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Plant-derived compounds are renowned for their remarkable pharmacological properties, holding immense promise for therapeutic interventions in human health. In this study, we aimed to assess the antimicrobial, anti-hemolytic, antioxidant, and wound healing attributes of watercress oil incorporated into Vaseline gel (OLG) compared to watercress oil alone. OLG was formulated through a meticulous process involving the addition of Vaseline gel to the oil under agitation conditions. High-performance liquid chromatography analysis of watercress oil unveiled a rich array of phenolic compounds, including gallic acid (10.18 µg/mL), daidzein (3.46 µg/mL), and hesperetin (3.28 µg/mL). The inhibitory zones caused by watercress oil alone against a spectrum of pathogens, including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Candida albicans, were measured at 25 ± 0.3, 26 ± 0.1, 22 ± 0.2, 25 ± 0.2, and 24 ± 0.1 mm, respectively. Notably, OLG exhibited slightly larger zones of inhibition (27 ± 0.2, 30 ± 0.2, 24 ± 0.1, 28 ± 0.1, and 25 ± 0.3 mm) against the same microbial strains. Furthermore, the minimum inhibitory concentration (MIC) of OLG against E. coli and E. faecalis was lower compared to watercress oil alone, indicating enhanced efficacy. Similarly, the minimum bactericidal concentration (MBC) of OLG was notably lower across all tested bacteria compared to watercress oil alone. Inhibition of bacterial hemolysis, particularly K. pneumoniae, was significantly enhanced with OLG treatment, showcasing reductions of 19.4%, 11.6%, and 6.8% at 25%, 50%, and 75% MIC concentrations, respectively, compared to watercress oil alone. The antioxidant activity of both oil and OLG was quantified with IC50 values of 2.56 and 3.02 µg/mL, respectively. Moreover, OLG demonstrated remarkable efficacy in wound healing assays, with notable enhancements in migration rate, wound closure, and area difference compared to control cells. In light of the observed antibacterial, antifungal, anti-hemolytic, and wound healing properties of OLG, this formulation holds therapeutic potential in treating microbial infections and promoting wound healing. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae, a major clinical pathogen known for causing severe infections, is attracting heightened attention due to its escalating antibiotic resistance. Phages are emerging as a promising alternative to antibiotics; however, their specificity to particular hosts often restricts their use. In this study, a collection of 114 phages is obtained and subjected to analysis against 238 clinical K. pneumoniae strains, revealing a spectrum of lytic behaviors. A correlation between putative tail protein clusters and lysis patterns leads to the discovery of six receptor‐binding protein (RBP) clusters that determine host capsule tropism. Significantly, RBPs with cross‐capsular lysis capabilities are identified. The newly‐identified RBPs provide a toolbox for customizing phages to target diverse capsular types. Building on the toolbox, the engineered phages with altered RBPs successfully shifted and broadened their host capsule tropism, setting the stage for tunable phage that offer a precise and flexible solution to combat K. pneumoniae infections. [ABSTRACT FROM AUTHOR]

Background: Sepsis remains a leading cause of mortality in intensive care units, and rapid and accurate pathogen detection is crucial for effective treatment. This study evaluated the clinical application of multi-site metagenomic next-generation sequencing (mNGS) for the diagnosis of sepsis, comparing its performance against conventional methods. Methods: A retrospective analysis was conducted on 69 patients with sepsis consecutively admitted to the Department of Intensive Care Medicine, Meizhou People's Hospital. Samples of peripheral blood and infection sites were collected for mNGS and conventional method tests to compare the positive rate of mNGS and traditional pathogen detection methods and the distribution of pathogens. The methods used in this study included a comprehensive analysis of pathogen consistency between peripheral blood and infection site samples. Additionally, the correlation between the pathogens detected and clinical outcomes was investigated. Results: Of the patients with sepsis, 57.97% experienced dyspnea, and 65.2% had underlying diseases, with hypertension being the most common. mNGS demonstrated a significantly higher pathogen detection rate (88%) compared to the conventional method tests (26%). The pathogen consistency rate was 60% between plasma and bronchoalveolar lavage fluid samples, and that of plasma and local body fluid samples was 63%. The most frequently detected pathogens were gram-negative bacteria, and Klebsiella pneumonia. There were no significant differences in the clinical features between the pathogens. Conclusion: mNGS is significantly superior to conventional methods in pathogen detection. There was a notable high pathogen consistency detection between blood and local body fluid samples, supporting the clinical relevance of mNGS. This study highlights the superiority of mNGS in detecting a broad spectrum of pathogens quickly and accurately. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: K. pneumoniae become multidrug-resistant (MDR) and commonly poses a serious health threat to patients due to limited therapeutic options. As a result, determining the prevalence and antimicrobial susceptibility patterns of K. pneumoniae isolates from clinical specimens is substantial to patient diagnosis and treatment. Methods and materials: A retrospective cross-sectional study was conducted from July 2021 to July 2022 at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Sociodemographic and laboratory data were collected from registered books using a data collection sheet. All types of samples were collected and processed using standard procedures. Identification of K. pneumoniae was done using Gram stain, colony characterization on culture media, anda series of biochemical tests. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion technique. The data were entered using Epi-info version 7 and exported to SPSS version 20 for analysis. Results: Among 2600 clinical specimens, 735 (28.3%) were positive for bacteria, and K. pneumoniae isolates accounted for 147 (20%). Most of them were isolated from neonates and mainly obtained from blood specimens (81.6%). These isolates were 100% resistant to Nalidixic acid, Cefotaxime, and Cefazolin. About 84% and 83.3% of the isolates were also resistant to Ceftriaxone and Tetracycline, respectively. However, they are sensitive to Nitrofurantoin (86.6%), Imipenem (85.7%), Meropenem (79%), and Amikacin (78.3%). The overall proportion of MDR K. pneumoniae isolates accounted for 57.1%. Conclusion: The magnitude of MDR K. pneumoniae was very alarming. Therefore, strengthening antimicrobial stewardship programs and antimicrobial surveillance practices is strongly recommended in the study area. [ABSTRACT FROM AUTHOR]

A recent scientific investigation has shown promising results of selenium nanoparticles (SeNPs) for the anticancer and antimicrobial activities. This study aims to evaluate the effects of PVP SeNPs on bacterial strains, including Staphylococcus aureus (S. aureus), Bacillus cereus (B. cereus), Klebsiella pneumoniae (K. pneumoniae), Escherichia coli (E. coli), and Pseudomonas aeruginosa (P. aeruginosa). Also, its antitumor activity against the MRC-5 carcinoma cell line. SeNPs were prepared via gamma irradiation using PVP as a capping agent, and their size and morphological structure were determined using HRTEM. The size of the SeNPs ranged from 36 to 66.59 nm. UV–vis spectra confirmed the formation of SeNPs, while FTIR measurement confirmed a change in the PVP structure after adding selenium nanoparticles. The highest effect was reported on HepG2 by an IC50 with a value of 8.87 µg/ml, followed by HeLa, PC3, MCF-7, and Caco2 cell lines, respectively. Furthermore, ZOI reached 36.33 ± 3.05 mm. The best value of the minimum inhibitory concentration (MIC) was 0.313 µg/ml. Scanning electron microscope (SEM) imaging against bacteria showed deformations and distortions in their structures. Transmission electron (TEM) revealed ultrastructure changes in treated bacteria because of the free radicals that made cytotoxicity which confirmed by Electron spin resonance (ESR). [ABSTRACT FROM AUTHOR]

Background: Pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae can vary in severity, and several risk factors for the development of organ dysfunction in PLA have been implicated. However, few studies to date have explored the most common risk factors for clinical severity. Methods: We conducted a study on patients with PLA caused by Klebsiella pneumoniae between February 2013 and December 2022.Using logistic regression analysis, we sought to identify factors associated with positive blood culture, septic shock, and intensive care unit (ICU) admission. Results: After included 200 patients, we found that an elevated procalcitonin (PCT) level (p = 0.03), higher glucose level (p = 0.03), and lower total cholesterol (TC) level (p = 0.01) were associated with a higher likelihood of positive blood bacteriological culture. Additionally, an increased PCT level (p = 0.02) and lower TC level (p < 0.01) were associated with an elevated risk of septic shock. Furthermore, a higher PCT level (p < 0.01) was associated with a higher probability of ICU admission. Conclusion: In patients with PLA caused by Klebsiella pneumoniae, the PCT, glucose, and TC levels were found to be associated with positive blood culture, septic shock, and ICU admission. [ABSTRACT FROM AUTHOR]

Introduction Bloodstream infections are a significant threat to soldiers wounded in combat and contribute to preventable deaths. Novel and combination therapies that can be delivered on the battlefield or in lower roles of care are urgently needed to address the threat of bloodstream infection among military personnel. In this manuscript, we tested the antibacterial capability of silver ions (Ag+), with long-appreciated antibacterial properties, against ESKAPEE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli) pathogens. Materials and Methods We used the GENESYS (RAIN LLC) device to deliver Ag+ to Gram-positive and Gram-negative ESKAPEE organisms grown in broth, human blood, and serum. Following the Ag+ treatment, we quantified the antibacterial effects by quantifying colony-forming units. Results We found that Ag+ was bactericidal against 5 Gram-negative organisms, K pneumoniae, A baumannii, P aeruginosa , E cloacae , and E coli , and bacteriostatic against 2 Gram-positive organisms, E faecium and S aureus. The whole blood and serum inhibited the bactericidal activity of Ag+ against a common agent of bloodstream infection, P aeruginosa. Finally, when Ag+ was added in conjunction with antibiotic in the presence of whole blood, there was no significant effect of Ag+ over antibiotic alone. Conclusions Our results confirmed that Ag+ has broad-spectrum antibacterial properties. However, the therapeutic value of Ag+ may not extend to the treatment of bloodstream infections because of the inhibition of Ag+ activity in blood and serum. [ABSTRACT FROM AUTHOR]

