Antibiotic Susceptibility Pattern 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.

Prevalence and antibiotic susceptibility patterns of Escherichia coli and Staphylococcus aureus isolated from bioaerosols of local markets located in Agulu, Anambara State

There is a need for improved understanding of aerosol-acquired disease due to the increasing environmental load of antibiotic resistant bacteria. Multidrug-resistant Escherichia coli and Staphylococcus aureus are examples of bacteria for which the role of exposure to aerosolized organisms in disease transmission should be more closely evaluated globally. This study is aimed at evaluating the prevalence and antibiogram of S. aureus and E. coli present in market bioaerosols, located in Nwagu-Agulu, Anambra Nigeria. Impaction sample collection method was used to collect bioaerosol samples within the market using nutrient agar as the collection media, A combination of the cultural and microscopic features as well as selected biochemical tests were employed to identify the isolates. The Kirby-Bauer disk diffusion method was used to determine antibiotic resistance to selected commonly used antibiotics. A total of 76 S. aureus and 24 E. coli were isolated. Both organisms have been implicated in community-acquired infections. The most common bacteria isolated were Staphylococcus aureus. Varying levels of resistance were observed by these isolates to selected commonly use antibiotics. There is high prevalence of S. aureus and E. coli within Nwagu market Agulu, Anambra State, Eastern region of Nigeria. The organisms have very high rates of resistance to antibiotics (MDR) as reported by other workers. The government as well as Health professionals must play an important role in the prevention of community acquired infections via regular environmental monitoring of open markets bioaerosol and establishing a common permissible limits or concentration for bioaerosols within the markets.

Microbiological and molecular studies on a multidrug-resistant Pseudomonas aeruginosa from a liver transplant patient with urinary tract infection in Egypt.

Pseudomonas aeruginosa is an opportunistic pathogen responsible for complicated UTIs and exhibits high antibiotic resistance, leading to increased mortality rates, especially in cases of multidrug-resistant strains. This study aimed to investigate the antibiotic susceptibility patterns and genomic characterization of XDR strains identified in end-stage liver disease patients who underwent liver transplants. In this study, a number of 30 individuals who underwent liver transplants were registered. Ninety urine and 60 wound site swab samples were collected and processed for culturing, identification, and antimicrobial sensitivity. Extensively drug-resistant strain EMARA01 was confirmed through Sanger sequencing and was then processed for whole genome sequencing to characterize the genomic pattern. Sequencing data were processed for de novo assembly using various tools and databases, including genome annotation, serotype identification, virulence factor genes, and antimicrobial resistance gene. Pangenome analysis of randomly selected 147 reference strains and EMAR01 sequenced strain was performed using the Bacterial Pan Genome Analysis (BPGA) software. Of these total examined samples, nosocomial infection due to P. aeruginosa was detected in twelve patients' samples. AST analysis showed that P. aeruginosa strains exhibit resistance to tobramycin, erythromycin, and gentamicin, followed by piperacillin and ofloxacin, and no strains exhibit resistance to meropenem and imipenem. The CARD database identified 59 AMR genes similar to the EMAR01 strain genome and mostly belong to the family involved in the resistance-nodulation-cell division (RND) antibiotic efflux pump. Five genes; nalC, nalD, MexR, MexA, and MexB, exhibit resistance to 14 classes of antibiotics, while two AMR; CpxR, and OprM, exhibit resistance to 15 classes of drugs. Pangenome analysis revealed that the pan-genome remained open, suggesting the potential for acquiring accessory and unique genes. Notably, the genes predominantly involved in amino acid transport metabolism were identified using the KEGG database. This study provides valuable insights into the antimicrobial resistance profile, genetic features, and genomic evolution of P. aeruginosa strains causing UTIs in liver transplant patients. The findings emphasize the significance of comprehending AMR mechanisms and genetic diversity in P. aeruginosa for developing effective treatment strategies and infection control measures.

