High Resistance Rates Research Articles

International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module

Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East. Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI). We gathered data from 204,770 patients, 1,480,620 patient days, 936,976 central line (CL)-days, 637,850 mechanical ventilators (MV)-days, and 1,005,589 urinary catheter (UC)-days. Our results showed 4,270 CL-associated bloodstream infections, 7,635 ventilator-associated pneumonia, and 3,005 UC-associated urinary tract infections. The combined rates of DA-HAIs were 7.28%, and 10.07 DA-HAIs per 1,000 patient days. CL-associated bloodstream infections occurred at 4.55 per 1,000 CL-days, ventilator-associated pneumonias at 11.96 per 1,000 MV-days, and UC-associated urinary tract infections at 2.91 per 1,000 UC days. In terms of resistance, Pseudomonas aeruginosa showed 50.73% resistance to imipenem, 44.99% to ceftazidime, 37.95% to ciprofloxacin, and 34.05% to amikacin. Meanwhile, Klebsiella spp had resistance rates of 48.29% to imipenem, 72.03% to ceftazidime, 61.78% to ciprofloxacin, and 40.32% to amikacin. Coagulase-negative Staphylococci and Staphylococcus aureus displayed oxacillin resistance in 81.33% and 53.83% of cases, respectively. The high rates of DA-HAI and bacterial resistance emphasize the ongoing need for continued efforts to control them.

Prevalence of Extended-Spectrum Beta-Lactamase Producer Gram-Negative Rods and Associated Factors Among Patients With Wound Infection at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Background: Multidrug-resistant (MDR) bacteria have significantly affected the management and treatment of wound infections globally. Data on the prevalence of MDR bacterial profiles that cause wound infections in Ethiopia are scarce. Therefore, this study aimed to determine MDR as well as extended-spectrum beta-lactamase production profiles of Gram-negative rods that are difficult to treat with conventional antibiotics and that cause wound infections. Objective: The aim of the study was to determine the prevalence of extended-spectrum beta-lactamase producer Gram-negative rods and associated factors among patients with wound infection at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Materials and Methods: This hospital-based cross-sectional study was conducted at University of Gondar Comprehensive Specialized Hospital between May and July 2022. Convenience sampling was used to recruit 228 participants. Swabs from different wound types were inoculated onto the MacConkey agar and blood agar plates and incubated overnight at 37°C for 24 h. Biochemical tests were performed on isolated colonies for the identification of bacterial species based on their biochemical reaction. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby-Bauer method by using Muller-Hinton agar, and the zone of inhibition was interpreted as resistant, intermediate, and sensitive as per the recommendation of Clinical Laboratory Standard Institute. Isolates were tested against ceftriaxone, cefotaxime, and ceftazidime for extended-spectrum beta-lactamase screening using the Kirby-Bauer disk diffusion method, and combined disk tests were applied for phenotypic confirmatory test of extended-spectrum beta-lactamase producing isolates. Result: Of 228 study participants, 162 (71.1%) were culture-positive. Among culture-positive patients, 165 Gram-negative bacteria were recovered. The most common Gram-negative isolates were Pseudomonas aeruginosa (47; 28.5%), followed by Escherichia coli (43; 26.1%) and Klebsiella pneumoniae (24; 14.5%). The susceptibility rates of the isolate for imipenem and tobramycin were 97.0% and 73.2%, respectively, and the overall multidrug resistance rate was 80.5%. Extended-spectrum beta-lactamase producer bacteria were also isolated. Besides, all (100%) of extended-spectrum beta-lactamase producer bacteria were MDR. Living in rural areas (AOR 5.8; 95% CI [2.01-16.7]), hospital admission (AOR 3.95; 95% CI [1.13-13.83]), antibiotic use (AOR 2.83; 95% CI [1.03-7.72]), and comorbidity (AOR 0.25; 95% CI [0.07-0.59]) were significantly associated with wound infection. Conclusions and Recommendations: There was a high prevalence of Gram-negative bacterial isolates in this study. Pseudomonas aeruginosa (28.5%) was the predominant isolate. In addition, high rates of multidrug resistance were observed. The high level of multidrug resistance in this study implies that definitive therapy should be based on culture and susceptibility analysis to promote the rational use of antibiotics and to reduce the emergence of bacterial resistance to antimicrobials.

