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The increasing threat of antibiotic resistance and shrinking treatment options for infections have pushed mankind into a difficult position. The looming threat of the return of the pre-antibiotic era has caused a sense of urgency to protect and conserve the potency of antibiotic therapy. One of the perverse effects of antibiotic resistance is the dissemination of its causative agents from non-clinically important strains to clinically important strains and vice versa. The popular saying "Prevention is better than cure" is appropriate for tackling antibiotic resistance. On the one hand, new and effective antibiotics are required; on the other hand, better measures for the use of antibiotics, along with increased awareness in the general public related to antibiotic use, are essential. Awareness, especially of appropriate antibiotic use, antibiotic resistance, its dissemination, and potential threats, can help greatly in controlling the use and abuse of antibiotics, and the containment of antibiotic resistance. Antibiotic drugs' effectiveness can be enhanced by producing novel antibiotic analogs or adding adjuvants to current antibiotics. Combinatorial therapy of antibiotics has proven successful in treating multidrug-resistant (MDR) bacterial infections. This review aims to highlight the current global situation of antibiotic resistance and discuss the methods used to monitor, prevent, inhibit, or reverse bacterial resistance mechanisms in the fight against antibiotic resistance. [ABSTRACT FROM AUTHOR]

The article examines a study comparing the effectiveness of ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T) in treating multidrug-resistant Pseudomonas aeruginosa infections. Topics discussed include the clinical success rates of each treatment, the demographic and clinical characteristics of the patient populations, and the implications of antibiotic resistance observed in both treatment groups.

The cutaneous microbiome represents a highly dynamic community of bacteria, fungi and viruses. Scientific evidence, particularly from the last two decades, has revealed that these organisms are far from being inconsequential microscopic hitchhikers on the human body, nor are they all opportunistic pathogens waiting for the chance to penetrate the skin barrier and cause infection. In this review, we will describe how dermatological diseases have been found to be associated with disruptions and imbalances in the skin microbiome and how this new evidence had shaped the diagnosis and clinical practice relating to these disorders. We will identify the microbial agents which have been found to directly exacerbate skin diseases, as well as those which can ameliorate many of the symptoms associated with dermatological disorders. Furthermore, we will discuss the studies which suggest that bacteriotherapy, either by topical use of probiotics or by bacteria‐derived compounds, can rectify skin microbial imbalances, thereby offering a promising alternative to antibiotic treatment and reducing the risks of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Bacterial evolution, particularly in hospital settings, is leading to an increase in multidrug resistance. Understanding the basis for this resistance is critical as it can drive discovery of new antibiotics while allowing the clinical use of known antibiotics to be optimized. Here, we report a photoactive chemical probe for superresolution microscopy that allows for the in situ probing of antibiotic-induced structural disruption of bacteria. Conjugation between a spiropyran (SP) and galactose via click chemistry produces an amphiphilic photochromic glycoprobe, which self-assembles into glycomicelles in water. The hydrophobic inner core of the glycomicelles allows encapsulation of antibiotics. Photoirradiation then serves to convert the SP to the corresponding merocyanine (MR) form. This results in micellar disassembly allowing for release of the antibiotic in an on-demand fashion. The glycomicelles of this study adhere selectively to the surface of a Gram-negative bacterium through multivalent sugar-lectin interaction. Antibiotic release from the glycomicelles then induces membrane collapse. This dynamic process can be imaged in situ by superresolution spectroscopy owing to the "fluorescence blinking" of the SP/MR photochromic pair. This research provides a high-precision imaging tool that may be used to visualize how antibiotics disrupt the structural integrity of bacteria in real time. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance in Escherichia coli presents a global challenge associated with nosocomial infections and increased mortality rates. Understanding resistance profiles is crucial for guiding treatment strategies and ensuring effective antibiotic use. This study aimed to investigate the prevalence and in vitro resistance of E. coli to community-acquired and nosocomial infections. Various clinical samples from 700 patients were cultured on MacConkey's medium and blood agar. The disk diffusion method was used to determine the antibiotic susceptibility profile of the E. coli isolates following the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Urine, pus, seminal fluid, vaginal swabs, and other body fluids were among the clinical samples analyzed. Of the 112 E. coli isolates, 48.2% were from inpatients and 51.8% were from outpatients, with the majority (66%) isolated from urine samples. Higher resistance levels were observed in the urinary isolates than that in the previously recorded data from the same institutions. Notably, isolates exhibited high resistance to penicillin (98.2%), ampicillin (97.3%), first-generation cephalosporins (90.2%), erythromycin (72.2%), and roxithromycin (95.4%), whereas lower resistance was noted against piperacillin-tazobactam (25.0%), nitrofurantoin (12.5%), and imipenem (9.8%). The overall multidrug resistance rate was 62.5%, with higher rates observed in nosocomial infections (70%) compared to community-acquired isolates (55.6%). However, this difference was not statistically significant (p>0.05). This study underscores the prevalence of E. coli isolates (27.0%) and highlights the concerning level of resistance, particularly to older antibiotics. These findings emphasize the importance of judicious antibiotic use and ongoing surveillance. [ABSTRACT FROM AUTHOR]

Background: Infection is a common cause of mortality within intensive care units (ICUs). Antibiotic resistance patterns and culture data are used to create antibiograms. Knowledge of antibiograms facilitates guiding empiric therapies and reduces mortality. Most major hospitals utilize data collection to create hospital-wide antibiograms. Previous studies have shown significant differences in susceptibility patterns between hospital wards and ICUs. We hypothesize that institutional or combined ICU antibiograms are inadequate to account for differences in susceptibility for patients in individual ICUs. Methods: Culture and susceptibility data were reviewed over a 1-year period for 13 bacteria in the following ICUs: Surgical/Trauma, Medical, Neuroscience, Burn, and Emergency department. Antibiotic management decisions are made by individual teams. Results: Nine species had sufficient data for inclusion into an All-ICU antibiogram. E coli and S aureus were the most common isolates. Seven species had significant differences in susceptibility patterns between ICUs. E cloacae showed higher rates of resistance to multiple antibiotics in the STICU than other ICUs. P aeruginosa susceptibility rates in the NSICU and BICU were 88% and 92%, respectively, compared to 60% and 55% in the STICU and MICU. Cephalosporins and Aztreonam had reduced efficacy against E coli in the NSICU, however remain effective in other ICUs. Conclusions: The results of this study show that different ICUs do have variability in antibiotic susceptibility patterns within a single hospital. While this only represents a single institution, it shows that the use of hospital-wide antibiograms is inadequate for creating empiric antibiotic protocols within individual ICUs. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTI) are a common problem in childhood. The clinical presentation is variable depending on age and whether there is pyelonephritis or cystitis. UTI are diagnosed by culturing an appropriately collected urine sample. Most children with UTI can be managed safely with oral antibiotics irrespective of whether they have cystitis or pyelonephritis. Following a single UTI a significant proportion of children will develop recurrent UTI and many of these children will have identifiable risk factors. Treating children with recurrent UTI with repeated courses of antibiotics or long term prophylactic antibiotics puts patients at risk of infections with multi-resistant organisms. Furthermore recurrent UTI are also associated with the risk of renal parenchymal damage with long term health implications. It is therefore essential that management of children with UTI focuses not only on early diagnosis and treatment but also on UTI prevention. [ABSTRACT FROM AUTHOR]

