Common Bacterial Agents Research Articles

Candida albicans and Staphylococcus Species: A Threatening Twosome.

Candida albicans and Staphylococcus species are, respectively, the most common fungal and bacterial agents isolated from bloodstream infections, worldwide. Moreover, it has been shown that 20% of all C. albicans bloodstream infections are polymicrobial in nature, with Staphylococcus epidermidis and Staphylococcus aureus being the first and third most common co-isolated organisms, respectively. These species are part of the commensal microbial flora but can cause hospital-acquired infections with an extreme ability to inhabit diverse host niches, especially in immunocompromised patients. They are well known for their ability to form persistent biofilms in the host or on abiotic surfaces such as indwelling medical devices. Interactions within these biofilm communities can lead to increased virulence, drug tolerance, and immune evasion. This can ultimately impact morbidity and infection outcome, often leading to an increased mortality. Therefore, characterizing the interactions between these species could lead to the development of novel therapeutic approaches that target polymicrobial infections. In this mini review, we briefly highlight the current knowledge and most recent insights into the complex interspecies interactions of C. albicans with Staphylococcus bacteria.

Clinical characteristics and molecular epidemiology of children with meningitis in Tehran, Iran: a prospective study.

The molecular epidemiology of meningitis in children is unclear in Iran, and data are scarce. We aimed to characterize its clinical and paraclinical features as well as to determine the distribution of genotype/capsular types of common bacterial meningitis agents in children in Iran. All children suspected to have meningitis aged 4 days to 15 years were enrolled onto a prospective cross-sectional study from January 2015 to September 2017. Diagnostic values of clinical features, cerebrospinal fluid and serum parameters were evaluated independently and in combination with each other by multivariate logistic regression to develop a diagnostic rule. Genotype/capsular types of all the isolates were determined by targeting serotype-specific genes with uniplex or multiplex PCR. Among 119 patients suspected of having meningitis, 43 had bacterial meningitis, 19 aseptic and one tuberculous; and there were 56 nonmeningitis cases (NMC). Presentation of four features at the same time—cerebrospinal fluid white blood cell count, protein, polymorphonuclear leukocytes and serum C-reactive protein—revealed 100% sensitivity and 86.4% specificity for diagnosis of bacterial meningitis. Haemophilus influenzae type b (60%), Streptococcus pneumoniae serotype 3 (28.5%) and Neisseria meningitidis B (63.5%) were the most prevalent serotypes. This study demonstrated that a well-designed combination of clinical and paraclinical features is useful, but these combinations are not good enough to be relied on as stand-alone exclusionary tests for the diagnosis of bacterial meningitis. In addition, public immunization of infants with the most prevalent bacterial meningitis serotypes is recommended.

Surveillance of community-acquired pneumonia in critically ill patients

Background: In this study, we aimed to investigate the epidemiology, causative agents and outcomes of severe community-acquired pneumonia (CAP) in Hong Kong. Also, the risk factors for mortality would be identified. Methods: This is a retrospective cohort study of patients with severe CAP admitted to an adult ICU in a tertiary hospital. The study period was from January 2010 to December 2014. The following patient data were extracted from the medical records: (I) demographic data; (II) comorbidities; (III) the APACHE IV scores; (IV) probable causative agents; (V) laboratory results; (VI) use of invasive interventions; (VII) outcomes in term of mortality and length of stay. Multivariate regression analysis was used to assess the impact of independent variables on hospital mortality. Results: Totally 390 patients were admitted to ICU for severe CAP. We were able to obtain the causative pathogens in about 60% of patients. Bacterial infection was identified in 154 patients and 88 patients suffered from viral infection. Twenty-seven of them suffered from co-infection of bacteria and viruses. Streptococcus pneumoniae was the most commonly isolated organism and accounted for almost 40% of the bacterial pneumonia. Gram-negative organisms constituted about 45% of bacterial chest infection. The common agents included Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Approximately 70% of viral infection was caused by influenza A infection, followed by influenza B and parainfluenza. Atypical pneumonia only contributed to a minority of CAP, of about 2%. Legionella pneumophila was the most common organism. The overall ICU and hospital mortality rate was 23.1% and 34.6%, respectively, with mean ICU stay of 11.3 days and mean hospital stay of 28.7 days. The hospital survivors had shorter ICU and hospital length of stay. The mortality rates for CAP caused by bacteria, viruses and atypical organisms were 44.3%, 24.4% and 10.0%, respectively (P Conclusions: CAP is an important cause of admission to our ICU with significant mortality. Etiological organisms could be identified in about 60% of CAP. Streptococcus pneumoniae was the most common bacterial agent and most viral infections were caused by influenza A. Atypical bacteria accounted for only a minority of CAP. Pneumococcal and influenza immunization may be effective to reduce the incidence and severity of CAP.

