MacConkey Agar Plates Research Articles

Incidence of Urinary Tract Infections, Etiological Agents, and Antibiotic Susceptibility Among Pregnant and Non-Pregnant Women in Amedi Region, Iraq

Urinary tract infection is a bacterial infection caused by bacteria from the digestive tract entering the urinary tract. It is more prevalent in women and remains the most common bacterial infection in humans. The study aimed to assess the prevalence of urinary tract infections (UTIs) in pregnant women, identify and diagnose uropathogenic bacteria, and examine the antibiotic susceptibility of the isolated bacteria. A total of 283 urine specimens were collected from pregnant and non-pregnant females of different ages who visited Amedi hospital between October 2020 and January 2021. The samples were cultured and incubated on Blood agar and MacConkey agar plates for 24 hours at 37°C. Bacterial isolates were identified and their antibiotic sensitivity was assessed using the Vitek-2 method. The study found a total UTI rate of 42.4% (120/283), with higher rates in pregnant patients (58.3%) compared to non-pregnant patients (41.7%). Among 120 positive urine cultures, bacterial isolates were identified in 92.5% (111/120), with Gram-positive bacteria being more prevalent (51.4%) than Gram-negative (48.6%). The most common Gram-negative bacteria was Escherichia coli (29.7%), while Gram-positive bacteria included Enterococcus faecalis, Staphylococcus haemolyticus, and Streptococcus agalactiae (each 12.6%; 14/111). The rate of fungal positive cultures (Candida spp.) was 7.5%. Gram-negative isolates showed high sensitivity to tigecycline (99.0%) and ertapenem (80.6%), but low sensitivity to ampicillin (2.7%) and cefuroxime (16.1%). Gram-positive isolates were highly sensitive to linezolid (98.7%) and tigecycline (98.5%). The findings of this study are valuable for understanding the nature of urinary tract infections (UTIs) and guiding appropriate treatment, leading to a reduction in the misuse of antibiotics. Keywords: Urinary tract infection; Pregnancy; Antibiogram; Uropathogenic bacteria; Iraq.

A Rare Report of Carbapenem Resistant Vibrio fluvialis Isolated from a case of Walled off Necrosis: A Sequelae of Acute Necrotising Pancreatitis

Vibrio fluvialis (V. fluvialis) is commonly found in coastal environments and is an emerging pathogen encountered in diarrhoeal outbreaks and sporadic extraintestinal cases. V. fluvialis infections usually manifest as watery bloody diarrhoea, nausea, vomiting, gastroenteritis and peritonitis. In this case report, an unusual presentation of Multidrug Resistant (MDR) V. fluvialis along with Klebsiella pneumoniae co-infection from a case of Walled Off Necrosis (WON)- A complication of Acute Necrotising Pancreatitis (ANP) is discussed. The patient presented with the acute abdomen and had peripancreatic collection for which Ultrasound (USG) guided 12F pigtail drain placed over the right lower quadrant of the abdomen and conservatively managed. Routine cultures were done and the growth on Sheep Blood Agar (SBA) plate and MacConkey (MAC) agar plates were subjected for automated phenotypic identification by Matrix Assisted Laser Desorption Ionisation Time of Flight-Mass Spectrometry (MALDITOF-MS) and Vitek-2 systems and was identified as V. fluvialis. Also, molecular tests like 16S rRNA Polymerase Chain Reaction (PCR) followed by Sanger’s sequencing was done and the identification was further confirmed. Phenotypic RESIST-5 TRURAPID O.K.N.V.I. commercial lateral flow immunochromatographic assay for detection of clinically relevant and common carbapenemase genes like NDM, OXA-48, VIM, IMP and KPC was done which revealed this V. fluvialis isolate as New Delhi Metallo betalactamase (NDM) type of Carbapenemase producer. Patient was managed with levofloxacin and doxycycline and patient condition improved and was discharged.

