Kirby-Bauer Method Research Articles

Bacterial Superinfection and Antibiotic Management in Patients with COVID-19 Admitted to Intensive Care Medicine in Central Iran: A Follow-Up Study.

Bacterial superinfections are one of the crucial challenges in patients with coronavirus disease 2019 (COVID-19) that are associated with a high mortality rate. The current study was designed to assess bacterial superinfections and antibiotic management in COVID-19 patients admitted to intensive care unit (ICU). Seventy-three adult intubated patients with COVID-19 were included in a cross-sectional study. The lung aspirate samples were collected in two stages and assessed for bacterial growth by standard methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method as recommended by the Clinical Laboratory Standard Institute guideline (2021 edition). Also, demographic and clinical data were collected. The statistical analysis was done by chisquare test and Student's t-test, and a P value <0.05 was considered significant. Forty men and thirty-three women with a mean age of 64.78 ± 13.90 have included in our study. The mean length of hospitalization and stay in ICU were 18.77 ± 12.94 and 13.51 ± 9.83 days, respectively; 84.9% of cases died. Thirty-three patients had a bacterial superinfection mainly caused by Klebsiella spp and Acinetobacter spp; 21.2% of piperacillin/tazobactam consumers' patients survived that; the differences were significant (p = 0.034). A significant relationship was seen between superinfection and length of hospital stay until intubation (p = 0.033). Bacterial superinfection and mortality rates were relatively high in COVID-19 patients admitted to ICU. According to the results, using beta-lactam/beta-lactamase inhibitors antibiotics in hospitalized patients in ICU can effectively control superinfection.

Antibiotic Resistance of Hemophilus influenzae Isolated from Children in Southwest China.

Hemophilus influenzae (Hi) is one of the major pediatric bacterial pneumonia pathogens that heavily threatens children's lives and global health. With widespread usage as first-line treatment, the prevalence of β-lactam-resistant strains is increasing sharply. In order to treat Hi more effectively, a systematic study on the antibiotic resistance profiles, β-lactamase-negative ampicillin-resistant (BLNAR) strains isolation rate, and potential BLNAR resistance mechanism in our region is needed. This study analyzed antimicrobial susceptibility of Hi, and clinical data of Hi-infected patients retrospectively. BLNAR and β-lactamase-positive ampicillin-clavulanate resistant strains (BLPACR) were confirmed by the Kirby-Bauer method and β-lactamase test. ftsI gene in BLNAR was sequenced to find out whether resistance was induced by penicillin-binding protein mutation. Ampicillin susceptibility test with or without efflux pump inhibitors were done to assess efflux pump contribution in BLNAR. RT-PCR was performed to evaluate the efflux pump genes' transcription levels. A total of 2,561 Hi strains were isolated in our hospital from January 2016 to December 2019. Male to female ratio was 1.52:1. Median age was 10 months. Infant (< 3 years old) infection accounted for 83.72%. Hi resistance rates to sulfamethoxazole-trimethoprim, ampicillin, cefathiamidine, cefaclor, cefuroxime, cephalothin, amoxicillin-clavulanate, tetracycline, chloramphenicol, ofloxacin, cefotaxime, and rifampin were 84.28%, 78.01%, 49.80%, 41.98%, 36.58%, 33.64%, 4.55%, 4.1%, 3.37%, 1.77%, 0.99%, and 0.12%, respectively, while 1.33% were BLNAR. BLNARs were classified into four groups by mutation patterns in ftsI gene and most strains were divided to Group Ⅲ/Ⅲ-like. EmrB, ydeA and norM transcription levels in some ampicillin-resistant strains were higher than their sensitive counterparts. Ampicillin is not sufficiently effective as a first-line Hi infection treatment. However, ampicillin-clavulanate and cefotaxime may be a better choice. Efflux pumps, emrB, ydeA and norM play roles in the high resistance to ampicillin.