Introduction: The dissemination of antimicrobial resistance (AMR) in critical priority pathogens is a significant threat. Non-clinical reservoirs of AMR, such as agriculture and food production facilities, may contribute to the transmission of clinically relevant pathogens such as multidrug-resistant (MDR) Klebsiella pneumoniae. There is currently very limited knowledge regarding the population structure and genomic diversity of K. pneumoniae in poultry production in Pakistan. Methods: We explored healthy broilers in a commercial farm from Faisalabad, Pakistan, and identified six K. pneumoniae strains from 100 broiler birds. We characterized the strains, determining clonality, virulence and antimicrobial resistance genes using next generation sequencing. Results: The evaluation of antimicrobial susceptibility revealed that all the strains were MDR. Genomic analysis showed that 3/6 strains belonged to ST152, harbouring acquired resistance aminoglycosides [aadA2, aph(4′)-Ia], β-lactams (blaSHV-187, blaLAP2), fosfomycin (fosA6), tetracycline (tetA), trimethoprim (dfrA12), quinolone (qnrS1), sulphonamides (sul2) and phenicol (floR). All the strains harboured the efflux pump genes oqxA, oqxB, emrR, kpnG, kpnH, kpnF, baeR, mtdB and mtdC. All six strains encoded identical virulence profiles possessing six genes, i.e., ureA, iutA, entB, allS, fimH and mrkD. Phylogenomic analysis of the dominant sequence type (ST152) present in our dataset with publicly available genomes showed that the isolates clustered to strains mainly from human sources and could pose a potential threat to food safety and public health. Discussion: The combination of these findings with antimicrobial use data would allow a better understanding of the selective pressures that may be driving the spread of AMR. This is the first report of MDR K. pneumoniae isolated from broiler hens in Pakistan, and the finding suggests that routine surveillance of WHO critical priority pathogens in such settings would be beneficial to the development of effective control strategies to reduce AMR. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae is a major cause of hospital-acquired infections (HAIs), primarily spread through environmental contamination in hospitals. The effectiveness of current chemical disinfectants is waning due to emerging resistance, which poses environmental hazards and fosters new resistance in pathogens. Developing environmentally friendly and effective disinfectants against multidrug-resistant organisms is increasingly important. Methods: This study developed a bacteriophage cocktail targeting two common carbapenem-resistant Klebsiella pneumoniae (CRKP) strains, ST11 KL47 and ST11 KL64. The cocktail was used as an adjunctive disinfectant in a hospital's respiratory intensive care unit (RICU) via ultrasonic nebulization. Digital PCR was used to quantify CRKP levels post-intervention. The microbial community composition was analyzed via 16S rRNA sequencing to assess the intervention's impact on overall diversity. Results: The phage cocktail significantly reduced CRKP levels within the first 24 hours post-treatment. While a slight increase in pathogen levels was observed after 24 hours, they remained significantly lower than those treated with conventional disinfectants. 16S rRNA sequencing showed a decrease in the target pathogens' relative abundance, while overall species diversity remained stable, confirming that phages selectively target CRKP without disrupting ecological balance. Discussion: The findings highlight the efficacy and safety of phage-based biocleaners as a sustainable alternative to conventional disinfectants. Phages selectively reduce multidrug-resistant pathogens while preserving microbial diversity, making them a promising tool for infection control. [ABSTRACT FROM AUTHOR]

Medicinal plants provide a significant supply of natural compounds that can be used to develop new therapeutic medicines for treating severe illnesses including microbial infections. The genus Bambusa, which belongs to the Poaceae family, encompasses a vast and widely distributed collection of plants that possess a wide range of traditional uses in the treatment of various diseases. This study examined the ethanolic extracts of Bambusa tulda, along with its fractions such as ethyl acetate, petroleum ether, n-butanol, and water, to investigate their qualitative and quantitative phytochemical, antioxidant, and antibacterial properties. FTIR analysis of ethanolic powdered shoot extracts shows, presence of different functional groups including C-H, C-O, O-H and aromatic groups by showing stretching’s in different wavelengths. The extracts underwent testing to evaluate their antimicrobial activity against various strains of bacteria by using agar disc diffusion method and micro-dilution techniques to determine the minimum inhibitory and bactericidal concentrations. Additionally, the antioxidant activity of the extracts was assessed using the scavenging activity of DPPH radical methods. The extracts exhibited a robust positive connection between their antioxidant activity and the combined amounts of phenolics and flavonoids. The IC50 values of n-butanol, ethanol, water, petroleum ether, and ethyl acetate fraction show in ascending order 10.77+0.24 μg/ml, 11.35+0.13 μg/ml, 13.36+0.11 μg/ml,13.93+0.71 μg/ml and14.25+ 0.27 μg/ml respectively. The extracts have been shown effective efficacy against Escherichia coli and Staphylococcus aureus bacteria. However, it did not show any responses against Klebsiella pneumoniae and Pseudomonas aeruginosa. Escherichia coli exhibited greater susceptibility to the extracts compared to S. aureus, with the n-butanol fraction being the most potent extract. [ABSTRACT FROM AUTHOR]

The successful evolution of KPC-2 in bacteria has limited the clinical practice of carbapenems. This dilemma deteriorated the prognosis of associated infections and hence attracted increasing attention from researchers to explore alternative therapeutic options. Here, the enzyme inhibition assay was first performed to screen for a potent KPC-2 inhibitor. The synergistic effect of the candidate with carbapenems was further confirmed by checkboard minimum inhibitory concentration (MIC) assay, time-killing assay, disk diffusion method, and live/dead bacteria staining analysis. The mechanisms by which the candidate acts were subsequently explored through molecular dynamics (MD) simulations, etc. Our study found that Ginkgolic Acid (C13:0) (GA) exhibited effective KPC-2 inhibitory activity in both laboratory strain and clinical strain containing KPC-2. It could potentiate the killing effect of carbapenems on KPC-2-positive Klebsiella pnenmoniae (K. pnenmoniae). Further explorations revealed that GA could competitively bind to the active pocket of KPC-2 with meropenem (MEM) via residues Trp104, Gly235, and Leu166. The secondary structure and functional groups of KPC-2 were subsequently altered, which may be the main mechanism by which GA exerted its KPC-2 inhibitory effect. In addition, GA was also found to synergize with MEM to disrupt membrane integrity and increase membrane permeability, which may be another mechanism by which GA reinforced the bactericidal ability of carbapenems. Our study indicated that GA was a significant KPC-2 inhibitor that could prolong the lifespan of carbapenems and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Background and Aim: The dearth of new antibiotics necessitates alternative approaches for managing infections caused by resistant superbugs. This study aimed to evaluate the lytic potential of the purified bacteriophage PKp-V1 against extendedspectrum β-lactamase (ESBL) harboring hypervirulent Klebsiella pneumoniae (hvKp)-K1 recovered from veterinary specimens. Materials and Methods: A total of 50 samples were collected from various veterinary specimens to isolate K. pneumoniae, followed by antimicrobial susceptibility testing and molecular detection of various virulence and ESBL genes. Multilocus sequence typing of the isolates was performed to identify prevalent sequence types. The bacteriophages were isolated using the double-agar overlay method and characterized using transmission electron microscopy, spot tests, plaque assays, stability tests, and one-step growth curve assays. Results: Among 17 (34%) confirmed K. pneumoniae isolates, 6 (35%) were hvKp, whereas 13 (76%) isolates belonging to the K1 type were positive for the wzy (K1) virulence gene. All (100%) hvKp isolates exhibited the allelic profile of ST258. Overall, PKp-V1 exhibited an 88 % (15/17; (p ≤ 0.05) host range, among which all (100 %; p ≤ 0.01) hvKp isolates were susceptible to PKp-V1. PKp-V1 exhibited a lytic phage titer of 2.4 × 108 plaque forming unit (PFU)/mL at temperatures ranging from 25°C to 37°C. The lytic phage titers of PKp-V1 at pH = 8 and 0.5% chloroform were 2.1 × 108 PFU/mL and 7.2 × 109 PFU/mL, respectively. Conclusion: Although the incidence of ESBL-infected K. pneumoniae in veterinary settings is worrisome, PKp-V1 phages showed considerable lytic action against the host bacterium, indicating the potential of PKp-V1 as a possible alternative therapeutic option against MDR K. pneumoniae. [ABSTRACT FROM AUTHOR]

Introduction: Klebsiella pneumoniae is an encapsulated Gram-negative bacterium that is responsible for numerous infections in healthcare facilities worldwide and is frequently isolated. The World Health Organization has listed K. pneumoniaeas as a critical antibiotic resistant bacterial pathogen for which new antibiotics are urgently needed. This study aimed to use molecular tools to identify and examine antibiotic resistance in clinical strains of K. pneumoniae. Methodology: A total of 15 unduplicated K. pneumoniae strains isolated from patient samples with multidrug-resistant (MDR) profiles were subjected to polymerase chain reaction (PCR) to amplify the most common carbapenem resistance genes. (GTG)5 PCR and phylogenetic analysis were performed to identify the genetic relationship between the strains. Results: All strains yielded a (GTG)5-PCR profile, and this allowed us to group these strains into 8 groups according to the size and number of characteristic bands. Phylogenetic analysis was done using the free software UPGMA and a single bacterial clone with a correlation coefficient of over 97% was identified. New Delhi metallo-beta-lactamase NDM-like (blaNDM) carbapenem resistance genes were detected in three strains of K. pneumoniae, which represented a resistance rate of 20%. However, carbapenemases type A [Klebsiella pneumoniae carbapenemase (KPC) and imipenem-hydrolysing beta-lactamase (IMI), type D [oxacillinase-48 (OXA-48)], and other metallo-ß-lactamase [Verona integron-encoded metallo-beta-lactamase (VIM), and enzyme active on imipenem (IMP)] were not detected. Conclusions: We identified and grouped the blaNDM resistance genes of Klebsiella pneumonia strains. [ABSTRACT FROM AUTHOR]