Asymptomatic nasopharyngeal carriage of multidrug resistant bacteria among children at University of Gondar Hospital Northwest Ethiopia Revealing Hidden Health Risks

Gram-negative bacteria in the nasopharynx can eventually invade bacteria-limited sites and cause serious illnesses such as meningitis, otitis media, and pneumonia. However, data related to the carriage of these bacteria in children attending outpatient departments in the study area are limited. To assess nasopharyngeal carriage, antibiotic susceptibility patterns, and associated factors of gram-negative bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A hospital-based cross-sectional study was conducted from September 1, 2023, to December 30, 2023. A total of 385 children aged 3 to 14 years were enrolled using a systematic random sampling technique. Sociodemographic and clinical data were collected using a semistructured questionnaire. A total of 385 nasopharyngeal samples were collected using a sterile specimen collection nasopharyngeal swab, transported using Amie’s transport medium, and subsequently inoculated on chocolate agar, blood agar, modified thayer martin agar, and MacConkey agar plates. Bacterial species were identified by colony morphology, Gram staining, and biochemical tests such as oxidase tests, satellitism tests, and carbohydrate utilization tests. An antibiotic susceptibility test was performed using the Kirby–Bauer and modified Kirby–Bauer methods on Mueller–Hinton agar plates. The data were entered into Epi-Data version 4.6.0.6 and exported to SPSS version 25 for analysis. The adjusted odds ratio at a 95% confidence interval with a P value of < 0.05 in the binary logistic regression model was considered to indicate statistical significance. The overall nasopharyngeal carriage of gram-negative bacteria was 146 (37.9%) (95% CI: 33.2–42.9). Among these, nonfastidious gram-negative bacteria represented 45 (11.7%), followed by M. catarrhalis 41 (10.6%), N. meningitidis 34 (8.8%), and H. influenzae 26 (6.8%). The isolates exhibited high resistance to tetracycline (85; 75.9%), trimethoprim-sulfamethoxazole (105; 71.9%), ampicillin (76; 67.9%), and amoxicillin/clavulanic acid (60; 69.8%) but high susceptibility to meropenem (122; 83.6%), gentamicin (73; 84.9%), and minocycline (87; 72.5%). There were 99 total multidrug-resistant strains (67.8%, 95% CI: 59.7–75.0). Male sex (AOR = 1.785, 95% CI: 1.102–2.892, P = 0.019), smoking (AOR = 2.675, 95% CI: 1.149–6.230, P = 0.022), and large family size (≥ 5) (AOR = 1.857, 95% CI: 1.140–3.023, P = 0.013) were risk factors for nasopharyngeal colonization. Increased nasopharyngeal colonization of multidrug-resistant gram-negative isolates was observed in this study. Gentamicin, minocycline, and meropenem were the most effective antibiotics for the tested isolates. Bacterial colonization increased with increasing family size, smoking status, and male sex. Therefore, a definitive diagnosis in the outpatient pediatric department should be based on culture and susceptibility test results.

Prevalence and Antibiotic Resistance of Klebsiella pneumoniae in Diabetic Foot Ulcer.

Introduction A serious global threat of antimicrobial resistance has emerged due tothe improper use of antibiotics, including polypharmacy and inappropriate prescribing. This misuse has led bacteria to develop immunity against these drugs.Klebsiella pneumoniae, a concerning gram-negative bacterium, has become resistant, especially among immunocompromised diabetic patients for multiple antibiotics. To fight effectively this growing crisis and regain control of these infections, it is crucial to comprehend the resistance mechanisms utilized by the bacteria anddevelop a new therapeutic strategy to prevent antibiotic resistance. Materials and methods A five-month study from January 2023 to May 2023 was conducted at the tertiary healthcare facility of Saveetha Medical Collegeby collecting 122 clinical specimens from patients with diabetic foot ulcers (DFUs) and ulcer-related infections. The microbiological testing methods followed by the identification of bacteria using matrix-assisted laser desorption/ionizationtime-of-flight mass spectrometry (MALDI-TOF) and antimicrobial susceptibility testing (AST) by the VITEK 2 Compact system were performed. Results A stout, rod-shaped, gram-negative bacilli was observed in gram staining, and growth of mucoid γ-hemolytic colonies and lactose-fermenting mucoid colonies were seen in blood and MacConkey agar plates. MALDI-TOF analysis confirmed the presence ofKlebsiella pneumoniaealong with other bacteria such as Klebsiella oxytoca, Staphylococcus spp., Proteus spp., and​​Escherichia ​coli. VITEKshowed high resistance rates to commonly used antibiotics, including carbapenems. Notably, isolates showed sensitivity and intermediate to tigecycline and colistin. Resistance patterns varied across specimen types, emphasizing the importance of considering clinical sources when interpreting data. Conclusion Hence, this study underscores the urgent need for novel antimicrobial agents and effective infection control measures to combat multidrug-resistant Klebsiella pneumoniae infections. Understanding resistance mechanisms is essential for the incorporation of treatment strategies and preserving antibiotic efficacy.

