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Background: With the continuous advancement of modern medical technology, the survival rate of premature infants has significantly increased. Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens causing neonatal infections, particularly posing a serious risk to premature infants. This study aimed to analyze the clinical characteristics, antibiotic susceptibility profiles, and treatment outcomes of K. pneumoniae infections in these infants. Methods: We retrospectively compared cases of K. pneumoniae infection in premature and term infants admitted in a tertiary hospital from January 2017 to December 2022 in China. Clinical and microbiological characteristics were evaluated. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), with statistical significance defined as P < 0.05. Results: We enrolled 166 premature infants and 68 term infants. In premature infants, fetal distress, patent ductus arteriosus, patent foramen ovale, enteritis, anemia, hypoproteinemia, bloodstream infections, abdominal infection, mechanical ventilation, nasogastric feeding, drainage tube, parenteral nutrition, and prior exposure to carbapenem antibiotics were identified as significant risk factors for K. pneumoniae infections in univariate analysis. Furthermore, septic shock, bloodstream infections, abdominal infections, indwelling catheters, drainage tubes, parenteral nutrition, and previous exposure to glycopeptide antibiotics were significantly correlated with mortality. Independent risk factors for K. pneumoniae infections in premature infants included fetal distress (OR: 3.702, [95% CI: 1.056–12.986], P = 0.041), enteritis (OR: 4.434, [95% CI: 1.066–18.451], P = 0.041), anemia (OR: 4.028, [95% CI: 1.550-10.466], P = 0.004), bloodstream infections (OR: 1.221, [95% CI: 0.061–1.802], P = 0.022), mechanical ventilation (OR: 4.974, [95% CI: 1.685–14.685], P = 0.004) and prior exposure to carbapenem antibiotic (OR: 14.738, [95% CI: 2.393–90.767], P = 0.004). Additionally, abdominal infections (OR: 8.598, [95% CI: 2.000-36.957], P = 0.004) and indwelling catheters (OR: 7.698, [95% CI: 0.998–59.370], P = 0.050) were positive predictors of mortality. Conclusion: K. pneumoniae isolates exhibit a notable prevalence of infection, poor treatment outcomes, and elevated resistance in preterm neonates. These findings enhance our understanding of K. pneumoniae infections and their association with clinical outcomes among premature infants. [ABSTRACT FROM AUTHOR]

The regulatory role of zinc in bone formation extends to the activation of proteins associated with bone homeostasis. Furthermore, copper is well known for its antibacterial properties. This dual function underscores the significance of zinc and copper in maintaining a balance of bone structure and function. In light of the aforementioned, zinc sulphide/copper oxide nanocomposites were created in this instance using a straightforward coprecipitation technique. Copper oxide was used as a nanocomposite to improve the structural, morphological, and biological performance of zinc sulphide nanoparticles. The X-ray diffraction pattern confirmed a transformation in the crystal structure from cubic to rhombohedral, along with increase in intensity. Fourier transforms infrared analysis indicated the presence of functional groups. Scanning electron microscopy images demonstrated a morphological shift from non-uniform to distinct spherical nanoparticles, impacting the enhancement of material properties. The pathogenic activity of the zinc sulphide/copper oxide nanocomposites was tested against nine bacterial strains. In antimicrobial testing, zinc sulphide/copper oxide nanocomposites showed promising results, particularly against Klebsiella pneumoniae (zone of inhibition: 14 mm at 100 µg/mL compared to 7 mm by standard) and Escherichia coli (zone of inhibition: 11 mm at 100 µg/mL compared to 10 mm by standard) after 24 h with zone of inhibition matching or exceeding that of the standard (chloramphenicol). Zinc sulphide nanoparticles and zinc sulphide/copper oxide nanocomposites were evaluated for their antifungal activity against fungal stains from Trichophyton rubrum, Aspergillus niger, and Aspergillus flavus. After a 24-h period, it was discovered that zinc sulphide/copper oxide nanocomposites were effective against Aspergillus flavus (zone of inhibition: 19.4 mm at 100 µg/mL compared to 6.3 mm by standard) at all concentrations (25–100 mg/mL), with zones of inhibition identical to or greater than those of the standard (fluconazole). Certainly, based on these results, zinc sulphide/copper oxide nanocomposites could be promising materials for drug delivery. Clinical trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Klebsiella is an encapsulated bacillus, a member of the family Enterobacteriaceae. Klebsiella can cause various illnesses, including pneumonia, bloodstream infections, urinary tract infections, and meningitis. Klebsiella has emerged as a nosocomial pathogen, particularly in premature infants and intensive care units (ICUs). This experiment aimed to investigate the toxic effects of K. pneumoniae on blood pictures and DNA structure. Thirty (30) male rabbits were divided into three groups. 1st group (GI) was given 1 milliliter/animal an oral dose of phosphate buffer saline (PBS) by a stomach tube as a control group for 60 days. The 2nd group (GII) was given one dose a week of 1 milliliter containing viable K. pneumoniae (1 X 106 CFU/ml) orally by stomach tube for 60 days. The 3rd group (GIII) was given the same dose twice a week. After 60 days, blood samples were collected from the heart and divided into 2 parts: 1st part for hematological analysis and 2nd part for detection of DNA damage using comet assay. The results of the hematological analysis showed significantly decreased RBCs, Hb and PCV, and considerably increased WBCs, lymphocytes, monocytes and neutrophils in the 2nd and 3rd groups, compared with the control group. In contrast, the comet assay showed DNA damage in the WBC of the different groups. The mean ± SE of tail length, tail intensity, tail moment and % DNA in the tail showed significant increases in the 2nd and 3rd groups, compared with the control group. [ABSTRACT FROM AUTHOR]

Response Surface Methodology (RSM) with Box–Behnken Design (BBD) is used to optimise the Phenanthrene (PHE) degradation process by Klebsiella pneumoniae (K bacteria) and Pseudomonas aeruginosa (P bacteria). Wherein substrate concentration, temperature, and pH at three levels are used as independent variables, and degradation rate of PHE as dependent variables (response). The statistical analysis, via ANOVA, shows coefficient of determination R2 as 0.9848 with significant P value 0.0001 fitting in second-order quadratic regression model for PAHs removal by Klebsiella pneumonia, and R2 as 0.9847 with significant P value 0.0001 by P bacteria. According to the model analysis, temperature (P < 0.0006) is the most influential factor for PHE degradation efficiency by K bacteria, while pH (P < 0.0001) is the most influential factor for PHE degradation by P bacteria. The predicted optimum parameters for K bacteria, namely, temperature, substrate concentration, and pH are found to be 34.00℃, 50.80 mg/L, and 7.50, respectively, and those for P bacteria are 33.30℃, 52.70 mg/L, and 7.20, respectively. At these optimum conditions, the observed PHE removal rates by two bacteria are found to be 83.36% ± 2.1% and 81.23% ± 1.6% in validation experiments, respectively. Thus RSM can optimise the biodegradation conditions of both bacteria for PHE. [ABSTRACT FROM AUTHOR]

The prevalence of antibiotic resistance has been demonstrated in various food-borne pathogens. Beta-lactam antibiotics are among the first-line antimicrobials that are normally administered in case of gastrointestinal infections. However, Escherichia coli (E. coli) and some other members of Enterobacteriaceae have indicated broad resistance against such antibiotics thanks to extended-spectrum beta-lactamase (ESBL) enzymes. In this research, 216 stool samples have been screened for ESBL-producing E. coli, using phenotypic antibiotic susceptibility tests. ESBL-producing E. coli isolates were further screened for the presence of antibiotic-resistance genes CTX-M, SHV, and TEM. Our isolation experiments resulted in 111 E. coli isolates among which 41 (36.9%) isolates were found as ESBL. Also, 51.2% of the above ESBL isolates harbored blaTEM. Furthermore, 18 (43.9%) and 2 (4.9%) of those ESBL isolates had blaCTX-M and blaSHV genes, respectively. Our results revealed a detectable prevalence of ESBL E. coli in stool samples collected during food outbreaks. Results of such researches can guide how to control the distribution of drug-resistant pathogens in various environments. In this line, the considerable prevalence of ESBL E. coli seems to have originated from the wide administration of various beta-lactam antibiotics.

