Antibiotic Group Research Articles

A retrospective analysis of carbapenem-resistant Acinetobacter baumannii infections in critically ill patients: Experience at a tertiary-care teaching hospital ICU

BackgroundAcinetobacter baumannii is a clinically significant pathogen with a high incidence of multidrug resistance that is associated with life-threatening nosocomial infections. Here, we aimed to provide an insight into the clinical characteristics and outcomes of a unique group of A. baumannii infections in which the isolates were resistant to carbapenems and most other antibiotic groups in a tertiary-care intensive care unit (ICU). MethodsWe performed a retrospective observational study in which records of patients hospitalized in the ICU between June 1, 2021 and June 1, 2023 were reviewed. We checked the clinical, laboratory, and microbiological records of all adult patients who had carbapenem-resistant A. baumannii (CRAB) infections. Prior antibiotic treatments and definitive antibiotic treatments after culture positivity and susceptibility test results were recorded. C-reactive protein (CRP) and procalcitonin levels and leukocyte counts were noted. Length of ICU stay and 30-day mortality were defined as the outcome parameters. ResultsDuring the study period, 57 patients were diagnosed with CRAB infections. The respiratory tract was the leading infection site (80.7%). In non-survivors, bloodstream infections (21.9% vs. 4.0% P=0.05) and colistin-resistant (col-R) CRAB infections (43.8% vs. 24.0%, P=0.12) were more common than in survivors, but these parameters were not statistically significant. The length of ICU stay was not different between survivors and non-survivors. Overall, the rate of col-R among CRAB clinical isolates was 35.1%. The 30-day mortality in all patients with CRAB infection was 56.1%. Mortality in col-R CRAB and colistin-susceptible (col-S) CRAB infections was 70.0% and 48.6%, respectively (P=0.12). Prior carbapenem use was 56.1%. Prior colistin use before col-R and col-S CRAB infections was not significant (35.0% vs. 27.0%, P=0.53). ConclusionsOur study provides real-world data on highly resistant A. baumannii infections and shares the characteristics of infections with such resistant strains. Unfortunately, carbapenem resistance in A. baumannii is a challenge for intensive care specialists who are faced with few treatment options, and colistin resistance further complicates the problem.

Availability of Access, Watch, and Reserve groups of essential antibiotics: a cross-sectional survey.

Lower-middle income countries face drastic challenges in Access to essential medicines. Data regarding Pakistan is scarce with no comprehensive study in this regard. The objectives of the study are to document and compare public and private sector availability of all essential antibiotics as well as to conduct a comparison among the AWaRe groups. The study analyzed 103 essential antibiotics comprising 51 Access, 29 Watch, 6 Reserve, and 17 anti-tuberculosis drugs from 15th August to 10th September 2020 in Lahore, Pakistan. It included on-spot physical availability and availability trend surveys. The survey sites included five public tertiary care hospitals with one as anchor and four randomly selected. Their hospital pharmacies and one randomly selected private retail pharmacy from the vicinity each hospital comprised the ten sampling sites. Percentage availability for each antibiotic was categorized as high (>80%), fairly high (50-80%), low (30-<50%), very low (<30->0%), and not available (0%). The mean percentage on-spot availability was 23.76% ± 5.19 (14-25%) for public facilities and 59.20% ± 4.45 (54-66%) for private sector retail pharmacies. The overall percentage of available essential antibiotics varied significantly (p** < 0.001) in public and private sector sampling sites. Except for the Watch group, all other groups showed the mode of 0% availability. A significant difference (p**** < 0.00001) was seen in percentage availability by Access, Watch, Reserve, and anti-TB-all groups of essential antibiotics. The availability trend survey revealed a list of 18 medicines as 'as never been available', and five medicines were 'not available for 5 years or more than 5 years.' Fourteen medicines as 'never been heard.' Non-availability of essential medicines is a significant public health challenge at public-sector facilities in Pakistan. It was observed that a number of essential antibiotics were not available in both public and private sectors. A number of corrective strategies are required. This includes the engagement of stakeholder and government bodies. This can help to improve supply chain barriers.

The Efficacy of Different Antibiotic Compounds in Regenerative Treatment of Immature Necrotic Teeth.

