Antimicrobial Drug Resistance Research Articles

Bioaerosols released from multistage biofilter for gaseous benzene removal: Escape behavior and pathogenicity

Biological deodorization systems are widely used to control odors and volatile organic compounds. However, the secondary contamination of bioaerosol emissions is a noteworthy issue in the operation of biofilters for off-gas purification. In this study, a multistage biofilter for benzene treatment was utilized to investigate the bioaerosol emissions under different flow rates and spray intervals. At the outlet of the biofilter, 99–7173 CFU/m3 of bioaerosols were detected, among which pathogens accounted for 8.93–98.73 %. Proteobacteria and Firmicutes dominated bioaerosols at the phylum level. The Mantel test based on the Bray-Curtis distance revealed strong influences of flow rate introduced to the biofilter and biomass colonized on the packing materials (PMs) on bioaerosol emissions. The non-metric multidimensional scaling results suggested a correlation between the bioaerosol community and bacteria on the PMs. Bacillus and Stenotrophomonas were the two main genera stripped from the biofilm on PMs to form the bioaerosols. SourceTracker analysis confirmed that microorganisms from the PMs near outlet contributed an average of 22.3 % to bioaerosols. Pathogenic bacteria carried by bioaerosols included Bacillus, Serratia, Stenotrophomonas, Achromobacter, Enterococcus, and Pseudomonas. Bioaerosols were predicted to cause human diseases, with antimicrobial drug resistance and bacterial infectious disease being the two main pathogenic pathways. Stenotrophomonas sp. LMG 19833, Pseudomonas sp., and Stenotrophomonas sp. were the keystone species in the bioaerosol co-occurrence network. Overall, results of present study promote the insight of bioaerosols, particularly pathogen emissions, and provide a basis for controlling bioaerosol contamination from biofilters.

Targeting FMN, TPP, SAM-I, and glmS Riboswitches with Chimeric Antisense Oligonucleotides for Completely Rational Antibacterial Drug Development.

Antimicrobial drug resistance has emerged as a significant challenge in contemporary medicine due to the proliferation of numerous bacterial strains resistant to all existing antibiotics. Meanwhile, riboswitches have emerged as promising targets for discovering antibacterial drugs. Riboswitches are regulatory elements in certain bacterial mRNAs that can bind to specific molecules and control gene expression via transcriptional termination, prevention of translation, or mRNA destabilization. By targeting riboswitches, we aim to develop innovative strategies to combat antibiotic-resistant bacteria and enhance the efficacy of antibacterial treatments. This convergence of challenges and opportunities underscores the ongoing quest to revolutionize medical approaches against evolving bacterial threats. For the first time, this innovative review describes the rational design and applications of chimeric antisense oligonucleotides as antibacterial agents targeting four riboswitches selected based on genome-wide bioinformatic analyses. The antisense oligonucleotides are coupled with the cell-penetrating oligopeptide pVEC, which penetrates Gram-positive and Gram-negative bacteria and specifically targets glmS, FMN, TPP, and SAM-I riboswitches in Staphylococcus aureus, Listeria monocytogenes, and Escherichia coli. The average antibiotic dosage of antisense oligonucleotides that inhibits 80% of bacterial growth is around 700 nM (4.5 μg/mL). Antisense oligonucleotides do not exhibit toxicity in human cell lines at this concentration. The results demonstrate that these riboswitches are suitable targets for antibacterial drug development using antisense oligonucleotide technology. The approach is fully rational because selecting suitable riboswitch targets and designing ASOs that target them are based on predefined criteria. The approach can be used to develop narrow or broad-spectrum antibiotics against multidrug-resistant bacterial strains for a short time. The approach is easily adaptive to new resistance using targeting NGS technology.