Abstract Background With the continuous advancement of modern medical technology, the survival rate of premature infants has significantly increased. Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens causing neonatal infections, particularly posing a serious risk to premature infants. This study aimed to analyze the clinical characteristics, antibiotic susceptibility profiles, and treatment outcomes of K. pneumoniae infections in these infants. Methods We retrospectively compared cases of K. pneumoniae infection in premature and term infants admitted in a tertiary hospital from January 2017 to December 2022 in China. Clinical and microbiological characteristics were evaluated. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), with statistical significance defined as P

Abstract The regulatory role of zinc in bone formation extends to the activation of proteins associated with bone homeostasis. Furthermore, copper is well known for its antibacterial properties. This dual function underscores the significance of zinc and copper in maintaining a balance of bone structure and function. In light of the aforementioned, zinc sulphide/copper oxide nanocomposites were created in this instance using a straightforward coprecipitation technique. Copper oxide was used as a nanocomposite to improve the structural, morphological, and biological performance of zinc sulphide nanoparticles. The X-ray diffraction pattern confirmed a transformation in the crystal structure from cubic to rhombohedral, along with increase in intensity. Fourier transforms infrared analysis indicated the presence of functional groups. Scanning electron microscopy images demonstrated a morphological shift from non-uniform to distinct spherical nanoparticles, impacting the enhancement of material properties. The pathogenic activity of the zinc sulphide/copper oxide nanocomposites was tested against nine bacterial strains. In antimicrobial testing, zinc sulphide/copper oxide nanocomposites showed promising results, particularly against Klebsiella pneumoniae (zone of inhibition: 14 mm at 100 µg/mL compared to 7 mm by standard) and Escherichia coli (zone of inhibition: 11 mm at 100 µg/mL compared to 10 mm by standard) after 24 h with zone of inhibition matching or exceeding that of the standard (chloramphenicol). Zinc sulphide nanoparticles and zinc sulphide/copper oxide nanocomposites were evaluated for their antifungal activity against fungal stains from Trichophyton rubrum, Aspergillus niger, and Aspergillus flavus. After a 24-h period, it was discovered that zinc sulphide/copper oxide nanocomposites were effective against Aspergillus flavus (zone of inhibition: 19.4 mm at 100 µg/mL compared to 6.3 mm by standard) at all concentrations (25–100 mg/mL), with zones of inhibition identical to or greater than those of the standard (fluconazole). Certainly, based on these results, zinc sulphide/copper oxide nanocomposites could be promising materials for drug delivery. Clinical trial registration: Not applicable.

As a last option, multidrug-resistant Gram-negative infections (caused by Enterobacteriaceae) are treated with the antibiotic colistin, also known as polymyxin E. Colistin-resistant superbugs predispose people to untreatable infections, possibly leading to a high mortality rate. This project aims to study the effect of Acacia nilotica aqueous extract and zinc oxide nanoparticles (ZnO-NPs) on colistin-resistant Klebsiella pneumonia (CRKP).

Allergic bronchopulmonary aspergillosis (ABPA) presents diagnostic hurdles in pediatrics due to its resemblance to asthma or infections. An 11-year-old girl, known for recurrent asthma-related hospitalizations, presented with ongoing cough and breathing issues. Initial asthma treatment provided temporary relief, but her reliance on oxygen spurred further investigation. Radiological assessments initially suggested infection, confirmed as Klebsiella pneumonia, but antibiotic treatment proved insufficient. Elevated eosinophils, IgE levels, and specific IgE for Aspergillus fumigatus hinted at ABPA. Confirmation led to a successful three-month oral steroid course, combining therapies for effective management. Distinguishing ABPA from asthma and infections demands a thorough approach for timely identification and treatment in pediatric cases.

Abstract Background Pulmonary abscesses resulting from epididymitis caused by extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae (ESBL-hvKp) in a nondiabetic patient are extremely uncommon. The infection caused by this disseminated drug-resistant bacteria, which is generally considered an intractable case, poses a potential challenge in clinical practice. Case presentation In this case report, we present the clinical course of a 71-year-old male patient with epididymitis, who subsequently developed cough and dyspnea following anti-infection treatment. Imaging examinations revealed severe pneumonia and pulmonary abscess. The infection of ESBL-hvKp in the epididymis led to bacteremia and subsequent lung lesions. Due to poor response to anti-infection therapy, the patient required an extended duration of anti-infection treatment and ultimately chosed to discontinue treatment. Conclusions Acute epididymitis caused by ESBL-hvKP infection can result in the spread of the infection through the bloodstream, leading to severe pneumonia and lung abscess. Given the critical condition of the patient, even with active anti-infection treatment, there is a risk of treatment failure or potentially fatal outcomes.

The emergence of multidrug resistance in bacteria due to the overuse of antibiotics has become an important health concern in recent years, which requires the development of novel alternatives to fight against. Essential oils (EOs) are secondary metabolites that have different components and chemical compositions, which may provide promising solutions to the problem of the rising number of drug-resistant bacteria. This study aims to determine the efficacy of Eucalyptus and Geranium oil against Klebsiella pneumoniae, antibiotic-sensitive profile, and detect the molecular of the PER-1 gene by PCR method. In total 60 isolates of K. pneumoniae were collected from different hospitals in Ahvaz, (Golestan and Imam, Iran). Clevenger-type apparatus was used for oils extraction of hydro-distilled plants aerial, to determine the efficacy of essential oils. The agar well diffusion method and disc diffusion method were applied for five antibiotic discs to detect the profile of antibiotic sensitivity. Molecular detection of the PER-1 gene was done by PCR method. The results indicated that the oil extract of each plants inhibit the growth of K. pneumoniae with zones of inhibition ranging from 25 mm. Klebsiella pneumonia isolates were highly resistant to ceftazidime (83.3%), and more sensitive to Eucalyptus camaldulensis Dehnh Molecular detection of extended-spectrum β-lactamase bla PER-1 gene was recorded 12 (20%). The Geranium and Eucalyptus essential oil can be used as an alternative treatment for diseases caused by resistance to clinical isolation of K. pneumoniae. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae has become one of the most common etiologic agents in the context of recurrent UTI. Capsule is the earliest recognized factor determining bacterial pathogenicity. This study aimed to test the effects of staphyloxanthin, meropenem and a combination of them on capsule genes of Klebsiella pneumoniae. Eighty-eight gram negative bacterial isolates were collected from 150 urine specimens between September and November of 2022.after cultivation on MacConkey agar medium. Oxidase (negative) and catalase (positive) tests were performed. In addition, all isolates were found to be non-motile when their motility was further examined. The results presented that 77 (51.3%) could ferment lactose (lactose fermenter), while 30 isolates (20%) of them were confirmed as K. pneumonia. The antibiotics sensitivity test of (30) K. pneumoniae revealed that 28 (93%) of isolates were sensitive to meropenem, and about 20 (67%), 16 (53%), 8 (27%), 7 (23%), 5 (17%) and 4 (13%) were sensitive toward amikacin, ciprofloxacin, trimethoprim, cefepime, tetracycline and Augmentin respectively. S. aureus (producers of staphyloxanthin) isolates were taken; the staphyloxanthin pigment was extracted, purified by Millipore filter (0.22 mm). Conventional PCR results revealed the presence of galF gene (141 bp) in all eight tested isolates (100%). In addition, the wzi gene (177bp) was found in seven isolates (87.5%). According to the quantitative real-time PCR results, most treatments resulted in downregulation of galF and wzi genes expression, whereas some treatments resulted in upregulation. [ABSTRACT FROM AUTHOR]

