Search

Pediatric oncology patients are usually immunosuppressed due to factors such as the neoplasm and its treatment, making them more susceptible to infections. This article aims to determine the infection profile of pediatric oncology patients admitted to an oncology reference hospital in Natal, Rio Grande do Norte, Brazil. A retrospective and cross-sectional study was conducted, collecting data from patients hospitalized due to infection in a pediatric oncology unit exclusively for the Brazilian public health system, spanning from 2018 to 2021. A total of 168 episodes of infections were identified in 96 patients, resulting in 157 hospitalizations. Among the patients with infections, 62.4% had hematological malignancies, and out of these cases, 74.6% specifically had Acute Lymphoid Leukemia. The Escherichia coli (31.9%) was the most prevalent microorganism isolated from the samples. Multidrug-resistant microorganisms accounted for 52% of all identified microorganisms. Fluoroquinolones and beta-lactam were the most prevalent antibiotic classes in the analyzed antibiograms. Factors such as Sex, type of cancer, chemotherapy in the last 30 days, were found to be associated with the occurrence of infection (p < 0.05). Conducting epidemiological studies regarding infections in pediatric oncology is crucial to development of empirical protocols, and the implementation of strategies to better control future infections. [ABSTRACT FROM AUTHOR]

Infectious diseases caused by resistant bacteria have been investigated by several researchers recently. Ofloxacin is a quinolone antibiotic used against resistant microorganisms and in different routes of administration. Transdermal drug delivery is used to reduce drug toxicity, avoid first‐pass metabolism, and reduce fluctuations in drug concentration in the body. Ofloxacin was formulated in a transdermal polymeric formula using hydroxypropyl methyl cellulose (HPMC) and chitosan at different ratios in the presence of palmitic acid as a permeation enhancer. Physical characterization, drug release and diffusion, drug matrix association, and antimicrobial assay have been investigated using different techniques including HPLC, fourier‐transform infrared spectroscopy (FTIR), Franz cells diffusion, and UV spectroscopy. Ofloxacin release was successfully accomplished in many polymeric formulas containing a high ratio of HPMC with a maximum drug release of 53%. Formulas selected for antimicrobial assay indicate that sustained release patches have successfully inhibited microbial and biofilm growth with a percentage inhibition of more than 90%. In conclusion, antibiotics can be formulated in transdermal polymeric film to target skin infection and reduce drug toxicity and avoid drug first metabolism for drugs reaching systemic circulation which has a direct influence on drug activity. [ABSTRACT FROM AUTHOR]

First marketed as RoundUp, glyphosate is history's most popular herbicide because of its low acute toxicity to metazoans and broad-spectrum effectiveness across plant species. The development of glyphosate-resistant crops has led to increased glyphosate use and consequences from the use of glyphosate-based herbicides (GBH). Glyphosate has entered the food supply, spurred glyphosate-resistant weeds, and exposed non-target organisms to glyphosate. Glyphosate targets EPSPS/AroA/Aro1 (orthologs across plants, bacteria, and fungi), the rate-limiting step in the production of aromatic amino acids from the shikimate pathway. Metazoans lacking this pathway are spared from acute toxicity and acquire their aromatic amino acids from their diet. However, glyphosate resistance is increasing in non-target organisms. Mutations and natural genetic variation discovered in Saccharomyces cerevisiae illustrate similar types of glyphosate resistance mechanisms in fungi, plants, and bacteria, in addition to known resistance mechanisms such as mutations in Aro1 that block glyphosate binding (target-site resistance (TSR)) and mutations in efflux drug transporters non-target-site resistance (NTSR). Recently, genetic variation and mutations in an amino transporter affecting glyphosate resistance have uncovered potential off-target effects of glyphosate in fungi and bacteria. While glyphosate is a glycine analog, it is transported into cells using an aspartic/glutamic acid (D/E) transporter. The size, shape, and charge distribution of glyphosate closely resembles D/E, and, therefore, glyphosate is a D/E amino acid mimic. The mitochondria use D/E in several pathways and mRNA-encoding mitochondrial proteins are differentially expressed during glyphosate exposure. Mutants downstream of Aro1 are not only sensitive to glyphosate but also a broad range of other chemicals that cannot be rescued by exogenous supplementation of aromatic amino acids. Glyphosate also decreases the pH when unbuffered and many studies do not consider the differences in pH that affect toxicity and resistance mechanisms. [ABSTRACT FROM AUTHOR]

The continuing need for the discovery of potent antibacterial agents against antibiotic-resistant pathogens is the driving force for many researchers to design and develop such agents. Herein, we report the design, synthesis, and biological evaluation of amidine derivatives as new antibacterial agents. Compound 13d was the most active in this study against a wide range of antibiotic-resistant, and susceptible, Gram-positive, and Gram-negative bacterial strains. Time–kill assay experiments indicated that compound 13d was an effective bactericidal compound against the tested organisms at the log-phase of bacterial growth. Docking simulations were performed to assess in silico its mode of action regarding UPPS, KARI, and DNA as potential bacterial targets. Results unveiled the importance of structural features of compound 13d in its biological activity including central thiophene ring equipped with left and right pyrrolo[2,3-b]pyridine and phenyl moieties and two terminal amidines cyclized into 4,5-dihydro-1H-imidazol-2-yl functionalities. Collectively, compound 13d represents a possible hit for future development of potent antibacterial agents. [ABSTRACT FROM AUTHOR]

Copyright of Peruvian Journal of Maternal Perinatal Research / Revista Peruana de Investigación Materno Perinatal is the property of Peruvian Journal of Maternal Perinatal Research / Revista Peruana de Investigacion Materno Perinatal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Microbial resistance to current antibiotics therapies is a major cause of implant failure and adverse clinical outcomes in orthopaedic surgery. Recent developments in advanced antimicrobial nanotechnologies provide numerous opportunities to effective remove resistant bacteria and prevent resistance from occurring through unique mechanisms. With tunable physicochemical properties, nanomaterials can be designed to be bactericidal, antifouling, immunomodulating, and capable of delivering antibacterial compounds to the infection region with spatiotemporal accuracy. Despite its substantial advancement, an important, but under-explored area, is potential microbial resistance to nanomaterials and how this can impact the clinical use of antimicrobial nanotechnologies. This review aims to provide a better understanding of nanomaterial-associated microbial resistance to accelerate bench-to-bedside translations of emerging nanotechnologies for effective control of implant associated infections.

