Antibacterial Resistance Patterns Research Articles

Multidrug-Resistant Infections After Liver Transplantation, Etiology and Risk Factors: A Single-Center Experience.

Patients undergoing liver transplant are at an increased risk of morbidity and mortality due to the development of infections. We aimed to evaluate the risk factors affecting the incidence of infectious diseases after liver transplant and to present the epidemiological data. We investigated patients aged ≥18 years who underwent liver transplant between 2012 and 2020 at our center. We collected infections, causative microorganisms, and antibacterial resistance patterns seen during the first 6 months posttransplant. Risk factors affecting the development of infectious diseases were also analyzed and evaluated. Of 112 patients included in our study, 76 (67.9%) were men, and the median age was 50 years (range, 20-66 years). Within month 1 and month 6 after transplant, at least 1 episode of infection occurred in 67 (59.8%) and 80 (71.4%) patients, respectively. Bacterial infections were the most common type (n = 78, 95.1%), followed by fungal (n = 2, 2.4%) and viral (n = 2, 2.4%) infections. The rate of multidrug resistance in bacterial infections was high (n = 38, 52.7%) and was also a risk factor for mortality in the first 6 months after transplant (P < .001). Pretransplant values of international normalized ratio, creatinine, bilirubin, and posttransplant intensive care unit stay, as well as the presence of encephalopathy, were shown to increase the risk of infection after transplant. Multidrug-resistant bacterial infections are a significant risk factor for mortality in liver transplant patients. Many risk factors that contribute to the development of infections aftertransplant have been included in prognostic scoring systems of liver failure. Consequently, the severity of end-stage liver failure is directly related to the risk of posttransplant infections.

Prevalence and antibacterial resistance patterns of uropathogenic staphylococci in Casablanca, Morocco.

The purpose of this research is to evaluate the resistance profile of uropathogenic staphylococci bacteria in Casablanca, Morocco. In this retrospective cross-sectional research carried out from January 2017 to December 2020, isolation and identification were carried out according to the usual techniques in medical microbiology. Staphylococcus aureus isolates were confirmed by polymerase chain reaction (PCR) amplification of the nuc gene, and the antibiogram was performed according to the guidelines of the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2021). The susceptibility of uropathogenic staphylococci to vancomycin was determined with broth microdilution following the recommendations of the Clinical and Laboratory Standards Institute. The mecA gene was tested on phenotypically cefoxitin-resistant S. aureus isolates by PCR. The prevalence of urinary tract infections (UTIs) was 18% (772/4374). UTIs were more common in females (n = 483, 63%) than males (n = 289, 37%). Among the Gram-positive bacteria isolated (198, 25.65%), the prevalence of staphylococci was (130/198, 65.66%). Among staphylococcal species identified, coagulase-negative staphylococci (CoNS) were more prevalent (112/130, 86.15%), and Staphylococcus saprophyticus was the most frequently isolated CoNS (46/112, 41.07%). Additionally, there were several S. aureus strains (18/130, 13.85%). Forty-four percent of S. aureus isolates (n = 8) were resistant to cefoxitin and also harboured the mecA gene. All S. aureus isolates were susceptible to linezolid, cotrimoxazole and vancomycin. The prevalence and antibacterial resistance patterns of uropathogenic staphylococci in this study, with a high percentage of methicillin resistance, require careful consideration of antimicrobial therapy for staphylococcal UTIs.

Correlation between biofilm formation and antibacterial resistance pattern among coagulase negative Staphylococcus.

Correlation between biofilm formation and antibacterial resistance pattern among coagulase negative Staphylococcus.

Antibacterial resistance pattern of transfusion transmissible bacteria from blood donors attending federal medical center, Birnin Kebbi

Antibacterial resistance pattern of transfusion transmissible bacteria from blood donors attending federal medical center, Birnin Kebbi

Antibacterial Resistance Patterns Among Common Infections in a Tertiary Care Hospital in Saudi Arabia.

