Antibiotic Susceptibility Profiles Research Articles

Carbapenem-resistant Acinetobacter baumannii infections among diabetic and non-diabetic patients and possible effective combination treatments

BackgroundCarbapenems are one of the most noteworthy choices for treating multidrug-resistant Acinetobacter baumannii (A. baumannii). Currently, carbapenem-resistant A. baumannii (CRAB) represents a healthcare problem worldwide, particularly among diabetic patients who are more susceptible to microbial infections. The aim of this study was to investigate the differences in antibiotic susceptibility profiles, the abundance of carbapenem resistance genes across A. baumannii-infected diabetic and non-diabetic patients, and the antimicrobial activity of different antibiotic combinations on highly resistant isolates.MethodsData of 99 A. baumannii-infected patients were collected during the period from 2018 to 2022 and categorized according to patients’ diabetes status into either diabetic or non-diabetic group. A total of 45 A. baumannii isolates were collected during 2021 and 2022 from the main hospital laboratory to be reidentified and genetically confirmed. Antibiotic susceptibility, including carbapenems, was determined using disc agar diffusion and broth microdilution methods. The isolates were screened for OXA-23, GES, VIM, and NDM carbapenem-resistant genes. Five antibiotic combinations were assessed using the double-disk synergy and checkerboard methods.ResultsThe findings of the current study revealed that multidrug resistance increased gradually, from 56% in 2018 to 95.6% in 2022. Moreover, CRAB increased among diabetics and non-diabetics. Resistance rates of imipenem, meropenem, and doripenem reached 68.8%, 61.8%, and 47.4% in diabetics and 97.9%, 83.3%, and 50% in non-diabetics, respectively. The VIM gene was the most prevalent gene with prevalence rates of 100% and 96.15% in diabetics and non-diabetics, respectively. Moreover, all A. baumannii isolates carried at least two of the selected carbapenem-resistant genes. Across the different used combinations, only the tigecycline-meropenem combination showed synergistic activity in 50% of diabetic and 66.7% of non-diabetic isolates.ConclusionsAn increased carbapenem resistance was observed among A. baumannii-infected individuals, both diabetic and non-diabetic. The MEM/TCG combination was the only one that showed synergistic or additive effects against highly resistant isolates making it a viable alternative treatment option.

Antimicrobial susceptibility of Pasteurella multocida strains isolated from different host species.

The spread of antibiotic resistance is one of the biggest challenges of our time, making it difficult to treat bacterial diseases. Pasteurella multocida is a widespread facultative pathogenic bacterium, which causes a wide range of diseases in both mammals and birds. In the present study, antibiotic susceptibility of 155 P. multocida strains were tested using the broth microdilution method to obtain the minimum inhibitory concentration (MIC) values for 15 antibiotics. The most effective antibiotics against pasteurellosis were ceftiofur, tetracycline, doxycycline, florfenicol and tilmicosin. Of the strains, 12 proved to be multi-drug resistant (MDR). To combat antibiotic resistance, it is important to establish a pre-treatment antibiotic susceptibility profile. A well-chosen antibiotic would not only make the treatment more successful but may also slow down the spread of resistance and the evolution of MDR strains.

Combinations of Antibiotics Effective against Extensively- and Pandrug-Resistant Acinetobacter baumannii Patient Isolates

Infections due to drug-resistant Acinetobacter baumannii strains are increasing and cause significant morbidity and mortality, especially in hospitalized and critically ill patients. A. baumannii rapidly develops resistance to numerous antibiotics, and antibiotics traditionally used against this deadly pathogen have been failing in recent years, highlighting the need to identify new treatment strategies. Treatment options that have shown promise include revisiting common antibiotics not typically used against A. baumannii, evaluating new antibiotics recently introduced to market, and identifying combinations of antibiotics that display synergistic interactions. In this study, we characterized the antibiotic susceptibility profiles of extensively (XDR) and pandrug-resistant (PDR) A. baumannii patient isolates. We examined the potency of 22 standard-of-care antibiotics and the newer antibiotics eravacycline, omadacycline, and plazomicin against these strains. Furthermore, we examined combinations of these antibiotics against our collection to identify synergistic effects. We found that this collection is highly resistant to most or all standard-of-care antibiotics, except for minocycline and rifampin. We show that eravacycline and omadacycline are effective against these strains based on minimum inhibitory concentrations. We also identified two highly effective combinations, cefepime and amikacin and cefepime and ampicillin–sulbactam, which exhibited high rates of synergy against this collection. This information is valuable in our battle against highly drug resistant and virtually untreatable A. baumannii infections.

