Antibiotic Group Research Articles

Studying the Prevalence of Multidrug Resistant Klebsiella pneumoniae in Kirkuk City

Klebsiella pneumonia is an opportunistic pathogen causes several diseases including sepsis, pneumonia, and wound infections. There are two pathotypes of Klebsiella pneumonia: classical K. pneumoniae (cKp) and hypervirulent K. pneumonia (hvkp), which is an emerging variant of (ckp), clinically distinguished by invasive and multiple site infections. K.pneumoniae is also responsible for majority of human infections, and can infected healthy members of the community and hospitalized patients. A total 150 samples were collected from different hospitals in Kirkuk city during the period between November 2021 to June 2022. The age of patients ranged between (1– 60) years old with both sexes. These samples were highly recovered from females with a rate 66.67% compared to the males 33.33%. Thirty K. pneumonia (20%) was recovered from different clinical specimens including urine, sputum, burn and wound swabs. The current study reported that females are more likely to be infected with K. pneumoniae than man. Likewise, the most common age group infected with K.pneumoniae was between (20-40) with a rate of 63.33%. K.pneumoniae was commonly recovered from inpatients 53.33% compared with outpatients (46.67%). Antibiotic susceptibility test was conducted to all the isolates by using disc diffusion test towards 8 antimicrobial agents. Klebsiella pneumoniae isolates showed multiple resistance against 3 or more of different antibiotic groups such as gentamicin 93%, ampicillin 96% and amoxicillin –clavulanate 90%, cefotaxime 83%, ceftazidime 96%, meropenem 36%, levofloxacin 76 %and gentamicin 93 %. K. pneumoniae isolated from inpatients and from sputum samples were more resistance to various kinds of antibiotics.

Screening and detection of antibiotic residues on broiler meat based on trade system variations, seasonal differences, and the impact on final consumer safety in Romania

IntroductionOne key factor contributing to microbial resistance is the deliberate and inappropriate use of antibiotics in human and animal health management. Recent studies point out various ways to tackle this controversy to mitigate the unnatural rapid evolution of pathogenic bacteria. Chicken meat remains at the top of Romanian consumers' preferences, being the most consumed type of meat, desired for its nutritional and dietetic attributes.MethodsThis research was conducted in 2022, aiming to evaluate the antibiotic residues (quinolones, aminoglycosides, tetracycline, and sulfonamides) in broiler chicken meat with various trade strategies [retail market (RM), n = 40, traditional market (TM), n = 185, and door-to-door vendors (DTD), n = 121] during two seasonal periods, spring (March–April) and summer (July–September). An efficient and precise protocol was employed for determining the meat organoleptic attributes, qualitative screening, and quantitative assay antibiotic of six antibiotics (enrofloxacin, marbofloxacin, streptomycin, oxytetracycline, doxycycline, and sulfamethoxazole), consumers' antibiotic exposure (estimated daily intake), and potential risk assessment (hazard quotient).ResultsThe antibiotic quality assessment revealed an overall antibiotic residue presence in groups TM (75%) and DTD (82%), while no antibiotic residues were detected in the RM group. Our results show that 32% (n = 110) of the total chicken meat samples were free of antibiotic residues, 4.5% (n = 16) contained antibiotic residues belonging to one class of antibiotics, 40% (n = 139) had two antibiotics groups, 22% (n = 77) had three antibiotics groups, and 1.5% of the chicken meat samples presented four groups of antibiotics.DiscussionDuring the spring season, the enrofloxacin antibiotic residue present in the meat samples was higher, showing an 84% presence in TM meat samples group when compared with the DTD meat sampled group (75%). The analysis data processing showed a strong correlation between the antibiotic residue's meat samples origin (trade market and door-to-door traded meat antibiotic residue variations) and seasonal variations. As a result of the hazard quotient assay, the meat antibiotic residue levels had subunit values, indicating the meat quality was proper for consumption. It is mandatory to strengthen the level of knowledge by continuously monitoring and providing updated information to each group of farmers to increase their understanding of and adherence to the proper handling of antibiotics when growing chickens. Regarding the use of prohibited growth-promoting antibiotics in chicken-rearing systems, local authorities should increase the guard level, at antibiotic supplier and end user levels.

Monooxygenases and Antibiotic Resistance: A Focus on Carbapenems.

