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In Pakistan, Urinary tract infections (UTI) are increasing day by day. The study therefore was designed for isolation identification and antibiotic resistance assessment of UTI causing bacteria. Bacterial pathogens causing UTI in dogs and human are becoming more resistant to antibiotic use. To evaluate the diversity and antibiotic resistance of uropathogenic bacteria, a total of 80 urine samples were collected in sterile containers. A total of 15 urine samples were taken from each gender of human and dogs with UTIs and 5 from each gender of healthy human and dogs. Samples were cultured for isolation and confirmed by biochemical tests and their antibiotic resistance pattern was checked by Kirby baur disk diffusion test. Samples that were taken from UTI males, E.coli, Proteus spp., Klebsiella spp. and Staph aureus was isolated from 93%, 6.67%,20% and 53% processed samples whereas from UTI females E.coli, Proteus spp., klebsiella spp., and Staph aureus was isolated 100%,13%,33%and 40% of samples respectively. Similarly 60% Staph aureus was isolated from healthy males and females urine samples. While Samples that were taken from UTI dogs E.coli., Proteus spp., Klebsiella spp., and Staph aureus was isolated from 66.7%, 6.67%, 33% and 26.6% of processed samples whereas Samples that were taken from bitches, E.coli., Proteus spp., klebsiella spp., and Staph aureus was isolated from 73%,13%,26.6% and 26.6% of samples respectively. In case of healthy dogs and bitches urine smalpes 60% and 80% of Staph aureus was isolated. Antibiotic resistance pattern of isolates E.coli, Proteus spp., klebsiella spp. and Staph aureus from human (male and female) samples showed resistance to ceftriaxone, Levofloxecine, and mild type of resistance to ofloxacin while sensitive to ciprofloxacin and sulfamethazole.The antibiotic resistance pattern of isolates E.coli, Proteus spp., Klebsiella spp. and Staph aureus from dogs and bitches samples showed high resistance to Lincomycin and kanamycin, and lower resistance to norfloxacin and doxycyclin while sensitive to ciprofloxacin, amoxaclin.

Abstract Background The emergence and spread of β-lactamase-producing Klebsiella spp. has been associated with a substantial healthcare burden resulting in therapeutic failures. We sought to describe the proportion of phenotypic resistance to commonly used antibiotics, characterize β-lactamase genes among isolates with antimicrobial resistance (AMR), and assess the correlates of phenotypic AMR in Klebsiella spp. isolated from stool or rectal swab samples collected from children being discharged from hospital. Methods We conducted a cross-sectional study involving 245 children aged 1–59 months who were being discharged from hospitals in western Kenya between June 2016 and November 2019. Whole stool or rectal swab samples were collected and Klebsiella spp. isolated by standard microbiological culture. β-lactamase genes were detected by PCR whilst phenotypic antimicrobial susceptibility was determined using the disc diffusion technique following standard microbiology protocols. Descriptive analyses were used to characterize phenotypic AMR and carriage of β-lactamase-producing genes. The modified Poisson regression models were used to assess correlates of phenotypic beta-lactam resistance. Results The prevalence of β-lactamase carriage among Klebsiella spp. isolates at hospital discharge was 62.9% (154/245). Antibiotic use during hospitalization (adjusted prevalence ratio [aPR] = 4.51; 95%CI: 1.79–11.4, p