Relationship between antimicrobial prescribing and antimicrobial resistance among UTI patients at Buraidah Central Hospital, Saudi Arabia

ABSTRACTIntroduction:Most of the decisions regarding diagnosis and treatment are based on laboratory test results. Urinary tract infections (UTIs) are among the most common infections in humans. The changing antimicrobial sensitivity in UTI requires appropriate antibiotics. Antimicrobial resistance is an emerging problem in the Kingdom of Saudi Arabia where the complete reversal of antimicrobial resistance is difficult due to irrational use of antibiotics.Objectives:This study aimed to determine the most common bacterial agents causing UTI in different seasons among patients who were admitted to Buraidah Central Hospital (BCH), Saudi Arabia. The study also evaluated the link between prescribing and resistance toward antimicrobials.Materials and Methods:A 6-month retrospective study was conducted among adult patients who were admitted to the inpatient department at BCH. A total of 379 files were collected from microbiological laboratory for inpatients.Results:Most UTI-causing bacteria prevailed in the same season. Of 15 bacterial strains, 12 were significantly correlated with 20 (of a total of 40) antibiotics that were used. Most bacteria were gram-negative. Gram-negative bacilli including Escherichia coli, Klebsiella spp., and Pseudomonadaceae and gram-positive Enterococcus faecalis were most frequently causing UTIs.Conclusion:Overall prevalence of antibiotic resistance was negative in bacterial isolates. However, the relationship between antimicrobial prescribing and antimicrobial resistance was significantly negative among UTI patients in BCH, Saudi Arabia.

Bovine Immunogenetic Response to S. aureus and E. coli Mastitis: A Review

The difference in the pattern of immune response between Escherichia coli and Staphylococcus aureus leads to different form of mastitis that they cause. A more hyper immune response by E. coli results in clinical mastitis whereas a subdued response of S. aureus changes the outcome to subclinical mastitis. The immune system of the animal recognises various antigens present in these bacteria (such as lipopolysaccharide, peptidoglycan and lipoteichoic acid) which induce or suppress the activity of major immune related genes resulting into the type of outcome the animal shows which either help the animal to recover quickly or may even amplify the response in such a way that causes discomfort or may even lead to death of the animal. This review reflects the importance and role of immune related genes involved in the mechanism of protection of the animal against two of the most common infectious bacterial agents, i.e., E. coli and S. aureus responsible for inducing inflammatory response in the mammary gland.