Antibiotic Susceptibility Profile of Bacteria Responsible for Urogenital Infections and Epidemiology in Women at the Ignace Deen National Hospital in Conakry (Republic of Guinea)

Antibiotic Susceptibility Profile of Bacteria Responsible for Urogenital Infections and Epidemiology in Women at the Ignace Deen National Hospital in Conakry (Republic of Guinea)

Clinical differences between Raoultella spp. and Klebsiella oxytoca.

Raoultella spp. is a genus of bacteria that is known to be closely related to Klebsiella. It has been debated whether Raoultella should be reclassified as a subgroup of Klebsiella. The aim of this study is to compare clinical aspects of Raoultella and Klebsiella oxytoca, a species of Klebsiella that is known to be bacteriologically similar to Raoultella spp. Using data collected at a tertiary care hospital in the United States, we identified 43 patients with Raoultella infection and 1173 patients with Klebsiella oxytoca infection. We compared patient demographics (age and sex), hospitalization status, isolation sites and antibiotic resistance profiles between the two species. There was no significant difference in patient demographics between the two bacteria species. The proportions of intensive care unit (ICU) admission were higher among patients with Raoultella infection (p=0.008). The most common site of isolation was urine for both species (39.5% of all patients with Raoultella spp. vs. 59.3% for K. oxytoca). The second most common site of isolation was blood stream for Raoultella spp. (23.3%) and respiratory tract for K. oxytoca (10.8%). Except for the high proportion of resistant isolates of Raoultella spp. for Trimethoprim/sulfamethoxazole, the antibiotic susceptibility profiles were similar between the two bacteria species. Both were susceptible to ciprofloxacin and meropenem. While there are no significant differences in the patient demographics and antibiotic susceptibility profiles between Raoultella spp. and K. oxytoca, Raoultella may cause more serious infection requiring ICU admissions. Also, Raoultella may cause blood stream infection more frequently than K. oxytoca.

Effect of Multiantibiotic-Loaded Bone Cement on the Treatment of Periprosthetic Joint Infections of Hip and Knee Arthroplasties-A Single-Center Retrospective Study.

Two-stage septic revision is the prevailing method for addressing late periprosthetic infections. Using at least dual-antibiotic-impregnated bone cement leads to synergistic effects with a more efficient elution of individual antibiotics. Recent data on the success rates of multiantibiotic cement spacers in two-stage revisions are rare. We conducted a retrospective follow-up single-center study involving 250 patients with late periprosthetic hip infections and 95 patients with prosthetic knee infections who underwent septic two-stage prosthesis revision surgery between 2017 and 2021. In accordance with the antibiotic susceptibility profile of the microorganisms, a specific mixture of antibiotics within the cement spacer was used, complemented by systemic antibiotic treatment. All patients underwent preoperative assessments and subsequent evaluations at 3, 6, 9, 12, 18, and 24 months post operation and at the most recent follow-up. During the observation period, the survival rate after two-step septic revision was 90.7%. Although survival rates tended to be slightly lower for difficult-to-treat (DTT) microorganism, there was no difference between the pathogen groups (easy-to-treat (ETT) pathogens, methicillin-resistant staphylococci (MRS), and difficult-to-treat (DTT) pathogens). Furthermore, there were no differences between monomicrobial and polymicrobial infections. No difference in the survival rate was observed between patients with dual-antibiotic-loaded bone cement without an additional admixture (Copal® G+C and Copal® G+V) and patients with an additional admixture of antibiotics to proprietary cement. Employing multiple antibiotics within spacer cement, tailored to pathogen susceptibility, appears to provide reproducibly favorable success rates, even in instances of infections with DTT pathogens and polymicrobial infections.