A new solution for control of respiratory infection by Streptococcus equi isolated from horses in northern Iran

Respiratory infections caused by Streptococcus equi are one of the most important diseases in the equine industry. The increasing rate of antibiotic resistance among this bacterial species necessitates new antimicrobial agents. In this research, nasopharyngeal samples were taken from horses (n=90) in some areas of the Golestan Province, Iran. After isolation and identification of S. equi strains, antibiotic resistance of the isolates was evaluated using the Kirby-Bauer method. The antibacterial effect of lavender essential oil was investigated by broth microdilution assay. The frequency of streptococcal strains was 27.8%. The most frequent isolates were S. equi subsp. equi (72%) and S. equi subsp. zooepidemicus (28%). The frequency of S. equi was highest in horses aged less than 2 years (69.3%) and thoroughbred Turkmen horses (61.5%). The highest rate of resistance was observed against amoxicillin, while the highest rate of sensitivity was to ceftriaxone. Furthermore, the essential oil of lavender inhibited 90% of the isolates at concentrations ≥2048 μL/mL. Our study revealed that the frequency of antibiotic-resistant S. equi isolates was relatively high in the studied population of horses in Iran. It was concluded that essential oil of lavender possessed more potent in vitro activity than the common antibiotics for treatment of infections caused by S. equi subspecies.

Bacterial Epidemiology and Antimicrobial Resistance Profiles of Respiratory Specimens of Children with Pneumonia in Hainan, China.

To investigate the bacterial species and antimicrobial susceptibility of respiratory specimens of children with pneumonia in Hainan, China. A total of 5017 specimens, including 4986 sputum samples, 19 bronchoalveolar lavage fluid samples and 12 tracheal tube tip samples from hospitalized children with pneumonia from April 1, 2021 to March 31, 2022 were studied. All the bacterial isolates were identified and confirmed with the VITEK 2 system. Antimicrobial susceptibility of all isolates was determined using the Kirby-Bauer method or the VITEK 2 Compact automatic system, following the breakpoints recommended by the Clinical and Laboratory Standards Institute. A total of 996 bacterial isolates were collected and classified into 24 species. The top 10 most frequent species were Haemophilus influenzae (356 isolates, 35.7%), Streptococcus pneumoniae (128, 12.9%), Moraxella catarrhalis (114, 11.5%), Escherichia coli (89, 8.9%), Staphylococcus aureus (89, 8.9%), Klebsiella pneumoniae (82, 8.2%), Acinetobacter baumannii (31, 3.1%), Pseudomonas aeruginosa (28, 2.8%), Enterobacter cloacae (18, 1.8%), and Streptococcus agalactiae (13, 1.3%). 70.5% strains had the resistant (R) and/or intermediate (I) phenotypes to at least one of the tested drugs, with a large proportion (54.6%) showing resistance to two or more commonly used antibiotics. In addition, 60.5% (69/114) of M. catarrhalis strains and 42.9% (153/356) of H. influenzae strains produced β-lactamases while 19.1% (17/89) E. coli and 6.1% (5/82) K. pneumoniae strains produced extended-spectrum β-lactamases. A diversity of pathogenic bacteria were isolated from the respiratory tract of children with pneumonia in Hainan, China. High-frequency resistance to first-line antimicrobial drugs was observed in Gram-negative and Gram-positive bacteria, including 544 isolates resistant to at least two antibiotics. Rapid identification and susceptibility testing should be implemented for children with bacterial pneumonia in Hainan before drug treatment is recommended.

Synthesis, characterization and antimicrobial property of novel series of 3-(4-substituted phenyl)-1-(4-((4-morpholino-6-((4-nitrophenyl)amino)-1,3,5-triazin-2-yl)amino)phenyl) prop −2-en-1-one conjugates

N- hetrocycles s-triazine derivatives having chalcone moiety are important organic compounds due to their significant, medicinal, pharmaceutical, and biological activities. With this consideration in mind a novel series of triazine derivatives were synthesised by base catalysed condensation of ketone with different substituted aromatic aldehydes. The structures of newly synthesised triazine derivatives were confirmed by various spectroscopic techniques such as IR,1H NMR,13C NMR. All synthesised compounds were screened for their antibacterial activity against gram positive (Streptococcus pneumonia, Salmonella typhy) gram negative (Escherichia coli) using Kirby-Bauer method was followed for disk diffusion method using ofloxacin as a reference,antifungal property against (Trichophyton rubrum, Candida albicans) fungi and flucanazole used as a reference while antiviral property against (SARS-CoV-2, hepatitis B)viruses using ofloxacin and acyclovir as a reference. It can be noticed that all synthesised compounds showed good antifungal activity,moderate antibacterial activity, mild antiviral activity.

Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has seriously threatened public health worldwide. This study aimed to investigate the antimicrobial resistance patterns, sequence types (STs), virulence and carbapenemase genes of CRKP isolates from patients in Zunyi, China. CRKP isolates were collected from the First People's Hospital of Zunyi between January 2018 and December 2020. Antimicrobial susceptibility was determined using a VITEK®2 analyzer and confirmed using either the broth dilution method, Kirby-Bauer method, or E-test assays. Carbapenemase production was examined using a modified carbapenem inactivation method. STs of the studied isolates were determined by multilocus sequence typing, and the presence of carbapenemase and virulence genes was examined using polymerase chain reaction assays. In total, 94 CRKP isolates were collected. All studied isolates produced carbapenemase, and the most common carbapenemase gene was New Delhi metallo-β-lactamase (NDM; 72.3%), followed by Klebsiella pneumoniae carbapenemase (KPC; 24.5%), and Verona integron-encoded metallo-β-lactamase (VIM; 3.2%). Of the studied isolates, 74.3% exhibited multidrug-resistant (MDR) phenotype, and 25.7% were either pandrug-resistant (PDR) or extensively drug-resistant (XDR) phenotypes. The most prevalent sequence type was ST2407 (37.2%), followed by ST76 (21.3%) and ST11 (11.7%). The NDM gene was present in 97.1% of ST2407 isolates and 90.0% of ST76 isolates, whereas the KPC gene was present in 90.9% of ST11 isolates. The majority of the isolates carried wabG, uge, and fimH virulence genes, with prevalence rates of 94.7%, 92.6%, and 94.7%, respectively. This study describes NDM-producing ST2407 and ST76, as well as KPC-producing ST11, as the major clonal types of CRKP isolates in Zunyi, China. All CRKP isolates were resistant to multiple types of antibiotics, and the majority of isolates carried carbapenemase and virulence genes. Clonal spread of NDM-producing CRKP ST2407 and ST76, and KPC-producing CRKP ST11 should be strictly monitored.

Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope.

Carbapenem-resistant Enterobacterales (CRE) are particularly worrisome pathogens because of their resistance to last-resort antibiotics, significant morbidity, and mortality. With limited treatment options, new therapeutic choices have become available for the management of CRE infections. Data regarding the efficacy of these novel agents are still limited particularly in a low-middle-income country like Egypt. This study aims to assess the prevalence of different carbapenemase genes among CRE isolates and the susceptibility of these isolates to novel antibiotics for improving antibiotic policy and infection control strategies in Egypt. In this cross-sectional study, 260 Enterobacterales were recovered from patients admitted to intensive care units between January and June 2021. Susceptibility testing was conducted using Kirby-Bauer method. Molecular detection of five carbapenemase genes, namely blaKPC, blaIMP, blaVIM, blaNDM, blaOXA-48 was done using polymerase chain reaction (PCR). Of the 260 Enterobacterales, 34.6% were found to be carbapenems resistant. All of the CRE isolates were multi-drug resistant exhibiting resistance to most antibiotics. All isolates harbored one or more carbapenemases genes. The most prevalent was blaNDM (84.4%), followed by blaOXA-48 (73.3%), blaKPC (13.3%), blaIMP (2.2%), while blaVIM gene wasn't detected. Among 62.2% of the CRE isolates, two or more carbapenemase genes co-existed. For the new antibiotics tested, 100% of CRE resisted ceftolozane/tazobactam, 86.7% resisted ceftazidime/avibactam, 51.1% were resistant to eravacyclin, and 42.2% were resistant to cefiderocol. A high percentage of resistance to carbapenems among Enterobacterales isolates was revealed. blaNDM was found to be the most predominant carbapenemase gene. A high rate of CRE resistance to novel agents signifies a major threat.

ANTIBIOTIC PROFILE OF BACTERIA ISOLATED FROM THE SKIN SURFACE FROM EXTENSIVELY RAISED SWINE

Antibiotic resistance of Staphylococcus is increasing worldwide and is becoming a global concern. The present report exposes the study of the antibiotic susceptibility in isolates of Staphylococcus spp obtained from farm pigs. The samples were collected from healthy pigs, from different farms, in the period between 2019-2020. Forty strains of Staphylococcus were isolated from the anterior nares of individual pigs, and from the skin behind the ears of the animals. These isolates were tested against 12 different antimicrobial agents using the Kirby-Bauer disk-diffusion method. The antibiotic susceptibility profile of different bacteria isolates was studied to detect MAR, MDR. Multiple antibiotic resistance (MAR) indices were determined and it was above 0.2 in 24 of the total of 40 bacteria studied. The highest MAR index was detected in Staphylococcus lentus (0.5) and Staphylococcus xylosus (0.41) and 26 (65%) strains was MDR. In conclusion, the high levels of antibiotic resistance generally correlates with high antibiotic usage and antibiotics used are a risk to humans with occupational contact with livestock antibiotics.

