Antibiotic Resistance Patterns Research Articles

Prevalence and Antibiogram of Escherichia coli Isolated from Children Under Five Years of Age Presented with Acute Diarrhoea: Cross Sectional Study from a Tertiary Care Centre in South India

Aim: The study aimed to analyze the prevalence and antibiogram of E. coli isolated from stool sample cultures collected from children below five years of age who were presented with acute diarrhoea in a tertiary care centre. Background: Multidrug-resistant strains of diarrheagenic E. coliremain a major public health concern for greater morbidity and mortality. Antibiotic resistance and susceptibility patterns of E. coli were found to vary with geographical location. Objective: To determine the prevalence and antibiogram of E. coli isolated from cultures of diarrhoea stool samples collected from children below five years of age from laboratory records. Methods: A cross-sectional study was designed to analyze the report on stool culture of children (aged below five years) presented with acute diarrhea during the period between 2017 and 2020. The prevalence of E. coli and its antibiogram were analyzed. The data were subjected to statis-tical analysis. Results: A total of 245 diarrhoea stool samples results were analyzed. E. coli was confirmed in 176 samples (72%). More number of isolates (51/176, 28.9%) were found in children below one year of age with male dominance. Amoxicillin resistance was found in all the E. coli strains isolated with no significant difference (p=0.2233) between genders and age groups below and above one year. A significant difference (p=0.0001) was found between male and female chil-dren of age below and above one year for cefotaxime and ciprofloxacin resistance. Polymyxin B (72%) followed by imipenem (69%) sensitivity was exhibited by the isolated E. coli strains. Conclusion: E. coli isolates were more sensitive to polymyxin B and imipenem while they were most resistant to amoxicillin. Effective antibiotic treatment strategies should be developed to control E. coli infections in children.

Phenotypic and Genotypic Antibiotic Resistance Patterns of Clinical Shigella Isolates from Tehran, Iran

Background: The emergence of multidrug-resistant (MDR) Shigella is a health concern in both developed and developing countries. The indiscriminate use of antibiotics without considering resistance patterns has led to the emergence of resistant strains. Objectives: This study aimed to investigate the phenotypic and genotypic patterns of antibiotic resistance and virulence gene distribution in Shigella isolates from patients in Tehran, Iran. Methods: In this cross-sectional study, 60 Shigella isolates were collected from patients referred to Milad Hospital and Pasargad Laboratory in Tehran. The isolates were gathered over four months, from February 2023 to June 2023. After biochemical and genetic confirmation of the isolates, the disk diffusion method was employed to determine antibiotic resistance patterns. The distribution of beta-lactamase genes (blaCTX-M1, blaCTX-M2, blaCTX-M8, blaSHV, blaTEM, and blaOXA) and virulence genes (ial, virF, invE, sigA, and pic) was investigated in Shigella isolates using the multiplex PCR method. SPSS statistical software version 22 was used for data analysis. Results: Thirty-six percent of isolates were found to be MDR. The highest rate of resistance was against tetracycline (90%) and ampicillin (80%). The lowest resistance rate was against azithromycin (1.9%) and amikacin (7.1%). The blaCTX-M1 and blaCTX-M8 genes were more prevalent, detected in 38.3% and 50% of the isolates, respectively. However, the blaSHV and blaCTX-M2 genes were not detected in any of the isolates. Additionally, 32% of the MDR isolates harbored both the blaCTX-M1 and blaCTX-M8 genes simultaneously. The distribution of virulence genes ial, virF, invE, sigA, and pic in the studied isolates was 28.3%, 85%, 68.3%, 81.7%, and 15%, respectively. Conclusions: The present study emphasizes the increasing trend of MDR Shigella isolates. Therefore, serious measures are needed to prevent the spread of resistant genes. Furthermore, the detection of virulence factors could help in controlling shigellosis, which is a significant global health issue.

Epidemiology of Streptococcus pyogenes upper respiratory tract infections in Poland (2003-2017).

Streptococcus pyogenes (group A Streptococcus, GAS) is a major human pathogen and causes every year over 600 millions upper respiratory tract onfections worldwide. Untreated or repeated infections may lead to post-infectional sequelae such as rheumatic heart disease, a major cause of GAS-mediated mortality. There is no comprehensive, longitudinal analysis of the M type distribution of upper respiratory tract strains isolated in Poland. Single reports describe rather their antibiotic resistance patterns or focus on the invasive isolates. Our goal was to analyse the clonal structure of the upper respiratory tract GAS isolated over multiple years in Poland. Our analysis revealed a clonal structure similar to the ones observed in high-income countries, with M1, M12, M89, M28, and M77 serotypes constituting over 80% of GAS strains. The M77 serotype is a major carrier of erythromycin resistance and is more often correlated with upper respiratory tract infections than other serotypes.

Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis.

Over the past decade, numerous studies have described the types of pathogens and their antibiotic resistance patterns in patients with burn injuries in China; however, the findings have generally been inconsistent. We conducted a literature search and meta-analysis to summarize the infection spectra and antimicrobial resistance patterns in patients with burn injuries. We searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature, Wanfang, and Weipu databases for relevant articles published between January 2010 and December 2023. The DerSimonian-Laird random-effects model was used to estimate the proportions and 95% confidence intervals (CIs) of pathogens among Chinese patients with burn injuries. Meta-regression analyses were performed to explore differences in the proportions of pathogens among different subgroups and their resistance patterns. This study was registered with PROSPERO (CRD42024514386). The database searches yielded 2017 records; after removing duplicates and conducting initial screening, 219 articles underwent full-text screening. Ultimately, 60 studies comprising a total of 62,819 isolated strains reported the proportions of pathogens in patients with burn injuries and were included in this meta-analysis. Meta-analyses were conducted on 18 types of pathogens. The most common pathogens causing infections in Chinese patients with burn injuries were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis. Similar results were observed in the subgroup analysis focusing on wound infections. Since 2015, there has been a significant decrease in the proportion of Pseudomonas aeruginosa (R2 = 4.89%) and a significant increase in the proportion of Klebsiella pneumoniae (R2 = 9.60%). In terms of antibiotic resistance, there has been a significant decrease in the resistance of Staphylococcus aureus to multiple antibiotics and an increasing trend in the resistance of Klebsiella pneumoniae. We systematically summarized the epidemiological characteristics and antibiotic resistance patterns of pathogens among individuals suffering from burns in China, thus providing guidance for controlling wound infections and promoting optimal empirical antimicrobial therapy. The observed high levels of antibiotic resistance underscore the need for ongoing monitoring of antibiotic usage trends.

Proteome analysis, genetic characterization, and antibiotic resistance patterns of Klebsiella pneumoniae clinical isolates

Klebsiella pneumoniae (K. pneumoniae) is a member of the ESKAPE group and is responsible for severe community and healthcare-associated infections. Certain Klebsiella species have very similar phenotypes, which presents a challenge in identifying K. pneumoniae. Multidrug-resistant K. pneumoniae is also a serious global problem that needs to be addressed. A total of 190 isolates were isolated from urine (n = 69), respiratory (n = 52), wound (n = 48) and blood (n = 21) samples collected from various hospitals in the Al-Qassim, Saudi Arabia, between March 2021 and October 2022. Our study aimed to rapidly and accurately detect K. pneumoniae using the Peptide Mass Fingerprinting (PMF) technique, confirmed by real-time PCR. Additionally, screening for antibiotic susceptibility and resistance was conducted. The primary methods for identifying K. pneumoniae isolates were culture, Gram staining, and the Vitek® 2 ID Compact system. An automated MALDI Biotyper (MBT) instrument was used for proteome identification, which was subsequently confirmed using SYBR green real-time polymerase chain reaction (real-time PCR) and microfluidic electrophoresis assays. Vitek® 2 AST-GN66 cards were utilized to evaluate the antimicrobial sensitivity of K. pneumoniae isolates. According to our results, Vitek® 2 Compact accurately identified 178 out of 190 (93.68%) K. pneumoniae isolates, while the PMF technique correctly detected 188 out of 190 (98.95%) isolates with a score value of 2.00 or higher. Principal component analysis was conducted using MBT Compass software to classify K. pneumoniae isolates based on their structure. Based on the analysis of the single peak intensities generated by MBT, the highest peak values were found at 3444, 5022, 5525, 6847, and 7537 m/z. K. pneumoniae gene testing confirmed the PMF results, with 90.53% detecting entrobactin, 70% detecting 16 S rRNA, and 32.63% detecting ferric iron uptake. The resistance of the K. pneumoniae isolates to antibiotics was as follows: 64.75% for cefazolin, 62.63% for trimethoprim/sulfamethoxazole, 59.45% for ampicillin, 58.42% for cefoxitin, 57.37% for ceftriaxone, 53.68% for cefepime, 52.11% for ampicillin-sulbactam, 50.53% for ceftazidime, 52.11% for ertapenem, and 49.47% for imipenem. Based on the results of the double-disk synergy test, 93 out of 190 (48.95%) K. pneumoniae isolates were extended-spectrum beta-lactamase. In conclusion, PMF is a powerful analytical technique used to identify K. pneumoniae isolates from clinical samples based on their proteomic characteristics. K. pneumoniae isolates have shown increasing resistance to antibiotics from different classes, including carbapenem, which poses a significant threat to human health as these infections may become difficult to treat.

