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ABSTRACT: Purpose: The impact of the COVID-19 pandemic on antimicrobial resistance (AMR) is largely studied in healthcare settings. There is a need to understand the fluctuations in AMR during pandemic at the community level. With urinary tract infection (UTI) being one of the most common infections in the community, the AMR profile of community-acquired UTI (CA-UTI) is considered representative AMR at the community level. Methods: The study was taken in a cohort of patients with a clinical diagnosis of CA-UTI. The four study sites represented different community health centres in India. Escherichia coli isolates were analysed phenotypically and genotypically for AMR pre-COVID (October 2019–February 2020) and in the first (March 2020–February 2021) and second waves of COVID-19 (March 2021–December 2021). Results: E. coli was the predominant uropathogen (229, 82%). Increased susceptibility to nitrofurantoin was observed during the pandemic. Reduced susceptibility to first-line oral antibiotics and carbapenems was seen during the second wave, and an increased minimum inhibitory concentration (MIC50) to beta-lactams and fluoroquinolones was seen during the pandemic. Genomic analysis of E. coli isolates showed some AMR genes (aacC1, aacC4, SHV, QepA) only during the second wave. Conclusion: One good outcome of the pandemic was increased susceptibility to nitrofurantoin, while drawback was a significant decrease in susceptibility to oral antibiotics during the second wave and increased MIC50 of some antibiotics. Decreased susceptibility to last-resort carbapenems and the occurrence of various AMR genes during the second wave of the pandemic are of great concern.

Introduction: Bacterial vaginosis is a common vaginal dysbiosis in women of reproductive age. Bacterial vaginosis is a dysbiosis characterized by a reduction of Lactobacillus species, such as L. crispatus, L. gasseri, and L. Jensenii. Anti-microbial resistance of BV pathogens and low long-term cure rates have been increasing in the few years. Aim: Probiotics are proposed as an alternative treatment for BV applying live micro-organisms with the capacity to confer health benefits to the patient. Methods: Patients with white discharge per vagina with or without foul smell, and itching visiting Obstetrics and Gynecology OPD are subjected to Amsel criteria. Those test positive for 3 out of 4 are diagnosed to have bacterial vaginosis and were enrolled in the study. Result: Highest prevalence of bacterial vaginosis was at the age group of 26-30 years (28%), with the lowest prevalence (16%) above 40 years of age. Among group A (probiotics), 68% and 32% of women were in not working and working groups, respectively, when compared with group B (antibiotics), 64% and 36% of women were in not working and working groups. Nulligravida (28% and 32%), Singleton Pregnancy (32% and 16%) in Group A and Group B. We observed that patients treated with both antibiotics (50%) and probiotics (50%) had similar recurrence rates of BV. Conclusion: Hence it would be prudent to prefer probiotics in patients with BV, as they colonize other normal commensals and have similar efficacy as that of antibiotics. The other beneficial factors of probiotics include acceptability to patients and nil side effect profile.

In current research study, a series of ten novel phenylthiazolidin-4-one glycinamide conjugates with piperazines compounds (7a-j) were designed by combining the crucial pharmacophoric features from the reported potential anticancer hit molecules, subsequently evaluated for the drug-likeness behaviour. Designed candidates were synthesized, purified, and characterized by non-spectral and spectral methods. Further, compounds were evaluated for anticancer activity against three cells line; as HEP-G2 cells (liver cancer cells line), MDA-MB-231 (breast cancer cells line) and U87MG cells (brain cancer cells line). Compound 7j exhibited encouraging antineoplastic activity against MDA-MB-231 and HEP-G2 cell line with IC50 of 4.02 and 15.04 µM, comparable to positive control, gemcitabine (IC50: 2.81 and 15.94 µM, respectively). The compound 7j displayed better anticancer activity against U87M with IC50 value of 13.96 µM in comparison to gemcitabine (IC50: 34.26 µM). SAR studies of the series illustrating the effect of different substitutions on the anticancer activity is discussed. Further, cytotoxicity of compound 7j was tested against the brain tumour spheroids (MTS), in which it showed significant apoptosis of MTS cells as compared to gemcitabine. To find the mechanistic basis of cytotoxicity, computational studies were performed against the six probable targets, in which compound 7j showed excellent binding affinity towards DHFR and hDHODH targets, illustrating both as probable targets of the compounds. Additionally, the synthesized compounds were tested for antimicrobial activity against bacterial (E. coli and P. aeruginosa) and fungal strains (C. albicans), in which majority of compounds showed moderate to weak activity.

Abstract Background Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST). Methods Children (> 1.5–18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated. Results Eleven percent of children had significant bacteriuria [male:female—1:1, > 50% were 11–18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including bla NDM-5 (33.3%), bla OXA-1 (53.3%), bla CTX-M-15 (60%) and bla TEM-4 (60%). Conclusions This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as bla NDM-5 and bla CTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India.