Rapid Mycobacterium abscessus antimicrobial susceptibility testing based on antibiotic treatment response mapping via Raman Microspectroscopy

ObjectivesAntimicrobial susceptibility tests (ASTs) are pivotal tools for detecting and combating infections caused by multidrug-resistant rapidly growing mycobacteria (RGM) but are time-consuming and labor-intensive.DesignWe used a Mycobacterium abscessus-based RGM model to develop a rapid (24-h) AST from the beginning of the strain culture, the Clinical Antimicrobials Susceptibility Test Ramanometry for RGM (CAST-R-RGM). The ASTs obtained for 21 clarithromycin (CLA)-treated and 18 linezolid (LZD)-treated RGM isolates.ResultsCAST-R-RGM employs D2O-probed Raman microspectroscopy to monitor RGM metabolic activity, while also revealing bacterial antimicrobial drug resistance mechanisms. The results of clarithromycin (CLA)-treated and linezolid (LZD)-treated RGM isolates exhibited 90% and 83% categorical agreement, respectively, with conventional AST results of the same isolates. Furthermore, comparisons of time- and concentration-dependent Raman results between CLA- and LZD-treated RGM strains revealed distinct metabolic profiles after 48-h and 72-h drug treatments, despite similar profiles obtained for both drugs after 24-h treatments.ConclusionsUltimately, the rapid, accurate, and low-cost CAST-R-RGM assay offers advantages over conventional culture-based ASTs that warrant its use as a tool for improving patient treatment outcomes and revealing bacterial drug resistance mechanisms.

Enhancing the Functional Properties of Tea Tree Oil: In Vitro Antimicrobial Activity and Microencapsulation Strategy.

In the context of addressing antimicrobial drug resistance in periocular infections, Tea Tree Oil (TTO) has emerged as a promising therapeutic option. This study aimed to assess the efficacy of TTO against bacterial strains isolated from ocular infections, with a particular focus on its ability to inhibit biofilm formation. Additionally, we designed and analyzed microcapsules containing TTO to overcome certain unfavorable physicochemical properties and enhance its inherent biological attributes. The quality of TTO was confirmed through rigorous analysis using GC-MS and UV-Vis techniques. Our agar diffusion assay demonstrated the effectiveness of Tea Tree Oil (TTO) against ocular bacterial strains, including Corynebacterium spp., coagulase-negative Staphylococcus spp., and Staphylococcus aureus, as well as a reference strain of Staphylococcus aureus (ATCC 25923). Notably, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for all tested microorganisms were found to be 0.2% and 0.4%, respectively, with the exception of Corynebacterium spp., which exhibited resistance to TTO. Furthermore, TTO exhibited a substantial reduction in biofilm biomass, ranging from 30% to 70%, as determined by the MTT method. Through the spray-drying technique, we successfully prepared two TTO-containing formulations with high encapsulation yields (80-85%), microencapsulation efficiency (90-95%), and embedding rates (approximately 40%). These formulations yielded microcapsules with diameters of 6-12 μm, as determined by laser scattering particle size distribution analysis, and exhibited regular, spherical morphologies under scanning electron microscopy. Importantly, UV-Vis analysis post-encapsulation confirmed the presence of TTO within the capsules, with preserved antioxidant and antimicrobial activities. In summary, our findings underscore the substantial therapeutic potential of TTO and its microcapsules for treating ocular infections.

The Antibacterial Resistance Leadership Group: Scientific Advancements and Future Directions.

In this overview, we describe important contributions from the Antibacterial Resistance Leadership Group (ARLG) to patient care, clinical trials design, and mentorship while outlining future priorities. The ARLG research agenda is focused on 3 key areas: gram-positive infections, gram-negative infections, and diagnostics. The ARLG has developed an innovative approach to clinical trials design, the desirability of outcome ranking (DOOR), which uses an ordinal measure of global outcome to assess both benefits and harms. DOOR was initially applied to observational studies to determine optimal dosing of vancomycin for methicillin-resistant Staphylcococcus aureus bacteremia and the efficacy of ceftazidime-avibactam versus colistin for the treatment of carbapenem-resistant Enterobacterales infection. DOOR is being successfully applied to the analysis of interventional trials and, in collaboration with the US Food and Drug Administration (FDA), for use in registrational trials. In the area of diagnostics, the ARLG developed Master Protocol for Evaluating Multiple Infection Diagnostics (MASTERMIND), an innovative design that allows simultaneous testing of multiple diagnostic platforms in a single study. This approach will be used to compare molecular assays for the identification of fluoroquinolone-resistant Neisseria gonorrhoeae (MASTER GC) and to compare rapid diagnostic tests for bloodstream infections. The ARLG has initiated a first-in-kind randomized, double-blind, placebo-controlled trial in participants with cystic fibrosis who are chronically colonized with Pseudomonas aeruginosa to assess the pharmacokinetics and antimicrobial activity of bacteriophage therapy. Finally, an engaged and highly trained workforce is critical for continued and future success against antimicrobial drug resistance. Thus, the ARLG has developed a robust mentoring program targeted to each stage of research training to attract and retain investigators in the field of antimicrobial resistance research.

