High Antibiotic Resistance Research Articles

Diverging Characteristics – Mercury Resistance and Antibiotic Susceptibility of Bacillus anthracis Isolated from Different Estuarine Environments

The present study focused on the isolation and selection of identically similar bacteria from two different estuaries: polluted (KM186605) and marginally polluted (KM186603). The selected strains were tentatively identified as Bacillus anthracis using biochemical and molecular characteristics. The comparative assessments were performed based on their mercury and antibiotic resistance capabilities. The mercury removal percentages of KM186605 were 57.76, 40.88, 30.24 and 24.88%, while those of KM186603 were 45.92, 36.16, 28.15 and 21.69% respectively, at 25, 50, 75 and 100 mg−l concentrations of mercury. The antibiotic profile showed that KM186605 was susceptible to erythromycin, novobiocin, oxytetracycline, vancomycin, and amikacin. On the other hand, KM186603 was susceptible to oxytetracycline, erythromycin, novobiocin, and amikacin. The notable finding of the present investigation is that the strain screened from the polluted estuary (KM186605) showed higher mercury resistance but lower antibiotic resistance. The strain screened from a marginally polluted estuary (KM186603) exhibited lower mercury resistance and higher antibiotic resistance.

Comparing the Bacterial Flora of Insectary and Filed Strains of Supella longipalpa (Blattaria: Ectobiidae) and Their Antibiotic Resistant Pattern in Qom Province, Central Iran.

Cockroaches play a role in the mechanical transmission of microbial pathogens. This study was designed to determine the isolated bacteria and their susceptibility to conventional antibiotics from brown-banded cockroach, Supella longipalpa, in Qom province, central Iran. In this cross-sectional study, brown-banded cockroaches were bred in an insectary and caught from hospitals of Qom. The samples were taken from the surface and alimentary canal and then cultured on microbial culture media; next, grown specimens were identified using differential culture media. Finally, after performing diagnostic tests and identifying the bacteria species, their susceptibility to various antibiotics was evaluated. A total of 120 adult cockroaches from the insectary and hospitals were included in the study. Ten bacterial genera were found; nine were Gram-negative and one was Gram-positive. The genus Klebsiella, Enterobacter, Staphylococcus, Citrobacter and Hafnia were isolated only from the hospital strain. On the other hand, Pseudomonas and Escherichia from both groups and other species such as Salmonella, Proteus and Shigella were isolated only from laboratory strains. The highest antibiotic resistance among Gram-positive cocci and Gram-negative bacilli were 100.0% and 98.1% for ampicillin and Ceftazidime, respectively. The results of this study showed that various pathogenic bacteria harbored by brown-banded cockroaches. Moreover, it was found that most of these bacteria belong to the Enterobacteriaceae family, which can be pathogenic and thus threaten human health.

Phylogenetic analysis, biofilm formation, antimicrobial resistance and relationship between these characteristics in Uropathogenic Escherichia coli.

In the present study, we examine the prevalence of phylogenetic groups, O-serogroups, adhesin genes, antimicrobial resistance, the level of gene expression associated with biofilm formation, and the presence of extended-spectrum beta-lactamase (ESBL) in UPEC strains isolated from both pediatric and adult patients. In this cross-sectional study, 156 UPEC isolates were collected from UTI patients. ESBL-producing isolates were detected using the double-disc synergy (DDS) method, and biofilm formation was assessed through a microplate assay. The presence of O-serogroups, adhesion factors and resistance genes, including ESBLs and PMQR genes, was detected by PCR, and isolates were categorized into phylogenetic groups using multiplex PCR. Additionally, the quantitative real-time PCR method was also used to determine the expression level of genes related to biofilm. During the study period, 50.6% (79/156) of the samples were obtained from children, and 49.4% (77/156) were from adults. The highest rate of resistance was to NA (91.7%), while FM (10.9%) had the lowest rate of antibiotic resistance. In addition, 67.9% (106/156) of UPEC isolates were ESBL producers. Most of UPEC isolates belonged to phylogenetic group B2 (37.1%). This study revealed that blaCTX-M and qnrS are widely distributed among UPEC isolates. The mean expression levels of fimA genes were significantly higher in non-biofilm producers than in biofilm producers (p < 0.01). The high antibiotic resistance rates in this study highlight the significance of local resistance monitoring and investigating underlying mechanisms. Our findings indicate the dominance of phylogroup B2 and group D as the prevailing phylogenetic groups. Consequently, it is imperative to investigate the epidemiological aspects and characterize UPEC isolates across diverse regions and time frames.