Evaluating the Sputum Bacteriological Profile of Lower Respiratory Tract Infections With Bartlett Score Analysis in a Tertiary Care Hospital in Southern Karnataka.

Lower respiratory tract infections (LRTIs) are one of the most commonly encountered infections with significant mortality and morbidity. Sputum is the most frequently obtained sample for LRTI diagnosis. However, sputum samples carry the risk of being non-representative due to the risk of contamination with oral colonizers. To overcome the dilemma with respect to representative sampling, the use of a scoring system such as the Bartlett scoring system is emphasized.This study probes the bacterial profile of sputum samples among patients presenting with LRTIs and their antibiotic susceptibility profile in relation to the Bartlett scoring system. Retrospective data for a period of three years, comprising 4960 sputum samples from patients presenting with LRTI, were collected to study the bacterial profile and antibiogram in comparison with the sputum quality analyzed by the Bartlett scoring system. Out of the 4960 sputum samples analyzed from patients with LRTI, 31.18% yielded the growth of bacterial pathogens, and 98.64% of the sputum samples yielding pathogenic growth had a significant Bartlett score. Sputum samples are non-invasive representative samples of lower airway infective pathologies. Sputum quality assessment by Bartlett scoring serves as a proxy marker to rule out respiratory colonization and aid culture-based diagnosis.

Antibiotic Susceptibility Profiling of Gram-Positive and Gram-Negative Bacterial Isolates in a Tertiary Care Hospital: Establishment of an Antibiogram.

Introduction Antimicrobial resistance poses a significant global healthcare challenge in the management of bacterial infections, which is frequently attributed to rapid bacterial adaptations. This study aims to develop an antibiogram for a tertiary care hospital, providing comprehensive antibiotic sensitivity profiles for Gram-positive and Gram-negative bacteria. It informs healthcare providers of antibiotic resistance trends, enabling informed treatment decisions and enhanced infection control measures. Methods We conducted a six-month prospective observational study, during which we gathered and analyzed data from the microbiology laboratory to identify patterns of antimicrobial sensitivity. Subsequently, the data underwent analysis and interpretation using the respected WHONET software, a readily available tool designed for this specific task. Our methodology adhered to the guidelines established by the Clinical & Laboratory Standards Institute for the standardization of antibiogram generation procedures, and these guidelines are easily integrated into the WHONET software for analytical purposes. Results There were a total of 357 isolates across various hospital departments, comprising 13 distinct bacterial species. Among them, nine were identified as Gram-negative bacteria, accounting for 262 (73.3%) isolates. Escherichia coli accounted for 131 (36.6%) isolates, while Klebsiella accounted for 62 (17.3%), emerging as the predominant species among them. The remaining four bacterial species were identified as Gram-positive bacteria, totaling 95 (26.6%) isolates, with Staphylococcus aureus being the most frequently isolated species at 51 (14.2%), followed by Enterococcus at 26 (7.2%). Subsequent analysis using the WHONET software facilitated the creation of an antibiogram. Among the Gram-negative bacteria, E. coli displayed high sensitivity (100%) to aztreonam and clindamycin, followed by nitrofurantoin (98%), imipenem (94%), and meropenem (95%). However, it exhibited decreased sensitivity to ampicillin (25%), cefuroxime (34%), and ceftriaxone (39%). Conversely, among the Gram-positive bacteria, S. aureus demonstrated 100% sensitivity to ampicillin, amoxiclav, cefazolin, teicoplanin, linezolid, rifampicin, nitrofurantoin, and cefotaxime. However, it exhibited zero sensitivity to vancomycin and only 6% sensitivity to cotrimoxazole. Conclusion This study advances the understanding of antibiotic susceptibility in a tertiary care setting and provides an invaluable tool for optimizing treatment strategies, enhancing infection control measures, and combating antibiotic resistance.

Pseudomonas aeruginosa Isolates from Water Samples of the Gulf of Mexico Show Similar Virulence Properties but Different Antibiotic Susceptibility Profiles than Clinical Isolates.

