Indiscriminate Use Of Antibiotics Research Articles

The Synergistic and Chimeric Mechanism of Bacteriophage Endolysins: Opportunities for Application in Biotherapeutics, Food, and Health Sectors.

A major growing concern in the human and animal health sector is the emergence of antibiotic-resistant pathogenic bacteria due to the indiscriminate use of antibiotics. The exogenous application of bacteriophage endolysins causes abrupt lysis of the bacterial cell wall, which computes them as alternatives to antibiotics. Although naturally occurring endolysins may display limitations in solubility, lytic activity, and narrow lytic spectrum, novel strategies like developing chimeric endolysins and using endolysins in synergism with other antimicrobial agents are required to improve the lytic activity of natural endolysins. The modular structure of endolysins led to the development of novel chimeric endolysins via shuffling enzymatic and cell wall binding domains of different endolysins, using endolysins in a synergistic approach, and their applications in various in vitro and in vivo experiments and different applicable areas. This article aims to review the role of chimeric endolysins and their use in synergistic mode with other biofilm-reducing agents to control biofilm formation and deteriorating pre-formed biofilms in food, dairy, and medical industries. Promoting further development of phage technology and innovation in antibiotic therapy can achieve long-term sustainable development and economic returns.

Avian Pathogenic Escherichia coli Isolated in Poultry Farms in Bangladesh that Use Antibiotics Extensively.

Colibacillosis caused by avian pathogenic Escherichia coli (APEC) is causing economic losses to the global poultry industry. Increased prevalence of antibiotic resistance in APEC is the leading cause for increased indiscriminate use of various antimicrobial compounds in farms. The study aimed to investigate the presence of phenotypic and genotypic markers for antibiotic resistance, metals, and biocides in APEC from Bangladeshi poultry and details about the antimicrobials used in poultry farms. In total, 55 APEC were isolated from hearts or liver samples of 86 sick or dead chickens using culture on agar plate and biochemical testing. APEC isolates were tested for antibiotic susceptibility to 14 antimicrobial agents according to the European Committee on Antimicrobial Susceptibility Testing. A series of PCRs was performed to screen the presence of genes for quinolones, colistin, aminoglycosides, ESBL, metals, and biocides. Detailed information regarding antibiotic use was collected from farmers during clinical investigations. Resistance was found to 10 antibiotics and prevalence was as follows: ampicillin (86%), ciprofloxacin (86%), trimethoprim-sulphamethoxazole (73%), chloramphenicol (33%), mecillinam (13%), gentamicin (11%), cefoxitin (11%), cefotaxime (9%), tigecycline (2%), and nitrofurantoin (2%). The most common multiresistance phenotype was CIP-AMP-SXT, and 35% of isolates were multidrug resistant. Genotypic analysis confirmed the presence of quinolone resistance genes [qnrS1 and aac-(6')-lb-cr], silver-resistant genes (silE), and mercury-resistant genes (merA) but not others. In total, 88% farmers were using different antimicrobial compounds, and, of them, 56% were using antimicrobials without prescriptions from veterinarians. Ciprofloxacin was most extensively used followed by oxytetracycline. Critically important antibiotics like ciprofloxacin, colistin, and gentamicin are extensively used in the farms. This study confirmed the presence of antibiotics, metals, and biocide-resistant APEC in poultry farms in Bangladesh. Increased resistance to quinolones is a serious ongoing problem. The indiscriminate use of antibiotics in poultry farms is alarming and should be stopped.