Effect of Neisseria gonorrhea Infection on Gene Expression of p53 and cIAP2 Genes in Cervical Cancer

Background: Neisseria gonorrhoeae (N. gonorrhea) is one of the most common bacterial infections causing health problems in the epithelial lining of the cervix. Previous studies did not adequately address its role in cervical cancer (CEC), therefore, the current study aimed to determine the impact of N. gonorrhea infection on gene expression of p53 and cIAP2 in CEC. Materials and Methods: samples were collected from 20 women suffering from cervical cancer with N. gonorrhea infection (CC-NG), and 20 women who had cervical cancer without N. gonorrhea infection (CC) and 40 healthy women as the control group. N. gonorrhea diagnosis was done by Modified Thayer-Martin (MTM) agar and gram stain. Gene expression of p53 and cIAP2 was carried out using real-time PCR. Results: P53 and cIAP2 genes had high molecular expression (folding change) in CC-NG (17.172 and 31.135 respectively) and CC (16.02 and 15.45 respectively) compared to healthy control (1.00) (P>0.05). Moreover, when the expression of both genetic indicators was compared to each other an increase in gene transcription in the cases of CC-NG compared to CC was observed. The antibiotic resistance pattern for the tested Neisseria gonorrhoeae strains was as follows: to ceftriaxone (100%), penicillin (96%), amoxicillin (90%), tetracycline (89%) and ciprofloxacin (77%) but low to cefixime (4%), spectinomycin (5%) and azithromycin (9 2%). Conclusion: N. gonorrhea infection can be determine as risk factor for CEC development.

Antibiotic resistance profiles of sentinel bacteria isolated from aquaculture in Cambodia

ABSTRACT The misuse of antibiotics and the emergence of antimicrobial resistance (AMR) is a concern in the aquaculture industry because it contributes to global health risks and impacts the environment. This study analyzed the AMR of sentinel bacteria associated with striped catfish (Pangasianodon hypophthalmus) and giant snakehead (Channa micropeltes), the two main fish species reared in the pond culture in Cambodia. Phenotypic and genotypic characterization of the recovered isolates from fish, water, and sediment revealed the presence of bacteria, such as 22 species belonging to families Aeromonadaceae, Enterobacteriaceae, and Pseudomonadaceae. Among 48 isolates, Aeromonas caviae (n = 2), Aeromonas hydrophila (n = 2), Aeromonas ichthiosmia (n = 1), and Aeromonas salmonicida (n = 4) were detected. Both A. salmonicida and A. hydrophila are known as fish pathogens that occur worldwide in both fresh and marine water aquaculture. Antibiotic susceptibility testing for Enterobacteriaceae and Pseudomonadaceae species and six antibiotics for Aeromonadaceae species revealed antibiotic resistance patterns of 24 (50%) isolates among the 48 isolates with higher multiple antibiotic resistance index scores (>0.2). All the isolates of Enterobacteriaceae were susceptible to ciprofloxacin. Ciprofloxacin is a frontline antibiotic that is not recommended for use in aquaculture. This study expands our knowledge of the AMR status in aquaculture farms, which is very limited in Cambodia.