To investigate the etiology, pathogens, treatment, and prognosis of endogenous endophthalmitis (EE). Patients diagnosed with EE over three decades at Peking Union Medical College Hospital were retrospectively reviewed and analyzed. A total of 97 eyes from 81 patients were included. Diabetes was the most common predisposing medical condition (34.6%). Klebsiella pneumoniae (31.3%) and Candida albicans (32.8%) were the most common pathogens. Liver abscess (20.6%) was the predominant cause EE due to liver abscess had a worse initial visual acuity (P < 0.05). Patients who initially underwent pars plana vitrectomy (PPV)+silicone oil tamponade underwent fewer total treatments (P < 0.05). In the past 10 years, the proportion of Gram-positive cocci, Gram-negative bacilli, and Candida showed an upward trend. Over the past 15 years, EE after liver abscess and immunosuppression has increased, while EE from genitourinary systems has decreased. EE was a devastating intraocular disease with a poor visual prognosis. The initial condition and prognosis of EE after liver abscess were the worst. PPV+silicone oil tamponade as an initial treatment may reduce additional therapy. [ABSTRACT FROM AUTHOR]

Zinc oxide nanoparticles (ZnONPs) are enormously popular semi-conductor metal oxides with diverse applications in every field of science. Many physical and chemical methods applied for the synthesis of ZnONPs are being rejected due to their environmental hazards. Therefore, ZnONPs synthesized from plant extracts are steered as eco-friendly showing more biocompatibility and biodegradability. Additionally, various synthesis conditions such as the type of precursor salt also play a role in influencing the physicochemical and biological properties of ZnONPs. In this study, green synthesis of ZnONPs from Acacia nilotica was carried out using zinc acetate (ZA-AN-ZNPs), zinc nitrate (ZN-AN-ZNPs), and zinc sulfate (ZS-AN-ZNPs) precursor salts. Surprisingly, characterization of ZnONPs using UV–visible spectroscopy, TEM, XRD, and EDX revealed the important role precursor salts played in influencing the size and shape of ZnONPs, i.e., 20–23 nm spherical (ZA-AN-ZNPs), 55–59 nm triangular (ZN-AN-ZNPs), and 94–97 nm nano-flowers (ZS-AN-ZNPs). FTIR analysis showed the involvement of alkaloids, alcohols, carboxylic acid, and phenolic compounds present in Acacia nilotica extract during the synthesis process. Since different precursor salts showed different morphology of ZnONPs, their biological activities were also variable. ZN-AN-ZNPs showed the highest cytotoxicity towards HepG2 cells with the lowest cell viability (28.92 ± 0.99%), highest ROS/RNS production (3425.3 ± 184.58 relative DHR123 fluorescence), and loss of mitochondrial membrane potential (1645.2 ± 32.12 relative fluorescence unit) as well as induced significant caspase-3 gene expression. In addition to this, studying the zone of inhibitions and minimum bactericidal and inhibitory concentrations of ZnONPs showed their exceptional potential as antibacterial agents. At MIC as low as 8 µg/mL, ZA-AN-ZNPs and ZN-AN-ZNPs exhibited significant bactericidal activities against human pathogens Klebsiella pneumoniae and Listeria monocytogenes, respectively. Furthermore, alkaline phosphatase, DNA/RNA leakage, and phosphate ion leakage studies revealed that a damage to the bacterial cell membrane and cell wall is involved in mediating the antibacterial effects of ZnONPs. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae (K. pneumoniae) is a major cause of nosocomial and community-acquired infections (CAIs). Understanding the antibiotic susceptibility of this bacterium is essential for selecting the most effective antibiotic for associated infections. Objectives: We investigated the sensitivity of K. pneumonia (KP) isolates obtained from inpatients in Isfahan, Iran. Methods: Organism identification and antibiotic susceptibility testing were conducted using standard tests. Stratification was performed based on extended spectrum beta-lactamase (ESBL) production and the source of infection acquisition (community versus hospital). Results: A total of 437 KP isolates were investigated, of which 5.5% were pan drug resistant (PDR), 56.8% were extensively drug resistant (XDR), and 18% were ESBL producers. The isolates were most susceptible to colistin (100%), aminoglycosides (62.8%), and carbapenems (55%). Nosocomial isolates showed lower sensitivity to most of the examined antibiotics. Conclusions: The high prevalence of PDR and XDR KP strains in hospitalized patients is a major problem in the studied area. [ABSTRACT FROM AUTHOR]

Abstract This study presents an enhanced fractional-order mathematical model for analyzing the dynamics of Klebsiella pneumonia infections and antibiotic resistance over time. The model incorporates fractional Caputo derivative operators and kernel, to provide a more comprehensive understanding of the complex temporal dynamics. The model consists of three groups: Susceptible (S), Infected (I), and Resistant (R) individuals, each controlled by a fractional differential equation. The model represents the interaction between infection, recovery from infection, and the possible development of antibiotic resistance in susceptible individuals. The existence, uniqueness, stability, and alignment of the model’s prediction to the observed data were analyzed and buttressed with numerical simulations. The results show that imipenem has the highest efficacy compared with ertapenem and meropenem category drugs. The estimated reproduction number and reproduction coefficient illustrate the potential impact of this model in improving treatment strategies, while the memory effects highlight the advantages of fractional differentiation. The model predicts an increased possibility of antibiotic resistance despite effective treatment, suggesting a new treatment approach.

Abstract As an alternative to antibiotics in response to antimicrobial-resistant infections, bacteriophages (phages) are garnering renewed interest in recent years. However, the massive preparation of phage is restricted using traditional pathogens as host cells, which incurs additional costs and contamination. In this study, an opportunistic pathogen, Klebsiella pneumoniae used to convert glycerol to 1,3-propanediol (1,3-PDO), was reused to prepare phage after fermentation. The phage infection showed that the fed-batch fermentation broth containing 71.6 g/L 1,3-PDO can be directly used for preparation of phage with a titer of 1 × 108 pfu/mL. Then, the two-step salting-out extraction was adopted to remove most impurities, e.g. acetic acid (93.5%), ethanol (91.5%) and cells (99.4%) at the first step, and obtain 1,3-PDO (56.6%) in the top phase as well as phage (97.4%) in the middle phase at the second step. This integrated process provides a cheap and environment-friendly manner for coproduction of 1,3-PDO and phage. Graphical abstract