The accelerated development of antibiotic resistance genes (ARGs) and antimicrobial resistance (AMR) in aquaculture environments due to the overuse of antibiotics is a global concern. To systematically understand the research trends in and key concepts of ARGs and AMR in aquaculture systems, this study employed the bibliometrix R-package to conduct a bibliometric analysis of the publication characteristics of ARGs and AMR in aquaculture systems from the Web of Science, published from 2000 to 2021. The results revealed that China has produced the most papers. China and the northern hemisphere countries work closely together. Collaboration and multidisciplinary research helped to better understand the impact of AMR in aquaculture on food security and human health. Antibiotic-resistant bacteria and ARGs in aquaculture, as well as the relationship between water environmental variables, antibiotic residuals, and ARGs, are the current research focus. One of the future directions is to establish a conclusive link among water environmental variables, antibiotics, and ARGs. Another future direction is the development of new economical and environmentally friendly technologies to treat AMR in aquaculture wastewater. Collectively, our findings investigate the development directions of AMR research in global aquaculture systems and provide future perspectives. [ABSTRACT FROM AUTHOR]

Nontyphoidal Salmonella species are one of the main bacterial causes of foodborne diseases, causing a public health problem. In addition, the ability to form biofilms, multiresistance to traditional drugs, and the absence of effective therapies against these microorganisms are some of the principal reasons for the increase in bacterial diseases. In this study, the anti-biofilm activity of twenty essential oils (EOs) on Salmonella enterica serovar Enteritidis ATCC 13076 was evaluated, as well as the metabolic changes caused by Lippia origanoides thymol chemotype EO (LOT-II) on planktonic and sessile cells. The anti-biofilm effect was evaluated by the crystal violet staining method, and cell viability was evaluated through the XTT method. The effect of EOs was observed by scanning electron microscopy (SEM) analysis. Untargeted metabolomics analyses were conducted to determine the effect of LOT-II EO on the cellular metabolome. LOT-II EO inhibited S. Enteritidis biofilm formation by more than 60%, without decreasing metabolic activity. Metabolic profile analysis identified changes in the modulation of metabolites in planktonic and sessile cells after LOT-II EO treatment. These changes showed alterations in different metabolic pathways, mainly in central carbon metabolism and nucleotide and amino acid metabolism. Finally, the possible mechanism of action of L. origanoides EO is proposed based on a metabolomics approach. Further studies are required to advance at the molecular level on the cellular targets affected by EOs, which are promising natural products for developing new therapeutic agents against Salmonella sp. strains. [ABSTRACT FROM AUTHOR]

The essential oils yield of Cedrus atlantica, Chenopodium ambrosioides and Eucalyptus camaldulensis was different. C. ambrosioides gave a relatively higher yield (2.1 ± 0.1%), while that of C. atlantica was low (1.0 ± 0.1%) and that of E. camaldulensis was lower (0.75 ± 0.1% of dry matter). The active ingredients of the essential oils and some of their biological effects were also determined. The characterization of their chemical compositions showed that the three essences have different chemical profiles: C. atlantica was richer in sesquiterpenes (β-Himachalene (54.21%) and γ -Himachalene (15.54%)), C. ambrosioides was very rich in monoterpene peroxides and monoterpenes (α-Terpinene (53.4%), ascaridole (17.7%) and ρ-Cymene (12.1%)) and E. camaldulensis was very rich in monoterpene compounds and monoterpenols (p-cymene (35.11%), γ-Eudesmol (11.9%), L-linalool (11.51%) and piperitone (10.28%)). The in vitro measurement of antioxidant activity by the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) reduction assay showed a significant performance of the eucalyptus oil and average performance of the other two (C. atlantica and C. ambrosioides). The in vitro bio-test for their antimicrobial effects showed that the antibacterial activity differed depending on the essential oil and the concentration used, and that their bactericidal efficacy was similar or superior to that of synthetic antibiotics. The toxicity test on rats revealed that the LD50 of the three essential oils was 500 mg/kg body weight, which classifies them as category four cytotoxic natural products at high doses. [ABSTRACT FROM AUTHOR]

Objective(s): Biofilm-associated infections are challenging to manage or treat since the biofilm matrix is impenetrable to most antibiotics. Therefore, the best approach to deal with biofilm infections is to interrupt the construction during the initial levels. Biofilm formation has been regulated through the quorum sensing (QS) network, making it an attractive target for any antibacterial therapy. Materials and Methods: Here, some coumarin members, including umbelliprenin, 4-farnesyloxycoumarin, gummosin, samarcandin, farnesifrol A, B, C, and auraptan, have been assessed as QS inhibitors in silico and in vitro. Their potential inhibitory effects on biofilm formation and virulence factor production of Pseudomonas aeruginosa PAO1 were evaluated. Results: First, the interaction of these compounds was investigated against one of the major transcriptional regulator proteins, PqsR, using molecular docking and structural analysis methodology. After that, in vitro evaluations indicated that 4-farnesyloxycoumarin and farnesifrol B showed considerable reduction in biofilm formation (62% and 56%, respectively), virulence factor production, and synergistic effects with tobramycin. Moreover, 4-farnesyloxycoumarin significantly (99.5%) reduced PqsR gene expression. Conclusion: The biofilm formation test, virulence factors production assays, gene expression analysis, and molecular dynamic simulations data demonstrated that coumarin derivatives are a potential antiQS family through PqsR inhibition. [ABSTRACT FROM AUTHOR]

We analyzed metagenome data of feces from sows at different physiological periods reared on large-scale farms in Anhui Province, China, to provide a better understanding of the microbial diversity of the sow intestinal microbiome and the structure of antibiotic-resistance genes (ARGs) and virulence genes it carries. Species annotation of the metagenome showed that in the porcine intestinal microbiome, bacteria were dominant, representing >97% of the microorganisms at each physiological period. Firmicutes and Proteobacteria dominated the bacterial community. In the porcine gut microbiome, the viral component accounted for an average of 0.65%, and the species annotation results indicated that most viruses were phages. In addition, we analyzed the microbiome for ARGs and virulence genes. Multidrug-like, MLS-like, and tetracycline-like ARGs were most abundant in all samples. Evaluation of the resistance mechanisms indicated that antibiotic inactivation was the main mechanism of action in the samples. It is noteworthy that there was a significant positive correlation between ARGs and the total microbiome. Moreover, comparative analysis with the Virulence Factor Database showed that adhesion virulence factors were most abundant.

