Common Bacterial Isolates Research Articles

56 The Impact of Inhalation Injury Grade on Bacterial Isolates from Diagnostic Bronchoscopy with Bronchoalveolar Lavage

Abstract Introduction Inhalation injury is associated with increased incidence of pneumonia. Bacteria are commonly isolated from bronchoalveolar lavage (BAL) within 12-48 hours of injury with unclear clinical significance. We aimed to determine if grade of inhalation injury is associated with different bacterial species isolated from initial BAL, and if higher inhalation injury grade is associated with increased risk of pneumonia. Methods Abbreviated injury scores (AIS) and clinical microbiology isolates from diagnostic bronchoscopy with BAL performed within 48 hours of injury among adults with inhalation injuries from 2009-2022 were extracted from medical records at an ABA-verified burn center. CDC PNU1 criteria was used to identify pneumonia >48 hours after admission. Modified Poisson regression with robust standard errors was used to assess the association of inhalation injury grade and subsequent pneumonia. Results Two hundred forty-six patients with inhalation injury who underwent diagnostic bronchoscopy for airway inspection and surveillance BAL within 48 hours of injury were included in this analysis. Fourteen (5.7%) were grade 0, 106 (43.1%) grade 1, 75 (30.5%) grade 2, 51 (20.7%) grade 3-4. The most common bacterial isolate was Streptococcus spp irrespective of AIS grade. Higher AIS grade was associated with increased incidence of pneumonia (IRR 1.3; 95% CI 1.09-1.61; p = 0.01) after adjustment for age, sex, and total body surface area of burn involvement. Conclusions Bacterial species isolated did not differ by inhalation injury grade. Higher inhalation injury grade was associated with increased risk of pneumonia. Applicability of Research to Practice Providers should be vigilant that patients with higher grade of inhalation injury are at increased risk of pneumonia. Further research is urgently needed to assess the clinical significance of organisms isolated on initial BAL and their role – if any – on the development of pneumonia.

Isolation of Bacteria Causing Secondary Bacterial Infection In TheDry l ,esions Of Cutaneous Leishmaniasis

Abstract Cutaneous loishrnaniasts (CL) is a parasitic disease characterized by single or multiple lesions,. Sc ontlay bacterial infection is one of the complications of the Jiscase that Can increase the titute destruction and the resultant sear. To determine effectively the u3cidence of real tamaindary bacterial infection in the dry type, of cutaneous leishmaniasis ,we designed the current study. This was a crusts-sectional study performed in the outpatient clinic of dermatology and vencriology nt Unit Teaching Hospital. A total of 37 patients with etinica3 diagnosis of Cutaneous leishmaniasis (dry type) were, carolled in this study. Samples were taken from all patients. The skin areas surrounding the lesions were thoroughly cleaned using cotton wool moistened with alcoholic iodine. After appropriate cleaning, the samples were collected aseptically by scraping of sterile swabs of the lesions All the samples were transferred uo Mac Cunkeys agar and blood agar_ After 24 hours incubation (aerobically& en aerobically) at 37 tIC, the species atilt bacteria were determined. Then site samples were transferred to Mueller-Hinton agar or nutrient agar for sensitivity test. After 24 hours incubation at 37 °C, the diameters of the inhibition zones were measured to determined the sensitivity Among the 37 patients with Cutaneous leislununiasis the results of the culture were positive in 12 patients (32.4%). 11 of them (91.6%) have more than one lesion and 9 patients (75%) of them were less than 5 years old. and 3 patients (25%) were more than 5 years old_ Bacteria isolated from the lesions were Staph. aureus in II patients (91.6%)( and all were sensitive to Rifampicin) and E.Coli in one patient (LI%) which was sensitive to Amikacin & Norlioxacini The incidence of secondary bacterial infection with a dry type of Cl., was (32.4%), (91.6%) of them had multiple lesions, and (75%) were less than 5 years old, The most common bacterial isolate was Staphylouocus ttureus