Development of a cell adhesion-based prognostic model for multiple myeloma: Insights into chemotherapy response and potential reversal of adhesion effects.

Multiple myeloma (MM) is a hematologic malignancy notorious for its high relapse rate and development of drug resistance, in which cell adhesion-mediated drug resistance plays a critical role. This study integrated four RNA sequencing datasets (CoMMpass, GSE136337, GSE9782, and GSE2658) and focused on analyzing 1706 adhesion-related genes. Rigorous univariate Cox regression analysis identified 18 key prognosis-related genes, including KIF14, TROAP, FLNA, MSN, LGALS1, PECAM1, and ALCAM, which demonstrated the strongest associations with poor overall survival (OS) in MM patients. To comprehensively evaluate the impact of cell adhesion on MM prognosis, an adhesion-related risk score (ARRS) model was constructed using Lasso Cox regression analysis. The ARRS model emerged as an independent prognostic factor for predicting OS. Furthermore, our findings revealed that a heightened cell adhesion effect correlated with tumor resistance to DNA-damaging drugs, protein kinase inhibitors, and drugs targeting the PI3K/Akt/mTOR signaling pathway. Nevertheless, we identified promising drug candidates, such as tirofiban, pirenzepine, erlotinib, and bosutinib, which exhibit potential in reversing this resistance. In vitro, experiments employing NCIH929, RPMI8226, and AMO1 cell lines confirmed that MM cell lines with high ARRS exhibited poor sensitivity to the aforementioned candidate drugs. By employing siRNA-mediated knockdown of the key ARRS model gene KIF14, we observed suppressed proliferation of NCIH929 cells, along with decreased adhesion to BMSCs and fibronectin. This study presents compelling evidence establishing cell adhesion as a significant prognostic factor in MM. Additionally, potential molecular mechanisms underlying adhesion-related resistance are proposed, along with viable strategies to overcome such resistance. These findings provide a solid scientific foundation for facilitating clinically stratified treatment of MM.

Resurgence of Mycoplasma pneumoniae: a new epidemic ?

Mycoplasma pneumoniae pneumonia occurs periodically in an endemic-epidemic pattern. The incidence of this disease has fallen drastically as a result of the health measures imposed for the COVID-19 pandemic. In Switzerland, as elsewhere in the world, a new epidemic has been affecting pediatrics and adult populations since September 2023. Transmitted by aerosols and requiring close contact, this bacterium causes respiratory infections of varying severity, as well as a variety of extra-pulmonary manifestations. Microbiological diagnosis is based on PCR of respiratory samples. Despite a very high rate of macrolide resistance in Asia, the resistance rate remains low in Europe.

Clinical Characteristics, Species Distribution, and Drug Resistance of Non-Tuberculous Mycobacteria Lung Disease in Qingdao, China.

To analyze the clinical characteristics, species distribution and drug resistance of patients with non-tuberculous mycobacteria (NTM) lung disease in Qingdao, China. Clinical data of patients with NTM lung disease and pulmonary tuberculosis (TB) treated at Qingdao Chest Hospital from July 2021 to July 2023 were retrospectively analyzed. The prevalence of NTM lung disease was 8.03%, with a high rate of drug resistance during the study period. Patients with NTM lung disease had higher rates of older age, bronchiectasis, malignancy, HIV infection and bronchial dilatation shadow and lower rates of hollow shadow compared to patients with pulmonary TB. Comprehensive understanding of NTM lung disease, improved laboratory testing techniques and appropriate treatment regimens are essential for the management of NTM lung disease.