Antimicrobial and antioxidant activities of Bromelin Propolis Spray

The indiscriminate use of antibiotics over the last 60 years has led to the development of resistant strains, leading an urgent need for new treatments, new molecules or combinations of products, safety and effective. In this regard, propolis has been used in traditional medicine due its therapeutic effects, such as antibacterial, antifungal and antiseptic, tested in vitro, in vivo and clinically. The aim of this study is to evaluate the antimicrobial and antioxidant activities of a commercial oral flavoring product against bacterial strains of clinical interest from the upper respiratory tract. Bacteria sensitivity against Bromelin Propolis Sprayâ (BPS) was evaluated using macrodilution in broth and no turbid tubes plated on TSA to confirm the results. Tested bacteria were Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa. BPS showed antimicrobial activity for all tested strains and the MBC was 2.5mg/mL. Moreover, the antioxidant activity was determined by the ability to scavenge the stable radical DPPH. 0.007% of BPS showed the maximum antioxidant effect, of 6.63mM, which demonstrate its high antioxidant effect. Therefore, these results indicate that the commercial product BPS at 0.7% can be a potential candidate as adjuvant in antibiotic therapy for upper respiratory tract disorders, due possible antimicrobial effect and its high antioxidant potential.

A-241 Verification and Validation Study for a Host Response Assay Based on TRAIL, IP-10, and CRP: Application to Pediatric Emergency Department

Abstract Background Acute febrile illnesses (AFIs) represent a significant disease burden globally; however, the lack of reliable, rapid point-of-care testing makes diagnosis difficult. A simple tool for distinguishing bacterial versus non-bacterial infections would radically improve patient management and reduce indiscriminate antibiotic use. MeMed BV® (MMBV) is a blood test to reliably differentiate between viral and bacterial infections. Three host proteins (TRAIL, IP-10, and CRP) are measured quantitatively and a combinational score (0-100) is computed that indicates the likelihood of bacterial infection (or co-infection) versus viral infection (BV Score). MMBV time to result is 15 min on the MeMed Key® analyzer that conducts chemiluminescence-based immunoassays to measure protein concentrations and calculates the test score, using 100 µL of serum. Methods The verification study design was a comparison of known results to on-site testing for contrived samples. The validation study design was a prospective, single-center, observational, blinded diagnostic accuracy study conducted between 8/3/22 to 5/30/23. The population was pediatric patients with suspected serious infections presenting to Geisinger’s quaternary care Pediatric Emergency Dept. in Danville, PA. The comparator was a clinical chart review and adjudication of over 60 clinical and laboratory variables related to systemic infections. The data review team consisted of one pediatric emergency department physician, one pediatric infectious disease physician, and one microbiology laboratory director. If clinical decisions differed among the three, the team adjudicated with a full chart review including knowledge of the eventual outcome, which served as the final reference standard result. The study aims were to assess the analytical and clinical accuracy of MMBV testing and to assess the test’s potential impact to further inform the provider’s decision to admit or discharge the patient. Results Of 60 contrived samples there was three failed tests (5% failure rate) and 2 discordant results. Analytical accuracy was 55/57 (96.5%) for 28 bacterial, 26 viral, and 1 equivocal control. Of 50 pediatric patients recruited, 8 were excluded because they were trauma patients. Among 42 patients tested, 22/42 (52.4%) were interpreted as bacterial or co-infection, 16/42 (38.1%) as viral or non-infectious, and 4/42 (9.5%) as equivocal. For 37/38 (97.3%) of patients with bacterial/viral MMBV results, the result was concordant with expert adjudication. Of the 42 patients for which potential utility was assessed, all results were in alignment with the clinical decisions made for admission or discharge. Conclusions MMBV performed accurately in pediatric ED patients with symptoms of severe infection, both clinically and analytically. A larger sample size will be tested to assess the utility in ED admission and discharge decisions and antimicrobial stewardship. The prevalence of viral and bacterial or coinfection cases within the sample population is representative of the pediatric population samples.