Uncovering the growing burden of enteric fever: A molecular analysis of Salmonella Typhi antimicrobial resistance

Enteric fever, a persistent public health challenge in developing regions, is exacerbated by suboptimal socioeconomic conditions, contaminated water and food sources, and insufficient sanitation. This study delves into the antimicrobial susceptibility of Salmonella Typhi, uncovering the genetic underpinnings of its resistance. Analyzing 897 suspected cases, we identified a significant prevalence of typhoid fever, predominantly in males (58.3 %) and younger demographics. Alarmingly, our data reveals an escalation in resistance to both primary and secondary antibiotics, with cases of multi-drug resistant (MDR) and extensively drug-resistant (XDR) S. Typhi reaching 14.7 % and 43.4 %, respectively, in 2021. The Multiple Antibiotic Resistance (MAR) index exceeded 0.2 in over half of the isolates, signaling widespread antibiotic misuse. The study discerned 47 unique antibiotic resistance patterns and pinpointed carbapenem and macrolide antibiotics as the remaining effective treatments against XDR strains, underlining the critical need to preserve these drugs for severe cases. Molecular examinations identified blaTEM, blaSHV, and blaCTX-M genes in ceftriaxone-resistant strains, while qnrS was specific to ciprofloxacin-resistant variants. Notably, all examined strains exhibited a singular mutation in the gyrA gene, maintaining wild-type gyrB and parC genes. The erm(B) gene emerged as the primary determinant of azithromycin resistance. Furthermore, a distressing increase in resistance genes was observed over three years, with erm(B), blaTEM and qnrS showing significant upward trends. These findings are a clarion call for robust antimicrobial stewardship programs to curtail inappropriate antibiotic use and forestall the burgeoning threat of antibiotic resistance in S. Typhi.

Microbiological Profile and Susceptibility Pattern of Bacterial Blood Culture Isolates in COVID-19 Patients with Septicemia from a Designated COVID Hospital in Pune

In severe Coronavirus disease 2019 (COVID-19), bloodstream infections (BSIs) are an increasing cause of morbidity and mortality. In critically ill patients with COVID-19, we aimed to evaluate the prevalence, clinical profiles, and outcomes of BSIs. This single-center prospective investigation was conducted at a tertiary care hospital in Western India. All patients (>18 years of age) hospitalized in the intensive care unit (ICU) or ward with RT-PCR-confirmed COVID-19 were included. Demographic information, clinical proficiency, and antibiotic resistance patterns were assessed. Of the 550 patients admitted to the COVID ICU, subsequent BSIs occurred in 7.45% of patients. Gram-negative pathogens comprised a significant proportion of BSIs (53/73, 72.6%). The most frequent isolates were Klebsiella pneumoniae (22/73, 30.1%), Acinetobacter baumannii (11/73,15.06%), and Escherichia coli (7/23, 9.58%). In 57.8% of the cases, multidrug-resistant organisms (MDRO) were discovered. The Enterococcus and K. pneumoniae families comprise the majority of MDRO. Gram-negative bacteria (30.18% [16/53]) were resistant to carbapenems. Increased total leukocyte count, mechanical ventilation, and the presence of comorbidities were significantly associated with the incidence of BSIs. In COVID-19-linked BSIs, we discovered a high frequency of A. baumannii. Clinicians should be aware of potential BSIs in the presence of comorbidities, elevated leukocyte count, and mechanical ventilation. To improve the results, empirical antibiotics must be started promptly, and the situation must be de-escalated quickly. The most frequent isolates were A. baumannii and K. pneumoniae ([11/73, 15.06%] and [22/73, 30.1%], respectively). To reduce the incidence of MDRO, infection control procedures should be strictly followed in patients with multidrug resistance.

Isolation and Molecular Detection of Bacteria Causing Omphalitis in Poultry with Look on Antibiotic and Disinfectant Resistance

Antimicrobial resistance is an international concern and creates critical health issues for both humans and animals. This research aimed to ascertain the prevalence of isolates, antibiotic, and disinfectant resistance patterns from omphalitis suspected chicks in Dinajpur, Bangladesh. A total of 24 yolk swab samples were collected from different hatcheries for microbiological analysis and antibiotic sensitivity tests. The PCR employing 16s and 23s RNA genes was conducted to detect Escherichia coli and invA genes were used to detect Salmonella spp. and 23S rRNA genes were applied for Staphylococcus spp. A total of 35 isolates were identified where 14 (40%) E.coli, 10 (28.58%) Salmonella spp., and 11 (31.42%) Staphylococcus spp. from day 1-8, respectively. The largest amount of bacteria on day 5, including day 7 (20%), followed by days 3, 4, and 6, including 6 (17.14%) observed, respectively. The PCR band of E. coli was detected at 232 bp, Salmonella spp. 284 bp and Staphylococcus spp. 1267 bp respectively. E. coli was highly resistant to Amoxicillin (100%), followed by Tetracycline (83.33%), whereas highly sensitive to cefotaxime (100%), Gentamicin and Co-trimoxazole (83.33%). Salmonella spp. indicates high susceptibility to Cefotaxime, Co-trimoxazole, and Ceftazidime (83.33%), followed by Gentamicin (66.67%) respectively, whereas Staphylococcus spp. was found to be highly resistant to Methicillin (100%) and Ampicillin (100%) followed by Gentamicin and Tetracycline (83.33%) respectively. The MAR index calculation of isolated E. coli, Salmonella spp., and Staphylococcus spp. from different sources of poultry hatcheries was measured at 0.77, 0.79, and 0.77, which affect the newly hatched chicks in poultry industries. Therefore, an urgent surveillance program is needed to fight antimicrobial resistance in poultry production sectors in Bangladesh.