The presence of skin bacteria in the sternal wound and contamination of implantation materials during cardiac surgery

Sternal wound infections (SWIs) and aortic graft infections (AGIs) are serious complications after cardiac surgery. Staphylococcus aureus and coagulase-negative staphylococci are the most common causes of SWIs, whereas AGIs are less studied. AGIs may occur from contamination during surgery or postoperative haematogenous spread. Skin commensals, such as Cutibacterium acnes, are present in the surgical wound; however, their ability to cause infection is debated. To investigate the presence of skin bacteria in the sternal wound and to evaluate their potential to contaminate surgical materials. Fifty patients undergoing coronary artery bypass graft surgery and/or valve replacement surgery at Örebro University Hospital from 2020 to 2021 were included. Cultures were collected from skin and subcutaneous tissue at two timepoints during surgery, and from pieces of vascular graft and felt that were pressed against subcutaneous tissue. The most common bacterial isolates were tested for antibiotic susceptibility with disc diffusion and gradient tests. Cultures from skin had bacterial growth in 48% of patients at surgery start and in 78% after 2h, and cultures from subcutaneous tissue were positive in 72% and 76% of patients, respectively. The most common isolates were C.acnes and S.epidermidis. Cultures from surgical materials were positive in 80-88%. No difference in susceptibility was found for S.epidermidis isolates at surgery start compared with after 2h. The results suggest that skin bacteria are present in the wound and may contaminate surgical graft material during cardiac surgery.

Isolated Bacteria from the Uteri of Camels with Different Reproductive Backgrounds: A Study on Sampling Methodology, Prevalence, and Clinical Significance.

The objectives of this study were to comparatively identify the common bacterial isolates from the uteri of camels coming from different reproductive backgrounds after standardizing the sampling method and to investigate the association of clinically measurable parameters with uterine colonization by these isolates. The uterine samples from 856 dromedary camels yielded a total of 17 different bacterial species with a higher proportion of sub-fertile camel uteri being colonized by bacteria (66.6%) as compared to nulliparous, recently calved, and those with unknown reproductive history combined (44.2%; p < 0.05). Camels with body condition scoring < 3 and those with a consistently echogenic appearance of the uterine lumen by sonography were more likely to be positive on uterine culture, while the presence of pus in uterine discharge was not associated with the odds of bacterial isolation (p > 0.05). While certain strains were more likely to be obtained from the uteri of the sub-fertile group (p < 0.05), embryo transfer to camels with a positive uterine culture in the absence of other gross reproductive pathologies did not necessarily affect the overall pregnancy rate compared to recipients with a negative uterine culture (p > 0.05). In conclusion, a relatively high bacterial load can be identified from the uteri of both sub-fertile and normal dromedary camels, with a higher frequency among the former. The uterine ultrasonography and evaluation of the body condition score can help in identifying the camels in which uterus is contaminated by bacteria.

Genome Sequences of Three Common Bacterial Isolates from Wastewater from the Water Processor Assembly at the International Space Station.

Bacteria from the genera Burkholderia, Ralstonia, and Methylobacterium were consistently detected in water of the life support systems at the International Space Station. Here, we report complete genomes of recent isolates that are representative of these genera to support future studies in biofilm and wastewater treatment in space habitats.

PS-C16-11: PREVALENCE AND HOSPITAL OUTCOME OF BACTERIAL CO-INFECTION IN RESPIRATORY TRACT SPECIMEN AMONG COVID 19 PATIENTS WITH SARS-COV-2 PNEUMONIA

