oral mucosal epithelial (OMECs) were used to evaluate the adhesion of P. aeruginosa isolates. Plate count and direct bacterial count were used to count the adhered bacteria to human OMECs in vitro. Results: Norfloxacin showed the highest antibacterial effect while the lowest antibacterial effect was seen in the case of using when Amoxicillin and Cefixime (all isolates were resistant). All isolates from, Pa2 form the highest biofilm followed by Pa6, while the lowest biofilm formation was seen in the case of Pa4. While Pa 6 showed the highest ability to attach to human OMECs followed by Pa2. Conclusion: It can be concluded that P. aeruginosa isolates are resistant to most antibiotics and that their ability to adhere and biofilm formation depends on the type of surface.

Urinary tract infection (UTI) is considered as one of the highly prevalent infections worldwide. Regarding its prevalence, UTI is more common in women. The outcome of the research is expected to predict the severity of the urinary tract infection. The study of prevalence and antibiotic susceptibility helps to provide data on the occurrence of uropathogens in different age groups and helps to treat the infection with effective antibiotics to prevent further progression of infection. The study has been carried out to identify and investigate the prevalence of uropathogens and to determine their antibiotic susceptibility potential. Overall, 713 urine samples were collected, MacConkey agar, Blood agar, CLED agar and Luria-Bertani agar were used for isolation of uropathogens by calibrated loop streak method and incubated at 37°C. Antibiotic susceptibility was carried out using the Kirby Disc diffusion method. A total of 665 showed positive bacteriuria. E. coli (37.3%) and K. pneumoniae (32.03%) were the most common uropathogens followed by E. fergusonii (17.9%), P. aeruginosa (8.4%), and A. baumannii (4.4%). The study found that above 70% of antibiotic susceptibility was observed in fluoroquinolones followed by imipenem, while all isolates showed high resistance to ampicillin. The organisms E. coli, E. fergusonii, and P. aeruginosa exhibited the least susceptibility (>50%) for third-generation cephalosporins. P. aeruginosa and A. baumannii showed no susceptibility to nitrofurantoin, whereas other isolates were least susceptible. The study concludes that K. pneumoniae and E. coli were highly prevalent within the study group and that fluoroquinolone and imipenem can be effective for treatment.

Abstract Background Staphylococcus aureus can colonize and infect a variety of animal species. In dairy herds, it is one of the leading causes of mastitis cases. The objective of this study was to characterize the S. aureus isolates recovered from nasal swabs of 249 healthy cows and 21 breeders of 21 dairy farms located in two provinces of Algeria (Tizi Ouzou and Bouira). Methods The detection of enterotoxin genes was investigated by multiplex PCRs. Resistance of recovered isolates to 8 antimicrobial agents was determined by disc-diffusion method. The slime production and biofilm formation of S. aureus isolates were assessed using congo-red agar (CRA) and microtiter-plate assay. Molecular characterization of selected isolates was carried out by spa-typing and Multi-Locus-Sequence-Typing (MLST). Results S. aureus was detected in 30/249 (12%) and 6/13 (28.6%) of nasal swabs in cows and breeders, respectively, and a total of 72 isolates were recovered from positive samples (59 isolates from cows and 13 from breeders). Twenty-six of these isolates (36.1%) harbored genes encoding for staphylococcal enterotoxins, including 17/59 (28.8%) isolates from cows and 9/13 (69.2%) from breeders. Moreover, 49.1% and 92.3% of isolates from cows and breeders, respectively, showed penicillin resistance. All isolates were considered as methicillin-susceptible (MSSA). Forty-five (76.3%) of the isolates from cows were slime producers and 52 (88.1%) of them had the ability to form biofilm in microtiter plates. Evidence of a possible zoonotic transmission was observed in two farms, since S. aureus isolates recovered in these farms from cows and breeders belonged to the same clonal lineage (CC15-ST15-t084 or CC30-ST34-t2228). Conclusions Although healthy cows in this study did not harbor methicillin-resistant S. aureus isolates, the nares of healthy cows could be a reservoir of enterotoxigenic and biofilm producing isolates which could have implications in human and animal health.