Bacillus Sp. as Potential Probiotics for Use in Tilapia Fish Farming Aquaculture – A Review

Abstract Aquaculture is a crucial and rapidly expanding industry in global food production. Fisheries are also an essential socio-economic activity, providing abundant resources and remarkable prospects. However, due to the deteriorating ecological environment, aquatic animals are often exposed to traumatic conditions and are susceptible to bacterial infections that pose significant challenges for aquaculture production. The indiscriminate use of antibiotics in the past has led to the emergence of multidrug-resistant pathogens and sudden outbreaks of infectious diseases, resulting in serious economic losses. Moreover, the use of expensive chemotherapeutic drugs and antibiotics has negative impacts on aquatic environments. Therefore, it is increasingly important to adopt alternative natural agents, such as probiotics and their metabolites, to enhance healthy fish production. Probiotics are microorganisms that have numerous beneficial effects on their hosts. They are environmentally friendly, non-toxic, and cost-effective. This review specifically focuses on the use of Bacillus sp. as probiotics to promote healthy tilapia production in the aquatic sector, while also examining their interactions with the immune system and gut micro-biota. The information presented in this review can guide future research and promote effective and healthy tilapia culture production.

Understanding the Evolution and Transmission Dynamics of Antibiotic Resistance Genes: A Comprehensive Review.

Antibiotic resistance poses a formidable challenge to global public health, necessitating comprehensive understanding and strategic interventions. This review explores the evolution and transmission dynamics of antibiotic resistance genes, with a focus on Bangladesh. The indiscriminate use of antibiotics, compounded by substandard formulations and clinical misdiagnosis, fuels the emergence and spread of resistance in the country. Studies reveal high resistance rates among common pathogens, emphasizing the urgent need for targeted interventions and rational antibiotic use. Molecular assessments uncover a diverse array of antibiotic resistance genes in environmental reservoirs, highlighting the complex interplay between human activities and resistance dissemination. Horizontal gene transfer mechanisms, particularly plasmid-mediated conjugation, facilitate the exchange of resistance determinants among bacterial populations, driving the evolution of multidrug-resistant strains. The review discusses clinical implications, emphasizing the interconnectedness of environmental and clinical settings in resistance dynamics. Furthermore, bioinformatic and experimental evidence elucidates novel mechanisms of resistance gene transfer, underscoring the dynamic nature of resistance evolution. In conclusion, combating antibiotic resistance requires a multifaceted approach, integrating surveillance, stewardship, and innovative research to preserve the efficacy of antimicrobial agents and safeguard public health.

Macrolide resistance outcomes after the Covid-19 pandemic: A one health approach investigation

During the Covid-19 pandemic period, the indiscriminate use of macrolide-class antibiotics was frequent among the Brazilian population due to the lack of knowledge and information with a scientific basis. Thus, the class of drugs that includes azithromycin, clarithromycin, and erythromycin, which alter metabolic reactions in the body and act on the immune system, was widely used without medical prescription. Samples of bacterial strains from hospital environments were obtained during the most extensive spread of Covid-19 and studied in the present article, emphasizing the investigation for macrolide resistance genes (erm and msr) and bacteria of the genus Staphylococcus isolated from urinary tract infections. In addition, the physiological, genetic, immunological, and socio-epidemiological aspects were highlighted with a focus on the One Health approach and implications on the gut-brain axis in this integrative research, revealing that the inappropriate use of antibiotics directly affects entire communities, representing a significant concern for public and environmental health.

Synthesis and Characterization of Multifunctional Chitosan-Silver Nanoparticles: An In-Vitro Approach for Biomedical Applications.

Antibiotics are successful in promoting health quality by preventing various infectious diseases and minimizing mortality and morbidity all over the world. However, the indiscriminate use of antibiotics has led to the emergence of multi-drug-resistant bacteria, which pose a serious threat to health care sector. Therefore, it is necessary to develop novel antimicrobial agents with versatile characteristics, such as antibacterial activity, low toxicity, wound healing potency, and antioxidant property. In this context, silver chitosan nanoparticles were synthesized in the present study, and their physical characterization revealed that the size of synthesized chitosan-silver nanoparticles was 14-25 nm, with positive surface charge. The functional groups and crystalline nature of the nanoparticles were confirmed by FT-IR and XRD analysis. Further, the silver chitosan nanoparticles showed antibacterial activity against two important clinical pathogens, S. aureus and E. coli. The MTT assay carried out in the present study showed that the synthesized nanoparticles are non-toxic to host cells. A scratch assay on fibroblast cells (L292) demonstrated that the silver chitosan nanoparticles showed promising wound healing activity. A fluorescent DCFH-DA staining assay revealed anantioxidant property of the synthesized nanoparticles. Overall, the study emphasizes the versatile nature of synthesized chitosan-silver nanoparticles, suggesting their great compatibility for biomedical applications.