Antimicrobial Resistance Profiles of Bacteria Isolated from Ear Swabs Specimens in a Tertiary Health Facility, North-eastern Nigeria

An ear infection is among the common diseases in children. There is an increased rate of antimicrobial resistance to pathogens that cause ear infections worldwide. We analyzed two years of data on bacterial isolates associated with suspected cases of ear infection and their antibiotic-resistant patterns. All records on ear swabs (n= 134) sent for culture and sensitivity, at the medical microbiology laboratory of a tertiary Health Facility in Northeastern Nigeria, from 2017 to 2018 were reviewed. The patients’ socio-demographic information, bacteria isolated, antibiotics tested, and their sensitivity patterns were extracted. Kirby-Bauer method of antibiotic sensitivity testing and CLSI guidelines were adopted. Descriptive analyses of the data were conducted. Of a total of 134 patients’ records extracted 50.7% were female, median age 12 (IQR 9-15 years). Of the 134 samples cultured, 124 (92.5%) yield bacterial growth. Eight (8) different isolates obtained were Staphylococcus aureus (38.7%), Pseudomonas aeruginosa (17.7%), Proteus mirabilis (16.1%) Proteus vulgaris (9.7%), Klebsiella oxytoca (9.0%), Klebsiella pneumoniae (5.6%) Escherichia coli (2.4%) and Enterococcus spp. (0.8%), Staphylococcus aureus was the predominant isolate, while Enterococcus spp. was the least. A high resistant rate was recorded against many of the antibiotics tested. All isolate demonstrated resistance to amoxicillin and cotrimoxazole, and high sensitivity to ciprofloxacin. Staphylococcus aureus and Pseudomonas aeruginosa were the most common pathogens isolated. Most isolates showed high sensitivity to ciprofloxacin. The high resistance rate recorded on most of the antibiotics tested highlight the need for appropriate prescription of antimicrobials based on local susceptibility profile in the treatments of ear infection.

Antimicrobial Resistance Pattern of Clinical Isolates of Pseudomonas aeruginosa from Urinary Tract Infections in Wukari, Taraba state, Nigeria

Pseudomonas aeruginosa is a potent nosocomial pathogen of immunocompromised individuals, causing several infections while also resisting chemotherapy with conventional antimicrobial agents. Hence, this study was carried out to determine the antimicrobial resistance pattern of P. aeruginosa associated with urinary tract infections (UTIs) in Wukari, Taraba State. Thirty (30) voided midstream urine were collected from clinically diagnosed UTI patients attending Wukari general hospital and cultured aerobically on MacConkey agar and cysteine-lactose-electrolyte-deficient (CLED) agar. Bacterial isolates were identified by Gram staining and conventional biochemical tests. Antimicrobial sensitivity testing was done using the modified Kirby-Bauer method of the disc diffusion test. A total of 46 uropathogens were isolated of which 8 (17.39%) were identified as P. aeruginosa. Of these 8 isolates, 6 (75%) were isolated from male patients while 2 (25%) were isolated from female patients. All isolates of P. aeruginosa were susceptible to imipenem, ofloxacin, gentamicin, and levofloxacin. The resistances included resistance to amoxicillin-clavulanate (100%), cefepime (87.5%), cefotaxime (87.5%), ampiclox (75%), ceftriaxone (62.5%), cefuroxime (62.5%), and nalidixic acid (37.5%). High resistance rates against penicillins and cephalosporins are an indication of intrinsic resistance in P. aeruginosa. Hence, chemotherapy with imipenem, ofloxacin, gentamicin, and levofloxacin should be regularly monitored to prevent the development of resistant strains.

Phenotypic and genotypic detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Accra, Ghana.