Background The rapid emergence of antibiotic-resistant bacteria threatens the control of infectious diseases by reducing treatment effectiveness, prolonging illness duration, and increasing healthcare costs. This study aimed to identify the common rate of bacterial resistance against antibacterial agents in tertiary healthcare providers in Saudi Arabia. Methodology This retrospective cross-sectional observational study was conducted from May 2016 to December 2019 on 1,151 urinary tract infection (UTI) and respiratory tract infection (RTI) positive cultures collected from participants aged 15 years or older who received antibiotic treatment. The obtained variables included age, gender, diagnosis, antibiotic type, specimen source, culture results, and sensitivity test results. Results The most common bacteria in UTI were Escherichia coli (46.7%), followed by Klebsiella pneumoniae (30.5%). Moreover, E. coli was most resistant to ampicillin (56.4%), followed by ceftriaxone (33.8%). Among the respiratory cultures, the most frequently isolated pathogen was Pseudomonas aeruginosa (28.5%), followed by K. pneumoniae (17.6%). The 162 respiratory P. aeruginosa isolates were most resistant to piperacillin/tazobactam (51.9%), followed by ciprofloxacin (25%) and ampicillin (10.6%). Conclusion High levels of antibiotic resistance were observed in both Gram-negative and Gram-positive bacteria. This indicates a need for better implementation of antibacterial stewardship and increased awareness of appropriate antibiotic use to limit the rapid spread of antibacterial resistance.

Bacterial Isolates and Antibacterial Resistance Patterns in a Patient with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Teaching Hospital, Southwest Ethiopia.

Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. The natural course of COPD is characterized by acute exacerbation. Infectious agents, particularly bacteria, cause exacerbation of COPD in the majority. This study aimed to determine the bacteriology and antibiotic resistance patterns among patients with acute exacerbations of COPD (AECOPD) at Jimma Medical Center. Methods A cross-sectional study was conducted from March to October 2019. Demographic, clinical, and sputa samples were collected from 39 study participants, who were diagnosed with AECOPD. Bacterial pathogens were identified using standard bacteriological techniques, and anti-microbial susceptibility testing was done by Kirby Bauer's disk diffusion method. Extended-spectrum β-lactamase (ESβL) and carbapenemase production were confirmed by MASTTM D68C and MASTTM D73C combination disc sets, respectively. Chi-square and odds ratios were calculated. Results Overall, 69.2% (27/39) of sputum samples were confirmed to be culture-positive. A total of 32 bacterial isolates with 78.1% (25/32) Gram-negative and 21.9% (7/32) Gram-positive bacteria were identified. The predominant bacterial isolates were Pseudomonas aeruginosa 21.9% (7/32), Klebsiella pneumoniae 18.75% (6/32), and Staphylococcus aureus 15.62% (7/32). Overall, 30 (93.8%) of the isolates were multidrug-resistant (MDR). About 48% (12/25) and 8 (32%)of gram negative bacterial isolates were ESBL betalatemase and OXA-48 carbapenemase producers, respectively. Having two or more exacerbation experiences in the previous year were found to be important determinants of the sputum culture positivity. Conclusions High rates of MDR, ESBL, and carbapenemase producer bacteria were isolated from patients with AECOPD. Empiric antibiotic therapy should consider the prevalence of antibiotic-resistant pathogens and the factor that may increase the occurrence of MDR bacterial pathogens.