Pseudomonas aeruginosa is an opportunistic pathogen found in a wide variety of environments, including soil, water, and habitats associated with animals, humans, and plants. From a One Health perspective, which recognizes the interconnectedness of human, animal, and environmental health, it is important to study the virulence characteristics and antibiotic susceptibility of environmental bacteria. In this study, we compared the virulence properties and the antibiotic resistance profiles of seven isolates collected from the Gulf of Mexico with those of seven clinical strains of P. aeruginosa. Our results indicate that the marine and clinical isolates tested exhibit similar virulence properties; they expressed different virulence factors and were able to kill Galleria mellonella larvae, an animal model commonly used to analyze the pathogenicity of many bacteria, including P. aeruginosa. In contrast, the clinical strains showed higher antibiotic resistance than the marine isolates. Consistently, the clinical strains exhibited a higher prevalence of class 1 integron, an indicator of anthropogenic impact, compared with the marine isolates. Thus, our results indicate that the P. aeruginosa marine strains analyzed in this study, isolated from the Gulf of Mexico, have similar virulence properties, but lower antibiotic resistance, than those from hospitals.

DIARRHEA CAUSING ENTEROBACTERIACEAE AND THEIR ANTIBIOTIC RESISTANCE PATTERNS AMONG DIARRHEA PATIENTS FROM SANA’A CITY, YEMEN

Background and aims: The rise of antibiotic-resistant strains of the bacteria causing diarrhea remains a major worldwide health concern, especially in children under five. The purpose of this surveillance study was to ascertain the prevalence and antibiotic susceptibility profile of Enterobacteriaceae, which cause diarrhea. Materials and Methods: The National Center for Public Health Laboratories (NCPHL) in Sana'a city was the site of this cross-sectional investigation. Patient stool samples exhibiting diarrhea were gathered and cultivated using standard differential/selective medium. Standard biochemical assays and serological investigations were employed to identify the isolates. With the aid of Kirby-Bauer disk diffusion, the antibiogram was identified. Results: Enterobacteriaceae isolates were obtained from 972 stool samples collected; 15.3% (149/972) were diarrheagenic Enterobacteriaceae bacteria, including E. coli, Salmonella, and Shigella. There were 8.3% (81/972) Salmonella spp., 5.7% (56/972) Shigella spp., and 1.2% (12/972) E. coli. E. coli strains were grouped, with the most prominent being serogroups O153 (3, 2%) and O25 (2, 1.4%). Fifty-six (37.6%) Shigella species were identified as Shigella boydii type 2 and Shigella bodii type 17, which were the most common Shigella isolated (11, 8.1%, and 16, 10.7%, respectively). We detected high resistance of Salmonella isolates to tetracycline (29/81, 35.8%) but relatively low resistance to ciprofloxacin (7/81, 8.6%) and ceftriaxone (5/81, 6.3%). Conclusion: The many Enterobacteriaceae linked to instances of diarrhea in Sana'a, Yemen, were demonstrated in this study, along with the necessity of differential diagnosis for improved treatment results. Salmonella, Shigella, and Escherichia coli have all been linked to episodes of diarrhea in Sana'a city. To stop Yemen's antimicrobial resistance from spreading, regular antimicrobial susceptibility testing, efficient monitoring, and national surveillance of AMR bacteria should be put into place. Peer Review History: Received 3 February 2024; Revised 12 March 2024; Accepted 20 April; Available online 15 May 2024 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, gehankandeel9@yahoo.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. e.djanga@yahoo.com

Occurrence of Pantoea agglomerans bloodstream infection in neonatal intensive care unit at tertiary hospital in Tanzania: antibiotic susceptibility profile and clinical outcome