Objectives: Endodontic treatment of immature teeth poses a significant challenge, especially in achieving a proper seal using traditional obturation methods. Revascularization presents itself as an alternative approach to this problem, and the application of triple antibiotic paste (TAP) has been suggested as a means to achieve disinfection during the procedure. This study aims to compare the antibacterial properties of three different antibiotic combinations to assess their effectiveness on root canal disinfection. Materials and Methods: Eighty samples were employed to assess the impact of three antibiotic combinations on Enterococcus faecalis, Escherichia coli, Streptococcus mutans, and a combination thereof. The antibiotics included metronidazole, ciprofloxacin, and cefaclor (CCM), the commonly used TAP, and a double antibiotic paste (DAP) composed of metronidazole and ciprofloxacin. Dentin shavings collected using Gates-Glidden drills were placed in microtubes containing a 2ml standard bacterial suspension. Microtube contents were diluted and cultured on BHI agar plates, with colony counts calculated based on dentine shavings' weight in CFU/mg. Kruskal-Wallis and Dunn's post-hoc tests were used for statistical analysis and P<0.05 was considered significant. Results: A significant difference in mean CFU was observed among all bacterial groups (P<0.05). Dunn's post-hoc analysis showed a significant difference only between the control group (methylcellulose) and the other antibiotic groups. There was no significant difference between the other antibiotic groups in two-by-two comparisons. Conclusion: There was no significant difference in the antimicrobial properties of DAP, TAP and CCM. Therefore, DAP and CCM may be used during regenerative treatment.

Impact of an oligosaccharide-based polymer on the metabolic profiles and microbial ecology of weanling pigs experimentally infected with a pathogenic E. coli

BackgroundOur previous study has reported that supplementation of oligosaccharide-based polymer enhances gut health and disease resistance of pigs infected with enterotoxigenic E. coli (ETEC) F18 in a manner similar to carbadox. The objective of this study was to investigate the impacts of oligosaccharide-based polymer or antibiotic on the host metabolic profiles and colon microbiota of weaned pigs experimentally infected with ETEC F18.ResultsMultivariate analysis highlighted the differences in the metabolic profiles of serum and colon digesta which were predominantly found between pigs supplemented with oligosaccharide-based polymer and antibiotic. The relative abundance of metabolic markers of immune responses and nutrient metabolisms, such as amino acids and carbohydrates, were significantly differentiated between the oligosaccharide-based polymer and antibiotic groups (q < 0.2 and fold change > 2.0). In addition, pigs in antibiotic had a reduced (P < 0.05) relative abundance of Lachnospiraceae and Lactobacillaceae, whereas had greater (P < 0.05) Clostridiaceae and Streptococcaceae in the colon digesta on d 11 post-inoculation (PI) compared with d 5 PI.ConclusionsThe impact of oligosaccharide-based polymer on the metabolic and microbial profiles of pigs is not fully understood, and further exploration is needed. However, current research suggest that various mechanisms are involved in the enhanced disease resistance and performance in ETEC-challenged pigs by supplementing this polymer.

Derivation of a risk-adjusted model to predict antibiotic prescribing among hospitalists in an academic healthcare network

Abstract Background: Among inpatients, peer-comparison of prescribing metrics is challenging due to variation in patient-mix and prescribing by multiple providers daily. We established risk-adjusted provider-specific antibiotic prescribing metrics to allow peer-comparisons among hospitalists. Methods: Using clinical and billing data from inpatient encounters discharged from the Hospital Medicine Service between January 2020 through June 2021 at four acute care hospitals, we calculated bimonthly (every two months) days of therapy (DOT) for antibiotics attributed to specific providers based on patient billing dates. Ten patient-mix characteristics, including demographics, infectious disease diagnoses, and noninfectious comorbidities were considered as potential predictors of antibiotic prescribing. Using linear mixed models, we identified risk-adjusted models predicting the prescribing of three antibiotic groups: broad spectrum hospital-onset (BSHO), broad-spectrum community-acquired (BSCA), and anti-methicillin-resistant Staphylococcus aureus (Anti-MRSA) antibiotics. Provider-specific observed-to-expected ratios (OERs) were calculated to describe provider-level antibiotic prescribing trends over time. Results: Predictors of antibiotic prescribing varied for the three antibiotic groups across the four hospitals, commonly selected predictors included sepsis, COVID-19, pneumonia, urinary tract infection, malignancy, and age &gt;65 years. OERs varied within each hospital, with medians of approximately 1 and a 75th percentile of approximately 1.25. The median OER demonstrated a downward trend for the Anti-MRSA group at two hospitals but remained relatively stable elsewhere. Instances of heightened antibiotic prescribing (OER &gt;1.25) were identified in approximately 25% of the observed time-points across all four hospitals. Conclusion: Our findings indicate provider-specific benchmarking among inpatient providers is achievable and has potential utility as a valuable tool for inpatient stewardship efforts.