Antibiotic sensitivity of common bacterial pathogens against levofloxacin

Levofloxacin is a member of the fluoroquinolone class of antibacterial agents with a safe and effective treatment. The aim of this study is to evaluate the susceptibility and resistance pattern of clinical isolates causing different types of infections to Levofloxacin. In vitro antibacterial activity and resistance patterns of levofloxacin antibiotic were studied using disk diffusion method. A total 485 strains isolated from various clinical specimens from September 2020 to November 2020 in Al Saleem Medical Laboratory. This is for isolation and identification of pathogenic gram negative and gram positive bacteria. The samples were involving urine, semen, swabs, High vaginal swab, Blood, Stool, CSF, Body Fluid and Sputum. The isolates were identified by biochemical tests as well as the sensitivity and resistant were tested by levofloxacin antibiotic. In present study, gram negative bacteria were prevalent, 75.6% than gram positive bacteria 47.7%. In the four hundred eighty five clinical isolates comprising of Escherichia coli, Klebseilla spp, Staph Aureus, Enterobacter spp, Streptococcus pneumonia, Pseudmonas spp, Streptococcus pyogen, Citrobacter spp, proteus spp and Staph epidermidis were collected from different clinical specimens. The predominantly isolated bacteria were Escherichia coli, followed by Klebseilla spp, staph Aureus and Enterobacter spp. The levofloxacin antibiotic has sensitive against most of the isolates, E Coli (31%), Klebseilla spp (14%), Staph Aureus (8.7), Enterobacter spp (6%), strep pneumonia (5%), Pseudomonas spp (3%), Strep pyogen (1%) and Citrobacter spp (0.6%). Levofloxacin exhibited statistically significantly high bactericidal activity against all strains of gram positive and gram negative bacteria. Levofloxacin was shown to be active against both Gram-positive and Gram-negative bacteria.

Risk Factors for Ciprofloxacin and Gentamycin Resistance among Gram Positive and Gram Negative Bacteria Isolated from Community-Acquired Urinary Tract Infections in Benghazi City

Urinary tract infections (UTIs) are a severe public health problem caused by a range of pathogens. The aims of the study were to investigate the prevalence of urinary tract infection and to see the pattern of Ciprofloxacin and Gentamycin susceptibility against uropathogens in Benghazi city. The study took place between 2021 April and October 2021. In-vitro antibacterial activity and resistance patterns of these two well-known antibiotics were studied and compared using the disk diffusion method. Laboratory reports and clinical data of patients with a positive urine culture (≥105 CFU/mL) were included in the study. Ciprofloxacin and gentamycin were tested against fourteen common bacterial pathogens, isolated from clinical samples of patients from Benghazi city Libya. A total of isolates were detected in 264 (75.4%) samples. Out of these, 75.4% were female and 24.6% were male. The majority of the study participants were in the age range of between 36-53 years (33.7%). The Increased bacterial resistance to ciprofloxacin has been shown. Most strains of E. coli and Staph aureus were resistant to ciprofloxacin and sensitive to gentamycin thereby showing that gentamycin is more effective than ciprofloxacin. This study showed that E. coli followed by staph aureus and K. pneumonia were the predominant uropathogen of UTIs in this geographical area. Most of the uropathogens were susceptible to Ciprofloxacin. The results showed that there is an alarming subject of resistance to Gentamicin against UTI patients in this area. Clinicians should be aware of the existing data and treat patients according to susceptibility patterns.

Audit to optimize antibiotics use in neonatal septicemia.

Objectives:To assess appropriate antibiotics use in neonatal sepsis and to highlight the need for developing an Antibiotic stewardship program at local levels.Methods:A clinical audit was conducted in the neonatal ward of the tertiary care hospital of Lahore for one year from May 2019 to May 2020. Reports of blood culture and drugs susceptibility were gathered from the microbiology department, and clinical records were evaluated about the choice of the antimicrobials, dosage, frequency, and clinical prognosis. The statistics were applied using SPSS software.Results:Eighty five neonates with the mean age of five days were treated in tertiary care hospital for septicemia. Every patient received more than one antibiotic empirically. The most prescribed drug combination (90.6%) was Cefotaxime and Amikacin. Optimum antibiotics dose was prescribed in only 70.2% of cases. Blood isolates showed gram-negative bacilli in 69 (81.2%) cases, gram positive cocci in 14 (16.5%) cases, two (2.3%) culture susceptibility reports showed growth of candida. Gram negative organisms were most susceptible to Imipenem (54%), Piperacillin-Tazobactam (48%) and Gentamicin (48%). Gram-positive organisms showed the most susceptibility to Vancomycin (100%), Amikacin (92%), and Co-amoxiclav (85%). Meropenem (39%), Linezolid (28%), and Vancomycin (27%) were the most commonly given alternate antibiotics. All the patients (n=10, 11.8%) whose culture sensitivity reporting showed susceptibility to empirical therapy survived.Conclusion:Due to poor availability of latest data about local antibacterial resistance pattern and lack of knowledge among pediatricians about latest antibiotic prescribing protocols, many inconsistencies were noted in the use of antibiotics in neonatal sepsis which resulted in a poor outcome hence, reflecting in international key health indicators (neonatal mortality rate) of country. Concerning the change in the resistance pattern of microorganisms to antimicrobials, it is high time to collect local data about antibacterial susceptibility and develop an antibiotic stewardship program to stop inappropriate use of antibiotics.

