Antibiotic Sensitivity Pattern Research Articles

Assessment of Biofilm Production and Antibiotic Sensitivity Patterns in Klebsiella pneumoniae Isolates from Al-Qadisiyah Hospitals, Iraq

Background: Klebsiella pneumoniae is one of the most common causative agents of nosocomial infections. Opportunistic pathogens can generate a thick layer of biofilm as an important virulence factor. Objectives: The current study was aimed in the detection of biofilm formation in Klebsiella pneumoniae pathogenic capability as a common opportunistic pathogen accounting pneumonia, urinary tract infections, with in nosocomial infections. Materials and Methods: In this observational study, a total of 140 clinical samples obtained from patients with bacterial infections were analyzed. The identification of Klebsiella pneumoniae isolates was performed using selective culture media and biochemical tests. Additionally, biofilm strains were characterized using the Crystal Violet assay and polymerase chain reaction (PCR) techniques. Results: Among the 140 samples collected from various specimens, a total of 100 isolates (43.47%) were identified as Klebsiella pneumoniae culturing and biochemical tests. Out of these isolates, 58 (58%) were obtained from male individuals, while 42 (42%) were obtained from female individuals. Using the phenotypic method, the analysis revealed that 18% isolates were classified as strong biofilm producers, 33% as medium biofilm producers, 49% as weak biofilm producers, and 30 as non-biofilm producers. The frequency of specific genes in the isolates was reported as follows: wzm (47%) and markA (69%). Conclusion: The presence of the markA gene is significant in the context of biofilm formation in Klebsiella pneumoniae strains, as it serves as a marker for distinguishing various types of biofilms.

PHENOTYPIC DETECTION OF ESBL AND AMPC BETA LACTAMASES AMONG GRAM-NEGATIVE ISOLATES FROM CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL

Objectives: Drug-resistant Gram-negative bacilli expressing extended-spectrum beta-lactamases (ESBLs) and AmpC pose a serious therapeutic threat in nosocomial infections. Cost-effective screening methods are a boon to patients. This study aims to detect gram-negative bacilli and their antibiotic sensitivity patterns, as well as detect the ESBL and AmpC-producing isolates among Gram-negative bacilli. Methods: A prospective study was conducted with 150 samples. Gram-negative bacilli were isolated, and their antibiotic sensitivity tests were performed by the Kirby–Bauer disk diffusion method. Potential ESBL producers were screened using Ceftazidime disc, and AmpC producers were screened by Cefoxitin discs by the disc diffusion method. ESBL producers were confirmed by the combined disc diffusion assay method using ceftazidime and ceftazidime/Clavulanic acid disc. AmpC producers were confirmed by the Cefoxitin Cloxacillin Double Disc Synergy Test. Results: About 38% of 150 samples were gram-negative bacilli, of which 40.35% were Escherichia coli, followed by Pseudomonas aeruginosa (35.08%). Maximum sensitivity by E. coli was found toward imipenem, meropenem, and cotrimoxazole. P. aeruginosa showed maximum sensitivity toward piperacillin/tazobactam, imipenem, meropenem, and ceftazidime. 28.07% of Gram-negative isolates were ESBL producers, with E. coli (11 isolates) being the maximum, and 15.78% were AmpC producers, with E. coli (four isolates) being the maximum. Seven isolates were both ESBL and AmpC producers. Conclusion: Routine screening and timely reporting of ESBL and AmpC producers help in preventing the spread of multidrug-resistant strains. Antibiotic resistance surveillance helps in the implementation of strict infection control and prevention practices.