Recombinase-aided amplification assay for rapid detection of imipenem-resistant Pseudomonas aeruginosa and rifampin-resistant Pseudomonas aeruginosa.

The indiscriminate use of antibiotics has resulted in a growing resistance to drugs in Pseudomonas aeruginosa. The identification of antibiotic resistance genes holds considerable clinical significance for prompt diagnosis. In this study, we established and optimized a Recombinase-Aided Amplification (RAA) assay to detect two genes associated with drug resistance, oprD and arr, in 101 clinically collected P. aeruginosa isolates. Through screening for the detection or absence of oprD and arr, the results showed that there were 52 Imipenem-resistant P. aeruginosa (IRPA) strains and 23 Rifampin-resistant P. aeruginosa (RRPA) strains. This method demonstrated excellent detection performance even when the sample concentration is 10 copies/μL at isothermal conditions and the results could be obtained within 20 minutes. The detection results were in accordance with the results of conventional PCR and Real-time PCR. The detection outcomes of the arr gene were consistently with the resistance spectrum. However, the antimicrobial susceptibility results revealed that 65 strains were resistant to imipenem, while 49 strains sensitive to imipenem with oprD were identified. This discrepancy could be attributed to genetic mutations. In summary, the RAA has higher sensitivity, shorter time, and lower-cost instrument requirements than traditional detection methods. In addition, to analyze the epidemiological characteristics of the aforementioned drug-resistant strains, we conducted Multilocus Sequence Typing (MLST), virulence gene, and antimicrobial susceptibility testing. MLST analysis showed a strong correlation between the sequence types ST-1639, ST-639, ST-184 and IRPA, while ST-261 was the main subtype of RRPA. It was observed that these drug-resistant strains all possess five or more virulence genes, among which exoS and exoU do not coexist, and they are all multidrug-resistant strains. The non-coexistence of exoU and exoS in P.aeruginosa is related to various factors including bacterial regulatory mechanisms and pathogenic mechanisms. This indicates that the relationship between the presence of virulence genes and the severity of patient infection is worthy of attention. In conclusion, we have developed a rapid and efficient RAA (Recombinase-Aided Amplification) detection method that offers significant advantages in terms of speed, simplicity, and cost-effectiveness (especially in time and equipment aspect). This novel approach is designed to meet the demands of clinical diagnostics.

Antibacterial Activity Test of Sumbawa White Honey against Escherichia coli ATCC 25922

Due to their high mortality and morbidity rates, E. coli infections are a serious issue. Antimicrobial Resistance (AMR) is a result of this indiscriminate antibiotic use. One approach to address this issue is to utilize natural antimicrobials such as Sumbawa white honey. Sumbawa white honey contains antibacterial components like glucose and fructose (80%), water (17%), polyphenols, and hydrogen peroxide. This study aimed to analyze the antibacterial activity of white honey from Sumbawa against E. coli ATCC 25922. The research method employed was a laboratory experiment using a post test only control group design. Antibacterial testing was conducted using disc diffusion at concentrations of 25%, 75%, and 100%, with chloramphenicol as positive control and DMSO as negative control, and honey processing involved dilution. Antibacterial tests were repeated five times and antibacterial activity was observed based on the diameter of inhibition zones around the disc. The outcomes showed that there was a restraint zone at 100 percent grouping of honey, to be specific 0.90 mm, while at 25% and 75% fixations there were no hindrance zones. According to the findings of this study, white honey from Sumbawa has a low antibacterial activity (0.90 mm), but this activity is ineffective against E. coli ATCC 25922. Further identification of the chemical components in Sumbawa white honey that are primarily responsible its antibacterial effect.