Conditions and Antimicrobial Resistant Profiles of Campylobacter Species from Cow Milk Samples in Oromia Region, Ethiopia

Campylobacter is one of the major causes of gastroenteritis and is commonly transmitted through the consumption of raw milk or improperly pasteurized milk. A cross-sectional study was conducted from January 2019 to March 2020 in four study sites in the Oromia region of Ethiopia to isolate, identify, and estimate the prevalence of Campylobacter species in milk samples and to determine their antibiotic susceptibility pattern. A total of 384 cow milk samples were randomly chosen from 192 samples of raw milk from farmers and collectors and 192 samples of pasteurized milk from processors and retailers. Standard bacteriological techniques and PCR were used to isolate and identify Campylobacter spp. Of the total 384 milk samples, 35 (9.1%) were found to be positive for Campylobacter spp. The prevalence of Campylobacter spp. was highest in collector raw milk (13.5%), farmer raw milk (12.5%), and pasteurized milk (5.2%).The antibiotic susceptibility test was performed using the disc diffusion method. The most prevalent Campylobacter spp. isolated from milk samples was Campylobacter jejune (C. jejuni) (100%). The overall prevalence of Campylobacter in dairy value chains, including producer, collector, processor, and retailer, was 12.5%, 13.5%, 5.2%, and 5.2%, respectively. Cold storage, material type for making collection rooms, calibrating the pasteurizer machine, restricting milk handlers that are sick, means of transportation, and maintaining temperature during transportation had a statistically significant association. 100% and 8.6% of the Campylobacter isolates were sensitive to ciprofloxacin and chloramphenicol, respectively. However, all of the isolates were resistant to ampicillin, clindamycin, oxytetracycline, and trimethoprim. Moreover, 80% of the C. jejuni were resistant to tetracycline and streptomycin. 26% of the species developed ciprofloxacin degradation. The result of this study revealed the prevalence and risk factors of Campylobacter species in raw and pasteurized milk samples. Hence, there is a chance of acquiring infection via the consumption of raw or undercooked milk. Thus, the implementation of hygienic practices from the producer to the retailer's market, proper handling to avoid cross-contamination and proper pasteurization are very important in preventing Campylobacter infection.

Comprehensive Bio-Screening of Phytochemistry and Biological Capacity of Oregano (Origanum vulgare) and Salvia triloba Extracts against Oral Cariogenic and Food-Origin Pathogenic Bacteria

This study utilized phytochemical screening to conduct the qualitative analysis of plant extracts, aiming to identify various classes of secondary metabolites. Moreover, the antibacterial activity of different types of Oregano vulgare and Salvia triloba extracts was determined. To achieve the aim of this study, aqueous, ethanolic, and enzymatic extracts were prepared and screened for phytochemical capacity and antioxidant activities. The determination of the antibacterial activity included phenotypic screening of antibiotic susceptibility pattern of oral and food pathogenic bacterial strains, determination of the minimum inhibitory concentration and minimum bactericidal concentration—via microdilution broth test and in vitro valuation of antibacterial efficacies—of the anti-biofilm properties of the studied herbal extractions. Results: Our study evaluated the phytochemical composition and the antioxidant, antibacterial, and anti-biofilm properties of O. vulgare and S. triloba extracts. The analyzed samples contained bioactive compounds, such as phenolics and flavonoids, contributing to the observed strong antioxidant effect. Furthermore, they exhibited notable activity against oral biofilm formation and demonstrated significant antibacterial efficacy against dental caries’ microorganisms as well as food pathogens. Despite methodological variations, all extracts showed significant antioxidant capacity and promising antibacterial activity against various pathogens, including resistant strains, while also inhibiting biofilm formation. Although limited to two plant species and facing methodological constraints, this study lays the groundwork for future research, indicating the therapeutic potential of O. vulgare and S. triloba extracts. Further exploration is needed to report on underlying mechanisms and validate efficacy through clinical trials.