Antibiotic resistance spectrums of Escherichia coli and Enterococcus spp. strains against commonly used antimicrobials from commercial meat-rabbit farms in Chengdu City, Southwest China.

Antimicrobial resistance (AMR) is commonly associated with the inappropriate use of antibiotics during meat-rabbit production, posing unpredictable risks to rabbit welfare and public health. However, there is limited research on the epidemiological dynamics of antibiotic resistance among bacteria indicators derived from local healthy meat-rabbits. To bridge the knowledge gap between antibiotic use and AMR distribution, a total of 75 Escherichia coli (E. coli) and 210 Enterococcus spp. strains were successfully recovered from fecal samples of healthy meat-rabbits. The results revealed that diverse AMR phenotypes against seven commonly used antimicrobials, including ampicillin (AMP), amoxicillin-clavulanic acid (A/C), doxycycline (DOX), enrofloxacin (ENR), florfenicol (FFC), gentamicin (GEN), and polymycin B (PMB), were observed among most strains of E. coli and Enterococcus spp. in two rabbit farms, although the distribution pattern of antibiotic resistance between young and adult rabbits was similar. Among them, 66 E. coli strains showed resistance against 6 antimicrobials except for PMB. However, 164 Enterococcus spp. strains only exhibited acquired resistance against DOX and GEN. Notably, the DOX-based AMR phenotypes for E. coli and Enterococcus spp. strains were predominant, indicating the existing environmental stress conferred by DOX exposure. The MICs tests suggested elevated level of antibiotic resistance for resistant bacteria. Unexpectedly, all GEN-resistant Enterococcus spp. strains resistant high-level gentamicin (HLGR). By comparison, the blaTEM, tetA, qnrS and floR were highly detected among 35 multi-resistant E. coli strains, and aac[6']-Ie-aph[2']-Ia genes widely spread among the 40 double-resistant Enterococcus spp. strains. Nevertheless, the presence of ARGs were not concordant with the resistant phenotypes for a portion of resistant bacteria. In conclusion, the distribution of AMR and ARGs are prevalent in healthy meat-rabbits, and the therapeutic antimicrobials use in farming practice may promote the antibiotic resistance transmission among indicator bacteria. Therefore, periodic surveillance of antibiotic resistance in geographic locations and supervisory measures for rational antibiotic use are imperative strategies for combating the rising threats posed by antibiotic resistance, as well as maintaining rabbit welfare and public health.

Prevalence and predictors of multidrug-resistant bacteremia in liver cirrhosis.

Improved knowledge of local epidemiology and predicting risk factors of multidrug-resistant (MDR) bacteria are required to optimize the management of infections. This study examined local epidemiology and antibiotic resistance patterns of liver cirrhosis (LC) patients and evaluated the predictors of MDR bacteremia in Korea. This was a retrospective study including 140 LC patients diagnosed with bacteremia between January 2017 and December 2022. Local epidemiology and antibiotic resistance patterns and the determinants of MDR bacteremia were analyzed using logistic regression analysis. The most frequently isolated bacteria, from the bloodstream, were Escherichia coli (n = 45, 31.7%) and Klebsiella spp. (n = 35, 24.6%). Thirty-four isolates (23.9%) were MDR, and extended-spectrum beta-lactamase E. coli (52.9%) and methicillin-resistant Staphylococcus aureus (17.6%) were the most commonly isolated MDR bacteria. When Enterococcus spp. were cultured, the majority were MDR (MDR 83.3% vs. 16.7%, p = 0.003), particularly vancomycin-susceptible Enterococcus faecium. Antibiotics administration within 30 days and/or nosocomial infection was a significant predictor of MDR bacteremia (OR: 3.40, 95% CI: 1.24-9.27, p = 0.02). MDR bacteremia was not predicted by sepsis predictors, such as positive systemic inflammatory response syndrome (SIRS) or quick Sequential Organ Failure Assessment (qSOFA). More than 70% of strains that can be treated with a third-generation cephalosporin have been cultured. In cirrhotic patients, antibiotic administration within 30 days and/or nosocomial infection are predictors of MDR bacteremia; therefore, empirical administration of broad-spectrum antibiotics should be considered when these risk factors are present.