Antibacterial Resistance Pattern in Clinical and Non-clinical Bacteria by Phenotypic and Genotypic Assessment

Bacterial infections represent a very serious problem that threatens human health, antibiotics were designed to attack the causative agents of infectious diseases, but some bacterial pathogens became virulent and resistant to antibiotics by different mechanisms, resistance genes represented one of those mechanisms. This study attempts to screen the existence of five different resistance genes (mecA, TEM, FemA, MexD, and AmpC) among 25 bacterial isolates divided into two groups the first was non-clinical bacterial type strains including Bacillus subtilis, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Salmonella typhi, and the other group includes some clinical bacterial isolates. Evaluation of their susceptibilities to different 12 antibiotic discs and attempting to find the relationship between genotype and phenotype assessment. Different responses were reported which varied from slightly susceptible to multidrug-resistant such as P. aeruginosa and K. pneumonia which could be considered as multidrug-resistant strains. Therefore, detection of resistance gene became crucial and critical to recognize the mechanism of resistance, five pairs of primers were included to investigate five responsible genes belonging to beta-lactamases, efflux pump, and methicillin resistance. Conclusively, the PCR technique is a very accurate tool to check the genetic resistance whether being expressed to phenotype or not. Moreover, the clinical bacterial isolates appeared more resistant that reflecting the impact of the surrounding environment on bacterial behavior.

Latency, Anti-Bacterial Resistance Pattern, and Bacterial Infection-Related Glomerulonephritis.

Bacterial infection-related GN occurs concurrent to or after known or unknown infections. It is important to understand the clinical implications of the bacterial isolates, antimicrobial resistance patterns, and effect of latency-based classification on kidney and patient outcomes. In total, 501 consecutive adults diagnosed with bacterial infection-related GN between 2005 and 2017 were included from a biopsy registry of 15,545 patients at a single center in South India, and follow-up data were collected from electronic medical records until December 2019. Latency was defined as time between resolution of infection and onset of GN, which was classified as parainfectious, peri-infectious, or postinfectious GN. Longitudinal kidney and patient outcomes were studied. The mean age of the cohort was 40 (± 15) years, 6% were above 65 years, and 330 (66%) were men. Diabetes was present in 93 (19%) patients. Seventy percent (353 of 501) of patients had known infections, with the median latent period for parainfectious (115 of 353, 33%), peri-infectious (97 of 353, 27%), and postinfectious (141 of 353, 40%) GN being 0, 5 (4-7), and 15 (10-31) days, respectively. The most common predisposing organism was Streptococcus pyogenes (137 of 353, 39%). Drug-resistant nonstreptococcal bacteria were methicillin-resistant Staphylococcus aureus (25%, four of 16), extended-spectrum β-lactamases (20%, 12 of 59), and carbapenem-resistant organisms (10%, six of 59). Twenty of 22 (91%) of the drug-resistant organisms were isolated from the parainfectious group. The most common site of infection was skin in peri- (23 of 97, 24%) and postinfectious GN (61 of 141, 43%), and urinary tract in parainfectious GN (35 of 115, 30%). Of 321 patients with >3 months of follow-up, 48 (15%) developed kidney failure over a median period of 10 (2-37) months and 14 (4%) died. Parainfectious GN, eGFR<30 ml/min per 1.73 m2, moderate-to-severe interstitial fibrosis and tubular atrophy, and nontreatment with renin-angiotensin system blockers were significant risk factors for progression to kidney failure by a Cox proportional-hazards model. Along with clinical and histologic predictors, parainfectious GN caused predominantly by nonstreptococcal and drug-resistant bacterial infections was associated with poor kidney prognosis.