345. Diagnosis of Acute Bacterial Meningitis by Polymerase Chain Reaction Vis-a-vis Conventional Culture Method

BackgroundBacterial Meningitis is one of the leading causes of mortality and morbidity worldwide requiring immediate diagnosis followed by medical intervention to prevent sequeale. Molecular methods can help to detect the pathogens offering a prompt and accurate diagnosis.MethodsOne hundred CSF and blood samples were collected from suspected/clinically diagnosed cases of meningitis over a period of 1year. CSF samples were processed by conventional and molecular methods. The objectives of the study were to identify the common bacterial etiological agent, to assess the utility of PCR in diagnosis of acute bacterial meningitis, and to know the antimicrobial susceptibility pattern.ResultsOut of 100 samples, maximum cases presented with frank meningeal signs (45%) followed by clinically suspected cases (42%). Microscopic examination, CSF culture, PCR detected 7%, 24%, and 40% positive cases, respectively. Thirteen percent were detected positive by blood culture. The positivity on CSF culture was comparable to the study done by Mani et al. (40.5%). The predominant pathogens isolated were K. pneumoniae (37.5%) followed by Streptococcus pneumoniae and Acinetobacter spp. (each 16.67%). PCR positive followed by Gene sequencing revealed Pseudomonas aeruginosa (34.78%) as the predominant pathogen. Culture is considered as the gold standard. However, it fails to identify fastidious organisms and often gives false-negative results. Therefore, the gold standard was modified to consider parameters like-clinical signs of meningitis, CSF biochemistry indicative of meningitis and CSF positive on any one microbiological test (CSF staining/CSF culture/blood culture). The performance of PCR was then improved to sensitivity (67.74%); specificity (72.46%); diagnostic accuracy (71%); PPV 52.50% and NPV 83.34%. The kappa coefficient −0.372 showed a fair agreement, considering the modified gold standard. This criterian was also used in study done by Welinder-Olsson et al.ConclusionGram-negative enteric bacteria were the most common etiology reported by both the methods. PCR could detect more cases than conventional culture method indicating its utility in the diagnosis of acute meningitis. Apart from microbiological parameters, clinical and other laboratory parameters should be considered to achieve a precise diagnosis.Disclosures All authors: No reported disclosures.

Antibacterial and Antioxidant Activities of Ocimum basilicum L. Against Mastitis Pathogens

The most common bacterial agents cause inflammation in the mammary gland (mastitis), which disease cause to less yields in cows. These bacteria are Staphylococcus aureus and Coagulase-negative Staphylococci (CNS). Therefore, these bacteria were selected in this study. The purpose of this study is to research the antibacterial and antioxidant potential of the various extracts of Ocimum basilicum L. The mastitis agents used in the study are 7 bacteria in total; 2 of them are Staphylococcus aureus and the other 5 bacteria are CNS. The antibacterial activities studies were carried out using Kirby-Bauer disc diffusion technique. The other antibacterial activity test performed within the scope of this study was minimum inhibitory concentration (MIC) test. Antioxidant activities were determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging method. This study showed that the largest inhibition zone was obtained from the methanol extract of O. basilicum. Result of this study is 9 mm. The lowest MIC value was recorded as 3250 μg/mL. It was found that O. basilicum used in the study had antibacterial activity against mastitis pathogens, and high antioxidant activity could be obtained from the water extracts (72%). Consequently, O. basilicum is a good candidate in developing new antibacterial and antioxidant agents.

Horizontal gene transfer plays a major role in the pathological convergence of Xanthomonas lineages on common bean

BackgroundHost specialization is a hallmark of numerous plant pathogens including bacteria, fungi, oomycetes and viruses. Yet, the molecular and evolutionary bases of host specificity are poorly understood. In some cases, pathological convergence is observed for individuals belonging to distant phylogenetic clades. This is the case for Xanthomonas strains responsible for common bacterial blight of bean, spread across four genetic lineages. All the strains from these four lineages converged for pathogenicity on common bean, implying possible gene convergences and/or sharing of a common arsenal of genes conferring the ability to infect common bean.ResultsTo search for genes involved in common bean specificity, we used a combination of whole-genome analyses without a priori, including a genome scan based on k-mer search. Analysis of 72 genomes from a collection of Xanthomonas pathovars unveiled 115 genes bearing DNA sequences specific to strains responsible for common bacterial blight, including 20 genes located on a plasmid. Of these 115 genes, 88 were involved in successive events of horizontal gene transfers among the four genetic lineages, and 44 contained nonsynonymous polymorphisms unique to the causal agents of common bacterial blight.ConclusionsOur study revealed that host specificity of common bacterial blight agents is associated with a combination of horizontal transfers of genes, and highlights the role of plasmids in these horizontal transfers.