Introduction: COVID-19, a zoonotic disease caused by the novel coronavirus SARS-CoV-2, is a highly transmittable pathogenic viral infection, infecting millions of people globally. Guidelines recommendthe use of empiric antimicrobials based on clinical judgment, patient host factors and local epidemiology in patients suspected or confirmed severe COVID-19. However, current evidence does not support a high rate of bacterial respiratory co-infections in patients with SARS-COV-2 infection. At present, there is no known study regarding the prevalence of bacterial co-infection in COVID-19 patients in the Philippines Methods: This research is a cross-sectional hospital-based study that utilized hospital electronic and printed medical records, chest radiograph and microbiologic results. All respiratory specimen bacteriologic results for the year 2020 and 2021 were collected from the hospital laboratory unit followed by review of the hospital electronic records, printed medical records and chest radiograph results. Data were analyzed using Two-tailed Z-test for significance test for proportions and Chi-square test. Results: Among 100 subjects, only 22% (n = 22) of the subjects were found to have bacterial isolates. the only demographic that is dependent with presence of bacterial infection is gender. The three most common bacterial isolate among COVID confirmed patients are Klebsiella pneumoniae (n = 9), Pseudomonas aeruginosa (n = 5), and Acinetobacter baumannii (n = 3). Although the most common bacterial isolate is Klebsiella pneumoniae, the most common bacterial co-infection in patients who died are Acinetobacter baumannii (n = 2, 29%)and Pseudomonas aeruginosa (n = 2, 29%). Conclusion: The prevalence of bacterial co-infection among COVID confirmed patients is relatively low, hence appropriate guidelines regarding antibiotic use should be formed taking into consideration local data on antimicrobial resistance.

Tracking Annual Antimicrobial Resistance at a Tertiary Care Hospital amidst Raging COVID-19 Pandemic

Background: Timely preparation and presentation of the annual cumulative antibiogram play an important role in the dissemination of an updated susceptibility pattern to clinicians and thus aid in the appropriate choice of antimicrobials for empirical therapy while minimizing adverse effects and resistance. The study aimed to present and analyze the annual AMR data that may be helpful in designing antibiotic policy. Methods: All clinical specimens routinely submitted to the Department of Microbiology from January to December 2021 for bacteriological culture and antimicrobial susceptibility testing (AST) were included. AST was performed for pathogenic isolates by disc diffusion/agar dilution/broth microdilution methods/VITEK® 2 compact system. All data were entered and analyzed using WHONET 2020 software. Results: A total of 46,629 routine specimens were processed, yielding 5792 non-repeat bacterial isolates. Relatively fewer specimens were received during the first few months when the hospital catered exclusively to COVID-19 patients. The most common bacterial isolates were Escherichia coli (30%), Staphylococcus aureus (21%), Klebsiella sp. (18%), Pseudomonas sp. (10%), Acinetobacter sp. (8%) and Enterococcus sp. (5%). Analysis showed low susceptibility to 3rd generation cephalosporins, fluroquinolones, and cotrimoxazole among Gram negative bacteria. Less than 50% Acinetobacter sp. were carbapenem susceptible. We report high rate of methicillin resistance in S. aureus (74%). Overall susceptibility was much lower in specimens from ICU followed by in-patients and out-patients. Conclusion: Antimicrobial resistance is rapidly assuming the proportions of a pandemic, with several authors calling it “invisible” pandemic. As is evident from the present study, low susceptibilities to all but a few last-resort drugs are leaving few choices for treatment. This mandates effective preparation, distribution, and presentation of annual antibiograms, which will help in formulating hospital antibiotic policy.

Viable Clostridium botulinum spores not detected in the household dust of major Canadian cities.

Clostridium botulinum causes infant botulism by colonising the intestines and producing botulinum neurotoxin in situ. Previous reports have linked infant botulism cases to C. botulinum spores in household dust, yet the baseline incidence of C. botulinum spores in residential households is currently unknown. Vacuum cleaner dust from 963 households in 13 major Canadian cities was tested for C. botulinum using a novel real-time PCR assay directed against all known subtypes of the botulinum neurotoxin gene. None of the samples tested positive for C. botulinum. Analysis of a random subset of samples by MALDI Biotyper revealed that the most common anaerobic bacterial isolates were of the genus Clostridium and the most common species recovered overall was Clostridium perfringens. Dust that was spiked with C. botulinum spores of each toxin type successfully produced positive real-time PCR reactions. These control experiments indicate that this is a viable method for the detection of C. botulinum spores in household dust. We make several recommendations for future work that may help discover a common environmental source of C. botulinum spores that could lead to effective preventative measures for this rare but deadly childhood disease.