ISOLATION AND CHARACTERISATION OF ANTI-BACTERIAL RESISTANCE PATTERNS OF BACTERIAL ISOLATES FROM URINARY TRACT INFECTION IN DIABETICS

Objective: Urinary tract infection (UTI) is one of the most common infections observed in diabetic patients. This study is aimed at identifying the organisms with their anti-bacterial resistance pattern.&#x0D; Methods: A total of 400 diabetic patients over a period of nine months presenting with symptom s of urinary tract infection were taken for the study. Their urine were cultured and an antibiogram done.&#x0D; Results: E. coli, Klebsiella and Enterococci were the commonest organism found. It was found that E. coli, which was the commonest organism E. Coli was sensitive to Norfloxacin and resistant to Ciprofloxacin.&#x0D; Conclusion: Empirical treatment with ciprofloxacin, Which is considered the drug of choice, will lead to failure of treatment.

Colonization and Antibiotic Resistance Profiling of Methicillin Resistant Staphylococcus Aureus (Mrsa) in Patients from Tertiary

The methicillin resistant Staphylococcus aureus (MRSA) is affecting the economy worldwide contributing to the increased morbidity and treatment costs. The present cross sectional study was conducted to determine the association of MRSA with kidney and liver patients from Tertiary Care Hospital in Lahore, Pakistan and its antibacterialresistance patterns. The study was conducted for the period of one year; from April 2019 to April 2020. A total of 1984 different samples were obtained and examined for bacterial cultures using standard procedures. From total samples, 51.05% were collected from male and the rest 48.95% were collected from females including different age groups. Samples were inoculated on different culture media for isolation of S. aureus and susceptibility testing. A total of 253/1984 clinical samples exhibited S. aureus characteristics while 39 of 253 S. aureus (15.41%) were identified as MRSA. MRSA strains were found highly resistant to Amikacin (AK), Cefoxitin (FOX),Clindamycin (DA), Fusidic acid (FD), Gentamicin (CN) and Tobramycin (TOB) while highest sensitivity was noted against Vancomycin (100%) and Linezolid (100%). The presence of MRSA and multidrug resistance pose serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to identify high-risk patients rapidly and to reduce the burden of antimicrobial resistance.

Pediatric Febrile Urinary Tract Infection Caused by ESBL Producing Enterobacteriaceae Species.

Background Over the past decade, drug resistance pattern has worsened for many of the uropathogens due to overuse of antibiotics for empiric treatment. The burden of extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae associated urinary tract infections (UTI) has become increasingly more common, limiting treatment options among children presenting with febrile UTI. We investigated the burden and correlates of ESBL producing Enterobacteriaceae associated UTI among children and antibacterial resistance pattern. Methods 284 midstream urine specimens were collected using standard aseptic techniques from 284 children who were diagnosed with suspected UTI. Urine culture and bacteria isolation were performed following standard bacteriological techniques. The Kirby-Bauer disk diffusion technique and the double-disc synergy test were used to investigate antibiotic susceptibility and presence of ESBL production. Results UTI was confirmed using a positive urine culture for a relevant pathogen in 96/284 (33.8%) of the cases. Enterobacteriaceae accounted for 75% (72/96) of etiologies of UTI in children. The most frequent Enterobacteriaceae spp. were E. coli, 44.4% (32/72) and K. pneumonia, 27.8% (20/72). The overall multidrug resistance rate was 86.1% (62/72). ESBL-producers accounted for 41.7% (30/72) of the isolated Enterobacteriaceae. ESBL producing K. pneumonia and E. coli isolates accounted for 70% (14/20) and 37.5% (12/32), respectively. History of UTI in the past 1 year (adjusted odds ratio (AoR) = 0.08, 95%CI (0.01 − 0.57)) and medium family wealth index (AoR = 0.03, 95%CI (0.00 − 0.27)) protected from infection with ESBL-producing Enterobacteriaceae. Conclusion. ESBL production was more common in K. pneumonia and appeared to be a major factor contributing drug resistance UTI in children. The findings call for the need to incorporate ESBL testing in the routine clinical practice. The resistance level to commonly prescribed first-line antibiotics observed within Enterobacteriaceae was alarming calling for strengthened antimicrobial stewardship.