Bacteriological profile of bloodstream infections in pediatric age group in a tertiary care centre, Solapur

Bloodstream infections (BSI) due to multidrug-resistant organisms from paediatric setup have become increasingly common. BSI can be transient and be rapidly cleared out by the host defence mechanism or be associated with high morbidity and mortality if it becomes persistent.Blood samples were collected from 1112 children within a 1-year study period (July 2022 to June 2023) which included all children admitted with complaint of fever and suspected of having sepsis in Paediatric department of Shri Chhatrapati Shivaji Maharaj Sarvopchar Rugnalaya (SCSMSR), Solapur. Blood volume was collected depending upon age and body weight of the patient with aseptic precautions and inoculated in Brain Heart Infusion broth (BHI) which was incubated at 37°C for 7 days. Subcultures were made on blood agar and MacConkey agar plates. Organisms were identified by biochemical reactions and antibiotic susceptibility test of the isolates were performed by disk diffusion. Out of 1112 suspected cases, 175 (15.74%) were culture positive. (27.43%) was the most common isolate followed by (16.57%) Most common Gram positive isolate was (11.43%) followed by (6.86%). Total Multidrug resistant (MDR) isolates in Gram negative and Gram positive were 50.35% and 31.25% respectively.High rates of antibiotic resistance are observed in both gram positive and gram negative organisms. Thus, there is an urgent need for proper implementation of antibiotic stewardship programme and infection prevention and control measures.

Assessment of bacteriological quality of fruits and vegetables sold in Gombe metropolitan market

Fruits and vegetables are important components of human diet that could be contaminated by different kinds of microorganisms. Microbial contamination may occur during any steps of transportation or processing from farm-to-table due to many environmental, animal, and human sources as well as technological applications. This study aimed at assessing the bacteriological contaminants of fruits and vegetables sold in Gombe metropolitan. A total of 30 fruits and vegetables samples were purchased from different vendors and transported to the Microbiology Laboratory for processing. Ten-fold serial dilution was performed on each sample and aliquots of 10-1-10-3 dilutions were inoculated on Nutrient Agar and MacConkey Agar plates using pour-plate technique. The plates were incubated for 24 hours at 37oC and then observed for aerobic mesophilic and faecal coliform counts. The bacterial loads of the samples ranged from 3.7x104 to 2.7x105 and 2.9x104 to 8.7x104 for total mesophilic and faecal coliform counts, respectively. Subsequently, a total of eight bacteria were isolated and identified as Escherichia coli, Salmonella spp., Klebsiella spp., Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, Bacillus cereus, and Shigella spp. In conclusion, the fruits and vegetables were found to be contaminated with different bacterial species of public health concern.