This study presents an enhanced fractional-order mathematical model for analyzing the dynamics of Klebsiella pneumonia infections and antibiotic resistance over time. The model incorporates fractional Caputo derivative operators and kernel, to provide a more comprehensive understanding of the complex temporal dynamics. The model consists of three groups: Susceptible (S), Infected (I), and Resistant (R) individuals, each controlled by a fractional differential equation. The model represents the interaction between infection, recovery from infection, and the possible development of antibiotic resistance in susceptible individuals. The existence, uniqueness, stability, and alignment of the model's prediction to the observed data were analyzed and buttressed with numerical simulations. The results show that imipenem has the highest efficacy compared with ertapenem and meropenem category drugs. The estimated reproduction number and reproduction coefficient illustrate the potential impact of this model in improving treatment strategies, while the memory effects highlight the advantages of fractional differentiation. The model predicts an increased possibility of antibiotic resistance despite effective treatment, suggesting a new treatment approach. [ABSTRACT FROM AUTHOR]

Introduction: Immunocompromised and hospitalized ICU (intensive care units) patients are susceptible to be infected by harboring microorganisms. This research is to identify the presence of fungal and bacterial species and determine the sensitivity test for anti-fungal and anti-bacterial through oral swabs in the ICU patients. Materials and methods: This research is a laboratory experiment with a cross-sectional design. Data was obtained using a sample of 48 geriatric patients from several ICU rooms at Dr. Ramelan Naval Medical Center Hospital Surabaya during March to April 2023 (for 3 months). All respondents who met the criteria were subjected to an oral swab, and identification and sensitivity testing using the VITEX ® 2 compact tool. Results: Identified 8.1% fungal infection and 3.8% bacterial infection. There were 5.7% of patients infected with both fungi and bacteria. The fungal species consist of candida and non-candida species. The Candida species involved are: C. albicans, C. tropicalis, C. dubliniensis, C. Guilermondi, and C Lusitania. In the sensitivity test, it was found that isolates were resistant to antifungals, namely fluconazole. A 100 percent sensitive antifungal is variconazole. From bacterial infection, we found Klebsiella pneumoniae, Enterobacteria aerogenes and Pseudomonas aeroginos. Conclusion: Types of microorganisms obtained in the oral cavity in geriatric patients in the ICU at Dr. Ramelan Naval Medical Center Hospital Surabaya during April-June 2023 were mostly dominated by fungal infection, with bacteria infection only 10 %. The sensitivity test showed 100 % sensitivity to voriconazole. [ABSTRACT FROM AUTHOR]

Background:Neonatal sepsis is a significant cause of neonatal mortality, particularly in developing countries, and Klebsiella pneumoniae is a significant contributor to this problem in some Egyptian hospitals. The aim of this study was to investigate the association between CTXM-15 and Klebsiella pneumoniae resistance in neonates. Results:Five hundred and nine positive samples were collected from newborns at some Egyptian hospitals between March 2019 and March 2021, and 101 isolates of Klebsiella pneumoniae were tested for antimicrobial susceptibility using VITEK® 2. The majority of the isolates were from late-onset infections and showed high levels of resistance to several antibiotics, including Ampicillin, Ampicillin/sulbactam, Ceftazidime, and Cefotaxime. The blaCTXM-15 gene was found to be highly expressed in 66% of the multidrug-resistant Klebsiella pneumoniae isolates, indicating the high level of resistance conferred by this gene. Double combination therapy was evaluated, and the combination of cefotaxime and amikacin showed the most promising results, with synergistic effects against the tested isolates. The addition of magnesium was suggested to enhance cell wall integrity, allowing cefotaxime to diffuse more easily into the cells, and the Cefotaxime-Ethylenediaminetetraacetic acid combined disc and double disc synergy test confirmed the absence of metallobeta-lactamase CTXM-15. Conclusion:The study highlights the high prevalence of antibiotic resistance in K. pneumoniae isolates in neonatal sepsis in Egypt and demonstrates that the combination of cefotaxime and amikacin may be an effective treatment option for multidrug-resistant isolates with high CTXM-15 expression. [ABSTRACT FROM AUTHOR]

Background and Objectives: Klebsiella pneumoniae is a healthcare-associated infections agent and could be an extended spectrum ß-lactamase (ESBL) producer. Understanding the transmission of this bacterium in a hospital setting needs accurate typing methods. An antibiogram is used to detect the resistance pattern of the isolates. Random Amplified Polymorphic DNA (RAPD) and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR are rapid, technically simple, and easy-to-interpret DNA typing methods. This study aimed to evaluate the use of antibiotyping, RAPD-, and ERIC-PCR to investigate the heterogeneity of K. pneumoniae isolated from clinical specimens. Materials and Methods: The antibiograms of 46 K. pneumoniae clinical isolates were determined by Vitek® 2 Compact. All isolates underwent RAPD-PCR using AP4 primer and ERIC-PCR using ERIC-2 primer. The dendrogram was generated using the GelJ software and analyzed to determine its similarity. The analysis of antibiogram and the molecular typing diversity index was calculated using the formula of the Simpson's diversity index. Results: About 71.7% of the isolates were ESBL-producers, and more than 80% of isolates were susceptible to amikacin, ertapenem, and meropenem. The antibiotyping produced 32 diverse types with DI = 0.964. In addition, the RAPD-PCR produced 47 different types with DI = 1, while ERIC-PCR was 46 (DI=0.999). Conclusion: Antibiotyping, RAPD- and ERIC-PCR showed powerful discrimination power among the isolates, supported the diversity of K. pneumoniae isolates in current study. These combination could be promising tools for clonal relationship determination, including in tracking the transmission of the outbreak's agent in hospital setting. [ABSTRACT FROM AUTHOR]

Background and Objectives: To explore the prevalence and characteristics of secondary bacterial infections among patients suffering from mucormycosis following COVID-19 infection. Materials and Methods: We conducted a cross-sectional, retrospective analysis from March 2020 to April 2022 at Imam Khomeini Hospital Complex in Tehran. The study included patients with histopathologically confirmed mucormycosis and documented secondary bacterial infections. We extracted and analyzed data from hospital records using SPSS software, version 26. Results: The study comprised 27 patients, with a predominance of females (70.4%) and an average age of 56 years. The majority of these patients (63%) had pre-existing diabetes mellitus. The severity of their COVID-19 infections varied. Treatment regimens included immunosuppressive drugs and antibiotics. Rhinocerebral mucormycosis was the most common form observed. The predominant secondary infections involved the urinary tract, respiratory system, bloodstream (bacteremia), and soft tissues, with resistant strains of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae being the most frequently identified microorganisms. Notably, cases of bacteremia and pneumonia exhibited a higher mortality rate. Ultimately, 55.6% of patients were discharged, while 44.4% succumbed to their infections. Conclusion: Patients recovering from COVID-19 with mucormycosis are significantly susceptible to secondary bacterial infections, particularly those with diabetes mellitus or those undergoing immunosuppressive therapy. Such infections compound the morbidity and mortality risks in this vulnerable patient cohort. [ABSTRACT FROM AUTHOR]

As an alternative to antibiotics in response to antimicrobial-resistant infections, bacteriophages (phages) are garnering renewed interest in recent years. However, the massive preparation of phage is restricted using traditional pathogens as host cells, which incurs additional costs and contamination. In this study, an opportunistic pathogen, Klebsiella pneumoniae used to convert glycerol to 1,3-propanediol (1,3-PDO), was reused to prepare phage after fermentation. The phage infection showed that the fed-batch fermentation broth containing 71.6 g/L 1,3-PDO can be directly used for preparation of phage with a titer of 1 × 108 pfu/mL. Then, the two-step salting-out extraction was adopted to remove most impurities, e.g. acetic acid (93.5%), ethanol (91.5%) and cells (99.4%) at the first step, and obtain 1,3-PDO (56.6%) in the top phase as well as phage (97.4%) in the middle phase at the second step. This integrated process provides a cheap and environment-friendly manner for coproduction of 1,3-PDO and phage. [ABSTRACT FROM AUTHOR]