Molecular identification of bacteria (Klebsiella aerogenes, PP335235) isolated from street food (Fried Rice); study of its antibiotic sensitivity pattern and probiotic fortification of fruit juice (Fragaria ananassa, Passiflora ligularis and Phyllanthus e

Street food is an integral part of India's culinary culture, offering patrons a wide range of affordable options. However, concerns about the public's health risks associated with street food consumption persist due to inadequate infrastructure and the transient nature of street vendors. Contaminated street food can lead to foodborne illnesses such as gastroenteritis, typhoid fever, pneumonia, food poisoning, and hepatitis A. Probiotics, which are beneficial bacteria, are potentially effective by targeting specific infections. Probiotic-enriched fruit drinks present an innovative approach to improving population nutrition and probiotic provision. Lactobacillus gasseri is a gram-positive bacterium that has been demonstrated to be a promising strain of probiotic due to its resistance to acidity and beneficial effects on gut health. Alginate encapsulation improves the stability and release of probiotic strain. Probiotic fruit juices can be made from fruits that are rich in antioxidants and nutrients, such as Passiflora ligularis, Fragaria ananassa, and Phyllanthus emblica. The aim of this study was to use molecular methods to discover Klebsiella aerogenes (PP335235) isolated from street foods. The study also sought to determine the isolate's pattern of antibiotic sensitivity and explore the potential of fortifying fruit juice with Lactobacillus gasseri as a probiotic nutraceutical therapeutic strategy.

Delayed infections following polybutylate-coated polyester (Ethibond) suture frontalis suspension surgery for severe blepharoptosis

ABSTRACT Purpose To describe the incidence and management of delayed infections following frontalis sling suspension with polybutylate-coated polyester suture (Ethibond). Methods Retrospective, interventional case series of 177 eyes of 150 patients, who underwent frontalis suspension surgery with Ethibond (Johnson and Johnson, USA), at L V Prasad Eye Institute, Hyderabad, India, between January 2016 and February 2022. Patients were assessed for chronic secondary sling infection, defined as infection/suture granuloma occurring beyond 6 weeks post-surgery. All patients received postoperative oral antibiotics. The clinical profile, microbiological evaluation, antibiotic sensitivity patterns, and management outcomes were analyzed. Results Delayed infection following Ethibond sling suspension was noted in 14 eyes of 13 patients (7.9%). Of these, eight cases (61.5%) were females. The average time interval from surgery to presentation was 7.5 months (range: 2.5 months to 2.5 years). Eleven eyes underwent sling removal. Of the three who received initial antibiotic course, two eventually needed sling removal. Microbiological evaluation was available in seven eyes (50%), with Staphylococcus aureus as the most common organism. Of the six positive cultures, five (83.3%) were resistant to fluoroquinolones (FQs). Conclusion Frontalis suspension with Ethibond has an 8% incidence of delayed infections, with Staphylococcus aureus as the most common organism. The authors recommend early sling removal in all patients with infection and recommend consideration of an alternative material in the event of future revision surgery.

Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries – Call for region and institution specific surgical antimicrobial prophylaxis

PurposeImproper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care. MethodsThis multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented. Results2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics. ConclusionOur study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.

Antibiotic Resistance in Salmonella typhi Strains Isolated From Patients in Pakistan: A Hospital Database Study.

The surge in antibiotic-resistant Salmonella enterica serotype Typhistrains has led to heightened morbidity, mortality, and treatment expenses. This study aims to assess the resistance patterns of Salmonella Typhi to diverse antibiotics among patients seeking care at a tertiary hospital in Pakistan. A database from a tertiary care hospital in Pakistan was reviewed, and data on blood cultures that isolated Salmonella enterica serotype Typhi were collected. Data were collected and analyzed using Microsoft Excel (Microsoft Corporation, USA) and IBM SPSS software (IBM Corp., Armonk, NY). Demographic information of the selected data was retrieved from the hospital database, and the results showed that 63.7% were male, 36.1% were female, and 0.2% were categorized as neutered. Regarding antibiotic resistance, ampicillin exhibited the highest resistance rate (91.50%), while meropenem demonstrated the lowest (3.00%). Antibiotic sensitivity patterns also varied across different age groups, although statistical analysis indicated no significant differences. Significant associations were found between antibiotic resistance and comorbidities, as well as previous antibiotic use. Salmonella enterica serotype Typhi showed a high resistancetoampicillin and fluoroquinolones, such as ciprofloxacin. The emergence of resistance and decreased sensitivity to current first-line antibiotics necessitates a shift towards alternative options, such as third-generation cephalosporins, azithromycin, and newer antibiotics like meropenem.