BackgroundPantoea agglomerans (P. agglomerans) is an environmental gram-negative bacterium that rarely infects humans. P. agglomerans infections have never been reported in Tanzania. We investigated the occurrence of P. agglomerans bloodstream infections among neonates in the Intensive Care Unit (NICU) and their subsequent clinical outcome that occurred in 2019.MethodologyBlood samples were collected from neonates with sepsis. A total of 19 P. agglomerans were isolated from 17 infected neonates; two of the neonates had P. agglomerans isolated twice. A total of 14 patient files were retrieved from medical records.ResultsThe mean age of the infected neonates were 3.75 ± 7.95 days. Isolated P. agglomerans showed high sensitivity to the antibiotics particularly chloramphenicol (94.7%), piperacillin-tazobactam (94.7%) and meropenem (94.7%). The mortality rate was 71.4% with 35.7% of infected neonates dying before Antibiotic Susceptibility Test results for appropriate management. The Infection Prevention and Control (IPC) team shut the NICU for thorough decontamination which helped to stop the P. agglomerans occurrence.ConclusionsP. agglomerans occurrence at the NICU was an uncommon aetiology pathogen for neonatal sepsis associated with high rates of mortality despite high sensitivity to multiple antibiotics. This calls for the strengthening of infection control measures and introduction of surveillance for environmental pathogens capable of causing human infections.

Antimicrobial susceptibility testing reveals reduced susceptibility to azithromycin and other antibiotics in Legionella pneumophila serogroup 1 isolates from Portugal

BackgroudAlthough not fully investigated, studies show that Legionella pneumophila can develop antibiotic resistance. As there is limited data available for Portugal, we determined the antibiotic susceptibility profile of Portuguese L. pneumophila serogroup 1 (LpnSg1) isolates against antibiotics used in the clinical practice in Portugal.MethodsMinimum inhibitory concentrations (MICs) were determined for LpnSg1 clinical (n = 100) and related environmental (n = 7) isolates, collected between 2006–2022 in the context of the National Legionnaire´s Disease Surveillance Programme, against azithromycin, clarithromycin, erythromycin, levofloxacin, ciprofloxacin, moxifloxacin, rifampicin, doxycycline, tigecycline, and amoxicillin/clavulanic acid, using three different assays. Isolates were also PCR-screened for the presence of the lpeAB gene.ResultsTwelve isolates had azithromycin MICs above the EUCAST tentative highest WT MIC, 9 of which were lpeAB negative; for erythromycin and clarithromycin, all isolates tested within the susceptible range. The number of isolates with MICs above the tentative highest WT MIC for the remaining antibiotics was: ciprofloxacin: 7; levofloxacin: 17; moxifloxacin: 8; rifampicin: 11; doxycycline: 82; tigecycline: 4. EUCAST breakpoints are not available for amoxicillin/clavulanic acid. We estimated the ECOFFs and one isolate had a MIC eightfold higher than the E-test ECOFF. Additionally, a clinical isolate generated three colonies growing on the E-test inhibition zone that resulted in MICs fourfold higher than for the parental isolate.ConclusionsWe report, for the first time, elevated MICs against first-line and other antibiotics (including azithromycin, fluoroquinolones and amoxicillin/clavulanic acid commonly used to treat pneumonia patients in Portugal) in Portuguese L. pneumophila strains. Results point towards decreased susceptibility in circulating strains, justifying further investigation.

Diabetes related foot infections: Bacterial epidemiology and antibiotic susceptibility profiling

Diabetes related foot infections: Bacterial epidemiology and antibiotic susceptibility profiling

Epidemiological aspects and resistance profile of bacteremia in the region of Marrakech

Introduction: bacteremia in hospitals is a major public health problem that can lead to mortality and morbidity. The aim of our study is to establish the bacteriological profile of bacteremia and the state of antibiotic resistance in order to optimize probabilistic antibiotherapy at the Avicenna military hospital in Marrakech. Materials and methods: This is a descriptive retrospective study spanning a period of 5 years (January 2019 - December 2023), conducted in the laboratory of bacteriology-virology and molecular biology of the Avicenna Military Hospital in Marrakech, on the all bacteria isolated from blood cultures in hospitalized patients. Results: During this period, we collected 839 blood cultures, 140 of which resulted to isolate a bacterium. The predominant causative organism was Staphylococcus aureus (27%), The resistance profile of the strains was as follows: 3.57% for methicillin for Staphylococcus aureus and 50% for staphylococcus coagulase negative. Regarding Enterobacteria; 30.28% were producing ESBL, ciprofloxacin resistance was involved in 41.8% of Enterobacteria while all strains were sensitive to kanamicin. The resistance of Acinetobacter baumanii was 100% to ciprofloxacin, and 91% to ticarcillin, ceftazidime, imipenem and amikacin while remaining 100% sensitive to colistin. Conclusion: surveillance of bacteria’s epidemiological characteristics and their antibiotic susceptibility profile should be continuous for appropriate adaptation of initial empirical treatment of bacteraemia.