Antibacterial Resistance and Extended-Spectrum Beta-Lactamase (ESBL) Phenotypes in Enterobacteriaceae Isolated from Fecal Samples of Humans and Animals in Selected Local Government Areas of Nasarawa State, Nigeria

It is quite alarming the increasing rate of antibacterial resistance all over the world considering the public health threat and the re-emergence of multi-drug resistant Enterobacteriaceae. The aim of this study is Antibacterial resistance and phenotypic detection of Extended Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae isolated from human and animal fecal samples in selected local government areas of Nasarawa state, Nigeria was carried out in the study. Hundred (100) samples comprising human and animal (goats, cattle, and chicken) were collected and 55 samples were multidrug resistant. A commercial biochemical kit (Eneterosystem 18R) was used for the isolation and identification of Enterobacteriaceae. Kirby Bauer Disk Diffusion Method was used for antibacterial susceptibility testing of Enterobacteriaceae isolates. The Double Disc Synergy Test (DDST) method was also used for the phenotypic confirmation test of Extended Spectrum Beta Lactamase (ESBL). The occurrence of multidrug-resistant isolates shows that Escherichia coli (100.00%) which is the highest, Proteus mirabilis (14.54%), Klebsiella pneumoniae, and Salmonella enterica (10.90%), while the occurrence of Shigella flexneri (9.09%) was the lowest. The Enterobacteriaceae isolates were more resistant to Cefuroxime, Cefexime, Amoxicillin Clavulanate, and Imipenem/Cilastatin with percentage resistance ranges from 66.6% - 100%. The occurrence of ESBL producers shows that Escherichia coli (60.00%) and Proteus mirabilis (62.5%) were high while Shigella flexneri (20.0%) had a low occurrence of ESBL. The sale and in-discriminate use of antibiotics without a prescription is an important regulatory issue in the abuse of antibiotics for both humans and animals. The Beta-Lactam and gentamycin antibiotics were not effective against the Multi-Drug Resistant (MDR) isolates and most of the isolates were ESBL producers.

Review on anti-microbial resistance patterns of staphylococcus aureus isolated from mastitic cow’s milk: Ethiopian context

Aim of this paper is to review antimicrobial resistance profile of Staphylococcus aureus (S. aureus) isolated from mastitic cow milk in Ethiopia between 2013- 2023. S. aureus causes chronic intramammary infections, causing financial losses and challenging antimicrobial therapy globally. In Ethiopia meta-analysis of the pooled prevalence of bovine mastitis was 47.6% showing S. aureus as the major isolates accounting for 13.4% and 16.5% of clinical and subclinical mastitis. In Ethiopia, there are indication of the misuse of antibiotics coupled with the rapid spread of resistant bacterial nature and inadequate surveillance, which contributed to the problem. According to this review resistance profile of S. aureus studied in Ethiopia, the bulk of tested isolates showed alarmingly high levels of resistance to widely used antimicrobial drugs for the treatment of mastitis, particularly penicillin G and tetracycline. Variuos studies warned low susceptibility of S. aureus to commonly used antimicrobials such as penicillin G and tetracycline as a great concern because this antibiotic represents the main antibiotic group recommended for staphylococcal mastitis infection in Ethiopia. If essential steps to stop the indiscriminate use of antibiotics are not implemented, the prevalence of antibiotic-resistant S. aureus could rise posing major risks to both animal and human health. Therefore, conducting regular antimicrobial sensitivity testing before treatment helps select effective antibiotics which reduce the development of resistance to commonly used antibiotics. Further studies should be conducted to detect antimicrobial resistant strains, continiuos surveillance and monitoring of S. aureus to prevent the spread of milk-borne drug-resistant strains throughout communities.