Background: The emergence and spread of β-lactamase-producing Klebsiella spp. has been associated with a substantial healthcare burden resulting in therapeutic failures. We sought to describe the proportion of phenotypic resistance to commonly used antibiotics, characterize β-lactamase genes among isolates with antimicrobial resistance (AMR), and assess the correlates of phenotypic AMR in Klebsiella spp. isolated from stool or rectal swab samples collected from children being discharged from hospital. Methods: We conducted a cross-sectional study involving 245 children aged 1–59 months who were being discharged from hospitals in western Kenya between June 2016 and November 2019. Whole stool or rectal swab samples were collected and Klebsiella spp. isolated by standard microbiological culture. β-lactamase genes were detected by PCR whilst phenotypic antimicrobial susceptibility was determined using the disc diffusion technique following standard microbiology protocols. Descriptive analyses were used to characterize phenotypic AMR and carriage of β-lactamase-producing genes. The modified Poisson regression models were used to assess correlates of phenotypic beta-lactam resistance. Results: The prevalence of β-lactamase carriage among Klebsiella spp. isolates at hospital discharge was 62.9% (154/245). Antibiotic use during hospitalization (adjusted prevalence ratio [aPR] = 4.51; 95%CI: 1.79–11.4, p < 0.001), longer duration of hospitalization (aPR = 1.42; 95%CI: 1.14–1.77, p < 0.002), and access to treated water (aPR = 1.38; 95%CI: 1.12–1.71, p < 0.003), were significant predictors of phenotypically determined β-lactamase. All the 154 β-lactamase-producing Klebsiella spp. isolates had at least one genetic marker of β-lactam/third-generation cephalosporin resistance. The most prevalent genes were blaCTX-M 142/154 (92.2%,) and blaSHV 142/154 (92.2%,) followed by blaTEM 88/154 (57.1%,) and blaOXA 48/154 (31.2%,) respectively. Conclusion: Carriage of β-lactamase producing Klebsiella spp. in stool is common among children discharged from hospital in western Kenya and is associated with longer duration of hospitalization, antibiotic use, and access to treated water. The findings emphasize the need for continued monitoring of antimicrobial susceptibility patterns to inform the development and implementation of appropriate treatment guidelines. In addition, we recommend measures beyond antimicrobial stewardship and infection control within hospitals, improved sanitation, and access to safe drinking water to mitigate the spread of β-lactamase-producing Klebsiella pathogens in these and similar settings. [ABSTRACT FROM AUTHOR]

Klebsiella species is a bacterial organism responsible for serious infections in both animals and people. This study try to spot highlights on the predominance of Klebsiella species among camels as well as screening of some virulence genes. For this purpose, 345 camel samples were taken, including 160 nasal swabs from camels with respiratory distress, off-feeding, or fever., severe nasal discharge, and depression, as well as organ samples (lung (90), trachea (40), intestine (30), and liver (25), were collected from east coast and west coast border in Egypt. The results reported that Klebsiella species was isolated with 36.8% (127/345). By PCR iutA, fimH, and traT genes were detected in all strains with 100% and mrkA gene with 85 %. In conclusion, Klebsiella species is an important circulating pathogen among camel populations and carried several virulence genes that have a critical role in their pathogenicity and strict control measures should be applied to prevent serious infections and complications. [ABSTRACT FROM AUTHOR]

Abstract Background The increasing spread of fluoroquinolone resistant enteric bacteria is a global public health concern. Children recently discharged from the hospital are at high risk of carriage of antimicrobial resistance (AMR) due to frequent exposure to antimicrobials during inpatient stays. This study aimed to determine the prevalence, correlates of ciprofloxacin (CIP) non-susceptibility, and distribution of plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli (E. coli) and Klebsiella spp isolated from children under five years being discharged from two Kenyan Hospitals. Methods E. coli and Klebsiella spp were isolated from fecal samples from children discharged from hospital and subjected to antimicrobial susceptibility testing (AST) by disc diffusion and E-test. CIP non-susceptible isolates were screened for seven PMQR genes using multiplex polymerase chain reaction (PCR). Poisson regression was used to determine the association between the carriage of CIP non-susceptible isolates and patient characteristics. Results Of the 280 CIP non-susceptible isolates: 188 E. coli and 92 Klebsiella spp isolates identified among 266 discharged children, 195 (68%) were CIP-non-susceptible with minimum inhibitory concentrations (MICs) of ≥ 1 µg/mL. Among these 195 isolates, 130 (67%) had high-level CIP MIC = ≥ 32 µg/mL). Over 80% of the isolates had at least one PMQR gene identified: aac(6’)lb-cr (60%), qnrB (24%), oqxAB (22%), qnrS (16%), and qepA (6%), however, qnrA was not identified in any isolates tested. Co-carriage of qnrB with acc(6’)-lb-cr was the most predominant accounting for 20% of all the isolates. Ceftriaxone use during hospital admission and the presence of extended spectrum beta-lactamase (ESBL) production were significantly associated with the carriage of CIP non-susceptible E. coli and Klebsiella spp. Conclusion CIP non-susceptibility is common among E. coli and Klebsiella spp isolated from hospital discharged children in Kenya. Carriage and co-carriage of PMQR, including the newly identified qepA gene, were frequently observed. These findings suggest that children leaving the hospital may serve as an important reservoir for transmission of resistant E. coli and Klebsiella spp to the community. Enhanced surveillance for AMR determinants is critical to inform interventions to control antimicrobial-resistant bacteria.