The availability of high concentration of sugar in the blood of diabetic patients makes them more susceptible to developing bacterial infections which are asymptomatic commonly referred to as asymptomatic bacteriuria (ASB) than the non-diabetic patients. Diabetes patients with ASB have a much higher risk of developing diabetic complications than individuals without ASB. There is a paucity of data on the burden of ASB and antimicrobial susceptibility in diabetes patients in Uganda. Between March and May 2023, a cross-sectional study was carried out at the Fort Portal Regional Referral Hospital, Uganda outpatient diabetic clinic and 160 diabetes patients were recruited for the study. Mid-stream urine was taken for culture and sensitivity. Data analysis were performed using IBM SPSS version 20. A pie chart was used to display the prevalence and antimicrobial susceptibility patterns of common uropathogens described in frequency and percentages. The overall prevalence of ASB among the study participants was 11%. The most common uropathogen isolated was Escherichia coli, followed by Klebsiella and S. aureus. The most sensitive drug in all the isolates was Nitrofrantoin and resistant drug was Ampicillin. In conclusion, routine testing for ASB and treatment should be according to the antimicrobial susceptibility of diabetic patients.

Tsung-Lung Lu,1 Chienhsiu Huang2 1Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin Town, Chiayi County, Taiwan; 2Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin Town, Chiayi County, TaiwanCorrespondence: Chienhsiu Huang, Department of Internal medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin Town, Chiayi County, Taiwan, Email hgssport@yahoo.com.twBackground: In recent years, Delftia acidovorans has gained attention for its rare occurrence in patient infections. The literature consists mostly of case reports, necessitating further research to comprehensively understand risk factors, clinical characteristics, and management strategies.Methods: We conducted a retrospective cohort study involving patients diagnosed with Delftia acidovorans infection at a tertiary teaching hospital between January 2014 and December 2022. The data included demographic details, comorbidities, bacterial cultures, antibiotic susceptibility, and treatment outcomes.Results: There were 26 patients diagnosed with Delftia acidovorans infection who were predominantly older with multiple comorbidities. Approximately 76.9% of Delftia acidovorans infection patients had polymicrobial infections. Twenty-one patients had received antibiotics within three months before they developed the Delftia acidovorans infection, and these antibiotics were primarily third-generation cephalosporins, glycopeptides and fluoroquinolones. Antibiotic susceptibility testing showed resistance to aminoglycosides and susceptibility to imipenem, meropenem, ceftazidime, and piperacillin/tazobactam. Treatment outcome showed a mortality rate of 11.5%, mainly in patients with malignancy and advanced age.Conclusion: Delftia acidovorans infections predominantly affect older patients with multiple comorbidities. In terms of antibiotic therapy, carbapenems, cephalosporins, and piperacillin/tazobactam with antipseudomonal activity could all be considered.Keywords: Delftia acidovorans, antibiotic susceptibility, mortality rate

Low-dose ionizing radiation can trigger a phenomenon known as hormesis in microorganisms, in which exposure to mild stressors like radiation results in beneficial adaptive responses. This study investigated the impact of low-dose X-rays on Escherichia coli's viability and their potential influence on antibiotic susceptibility. The irradiated samples displayed increased bacterial viability compared to non-irradiated controls, with a significant increase observed at 5 and 10 mGy of X-ray radiation exposure. This suggests a stimulating effect of low-dose ionizing radiation on E. coli's viability. To explore the correlation between viability and antibiotic susceptibility, we assessed the inhibition zone diameters for various antibiotics in non-irradiated and irradiated samples. The obtained results showed that the exposure of bacteria to low-dose ionizing radiation resulted in a significant reduction in the inhibition zone diameters for marbofloxacin, amoxicillin/clavulanic acid, ceftiofur, and cefoxitin. These findings suggest that low-dose X-ray radiation exposure can enhance E. coli's viability and its ability to withstand antibiotics, raising potential concerns.