In this research, biodegradable Chitosan–Nano-Cellulose–Nisin (CH-NC-N) film was synthesized and utilized for antibacterial application in medicine and food packaging. The antibacterial chitosan–nano-cellulose–nisin film was characterized using various techniques such as mechanical and physical properties analysis, Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), and Fourier Transform Infrared Spectroscopy (FTIR) techniques. The film ’ s ability to inhibit growth of pathogenic bacteria including Escherichia coli, Escherichia coli XDR, Klebsiella pneumonia XDR, Listeria monocytogenes, and Staphylococcus aureus was examined. Furthermore, the film was used for meat packaging at a temperature of 4°C for a duration of 26 days. Data analysis revealed an improvement in the mechanical properties and water absorption of the film following the addition of nano-cellulose and nisin. The presence of nisin in the CH-CN film was confirmed through analysis of FTIR, XRD, and SEM data. Antimicrobial analysis of film determined the high potential of nisin as an antimicrobial agent in CH-CN-N film. Compared to the control, the CH-CN-N film successfully inhibited the growth of spoilage bacteria in meat for 26 days. Additionally, the sensory properties of meat packaged with this film were minimally affected. These results indicate that the chitosan-nano-cellulose-nisin film is suitable for utilization in food systems and medical applications. [ABSTRACT FROM AUTHOR]

Objective • The purpose of this study is to gain a better understanding of the impact of microgravity on antibiotic resistance. Methods • K. pneumoniae original (KPO) strain was cultured under either simulated microgravity (SMG) conditions with background antibiotic exposure (SMGA) for the experimental strain or a normal gravity condition with background antibiotic exposure (NGA) for the control strain. The K. pneumoniae original (KPO) strain was also cultured under normal gravity (NG) as an additional control. Antibiotic susceptibility was evaluated prior to their incubation under SMGA, NGA, or NG conditions. After 20 cycles of incubation, antibiotic susceptibility, genomic, transcriptomic, and proteomic tests were conducted on them. Results • SMGA and NGA strains both showed resistance to ciprofloxacin and intermediate resistance to levofloxacin. Genes associated with antibiotic resistance of Klebsiella pneumoniae, including acrB, oqxB, oqxA, ompC, ompF, and tolC were found to be differently expressed between SMGA and NGA strains or between SMGA and NG strains. It was found that the biggest family of genes in the differently expressed gene (DEG) cluster between SMGA and NGA and between SMGA and NG was the same, paaBCDFGHI, but with opposite change direction, i.e., downregulation between SMGA and NGA strains, while upregulation between SMGA and NG strains. Besides, the top-ranking functional descriptions in terms of the number of DEGs whether between SMGA and NGA or between SMGA and NG were “amino acid transport and metabolism”, “carbohydrate transport and metabolism”, “transcription”, and “inorganic ion transport and metabolism”. Two pathways of “citrate cycle (TCA cycle)” and “oxidative phosphorylation” were significantly enriched by DEGs both between SMGA and NGA and between SMGA and NG. Conclusion • Our study confirmed that low levels of antibiotics present in SMG can select for resistant K. pneumoniae strains. However, SMG did not alter the antibiotic resistance in K. pneumoniae induced by exposure to trace antibiotic. [ABSTRACT FROM AUTHOR]

Chiliadenus montanus(Vahl.) Brullo is a wild herb that grows in narrow parts of Jordan and is locally named Hneedeh. Despite being used for treating mild abdominal and respiratory ailments, Hneedeh is still locally known on a very small scale, and its healing capabilities are still waiting for a solid scientific justification. No previous studies were made to explore the antibacterial potential of Jordanian Hneedeh as well as its chemical composition despite being researched by scientists from neighboring countries. For this reason, this research aimed to unveil the active compounds behind the medicinal properties of wild C. montanus collected from Garissa-Jordan by analyzing the essential oil using the GC MS system. Also, the antibacterial activity was explored in two extracts (methanolic and ethanolic) collected from the succulent branches of C. montanus was examined using Microdilution and Disc Diffusion Assays. Data revealed the presence of 23 compounds grouped into eight classes and oxygenated monoterpenes were the predominant class (40.36%).Terpinen-4-ol, which is known for its super curative antibacterial and antitumoral powers, was indicated to be the major chemical compound in the essential oil of Hneedeh as it comprised (23.3%) of the essential oil, which disagreed with other previous studies made on the same plants growing in neighboring counties. Moreover, both extract types restricted growth in most tested bacterial types. The results recorded in the Microdilution Assay showed that the inhibitory effect of both extract types was stronger thanthose obtained in the antibiotic treatment (control) in E. coli and Staphylococcus aureus. Meanwhile, both methanolic and ethanolic extracts were as effective as the antibiotic when administrated to Bacillus subtilis and Salmonella sp. at similar minimal inhibition concentration (MIC) values. Moreover, Disc Diffusion Assay showed that both extract types could prevent the development of six bacteria types while no effect was recorded in Klebsiella pneumoniae. However, E coli bacteria was the most affected strain. The presence of the oxygenated monoterpenes, especially Terpinen-4-ol at premium levels, might be the causal agent behind the remarkable antibacterial powers of C. montanus extract. To our knowledge, this is the first time that C. montanus which grows wild in the village of Ghareesa is reported to contain Terpinen-4-ol as the main active ingredient, which is unlike results reported in other studies conducted on similar plant species growing in other countries. [ABSTRACT FROM AUTHOR]

The detection of bacterial contamination in drinking water is essential for monitoring the spread of foodborne diseases. We developed a simple, portable, and low-cost method of mini most probable number (mini MPN) to semi-enumerate bacterial suspension in water as a drinking water analogue. In this study, there is no significant difference between mini MPN and the standard method, technique plate count (TPC), at 10 and 100 CFU/ml Klebsiella pneumoniae suspension with a P-value of 0.28. For the ease-of-use aspect of this method, we tested several variables to prove it can be mass-applied in society. The usage of a sterile-plastic pipette, sample inoculation conducted in a biosafety cabinet (BSC), the usage of a 3-month storage medium, and incubation temperature conducted at room temperature compared to aseptic standard laboratory technique showed P-value . 0.05. In a trial for this method, we used commercialized drinking water for bacterial enumeration and characterization. We found multi-drug resistant (MDR) Ralstonia insidiosa which was resistant to at least four antimicrobial classes, including aminoglycosides, penicillins, cephalosporin, and carbapenem. Vitek 2 Compact was used for bacterial identification and antimicrobial susceptibility testing. A virulence test in Omphisa fuscidentalis larvae showed R. insidiosa strain D had a low virulence. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae is an opportunistic Gram-negative bacterium in the Enterobacteriaceae family associated with a wide range of diseases, such as pneumonia, bloodstream infections, meningitis and urinary tract infections. Infections caused by drug-resistant strains of Klebsiella pneumoniae pose a significant threat to the effectiveness of conventional antibiotics. Hence, this has led to the need to explore alternative antimicrobial therapies, especially natural products derived from plant sources. This study assessed the phytochemical composition and antibacterial properties and performed a molecular docking analysis of Henna leaves (Lawsonia inermis L.) extracts on strains of Klebsiella pneumoniae. Crude ethanol and methanol extracts of L. inermis L. were prepared at different concentrations (25, 50, 75 and 100 mg/mL) and tested on extended spectrum beta-lactamases (ESBLs)-producing strains of Klebsiella pneumoniae. Phytocompounds were identified using gas chromatography–mass spectrometry (GC-MS) and further subjected to virtual ligands screening with DataWarrior (v05.02.01) and a molecular docking analysis using AutoDock4.2 (v4.2.6). The active compounds of L. inermis L. were determined by the docking analysis, including phytochemical, physicochemical, pharmacokinetics and docking score. The GC-MS analysis identified 27 phytoconstituents, including ethyl acetate, sclareol, 2-[1,2-dihydroxyethyl]-9-[β-d-ribofuranosyl] hypoxanthine, α-bisabolol and 2-Isopropyl-5-methylcyclohexyl 3-(1-(4-chlorophenyl)-3-oxobutyl)-coumarin-4-yl carbonate. The 27 compounds were then screened for their physicochemical and pharmacokinetic properties. The results revealed that the methanol extracts at 100 mg/mL showed significantly higher (p < 0.05) zones of inhibition (13.7 ± 1.2 mm), while the ethanol extracts at 50 mg/mL were significantly lower (6.3 ± 0.6 mm) compared to all the other treatments. The docking analysis revealed that out of the 27 compounds identified, only twelve (12) compounds have a drug-likeness activity. The 12 compounds were further subjected to docking analysis to determine the binding energies with the CTX-M protein of Klebsiella pneumoniae. Only one compound [CID_440869; (2-[1,2-dihydroxyethyl]-9-[β-d-ribofuranosyl] hypoxanthine)] had the best binding energy of −9.76 kcal/mol; hence, it can be considered a potentially suitable treatment for infections caused by ESBLs-producing strains of Klebsiella pneumoniae. This study has demonstrated that L. inermis L. extracts have antibacterial effects. Further research could explore the potential antimicrobial applications of L. inermis L. extracts to many bacterial strains. [ABSTRACT FROM AUTHOR]