Background: The rapid rise of microbial resistance to traditional antibiotics has caused grave concerns for the treatment of infectious diseases. This serious problem increases the demand for significant plant-based antibacterial and antimicrobial drugs. Kalanchoe pinnata is one of the plants that has had significant antibacterial effects due to the presence of a wide range of bioactive compounds, so it could be an effective substitute for the current synthetic antibiotics. The study aimed to evaluate the anti-bacterial and antioxidant properties of a methanolic extract of Kalanchoe pinnata leaves. Materials and Methods: The preliminary phytochemical screening was performed using standard biochemical assays. The anti-bacterial activity was determined against multidrugresistant E. coli and S. aureus using the well-diffusion method. The 2,2-diphenyl-1-picrylhydrazyl and ferric ion reducing antioxidant potential assays were used to evaluate the antioxidant activity. Results: The methanolic extract of Kalanchoe pinnata leaves showed the presence of flavonoids, saponins, steroids, phenol, quinones, and proteins. The remarkable anti-bacterial activities were displayed against multidrug-resistant E. coli and S. aureus, with minimum inhibitory concentration values of 50 mg/mL and 12.5 mg/mL, respectively. The significant antioxidant activity was exhibited in 2,2-diphenyl-1-picrylhydrazyl and ferric ion reducing antioxidant potential assays. Conclusion: The results of this investigation suggested that the Kalanchoe pinnata extract may be useful as an alternative for antibiotics and may have pharmacological promise in the treatment of many diseases. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance in Escherichia coli presents a global challenge associated with nosocomial infections and increased mortality rates. Understanding resistance profiles is crucial for guiding treatment strategies and ensuring effective antibiotic use. This study aimed to investigate the prevalence and in vitro resistance of E. coli to community-acquired and nosocomial infections. Various clinical samples from 700 patients were cultured on MacConkey’s medium and blood agar. The disk diffusion method was used to determine the antibiotic susceptibility profile of the E. coli isolates following the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Urine, pus, seminal fluid, vaginal swabs, and other body fluids were among the clinical samples analyzed. Of the 112 E. coli isolates, 48.2% were from inpatients and 51.8% were from outpatients, with the majority (66%) isolated from urine samples. Higher resistance levels were observed in the urinary isolates than that in the previously recorded data from the same institutions. Notably, isolates exhibited high resistance to penicillin (98.2%), ampicillin (97.3%), first-generation cephalosporins (90.2%), erythromycin (72.2%), and roxithromycin (95.4%), whereas lower resistance was noted against piperacillin-tazobactam (25.0%), nitrofurantoin (12.5%), and imipenem (9.8%). The overall multidrug resistance rate was 62.5%, with higher rates observed in nosocomial infections (70%) compared to community-acquired isolates (55.6%). However, this difference was not statistically significant (p>0.05). This study underscores the prevalence of E. coli isolates (27.0%) and highlights the concerning level of resistance, particularly to older antibiotics. These findings emphasize the importance of judicious antibiotic use and ongoing surveillance.

This case series describes the clinical course of 10 patients who received eravacycline antimicrobial therapy for a variety of different Acinetobacter baumannii infection types at a community care hospital. [ABSTRACT FROM AUTHOR]

Infection with multidrug resistant bacteria is a significant public health concern. Bacteria culture of water samples (n=120) collected in San Cristobal River, Philippines, showed that half (n=60) were positive for Salmonella spp. Screening of all isolates (n=179) for susceptibility to antibiotics showed that most (76.4%; n=113) were positive for class 1 integrons, of which one isolate was also positive for the class 2 integron. The presence of class 1 integrons was associated with resistance to antibiotics (p<0.05). Sequencing of class 1 integron variable regions (VRs) differeciated 11 gene cassettes: dfrA1 or dfrA17; aadA1 or aadA2; blaCTX-M-2 or bla-OXA-1; SmdAB; CmlA1 and aaC 3-Id. However, sequencing of class 2 integron VR differenciated estX, sat2, and aadA1. These results provide insights into evolutionary changes within bacterial multidrug resistant cassettes, more accurately to estimate heath risk associated with the river water. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to investigate the effect of antibiotics on the eradication of multidrug-resistant organisms (MRO) in intestinal carriers. We defined multidrug-resistant organisms as vancomycin-resistant Enterococcus faecium (VREfm), and multidrug-resistant Gram-negative Enterobacterales. Methods: We searched the EMBASE, Cochrane Central, and PubMed databases from inception to medio November 2023. We included randomised and controlled clinical trials (RCTs), that investigated the effect of antibiotics on the eradication of multidrug-resistant organisms in intestinal carriers. Finally, we performed a meta-analysis. Results: We included five RTCs in the systematic review. In four studies an effect of antibiotics on the eradication of MRO was shown at the end of intervention, but it was not sustained at follow-up. In the fifth study, the effect at the end of intervention was not reported, and there was no observed effect of the intervention at follow-up. We included four studies in the meta-analysis, and it suggests an effect of antibiotics on the eradication of MRO in intestinal carriers at the end of follow-up with a p-value of 0.04 (95% confidence interval 1.02–1.95). None of the studies reported a significant increase in resistance to the study drug. Gastrointestinal disorders were the most frequent non-severe adverse event. Conclusions: The effect of antibiotics on the eradication of multidrug-resistant organisms in intestinal carriers was not statistically significant in any of the five included studies; however, we found a significant effect in the pooled meta-analysis. As the confidence interval is large, we cannot determine the clinical importance of this finding, and it should be further investigated. [ABSTRACT FROM AUTHOR]

Due to the serious scarcity of water resources and the aggravation of water pollution in northern China, replenishing reclaimed water can alleviate the water shortage problem in northern rivers to a certain extent, but has also become an important way for antibiotic resistance genes (ARGs) to spread into rivers. In order to study the characteristics of ARGs in reclaimed water recharge rivers (Wenyu River), the abundance and distribution of ARGs in a typical reclaimed water replenishment river were analyzed by metagenomic sequencing technology combined with river water quality. The results showed that: due to the input of reclaimed water, the water quality characteristics of downstream sampling points of the river were significantly different from those upstream. Water quality factors such as total organic carbon, chemical oxygen demand, chlorophyll, and total nitrogen tended to increase gradually. Quinolones and macrolides were the main types of antibiotics. A total of 1217 ARGs were detected in the reclaimed water river system, including multidrug resistance, macrolide-lincosamide-streptogramin (MLS), tetracycline, glycopeptide, peptide, aminocoumarin, etc. The average abundance of ARGs in reclaimed water was higher than that in rivers. Among them, multidrug ARGs existed most widely, which may gradually become the main trend of ARGs' evolutionary variation. RDA results revealed that the environmental factors EC and DO, as well as tetracycline antibiotics (TCs), may be important environmental factors affecting the distribution of ARGs. [ABSTRACT FROM AUTHOR]

Introduction: This study characterized Vibrio alginolyticus isolated from seafood and freshwater products in China (2020). Methods and Results: In total, 122 (95.31%) V. alginolyticus isolates were resistant to at least 1 antibiotic category, and 2 (1.56%) isolates were resistant to at least 3 antibiotic categories and belong to multi-drug resistance (MDR) isolates. A high prevalence rate was observed to be blaCARB (98.04%) encoding beta-lactam resistance, followed by tet (97.06%) encoding tetracycline resistance and fos (4.90%) encoding resistance to fosfomycin. Among the 57 V. alginolyticus isolates, the commonest virulence genes were type III secretion system translocated gene vopD, vopB, and vcrH (54.4%, 31/57), type III secretion system regulated gene tyeA (54.39%), followed by vscI and vscF (50.88%) encoded type III secretion system inner rod protein and needle protein, respectively. Multilocus sequence typing (MLST) showed considerable genetic diversity, with 34 distinct sequence types (STs) identified among 55 isolates. ST421 (n = 5), ST166 (n = 4), ST523 (n = 3), ST516 (n = 3), and ST507 (n = 3) were dominant STs among 55 V. alginolyticus isolates. Discussion: These findings highlight the widespread occurrence of V. alginolyticus in both freshwater and seafood products, underscoring the critical need for vigilant monitoring of these bacteria. Such measures are essential for ensuring effective food safety management and safeguarding public health. [ABSTRACT FROM AUTHOR]

