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Background: Empirical antibiotherapy (EA) should target all bacteria in post-operative peritonitis (PP). Nevertheless, recent studies failed to prove a link between adequacy of EA and prognosis of PP. We sought to confirm this loss of association between adequate EA and prognosis and to analyze the evolution of patients' characteristics and antimicrobial strategies. Methods: This is was retrospective study. Patients with a positive fungal culture were excluded. The cohort was divided into two time periods. Data of survivors and non-survivors were compared within each time period. Differences between the two periods were assessed. A multivariable analysis searched for parameters associated with a higher hospital mortality rate. Results: Two hundred fifty-one patients were included, with 92 patients in the first period (P1) and 152 patients in the second period (P2). Inadequate EA was associated with a worse outcome only in P1. The multivariable analysis in the whole cohort showed that inadequate EA was associated with a higher mortality rate. When the differences noticed between the two periods were entered in the model (presence of resistant gram-positive cocci and EA comprising glycopeptides), inadequate EA was no longer associated with worse outcome. In P1, the most severe patients had more resistant bacteria, hence, had a higher rate of inadequate EA. This artifact disappeared in P2, during which broader antibiotherapies with triple EA were more often prescribed for the most severe patients. Conclusion: This study showed that the link between inadequate EA and outcome of patients with PP was at least partly artifactual in older studies.

The spread of antibiotic resistant organisms and those producing extended spectrum -lactamases (ESBL) has become a health care problem worldwide in communities and hospitals, as it leads to more complicated infections, longer duration of treatment, and increases in patient mortality. In the present study, we analyzed 226 clinical samples in order to assess the spread of ESBL-producing Enterobacteriaceae. 196 Enterobacteriaceae were identified and classified as members of the genera Pantoea, Klebsiella, Escherichia, Enterobacter, Serratia, Proteus, Citrobacter, and Raoultella. The results of susceptibility testing of isolated strains to 19 antibiotics showed that the most part of the isolates were highly resistant (p.0.01) to the tested -lactams: penicillins and penicillin like antibiotics (amoxicillin, ticarcillin and amoxicillin-clavulanic acid), first-generation cephalosporins (cephalexin), and second generation cephalosporins (cefoxitin). 60.20% of the Enterobacteriaceae isolates were multi-drug resistant (MDR) strains. Resistant isolates to third generation cephalosporins were tested for ESBL by tree methods, concluding its presence in 29.59% of the isolates by double-disk synergy test, 27.55% by the disk approximation method and by 31.63% double-disk test. High levels of MDR strains and ESBL- producing Enterobacteriaceae in our study suggest the need for applying specific infection control measures, and rational antibiotic use to reduce the selection pressure and prevent dissemination of resistant bacteria.

Infectious diseases account for 25% of the causes of death worldwide and this rate is expected to increase with the increasing rate of antibiotic resistance observed for many pathogens. Among the bacterial pathogens usually found in healthcare associated infections, Escherichia coli and Staphylococcus aureus are the most prevalent pathogens and, for the former, about 50% of the isolates are found to be methicillin resistant. Given the limited number of targets/pathways observed for the mechanism of action for the existing antibiotics, the discovery of newer targets and their evaluation becomes an urgent and necessary task. Here we describe the structure-based identification of ticarcillin as a weak binder of the UDP-N-acetylglucosamine 2-epimerase (MnaA) from S. aureus. After a docking-based screening of existing drugs, ticarcillin was identified as a ligand in isothermal analysis of differential scanning fluorimetry data. An equilibrium molecular dynamics simulation confirmed the docking binding mode as a stable pose, with large contributions to the binding energy coming from interactions between Arg206 and Arg207 and the carboxylate groups in ticarcillin.

Introduction : Les infections à Pseudomonas constituent un réel problème de santé publique mondiale. L'objectif de cette étude était de déterminer les espèces de Pseudomonas isolées de diverses secrétions biologiques ainsi que leur sensibilité aux antibiotiques. Matériel et méthodes : Il s'agit d'une étude rétrospective réalisée à l'Hôpital de l'Amitié Sino-Guinéenne de Juin 2014 à Juin 2018. Les cultures ont été faites sur milieux gélosés. L'identification bactérienne, les antibiogrammes et la détermination des concentrations minimales inhibitrices (CMI) ont été faites à l'automate Vitek2 Compact 15. Résultats : Soixante-quinze souches de Pseudomonas ont été identifiées : Pseudomonas aeruginosa (44), de Pseudomonas luteola (15), Pseudomonas fluorescens (13), Pseudomonas mendocina (1), Pseudomonas oryzihabitans (1) et Pseudomonas putida (1). L'âge moyen des patients était de 49,12±23,48 ans [18 jours-90 ans]. Le sexe-ratio (M/F) = 0,875. La majorité des souches étaient sensibles à l'imipénème (93,33%), l'amikacine (88,00%), la gentamicine (72,00%), la tobramycine (70,66%), piperacilline/tazobactam (70,66%), la ceftazidime (60,00%), céfotaxime (54,66%), à l'ofloxacine (57,33%) et la ciprofloxacine (58,66%). En revanche, ces souches étaient résistantes à l'ampicilline (89,33%), triméthoprime/sulfaméthoxazole (89,33%), l'acide nalidixique (85,33%), la céfalotine (77,33%), la ticarcilline (68,00%), la cefoxitine (64,00%), et la nitrofurantoine (57,33%). Des cas de multi-résistance aux antibiotiques ont été observés avec CMI élevées. Particulièrement, une souche de Pseudomonas aeruginosa désignée N°64 était multi-résistante à tous les d'antibiotiques testés. Conclusion : Six espèces de Pseudomonas ont été identifiées avec des phénotypes de multi-résistance aux antibiotiques habituellement utilisés en Guinée.

Microbial contamination is a common problem that causes significant losses in plant micropropagation systems. The present study reports on the identification and control of bacterial contaminants in banana in vitro cultures. Twelve isolates belonging to Bacillus pumilus (S2), Bacillus subtilis (R2 and M4), Geobacillus stearothermophilus (S1, S3, S4, P2, M3 and R3) and Paenibacillus spp. (P1, R1 and M2) were identified by sequencing of 16S rRNA, gyrA or gyrB genes. Antibiotic susceptibility testing was performed with the disk diffusion method on bacterial isolates using 36 antimicrobial agents. Some antibiotics, notably Ticarcillin, Penicillin, Ampicillin, Cefazolin and Imipenem, had a broader range of bactericidal activity than others did. When contaminated axillary shoot cultures of banana were treated with 100 or 200 mg·L−1 of ticarcillin, ampicillin or penicillin the bacteria were eliminated, but a reduction in shoot multiplication and growth was observed. These findings contribute to minimizing the losses in the commercial micropropagation of banana.

The overuse of biocides in healthcare-facilities poses risk for emergence and spread of antibiotic resistance among nosocomial pathogens. Hospital-acquired infections due to S. maltophiliahave been increased. The objective of this study was to evaluate the susceptibility of S. maltophilia clinical isolates to commonly used biocides in hospitals, as well asthe frequency of biocides resistance genes among them. This study also intended to assess the effect of exposureof S. maltophilia isolates to sub-inhibitory concentrations of sodium hypochlorite upon the antimicrobial susceptibility patterns.This study included 97 S.maltophiliaisolates.Biofilm formation was determined by microtiter plate assay. The susceptibility tests of five biocides were studied against all S. maltophilia isolates by microbroth dilution method. Susceptibility of isolates to antibiotics by disk diffusion method were compared before and after exposure to sub-inhibitory concentrations of sodium hypochlorite. Presence of qacE, qacEΔ1, SugE genes was screened by PCR. Based on minimum inhibitory and bactericidal concentrations of biocidessodium hypochlorite 5% and ethyl alcohol 70% were the strongest and weakest against S. maltophilia isolates, respectively. The frequency of sugE gene resistance genes was found 90.7% in our clinical S. maltophilia isolates. None of the isolates carried qacE and qacEΔ1 gene. Exposure to sub-inhibitory concentration of sodium hypochlorite showed significantly change the susceptibility of isolates towards ceftazidime (P = .019), ticarcillin/clavulanate (P = .009), and chloramphenicol (P = .028).This study demonstrated that exposure to sub-inhibitory concentrations of sodium hypochlorite leads to reduced antibiotic susceptibility and development of multidrug-resistant S.maltophilia strains.