Antibiotic Susceptibility Profile of Soil-Borne Microorganisms Isolated from Selected Dump-sites in Ogbomoso, Oyo State

Due to the lack of a leachate collection mechanism at most dump-sites waste is known to be a source of soil pathogens. This study aimed to detect microorganisms in dump-site soils coupled with testing the susceptibility of the detected microorganisms to selected antibiotics Soil samples were collected from five separate dump-sites in Ogbomoso, Oyo State, Nigeria. From the soil samples that were collected, eight species of bacteria and eight species of fungi were isolated. The bacterial and fungal derived from the collected soil samples were tested for antibiotic susceptibility using the conventional disc diffusion method. Results obtained indicate that the microbial loads varied between 1.7 and 4.8 x 105 CFU/g for fungal isolates while it varied from 1.0 to 8.0 x 105 CFU/g for bacterial population. Fungal isolates;Alternaria alternata, Candida albicans, Rhodotorula minuta, Fusariun oxysporum, Aspergillus flavus, Aspergillus tamarii, Fusarium solani and Penicillium digitatum were detected while bacterial isolates; Bacillus subtilis, Bacillus cereus, Staphylococcus epidermis, Clostridium sp., Acetobacter sp., Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa were equally detected from the dump-sites’ soil samples. The bacterial species tested were completely resistant to cefuroxime, but completely susceptible to gentamicin and ofloxacin. At varying doses, the fungal isolates demonstrated resistance to and susceptibility to griseofulvin, itraconazole, and ketoconazole.Based on the results of this study, antibiotics such as gentamicin and oflaxacin should be considered first line of defense against infections caused by both soil-borne Gram-positive and Gramnegative bacteria

Genome analysis of Streptococcus spp. isolates from animals in pre-antibiotic era with respect to antibiotic susceptibility and virulence gene profiles.

Lyophilized Streptococcus spp. isolates(n = 50) from animal samples submitted to the diagnostic laboratory at the University of Connecticut in the 1940s were revivified to investigate the genetic characteristics using whole-genome sequencing (WGS). The Streptococcus spp. isolateswere identified as follows; S. agalactiae (n = 14), S. dysgalactiae subsp. dysgalactiae (n = 10), S. dysgalactiae subsp. equisimils (n = 5), S. uberis (n = 8), S. pyogenes (n = 7), S. equi subsp. zooepidemicus (n = 4), S. oralis (n = 1), and S. pseudoporcinus (n = 1). We identified sequence types (ST) of S. agalactiae, S. dysgalactiae, S. uberis, S. pyogenes, and S. equi subsp. zooepidemicus and reported ten novel sequence types of those species. WGS analysis revealed that none of Streptococcus spp. carried antibiotic resistance genes. However, tetracycline resistance was observed in four out of 15 S. dysgalactiae isolates and in one out of four S. equi subsp. zooepidemicus isolate. This data highlights that antimicrobial resistance is pre-existed in nature before the use of antibiotics. The draft genome sequences of isolates from this study and 426 complete genome sequences of Streptococcus spp. downloaded from BV-BRC and NCBI GenBank database were analyzed for virulence gene profiles and phylogenetic relationships. Different Streptococcus species demonstrated distinct virulence gene profiles, with no time-related variations observed. Phylogenetic analysis revealed high genetic diversity of Streptococcus spp. isolates from the 1940s, and no clear spatio-temporal clustering patterns were observed among Streptococcus spp. analyzed in this study. This study provides an invaluable resource for studying the evolutionary aspects of antibiotic resistance acquisition and virulence in Streptococcus spp.