Wandering spleen (WS) is a rare condition often linked with torsion or infarction, but its association with Bochdalek hernia, acute appendicitis, and thrombocytopenia is exceptionally rare. We present a case of a nine-year-old girl who was admitted with acute abdominal pain, later diagnosed with WS, Bochdalek hernia, and acute appendicitis. A literature search was performed on PubMed and Google Scholar on 30 May 2024 with keywords including "Wandering spleen" and ("Bochdalek Hernia" OR "Sepsis" OR "Acute Appendicitis" OR "Thrombocytopenia"). The management was complicated by severe thrombocytopenia and post-operative sepsis, with Klebsiella pneumoniae as the causative agent. Imaging revealed an abnormally located spleen and significant splenic enlargement over time. The patient's condition was managed non-operatively concerning the WS, avoiding splenectomy due to the risks of post-splenectomy sepsis. Instead, laparotomy was performed to address the appendicitis and diaphragmatic hernia. The patient experienced post-operative complications, including a seizure and persistent fever, which resolved with appropriate antibiotic therapy. This case underscores the complexity of managing WS with concurrent severe conditions, highlighting the importance of individualised treatment strategies. It also emphasises the need for further studies to explore optimal treatment modalities for such rare and complex presentations. This case serves as an educational example in clinical settings, demonstrating the challenges and considerations when treating multiple rare pathologies simultaneously. [ABSTRACT FROM AUTHOR]

Introduction: Carbapenem-resistant Gram-negative Bacilli (CRGNB) cause many serious infections, resulting in increased treatment costs, prolonged hospitalisation, and a high mortality rate among infected patients. The survival of carbapenemaseproducing Gram-negative organisms is enhanced by mechanisms such as the presence of carbapenemases, reduced expression, and porin mutations. Accurate tests for rapid detection of bacterial antibiotic resistance are crucial for tracking, preventing, and containing the spread of resistant genes within hospitals and communities, as well as for guiding therapy. Aim: To evaluate the performance of the 'Carba M test' compared to phenotypic Carba NP tests, Carbapenem Inactivation Method (mCIM/eCIM) tests, and genotypic Carba R tests for the phenotypic detection and characterisation of various types of carbapenemase-producing GNB. Materials and Methods: A cross-sectional study was conducted in the Department of Microbiology at PSG Hospitals, Coimbatore, Tamil Nadu, India which has 1400 beds. The study was carried out over a period of 15 months (from June 2022 to August 2023). A total of 250 CR-GNB were included as the study population. A comparative evaluation of the Carba M test, Carba NP test, Carbapenem Inactivation Method (mCIM/eCIM), and Carba R test for the rapid detection of carbapenemase-producing GNB using standard methods was done. The data were analysed, and odds ratios and p-values were calculated for statistical significance at a 95% Confidence Interval (CI). Results: A total of 250 CR-GNB were isolated during the study period, of which 83 (33.2%) were from the Medical Intensive Care Unit (MICU), followed by the Medicine department with 24 (9.6%). Enterobacteriaceae accounted for the majority of the isolates, with 229 (91.6%), followed by Pseudomonas aeruginosa with 17 (6.8%) and Acinetobacter species with 4 (1.6%). Klebsiella pneumoniae was the most common isolate among Enterobacteriaceae, accounting for 216 (86.4%). Out of the 250 CR isolates tested by the Carba R test, 100 (40%) were positive for the Oxacillinase (OXA)-48 enzyme, 35 (14%) for the New Delhi Metallobetalactamase (NDM) enzyme, 4 (1.6%) for Verona Integron-encoded Metallobetalactamase (VIM), and all were negative for Imipenemase (IMP), and Oxacillinase (OXA), and Klebsiella pneumoniae Carbapenemase (KPC) genotypes. The sensitivity of mCIM/eCIM observed in the study was 67.12%, and specificity was 85.71% when compared to the molecular genotype (GeneXpert® Carba R test). The modified Carba NP test detected carbapenemases in 229 isolates, yielding an overall sensitivity of 95.07% and a specificity of 74.07%. The overall sensitivity and specificity of the Carba M test for detecting carbapenemase-producing GNB were 97.31% and 70.37%, respectively. The isolates producing Class A/D (OXA-48-like) enzymes were identified with sensitivities of 98% and specificities of 73.68%, while those producing Class B (NDM, VIM) enzymes showed sensitivities of 94.87% and specificities of 87.5%. Conclusion: The Carba M test is a cost-effective, feasible, and rapid phenotypic test for detecting and differentiating Class B from Class A/D carbapenemases. The Carba M test could serve as a supplemental test alongside the Carba R, Carba NP test, or mCIM/eCIM for diagnosing carbapenemase production in GNB. [ABSTRACT FROM AUTHOR]

Background/Objectives: Bacterial resistance and virulence are challenges in treating bacterial infections, especially in Klebsiella pneumoniae. Plants of the Launaea Cass. genus are used traditionally to address a variety of diseases, including infections, but the potential bioactive compounds are unknown. Our goals were to verify the potential contribution of two major polyacetylene glycosides isolated from our previous study, (3S,6E,12E)-6,12-tetradecadiene-8,10-diyne-1-ol 3-O-β-D-glucopyranoside (1) and bidensyneoside A (syn. gymnasterkoreaside A) [(3R,8E)-3-hydroxy-8-decene-4,6-diyn-1-yl β-D-glucopyranoside] (2), to the anti-infective properties of Launaea capitata and to develop a dependable HPLC method for their quantification; Methods: On a panel of K. pneumoniae clinical isolates, the antibacterial action of 1, 2, and the methanol extract of the whole L. capitata plant were evaluated by broth microdilution assay, while their antibiofilm action was evaluated by the crystal violet assay. qRT-PCR investigated luxS, mrkA, wzm, and wbbm genes that encode biofilm formation and quorum sensing (QS). The antibacterial activity of 1 was revealed by employing mice infection. Chromatographic separation was conducted using isocratic elution on a Hypersil BDS C18 column using a photodiode array (PDA) detector; Results: Compound 1 showed antibacterial activity with MIC values of 16–128 µg/mL. It remarkably reduced strong and moderate biofilm-forming bacterial isolates from 84.21% to 42.1% compared with the extract (68.42%) and 2 (78.95%). Compound 1 also downregulated the QS genes, luxS, mrkA, wzm, and wbbm, and exhibited in vivo antibacterial action through the enhancement of the histological construction of the liver and spleen, decreased TNF-α immunoreaction, bacterial burden, and the inflammatory mediators IL-1β and IL-6. A successful HPLC-PDA approach was developed to separate the binary mixture of 1 and 2 in less than 10 min with high sensitivity, with detection limits down to 0.518 and 0.095 µg/mL for 1 and 2, respectively; Conclusions: Compound 1 exhibited remarkable antibacterial and antibiofilm properties and may contribute to the anti-infectious traditional uses of L. capitata, meriting further clinical studies and serving as a reliable quality control biomarker for the plant. [ABSTRACT FROM AUTHOR]

The rise of antibiotic resistance and the dwindling antimicrobial pipeline have emerged as significant threats to public health. The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a global threat, with limited options available for targeted therapy. The CRKP has experienced various changes and discoveries in recent years regarding its frequency, transmission traits, and mechanisms of resistance. In this comprehensive review, we present an in-depth analysis of the global epidemiology of K. pneumoniae, elucidate resistance mechanisms underlying its spread, explore evolutionary dynamics concerning carbapenem-resistant hypervirulent strains as well as KL64 strains of K. pneumoniae, and discuss recent therapeutic advancements and effective control strategies while providing insights into future directions. By going through up-to-date reports, we found that the ST11 KL64 CRKP subclone with high risk demonstrated significant potential for expansion and survival benefits, likely due to genetic influences. In addition, it should be noted that phage and nanoparticle treatments still pose significant risks for resistance development; hence, innovative infection prevention and control initiatives rooted in One Health principles are advocated as effective measures against K. pneumoniae transmission. In the future, further imperative research is warranted to comprehend bacterial resistance mechanisms by focusing particularly on microbiome studies' application and implementation of the One Health strategy. [ABSTRACT FROM AUTHOR]

Klebsiella (K.) pneumoniae is a major pathogen in human and veterinary medicine, known for its high resistance rates. Comprehensive resistance data are essential to combat global antibiotic resistance. This study aims to (a) document the prevalence of resistant K. pneumoniae and (b) assess the utility of routine laboratory data for passive monitoring. We analyzed a dataset of 175,171 samples from diseased dogs and cats in Germany collected between 2019 and 2021, identifying 1185 K. pneumoniae isolates with measurable minimum inhibitory concentration values. We evaluated resistance rates to a third-generation cephalosporin (cefovecin) (16.3%), chloramphenicol (16.1%), doxycycline (13.9%), enrofloxacin (8.9%), gentamicin (6.0%), nitrofurantoin (24.8%), and sulfamethoxazole-trimethoprim (15.0%). Notably, feline K. pneumoniae isolates from the urinary tract showed a high cefovecin resistance rate of 70.0%. Comparing our findings with third-generation cephalosporin-resistant human isolates from the Antimicrobial Resistance Surveillance database (ARS) maintained by the Robert Koch Institute revealed a lower resistance rate (7.7%). This study presents Germany's most comprehensive dataset on K. pneumoniae resistance in companion animals over a three-year period. These findings can strengthen national resistance monitoring efforts and enhance data interpretation through substantial datasets. [ABSTRACT FROM AUTHOR]