To describe the occurrence of carbapenem resistance among multidrug-resistant (MDR) Escherichia coli and Klebsiella pneumoniae isolated from clinical specimens in Accra using phenotypic and genotypic methods. The study was cross-sectional, involving 144 clinical MDR E. coli and K. pneumoniae isolates recovered from the Central Laboratory of the Korle Bu Teaching Hospital (KBTH). The isolates were re-cultured bacteriologically, identified using standard biochemical tests, and subjected to antibiotic susceptibility testing using the Kirby-Bauer method. Carbapenem resistance was determined based on imipenem, meropenem, and ertapenem zones of inhibition, as well as minimum inhibitory concentrations (MICs). Carbapenemase production was determined phenotypically by modified Hodge test (MHT) and modified carbapenem inactivation method (mCIM), and genotypically with multiplex PCR targeting the blaKPC, blaIMP, blaNDM, blaVIM, and blaOXA-48 genes. Of the 144 MDR isolates, 69.4% were E. coli, and 30.6% were K. pneumoniae. The distribution of antimicrobial resistance rates among them was ampicillin (97.2%), cefuroxime (93.1%), sulfamethoxazole-trimethoprim (86.8%), tetracycline (85.4%), cefotaxime and cefpodoxime (77.1% each), amoxicillin-clavulanate (75%), ceftriaxone (73.6%), ciprofloxacin (70.8%), levofloxacin (66.0%), cefepime (65.3%), ceftazidime (64.6%), gentamicin (48.6), piperacillin-tazobactam (40.3%), cefoxitin (14.6%), amikacin (13.9%), ertapenem and meropenem (5.6% each), and imipenem (2.8%). In total, 5.6% (8/144) of them were carbapenem-resistant (carbapenem MIC range = 0.094-32.0 μg/ml), with 75% (6/8) of these testing positive by the phenotypic tests and 62.5% (5/8) by the genotypic test (of which 80% [4/5] carried blaOXA-48 and 20% (1/5) blaNDM). The blaVIM, blaIMP, and blaKPC genes were not detected. Although the rates of antibiotic resistance among the isolates were high, the prevalence of carbapenemase producers was low. The finding of blaOXA-48 and blaNDM warrants upscaling of antimicrobial resistance surveillance programmes and fortification of infection prevention and control programmes in the country.

High Virulence and Multidrug Resistance of Escherichia coli Isolated in Periodontal Disease.

Periodontal disease is caused by different gram-negative anaerobic bacteria; however, Escherichia coli has also been isolated from periodontitis and its role in periodontitis is less known. This study aimed to determine the variability in virulence genotype, antibiotic resistance phenotype, biofilm formation, phylogroups, and serotypes in different emerging periodontal strains of Escherichia coli, isolated from patients with periodontal disease and healthy controls. E. coli, virulence genes, and phylogroups, were identified by PCR, antibiotic susceptibility by the Kirby-Bauer method, biofilm formation was quantified using polystyrene microtiter plates, and serotypes were determined by serotyping. Although E. coli was not detected in the controls (n = 70), it was isolated in 14.7% (100/678) of the patients. Most of the strains (n = 81/100) were multidrug-resistance. The most frequent adhesion genes among the strains were fimH and iha, toxin genes were usp and hlyA, iron-acquisition genes were fyuA and irp2, and protectin genes were ompT, and KpsMT. Phylogroup B2 and serotype O25:H4 were the most predominant among the strains. These findings suggest that E. coli may be involved in periodontal disease due to its high virulence, multidrug-resistance, and a wide distribution of phylogroups and serotypes.

Association of Multidrug Resistance With Biofilm Formation in Pseudomonas Aeruginosa Isolated from Clinical Samples in Kirkuk City

Pseudomonas aeruginosa is one of the most prevalent nosocomial pathogenic microorganisms that cause life-threatening infections. The formation of biofilm is one of the important features that lead resistance to antibiotics. The study aimed to clarify the relationship between biofilm formation, antibiotic resistance, and pigment production P. aeruginosa. A total of 33 isolates have been obtained from 220 different clinical samples, 42% of isolates obtained from burn swabs,15% wound swabs,12% from urine samples, 12% ear swabs ,6% sputum samples, and 3% from bronchial washes. The highest prevalence of these bacteria in our study was found in isolates obtained from burn swabs. Pyocyanin and pyoverdine are frequently seen on Cetrimide agar. P. aeruginosa can be completely isolated on Cetrimide agar. The production of biofilms detected by microtiter plate method and the result distributed as, 22% of strongly, 50% moderately, 27% weakly, and 4% were non biofilm producer. The Kirby-Bauer method (disc diffusion susceptibility method) was used to measure antibiotic resistance, and the results revealed a correlation as 86% multidrug resistance were strongly biofilm former, 75% multidrug resistance were moderately biofilm former and 11% multidrug resistance were weakly biofilm producers. Conclusion, P. aeruginosa from clinical isolates has highly proportional capability to form biofilm and recorded a positive correlation with multidrug resistance, while this relation was not significant with pigment production.