Background and Aim: Antimicrobial resistance (AMR) is a serious global threat and the World Health Organization (WHO) declared AMR is one of 10 public health threatsfacing humanity. An increase in Carbapenem resistance is the major problem that hinders patient treatment. Various genes are responsible for carbapenem resistance but the gene bla-NDM can inactivate various carbapenem antibiotics namely meropenem and imipenem etc. Therefore, this study aimed to observe the prevalence of the bla-NDM gene in the carbapenem-resistant Klebsiella spp. isolates. Materials and Methods: The isolates of multidrug-resistant Klebsiella spp. were collected from the central diagnostic laboratory, Sree Balaji Medical College and Hospital, India after obtaining ethical clearance. The isolates were screened for carbapenem resistance using the Rapidec Carba NP method. The presence of bla-NDM was confirmed using the conventional PCR technique. Results & Conclusion: Most of the isolates showed resistance to ampicillin, gentamycin, cefazolin, imipenem, and meropenem. 45% of the isolates of K. pneumonia showed resistance to the carbapenem group of antibiotics and 20% of the K. oxytoca showed carbapenem resistance. Among the carbapenem-resistant 23.75% of K. pneumonia showed the presence of the bla-NDM gene and 6.6% of K. oxytoca showed the presence of the bla-NDM gene. Continuous increase in carbapenem drug-resistant organisms is worrisome and the judicious usage of antibiotics should be practiced. [ABSTRACT FROM AUTHOR]

ABSTRACT: Objectives: This study aimed to characterize Gram negative bacteria carrying blaGES carbapenemase genes detected in wastewater from a hospital with no history of detection of clinical isolates producing GES carbapenemases. Methods: Six hospital effluent samples were screened for carbapenemase-producing organisms (CPO) using CHROMagar mSuperCARBA and MacConkey agar with 1 µg/mL imipenem. Polymerase chain reaction (PCR) amplification and sequencing of carbapenemase genes, multilocus sequence typing, antimicrobial susceptibility testing, and whole-genome sequencing were performed. Results: Among 21 CPO isolates, 11 Klebsiella spp. and 5 Enterobacter kobei isolates carried blaGES-24, and 4 E. roggenkampii and 1 Pseudomonas aeruginosa isolates carried blaGES-5. Genomic analysis of 8 representative isolates comprising 6 blaGES-24-positive and 2 blaGES-5-positive revealed that class 3 integrons with complete or defective Tn402-like transposition modules were predominantly associated with two tandem copies of blaGES-24. Furthermore, a total of 5 new class 3 integrons, In3-18 to In3-22, were identified among 5 blaGES-24 and 1 blaGES-5 plasmids. One strain each of K. pneumoniae subsp. pneumoniae and K. quasipneumoniae subsp. similipneumoniae harboring blaGES-24 plasmids also carried a rare blaVEB-1-positive class 1 integron on a non-typeable plasmid, where these blaVEB-1 plasmids had high sequence similarity. Virulence gene profiles differed between Klebsiella spp. and Enterobacter spp.; the former harbored type III fimbriae cluster, salmochelin, and T6SS type i2 gene clusters, while the latter had curli pili operon, aerobactin, T2SS gene clusters, and T6SS type i3 gene clusters. Conclusion: Our findings confirmed the linkage of blaGES-24 with rare Tn402-like class 3 integrons and the structural diversity of their gene cassette arrays.