ABSTRACT Background: Urinary Tract Infections (UTIs) are one of the most commonly occurring infections in medical practice despite the widespread availability of antibiotics. The emergence of antimicrobial resistance in uropathogens may lead to poor treatment outcomes in individuals with UTIs. The knowledge of the microorganism involves and antibiograms are important for the empirical treatment of UTIs. Aims and Objectives: This study was undertaken to evaluate the bacteriological profile of UTI patients and to know their antimicrobial susceptibility pattern. Material and Methods: A cross-sectional study was carried out over 6 months (from July 2021 to December 2021) with a focus on the identification of bacterial pathogens causing UTI and the evaluation of their antibiogram. Mid-stream urine samples were collected from a total of 2825 subjects with clinically suspected acute UTI. Urine samples were aseptically collected in sterile containers and inoculated aseptically on to Hi-Chrome UTI agar. Isolation and identification of the bacterial strains were performed using standard microbiological protocols. Antibiotic susceptibility was carried out following CLSI recommended guidelines. Only culture proven cases, were included in this study. Results: A total of 2825 urine samples were processed for urine culture and sensitivity out of which 804 samples were found to be positive for bacterial infection (amounting to 28.46% positivity). Gram -negative bacteria accounted for 58.5 % (471/804) and Gram -positive 33% (267/804) of the positive results. Among Gram -negative isolates, E. coli(33.8%) and K. pneumoniae (10.8%) were the most prevalent microorganisms while as Enterococcus sp (26.3%) was the most common Gram -positive organism isolated followed by Staphylococcus aureus. Gram negative bacteria on the whole showed a high degree of resistance to cephalosporins and quinolones while as nitrofurantoin was the most effective antibiotic against E. coli and K. pneumoniae. In case of Gram-positive bacteria linezolid and vancomycin were the most effective antibiotics. Conclusion: The results of this study revealed a great concern for emerging UTI‑related multidrug‑resistant strains of bacteria causing UTI. The need of the hour is continuous monitoring of susceptibility patterns of specific pathogens to commonly used antimicrobial agents before initiation of antibiotic therapy.

Background and Aim: Milk, a nutritious food, is widely consumed in human diets; however, contamination by micro-organisms can negatively impact its quality and consumer health. Contamination by micro-organisms affects the quality of milk, which can affect the quality of the milk production chain. This study aimed to determine the changes in milk composition and antibiotic susceptibility related to bacteria isolated from dairy cow milk. Materials and Methods: Raw milk samples were collected from 72 dairy cows. All milk samples were subjected to the California Mastitis Test (CMT) for CMT score determination. We also investigated milk composition, bacterial culture (BC), and antibiotic susceptibility. Results: About 47.22% and 30.56% of dairy cattle were positive for CMT + BC and automatic somatic cell count (ASCC) + BC, respectively. Fecal appearance and animal age were found to be risk factors for ASCC + BC positivity in dairy cattle. Bacteria were found in approximately 76% of milk samples, with the most common isolated species being α-hemolytic Streptococcus spp., coagulase-negative Staphylococcus spp., and Escherichia coli. Of these, 70% are resistant to at least one antibiotic. Variation in the multidrug resistance pattern was high in Klebsiella spp. Conclusion: Fecal appearance and animal age are risk factors for ASCC + BC positivity in dairy cattle. This study identified antibiotic and multidrug resistance patterns, which require comprehensive studies and effective surveillance systems. Remarkably, the use of antibiotic therapy in dairy cattle should be monitored.

Background: Staphylococcus aureus can colonize and infect a variety of animal species. In dairy herds, it is one of the leading causes of mastitis cases. The objective of this study was to characterize the S. aureus isolates recovered from nasal swabs of 249 healthy cows and 21 breeders of 21 dairy farms located in two provinces of Algeria (Tizi Ouzou and Bouira). Methods: The detection of enterotoxin genes was investigated by multiplex PCRs. Resistance of recovered isolates to 8 antimicrobial agents was determined by disc-diffusion method. The slime production and biofilm formation of S. aureus isolates were assessed using congo-red agar (CRA) and microtiter-plate assay. Molecular characterization of selected isolates was carried out by spa-typing and Multi-Locus-Sequence-Typing (MLST). Results: S. aureus was detected in 30/249 (12%) and 6/13 (28.6%) of nasal swabs in cows and breeders, respectively, and a total of 72 isolates were recovered from positive samples (59 isolates from cows and 13 from breeders). Twenty-six of these isolates (36.1%) harbored genes encoding for staphylococcal enterotoxins, including 17/59 (28.8%) isolates from cows and 9/13 (69.2%) from breeders. Moreover, 49.1% and 92.3% of isolates from cows and breeders, respectively, showed penicillin resistance. All isolates were considered as methicillin-susceptible (MSSA). Forty-five (76.3%) of the isolates from cows were slime producers and 52 (88.1%) of them had the ability to form biofilm in microtiter plates. Evidence of a possible zoonotic transmission was observed in two farms, since S. aureus isolates recovered in these farms from cows and breeders belonged to the same clonal lineage (CC15-ST15-t084 or CC30-ST34-t2228). Conclusions: Although healthy cows in this study did not harbor methicillin-resistant S. aureus isolates, the nares of healthy cows could be a reservoir of enterotoxigenic and biofilm producing isolates which could have implications in human and animal health. [ABSTRACT FROM AUTHOR]