Parenteral Diarrhea and Pediatric Urinary Tract Infections: A Systematic Review

Background Parenteral diarrhea is non-infectious diarrhea associated with extraintestinal infections such as urinary tract infection (UTI), but evidence supporting this association is limited. We performed a systematic literature review to determine the reported frequency of UTI in pediatric patients who had diarrhea. Methods We searched electronic databases (PubMed, Scopus, Google Scholar, and CINAHL) to identify articles about diarrhea and UTI. We included English-language articles about studies of children (age, ≤5-years) who presented with diarrhea in which the frequency of culture-positive UTI was reported. We excluded studies that examined particular diets or specific pediatric patient populations presenting with diarrhea. Patient and study characteristics were extracted manually. Results The database search identified 32 articles. After excluding 25 articles and adding 3 articles identified during manual review of article references, there were 10 articles in the final review including 8 cohort and 2 case control studies. In all 10 studies combined, UTIs were observed in 172 of 1086 children who presented with diarrhea (15.8%), but the frequency of UTI varied between studies (range, 5 to 32%). Escherichia coli was the most common bacterial isolate from urine in all 9 studies that reported microbiology results. The stool and urine culture results (E. coli) were similar in 4 of the 6 studies that reported stool culture results. Conclusion In infants and children up to age 5-years, diarrhea may be associated with an UTI. In patients who have diarrhea of unknown cause, it may be prudent to consider an evaluation for a coexisting UTI.

Prevalence and Plasmid Profiles of Enterobacteriaceae Isolates Obtained from Individuals with Asymptomatic Bacteriuria in Okada, Edo State, Nigeria

Asymptomatic bacteriuria (ASB) is the presence of bacteria in apparently healthy individuals. Although, the prevalence varies widely with age, gender, and the presence or absence of genitourinary abnormalities, the detection of pathogenic bacteria in urine constitutes firm evidence of infection. The objectives of this study were to isolate members of the family Enterobacteriaceae from urine samples of research participants, and to determine the antibacterial susceptibility and plasmid profiles of the isolates. A total of 122 mid-stream urine samples consisting of 72 male and 50 female participants from selected primary and secondary schools were collected. The age of the participants used in this study ranged between 4 years to 19 years old. Isolates were cultured on MacConkey agar and Cysteine lactose electrolyte deficient agar and then incubated for 24 hr at 37 °C. The overnight culture was then subjected to antibiotic susceptibility testing using the disk diffusion test as described by Kirby-Bauer. Thereafter, plasmid analysis was carried out. The statistical package used to analyze the samples was IBM SPSS v23 to cover the calculations for the chi-square, student t-test, and analysis of variance. The frequency of bacterial isolates with respect to age were obtained, as follows: 4–8 (9.0%), 9–13 (16.4%), 14–18 (2.5%) and >19 (1.6%). The prevalence of the four (23; 63.9%) Enterobacteriaceae isolate groups were: Escherichia coli (36.1%), Citrobacter species (11.1%), Klebsiella species (8.3%) and Enterobacter species (8.3%) while non Enterobacteriaceae (13) was 36.1%. A prevalence of 25.9% of ASB was reported in this study where the percentage occurrence of bacteria isolates showed high prevalence in the male participants, at 17.2% compared to the 12.3% reported for the female participants. The antibiogram showed that all isolates were susceptible to Cefprozil except isolates belonging Klebsiella species that showed resistance to the antibiotic. Citrobacter species and Klebsiella species isolates were susceptible to Ofloxacin while Enterobacter species isolates was only susceptible to Cefixime. The percentage figures from resistant plasmid profile analysis indicated that Cefuroxime, Cefprozil and Ofloxacin showed relatively good susceptibility profile against the nine bacterial isolates that were subjected to the analysis. Resistance After plasmid curing was majorly chromosomally-borne. From this research, the prevalence of ASB was found yo be high in Okada, with the infection being higher in males having Escherichia coli as the commonest bacterial isolate. Hence, there is need for early routine evaluation as well as detection of this silent infection for prompt referral and intervention.