Real-world utilization of ceftazidime/avibactam among inpatients in the national Veterans Affairs Healthcare System.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Multidrug-resistant (MDR) infections are challenging to treat due to underlying patient conditions, pathogen characteristics, and high antibiotic resistance rates. As newer antibiotic therapies come to market, limited data exist about their real-world utilization. This was a national retrospective cohort study of ceftazidime/avibactam (approved in 2015) utilization among inpatients from the Veterans Affairs (VA) Healthcare System, from 2015 through 2021. Joinpoint regression was used to estimate time trends in utilization. Ceftazidime/avibactam use increased by 52.3% each year (days of therapy per 1,000 bed days; 95% confidence interval, 12.4%-106.4%). We identified 1,048 unique predominantly male (98.3%) and white (66.2%; Black, 27.7%) patients treated with ceftazidime/avibactam, with a mean (SD) age of 71.5 (11.9) years. The most commonly isolated organisms were Pseudomonas aeruginosa (36.3%; carbapenem resistant, 80.6%; MDR, 65.0%) and Klebsiella species (34.1%; carbapenem resistant, 78.4%; extended-spectrum cephalosporin resistant, 90.7%). Common comorbid conditions included hypertension (74.8%), nervous system disorders (60.2%), diabetes mellitus (48.7%), and cancer (45.1%). Median time to ceftazidime/avibactam initiation from admission was 6 days, with a median of 3 changes in therapy before ceftazidime/avibactam initiation and a subsequent median length of inpatient stay of 14 days (median of 8 days of ceftazidime/avibactam therapy). Treatment heterogeneity was high, both before ceftazidime/avibactam initiation (89.6%) and during ceftazidime/avibactam treatment (85.6%), and common concomitant antibiotics included vancomycin (41.4%), meropenem (24.1%), cefepime (15.2%), and piperacillin/tazobactam (15.2%). The inpatient mortality rate was 23.6%, and 20.8% of patients had a subsequent admission with ceftazidime/avibactam treatment. Utilization of ceftazidime/avibactam increased from 2015 to 2021 in the national VA Healthcare System. Ceftazidime/avibactam was utilized in complex, difficult-to-treat patients, with substantial treatment heterogeneity and variation in the causative organism and culture site.

The prevalence, enterotoxigenic properties and antimicrobial susceptibility of Staphylococcus aureus isolated from various foods of animal origin

This study aimed to determine the prevalence, enterotoxigenic properties and antimicrobial resistance profile of Staphylococcus aureus isolated from 850 food samples, including bulk tank milk, Tulum cheese, chicken meat and beef carcasses, in Türkiye. S. aureus contamination rates and the mean contamination levels of 86 positive samples from bulk tank milk, Tulum cheese, chicken meat and beef carcasses were 10.8% (n:49) and 3.01±0.48 log cfu/ml, 17% (n:17) and 3.08±0.42 log cfu/g, 12% (n:12) and 2.89±0.27 log cfu/g, and 4% (n:8) and 1.28±0.54 log cfu/cm2 , respectively. 39 out of 86 isolates (45.3%) had one or more enterotoxin genes (sea-see, seg-selj, sep). sed was the most common classical enterotoxin gene, whereas sei was the most common new enterotoxin gene. Antimicrobial susceptibility testing against 16 antibiotics performed by VITEK 2 showed that 61 isolates (70.9%) were resistant to various antibiotics. 32.8% of the resistant isolates were multidrug resistant (MDR) and the mean multiple antimicrobial resistance (MAR) index was 0.301. The isolates were mostly resistant to penicillin (63.9%), followed by oxacillin (24.4%), clindamycin (19.7%) and erythromycin (12.7%). mecA was detected in 13 isolates (15.1%), but no mecC was found. It was concluded that most of the S. aureus isolates had enterotoxin genes which might cause foodborne intoxications. The high antibiotic resistance rates observed in these strains, including MRSA, may also result in some public health hazards.