Halogenated Antimicrobial Agents to Combat Drug-Resistant Pathogens.

Antimicrobial resistance presents us with a potential global crisis as it undermines the abilities of conventional antibiotics to combat pathogenic microbes. The history of antimicrobial agents is replete with examples of scaffolds containing halogens. In this review, we discuss the impacts of halogen atoms in various antibiotic types and antimicrobial scaffolds and their modes of action, structure-activity relationships, and the contributions of halogen atoms in antimicrobial activity and drug resistance. Other halogenated molecules, including carbohydrates, peptides, lipids, and polymeric complexes, are also reviewed, and the effects of halogenated scaffolds on pharmacokinetics, pharmacodynamics, and factors affecting antimicrobial and antivirulence activities are presented. Furthermore, the potential of halogenation to circumvent antimicrobial resistance and rejuvenate impotent antibiotics is addressed. This review provides an overview of the significance of halogenation, the abilities of halogens to interact in biomolecular settings and enhance pharmacological properties and their potential therapeutic usages in preventing a post-antibiotic era. Significance Statement Antimicrobial resistance and the increasing impotence of antibiotics are critical threats to global health. The roles and importance of halogens atoms in antimicrobial drug scaffolds have been established, but comparatively little is known of their pharmacological impacts on drug resistance and antivirulence activities. This review is the first to extensively evaluate the roles of halogen atoms in various antibiotic classes and pharmacological scaffolds and to provide an overview of their abilities to overcome antimicrobial resistance.

Isolation and characterization of biosurfactant-producing microbes isolated from the gastrointestinal system of broiler birds fed a commercial diet

Antimicrobial drug resistance (AMR) from improper use of antibiotics in various livestock products is a growing hazard for humans worldwide, with current death rate in excess of 700,000 per annum linked to the problem. Microorganisms are a rich source of structurally distinct bioactive compounds designed to protect the microbes and can offset AMR challenge. A study was conducted at Chinhoyi University of Technology to isolate, identify and characterize biosurfactant secreting microbes from broiler bird’s gastrointestinal tract. Analysis of variance was performed in Genstat software. 16S rRNA technique was used to identify the DNA of isolates, annotated by similarity using BLASTn analysis against the NCBI nucleotide database. Phylogenetic analysis was performed on the BLASTn outcome to have an appreciation of the evolutionary genetic relationships. Small intestine-derived samples had a wider hemolytic activity of 5.6 mm, with a 39% emulsification index. At 98.29% sequence similarity, the bacterium producing biosurfactants was identified as an Escherichia coli strain similar to the 7.1994/NIST 0056 strain. The biosurfactant substance is a derivative of decane with beta lactams, tetracyclines and sulfa drugs properties which were responsible for the observed antibacterial activity. We recommend endogenous biosurfactant production optimization experiments and in-vivo trials to evaluate the potential impacts of a biosurfactant based feed additive in broilers.

Human Disturbance Increases Health Risks to Golden Snub-Nosed Monkeys and the Transfer Risk of Pathogenic Antibiotic-Resistant Bacteria from Golden Snub-Nosed Monkeys to Humans.