Antibiotic susceptibility profile of Pseudomonas species isolated from clinical specimens to access, watch and reserve drugs across various hospital settings at a tertiary care hospital of central India

Background and Objectives: Over the last decade, hospital-acquired infections, particularly in the critical care setting, have become more common, with Gram-negative bacterial infections having the highest prevalence. This study aims to determine the prevalence and antibiotic susceptibility pattern of Pseudomonas species to WHO’s, aware class of antibiotics, which are commonly prescribed across various ICU’s, medical and surgical wards of our tertiary care teaching hospital.
 Materials and Methods: This prospective study conducted from January 2021 to June 2022 at a tertiary care centre of cen- tral India identified Pseudomonas species from clinical samples using standard procedures and antimicrobial susceptibility testing performed as per Clinical Laboratory Standards Institute (CLSI) guidelines (M100; 32th Edition).
 Results: A total of 1490 non duplicate Pseudomonas species isolates were grown from 21,019 culture positive clinical sam- ples, of which 1247 were Pseudomonas aeruginosa. Out of these 1247 Pseudomonas aeruginosa 384 were MDR (30.7%). Pseudomonas aeruginosa were most commonly isolated from the pus samples (85%). ICU isolates were significantly more resistant to antibiotics than those from other units. P. aeruginosa strains from ICUs showed the highest rates of resistance to ceftazidime (93.9%). Reserve drug colistin showed good susceptibility (98.2%). All the 18 colistin resistant strains were found to be negative for plasmid mediated mcr-1,2,3 genes.
 Conclusion: The study shall help to generate and disseminate the data so that proper antibiotic policy can be made for judi- cious use of Access, Watch and Reserve antibiotics and antibiotic de-escalation plan can be put forth.

Catheter-related Infections in Pediatric Patients Due to a Rare Pathogen: Herbaspirillum huttiense.

Herbaspirillum species are nonfermenting, aerobic, helical or curved, Gram-negative bacteria belonging to the class Betaproteobacteria, order Burkholderiales. To date, only a few studies have reported on the epidemiology, clinical symptoms, antibiotic susceptibility profiles, treatment and outcomes of Herbaspirillum huttiense -related infections in pediatric patients. The aim of this study was to present 3 years of H.huntiense data, antibiotic susceptibility profiles, systemic antibiotics and antibiotic lock therapy (ALT) options and clinical outcomes. Fourteen episodes of infection in 12 patients were included in this retrospective study. The patients had a male/female ratio of 1:1 and a median age of 160.5 months (range, 3-198 months). Catheter-related bloodstream infection (CRBSI) was detected in 11 patients. Only 1 patient developed catheter-related infective endocarditis. The patient's catheter was removed, and she was successfully treated with systemic antibiotics for 4 weeks. Systemic antibiotics were used in all infections related to H. huttiense . In septic, critically ill patients, the catheter was removed, and systemic antibiotics were started. Port catheters were removed in 5 patients. ALT was performed in clinically stable patients. ALT using amikacin was administered to 6 patients through the port catheter. Two patients had a 2nd attack. After the 2nd ALT treatment, 1 patient cured, and the catheter of the other patient was removed due to persistent microbial growth in cultures. Antimicrobial susceptibility testing of the reported isolates showed susceptibility to meropenem (90%), ceftazidime (87%) and piperacillin/tazobactam (65%), with 92% resistance to colistin. H. huttiense is an emerging pathogen in CRBSI. Piperacillin/tazobactam, ceftazidime and meropenem appear to be good therapeutic options for the treatment of H. huttiense infections. ALT and systemic antibiotics can be used in H. huttiense -CRBSI to sterilize and preserve the central venous catheter.