Background: The increasing spread of fluoroquinolone resistant enteric bacteria is a global public health concern. Children recently discharged from the hospital are at high risk of carriage of antimicrobial resistance (AMR) due to frequent exposure to antimicrobials during inpatient stays. This study aimed to determine the prevalence, correlates of ciprofloxacin (CIP) non-susceptibility, and distribution of plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli (E. coli) and Klebsiella spp isolated from children under five years being discharged from two Kenyan Hospitals. Methods: E. coli and Klebsiella spp were isolated from fecal samples from children discharged from hospital and subjected to antimicrobial susceptibility testing (AST) by disc diffusion and E-test. CIP non-susceptible isolates were screened for seven PMQR genes using multiplex polymerase chain reaction (PCR). Poisson regression was used to determine the association between the carriage of CIP non-susceptible isolates and patient characteristics. Results: Of the 280 CIP non-susceptible isolates: 188 E. coli and 92 Klebsiella spp isolates identified among 266 discharged children, 195 (68%) were CIP-non-susceptible with minimum inhibitory concentrations (MICs) of ≥ 1 µg/mL. Among these 195 isolates, 130 (67%) had high-level CIP MIC = ≥ 32 µg/mL). Over 80% of the isolates had at least one PMQR gene identified: aac(6')lb-cr (60%), qnrB (24%), oqxAB (22%), qnrS (16%), and qepA (6%), however, qnrA was not identified in any isolates tested. Co-carriage of qnrB with acc(6')-lb-cr was the most predominant accounting for 20% of all the isolates. Ceftriaxone use during hospital admission and the presence of extended spectrum beta-lactamase (ESBL) production were significantly associated with the carriage of CIP non-susceptible E. coli and Klebsiella spp. Conclusion: CIP non-susceptibility is common among E. coli and Klebsiella spp isolated from hospital discharged children in Kenya. Carriage and co-carriage of PMQR, including the newly identified qepA gene, were frequently observed. These findings suggest that children leaving the hospital may serve as an important reservoir for transmission of resistant E. coli and Klebsiella spp to the community. Enhanced surveillance for AMR determinants is critical to inform interventions to control antimicrobial-resistant bacteria. [ABSTRACT FROM AUTHOR]

Objectives: We studied the profile of bloodstream infections (BSI) in the pediatric intensive care unit (PICU) and identified predictors of mortality. Methods: The study collected data from hospital records for children younger than 18-years who developed BSI during their PICU stay between 2014 and 2019. Results: In 114 patients, 136 PICU-acquired BSIs with 152 pathogens were documented. The incidence of BSI was 47.12/1000 PICU admissions and 7.95/1000 PICU hospital days. Gram-negative rods accounted for 75% of isolates, Gram-positive cocci accounted for 21.7% of isolates, and fungi accounted for 3.3% of isolated pathogens. ICU mortality was observed in 25 (21.9%) patients with a BSI compared to 94 (3.1%) patients without a BSI (P<0.001). Hemodynamic instability (P=0.014, OR 4.10, 95%CI 1.33–12.66), higher blood urea nitrogen (BUN) (P=0.044), and lower albumin levels (P=0.029) were associated with increased risk of ICU mortality. Conclusion: BSI in the PICU is associated with increased mortality. Early identification and management of risk factors independently associated with poor clinical outcomes in these patients should be aimed to ensure improved survival. [ABSTRACT FROM AUTHOR]

Background and aim Wound infection constitutes a major barrier to healing and can have a harmful effect on the patient's quality of life and also on the healing rate of the wound. The widespread use of antibiotics, along with their extensive history of availability, has resulted in significant issues with resistant organisms contributing to morbidity and mortality. The study was conducted to determine the prevalence of bacterial species obtained from the wound sample and its antibiotic resistance pattern. Materials and methods The cross-sectional observational study was conducted from November 2022 to November 2023 in a tertiary care hospital in Karad. 100 clinical samples of wound swabs and pus were studied. The isolates from these clinical samples were further processed as per the standard prescribed for the identification and antimicrobial susceptibility testing. Results  Out of 100 isolates, 75 were gram-negative and 25 gram-positive. Among the gram-negative isolates, the predominantly isolated organism was  Klebsiella  spp. 20(26.66%), and gram-positive bacteria was mainly Staphylococcus aureus  (23, 92%). Most of the isolates showed sensitivity to vancomycin (20, 86.95%) and resistance to penicillin (18, 78.26%).  Klebsiella  spp. (20, 26.66%) was mostly sensitive to piperacillin/tazobactam (7, 50%), and resistance was seen to ampicillin (12, 85.71%). Conclusion This study showed that Staphylococcus aureus was the most common bacterial isolate causing wound infection, followed by Klebsiella spp. Antimicrobial susceptibility test showed that vancomycin was effective, followed by tetracycline for Staphylococcus aureus and piperacillin/tazobactam, and tigecycline was effective for Klebsiella spp., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee Krishna Vishwa Vidyapeeth Deemed to be University, Karad issued approval 066/2021-2022. The Institutional Ethics Committee has hereby given permission to initiate the research project (Protocol Number 066/2021-2022). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bhujugade et al.)