Carbapenems are a group of broad-spectrum beta-lactam antibiotics that in many cases are the last effective defense against infections caused by multidrug-resistant bacteria, such as some strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Resistance to carbapenems has emerged and is beginning to spread, becoming an ongoing public-health problem of global dimensions, causing serious outbreaks, and dramatically limiting treatment options. This paper reviews the role of flavin monooxygenases in antibiotic resistance, with a specific focus on carbapenem resistance and the recently discovered mechanism mediated by Baeyer-Villiger monooxygenases. Flavin monooxygenases are enzymes involved in the metabolism and detoxification of compounds, including antibiotics. Understanding their role in antibiotic resistance is crucial. Carbapenems are powerful antibiotics used to treat severe infections caused by multidrug-resistant bacteria. However, the rise of carbapenem-resistant strains poses a significant challenge. This paper explores the mechanisms by which flavin monooxygenases confer resistance to carbapenems, examining molecular pathways and genetic factors. Additionally, this paper highlights the discovery of Baeyer-Villiger monooxygenases' involvement in antibiotic resistance. These enzymes catalyze the insertion of oxygen atoms into specific chemical bonds. Recent studies have revealed their unexpected role in promoting carbapenem resistance. Through a comprehensive analysis of the literature, this paper contributes to the understanding of the interplay between flavin monooxygenases, carbapenem resistance, and Baeyer-Villiger monooxygenases. By exploring these mechanisms, it aims to inform the development of strategies to combat antibiotic resistance, a critical global health concern.

Dietary Supplementation of Mixed Organic Acids Improves Growth Performance, Immunity, and Antioxidant Capacity and Maintains the Intestinal Barrier of Ira Rabbits.

The aim of this study was to investigate the effects of mixed organic acids (MOAs) on growth performance, immunity, antioxidants, intestinal digestion, and barrier function in Ira rabbits. A total of 192 weaned male Ira rabbits at 35 days of age were randomly assigned to four groups with six replicates of eight rabbits each. The rabbits in the control group (CON) were fed a basal diet, and the antibiotic group (SAL) was fed a basal diet supplemented with 60 mg/kg salinomycin. The test groups were fed a basal diet supplemented with 1000 mg/kg and 2000 mg/kg MOAs (MOA1 and MOA2, respectively). The experiment lasted for 55 days. The results showed that the ADG of Ira rabbits in the SAL group and MOA1 group was higher than that in the CON group (p < 0.05). The serum IL-6 and liver MDA levels of Ira rabbits in the SAL group, MOA1 group, and MOA2 group were lower than those in the CON group (p < 0.05). In addition, sIgA levels in the jejunal mucosa of Ira rabbits in the SAL group and MOA1 group were increased compared with those in the CON group (p < 0.05). Compared with the CON group, the gene expression of IL-6 was decreased (p < 0.05) in the jejunal mucosa of Ira rabbits in the SAL, MOA1, and MOA2 groups, while the gene expression of IL-1β tended to decrease (p = 0.077) and the IL-10 content tended to increase (p = 0.062). Moreover, the gene expression of ZO-1 in the jejunal mucosa of Ira rabbits was elevated in the MOA1 group compared with the CON group (p < 0.05). In conclusion, dietary supplementation with MOAs can improve growth performance, enhance immune function and antioxidant capacity, and maintain the intestinal barrier in weaned Ira rabbits.

Prescription Pattern of Different Groups of Antibiotics at Out Patient Department of a Tertiary Medical College Hospital in Dhaka City

Background: Drugs prescription pattern is very important at outpatient department in the tertiary care hospital. Objective: The purpose of the present study was to evaluate the distribution of patients and antibiotic prescribing trends in OPD of a Tertiary Medical College hospital. Methodology: This cross-sectional study was undertaken in the medicine, surgery, gynaecology &amp; obstetrics and paediatrics Out Patient Department of Shaheed Suhrawardy Medical college hospital, Dhaka. The duration of the study period was 5 weeks (25th March, 2017 to 29th April, 2017). The study was designed to obtain information regarding prescribing pattern of drugs by physicians and also to analyze basal information of the prescription. The prescription were observed from the hospital’s OPD and few prescriptions were from each unit. Results: A total 320 prescription were observed from the hospital’s OPD where 80 prescriptions were from each unit. The mean age of the patients was 24.50±14.976 years. The most commonly prescribed antibiotics at medicine OPD was Cephalosporin which was 19(51.4%) cases followed by others antibiotics and azithromycin which was 9(24.3%) cases and 8(21.6%) cases respectively. In surgery OPD, the most commonly used antibiotics were flucloxacillin and cephalosporin which was 66(82.5%) cases and 24(30.0%) cases respectively. In Gynae &amp; obstetrics OPD, the most commonly prescribed antibiotics were quinolones as well as other groups of antibiotics which were 23(46.0%) cases and 27(54.0%) cases respectively. Conclusion: In conclusion most commonly used antibiotic are Cephalosporin, azithromycin and Flucloxacillin in different OPD of the hospital. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):54-58