Characterization of Sodium Alginate-Based Edible Film with Addition of Gelatin and Casein

Edible film is a form of biodegradable packaging that is easily biodegradable and can be consumed at the same time with the product. The purpose of this study is to find characterization of edible films including physical tests (thickness, tensile strength, elongation, elasticity and high temperature resistance), chemical tests (water content and water vapor transmission rate), solubility tests and biodegradability tests on sodium alginate/glicerol-based edible films with the addition of gelatin and casein. This study was conducted using the single factor group random design method with data analysis using SPSS 29 software. The results showed that edible films made from only sodium alginate and glycerol only have advantages in characteristics of elasticity, edible films made from sodium alginate, glycerol and gelatin have advantages in characteristics of elongation, water content, solubility and biodegradability. Edible films made from sodium alginate, glycerol and casein have advantages in characteristics of consumer preferences, thickness, tensile strength, high temperature resistance and water vapor transmission rate.

Comparison of molecular and microbiological detection rates of Mycobacterium tuberculosis and prevalence of SARS-CoV-2 variants in Monterrey, Mexico

BackgroundTuberculosis (TB) is a severe global health problem, with high drug resistance rates. The emergence of the coronavirus disease 2019 (COVID-19) pandemic caused worldwide setback progress in TB control. Our aim was to compare detection rates of Mycobacterium tuberculosis at different COVID-19 pandemic waves. MethodsPatients (n = 1800) were evaluated using microbiological and molecular assays for mycobacterial detection in a hospital from Monterrey, Mexico. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected by real-time PCR. Data from existing reports of circulating SARS-CoV-2 variants was compared to data of TB prevalence. ResultsThe prevalence of TB was 30.4%. Compared to pre-pandemic, the detection rate of mycobacteria was higher during the first wave. The co-infection of Mycobacterium tuberculosis complex (MTC) and SARS-CoV-2 occurred in seven patients. MTC cases showed several waves which might depend on the prevalence of specific SARS-CoV-2 variants. ConclusionThe COVID-19 pandemic impacted on TB detection on our population, although it is still uncertain if it was mostly due to the influence of specific SARS-CoV-2 variants or to restrictions measures in the region. Public health measures should include the combination of TB and COVID-19 diagnostic screening in TB-endemic settings, such as ours, to restore TB control attempts.

Epidemiological characteristics of mycoplasma pneumoniae in hospitalized children before, during, and after COVID-19 pandemic restrictions in Chongqing, China.

Mycoplasma pneumoniae (MP) is a significant cause of community-acquired pneumonia with high macrolide resistance rates. Various COVID-19 pandemic restrictions have impacted the prevalence of MP. To assess the changes in the pattern of MP infections among children before, during, and after the COVID-19 pandemic. A total of 36685 enrolled patients, aged 0-18 years, diagnosed with pneumonia and admitted to Children's Hospital of Chongqing Medical University from January 2019 to December 2023, were retrospectively reviewed in this study. The epidemiological characteristics of pediatric MP infection were analyzed. Among 36685 patients, 7610 (20.74%) tested positive for MP. The highest positive rate was observed among children aged over 6 years (55.06%). There was no gender disparity in MP infection across the three phases of the COVID-19 pandemic. Hospital stays were longest for children during the COVID-19 pandemic (P <0.001). MP infection was most prevalent in the summer (29.64%). The lowest positive rate was observed during the pandemic, with the highest rate found after easing the measures across all age groups (P <0.001). There was a surge in the positive rate of MP in the third year after the COVID-19 pandemic. Regression analyses demonstrated a shift in the age range susceptible to MP infection, with children aged 3.8 to 13.5 years post-pandemic compared to the pre-pandemic range of 5.3 to 15.5 years old. Additionally, the average macrolide resistance rate was 79.84%. We observed a higher resistance rate during the pandemic than in the pre- and post-pandemic phases (P <0.001). The restrictive measures implemented during the COVID-19 pandemic have influenced the spread of MP to some extent and altered demographic and clinical characteristics, such as age, age group, season, length of stay, and macrolide resistance. We recommend continuous surveillance of the evolving epidemiological characteristics of MP infection in the post-pandemic period when restrictions are no longer necessary.