ANALYSIS OF ANTIBIOTIC RESISTANCE GENES OF ESCHERICHIA COLI FROM THE GUT OF THE PIGLETS WITH DIARRHEA

The study is devoted to the analysis of the prevalence of antibiotic resistance genes in cultures of E. coli isolated from the gut of the piglets with diarrhea. With the use of high-throughput sequencing, it was possible to identify 26 antibiotic resistance genes. They belonged to 7 groups of antibiotics: aminoglycosides, beta-lactam antibiotics, quinolones, sulfonamides, tetracyclines, diaminopyrimidine, phenicols. The relative abundance of the QnrD gene was maximal in the studied sample of E. coli isolates (50%). For other sequences of antibiotic resistance genes, the percentage ratio of each separate group of genes did not exceed 10%. The largest number of gene variants was characteristic of the class of genes resistant to beta-lactam antibiotics (AmpC1_Ecoli, OXA-10, OXA-14, OXA-16, Penicillin_Binding_Protein_Ecoli, TEM-143, TEM-166, TEM-215 and TEM-76, TEM- 95).

Assessment of risk for antibiotic residues in milk of dairy livestock: A meta-analysis over the last decade

Nowadays, different types of antibiotics are being widely used in livestock for therapeutic purposes to treat infections. Significant quantities of them are excreted and remain in produced food items, including milk. This indicates improper use of antibiotics which may have serious consequences for human health. This comprehensive review was conducted with the aim to summarize existing knowledge about evaluation of antibiotic residues in milk of different livestock animals. This review involves 35 articles retrieved from PubMed, Google Scholar, ScienceDirect and Web of Science databases published from 2010 to 2023 and compares on the group of antibiotics identified, type of milk selected and various methods that were applied to undertake the research. Results showed that cow milk is the most intensively examined milk type (88.6%), whereas others, namely goat, camel, buffalo and sheep are less investigated on antibiotic residues. Among the techniques, chromatographic is revealed to be the most common due to its significant advantages over other methods. In addition, it was concluded that tetracyclines with the share of 85.6% are the group of antibiotics that is the most frequently studied in research articles.

Prescription pattern of antibiotics in dermatology: A Profile from a tertiary care teaching hospital, Kerala

Background: Antibiotics are commonly used in dermatology for infectious and inflammatory diseases. A study on the pattern of prescriptions will help in establishing fundamental data to enhance the utilization pattern of medications, elevate the standard of treatment, and enable prescribers to identify issues associated with drug usage, including adverse drug reactions, antibiotic resistance, drug interactions, and polypharmacy. Aim and Objective: The aim of the study was to describe the prescription pattern of antibiotics given to inpatients with dermatological disorders. Materials and Methods: This was a record-based descriptive study where the case records of 240 inpatients of the dermatology department of a tertiary care teaching hospital during the period from January 2019 to January 2022 were studied. The demographic profile, pattern of skin diseases reported, and pattern in antibiotic drugs usage were recorded with the help of a predesigned pro forma. Results: The mean age of the study population was 52.04 ± 16.91 years with male to female ratio 2.62:1. The most common skin disease diagnosed was Psoriasis (17.91%). Out of the 518 antibiotics prescribed to the patients in the study, the most preferred route of antibiotic administration was oral (48.84%). The most common oral antibiotic was cloxacillin (37.94%) while the most common parenteral antibiotic prescribed was cefotaxime (83%). Fusidic acid (78%) and mupirocin (16%) were commonly prescribed among the topical antibiotics. Amoxicillin-clavulanic acid combination (76%) was commonly prescribed among the fixed drug combinations. Among the topical antibiotics, 8.78% were prescribed as fixed-dose combination with steroids. Antibiotics (29%) constitute the major class of drugs among prescriptions followed by steroids (14%) and antacids (11%). Most of the prescribed antibiotics belonged to the Access group of antibiotics according to AWaRe classification of antibiotics (63.2%). Conclusion: The most common class of antibiotics prescribed was beta-lactam group of antibiotics. The study will help in formulating guidelines for rational prescription of antibiotics with special reference to dermatological cases and create awareness among physicians for effective therapeutic outcome. This will avoid the burden of antimicrobial resistance and pave pathway for the strengthening of economy.