Utilización de antibióticos en faringoamigdalitis aguda en la provincia de Albacete

Introduction: acute tonsillitis is one of the most prevalent pathologies among the pediatric population and one of the leading causes of antibiotic prescribing in this group. Materials and methods: observational and descriptive study of the use of antibiotics in acute tonsillitis. We have included all the children from our health area who have been prescribed antibiotics as treatment of an acute tonsillitis during the three years of the study. Results: a total of 53,995 acute tonsillitis were diagnosed during the three years of the project, some of which, 33,426 (61.9%), were treated with antibiotics. In children under the age of 3 years, 10,901 cases of acute tonsillitis were diagnosed (20.2% of the tonsillitis), being treated with antibiotics 6,494 (59.6%). We have observed that the most prescribed antibiotics were beta-lactamase sensitive penicillins (phenoxymethylpenicillin, benzathine phenoxymethylpenicillin) and amoxicillin: 60.3% in the first year, 60.9% in the second one and 66.8% in the third year, meanwhile other groups of antibiotics were less commonly used: amoxicillin/clavulanic acid in 2,475 cases (18.2%) in the first year of the study, 1,754 (17.7%) in the second and 1,644 (16.6%) in the third one. Furthermore, a decreased use of macrolides has been observed: 2,825 (20.7%) in the first year, 1,933 (19.6%) in the second and 1,419 (14.3%) in the last one. Conclusions: the use of amoxicillin/clavulanic acid and macrolides is significantly above from what could be expected considering the low prevalence of carriers of Streptococcus pyogenes in the pharynx or of children allergic to penicillin.

Nephroprotective effect of ethanol extract Abelmoschus manihot l. Leaves in gentamicin-induced mice

Nephrotoxicity is the most common side effect of gentamicin, an aminoglycoside antibiotic group. It was mediated by oxidative stress mechanisms. Abelmoschus manihot L. leaves (AML) have antioxidant activity flavonoids. This study aims to determine the nephroprotective effect of AML in gentamicin-induced nephrotoxicity using mice models. It conducted an experimental design study in a pharmacology laboratory using mice models. It was conducted experimentally in 7 groups. There are normal, solvent, negative control, and four test groups (given an ethanolic extract of AML at doses of 50, 100, 200, and 400 mg/kgBW) which were administered orally for 7 days. Gentamicin 112 mg/kgBW was induced intraperitoneally on the 8th day. All mice were anesthetized on the 11th day to collect blood serum and renal organs for further examination. The data were analyzed using SPSS version 26 for One Way ANOVA test and followed by Duncan's post-hoc analysis test. The difference is considered significant if the p-value &lt;0.05. Gentamicin successfully induced renal damage based on increasing creatinine and blood urea nitrogen (BUN) levels. This was by histopathology analysis which showed renal necrosis in the negative control group. Ethanolic extract of AML prevents nephrotoxicity due to gentamicin in a dose-dependent manner in creatinine level but not in BUN and histopathology. However, taken together all results showed that ethanol extract of AML has a nephroprotective effect in gentamicin-induced nephrotoxicity.&#x0D; Keywords: Abelmoschus manihot L., gentamicin, nephroprotection, renal histopathology

Preoperative antibiotic prophylaxis in acute cholecystectomy: a systematic review and meta-analysis of randomised controlled trials.