The Prevalence of Multidrug-Resistant Uropathogenic Bacterial Profile With Antibiotic Susceptibility Patterns Among the Community and Hospitalized Patients During COVID Waves

The Prevalence of Multidrug-Resistant Uropathogenic Bacterial Profile With Antibiotic Susceptibility Patterns Among the Community and Hospitalized Patients During COVID Waves

Prevalence and Antibiotic Sensitivity Profile of Pseudomonas aeruginosa Isolated from Patients with Otitis Media in Kirkuk City

Background: Otitis media (OM) is middle ear inflammation, it is a prevalent health care disorder that affects people of all ages and both genders. Pseudomonas aeruginosa (P. aeruginosa) is the most prevalent pathogen bacteria that causes the disease and has a high level of antibiotic resistance. The P. aeruginosa possess virulence characteristics which cause damages to the middle ear mucosa.Antibiotic resistance constitutes the main threat to people's health. Objective: The objective of the current study is to evaluate the frequency of P. aeruginosa isolated from Otitis media patients and investigate their antibiotic susceptibility pattern. Materials and Methods: total of 235 ear swabs were collected from otitis media patients who visited a specialized outpatient center in Kirkuk City and the ENT consultation facility at Kirkuk Hospitals. Antibiotic susceptibility testing by the VITEK 2 AST card and bacterial isolation and identification were both done. Results: The results of this study reveal that out of 235 ear swabs collected from patients with otitis media showed 22/235 (9.4 %) isolation rate for P. aeruginosa. And among the most effective antibiotics against the most of the detected pathogenic bacteria were Amikacin (95.4%), followed by Ceftazidime/ Avibactam, Piperacillin /Tazobactam, and Ceftolozane/ Tazobactam each with (91%), Colistin (86%), Imipenemand and Meropenem (81.8%, 86.4%) respectively, Ceftazidime, Cefeime, Levofloxacin, and Azreonam each with ( 77.3%), Ciprofloxacin and Ofloxacin both (72.7%) with Gentamicin (68.2%). Conclusion: The bacteria P. aeruginosa was most common prevalent isolate in the ear swabs, and this bacteria is multidrugs resistance (MDR). Additionally, the most efficient antibiotic against P. aeruginosa isolates responsible for otitis media was Amikacin.

Antibiotic susceptibility patterns and trends of the gram-negative bacteria isolated from the patients in the emergency departments in China: results of SMART 2016–2019

BackgroundThe study aims were to evaluate the species distribution and antimicrobial resistance profile of Gram-negative pathogens isolated from specimens of intra-abdominal infections (IAI), urinary tract infections (UTI), respiratory tract infections (RTI), and blood stream infections (BSI) in emergency departments (EDs) in China.MethodsFrom 2016 to 2019, 656 isolates were collected from 18 hospitals across China. Minimum inhibitory concentrations were determined by CLSI broth microdilution and interpreted according to CLSI M100 (2021) guidelines. In addition, organ-specific weighted incidence antibiograms (OSWIAs) were constructed.ResultsEscherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the most common pathogens isolated from BSI, IAI and UTI, accounting for 80% of the Gram-negative clinical isolates, while Pseudomonas aeruginosa (P. aeruginosa) was mainly isolated from RTI. E. coli showed < 10% resistance rates to amikacin, colistin, ertapenem, imipenem, meropenem and piperacillin/tazobactam. K. pneumoniae exhibited low resistance rates only to colistin (6.4%) and amikacin (17.5%) with resistance rates of 25–29% to carbapenems. P. aeruginosa exhibited low resistance rates only to amikacin (13.4%), colistin (11.6%), and tobramycin (10.8%) with over 30% resistance to all traditional antipseudomonal antimicrobials including ceftazidime, cefepime, carbapenems and levofloxacin. OSWIAs were different at different infection sites. Among them, the susceptibility of RTI to conventional antibiotics was lower than for IAI, UTI or BSI.ConclusionsGram-negative bacteria collected from Chinese EDs exhibited high resistance to commonly used antibiotics. Susceptibilities were organ specific for different infection sites, knowledge which will be useful for guiding empirical therapies in the clinic.