Objective: Determination of clinical features and antibiotic susceptibility of microorganisms rarely grown in lower respiratory tract (LRT) cultures of patients hospitalized in respiratory intensive care unit Material and Method: Demographic characteristics, underlying diseases and risk factors, APHACHE-II scores, culture results and antibiotic resistance patterns, mortality status of 42 patients in whom rare microorganisms were detected as infectious agents in the LRT samples who were followed up and treated as inpatients in the respiratory intensive care unit between January 2019 and April 2023 were evaluated retrospectively. Results: 42 patients, 30 males and 12 females, whose rare microorganisms were detected as the infectious agent in LRT samples, were included in the study. The average age was 73.7±10.9 years. The most common comorbidities in the patients were hypertension, chronic obstructive pulmonary disease (COPD), and heart failure. The most common rare pathogenic microorganisms were burkholderia cepaci (n=8), Stenotrophomonas maltophilia (n=6), proteus mirabilis (n=5), and entobacter aerogenes (n=5). The most common risk factors were urinary catheterization and the usage of antibiotics before the growth of rare pathogenic microorganisms. While 22 of the patients survived during their stay in intensive care, 20 of them died. The day when the first reproduction was detected in LRT samples (p=0.012) and APHACHE-II scores in the surviving group were significantly lower than those in the surviving group (p=0.012). Conclusion: We think that the determination of antibiotic resistance patterns against microorganisms that rarely reproduce in intensive care units, such as microorganisms that reproduce frequently, will contribute to the use of antibiotics in our country and in our intensive care units. [ABSTRACT FROM AUTHOR]

Filamentous bacteriophages belonging to the order Tubulavirales, family Inoviridae, significantly affect the properties of Gram-negative bacteria, but filamentous phages of many important pathogens have not been described so far. The aim of this study was to examine A. baumannii filamentous phages for the first time and to determine their effect on bacterial virulence. The filamentous phages were detected in 15.3% of A. baumannii strains as individual prophages in the genome or as tandem repeats, and a slightly higher percentage was detected in the culture collection (23.8%). The phylogenetic analyses revealed 12 new genera within the Inoviridae family. Bacteriophages that were selected and isolated showed structural and genomic characteristics of the family and were unable to form plaques. Upon host infection, these phages did not significantly affect bacterial twitching motility and capsule production but significantly affected growth kinetics, reduced biofilm formation, and increased antibiotic sensitivity. One of the possible mechanisms of reduced resistance to antibiotics is the observed decreased expression of efflux pumps after infection with filamentous phages. [ABSTRACT FROM AUTHOR]

Urinary tract infection (UTI) is considered as one of the highly prevalent infections worldwide. Regarding its prevalence, UTI is more common in women. The outcome of the research is expected to predict the severity of the urinary tract infection. The study of prevalence and antibiotic susceptibility helps to provide data on the occurrence of uropathogens in different age groups and helps to treat the infection with effective antibiotics to prevent further progression of infection. The study has been carried out to identify and investigate the prevalence of uropathogens and to determine their antibiotic susceptibility potential. Overall, 713 urine samples were collected, MacConkey agar, Blood agar, CLED agar and LuriaBertani agar were used for isolation of uropathogens by calibrated loop streak method and incubated at 37°C. Antibiotic susceptibility was carried out using the Kirby Disc diffusion method. A total of 665 showed positive bacteriuria. E. coli (37.3%) and K. pneumoniae (32.03%) were the most common uropathogens followed by E. fergusonii (17.9%), P. aeruginosa (8.4%), and A. baumannii (4.4%). The study found that above 70% of antibiotic susceptibility was observed in fluoroquinolones followed by imipenem, while all isolates showed high resistance to ampicillin. The organisms E. coli, E. fergusonii, and P. aeruginosa exhibited the least susceptibility (>50%) for third-generation cephalosporins. P. aeruginosa and A. baumannii showed no susceptibility to nitrofurantoin, whereas other isolates were least susceptible. The study concludes that K. pneumoniae and E. coli were highly prevalent within the study group and that fluoroquinolone and imipenem can be effective for treatment. [ABSTRACT FROM AUTHOR]