Faecal carriage of extended spectrum beta-lactamase (ESBL) and New Delhi metallo beta-lactamase(NDM) producing Escherichia coli between piglets and pig farmworkers

A cross-sectional study on five organized pig farms was conducted to assess the faecal carriage of ESBL and blaNDM carbapenemase-producing E. coli in piglets and pig farmworkers. Faecal samples from piglets (n = 155) and pig farmworkers (n = 21) were processed for isolation and characterization of E. coli. A total of 124 E. coli isolates from piglets and 21 E. coli isolates pig farmworkers were recovered and screening for ESBL production showed that 44.4 % (55/124) of the isolates from piglets and 42.9 % (9/21) of the isolates from farmworkers were ESBL positive. The ESBL positive isolates from piglets and farmworkers harbored blaCTX-M and also co-harbored other beta-lactams, sulphonamide, quinolone and tetracycline resistance genes. Diarrhoeic (50%, 49/98) and crossbred piglets (52.7%, 39/74) harbored a significantly higher number of ESBL producing isolates than non-diarrhoeic (23.1 %, 6/26) and purebred piglets (32%, 16/50) (p < 0.05). Piglets and pig farmworkers harbored nine and two carbapenem-resistant isolates, respectively. Interestingly, two isolates from piglets and one isolate from farmworkers harbored the blaNDM gene. The blaNDM positive E. coli isolated from piglets and farmworkers of the same farm revealed similar antibacterial resistance patterns, resistant genes, sequence (ST-167) and plasmid type (IncX3). In India, carbapenems are not used in food animal treatment, hence carbapenem resistant E. coli in piglets possibly originated from the human contact or common environment and is of public health importance.

An Investigation of Antibacterial Resistance Patterns in Isolated Bacteria from Contaminated Water Samples in Poultry Slaughterhouses

Nowadays, in the poultry industry, antibiotics are used to treat, prevent, and enhance poultry growth and production efficiency. Their irregular consumption has resulted in the spread of antibiotic-resistant bacteria in this industry. Antibiotic-resistant bacteria in contaminated waters can be transmitted into soil. The purpose of this study was to investigate the antibiotic resistance pattern of bacteria isolated from the water of chicken slaughterhouses around Hamadan (Iran) province. In this study, 20 water samples were collected from four slaughterhouses in Hamadan province (during spring and summer 2019). Initial isolation and identification of the bacteria were performed by pour plate culture and biochemical tests. The disc diffusion method was applied to investigate the resistance pattern. This study presents 109 screened isolates. Of these, 57.8% E.coli, 35.7% Salmonella spp., and 6.42% Klebsiella spp. were detected. Antibiograms of isolates showed that in E.coli, 23.09% were resistant to four types of the antibiotic tetracycline, amoxicillin, gentamicin, and chloramphenicol, 76.19% had only one type of antibiotic. Antibiotics for Salmonella spp. showed that 35.9% were resistant to tetracycline, gentamicin, and chloramphenicol, 64.10% to only one type of antibiotic. Also, in Klebsiella spp., 85.71% were sensitive to antibiotics, and only 14.28% were resistant to tetracycline. Conclusion: The results showed that the rate of multiple antibiotic resistance is relatively high, and contaminated water has a high potential for soil contamination. Therefore, resistant bacteria become more stable in the environment, and the health of the environment will be endangered. Therefore, it is necessary to study the antimicrobial resistance patterns of bacteria to study and maintain the health of the environment.