Background: Pseudomonas aeruginosa is a unique Gram-negative opportunistic pathogen that is the leading cause of nosocomial infections. Objectives: This study aimed to investigate the prevalence of the main carbapenemase and extended-spectrum β-lactamases encoding genes in P. aeruginosa clinical isolates. Methods: In the present study, we collected 85 P. aeruginosa clinical isolates from different wards of three military hospitals in Tehran, Iran. We used disk diffusion and agar dilution methods to determine resistance to 12 different antibiotics in these isolates. Also, we assessed the blaIMP, blaVIM, blaSHV, blaTEM, and blaCTX genes by polymerase chain reaction methods among all isolates. Results: Our results revealed that all isolates were resistant to two antibiotics, and 76 (89.4%) of isolates were multidrug-resistant. We observed maximum and minimum resistance rates against ticarcillin (n = 77; 90.5%) and colistin (n = 7; 8.2%), respectively. The blaVIM, blaIPM, blaTEM, blaSHV, and blaCTX genes were harbored by 44 (51.8%), 20 (23.5%), 41 (48.2%), 24 (28.2%), and 16 (18.8%) isolates, respectively. Conclusions: The resistance rate among P. aeruginosa strains is significantly increasing that causes nosocomial infections due to different mechanisms, including the high frequency of metallo-β-lactamases and extended-spectrum β-lactamases genes.

Background Bacterial lower respiratory tract infections (bLRTIs) are common and potentially life threatening in cats and dogs. Antibiotic treatment is often initiated before the diagnosis of bLRTI; therefore improved knowledge of the aetiology and antibiotic susceptibility patterns of these infections is essential to inform empiric antibiotic choices. Methods A retrospective study of microbiological, cytological results and their drug susceptibilities from lower respiratory samples (n = 1989) processed in a UK commercial laboratory between 2002 and 2012 was carried out. Results Thirty-nine per cent of feline samples and 50% of canine samples were positive for bacterial growth with most yielding a single organism (72 % and 69%, respectively). Bordetella bronchiseptica (20.2% from dogs and 2.3% from cats), Pasteurella spp. (23.2%, 31.8%), E. coli (16.2%, 13.6%) and Pseudomonas spp. (11.1%, 11.4%) were most frequently isolated from cytologically positive samples which contained intracellular bacteria (10%, 14%). Amoxycillin-clavulanate, cephalothin, cefovecin, oxytetracycline and trimethoprim/sulfamethoxazole showed modest in vitro activity against E. coli from dogs (approximately 70% susceptibility). Pseudomonas spp. were resistant to enrofloxacin (50%), ticarcillin (25%) and marbofloxacin (13%) but showed lower or zero resistance to aminoglycosides (approximately 7%) and ciprofloxacin (0%). Multi drug resistance (acquired resistance to three or more antimicrobial drug classes) was particularly common among E. coli isolates, with 23% from feline samples and 43% from canine samples. Conclusion Resistance to certain first-choice antibiotics was detected in bLRTIs highlighting the need for continued monitoring and sound evidence to inform decision-making in the management of these infections.

Background Recent years, the treatment of multi-drug resistant bacteria and their effect are very difficult due to the virulence factors modification. Based on the world wide thread, we have tried to identify the ESBLs producing bacteria from urinary tract infection patients. In result, the highly antibiotic resistant effect of Pseudomonas aeruginosa and Klebsiella pneumoniae were identified. Methods Initially, Hexa disc diffusion method was performed to detect the multi-drug resistant bacteria using respective antibiotics of HX066, HX033 and HX077, HX012 discs. Consecutively, the ESBL producing ability of confirmed multi drug resistant bacteria was performed to detect their ESBL producing ability using specific extended spectrum beta lactamase (ESBLs) detection discs of Hexa G-minus 24. Furthermore, the ESBL producing ability of the bacteria was confirmed by ESBLs detection Ezy MIC™ E-test stripe method. Results and conclusions In result, 10, 5 and 4 mm and 10, 14 and 8 mm zone of inhibition against imipenem (IPM), Ticarcillin/Clavulanic acid (TCC), Cefoperazone (CPZ) and Ampicillin (AMP), Norfloxacin (NX), Nalidixic acid (NA) antibiotics for P. aeruginosa and 16, 22 and 10, 18 mm zone of inhibition against ceftazidime (CAZ), methicillin (MET), ampicillin amoxyclav (AMC), co-trimoxazole (COT) of the HX077 HX012 for K. pneumoniae were observed. Based on the Clinical & Laboratory Standards Institute (CLSI) guidelines, both the bacteria were more resistant to tested antibiotics and it could be developed more resistant against all the tested antibiotics. In addition, the phenotypic detection of ESBL production effect was also performed against both the selected uropathogens, and the results were shown ≥22 mm, ≥27 zone of inhibition against all the tested antibiotics. Further, the genetic identification of multi plux PCR result was shown TEM, SHV and CTX-m genes were present in both the selected uropathogens. Finally, our results were correlated each other and concluded that the selected uropathogens were multi drug resistant effect and also ESBLs producer.

erreur pour le nom d'un auteur dans le pdf initial (Tourtereau au lieu de Trotereau), corrigé en janvier 2020; International audience; Background and Aim: Avian pathogenic Escherichia coli cause extensive mortality in poultry flocks, leading to extensive economic losses. To date, in Algeria, little information has been available on virulence potential and antibiotics resistance of avian E. coli isolates. Therefore, the aim of this study was the characterization of virulence genes and antibiotic resistance profile of Algerian E. coli strains isolated from diseased broilers. Materials and Methods: In this study, 43 avian E. coli strains isolated from chicken colibacillosis lesions at different years were analyzed to determine their contents in 10 virulence factors by polymerase chain reaction, antimicrobial susceptibility to 22 antibiotics belonging to six different chemical classes and genomic diversity by pulsed-field gel electrophoresis (PFGE). Results: Mainly E. coli isolates (58.1%) carried two at six virulence genes and the most frequent virulence gene association detected were ompT (protectin), hlyF (hemolysin) with 55.8% (p

Ten new quinoline-carboxamides have been synthesized using the coupling reaction between 2-oxo-1,2-dihydroquinoline-4-carboxylic acid as a substrate and five different amino ester at room temperature with basic media (triethylamine). The products were obtained with a good yield ranging from 60 to 80 % and were structurally characterized by 1H and 13C NMR spectroscopy and mass spectrometry. The antibacterial activities of the synthesized compounds have been evaluated against 9 strains of bacteria and compared to references (erythromycin, ofloxacin, ticarcillin, oxacillin, ampicillin, norfloxacin, ceftazidim, cefotaxim). The results showed that the majority of carboxamides-quinoline ester groups present a larger inhibition diameters than those of the antibiotics references. The highest antibacterial activity in vitro against the Enterococcus feacalis has been revealed for compound 1a (methyl 2-oxo-1.2-dihydroquinoline-4-yl-L-alaninate).