A Temporal Study on Incidence of Bovine Mastitis in Haryana, India

Mastitis affects dairy animal’s productivity and causes financial losses for dairy farmers in India and across the world. In this study, a total of 52,494 quarter milk samples from 14,381 bovines were screened for the primary microorganisms causing mastitis in Hisar and adjoining districts of Haryana and their antibiotic sensitivity patterns were analyzed. The cultural positivity from subclinical form of mastitis was observed as 86.32% and 87.73% from cows and buffaloes, respectively while that from clinical mastitis was 87.36% and 87.57%. The major Gram positive bacterial pathogens associated with mastitis in the entire study period were found as Staphylococcus species with an average incidence rate of 45.53% and 44.1% from cows and buffaloes, respectively. The Streptococcus species were found to be 33.76% and 29.94% of total isolates. Escherichia coli were the most predominant Gram negative bacteria isolated (17.37% and 13.85%), thereafter Klebsiella spp. (5.54% and 5.19%) from both cows and buffaloes. A significant proportion of clinical cases of mastitis were chronic in nature from both the species of bovines. The incidence of mastitis with respect to different lactation number and lactation months was found as significant. The highest incidences of mastitis was observed in the first lactation among buffaloes (20.69%), while the maximum incidences were observed in second and third lactation in cows with 16.59% and 16.99%, respectively. However, in both the species maximum occurrence of mastitis was observed during the first lactational month. The antibiotic sensitivity patterns of most of the isolates had shown higher sensitivity towards enrofloxacin and gentamicin, while the penicillin had shown least sensitivity. The knowledge regarding the mastitis causing pathogens and their sensitivity pattern in Hisar and adjoining districts of Haryana enables the veterinarians to adopt for the proper treatment protocols and dairy farmers to assure optimal health, welfare and productivity of bovines in the State, in turn reducing antimicrobial resistance.

Antibacterial Property of Silver Nanoparticles Green Synthesized from Stachys schtschegleevii Plant Extract on Urinary Tract Infection Bacteria.

Urinary tract infections are one of the most common infections worldwide. Given the increasing antibiotic resistance, monitoring antibiotic sensitivity patterns is crucial. Furthermore, silver nanoparticles synthesized from Stachys schtschegleevii can exhibit potent antibacterial, antibiotic, and antifungal properties. The plant S. schtschegleevii was collected from its natural habitat, dried, and its extract was then exposed to silver nitrate. Under specific conditions, silver nanoparticles were synthesized from it. Subsequently, the production and validation of silver nanoparticles were confirmed through techniques such as FTIR analysis, UV-Vis analysis, TEM, SEM, EDX analysis, and zeta potential analysis. In the in vitro section of the research, the impact of the extracted silver nanoparticles on bacteria isolated from patients' urine and standard bacterial culture (control) was assessed using the disc diffusion and MIC test methods. The results of the analyses are FTIR (high protein content; proteins and phenols serve as stabilizing agents), UV-Vis (peak of 460nm), TEM (spherical to occasionally elliptical shapes), SEM (sizes: 26 to 72nm), EDX (peak at 3keV), and zeta potential (- 15.76 ± 0.05mV). The effect of silver nanoparticles by disc diffusion method (mm) is Enterococcus faecalis = 18.31 ± 0.35, Escherichia coli = 21.51 ± 0.61, and Staphylococcus aureus = 19.02 ± 1.28, and by MIC test (μg/ml), E. faecalis = 19, E. coli = 18, and Staphylococcus aureus = 16. Antibacterial activity of the silver nanoparticles synthesized from S. schtschegleevii means that these herbal nanoparticles treat urinary tract infections caused by some of the test isolates.