Gram Positive Cocci Associated Urinary Tract Infections, their Prevalence and Antibiotic Susceptibility Patterns

Background: Urinary tract infections (UTIs) are the third most common type of infection in humans globally. Gram-positive bacteria are said to be responsible for ten percent of urinary tract (UTI) infections. The study's goal was to profile gram-positive cocci-associated UTIs and their antibiogram, as they were observed at LASUTH. Methods: This was a retrospective assessment of the Medical Microbiology Laboratory records of the LASUTH to review the in vitro antibiotic susceptibility patterns of gram-positive urinary bacterial isolates between April 2020 and March 2021. The bacteria were isolated and identified from routine urine samples using standard bacteriological methods and the API. In vitro antibiotic susceptibility test (AST) was routinely performed by the modified Kirby-Bauer disk diffusion test and susceptibility breakpoints were determined using the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: 2,253 urine samples were processed in the medical microbiology laboratory over the one year and 662 (29.4%) samples yielded Positive cultures. Of the 662 isolates, 494 (74.6%) were gram-negative bacteria. 164 (24.8%) were gram-positive cocci while 4 (0.6%) were gram positive rod. Among the gram-positive cocci’s isolated Enterococcus faecalis had the highest frequency 58 (35.4%). Aminoglycosides (Gentamycin and Amikacin) and Linezolid antibiotics were found to be the most effective drugs against gram-positive cocci bacteria except Enterococcus spp. For empirical treatment of Enterococcus spp in our facility Fosfomycin and Tigecycline are the best options, while for Streptococcus agalactiae associated UTI, Amikacin, Cefuroxime, Linezolid, and levofloxacin can be used for empirical treatment. Conclusion: The prevalence rate of gram-positive cocci associated UTI in this study was 7.3% (164/2253). The emergence of drug resistance in these pathogens to commonly used antibiotics is a thing of concern. Therefore, efficient antimicrobial stewardship programmes must be in place.

Prevalence of Ventilator Associated Pneumonia Caused by Multidrug Resistant Isolates in an Intensive Care Unit Setting at a University Hospital

Abstract Background: Ventilator-associated pneumonia (VAP) in acute respiratory distress syndrome patients is expected in the setting of prolonged mechanical ventilation due to abridged immunity and dysregulation of the microorganisms inhabiting the oral cavity. We conducted this study to identify the spectrum of microorganisms causing VAP in patients admitted to the medicine intensive care unit (MICU) and their antibiotic susceptibility patterns. Materials and Methods: We conducted a retrospective cross-sectional laboratory-based study from January 2021 to April 2021. Our cohort included patients with respiratory distress who were admitted to the MICU. We observed the incidence of VAP and the risk factors responsible for multidrug resistance (MDR) microorganisms in the MICU, along with 250-day survival in the existence of specific comorbidities along with VAP. Results: Clinical charts of patients (n = 366) admitted to the MICU between January 2021 and April 2021 were used. The mean age of patients admitted to MICU was 57.3 ± 18.7 years with a male predominance (n = 252, 68.8%). VAP was diagnosed in 69.1% (n = 253) of patients, and the most common microorganism in our cohort was Klebsiella pneumoniae (n = 78, 30.8%), followed by Acinetobacter spp. (n = 77, 30.4%). None of the K. pneumoniae isolates (n = 0/78) and only a minority of Acinetobacter spp. (n = 4/77, 5.2%) and Pseudomonas aeruginosa isolates (n = 8/54, 14.8%) were susceptible to fluoroquinolones. A higher proportion of K. pneumoniae (n = 1/78, 1.3%), Acinetobacter spp. (n = 2/77, 2.6%), and P. aeruginosa isolates (n = 9/54, 16.7%) were susceptible to aminoglycosides. The incidence rate of MDR microorganisms among the 253 patients diagnosed with VAP was 92.8% (n = 219/253). Conclusion: There is a high prevalence of multidrug resistance (MDR) isolates among those causing VAP in the MICU setting. Knowing the broad spectrum of causative pathogens and their susceptibility to various antibiotics may guide the physician injudicious and appropriate use of antibiotics for treatment.

Outcomes associated with initial narrow-spectrum versus broad-spectrum antibiotics in children hospitalized with urinary tract infections.