Detection and Antibiotic Resistance Pattern of Multidrug Resistant Staphylococccus aureus from Wound Infection at Tertiary Hospital in Yenagoa, Nigeria

Multidrug resistant Staphylococcus aureus is increasingly prevalent worldwide, albeit with significant regional variations. The development of bacterial resistance to various antibacterial agents coupled with its virulence factors have significantly contributed to its pathogenicity. This investigation aimed to identify multidrug resistant S. aureus in wound infections. A total of 40 specimens from burn and cut wound specimens were examined utilizing culture, Gram staining, biochemical analysis, Kirby Bauer disc diffusion technique using ten multidisc antibiotics and plasmid profiling. Descriptive analysis was employed to determine the prevalence of S. aureus in specimens collected from individuals with open wounds, comprising 18 (45%) males and 22 (55%) females. Antibiogram profiles were used to determine the antibiotic resistance of the isolates. A total number of 19 (48%) S. aureus isolates were obtained in this study. Among patients with burn wounds, 12 (63.5%) exhibited the highest number of isolates, while those with cut wounds accounted for 7 (36.8%) representing the lowest count. The number of males with burn wounds was 7 (58.3%), higher than that of females 5 (41.7%). Females had a greater number of cut wounds with 5 (71.4%) compared to males with 2 (28.6%). The age group 16-25 years exhibited the highest number of isolates at 7 (37%), while the lowest was observed in the age group 66-75 years, with 1 (5%). Notably, these age intervals showed a statistically significant difference with P<0.05. The highest occurrence of isolate was recorded in males within the age group 16-25 years, totalling 5 (24%). In contrast, for females, the most prevalent isolate was found in the age 26-35 years, amounting to 3 (16%). The susceptibility profile of S. aureus revealed sensitivity to gentamycin 7 (36.8%) and levofloxacin 11 (57.9%), while resistance to norfloxacin, chloramphenicol, erythromycin, amoxil and ampiclox was 100%. Plasmid profiling identified multiple plasmid bands in the obtained multidrug resistant S. aureus, with a molecular weight of 9466kbp. The susceptibility pattern of the multidrug S. aureus both before and after plasmid curing indicated that previously resisted antibiotics became susceptible after curing except for amoxicillin-clavulanic acid and cefpodoxime. Cefotaxime, with a 25 mm zone of inhibition, was the most sensitive antibiotic after the plasmid curing. The discovery of plasmid in this study may prove valuable for the effective monitoring of antibiotic resistance patterns in bacteria from wound infections and clinical settings.

Quantitative stool culture in hospitalized neonates: Microbiological analysis, antibiotic resistance patterns, and clinical management implications

Quantitative stool culture in hospitalized neonates: Microbiological analysis, antibiotic resistance patterns, and clinical management implications

Antibiotic-resistant Pattern of Isolated Bacteria from Selected Foods Sold at the Street Side Stalls and Restaurants of Tangail Municipality, Bangladesh

Objectives:: The goal of this investigation was to determine the microbial load with special emphasis on total viable count (TVC), total coliform count (TCC), total E. coli (TE.cC), and Staphylococcus spp. counts (TSC) in food samples collected from selected areas of Tangail municipality, Bangladesh. Methods:: An intensive study was carried out from December 2021 to March 2022 in the Tangail district of Bangladesh for investigation. A total of 5 types of food samples (15 from street side stalls and 15 from the selected restaurants; n= 30) were collected with a semi-structured-based questionnaire and tested by using different standard microbiological methods. Biochemical and antibiogram tests were performed to confirm the bacterial isolates and antibiotic-resistant patterns Results:: The results revealed that the values of TVC, TCC, TE.cC and TSC were found in the range of 2.5 ×106 - 8.9 ×108, 2.5×105 - 7.1×107, 1.9×103 - 5.6×105 and 5.0×105 - 4.6×106 CFU/ml in street vended foods and 5.5 ×105 - 9.5 ×106, 4.3×104 - 7.1×105, 0 to 3.9×104 and 3.1×104 - 6.6×105 CFU/ml in restaurant foods. The E. coli isolates displayed the highest resistance rates to amoxicillin (80%), whereas Staphylococcus spp. showed 90% resistance to ampicillin. Conclusion:: From the interview and observational assessment, it was found that the food service system was not well managed, and there was a lack of hygiene practices. Thus, the study identified the foods from selected areas as carriers of food-borne pathogens.