Laparoscopic cholecystectomy (LC) in patients admitted with acute cholecystitis is considered the preferred, feasible and safe mode of managing gallstone disease. The objective of this study is to evaluate the role of single-dose pre-operative prophylactic antibiotics in patients undergoing emergency LC for mild to moderate acute cholecystitis. All randomized control trials (RCTs) reporting the use of single-dose pre-operative prophylactic antibiotics in patients undergoing acute cholecystectomy were retrieved from the search of standard medical electronic databases and analysis was conducted by using the principles of meta-analysis on the statistical software RevMan version 5. Standard medical databases search produced only 3 RCTs on 781 patients undergoing acute cholecystectomy. There were 384 patients in single dose pre-operative antibiotics group whereas 397 patients were recruited in the no-antibiotics group. In the random effects model analysis, the use of single-dose preoperative prophylactic antibiotics in patients undergoing acute cholecystectomy for mild to moderate cholecystitis failed to demonstrate any extra advantage of reducing the risk of [risk ratio (RR) =0.69; 95% confidence interval (CI): 0.46-1.03; Z=1.80; P=0.07] infective complications. There was no heterogeneity [Tau2 =0; Chi2 =1.74, df =2 (P=0.42; I2=0%)] among included studies. A preoperative single dose of prophylactic antibiotics in patients undergoing acute LC for mild to moderate acute cholecystitis does not offer extra benefits to reduce infective complications.

Empirical Antibiotic Therapy in Diabetic Foot Ulcer Infection Increases Hospitalization.

We evaluated the outcomes associated with initial antibiotic management strategies for infected diabetic foot ulcers (DFUs) diagnosed in an outpatient multidisciplinary center. Consecutive outpatient individuals with infected DFUs, stratified according to Infectious Diseases Society of America infection severity, were followed for 1 year from the initial antibiotic administration to treat acute infection. The main outcomes were hospitalization rates for a diabetes-related foot complication within 30 days of diagnosis and requiring an amputation or death during follow-up. Outcomes were analyzed by regression analysis, accounting for demographics, clinical characteristics, and antibiotic therapy. Among 147 outpatients with infected DFUs, 116 were included. Infections were categorized as mild (68%), moderate (26%), and severe (6%). Empirical antibiotics (not culture-guided) were prescribed as initial treatment in 39 individuals, while 77 received culture-based antibiotics. There were no differences in demographic or clinical characteristics between the antibiotic administration groups, except for a higher body mass index and prevalence of chronic kidney disease in the empirical cohort. Forty-two infected DFU patients required hospitalization within 30 days of diagnosis for the same reason. The relative risk for hospitalizations was 1.87 greater in those with mild infections when treated with empirical antibiotics compared with culture-directed antibiotics. There were no differences in amputations and/or death at 1 year follow-up. These data support obtaining tissue culture to guide antibiotic therapy, regardless of DFU infection severity, to decrease hospitalizations.

Microbiome-transcriptome analysis reveals that dietary supplementation with macleaya cordata extract alters multiple immune pathways with minimal impact on microbial structure.

As a potential antibiotic alternative, macleaya cordata extract (MCE) has anti-inflammatory, antioxidant, and antimicrobial properties. This study was conducted to assess the impact of MCE supplementation on the gut microbiota and its interplay with the host in young goats. Thirty female black goats with similar body weight (5.63 ± 0.30kg) were selected and randomly allotted into one of three diets: a control diet (Control), a control diet with antibiotics (Antibiotics, 21 mg/kg/day vancomycin and 42 mg/kg/day neomycin), and a control diet with MCE (MCE, 3.75% w/w premix). Principal coordinate analysis of the microbial community showed that samples of Antibiotic clustered separately from both Control and MCE (p<0.001). The random forest analysis revealed that, in comparison to the Control group, the impact of Antibiotics on the microbiota structure was more pronounced than that of MCE (number of featured microbiota, 13 in Antibiotics and >6 in MCE). In addition, the pathways of significant enrichment either from DEGs between Antibiotics and Control or from DEGs between MCE and Control were almost identical, including Th17 cell differentiation, butanoate metabolism, T-cell receptor signaling pathway, intestinal immune network for IgA production, antigen processing and presentation, and ABC transporters. Furthermore, an integrative analysis indicated that significant positive correlations (p < 0.05) were observed between HEPHL1 and the featured biomarkers Atopostipes, Syntrophococcus, Romboutsia, and Acinetobacter in the MCE group. Conversely, several significant negative correlations (p < 0.05) were identified between HEPHL1 and the featured biomarkers Clostridium_XlVa, Phascolarctobacterium, Desulfovibrio, Cloacibacillus, Barnesiella, Succinatimonas, Alistipes, Oscillibacter, Ruminococcus2, and Megasphaera in the Antibiotics group. Collectively, the analysis of microbiome-transcriptome data revealed that dietary supplementation with MCE produced significant alterations in multiple immune pathways, while having minimal impact on the microbial structure.