The aim of this study is to describe the proportion of children hospitalized with urinary tract infections (UTIs) who receive initial narrow- versus broad-spectrum antibiotics across children's hospitals and explore whether the use of initial narrow-spectrum antibiotics is associated with different outcomes. We performed a retrospective cohort analysis of children aged 2 months to 17 years hospitalized with UTI (inclusive of pyelonephritis) using the Pediatric Health Information System (PHIS) database. We analyzed the proportions of children initially receiving narrow- versus broad-spectrum antibiotics; additionally, we compiled antibiogram data for common uropathogenic organisms from participating hospitals to compare with the observed antibiotic susceptibility patterns. We examined the association of antibiotic type with adjusted outcomes including length of stay (LOS), costs, and 7- and 30-day emergency department (ED) revisits and hospital readmissions. We identified 10,740 hospitalizations for UTI across 39 hospitals. Approximately 5% of encounters demonstrated initial narrow-spectrum antibiotics, with hospital-level narrow-spectrum use ranging from <1% to 25%. Approximately 80% of hospital antibiograms demonstrated >80% Escherichia coli susceptibility to cefazolin. In adjusted models, those who received initial narrow-spectrum antibiotics had shorter LOS (narrow-spectrum: 33.1 (95% confidence interval [CI]: 30.8-35.4) h versus broad-spectrum: 46.1 (95% CI: 44.1-48.2) h) and reduced costs [narrow-spectrum: $4570 ($3751-5568) versus broad-spectrum: $5699 ($5005-$6491)]. There were no differences in ED revisits or hospital readmissions. In summary, children's hospitals have low rates of narrow-spectrum antibiotic use for UTIs despite many reporting high rates of cefazolin-susceptible E. coli. These findings, coupled with the observed decreased LOS and costs among those receiving narrow-spectrum antibiotics, highlight potential antibiotic stewardship opportunities.

Prevalence and Antibiotic Susceptibility of Gram-Negative Bacteria Isolated from Different Meat Samples in Baghdad City

Background: The occurrence of Gram-negative (G -ve) bacteria in meat samples raises a major concern due to the possibility of drug resistance incidence since G -ve bacteria have built-in resistance mechanisms and can pass on genetic elements that enable other bacterial species to develop into drug-resistant as well. This drug resistance could be transferred to consumers through a food-borne route. This study aimed to evaluate the prevalence of Gram-negative bacteria in meat samples as well as to detect their antibiotic susceptibility patterns. Methods: For this purpose, 100 meat samples (ground meat, raw burgers, frozen chicken, and chicken carcasses) were collected, and obtained isolates were identified using conventional microbiological techniques including cultural and microscopic identification. After that antibiotic susceptibility patterns were detected using Kirby Bauer's disc diffusion method. Results: Results showed that 91 of the samples were harboring Gram-negative bacteria and E.coli was the most common isolate (51.64%) followed by Klebsiella pneumoniae (18.68%) while the least common isolate was each of E. coli O157:H7, Aeromonas hydrophila, Kluyvera spp., Raoultella terrigena, Hafnia alvei, and Serratia marcescens (1.10%). Susceptibility test showed that all isolates were susceptible to Meropenem and Imipenem while Ampicillin was the most resisted antibiotic. Conclusion: We conclude that meat samples harbor numerous pathogenic Gram-negative bacteria which showed antibiotic-resistant ability toward most tested drugs. However, Meropenem and Imipenem were the least resisted drugs which makes them an appropriate choice for the treatment of foodborne infections.

Systematic Review and Meta-Analysis on the Prevalence and Antibiotic Susceptibility Pattern in Pseudomonas aeruginosa Isolated from Cystic Fibrosis Patients

Systematic Review and Meta-Analysis on the Prevalence and Antibiotic Susceptibility Pattern in Pseudomonas aeruginosa Isolated from Cystic Fibrosis Patients

Detection of Biofilm Production and Antibiotic Susceptibility Pattern among Clinically Isolated Staphylococcus aureus.