Characterization of Aminoglycoside-Resistant Acinetobacter baumannii in Respiratory Specimens: Phenotypic and Molecular Insights

Background: The global rise of antibiotic-resistant bacteria presents a formidable challenge to healthcare systems, with Acinetobacter baumannii standing out as a particularly resilient pathogen in hospital settings. The propensity of this organism to exhibit multidrug resistance complicates treatment protocols and underscores the need for in-depth research into its resistance mechanisms. Objective: The objective of this study was to characterize the allelotypic and molecular features of aminoglycoside-resistant Acinetobacter baumannii isolates from respiratory specimens and to determine their antibiotic susceptibility profiles to inform better clinical decision-making and treatment approaches. Methods: This cross-sectional study was conducted at the different labs of various institute of Lahore. A total of 50 respiratory specimens were cultured on selective media. The isolates underwent phenotypic characterization through colony morphology and biochemical tests. Antimicrobial susceptibility was assessed using the disc diffusion method, and molecular analysis was performed using polymerase chain reaction (PCR) to identify the armA gene associated with aminoglycoside resistance. Statistical analysis was executed using SPSS Version 25. Results: Of the 50 isolates, 54% were from male patients and 46% from female patients. Antibiotic resistance was alarmingly high, with resistance rates of 92% for TZP, 90% for FEP, CAZ, IPM, MEM, 86% for AK, 74% for CN, 54% for TOB, and 48% for DO. The presence of the armA gene was detected in 86% of the isolates, suggesting a link to the high levels of aminoglycoside resistance observed. Conclusion: The study revealed a high prevalence of multidrug-resistant Acinetobacter baumannii in respiratory specimens, with significant resistance to commonly used antibiotics. These findings highlight the necessity for continuous surveillance of antibiotic resistance patterns and call for innovative approaches to antimicrobial therapy.

Investigation of the antidiabetic and probiotic properties of lactic acid bacteria isolated from some ethnic fermented foods of Darjeeling District

BackgroundIndigenous communities residing in the Darjeeling Himalayan region and its adjacent hilly areas have a deeply rooted cultural tradition of consuming a diverse range of vegetable and milk-based fermented products, believed to confer various health advantages. With this traditional knowledge, lactic acid bacteria (LAB) were isolated from popular fermented foods such as Chhurpi (derived from Bos grunniens milk), Gundruk (made from Brassica juncea leaves), Sinki (derived from Raphanus sativus taproots), and Kinema (produced from Glycine max beans). This study aimed to investigate the probiotic properties of the prevalent LABs, including aggregation properties, bile salt hydrolase activities, survival under gastro-inhibitory conditions, safety evaluations, and their potential health-promoting attributes, with a specific focus on inhibiting α-amylase and α-glucosidase enzymes.ResultsFive of the LAB isolates demonstrated notable viability rates exceeding 85% when exposed to gastro-inhibitory challenges. Based on 16S rRNA gene sequencing, these isolates were identified as Pediococcus pentosaceus (isolate GAD), Lactobacillus plantarum (isolates KAD and CAD), Lactobacillus brevis (isolate SAD), and Lactiplantibacillus plantarum (isolate CMD). These LAB isolates exhibited versatile carbon source utilization, significant auto- and co-aggregation, and bile salt hydrolase (BSH) properties. Auto-aggregation capacity notably increased over time, ranging from 30 to 150 min, with percentage increments from 4.83 ± 1.92% to 67.60 ± 5.93%. L. brevis SAD displayed the highest co-aggregation increment (%) against Staphylococcus aureus, while L. plantarum KAD demonstrated potent antimicrobial activity. In vitro analyses postulated potential health benefits related to antidiabetic properties, particularly inhibiting α-amylase and α-glucosidase enzymes. L. brevis SAD exhibited the highest α-glucosidase inhibitory activity, while L. plantarum KAD displayed the most potent α-amylase inhibitory activity. Comprehensive safety assessments, including antibiotic susceptibility profiling, hemolytic activity evaluation, and in vivo acute toxicity studies, confirmed the suitability of these LAB isolates for human consumption.ConclusionsThe isolates show promising probiotic characteristics and significant potential in addressing metabolic health. These results carry substantial scientific implications, suggesting the pharmaceutical-based applications of these traditional fermented foods. Further in vivo investigation is recommended to fully elucidate and exploit the health benefits of these LAB isolates, opening avenues for potential therapeutic interventions and the development of functional foods.