Perturbation of Gut Microbiota Modulated the Abscopal Effects of Immunoradiotherapy in Rectal Cancer

The abscopal effect-the regression of malignancies outside the irradiation zone-can be increased by combining radiotherapy (RT) with immunotherapy. In this study, we aimed to investigate whether the gut microbiota affected the abscopal effect following immunoradiotherapy (iRT) in rectal cancer. Bilateral MC38 subcutaneous tumors (primary and abscopal tumor) were established in C57/B6 mice with or without oral antibiotic treatment (preadministration of vancomycin, streptomycin, and ampicillin 14 days before therapy). Mice with or without antibiotic therapy were then randomized into eight groups to receive one of four treatments: (1) RT to the primary tumor + anti-PD-1 therapy (iRT), (2) RT to the primary tumor (RT), (3) anti-PD-1 therapy (anti-PD-1), and (4) no treatment. Flow cytometry was used to determine the composition and function of immune cells in the primary and abscopal tumors as well as in the spleen. 16S rRNA sequencing was used to assess the gut microbiome alteration following antibiotic intervention. Multiple bioinformatics were then explored to investigate the impact of specific flora that related to abscopal antitumor effect. We found that radiation on primary tumors exhibited cytotoxic effect in nonirradiated (abscopal) tumors (p=0.0057, RT vs. untreated group; p=0.0037, iRT vs. anti-PD-1 group). In contrast, abscopal tumors were resistant to the anticancer effects of RT when antibiotics were given (p=0.5374, RT + antibiotics vs. untreated group + antibiotics; p=0.42, iRT + antibiotics vs. anti-PD-1 + antibiotics group). Comparing the RT+antibiotics group to the RT group, we discovered that the number of CD8+CD44+ T cells decreased significantly in both abscopal tumors (p<0.001) and spleens (p=0.0061). In anti-PD-1-treated groups, antibiotics significantly reduced the number of CD8+GranzymeB+ T cells in primary tumors (p=0.0061) and CD4+CD25+ T cells in spleens (p<0.001). In iRT-treated groups, the antibiotic reduced the fraction of CD4+INF-γ+ cells in abscopal tumors (p=0.0134), and increased the number of CD4+PD-1+ T cells in spleens (p<0.001). Moreover, we found that both α- and β-diversity decreased significantly in the gut microbiota after antibiotic treatment (p=0.0079 and p<0.001, respectively). The abundance of g_Alistipes, g_Lactobacillus, g_Lachnospiraceae and g__Lactobacillus fell dramatically in the presence of antibiotics. In addition, functional analyses of Picrust2 and KEGG revealed that antibiotic therapy had the most profound impact on the D-Alanine metabolism pathway (p<0.001). We found that the alteration of the gut microbiome by antibiotics significantly affects the local and systemic antitumoral effect of iRT, our results may provide new insight on how gut modification converts the local anticancer effects of RT into a systemic response that targets metastatic tumors.

Antibiotic resistances from slaughterhouse effluents and enhanced antimicrobial blue light technology for wastewater decontamionation

The frequencies of 6 different facultative pathogenic bacteria of the ESKAPE group (priority list WHO) and a total of 14 antibiotic resistance genes (ARGs) with different priorities for human medicine were quantified in wastewaters of poultry and pig slaughterhouses using molecular biological approaches. Raw sewage from poultry and pig slaughterhouses was found to be contaminated not only with facultative pathogenic bacteria but also with various categories of clinically relevant ARGs, including ARGs against the reserve antibiotics group. The concentration of the different gene targets decreased after on-site conventional biological or advanced oxidative wastewater treatments, but was not eliminated. Hence, the antimicrobial BlueLight (aBL) in combination with a porphyrin photo-sensitizer was studied with ESKAPE bacteria and real slaughterhouse wastewaters. The applied broad LED-based blue light (420–480 nm) resulted in groups of sensitive, intermediate, and non-sensitive ESKAPE bacteria. The killing effect of aBL was increased in the non-sensitive bacteria Klebsiella pneumoniae and Enterococcus faecium due to the addition of porphyrins in concentrations of 10−6 M. Diluted slaughterhouse raw wastewater was treated with broad spectrum aBL and in combination with porphyrin. Here, the presence of the photo-sensitizer enhanced the aBL biocidal impact.

Lipophosphonoxins-A Novel Group of Broad Spectrum Antibacterial Compounds.