The majority of tympanoplasty surgeons recommend air-conduction hearing aids to patients who have residual hearing loss. The present study aimed to use silico stimulation against gram positive and negative bacteria isolated from hearing aids that produce biofilm formations. More than 150 patients (hearing aid users), including both sexes, were surveyed to gather samples for the study of hearing aids. From September to December 2023, the samples were collected from Ramadi Teaching Hospital and Ramadi Children and Maternity Hospital in Ramadi, Iraq. There was a 64/53.3% increase in the prevalence of harmful microorganisms in men compared to females who used hearing aids. Most infected individuals were 70 and older (25/20.8%). The microtitration plate method was used to determine the biofilm formation ability of the isolates. The findings showed that 15% of Staphylococcus aureus isolates formed strong biofilms, 5.8% of the isolates of Psuedomonas. aeruginosa formed strong biofilms, and only 1% of the isolates of Stapylococcus. epidermidis, Escherichia coli, Proteus mirabilis and Klebsiella pneumonia formed strong biofilms. There is a According to the latest research, the risk of microbial infection in those who use hearing aids increases over time. When different protein-drug docking analyses were done, different species (P. mirabilis, Ps aeruginosa, Staphylococcus aureus, and Streptococcus pneumonia) had different binding affinities. The molecular docking analysis of all the proteins with the selected drug compounds resulted in varied binding affinities for all the species (P. mirabilis, Ps. aeruginosa, S. aureus, and St. pneumoniae). The binding affinities for all species resulted in the range from -13.52 kcal/mol (aliBCefilavancin complex) to -2.72 kcal/mol (fib-Disulfiram complex). The ear canal's microbiota changes when a hearing aid (HA) is worn. It raises the risk of otitis externa by promoting the growth of pathogenic bacteria. [ABSTRACT FROM AUTHOR]

Community‐acquired necrotizing pneumonia is a rare but potentially fatal infection, mainly caused by specific pathogens such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa. Escherichia coli is extremely rare as a pathogen for community‐acquired necrotizing pneumonia, typically accompanied with bloodstream infection. Here, we report an unusual case of a 60‐year‐old man with uncontrolled diabetes mellitus and no bloodstream infections, who had severe necrotizing E. coli pneumonia leading to massive hemoptysis and death. Clinicians should be aware of this pathogen in respiratory infections, as it requires immediate pathogen detection and usually aggressive antibiotic treatment. [ABSTRACT FROM AUTHOR]

A series of 2-[(2,6-diarylpiperidin-4-yl)hydrazono]-2,3-dihydrothiazoles (25–40) were synthesized by the reaction of respective thiosemicarbazones (9–24) with phenacyl bromide in the presence of sodium acetate-acetic acid buffer and refluxing in ethanol for 12–16 h. The newly synthesized target compounds were characterized by elemental analysis, mass, FT-IR, 1H and 13C NMR spectroscopic methods. A Structure activity relationship study was carried out for the title compounds against a panel of bacterial strains viz Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Bacillus subtilis and Klebsiella pneumonia and the fungal strains Cryptococcus neoformans, Candida albicans, Rhizopus sp, Aspergillus niger and Aspergillus flavus, respectively, using ciprofloxacin and amphotericin-B as standard drugs. These studies proved that compounds 26 and 34 against Staphylococcus aureus, 35 against P. aeruginosa,38 against B. subtilis, and 27 against K. pneumonia showed maximum inhibitory potency at the lowest concentration (6.25 µg/mL), whereas 26, 34 and 35 against C. neoformans and 26 and 27 against Candida albicans showed beneficial antifungal activity at a minimum concentration (MIC) of 6.25 µg/mL. [ABSTRACT FROM AUTHOR]

The rise of carbapenem-resistant Klebsiella pneumoniae (CRKP) presents a significant global challenge in clinical and healthcare settings, severely limiting treatment options. This study aimed to utilize a bacteriophage as an alternative therapy against carbapenem-resistant K. pneumoniae. A novel lytic N4-like Klebsiella phage, vB_kpnP_KPYAP-1 (KPYAP-1), was isolated from sewage. It demonstrated efficacy against the K62 serotype polysaccharide capsule of blaOXA-48-producing K. pneumoniae. KPYAP-1 forms small, clear plaques, has a latent period of 20 min, and reaches a growth plateau at 35 min, with a burst size of 473 plaque-forming units (PFUs) per infected cell. Phylogenetic analysis places KPYAP-1 in the Schitoviridae family, Enquatrovirinae subfamily, and Kaypoctavirus genus. KPYAP-1 employs an N4-like direct terminal repeat mechanism for genome packaging and encodes a large virion-encapsulated RNA polymerase. It lacks integrase or repressor genes, antibiotic resistance genes, bacterial virulence factors, and toxins, ensuring its safety for therapeutic use. Comparative genome analysis revealed that the KPYAP-1 genome is most similar to the KP8 genome, yet differs in tail fiber protein, indicating variations in host recognition. In a zebrafish infection model, KPYAP-1 significantly improved the survival rate of infected fish by 92% at a multiplicity of infection (MOI) of 10, demonstrating its potential for in vivo treatment. These results highlight KPYAP-1 as a promising candidate for developing phage-based therapies targeting carbapenemase-producing K. pneumoniae. [ABSTRACT FROM AUTHOR]

Multidrug-resistant Klebsiella pneumoniae (MDR-KP) infections have become a major global issue in the healthcare sector. Alternative viable tactics for combating bacterial infections, such as the use of bacteriophages, can be considered. One of the major challenges in phage therapy is the emergence of phage-resistant bacteria. This study isolated bacteriophages from water and soil samples against MDR-KP isolates. Susceptible bacterial hosts were exposed to phages at different concentrations and prolonged durations of time to obtain phage-resistant survivors. Phenotypic changes such as changes in growth rates, biofilm formation ability, antibiotic sensitivity patterns, and outer membrane proteins (OMPs) profiling of the survivors were studied. Our findings indicate that the phage ØKp11 and ØKp26 survivors had reduced growth rates and biofilm formation ability, altered antibiotic sensitivity patterns, and reduced OMPs expression compared with the parent MDR-KP002 isolate. These results suggest that the alternations in the bacterial envelope result in phenotypic phage resistance among MDR bacterial isolates. [ABSTRACT FROM AUTHOR]

Endophytic fungi (EF) are excellent sources of diverse and pharmacologically relevant molecules for drug development. The mangrove genus Rhizophora have been identified to contain fungal isolates. In this study, the EF Fusarium solani was isolated and characterized from R. apiculata. Disk diffusion assay of the crude ethyl acetate extract of F. solani on the ESKAPE clinical isolate pathogens showed inhibitory activities against Escherichia coli 5218S (ZOI 12.20 mm), methicillin-resistant Staphylococcus aureus 2729B (ZOI 8.90 mm), Klebsiella pneumoniae 4830WD (ZOI 12.58 mm), Acinetobacter baumannii 3975B (ZOI 12.85 mm), and Enterobacter cloacae 5276S (ZOI 15.53 mm). Bioassay guided isolation and spectroscopic analysis led to the identification of benzoic acid (1) and bis(3-methylhexyl) phthalate (2). Microtiter plate antimicrobial assay gave minimum inhibitory concentration (MIC) of 125 µg/mL for compound 1 and 250 µg/mL for compound 2. To the best of our knowledge, this is the first report on the isolation of F. solani from R. apiculata and the isolation of compounds 1 and 2 from the genus Fusarium. Hence, this study validated the importance of the EF as sources of bioactive molecules. [ABSTRACT FROM AUTHOR]

The main goal of this research is to assess the antibacterial effectiveness of commonly used UAE natural herbs, including Turmeric, Henna, Sidr, and Myrrh, against a range of bacteria such as Staphylococcus aureus, Streptococcus agalactiae (group B streptococci), Streptococcus pyogenes (group A streptococci), Escherichia coli, Enterococcus faecalis, Proteus mirabilis, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Agar diffusion technique was utilized in this study. The herbs were extracted and prepared in serial dilution, a standardized amount of the test microorganisms were inoculated on the agar plates. Subsequently, extracted herbs were placed in the wells that formed on the surface of the media. The agar plates are then incubated at 37°C under appropriate condition. Typically, the herbs extract diffuses in the media, inhibiting the germination of the bacteria, the zone of inhibition is subsequently measured. Significant inhibitory effects were observed with henna herbal extract against 75% of Gram-positive bacteria, while 25% of the bacteria showed inhibition when using sidr extract. Myrrh exhibited an antibacterial effect against most tested bacteria. Comparatively less of an impact was seen by turmeric extract on both Gram-negative and Gram-positive. The antibacterial efficacy of the four plant extracts suggests that Henna displayed the highest effectiveness, followed by Sidr and Myrrh, with Turmeric showing the least potency. Additionally, strains such as E. coli, E. faecalis, P. aeruginosa, K. pneumoniae, and P. mirabilis demonstrated resistance to the plant extracts, while S. aureus, S. pyogenes, and S. agalactiae appeared to be the most susceptible strains. These findings underscore the potential of plant extracts in treating bacterial infections, offering insights for the development of novel compounds with enhanced activity against both resistant and susceptible bacteria, thereby addressing the limitations of current antibiotic agents. [ABSTRACT FROM AUTHOR]