Staphylococcus aureus is the most common bacterial agent of the skin flora of patients with seborrheic dermatitis.

BackgroundSeborrheic dermatitis is an inflammatory skin disease that affects 1–3% of the general population. The Malassezia species has been implicated as the main causative agent; however, the bacterial flora of the skin may also play role in the etiopathogenesis. Therefore, we investigated the most common bacterial agent of the skin flora of patients with seborrheic dermatitis.Materials and MethodsFifty-one patients with seborrheic dermatitis and 50 healthy individuals are included in this study. Sterile cotton swabs were rubbed on the scalp of the participants for bacterial culture. Colonial morphology was identified with gram stain and catalase test.ResultsStaphylococcus aureus was isolated from 25 (49%) patients with seborrheic dermatitis and 10 (20%) healthy individuals within the control group. Coagulase-negative staphylococci were isolated from 24 (47.1%) patients with seborrheic dermatitis and 17 (34%) healthy individuals within the control group. Diphtheroids were present in 2 (3.9%) patients and 1 (2%) subject within the control group. Gram-negative bacilli were present only in 1 (2%) patient. Hemolytic streptococci and bacilli were identified in 1 (2%) subject from each group. Colonization of coagulase-negative staphylococci, diphtheroids, gram-negative bacilli, hemolytic streptococci, and bacillus did not differ between patients and healthy controls. However, S. aureus colonization was significantly more common in patients with seborrheic dermatitis than in healthy controls.ConclusionWithin this study we revealed that S. aureus colonization was significantly higher among the patients. Therefore, we propose that, in addition to the Malassezia species, S. aureus may play a role in the etiopathogenesis of seborrheic dermatitis.

Activation of neutrophils by Chlamydia trachomatis-infected epithelial cells is modulated by the chlamydial plasmid

The obligate intracellular bacterium Chlamydia trachomatis is the most common bacterial agent of sexually transmitted disease world-wide. Chlamydia trachomatis primarily infects epithelial cells of the genital tract but the infection may be associated with ascending infection. Infection-associated inflammation can cause tissue damage resulting in female infertility and ectopic pregnancy. The precise mechanism of inflammatory tissue damage is unclear but earlier studies implicate the chlamydial cryptic plasmid as well as responding neutrophils. We here rebuilt the interaction of Chlamydia trachomatis-infected epithelial cells and neutrophils in-vitro. During infection of human (HeLa) or mouse (oviduct) epithelial cells with Chlamydia trachomatis, a soluble factor was produced that attracted neutrophils and prolonged neutrophil survival, independently of Toll-like receptor signaling but dependent on the chlamydial plasmid. A number of cytokines, but most strongly GM-CSF, were secreted at higher amounts from cells infected with plasmid-bearing, compared to plasmid-deficient, bacteria. Blocking GM-CSF removed the secreted pro-survival activity towards neutrophils. A second, neutrophil TNF-stimulatory activity was detected in supernatants, requiring MyD88 or TRIF independently of the plasmid. The results identify two pro-inflammatory activities generated during chlamydial infection of epithelial cells and suggest that the epithelial cell, partly through the chlamydial plasmid, can initiate a myeloid immune response and inflammation.