The Gram-negative ESKAPE bacterium Pseudomonas aeruginosa has become a pathogen of serious concern due its extensive multi-drug resistance (MDR) profile, widespread incidences of hospital-acquired infections throughout the United States, and high occurrence in wound infections suffered by warfighters serving abroad. Bacteriophage (phage) therapy has received renewed attention as an alternative therapeutic option against recalcitrant bacterial infections, both as multi-phage cocktails and in combination with antibiotics as synergistic pairings. Environmental screening and phage enrichment has yielded three lytic viruses capable of infecting the MDR P. aeruginosa strain PAO1. Co-administration of each phage with the carbapenem antibiotics ertapenem, imipenem, and meropenem generated enhanced overall killing of bacteria beyond either phage or drug treatments alone. A combination cocktail of all three phages was completely inhibitory to growth, even without antibiotics. The same 3× phage cocktail also disrupted PAO1 biofilms, reducing biomass by over 75% compared to untreated biofilms. Further, the phage cocktail demonstrated broad efficacy as well, capable of infecting 33 out of 100 diverse clinical isolate strains of P. aeruginosa. Together, these results indicate a promising approach for designing layered medical countermeasures to potentiate antibiotic activity and possibly overcome resistance against recalcitrant, MDR bacteria such as P. aeruginosa. Combination therapy, either by synergistic phage-antibiotic pairings, or by phage cocktails, presents a means of controlling mutations that can allow for bacteria to gain a competitive edge. [ABSTRACT FROM AUTHOR]

Objectives: To determine the antimicrobial activity of silver nano-particles(AgNPs) with tetracycline and ampicillin against multi-drug resistance (MDR) and extensively-drug resistance (XDR) Salmonella typhi. Methods: Cross sectional non-probability purposive study was conducted from September, 2021 to May, 2022 at Microbiology department PNS Shifa, Hospital Karachi. Blood cultures of patients suspicious of typhoid fever were collected and incubated in automated Bact/Alert system. Positive cultures were identified on blood and MacConkey and processed by API-10S, confirmed by serotyping (O9 antisera) (SSI Diagnostica's Salmonella). Antibiotic resistance was done by Kirby-Bauer disk diffusion (Sigma and Rich). MDR and XDR isolates were preserved in Brain Heart Infusion in a volume of 2ml in screw capped bottles at -70°C. Antimicrobial powders (ampicillin and tetracycline (Alfa Aesar) weighed by an electrical weighing balance (OHAUS) to take 1mg of antimicrobial drug. Absorbance spectra of serial concentrations of antibiotics (UV-Vis spectrophotometer (Mole-Qule-) AgNPs (10nm) (nanocomposix) + Antibiotic in (1:1 volume ratio). Conjugation of silver nanoparticles with tetracycline and ampicillin was done by FTIR (thermos scientificThermos ScientificNicolet 50). Results: Out of 77 isolates, 54 were resistant to ceftriaxone (XDR) and 23 sensitive to ceftriaxone (MDR). All isolates were susceptible to azithromycin and meropenem. Comparison of zone of inhibitions of ampicillin and Amp-AgNPsas and tetracycline with Tet-AgNPs was done. Minimal inhibitory concentration was also done to determine antimicrobial activity. Conclusion: Significant synergistic inhibitory effects against Salmonella Typhi isolates were obtained by combination of tetracycline with silver nano-particles even at low concentration. [ABSTRACT FROM AUTHOR]

Background: Multidrug resistant bacterial pathogens employ different mechanisms in evading the action of antibiotics. Multidrug resistance is wide spread among strains of Escherichia coli implicated in several infections including urinary tract infections, gastrointestinal infections, meningitis and bacteraemia. Aim/Objective: This study investigates the antibiotic resistance profile, efflux pump activity and biofilm formation ability of E. coli strains isolated from clinical samples. Methods: A total of 32 E. coli strains isolated from clinical samples were characterized and subjected to antibiotic susceptibility testing using standard methods. Isolates were screened phenotypically for biofilm formation and efflux pump activity. While molecular detection of genes encoding curli fimbriae and efflux pump activity was done by PCR. Results: All 32 (100%) E. coli isolates were resistant to ceftazidime, cefuroxime, cefixime, amoxicillin-clavulanate, ofloxacin and ciprofloxacin. While 30 (93.8%) were resistant to gentamicin, 27 (84.4%) were resistant to cefepime and the least resistance of 15.6% was to imipenem. Efflux pump encoding gene tolC was detected in 13(40.6%) of the isolates, while 1(3.1%) harboured acrA gene. acrB gene was not detected in any of the isolates. Seven (21.9%) of the isolates were strong biofilm formers, while 5 (15.6%) and 20 (62.5%) were moderate and weak biofilm formers respectively. csgA gene was detected in all E. coli isolates. Discussion: High antibiotic resistance of E. coli strains observed in this study is of public health significance.. It is therefore important to scale up efforts in regular monitoring of antibiotic resistance in both community and hospital settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Enterococci are bacteria found naturally in the gastrointestinal tract of both chickens and humans, serving as a commensal bacterium. These opportunistic pathogens are recognized for their involvement in human diseases like urinary tract infections (UTIs), endocarditis, and sepsis. Infection sources encompass food, hospital environments, and animals, particularly chickens. Their increasing resistance to multiple drugs poses a growing concern for public health This study aimed to isolate the enterococcus species and to determine their antibiotic susceptibility profiles. METHOD: Swab samples of gut content from poultry in specific slaughterhouses located within selected markets in Accra were collected, cultured on MacConkey agar No.2, and incubated overnight for growth. Colonies suspected to be Enterococcus species were subjected to biochemical testing, and confirmed colonies underwent antibiotic testing against commonly used medications for bacterial infections. The Kirby-Bauer disk diffusion method was used to assess the antibiotic susceptibility of the recovered isolates. RESULTS: Among the 160 samples examined, 97 (61%) were found to be contaminated with Enterococcus species. Each of the isolates displayed resistance to a minimum of three antibiotic classes tested in the study. Notably, high levels of resistance were observed for specific antibiotics, including penicillin (91.75%), vancomycin (87.63%), and tetracycline (80.41). CONCLUSION: The findings of this study revealed a high prevalence of multi-drug resistant Enterococcus species isolated from chicken rectal swab samples collected from three selected markets in Accra, Ghana. All the isolates exhibited resistance to at least three classes of antibiotics tested [ABSTRACT FROM AUTHOR]