Profile of febrile neutropenia in childhood cancer patients and the clinical utility of procalcitonin and C-reactive protein in identifying severe infections

Objectives: Febrile neutropenia (FN) is a medical emergency requiring prompt diagnosis of underlying infection and early administration of antibiotics. Updates about the spectrum and resistance patterns of pathogens isolated are essential for the successful management of FN. Materials and Methods: The purpose of this study was to describe the clinical profile, outcome, infective pattern and the clinical utility of procalcitonin (PCT) and C-reactive protein (CRP) in febrile neutropenic children, admitted to our center between 2017 and 2019. Children aged <18 years with confirmed malignancy and FN were enrolled in the study. Results: The study population was 54 patients. A total of 90 episodes of FN were noted. Hematologic malignancies accounted for 74% of the cases. Only 15 (16.6%) of the study population had clinical foci of infection. Overall culture positivity was 20 %. Among the children with central venous catheter, 21.8% had culture positivity. The most common bacterial isolates were Gram-negative bacilli, with Acinetobacter being the most common pathogen. The overall mortality rate was 5.5%. Among 18 culture positive cases, CRP was positive in 10 (55.5 %) cases and PCT was positive in 12 (66.6 %) cases. Conclusion: Gram-negative organisms are the major infective agents in developing countries. Central venous catheter remains the foci of infection in these patients. Raised CRP and PCT are predictors of complications during FN.

Recurrent Urinary Tract Infection in Living Donor Renal Transplant Recipients and the Role of Behavioral Education Program in Management: A Single-Center Experience

Urinary tract infections (UTIs) are the most prevalent type of kidney transplant (KT) recipients. We aimed to investigate the incidence, causes, and clinical impact of early recurrent UTI post-living donor KT and to examine the role of behavioral education program in management. This retrospective cohort chart-review study included all KT recipients with recurrent UTI necessitating hospital admission between September 2017 and August 2021. All patients with recurrent UTI were subjected to behavioral education for a month. UTI was found in 14 of 145 patients (9.6%), with recurrent UTI in 11 (7.6%). A total of 93% of UTIs occurred during the first 6 months post-transplant and represented 52% of KT readmissions during the same period. A total of 64.3% of patients were older than 50 years. The mean (SD) length of hospital stay was 5 (2.5) days, with an equal incidence in both sexes. The most common bacterial isolates in early recurrent UTI were Escherichia coli in 80.9%. Both Extended-spectrum beta-lactamases and multidrug-resistant organisms (resistance in ≥3 drugs) were seen in 82.4% of isolates. Furthermore, the most effective antibiotic was meropenem, with 86.7% effectiveness. A total of 65% of UTIs were managed with a single antibacterial course. A total of 64.3% of patients were older than 50 years. In patients who developed UTI, the mean (SD) serum creatinine was 1.31 (0.52) mg/dL, with a mean increase in serum creatinine of 0.19 mg/dL on having the episodes; at 1 year post-transplant, serum creatinine declined to 1.23 (0.43) mg/dL. Four patients (36%) had no recurrence of UTI after behavioral education. The multidrug-resistant bacterial isolates account for 82.4% of the UTIs. Therefore, antibiotic prescription should follow the antimicrobial stewardship guidelines. Behavioral education significantly reduced the incidence of recurrent UTI.