Origin, evolution, and distribution of the molecular machinery for biosynthesis of sialylated lipooligosaccharide structures in Campylobacter coli

Campylobacter jejuni and Campylobacter coli are the most common cause of bacterial gastroenteritis worldwide. Additionally, C. jejuni is the most common bacterial etiological agent in the autoimmune Guillain-Barré syndrome (GBS). Ganglioside mimicry by C. jejuni lipooligosaccharide (LOS) is the triggering factor of the disease. LOS-associated genes involved in the synthesis and transfer of sialic acid (glycosyltranferases belonging to family GT-42) are essential in C. jejuni to synthesize ganglioside-like LOS. Despite being isolated from GBS patients, scarce genetic evidence supports C. coli role in the disease. In this study, through data mining and bioinformatics analysis, C. coli is shown to possess a larger GT-42 glycosyltransferase repertoire than C. jejuni. Although GT-42 glycosyltransferases are widely distributed in C. coli population, only a fraction of C. coli strains (1%) are very likely able to express ganglioside mimics. Even though the activity of C. coli specific GT-42 enzymes and their role in shaping the bacterial population are yet to be explored, evidence presented herein suggest that loss of function of some LOS-associated genes occurred during agriculture niche adaptation.

Antibiogram of bacterial agents of lower respiratory tract infections in a central Nigerian hospital

BACKGROUND: Lower respiratory tract infections (LRTIs) are one of the major public health concerns in Nigeria. They are associated with significant morbidity and mortality in children and adults.AIM: To identify bacterial causative agents of lower respiratory tract infections and to determine their antibiotic susceptibility profile to locally available antibiotics.METHODS: This was a retrospective study conducted at National Hospital Abuja (NHA). Laboratory data of processed sputum samples of patients with suspected lower respiratory tract infection at National Hospital Abuja were extracted, reviewed and analyzed from 1st January 2016- 1st December 2016. RESULT: Out of the six hundred and thirteen cases, 89 (14.5%) had an established bacterial cause. The prevalence of LRTIs was higher in males (56.1%) than females. Age group 21-40 (25.8%) had the highest cases of LRTIs followed by those aged 41- 60 (20.2%). Klebsiellapneumoniae (52.8%) was the most predominant isolates, followed by Pseudomonas aeruginosa (15.7%), Staphylococcus aureus (13.5%), Escherichia coli (7.9%), Enterococcus spp (5.6%) and Proteus spp (4.5%). The predominant bacterial pathogens were generally highly susceptible to fluoroquinolones, aminoglycosides and carbapenems.CONCLUSION: Klebsiellapneumoniae was the most common bacterial causative agent of LRTIs in Abuja. Fluroquinolones, aminoglycosides and carbapenemsare antibiotics of good choice for empiric management of this infection in this locality. Regular monitoring of trends of this aetiologic agent and its antimicrobial susceptibility profile is important in effective management of these infections.KEY WORDS: Antibiogram, Bacterial Isolates, LRTIs, National Hospital Abuja, Nigeria

Comparison of clinical signs and bacterial isolates of postpartum endometritis in holstein dairy cows in Iran

The aim of this study was to determine the uterine bacteria in cows with endometritis and to compare other characteristics in cases of endometritis without bacterial growth, with Trueperella pyogenes (Arcanobacterium pyogenes) or other bacteria. In total, 86 Holstein cows with postpartum endometritis from 13 commercial dairy herds were sampled once between 21-35 days postpartum. We used several diagnostic techniques for endometritis such as external observation, vaginal exam, rectal palpation, ultrasonography, and cervical and uterine cytological examination. Clear mucus with flakes of pus (E1), mucopurulent discharge (E2), and purulent discharge (E3) are three groups of endometritis. A transcervical double-guarded swab was used for bacterial sampling. The samples were cultured aerobic and anaerobically and biochemical tests were used for differentiation. Measurements were compared between groups: A, no growth (n=47); B, positive bacterial growth without T. pyogenes (n=21); and C, positive bacterial growth with T. pyogenes (n=18). There were no differences (P>0.05) in uterine wall thickness, body condition score (BCS) and milk yield between the groups. The uterine horn diameter was largest in groups A (4.30±0.88) in comparison with groups B (4.81±1.17) and C (5.53±2.17) (P<0.05). The percentage of neutrophiles in smears of the uterine discharge (45.7±33.4) in group C was higher (P<0.05) than in groups A (14.5±22.7) and B (23.5±24.0). Eighty-three percent of group C have shown purulent discharge. In conclusion, the facultative anaerobe T. pyogenes may be the most common bacterial agent of postpartum endometritis in Holstein dairy cows in Iran.