Patients with chronic limb‐threatening ischaemia (CLTI) are at risk of foot infections, which is associated with an increase in amputation rates. The use of antibiotics may lead to a higher incidence of antimicrobial resistance (AMR) in subsequent episodes of ischaemic foot infections (IFI). This retrospective single‐centre cohort study included 130 patients with IFI undergoing endovascular revascularisation. Staphylococcus aureus and Pseudomonas aeruginosa were the two most common pathogens, accounting for 20.5% and 10.8% of cases, respectively. The prevalence of antimicrobial resistance (AMR) and multi‐drug resistance did not significantly increase between episodes (10.2% vs. 13.4%, p = 0.42). In 59% of subsequent episodes, the identified pathogens were unrelated to the previous episode. However, the partial concordance of identified pathogens significantly increased to 66.7% when S. aureus was identified (p = 0.027). Subsequent episodes of IFI in the same patient are likely to differ in causative pathogens. However, in the case of S. aureus, the risk of reinfection, particularly with S. aureus, is increased. Multi‐drug resistance does not appear to change between IFI episodes. Therefore, recommendations for empirical antimicrobial therapy should be based on local pathogen and resistance statistics without the need to broaden the spectrum of antibiotics in subsequent episodes. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance among Enterobacterales continues to be a growing problem, particularly in those with urinary infections. Previous studies have demonstrated safety and efficacy with the use of single‐dose aminoglycosides in uncomplicated cystitis. However, data in complicated infections are limited. Single‐dose aminoglycosides may provide a convenient alternative for those with or at risk for resistant pathogens causing complicated urinary infections, especially when oral options are unavailable due to resistance, allergy, intolerance, or interactions with other medications. This study evaluated the safety and effectiveness of single‐dose aminoglycosides in treatment of complicated cystitis in the emergency department (ED). Methods: This was a multicenter, prospective study performed between July 2022 and March 2023 of patients who met criteria for complicated cystitis and were otherwise stable for discharge at an academic ED. Primary outcomes were clinical or microbiologic failure within 14 days of treatment. Safety was assessed by review of adverse events. Descriptive statistics were used. Results: Thirteen patients were included. Complicating factors were male sex (n = 4), kidney stone (n = 2), urinary catheter (n = 6), recent urologic procedure (n = 1), urinary hardware (n = 1), antibiotic allergy precluding use of alternate oral options (n = 4), immunocompromised status (n = 2), and <1‐year history of multidrug‐resistant organisms on urine culture (n = 8). Eleven patients (85%) had positive urine cultures in the preceding 12 months with no oral antimicrobial option. Eight patients (62%) received amikacin (median dose 15 mg/kg), four patients (31%) received gentamicin (median dose 5 mg/kg), and one patient (8%) received tobramycin (5 mg/kg) for treatment. Ten patients (77%) reported resolved urinary symptoms after treatment and 11 patients (85%) reported no new urinary symptoms since discharge. No patient required hospital admission for treatment failure, and no adverse events were noted. Conclusions: Single‐dose aminoglycosides appear to be a reasonably effective and safe treatment for complicated cystitis, which avoided hospital admission in this cohort. [ABSTRACT FROM AUTHOR]

As the most widely distributed scavenger birds on the Qinghai-Tibetan Plateau, Himalayan vultures (Gyps himalayensis) feed on the carcasses of various wild and domestic animals, facing the dual selection pressure of pathogens and antibiotics and are suitable biological sentinel species for monitoring antibiotic resistance genes (ARGs). This study used metagenomic sequencing to comparatively investigate the ARGs and mobile genetic elements (MGEs) of wild and captive Himalayan vultures. Overall, the resistome of Himalayan vultures contained 414 ARG subtypes resistant to 20 ARG types, with abundances ranging from 0.01 to 1,493.60 ppm. The most abundant resistance type was beta-lactam (175 subtypes), followed by multidrug resistance genes with 68 subtypes. Decreases in the abundance of macrolide-lincosamide-streptogramin (MLS) resistance genes were observed in the wild group compared with the zoo group. A total of 75 genera (five phyla) of bacteria were predicted to be the hosts of ARGs in Himalayan vultures, and the clinical (102 ARGs) and high-risk ARGs (35 Rank I and 56 Rank II ARGs) were also analyzed. Among these ARGs, twenty-two clinical ARGs, nine Rank I ARG subtypes, sixteen Rank II ARG subtypes were found to differ significantly between the two groups. Five types of MGEs (128 subtypes) were found in Himalayan vultures. Plasmids (62 subtypes) and transposases (44 subtypes) were found to be the main MGE types. Efflux pump and antibiotic deactivation were the main resistance mechanisms of ARGs in Himalayan vultures. Decreases in the abundance of cellular protection were identified in wild Himalayan vultures compared with the captive Himalayan vultures. Procrustes analysis and the co-occurrence networks analysis revealed different patterns of correlations among gut microbes, ARGs, and MGEs in wild and captive Himalayan vultures. This study is the first step in describing the characterization of the ARGs in the gut of Himalayan vultures and highlights the need to pay more attention to scavenging birds. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is a global threat that requires urgent attention to slow the spread of resistant pathogens. The United States Centers for Disease Control and Prevention (CDC) has emphasized clinician-driven antimicrobial stewardship approaches including the reporting and proper documentation of antimicrobial usage and resistance. Additional efforts have targeted the development of new antimicrobial agents, but narrow profit margins have hindered manufacturers from investing in novel antimicrobials for clinical use and therefore the production of new antibiotics has decreased. In order to combat this, both antimicrobial drug discovery processes and healthcare reimbursement programs must be improved. Without action, this poses a high probability to culminate in a deadly post-antibiotic era. This review will highlight some of the global health challenges faced both today and in the future. Furthermore, the new Infectious Diseases Society of America (IDSA) guidelines for resistant Gram-negative pathogens will be discussed. This includes new antimicrobial agents which have gained or are likely to gain FDA approval. Emphasis will be placed on which human pathogens each of these agents cover, as well as how these new agents could be utilized in clinical practice. [ABSTRACT FROM AUTHOR]

Mycobacterium avium subsp. avium is pathogenic mainly to birds, although cases of mycobacteriosis caused by these bacteria have also been reported in other animals and humans. Not much is known about the effects of this pathogen on otters. The aim of this study was to report for the first time the isolation of M. avium subsp. avium in wild otter and to describe its multidrug resistance profile. A female otter injured in a car accident was found dead and subjected to postmortem examination. Apart from the trauma changes, no other macroscopic pathological changes were detected. Bacteriologic examination revealed the presence of acid-fast bacilli in the lymph nodes, which were confirmed by molecular methods as M. avium subsp. avium. Antimicrobial susceptibility testing revealed susceptibility to clarithromycin and amikacin, but resistance to linezolid, moxifloxacin, streptomycin, isoniazid, trimethoprim/sulfamethoxazole, ciprofloxacin, doxycycline, and ethionamide. This is unusual for wild species, which generally should not come into contact with antimicrobials, and may suggest that multidrug-resistant MAC strains are circulating between wild and domestic animals. These results emphasise the need for additional epidemiological studies on non-tuberculous mycobacteria in wildlife and their implications for one health. [ABSTRACT FROM AUTHOR]

We report a fatal case of New Delhi metallo-β-lactamase (NDM)–producing Escherichia coli in a bacteremic patient with sequential failure of aztreonam plus ceftazidime-avibactam followed by cefiderocol. Acquired resistance was documented phenotypically and mediated through preexisting and acquired mutations. This case highlights the need to rethink optimal treatment for NDM-producing organisms. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance arises due to the overuse of antibiotics, leading to bacterial strains becoming resistant to previously effective treatments. This can result in infections that are harder to treat and can lead to longer hospital stays, increased healthcare costs, and even mortality. Objectives: To determine the most common bacterial uropathogens and their sensitivity to antibiotics among patients diagnosed with urinary tract infections (UTIs). Materials and methods: In Mosul, Iraq, researchers conducted a retrospective cross-sectional analysis to evaluate the effectiveness of antibiotics commonly used to treat UTIs. In this study, researchers collected and analyzed urine samples from three centers that conducted culture and sensitivity tests over five years, from January 2018 to December 2022. Results: Of the 1326 urine samples collected during the study period, 1265 (95.5%) showed significant bacteriuria caused by a variety of bacterial strains, with Escherichia coli being the most common. The study evaluated the effectiveness of 21 antibiotics frequently used to treat UTIs against the identified bacterial strains. The results indicated that only a limited number of antibiotics have shown effectiveness against particular strains of Escherichia coli, with a mere 10 out of the 21 drugs exhibiting significant antibacterial efficiency. The presence of bacterial resistance to all tested antibiotics was observed, indicating a significant prevalence of antibiotic resistance and a decline in the availability of effective antibiotics. Conclusion: This study revealed a concerning rise in antibiotic resistance in bacterial strains responsible for UTIs, as well as multidrug resistance, especially among gram-negative bacteria. [ABSTRACT FROM AUTHOR]