Thymol and carvacrol against Klebsiella: anti-bacterial, anti-biofilm, and synergistic activities-a systematic review.

Klebsiella poses a significant global threat due to its high antibiotic resistance rate. In recent years, researchers have been seeking alternative antimicrobial agents, leading to the introduction of natural compounds such as monoterpenes, specifically thymol and carvacrol. This review aims to illustrate the potential antimicrobial, anti-biofilm, and synergistic traits of thymol and carvacrol in combat against Klebsiella. Searching PubMed, Scopus, and Web of Science, we reviewed available evidence on the antibacterial effects of thymol, carvacrol, or combined with other compounds against Klebsiella until May 2024. Reference checking was performed after the inclusion of studies. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), fractional inhibitory concentration (FIC), and anti-biofilm activity were gathered, and the MBC/MIC ratio was calculated to assess the bactericidal efficacy. We retrieved 38 articles out of 2,652 studies screened. The gathered data assessed the anti-microbial activity of thymol, carvacrol, and both compounds in 17, 10, and 11 studies, respectively. The mean (± standard deviation) non-weighted MIC was 475.46μg/mL (±509.95) out of 60 MIC for thymol and 279.26μg/mL (±434.38) out of 68 MIC for carvacrol. Thymol and carvacrol showed anti-biofilm activities in the forms of disruption, inhibition, and mass reduction of biofilms. The MBC/MIC ratio was lower than 4 in 45 out of 47 cases, showing high bactericidal efficacy. FIC values were gathered for 68 combinations of thymol and carvacrol with other compounds, and they were mostly synergistic or additive. Thymol and carvacrol alone or in combination with other compounds, specifically known antibiotics, show great antimicrobial activity.

Occurrence of high level methicillin resistance Staphylococcus aureus in patients from health facilities in Akwa Ibom State, Nigeria

Background: Methicillin resistant S. aureus (MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureus among patients in two health facilities in Akwa Ibom State, Nigeria. Materials and Methods: Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureus and MRSA strains were done according to standard protocols while antibiotic susceptibility testing of MRSA isolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines. Results: The prevalence of MRSA strains in this study was 42.9%. Majority of patients with MRSA were from UUTH (44%) closely followed by patients from GHIA (40%). High antibiotics resistant rates of MRSA were recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively. Conclusion: Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureus for MRSA strains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications.

Key drivers of the TB epidemic in Suriname and priority actions to reduce incidence and mortality.

The WHO has recently published updated guidance for national strategic planning for TB. To address the TB epidemic comprehensively, it is necessary to conduct an epidemiological review as part of the situation analysis in the national strategic plan. A descriptive epidemiological study was conducted using data from the national TB register for the period of 2010-2020. Simple frequencies were calculated for demographic and clinical variables. Trends in TB notification rates for the period 2010-2020 were also calculated. TB notification rates between 2011 (24.3/100,000) and 2019 (23.9/100,000) remained almost the same. The HIV status was known for 97.1% of TB cases, 22.7% of whom had HIV co-infection; 10.9% of patients with detected Mycobacterium tuberculosis were also resistant to rifampicin. Case fatality rate for all cases was 13.0%. Of the identified contacts, 66% were screened; 28.3-47.5% of those with TB infection started treatment, 63.3-75.9% of whom completed treatment. The review identified the following areas of concern: no decline in TB rates, high proportion of TB-HIV co-infection, high rate of resistance to rifampicin, high case-fatality rates and suboptimal contact investigation care cascade . The review was used to inform interventions and key actions to reduce TB morbidity and mortality in Suriname.