P. aeruginosa is a gram negative rod non-fermenter bacterium that commonly cause opportunistic hospital acquired infection. The antibiotic susceptibility of bacteria frequently changes over time and differs from place to place so regular surveillance of antibiotic susceptibility in institute is needed to treat the infection empirically and efficiently. Objectives: 1) To determine frequency of respiratory tract infections by P.aeruginosa 2) To determine antimicrobial susceptibility of P. aeruginosa isolated from patients with respiratory tract infections 3) To determine antimicrobial susceptibility of P. aeruginosa isolates of respiratory tract infections in indoor versus outdoor patients 4) To determine antimicrobial susceptibility of P. aeruginosa isolates from patients with respiratory tract infections from various clinical departments. 5) To determine frequency of respiratory tract infections by multi drug resistant (MDR) P. aeruginosa Material and Methods: A total of 66 P. aeruginosa isolated from clinical specimens from patients of respiratory tract infections were included in the presents study and antibiotic susceptibility of the isolates was determined by Clinical Laboratory and Standard Institute [CLSI] guidelines. Data including patient’s age, gender, organism and antibiotic susceptibility results were collected, and analyzed using Microsoft Excel 2007, and Whonet 5.6. Results: Prevalence of P. aeruginosa in respiratory tract infections is 26%. In present study, P. aeruginosa isolates showed highest sensitivity towards Colistin (100%), followed by Meropenem (98.4%), Piperacillin/Tazobactam (98.4%), Ciprofloxacin (98.4%), Ceftazidime (93.8%), Cefoperazone (94.8%), and Amikacin (92.2%), and lowest sensitivity towards to Piperacillin (90.6%) and Ticarcillin (87.5%) observed. P. aeruginosa from indoor patients showed higher resistance towards antipseudomonal drugs than isolated from outdoor patients. There is difference in antibiotic sensitivity of P. aerugi

Objectives In this study, 77 Enterobacter spp. isolates from a collection of 175 Gram-negative bacilli isolated from Tlemcen University Hospital Center (North-West of Algeria) were tested for antibiotic resistance, biocide tolerance and genetic determinants of antimicrobial resistance. Methods The isolates were identified by 16S rDNA gene sequencing. Biocide tolerance was determined by broth microdilution, and antibiotic resistance was determined by disk diffusion. Genetic determinants of resistance were studied by PCR amplification using suitable primers. Results The most common Enterobacter species was Enterobacter cloacae (58.4%), followed by Enterobacter hormaechei (24.7%). The most common antibiotic resistance was to ticarcillin either alone or in combination with clavulanic acid (70.1%), followed by cefepime (68.8%), cefotaxime (63.6%), ceftazidime (54.5%) and gentamicin (54.5%). Tobramycin was active against 87.0% of the isolates. Levels of biocide tolerance were high for hexachlorophene and to a lesser extent for benzalkonium chloride. The extended-spectrum β-lactamase genes blaTEM and blaCTX-M were detected in 44.2% and 36.4% of isolates, respectively. Other antimicrobial resistance genes (ARGs) frequently detected were aac(6ʹ)-Ib (57.1%) and sul2 (50.6%). Multidrug-resistant isolates carrying several ARGs were common. Significant positive correlations were detected for efflux pump genes with ARGs and also between ARGs. Conclusion The results of this study reveal thatEnterobacter spp. isolates from hospital settings are both resistant to clinically-used antibiotics and tolerant to biocides. Biocide tolerance could be an advantage for antibiotic-resistant strains in hospitals.

The aim of this study was to describe the population pharmacokinetics of ticarcillin during extended daily diafiltration (EDDf) in critically ill patients with acute kidney injury. Blood samples were collected from critically ill patients prescribed ticarcillin during one to two dosing intervals during which EDDf was performed. Plasma samples were measured using a validated ultra high performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) method. Concentration–time data were analysed using a population pharmacokinetics approach with Pmetrics®. A total of 53 blood samples were collected from six critically ill patients (three male). The mean ± standard deviation patient age, weight and body mass index (BMI) was 43 ± 22 years, 88 ± 14 kg and 31 ± 5 kg/m2, respectively. A two-compartment linear model adequately described the data. Median population pharmacokinetic parameter estimates were as follows: clearance in the presence of EDDf (CLEDDf), 6.41 L/h; clearance of EDDf (CLnon-EDDf), 4.97 L/h; volume of distribution of the central compartment (Vc), 56.46 L; intercompartmental clearance from the central to peripheral compartment (kCP), 13.54 L/h; and intercompartmental clearance from the peripheral to central compartment (kPC), 21.93 L/h. This is the first population pharmacokinetic model of ticarcillin in patients receiving EDDf. Large pharmacokinetic variability was found, supporting further investigation of the pharmacokinetics of less-studied β-lactam antibiotics in prolonged intermittent renal replacement therapy.

There are very limited data on ticarcillin-clavulanate elimination by haemofiltration. We measured in vitro ticarcillin-clavulanate adsorption to polyacrylonitrile (PAN) filters and the sieving coefficient using a well-described bench model of haemofiltration. The dose of ticarcillin-clavulanate was 60/2 mg or 180/3 mg, and 0 or 12 g albumin was added to the 1 L of circulating blood-crystalloid mixture to produce four different experimental conditions. The experiment was repeated four times under each condition. Median (interquartile range [IQR] ) ticarcillin adsorption varied from 28 (27-30) mg to 85 (78-90) mg. Adsorption was increased when the dose of ticarcillin was higher (P

Dissemination of mcr-1 encoding colistin resistance in Gram-negative bacteria has created critical situation in poultry, livestock farming, and public health. In Nepal, for the first time, we initiated surveillance of colistin-resistant Escherichia coli in broilers from seven different chicken farms. A total of 324 cloacal swabs were collected and 118 E. coli were isolated, of which 27 (22.8%) were colistin resistance all harboring mcr-1 gene, but lacking ISApI1. Colistin-resistant isolates were characterized by antibiotic susceptibility testing, detecting antibiotic resistance genes, phylogenetic analysis, and plasmid replicon typing. These isolates belonged to the phylo-group A (70.37%) and phylo-group D (29.63%). In addition, most isolates (>80%) were resistant to ciprofloxacin, tetracycline, and sulfamethoxazole-trimethoprim. As much as 3 of the 27 mcr-1 encoding isolates were confirmed as extended-spectrum β-lactamase (ESBL) producer, all 3 isolates carrying blaCTX-M gene. We performed the conjugation experiment to check transferability of mcr-1, tet, and blaCTX-M genes, and only two donors were found to have transferred resistance to ticarcillin. The transfer of colistin and tetracycline resistance was not detected, which suggests the chromosomal location of mcr-1 and tet genes. The prevalence of Inc K/B and Inc I1 was 96.3% and 81.48%, respectively. This study shows the co-existence of mcr-1 with tet, sul, qnr, dfr, and blaCTX-M genes and dissemination of these resistant isolates in Nepalese chicken farms, which may pose huge threat to the livestock, especially chickens, and public health in Nepal.