Background and aims: The spread of antimicrobial resistance (AMR) is a serious public health threat complicating treatment and resulting in prolonged hospitalization. The prevalence of AMR threat is not well defined due to the dearth of appropriate surveillance systems. This study sought to assess the prevalence of AMR among bacterial isolates from sputum specimens obtained from patients with pneumonia presenting at two secondary healthcare facilities in Zaria from June 1 to August 31, 2018. Methods: Standard methodology was followed in processing sputum samples that met the acceptance criteria. The antibiotic susceptibility patterns of bacterial pathogens cultured from sputum specimens obtained from June 1 to August 31, 2018) were evaluated using the recommendation of the Clinical and Laboratory Standards Institute. Finally, data were analyzed using descriptive statistics. Results: Acinetobacter spp. were the predominant pathogens accounting for 32% of recovered isolates, followed by Staphylococcus spp. (18%) and Klebsiella spp. (17%), respectively. AMR was found in 91% of the isolates. Most isolates were resistant to erythromycin (ERY) (80%) and amoxicillin (83.3%). Eventually, the multiple antibiotic resistance index ≥0.3 was observed in 76% of the isolates. Conclusion: Based on the findings, AMR rates were observed to be high, and may display a serious therapeutic challenge to the management of community-acquired pneumonia. Concerted efforts are needed to combat the worrisome AMR trends revealed in this study.

Objective: The production of β-lactamase enzymes such as AmpC β-lactamases and extended-spectrum β-lactamases (ESBLs) is among the main mechanisms for resistance to expanded-spectrum cephalosporins. The present study was conducted to investigate the prevalence and molecular epidemiology of plasmid-mediated AmpC beta (β)-lactamase in ESBL co-producing Escherichia coli (E. coli) and Klebsiella spp. (Klebsiella pneumoniae and Klebsiella oxytoca) clinical isolates in the northeast of Iran. Methods: A total of 602 E. coli and Klebsiella spp. clinical isolates were collected from three hospitals in Mashhad (northeast of Iran). A combination disk test (CDT) was performed for the phenotypic detection of ESBLs. Screening for the detection of AmpC β-lactamases was performed by a susceptibility test to a cefoxitin disc among ESBL producing isolates. A confirmatory test for AmpC β-lactamases was performed using the Mast® D68C test. Identification of plasmid-mediated AmpC cluster genes was done by multiplex polymerase chain reaction (PCR). Results: Among 336 ESBL-producing strains, 230 (68.4%) isolates were resistant to cefoxitin. Results of the Mast® D68C test showed that 30% (69/230) of cefoxitin-resistant isolates simultaneously exhibited ESBL and AmpC activity and 22% (51/230) of isolates probably showed multi-drug resistant (MDR) phenotype. Results of multiplex PCR among ESBL-positive isolates showed that, 16.7% (56/336) of isolates were positive for plasmid-borneampC cluster genes, and CMY (38%) was the most frequent genotype of plasmid mediated AmpC. Conclusion: Findings of the study revealed that an increase in the prevalence of ESBL and AmpC co-producer in E. coli and Klebsiella spp. strains may become an important public health issue. Therefore, there is a vital need for surveillance of spread of these clinical isolates.