From the perspective of interactions in the human-animal-ecosystem, the study and control of pathogenic bacteria that can cause disease in animals and humans is the core content of "One Health". In order to test the effect of human disturbance (HD) on the health risk of pathogenic antibiotic-resistant bacteria (PARBs) to wild animals and transfer risk of the PARBs from wild animals to humans, golden snub-nosed monkeys (Rhinopithecus roxellana) were used as sentinel animals. Metagenomic analysis was used to analyze the characteristics of PARBs in the gut microbiota of golden snub-nosed monkeys. Then, the total contribution of antibiotic resistance genes (ARGs) and virulence factors (VFs) of the PARBs were used to assess the health risk of PARBs to golden snub-nosed monkeys, and the antimicrobial drug resistance and bacterial infectious disease of PARBs were determined to assess the transfer risk of PARBs from golden snub-nosed monkeys to humans. There were 18 and 5 kinds of PARBs in the gut microbiota of golden snub-nosed monkeys under HD (HD group) and wild habitat environments (W group), respectively. The total health risks of PARBs to the W group and the HD group were -28.5 × 10-3 and 125.8 × 10-3, respectively. There were 12 and 16 kinds of KEGG pathways of human diseases in the PARBs of the W group and the HD group, respectively, and the gene numbers of KEGG pathways in the HD group were higher than those in the W group. HD increased the pathogenicity of PARBs to golden snub-nosed monkeys, and the PARBs in golden snub-nosed monkeys exhibited resistance to lincosamide, aminoglycoside, and streptogramin antibiotics. If these PARBs transfer from golden snub-nosed monkeys to humans, then humans may acquire symptoms of pathogens including Tubercle bacillus, Staphylococcus, Streptococcus, Yersinia, Pertussis, and Vibrio cholera.

Analysis of resistance genes of carbapenem-resistant Providencia rettgeri using whole genome sequencing

ObjectiveThis study aimed to investigate the clinical infection characteristics and analyze the resistance gene carrying status of carbapenem-resistant Providencia rettgeri via whole genome sequencing (WGS).MethodsCarbapenem-resistant P. rettgeri were collected from clinical patients between January 2020 and December 2021, and their susceptibility to 19 antimicrobial drugs was determined using the VITEK 2 Compact system and Kirby–Bauer (KB) disk diffusion method. The Illumina platform was used to perform WGS of the P. rettgeri isolates, and the resistance genes carried by the Carbapenem-resistant P. rettgeri strains were detected via ABRicate software. The phylogenetic tree was constructed by thirty-four strains including twenty-eight strains downloaded from NCBI database and the carbapenem-resistant six P. rettgeri strains in this study. Which based on genomic single nucleotide polymorphism (SNP) to understand the affinities of the carbapenem-resistant P. rettgeri strains.ResultsSix carbapenem-resistant P. rettgeri strains were isolated from five different clinical departments using the blood, urine, sputum, and secretion specimens. These infected patients are middle-aged and elderly people with a history of severe trauma, tumors, hypertension, and various other underlying diseases, and invasive procedures. Antimicrobial sensitivity testing showed that all strains presented resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, levofloxacin, and ertapenem, whereas they exhibited full susceptibility to cefepime and amikacin. Most strains demonstrated high resistance to β-lactams, aminoglycosides, and sulfonamides. Thirty-five resistance genes were identified by ABRicate. All carbapenem-resistant P. rettgeri strains carried aminoglycoside, fluoroquinolone, chloramphenicol, rifampicin, sulfonamide, and β-lactam resistance genes, and most importantly, all strains possessed the carbapenem resistance gene blaNDM−1. The six P. rettgeri strains in this study and the 28 carbapenem-resistant P. rettgeri strains from the NCBI database were divided into four evolutionary groups. The WF3643, WF3849, WF3822, and WF3821 strains in this study were in the same evolutionary group (clade A), while the closely related WF3099 and WF3279 strains were in different evolutionary groups (clade B and clade D), respectively. The WF3099 strain was distantly related to the other five strains.ConclusionCarbapenem-resistant P. rettgeri strains were mostly isolated from middle-aged and older patients with a history of surgery or serious underlying diseases, and they were found to cause multisystem infections. All Carbapenem-resistant P. rettgeri strains in this study carried blaNDM−1 and multiple antimicrobial drug resistance genes. Furthermore, the P. rettgeri strains in this study were closely related, suggesting the possibility of nosocomial infections. Therefore, our study highlights the need for research on P. rettgeri to control the spread of these nosocomial infections.

Short notes on molecular mechanisms behind antimicrobial drug resistance

Infectious disease mortality have occurred often, raising public awareness of their hazards and advancing global antibiotic research. On the other hand, higher antibiotic levels in natural ecosystems are a result of increased antibiotic demand and use. Gene mutations causing antibiotic resistance in bacterial populations were brought on by natural selection and adaption. The emergence of antibiotic-resistant bacteria was caused by the spread of antibiotic resistance genes in ecosystems, which resulted in a number of antibiotic-resistant diseases on a global scale. An overview of the history of antibiotic discovery, antibiotic use, and antibiotic resistance mechanisms is given in this review study. Bioinformatics is also used to combat antibiotic resistance. To control bacteria that no longer respond to the therapy, the creation of new medications appears to be the primary requirement today.