Multidrug-resistant (MDR) Gram-negative bacterial infections have emerged as a major public health concern. The aim of the present study was to detect the rate of infections due to MDR Gram-negative bacteria (GNB) in a tertiary care hospital, the rate of Carbapenemases and AmpC-b-lactamases production and the Antimicrobial susceptibility test pattern (AST) among MDR GNB. The rate of MDR GNB during the study period was 25.70%. Urine samples showed the highest contribution to the total MDR GNB. Among the total MDR GNB isolates, 166 were randomly selected and included in the present study. A higher rate of MDR GNB was reported among male patients (61.5%) compared to the females (38.5%) and most of them were from the patients aged between 61-70 years (30.7%). The most prevalent MDR GNB was Klebsiella pneumoniae 80 (48.12%), followed by Escherichia coli 43 (25.9%). AST of MDR GNB revealed their significant resistance to b-lactamases/b-lactamases inhibitors, cephalosporins, fluoroquinolones and carbapenem drugs (98%). Of 123 MDR Enterobacterales, 83% of them were found to be Metallo b-lactamase (MBLs) producers by mCIM and eCIM methods. Of 43 MDR non-fermenters, 29 (67.4%) of them were found to be carbapenemase producers by MHT. About 29.51% of MDR GNB isolates were found to be AmpC producers by AmpC disk test. A reliable and rapid phenotypic method to detect carbapenemases and AmpC b-lactamases among MDR GNB in a routine microbiology laboratory method is clinically important to guide antibiotic therapy and implementation of effective infection control practices. [ABSTRACT FROM AUTHOR]

Digera muricata Mart, a plant having therapeutic characteristics that has been utilised traditionally, belongs to the Amaranthaceae family, and a promising source of specific natural products utilized as antioxidant, prophylactic, antimicrobial, anthelmintic, anti-diabetic, and allelopathic agent. In the present study, a biologically active phytosterol was isolated from Digera muricata Mart. The isolated compound was characterized by 13C, 1H NMR, FTIR, and HRMS. Characterization of the isolate was done by antimicrobial assay, and molecular docking. The antimicrobial potential of the isolated phytosterol (50 µl) against Streptococcus pyogenes was found to be maximum (ZOI-20.0 ± 1.0), followed by Streptococcus agalactiae (ZOI-11.3±1.5), Candida albicans (ZOI-09.0 ± 1.0), Klebsiella pneumonia (ZOI-8.6 ± 1.5) and Escherichia coli (ZOI-8.6 ± 1.5). The molecular docking results indicate that the phytosterol binds to the receptor 1AI9 at the 32th and 58th positions; 1KZN receptor at the 76th position, the 5L3J receptor at the 46th (ASN) and 136th (ARG) position; 7WIJ receptor at the 419th (ARG) and 582th (ASP) and 585th (ASN) positions. [ABSTRACT FROM AUTHOR]

Objective To identify early Klebsiella pneumoniae (KP) infection after liver transplantation and its impact on prognosis. Methods Clinical data of 171 liver transplant recipients were retrospectively analyzed, and they were divided into the non-infection (n=52) and infection groups (n=119) according to the bacterial culture results at postoperative 2 weeks. In the infection group, KP was not detected in 86 cases (non-KP infection group), and KP was cultured in 33 cases (KP infection group). Preoperative, intraoperative and postoperative data were statistically compared between the non-infection and infection groups, and between the non-KP infection and KP infection groups. The risk factors of early KP infection after liver transplantation and the influencing factors of long-term survival of the recipients were analyzed.Results Compared with the non-infection group, model for end-stage liver disease (MELD) score and total bilirubin level were higher, the operation time was longer, the length of postoperative intensive care unit (ICU) stay and the length of hospital stay were longer, the amount of intraoperative red blood cell transfusion was higher, the hospitalization expense was higher, the incidence of severe complications was higher, white blood cell count, absolute neutrophil cell count and neutrophil-to-lymphocyte ratio at postoperative 14 and 30 d were higher, absolute lymphocyte count at postoperative 14 d was lower and hemoglobin level at postoperative 30 d was lower in the infection group. The differences were statistically significant (all P<0.05). Compared with the non-KP infection group, MELD score, total bilirubin level and aspartate aminotransferase (AST) level were higher, the operation time and the length of postoperative ICU stay were longer, the hospitalization expense was higher, the 90-d fatality was higher, the albumin level at postoperative 14 d was lower, and total bilirubin level at postoperative 30 d was higher in the KP infection group. The differences were statistically significant (all P<0.05). Among 33 recipients with KP infection, 16 cases were resistant to carbapenem antibiotics, and 7 of them died within postoperative 90 d. Seventeen cases were intermediate or sensitive to carbapenem antibiotics, and 4 of them died within postoperative 90 d. Preoperative MELD score ≥17 and operation time≥415 min were the independent risk factors for KP infection after liver transplantation (both P<0.05). The length of postoperative ICU stay ≥44 h and KP infection were the independent risk factors for long-term prognosis of liver transplantation (both P<0.05). Conclusions KP infection is an independent risk factor for death after liver transplantation. High preoperative MELD score and long operation time are the independent risk factors for early KP infection after liver transplantation. [ABSTRACT FROM AUTHOR]

The majority of Klebsiella pneumonia isolates possess the extended-spectrum beta-lactamase (ESBL) enzymes. Therefore, K. pneumoniae can easily develop drug resistance. How to effectively overcome the problem of drug resistance in K. pneumoniae is still a research hotspot. This study aimed to compare the mutant prevention concentration (MPC) of ESBL-positive and ESBL-negative K. pneumoniae isolated from orthopedic patients, which may provide a basis for the effective use of drugs to control the enrichment of resistance mutants of K. pneumoniae. The MPC90 values of 55 isolates of ESBL-positive K. pneumoniae against 4 fluoroquinolones were 32 µg/mL for levofloxacin and gatifloxacin, 16 µg/mL for ciprofloxacin, and 4 µg/mL for gemifloxacin. The selection index value was 8 for levofloxacin and ciprofloxacin and 2 for gemifloxacin and gatifloxacin, respectively. For ESBL-negative K. pneumoniae isolates, the MPC90 values were 16 µg/mL for levofloxacin and ciprofloxacin, 4 µg/mL for gemifloxacin, and 32 µg/mL for gatifloxacin. The selection index value was 8 for levofloxacin and ciprofloxacin, 2 for gemifloxacin, and 4 for gatifloxacin. For the ESBL-positive K. pneumoniae, the %T>MIC90 order was gemifloxacin > levofloxacin > ciprofloxacin > gatifloxacin. For the ESBL-negative K. pneumoniae, the %T>MIC90 order was levofloxacin > gemifloxacin > ciprofloxacin > gatifloxacin. The mutant-preventing ability of gatifloxacin and gemifloxacin was the strongest among the 4 fluoroquinolones. So gemifloxacin may be the first choice of drug to treat K. pneumoniae infection. [ABSTRACT FROM AUTHOR]

Objectives Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major nosocomial infectious pathogen with rapidly increasing prevalence. The genomic epidemiological characteristics of CRKP nationwide, especially the evolving trends within the predominant clones, should be evaluated clearly. Methods We collected 3415 K. pneumoniae strains from 28 hospitals across China. Antimicrobial susceptibility testing and WGS were performed. Subsequent genomic analyses, including sequence typing, K-locus (KL) identification, antimicrobial resistance gene screening, and virulence score assessment were performed. The phylogenetic relationship of clonal group 11 was determined based on core-genome analysis, and the presence of the pLVPK-like virulence plasmid in ST11 isolates was confirmed using plasmid core-gene analysis. Additionally, the trends of the ST11 lineage with different KL types on a global scale were investigated using Beast2. Results Of the K. pneumoniae strains, 708 were identified as CRKP isolates (20.7%), of which 97.7% were MDR. ST11 was the predominant clone, and KPC-2 was the prevalent carbapenemase in China, although the prevalence of specific clones and carbapenemases varied by geographic region. Among ST11 isolates, KL47 and KL64 were the predominant KL types, and KL64 gradually replaced KL47, with a higher percentage of KL64 isolates harbouring the pLVPK-like plasmid. Global genome data showed a significant increase in the effective population size of KL64 over the last 5 years. Conclusions The prevalence of CRKP was very high in certain regions in China. The increasing convergence of virulence and resistance, particularly in ST11-KL64 isolates, should be given more attention and further investigation. [ABSTRACT FROM AUTHOR]

Objectives To establish the epidemiology cut-off (ECOFF) values of eravacycline against Escherichia coli , Klebsiella pneumoniae , Enterobacter cloacae , Acinetobacter baumannii and Staphylococcus aureus , from a multi-centre study in China. Methods We collected 2500 clinical isolates from five hospitals in China from 2017 to 2020. The MICs of eravacycline were determined using broth microdilution. The ECOFF values of eravacycline against the five species commonly causing cIAIs were calculated using visual estimation and ECOFFinder following the EUCAST guideline. Results The MICs of eravacycline against all the strains were in the range of 0.004–16 mg/L. The ECOFF values of eravacycline were 0.5 mg/L for E. coli , 2 mg/L for K. pneumonia and E. cloacae , and 0.25 mg/L for A. baumannii and S. aureus , consistent with the newest EUCAST publication of eravacycline ECOFF values for the populations. No discrepancy was found between the visually estimated and 99.00% ECOFF values calculated using ECOFFinder. Conclusions The determined ECOFF values of eravacycline against the five species can assist in distinguishing wild-type from non-wild-type strains. Given its promising activity, eravacycline may represent a member of the tetracycline class in treating cIAIs caused by commonly encountered Gram-negative and Gram-positive pathogens. [ABSTRACT FROM AUTHOR]