The increasing antibiotic resistance and the ability to form biofilms in medical devices have become the leading cause of severe infections associated with Staphylococcus aureus (S. aureus). Since the bacteria living in biofilms can exhibit 10- to 1,000-fold increase in antibiotic resistance and implicate chronic infectious diseases, the detection of S. aureus ability to form biofilms is of great importance for managing, minimizing, and effectively treating infections caused by it. This study aimed to compare the tube and tissue culture methods to detect biofilm production and antibiotic susceptibility in MRSA and MSSA. The S. aureus isolates were identified by the examination of the colony morphology, Gram staining, and various biochemical tests. Antimicrobial susceptibility testing of all isolates was performed by the modified Kirby-Bauer disc diffusion method as recommended by CLSI guidelines. MRSA screening was performed phenotypically using a cefoxitin disc (30 µg). Isolates were tested for inducible resistance using the D-test, and two phenotypic methods detected biofilm formation. Among 982 nonrepeated clinical specimens, S. aureus was isolated from 103 (10.48%). Among 103 clinical isolates of S. aureus, 54 (52.42%) isolates were MRSA, and 49 (47.57%) were MSSA. Among 54 MRSA isolates, the inducible MLSB phenotype was observed in 23/54 (42.59%) with a positive D-test. By TCP method, 26 (48.1%) MRSA isolates were strong biofilm producers, whereas, among all MSSA isolates, only 6 (12.2%) were strong biofilm producers. MRSA showed strong biofilm production in comparison with MSSA. The TCP method is a recommended reliable method to detect the biofilm among S. aureus isolates, and the TM method could be useful for the screening of biofilm production in S. aureus in the routine clinical laboratory.

An In Vitro Study to Evaluate the Synergy of Baptisia tinctoria against Salmonella typhi

AbstractAs a consequence of gradual emergence of anti-microbial resistance, the anti-biogram profile of the microbe Salmonella typhi has undergone substantial changes. Patients frequently utilise homeopathy for the flu season and other serious illnesses. Although the use of Baptisia tinctoria (BT) is extensively described in homeopathic literature and in phytomedicine, scientific exploration has never been done. In this study, we have made an effort to understand the anti-typhoidal effect of BT at different concentrations. S. typhi (ATCC 6539) from a freshly prepared stock culture was used in this experiment. We also procured an international strain of Escherichia coli (ATCC 25922 strain) which was taken as control. The antibiotic susceptibility patterns of the isolates were determined by the Kirby-Bauer disc diffusion method according to the Clinical and Laboratory Standards Institute guidelines and interpretative criteria (National Committee for Clinical Laboratory Standards 2000) using antibiotic discs (Hi Media Laboratory. Pvt. Ltd., Mumbai, Maharashtra, India), namely cefotaxime (30 μg), ceftazidime (30 μg), ciprofloxacin (5 μg), tetracycline (30 μg), chloramphenicol (30 μg), streptomycin (10 μg), ampicillin (10 μg), gentamicin (10 μg), kanamycin (30 μg), nalidixic acid (30 μg) and trimethoprim (5 μg). BT in its 6CH potency showed the greatest growth inhibition zone, not just amidst the homeopathic potency gradient. It has shown the highest growth inhibition zone of 28mm, more than any conventional antibiotic. Ethanolic extract of BT can be considered to combat against array of infections caused by S. typhi species alongside that it can also be considered as adjuvant with conventional antibiotics for better result.

Prevalence and Antibiotic Susceptibility Pattern of Pseudomonas Aeruginosa from the Foot Ulcer of Diabetic Patients in Hayatabad Medical Complex Peshawar, Pakistan

Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, affecting 15% of diabetic patients and often leading to severe outcomes like amputation. These ulcers frequently become infected with bacteria such as Pseudomonas aeruginosa, which is known for its robust antibiotic resistance. Objective: To investigate the prevalence and antibiotic susceptibility patterns of Pseudomonas aeruginosa isolated from the foot ulcers of diabetic patients in Hayatabad Medical Complex, Peshawar. Methods: A total of 103 clinical samples from diabetic foot ulcers were collected and analyzed for the presence of Pseudomonas aeruginosa using culture techniques and biochemical tests. The antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method to identify effective treatments. Results: Pseudomonas aeruginosa was identified in 48 (46.60%) of the samples. High resistance was noted against amoxicillin-clavulanic acid (100%), and notable sensitivity was observed to gentamicin (79.16%) and cefoperazone-sulbactam (87.5%). The susceptibility to other tested antibiotics varied, with moderate resistance seen in agents like cefotaxime (25%) and trimethoprim-sulfamethoxazole (33.33%). Conclusion: The study highlights a significant presence of Pseudomonas aeruginosa in diabetic foot ulcers with substantial antibiotic resistance, emphasizing the need for precise susceptibility testing to guide effective treatment strategies.