Antibiotic resistance of enteropathogenic bacteria in a teaching hospital in North Khuzestan during a three-year period

ABSTRACT Introduction: Gastrointestinal infections affect many people annually. The most common bacterial agents involved in these infections are enteropathogenic bacteria and in the continuation of using broad-spectrum antibiotics, Clostridium difficile-associated diarrhea is involved, especially in hospitalized patients. The aim of the present study was to investigate the pattern of antibiotic resistance among enteropathogenic bacteria. Materials and Methods: In this cross-sectional study, 163 samples of patients with diarrhea in Dezful Ganjavian Hospital were examined. The samples were cultured in MacConkey, Hektoen enteric agar and GN broth, and cycloserine cefoxitin fructose agar media and incubated under standard conditions. In order to identify enteropathogenic bacteria, biochemical tests and serological confirmatory tests were used. Antibiotic resistance pattern of the isolates was investigated by Kirby–Bauer disk diffusion susceptibility test. Results: The frequency of pathogenic bacteria includes 41.1% of Shigella flexneri, followed by 41.1% of S. sonnei, 6.7% of Enteropathogenic E. coli, 5.5% of Salmonella enterica Serogroup B, and 5.5% of Shigella dysenteriae. The results revealed a total of 46 patients with orders regarding C. difficile culture, no C. difficile was isolated from the samples. The studied isolates showed the highest resistance to trimethoprim-sulfamethoxazole, and ceftriaxone (88.3%), and the most effective antibiotic in the treatment of patients was ciprofloxacin with 86% sensitivity. Conclusion: Susceptibility to antibiotics was different among the isolates, which shows that the early identification of the infection agent and the selection of the correct antibiotic treatment are effective in improving the gastrointestinal infection and preventing the spread of the infection.

A situational analysis of antibiotic prescription, dispensing practices and resistance pattern in Nepal: Are we losing the battle?

Background: Antibiotics are widely utilized to treat infections and provide preventative and therapeutic benefits in animal and human healthcare. However, because of the emergence and spread of resistance mechanisms, which cause bacteria to become less susceptible to antibiotics and other treatments and less effective, antimicrobial resistance (AMR) has grown to be one of the most significant worldwide public health concerns. Low- and middle-income countries (LMICs) such as Nepal have a high rate of infectious illnesses and antibiotic resistance, which can lead to both human and financial losses. Methods: The information for the scenario analysis was acquired through a review of published and grey literature, as well as interviews with important stakeholders from all sectors. Conclusion: Besides knowing all the challenges of antibiotic resistance, the programs assuring towards AMR is conducted in Nepal in very infrequent way. The antibiotic use should be optimize by giving various personalized treatment approaches and accurate diagnosis which plays vital roles in minimizing unnecessary antibiotic prescriptions. We can organize different awareness programs to reduce antibiotic resistance that may enhance the proper use of antibiotic with proper dose and prescription in accordance health care professionals. Interpreting all the problems, government should give more priority to antibiotic resistance and should be able to minimize the problems. If antibiotic resistance is not taken in a very serious way by all the healthcare workers like doctors, nurses, pharmacists, lab technicians, etc. then the battle we are fighting leads to be defeated and problem will never end.