Genomic Landscape of Multidrug Resistance and Virulence in Enterococcus faecalis IRMC827A from a Long-Term Patient.

We report on a highly virulent, multidrug-resistant strain of Enterococcus faecalis IRMC827A that was found colonizing a long-term male patient at a tertiary hospital in Khobar, Saudi Arabia. The E. faecalis IRMC827A strain carries several antimicrobial drug resistance genes and harbours mobile genetic elements such as Tn6009, which is an integrative conjugative element that can transfer resistance genes between bacteria and ISS1N via an insertion sequence. Whole-genome-sequencing-based antimicrobial susceptibility testing on strains from faecal samples revealed that the isolate E. faecalis IRMC827A is highly resistant to a variety of antibiotics, including tetracycline, doxycycline, minocycline, dalfopristin, virginiamycin, pristinamycin, chloramphenicol, streptomycin, clindamycin, lincomycin, trimethoprim, nalidixic acid and ciprofloxacin. The isolate IRMC827A carries several virulence factors that are significantly associated with adherence, biofilm formation, sortase-assembled pili, manganese uptake, antiphagocytosis, and spreading factor of multidrug resistance. The isolate also encompasses two mutations (G2576T and G2505A) in the 23S rRNA gene associated with linezolid resistance and three more mutations (gyrA p.S83Y, gyrA p.D759N and parC p.S80I) of the antimicrobial resistance phenotype. The findings through next-generation sequencing on the resistome, mobilome and virulome of the isolate in the study highlight the significance of monitoring multidrug-resistant E. faecalis colonization and infection in hospitalized patients. As multidrug-resistant E. faecalis is a serious pathogen, it is particularly difficult to treat and can cause fatal infections. It is important to have quick and accurate diagnostic tests for multidrug-resistant E. faecalis, to track the spread of multidrug-resistant E. faecalis in healthcare settings, and to improve targeted interventions to stop its spread. Further research is necessary to develop novel antibiotics and treatment strategies for multidrug-resistant E. faecalis infections.

The Antibacterial Effect of Tinospora Cordifolia (Guduchi) and Its Role in Combating Antimicrobial Resistance.

Tinospora cordifolia, often known as "Guduchi," has a variety of medicinal characteristics, including those that are anti-diabetic, ant-iinflammatory, anti-periodic, anti-arthritic, anti-oxidant, anti-allergic, and anti-stress. Drug development projects face significant obstacles because of the rapid rise in antimicrobial drug resistance in the world healthcare system and the introduction of multidrug-resistant (MDR) strains. In order to combat the MDR infections isolated from patients' bodies, the current study was conducted to evaluate and investigate the antibacterial capabilities of Tinospora cordifolia. Using the agar well diffusion method, Tinospora cordifolia extracts (aqueous, chloroform, and ethanol) were tested for their antibacterial effectiveness against 30 MDR pathogens, and the 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay was used to determine the minimal inhibitory concentration. To determine whether there were any medicinally useful and significant bioactive ingredients in the plant extract, phytochemical analysis was performed. In comparison to the aqueous extract which had little effect, the antibacterial activity of ethanol and chloroform extracts exhibited a potential antimicrobial effect against most of the tested bacterial isolates. Phytochemical analysis of Tinospora cordifolia extract showed alkaloids, carbohydrates, phytosterols, saponins, tannins, proteins, flavonoids, and terpenoids. Our findings show that Tinospora cordifolia plays a potential role in combating the antimicrobial resistance of clinical isolates.

Factors Influencing the Emergence of Antimicrobial Drug Resistance in Clinical Dental Practice