Background: The prevalence of community-onset infections of extended spectrum β-lactamase (ESBL)–producing strains has increased globally, yet surveillance and resistance in patients with oral and maxillofacial surgery site infections is less investigated. Patients and Methods: A retrospective cohort study was performed to investigate risk factors and resistance of ESBL-producing Escherichia coli (ESBL-EC) and ESBL-producing Klebsiella pneumonia (ESBL-KP) among community-onset patients with oral and maxillofacial surgery during January 2010 to December 2016. Demographic features, predisposing factors, clinical outcomes, and antibiotic agent costs were analyzed. Antimicrobial susceptibility testing of nine antimicrobial agents against ESBL-KP and ESBL-EC were measured. Results: Among 2,183 cultures from infection sites in patients with oral and maxillofacial surgery site (45 cases [2.06%]) were confirmed with community-onset ESBL-KP (24; 1.10%) or ESBL-EC (21; 0.96%) infection. Multivariable analysis showed the independent risk factors for ESBL-producing bacterial infection were prior history of hospitalization (adjusted odds ratio [aOR], 10.984; 95% confidence interval [CI], 5.965–59.879; p = 0.025) and malignant condition (aOR, 3.373; 95% CI 2.947–7.634; p = 0.024). Based on antimicrobial susceptibility testing, 57.8% ESBL-KP and ESBL-EC were found receiving inappropriate antimicrobial therapy, and antibiotic agent costs were higher than non-ESBL–producing bacterial infections ($493.8 ± $367.3 vs. $304.1 ± $334.7; p = 0.031). Conclusions: Infections caused by ESBL-KP and ESBL-EC among patients in sites with oral and maxillofacial surgery are associated with prior history of hospitalization and malignant conditions. Prompt detection and appropriate antibiotic administration for community-onset infections of ESBLs are necessary for such populations. [ABSTRACT FROM AUTHOR]

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

Introduction: Klebsiella is the primary cause of respiratory tract infection like pneumonia, Rhinoscleromatis, sinusitis and cholecystitis. Klebsiella pneumoniae is primary pathogens and can cause a classic from of primary pneumoniae. Klebsiella pneumonia can also cause urinary tract infection, nosocomial infection, wound infection biliary tract infection, peritonitis, meningitis, bacteremia, enteritis, septicemia. Multidrug-resistant Klebsiella pneumoniae (MDRKP) has become an urgent risk to public health as its prevalence has sharply surged around the globe in recent decades. Therefore, to understand the antibiotic sensitivity pattern of K. pneumoniae from various specimens in West India and to provide a basis for the selection of appropriate antibiotics, this study was investigated. Materials and methods: This study was conducted at Diagnostic Microbiology section of Central laboratory, Dhiraj General Hospital, SBKS MI and RC, Piparia, Vadodara over the period of April 2022 to September 2022. There were various sample should be collected according to site of infection like urine, blood, pus, sputum and other body fluids. Data collection was carried out based on a questionnaire that was previously designed in terms of gender, age, the type of antibiotic. Detection and differentiation of sensitive, semi-sensitive and resistant conditions from each other was performed based on the diameter of the around the colony as millimeters and according to the relevant table in laboratory. The data were collected, recorded and analyzed statistically. Results: At the time study period, total 750 specimens was collected and 114 specimen was positive for Klebsiella isolates from various specimen. Most affected age group were 31-40 years (30), 41-50 years (23), 51-60 years (18). In the present study, out of 117 Klebsiella isolates, 91.87% resistant to Ampicillin, 58% to Amikacin, 88.03% to Cefuroxime, 69% to Ceftazidime, 63% to Cefepime, 86% to Ciprofloxacin, 61% to Imipenem, 62% to Gentamicin, 58% to Cotrimaxazole. Conclusion: We may draw the conclusion that K. pneumoniae antibiotic resistance is a real threat and requires close monitoring to be controlled. This study indicated relatively high prevalence of multidrug resistance Klebsiella species. This data had important implication for the quality of patient care in hospital settings specially in antibiotics selection, infection control practices and need for additional studies. [ABSTRACT FROM AUTHOR]

Background: In a system of two oppositely charged colloids a spontaneous liquid-liquid phase separation is termed as complex coacervation and the separated phase is called coacervate. In recent times coacervates prepared from different colloidal systems have found extensive uses in the microencapsulation of bioactive molecules including drugs. The search for new coacervation systems and coacervates with novel properties remains an active area of research. In the present work preparation of complex coacervate from chitosan phosphate and sodium alginate for subsequent use for encapsulation of curcumin is reported. Materials and Methods: Chitosan was first modified to chitosan phosphate. It was then reacted with sodium alginate to form the complex coacervate. Several parameters like ratio of concentration of the chitosan phosphate to alginate, pH of the reaction media were varied to attain the optimum condition for the maximum yield of the coacervate. Results: It was found that the maximum amount of coacervate formed at pH 3.6 and at the ratio of 5:4 by volume of the 3% solution of alginate and chitosan phosphate. The maximum loading efficiency of curcumin was found to be 84%. Swelling and release studies were carried out at different pH and the maximum swelling and percentage of release was observed at pH 9. The curcumin loaded coacervate showed mild antibacterial activity against Staphylococcus aureus, Bacillus subtilis and Enterobacter aerogenes. Conclusion: Results from Fourier transform infrared spectroscopy, thermogravimetric analysis, powder x-ray diffraction and scanning electron microscopy supported successful encapsulation of curcumin in the chitosan phosphate/alginate coacervate. Swelling and release studies could be modulated by changing the pH of the medium. A sustained release behavior of curcumin over a period of 72 hr was observed without the loss of physical integrity of the coacervate. [ABSTRACT FROM AUTHOR]