Acinetobacter spp. are often isolated from natural sources, but knowledge about their presence in wild animals is fragmented and uncomplete. The present study aimed to characterize a series of Acinetobacter radioresistens isolated from Humboldt penguins (Spheniscus humboldti). Fifteen Humboldt penguins from an inhabited northern Peruvian island were sampled. Microorganisms were identified by MALDI-TOF MS. Antibiotic susceptibility to 12 antimicrobial agents was established, and clonal relationships were determined. A representative isolate was selected for whole genome sequencing (WGS). A. radioresistens were isolated from the feces of 12 (80%) Humboldt penguins, being susceptible to all the antimicrobial agents tested, except eight cefotaxime-intermediate isolates. All A. radioresistens were clonally related. WGS showed that the isolate belonged to ST1972, the presence of two chromosomal encoded carbapenemases (bla OXA-23 and a putative subclass B3 metallo-β-lactamase), and a series of point mutations in antibiotic-resistance related chromosomal genes, which were considered as polymorphisms. In addition, a few virulence factors, including a capsule-encoding operon, superoxide dismutases, catalases, phospholipases and a siderophore receptor were identified. The present results suggest that A. radioresistens may be a common member of the gut microbiota of Humboldt penguins, but further studies in other geographical areas are needed to establish this finding. [ABSTRACT FROM AUTHOR]

The occurrence of antibiotic-resistant bacteria in foodstuff involves a human health risk. Edible insects are a precious resource; however, their consumption raises food safety issues. In this study, the occurrence of antibiotic resistant bacteria in laboratory-reared fresh mealworm larvae (Tenebrio molitor L.) and frass was assessed. Antibiotics were not used during the rearing. Enterobacteriaceae and enterococci were isolated from 17 larvae and eight frass samples. In total, 62 and 69 isolates presumed to belong to Enterobacteriaceae and Enterococcus spp., respectively, were obtained and tested for antibiotic susceptibility via disk diffusion. Based on the results, isolates were grouped, and representative resistant isolates were identified at species level through 16S rRNA gene sequencing. For enterococci resistance, percentages higher than 15% were observed for vancomycin and quinupristin–dalfopristin, whereas Enterobacteriaceae resistance higher than 25% was found against cefoxitin, ampicillin, and amoxicillin–clavulanic acid. Based on the species identification, the observed resistances seemed to be intrinsic both for enterococci and Enterobacteriaceae, except for some β-lactams resistance in Shigella boydii (cefoxitin and aztreonam). These could be due to transferable genetic elements. This study suggests the need for further investigations to clarify the role of edible insects in the spreading of antibiotic resistance determinants through the food chain. [ABSTRACT FROM AUTHOR]

Proteus mirabilis, a urease-producing bacterium, is a frequent culprit in urinary tract infections (UTIs). Most Gram-negative bacteria are characterized by their ability to produce biofilms outside their bodies, which usually adhere to solid surfaces. Biofilm formation is a significant concern in UTIs as it can hinder the efficacy of antibiotic treatment. The connection between antibiotic susceptibility and biofilm development was examined in this study in P. mirabilis isolates from UTI patients to identify the profiles of antibiotic susceptibility of P. mirabilis, assess biofilm formation ability among these isolates, and explore potential links between antibiotic resistance and biofilm production. The urine samples of 300 UTI patients from August to November 2023 were taken in Hilla city, Iraq. P. mirabilis isolates were identified and subjected to disc diffusion testing for antibiotic susceptibility and microtiter plate assays for biofilm formation. The results showed that all 67 P. mirabilis isolates harbored the urease gene and exhibited the highest resistance rates to trimethoprim (43.28%), chloramphenicol (31.34%), vancomycin (41.79%), and nitrofurantoin (29.85%), while all isolates were imipenem susceptible. Resistance to other antibiotics ranged from 2.9% to 13.43%. Importantly, 21 (31.34%) isolates were multidrug-resistant (MDR). All isolates formed biofilms with 23 (34.3%) demonstrating strong biofilm production, significantly associated with MDR isolates. This study revealed a substantial proportion of P. mirabilis isolates from UTI patients displaying the development of biofilms and carrying antibiotic resistance, especially among MDR isolates. These findings underscored the crucial need for continuous antibiotic resistance surveillance and novel strategies for preventing and treating UTIs caused by P. mirabilis. [ABSTRACT FROM AUTHOR]