The rise of multidrug-resistant organisms has significantly complicated the clinical management of urinary tract infections (UTIs), particularly in the context of pregnancy. This study aimed to identify and analyze the significant differences in microbial species and multidrug resistance patterns associated with UTIs in preterm versus full-term births, determine the bacterial species significantly associated with preterm birth, and describe the antibiotic resistance patterns affecting pregnant women with UTIs. This case–control study was conducted in western Romania and focused on pregnant women with UTIs admitted from 2019 to 2023. Data were retrospectively collected from 308 patients with positive cultures. Statistical analyses, including the Chi-square test, Fisher’s exact test, and logistic regression models, were employed to compare the proportions of microbial species and resistance patterns between preterm (n = 126) and full-term (n = 182) birth groups and identify factors independently associated with preterm birth. The study found no significant differences in demographic or lifestyle factors between the groups. However, significant differences were observed in several infection and inflammation markers. The median white blood cell count was higher in the preterm group (12.3 vs. 9.1, p = 0.032), and the median C-reactive protein level was significantly higher in the preterm group (18 vs. 7, p < 0.001). The preterm group exhibited a higher incidence of multidrug-resistant organisms, notably ESBL-producing organisms (19.8% vs. 4.4%, p < 0.001) and carbapenem-resistant Enterobacteriaceae (4.8% with p = 0.003). Notably, the resistance to amoxicillin was significantly higher in the preterm group (20.6% vs. 6.6%, p < 0.001). Significant bacterial associations with preterm births included Group B Streptococcus (OR 2.5, p = 0.001) and Enterobacter spp. (OR 1.8, p = 0.022). The study confirmed significant differences in microbial species and multidrug resistance patterns between UTIs associated with preterm and full-term births. The higher prevalence of certain bacteria and increased resistance to commonly used antibiotics in the preterm group underscore the need for tailored antimicrobial therapies and robust microbial identification in managing UTIs during pregnancy.

Magnetic nanoparticles with green cover sodium alginate and Ag, MnCoFe2O4@Sodium alginate/Ag (MCF@S-ALG/Ag) MNPs were prepared by a simple and clean method from Sargassum Vulgare brown algae. The structure of these nanoparticles was characterized by the Fourier transform infrared (FT-IR), X-ray powder diffraction (XRD), field emission-scanning electron microscope (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), thermogravimetric analysis (TGA), and vibrating sample magnetometer (VSM). Furthermore, the antibacterial activity of MCF@S-ALG/Ag MNPs was tested for two bacteria of gram-negative (Escherichia coli (E. coli)) bacteria and gram-positive (Staphylococcus aureus (S. aureus)) bacteria. The MCF@S-ALG/Ag MNPs showed the inhibition zone 16.32 mm for S. aureus and 12.84 mm for E. coli bacteria. The minimal inhibitory concentration (MIC) and the minimal bactericidal concentration (MBC) of MCF@S-ALG/Ag MNPs for both bacteria were found 20 µg/mL and 40 µg/mL, respectively. [ABSTRACT FROM AUTHOR]

Over the past decade, researchers have made several efforts to develop gel-based formulations that provide an alternative to traditional hydrogels and emulgel. Due to its excellent antibacterial properties, anise, the main constituent of Pimpinella anisum L., widely used in pharmaceuticals, was selected as the active ingredient in this study. Since many bacteria have developed considerable antibiotic resistance, this research aimed to develop an herbal emulgel for treating skin infections caused by bacteria. Given these obstacles, we developed and evaluated a new, cost-effective topical emulgel solution containing anise essential oil against Escherichia coli (E. coli). Anise-based emulgels, potential drug delivery platforms, have been evaluated for various parameters, including physical properties, viscosity, pH, rheology, encapsulation efficiency, and in vitro release research. The AEOs emulgel demonstrated remarkable colloidal stability, with a zeta potential of 29 mV, a size of 149.05 nm, and considerable polydispersity. The efficacy of anise-loaded emulgels as antibacterial formulations was evaluated in vitro. E. coli was used as a model microbial organism for the antibacterial study. Human keratinocytes (HaCaT) were used to examine the biocompatibility of the emulgel. Molecular docking revealed that the essential oil components of Pimpinella anisum L. possess a high affinity for the bacterial adhesin protein FimH of E. coli. These findings indicate that the developed AEOs have the potential to be analyzed using E. coli as a model organism. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 which initially causes an acute respiratory infection with primary damage to the lungs, has shown that it later causes multiple lesions, being considered a systemic disease. Pneumonia caused by the coronavirus is characterized by the development of a marked inflammatory process by direct damage to the pulmonary alveolocytes, as well as by an imbalance of the innate and adaptive immune status, pro-inflammatory and anti-inflammatory cytokines and chemokines, coagulation and fibrinolysis processes. The empirical use of antibacterial preparations has shown an evolution depending on the epidemiological situation, the data of experimental and clinical studies and the accumulated experience. The excessive prescription of antibiotics was determined by of subjective reasons, and with the accumulation of data confirming coinfections and/or secondary infections, the administration of antibacterial preparations was redirected. Beta-lactams, macrolides and fluoroquinolones were the most prescribed antibacterial drugs, for which possible antiviral effects were also estimated (azithromycin etc.). The use of antibiotics from the surveillance and reserve groups, according to WHO policy, was one of the major problems during the pandemic due to the aspect of dangerous microbial resistance. The elucidation of the microbial agents involved in the etiology of bacterial infections in COVID-19 has allowed for a more targeted selection of antibiotics, including regarding the danger of threatening microbial resistance. [ABSTRACT FROM AUTHOR]

Abstract Background Nowadays, engineers face challenges in developing novel technologies to find environmental and industrial solutions to address microbial contamination Microbes and treated objects differ significantly in their ability to tolerate the decontamination methods. Main text This work introduces a comprehensive review of recent trends of microbial decontamination for occupational, industrial, and domestic applications to help design and optimize suitable decontamination approaches. Conclusions Decontamination methods vary in their effectiveness towards microorganisms as sanitizing is the least effective decontamination method; disinfectants and antiseptics provide a higher level of decontamination. However, the best decontamination method is sterilizing. Hence, Microbial decontamination methods must be designed according to the level of microbes resistivity and the sensibility of the treated material. Graphical abstract

What is known and objective: Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID‐19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID‐19 pandemic in Iran. Methods: A multi‐centre retrospective study was designed to investigate the use of 16 broad‐spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed‐days. The bacterial co‐infection rate was also reported. Results and discussion: Totally, 43,791 hospitalized COVID‐19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed‐days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co‐infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non‐ICU settings (p = 0.15). What is new and conclusion: In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID‐19 patients. This over‐consumption of broad‐spectrum antibiotics may be associated with increased mortality in hospitalized COVID‐19 patients, which can be an alarming finding. [ABSTRACT FROM AUTHOR]

Antimicrobial drugs have been noticed to have reduce activity effective due to upsurge witnessed in resistance of microbes. To deal with viewpoint of such a circumstance, we must seek ways to prevent it or atleast mitigate its effects in order to provide its activity against the microbes. Hence, novel antimicrobials are the one of the most promising solution for ending antimicrobial resistance. Furthermore, due to the less development of newer antimicrobials in recent years, the only way to combat microbial resistance are various synergistic approaches of exploring antimicrobial drug combinations. This combination's efficacy is due to a synergistic chemical that re-sensitizes the resistant microbial strain. It has been observed that classes of β-lactamases inhibitors, efflux pump inhibitors and membrane permeabilizers are of particular relevance, since they can break resistance to the most commonly used antimicrobials. This review explains the readers that how these synergistic combinations can help to reduce or eliminate the microbial resistance supported with clinical evidence. [ABSTRACT FROM AUTHOR]