Detecting the Variation in the lasI Gene and Their Relation with Biofilm in Pseudomonas aeruginosa Isolates

One of the most causative agents for many opportunistic diseases is the Pseudomonas aeruginosa which has a high percentage of multidrug resistance disease through construction of biofilm. The current study aimed for evaluating the correlation between quorum sensing genes (which is lasI gene) and biofilm formation. The biofilm construction and antibiotics susceptibility test were achieved for all the isolates under the study. The PCR and sequencing techniques were also carried out to detect the type of variation in lasI gene for each scheme of biofilm formation (weak, strong, and moderate). High antibiotic resistance was recorded among biofilm producing isolates. The genic pattern for the weak biofilm producer, which is isolate No 19, carries lysine instead of arginine in position 92 and aspartic acid instead of asparagine in position 115. Phylogenetic analysis indicated that the horizontal genetic transfer between isolates was very high. Finally, we conclude that the lasI gene does participate in biofilm construction of P. aeruginosa.

Antibacterial effects of Melaleuca leucadendra Ecoenzyme on Pseudomonas aeruginosa

Introduction: Pseudomonas aeruginosa, a Gram-negative opportunistic pathogen, poses a significant threat in hospital settings, causing nosocomial infections with severe consequences. The bacterium’s high antibiotic resistance, particularly through biofilm formation via quorum sensing (QS), complicates treatment strategies. This study explores the potential of eucalyptus (Melaleuca leucadendra), known for its antimicrobial properties especially due to 1,8-cineole, ecoenzyme in inhibiting Pseudomonas aeruginosa. Materials and Methods: This study is a posttest-only control group design. Pseudomonas aeruginosa bacteria were samped using simple random sampling. The study utilized the agar-well diffusion method on Mueller Hinton agar to assess the antibacterial effect of eucalyptus (Melaleuca leucadendra) ecoenzyme. Concentrations tested ranged from 10% to 100% with three repetitions and incubation at 37 °C for 24 hours. Data were obtained by measuring the inhibition zone using calipers. Results: Contrary to expectations, the study found no antibacterial effect of eucalyptus (Melaleuca leucadendra) ecoenzyme on Pseudomonas aeruginosa at all concentrations tested (100%, 90%, 70%, 60%, 50%, 40%, 30%, 20%, and 10%). Conclusion: The investigation into eucalyptus (Melaleuca leucadendra) ecoenzyme revealed no discernible antibacterial activity against Pseudomonas aeruginosa. These findings challenge the initial hypothesis and underscore the importance of thorough experimentation in assessing the potential of natural agents for combating nosocomial infections. Further research is needed to elucidate the complex interactions between Pseudomonas aeruginosa and eucalyputs (Melaleuca leucadendra).

In vitro study: methylene blue-based antibacterial photodynamic inactivation of Pseudomonas aeruginosa

Pseudomonas aeruginosa is one of the most antibiotic-resistant and opportunistic pathogens in immunocompromised and debilitated patients. It is considered the cause of most severe skin infections and is frequently found in hospital burn units. Due to its high antibiotic resistance, eliminating P. aeruginosa from skin infections is quite challenging. Therefore, this study aims to assess the novel in vitro antibacterial activity of methylene blue using a 635-nm diode laser to determine the effective power and energy densities for inhibition of P. aeruginosa. The strain was treated with various concentrations of methylene blue and 635-nm diode laser at powers of 300 mW/cm2 and 250 mW/cm2. The diode laser’s potency in the photo-destruction of methylene blue and its degradation through P. aeruginosa were also evaluated. Colony-forming unit (CFU)/ml, fluorescence spectroscopy, optical density, and confocal microscopy were used to measure the bacterial killing effect. As a result, the significant decrease of P. aeruginosa was 2.15-log10, 2.71-log10, and 3.48-log10 at 60, 75, and 90 J/cm2 after excitation of MB for 240, 300, and 360 s at a power of 250 mW/cm2, respectively. However, a maximum decrease in CFU was observed by 2.54-log10 at 72 J/cm2 and 4.32-log10 at 90 and 108 J/cm2 after 300 mW/cm2 of irradiation. Fluorescence images confirmed the elimination of bacteria and showed a high degree of photo-destruction compared to treatment with methylene blue and light alone. In conclusion, MB-induced aPDT demonstrated high efficacy, which could be a potential approach against drug-resistant pathogenic bacteria.Key points• Combination of methylene blue with 635-nm diode laser for antibacterial activity.• Methylene blue photosensitizer is employed as an alternative to antibiotics.• aPDT showed promising antibacterial activity against Pseudomonas aeruginosa.