The aim of this study was to identify and quantify faecal indicator bacteria in blackwater collected from a source separation unit and determine the amount of E. coli isolates resistant to antimicrobials and their potential to produce extended spectrum β-lactamases (ESβLs) and metallo-β-lactamases (MβLs), which hydrolyse the most important antibiotics used in clinical practice. Most of the isolates were resistant to amoxicillin with clavulanic acid (36.4 %), followed by ticarcillin with clavulanic acid (22.7 %) and tetracycline (18.2 %). ESβL-producing genes blaCTX-M and blaTEM were found in three (13.6 %) and four (18.2 %) E. coli strains, respectively, while MβL genes were found in two (9.1 %). By separating at source, this pilot study clearly shows that gastrointestinal bacteria of healthy people can be an important source of antibiotic resistance released into the environment through wastewaters. One way to prevent that is to treat wastewater with a combination of TiO2, UV light, or ozone, as successful methods to remove resistant bacteria and prevent their spread in the environment., V vzorcih črne vode, ki je ena od frakcij odpadne vode, smo ugotavljali prisotnost in število fekalnih indikatorskih bakterij, vključno z bakterijo Escherichia coli (E. coli). Pri osamljenih sevih E. coli smo ugotavljali njihovo odpornost proti izbranim antibiotikom in njihov potencial za tvorbo nekaterih β-laktamaz razširjenega spektra in metalo-β-laktamaz. Preizkušeni sevi so bili najpogosteje odporni proti amoksicilinu s klavulansko kislino (36,4 %), tikarcilinu s klavulansko kislino (22,7 %) in tetraciklinu (18,2 %). Nukleotidne sekvence za blaCTX-M in blaTEM smo našli pri treh (13,6 %) in štirih (18,2 %) sevih, medtem ko smo gene za izbrane metalo-β-laktamaze ugotovili pri dveh (9,1 %) sevih E. coli. Pilotna študija, z ločevanjem odpadne vode na viru nastanka, kaže, da so bakterije v prebavnem traktu zdravih ljudi lahko pomemben vir prenosa odpornosti proti antibiotikom v okolju preko odpadne vode. Eden izmed načinov za preprečevanje širjenja odpornosti proti antibiotikom je čiščenje odpadne vode z uporabo kombinacije TiO2, UV svetlobe in ozona, ki so se pokazale kot uspešne metode za odstranjevanje bakterij, odpornih proti antibiotikom.

The medicinal value of the plants is due to their chemical components that bring a definite physiological action on the human body to prevent the diseases. In this work, we investigated the antimicrobial activity of leaves’ extracts of Quercus robur L., collected from the Algerian upper highlands, on ten bacterial strains and one fungal strain known to be pathogenic. First, we performed a qualitative phytochemical analysis, and second, antimicrobial activity tests performed by agar diffusion method (disc and well) with the determination of MIC by broth macro-dilution method. Given the results, it appears that obtained macerates of Quercus robur L. were rich in bioactive phytoconstituents such as alkaloids, anthraquinones, saponins, tannins, and other components. The yield of aqueous and methanolic macerates of leaves was 8.5 ± 1.41 and 22.4 ± 4.36%, respectively. The bacterial resistance was relatively important to several antibiotics, namely, ampicillin, amoxicillin + clavulanic acid for strains of Escherichia coli and Salmonella sp. However, Staphylococcus aureus strains were resistant to fusidic acid, penicillin, and oxacillin; while Enterococcus faecalis was resistant to fusidic acid, penicillin, oxacillin, and ticarcillin. The antibacterial activity of the macerates toward tested microbial strains showed that the aqueous and methanolic macerates of the leaves were proportional to the tested concentration and active not only against Gram-positive and Gram-negative bacteria but also on the fungal species Candida albicans. The estimated MIC for Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus was in the order of 10 mg/mL, which seems more effective than toward Salmonella sp., Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans which were in the order of 30 mg/mL. These preliminary results confirm that the part of the studied plant had a very good antimicrobial activity that was proportional to the serial concentrations of the tested extracts.

Background: Urinary tract infection (UTI) is a common health-associated problem worldwide. Like other medical conditions, UTI patients may suffer from poor treatment outcomes due to the emergence of antimicrobial resistance. Determining patterns of antimicrobial susceptibility in uropathogens will guide physicians to choose the best antibiotics for treating affected patients. In this project we aimed to evaluate the frequencies of pathogens associated with UTI and their antimicrobial susceptibility patterns. Methods: This study was conducted on 2692 urine samples of patients visited Rizgary Teaching Hospital in Erbil city. Aerobic bacterial growth identification and antimicrobial susceptibility tests were performed using VITEK®2 compact system. Results: Our data show that more than 20% of all studied samples were negative for bacterial growth; only 16.72% of them were pathogenic bacteria in which 82.44% of them were Gram negative bacteria (GNB) and the rest were Gram positive bacteria (GPB). Escherichia coli was the most frequent, and Acinetobacter baumannii was the most resistant GNB. Staphylococcus haemolyticus was the most frequent, and Enterococcus faecalis was the most resistant GPB. In general GNB were highly resistant to Ticarcillin and Cefepime, and GPB were also resistant to Ticarcillin, and Tigecycline antibiotics. Conclusions: The amount of negative culture growth indicates that symptoms only based diagnosis for UTI detection is unreliable. E. coli is the most UTI related pathogen, E. faecalis and A. baumannii were among highly antibiotic resistant bacteria. Finally, since many of GNG and GPB isolates were resistant to several antibiotics, there might be a high possibility for multi drug resistant among local population in Erbil. Keywords: Antimicrobial susceptibility, Bacterial profile, E. coli, Multi drug resistant, Urinary Tract Infection (UTI)

BACKGROUND: The purpose of the study was to determine the prevalence and characterize the resistance profiles of Escherichia coli isolated from various clinical specimens by various phenotypic and genotypic methods. MATERIALS AND METHODS: A total of 196 consecutive, nonduplicate strains of clinically significant E. coli isolated from various clinical specimens were included in the study. Identification and antimicrobial susceptibility testing was performed by using Vitek-2 system (Biomerieux, France). Phenotypic detection of extended spectrum beta-lactamase (ESBLs), Amp-C-β lactamase (Amp C), and carbapenemase production was done by various combination of disc diffusion methods, minimum inhibitory concentration determination by E-test, followed by polymerase-chain-reaction for the detection of β-lactamase-encoding genes. RESULTS: Overall prevalence of ESBLs, Amp C, and carbapenemase production was found to be 88.3%, 42.2%, and 65.1% by the phenotypic detection methods. Our study also revealed high resistance rates against other antibiotics such as cefepime (89%), cefotaxime (95.4%), ceftazidime (85.4%), ceftriaxone (91.8%), cefpodoxime (92.7%), aztreonam (56.3%), piperacillin/tazobactam (89.2%), and ticarcillin/clavulanic acid (76.3%). The most prevalent ESBL gene was blaTEM(67.30%), and least prevalent ESBL gene was blaVEB(2.61%). In case of Amp C, blaFOXgene (21.9%) was predominant. Among the genes encoding for carbapenemases, the most common gene was blaNDM(61.7%) followed by blaVIM(30.8%), blaKPC(10.6%), blaOXA-48 (5.3%), and blaIMP(2.1%). CONCLUSION: Our findings suggest a high rate of ESBLs, Amp C, and carbapenemase production among the E. coli isolates. A combination of both phenotypic and genotypic methods would be ideal for better characterization of resistance patterns among the E. coli isolates.