Genetic Characterization and Phylogenetic Analysis of Escherichia Coli Isolates from Urinary Tract Infections in Iraq

This study aimed to characterize Escherichia coli (E. coli) isolates from urinary tract infections (UTIs) in Iraq and compare them with international strains. Twenty midstream urine samples from UTI patients were cultured on MacConkey and nutrient agar plates. All bacterial isolates were identified using Vitek 2 system, followed by DNA extraction with the Goya Gene kit. Specific primers were used to detect E. coli, and positive samples were sequenced using the Sanger method. Phylogenetic analysis was conducted to elucidate the genetic relationships among the isolates. The results revealed a high similarity between local Iraqi E. coli isolates and national strains, with minor differences. The phylogenetic tree analysis identified three distinct strains, with an 81% similarity among most isolates, though one international strain was notably distant. The study highlights on rising the frequency of UTIs and the monetary problems they impose on both the governments and patients, emphasizing the need for active drugs that can be rapidly implemented in medical settings. This research underscores the importance of understanding local bacterial populations to inform treatment strategies, as UTIs commonly result from bacterial resistance to existing treatments. UPEC frequently targets the urethra, bladder, and kidneys, initiating infections through colonization and subsequent invasion of the bladder epithelium.

Occurrence and characteristics of blaOXA-181-carrying Klebsiella aerogenes from swine in China

Klebsiella aerogenes is a largely understudied opportunistic pathogen that can cause sepsis and lead to high mortality rates. In this study, we reported the occurrence of carbapenem-resistant blaOXA-181-carrying Klebsiella aerogenes from swine in China and elucidate their genomic characteristics. A total of 126 samples, including 109 swine fecal swabs, 14 environmental samples, and three feed samples were collected from a pig farm in China. The samples were enriched with LB broth culture and then inoculated into MacConkey agar plates for bacterial isolation. After PCR detection of carbapenemases genes, the blaOXA-181-carrying isolates were subjected to antimicrobial susceptibility testing, and whole-genome sequence analysis. Four Klebsiella aerogenes isolates carrying the blaOXA-181 gene were obtained from swine faecal samples. All the 4 strains were belonged to ST438. The blaOXA-181 genes were located in IncX3-ColKP3 hybrid plasmids with the core genetic structure of IS26-ΔIS3000-ΔISEcp1-blaOXA-181-ΔlysR-ΔereA-ΔrepA-ISKpn19-tinR-qnrS1-ΔIS2-IS26, which suggests the potential for horizontal transfer and further dissemination of this resistance gene among Enterobacteriaceae and other sources. This study represents the first instance of OXA-181-producing K. aerogenes being identified from swine faeces in China. It is crucial to maintain continuous monitoring and ongoing attention to the detection of K. aerogenes carrying blaOXA-181 and other resistance genes in pigs.

Prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in Urine Samples of Pregnant Women in South-East, Nigeria

Background: Pregnancy induces so many changes in the woman’s body that likely predisposes them to Klebsiella pneumoniae and Acinetobacter baumannii which causes Urinary Tract Infections (UTIs). Aims: To determine the prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in urine samples of pregnant women attending ante-natal clinics at three health institutions within the study area. Study Design: This study was a descriptive cross-sectional study. Place and Duration of Study: Department of Microbiology Federal University Teaching Hospital, Owerri, Teaching Hospital Orlu and General Hospital Okigwe, Imo State between October 2021 and February 2022. Methodology: Urine samples were collected aseptically from 408 pregnant women between 18-45 years and analyzed by culturing onto the surface of freshly prepared MacConkey and Chromogenic agar plates for the isolation of Klebsiella pneumoniae and Acinetobacter baumannii respectively and confirmed by appropriate biochemical tests. Results: From the results, there was a prevalence rate of 145/408 (35.54%) for both isolates with Klebsiella pneumoniae being more dominant with a prevalence rate of 96/408 (23.53%) as against Acinetobacter baumannii that was 49/408 (12.01%). The highest prevalence of the isolates was seen in the Owerri zone with a prevalence rate of 37 (9.07%) for Klebsiella pneumoniae and 23 (5.64%) for Acinetobacter baumannii, respectively. The highest age-specific prevalence of the isolates within the three zones was observed in the 24–29-year-olds with a prevalence rate of 42 (10.29%) in the Owerri zone. In contrast, the prevalence of both organisms was higher in pregnant women in their third trimester of pregnancy with a prevalence rate of 72 (17.65%) and in multigravida women with a prevalence rate of 217 (53.2%). Conclusion: The results from this study showed that these isolates are becoming more predominant in causing both symptomatic and asymptomatic urinary tract infections in pregnant women, hence regular check-ups and proper treatments of urinary tract infections in pregnant women should be encouraged.