Objective(s): Plasmid-mediated quinolone resistance (PMQR) determinants and integrons have a considerable contribution to bacterial drug resistance in Gram-negative pathogens. We studied the prevalence of PMQR genes and integron carriage in multidrug-resistant community isolates of Klebsiella spp.Materials and Methods: Two hundred and fifty Klebsiella spp. isolates were collected from outpatient specimens between August 2015 and October 2017 in Yazd central Laboratory, Iran. Antibiotic susceptibility was determined against 17 antibiotics and minimum inhibitory concentration (MIC) of ciprofloxacin was measured by E-test. Polymerase chain reaction (PCR) was employed for detection of qnrA, qnrB, qnrS, aac(6’)-Ib-cr, oqxAB and qepA genes. Results: Disc diffusion results showed that 17 isolates (6.8%) were multidrug resistant (MDR), two of which were Klebsiella oxytoca and 15 were Klebsiella pneumoniae. MIC measurements revealed 11 ciprofloxacin-resistant isolates (including the two K. oxytoca), three intermediately-resistant and three ciprofloxacin-susceptible isolates. All ciprofloxacin-resistant and intermediately-resistant isolates carried at least one and up to four PMQR genes. The most prevalent PMQR gene was oqxAB (93.75%) followed by aac(6’)-ib-cr (50.0%), qnrB (25.0%) and qnrS (18.75%) but qnrA and qepA were not detected. Class 1 integron was observed in 14 (82.3%) isolates including nine ciprofloxacin-resistant, two intermediately-resistant, and three susceptible isolates. Class 2 and 3 integrons were not observed. Conclusion: Presence of MDR, multiple PMQR determinants as well as class 1 integron in community isolates of Klebsiella spp. can be an important source of transmission of these opportunistic pathogens.

Objective: To characterize the pediatric patients presenting at the two pediatric centers in Bogotá, with first isolate urine culture of community-acquired extended-spectrum β-lactamase (ESBL)-producing enterobacteriaceae. Methods: Review of microbiological data of children between January, 2012 and December, 2018, obtained using the WHONET software. Results: A total of 2657 Escherichia coli, Klebsiella spp and Proteus mirabilis — positive urine cultures were obtained within a 6-year period; data of 132 patients were finally selected. Frequency of ESBL-producing bacteria infections in community-acquired urinary tract infections (UTI) was 5%: 123 E. coli (93.2%), 7 K. pneumoniae (5.2%), 1 K. oxytoca (0.8%), and 1 P. mirabilis (0.8%). Conclusion: A predominance of female sex, preschool children, and lower tract urinary infections were found, as well as a low frequency of comorbidities. Adequate sensitivity to amikacin and nitrofurantoin was found in this study. [ABSTRACT FROM AUTHOR]

Abstract Background Colistin is a last resort antibiotic for the treatment of carbapenem-resistant Gram negative infections. Until recently, mechanisms of colistin resistance were limited to chromosomal mutations which confer a high fitness cost and cannot be transferred between organisms. However, a novel plasmid-mediated colistin resistance mechanism, encoded by the mcr-1 gene, has been identified, and has since been detected worldwide. The mcr-1 colistin resistance mechanism is a major threat due to its lack of fitness cost and ability to be transferred between strains and species. Surveillance of colistin resistance mechanisms is critical to monitor the development and spread of resistance.This study aimed to determine the prevalence of the plasmid-mediated colistin resistance gene, mcr-1, in colistin-resistant E. coli and Klebsiella spp. isolates in the Western Cape of South Africa; and whether colistin resistance is spread through clonal expansion or by acquisition of resistance by diverse strains. Methods Colistin resistant E. coli and Klebsiella spp. isolates were collected from the NHLS microbiology laboratory at Tygerberg Hospital. Species identification and antibiotic susceptibility testing was done using the API® 20 E system and the Vitek® 2 Advanced Expert System™. PCR was used to detect the plasmid-mediated mcr-1 colistin resistance gene and REP-PCR was used for strain typing of the isolates. Results Nineteen colistin resistant isolates, including 12 E. coli, six K. pneumoniae and one K. oxytoca isolate, were detected over 7 months from eight different hospitals in the Western Cape region. The mcr-1 gene was detected in 83% of isolates which were shown to be predominantly unrelated strains. Conclusions The plasmid-mediated mcr-1 colistin resistance gene is responsible for the majority of colistin resistance in clinical isolates of E. coli and Klebsiella spp. from the Western Cape of South Africa. Colistin resistance is not clonally disseminated; the mcr-1 gene has been acquired by several unrelated strains of E. coli and K. pneumoniae. Acquisition of mcr-1 by cephalosporin- and carbapenem-resistant Gram negative bacteria may result in untreatable infections and increased mortality. Measures need to be implemented to control the use of colistin in health care facilities and in agriculture to retain its antimicrobial efficacy.