Objectives Pseudomonas aeruginosa is an important aetiological agent causing pneumonia, urinary tract infections and bacteraemia. High antibiotic use in nosocomial settings and for immunocompromised conditions results in increasing multidrug resistance. This study analysed the antimicrobial resistance profile of P. aeruginosa isolates in an HIV setting. Methods A total of 7386 clinical specimens were collected from HIV patients attending YRG CARE from 2010–2017. P. aeruginosa isolated from clinical specimens were identified conventionally, and antimicrobial susceptibility testing was performed by the Kirby–Bauer disk diffusion method. Results A total of 260 P. aeruginosa strains were isolated, with 165 P. aeruginosa (63.5%) being isolated from hospitalised patients. A higher incidence of P. aeruginosa infection (25.8%) was observed in 2017, and most of the P. aeruginosa were isolated from sputum specimens (57.3%). A high level of resistance was noted to ceftazidime (49.6%), followed by ticarcillin (41.5%). Imipenem and meropenem resistance was observed in 15.0% and 16.9% of P. aeruginosa isolates, respectively. A high rate of imipenem resistance was noted in 2016 (46.2%) and a high rate of meropenem resistance was noted in 2017 (20.5%). An increasing resistance rate of P. aeruginosa was observed against aztreonam, cefepime, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam, ticarcillin and tobramycin from 2010 to 2017. Conclusion A constant increase in drug-resistant P. aeruginosa isolates from HIV patients was observed from 2010 to 2017. Findings from this study urge the need for periodical monitoring and surveillance of the P. aeruginosa resistance profile, especially in hospitalised and immunocompromised patients in resource-limited settings.

Background & objectives: Nosocomial infections caused by multidrug-resistant, Pseudomonas species have become a major clinical and public health concern. The aim of this study was to characterize phenotypic and genotypic profile of antimicrobial resistance (AMR) in Pseudomonas spp. isolated from hospitalized patients. Methods: A total of 126 consecutive, non-duplicate isolates of Pseudomonas spp. isolated from various clinical samples were included in the study over a period of two years. Identification and antimicrobial sensitivity was performed using automated culture system according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Phenotypic detection of extended-spectrum β-lactamases (ESBLs), Amp-C β-lactamase (AmpC) and metallo-β-lactamases (MBLs) were done by various combinations of disc-diffusion and E-test methods, followed by polymerase chain reaction-based detection of β-lactamase-encoding genes. Results: Among 126 clinical isolates, 121 (96.1%) isolates were identified as Pseudomonas aeruginosa. Most of the isolates were recovered from pus sample, 35 (27.8%) followed by urine, 25 (19.84%); endotracheal aspirate, 24 (19.04%); blood, 14 (11.11%) and sputum, four (3.17%). The highest rate of resistance was against ticarcillin-clavulanic acid, 113 (89.7%) followed by meropenem, 92 (72.5%) and ceftazidime, 91 (72.3%). Overall, ESBLs, AmpC and carbapenemase production was detected in 109 (96.4%), 64 (50.8%) and 105 (94.6%) isolates by phenotypic methods. The most prevalent ESBL gene was blaTEM in 72 (57.1%) and the least prevalent was blaSHV in 19 (15.1%) isolates. AmpC gene was seen less compared to ESBL gene. The most prevalent carbapenemases gene was blaNDM-1 41 (46.06%) followed by blaVIM and blaOXA-1. Interpretation & conclusions: Our findings suggested that a high rate of ESBLs and carbapenemases production was observed in Pseudomonas spp. Therefore, phenotypic and genotypic detection of AMR needs to be combined for better characterization of resistance patterns in Pseudomonas spp.

This study was performed to investigate the distribution of antimicrobial resistance genes and extra-intestinal virulence determinants in a collection of 98 Escherichia coli strains isolated from rectal swabs of healthy children. Forty-six isolated strains were resistant to at least one of the tested antibiotics (usually active against enterobacteria). They were mainly resistant to ampicillin and ticarcillin (42.97%), tetracyclin (26.5%), and trimethoprim/sulfamethoxazole (18.4%). No resistance to the third generation of cephalosporins, carbapenems, aminoglycosides and colistin was found. Resistance to penicillins was encoded by blaTEM-1 (n=34) and blaSHV-1 genes (n=4). Tetracyclin resistance was encoded by tetB (n=12), tetA (n= 5), and tetC (n=1) genes. Amongst resistant quinolones isolated (n=5), chromosomal mutations in gyrA and parC genes were detected in four isolates and qnrS1 gene in two strains. Nine plasmid replicon types were detected; IncFIB (n=36) and IncI1 (n=7) were the most frequent ones. Isolates frequently belonged to phylogenetic groups A (51.1%) and D (27.5%). Extra-intestinal pathovar (n=38) occurred mainly in B2 phylogroup (P=0.0002). Amongst them, two isolates (non-extended-spectrum-β-lactamase (ESBL)-producers) belonged to the pandemic clone ST131. A significant distribution of virulence determinants and pathogenicity island marker was observed within strains belonging to B2 and D phylogroups. Interestingly, our results showed that ExPEC strains, including ST131 pandemic clone, are present within fecal isolates in healthy children. These findings highlight the importance of intestinal microbiota as a reservoir for virulent and resistant strains. Thus, reinforcing hand hygiene and antibiotic rational use is imperative to avoid the diffusion of these pathogens in the community.

Two experiments were conducted to evaluate the effects of antibiotic-containing extender of on sperm quality and control of bacterial growth. In Experiment 1, ejaculates were diluted in extender containing no antibiotics, potassium penicillin G-amikacin disulfate (PEN-AMIK), ticarcillin disodium-potassium clavulanate (TICAR-CLAV), piperacillin sodium/tazobactam sodium (PIP-TAZ), or meropenem (MERO). In freshly extended semen, only slight differences were detected among some antibiotic treatments for total sperm motility, curvilinear velocity, and viable acrosome-intact sperm (P 0.05). In cool-stored semen, slight differences were also detected among certain antibiotic treatments for curvilinear velocity and chromatin integrity (P 0.05). In Experiment 2, ejaculates were diluted in extender and subjected to no bacterial spiking, or inoculated with lower or higher doses of K. pneumoniae or P. aeruginosa. Following cooled storage of semen, colony forming units/ml (CFU/mL) were less in PEN-AMIK (706 ± 244) and MERO (1576 ± 1076) treatment groups than in TICAR-CLAV (4678 ± 1388) or PIP-TAZ (8108 ± 3198) treatment groups (P 0.05). The CFU/mL were lower in all antibiotic-containing treatment groups than the control group (18478 ± 4374; P 0.05). The percentage of culture plates containing no bacterial growth in unspiked semen was greater in PEN-AMIK (75%) than PIP-TAZ (15%) or TICAR-CLAV (20%; P 0.05). The percentages of culture plates containing no bacterial growth in semen spiked with a lower doses of K. pneumoniae or P. aeruginosa were higher in PEN-AMIK (70% and 50%, respectively) then in all other treatment groups (0-40% and 0-15% for K. pneumonia and P. aeruginosa, respectively; P 0.05); however, complete control of bacterial load was only modest even with PEN-AMIK. In both experiments, freezing and thawing extender prior to use did not have any appreciable detrimental effect on sperm quality or antibiotic efficacy. In summary, all antibiotics tested had minimal effects on measures of sperm quality in fresh or cool-stored semen extenders; however, PEN-AMIK, followed by MERO, yielded the best results in terms of antimicrobial efficacy. None of the antibiotic types controlled bacterial growth, in comparison with the antibiotic-free control group, when extended semen was spiked with a high concentration of Pseudomonas aeruginosa. Cooled storage of extended semen reduced bacterial growth in comparison with freshly extended semen.