Globally, pathogenic microbes have reached a worrisome level of antibiotic resistance. Our work aims to identify and isolate the active components from the bioactive Ficus retusa bark extract and assess the potential synergistic activity of the most major compounds' constituents with the antibiotic tetracycline against certain pathogenic bacterial strains. The phytochemical screening of an acetone extract of F. retusa bark using column chromatography led to the identification of 10 phenolic components. The synergistic interaction of catechin and chlorogenic acid as the most major compounds with tetracycline was evaluated by checkerboard assay followed by time-kill assay, against Bacillus cereus, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, and Salmonella typhi with fraction inhibitory concentration index values (FICI) of 0.38, 0.43, 0.38, 0.38, 0.38, and 0.75 for catechin and 0.38, 0.65, 0.38, 0.63, 0.38, and 0.75 for chlorogenic acid. The combination of catechin and chlorogenic acid with tetracycline significantly enhanced antibacterial action against gram-positive and gram-negative microorganisms; therefore, catechin and chlorogenic acid combinations with tetracycline could be employed as innovative and safe antibiotics to combat microbial resistance. [ABSTRACT FROM AUTHOR]

Copyright of Asian Journals of Ecotoxicology is the property of Gai Kan Bian Wei Hui and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the knowledge, attitudes and behavior regarding antibiotics, use of antibiotics, and antibiotic resistance in students and health care professionals of the district of Barranquilla, Colombia. Study design: Descriptive, cross-sectional. Methods: A sample of 399 respondents was selected, that included health professionals and medical students from 12 health institutions in the district of Barranquilla (Colombia), using an established stratified sampling method. Each of the respondent professionals completed a survey that included 43 items in the Likert scale. A descriptive analysis of the study variables was performed using the software SPSS version 25. Results: Most of the respondents were women (64.4%), aged between 26 and 35 years (47.6%); 28.8% were nurses and 26.1% general practitioners, with ≤10 years of professional experience (63.4%). Overall, the survey revealed that the participants had considerable knowledge about antibiotic use (89.5%–98% correct answers) and the spread of antibiotic resistance (67.4%–89% correct answers). Approximately 74% of the respondents agreed or fully agreed with the questions related to the management of infections and the provision of advice. Conclusions: The present study revealed that most of the health care professionals surveyed had a good knowledge about antibiotic use, although strategies must be developed to strengthen knowledge regarding the spread of antibiotic resistance. Likewise, it is important to identify opportunities for improvement related with access to the guidelines and/or materials necessary to treat infections and to provide advice on antibiotic use and antibiotic resistance.

Antimicrobial resistance is a global crisis which requires urgent action to halt its spread. The rate of deaths due to antibiotic resistance from bacterial infection reached 25,000 annually. Resistance rates to Escherichia coli and Klebsiella pneumoniae has risen to reach 40% and 56% respectively, in addition to high resistance rates of Acinetobacter baumannii to fluroquinolones and other antibiotics that reached 56%. So it has become an urgent need to establish robust programs to control antibiotic resistance and optimize the use of antibiotics in hospitals. In Egypt particularly, the rate of antibiotic resistance becomes high due to wrong traditions of dispensing and administration antibiotics in hospitals and pharmacies, all that drove us to build a program controlling all these obstacles. Antimicrobial stewardship programs (ASPs) are strategic programs to prevent development of microbial resistance and monitor prescription patterns of clinicians inside hospitals. In addition to minimize the toxic effects, overuse of antibiotics and improve the patient health, and minimize the emergence of antibiotic resistance in shadow of the lack of development of novel antimicrobial agents. In this review, we aimed to discuss antimicrobial stewardship programs, their core elements, clinical importance, essential requirements and their implementation in Egypt. In conclusion, the development of national guidelines for antimicrobial stewardship programs would be a useful step to help clinicians in making evidence-based treatment choices regarding antibiotic therapy and implementation of better antibiotic during pandemics. We hope this review help the medical staff to perform stewardship programs to control the antibiotic resistance in Egypt healthcare settings.

The impacts of climate change, such as drought, can affect soil microbial communities. These communities are crucial for soil functioning and crop production. Organic and conventional cropping systems can promote distinct soil microbiomes and soil organic carbon contents, which might generate different capacities to mitigate drought effects on these cropping systems. A field-scale drought simulation was performed in long-term organically and conventionally managed cropping systems differing in fertilization and pesticide application. The soil microbiome was assessed during and after drought in bulk soil, rhizosphere, and roots of wheat. We found that drought reduced soil respiration and altered microbial community structures, affecting fungi in the bulk soil and rhizosphere more strongly than prokaryotes. Microbial communities associated with crops (i.e. rhizosphere and root) were more strongly influenced by drought compared to bulk soil communities. Drought legacy effects were observed in the bulk soil after harvesting and rewetting. The extent of the structural shifts in the soil microbiome in response to severe drought did not differ significantly between the organic and conventional cropping systems but each cropping system maintained a unique microbiome under drought. All cropping systems showed relative increases in potential plant growth-promoting genera under drought but some genera such as Streptomyces , Rhizophagus, Actinomadura , and Aneurinibacillus showed system-specific drought responses. This agricultural field study indicated that fungal communities might be less resistant to drought than prokaryotic communities in cropping systems and these effects get more pronounced in closer association with plants. Organic fertilization and the associated increase in soil organic carbon, or the reduction in pesticide application might not have the proposed ability to buffer severe drought stress on soil microbial taxonomic diversity. Yet, it remains to be elucidated whether the ability to maintain system-specific soil microbiomes also during drought translates into different functional capabilities to cope with the stress. • Drought reduced in-situ soil respiration and altered microbial community structures. • Soil fungi were more strongly affected by drought than prokaryotes. • Drought effects on microbes increased in close association with the plant. • No cropping system effectively mitigated drought's impact on soil microbial diversity. [ABSTRACT FROM AUTHOR]

The struggle against antibiotic-resistant microorganisms constitutes a real challenge for the contemporary medicine. Multidrug resistant (MDR) strains cause chronic, difficult to treat infections which more frequently emerge in healthcare nowadays. The abovementioned steadily increasing issue prompts a search for new solutions, which aim at reducing the spread of dangerous pathogens. Previous studies using metal nanoparticles have provided encouraging results. Interestingly, copper nanoparticles which have an antimicrobial effect against many bacteria, viruses or fungi, are particularly prominent in this group. In fact, copper is currently used as an antimicrobial material. Numerous healthcare facilities have replaced the existing equipment, or its components, with copper, or copper-coated items (door handles, bed frames, light switches). This, in turn, effectively reduces the occurrence of pathogens in healthcare environments, thus, limiting the spread of infections. Another vital aspect is the potential cytotoxicity of copper and their nanoparticles. Data obtained up to now have shown that metal nanoparticles present 7--50 times less toxicity than ionic forms. The knowledge regarding the safety of using nanoparticles in medicine is insufficient, therefore, further research is necessary. [ABSTRACT FROM AUTHOR]