Brucellosis is a rising veterinary and human health problem in India. It may manifest with a varied multisystem clinical presentation. In our case patient was of 72 years male with a complaint of abdominal pain for 2 months following COVID-19 infection. He was a known case of CAD (coronary artery disease) post PTCA status, on regular follow up & treatment. Patient had post COVID pulmonary fibrosis. When the patient admitted in our hospital with above mentioned complaints, necessary investigations along with blood culture by automated method was sent and patient was started on empirical doxycycline along with other symptomatic treatment. As the patient was not very sick and was reluctant to stay in hospital during the COVID-19 situation, he was discharged on request with a treatment and follow up plan. Blood culture was found to be positive for Brucella melitensis. When we got the blood culture report the patient was contacted telephonically and started Rifampicin along with Doxycycline for 6 weeks.

Urinary tract infection (UTI) poses a serious health issue for all age groups from neonates to geriatric age groups. Majority of the women experience urinary tract infections once in their lifetime. Escherichia coli (E.coli) is the most common uropathogen causing UTI which is followed by Klebsiella and Enterococci. Amoxicillin is the most resistant antibiotic against both E.coli and Klebsiella pneumonia whereas Gentamycin and Nitrofurantoin have been sensitive to both E.coli and Klebsiella pneumonia. Gram-negative bacteria such as E. coli, Klebsiella species, Proteus species, Acinetobacter species, Enterobacter species, Pseudomonas aeruginosa, and Citrobacter species are the most common causes of UTI. Enterococcus species, Staphylococcus saprophyticus, and Coagulase-negative bacteria are among Gram-positive bacteria. Staphylococcus aureus is a coagulase-positive gram-positive bacteria that cause urinary tract infections (UTIs). Hence, we come to the serious conclusion that Uropathogens are becoming increasingly resistant to a different group of antibiotics. The misuse and indiscriminate use of antimicrobials have led to the emergence of antibiotic resistance in bacteria all over the world, posing a threat to the public. Estimating the local etiology and sensitivity pattern could help in successful treatment. Inquiring into UTI epidemiology, such as risk factors, bacterial strains, and antimicrobial susceptibility, could help healthcare planners determine the best course of action.

Abstract Background Indiscriminate and widespread use of antibiotics has resulted in emergence of many antibiotic-resistant organisms. Antibiotic administration during pregnancy is mostly avoided, unless there is compelling medical condition. We hypothesized that the uropathogens isolated from pregnant women would be more susceptible to antibiotics compared to those isolated from nonpregnant women, thus will be helpful in formulating separate empiric guideline for pregnant women based on the resistance pattern. Methods This was a prospective cross-sectional study conducted over a period of 2 years in which females with the clinical diagnosis of either cystitis or asymptomatic bacteriuria during pregnancy were included from the community settings. Uropathogen species and their antimicrobial resistance pattern were compared between the pregnant and nonpregnant groups. After accounting for centre-to-centre variation and adjusting for age and socio-economic status, the adjusted odds ratio for antibiotic resistance was calculated and compared between pregnant and nonpregnant women using logistic regression analysis. Results A total of 1758 women (pregnant: 43.3%; nonpregnant: 56.6%) were screened in the study over a period of 2 years, out of which 9.3% (163/1758) were having significant bacteriuria. Escherichia coli and Klebsiella pneumoniae were the two commonest uropathogen in both the groups; their prevalence being 83.6% in pregnant women and 85.2% in nonpregnant women, respectively. Resistance against ampicillin, cefixime, cefoxitin, ceftazidime, ceftriaxone and amoxicillin-clavulanic acid were found significantly lower in the pregnant women compared to nonpregnant. After adjusting the age and socio-economic status accounting for centre-to-centre variation, the odds of resistance for cefixime, amoxicillin-clavulanic acid and co-trimoxazole were found lower and statistically significant among the pregnant women group. Conclusions The antimicrobial resistance was significantly higher among the community-dwelling nonpregnant women compared to pregnant women in case of few antibiotics. The study highlighted the need of building local antibiogram that could help to initiate the empirical treatment and thus prevent emergence of antimicrobial resistance.

Urinary tract infection (UTI) in the community is a common infection in humans. The causative microorganisms for UTIs may vary in different places and also vary in their antibiotic sensitivity and resistant patterns. This study aimed to find out the incidence of gram-negative bacteria along with their antibiotic sensitivity pattern in community-acquired UTIs and to calculate the existence of Extended-spectrum beta-lactamase (ESBL) positivity among them. A Sum of 515 urine samples was tested and the causative organisms were identified. Antibiotic susceptibility tests were executed where it had shown growth for bacteria by both manual and automated methods. ESBL tests were performed to identify ESBL-producing isolates. From a total of 515 samples, 65 (12.65%) were culture positive for UTIs. The rate of infection was higher in females than in males. The most prevailing bacteria were Escherichia coli and Klebsiella pneumoniae. Out of total culture-positive isolates, only 43.08% were ESBL positives. The study found that the organisms displayed resistance to Ciprofloxacin and Cefixime and sensitivity to Gentamicin, Ertapenem, and Nitrofurantoin. Females have a higher prevalence of UTIs than males. Mostly, females suffer from UTIs in their reproductive years whereas males suffer in their old age. The prevalence of gram-negative bacteria is higher in community-acquired UTIs. These pathogens though present in the community, becoming resistant to commonly used antibiotics like Ciprofloxacin and Cefixime because of overuse and misuse of antibiotics at the community level.