A Retrospective Study of the Antimicrobial Resistant Escherichia Coli, Klebsiella Pneumoniae and Pseudomonas Aeruginosa in Clinical Samples from a Healthcare Facility in Osogbo, Nigeria

Background: Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae are gram-negative bacteria that have been linked with various healthcare-associated and community-acquired infections. These three organisms have been identified as critical multi-drug resistant pathogens that require new drugs to combat their infections in humans. Due to the scarcity of data about the true burden of AMR in the 3 microorganisms in this locality, this study investigated the prevalence, pattern and trend of antimicrobial resistance exhibited by K. pneumoniae, P. aeruginosa and E. coli within Osogbo metropolis. Method: Antimicrobial resistance prevalence, patterns and trends in E. coli, K. pneumoniae and P. aeruginosa isolates from clinical samples submitted for microbial culture and sensitivity test between January and December 2022 were analyzed. In this study, nine antibiotics including Cefixime, Cefotaxime, Cefuroxime, Ceftriaxone, Gentamicin, Augmentin, Imipenem, Ciprofloxacin and Levofloxacin were selected based on the spectrum of activity. Data analysis was done using SPSS version 25 for statistical analyses. Results: There were 171, 83 and 32 isolates of E. coli, K. pneumoniae and P. aeruginosa identified in this study respectively. Overall, the three organisms showed higher AMR prevalence to IMP and ZEM, and least resistance to LBC. Essentially, 24 P. aeruginosa, 113 E. coli, and 59 K. pneumoniae isolates demonstrated multidrug resistance pattern. All P. aeruginosa isolates exhibited resistance to at least one antibiotic. AUG-CIP-CRO-CTX-CXM-GEN-IMP-LBC-ZEM resistance pattern occurred in both urine and wound samples for P. aeruginosa, as well as E. coli isolated from high vagina swab. Observed AMR in respect of carbapenem (IMP) and cephalosporin (cefuroxime, cefixime and cefotaxime) was above average for the 3 microorganisms. Patient age, nature and source of specimen are marginal factors influencing AMR of these isolates. Conclusion: This study identified the high rate of resistance by the bacterial isolates most especially to cephalosporins. The high MAR-index suggests the practice of self-medication due to unrestricted access to over-the-counter medications. Hence, there is the need for effective campaigns to sensitize the public on the need to halt indiscriminate use of antibiotics, as well as advocate for laws and policies to guide the sale and purchase of antibiotics at the community level.

Antibiotic Resistance Profiles and MLST Typing of Staphylococcus Aureus Clone Associated with Skin and Soft Tissue Infections in a Hospital of China.

To analyze the antibiotic resistance profile, virulence genes, and molecular typing of Staphylococcus aureus (S. aureus) strains isolated in skin and soft tissue infections at the First Affiliated Hospital, Gannan Medical University, to better understand the molecular epidemiological characteristics of S. aureus. In 2023, 65 S. aureus strains were isolated from patients with skin and soft tissue infections. Strain identification and susceptibility tests were performed using VITEK 2 and gram-positive bacteria identification cards. DNA was extracted using a DNA extraction kit, and all genes were amplified using polymerase chain reaction. Multilocus sequence typing (MLST) was used for molecular typing. In this study, of the 65 S. aureus strains were tested for their susceptibility to 16 antibiotics, the highest resistance rate to penicillin G was 95.4%. None of the staphylococcal isolates showed resistance to ceftaroline, daptomycin, linezolid, tigecycline, teicoplanin, or vancomycin. fnbA was the most prevalent virulence gene (100%) in S. aureus strains isolated in skin and soft tissue infections, followed by arcA (98.5%). Statistical analyses showed that the resistance rates of methicillin-resistant S. aureus isolates to various antibiotics were significantly higher than those of methicillin-susceptible S. aureus isolates. Fifty sequence types (STs), including 44 new ones, were identified by MLST. In this study, the high resistance rate to penicillin G and the high carrying rate of virulence gene fnbA and arcA of S.aureus were determine, and 44 new STs were identified, which may be associated with the geographical location of southern Jiangxi and local trends in antibiotic use. The study of the clonal lineage and evolutionary relationships of S. aureus in these regions may help in understanding the molecular epidemiology and provide the experimental basis for pathogenic bacteria prevention and treatment.