Simple Summary: Every year, more than a million tons of fecal sludge (FS) containing biocides based on quaternary ammonium compounds and guanidine derivatives, which are widely used for FS deodorization and control of microbial activity, are generated in the environmentally safe toilet complexes of Russian Railways trains. Higher disposal costs for such biocide-contaminated FS due to activated sludge toxicity increases pressure on sanitary equipment servicing companies («Ecotol Service» LLC) to more efficiently discharge FS to wastewater treatment plants. In this work, we have developed a new environmentally friendly approach to reducing the toxicity of FS, based on the use of biological products from biocide-resistant bacterial strains isolated from FS. Our approach has proven to be effective in a series of FS biodegradation experiments, biological oxygen demand tests, and a newly developed disk-diffusion bioassay. Toxic shock caused by the discharge of biocide-contaminated fecal sludge (FS) from chemical toilets to conventional wastewater treatment plants (WWTP) can be a major problem in activated sludge operation. It is necessary to develop new environmental approaches to mitigate the toxicity of biocides in order to avoid degrading the performance of WWTP. "Latrina", a chemical toilet additive containing didecyldimethylammonium chloride and polyhexamethylene guanidine, is widely used in environmentally safe toilet complexes (ESTC) on Russian railway trains to deodorize FS and control microbial activity. In this work, seven biocide-resistant bacterial strains were isolated and identified from the FS of ESTC. The values of the minimum inhibitory and bactericidal concentrations of biocides for the isolated strains were 4.5–10 times higher than for the collection microorganisms. The bacterium Alcaligenes faecalis DOS7 was found to be particularly resistant to "Latrina", the minimum inhibitory concentration of which was almost 30 times higher than recommended for ESTC. Biological products based on isolated bacterial strains proved to be effective for FS biodegradation under both aerobic and anaerobic conditions. The results of the biochemical oxygen demand test and the newly developed disk-diffusion bioassay confirmed that isolated strains contribute to reducing toxicity of biocidal agents in FS. Hyper-resistance, non-pathogenicity, and potential plant growth-promoting ability make A. faecalis DOS7 promising for use in various biological products for wastewater treatment and bioremediation of soils contaminated with biocides, as well as in agriculture to increase plant productivity. [ABSTRACT FROM AUTHOR]

Background and Objectives: Escherichia coli (E. coli) is an important member of Enterobacteriaceae family involved in severe infections. The increased rate of resistance towards different classes of antibiotics limits their treatment options. The aim of this study was to assess the in vitro activity of classical and novel combinations of β-lactam/ β-lactamase inhibitor against E. coli clinical isolates. Materials and Methods: 140 clinical isolates of E. coli were collected from clinical specimens from Gastrointestinal Surgery Center (GISC) in Egypt. Extended spectrum β-lactamase (ESBL) was detected by double disk synergy test. Furthermore, the minimum inhibitory concentrations (MICs) for five different combinations were determined using the broth microdilution method including: amoxicillin/clavulanate and ampicillin/sulbactam as an example for classical combinations and cefoperazone/sulbactam, ceftazidime/avibactam, and cefepime/enmetazobactam as an example for new combinations. Results: The percentage of ESBL production among the tested isolates was 46.4%. Isolates were highly resistant to classical β-lactam/ β-lactamase inhibitor combinations, where (40.7%) and (42.9%) of isolates were resistant to amoxicillin/clavulanate and ampicillin/sulbactam, respectively. While new β-lactam/ β-lactamase inhibitor combinations had promising inhibitory action. The addition of novel β-lactamase inhibitors restored the susceptibility of isolates, where (94.3%) of isolates became susceptible to ceftazidime/avibactam combination, followed by cefoperazone/sulbactam (89.2%) and cefepime/enmetazobactam (85.7%). The synergistic effect seems to be effective where ceftazidime and avibactam were synergistic in 80% of isolates. Conclusion: The antibacterial activity of some antimicrobial agents can be enhanced by the addition of new β-lactamase inhibitors. Further in vivo investigation is needed to confirm their therapeutic efficacy against local isolates. [ABSTRACT FROM AUTHOR]

Background and Objectives: Escherichia coli (E. coli) is an important member of Enterobacteriaceae family involved in severe infections. The increased rate of resistance towards different classes of antibiotics limits their treatment options. The aim of this study was to assess the in vitro activity of classical and novel combinations of β-lactam/ β-lactamase inhibitor against E. coli clinical isolates. Materials and Methods: 140 clinical isolates of E. coli were collected from clinical specimens from Gastrointestinal Surgery Center (GISC) in Egypt. Extended spectrum β-lactamase (ESBL) was detected by double disk synergy test. Furthermore, the minimum inhibitory concentrations (MICs) for five different combinations were determined using the broth microdilution method including: amoxicillin/clavulanate and ampicillin/sulbactam as an example for classical combinations and cefoperazone/sulbactam, ceftazidime/avibactam, and cefepime/enmetazobactam as an example for new combinations. Results: The percentage of ESBL production among the tested isolates was 46.4%. Isolates were highly resistant to classical β-lactam/ β-lactamase inhibitor combinations, where (40.7%) and (42.9%) of isolates were resistant to amoxicillin/clavulanate and ampicillin/sulbactam, respectively. While new β-lactam/ β-lactamase inhibitor combinations had promising inhibitory action. The addition of novel β-lactamase inhibitors restored the susceptibility of isolates, where (94.3%) of isolates became susceptible to ceftazidime/avibactam combination, followed by cefoperazone/sulbactam (89.2%) and cefepime/enmetazobactam (85.7%). The synergistic effect seems to be effective where ceftazidime and avibactam were synergistic in 80% of isolates. Conclusion: The antibacterial activity of some antimicrobial agents can be enhanced by the addition of new β-lactamase inhibitors. Further in vivo investigation is needed to confirm their therapeutic efficacy against local isolates.

Abstract Disposal of municipal solid waste (MSW) can be considered a risk to human health representing a great environmental problem in several countries. MSW landfills are a significant source of toxic elements in the environment. Microorganisms able to thriving in leachate wastewater may exhibit metabolic machinery to synthesize a wide range of enzymes able to degrade and/or discolor toxic compounds from leachate. The use of non-pathogenic microbial cells for human health, recovered from leachate for biotechnological application, can be considered a promising approach in bioremediation processes of toxic compounds found in these environments. The present work aimed to the isolation, antibiotic resistance evaluation and leachate discoloration by microorganisms isolated from landfill leachate of Foz do Iguaçu. Forty bacteria and fifteen filamentous fungi were isolated. From these, six bacterial showed resistance at least one tested antibiotic, while six fungal isolates showed resistance to the antimycotic nystatin. CCMIBA_4L (unidentified bacteria) and Paecilomyces sp. CCMIBA_5N, were able to discolor 19.15% and 25.26% of the leachate, respectively. The results of the present work encourage future studies to characterize the enzymes involved in the discoloration and degradation of the leachate. The findings demonstrated the potential for the use of microorganisms from landfill leachate as bioremediation tools.