In this study, the composition and antibacterial activity of essential oil from the flower of Nyctanthes arbor-tristis were determined. The extraction was carried out utilizing the microwave-assisted extraction technique with a short extraction time of 60 min, yielding 0.342% (w/w). Separation and characterization were performed by gas chromatography-mass spectrometric analysis, identifying a total of 34 constituents, including major compounds: phenyl ethyl alcohol (26.1%), eucarvone (18.7%), furfural (10.7%), benzaldehyde (4.8%), phytol (4.7%), and methyl hexadecanoate (3.1%). In the next step, an agar disk diffusion assay was performed to assess the antimicrobial activity of the oil against four different bacterial strains, namely Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, resulting in zones of inhibition measuring 9, 12, 11, and 9 mm, respectively. However, the broth macrodilution method was carried out against Staphylococcus aureus and Klebsiella pneumoniae, revealing minimum inhibitory concentrations of 2.5 and 5 mg/mL, respectively. [ABSTRACT FROM AUTHOR]

A total of sixty-two isolates were tested to assess the presence of the irp2 gene in different isolates of Klebsiella pneumoniae. The isolates discussed in this study were obtained from patients who had acquired illnesses either within the hospital premises or in the surrounding vicinity. These isolates were sourced from three hospitals located in Baghdad, namely Al-Imam Ali, Al-Zaafaranya, and Ibin-Albady hospitals. One interesting thing about Klebsiella pneumoniae is that it makes siderophores, especially yersiniabactin. This is because of a gene that controls this trait. The application of DNA sequencing methodologies has facilitated the identification of the irp2 gene in 44% of Klebsiella pneumoniae. According to amino acid sequences and differentiation of nucleotide, the current work reports findings on the identification of the K. pneumoniae irp2 gene isolates collected from patients in Iraq. This event represents the initial recorded occurrence of such detection. The presence of this gene is considered an unconventional human pathogen. The aim is to explore the correlation between genetic analysis and the diagnosis of genetic variation by examining isolates documented in the global GenBank database (LC791754.1, LC791755.1, LC791756.1, LC791757.1, LC791758.1, LC791759.1, LC791760.1). Additionally, it seeks to provide insights into the magnitude of genetic variation observed within these isolates. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae , a highly prevalent Gram-negative bacterium, is widely known for causing nosocomial infections, leading to various diseases including systemic infections and fever. In traditional medicine, Launaea nudicaulis (L.) Hook. f. (Asteraceae), is often used to alleviate fever caused by bacterial infections. This study aimed to assess the antibacterial efficacy of the key phytochemicals present in the extract of L. nudicaulis against a panel of K. pneumoniae isolates. Three main constituents were isolated from this plant: cichorin (1), methyl-3,5-di- O -caffeoylquinate (syn. macranthoin G) (2), and cynaroside (3). Among these compounds, macranthoin G demonstrated notable antibacterial activity, with minimum inhibitory concentrations ranging from 64 to 256 µg/mL. It was found to inhibit the growth of the tested isolates and significantly affect the integrity of their cell membranes in 65.2 % of cases. Moreover, it increased the permeability of both the inner and outer membranes in 60.87 % and 52.17 % of K. pneumoniae isolates, respectively. Docking studies revealed that it exhibited strong binding scores to LpxC and FabI enzymes, with significant interactions occurring with key amino acids in their active sites. Based on these findings, macranthoin G shows promise as a potential antimicrobial drug, warranting further research to validate its antimicrobial and pharmacokinetic properties. [Display omitted] • Three main components were isolated from Launaea naudicaulis. • The isolated compounds are cichorin, macranthoin G, and cynaroside. • Macranthoin G exhibited notable antibacterial action. • It impaired the inner and outer membrane integrity of Klebsiella pneumoniae. • It showed significant docking scores and interactions with LpxC and FabI enzymes. [ABSTRACT FROM AUTHOR]

Background: Infections caused by Klebsiella pneumoniae are common and result in high mortality rates. In vitro studies demonstrated the potency of cefoperazone/sulbactam (CPZ/SUL) against Klebsiella pneumoniae. However, the clinical efficacy of CPZ/SUL for the treatment of K. pneumoniae bacteremia has not been studied. Objectives: This study aimed to associate the clinical outcomes of patients with bacteremia with the minimal inhibitory concentrations (MICs) of CPZ/SUL against the causative K. pneumoniae isolates. Methods: This multicenter, retrospective study was conducted in Taiwan between July 2017 and April 2021. Patients with K. pneumoniae bacteremia treated with CPZ/SUL were enrolled in this study. CPZ/SUL MICs were determined using the agar dilution method. Data on the patients' clinical outcomes and characteristics were collected and analyzed. Results: In total, 201 patients were enrolled. Among the causative K. pneumoniae isolates, 180 (89.5%) were susceptible to CPZ/SUL. Most patients (n = 156, 77.6%) had favorable outcomes. The 30-day mortality rate was 11.9% (n = 24). Multivariate risk analyses showed that higher APACHE II score (Odds Ratio [OR], 1.14; Confidence Interval [CI], 1.07–1.21; p < 0.001), metastatic tumors (OR, 5.76; CI, 2.31–14.40; p < 0.001), and causative K. pneumoniae CPZ/SUL MICs > 16 µg/ml (OR, 4.30; CI, 1.50–12.27; p = 0.006) were independently associated with unfavorable outcomes. Conclusion: Patients with K. pneumoniae bacteremia treated with CPZ/SUL at a ratio 1:1 had favorable outcomes when the CPZ/SUL MICs were ≤ 16 µg/ml. Patients with higher APACHE II scores and metastatic tumors had unfavorable outcomes. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae species complex (KpSC) is an important disseminator of carbapenemase‐encoding genes, mainly blaKPC‐2 and blaNDM‐1, from hospitals to the environment. Consequently, carbapenem‐resistant strains can be spread through the agrifood system, raising concerns about food safety. This study therefore aimed to isolate carbapenem‐resistant KpSC strains from the agricultural and environmental sectors and characterize them using phenotypic, molecular, and genomic analyses. Results: Klebsiella pneumoniae and Klebsiella quasipneumoniae strains isolated from soils used for lemon, guava, and fig cultivation, and from surface waters, displayed an extensive drug‐resistance profile and carried blaKPC‐2, blaNDM‐1, or both. In addition to carbapenemase‐encoding genes, KpSC strains harbor a broad resistome (antimicrobial resistance and metal tolerance) and present putative hypervirulence. Soil‐derived K. pneumoniae strains were assigned as high‐risk clones (ST11 and ST307) and harbored the blaKPC‐2 gene associated with Tn4401b and Tn3‐like elements on IncN‐pST15 and IncX5 plasmids. In surface waters, the coexistence of blaKPC‐2 and blaNDM‐1 genes was identified in K. pneumoniae ST6326, a new carbapenem‐resistant regional Brazilian clone. In this case, blaKPC‐2 with Tn4401a isoform and blaNDM‐1 associated with a Tn125‐like transposon were located on different plasmids. Klebsiella quasipneumoniae ST526 also presented the blaNDM‐1 gene associated with a Tn3000 transposon on an IncX3 plasmid. Conclusion: These findings provide a warning regarding the transmission of carbapenemase‐positive KpSC across the agricultural and environmental sectors, raising critical food safety and environmental issues. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Purpose: Liver abscesses concomitant with acute prostatitis are rare and potentially fatal. We analyzed the occurrence of this condition and clinical characteristics of the affected patients. Materials and Methods: The medical records of 474 patients diagnosed with acute prostatitis between June 2006 and July 2022 were retrospectively reviewed. Patients in whom pathogens were not detected in serum or urine cultures were excluded. A total of 271 patients were included in the analysis. Patient characteristics and laboratory test results were compared between patients with acute prostatitis with and without liver abscesses. Results: Fifteen patients (5.5%) were identified with simultaneous liver abscesses and acute prostatitis. The liver abscess group was younger than the non-liver abscess group in terms of mean age. In the univariate analysis, a high proportion of patients had diabetes mellitus, whereas a low proportion had hypertension. None of the underlying diseases, including benign prostatic hyperplasia, malignancy, or alcoholism, demonstrated a significant association with liver abscess in multivariate analysis; however, an association was observed in liver function test results. All patients with liver abscesses tested positive for Klebsiella pneumoniae. Conclusions: When K. pneumoniae is identified in patients with acute prostatitis and abnormal liver function tests, considering the possibility of metastatic infection in other organs, including the liver, and performing an active evaluation is essential. [ABSTRACT FROM AUTHOR]