Prevalence of diverse antimicrobial resistance genes and bacteria in sewage treatment plant-derived sludge environment.

Antimicrobial resistance (AMR) contamination in the environment is one of the most significant worldwide threats of the 21st century. Since sludge is heavily exposed to diverse contaminants, including pharmaceuticals, the inhabitant bacterial population is expected to exhibit resistance to antimicrobial agents. In this study, sewage treatment plant (STP) sludge samples were analyzed to assess the antibiotic-resistant bacterial population, abundance of AMR genes (ermF, qnrS, Sul1, blaGES, blaCTX-M, and blaNDM), and mobile genetic elements (intl1 and IS26). Out of 16, six bacterial isolates exhibited resistance to 13 antibiotics with a high multiple antibiotic resistance index (MARI) (0.93) and high metal tolerance. Quantitative polymerase chain reaction showed the abundance of target genes ranging from 6.6×103 to 6.5×108 copies g-1 sludge. The overall outcome reveals that STP sludge comprised varied multidrug-resistant bacterial populations. It will give insights into the functions of heavy metals and biofilm development in the selection and spread of AMR genes and the associated bacteria. Therefore, the application of sludge needs proper screening for AMR and metal contamination prior to its countless applications. This study will contribute immensely to the risk analysis of STP effluents on environmental health, including control of AMR transmission.

Plasmid content of carbapenem resistant Acinetobacter baumannii isolates belonging to five International Clones collected from hospitals of Alexandria, Egypt.

Multidrug resistant Acinetobacter baumannii is one of the most important nosocomial pathogens worldwide. During the last decades it has become a major threat for healthcare settings due to the high antibiotic resistance rates among these isolates. Many resistance determinants are coded by conjugative or mobilizable plasmids, facilitating their dissemination. The majority of plasmids harbored by Acinetobacter species are less than 20 Kb, however, high molecular weight elements are the most clinically relevant since they usually contain antibiotic resistance genes. The aim of this work was to describe, classify and determine the genetic content of plasmids harbored by carbapem resistant A. baumannii isolates belonging to predominant clonal lineages circulating in hospitals from Alexandria, Egypt. The isolates were subjected to S1-Pulsed Field Gel Electrophoresis experiments to identify high molecular weight plasmids. To further analyze the plasmid content and the genetic localization of the antibiotic resistance genes, isolates were sequenced by Illumina Miseq and MinION Mk1C and a hybrid assembly was performed using Unicycler v0.5.0. Plasmids were detected with MOBsuite 3.0.3 and Copla.py v.1.0 and mapped using the online software Proksee.ca. Replicase genes were further analyzed through a BLAST against the Acinetobacter Plasmid Typing database. Eleven plasmids ranging in size from 4.9 to 205.6 Kb were characterized and mapped. All isolates contained plasmids, and, in many cases, more than two elements were identified. Antimicrobial resistance genes such as bla OXA-23, bla GES-like, aph(3')-VI and qacEΔ1 were found in likely conjugative large plasmids; while virulence determinants such as septicolysin or TonB-dependent receptors were identified in plasmids of small size. Some of these resistance determinants were, in turn, located within transposons and class 1 integrons. Among the identified plasmids, the majority encoded proteins belonging to the Rep_3 family, but replicases of the RepPriCT_1 (Aci6) family were also identified. Plasmids are of high interest as antibiotic resistance control tools, since they may be used as genetic markers for antibiotic resistance and virulence, and also as targets for the development of compounds that can inhibit transfer processes.

Resistance mechanism of Escherichia coli strains with different ampicillin resistance levels.