The aim of this study is to isolation of Klebsiella spp. from different environmental sites ( Human , Soil , Water ) and study their susceptibility against some antibiotics . 247 clinical and environmental samples were collected from different sources from Baghdad governorate (urine and sputum, burns , wounds , water liquefaction , sewage , agricultural soil , soil of poultry farms). The results of bacterial cultural ,microscopical and biochemical tests, and Vitik -2- compact dvice had shown that 46 isolates were belong to Klebsiella spp., the susceptibility of these isolates toward 7 antibiotics were done by using by the diffusion method disk, and the results showed that 44 isolates (95%) were resistant to Augmantin and 38 isolates (82.6%) to Cefotaxime , tetracycline (76%), while isolates showed good sensitivity toward Imikacin, Imipenem, Aztreonam, Gentamicin. On the other hand the results showed that there is variation in the response of these isolates to antibiotics according to the environmental sites , the burns and wounds clinical samples were more susceptibal toward Augmantin and Cefotaxime, while the isolates which were taken from water, agricultural soil were sensitive towards Imikacin , Imipenem , Aztreonam , Gentamicin.

Introduction: Cross-linked hyaluronic acid (HA) gel is widely used in esthetic medicine. Late bacterial infection (LBI) is a rare, but severe complication after HA augmentation. The aim of this study was to determine whether patients who underwent the HA injection procedure and developed LBI had qualitatively different bacterial flora on the skin compared to patients who underwent the procedure without any complications. Methods: The study group comprised 10 previously healthy women with recently diagnosed, untreated LBI after HA augmentation. The control group comprised 17 healthy women who had a similar amount of HA injected with no complications. To assess the difference between the two groups, their skin flora was cultured from nasal swabs, both before and after antibiotic treatment in the study group. Results: A significant increase in the incidence of Staphylococcus epidermidis was detected in the control group (P=0.000) compared to the study group. The study group showed a significantly higher incidence of Staphylococcus aureus (P=0.005), Klebsiella pneumoniae (P=0.006), Klebsiella oxytoca (P=0.048), and Staphylococcus haemolyticus (P=0.048) compared to the control group. Conclusion: The bacterial flora on the skin differed in patients with LBI from the control group. The control group's bacterial skin flora was dominated by S. epidermidis. Patients with LBI had a bacterial skin flora dominated by potentially pathogenic bacteria. [ABSTRACT FROM AUTHOR]

The article presents the results of detection of genetic determinants of pathogenicity in 120 Klebsiella strains (Klebsiella pneumoniae, Klebsiella oxytoca) and 48 Staphylococcus aureus strains isolated from the intestinal habitat of infants with intestinal dysbiosis. Registration of the investigated determinants in Klebsiella spp. autostrains DNA, which are non-clinical isolates, indicates the circulation of pathogenicity factors and, consequently, their possible causation in the formation of intestinal dysbiosis in infants.

The article presents the results of detection of genetic determinants of pathogenicity in 44 strains of Klebsiella (Klebsiella pneumoniae, Klebsiella oxytoca), isolated from the intestinal habitat of infants with intestinal dysbiosis. The presence of the uge gene was detected in 92 % of cases in K. oxytoca and in 90 % of K. pneumoniae. Kfu gene was detected twice as frequent (30 %) in K. pneumoniae strains than in K. oxytoca (12,5 %); bfp gene was detected in K. oxytoca 5 times more frequently (25 %) than in K. pneumoniae (5 %), as well as stx 1 - 29,2 % and 15 %, correspondingly. The presence of stx 2 gene wasn't recorded in any of the DNA samples. Registration of investigated determinants in DNA of Klebsiella spp. autostrains which are non-clinical isolates indicates pathogenicity factors circulation among them and therefore the risk of the formation of intestinal dysbiosis in children.