Bacteriocins are antimicrobial peptides produced by bacteria to prevent the growth of pathogens. Combining bacteriocins with metal nanoparticles, like silver nanoparticles (AgNPs), has developed into a viable strategy to get over bacteriocin limitations. In this study, bacteriocin BacZY05 was extracted from Bacillus subtilis ZY05 and purified using various techniques. The resulting purified bacteriocin was then combined with silver nanoparticles to form bacteriocin silver nanoconjugates (BacZY05-AgNPs). The physicochemical properties of the BacZY05-AgNPs were characterized using various analytical techniques. The mean diameter of the synthesized AgNPs was approximately 20–60 nm with an oval or spherical shape. The antimicrobial activity of the BacZY05-AgNPs was evaluated against several indicator strains by their zone of inhibition (ZOI), using the agar well diffusion method. Compared to bacteriocin (ZOI- 13 to 20 mm) and AgNPs (ZOI- 10–22 mm) alone, the antibacterial activity data demonstrated a 1.3-1.5-fold increase in the activity of bacteriocin-nanoconjugates (ZOI- 22 to 26 mm). For Staphylococcus aureus MTCC3103 and Klebsiella pneumoniae MTCC109, BacZY05-capped AgNPs exhibited the lowest minimum inhibitory concentration (MIC), measuring 10.93 µg/mL. For Salmonella typhi NCIM2501, the MIC was 28.75 µg/mL. The highest MIC value was 57.5 µg/mL for Escherichia coli DH5α and Vibrio cholerae MTCC3909. With BacZY05-capped AgNPs, the lowest minimum bactericidal concentration (MBC) of 28.75 µg/mL was observed for Staphylococcus aureus MTCC31003. In the cases of Salmonella typhi NCIM2501 and Klebsiella pneumoniae MTCC109 concentration was 57.5 µg/mL. Vibrio cholerae MTCC3909 and Escherichia coli DH5α had the highest MBC values at 115 µg/mL. [ABSTRACT FROM AUTHOR]

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Gram-negative bacilli Klebsiella pneumoniae are among the most important pathogens responsible for healthcare-associated infections (HAIs). These bacteria often have high pathogenic and epidemic potential, contributing to infection outbreaks worldwide. K. pneumoniae is part of the natural microbiota of humans. At the same time, as an opportunistic microorganism, when the host organism is weakened, it can cause serious infections such as pneumonia, urinary tract infections, septic infections and intra-organ abscesses. Widespread distribution in nature and exceptional adaptability provide K. pneumoniae with the opportunity to master new niches in the hospital environment, which poses a threat to hospitalized patients. Also, the bacteria are increasingly causing life-threatening infections in the non-hospital environment. The pathogenicity of K. pneumoniae is determined by the presence of many virulence factors such as capsular polysaccharide (CPS, K antigen), lipopolysaccharid (LPS, O antigen), fimbrial and non-fimbrial adhesins, siderophores (aero-bactin, enterobactin, salmochelin and yersiniabactin), heat-stabile and heat-labile enterotoxins, cytotoxins and biofilm-forming ability. Currently, hypervirulent strains of K. pneumoniae (hvKp) equipped with new virulence traits constitute a significant danger. The paper presents these bacteria concerning the global threat arising from the dynamic spread of hvKp strains in hospitals in Poland and worldwide. [ABSTRACT FROM AUTHOR]

To investigate the characteristics and drug resistance patterns of Klebsiella pneumoniae (K. pneumoniae) infection in pediatric intensive care unit (PICU). Methods: K. pneumoniae strains from 17 domestic PICUs were analyzed for overall condition and drug resistance using WHO-NET software. Results: From 2016 to 2022, there was a linear increase in the detection rate of K. pneumoniae (P< 0.05), with a total of 2591 (9.7%) strains detected. The primary sites of K. pneumoniae detection were the respiratory tract (71.1%), blood (8.6%), and urinary tract (7.1%). K. pneumoniae's resistance to penicillin drugs exceeded 90%, and are over 50% to cephalosporins. Resistance to cefoperazone-sulbactam decreased from 51.7% to 25.7%, and ranged from 9.1% to 20.8% for ceftolozane-tazobactam. Carbapenem-resistant K. pneumoniae strains constituted 32.3%. Resistance to imipenem and meropenem have decreased to 33.8% and 40.2%, while increased to 35.2% for ertapenem. Levofloxacin and amikacin resistance rates have decreased to 25.7% and 9.1%, but remain high at 63.8% for moxifloxacin and 44.6% for ciprofloxacin. K. pneumoniae demonstrated the lowest resistance rates to polymyxin B (0.9%), tigecycline (2.2%), and polymyxin E (3.1%). No strain of K. pneumoniae was resistant to both polymyxin B and meropenem. However, some strains showed co-resistance to meropenem with other antibiotics, including tigecycline (2%), imipenem (16%), amikacin (27%), colistin (37%), and levofloxacin (41%). Conclusion: The rates of isolation and drug resistance of K. pneumoniae in PICU have significantly increased over 7 years. Careful antibiotic use, infection control strategies, and appropriate antibiotic combinations are crucial in addressing this problem. [ABSTRACT FROM AUTHOR]

Bloodstream infections (BSIs) caused by Klebsiella pneumoniae (K. pneumoniae) are associated with high morbidity and mortality rates. This study presents a sequence type 25 (ST25) strain of hypermucoid K. pneumoniae A1 isolated from the blood of a patient with liver cirrhosis (LC) who succumbed to severe infections. We performed whole-genome sequencing of K. pneumoniae A1, which revealed virulence factors and antibiotic resistance genes. The strain harbors virulence genes encoding aerobactin, salmochelin, yersiniabactin, enterobactin, and rmpA. Additionally, the strain possessed five drug resistance genes: blaSHV-110, blaSHV-81, fosA6, OqxA, and OqxB. We further constructed a phylogenetic tree using 98 ST25 K. pneumoniae strains downloaded from NCBI together with K. pneumoniae A1. Phylogenetic analysis revealed that our isolated strain was closely related to a highly virulent strain isolated from a neonate in our region, differing by only 123 single nucleotide polymorphisms (SNPs). K. pneumoniae A1 is highly suspected to be Hypervirulent Klebsiella pneumoniae (hvKp). This study provided the first in-depth genomic analysis of ST25 K. pneumoniae in a patient with LC in China, highlighting the urgent need for early identification and diagnosis to combat this emerging threat. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association between antimicrobial resistance genes and virulence factors in ST11 and non-ST11 types of CR-KP in bloodstream infections in the intensive care unit, providing a theoretical basis for infection control and clinical diagnosis and treatment. Methods: From January 2021 to June 2023, samples of Klebsiella pneumoniae from bloodstream infections were collected at our hospital, focusing on those resistant to carbapenems. The resistance genes, housekeeping genes, and virulence genes were identified through PCR and analyzed using the GrapeTree software to perform MLST-based minimum spanning tree typing. Results: Among the 85 CR-KP cases, 61.18% were of the ST11 type, predominantly of the KL64 capsular type; non-ST11 types were mainly ST15, accounting for 25.88%, predominantly of the KL5 capsular type. The carriage rates of virulence genes such as rmpA2, entB, silS, kpn, iucA, peg-344, and terB were significantly higher in the ST11 group than in the non-ST11 group. The primary carbapenemase identified was class A enzyme blaKPC-2, with a higher carriage rate in the ST11 group. Drug susceptibility tests showed that the resistance rates for cefepime, ertapenem, nitrofurantoin, amikacin, and gentamicin were also higher in the ST11 group, consistent with the resistance genotype findings. Conclusion: The study reveals that ST11 type CR-KP in intensive care unit bloodstream infections exhibits stronger resistance and higher virulence compared to non-ST11 types, posing significant challenges to clinical treatment. Thus, strict control over the use of carbapenem antibiotics is essential to prevent the spread of resistant plasmids. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) presents a formidable challenge to public health and clinical medicine. This dual phenotype of hypervirulence and multi-drug resistance often complicates treatment options, leaving patients with limited antimicrobial regimens. Consequently, adverse clinical outcomes and high mortality rates are common. Ceftazidime-avibactam (CAZ-AVI) is recognized globally as a critical option for treating infections caused by resistant gram-negative bacteria. Case Report: We present a case of invasive Klebsiella pneumoniae liver abscess syndrome caused by a CR-hvKP infection. The patient exhibited a bloodstream infection, lung and liver abscesses, and suppurative meningitis, eventually developing a brain abscess. Treatment with a combination of meropenem and CAZ-AVI led to a favorable clinical outcome. Conclusion: This case report indicates that combining CAZ-AVI with an antimicrobial agent that is in vitro non-susceptible (carbapenems in this case) is safe and effective for treating severe, multi-site infections caused by CR-hvKP, including central nervous system infections. This case serves as a clinical reference for managing similar patients in practice. [ABSTRACT FROM AUTHOR]

Emphysematous pyelonephritis (EPN) is a severe, life-endangering, necrotising, gas-producing infection affecting the kidney and perinephric tissue. It is associated with renal loss, high morbidity, and mortality. Diabetes, obstructive uropathy, female gender and hypertension are the most common risk factors. Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis are the most common pathogens causing Emphysematous pyelonephritis. EPN presents as a clinical triad of fever, flank pain, and nausea. Non-contrast CT scan is the mainstay of early diagnosis of EPN. It is diagnosed by demonstrating gas in renal parenchyma and perinephric tissue. Huang and Sang's classification is used for the classification and management of EPN. Treatment of EPN progressed from early nephrectomy to minimally invasive treatments including newer and advanced antibiotics and percutaneous drainage along with Percutaneous nephrostomy and DJ stenting. Early nephrectomy was the treatment of choice in the last century however newer studies suggest conservative treatment is associated with renal preservation, decreased morbidity and mortality. The initial use of broad-spectrum antibiotics such as Third-or fourth generation cephalosporins and carbapenems is recommended. Emergency drainage is indicated with a larger-sized pigtail catheter as pus is thick and frequent blockage of tubes is common. Nephrectomy should be done for those patients who fail to respond to conservative therapy i.e., antibiotics and percutaneous drainage. This review aims to provide comprehensive, evidence-based recommendations for the diagnosis and management of this life-threatening urological infection Emphysematous pyelonephritis. [ABSTRACT FROM AUTHOR]