Characterization of Shiga Toxin-producing Escherichia coli Isolated from Cattle Around Ulaanbaatar City, Mongolia

Shiga toxin-producing Escherichia coli (STEC) are associated with severe infections including hemorrhagic colitis and hemolytic uremic syndrome in humans. Ruminants are known as reservoirs of STEC; however, no data are available on STEC in ruminants in Mongolia, where more than 5 million cattle and 25 million sheep are raised. To disclose the existence and characteristics of STEC in Mongolia, in this study, we isolated and characterized STEC from cattle in Mongolia. We collected 350 rectal swabs of cattle from 30 farms near Ulaanbaatar city and isolated 45 STEC from 21 farms. Rectal swabs were precultured with modified Escherichia coli broth and then inoculated to Cefixime-Tellurite Sorbitol MacConkey agar plate and/or CHROMagar STEC agar plate for the isolation of STEC. The isolation ratios in each farm were from 0% to 40%. Multiplex PCR for the estimation of O- and H-serotypes identified 12 O-genotypes (Og-types) and 11 H-genotypes (Hg-types) from 45 isolates; however, Og-types of 19 isolates could not be determined. Stx gene subtyping by PCR identified 2 stx1 subtypes (1a and 1c) and 4 stx2 subtypes (2a, 2c, 2d, and 2g). Forty-five isolates were divided into 21 different groups based on the Og- and Hg-types, stx gene subtypes and the existence of virulence factors, ehxA, eae, and saa, which includes several major serotypes associated with human illness such as O26:H11 and O157:H7. The most dominant isolate, OgUT:H19 [stx1a (+), stx2a (+), ehxA (+) and saa (+)], was isolated from eight farms. This is the first report on the characterization of STEC in cattle in Mongolia, and the results suggest the importance of further monitoring of STEC contamination in the food chains as well as STEC infection in humans.

Nanoparticles on pathogenic strains of Staphylococcus aureus and Escherichia coli

Background: Nanoparticles are increasingly being used as an alternative antibiotic to target microorganisms, particularly for treating bacterial infections. In current study it was recognized processes such as metal ion release, induction of oxidative stress, and non-oxidative mechanisms. Developing resistance to nanoparticles is challenging for bacterial cells due to the multiple simultaneous actions against microorganisms, and require several simultaneous gene alterations within the same bacterial cell. Objective: To determine the effect of the titanium dioxide nanoparticles (TiO2NPs) on the activity of the same bacteria that participate in dental caries (Staphylococcus aureus and Escherichia coli). Patients and Methods: The study included 50 patients who attended the dental clinic and took the samples by the wooden swap from the molar area (cervical area of inflamed gingiva and same samples taken from occlusal surface of molar). The collected samples were cultured on “Mannitol salt agar, Blood agar, and MacConkey's agar plates” for separation of the needed bacteria (Staphylococcus aureus and Escherichia coli) that showed wide spreading in the oral cavities and dental carries. TiO2NPs are then created using pulse laser ablation, followed by coating preparation the nanoparticles materials (using a hybrid sol-gel and organ silicate nanoparticles), and finally the prepared nanoparticles to the coating solution and local paint were used for antimicrobial activity of the separated bacteria using different concentrations of TiO2 in the cultures. Results: Characterization showed the phase of the TiO2NPs was spherical, with very few irregularly shaped particles, and had an average small size in millimeters. Antimicrobial activity results showed a strong bactericidal effect against Gram-positive bacteria and demonstrated greater sensitivity to TiO2 nanoparticles at lower concentrations when compared to Gram-negative bacteria. Conclusion: It was shown that nanotechnology promise in treating various infections caused by bacteria, including dental caries. Notably, nanoparticles have demonstrated broad-spectrum antibacterial effects against Gram-positive bacteria. Keywords: TiO2, nanoparticles, Staphylococcus aureus, and E. coli