Neonatal sepsis is a major cause of morbidity and mortality. It is the third leading cause of neonatal mortality globally constituting 13% of overall neonatal mortality. Despite the high burden of neonatal sepsis, high-quality evidence in diagnosis and treatment is scarce. Due to the diagnostic challenges of sepsis and the relative immunosuppression of the newborn, many neonates receive antibiotics for suspected sepsis. Antibiotics have become the most used therapeutics in neonatal intensive care units, and observational studies in high-income countries suggest that 83% to 94% of newborns treated with antibiotics for suspected sepsis have negative blood cultures. The last Cochrane Review was updated in 2005. There is a need for an updated systematic review assessing the effects of different antibiotic regimens for late-onset neonatal sepsis.To assess the beneficial and harmful effects of different antibiotic regimens for late-onset neonatal sepsis.We searched the following electronic databases: CENTRAL (2021, Issue 3); Ovid MEDLINE; Embase Ovid; CINAHL; LILACS; Science Citation Index EXPANDED and Conference Proceedings Citation Index - Science on 12 March 2021. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs.We included RCTs comparing different antibiotic regimens for late-onset neonatal sepsis. We included participants older than 72 hours of life at randomisation, suspected or diagnosed with neonatal sepsis, meningitis, osteomyelitis, endocarditis, or necrotising enterocolitis. We excluded trials that assessed treatment of fungal infections.Three review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. We used the GRADE approach to assess the certainty of evidence. Our primary outcome was all-cause mortality, and our secondary outcomes were: serious adverse events, respiratory support, circulatory support, nephrotoxicity, neurological developmental impairment, necrotising enterocolitis, and ototoxicity. Our primary time point of interest was at maximum follow-up.We included five RCTs (580 participants). All trials were at high risk of bias, and had very low-certainty evidence. The five included trials assessed five different comparisons of antibiotics. We did not conduct a meta-analysis due to lack of relevant data. Of the five included trials one trial compared cefazolin plus amikacin with vancomycin plus amikacin; one trial compared ticarcillin plus clavulanic acid with flucloxacillin plus gentamicin; one trial compared cloxacillin plus amikacin with cefotaxime plus gentamicin; one trial compared meropenem with standard care (ampicillin plus gentamicin or cefotaxime plus gentamicin); and one trial compared vancomycin plus gentamicin with vancomycin plus aztreonam. None of the five comparisons found any evidence of a difference when assessing all-cause mortality, serious adverse events, circulatory support, nephrotoxicity, neurological developmental impairment, or necrotising enterocolitis; however, none of the trials were near an information size that could contribute significantly to the evidence of the comparative benefits and risks of any particular antibiotic regimen. None of the trials assessed respiratory support or ototoxicity. The benefits and harms of different antibiotic regimens remain unclear due to the lack of well-powered trials and the high risk of systematic errors.Current evidence is insufficient to support any antibiotic regimen being superior to another. RCTs assessing different antibiotic regimens in late-onset neonatal sepsis with low risks of bias are warranted.La sepsis neonatal es una causa importante de morbilidad y mortalidad. Es la tercera causa de mortalidad neonatal a nivel mundial y constituye el 13% de la mortalidad neonatal total. A pesar de la elevada carga de la sepsis neonatal, la evidencia de alta calidad en el diagnóstico y el tratamiento es escasa. Debido a las dificultades de diagnóstico de la sepsis y a la relativa inmunosupresión del neonato, muchos reciben antibióticos por sospecha de sepsis. Los antibióticos se han convertido en el tratamiento más utilizado en las unidades de cuidados intensivos neonatales, y los estudios observacionales realizados en países de ingresos altos indican que entre el 83% y el 94% de los neonatos tratados con antibióticos por sospecha de sepsis tienen hemocultivos negativos. La última revisión Cochrane se actualizó en 2005. Se necesita una revisión sistemática actualizada que evalúe los efectos de los diferentes regímenes de antibióticos para la sepsis neonatal de inicio tardío.Evaluar los efectos beneficiosos y perjudiciales de diferentes regímenes antibióticos para la sepsis neonatal de inicio tardío. MÉTODOS DE BÚSQUEDA: Se hicieron búsquedas en las siguientes bases de datos electrónicas: CENTRAL (2021, número 3); Ovid MEDLINE; Embase Ovid; CINAHL; LILACS; Science Citation Index EXPANDED y Conference Proceedings Citation Index ‐ Science el 12 de marzo de 2021. También se buscaron ensayos controlados aleatorizados (ECA) y cuasialeatorizados en las bases de datos de ensayos clínicos y en las listas de referencias de artículos identificados. CRITERIOS DE SELECCIÓN: Se incluyeron ECA que compararon diferentes regímenes de antibióticos para la sepsis neonatal de inicio tardío. Se incluyeron participantes mayores de 72 horas de vida en el momento de la asignación al azar, con sospecha o diagnóstico de sepsis neonatal, meningitis, osteomielitis, endocarditis o enterocolitis necrosante. Se excluyeron los ensayos que evaluaron el tratamiento de las infecciones micóticas. OBTENCIÓN Y ANÁLISIS DE LOS DATOS: Dos autores de la revisión, de forma independiente, evaluaron los estudios para inclusión, extrajeron los datos y evaluaron el riesgo de sesgo. Se utilizó el método GRADE para evaluar la certeza de la evidencia. El desenlace principal fue la mortalidad por todas las causas, y los desenlaces secundarios fueron: eventos adversos graves, asistencia respiratoria, apoyo circulatorio, nefrotoxicidad, deterioro del desarrollo neurológico, enterocolitis necrosante y ototoxicidad. El punto temporal principal de interés fue el seguimiento máximo.Se incluyeron cinco ECA (580 participantes). Todos los ensayos tuvieron alto riesgo de sesgo y evidencia de certeza muy baja. Los cinco ensayos incluidos evaluaron cinco comparaciones diferentes de antibióticos. No se realizó un metanálisis debido a la falta de datos relevantes. De los cinco ensayos incluidos, un ensayo comparó cefazolina más amikacina con vancomicina más amikacina; un ensayo comparó ticarcilina más ácido clavulánico con flucloxacilina más gentamicina; un ensayo comparó cloxacilina más amikacina con cefotaxima más gentamicina; un ensayo comparó meropenem con atención estándar (ampicilina más gentamicina o cefotaxima más gentamicina); y un ensayo comparó vancomicina más gentamicina con vancomicina más aztreonam. Ninguna de las cinco comparaciones encontró evidencia de una diferencia al evaluar la mortalidad por todas las causas, los eventos adversos graves, el apoyo circulatorio, la nefrotoxicidad, el deterioro del desarrollo neurológico o la enterocolitis necrosante; sin embargo, ninguno de los ensayos se acercó a un tamaño de información que pudiera contribuir significativamente a la evidencia de los beneficios y los riesgos comparativos de cualquier régimen antibiótico en particular. Ninguno de los ensayos evaluó la asistencia respiratoria o la ototoxicidad. Los efectos beneficiosos y perjudiciales de los diferentes regímenes de antibióticos aún no están claros debido a la falta de ensayos con un poder estadístico adecuado y al alto riesgo de errores sistemáticos.La evidencia actual no es suficiente para apoyar que un régimen de antibióticos sea superior a otro. Se justifica la realización de ECA con bajo riesgo de sesgo que evalúen diferentes regímenes antibióticos en la sepsis neonatal de inicio tardío.