Urinary Tract Infections and Antibiotic Sensitivity Patterns Among Women Referred to Azadi Teaching Hospital, Duhok, Iraq

Background: Urinary tract infections (UTIs) are very common worldwide. Such an infection is usually treated with empirical antimicrobial therapy. However, there are trends of increasing rates of antibiotic resistance. The aims of this study were to determine the most common bacterial causative agents and their antibiotic sensitivity pattern in women suffering from UTI in Duhok, Kurdistan, northern Iraq. Methods: Urine samples were collected from 371 subjects afflicted with UTI and inoculated directly on blood and MacConkey agar and then incubated at 37°C for 24 hours. Bacterial colonies were determined by standard culture and biochemical characteristics. All isolates were tested for their antibiotic susceptibility. Results: The vast majority of the isolates were Gram-negative and only 2 (0.5%) of them were Gram-positive. The highest infection by Gram-negative bacteria belonged to Escherichia coli 276/371 (74.4%) and about 74.2% of which were resistant to amoxicillin/clavulanic acid. Additionally, around 65% of the isolated E. coli were resistant to ceftriaxone, ceftazidime, and cefepime. It was found that the Pseudomonas strains were resistant to ceftazidime (42%), ertapenem (75%), and ciprofloxacin (50%). Conclusions: There were increasing rates of antibiotic resistance especially in E. coli. Urgent measures are needed to contain such a resistance pattern and a plan for continuous surveillance is required to monitor antibiotic sensitivity pattern.

Systemic cytokines and chemokines on admission of children hospitalized with community-acquired pneumonia

Community-acquired pneumonia (CAP) is the main cause of death in children under-5 years worldwide and Streptococcus pneumoniae is the most common bacterial agent. However, it is difficult to identify pneumococcal infection among children with CAP. We aimed to assess association between any cytokine/chemokine and pneumococcal infection in childhood CAP. Furthermore, we evaluated the diagnostic value of cytokine/chemokine for pneumococcal infection. This prospective study was conducted at an Emergency Room, in Salvador, Brazil. Children <5-years-old hospitalized with CAP in a 21-month period were evaluated. On admission, clinical and radiological data were collected along with biological samples to investigate 20 etiological agents and determine serum cytokines (interleukin (IL)-8, IL-6, IL-10, IL-1β, IL-12, TNF-α, IL-2, IL-4, IL-5, γ-interferon), and chemokines (CCL2, CCL5, CXCL9, CXCL10) concentration. From 166 patients with etiology detected, pneumococcal infection was detected in 38 (22.9%) cases among which the median IL-6(pg/ml) was 31.2 (IQR: 12.4–54.1). The other 128 cases had other causative agents detected (Haemophilus influenzae, Moraxella catarrhalis, atypical bacteria and viruses) with the median IL-6 concentration being 9.0 (IQR: 4.1–22.0; p < 0.001). The area under the ROC curve for IL-6 to predict pneumococcal CAP was 0.74 (95%CI: 0.65–0.83; p < 0.001). By multivariate analysis, with pneumococcal CAP as dependent variable, IL-6 was an independent predictor for pneumococcal infection (OR = 5.56; 95%CI: 2.42–12.75, cut-off point = 12.5 pg/ml; p = 0.0001). The negative predictive value of IL-6 under 12.5 pg/ml for pneumococcal infection was 90% (95%CI: 82–95%). Independently significant difference was not found for any other cytokines/chemokines. Serum IL-6 concentration on admission is independently associated with pneumococcal infection among children under-5 years hospitalized with CAP.