Electron Microscope Scanning, and Antibacterial Activity of Tio2 Nanoparticles on pathogenic strains of Staphylococcus aureus and Escherichia coli

Background: Nanoparticles are increasingly being used as an alternative antibiotic to target microorganisms, particularly for treating bacterial infections. In current study it was recognized processes such as metal ion release, induction of oxidative stress, and non-oxidative mechanisms. Developing resistance to nanoparticles is challenging for bacterial cells due to the multiple simultaneous actions against microorganisms, and require several simultaneous gene alterations within the same bacterial cell. Objective: To determine the effect of the titanium dioxide nanoparticles (TiO2NPs) on the activity of the same bacteria that participate in dental caries (Staphylococcus aureus and Escherichia coli). Patients and Methods: The study included 50 patients who attended the dental clinic and took the samples by the wooden swap from the molar area (cervical area of inflamed gingiva and same samples taken from occlusal surface of molar). The collected samples were cultured on “Mannitol salt agar, Blood agar, and MacConkey's agar plates” for separation of the needed bacteria (Staphylococcus aureus and Escherichia coli) that showed wide spreading in the oral cavities and dental carries. TiO2NPs are then created using pulse laser ablation, followed by coating preparation the nanoparticles materials (using a hybrid sol-gel and organ silicate nanoparticles), and finally the prepared nanoparticles to the coating solution and local paint was used for antimicrobial activity of the separated bacteria using different concentrations of TiO2 in the cultures. Results: Characterization showed the phase of the TiO2NPs was spherical, with very few irregularly shaped particles, and had an average small size in millimeters. Antimicrobial activity results showed a strong bactericidal effect against Gram-positive bacteria and demonstrated greater sensitivity to TiO2 nanoparticles at lower concentrations when compared to Gram-negative bacteria. Conclusion: It was shown that nanotechnology promise in treating various infections caused by bacteria, including dental caries. Notably, nanoparticles have demonstrated broad-spectrum antibacterial effects against Gram-positive bacteria.

Investigation of Uropathological Bacterial Profile and Antibiotic Susceptibility Patterns Among Pregnant Women in Rawalpindi and Islamabad: A Comprehensive Analysis

Background: Urinary tract infections (UTIs) represent a significant health concern for pregnant women, potentially leading to adverse outcomes for both mother and child. The anatomical and physiological changes during pregnancy increase the risk of UTIs, making the study of their bacteriological profile and antibiotic susceptibility patterns especially pertinent. Objective: This study aimed to assess the bacteriological profile and antibiotic susceptibility patterns of UTIs among pregnant women in Rawalpindi and Islamabad, to identify the most prevalent pathogens and their resistance to commonly used antibiotics. Methods: A cross-sectional study was conducted on 165 early morning mid-stream urine samples collected from pregnant women attending the Railway General Hospital, Rawalpindi, over four months. Samples were analyzed for UTI-causing organisms using Cysteine Lactose Electrolyte Deficient (CLED) medium, MacConkey agar, and blood agar plates. Gram staining and biochemical tests were utilized for bacterial identification, while the Kirby-Bauer disk diffusion method determined antibiotic susceptibility. Statistical analysis was performed using SPSS version 25. Results: The study population predominantly consisted of residents from Rawalpindi (94.5%). The highest incidence of UTIs was observed in the age group of 31-36 years (34.5%). Staphylococcus aureus (28%) and Pseudomonas aeruginosa (30%) were the most prevalent pathogens. High resistance rates were noted against ampicillin and azithromycin among gram-positive isolates, whereas gram-negative bacteria showed considerable resistance to ciprofloxacin. However, gentamicin displayed relative effectiveness across various pathogens. Conclusion: The study highlights a significant prevalence of antibiotic-resistant UTIs among pregnant women in the studied regions, with Staphylococcus aureus and Pseudomonas aeruginosa being the dominant pathogens. The findings call for an urgent need to implement effective antibiotic stewardship and screening programs during pregnancy to mitigate the risk of UTIs and their associated complications.