An Evaluation Study of Hospital Acquired Infections in Thi-Qar province, Iraq

The present study was evaluated for the six months (1st October 2014 to 30th March 2015), the proportion of acquired infection in the Al-Imam Hussain Teaching Hospital at Al-Nasiriya province south of Iraq has studied. The relationship also estimated between employments and their variables such as age, gender, residence, medical department, social status and different distribution infections among staff in the hospital. The result showed discrepancy rate of occurrence and recording the incidence of cases. Common causes of hospital-acquired infections include urinary bladder catheterization, respiratory procedures, surgery and wounds and intravenous procedures. The most common bacterial isolates were Staphylococcus spp., Pseudomonas spp., Escherichia coli and Klebseilla spp. respectively. In conclusion, the acquired infection rate is an indicator of quality and safety of care. The development of a surveillance process to monitor this rate is an essential step to identify local problems and priorities, and evaluate the effectiveness of infection control activity.

165. Biofire pneumonia panel use in severe pneumonia and antibiotic treatment in COVID-19 patients

Abstract Background Hospitalized COVID-19 patients with severe pneumonia are commonly treated for secondary bacterial pneumonia. The Biofire pneumonia panel, a rapid molecular diagnostic tool with 18 bacterial, 8 viral and 7 resistance gene targets, was made available to critical care and infectious disease clinicians in May 2020 at our institution. We sought to describe its utilization and influence on antibiotic use in patients hospitalized with COVID-19 lower respiratory tract infection (LRTI). Methods Eligible patients with COVID-19 LRTI (positive PCR test and abnormal chest imaging) had sputum or bronchoalveolar lavage pneumonia panel (PNP) paired with a respiratory tract culture between May 4 and Dec. 8, 2020, were included. Demographics, comorbidities, clinical data including microbiologic testing, PNP indication(s), and antibiotic use after testing were abstracted through chart review. Descriptive statistics were utilized. Results Characteristics of 133 patients are provided in Table 1. Median age was 61 years, 93 (70%) were male, 93 (70%) were mechanically ventilated, and 68 (51%) died within 30 days on PNP testing. PNP results, including culture results are listed in Table 2. No target was identified in 63 (47%) patients. Staphylococcus aureus was the most common bacterial isolate identified (MSSA in 32 [24%], MRSA in 8 [6%]) with culture growth in 21 specimens. More than 1 target was identified in 29 patients (22%). Empiric antibiotics and subsequent modifications within 24h hours of pneumonia panel are provided in Table 3. Vancomycin and cefepime were most frequently prescribed. Antibiotic modifications were made in 71/133 patients. Cessation of the anti-MRSA agent occurred in 39/72 (54%) of eligible patients and the anti-Pseudomonal agent in 21/78 (27%). Conclusion The PNP is a useful tool to evaluate secondary bacterial pneumonia in critically ill COVID-19 patients and may assist clinicians and antimicrobial stewardship programs in expedited antibiotic discontinuation or de-escalation particularly where rates of secondary bacterial infection are low, such as COVID-19 LRTI. Disclosures Erica J. Stohs, MD, MPH, bioMerieux: Grant/Research Support Paul D. Fey, PhD, BioFire: Advisor/Consultant|BioFire: Grant/Research Support|Merck: Grant/Research Support Trevor C. Van Schooneveld, MD, bioMerieux: Advisor/Consultant|bioMerieux: Grant/Research Support|Insmed: Grant/Research Support|Merck: Grant/Research Support|Thermo-Fischer: Advisor/Consultant.