Detection of Methicillin Resistance and Methicillin Sensitive Staphylococcus Aureus from Various Clinical Specimens in Tertiary Care Hospital

INTRODUCTION : Staphylococcus aureus is one of the most common Gram-positive pyogenic bacteria responsible for variety of disease. Methicillin resistance Staphylococcus aureus (MRSA) has become a major cause of hospital associated infection. MRSA can also acquire resistance to multiple alternative antimicrobials, further complicating treatment of infection. For the severe infection of MRSA, vancomycin considered one of the last treatments relatively new agents such as Linezolid and Daptomycin is used. MATERIAL AND METHODS: 141 Staphylococcus aureus were isolated from samples such as pus, sputum, urine, blood, body fluid, wound swab received in microbiology department of Krishna institute of medical sciences, karad. They were conformed by microscopy, culture, and biochemical reaction. Then MRSA were detected by using disc diffusion test using cefoxitin (30ug) disc. RESULTS: Majority of Staphylococcus aureus were isolated from pus samples 71 (50.35%). Out of 141 isolates, 81 (57.44%) were MRSA and 60 (42.55%) were MSSA. In MRSA and MSSA isolates, higher percentage of resistance was seen in Penicillin 78 (96.29%) and 55 (90.16%) respectively. CONCLUSION :The present study emphasized the burden of MRSA in patients at our hospital. The determination of antibiotic sensitivity patterns and screening for MRSA among Staphylococcus aureus isolates are important for controlling the clinical Staphylococcal infection. The antibiotic sensitivity pattern helps in judicious use of antimicrobial agents.

BACTERIOLOGICAL PROFILE OF CLINICALLY SUSPECTED SEPTICEMIA AMONG NEONATES AND THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF THEIR ISOLATES: A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL OF JHARKHAND

Objectives: Neonatal septicemia is a generalized bacterial infection that occurs during the first 4 weeks of life and is one of the four primary causes of neonatal mortality and morbidity in India. This study aims to determine the bacteriological profile and antibiotic sensitivity patterns of isolates from blood cultures of suspected septicemic neonates in a tertiary care hospital. Methods: Two hundred and twenty-eight blood samples were collected and processed from patients in accordance with standard protocol. The antibiotic susceptibility of the isolates was determined by the disk diffusion method according to Clinical and Laboratory Standards Institute recommendations. Results: Blood culture results were positive in 44.7% of the patients. Late-onset sepsis was present in 53.92%, and early-onset sepsis was observed in 46.08% of the cases. The best overall sensitivity among Gram-negative isolates was to Amikacin, followed by Gentamycin and Meropenem. Gram-positive isolates had sensitivity to Chloramphenicol, tetracycline, Linezolid, Tetracycline, Vancomycin, and Piperacillin. Conclusion: The most common causes of newborn sepsis in this study were Gram-negative organisms (Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii) and Gram-positive organisms (Staphylococcus aureus), the majority of which are antibiotic-resistant.

Frequency of asymptomatic bacteriuria, causative pathogens and antibiotic sensitivity pattern in antenatal women.

Objective: To determine the frequency of asymptomatic bacteriuria (ASB), causative pathogens and antibiotic sensitivity pattern in antenatal women. Study Design: Cross-sectional study. Setting: Department of Obstetrics and Gynaecology, Nishtar Hospital, Multan, Pakistan. Period: February 2022 to July 2023. Methods: A total of 110 women with singleton pregnancy with gestational age 13-42 weeks, and aged 18 to 40 years were included. Once the patients were enrolled, demographic characteristics (age, gestational age, parity (primiparous or multiparous), body mass index (BMI), place of living (rural or urban), gestational diabetes mellitus (yes or no), educational status (illiterate, primary, middle, matric, or graduate)) were noted. Presence or absence of asymptomatic bacteriuria was noted. Results: In a total of 110 pregnant females, the mean age and gestational age were 28.7±3.9 years and 29.4±4.0 weeks, respectively. The frequency of ASB among pregnant women was found in 19 (17.3%) patients. The frequency of causative pathogens showed that E. coli was the most frequent isolates noted among 7 (36.8%) women while staphylococcus aureus, Klebsiella, pseudomonas spp, and Proteus spp were identified in 5 (26.3%), 4 (21.0%), 2 (10.5%), and 1 (5.26%) respectively. Antibiotic susceptibility patterns revealed that Amikacin, Nitrofurantoin, cephalexin, and Ciprofloxacin were the most sensitive antibiotics noted in 18 (94.7%), 17 (89.5%), 15 (79.0%) and 14 (73.7%) samples respectively. Conclusion: The frequency of asymptomatic bacteriuria in pregnant women is high with E. coli as the most common causative organism. Antibiotic susceptibility patterns revealed that Amikacin, Nitrofurantoin, cephalexin, and Ciprofloxacin to have good sensitivities.