Antimicrobial resistance associated with the spread of plasmid-encoded extended-spectrum β-lactamase (ESBL) genes conferring resistance to third generation cephalosporins is increasing worldwide. However, data on the population of ESBL producing E. coli in different animal sources and their antimicrobial characteristics are limited. The purpose of this study was to investigate potential reservoirs of ESBL-encoded genes in E. coli isolated from swine, beef, dairy, and poultry collected from different regions of the United States using whole-genome sequencing (WGS). Three hundred isolates were typed into different phylogroups, characterized by BOX AIR-1 PCR and tested for resistance to antimicrobials. Of the 300 isolates, 59.7% were resistant to sulfisoxazole, 49.3% to tetracycline, 32.3% to cephalothin, 22.3% to ampicillin, 20% to streptomycin, 16% to ticarcillin, resistance to the remaining 12 antimicrobials was less than 10%. Phylogroups A and B1 were most prevalent with A (n = 92, 30%) and B1 (87 = 29%). A total of nine E. coli isolates were confirmed as ESBL producers by double-disk synergy testing and multidrug resistant (MDR) to at least three antimicrobial drug classes. Using WGS, significantly higher numbers of ESBL-E. coli were detected in swine and dairy manure than from any other animal sources, suggesting that these may be the primary animal sources for ESBL producing E. coli. These isolates carry plasmids, such as IncFIA(B), IncFII, IncX1, IncX4, IncQ1, CollRNAI, Col440I, and acquired ARGs aph(6)-Id, aph(3″)-Ib, aadA5, aph(3′)-Ia, blaCTX-M-15, blaTEM-1B, mphA, ermB, catA1, sul1, sul2, tetB, dfrA17. One of the E. coli isolates from swine with ST 410 was resistant to nine antibiotics and carried more than 28 virulence factors, and this ST has been shown to belong to an international high-risk clone. Our data suggests that ESBL producing E. coli are widely distributed in different animal sources, but swine and dairy cattle may be their main reservoir.

Objective: To determine the prevalence of metallo-β-lactamase (MBL) including imipenemase (IMP) and Verona integronencoded metallo-β-lactamase (VIM) in imipenem-resistant Pseudomonas aeruginosa (IRPA) isolates and investigate the in vitro activities of 9 antimicrobial agents against MBL-positive isolates. Material and Methods: Seventy-eight IRPA isolates were obtained from Songklanagarind Hospital. MBL production was detected by the combined-disk test, and the blaIMP and blaVIM genes were determined via Polymerase Chain Reaction (PCR). The in vitro activities of amikacin, gentamicin, aztreonam, ceftazidime, meropenem, ciprofloxacin, colistin, piperacillin/ tazobactam, and ticarcillin/clavulanate were determined using the E-test method. Results: Of the 78 IRPA isolates, 20 (25.6%, 95% CI 17.2-36.4%) were MBL phenotype-positive, and 30 (38.5%, 95% CI 28.5-49.6%) were MBL genotype-positive (29 Imipenemase (IMP)-type and 1 Verona integron-encoded metallo-βlactamase (VIM)-type). Ninety percent of the MBL genotype-positive isolates were MDR. Most MBL genotype- positive isolates were susceptible to colistin (susceptibility rate of 96.7% and MIC50 value of 1.5 µg/mL). Conclusion: Our results showed a high prevalence of MBL-positive isolates (38.5%) in IRPAs, and the IMP-type isolates were dominant among the metallo-β-lactamase-producing imipenem-resistant P. aeruginosa tested. Most MBL-positive isolates were susceptible to colistin and had low MIC50 values.

Pseudomonas aeruginosais an opportunistic pathogen, causing great concern due to the rapid increase in its resistance to antibiotics. The objective of the research was to describe the resistance mechanisms thatP. aeruginosapossesses, as well as to report its behavior against antibiotics in the years 2003 to 2018 in Mexico. A retrospective and longitudinal documentary research was carried out in different digital resources referring to antibiotic resistance inP. aeruginosa. The results showed that the main resistance mechanisms ofP. aeruginosaare β-lactamases, ejection pumps, mutations in porins, acquisition of plasmids, low permeability, formation of biofilms, alterations in penicillin-binding proteins, modifying enzymes of aminoglycosides and mutations in the active site. The antibiotics with the highest percentage of resistance presented between the years 2003 to 2018 were imipenen IMP, gentamicin GEN, ticarcillin / clavulanate TIC, trimethoprim / sulfamethoxazole TMS, ticarcillin TC, ceftriaxone CRO, aztreonam AZT, ceftazidime CAZ, cefepime FEP, levofloxacin LEV, chloramphenicol CL, tigecilcin TIG and ciprofloxacin CIP, with a peak of resistance between the years 2007 to 2008 and a possible downward trend in 2018. The behavior of resistance between the years 2003 to 2018 report a downward trend in the last two years.&nbsp

Background Acinetobacter baumannii is a gram-negative bacterium which causes opportunistic infections in immunocompromised hosts. Genome plasticity has given rise to a wide range of strain variation with respect to antimicrobial resistance profiles and expression of virulence factors which lead to altered phenotypes associated with pathogenesis. The purpose of this study was to analyze clinical strains of A. baumannii for phenotypic variation that might correlate with virulence phenotypes, antimicrobial resistance patterns, or strain isolation source. We hypothesized that individual strain virulence phenotypes might be associated with anatomical site of isolation or alterations in susceptibility to antimicrobial interventions. Methodology A cohort of 17 clinical isolates of A. baumannii isolated from diverse anatomical sites were evaluated to ascertain phenotypic patterns including biofilm formation, hemolysis, motility, and antimicrobial resistance. Antibiotic susceptibility/resistance to ampicillin-sulbactam, amikacin, ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, cefepime, gentamicin, levofloxacin, meropenem, piperacillin, trimethoprim-sulfamethoxazole, ticarcillin- K clavulanate, tetracyclin, and tobramycin was determined. Results Antibiotic resistance was prevalent in many strains including resistance to ampicillin-sulbactam, amikacin, ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, cefepime, gentamicin, levofloxacin, meropenem, piperacillin, trimethoprim-sulfamethoxazole, ticarcillin- K clavulanate, tetracyclin, and tobramycin. All strains tested induced hemolysis on agar plate detection assays. Wound-isolated strains of A. baumannii exhibited higher motility than strains isolated from blood, urine or Foley catheter, or sputum/bronchial wash. A. baumannii strains isolated from patient blood samples formed significantly more biofilm than isolates from wounds, sputum or bronchial wash samples. An inverse relationship between motility and biofilm formation was observed in the cohort of 17 clinical isolates of A. baumannii tested in this study. Motility was also inversely correlated with induction of hemolysis. An inverse correlation was observed between hemolysis and resistance to ticarcillin-k clavulanate, meropenem, and piperacillin. An inverse correlation was also observed between motility and resistance to ampicillin-sulbactam, ceftriaxone, ceftoxamine, ceftazidime, ciprofloxacin, or levofloxacin. Conclusions Strain dependent variations in biofilm and motility are associated with anatomical site of isolation. Biofilm and hemolysis production both have an inverse association with motility in the cohort of strains utilized in this study, and motility and hemolysis were inversely correlated with resistance to numerous antibiotics.

Burn injury and wound is a pig problem that assists the pathogens to grow and cause infection. 149 burninjury swabs were taken from different site of the patients’ body ages (11-53 years old). All samples weretested to isolate the sigificant microorganisms that found in burn injury. Antibiotics test was performed byusing disc diffusion way that stated by Kirby-Baucer. Results appeared that the most frequent pathogen inburn injury was Pseudomonas aeruginosa 33(22.14%) and followed by E.coli 31(20.8%), Staphylococcusaureus 28(18.79%), Proteus vulgaris 26(17.48%), Coagulase-negative Staphylococci 12(8.05%), Proteusmirabilis 10(6.71%), Klebsiella pneumonia 5(3.35%) and Candida spp. 4(2.68%) respectively. Antibiotictest showed that Staphylococcus aureus was a high resistance against Gentamycin and ciprofloxacin, butit was sensitive to Vancomycin and Imipenem. Coagulase negative Staphylococci showed a resistanceto Gentamicin, Ciprofloxacin and Ceftazidime, but it was sensitive to Amikacin, Oxacillin, Cefotaxim,Vancomycin, Imipenem and Cefepime. P. aeruginosa showed resistance against Cefotaxime, Aztreonam,Gentamicin and Ceftazidime. Whlist it showed a high sensitivity against Imipenem, Cefepime andTobramycin. E.coli showed a high resistance against Ceftriaxone, Ciprofloxacin and Cephalothin. whilstit showed a high sensitivity against Ticarcillin/clavulanic acid, Imipenem, Cefepime and Tobramycin.Proteus vulgaris showed a high resistance against Ceftriaxone, Ceftazidime, Amikacin, Cephalothin andGentamicin. Whilst it showed a high sensitivity against Cefotaxime, Aztreonam, Ticarcillin/clavulanicacid and Imipenem. Proteus mirabilis showed resistance against Amikacin, Ciprofloxacin, Ceftriaxone,Gentamicin and Cephalothin. Whilst it showed a high sensitivity against Ceftazidime, Cefotaxime,Aztreonam, Ticarcillin/clavulanic acid, Imipenem, Cefepime and Tobramycin. Klebsiella pneumoniashowed resistance against Ciprofloxacin, Ceftazidime, Cefotaxime and Aztreonam. whilst it showed a highsensitivity against Ceftriaxone, Amikacin, Gentamicin, Cephalothin, Ticarcillin/clavulanic acid, Imipenem,Cefepime and Tobramycin. The current study was aimed to determine the most frequent pathogens in burninjury and test their antibiotics susceptibility in hospitalize patients in Najaf city.