Etiology, Sensitivity and Resistance Pattern of Urinary Tract Infection Among Children (0 To 16 Years)

Objective: To determine etiology, sensitivity and resistance pattern of urinary tract infection in pediatrics age group 0 to 16 years at tertiary care hospital. Methodology: It was a cross-sectional study conducted inPediatric department of Aga khan university hospital and its affiliated secondary care centers in Karachi and Hyderabad. All urine culture proven children aged 0-16 years were included in the study. Urine culture showed growth of single pathogen and pathogen had more 10,000 colonies. Urine samples were obtained by SPA, clean catch, urinary catheter. Pre-designed proforma was used to note down the etiology and resistance pattern of urinary tract infection. SPSS version 25 was used to analyse data. Results: Of 177 patients, 70.1 % were females and 29.9% were males. Most common organism was E.coli 71.2% (n=126) followed by Klebsiella pneumonia 16.9% (n=30). Proteus Mirabilis 6.8% (n=12), and Pseudomonas aeruginosa 5.1% (n=9). Most common organism E.coli was 78% and 72.7% sensitive to nitrofurantoin and amikacin respectively and 85.1%, 91.4% and 77.3% resistance to ceftriaxone, ciprofloxacin and ampicillin respectively. This study will help in choosing choice of antibiotic on empirical basis for better outcome in resources limited setting like in remote areas and reduced financial burden on community. Conclusion: E.coli was the most common bacterial isolates among children with UTI. Nitrofurantoin and Amikacin showed higher sensitivity against E.coli., while Ciprofloxacin, Ceftriaxone and Ampicillin showed high resistance against E.coli. Keywords: Bacterial resistance, E.coli, urinary tract infection, paediatric population, antimicrobial sensitive

Evaluation of the Simultaneous Effects of Lactobacillus delbrueckii and L. lactis on Biofilms of Isolates from Chronic Ulcer Infections with Multiple-drug Resistance

Background: Bacterial biofilm is a major barrier to chronic wound healing. Therefore, the prevention of biofilm formation has an effective role in accelerating the healing of these wounds. Today, probiotics' anti-biofilm and antibacterial activity have been proven, and bacteriotherapy by probiotics is a new strategy for treating chronic ulcer infections. Objectives: The present study aimed to investigate the synergistic effects of L. delbrueckii and L. lactis on biofilms of bacterial agents isolated from these ulcers in the human plasma biofilm model (hpBIOM). Methods: This study examined 82 specimens of chronic ulcer biofilms and identified bacterial isolates using phenotypic and molecular methods. After preparing the hpBIOM, 50 µL of each probiotic (109 CFU/mL) was added in two doses separately and simultaneously. After 24 hours, 1 mL of bromelain (0.1 g/mL) was added to the complex and incubated at 37°C for two hours. Then, the surviving bacterial cells were counted by serial dilutions. Results: Among 119 bacterial isolates, Staphylococcus aureus (19%), Escherichia coli (17.0%), and Pseudomonas aeruginosa (14%) were the most common bacterial isolates. Lactobacillus delbrueckii showed anti-biofilm activity against multiple-drug resistance pathogens, Staphylococcus, P. aeruginosa, and Klebsiella pneumoniae. Although L. lactis had anti-biofilm activity against these three pathogens, its effect was less than that of L. delbrueckii. The two probiotics did not have any synergistic effect on the biofilms of the isolates. Conclusions: The results of the present study emphasized the potential of probiotics in destroying biofilms of isolates with multiple-drug resistance; however, their simultaneous use for this purpose requires further investigation.

Acute-onset postoperative endophthalmitis after cataract surgery performed by resident and attending physicians at a university teaching hospital.