OBJECTIVE: To investigate the perception of general dentists regarding the over-prescription of antibiotics leading to Antimicrobial drug resistance in their clinical practice. METHODOLOGY: A cross-sectional study encompassing a personalized Likert scale questionnaire on factors influencing anti-microbial resistance in dental general practices was conducted on 196 practitioners. The questionnaire inquired about different factors which tend to affect the over-prescription of antibiotics and influence anti-microbial resistance. It was piloted on 30 participants before dissemination. RESULTS: Factors showing the highest level of agreement were "lack of patient awareness regarding use of antibiotics" (96.9%), "over-the-counter availability" (95.4%), and self-medication" (95.4%). General dental practitioners were overprescribing in their clinical setup due to improper guidelines (24.4%), for their patient's satisfaction (21.2%), and lack of knowledge (19.2%).33.5% of them stated that patients reporting to them were self-medicating and 27.2% found that their patients had a lack of awareness. CONCLUSIONS: This study concluded that all the factors were responsible for the Antimicrobial Drug Resistance phenomenon in clinical dental practice. However, the majority of the dentists were over-prescribing antibiotics due to improper guidelines, lack of knowledge, and for the patient's satisfaction. KEYWORDS: Antimicrobial Drug Resistance; Awareness; Antibiotics; Dental General Practices; Over-the-Counter Drugs.

Bacterial Profile and their Antimicrobial Susceptibility Pattern in Pediatric Septicemia patients from Tertiary Care Hospital.

Background:
 Blood stream infection is a life-threatening infection, leading to increased morbidity and mortality in pediatric population. Antimicrobial drug resistance is a major therapeutic challenge and may result in treatment failure. Thus, this study aimed to assess the bacterial profile causing septicemia and their antimicrobial resistance pattern among pediatric population.
 Methods: 
 This reterospective study was conducted in pathology department of Hameed Latif Hospital, Lahore, over a period of two years, from 1st January 2021 to 31 December 2022. Blood samples were aseptically collected and were transferred into Bact/Alert blood culture bottle. After the detection of microbial growth by Bact/Alert 3D system, bacterial isolates were identified by standard microbiological procedures. Antimicrobial sensitivity pattern was determined by Modified Kirby-Bauer disc diffusion method on Mueller Hinton agar. Data was entered and analyzed by using Microsoft Excel 2010.
 Results:
 In our study, out of 1306 blood culture samples, 217(16.6%) were positive for bacterial growth. Among positive cases, Gram negative organisms were predominant isolates 181(83.4%), while Gram positive organisms were isolated in 36(16.6%) samples. Most common bacterial isolates were S. typhi (24%), A.baumanii (19%), P.aeruginosa (9%), while S.aureus and MRSA were 8% each. Highly resistant class of drugs for Gram-positive bacteria were found to be Aminopenicillin (69.1%) and Macrolides (68.6%), while Gram-negative organisms showed maximum resistance against Tetracycline (72.9%), Fluoroquinolones (62.1%) and Cephalosporins (61%).
 Conclusion:
 Bacterial isolates clinically suspected cases of septicemia were high. Majority of bacterial isolates showed maximum drug resistance against different classes of antibiotics. To prevent antibiotic resistance, strict regulation of antibiotic utilization and infection control programs should be implemented.

Biofilm producer multi drug resistance alert bugs in ventilator associated pneumonia patients. Threat to antibiotic era and future concern

Background Emerging threat of drug resistance among Bacteria causing ventilator-associated pneumonia (VAP) has resulted in higher hospital costs, longer hospital stays, and increased hospital mortality. Biofilms in the endotracheal tube of ventilated patients act as protective shield from host immunity for bacterial growth and emerge them as multidrug resistant. Aim To know the prevalence of various bacterial isolates causing VAP, ability to form biofilm and their antibiotic susceptibility pattern. Material & Methods This study was conducted in the department of Microbiology in collaboration with the Respiratory Medicine department for a period of one year (November 2018-19). Endotracheal aspirate (ETA) along with 1 cm tube tip from clinically confirmed VAP patients were processed as per the standard microbiological procedure for the detection of bacterial biofilm formation and their antimicrobial resistance pattern. Statistical Analysis: Data was statistically evaluated using SPSS-PC-20 version. ‘P’ value less than 0.05, considered statistically significant. Results 72 patients with CPIS score > 6 were clinically confirmed as VAP. Various Bacteria isolated were Klebsiella pneumoniae in 52 (53%), Escherichia coli 16 (16.3%), Pseudomonas aeruginosa 14 (14.2%), Acinetobacter spp. 8 (8.1%), Proteus mirabilis 6 (6.1%) and Pseudomonas luteola 2 (2%). All bacterial isolates were processed for their ability to form biofilm, 86 (87.7%) were biofilm producers (BFP) while 12 (12.2%) were biofilm non-producers (BFNP). Conclusion Bacterial etiology, prolonged intubation, biofilm formation, and drug resistance have ramification on outcome of VAP. Keywords: Ventilator associated pneumonia (VAP), CPIS score, Biofilm formation, Tissue culture plate method (TCP), Antimicrobial drug resistance (AMR)

Antimicrobial resistance patterns of Acinetobacter baumannii and Klebsiella pneumoniae isolated from dogs presented at a veterinary academic hospital in South Africa.