Whole Genome Sequencing of Antibiotic Resistant Genes in Isolates from Surfaces in a Science Laboratory.

Isolates obtained from laboratory surfaces were identified and characterized. Ten consecutive isolates were obtained from 30 sample surfaces of a University Science Laboratory in Edo State Nigeria in May, 2021. Swabs of surfaces from the laboratory were obtained aseptically. The sample swabs were streaked on MacConkey, eosin methylene blue, mannitol salt, and nutrient agar plates, respectively, and incubated appropriately. Distinct colonies were randomly obtained from culture plates and characterized phenotypically. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was used to analyze four isolates (40%) obtained by selection criteria. Susceptibility testing using antibiotics was performed for the identified isolates by Kirby-Bauer method for 15 antibiotics. Isolate characterization and identification of resistance determinants were determined using whole genome sequencing (WGS). Microorganisms identified included Leclercia adecarboxylata, Enterobacter hormaechei, Atlantibacter hermanii, and Stenotrophomonas maltophilia. Three identified isolates were antibiotics-resistant and were investigated by WGS. Resistance genes were found in all (100%) of the resistant laboratory isolates. The resistance determinants included β-lactamase genes, aminoglycoside modifying enzymes, qnr genes, sulfonamide, tetracycline, and trimethoprim resistance genes, respectively. Two isolates carried ESBL genes and blaCTX-M-15 was detected. Our study displays the dissemination of antibiotic resistance among isolates obtained from surface of a University Science Laboratory. To the best of our knowledge, we have reported the first genomic characterization of resistance to antibiotics in isolates obtained from surfaces of a University Science Laboratory in Nigeria.

144. Gram Negative Bacteria with Increased Minimal Inhibitory Concentration for Cefiderocol among Pediatric Patients in a Northern Italy Hospital.

Abstract Background Cefiderocol is a siderophore cephalosporin active against Gram negative (GN) carbapenem resistant bacteria, approved in Italy in September 2020 for adult patients. In pediatric population off label use is allowed when severe infections from multidrug resistance (MDR) GN bacteria occur. Recently, some authors reported the emergence, among strains of Enterobacterales resistant to ceftazidime avibactam, of cross-resistance with cefiderocol. The aim of this study is to describe GN strains with increased Minimal Inhibitory Concentration (MIC) for cefiderocol isolated in our hospital. Methods This is a retrospective, single-center study conducted in Istituto Giannina Gaslini Pediatric Hospital (Genoa, Italy) from 1st January 2020 to 31st April 2022. We collected all strains of MDR GN bacteria whit increased MIC for cefiderocol isolated in our hospital. Cefiderocol susceptibility testing was performed by disk diffusion assay with the disk of 30 μg (Kirby-Bauer method, KB) according to EUCAST’s recommendations and KB breakpoints. We collected demographical data, previous colonization (if note), carbapenemases production, clinical outcomes (infections from MDR; death at 7 and 30 days; ICU admission). Results Overall, 10 GN strains with increased MIC for cefiderocol were collected. 9/10 were Enterobacterales (4 Escherichia coli, 2 Enterobacter cloacae complex, 3 Klebsiella pneumoniae), one was Acinetobacter baumannii. 8/10 patients were admitted to other hospital in the six months before admission in our hospital, data about previous colonization were unknown. All MDR isolated produced metallo-β-lactamase [MBL] (5/10 New Delhi metallo-β-lactamase [NDM], 5/10 Verona integron-encoded metallo β-lactamase [VIM]). Four patients developed infection due to MDR (2 urinary tract infections, 1 bloodstream infection, 1 surgical wound), 2/4 patients died during the hospitalization. Conclusion Our study confirms that MDR producing MBL carbapenemases may have reduce susceptibility to cefiderocol, even if never exposed to this siderophore cephalosporin. Due to the possibility of cross resistance with MDR resistant to ceftazidime/avibactam, cefiderocol should be carefully prescribe in empirical treatment of MBL producers strains. Disclosures All Authors: No reported disclosures.