CA is a plant derivative with antibacterial and antiviral pharmacological effects, however, the therapeutic effect of CA on Klebsiella pneumonia and its mechanism study is still unclear. A rat KP model was established in vitro, a pneumonia cell model was established in vivo, the histopathological changes in the lungs were observed by HE staining after CA treatment, the expression of relevant inflammatory factors was detected by ELISA, the changes in the expression of proteins related to the AhR‐Src‐STAT3‐IL‐10 signaling pathway were detected by Western blot and immunofluorescence in the lungs, and the interactions between the proteins were verified by COIP relationship. The results showed that CA was able to attenuate the injury and inflammatory response of lung tissues, and molecular docking showed that there were binding sites between CA and AhR, and COIP demonstrated that AhR interacted with both STAT3 and Ser. In addition, CA was able to up‐regulate the expression levels of pathway‐related proteins of AhR, IL‐10, p‐Src, and p‐STAT3, and AhR knockdown was able to reduce LPS‐induced inflammatory responses and up‐regulate pathway‐related proteins, whereas CA treatment of AhR‐knockdown‐treated A549 cells did not show any statistically significant difference compared with the AhR knockdown group, demonstrating that CA exerts its pharmacological effects. These findings elucidated the mechanism of CA in the treatment of KP and demonstrated that CA is a potential therapeutic agent for KP. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance in common pathogenic bacteria is linked with the genetic makeup. The genetic basis of antibiotic resistance may vary in different species or pathophysiological conditions. Objectives: We studied the antibiotic resistance in Klebsiella pneumonia isolates from DFU in the western Indian population. We also studied the presence of ESBL and MBL mechanisms of antibiotic resistance along with the prevalence of the genes involved in ESBL (TEMESBL, SHVESBL, and CTX-MESBL) and MBL (NDM-1bla, KPCbla, OXA-48bla, and VIMbla) production. Results: A total of 161 K. pneumoniae isolates were analyzed; among which 50.93% were positive for ESBL and 45.96% were positive for MBL production. Most of the isolates were resistant to antibiotics used in the present study and partially resistant to Imipenem and Amikacin. There was no relation between the antibiotic resistance of the isolates and the production of ESBL or MBL mechanism of antibiotic resistance. Further, TEMESBL was the most prevalent gene in K. pneumoniae isolates followed by CTX-MESBL, NDM-1bla, SHVESBL, and KPCbla. VIMbla was the least prevalent gene found in K. pneumoniae isolates. There was no difference in the prevalence of the genes with respect to the presence or absence of ESBL and MBL mechanism of resistance. Further, there was no relation between the prevalence of the genes and antibiotic resistance in K. pneumoniae isolates. Conclusion: These results along with the literature review suggest that the prevalence of the genes involved in antibiotic resistance mechanisms are widespread in India and their distribution varies in different studies.

Objective To investigate the ocular clinical features and diagnostic and therapeutic protocol of patients with endogenous endophthalmitis (EE) secondary to Klebsiella pneumoniae liver abscess (KPLA). Methods Six patients (seven eyes) with EE secondary to KPLA who attended our hospital from January 2019 to December 2020 were enrolled and analyzed in terms of clinical manifestation, examination findings, treatment regimen, and prognosis. Results All six patients were male, among whom five had pyrexia. All patients had impaired vision, and at initial diagnosis, there were four patients (five eyes) with no light perception, one patient (one eye) with manual vision, and one case (one eye) with light perception. All patients had the typical clinical manifestations of endophthalmitis such as impaired vision, conjunctival congestion and edema, ocular swelling and pain, and inflammatory response in the anterior chamber, and postoperative microbial culture of intraocular fluid showed positive Klebsiella pneumoniae. At the last visit, four patients (four eyes) had loss of vision, one patient (one eye) did not cooperate in vision check, and one patient (two eyes) was lost to follow-up. Conclusion EE secondary to KPLA is highly destructive to eyeball structure and visual function, and patients with KPLA who develop systemic symptoms (such as fever) or ocular discomfort (such as loss of vision, eye redness, and eye pain) should attend the outpatient service of ophthalmology department and receive regular follow-up examination to be alert to the development of endophthalmitis.

Background: The use of herbal medicine has increased globally due to people's dissatisfaction with conventional medicine, family traditions, poverty, and prior positive experiences. Since the last decade, the general public has become increasingly interested in herbal products from several medicinal plants. This study sought to evaluate the microbial contamination of liquid herbal drinks sold in Benin City, Nigeria. Materials and Methods: Fifty different herbal medicines were purchased from three different locations in the study area. The 50 herbal medicines were centrifuged and the sediment was used for culture, biochemical, and antibiotic tests for the identification of isolated microorganisms and the assessment of the total viable bacterial count. Results: In comparison to regulated herbal preparations (4%), a percentage (36%) of unregulated herbal preparations contained viable bacteria. The most common bacterium found in unlicensed herbal medicines was Klebsiella pneumonia (10%). The percentage of regulated and unregulated herbal preparations that had microbiological contamination that was above the permissible limit (>10 colony-forming unit/ml) was 2% and 26%, respectively. Conclusions: Numerous unlicensed herbal treatments in Benin City have microbial contamination over the World Health Organization-permitted limit for aerobic and coliform bacteria. The regulatory bodies should step up their efforts to make sure that all herbal medicines marketed in the nation are legally registered and created in compliance with current Good Manufacturing Practice standards.

Ceftazidime/avibactam (CAZ-AVI) is FDA-approved for managing infections caused by resistant gram-negative bacilli, particularly infections via carbapenem-resistant Enterobacterales pathogens. The clinical data are still limited, particularly those in Saudi Arabia. The present study is a retrospective cohort study that was carried out at the Armed Forces Hospital in the southern region of Saudi Arabia to compare the clinical and microbiological outcomes for CAZ-AVI-treated patients as monotherapy and as an add-on to standard therapy for carbapenem-resistant Klebsiella pneumonia (CRKP) OXA-48 infections to those treated with standard drugs. The study included CRKP OXA-48-like infected patients who were administered antibiotics for more than seven days from 1 August 2018 to May 2023. Patients' baseline characteristics and demography were extracted from the clinical records, and their clinical/microbiology efficiencies were assessed as per the corresponding definitions. Univariate and multivariate logistic regressions were conducted to identify the potential independent variable for CAZ-AVI efficiency. A total of 114 patient files were included for the evaluation. Among these patients, 64 used CAZ-AVI combined with standard therapy and were included in the intervention group, and 50 of them used standard therapy and were included in the comparative group. Following analysis, CAZ-AVI's clinical success was 42.2% (p = 0.028), while the intervention versus comparative groups showed decreased 30-day all-cause mortality (50.0% versus 70.0%; p = 0.036) and infection recurrence (7.8% versus 24.0%; p = 0.019), as well as substantially increased rates of microbial eradication (68.8% versus 42.0%; p = 0.007). CAZ-AVI add-on therapy rather than monotherapy showed statistically significant favored clinical and microbial outcomes over the standard therapy. Furthermore, sex (female %), ICU admission, and fever were negatively associated with patients' 30-day all-cause mortality, serving as independent negative factors. Only fever, CRP bio levels, inotropes, and ICU admissions were significant predictors influencing the CAZ-AVI's clinical efficiency. The duration of CAZ-AVI therapy positively influenced CAZ-AVI's microbial eradication, while both WBC counts and fever experiences were negative predictors. This study shows the effective usage of CAZ-AVI against CRKP OXA-48-like infections. The influencing independent variables depicted here should recommend that clinicians individualize the CAZ-AVI dose based on co-existing risk factors to achieve optimal survival and efficacy. Prospective multicenter and randomized control studies are recommended, with individualized CAZ-AVI precision administration implemented based on patients' characteristics. [ABSTRACT FROM AUTHOR]

Bovine mastitis, a growing issue in dairy farms, with Klebsiella species being associated with severe mastitis. This study was designed to evaluate the prevalence, biochemical changes, antibiogram susceptibility profile, and biofilm-producing capacity of Klebsiella pneumoniae isolated from Holstein cows with clinical mastitis at a private farm in Alexandria, Egypt. The overall isolation rate of Klebsiella species was 28%, which was further characterized by polymerase chain reaction (PCR) targeting the 16S-23S internal transcribed spacer gene as K. pneumoniae. Clinical mastitis significantly impacted milk composition and blood biochemistry, causing a decline in milk composition, reduction of antioxidant capacity, and increased enzymatic levels compared to normal controls. K. pneumoniae isolates showed 100% resistance to beta-lactam antibiotics, followed by resistance rates of 57, 43 and 43% to chloramphenicol, streptomycin, and sulfamethoxazole--trimethoprim, respectively, while ciprofloxacin and ceftriaxone showed complete susceptibility. The study found that all K. pneumoniae strains expressed the fimA, mrkA, and mrkD fimbrial genes, and the ecpA gene. The study highlights the high prevalence of multidrug-resistant and biofilm-producing K. pneumoniae strains in bovine clinical mastitis, emphasizing the need for improved antimicrobial usage and antibiofilm approaches to overcome the poor treatment response, as well as measuring antioxidant level and enzymatic activity in milk improved milk health screening. [ABSTRACT FROM AUTHOR]