Lipophosphonoxins (LPPOs) represent a new group of membrane-targeting antibiotics. Three generations of LPPOs have been described: First-generation LPPOs, second-generation LPPOs, and LEGO-LPPOs. All three generations have a similar mode of bactericidal action of targeting and disrupting the bacterial cytoplasmic membrane of prokaryotic cells, with limited effect on eukaryotic cells. First-generation LPPOs showed excellent bactericidal activity against Gram-positive species, including multiresistant strains. Second-generation LPPOs broaden the antibiotic effect also against Gram-negative bacteria. However, both first- and second-generation LPPOs lose their antibacterial activity in the presence of serum albumin. LEGO-LPPOs were found to be active against both Gram-positive and Gram-negative bacteria, have better selectivity as compared to first- and second-generation resistance to LEGO-LPPOs was also not observed, and are active even in the presence of serum albumin. Second-generation LPPOs have been studied as antimicrobial additives in bone cement and as nanofiber dressing components in the treatment of wound infections in mice. Second-generation LPPOs and LEGO-LPPOs were also tested to treat ex vivo simulated endodontic infections in dental root canals. The results of all these studies were encouraging and suggested further investigation of LPPOs in these indications. This paper aims to review and compile published data on LPPOs.

A-272 Challenges in Designing an Antibiotic Gene Resistance Panel for Clinical Use

Abstract Background We faced 3 major challenges in our journey of designing a custom panel for antibiotic resistance genes (ABR). Challenge 1# Fast, robust, and affordable antimicrobial resistance testing (ABR) In general, qPCR-based methods are efficient, reliable, and fast with high specificity and sensitivity, and with the test results available within 2–3 h. We offer urinary tract infection identification by qPCR and wanted to supplement this test with detection of antibiotic resistance genes. we narrowed our choice of method to be qPCR based, Applied Biosystems™ OpenArray™ technology on the Applied Biosystems™ QuantStudio™ 12K Flex Real-Time PCR System. Challenge2# Genes to be tested. Antibiotic resistance occurs via various mechanism. Based on the literature review, we included the following gene in our custom panel 1. Aminoglycosides: aac(6′)-Ib-cr6, aac(6′)-Ib-cr, aac(6′)-Ib-cr4 2. Tetracycline: tet(M), tet(B) 3. Sulfonamides: sul1, sul2 4. Macrolide-lincosamide-streptogramin B-ketolides-oxazolidinones: erm C, erm A, erm B 5. Quinolone/(fluoroquinolones): qnrS , qnrA, aac(6′)-Ib-cr6, aac(6′)-Ib-cr, aac(6′)-Ib-cr4 6. Glycopeptides: VanA, VanB 7. Beta-lactam Class A: SHV, KPC, CTX-M 8. Beta-lactam Class B: NDM, VIM, IMP 9. Beta-lactam Class C: CMY, DHA, FOX, KPC 10. Beta-lactam Class D: OXA1, OXA-23, OXA- 48, 11. Methicillin resistance: mecA. Results Validation of the ABR panel Accuracy: 50 isolates were ordered from CDC AR isolate bank and were used to test the accuracy. The accuracy was detected to be 98% concordant. Sensitivity: The assay was sensitive to detect all urinary pathogens upto 10^3 CFU/mL. Precision: the inter and intra reproducibility was shown to be 99% concordant Specific: when tested against the CDC controls, the assays were 100% specific Challenge 3# Genotype—Phenotype correlation and prevalence of antibiotic resistance genes in USA. We compared 100 consecutive clinical specimens (urine) for genotype -phenotype co-relation. Data from the current qPCR panel and Microscan instrument was compared. It was observed for the pathogens that were phenotypically resistant to certain antibiotics, the corresponding gene association was not found in (2–50%) of antibiotic groups. This can be explained due to the limited number of genes in each drug class. Resistance to some antibiotics such as nitrofurantoin drug (100% missed) and sulphonamide drug resistance (50% missed) is induced by point mutations, which are not captured in open array genotyping qPCR assay. To overcome this gap between genotype and phenotype correlation and to understand the prevalence of antibiotic resistance genes in USA, we initiated a new project. We aim to test for 300–400 clinical samples which known resistance phenotypes and check for antibiotic resistance gene in a new expanded panel. We were successful in designing the new panel to include 88 genes (vs 30 genes in the old panel). Conclusion The current assay was approved by the CLIA authorities for clinical testing. In general, qPCR-based methods are efficient, reliable, and fast with high specificity and sensitivity, and with the test results available within 2–3 h.