Localised 0.2% chlorhexidine irrigation delivery system versus oral antibiotics in reducing postoperative complications in the surgical extraction of impacted mandibular third molar (IMTM). - a randomised controlled trial.

The purpose of the study was to compare the efficacy of the use of 0.2% chlorhexidine irrigation and the oral antibiotics for the prevention of postoperative complication like pain, trismus, swelling and infection after the surgical extraction of IMTM. A randomised, double blinded clinical trial was planned with two equal groups. Patients were randomly divided into two groups using computer-generated codes with an allocation ratio of 1:1. Group I (Control): Standard preoperative and postoperative systemic oral antibiotics and Group II (Study): No systemic antibiotics and Chlorhexidine irrigation local delivery. The primary outcomes evaluated were postoperative pain, mouth opening, swelling and infection. The secondary outcome variables were the number of analgesics and antibiotics taken by the patient in the postoperative period, the satisfaction of the patient and adverse events, were followed up regulary for 7 days postoperatively. A total of 84 patients, divided into two equal groups participated in the study. In intergroup comparison of swelling, the difference was non-significant on postoperative day (POD) 1 and 7, except for POD 3, where it showed significantly lower results in the antibiotic group (p = 0.012). However, there was no significant difference in pain found between both groups at any of the postoperative time points, and the study group had a lesser need for rescue analgesics than the control group. A statistically significant difference in incidence of dry socket was observed (p = 0.03) and gastrointestinal adverse symptoms, but it showed insignificant results for wound dehiscence and pus discharge. Also, patient satisfaction was higher in the study group. both antibiotics and localised delivery demonstrated comparable results in terms of swelling, pain and trismus. However, with lesser adverse events, the localised chlorhexidine delivery with curved tips outperformed the antibiotic group.

Dynamics of antimicrobial resistance of uropathogenic isolates of Escherichia coli

Objective. To evaluate the dynamics of antimicrobial resistance of Escherichia coli isolates from the urine of patients hospitalized in medical institutions of Tashkent city from 2018 to 2021. Materials and Methods. The study included 1020 E. coli isolates from the urine of patients with clinical symptoms of urinary tract infections admitted to the reference laboratory of the Antimicrobial Resistance Research Center (ARRC) from three medical institutions in Tashkent city for the period 2018– 2021. Determination of sensitivity to 15 antimicrobial agents was carried out by disc-diffusion method in accordance with the guidelines of the European Committee for the Determination of Sensitivity to Antimicrobial Agents (EUCAST v.8-v.12, depending on the year of isolates isolation and testing). Results. A high level of resistance to aminopenicillins, including inhibitor-protected ones (88.0–91.1%), 3–4 generation cephalosporins (84.5–87.7%) and fluoroquinolones (74.2–81.8%) was detected. Carbapenems showed the highest activity among the tested antimicrobials: resistance to imipenem, meropenem and ertapenem was 0%, 0.8% and 18%, respectively. Notable increase in resistance to ampicillin and ceftazidime was found, but a consistently high level of resistance to piperacillin-tazobactam. A statistically significant increase (p &lt; 0.001) was found between 2018–2021 in resistance to the aminoglycoside antibiotics amikacin and gentamicin from 3.2% and 37.8% to 85.4% and 80.6%, respectively. Conclusions. In our study, for most antibiotic groups, the level of resistance remained relatively stable from 2018 to 2021, except for an explosive increase in the frequency of resistance to aminoglycosides, as well as a further increase in resistance to ampicillin and ceftazidime. The need for monitoring and tracking of antibiotic pathogens when choosing treatment regimens for various infections is obvious.

Do We Need Routine Postoperative Prophylactic Oral Antibiotics in Elective Foot and Ankle Surgery?