Antibacterial Activity Ethanolic Extract of Ocimum basilicum L. Leaves in Inhibiting the Growth of Escherichia coli and Pseudomonas aeruginosa

Infectious disease is the biggest problem in the world. The problem with this infection is related to antibiotic resistance if its use is not consistent. Utilization of kemangi leaves, which are always used as fresh vegetables, has potential as an antibacterial in inhibiting the growth of Escherichia coli and Pseudomonas aeruginosa bacteria. This study aims to analyze the inhibition of an ethanol extract of kemangi leaves against Escherichia coli and Pseudomonas aeruginosa. The Kirby-Bauer method with the disc diffusion method was used to determine the minimum inhibitory diameter and to calculate the activity index value. The test results at a concentration of 500 mg/mL showed activity in the strong category, namely 13.70 ± 0.10 mm (Escherichia coli) and 12.93 ± 0.06 mm (Pseudomonas aeruginosa), and the minimum inhibitory concentration was at a concentration of 3.125 mg/mL. Conclusion the ethanol extract of kemangi leaves shows antibacterial activity.

Antibacterial efficacy of silver nanoparticles (AgNPs) against metallo-β-lactamase and extended spectrum β-lactamase producing clinically procured isolates of Pseudomonas aeruginosa

Resistance to carbapenems is a global threat, especially in developing countries with limited health resources. Prevalence, antibiogram, PCR detection of antibiotic resistance genes, and potency of Silver Nanoparticles (AgNPs) against multidrug-resistant (MDR) Pseudomonas aeruginosa were studied. Kirby-Bauer disc method and PCR were used to study antibiogram and drug resistance genes respectively in 255 isolates of Pseudomonas aeruginosa obtained from a tertiary care hospital. Silver nitrate (AgNO3) precursor salts were reacted with Aspergillus flavus culture filtrate to trigger the extracellular mycosynthesis of AgNPs. Mycosynthesis was first monitored regularly by visible ultraviolet spectroscopy that recorded AgNP peaks of approximately 400–470 nm. Confirmation by Transmission electron micrographs provided confirmation of AgNPs formed within a range of 5–30 nm. Individual and combined antibacterial activity of ten antibiotics and AgNPs was analyzed. Pearson correlation coefficients (r) were calculated for phenotypic and genotypic multidrug resistance. Data were evaluated using SPSS version 20. p-value < 0.05 was considered statistically significant. 61.5% were carbapenemase producers (p < 0.01). The recorded frequency of blaIMP-1, blaSHV, blaVIM, blaOXA, and blaTEM were 13%, 32%, 15%, 21%, and 43%, respectively. The reducing order of antimicrobial activity of antibiotics and AgNPs was piperacillin/tazobactam + AgNPs (31 mm), cefoxitin + AgNPs (30 mm) > amikacin + AgNPs (25 mm) > aztreonam + AgNPs (23 mm) > meropenem + AgNPs (22 mm) > imipenem + AgNPs (20 mm) > gentamycin + AgNPs (17 mm) > ciprofloxacin + AgNPs (16 mm) > cefoperazone/sulbactam + AgNPs (14 mm) ≥ ceftazidime + AgNPs (14 mm). The conjugated effect of AgNPs plus antibiotics showed a 0.15–3.51 (average of 2.09) fold-area augmentation of antimicrobial activity. AgNPs conjugated with antibiotics effectively inhibited MDR Pseudomonas aeruginosa. To the best of our understanding, this is an inaugural report from Punjab Pakistan enlisting co-expression of Metallo-β-lactamases, extended-spectrum β-lactamases, and AmpC-β-lactamase plus activity of antibiotic-AgNPs.