Association of Osteoporosis with Antibiotic Resistance among Postmenopausal Women with Open Tibial Fractures

Osteoporosis is common among postmenopausal women and can complicate the healing of open tibial fractures. Antibiotic resistance is a growing concern in treatment. Yet, the connection between osteoporosis and antibiotic resistance remains unclear, needing the investigation for improved patient care. Objective: To explore the association between osteoporosis and antibiotic resistance among postmenopausal female patients with open tibial fractures. Methods: This cross-sectional study was conducted at Department of Orthopedic Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, with sample size of 240 postmenopausal women with open tibial fractures and signs of infection within one week of the fracture. Participants were chosen via non-probability sampling method. Bacteriological samples for culture were obtained from secretions adjacent to the infected tissue. Data analysis was conducted using SPSS version 21.0. Results: The majority of osteoporotic patients experienced Road Traffic Accidents (RTA) (42.5%), followed by falls from height (35.3%), while firearm injuries were less common (22.2%). Staphylococcus aureus was the most common pathogen in both osteoporotic (40%) and non-osteoporotic (39.9%) patients, followed by Escherichia coli, Methicillin-Resistant Staphylococcus Aureus (MRSA), Klebsiella, and Pseudomonas aeruginosa. Antibiotic resistance was predominantly found against S. aureus, MRSA, Klebsiella and E. coli. Co-Trimoxazole exhibited the highest resistance rates across all four bacterial organisms, ranging from 34% to 50%. Conclusions: The study found varying antibiotic resistance patterns across various pathogens, with notable resistance observed MRSA strains. Antibiotic resistance was observed in osteoporotic group, with Co-Trimoxazole showing the highest resistance rates.

Molecular and Insilico Characterization of Antimicrobial Resistant Escherichia fergusonii and Morganella morganii causing Urinary Tract Infections

Urinary tract infections (UTIs) are a major public health concern causing mortality and morbidity worldwide. There are approximately 13,000 deaths that are linked to UTIs every year. Bacterial antibiotic resistance is increasing globally, making it difficult to treat urinary tract infections. Biochemical tests have resulted in inaccurate identification, due to which wrong empirical treatment of antibiotics is prescribed. The present research work aims to identify rare bacterial isolates along with the assessment of antibiotic resistance patterns. A total of 339 samples were examined for urine cultures. Based on biochemical testing, three positive samples were selected. Culture sensitivity results revealed two multidrug-resistant and one extensively drug-resistant bacteria. MDR strains showed sensitivity to meropenem, gentamicin, cefoperazone-sulbactam, nitrofurantoin, tigecycline and imipenem, and co-amoxiclav while XDR bacteria showed sensitivity to nitrofurantoin and tigecycline. The 16S rRNA sequencing results revealed two Escherichia fergusonii strains and one Morganella morganii strain. Our findings revealed the identification of rare and opportunistic bacteria less reported from Pakistan. In addition, it is the first report of E. fergusonii from Pakistan. In conclusion, using molecular identification of rare and neglected bacteria via PCR is more sensitive and highly specific than other identification methods. In the future, this approach will help in accurate diagnosis and will help in minimizing antibiotic resistance.

The clinical Spectrum of Viridans Group Streptococci infections in paediatric patients at a tertiary hospital.

Viridans Group Streptococci (VGS) are often considered organisms of low virulence; however, infection can result in clinically significant sepsis and life-threatening complications in paediatric patients. This study aimed to describe the spectrum of clinical presentation of VGS bacteraemia in paediatric patients, to analyse risk factors, and to describe the antibiotics resistance patterns of VGS. Cultures of VGS in paediatric patients admitted to Chris Hani Baragwanath Academic Hospital in 2019 were identified through National Health Laboratory Service. Data were extracted from archived clinical records and analysed. Sepsis scores were calculated at the time of bacteraemia. A total of 133 cultures were identified; 64 (48.1%) polymicrobial cultures and no records 4 (0.03%) were excluded; 65 (48.9%) were analysed. The median age was 1.5 months (range 0.03 to 168, interquartile range [IQR]: 0.3-13.25), 27/65 (42%) were neonates. The median duration of hospitalisation was 7 days (IQR: 3-21). The commonest diagnoses were neonatal sepsis 30.8% (n = 20) and pneumonia 28% (n = 18). The systemic inflammatory response syndrome (SIRS) score was ≥ 2 in 57% (16/28) patients; paediatric sequential organ failure assessment (pSOFA) score was > 2 in 10/24 (42%). Fifty-seven (88%) patients were discharged; three (5%) required ICU admission and 8/65 (12.3%) died. Malnutrition was present in 50% of patients who died. Cephalosporins and penicillin had sensitivity of 89% and 55%, respectively. Viridans Group Streptococci bacteraemia was common in neonates, and pneumonia was a common presentation in this cohort. The VGS bacteraemia was associated with morbidity and deaths in this cohort. The VGS should be considered a significant organism when cultured from sterile sites and routine antibiotic susceptibility testing should be performed. Prospective studies are recommended.