The unearthing of various forms of broad and narrow-spectrum antibiotics have helped mankind combat various forms of microbic infections ranging from protozoal to bacterial. The applicability of antibiotics has been decisive in a wide range of frontline therapeutic dealings. An extensive use of antibiotics and certain genetic modifications in microbes has paved the way for a new issue to be answered by the scientific community, an antibiotic resistance. An unparallel infections triggered by multidrug-resistant organisms (MDRO) account to be a major cause of mortality and morbidity, today this situation demands the development of alternative strategies of cure and medicine by the scientific community. Study shows the amplification of the effect of antibiotics may be a possible route to address antibiotic resistivity. The assortment of various surface properties of nanoparticles (NPs) coupled with their ability to efficiently bind with bacterial surfaces leading to the rupture and lysis of cell deliberates potential strategies to manage infections caused by MDROs.The present study scrutinizes the amplification of the antibacterial activity of ciprofloxacin (CIP) against the bacterial strains of Staphylococcus aureus, Escherichia coli, Pseudomonas and Streptococcus mutans on coupling with synthesized copper, silver and zinc oxide NPs (ZnO NPs) by disc diffusion technique. The current study describes the efficacious synthesis and characterization of ZnONP, copper Nps (CuNPs) and silver NPs (AgNPs) followed by the induced amplification of the antibacterial activity of CIP by coupling it with synthesized metal/metal oxide (M/MO NP). The synthesized M/MO NPs were characterized using XRD and FE-SEM studies and TEM. The results indicated that among the ZnONP, AgNP, the Cu NPs potentiate the bactericidal efficacy of CIP antibiotics. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae, common pathogenic bacteria, cause dangerous infectious diseases in animals and humans. Klebsiella pneumoniae have numerous resistance mechanisms to antibacterials and the frequency of resistant K. pneumoniae isolates increases, making treatment of K. pneumoniae-induced infections difficult. Farm animals are a possible source of antibacterial resistant K. pneumoniae. The aim of this literature review (2018–2024) was to evaluate the antibacterial resistance of K. pneumoniae isolated from poultry, cattle and pigs in various countries. The analysis shows that farm animals are an important source of antibacterial-resistant and multidrug-resistant K. pneumoniae and that resistance patterns differ among antibacterial groups, animals and locations. In poultry, high resistance to penicillins (91%), III and IV generation cephalosporins (> 50%) occurred, and low to carbapenems (5%) and polymyxins (6%). In cattle, high resistance to sulphonamides (76%), IV generation cephalosporins, macrolides and lincosamides, and penicillins occurred (> 50%), and low to carbapenems (10%) and polymyxins (1%). Isolates from pigs showed high resistance to I and II-generation cephalosporins, I-generation fluoroquinolones, macrolides and lincosamides, tetracyclines (> 50%) and carbapenems (> 20%), and low to polymyxins (5%). The highest resistance rates to most antibacterial groups occurred in pigs, and in Africa and Asia, while the lowest in cattle, and in North and South America. Particularly, the relatively high resistance of K. pneumoniae to carbapenems and polymyxins in Africa poses a threat to animal and human health as these antibiotics are the last resort therapeutics used to treat severe infections. Different rates of K. pneumoniae resistance to antibacterials among isolates from farm animals probably result from differences in the treatment of each animal group with various antibacterial agents and different regimes of their use in various locations.

The increasing threat of antibiotic resistance and shrinking treatment options for infections have pushed mankind into a difficult position. The looming threat of the return of the pre-antibiotic era has caused a sense of urgency to protect and conserve the potency of antibiotic therapy. One of the perverse effects of antibiotic resistance is the dissemination of its causative agents from non-clinically important strains to clinically important strains and vice versa. The popular saying “Prevention is better than cure” is appropriate for tackling antibiotic resistance. On the one hand, new and effective antibiotics are required; on the other hand, better measures for the use of antibiotics, along with increased awareness in the general public related to antibiotic use, are essential. Awareness, especially of appropriate antibiotic use, antibiotic resistance, its dissemination, and potential threats, can help greatly in controlling the use and abuse of antibiotics, and the containment of antibiotic resistance. Antibiotic drugs’ effectiveness can be enhanced by producing novel antibiotic analogs or adding adjuvants to current antibiotics. Combinatorial therapy of antibiotics has proven successful in treating multidrug-resistant (MDR) bacterial infections. This review aims to highlight the current global situation of antibiotic resistance and discuss the methods used to monitor, prevent, inhibit, or reverse bacterial resistance mechanisms in the fight against antibiotic resistance.

Background: The purpose of this analysis is to evaluate the antimicrobial susceptibility of eight drugs effective against Helicobacter pylori (H. pylori) strains and the genetic diversity of H. pylori virulence genes to foresee clinical outcomes in North India. Materials and Methods: Fifty‐eight H. pylori strains isolated from patients suffering from various gastrointestinal (GI) diseases were included in the study. MICs of various antibiotics were determined by the agar dilution method. The chi‐squared test and Fisher exact test were used to determine the p‐value, which was considered significant at p‐value ≤ 0.05. RStudio 4.0 was used to for the data visualization. Results: The prevalence of drug resistance was found to be: cefixime (CFM) (41.3%), furazolidone (FZD) (34.4%), amoxicillin (AMX) (20.7%), levofloxacin (LVFX) (70.7%), metronidazole (MTZ) (39.6%), tetracycline (TET) (20.7%), clarithromycin (CLA) (17.2%), and rifabutin (RIF) (17.2%). Out of 58 H. pylori strains, 3 were pan susceptible. There were H. pylori strains with single‐drug resistance (21.8%, 12/55), dual resistance (30.9%, 17/55), triple resistance (20%, 11/55), and multidrug resistance (27.3%, 15/55). The resistance rate in MTZ, CLA and RIF were found to be significantly higher in females as compared to males (p = 0.005, p = 0.002, and p = 0.02), respectively. The resistance to TET exhibited significantly higher levels in gastritis compared to GERD, DU, and other disease groups (p = 0.04) respectively. Conclusion: TET, AMX, CLA, and RIF were found to be more effective antibiotics against H. pylori infections, whereas more studies are required to provide evidence on increasing resistance rate of LVFX. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) poses a significant global health challenge, complicating the treatment of infections caused by bacteria, parasites, viruses, and fungi. Armed conflict is an underexplored and complex contributor to AMR, with numerous interrelated pathways influencing its emergence and dissemination. These mechanisms include the widespread use of antibiotics in conflict zones, inadequate infection control measures, the role of conflict-related injuries, and the breakdown of surveillance and monitoring systems. This study aims to investigate the relationship between armed conflict and AMR and to assess the extent and impact of this link on global health. Case studies, such as the Syrian civil war and the conflicts in Iraq over the past four decades, are utilized to illustrate the association between armed conflict and AMR. Recognizing and addressing this neglected aspect of AMR is essential for developing comprehensive strategies to combat its spread and preserve the efficacy of antimicrobial drugs. Further research is needed to fully understand the intricate relationship between armed conflict and AMR, which will ultimately contribute to the creation of more effective interventions and policy recommendations. This study serves as a critical step in raising awareness and stimulating discussion on the role of armed conflict in the ongoing battle against antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Evidence on the optimal antibiotic strategy for empyema is lacking. Our database study aimed to evaluate the effectiveness of empirical anti-pseudomonal antibiotics in patients with empyema. We utilised a Japanese real-world data database, focusing on patients aged ≥40 diagnosed with empyema, who underwent thoracostomy and received intravenous antibiotics either upon admission or the following day. Patients administered intravenous vasopressors were excluded. We compared thoracic surgery and death within 90 days after admission between patients treated with empirical anti-pseudomonal and non-anti-pseudomonal antibiotics. Cause-specific hazard ratios for thoracic surgery and death were estimated using Cox proportional hazards models, with adjustment for clinically important confounders. Subgroup analyses entailed the same procedures for patients exhibiting at least one risk factor for multidrug-resistant organisms. Between March 2014 and March 2023, 855 patients with empyema meeting the inclusion criteria were enrolled. Among them, 271 (31.7%) patients received anti-pseudomonal antibiotics. The Cox proportional hazards models indicated that compared to empirical non-anti-pseudomonal antibiotics, empirical anti-pseudomonal antibiotics were associated with higher HRs for thoracic surgery and death within 90 days, respectively. Thus, regardless of the risks of multidrug-resistant organisms, empirical anti-pseudomonal antibiotics did not extend the time to thoracic surgery or death within 90 days. [ABSTRACT FROM AUTHOR]