Multidrug and Mupirocin Resistance in Environmental Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Homes of People Diagnosed with Community-Onset MRSA Infection.

Patients with community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) infections contribute to MRSA contamination of the home environment and may be reexposed to MRSA strains from this reservoir. This study evaluates One Health risk factors, which focus on the relationship between humans, animals, and the environment, for the increased prevalence of multiple antimicrobial-resistant MRSA isolates in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at the baseline and 3 months later, following randomization of patients and household members to mupirocin-based decolonization therapy or an education control group. Up to two environmental MRSA isolates collected at each visit were tested. MRSA isolates were identified in 68% (65/95) of homes at the baseline (n = 104 isolates) and 51% (33/65) of homes 3 months later (n = 56 isolates). The rates of multidrug resistance (MDR) were 61% among isolates collected at the baseline and 55% among isolates collected at the visit 3 months later. At the baseline, 100% (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use by humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated with an increased risk for the isolation of MDR MRSA. Incident low-level mupirocin-resistant MRSA strains were isolated at 3 months from 2 (5%) of 39 homes that were randomized to mupirocin treatment but none of the control homes. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs, except for clindamycin, is associated with MDR MRSA in the home environmental reservoir. (This study has been registered at ClinicalTrials.gov under registration no. NCT00966446.)IMPORTANCE MRSA is a common bacterial agent implicated in skin and soft tissue infections (SSTIs) in both community and health care settings. Patients with CO-MRSA infections contribute to environmental MRSA contamination in these settings and may be reexposed to MRSA strains from these reservoirs. People interact with natural and built environments; therefore, understanding the relationships between humans and animals as well as the characteristics of environmental reservoirs is important to advance strategies to combat antimicrobial resistance. Household interactions may influence the frequency and duration of exposure, which in turn may impact the duration of MRSA colonization or the probability for recurrent colonization and infection. Therefore, MRSA contamination of the home environment may contribute to human and animal recolonization and decolonization treatment failure. The aim of this study was to evaluate One Health risk factors that may be amenable to intervention and may influence the recovery of MDR and mupirocin resistance in CO-MRSA isolates.

Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011\u20132016)

BackgroundBacterial pathogens are a major cause of childhood community acquired lower respiratory tract infections (CA-LRTIs), and few data described the impact of antimicrobial resistance on children with CA-LRTIs. This study aims to investigate the antimicrobial resistance in common bacterial agents among hospitalized children with CA-LRTIs between 2011 and 2016 in Dongguan, China.MethodsSputum samples were collected from hospitalized children (0–5 years old) with CA-LRTIs in Dongguan Children’s Hospital. Bacterial pathogens were detected using traditional culture methods, and disc diffusion tests were used to determine antibiotic resistance.ResultsAmong the 2360 samples analyzed, 342 (14.5%) were positive for bacterial infection. The most prevalent pathogen was MSSA (2.3%), followed by MRSA (1.5%), E. coli (1.7%), E. coli ESBLs (1.2%), K. pneumonia ESBLs (1.5%), K. pneumonia (1.4%) and S. pneumonia (1.3%). Of the hospitalized patients with bacteria causing of CA-LRTIs, 90.1% were less than 1-year-old. MSSA and MRSA were more commonly isolated in infants less than 3 months. E. coli, K. pneumonia and K. pneumonia ESBLs were more common bacteria causing CA-LRTIs in infants less than 1 month. Resistance levels to penicillins, fluoroquinolones, macrolides, cephalosporins, carbapenems and vancomycin varied in different bacteria.ConclusionsS. aureus, E coli and K. pneumonia were the common bacterial isolates recovered from chidren with CA-LTRIs during 2011–2015. Age group of under 1 year old was at a high risk of bacterial infections. Many isolates showed antibiotic resistance level was associated with antibiotic usage in clinic. Increasing surveillance of antibiotic resistance is urgently needed and develops better strategies to cure the antibiotic abuse in China.