Punica granatum peel extract modulates levofloxacin-induced oxidative stress and testicular damage in rats

Levofloxacin (LEV) is one of the Fluoroquinolones antibiotic groups, which are utilized in the therapy of numerous diseases, particularly in reproductive organs. Punica granatum peel is a waste byproduct rich in phytochemicals that are known for their different biological activities. The current research was designed to assess the capability of pomegranate peel extract (PGPE) in counteracting LEV-induced oxidative stress and testicular injury in rats. Rats groups were divided as follows: control, PGPE (500 mg/kg BW), LEV (300 mg/kg BW), and PGPE plus LEV. Rats were treated orally for two weeks daily. The chemical and nutritional content of Punica granatum peel (PGP) were investigated. GC/MS analysis showed the major phytochemical constituents in PGPE as gallic acid, ellagic acid, 4H-Pyran-4-one, 2,3-dihydro-3,5-dihydroxy-6-methyl, and caffeic acid with DPPH, ABTS, and NO radical scavenging activity, as well as Fe3+- reducing antioxidant activity. Results revealed that LEV increased TBARS and H2O2 concentrations and LDH activity in rat testes significantly. While the activities of antioxidant enzymes, phosphatases, aminotransferases, and reduced glutathione content as well as protein levels, were significantly reduced. Worthy changes in testosterone, luteinizing, and follicle-stimulating hormone levels, as well as sperm characteristics, were also discovered. LEV was also found to trigger apoptosis, as evidenced by elevated p53 and caspase-3 levels and decreased Bcl2 levels. Furthermore, alterations in histological and immunohistochemical PCNA expression were observed in rat testes, confirming the biochemical findings. Furthermore, PGPE pretreatment of LEV-treated rats restored the majority of the tested parameters when compared to the LEV-treated group. In conclusion, pomegranate peel extract had a powerful modulating role against the adverse effects of levofloxacin in rat testes and represents a perspective of the utilization of food waste by-products.

Cessation of Antibiotics for Complicated Appendicitis at Discharge Does Not Increase Risk of Post-operative Infection

PurposeThe utilization of home antibiotic therapy following surgery for complicated pediatric appendicitis is highly variable. In 2019, we stopped home antibiotic therapy in this cohort at our institution. We sought to evaluate our outcomes following this protocol change. MethodsWe queried our institutional NSQIP Pediatrics data for all children undergoing appendectomy for complicated appendicitis between January 2015 and May 2022. We identified two cohorts: those discharged with home antibiotics (1/1/15-4/30/19) and those discharged with no home antibiotics (5/1/19-4/30/22). Both groups were treated with response based parenteral antibiotics while hospitalized and discharged when clinically well. Our primary outcome was postoperative deep organ space infection requiring intervention (drainage, aspiration, reoperation, or antibiotics). Secondary outcomes included length of stay, superficial site infection, Clostridium difficile colitis, ER visits, post-operative CT imaging, and readmission. ResultsThere were 185 patients in the home antibiotic group (83% discharged with antibiotics) and 121 patients in the no home antibiotic group (8.3% discharged with antibiotics). There were no significant differences in deep organ space infection requiring intervention (7% vs. 7.4%, p = 1.0). Our length of stay was not different (4.5 days vs. 3.95 days, p = 0.32), nor were other secondary outcomes or patient characteristics. All patients had documented follow-up. ConclusionsWe did not identify differences in deep organ space infections, length of stay or other events after eliminating home antibiotic therapy in our complicated appendicitis cohort. The use of home antibiotics following surgery for complicated appendicitis should be reconsidered. Level of EvidenceIII.

Green Synthesis of Titanium Oxide Nanoparticles With Rosemary and Ginger and Their Bactericidal Action Against Staphylococcus aureus.

Titanium oxide (TiO2) nanoparticles (NPs) have significantly proved to be highly useful in restorative materials, dental adhesives, sealants, cements, and other dental applications to prevent microbial colonization and reduce the risk of infections. The present study was aimed at developing a dental material with antibacterial properties by combining titanium oxide NPs using ginger and rosemary extracts. The formulation was prepared using rosemary and ginger, mediated by TiO2 NPs. The preparation was then introduced into the wells of a microplate consisting of cultured Staphylococcus aureus and was kept for incubation for four hours. To record the minimum inhibitory concentration, the test solution was added into Kimble tubes consisting of Muller-Hinton broth. The results obtained were statistically analyzed using one-way ANOVA. Increasing concentration led to decreased optical density, indicating bactericidal effects. Significantly lower optical density values were observed in decreasing order among the test samples (25, 50, and 100 μL) compared to control and antibiotic groups against Streptococcus, highlighting the potent antibacterial and antibiofilm properties of the greenly generated combination of titanium oxide NPs with herbs. This was also confirmed by moderate minimum inhibitory concentration at 100 μL. The present study suggests that there is a bactericidal process at play, leading to a reduction in the overall bacterial count. It can be concluded that the ginger and rosemary-mediated titanium oxide NPs serve as potential antibacterial agents against S. aureus. This study can be used as a preliminary study, and further studies can be conducted to use this formulation in the field of medicine.