Antibiotic resistance is an important problem that threatens medical treatment. Differences in the resistance levels of microorganisms cause great difficulties in understanding the mechanisms of antibiotic resistance. Therefore, the molecular reasons underlying the differences in the level of antibiotic resistance need to be clarified. For this purpose, genomic and transcriptomic analyses were performed on three Escherichia coli strains with varying degrees of adaptive resistance to ampicillin. Whole-genome sequencing of strains with different levels of resistance detected five mutations in strains with 10-fold resistance and two additional mutations in strains with 95-fold resistance. Overall, three of the seven mutations occurred as a single base change, while the other four occurred as insertions or deletions. While it was thought that 10-fold resistance was achieved by the effect of mutations in the ftsI, marAR, and rpoC genes, it was found that 95-fold resistance was achieved by the synergistic effect of five mutations and the ampC mutation. In addition, when the general transcriptomic profiles were examined, it was found that similar transcriptomic responses were elicited in strains with different levels of resistance. This study will improve our view of resistance mechanisms in bacteria with different levels of resistance and provide the basis for our understanding of the molecular mechanism of antibiotic resistance in ampicillin-resistant E. coli strains. KEY POINTS: •The mutation of the ampC promoter may act synergistically with other mutations and lead to higher resistance. •Similar transcriptomic responses to ampicillin are induced in strains with different levels of resistance. •Low antibiotic concentrations are the steps that allow rapid achievement of high antibiotic resistance.

Molecular detection of Shiga toxin and extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates from sheep and goats.

The Shiga toxin (Stx)-producing Escherichia coli (STEC) have become important global public health concerns. This study investigated the prevalence, antimicrobial resistance profile, and extended-spectrum beta-lactamase-producing E. coli in sheep and goat faeces. A total of 53 E. coli isolates were confirmed by PCR targeting the uidA [β-D glucuronidase] gene. The Shiga toxin genes stx1 and stx2, as well as bfpA, vir, eaeA, lt and aafII virulence genes, were detected in this study. Of the 53 isolates confirmed to be STEC, 100% were positive for stx2 and 47.2% for stx1. Three isolates possessed a combination of stx1 + stx2 + eaeA, while four isolates harboured stx1 + stx2 + vir virulence genes. The isolates displayed phenotypic antimicrobial resistance against erythromycin (66.04%), colistin sulphate (43.4%), chloramphenicol (9.4%) and ciprofloxacin (1.9%). A total of 28.8% of the strains were phenotypically considered ESBL producers and contained the beta-lactamase blaCTX-M-9 and blaCTX-M-25 gene groups. A larger proportion of the E. coli strains (86.8%) contained the antibiotic sulphonamide resistant (sulII) gene, while 62.3%, 62.3%, 52.8%, 43.4%, 41.5%, 20.8%, 18.9%, 11.3%, 11.3%, 9.4%, 9.4% and 5.7% possessed mcr-4, floR, mcr-1, tet(A), sulI, tet(O), tet(W), parC, mcr-2, ampC 5, qnrS and ermB genes, respectively. Thirteen isolates of the ESBL-producing E. coli were considered multi-drug resistant (MDR). One Shiga toxin (stx2) and two beta-lactamase genes (blaCTX-M-9 and blaCTX-M-25 groups) were present in 16 isolates. In conclusion, the E. coli isolates from the small stock in this study contained a large array of high antibiotic resistance and virulence profiles. Our findings highlight the importance of sheep and goats as sources of virulence genes and MDR E. coli. From a public health and veterinary medicine perspective, the characterization of ESBL producers originating from small livestock (sheep and goats) is crucial due to their close contact with humans.

Ultrasound-responsive gallium protoporphyrin and oxygen loaded perfluoropentane nanodroplets for effective sonodynamic therapy of implant infections.