Abstract Background This review aims at establishing the emerging applications of phytobiotics in water treatment and disinfection. Results Statistical analysis of data obtained revealed that the use of plant product in water treatment needs more research attention. A major observation is that plants possess multifaceted components and can be sustainably developed into products for water treatment. The seed (24.53%), flower (20.75), leaf (16.98%) and fruit (11.32%) biomasses are preferred against bulb (3.77%), resin (1.89%), bark (1.89%) and tuber (1.89%). The observation suggests that novel applications of plant in water treatment need further exploration since vast and broader antimicrobial activities (63.63%) is reported than water treatment application (36.37%). Conclusions This review has revealed the existing knowledge gaps in exploration of plant resources for water treatment and product development. Chemical complexity of some plant extracts, lack of standardisation, slow working rate, poor water solubility, extraction and purification complexities are limitations that need to be overcome for industrial adoption of phytochemicals in water treatment. The field of phytobiotics should engage modern methodologies such as proteomics, genomics, and metabolomics to minimise challenges confronting phytobiotic standardisation. The knowledge disseminated awaits novel application for plant product development in water treatment.

The crisis of antibiotic resistance in bacteria is one of the most important concerns of World Health Organization (WHO), which requires further global research and studies in order to develop more effective antimicrobial compounds. Nanoparticles as an alternative to antibiotics have been widely used to target bacteria and they are useful in the treatment of bacterial infections. In this narrative review study, the advantages of using nanoparticles against bacteria are discussed. Due to their unique properties compared to the bulk form, nanoparticles have a high potential to be used as carriers and adjuvants with the ability to strengthen the immune system and fight bacteria using several mechanisms simultaneously. Recently, a number of nanoparticle-based drugs have been designed and used for clinical use as an alternative to antibiotics. Despite special attention to nanoparticles, their antibacterial mechanisms are not very well known. However, in this study, we have examined in detail a number of accepted antibacterial mechanisms such as oxidative stress induced by ROS and the function of nanoparticles for releasing soluble metal ions. Further over, we also examined important factors affecting the antibacterial properties of nanoparticles, including size, charge, zeta potential, and surface morphology will be investigated too. The limitations of the research will also be discussed.

Antibiotic resistance is considered a major health concern globally. It is a fact that the clinical need for new antibiotics was not achieved until now. One of the most commonly prescribed classes of antibiotics is β-Lactam antibiotics. However, most bacteria have developed resistance against β-Lactams by producing enzymes β-Lactamase or penicillinase. The discovery of new β-Lactamase inhibitors as new antibiotics or antibiotic adjuvants is essential to avoid future catastrophic pandemics. In this study, five dihydroisocoumarin: 6-methoxy mellein (1); 5,6-dihydroxymellein (2); 6-hydroxymellein (3); 4-chloro-6-hydroxymellein (4) and 4-chloro-5,6-di-hydroxymellein (5) were isolated from Wadi Lajab sediment-derived fungus Penicillium chrysogenum, located 15 km northwest of Jazan, KSA. The elucidation of the chemical structures of the isolated compounds was performed by analysis of their NMR, MS. Compounds 1–5 were tested for antibacterial activities against Gram-positive and Gram-negative bacteria. All of the compounds exhibited selective antibacterial activity against Gram-positive bacteria Staphylococcus aureus and Bacillus licheniformis except compound 3. The chloro-dihydroisocoumarin derivative, compound 4, showed potential antimicrobial activities against all of the tested strains with the MIC value between 0.8–5.3 μg/mL followed by compound 5, which exhibited a moderate inhibitory effect. Molecular docking data showed good affinity with the isolated compounds to β-Lactamase enzymes of bacteria; NDM-1, CTX-M, OXA-48. This work provides an effective strategy for compounds to inhibit bacterial growth or overcome bacterial resistance. [ABSTRACT FROM AUTHOR]

Simple Summary: Coumarins are a large family of benzopyrones, and more than 1300 coumarins have been reported to date. Natural, as well as synthetic, coumarins have demonstrated a diverse activity spectrum. On the other hand, the demands of the current health scenario witnessing morbidity and mortality due to microbial infections and multidrug-resistant bacterial strains, the well-reported phytochemical coumarin can be of interest. Some of the well-reported coumarin analogues as antimicrobial agents include β-lactum derivatives, coumarin-based 1,2,3-triazole compounds, the miconazole analogue, coumarin-substituted pyrazole hybrids, pyranocoumarin, coumarin−sulphonamide hybrids, pyranocoumarins, coumarin−sulphonamide derivatives, chromenylpyrazoles candidates, 3-amidocoumarins analogues, uracil−coumarin hybrids, indolinedione−coumarin hybrids, coumarin−imidazole hybrids, coumarin-fused pyrazolones and methyl thiazole derivatives, coumarin−theophylline hybrids, etc. In the present review, several methods for the synthesis of coumarin derivatives as antimicrobial agents are reported, along with structure−activity relationship (SAR) studies focusing on the developments reported since 2016. A major global health risk has been witnessed with the development of drug-resistant bacteria and multidrug-resistant pathogens linked to significant mortality. Coumarins are heterocyclic compounds belonging to the benzophenone class enriched in different plants. Coumarins and their derivatives have a wide range of biological activity, including antibacterial, anticoagulant, antioxidant, anti-inflammatory, antiviral, antitumour, and enzyme inhibitory effects. In the past few years, attempts have been reported towards the optimization, synthesis, and evaluation of novel coumarin analogues as antimicrobial agents. Several coumarin-based antibiotic hybrids have been developed, and the majority of them were reported to exhibit potential antibacterial effects. In the present work, studies reported from 2016 to 2020 about antimicrobial coumarin analogues are the focus. The diverse biological spectrum of coumarins can be attributed to their free radical scavenging abilities. In addition to various synthetic strategies developed, some of the structural features include a heterocyclic ring with electron-withdrawing/donating groups conjugated with the coumarin nucleus. The suggested structure−activity relationship (SAR) can provide insight into how coumarin hybrids can be rationally improved against multidrug-resistant bacteria. The present work demonstrates molecular insights for coumarin derivatives having antimicrobial properties from the recent past. The detailed SAR outcomes will benefit towards leading optimization during the discovery and development of novel antimicrobial therapeutics. [ABSTRACT FROM AUTHOR]