Bauhinia purpurea L. is a medium-sized tree from the family Fabaceae. The plant is traditionally used as medicine by different tribes in Sikkim. The present study aimed to evaluate the modulation in minimum inhibitory concentration (MIC) of the bark methanol extract of Bauhinia purpurea L. against the clinical isolates of multidrug resistant Staphylococcus aureus. The synergistic activity of the test plant extract with different classes of antibiotics was also evaluated. The methanol extract of Bauhinia purpurea exhibited modulation by a 16-fold reduction in the MIC of clindamycin against both resistant and susceptible isolates, followed by penicillin and gentamicin, whereas a maximum of only a 4-fold MIC reduction was observed with ciprofloxacin. The lowest minimum inhibitory concentration and minimum bactericidal concentration showed by the plant extract was 0.48 and 0.97 mg/mL, respectively. The methanol extract of Bauhinia purpurea exhibited synergistic activity with penicillin, gentamicin, ciprofloxacin, and clindamycin against most of the tested isolates of multidrug-resistant Staphylococcus aureus (MDR-SA). Gas chromatography-mass spectrometry analysis of Bauhinia purpurea L. bark methanol extract revealed 16 phytocompounds. The results provide an insight into the potential antibacterial property of the plant extract in terms of its antibiotic MIC modulation and synergistic properties with the selected antibiotics. This is the first report of the antibiotic potentiation property of Bauhinia purpurea L., collected from Sikkim, India. [ABSTRACT FROM AUTHOR]

Industrial wastewater typically contains many organic and inorganic pollutants and is also contaminated by various microorganisms. Microbial species in industrial wastewater have not been extensively investigated. In this experiment, a Klebsiella pneumoniae strain was isolated for the first time from industrial wastewater containing a high concentration of sulfate and phosphate. Mass spectrometry, genetic analysis, and biochemical identification were conducted to understand the genetic and biochemical characteristics of this Klebsiella pneumoniae strain recovered from industrial wastewater. Growth experiments revealed that it exhibited an excellent growth rate in nutrient broth. Further analyses showed that the strain was sensitive to most antibiotics but resistant to chloramphenicol and nitrofurantoin. It also exhibited significant resistance to piperacillin/tazobactam and cefotaxime/clavulanic acid. Resistance gene experiments indicated the presence of gyrA, OqxB, and ParC genes associated with antibiotic resistance in the isolated Klebsiella pneumoniae strain. Proteomics uncovered the following three proteins related to drug resistance: the multi-drug resistant outer membrane protein MdtQ, the multi-drug resistant secretion protein, and the modulator of drug activity B, which are coexistent in Klebsiella pneumoniae. Proteomics and bioinformatics analyses further analyzed the protein composition and functional enrichment of Klebsiella pneumoniae. The isolation of Klebsiella pneumoniae from a high concentration in sulfate and phosphate industrial wastewater provides a new direction for further research on the characteristics and drug resistance traits of industrial wastewater microorganisms and the potential risks they may pose when released into the environment. [ABSTRACT FROM AUTHOR]

The effect of wastewater treatment plants in Pushchino, Russia, on abundance of antibiotic-resistant microorganisms and determinants of multiple drug resistance in the Oka River water and sediments was investigated. Treated wastewater was found to contribute to contamination of the Oka surface water layer with aminoglycoside-resistant strains. The role of Pushchino waste treatment plants in the dissemination of multidrug-resistant strains and plasmids of the A/C incompatibility groups (IncA/C) was demonstrated. Waste treatment plants were shown to affect both the total abundance of eubacteria in sediments and their composition, increasing the relative abundance of pseudomonads. [ABSTRACT FROM AUTHOR]

Background: Patients with hematologic malignancies frequently develop febrile neutropenia (FN) and subsequently receive long courses of broad-spectrum antibiotics. Limited data is available on de-escalation strategies. Methods : This was a retrospective observational cohort study of adult patients with a hematologic malignancy, FN, and positive culture results from June 2017 to June 2020. A conventional group (patients who remained on empiric, broad-spectrum agents) was compared to a de-escalation group (patients whose antibiotic therapy was de-escalated based on culture results). The primary outcome was the incidence of recurrent fever or antibiotic escalation due to infection while neutropenic. Results: Of the 123 patients included, the composite primary outcome occurred in 35.3% in the de-escalation group and 39.3% in the conventional group (P =.83). For secondary outcomes, median time to recurrent fever was 7 days in the de-escalation group and 7 days in the conventional group (P =.73). Incidence of Clostridioides difficile was 5.9% in the de-escalation group and 6.7% in the conventional group (P = 1.00). Development of multidrug resistant pathogens during hospital admission was 20.6% in the de-escalation group and 14.6% in the conventional group (P =.59). Median length of broad-spectrum antibiotics was 3 days in the de-escalation group and 8 days in the conventional group (P <.001). All-cause mortality within 30 days was 0 in the de-escalation group and 5.6% in the conventional group (P =.32). Conclusion: In a small sample of patients with a hematologic malignancy and FN, de-escalating antibiotics based on positive cultures decreased the duration of antibiotic therapy without increasing the rate of antibiotic failure. [ABSTRACT FROM AUTHOR]

Background: To develop a probiotic formulation for poultry feed, a few poultry gastrointestinal derived lactic acid bacteria (pGIT-d-LAB) were isolated from chicken intestinal specimens and in vitro experiment was performed to evaluate their efficacy as potential probiotic candidate. Methods: A total of 6 strains of LAB: Lactobacillus brevis (L. brevis), Lactobacillus acidophilus (L. acidophilus), Lactobacillus casei (L. casei), Pediococci spp, Lactobacillus fermentum (L. fermentum) and Lactobacillus plantarum (L. plantarum) were isolated and cultured for collection of Cell Free Supernatant (CFS). CFS collected was tested against pathogenic bacterial isolated from chicken feces as well as prevalent fungal pathogens, utilizing agar-well diffusion techniques. A preliminary investigation into the susceptibility of the pathogens to diverse antibiotics and antifungal drugs was conducted. Bacterial pathogens exhibiting resistance to a minimum of three classes of antibiotics were subsequently identified for pGIT-d-LAB CFS screening. Results: The observed results revealed that the CFS derived from the isolates exhibited varying degrees of growth inhibition against different pathogens. Among the tested pGIT-d-LAB isolates, L. acidophilus demonstrated the most prominent zone of inhibition, measuring 18 mm against Klebsiella pneumoniae ZTAC 1233. Notably, Citrobac-ter diversus ZTAC 1255 showed resistance to all tested pGIT-d-LAB. Quantification of the metabolites produced was performed, and peak production levels was determined. L. acidophilus produced the highest amount of lactic acid (1.789g/l), Pediococci spp. produced the highest amount of diacetyl and H2O2 (1.918g/l) (0.0025g/l) at 48 hr peak values respectively. Conclusion: The test isolates are potential probiotic candidates for controlling pathogens in poultry. [ABSTRACT FROM AUTHOR]