Implant infections are severe complications in clinical treatment, which often accompany the formation of bacterial biofilms with high antibiotic resistance. Sonodynamic therapy (SDT) is an antibiotic-free method that can generate reactive oxygen species (ROS) to kill bacteria under ultrasound (US) treatment. However, the extracellular polymeric substances (EPS) barrier of bacterial biofilms and the hypoxic microenvironment significantly limit the antibiofilm activity of SDT. In this study, lipid-shelled perfluoropentane (PFP) nanodroplets loaded with gallium protoporphyrin IX (GaPPIX) and oxygen (O2) (LPGO NDs) were developed for the treatment of implant infections. Under US stimulation, LPGO NDs undergo the cavitation effect and disrupt the biofilm structure like bombs due to liquid-gas phase transition. Meanwhile, the LPGO NDs release O2 and GaPPIX upon US stimulation. The released O2 can alleviate the hypoxic microenvironment in the biofilm and enhance the ROS formation by GaPPIX for enhanced bacterial killing. In vivo experimental results demonstrate that the LPGO NDs can efficiently treat implant infections of methicillin-resistant Staphylococcus aureus (MRSA) in a mouse model by disrupting the biofilm structure, alleviating hypoxia, and enhancing bacterial killing by SDT. Therefore, this work provides a new multifunctional sonosensitizer to overcome the limitations of SDT for treating implant infections.

Prevalence of extended-spectrum beta-lactamases producing isolates obtained from patients of pediatric critical care unit in a tertiary care hospital

Background: Over the past decades, antibiotic-resistant Gram-negative bacteria commonly Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae have increased significantly. These microorganisms have great clinical importance because they increase hospital stay of the patients in the intensive care unit (ICU) leading to high morbidity and mortality. Because of their role in increasing morbidity and mortality, this study was performed to isolate extended-spectrum beta-lactamase (ESBL) producing Gram-negative bacilli screened by phenotypical method and further projected into molecular characterization by polymerase chain reaction. Aims and Objectives: The aims and objectives are to isolate the Gram-negative multidrug-resistant strains from clinically suspected bacterial infections in patients of neonatal, sick newborn, and pediatric ICU and to study antibiotic sensitivity pattern of isolated Gram-negative multidrug-resistant strains with special reference to molecular characterization. Materials and Methods: A total of 100 Gram-negative bacilli were isolated. Screening of ESBL positivity was done by double-disk synergy test (combined disc test method). Their antibiogram profile was interpreted. With the use of designed primers, 26 ESBL isolates each of E. coli and Klebsiella spp. were processed for molecular analysis of beta-lactamase family genes TEM and CTX-M. Results: Within the 100 samples, majority of the isolates (45%) were Klebsiella spp. and 40% was E. coli isolates. Highest ESBL-producing organisms were observed within E. coli (65%). Prevalence bla-TEM gene was highest followed by bla-CTX-M. These ESBL-producing organisms were found to be resistant to multiple classes of antibiotics. With extensive ESBL surveillance and proper usage of antibiotics, this threatening rise of antibiotic resistance can be mitigated. Conclusion: Gram-negative isolates showed high resistance to commonly used antibiotics. Significant proportions of them were MDR strains. Such high antibiotic resistance is associated with significant morbidity and mortality among pediatric population. MDR along with possession of ESBL associated resistance genes among Gram-negative bacilli pose a serious problem in therapeutic management of patients. Our study signifies that there is a high probability of Gram- negative bacilli to be multi-drug resistant and ESBL positive and earliest detection of such cases should be made.

Detection of Some Virulence Factors of Listeria Species Isolated from Chicken and their Products