Profile of Multidrug Resistance and Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from cats in Surabaya, Indonesia

Abstract. Afnani DA, Fatih N, Effendi MH, Tyasningsih W, Kairullah AR, Kurniawan SC, Silaen OSM, Ramandianto SC, Widodo A, Hendriana K, Riwu KHP. 2022. Profile of Multidrug Resistance and Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from cats in Surabaya, Indonesia. Biodiversitas 23: 5703-5709. Methicillin-Resistant Staphylococcus aureus (MRSA) is the name given to Staphylococcus aureus that has multidrug-resistance (MDR) characteristics and is resistant to ?-lactam drugs. Compared to other livestock, companion animals have been mentioned as potential MRSA reservoirs more frequently. This study aimed to identify MDR and detects MRSA strains from cats in Surabaya. A total of 150 nasal swab of cats were taken from several clinics and veterinary hospital. Samples were swabbed using Amies Medium Transport then identified using microbiological standard method. Kirby-Bauer diffusion method was performed for S. aureus antibiotic resistance profile on five different antibiotic discs. As a confirmatory test for MRSA, S. aureus isolates that were resistant to cefoxitin continued to grow on Oxacillin Resistance Screening Agar Base (ORSAB). The findings of the isolation and identification and process revealed 18 (12%) S. aureus isolates. The antibiotic resistance test revealed 3 (2%) MDR S. aureus isolates and 4 (2.6%) MDR S. aureus isolates that were ORSAB positive. It has been discovered that there are MDR and MRSA S. aureus isolates. It could be used as an indicator of irrational usage of antibiotics and it explained that cats could be source of infection to public health.

The EFEK ANTI-BAKTERI EKSTRAK BIJI PEPAYA (Carica papaya L.) TERHADAP PERTUMBUHAN BAKTERI STAPHYLOCOCCUS AUREUS ATCC 25923 SECARA IN VITRO

Staphylococcus aureus ATCC 25923 is a bacteria that has been resistant to some antibiotics and cause a serious problem in infectious disease. Therefore, an antibacterial agent is necessary to solve this problem. Papaya seeds (Carica papaya L.) contains Flavonoid-Saponin which is very potent as an antibacterial that can be used in world health. The aim of this study is to determine the antibacterial effect of ethanol extract of papaya seed against Staphylococcus aureus ATCC 25923. Papaya fruit is collected from one plantation in the Tabanan area, Bali. Papaya seeds were extracted by maceration method. Antibacterial test using Kirby-Bauer diffusion method. Kirby-Bauer method is created using a blank disk or disk disc. Six treatments were carried out, namely papaya seed ethanol extract with a concentration of 25%, 50%, 75% and 100%, and also with the positive control of vancomycin 30µg and the negative control of dimethyl sulfoxide (DMSO). Each treatment is repeated fourth times. Evaluation of antimicrobial activity using the agar disk diffusion method is by measuring inhibition zone diameter (mm) and this data was analyzed by SPSS. The result showed that ethanol extract of papaya seeds has an inhibition zone in agar disk. The mean score of the inhibition zone such as 25% is 6.67±0.577 mm, 50% is 9.00±1.000 mm, 75% is 10.00±1.000 mm, and 100% is 11.67±0.577 mm. Compare mean statistical test has results showed that the significant differences in all treatments (p&lt;0.05). Based on the result, the conclusion is the extract of papaya seeds has antibacterial activity against Staphylococcus aureus ATCC 25923 bacteria.

Prevalence of multidrug-resistant Escherichia coli in household drinking water in rural Ghana

Abstract Even in the 21st century, households in rural Ghana still rely on drinking water sources that are contaminated with pathogenic Escherichia coli, the consumption of which results in morbidity and mortality of children and adults. The present study sought to determine the prevalence and antimicrobial susceptibility profile of E. coli isolated from household drinking water. A total of 49 water samples were analyzed. E. coli was isolated and confirmed from the water samples using the spread plate and biochemical tests, respectively. The Kirby–Bauer method was used for antimicrobial susceptibility testing. E. coli was isolated from 79.6% of the water samples with a mean colony growth of 15 cfu/100 μl. The isolates were absolutely resistant to ceftazidime, cefixime, augmentin, and cefuroxime. In contrast, the isolates were most susceptible to ciprofloxacin, ofloxacin, gentamicin, and nitrofurantoin. Multidrug resistance was registered in 48.7% of the isolates. E. coli isolates from each water sample had a Multiple Antibiotic Resistance (MAR) index greater than 0.2, indicating increased use or misuse of antibiotics in the study area. This study revealed a high occurrence of multidrug-resistant E. coli and a record-high reduction in the efficacy of important antimicrobials.