Previous studies about antibiotic prophylaxis in foot and ankle surgery have focused on perioperative intravenous administration, with few studies reporting on the efficiency of postoperative oral antibiotics. The purpose of this study is to investigate differences in the rate of postoperative infection and wound complications between patients with and without postoperative oral antibiotics and to identify independent risk factors for these complications following foot and ankle surgeries. A retrospective review of all elective foot and ankle surgeries with at least a 6-month follow-up was performed over a 2-year time span. Patients were divided into 2 groups based on if they received postoperative oral antibiotics. We compared the rates of postoperative infections and wound complications between the 2 groups. The surgical site, the number of Current Procedural Terminology codes, and the number of surgical incisions were also noted. Multivariable logistic regression analysis was performed to identify independent risk factors of postoperative infection and wound complications. A total of 366 patients were included in this study-240 with antibiotics and 126 without antibiotics. There was no significant difference in the rates of postoperative infection and wound complications between the 2 groups. The rate of superficial infection, deep infection, and wound complications was 1.7%, 0.8%, and 5.8% in the antibiotic group vs 3.2%, 0.0%, and 4.0% in patients without antibiotics, respectively. Multivariable logistic regression analysis identified independent risk factors of postoperative infection and wound complications as follows: smoking (OR: 4.7), male (OR: 4.0), history of neoplasm (OR: 6.7), and multiple incisions (OR: 4.1). Our results suggest that routine postoperative prophylactic oral antibiotics are not needed following elective foot and ankle surgeries. However, certain risk factors may increase the risk for postoperative infection and wound complications in foot and ankle surgery. Level III, case-control study.

Prevalence and antimicrobial resistance of Enterobacteriaceae in the north of Kazakhstan.

An increasing number of drugs are used each year in the treatment of small pets (cats and dogs), including medicines (cephalosporins and fluoroquinolones) used in human therapy. The purpose of this study was to isolate and explore the antibiotic resistance of opportunistic Enterobacteriaceae (Escherichia coli, Klebsiella, Proteus, Ci trobacter, Enterobacter) from cats and dogs, and to isolate resistance genes in the microorganisms. In 2021, 808 samples of biological material from small domestic animals were collected in veterinary clinics in Kostanay. From these, 210 microorganisms were isolated and identified. A large majority of the strains sampled belonged to E. coli-149 (70.9%), Enterobacter-11 (5.2%), Klebsiella-28 (13.3%), Proteus-12 (5.7%) and 10 Citrobacter isolates (4.8%). In all isolates identified, antibiotic resistance/sensitivity was determined by disc-diffusion method to ampicillin, cefoxitin, gentamicin, levomycetin, tetracycline, ciprofloxacin, norfloxacin, ofloxacin, cefoperazone, cefpodoxime, streptomycin, kanamycin, doxycycline, gemifloxacin, nalidixic acid, furazolidone, furadonine, amoxicillin, and enrofloxacin. The study has demonstrated that the greatest number of Enterobacteriaceae were sensitive to the action of meropenem, which belongs to the group of beta-lactam antibiotics; resistance was demonstrated against tetracycline, doxycycline, ampicillin, amoxicillin, ofloxacin, and cefpodoxime. The most common genes encoding antimicrobial resistance were as follows: BlaTEM and OXA in 41 and 28 isolates, respectively, encoding resistance to beta-lactams; StrA and StrB in 45 and 48 isolates encoding aminoglycosides; and tetA and tetB in 43 and 28 isolates encoding tetracyclines. Obtained data demonstrate that uncontrolled and frequent use of beta-lactam and tetracycline antibacterials, in cats and dogs, results in the spread of genotypic resistance among micro-organisms of the family Enterobacteriaceae.

Detection of Macrolide and/or Tetracycline Genetic Resistance Determinants by PCR.

Globally, the main molecular trials being developed to study the genetic determinants responsible for conferring resistance to bacterial organisms are amplification-based methods, hybridization-based methods, and sequence-based methods. In the specific case of Streptococcus suis, polymerase chain reaction is the only test tuned up until now for detecting resistant clinical isolates to macrolides and/or tetracyclines, the two main groups of antibiotics being ineffective against this human and animal pathogen.