Background: The use of herbal medicine has increased globally due to people's dissatisfaction with conventional medicine, family traditions, poverty, and prior positive experiences. Since the last decade, the general public has become increasingly interested in herbal products from several medicinal plants. This study sought to evaluate the microbial contamination of liquid herbal drinks sold in Benin City, Nigeria. Materials and Methods: Fifty different herbal medicines were purchased from three different locations in the study area. The 50 herbal medicines were centrifuged and the sediment was used for culture, biochemical, and antibiotic tests for the identification of isolated microorganisms and the assessment of the total viable bacterial count. Results: In comparison to regulated herbal preparations (4%), a percentage (36%) of unregulated herbal preparations contained viable bacteria. The most common bacterium found in unlicensed herbal medicines was Klebsiella pneumonia (10%). The percentage of regulated and unregulated herbal preparations that had microbiological contamination that was above the permissible limit (>10 colony-forming unit/ml) was 2% and 26%, respectively. Conclusions: Numerous unlicensed herbal treatments in Benin City have microbial contamination over the World Health Organization-permitted limit for aerobic and coliform bacteria. The regulatory bodies should step up their efforts to make sure that all herbal medicines marketed in the nation are legally registered and created in compliance with current Good Manufacturing Practice standards. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae ESBL is the major causative organism of pneumonia, a lower respiratory tract infection that could be lethal. In 2019, pneumonia was ranked the fourth-leading cause of death worldwide. This study aims to investigate the antibacterial activity of the ethanol extract of Bacillus cereus MH997647 IA5, a symbiont of the marine sponge Agelas sp. against Klebsiella pneumoniae ESBL as well as to identify the secondary metabolites present in the extract. The antibacterial activity of the sponge symbiont was assessed using the disc diffusion assay. The ethanol extract of the sponge symbiont was subjected to liquid chromatography-mass spectrometry (LC-MS-MS) to identify the compounds present in the extract. The results of the antibacterial activity screening showed that the sponge symbiont had growth inhibitory activity against Klebsiella pneumoniae ESBL with an average inhibition zone diameter of 7.72 mm. The LC-MS/MS analysis identified seven compounds in the ethanol extract of the sponge symbiont Bacillus cereus MH997647 IA5, namely DL-phenylalanine, L-(+)-leucine, DL-tyrosine, L-(+)-valine, choline, noradrenaline, and tributyl citrate acetate. These compounds could be responsible for the antibacterial activity of the ethanol extract of Bacillus cereus MH997647 IA5 against Klebsiella pneumoniae ESBL. Therefore, Bacillus cereus MH997647 IA5 could be a potential source of active compounds for the treatment of bacterial infection particularly pneumonia. [ABSTRACT FROM AUTHOR]

Background and Objectives: To explore the prevalence and characteristics of secondary bacterial infections among patients suffering from mucormycosis following COVID-19 infection. Materials and Methods: We conducted a cross-sectional, retrospective analysis from March 2020 to April 2022 at Imam Khomeini Hospital Complex in Tehran. The study included patients with histopathologically confirmed mucormycosis and documented secondary bacterial infections. We extracted and analyzed data from hospital records using SPSS software, version 26. Results: The study comprised 27 patients, with a predominance of females (70.4%) and an average age of 56 years. The majority of these patients (63%) had pre-existing diabetes mellitus. The severity of their COVID-19 infections varied. Treatment regimens included immunosuppressive drugs and antibiotics. Rhinocerebral mucormycosis was the most common form observed. The predominant secondary infections involved the urinary tract, respiratory system, bloodstream (bacteremia), and soft tissues, with resistant strains of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae being the most frequently identified microorganisms. Notably, cases of bacteremia and pneumonia exhibited a higher mortality rate. Ultimately, 55.6% of patients were discharged, while 44.4% succumbed to their infections. Conclusion: Patients recovering from COVID-19 with mucormycosis are significantly susceptible to secondary bacterial infections, particularly those with diabetes mellitus or those undergoing immunosuppressive therapy. Such infections compound the morbidity and mortality risks in this vulnerable patient cohort.

Background and Objectives: Klebsiella pneumoniae is a healthcare-associated infections agent and could be an extended spectrum β-lactamase (ESBL) producer. Understanding the transmission of this bacterium in a hospital setting needs accurate typing methods. An antibiogram is used to detect the resistance pattern of the isolates. Random Amplified Polymorphic DNA (RAPD) and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR are rapid, technically simple, and easy-to-interpret DNA typing methods. This study aimed to evaluate the use of antibiotyping, RAPD-, and ERIC-PCR to investigate the heterogeneity of K. pneumoniae isolated from clinical specimens. Materials and Methods: The antibiograms of 46 K. pneumoniae clinical isolates were determined by Vitek® 2 Compact. All isolates underwent RAPD-PCR using AP4 primer and ERIC-PCR using ERIC-2 primer. The dendrogram was generated using the GelJ software and analyzed to determine its similarity. The analysis of antibiogram and the molecular typing diversity index was calculated using the formula of the Simpson’s diversity index. Results: About 71.7% of the isolates were ESBL-producers, and more than 80% of isolates were susceptible to amikacin, ertapenem, and meropenem. The antibiotyping produced 32 diverse types with DI = 0.964. In Conclusion: Antibiotyping, RAPD- and ERIC-PCR showed powerful discrimination power among the isolates, supported the diversity of K. pneumoniae isolates in current study. These combination could be promising tools for clonal relationship determination, including in tracking the transmission of the outbreak’s agent in hospital setting.

Enterobacteriaceae are Gram-negative bacteria that have many mechanisms to survive in contaminated environments. Klebsiella pneumoniae is one of them that express efflux pump genes in the presence of heavy metals, like AcrAb and OqxA genes. The purpose of this study is to investigate the relationship between the existence of efflux pump genes in K. pneumoniae, and heavy metal contamination in the Tigris River. By comparing important indicators to World Health Organization (WHO) criteria, this study aims to analyze the river's water quality. It focuses on detection of cadmium (Cd), lead (Pb), nickel (Ni), arsenic (As), mercury (Hg), iron (Fe), and cobalt (Co). Fifteen samples of the Tigris River near the Al-Dura project of water remediation were obtained and cultured on selective media, and the water quality parameters, like TSS, TDS, TH, pH, turbidity, EC, BOD, COD, OD, TOC, and heavy metals, were estimated. Bacterial DNA was extracted, then efflux genes were detected with the presence of heavy metals in the tested samples. Results illustrated that K. pneumoniae gave positive results in nine of the total fifteen samples, and the water quality parameters were within the normal ranges, except for elevated levels of DO and TOC, and decreased levels of BOD and COD, with a significant relationship among heavy metal levels with both AcrAB and OqxA genes at a significance level of p ≤ 0.05.