Current Microbiological Profile and Antibiotic Sensitivity Pattern in Chronic Suppurative Otitis Media in the Post- Antibiotic Era

Current Microbiological Profile and Antibiotic Sensitivity Pattern in Chronic Suppurative Otitis Media in the Post- Antibiotic Era

Streptococcus sinensis Causing Tricuspid Endocarditis in a Child: An Unusual Pathogen at an Unusual Site: A Case Report with Review of Literature

Background: Infective endocarditis (IE) involving tricuspid valve is rarely reported in children. Common etiological organisms of IE include Staphylococci, viridans group Streptococci, and Enterococci. Other less frequent organisms include Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella (HACEK) group, and Candida, accounting for 1% of cases. We describe the rare case scenario of tricuspid valve endocarditis caused by an unusual pathogen. Clinical Description: An 8-year-old girl presented with complaints of cough, shortness of breath, and intermittent fever for the past 2 months. Since 10 days before presentation, the fever had become high grade, continuous, and associated with chills and rigors. As per parents, the child had incidentally been detected with some congenital heart disease (CHD) at 3 months of age, documents being unavailable, child remaining asymptomatic till this presentation, without any medications. On examination, the child was malnourished with pallor, Grade 3 clubbing, tachypnea, and tachycardia. Auscultation revealed bilateral basal crepitations and a pansystolic murmur of Grade 4 in tricuspid area. Management and Outcome: Along with routine investigations, a two-dimensional echocardiography was done which revealed perimembranous ventricular septal defect with left-to-right shunt, tricuspid valve vegetations with anterior tricuspid leaflet prolapse with ruptured chordea, severe tricuspid regurgitation, and thickened aortic valve with good biventricular function. Blood culture showed growth of Streptococcus sinensis. The child was treated with oxygen, diuretics, and intravenous ciprofloxacin and gentamicin according to antibiotic sensitivity pattern. The child became hemodynamically stable and symptomatically improved after 3 weeks of treatment. Conclusion: This case creates awareness regarding an usual pathogen – S. sinensis as an etiological agent of IE, involving an unusual site – the tricuspid valve, in a child with CHD.

Etiologies, risk factors, and antibiotic pattern of lower respiratory tract infection in patients coming to Deccan College of Medical Sciences, Hyderabad, South India

Background. Lower Respiratory Tract Infections (LRTI) impose a huge problem on society due to their tenacious and unescapable health problems, and they were the reasons for consultation and hospitalization. Patients with LRTI were present with a wide spectrum of diseases that range from life-threatening infections to minor self-limiting illnesses. Materials and methods. Sputum samples from 310 patients with complaints of lower respiratory tract infections were collected and analyzed. After microscopic analysis, 30 were excluded from the study. Of the 280 that were included in the study, 171 were males and 109 were females. The age group between 56 and 65 years comprised the highest number of patients in the study. Different antibiotics were used to check antibiotic sensitivity patterns against isolated Gram-positive and negative bacteria. Results. Of the 280 samples processed, 122 (43.5%) were culture-positive. Among the 122 bacterial isolates, the predominant organism was Klebsiella pneumoniae 55 (45%). The most common predisposing factor identified in 115 (37%) patients was smoking. Using the Double Disk Synergy Test, 11 (20%) out of a total of 55 K. pneumoniae isolates and 4 (30.7%) out of 13 Pseudomonas isolates showed Extended Spectrum Beta Lactamases (ESBL). The Klebsiella and Pseudomonas isolates showed resistance to 2nd and 3rd generation Cephalosporins. Conclusion. Because of different geographical regions and conditions, the etiology and the antibiotic sensitivity patterns of LRTI vary, so the etiology, predisposing factors, and the antibiotic sensitivity pattern of LRTI need to be updated regularly. The diagnostic facilities for early and rapid identification of LRTI also need to be improved.

Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Introduction: Surgical site infections (SSIs) in orthopaedic surgeries pose a significant risk to outcomes. These infections ranging from superficial to periprosthetic joint complications result from various factors including patient-related conditions and environmental factors. Staphylococcus aureus, with increasing antibiotic resistance, is a predominant cause. Perioperative antibiotic prophylaxis recommended by the WHO is crucial. Establishing national surveillance considering local antibiotic resistance and continuous auditing are essential for formulating effective guidelines to prevent and manage SSIs. Methods: This is a retrospective study conducted at a tertiary care hospital from December 2022 to November 2023 at the orthopaedic unit. The study population was all the patients who had surgical site infections following clean orthopaedic surgeries during the study period. An institutional-level ethical clearance was obtained. Results: This retrospective study conducted at a tertiary orthopaedic unit in Jaffna, Sri Lanka, aimed to investigate surgical site infections (SSI) following clean orthopaedic surgeries. Analyzing data from 1676 surgeries over one year, the study identified 83 culture-proven SSIs, yielding an annual incidence of 4.95%. The majority of SSIs occurred in males (62.7%) and were associated predominantly with lower limb surgeries (83.1%). Contrary to global trends, Pseudomonas emerged as the most common causative organism (31.3%). Discussion: Notably, the study revealed significant variations in antibiotic sensitivity patterns among isolated organisms. While Pseudomonas exhibited sensitivity to a wide range of antibiotics, coliforms displayed resistance to several agents. This emphasizes regional and institutional differences in antibiotic resistance patterns. Conclusion: Continuous large-scale institutional audits are crucial for shaping effective antibiotic policies. The study underscores the dynamic nature of SSI aetiology, emphasizing the need for tailored preventive measures based on regional data.

Frequency of drug-resistant bacterial isolates among pregnant women with UTI in maternity and children’s hospital, Bisha, Saudi Arabia

Urinary tract infections (UTIs) are one of the most prevalent bacterial infections affecting humans, with a higher incidence among women. Pregnant women are at an increased risk of developing UTIs, which can have detrimental consequences for both the mother and fetus. UTIs can be caused by various bacteria, and the prevalence of drug-resistant UTIs in maternity and children’s hospitals is a cause for concern due to the potential for severe complications if left untreated. The primary objective of the current study was to determine the distribution of UTI-causing bacteria and investigate the antibiotic sensitivity patterns of isolated cultures obtained from pregnant women with UTIs at the Maternity and Children’s Hospital, Bisha, Saudi Arabia. This cross-sectional study was conducted from October 2021 to October 2023, involving the analysis of urine samples collected from 321 participants who acquired UTIs during pregnancy. Using biochemical tests and standard cultures, the urine samples were examined for pathogenic bacteria and their anti-microbial sensitivity patterns. The study analyzed susceptibility results according to the Clinical Laboratory Standards Institute guidelines (M100, 28th Edition, 2018). Bacterial strains demonstrating resistance to three or more antibiotics were classified as multidrug-resistant (MDR). This study revealed the distribution of UTI-causing bacteria to be as follows: Escherichia coli, 57.01%; Klebsiella pneumoniae, 24.61%; Pseudomonas aeruginosa, 4.36%; Proteus mirabilis and Enterobacter cloacae, 3.74%; Streptococcus agalactiae, 3.11%; Enterococcus faecalis, 2.18%; and Staphylococcus aureus, 1.24%. Antimicrobial susceptibility testing varied among gram-positive and gram-negative bacteria. Gentamicin demonstrated the highest sensitivity among both gram-positive and gram-negative bacteria; piperacillin-tazobactam was the second most effective drug against gram-negative bacteria. The bacterial isolates showed varying susceptibility to different antibiotics, with Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa being mainly sensitive to gentamicin, piperacillin-tazobactam, and ciprofloxacin, respectively. The strategies for reducing the risk of UTIs need to be improved to limit the spread of MDR bacteria. These strategies may include promoting hygienic practices and administering appropriate antibiotics to prevent the emergence and spread of drug-resistant bacteria. Further research is required to monitor the trends in antibiotic resistance among UTI-causing bacteria and develop effective strategies for managing this public health menace.