ОПРЕДЕЛЕНИЕ ЧУВСТВИТЕЛЬНОСТИ МИКРОБИОЛОГИЧЕСКОГО МЕТОДА ОБНАРУЖЕНИЯ АНТИБАКТЕРИАЛЬНЫХ ПРЕПАРАТОВ В РЫБЕ

The article presents experimental data on expanding the spectrum of detectable groups of antibiotics according to GOST R 55481-2013. The sensitivity for the fluoroquinolone group was 100 μg/kg. For the cephalosporin group, sensitivity ranged from 50 to 100 μg/kg, and for the aminoglycoside group, from 50 to 500 μg/kg. The sensitivity of lincosamides, nitrofurans and macrolides is 100 μg /kg. The method is insensitive to the amphenicol group (5000 μg/kg). The advantages of this method are that it is quite inexpensive, accessible and the duration of the analysis is only 6...7 hours.

Targeting the Enterococcal Fibronectin Binding Protein- A of Enterococcus faecalis with Bioactive Compounds from Aegle Marmelos: An In-vitro and In-silico Pilot Study

Introduction: Enterococcus faecalis (E. faecalis) is a significant endodontic pathogen, and its virulence has been shown to be significantly influenced by Enterococcal fibronectin binding protein-A (EfbA). Targeting this virulent protein using alternative strategies would be a novel idea to combat the complications of E. faecalis in dental healthcare settings. Thus, the rationale of this investigation is to identify potent bioactive compounds from Aegle marmelos for their antimicrobial properties against EfbA of E. faecalis. Aim: To assess the frequency of EfbA among clinical isolates of E. faecalis and evaluate the antibacterial activity of essential bioactive compounds from Aegle marmelos. Materials and Methods: An in-vitro and in-silico pilot study was conducted from April 2022 to June 2022 in the Department of Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India to detect the frequency of EfbA in E. faecalis. Patients with typical root caries were included. Microbiological processing of 20 root caries samples was performed to characterise E. faecalis and detect the EfbA gene using Polymerase Chain Reaction (PCR) amplification. Crude methanol extract was obtained from A. marmelos and assessed for its antimicrobial effect against the isolated strains of E. faecalis. Furthermore, several biomolecules from A. marmelos were evaluated for their inhibitory properties through in-silico docking analysis. Results: E. faecalis was identified in 12 (60%) out of 20 root caries samples, and three isolates (25%) were identified as Multidrug-Resistant (MDR) strains based on the antibiogram susceptibility profile, showing resistance to more than three different tested antibiotic groups. EfbA was detected in two of the three MDR strains (66.7%). The crude extract of A. marmelos exhibited promising antibacterial activity. In-silico analysis of the essential oil compounds from A. marmelos revealed that Aegeline had a high interaction with low docking energy and a high number of hydrogen bonds. Conclusion: The current study highlights the potential of aegeline from A. marmelos as an antibacterial agent against resistant strains of E. faecalis. However, additional in-vivo research must be conducted to experimentally validate these findings.

Prophylactic Antibiotic Use Prior to Port Placement and Its Effect on Insertion-Related Infection Rates: A Five-Year Retrospective Review

Abstract Purpose The aim of this study was to compare insertion-related port infection rates between patients who received intraprocedural prophylactic antibiotics versus those who did not. Materials and Methods All patients who underwent port insertion by interventional radiology from 7/1/ 2015 through 7/1/2020 at a single U.S.-based Health System were identified using electronic medical records database. During this period, 2,099 patients underwent port placement at three hospitals within the same health system. One-thousand sixty-three patients who underwent port placement at one hospital received periprocedural antibiotics and 1,036 patients at the two other hospitals did not receive antibiotics. Retrospective data were reviewed on each patient including demographics, reason for port insertion, and evidence of port infection. All relevant data up to 30 days postinsertion were reviewed, including blood cultures, unplanned readmissions, emergency room visits, and clinic visits. Qualitative trends were evaluated for various subgroups including presence of bacteremia, time from insertion, and demographics. Patients with an obvious external source of infection were excluded. Results Insertion-related infection rate was 0.9% for the entire cohort, 1.23% for the antibiotic group, and 0.68% for the nonantibiotic group. The insertion-related infection for adult patients was 0.88% for the antibiotic group and 0.68% for the nonantibiotic group. The pediatric insertion-related infection rate was 7.69%, all of whom received intravenous antibiotics. No other clear qualitative differences were noted for analyzed subgroups. Conclusion This study demonstrates low insertion-related port infection rate with no clinically significant difference between the groups that did or did not receive antibiotics. Subgroup analysis showed an exceptionally high infection rate in the pediatric population despite receiving preprocedure antibiotics.