Multiple NDM-5-Expressing Escherichia Coli Isolates From an Immunocompromised Pediatric Host.

BackgroundGenes conferring carbapenem resistance have disseminated worldwide among Gram-negative bacteria. Here we present longitudinal changes in clinically obtained Escherichia coli isolates from 1 immunocompromised pediatric patient. This report demonstrates potential for antibiotic resistance genes and plasmids to emerge over time in clinical isolates from patients receiving intensive anticancer chemotherapy and broad-spectrum antibiotics.MethodsThirty-three isolates obtained over 7 months from 1 patient were included. Clinical data were abstracted from the medical record. For each isolate, studies included phenotypic antibacterial resistance patterns, sequence typing, bacterial isolate sequencing, plasmid identification, and antibiotic resistance gene identification.ResultsSites of isolation included blood, wound culture, and culture for surveillance purposes from the perianal area. Isolates were of 5 sequence types (STs). All were resistant to multiple classes of antibiotics; 23 (69.6%) were phenotypically resistant to all carbapenems. The blaNDM-5 gene was identified in 22 (67%) isolates, all of ST-167 and ST-940, and appeared to coincide with the presence of the IncFII and IncX3 plasmid.ConclusionsWe present unique microbiologic data from 33 multidrug-resistant E. coli isolates obtained over the course of 7 months from an individual patient in the United States. Two E. coli sequence types causing invasive infection in the same patient and harboring the blaNDM-5 gene, encoded on the IncX3 plasmid and the IncFII plasmid, were identified. This study highlights the emergence of multidrug-resistant bacteria on antibiotic therapy and the necessity of adequate neutrophil number and function in the clearance of bacteremia.

Infertile Semen Bacterial Isolates and their Local Multiple Antibacterial Resistance Pattern in Lagos, Nigeria

Introduction: Infertility affects about 15% of couples globally and male contributory factor accounts for 20-30% of such cases. Antibacterial treatment is recommended for infertility of bacterial aetiology. However, Multidrug Resistance (MDR) of the organisms could impair the effectiveness of such infertility treatment. Aim: The present study researched on the MDR pattern of bacteria from semen of infertile men in Lagos, Nigeria. Materials and Methods: This was a controlled cross-sectional study, where in-vitro antibiotic sensitivity tests were conducted on consecutive bacterial isolates from prospective infertile and fertile semen control groups, using Clinical and Laboratory Standard Institute’s (CLSI) interpretative criteria. Antibacterial resistance was expressed in % and semen quality of “before and after” treatment was compered using t-test, p-value &lt;0.05, at 95% confidence interval. Results: A total of 174 (117 Gram positive and 55 Gram negative and 2 yeast-like cells) mainly Staphylococcus spp. and Escherichia coli were studied, between 2009 and 2014. The Gram-positive cocci showed low resistance to Cefoxitin (9.2%) and Fluoroquinolone (45.9%); while Penicillin showed the highest resistance (98.37%). Within organisms’ total resistance rates of 98.3% Amoxicillin (AMX), 89.7% Cloxacillin (CXC), 87.2% Nalidixic acid (NAL) and 83.7% Sulfonamide (Cotrimoxazole) (COT) were recorded. The most prevalent Gram negative isolate (E.coli), showed 100% resistance to AMX, 95.8% Erythromycin, 95.8% Streptomycin, 91.7% amoxicillin/clavulanic acid, 83.3% tetracycline and 83.3% NAL. The most prevalent Gram positive isolate (S. aureus) had resistance rates 97% for AMX, 92.6% NAL, and 91.2% CXC among others. All MDR strains had MICs ranging 4-256 mg/L to the panel of antibiotics tested. Conclusion: There is concurrence in the pattern of MDR in this study to those seen across the world; however, increasing rates were apparent, probably due to lack of effective control policies. There is need for drug surveillance and control in Nigeria.