Assessing bacterial prevalence and resistance in paediatric meningitis: safeguarding the central nervous system.

Paediatric bacterial meningitis (PBM) represents a major contributor to childhood morbidity and mortality globally, with heightened susceptibility in low- and middle-income nations where antimicrobial resistance (AMR) is highly prevalent. Pakistan exemplifies this setting, with widespread antibiotic overuse driving AMR expansion. Thus, expediting PBM diagnosis and targeted antibiotic therapy is imperative yet challenged by the dynamic local epidemiology. This study aimed to delineate the recent bacterial etiologies and AMR profiles of PBM from a major Pakistani diagnostics laboratory to inform empirical treatment. This prospective observational investigation evaluated PBM epidemiology in patients under 18 years old admitted to the study hospital. Standard cerebrospinal fluid analysis identified bacterial pathogens and antibiotic susceptibility patterns. Among 171 PBM cases, 152 (88.9%) had bacterial isolates confirmed via culture. The cohort was 42.7% male with a mean age of 3 months. The most prevalent pathogens among infants younger than 3 months were Escherichia coli, Enterococcus faecium, and Staphylococcus epidermidis, contrasting with S. epidermidis, Streptococcus pneumoniae, and Staphylococcus hominis predominating in older children. Staphylococcal isolates exhibited considerable penicillin and erythromycin resistance but maintained vancomycin and linezolid susceptibility. Other resistance patterns varied. These findings highlight the pressing threat of paediatric AMR in Pakistan, underscoring the need for vigilant AMR surveillance and judicious antimicrobial use. This study provides a reference to current PBM epidemiology to guide context-specific empirical therapy.

Characterization of Weissella Species during a 3-Year Observational Study - An Emerging Threat.

Weissella species are mistaken for Lactobacillus or Leuconostoc because of their Gram-staining property and resistance to vancomycin. In this study, we aimed to evaluate the demographic pattern, presenting symptoms, risk factors, associated pathologies, and clinical outcomes in patients with Weissella infection. We also analyzed the antibiotic susceptibility pattern of the Weissella species isolated. This retrospective observational study was done from January 2021 to August 2023 in a tertiary care referral center in Uttar Pradesh. All Weissella species isolated from blood cultures or cerebrospinal fluid (CSF) samples during this period were included in the study. Twenty-four-hour growth from a positive blood culture or CSF sample was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Demographic and clinical details of the patients were extracted from the hospital information system. Kirby-Bauer disk diffusion was used for antibiotic susceptibility testing. During the 3-year study, 13 isolates of Weissella species were identified in our laboratory. Among the patients, male predominance was seen. The age range of the patients was 5-53 years. The samples were blood samples (n = 11) and CSF samples (n = 2). Of these isolates, 12 (92.3%) were identified as Weissella confusa and 1 (7.69%) was identified as Weissella viridescens. Common risk factors were anemia, prolonged hospital stay, indwelling catheter, chemotherapy, and chronic kidney disease. All the isolates in this study were sensitive to amikacin, daptomycin, amoxicillin-clavulanate, minocycline, and linezolid. Death was attributed to Weissella infection in three patients. Weissella species are opportunistic organisms that need to be identified quickly and precisely to guarantee the right course of treatment.

Lipase and Protease Production Ability of Multi-drug Resistant Bacteria Worsens the Outcomes of Wound Infections