Characterization of Virulence Genotypes, Antimicrobial Resistance Patterns, and Biofilm Synthesis in Salmonella spp Isolated from Foodborne Outbreaks.

Salmonella is the main bacterial pathogen that causes foodborne disease, particularly in developing countries. Nontyphoidal Salmonella (NTS) include Enteritidis and Typhimurium as the most prevalent strains which are one of the significant causes of acute gastroenteritis in children. Therefore, identifying the most predominant serovars, types of common contaminated food, and paying attention to their antibiotic resistance are the main factors in the prevention and control strategy of salmonellosis. This study was undertaken to evaluate the prevalence rate of serovars, the biofilm formation, antimicrobial resistance (AMR) status, and phenotypic virulence factors of Salmonella strains isolated from diarrhea samples in some cities of Iran. A total of 40 (10.41%) Salmonella isolates were recovered from 384 diarrhea samples processed and the most common serovar was Salmonella serovar Typhimurium (82.5). Also, all isolates belonging to serovar Typhimurium showed more virulence factors compared to other serovars. The isolates showed a high resistance rate to ampicillin (95%) and nalidixic acid (87.5%), while a low resistance rate was found for chloramphenicol (2.5%). Moreover, significant variances in the capacity of biofilm formation were found between different Salmonella serotypes. The resistance of NTS to extant choice drugs is a potential public health problem. Constant monitoring of AMR pattern and virulence profile of NTS serovars is suggested for the prevention of salmonellosis in humans.

Antimicrobial Resistance Patterns of Pathogens Isolated from Patients with Wound Infection at a Teaching Hospital in Vietnam.

At a teaching Hospital in Vietnam, the persistently high incidence of diagnosed wound infection poses ongoing challenges to treatment. This study seeks to explore the causative agents of wound infection and their antimicrobial and multidrug resistance patterns. A cross-sectional study was conducted at the Department of Microbiology, Military Hospital 103, Vietnam. Data on microorganisms that caused wound infection and their antimicrobial resistance patterns was recorded from hospitalized patients from 2014 to 2021. Using the chi-square test, we analyzed the initial isolation from wound infection specimens collected from individual patients. Over a third (34.9%) of wound infection samples yielded bacterial cultures. Staphylococcus aureus was the most prevalent bacteria, followed by Pseudomonas aeruginosa. Worryingly high resistance rates were observed for several antibiotics, particularly among Gram-negative bacteria. Ampicillin displayed the highest resistance (91.9%), while colistin and ertapenem remained the most effective. In Gram-positive bacteria, glycopeptides like teicoplanin and vancomycin (0% and 3.3% resistance, respectively) were most effective, but their use was limited. Clindamycin and tetracycline showed decreasing effectiveness. Resistance rates differed between surgical and non-surgical wards, highlighting the complex dynamics of antimicrobial resistance within hospitals. Multidrug resistance (MDR) was substantial, with Gram-negative bacteria exhibiting a 63.6% MDR rate. Acinetobacter baumannii showed the highest MDR rate (88.0%). This study investigated wound infection characteristics, antibiotic resistance patterns of common bacteria, and variations by hospital ward. S. aureus was the most prevalent bacteria, and concerning resistance rates were observed, particularly among Gram-negative bacteria. These findings highlight the prevalence of multidrug resistance in wound infections, emphasizing the importance of infection control measures and judicious antibiotic use.

Antimicrobial Susceptibility Profile of Methicillin-Resistant Staphylococcus Aureus Isolated from Clinical Samples at Bac Ninh Provincial General Hospital, Vietnam.

Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA) strain, can become resistant to all classes of clinically available antibiotics and causes skin infections and severe infections in the lungs, heart, and bloodstream. The study aimed to evaluate antimicrobial susceptibility patterns and MRSA exhibiting multidrug resistance obtained through a microbiological culture of clinical specimens at Bac Ninh Provincial General Hospital in Bac Ninh Province, Vietnam. We employed a cross-sectional analysis at Bac Ninh Provincial General Hospital in Vietnam. 15,232 clinical samples from inpatients were examined. S. aureus isolates were identified using established protocols and tested for MRSA and antibiotic susceptibility. Data was analyzed using R software, with statistical calculations to assess associations between variables. Staphylococcus aureus was isolated from 417 samples (2.7%), with 77.2% being MRSA and 22.8% methicillin-susceptible Staphylococcus aureus (MSSA). Significant sources of MRSA were wounds (64.6%) and the surgical unit (50%) according to sample types and hospital wards, respectively. S. aureus showed high resistance rates, the highest being azithromycin (83.2%), and was fully susceptible to vancomycin. Among 294 multidrug-resistant (MDR) strains, the prevalence was 82.0% in MRSA and 18.0% in MSSA. The study highlights widespread antimicrobial resistance among MRSA isolates from a provincial hospital in Vietnam, emphasizing the urgent need for antibiotic surveillance, formulation of antibiotic policies, and preventive measures to tackle the increasing prevalence of multidrug-resistant MRSA.

Antibiotic Resistance and Virulence Factors in Clinical Isolates of Stenotrophomonas maltophilia from Hospitalized Patients in Tehran, Iran.

Stenotrophomonas maltophilia causes challenging infections in immunocompromised patients, exhibiting increasing resistance to multiple antimicrobials and possessing various virulence genes, including emerging resistance to trimethoprim-sulfamethoxazole. A total of 80 clinical isolates of S. maltophilia were collected from multiple hospitals in Tehran, Iran. This study conducted an analysis of antibiotic susceptibility by disc diffusion method and E-test assay, resistance and virulence gene frequencies were examined by PCR-sequencing, and multilocus sequencing typing (MLST) was performed for strain typing. Across the tested isolates, we observed notably high resistance rates for imipenem 80 (100%), meropenem 78(97.5%), and ceftazidime 72 (90%), while trimethoprim-sulfamethoxazole (SXT) showed a lower resistance rate of 2 (2.5%). Minocycline and levofloxacin demonstrated the highest susceptibility rates, with 70 (87.5%) and 80 (100%), respectively. The prevalence of antibiotic resistance genes bla L1, and bla L2 was 71 (88.75%) and 76 (95%), respectively. Additionally, the PCR analysis revealed that the frequency of virulence genes (fliC, virB, papD, pilU, hlyIII, stmPr1, and stmPr2) was 78 (97.5%), 77 (96.25%), 58 (72.5%), 77 (96.2%), 76 (95%), 31 (38.75%), and 80 (100%), respectively. Resistance to SXT isolate belong to the sequence type (ST15) and exhibits allelic profiles of (10, 29, 21, 21, 32, 32, and 10). The data obtained from our investigation have indicated that SXT remains an efficacious antibiotic and also highlighted the importance of effective management, identification of resistant isolates, and typing methods to address the global prevalence of antibiotic resistance in S. maltophilia.

Occurrence, Serodiagnosis and Antimicrobial Resistance of Listeria monocytogenes Isolated from Different Types of Meat Products and Milk

Listeriosis is one of the most common bacterial zoonotic illnesses with significant death rate worldwide. The goal of this investigation was to ascertain the incidence and antibiotic resistance patterns of L. monocytogenes in various food items. In addition, an experiment was carried out to look at the anti-listerial properties of boiling and thyme oil. The isolation percentages of L. monocytogenes which confirmed by PCR using 16S rRNA gene were 10%, 3.3%, 6.6%, 13.3% and 3.3%, from the examined raw milk, beef burger, beef sausage, minced meat and chicken fillet meat samples respectively. The pathogenicity test by CAMP (Christie, Atkinson, Munch, Peterson) test indicated that all examined L. monocytogenes isolates were virulent. Serogrouping of isolated L. monocytogenes revealed that isolates belonged to (1/2a, 4b, 3c and 7) serotypes. The in-vitro antimicrobial sensitivity test showed that a high resistant rate for amoxicillin 9/11(81.8%), erythromycin 9/11 (81.8%), vancomycin 8/11 (72.7%), followed by doxycycline 7/11(63.6%), oxacillin 6/11(54.50%) and chloramphenicol 5/11(45.4%).The least resistance was found to be against gentamicin 4/11 (36.3%),sulfamethoxazole/trimethoprim 3/11(27.2%) and ciprofloxacin 3/11(27.2%). Molecular characterization of L. monoctogenes virulence genes showed that 63.6% harbored hlyA gene and 81.8% amplified InlA gene. It's interesting to note that L. monocytogenes was completely removed from experimentally contaminated milk after boiling it for three minutes. Additionally, adding 1% thyme oil to samples of contaminated chicken fillets reduces the amount of L. monocytogenes by log 2.13. They might be employed as substitute antibacterial aids in the food business because of their inhibitory activity.