Acinetobacter baumannii and Klebsiella pneumoniae are opportunistic bacterial pathogens responsible for hospital-acquired infections in veterinary medicine. Infection with these bacteria always requires urgent antimicrobial therapy. However, there is no evidence of studies that have investigated the antimicrobial drug resistance profile of these organisms in a veterinary setting in South Africa. This study investigated the antimicrobial resistance (AMR) patterns of A. baumannii and K. pneumoniae from clinical specimens obtained from dogs presented at a veterinary academic hospital. The findings of this study contribute to an improved understanding of the AMR profile of these bacteria in veterinary medicine. Retrospective data of clinical samples from dogs that were positive for A. baumannii and K. pneumoniae between 2007 and 2013 were used in this study. The antimicrobial susceptibility of the isolates was determined using the disk diffusion method following the Clinical and Laboratory Standards Institute guidelines. The A. baumannii isolates were subjected to a panel of 20 antibiotics, while K. pneumoniae isolates were subjected to a panel of 22 antibiotics. Data were analyzed using descriptive statistics and presented using tables and figures. Twenty (n = 20) A. baumannii isolates were isolated from bronchoalveolar lavage, foreign objects, bone, urine, skin, blood, ear, nasal, and oral cavity. Almost all A. baumannii (95%, 19/20) isolates were resistant to at least one antibiotic, and 60% (12/20) were multidrug-resistant (MDR). Klebsiella pneumoniae (n = 56) was isolated from urine, foreign objects, abscesses, ears, eyes, tracheal aspirations, bronchoalveolar lavages, eyes, abdominal aspirates, anal glands, bones, and intestinal and lung biopsies. All K. pneumoniae (100%, 56/56) isolates were resistant to at least one antibiotic, and 98% (55/56) were MDR. Both A. baumannii and K. pneumoniae were isolated in various clinical tissue samples and exhibited a high prevalence of resistance to multiple antibiotics. In addition, these bacteria exhibited a high prevalence of resistance to β-lactam compared to other classes of antibiotics, which is likely to impact treatment options and patient prognosis.

Antibacterial Effect of Berberrubine on the Salmonella typhimurium Type III Secretion System

The increasing antimicrobial drug resistance of Salmonella typhimurium has been a major public health problem in many countries. The type III secretion system (TTSS) of S typhimurium is an attractive target for the development of new antibiotics against this bacterium. In this study, we determined whether berberrubine derived from Berberis vulgaris could inhibit TTSS expression in S typhimurium . Berberrubine inhibited TTSS expression at a concentration of 60.9 µM. Additionally, TTSS-related mRNA expression of sipA, sipB, sopA, and sopD was downregulated in the presence of berberrubine. Collectively, we anticipate that berberrubine can be a useful tool to prevent the risks of infections caused by pathogenic bacteria.

Surveillance of urine cultures and evaluation gram negative uropathogens;five year data from Erbil

Objective: Urinary tract infections (UTIs) are most common infectious disease and a public health problem that imposes a large economic burden. Determining the distribution and resistance profiles of uropathogens in a region is important for planning empirical treatments, preventing antimicrobial drug resistance and establishing rational antibiotic use policies. The aim of this study is to gather surveillance data of urine cultures and determine the prevalence of uropathogens in urine samples of patients referred to outpatient clinics in Erbil region and to evaluate the antimicrobial susceptibility of the gram negative uropathogens.
 
 Methods: All urine cultures result of patients referred to Erbil hospitals in the last 5 years (2015-2020) are retrospectively examined in this study. Microorganisms are identified by standard bacterial methods and their susceptibilities are assessed by VITEK 2 (bioMérieux, Marcy l’Etoile, France) automated system.
 
 Results: The results of urine culture of 3380 suspected UTI cases are examined and out of 3097 positive cultures observed, a total of 1961 (63.3%) isolates are gram-negative and 1136 (36.7%) are gram-positive pathogens.
 