Objective: To measure the frequency of antimicrobial resistance in pediatric blood culture isolates of Escherichia coli and Klebsiella spp. with focus on carbapenem resistance. Methods: Over a period of three years, pediatric blood culture isolates were tested for antimicrobial susceptibility, including molecular investigations for carbapenem resistance. Results: Amikacin, carbapenems, colistin and tigecycline had an antimicrobial efficacy of >70% ( n=140). 7 of the 15 randomly selected isolates were positive for carbapenemase gene; among them, five were New Delhi Metallo β-lactamase (NDM). Conclusion: There was a high prevalence of Klebsiella spp. in pediatric bacteremia and dissemination of NDMmediated carbapenem resistance in pediatric wards. [ABSTRACT FROM AUTHOR]

Background: Colistin is a last resort antibiotic for the treatment of carbapenem-resistant Gram negative infections. Until recently, mechanisms of colistin resistance were limited to chromosomal mutations which confer a high fitness cost and cannot be transferred between organisms. However, a novel plasmid-mediated colistin resistance mechanism, encoded by the mcr-1 gene, has been identified, and has since been detected worldwide. The mcr-1 colistin resistance mechanism is a major threat due to its lack of fitness cost and ability to be transferred between strains and species. Surveillance of colistin resistance mechanisms is critical to monitor the development and spread of resistance.This study aimed to determine the prevalence of the plasmid-mediated colistin resistance gene, mcr-1, in colistin-resistant E. coli and Klebsiella spp. isolates in the Western Cape of South Africa; and whether colistin resistance is spread through clonal expansion or by acquisition of resistance by diverse strains. Methods: Colistin resistant E. coli and Klebsiella spp. isolates were collected from the NHLS microbiology laboratory at Tygerberg Hospital. Species identification and antibiotic susceptibility testing was done using the API® 20 E system and the Vitek® 2 Advanced Expert System™. PCR was used to detect the plasmid-mediated mcr-1 colistin resistance gene and REP-PCR was used for strain typing of the isolates. Results: Nineteen colistin resistant isolates, including 12 E. coli, six K. pneumoniae and one K. oxytoca isolate, were detected over 7 months from eight different hospitals in the Western Cape region. The mcr-1 gene was detected in 83% of isolates which were shown to be predominantly unrelated strains. Conclusions: The plasmid-mediated mcr-1 colistin resistance gene is responsible for the majority of colistin resistance in clinical isolates of E. coli and Klebsiella spp. from the Western Cape of South Africa. Colistin resistance is not clonally disseminated; the mcr-1 gene has been acquired by several unrelated strains of E. coli and K. pneumoniae. Acquisition of mcr-1 by cephalosporin- and carbapenem-resistant Gram negative bacteria may result in untreatable infections and increased mortality. Measures need to be implemented to control the use of colistin in health care facilities and in agriculture to retain its antimicrobial efficacy. [ABSTRACT FROM AUTHOR]

The incidence of Klebsiella spp. (K) in raw milk of different animal species was determined. A total of 240 random raw milk samples were collected from cows, buffaloes, sheep and goats in Assiut and Qena cities, Egypt (30 samples each). Thirty one strains of Klebsiella were isolated from raw milk. On the basis of biochemical characterization the strains were divided into 4 species as follow K. pneumonia, K. ozaenae, K. planticola and K. rhinoscleromatis. The most prevalent isolated species was K. pneumonia which was isolated from 13.33% of buffaloe’s milk samples collected from Assiut City and from 10% of Goat’s milk samples collected from Qena City. K. pneumonia show in vitro resistance to almost all tested types of antibiotics except for Ciprofloxacin and Ofloxacin. The antimicrobial effect of cinnamon oil on K. pneumonia isolates was tested via performing disk diffusion method and minimum inhibitory concentration. The results revealed that cinnamon oil showed maximum activity with MIC values ranging from 1:25 mg/ml to 1:6.25 mg/ml. The study concluded that cinnamon oil could be used as an effective antimicrobial. [ABSTRACT FROM AUTHOR]