Precursor effect on the hydrothermal synthesis of pure ZnO nanostructures and enhanced photocatalytic performance for norfloxacin degradation

The indiscriminate production and use of antibiotics have caused an environmental imbalance. Therefore, advanced oxidative processes such as photocatalysis have been proposed to eliminate the presence of such emerging pollutants. On the other hand, the use of photocatalytic processes requires the development of highly efficient photocatalysts. This paper introduces photocatalysts based on ZnO nanostructures with different morphologies and grown by low-temperature hydrothermal synthesis. The choice of zinc precursor resulted in significant variations in both the morphology and size of the ZnO particles. Morphologies, such as, dumbbell-like structures, nanogranules, and ellipsoidal particles were obtained by altering the zinc precursor in a slightly alkaline medium, and parameters such as photocatalyst dosage, initial concentration of antibiotic Norfloxacin (NOR), and pH in photocatalysis were thoroughly investigated. The reactive species responsible for NOR degradation were photogenerated holes, superoxide radicals, and hydroxyl radicals, with the latter showing a greater contribution. Degradation pathways are also proposed, and intermediate products were identified by LC-MS. Thirteen degradation products, of which six were reported for the first time, were detected. Among the synthesized morphologies, nanogranules exhibited superior photocatalytic activity, achieving 100% NOR degradation after 70 min under UV-C light and excellent reusability after three cycles (97%). The results surpass those from previous studies, since the simple and efficient photocatalysts employed led to shorter degradation times.

Gonorrhoea treatment guideline compliance and influence factors in Guangdong province, China: a cross-sectional survey

BackgroundThe indiscriminate use of antibiotics has accelerated antimicrobial resistance (AMR) in Neisseria gonorrhoeae (NG), emphasising the need to follow treatment guidelines. This study aimed to assess the rate of adherence...

A confirmation of the predictive utility of the Antibiotic Use Questionnaire

BackgroundThe change in the efficacy of antimicrobial agents due to their misuse is implicated in extensive health and mortality related concerns. The Antibiotics Use Questionnaire (AUQ) is a theory driven measure based on the Theory of Planned Behaviour (TpB) factors that is designed to investigate drivers of antibiotic use behaviour. The objective of this study is to replicate the factor structure from the pilot study within a similar Australian confirmation cohort, and to extend this through investigating if the factor structure holds in a Chinese-identifying cohort.MethodsThe AUQ was disseminated to two cohorts: a confirmation cohort similar to the original study, and a Chinese identifying cohort. Data analysis was completed on the two data sets independently, and on a combined data set. An orthogonal principal components analysis with varimax rotation was used to assess the factor structure, followed by general linear models to determine the influence of the TpB factors on reported antibiotic use.Results370 participant responses from the confirmation cohort, and 384 responses from the Chinese-identifying cohort were retained for analysis following review of the data. Results showed modest but acceptable levels of internal reliability across both cohorts. Social norms, and the interaction between attitudes and beliefs and knowledge were significant predictors of self-reported antibiotic use in both cohorts. In the confirmation cohort healthcare training was a significant predictor, and in the Chinese-identifying cohort education was a significant predictor. All other predictors tested produced a nonsignificant relationship with the outcome variable of self-reported antibiotic use.ConclusionsThis study successfully replicated the factor structure of the AUQ in a confirmation cohort, as well as a cohort that identified as culturally or legally Chinese, determining that the factor structure is retained when investigated across cultures. The research additionally highlights the need for a measure such as the AUQ, which can identify how differing social, cultural, and community factors can influence what predicts indiscriminate antibiotic use. Future research will be required to determine the full extent to which this tool can be used to guide bespoke community level interventions to assist in the management of antimicrobial resistance.

Evaluation of the Impact of Antibiogram Availability and Utilization on Antibiotic Use among Healthcare Providers in Saudi Arabia: A Cross-Sectional Study.