The use of antimicrobials in animals is broader compared to humans, which can influence the increase in microbial resistance. This study was a systematic review which determined the prevalence of resistant Enterococcus faecium in commercial cattle. Eighteen studies were included, mainly carried out in European countries (n= 9) and in the production (n= 11) and retail (n= 7) environments. The main material used in the detection of the microorganism was milk. The mean prevalence of resistant E. faecium in cattle was 4.3% (95% CI= 2.8-5.0%), but the prevalence in Asia was higher [25.4% (95% CI= 20.5-30.6%)]. There was a higher prevalence in samples from retail (13.7%; 95% CI= 11.5-16.1%) and collected mainly from equipment surfaces (12.5%; 95% CI= 5.5-26.1%) than in the others tested samples. Antibiotics frequently tested were vancomycin, tetracycline, ciprofloxacin, and erythromycin, with resistance percentages of 50%, 59%, 79%, and 94%, respectively. These results reinforce the need to plan interventions to reduce antimicrobials in food-producing animals. [ABSTRACT FROM AUTHOR]

The antioxidant, antibacterial and antifungal properties of essential oils (EOs) of Juniperus thurifera L., a plant utilized in traditional, herbal medicine, were investigated. The EOs were extracted by use of a Clevenger apparatus and phytochemicals identified by gas chromatography coupled with mass spectrometry (GC/MS/MS). The antioxidant capacity of EOs of J. thurifera was determined by 2,2-diphenyl-1-picrylhydrazil (DPPH), total antioxidant capacity (TAC), and ferric reducing antioxidant power (FRAP). Antimicrobial activity of EOs of J. thurifera was determined against four fungal strains, Candida albicans; ATCC 10231, Aspergillus niger; MTCC 282, Aspergillus flavus; MTCC 9606 and Fusarium oxysporum; MTCC 9913 and four bacterial strains, Staphylococcus aureus; ATCC 6633, Escherichia coli; K12, Bacillus subtilis; DSM 6333, and Pseudomonas aeruginosa; CIP A22, by use of the disk diffusion method, and microdilution method used to determine the minimum inhibitory concentration (MIC). EOs of J. thurifera consisted of 31 compounds and were dominated by α-thujene (25%), elemol (12%) and muurolol (12%). Antioxidant activity recorded an IC50 of 24 ± 0.71 µg/mL (DPPF), EC50 of 0.19 ± 0.01 mg/mL (FRAP), and 9.3 × 102 ± 38 mg EAA/g (TAC). The EOs of J. thurifera exhibited significant antibacterial activity against all bacterial strains under investigation, especially P. aeruginosa; CIP A22 with an inhibition diameter of 28 ± 1.5 mm and MIC of 4.8 × 10−2 ± 0. 001 µg/mL. EOs of J. thurifera also exhibited significant antifungal activity against C. albicans; ATCC 10231 and F. oxysporum; MTCC 9913 with an activity of 21 ± 2.1 mm, 32 ± 2.3%, and MIC of 9.5 × 10−2 ± 0.001 Bioactive molecules found in EOs of J. thurifera could be used as an alternative solution to antibiotics available on the market to combat microbial resistance. [ABSTRACT FROM AUTHOR]

The use of mobile phones by healthcare personnel, doctors, patients, and patients’ companions are unavoidable in health centers, especially in hospitals. Besides being rarely clean, the mobile phone is a potential reservoir of disease and pathogens and hospital infections on bedside of hospitalized patients. In this study, the microbial contamination of mobile phones and potential of transmitting infections and their antibiotic resistance pattern were investigated. In this descriptive cross-sectional study, a questionnaire was prepared to assess the importance of maternity, neonatal, and intensive care unit (ICU) staff attention to how to use and clean the cell phones in terms of valid sources. Samples were taken from 116 cell phones using a sterile swab. The standard plate count was used to detect the existing bacteria, and the antimicrobial resistance patterns of isolated bacteria were determined by standard methods. The microbial culture experiments indicated that 107 cell phones had microbial contamination, accounting for 92.24% of mobile phones. From 132 isolated strains, 115 strains (87.12%) were gram-positive while 17 were Gram-negative (12.88%). Furthermore, 67 (57.76%), 9 (7.7%), 4 (3.45%), 10 (8.62%), 12 (10.35%), 22 (19%), and 8 (6.9%) strains were coagulase-negative staphylococci, Pseudomonas aeruginosa, Staphylococcus aureus, Corynebacterium, Bacillus, Streptococcus, and Escherichia coli, respectively. The results of this study indicated that cell phones were contaminated with different types of bacteria, and that all species isolated partially played an important role in the development of hospital-acquired and opportunistic infections. Therefore, continuous disinfection of mobile phones and non-use or limited use of them in the hospitals are recommended.

Background and Aim: Campylobacteriosis is a common foodborne disease epidemiologically linked to the consumption of poultry products. However, other sources, such as raw or contaminated milk, contaminated water or ice, contact with infected livestock, and pets, are reported. This study aimed to evaluate the prevalence and resistance to microbial resistance of Campylobacter coliM in broiler farms in the region of Marrakesh Safi, Morocco. Materials and Methods: The study was conducted between May and December 2017 and involved 35 broiler farms. One hundred and five cloacal swabs were collected from the eight provinces in the region of Marrakesh Safi, Morocco. Bacteriology method NM ISO/TS 10272-3: 2013 was used to isolate and identify Campylobacter spp. Molecular identification (polymerase chain reaction) was used for confirmation. A disk diffusion method on Mueller-Hinton agar was used for susceptibility testing. Five antibiotic agents, including first-line drugs, were evaluated. Results: Among 105 samples, 71.4% (75/105) were positive for Campylobacter spp. test and 56% (42/75) of isolates belonged to the species coli. Susceptibility profiles showed that 95.2% of C. coli strains were resistant to ampicillin, 92.8% to erythromycin and tetracycline, 85.7% to ciprofloxacin, and 7.1% to gentamicin. Conclusion: This study underlines the need to strengthen implementation of specific control procedures to decrease contamination of poultry meat with Campylobacter spp. and to reduce the use of antibiotics in the poultry sector.

Background: Multidrug-resistant bacteria present in food of animal origin raise human and animal health concerns. Objective: To assess antimicrobial resistance of Escherichia coli isolates from sheep carcasses subjected to spray-chilling with water (4 and 10 hours) during cooling. Methods: Thirty surface swabs were collected from carcasses before and after the last water spray in two slaughter periods. In a first assessment (1st sampling), three spray-chilled carcasses (4 hours), three non-sprayed and one control carcass were sampled. In a second assessment (2nd sampling), the same number of carcasses and treatments were maintained, but spray-chilling was extended to 10 hours. All samples collected were isolated and submitted to susceptibility test using 16 (1st sampling) and 17 (2nd sampling) antimicrobials, respectively. Results: Overall, E. coli isolates were resistant most antimicrobials. Spray-chilled and control carcasses (10 hours) showed resistance to meropenem. Conclusion: E. coli isolates from carcasses subjected to spray-chilling with water for 10 hours had higher antimicrobial resistance to one, two, and four antimicrobial classes, characterizing a multidrug resistance profile. These results highlight the need to monitor health status throughout the meat production processes.