 Conclusion: The most common urinary pathogen determined in this study is Escherichia coli. The highest resistances of gram-negative urinary pathogens are against the ampicillin, trimethoprim/sulfamethoxazole and ceftriaxone. It is thought that the data obtained from this study will be useful in the planning of empirical treatment of urinary tract infections and in the development of rational antibiotic use policies.

Antimicrobial Drug Resistance Trends of Bacteria Causing Bloodstream Infections in a Diagnostic Centre in Lahore

Bacteraemia due to multidrug-resistant (MDR) bacteria, particularly those producing carbapenemase or extended-spectrum beta-lactamase (ESBL), causes a significant threat to patients and associated morbidity and mortality. The global rise in the incidence of bacteremia necessitates the rapid and accurate identification of pathogens to ensure effective patient health management. Objective: To investigate antimicrobial drug resistance trends among bacteria causing bloodstream infections from a diagnostic centre in Lahore. Methods: This research was conducted at the Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore and Citilab and Research Centre, Lahore, from January 2020 to December 2022. A total of 2919 blood samples were cultured to screen the bacteremia patients. Following standard protocols, four hundred twenty isolates proceeded for gram-staining, biochemical characterization, and antimicrobial susceptibility testing (AST). The AST results of each strain calculated multiple antibiotic resistance (MAR). Results: Of 420 bacterial isolates, Gram-negative and Gram-positive isolates accounted for 48.57% and 51.43%, respectively. The predominant pathogens were Staphylococcus epidermidis (48.10%) and Salmonella typhi (27.14%), with other significant pathogens including Klebsiella spp., Pseudomonas spp., Enterobacter, Acinetobacter spp., Escherichia coli, Staphylococcus aureus, Enterococcus spp., Citrobacter, Morganella morganii, and Proteus mirabilis. AST revealed high resistance to Cephalosporins, Nitrofurantoin, Fosfomycin, and Quinolones. In contrast, Carbapenems demonstrated notable sensitivity. Salmonella typhi and Staphylococcus epidermidis exhibit the highest MAR values. Conclusions: The study highlights the prevalence of multidrug resistance bacteremia-causing pathogens, with a concerning trend towards decreasing antibiotic efficacy.

Knowledge and Beliefs about Antimicrobial drug resistance and its Implications in Future Prescribers

Background & Objective: Antimicrobial drug resistance is the ability of microorganisms to persist or grow in the presence of antimicrobial drugs designed to inhibit or kill them. Since, Bachelor of Medicine and Bachelor of Surgery (MBBS) students will be the future prescribers of antimicrobial drugs, this study aims to observe the existing knowledge and beliefs about antimicrobial drug resistance and its impact on the future use of antimicrobial drugs.
 Material and Methods: This cross-sectional study was conducted at Janaki Medical College, Janakpurdham, Nepal, among 223 students of Bachelor of Medicine and Bachelor of Surgery (MBBS) program. Data was collected through a structured and customized self administered questionnaire as a tool from the respondents of MBBS first year to MBBS final Year. Chi square test was applied to test the association between different academic years of MBBS and their knowledge on antimicrobial drugs, antimicrobial drug resistance, beliefs about antimicrobial drugs, and implications of the knowledge of antimicrobial drugs and antimicrobial drug resistance. p<0.05 was considered statistically significant.
 Results: Out of the total participants (n=223), the majority participants were male (n=150) and the mean age of study participants was 22.93±2.15 years. There was no statistically significant difference (p>0.05) in the knowledge on antimicrobial drugs among the different academic years of MBBS. However, there was statistically significant difference (p<0.05) between different academic years of MBBS, in most of the responses related to the knowledge on antimicrobial drug resistance and beliefs on antimicrobial drugs. Most of the students from all the academic years agreed that, their current knowledge of antimicrobial drugs and antimicrobial drug resistance was inadequate, and that they would like to have more education on antimicrobial drugs and antimicrobial drug resistance, for their future career as a doctor.
 Conclusion: There is a need for more rigorous academic and clinical intervention so that only specific antimicrobial drugs are prescribed with an overall reduction in further development of antimicrobial drug resistance to the existing as well as to the antimicrobial drugs that are still in their clinical trial phases.