Background: Pyogenic liver abscess (PLA) is a potentially life-threatening intra-abdominal infection. We compared the clinical features, treatments, and prognoses of patients who had Klebsiella pneumonia pyogenic liver abscess (KPPLA) and non-Klebsiella pneumonia pyogenic liver abscess (non-KPPLA). Methods: A retrospective analysis was used to compare the medical records of KPPLA and non-KPPLA patients with positive pus cultures at a single hospital in China from January 2017 to December 2019. Results: We examined 279 patients with definitively established PLA, 207 (74.2 %) with KPPLA, and 72 with non-KPPLA. The non-KPPLA group had a higher Charlson comorbidity index, longer hospital stay, longer duration of fever, and greater hospital costs. Multivariate analysis showed that alcohol intake (OR: 2.44, P = 0.048), cancer (OR: 4.80, P = 0.001), ICU admission (OR: 10.61, P = 0.026), resolution of fever OR: 1.04, P = 0.020), and a positive blood culture (OR: 2.87, P = 0.029) were independent predictors of primary treatment failure. Percutaneous needle aspiration (PNA) and pigtail catheter drainage (PCD) provided satisfactory outcomes, but PNA led to shorter hospital stays and reduced costs, especially in KPPLA patients whose abscesses were smaller than 10 cm. Conclusion: KPPLA and non-KPPLA patients had some differences in comorbidities and treatment strategies, and non-KPPLA patients had a significantly worse prognosis.

Abstract Background Klebsiella pneumoniae is a pathogen that often infects patients in clinical practice. Due to its high virulent and drug resistance, infected patients are difficult to treat. In clinical practice, Klebsiella pneumoniae can infect patients' intestines, intestines, blood, etc., causing pathological changes. However, there is relatively little information on the impact of Klebsiella pneumoniae on intestinal inflammation and microbial populations. Zebrafish is an excellent biomedical model that has been successfully applied to the virulence assessment of Klebsiella pneumoniae. Methods In this study, three clinically isolated representative strains of Klebsiella pneumoniae (high virulence non-resistant, high virulence resistant, and low virulence resistant) were used to infect zebrafish, and their effects on intestinal colonization, inflammation, pathology, and microbial diversity were tested. Results Enzyme-linked immunoassay (ELISA) showed that Klebsiella pneumoniae significantly increased levels of the cytokines interleukin-1α (Il-1α), interleukin-1β (Il-1β), and tumor necrosis factor-α (Tnf-α), which increased inflammatory symptoms. Hematoxylin eosin staining(H&S) showed that Klebsiella pneumoniae treatment caused intestinal lesions in zebrafish, in which KP1053 exposure significantly decreased the number of goblet cells, KP1195 caused epithelial dissolution and exfoliation. In addition, Klebsiella pneumoniae disturbed the composition of intestinal microbiota, and the Shannon index increased, which increased the number of harmful bacteria. Conclusions Klebsiella pneumoniae infection can lead to intestinal colonization, inflammation, pathological changes, and changes in microbial biodiversity. This study provides a reference for the intestinal pathology of clinical Klebsiella pneumoniae infection.

Abstract Background Hyaluronic acid (HA) has gained significant attention due to its unique physical, chemical, and biological properties, making it widely used in various industries. This study aimed to screen bacterial isolates for HA production, characterize favorable fermentation conditions, and evaluate the inhibitory effect of bacterial HA on cancer cell lines. Results A total of 108 bacterial isolates from diverse sources were screened for HA production using HPLC, turbidimetric, and carbazole determination methods. Among the HA-producing isolates, Klebsiella pneumoniae H15 isolated from an animal feces sample, was superior in HA production. The strain was characterized based on its morphological, cultural, and biochemical characteristics. Molecular identification using 16S rDNA sequencing and phylogenetic analysis confirmed its identity. Fermentation conditions, including pH, temperature, time, and agitation rate, were optimized to maximize HA production. The basal medium, comprising sucrose (7.0%) as carbon source and combined yeast extract with peptone (1.25% each) as nitrogen substrate, favored the highest HA production at pH 8.0, for 30 h, at 30 °C, under shaking at 180 rpm. The average maximized HA concentration reached 1.5 g L−1. Furthermore, bacterial HA exhibited a significant inhibitory effect on three cancer cell lines (MCF-7, HepG-2 and HCT), with the lowest concentration ranging from 0.98–3.91 µg mL−1. Conclusions K. pneumoniae H15, isolated from animal feces demonstrated promising potential for HA production. The most favorable fermentation conditions led to a high HA production. The inhibitory effect of bacterial HA on cancer cell lines highlights its potential therapeutic applications. These findings contribute to a broader understanding and utilization of HA in various industries and therapeutic applications.

ABSTRACT K2-capsular Klebsiella pneumoniae is a hypervirulent pathogen that causes fatal infections. Here, we describe a phage tailspike protein, named K2-2, that specifically depolymerizes the K2 capsular polysaccharide (CPS) of K. pneumoniae into tetrasaccharide repeating units. Nearly half of the products contained O-acetylation, which was thought crucial to the immunogenicity of CPS. The product-bound structures of this trimeric enzyme revealed intersubunit carbohydrate-binding grooves, each accommodating three tetrasaccharide units of K2 CPS. The catalytic residues and the key interactions responsible for K2 CPS recognition were identified and verified by site-directed mutagenesis. Further biophysical and functional characterization, along with the structure of a tetrameric form of K2-2, demonstrated that the formation of intersubunit catalytic center does not require trimerization, which could be nearly completely disrupted by a single-residue mutation in the C-terminal domain. Our findings regarding the assembly and catalysis of K2-2 provide cues for the development of glycoconjugate vaccines against K. pneumoniae infection.IMPORTANCEGenerating fragments of capsular polysaccharides from pathogenic bacteria with crucial antigenic determinants for vaccine development continues to pose challenges. The significance of the C-terminal region of phage tailspike protein (TSP) in relation to its folding and trimer formation remains largely unexplored. The polysaccharide depolymerase described here demonstrates the ability to depolymerize the K2 CPS of K. pneumoniae into tetrasaccharide fragments while retaining the vital O-acetylation modification crucial for immunogenicity. By carefully characterizing the enzyme, elucidating its three-dimensional structures, conducting site-directed mutagenesis, and assessing the antimicrobial efficacy of the mutant enzymes against K2 K. pneumoniae, we offer valuable insights into the mechanism by which this enzyme recognizes and depolymerizes the K2 CPS. Our findings, particularly the discovery that trimer formation is not required for depolymerizing activity, challenge the current understanding of trimer-dependent TSP activity and highlight the catalytic mechanism of the TSP with an intersubunit catalytic center.

The antibacterial property of silver nanofluid was investigated on Pseudomonas aeruginosa and Klebsiella pneumoniae. Silver nanoparticles were synthesized using Nigella sativa (black seeds), green tea, ginger, and garlic as reductant agents through hydrothermal and microwave methods. The physical characteristics of nanoparticles were examined by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), Energy-dispersive X-ray spectroscopy (EDX), and visible ultraviolet spectroscopy (UV–vis). The crystal size measured from SEM analysis on average was about 60 nm and calculated from Debey-Scherer equation was around 43 nm. The nanofluid was prepared by solving the nanoparticles in deionized water. The effect of prepared nanofluid was examined on the growth of two kinds of bacteria that is Pseudomonas aeruginosa and Klebsiella pneumoniae by an antibacterial sensitivity test using the pour plate method. The nanofluids showed a considerable antibacterial effect on Pseudomonas aeruginosa and a moderate effect on Klebsiella pneumoniae on agar plates.