Topical antibiotics in the prevention of port-site infection after elective day care laparoscopic cholecystectomy.

Wound-related infections and complications are rare after day care laparoscopic cholecystectomy (LC). They can have a significant adverse impact on the postoperative course after an uneventful elective LC. The use of topical antibiotics over the port site may prevent such complications. This trial was conducted from January 2018 to June 2019. Two hundred and fifty patients who met the inclusion and exclusion criteria were included in the study. They were randomized into the topical antibiotic group (Group A, n = 125) and control group (Group B, n = 125). All patients underwent four-port LC. Mupirocin 2% topical antibiotic ointment was applied to all four-port sites in Group A, whereas no topical antibiotic was used in Group B. One dose of prophylactic systemic antibiotics was given to all patients in both groups. The mean age was 43.22 ± 12.7 years in Group A and 43.44 ± 12.5 years in Group B. The comorbidities and the other variables were comparable between the two groups. The port-site infection (PSI) was observed in one patient in Group A and three patients in Group B, which was statistically nonsignificant (P = 0.622). The mean time of detection of infection was 4.75 ± 1.7 days. All the infections were superficial surgical site infections. Microbiological swabs culture of the infected wounds yielded no growth of bacteria. The PSI after LC is very less. The use of topical antibiotics to prevent PSIs after LC could not be established.

Phenotypic Resistance of (MRSA) Clinical Isolates to Some Macrolide Antibiotic Groups

Antimicrobial resistance is one of the most significant global threats to human health in recent times, and it limits the achievement of several of the sustainable development goals. Methicillin-resistant Staphylococcus aureus (MRSA) is among the most essential multidrug-resistant bacterial pathogens. The study aimed to determine the prevalence of (MRSA) from different clinical samples to emphasise the suitable treatment. One hundred fifty different clinical samples were collected. All these samples were subjected to classical microbiological testing, which included culturing directly on mannitol salt agar and antibiotic susceptibility test (A.S.T). The results observed that only 32 out of 150 samples of MRSA isolates were identified using cefoxitin 30 (µg) as a screening antibiotic, as suggested by CLSI. These 32 MRSA isolates showed resistance toward penicillin and cefoxitin, high sensitivity against vancomycin, and moderate resistance against doxycycline and azithromycin. Considering the phenotyping resistance toward macrolide antibiotic groups, 10/32 (31.25%) showed S-phenotype,18/32 (52.65%) showed R-phenotype,4/32 (12.5%) showed D-phenotype while no MRSA isolated showed D+ phenotype. This study concludes that inducible clindamycin resistance of S. aureus (MRSA) increases the difficulty of treating S. aureus bacterial infections.

Method Validation for Detection of Ciprofloxacin Residues in Hospital's Drinking Water in Khartoum State, Sudan

In fluoroquinolone antibiotic group ciprofloxacin antibiotic is used for the treatment of human and animal infection because of their wide antibacterial spectrum. The rampant and extralable use of these antibiotics could lead to contamination of environment.

Mec Genes in Methicillin Resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) manifests antibiotic resistance, especially for the β-lactams antibiotic group. MRSA bacteria are a common cause of infection in humans. The antibiotic resistance characteristic comes from the mecA, mecB, and mecC genes in the bacterial chromosome. mecA is the most common gene found in MRSA. Therefore, it is essential to know the role of the mecA gene in antibiotic resistance. This paper searched the literature about MRSA bacteria, the mec gene, and their relationship to cause resistance. The results showed that the mec gene found in MRSA bacteria causes antibiotic resistance in penicillin groups. Methicillin-resistant Staphylococcus aureus (MRSA) manifests antibiotic resistance, especially for the β-lactams antibiotic group. MRSA bacteria are a common cause of infection in humans. The antibiotic resistance characteristic comes from the mecA, mecB, and mecC genes in the bacterial chromosome. mecA is the most common gene found in MRSA. Therefore, it is essential to know the role of the mecA gene in antibiotic resistance. This paper searched literature about MRSA bacteria, the mec gene, and their relationship to cause resistance. The results showed that the mec gene found in MRSA bacteria causes antibiotic resistance in penicillin groups.