Background: The present study was undertaken to study the percentage of pathogenic bacteria present in different fruit and vegetable samples available in the market in and around Kalaburagi, Karnataka, South India. Methods: A total of 940 different samples were collected from Kalaburagi, out of which 390 (23.84%) were fruits and 550 (35.27%) were vegetables. The pathogenic bacteria were isolated, by enrichment culture method using peptone water. The bacterial isolates were identified by convention microbial identification procedures. Result: Antibiotic resistant testing by disc diffusion method performed for E. coli, Salmonella and Shigella. Among the pathogens, E. coli (86.50%) of the isolates were resistant to Nalidixic acid while Imipenem and Trimethoprim-Sulfamethoxazole has the lowest resistance (19.84%), Salmonella (86.66%) isolates were resistant to Ciprofloxacin while Norfloxacin has the lowest resistance (4.76%) and Shigella (80.35%) isolates were resistant to Vancomycin while Amoxicillin has the lowest resistant (3.57%). Multiple drug resistance (MDR) was seen in E. coli at (38.88%), Salmonella at (26.66%) and Shigella at (10.71%) accordingly. The study therefore shown that E.coli, Salmonella and Shigella occur in Fruits and vegetables which collected from market place in Kalaburagi, Karnataka India, As per the results, adequate precaution should be taken while handles these fruits and vegetables. The antimicrobial resistance pattern shown by the isolates is an indication that adequate measurement needs to be taken to regulate the drug use in both humans and animals in order to minimize the risk of increasing antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Despite extensive knowledge of antibiotic-targeted bacterial cell death, deeper understanding of antibiotic tolerance mechanisms is necessary to combat multi-drug resistance in the global healthcare settings. Regulatory RNAs in bacteria control important cellular processes such as cell division, cellular respiration, metabolism, and virulence. Here, we investigated how exposing Escherichia coli to the moderately effective first-generation antibiotic cephalothin alters transcriptional and post-transcriptional dynamics. Bacteria switched from active aerobic respiration to anaerobic adaptation via an FnrS and Tp2 small RNA-mediated post-transcriptional regulatory circuit. From the early hours of antibiotic exposure, FnrS was involved in regulating reactive oxygen species levels, and delayed oxygen consumption in bacteria. We demonstrated that bacteria strive to maintain cellular homeostasis via sRNA-mediated sudden respiratory changes upon sublethal antibiotic exposure. [ABSTRACT FROM AUTHOR]

Background and Aim: To observe presentation and outcome of diabetic foot infection (DFI) in hospitalized patients at a tertiary care center. Materials and Methods: This prospective clinical study included all those patients who visited the out-patient department (OPD) of the foot clinic of Baqai Institute of Diabetology and Endocrinology and were admitted to the hospital due to DFI from August 2020 to April 2021. Patients with DFI were assessed and classified into mild, moderate, and severe infections according to the Infectious Disease Society of America (IDSA)/International Working Group On Diabetic Foot guideline protocol. Primary outcome was healing either without amputation, or with minor or major amputation. Results: A total of 2405 patients visited the OPD and 658 got admitted. Of these 211 patients with DFI were included. Males 158 (75%) were predominant. As per IDSA classification, 99 (46.9%) had severe infection, 94 (44.5%) had moderate, while 18 (8.53%) had mild infection. Overall, 150 (71.1%) infected Diabetic Foot Ulcers (DFUs), 67 (44.6%) and 65 (43.3%) DFUs with moderate infection and severe infection respectively were healed without any amputation. Conclusion: Infection was found to be the major cause of amputation in most patients with toe amputation being more common. Early referral of patients to the tertiary care unit and a multidisciplinary approach may help prevent DFI from major and minor amputations. [ABSTRACT FROM AUTHOR]

Escherichia coli is a typical flora of an animals' digestive tract. Based on these details, this study was done on the detection and identification of multidrug-resistant E. coli in cattle in Surabaya abattoirs. Each cattle rectum swab sample was streaked into EMB agar media and followed by Gram staining. The IMViC test was used to confirm the presence of E. coli. Based on morphological culture features, Gram staining, and biochemical testing, the sample examination results revealed that 41 samples (41%) of the 100 cattle rectal swab samples that were isolated were confirmed to be positive for E. coli. The profile of antibiotic resistance from the results of the E. coli resistance test to antibiotics showed that out of a total of 41 isolates of E. coli, 12 isolates (29.27%) were detected as resistant to 1 class of antibiotics tested, while 2 isolates (4.88%) were resistant to 2 classes of antibiotics, and 3 isolates (7.32%) were confirmed to be multidrug resistance (MDR). [ABSTRACT FROM AUTHOR]

Purpose: Over the last decade, surgery rates have risen alarmingly, and surgical-site infections are expanding these concerns. In spite of advances in infection control practices, surgical infections continue to be a significant cause of death, prolonged hospitalization, and morbidity. As well as the presence of bacterial infections and their antibiotic resistance, biofilm formation is one of the challenges in the treatment of surgical wounds. Methods: This review article was based on published studies on inpatients and laboratory animals receiving phage therapy for surgical wounds, phage therapy for tissue and bone infections treated with surgery to prevent recurrence, antibiotic-resistant wound infections treated with phage therapy, and biofilm-involved surgical wounds treated with phage therapy which were searched without date restrictions. Results: It has been shown in this review article that phage therapy can be used to treat surgical-site infections in patients and animals, eliminate biofilms at the surgical site, prevent infection recurrence in wounds that have been operated on, and eradicate antibiotic-resistant infections in surgical wounds, including multi-drug resistance (MDR), extensively drug resistance (XDR), and pan-drug resistance (PDR). A cocktail of phages and antibiotics can also reduce surgical-site infections more effectively than phages alone. Conclusion: In light of these encouraging results, clinical trials and research with phages will continue in the near future to treat surgical-site infections, biofilm removal, and antibiotic-resistant wounds, all of which could be used to prescribe phages as an alternative to antibiotics. [ABSTRACT FROM AUTHOR]

The spread of antibiotic resistance represents a serious worldwide public health issue, underscoring the importance of epidemiology research in determining antimicrobial strategies. The purpose of this research was to investigate antibiotic resistance in Serratia marcescens isolates from clinical samples over seven years at the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in Salerno, Italy. S. marcescens is an important opportunistic pathogen associated with a wide spectrum of clinical diseases, including pneumonia, keratitis, meningitis, and urinary tract and wound infections. Outbreaks of nosocomial infections by S. marcescens strains have been documented in high-risk settings, mainly affecting immunocompromised patients and newborns. The primary objective of this study is to assess the rates of antibiotic resistance over the years to deal with a future emergency which includes the failure of various therapies due to antibiotic resistance. During the investigation, a total of 396 species of S. marcescens were isolated from various clinical samples, mainly from broncho-aspirates and sputum (31.6%) and blood cultures (21.5%). Antibiotics that showed the greatest susceptibility included ceftazidime/avibactam, amikacin, trimethoprim/sulfamethoxazole, and selected members of the cephalosporin class. However, a disconcerting trend of increasing rates of carbapenem resistance was outlined over the observation period. The absence of effective countermeasures, combined with growing antibiotic resistance that negates the effectiveness of multiple antibiotics, highlights the potential for S. marcescens infections to trigger serious clinical complications and increased mortality rates. The surveillance of Serratia marcescens infections constitutes a pivotal element in refining empiric therapy to mitigate the dissemination of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Purpose To characterize the susceptibilities of positive bacterial cultures and the appropriateness of empiric antimicrobial regimens for patients admitted from post–acute care facilities (PACFs). Methods This was a retrospective quality improvement study. The study included patients admitted from a PACF to one of 2 tertiary care teaching hospitals within the University of Pennsylvania Health System, located in Philadelphia, PA, from August 2020 to December 2021. Patients were included if they had at least one positive culture within 72 hours of admission. Results A total of 167 patients and 230 isolates from the study period were evaluated. The majority of positive cultures were from a urinary source (114 of 230, 49.6%). Nineteen patients (11.4%) had a history of multidrug-resistant organisms. The most common empiric antibiotics used were vancomycin (61.7%) and cefepime (59.3%). Sixty-one patients (36.5%) received inappropriate empiric therapy based on the culture results. When comparing our hospitals' general antibiogram to that of only PACF patients, Escherichia coli and Klebsiella pneumoniae had at least a 20% difference in susceptibility to levofloxacin, ceftriaxone, and cefepime. Extended-spectrum β-lactamase resistance was also higher in the PACF cohort (odds ratio, 2.09; 95% confidence interval, 1.4-3.1). Conclusion Clinically significant differences in antimicrobial susceptibility were found among patients admitted from PACFs compared to our health system's general antibiogram. The increased resistance rates identified in this study support the need for hospitals to evaluate this at-risk patient population, which may drive changes to empiric antibiotic prescribing practices. [ABSTRACT FROM AUTHOR]