Evaluation of Mex A' Mex B Efflux Pump Gene in Pseudomonas aeruginosa Isolated from Milk in Qom Province, Iran

Background:: Pseudomonas aeruginosa is an opportunistic pathogen protected from antibiotics' harmful effects by various mechanisms. One of the most important mechanisms is the activation of exudation systems. Therefore, identifying such targets in food contaminating bacteria can help us target them and eliminate bacteria resistant to several drugs, making food safe. Therefore, the present study aimed to trace Mex A and Mex B efflux pump genes in Pseudomonas aeruginosa isolated from dairy products in Qom City, Iran. Methods:: 300 samples of raw milk, 30 samples of pasteurized milk, and 30 samples of local cream were collected. After a 24-hour culture on nutrient agar and blood agar and performing warm staining, confirmatory biochemical tests were performed to identify bacteria. The disk method was used according to CLSI guidelines to determine the antibiotic sensitivity pattern. Then Mex A and Mex B efflux pump genes were detected using specific primers with PCR technique. Results:: 117 strains of Pseudomonas aeruginosa were isolated from 300 raw milk samples, and 7 strains were resistant to ciprofloxacin. Out of 117 Pseudomonas aeruginosa isolates, 51 isolates (43.5%) had Mex A gene and 10 isolates (8.5%) had Mex B gene. Three isolates had both Mex A and Mex B genes. Among the strains with resistance to ciprofloxacin (7 isolates), 4 isolates did not have any of the genes. One isolate had Mex A and Mex B genes; 2 isolates were Mex A positive and Mex B negative, and Mex B positive and Mex A negative isolates were not observed. Conclusions:: Based on the results, among the studied isolates, the Mex A gene was more abundant. In addition, no significant relationship was found between the existence of Mex A and Mex B genes and ciprofloxacin resistance.

Investigation of the Multidrug Resistance Pattern of Bacteria Isolated from Car and Office Door Handles in a Tertiary Institution

Multidrug-resistant bacteria have posed a public health concern over the years, especially with the difficulty and cost of treatment of infections they cause. Fomites such as door handles are thus potent means through which pathogens are transmitted from one person to another as contact with them is made. This study thus involves isolating antibiotic-resistant bacteria from car and office door handles in a university environment. Using the simple random sampling method, twenty samples (20) from car door handles and twenty samples (20) from office door handles were collected, the isolation of bacteria was done using standard microbiological procedures and identification of the isolates was done using cultural, microscopic and biochemical characterization. Determination of the antibiotic sensitivity pattern of the isolates was done using the Kirby-Bauer disc diffusion method on Muller Hinton agar. Antibiotics used included Ofloxacin (5 µg), Gentamicin (10 µg), Ceftriaxone (30 µg), Augmentin (30 µg), Ciprofloxacin (5 µg), Erythromycin (5 µg), Streptomycin (30 µg) and Cloxacillin (30 µg). The results showed a significant frequency of occurrence of Staphylococcus aureus at 35% and Klebsiella pneumoniae having least at 5%. From car door handles, S. epidermidis recorded 37% while K. pneumoniae recorded the least with 17.4%. The isolates exhibited resistance to antibiotics including Augmentin and Ceftriaxone (≤22 mm) while they were more susceptible to Ofloxacin (≥16 mm). All the K. pneumoniae isolated from car door handles exhibited resistance to Augmentin and Ceftriaxone. These results show that these surfaces could be a possible reservoir of infections caused by resistant bacteria, leading to difficulty in the treatment of infections caused by them.