The current study was conducted to determine the occurrence of Listeria species in live chicken and some chicken products (fillets, burger and luncheon). In addition, determine the antibiogram profile of Listeria strains and detection of some virulence genes of Listeria monocytogenes which recovered from the examined samples. The study included 100 samples including cloacal swabs from broiler chicken (n =25) from 5 different broiler chicken farms beside as well as chicken products (25 samples each of chicken fillets, burger and luncheon) that were randomly purchased from supermarkets. Isolation and identification of Listeria was performed according to the standard protocol provided by ISO (2017) using Listeria selective agar (Oxford formulation) with Listeria selective supplement then the suspected colonies were identified using a panel of biochemical tests. It was recorded that the recovery rate of Listeria species from the examined samples was 24, 20, 8 and 16%, in cloacal swabs, chicken fillets, burger and luncheon, respectively with an overall incidence of 17%. In addition, biochemical identification of the recovered Listeria isolates revealed the presence of L. monocytogenes, L. innocua, L. ivanovii, L. seeligeri and L. grayi with various rates where L. monocytogenes scored the highest rate 29.4% (5 isolates). Antimicrobial susceptibility of Listeria strains (n=17) clarified that the highest antibiotic resistance was recorded when using streptomycin (82.4%) followed by Neomycin (76.5%) then Doxycycline and Cefotaxime (52.9%) while the lowest resistance was noticed when using Amikacin (11.8%) then Ciprofloxacin (35.3%). Finally, molecular detection of virulence genes in the identified L. monocytogenes strains (n= 5) clarified the detection of iap and actA genes in the five isolates while hylA gene was detected in three isolates only. At the end, results obtained by this study emphasize a significant occurrence of resistant Listeria in chicken and chicken products including processed animal-originated foods commonly purchased by the public in including; chicken fillets, burger and luncheon. Seriously, the presence of such resistant bacteria endangers human health by making routine antibiotic courses useless in the treatment of such infections. Finally, data proved that retail foods of animal origin pose a risk to human health.

Cross-talk of MLST and transcriptome unveiling antibiotic resistance mechanism of carbapenem resistance Acinetobacter baumannii clinical strains isolated in Guiyang, China.

Acinetobacter baumannii (A. baumannii) is an important opportunistic pathogen causing nosocomial infection in the clinic. The occurrence rate of antibiotic resistance is increasing year by year, resulting in a highly serious situation of bacterial resistance. To better understand the local epidemiology of multidrug-resistant A. baumannii, an investigation was conducted on the antibiotic resistance of different types of A. baumannii and its relationship with the genes of A. baumannii. Furthermore, the molecular mechanism underlying antibiotic resistance in A. baumannii was investigated through transcriptome analysis. These results showed that a total of 9 STs were detected. It was found that 99% of the strains isolated in the hospital belonged to the same STs, and the clone complex CC208 was widely distributed in various departments and all kinds of samples. Furthermore, these A. baumannii strains showed high resistance to ertapenem, biapenem, meropenem, and imipenem, among which the resistance to ertapenem was the strongest. The detection rate of bla OXA-51 gene in these carbapenem resistance A. baumannii (CRAB) reached 100%; Additionally, the transcriptome results showed that the resistance genes were up-regulated in resistance strains, and these genes involved in biofilm formation, efflux pumps, peptidoglycan biosynthesis, and chaperonin synthesis. These results suggest that the CC208 STs were the main clonal complex, and showed high carbapenem antibiotic resistance. All these resistant strains were distributed in various departments, but most of them were distributed in intensive care units (ICU). The bla OXA-23 was the main antibiotic resistance genotype; In summary, the epidemic trend of clinical A. baumannii in Guiyang, China was analyzed from the molecular level, and the resistance mechanism of A. baumannii to carbapenem antibiotics was analyzed with transcriptome, which provided a theoretical basis for better control of A. baumannii.

Evaluation of Antimicrobial Efficacy of 3.8% Silver Diamine Fluoride as a Root Canal Irrigant against Enterococcus Faecalis in Primary Teeth: A Randomised Clinical Trial

Introduction: During a pulpectomy, the infected or inflamed pulp tissues are removed, and the root canal is thoroughly cleaned with mechanical instrumentation and copious irrigation. Various endodontic irrigants are available, such as Sodium Hypochlorite (NaOCl), Chlorhexidine (CHX) gluconate, Ethylene Diamine Tetra Acetic Acid (EDTA), Mixture of doxycycline, citric acid, and a detergent (MTAD), etc. Among these, CHX gluconate is widely used as an endodontic irrigant and medicament due to its antibacterial effect and substantivity. Enterococcus faecalis is the most common bacterial species found in necrotic teeth, with high viability and antibiotic resistance. A 3.8% Silver Diamine Fluoride (SDF) has antimicrobial properties and has been shown to eliminate E. faecalis from the root canals of permanent teeth. However, there are no studies in the literature that have evaluated its efficacy as a root canal irrigant in primary teeth. Aim: To evaluate the antimicrobial efficacy of 3.8% SDF against E. faecalis in primary teeth. Materials and Methods: This was a in-vivo double-blinded randomised clinical trial conducted at Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India in children aged 3-8 years old. The study included 60 primary teeth that required pulpectomy. The teeth were divided into two groups and irrigated: 30 teeth with 3.8% SDF (Group I) and 30 teeth with 2% CHX (Group II). In all cases, two microbiological samples were taken using sterile absorbent paper points: the first after access opening and the second after the final irrigation. All samples were assessed using the agar plate method. The results were analysed statistically using a Student's paired t-test. Results: After analysing the pre- and postirrigation samples, there was a statistically significant reduction in Colony Forming Units (CFU)mL (p&lt;0.05) in both groups. When comparing the two groups, no statistical difference was observed in the percentage reduction of bacterial colonies (p&gt;0.05). Conclusion: The reduction in CFU/mL of E. faecalis was comparable in both groups. Thus, 3.8% SDF can be used as an alternative root canal irrigant to 2% CHX.