Background Risk factors for ciprofloxacin or MDR in primary care urine specimens are not well defined. Objectives We created a primary care-specific antibiogram for Escherichia coli isolates from cases with complicated and uncomplicated urinary tract infection (UTI) and evaluated risk factors for ciprofloxacin, trimethoprim/sulfamethoxazole and MDR among Enterobacterales. Methods We conducted a cross-sectional study to determine resistance and risk factors by collecting urine cultures from all patients (≥18 years) presenting with provider-suspected UTI at two primary care, safety-net clinics in Houston, TX, USA between November 2018 and March 2020. Results Among 1262 cultures, 308 cultures grew 339 uropathogens. Patients with Enterobacterales (n  = 199) were mostly female (93.5%) with a mean age of 48.5 years. E. coli was the predominant uropathogen isolated (n  = 187/339; 55%) and had elevated trimethoprim/sulfamethoxazole (43.6%) and ciprofloxacin (29.5%) resistance, low nitrofurantoin (1.8%) resistance, and no fosfomycin resistance. Among E. coli , 10.6% were ESBL positive and 24.9% had MDR. Birth outside the U.S.A. prior (2 year) trimethoprim/sulfamethoxazole resistance, and diabetes mellitus were associated with trimethoprim/sulfamethoxazole resistance. Prior (60 day) fluoroquinolone use, prior ciprofloxacin resistance and both diabetes mellitus and hypertension were strongly associated with ciprofloxacin resistance. Prior fluoroquinolone use and a history of resistance to any studied antibiotic were associated with MDR, while pregnancy was protective. Conclusions We found elevated resistance to UTI-relevant antimicrobials and novel factors associated with resistance; these data can be incorporated into clinical decision tools to improve organism and drug concordance. [ABSTRACT FROM AUTHOR]

The emergence and spread of resistance in Enterobacteriaceae are complicating the treatment of serious nosocomial infections and threatening to create species resistant to all currently available agents. They are inhabitants of normal intestinal flora and are among the most common human pathogens, causing multiple infections . They are the source of communityand hospital-acquired infections. An observational study was conducted over a period of six months (July 2023 -- December 2023) in the microbiology laboratory of Swami Ramanand Teerth Government Medical College, Ambajogai, Maharashtra . A total of 468 bacterial isolates of Enterobacteriaceae from clinical specimens were processed for antimicrobial susceptibility testing The rate of multidrug resistance and extended spectrum beta-lactamases production was 54.2% and 23.8% respectively. Of the total ESBL producers 92.4% were multidrug resistance. The rate of multidrug resistance and extended spectrum beta-lactamases production were higher in organisms isolated from clinical samples collected from inpatients. High rate of MDR and ESBL was seen in E. coli (54.7% & 21.4%), Klebsiella spp. (68% & 16.8%) and Citrobacter spp. (41.1% & 44.1%). The antimicrobial resistance rate was highest against ampicillin (80.3%) followed by cefixime (56.4%), ceftazidime (53.6%), ceftriaxone (53.0%), cotrimoxazole (51.2%), ciprofloxacin (45%) and ofloxacin (42.3%). Multidrug resistance is common among Enterobacteriaceae. These bacteria have high rate of resistance against commonly used groups of antibiotics like cephalosporins and quinolones. Continuous monitoring, surveillance of antimicrobial resistance, proper infection control and practices are important to combat with these issues. [ABSTRACT FROM AUTHOR]

The growing global importance of antimicrobial resistance (AMR) in public health has prompted the creation of innovative approaches to combating the issue. In this study, the promising potential of bimetallic nanoparticles (BMNPs) was investigated as a novel weapon against AMR. This research begins by elaborating on the gravity of the AMR problem, outlining its scope in terms of the effects on healthcare systems, and stressing the urgent need for novel solutions. Because of their unusual features and wide range of potential uses, bimetallic nanoparticles (BMNPs), which are tiny particles consisting of two different metal elements, have attracted a lot of interest in numerous fields. This review article provides a comprehensive analysis of the composition, structural characteristics, and several synthesis processes employed in the production of BMNPs. Additionally, it delves into the unique properties and synergistic effects that set BMNPs apart from other materials. This review also focuses on the various antimicrobial activities shown by bimetallic nanoparticles, such as the rupturing of microbial cell membranes, the production of reactive oxygen species (ROS), and the regulation of biofilm formation. An extensive review of in vitro studies confirms the remarkable antibacterial activity of BMNPs against a variety of pathogens and sheds light on the dose-response relationship. The efficacy and safety of BMNPs in practical applications are assessed in this study. It also delves into the synergistic effects of BMNPs with traditional antimicrobial drugs and their ability to overcome multidrug resistance, providing mechanistic insight into these phenomena. Wound healing, infection prevention, and antimicrobial coatings on medical equipment are only some of the clinical applications of BMNPs that are examined, along with the difficulties and possible rewards of clinical translation. This review covers nanoparticle-based antibacterial regulation and emerging uses. The essay concludes with prospects for hybrid systems, site-specific targeting, and nanoparticle-mediated gene and drug delivery. In summary, bimetallic nanoparticles have surfaced as a potential solution, offering the public a more promising and healthier future. [ABSTRACT FROM AUTHOR]

Bacteria express a plethora of efflux pumps that can transport structurally varied molecules, including antimicrobial agents and antibiotics, out of cells. Thus, efflux pump systems participate in lowering intracellular concentrations of antibiotics, which allows phenotypic multidrug-resistant (MDR) bacteria to survive effectively amid higher concentrations of antibiotics. Acinetobacter baumannii is one of the classic examples of pathogens that can carry multiple efflux pump systems, which allows these bacteria to be MDR-to-pan-drug resistant and is now considered a public health threat. Therefore, efflux pumps in A. baumannii have gained major attention worldwide, and there has been increased interest in studying their mechanism of action, substrates, and potential efflux pump inhibitors (EPIs). Efflux pump inhibitors are molecules that can inhibit efflux pumps, rendering pathogens susceptible to antimicrobial agents, and are thus considered potential therapeutic agents for use in conjunction with antibiotics. This review focuses on the types of various efflux pumps detected in A. baumannii, their molecular mechanisms of action, the substrates they transport, and the challenges in developing EPIs that can be clinically useful in reference to A. baumannii. [ABSTRACT FROM AUTHOR]