Antibiotic resistance is a significant global health issue, exacerbated by the indiscriminate use of antibiotics without antibiograms. Implementing appropriate stewardship programs that monitor and control antibiotic use is essential to minimize resistance development and ensure optimal patient outcomes. This study aims to assess the impact of antibiogram availability and utilization on antibiotic use among healthcare providers in Saudi Arabia, focusing on whether antibiogram data and utilization influence the appropriateness of antibiotic prescribing practices. A cross-sectional study design was employed, utilizing a self-administered online survey distributed to physicians, pharmacists, and other healthcare providers across various healthcare settings in Saudi Arabia. Data were collected over a 90-day period, from 1 December 2023 to 29 February 2024. Descriptive statistics were used to summarize participants' characteristics, and data were analyzed based on geographical region, participants' positions, and other predetermined differences. Out of 23,860 contacted individuals, 333 responded, and 283 were included in the analysis. The majority (62.2%) reported the availability of antibiograms at their facilities, with 84.1% utilizing them in clinical practice. The frequency of consulting antibiograms varied, with only 21.6% doing so daily. Key barriers to antibiogram availability included lack of expertise, technological infrastructure, and funding. Most participants (68.8%) observed changes in antibiotic prescription practices post-antibiogram introduction, and 86.9% believed antibiograms could shorten patients' length of stay and improve outcomes. However, only 40.9% had received training on antibiogram use. While healthcare providers in Saudi Arabia have a relatively high level of antibiogram availability and utilization, several barriers hinder their consistent use. Enhancing accessibility, promoting frequent use, and providing targeted training could strengthen the impact of antibiograms on antibiotic prescribing practices and antimicrobial stewardship efforts.

Antimicrobial resistance pattern of Klebsiella species isolated from various clinical specimens

Objective: The present study was carried out to identify Klebsiella species and their antimicrobial resistance pattern from various clinical specimens. Methods: This cross study was conducted at a tertiary care hospital, Dhaka, Bangladesh from July2020 to June 2021. Written consent was taken from the concerned authority. A total 6739 clinical samples including urine, wound swab/ pus, sputum, blood and endotracheal aspirates were collected and processed for isolation of bacteria by following standard guidelines from adult patients. All the urine, wound swab, blood and endotracheal aspirates were inoculated in both blood agar and MacConkey agar media, for blood samples blood culture was done in BacT/ALERT 3D 60 aerobic bottles irrespective to antibiotics administration. After incubation at 370C aerobically for 24 hours incubated plates were examined. Phenotypic identification of the organisms were done by observing colony morphology, hemolytic properties, pigment production, Gram staining and biochemical tests (oxidase test, catalase test and biochemical reactions after inoculation in TSI, MIU, citrate agar media). The Kirby - Bauer disk diffusion method was used for antimicrobial susceptibility testing of the isolated organism using Mueller-Hinton agar and commercially available antibiotic discs (Oxoid Ltd, UK). The data were analyzed using SPSS software Version-20 (SPSS Inc., Chicago, IL, USA). Categorical variables were expressed as numbers (n) and percentages (%). Results: A total 6739 samples were included in the present study. Of which, 170 were urine, 162 were wound swabs, 71 were sputum, 52 were endotracheal aspirates and 45 were blood samples. Culture positivity among the samples is shown in table I. Conclusion: Most of the Klebsiella species are highly resistant to commonly used antibiotics. This higher resistance is the major cause morbidity and mortality related with infections in hospitalized patients. So, a regular surveillance of antibiotic susceptibility pattern is needed to prevent indiscriminate use of antibiotics. CME J 2024; 3(2); 12-15

Antimicrobial Activity of Essential-Oil-Based Nanostructured Lipid Carriers against Campylobacter Spp. Isolated from Chicken Carcasses.

Campylobacter is a virulent Gram-negative bacterial genus mainly found in the intestines of poultry. The indiscriminate use of traditional antibiotics has led to drug resistance in these pathogens, necessitating the development of more efficient and less toxic therapies. Despite their complex biologically active structures, the clinical applications of essential oils (EOs) remain limited. Therefore, this study aimed to increase the bioavailability, stability, and biocompatibility and decrease the photodegradation and toxicity of EO using nanotechnology. The diffusion disk test revealed the potent anti-Campylobacter activity of cinnamon, lemongrass, clove, geranium, and oregano EOs (>50 mm). These were subsequently used to prepare nanostructured lipid carriers (NLCs). Formulations containing these EOs inhibited Campylobacter spp. growth at low concentrations (0.2 mg/mL). The particle size, polydispersity index, and zeta potential of these systems were monitored, confirming its physicochemical stability for 210 days at 25 °C. FTIR-ATR and DSC analyses confirmed excellent miscibility among the excipients, and FE-SEM elucidated a spherical shape with well-delimited contours of nanoparticles. The best NLCs were tested regarding nanotoxicity in a chicken embryo model. These results indicate that the NLC-based geranium EO is the most promising and safe system for the control and treatment of multidrug-resistant strains of Campylobacter spp.