Background: Surgical site infections are one of the major clinical problems in surgical departments that cost hundreds of millions of dollars to healthcare systems around the world. Aim: The study aimed to address the pressing issue of surgical site infections, which pose significant clinical and financial burdens on healthcare systems globally. Recognizing the substantial costs incurred due to these infections, the research has focused on understanding the role of lipase and protease production by multi-drug resistant bacteria isolated from surgical wounds in the development of post-surgical wound infections. Methods: For these purposes, 153 pus specimens were collected from patients with severe post-surgical wound infections having prolonged hospital stays. The specimens were inoculated on appropriate culture media. Gram staining and biochemical tests were used for the identification of bacterial growth on suitable culture media after 24 hours of incubation. The isolated pathogens were then applied for lipase and protease, key enzymes that could contribute to wound development, on tributyrin and skimmed milk agar, respectively. Following the CSLI guidelines, the Kirby-Bauer disc diffusion method was used to assess antibiotic susceptibility patterns. The results revealed that a significant proportion of the samples (127 out of 153) showed bacterial growth of Gram-negative (n = 66) and Gram-positive (n = 61) bacteria. In total, isolated 37 subjects were declared MDR due to their resistance to three or more than three antimicrobial agents. The most prevalent bacteria were Staphylococcus aureus (29.13%), followed by S. epidermidis (18.89%), Klebsiella pneumoniae (18.89%), Escherichia coli (14.96%), Pseudomonas aeruginosa (10.23%), and Proteus mirabilis (7.87%). Moreover, a considerable number of these bacteria exhibited lipase and protease activity with 70 bacterial strains as lipase positive on tributyrin agar, whereas 74 bacteria showed protease activity on skimmed milk agar with P. aeruginosa as the highest lipase (69.23%) and protease (76.92%) producer, followed by S. aureus (lipase 62.16% and protease 70.27%). Results: The antimicrobial resistance was evaluated among enzyme producers and non-producers and it was found that the lipase and protease-producing bacteria revealed higher resistance to selected antibiotics than non-producers. Notably, fosfomycin and carbapenem were identified as effective antibiotics against the isolated bacterial strains. However, gram-positive bacteria displayed high resistance to lincomycin and clindamycin, while gram-negative bacteria were more resistant to cefuroxime and gentamicin. Conclusion: In conclusion, the findings suggest that lipases and proteases produced by bacteria could contribute to drug resistance and act as virulence factors in the development of surgical site infections. Understanding the role of these enzymes may inform strategies for preventing and managing post-surgical wound infections more effectively.

Molecular detection of Class 1, 2, and 3 integrons in hypervirulent and classic Klebsiella pneumoniae isolates: A cross-sectional study.

The "hypervirulent" variant of Klebsiella pneumoniae (hvKp) is an emerging pathogen that cause life-threatening infection. The present study was conducted to identify the prevalence of hvKp and to investigate the presence class 1, 2, and 3 integrons in these isolates. A cross-sectional study was conducted at three teaching hospitals, Ahvaz, South-west of Iran, from January 1, 2019 to December 31, 2020. Samples were collected from inpatients and included only the first samples collected from each patient. K. pneumoniae strains were isolated from different specimens using biochemical test and confirmed by targeting 16S-23S rDNA internal transcribed spacer. HvKp isolates were recovered using string test and were further characterized by detection virulence-associated genes (rmpA, iucA, and magA). Antibiotic susceptibility patterns of isolates were determined using the disc diffusion method. Isolates were screened for presence the integron genes (intI, intII, and intIII) and repetitive element sequence-based polymerase chain reaction (PCR) performed to determine strain relatedness. SPSS version 22 was used for the data analysis. Seventy-one (77%) of isolates showed multidrug-resistant (MDR) phenotype. HvKP accounted for 14% (13/92) of cKp isolated from blood (46%) and urinary tract infection (38%), and the great majority of them (61.5%; 8/13) exhibited MDR phenotype. Using the PCR assay, 29 of 92 isolates (31.5%) were found to have positive results for the presence of IntI. Three of the IntI-positive strains were hvKP. Class 2 integron was present in 8/92 cKp isolates. Integron Class 2 was found to coexist with Class 1 integron in 3/8 isolates. All integron-positive isolates (IntI and/or IntII) were resistant to at least three different classes of antibiotics and showed MDR phenotype. No Class 3 integrons were detected among the isolates. The results of our study revealed that considering the role of integrons in facilitating the acquisition and dissemination of resistance genes among bacteria, monitoring the emergence of hvKp, emphasizing on the mechanism of antimicrobial resistance, can prevent from the spread of carbapenemase-producing hvKp strains.