Antibacterial Resistance Pattern of Acinetobacter baumannii in Burn Patients in Northeast of Iran

Background: Globally, Acinetobacter spp., most commonly, Acinetobacter baumannii, are one of the most common Gram-negative nosocomial infections, especially in Intensive Care units (ICUs) and burn wards. Because of the pathogens’ ability to survive for a long time, the eradication of the pathogen from these wards remains a great concern. Simultaneously, the remarkable increase in antibacterial resistance among A. baumannii strains in recent years has raised a great deal of concern. Objectives: The study assessed the prevalence and antibacterial resistance pattern of A. baumannii in the only academic-affiliated burn center in northeastern Iran. Methods: In this cross-sectional study, 5,080 samples from patients admitted to two burnt wards and one burn ICU were included in 2012-2014. The samples were from different sources including wound tissue, blood, bronchial secretion, and urine. The antibacterial resistance pattern was determined using relevant antibiotics based on the Clinical and Laboratory Standards Institut (CLSI) instructions. Results: Acinetobacter spp. were found in 39 of the acquired cultures (1,985 out of 5,080) and 51.9 of bacterial positive cultures (1985 out of 3823). The resistance rate of Acinetobacter spp. against antibiotics varied from 0.9 for colistin to 100 for piperacillin-tazobactam. All Acinetobacter spp. were multidrug-resistant (MDR) due to considerable resistance to fluoroquinolones (95), cephalosporins (93-98), penicillins (97), carbapenems (94-95), and beta-lactamase inhibitors (87-100). Conclusions: Given that infections are a major cause of mortality in burn wards, the high prevalence of MDR isolates of Acinetobacter spp. in this burn center suggests that local antibiotic prescription policies should be revised and infection control strategies should be improved. Also, antibiotic cycling and restrict infection control strategies should be implemented in high-risk wards such as burn units. © 2019, Author(s).

Occurrence and Antibiogram of Extended-Spectrum Cephalosporin- and Cephamycin-Resistant Escherichia coli in Asymptomatic University Students

Background: Apparently healthy individuals could serve as reservoirs and disseminators of extendedspectrum cephalosporin (ESC)- and cephamycin (cefoxitin, FOX)-resistant, and extended-spectrum β-lactamase-producing (ESBL-P) Escherichia coli which jeopardizes antibacterial therapy thereby posing a threat to the health of infected individuals/carriers. Objectives: This study aimed to screen healthy asymptomatic students in the University of Nigeria, Nsukka (UNN) as potential reservoirs of ESC- and FOX-resistant and ESBL-P E. coli and to determine the antibacterial resistance profile. Materials and Methods: Anal swabs were collected from 190 randomly selected healthy asymptomatic students of both genders in UNN between March and July 2018. ESC-resistant E. coli was isolated using MacConkey agar with 2 µg/mL ceftazidime. ESBL production was assessed by combination disc method while cephamycin resistance was determined using cefoxitin disc screening. Phenotypic resistance of the isolates was determined using disc diffusion method. Results: Out of 190 samples, 20 (10.2%) demonstrated growth. Of these, 6 (30%) were FOX resistant (putative AmpC-producers) but none produced ESBL. The resistance of the isolates was 100% to ampicillin (AMP), 95% to ceftazidime (CAZ), tetracycline (TET) and sulfamethoxazole-trimethoprim (SXT), 30% to FOX and chloramphenicol (CHL), 85% to ciprofloxacin (CIP), enrofloxacin (ENR) and streptomycin (STR), and 65% to kanamycin (KAN). All the isolates were susceptible to meropenem (MEM). Among the 20 isolates, 1 (5%) was resistant to 2 classes of antibacterial agents while 19 (95%), including all the FOX-resistant strains, were resistant to ≥ 3 classes of antibacterial agents. The isolates exhibited 11 multiple antibacterial resistance patterns with AMP, CAZ, FOX, TET, CIP, ENR, STR, KAN, SXT being predominant. Conclusion: Healthy asymptomatic students in UNN are potential reservoirs and disseminators of ESC- and cephamycin (FOX)-resistant E. coli.