Prevalence of Antibiotic Resistance Genes in Bacterial Isolates in Iran: A Systematic Review

Context: The widespread use of biocides containing quaternary ammonium compounds (QACs) in medical centers has led to resistant strains of microorganisms. This study aimed to evaluate the frequency of genes resistant to antiseptics in Iranian bacterial isolates. Methods: The present study was conducted as a systematic review. The keywords in the titles or abstracts of articles published in Persian and English were monitored. The search was performed in databases without a time limit. Results: The results showed a total of 975 bacterial isolates. The most common disinfectant-resistant genes in gram-positive isolates were QacAB genes, with an average of 28.48; SMR gene, with an average of 19.8; and qacE and qacEΔ1 genes, with an average of 45 in gram-negative isolates. Gram-negative isolates containing qacE and qacEΔ1 genes were mainly detected in patients hospitalized in intensive care, internal diseases, and infectious diseases wards and from trachea and urine samples. Conclusions: The unique conditions of the intensive care units and the use of invasive tools such as urinary catheters were the leading causes of infection with resistant pathogens. In addition, diversity in infection control measures like the type, amount, and concentration of disinfectants used in different hospital departments were other reasons for resistance to antiseptics in medical environments. Indiscriminate use of antibiotics caused microbial resistance in the same way antibiotics did not affect many microbial diseases, and arbitrary use caused the highest microbial resistance.

Combatting Antibiotic Resistance: Identifying Gaps in Knowledge, Attitude, and Practice Among Medical Interns.

Antibiotic resistance presents a significant global health threat to modern medicine. The awareness and attitude of future doctors undergoing training may play a crucial role in addressing this important issue, influencing the control of resistance and promoting responsible antibiotic stewardship. This study aimed to estimate knowledge, attitudes, and practices regarding antibiotic usage and antimicrobial resistance among tertiary care teaching hospital medical interns. The questionnaire-based cross-sectional study was conducted on 123 MBBS interns from multiple medical institutions. Intern's knowledge, attitudes, and self-reported practices regarding antibiotic use were recorded. Based on survey responses from 123 participants, 116 (94.31%) were aware of the adverse effects of indiscriminate antibiotic use, recognizing the risks of ineffective treatment, increased adverse effects, prolonged illness, bacterial resistance, and higher medical costs. Most (106, 86.18%) acknowledged the challenges of treating antibiotic-resistant infections, and 69 (56.10%) correctly identified that bacteria are not a cause of the common cold and flu. Most (115, 93.5%) recognized antibiotic resistance as a significant global health problem. In attitude, 90 (73%) believed antibiotics should be avoided for colds, but 80 (65%) thought they hastened fever recovery. Only 48 (39%) recognized that antibiotics contribute to resistance, while 102 (83%) agreed skipping doses fosters resistance. Most support hospital policies (118, 96%) and curriculum courses (112, 91%) for rational antibiotic use.Regarding practice, 12 (9.76%) interns admitted to overusing antibiotics, 68 (55.28%) consulted a doctor before starting antibiotics, and 87 (70.73%) checked expiry dates. Additionally, 62 (50.41%) preferred antibiotics for cough and sore throat symptoms. The study highlights that while interns have a good knowledge and awareness of the harms of antibiotic misuse, they are not translating this knowledge into practice. This indicates a disconnect between understanding and application. Therefore, there is a need to add a rational antibiotic prescription and stewardship module to the medical curriculum to ensure that knowledge is effectively translated into changing beliefs and practices.