Acute conjunctivitis – antibiotic susceptibility and resistance to different antibiotics in main Eye Hospital, Tripoli, Libya

Acute conjunctivitis is characterized by inflammation of the conjunctiva of less than 3 to 4 weeks duration, cellular infiltration, and exudation. It may also result in corneal, lid, or orbital involvement which may lead to various complications. Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. A hospital-based prospective study was conducted in the emergency and casualty department in Zawyat Aldahmani Eye Hospital, Tripoli /Libya comprising out-patients (OPD) visiting the department from June to December 2019 (186 cases). The primary objective was to evaluate the bacteriological pattern and the secondary objectives were to evaluate seasonal variation and antibiotic sensitivity pattern of the isolates. Conjunctival swabs included patients from both sexes (males n_106 and females n_80) and different ages; 80.1% of adults of the whole studied cases and the rest were children under 12 years old. Staph. hominis (26.17%) was the predominant organism isolated throughout the study. The commonest single organism isolates were Staph. haemolyticus (11.21%) Staph. aureus (9.35%). All isolates were identified and susceptibility patterns towards about 34 different antibiotics were studied. There were 186 patients enrolled. Of all cultures, 57.5% (107) yielded one of the study pathogens. Gram-positive organisms were isolated from 83 (77.57%) of cultures, gram-negative organisms were isolated from 15 (14.02%), and 9 (8.4%) were fungal growth. From 107 gram-positive isolates, 19 samples (22.9%) gave coagulase-positive results and 64 samples (77.1%) gave negative results. All the major organisms (S. aureus, S. hominis, S. hemolytic, S. epidermidis, E. coli, Mycobacterium, and Moraxilla catarrhalis) susceptible to cephalosporins, macrolides, aminoglycosides and fluoroquinolones (levofloxacin). Tetracycline has the lowest effect on both gram-positive and gram-negative isolates. In conclusion, our findings should alert physicians on the choice of appropriate antibiotic treatment after applying AST to the identified strains and on the potential role of conjunctivitis in the spread of antibiotic-resistant pathogens. In addition, external bacterial infections of the eye were most frequently caused by the common skin bacteria. Staphylococci spp. was by far the most common bacterial pathogen.

The Enterics for Global Health (EFGH) Shigella Surveillance Study in Mali.

In 2002, the Centre pour le Développement des Vaccins du Mali (CVD-Mali) was established as a partnership between the Mali Ministry of Health and the University of Maryland, Baltimore. Since its creation, CVD-Mali has been dedicated to describing the epidemiology of infectious diseases, supporting the development of vaccines, and training a team of local researchers. CVD-Mali participated in the Global Enteric Multicenter Study from 2007 to 2010 and the Vaccine Impact on Diarrhea in Africa study from 2015 to 2018, where the importance of Shigella as an enteric pathogen was established. In the Enterics for Global Health (EFGH) Shigella surveillance study, CVD-Mali will conduct Shigella surveillance at 4 health centers serving the population currently participating in a demographic surveillance system and will measure the local incidence of Shigella diarrhea and related outcomes in 6- to 35-month-old children. Antibiotic sensitivity patterns and the costs related to these cases will also be measured. We anticipate reporting the number of diarrhea episodes that are positive by stool culture, the antibiotic susceptibility of these isolates, and the management and outcomes of these cases. In Mali, the EFGH study will contribute valuable information to understanding the burden of Shigella in this population. These data will inform the evaluation of vaccine candidates.