Analysis of Pathogen Distribution and Antimicrobial Resistance in Bone and Joint Infections Among Young Children.

This study aimed to analyze the distribution of pathogens and antimicrobial resistance in bone and joint infections (BJIs) among children under four years old. A retrospective analysis was conducted on the clinical data of children under four years old who received inpatient treatment for BJIs at the Children's Hospital of Soochow University between January 2016 and December 2022. Results of bacterial culture and antimicrobial resistance were analyzed. Among the 131 patients, 52 (39.7%) showed positive bacterial culture results. There were Gram-positive (G+) bacteria detected in 38 strains (73.07%), Gram-negative (G-) bacteria in 12 strains (23.08%), and fungi in 2 strains (3.85%). Thirty-one strains of Staphylococcus aureus (S. aureus) were detected (59.62%), including 7 MRSA strains (22.58%). The resistance rate of G+ bacteria to penicillin was 72.97%, while resistance to erythromycin and clindamycin was approximately 50%. No resistance was found against linezolid, vancomycin, and teicoplanin. G- bacteria showed a sensitivity of 100% to carbapenems, including meropenem, ertapenem, and imipenem, a resistance rate of 91.67% to ampicillin-sulbactam, and relatively high resistance rates to compound sulfamethoxazole, ampicillin/sulbactam, and piperacillin. Regional variations existed in the distribution of pathogens and antimicrobial resistance in children under four years old with BJIs. In our hospital, the most common pathogen is S. aureus, with MRSA accounting for approximately one-fourth of all S. aureus patients. Additionally, extended-spectrum β-lactamase (ESBL)-producing G- bacteria have been identified, underscoring the importance of careful consideration during empirical antibiotic therapy.

Escherichia coli: Epidemiology, Impact, Antimicrobial Resistance and Prevention: A review

Public health aims to protect and improve community health by preventing and controlling infectious diseases. This includes surveillance, policy development, health education, immunization, research, and collaboration. Escherichia coli (E. coli) is a bacterium found in the intestines of humans and animals, with harmless and pathogenic strains causing serious illnesses. Pathogenic E. coli, like Shiga toxin-producing E. coli (STEC), can lead to severe food poisoning and outbreaks, making it a major public health concern. E. coli is transmitted through contaminated food, water, and direct contact with infected animals or individuals. It can survive in various environments and acquire antibiotic resistance. Vulnerable populations, such as children, elderly, and immunocompromised individuals, are at higher risk of severe infections. Studies in Egypt show high resistance rates to commonly used antibiotics in both clinical and food samples.E. coli isolates from various sources in Egypt and Tunisia demonstrated high resistance to commonly used antibiotics, limiting treatment options and posing a public health risk. E. coli isolates from patient urine in Nigeria showed high resistance to most antibiotics tested except newer drugs, indicating misuse of antibiotics in healthcare. The typical symptoms of infection include diarrhea, abdominal pain, symptoms of urinary tract infection and fever. The most serious complication is hemolytic uremic syndrome (HUS), which can cause acute kidney failure and be life-threatening, especially in young children and elders. Long-term consequences of infection and HUS can include chronic kidney disease and neurological impairment. The present review article summarizes the current knowledge, highlights the challenges and gaps and provides recommendations and solutions.