Predictors of Mortality, Drug Resistance, and Determinants among Carbapenem‐Resistant Enterobacteriales Infections in Chinese Elderly Patients

Elderly patients with carbapenem‐resistant Enterobacteriales (CRE) infections represent considerable mortality rates. But data on the risk factors for the death of elderly patients following such infection remain limited. We aimed to assess the clinical outcomes, identify mortality‐associated risk factors, and determine the antibiotic resistance and resistance genes of isolates for these patients. Hospitalized patients aged ≥65 years with CRE infection from January 2020 to December 2020 were retrospectively reviewed. Isolates identification and molecular characterization of CRE were carried out. Logistic regression analysis was applied to assess the potential factors associated with mortality. Of the 123 elderly patients with CRE infection included in our study, the all‐cause mortality rate was 39.8% (49/123). The most prevalent pathogen was carbapenem‐resistant Klebsiella pneumoniae (CRKP, 116 of 123). The overall rates of multidrug‐resistant (MDR) and extensively drug‐resistant (XDR) were 100.0% and 66.7%. All CRE isolates exclusively harbored a singular variant of carbapenemase gene, such as blaKPC−2, blaIMP−4, blaNDM−5, or blaOXA−48, while 98.4% of isolates harbored more than one β‐lactamase gene, of which 106 (86.2%) isolates harbored blaCTX−M, 121 (98.4%) isolates harbored blaTEM, and 116 (94.3%) isolates harbored blaSHV. Multivariable logistic regression analysis revealed that mechanical ventilation (adjusted odds ratio (AOR) = 33.607, 95% confidence interval (CI): 4.176‐270.463, P &lt; 0.001), use of tigecycline during hospitalization (AOR = 5.868, 95% CI: 1.318‐26.130, P = 0.020), and APACHE II score (AOR = 1.305, 95% CI: 1.161–1.468, P &lt; 0.001) were independent factors associated with increasing the mortality of patients with CRE infection, while admission to intensive care unit (ICU) during hospitalization (AOR = 0.046, 95% CI: 0.004–0.496, P = 0.011) was a protective factor. CRE‐infected elderly patients with mechanical ventilation, use of tigecycline during hospitalization, and high APACHE II score were related to poor outcomes. The isolates carried various antibiotic genes and presented high antibiotic resistance. These findings provide crucial guidance for clinicians to devise appropriate strategies for treatment.

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.

Survey the proportion and antibiotic sensitivity of methicillin-resistant staphylococcus aureus among patients in Danang Oncology Hospital

In this study, 134 patients including 80 adult men and 54 women treated at Danang Oncology Hospital from January 2019 to July 2021 had specimen culture results found Staphylococcus aureus was investigated. All study patient data was collected according to an established uniform form on Microsoft Excel spreadsheet software and processed by Python programming language. We found that 76.1% of patients infected with S. aureus during this time were MRSA. Of which, 100% MRSA and MSSA isolates were resistant to Amoxicillin, 61.2% to Cefuroxime. Multi-resistance and broad-spectrum multi-resistance to other antibiotics belonging to the Carpapenem, Quinolone and Aminoglycoside groups were recorded in most isolated S. aureus. The results showed that S. aureus causing bacterial infection at Danang Oncology Hospital during the survey period had a high antibiotic resistance rate.