Background: Resistance to antibiotics, including aminoglycosides (AMG) is one of the problems associated with inappropriate administration of broad-spectrum antibiotics. Objectives: This study aimed to assess the clinical features of aminoglycosides consumption based on the Defined Daily Dose (DDD) index in open heart surgery. Methods: This study was done on 268 patients who underwent heart surgery during 2015 and 2016. Clinical and demographic characteristics, laboratory data, and aminoglycoside-related data such as dose and the total duration of administration were collected through a questionnaire designed by the authors. The patients’ DDD/100 bed-days were calculated, too. Results: Out of 268 patients, 170 patients (63.4%) were male. The Mean±SD age of the patients was 60.65±10.71 years and the Mean±SD duration of hospitalization was 12.19±7.02 days. Ischemic heart disease was the most prevalent cause of hospitalization. The Mean duration of receiving aminoglycosides was 3.61 days. In 134 patients (50%), creatinine clearance was less than 60 mL/min during aminoglycosides administration. In 25 patients (9.32%), a 50% increase in serum creatinine during receiving aminoglycosides was observed. Creatinine clearance had not been calculated for any patient. Conclusion: In this study, monitoring the side effects of aminoglycosides and the serum concentration was not routinely performed. Dose adjustment of aminoglycosides based on renal function test was not considered in a large number of patients and as a result, the dose was inappropriate in many patients. Therefore, it is recommended that the guidelines of drug usage were followed and the patients were monitored more closely for side effects.

One of the reasons of the failure of educational activities in the field of rational antimicrobial therapy is, most likely, the discrepancy between the level of initial training of students and the complexity of the presented material. The aim of this study was to assess the baseline knowledge of physicians in the field of microbiology, clinical pharmacology of antimicrobial agents and the level of antibiotic resistance in health facilities to develop an effective training program. Materials and methods. The study was conducted in the framework of implementation of the first phase of the antimicrobial stewardship program - SCAT program (Strategy for the Control of Antimicrobial Therapy). An anonymous survey of physicians of different specialties was carried out. Clinical pharmacologists composed the questionnaire, which included questions of different levels of complexity, divided into thematic blocks. The results of the survey were evaluated and compared depending on specialty and experience. The expected and real level of knowledge was analyzed. Results. 110 doctors of different specialties have participated in the survey. The respondents showed a low level of knowledge in the scope of the inquiry (50% correct answers on average), survey results significantly depended on specialty. The correlation between results and experience was also revealed - the knowledge was accumulated in the first 15 years of experience, while the number of correct answers among specialists with more extensive professional experience had a tendency to decrease. The complexity of the questions predicted by the experts did not correspond with the actual one in 66% of the cases. In 96% of inconsistencies, the real complexity was higher than the predicted one. Conclusion. The results of the study revealed that experts should assess the baseline level of knowledge of specialists more objectively. The training course should be as understandable and interesting for the audience as possible. It may also be advisable to develop various training programs for doctors of different specialties. The main emphasis should be placed on the training of young doctors, unobtrusively involving doctors with greater clinical experience in the process, if possible. The small group of respondents and only one center that participated in the survey do not allow making generalizing conclusions.

Background: Inappropriate use of broad-spectrum antibiotics has contributed to the emergence of resistant microorganisms, increased treatment costs, morbidity and mortality, drug toxicity, and prolonged hospitalization period. Determining the epidemiology of antibiotic resistance in various hospital wards allows for more precise drug selection in the hospital setting. This study evaluated the use and resistance pattern of a broad-spectrum antibiotic, Piperacillin/tazobactam, in Imam Khomeini, a referral teaching hospital in Urmia, Iran. Methods: All hospitalized patients who were treated with Piperacillin\Tazobactam from January to August 2018 were included. Demographic (age, sex, weight, comorbidities) and clinical data (Indication, dosing, duration of the treatment, susceptibility test, creatinine clearance, need for dose adjustment, clinical outcome, and mortality) of the patients were collected, and the compliance of piperacillin\tazobactam administration and its resistance pattern was assessed according to Lexi-comp- 2019 recommendations. Results: Among 177 patients, 88.7% received piperacillin\tazobactam without any appropriate susceptibility tests. The piperacillin disk was used in only 33.3% of the culture-positive cases in our research, with 70% resistance. Acinetobacter was the most common bacteria found in our culture-positive samples. The average duration of piperacillin\tazobactam treatment was 8.52 ± 5.84 days. Indications in 8.5%, doses in 18.5%, prescription period in 19.7%, and dose intervals in 31.4% of the cases were inappropriate. Piperacillin\tazobactam was mainly administered for pneumonia (34.5%) Conclusion: This study showed an injudicious use of Piperacillin/tazobactam in our hospital, evidenced by the significant number of inappropriate doses, intervals, and treatment duration. Decision-making based on susceptibility tests using appropriate and accurate methods, close monitoring of the patients' clinical status, including creatinine clearance, and antimicrobial stewardship programs may optimize the rational administration of broad-spectrum antimicrobials and avoid the emergence of bacterial resistance.

Nontyphoidal Salmonella species are one of the main bacterial causes of foodborne diseases, causing a public health problem. In addition, the ability to form biofilms, multiresistance to traditional drugs, and the absence of effective therapies against these microorganisms are some of the principal reasons for the increase in bacterial diseases. In this study, the anti-biofilm activity of twenty essential oils (EOs) on Salmonella enterica serovar Enteritidis ATCC 13076 was evaluated, as well as the metabolic changes caused by Lippia origanoides thymol chemotype EO (LOT-II) on planktonic and sessile cells. The anti-biofilm effect was evaluated by the crystal violet staining method, and cell viability was evaluated through the XTT method. The effect of EOs was observed by scanning electron microscopy (SEM) analysis. Untargeted metabolomics analyses were conducted to determine the effect of LOT-II EO on the cellular metabolome. LOT-II EO inhibited S. Enteritidis biofilm formation by more than 60%, without decreasing metabolic activity. Metabolic profile analysis identified changes in the modulation of metabolites in planktonic and sessile cells after LOT-II EO treatment. These changes showed alterations in different metabolic pathways, mainly in central carbon metabolism and nucleotide and amino acid metabolism. Finally, the possible mechanism of action of L. origanoides EO is proposed based on a metabolomics approach. Further studies are required to advance at the molecular level on the cellular targets affected by EOs, which are promising natural products for developing new therapeutic agents against Salmonella sp. strains.