Laparoscopic Appendectomy Combined with an "Antimicrobial-Free" Strategy for Acute Uncomplicated Appendicitis.

Objective: To explore the efficacy and safety of enhanced recovery protocol (ERP) combined with laparoscopic appendectomy (LA) in the treatment of acute uncomplicated appendicitis (AUA) without antibiotics. Methods: In this study, a total of 160 patients with AUA who underwent LA between January 2018 and December 2021 were included and divided into the antibiotic group (n = 80) or the no-antibiotic group (n = 80). The patients in the antibiotic group received the ERP combined with antimicrobials during the perioperative period, while those in the no-antibiotic group only received the ERP during the perioperative period. The clinical data of these patients were collected to compare the inflammation level and stress state before and after surgery. In addition, the incidence of postoperative complications and the recovery speed of the patients were compared between groups. Results: There were no significant differences in the inflammation level and stress state before or after surgery, the incidence of postoperative complications or the recovery speed between the antibiotic group and the no-antibiotic group (P > .05). Conclusion: The use of ERP combined with LA as an antimicrobial-free treatment scheme in the perioperative period was found to be safe and effective for patients with AUA. Therefore, this approach is clinically valuable.

QSAR analysis of five generations of cephalosporins to establish the structural basis of activity against methicillin-resistant and methicillin-sensitive Staphylococcus aureus.

Solving the worldwide problem of growing bacterial drug resistance will require a short-run and medium-term strategy. Structure-activity relationship (SAR) and quantitative SAR (QSAR) analyses have recently been utilized to reveal the molecular basis of the antibacterial activity and antibacterial spectrum of penicillins, the use of which is no longer solely empirical. Likewise, a more rational drug design can be achieved with cephalosporins, the largest group of β-lactam antibiotics. The current contribution aimed to establish the molecular and physicochemical basis of the antibacterial activity of five generations of cephalosporins on methicillin-sensitive (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA). With SAR and QSAR analyses, the molecular portions that provide essential and additional antibacterial activity were identified. The substitutions with greater volume and polarity on the R2 side chain of the cephem nucleus increase potency on MSSA. The best effect is produced by substitutions with polar nitrogen atoms at the alpha-carbon (Cα). Substitutions with greater volume and polarity on the R1 side chain further enhance antibacterial activity. In contrast, the effect against MRSA seems to be independent of any substitution on R2 or at the Cα, while depending on the accessory portions with greater volume and polarity on R1.

Antimicrobial Resistance of Heterotrophic Bacteria and Enterobacteriaceae Inhabiting an Anthropogenic-Affected River Stretch in Bulgaria

The increasing antimicrobial resistance (AMR) of pathogens is a significant threat to human and animal health, but it is also an environmental challenge for water resources. The present study aimed to quantify heterotrophic bacteria resistant to five groups of antibiotics (ABs) in a selected Yantra River stretch (including its tributary, the Belitsa River); to assess AMR prevalence among Enterobacteriaceae; and to assess the impact of urban effluents or rural runoff on AMR prevalence along the river course at eight sampling points. Culture-dependent methods were used in a population-based study of total AMR and for AB susceptibility testing of Enterobacteriaceae isolates. The data reveal significant differences in AMR dissemination and a lower (up to 10%) proportion of different types of antibiotic-resistant bacteria (ARB) in the Yantra River water compared to the Belitsa River (up to 20%). The incidence of resistant Enterobacteriaceae isolates was in the range of 1% to gentamicin to 36% to ampicillin, including multidrug resistance of 19%, and different AMR patterns of isolates from each river. The prevalence of AMR among aquatic bacteria highlights the need for adequate waste water treatment and for management, monitoring and control of treatment processes to limit anthropogenic pressure through discharge of untreated or incompletely treated waste water and to ensure the ecological well-being of receiving waters.