To evaluate acute-onset postoperative endophthalmitis following cataract surgery and to compare rates between resident and attending physician-performed cohorts. Bascom Palmer Eye Institute, Miami, Florida. Retrospective chart review. Records of patients diagnosed with endophthalmitis within 6 weeks of surgery performed by attending and resident physicians between January 1, 2015, and December 31, 2020, were reviewed. Total cataract volume was obtained from institutional records, and resident case totals were obtained from case logs. Endophthalmitis cases were obtained from billing records and confirmed with chart review. There were 22 cases of endophthalmitis among 32 505 cases (0.068%). Endophthalmitis occurred in 6 of 6447 (0.093%) resident cases and 16 of 26 058 (0.061%) attending cases ( P = .55). The most common bacterial isolates were coagulase-negative Staphylococcus (8/22, 36.3%) and Streptococcus species (3/22, 13.6%), with negative cultures in 10 (10/22, 45.5%). Initial treatment with vitreous tap and injection of intravitreal antibiotics was performed in 21 eyes (21/22, 95.4%) and vitrectomy with intravitreal antibiotic injection in one (1/22, 4.5%). Vitrectomy was performed secondarily in 9 patients (9/22, 40.9%). Corrected distance visual acuity (CDVA) at last follow-up was ≥20/40 in 13 eyes (13/22, 59%) and ≤hand motions in 3 eyes (3/22, 13.6%). CDVA (logMAR mean ± SD) was 1.22 ± 1.16 in resident and 0.49 ± 0.79 in attending cases ( P = .11). In the current study, acute-onset postoperative endophthalmitis developed infrequently following cataract surgery. The rates and visual outcomes of endophthalmitis were similar in resident and attending cases.

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China.

To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis (EE) in a group of Chinese patients. The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. The initial visual acuity (VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis. The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.

ANTIBACTERIAL EFFICACY OF PALM WINE AGAINST COMMON BACTERIAL ISOLATES FROM VARIOUS CLINICAL SAMPLES

Palm wine is a traditional alcoholic beverage produced by natural fermentation of the sap of palm trees. This drink is common in various parts of the Asia & Africa and it is known by various common names such as Maharashtra (Tadi, Shindhi). The unfermented sap is called neera (Palghar in Maharashtra) and is refrigerated, stored and distributed by semi-government agencies. This study was conducted to investigate the antibacterial potential of palm wine on as an alternative to antibiotics by studying its antibacterial efcacy again common bacterial isolates from clinical samples.Freshly top-tapped palm wine samples were obtained from a local palm wine tapper in Palghar, Maharashtra state, India. Various strains of Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus was carried out using agar diffusion method. The palm wine used in this assay inhibited the growth of all the selected bacterial isolate used. The inhibition ranged from 2.3 mm- 29.5mm. Palm wine subjected to fermentation at room temperature for 7 days (168 hours). Growth inhibitory effect of undiluted palm wine superior than groups of antibiotics such as Ampicillin, Ampliclox, Chloramphenicol, Tetracycline and Ciprooxacin.This study established that palm wine possess considerable antibacterial activity against selected common bacterial isolates. Since palm wine has shown potent antibacterial activity on the test bacteria, further clinical trials will be required that will prove the potential of palm wine as an alternative to antibiotics treatment among patients suffering from common infection caused by there organism.

An Assessment of Asymptomatic Bacteriuria During Pregnancy and Antimicrobial Resistance to its Common Bacterial Isolates in the Urine

Objective: The objective of this study is to assess asymptomatic bacteriuria during pregnancy and its antimicrobial resistance to the common bacterial isolates in the urine. Study Design and Setting: The cross-sectional study was carried out in the Antenatal Clinic, Obstetrics and Gynaecology Unit of Avicenna Medical and Dental Hospital, Lahore, Pakistan. Methodology: This descriptive, cross-sectional study lasted for nine months and information was collected with the help of a self-designed questionnaire using non-probability random sampling. The frequency distribution of socio-economic and demographic factors of 167 pregnant women was observed while the cultural examination was performed on urine samples of diagnosed cases of asymptomatic bacteriuria through microscopy to find out antimicrobial resistance against bacterial isolates. Results: The prevalence rate of asymptomatic bacteriuria was 13.2%. The most common pathogen was E. coli followed by Klebsiella Pneumoniae and Staphylococci. Resistance of urine pathogens was observed against Ampicillin, Amoxiclav, Norfloxacin, and Piperacillin/Tazobactam. Conclusion: E. coli was identified as the most predominant pathogen that showed higher resistance to Cefotaxime. History of renal stone, trimester, parity, education and low-socio-economic status were the significant factors for ASB