Objective To establish a specific and rapid ultra-high-performance liquid chromatography–electrospray ionization–tandem mass spectrometry (UPLC-ESI-MS/MS) method for measuring ticarcillin and clavulanate levels in rat plasma. Methods A Waters ACQUITY BEH C18 column (50 mm × 2.1 mm, 1.7 μm) and SCIEX QTRAP® LC-MS/MS System were used. Analyses were conducted to optimize the chromatographic and MS conditions, and the pharmacokinetic parameters of ticarcillin and clavulanate were assessed. Results Linear relationships were observed in the ranges of 10 to 10,000 ng/mL for ticarcillin R (r2 = 0.9967) 30 to 10,000 ng/mL for ticarcillin S (r2 = 0.9961), and 30 to 10,000 ng/mL for clavulanate (r2 = 0.9981). The average extraction recoveries of all compounds ranged from 86.9% to 96.4%. The pharmacokinetic parameters of the ticarcillin R and S isomers in rats were distinctive. The ticarcillin R and S isomers and clavulanate were rapidly absorbed in vivo. Ticarcillin S and clavulanate had similar elimination rates, whereas that of ticarcillin R was slower. Conclusion A UPLC-ESI-MS/MS method was developed and validated for the determination of ticarcillin and clavulanate in rat plasma.

Recognition of etiologies of lower respiratory tract infection (LRTI) may help in delivering effective treatment options and circumvent emergence of antibiotic resistance. This study was carried out to uncover bacterial profile and antibiotic sensitivity patterns among 310 LRTI patients attended Rizagary Hospital between January 2014 to December 2016. Standard laboratory techniques were applied in collecting, processing, and culturing sputum and bronchial wash specimens. VITEK® 2 compact systems were used to identify bacteria and their antibiotic sensitivity patterns. Results showed that Streptococcus parasanguinis and Acinetobacter baumannii were the most abundant gram-positive and gram-negative bacteria (GPB & GNB), respectively, isolated from sputum specimens. From bronchial wash specimens, only GNB were detected and Serratia marcescens was the most abundant one. Antibiotic sensitivity tests revealed that Streptococcus parasanguinis was the most resistant GPB and Acinetobacter baumannii was the most resistant GNB. Sputum recovered GPB were highly resistant to Ampicillin, Erythromycin, Levofloxacin, Trimethoprim/Sulfamethoxazole, and Tetracycline. Bronchial wash recovered GNB were highly resistant to Ampicillin, Minocycline, Pefloxacin, Piperacillin, and Ticarcillin. In conclusion, LRTIs are mainly associated with GNB rather than GPB. The recovered Streptococcus parasanguinis and Acinetobacter baumannii were found to be multidrug-resistant pathogens. Ampicillin was ineffective against any of recovered pathogenic bacteria.

Plasmid-mediated polymyxin resistance was first described in 2015, in China, in Escherichia coli carrying the mcr-1 (Mobile Colistin Resistance-1) gene. Since then, it has become a major public health challenge worldwide, representing a major threat to human and animal health. In addition, there are still few reports on the prevalence of mcr-1 in Enterobacteriaceae isolated from humans, animals and food. Therefore, the purpose of the study was to investigate the occurrence of the mcr-1 gene in bacterial isolates with phenotypic resistance to polymyxin B obtained from clinical specimens of companion animals. Phenotypic resistance to polymyxin B were determined by broth microdilution and the susceptibility profile to other antimicrobials (amikacin, amoxicillin/clavulanate, ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefepime, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, chloramphenicol, ciprofloxacin, doxycycline, ertapenem, gentamicin, imipenem, marbofloxacin, meropenem, phosphomycin, piperacillin/tazobactam, tetracycline, ticarcillin/clavulanate, tobramycin and trimethoprim/sulfamethoxazole) by disc-diffusion agar method. The extraction of bacterial DNA was performed via heat shock followed by spectrophotometric evaluation. To verify the presence of mcr-1, the Polymerase Chain Reaction was employed using specific primers, followed by agarose gel electrophoresis. The positive isolates had the corresponding amplicons sequenced. In this study, there were identified the first isolates of Escherichia coli, Klebsiella spp. and Enterobacter spp. carrying the mcr-1 gene derived from specimens of companion animals in Brazil. Our results suggest the dissemination of resistance to polymyxins in the community and the environment, highlighting the need for surveillance and optimized treatment guidelines. RESUMO: A resistência à polimixina mediada por plasmídeo teve sua primeira descrição em 2015, na China, em Escherichia coli portadora do gene mcr-1 (Mobile Colistin Resistance-1) e a partir de então tornou-se um grande desafio para a saúde pública em todo o mundo, constituindo uma grande ameaça à saúde humana e animal. Além disso, ainda existem poucos relatos sobre a prevalência de mcr-1 em Enterobacteriaceae isoladas de humanos, animais e alimentos. Sendo assim, o objetivo do estudo foi investigar a ocorrência do gene mcr-1 em isolados bacterianos com resistência fenotípica à polimixina B, oriundos de materiais clínicos de animais de companhia. A resistência fenotípica à polimixina B foi determinada por microdiluição em caldo e o perfil de sensibilidade aos demais antimicrobianos (amicacina, amoxicilina/clavulanato, ampicilina, ampicilina/sulbactam, aztreonam, cefazolina, cefepime, cefotaxima, cefoxitina, ceftazidima, ceftriaxona, cloranfenicol, ciprofloxacina, doxiciclina, ertapenem, gentamicina, imipinem, marbofloxacino, meropenem, fosfomicina, piperacilina/tazobactam, tetraciclina, ticarcilina/clavulanato, tobramicina sulfametoxazol/trimetoprim) foram determinados pelo método disco difusão. A extração do DNA bacteriano foi realizada via choque térmico, seguido de avaliação espectrofotométrica. Para a verificação da presença do mcr-1 foi utilizada a Reação em Cadeia da Polimerase com emprego de iniciadores específicos, seguida de eletroforese em gel de agarose. Os isolados positivos tiveram os correspondentes amplicons sequenciados. Nesse estudo foram identificados os primeiros isolados de Escherichia coli, Klebsiella spp. e Enterobacter spp. portadores do gene mcr-1 derivados de espécimes de animais de companhia no Brasil. Este estudo sugere a disseminação da resistência às polimixinas na comunidade e no meio ambiente, destacando a necessidade de vigilância e diretrizes otimizadas de tratamento.