The microorganism and underlying urological anomalies causing the urinary tract infection in the children attended the pediatric surgery clinic at the maternity and children teaching hospital al-qadisiya\ iraq

Urinary tract infections (UTI) are among the most common infections in children. UTI related morbidity remains high despite the use of numerous effective antibacterial agents . The sample of this study was conducted in the pediatric surgery unit at the Maternity and Children Teaching Hospital , Al-Diwaniya ( Iraq) and from the 1st of August 2005 to the end of July 2008. All the patients presenting with UTI to the outpatient clinic or to the surgical ward were investigated prospectively . The aim of this study was to determine how many patients had underlying urological abnormalities, the specific type of abnormality, and the microorganism causing the UTI in the patients with or without urological anomalies.There were 78 (70.9%) girls and 32 (29%) boys , 19 (17.2%) were between 0-1 year, 68 (61.8%) were at an age between 1-5 years, and 23 (20.9%) were more than 5 years of age. Forty seven (42.7%) of these patients had abnormal urological findings. Of 78 girls, 31 (39.7%) had urological abnormalities. Sixteen children had VUR as an only abnormality. The distribution of abnormalities showed some changes by age and sex. Bacteriuria (&gt;105 bacteria per milliliter of urine) was found in 44 (40%) of patients. The most common bacterial agent of urinary infections was E. coli (61.3%) of total isolates in both sexes , it was the most common pathogen among all patients (those with urological abnormalities and those without). There was no difference in the distribution of microorganisms in patients with and without urological anomalies. The diagnosis of UTI in young children is important as it is a marker for urinary tract abnormalities. A child with a suspected UTI should have a urine culture and colony count performed in order to identify organisms for confirmation of diagnosis and recommend prompt treatment to reduce UTI related morbidity and mortality in children.

Imaging of Meningitis and Meningoencephalitis in Children

AbstractAlthough central nervous system infections in children are rare, when suspected, urgent diagnosis and treatment are mandated to prevent morbidity and mortality. Inflammation of the meninges alone is termed meningitis; associated involvement of the underlying brain leads to meningoencephalitis. CSF analysis remains the gold standard in identifying the infectious agent. Imaging plays a vital role not only in supporting the diagnosis of meningitis or meningoencephalitis but also in identifying potential complications, monitoring treatment response, and follow-up. The pattern of meningeal and brain involvement can vary depending on the infectious agent; cerebral convexity meninges is commonly involved in acute bacterial infection, basilar meninges in tuberculosis, and meningoencephalitis in viral infection. In this article, we review the characteristic imaging appearances of common bacterial, mycobacterial and viral agents, role of newer imaging technique, and list potential complications.

Epidemiology, clinical features, and microbiology of patients with diarrhea in community clinics in Taiwan.

To investigate the clinical features and microbiology of patients with diarrheal diseases in Taiwan. From March 2014 to October 2014, patients with diarrheal diseases referred from the community clinics were enrolled into our prospective study. Demographics and clinical features of the participants were acquired. Stool samples were examined by the Luminex Gastrointestinal Pathogen Panel assay. Data were analyzed by SAS version 9.4. A total of 545 patients were enrolled into this study. Male and adults accounted for 52.3% and 82.6% of patients, respectively. The median age was 36 years. Enteropathogen(s) was identified in 43.3% of patients and 8.5% of them had more than one agent in their stool samples. Viruses, especially norovirus GI/GII, were the predominant agents of gastroenteritis. Moreover, Campylobacter species was the most common bacterial agent. Bloody stool was frequently reported in patients with bacterial diarrhea (P=0.002); contrarily, watery stool was significantly associated with viral diarrhea (P<0.0001). Regional variation and seasonality of microbiological distribution were also observed. In Taiwan, viruses were the predominant pathogens among patients with diarrheal diseases who visited community clinics. The therapeutic strategies for diarrheal patients should be based on the epidemiological and clinical characteristics.