Prevalence and Concentration of Airborne Microorganisms Isolated from Domestic Toilets in Port Harcourt, Rivers State, Nigeria

Introduction: Microorganisms are ubiquitous in nature and transient airborne microorganisms have been shown to constitute major health hazards.&#x0D; Aim: This study was carried out to assess the microbial air quality in ten (10) domestic toilets located in mile-3, Alakahia, Choba, Ada-George and Rumuokwuta, Port Harcourt, Rivers state, Nigeria.&#x0D; Methodology: Microbial air quality was sampled using sedimentation techniques. Freshly prepared Nutrient Agar, MacConkey and Sabouraud Dextrose Agar (SDA) plates were placed one meter above the floor of the toilets for 1 hours at different sections of each toilet exposed to an open air. The agar plates were closed and transported to the Laboratory were incubation took place at 37°C for 24 hours and 25°C for 3-5 days for growth of bacteria and fungi respectively. Isolates were characterized and identified by standard microbiological methods.&#x0D; Results: The bacteria isolated were Staphylococcus species 22(22.45%), Bacillus species 20 (20.41%), Enterococcus species 20(20.41%), Escherichia coli 16(16.32%), Micrococcus species 15 (15.31%), Klebsiella species 3(3.06%), and Proteus species 2(2.04%) while Aspergillus species 14(27.45%), Penicillium species 16(23.53%), Fusarium species 10(19.60%), Mucor species 8(15.69%), and Rhizopus species 7(13.73%) were the fungi identified. The highest bacteria colony count before and after flushing were 52.380×103CFU/m3/hr &amp; 67.261× 103CFU/m3/ hrrespectively while the lowest bacteria counts observed before and after flushing 19.047× 103CFU/m3/hr &amp; 39.286×103CFU/m3/hr while the highest and lowest fungal count before and after flushing were 10.119×103CFU/m3/hr &amp; 13.690×103CFU/m3/hr and 5.952×103CFU/m3/hr &amp; 5.953×103CFU/m3/hr respectively.&#x0D; Conclusion: This study shows that considerable numbers of both pathogenic bacteria and fungi particles were released into the air in higher quantity after flushing domestic toilets when compared to air quality before flushing. These organisms have been implicated in major and minor infectious diseases. Inhalation or contact may easily lead to infection especially in immunocompromised individuals and the older adults. To maintain the health of users, it is necessary to carefully manage the environmental factors that promote the growth and multiplication of microorganisms in domestic toilet environment.

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

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

Evaluation of the bacteriological quality of underground well water in Oyi local government area of Anambra State, Nigeria

Background: Water is indispensable for man’s existence on earth. In urban and predominantly rural communities in Nigeria, with over 85% of the population living below an average income, traditional drinking water sources such as open reservoirs, springs and open wells are still being used. The study assessed the bacteriological qualities of underground well water in Oyi L.G.A of Anambra State. Methods: Water samples collected by random sampling from various wells in the selected thirteen (13) wards of the study area were subjected to bacteriological analysis using standard methods. The bacteriological analysis examined differential and presumptive coliform counts. Confirmatory coliform tests were carried out using a loopful of presumptive positive and negative tests already sub-cultured on MacConkey agar plate and incubated at 37 0c for 24 hours to obtain bacterial isolates. Results: Escherichia coli was the most frequently occurring isolate of all the bacteria identified. Other isolates include Streptococcus spp., Staphylococcus aureus, Shigella spp., Enterococcus spp., Salmonella spp., Pseudomonas spp., Proteus spp. and Bacillus spp. The majority of these organisms are Gram-negative microorganisms which are most times implicated in gastrointestinal abnormalities. Conclusions: There is a high incidence of contamination of well waters by pathogenic organisms in most well waters from the Study area. Underground well water sources to be utilized for domestic purposes such as cooking should be treated or disinfected before use, either by boiling and filtration or by chemical sterilization or a combination of both.

Surgical site infections - A threat to the health-care system: An observational study from a tertiary care hospital of Bihar

Background: A surgical site infection (SSI) is any infection occurring after a medical intervention. It is the most common nosocomial infection in low- and middle-income countries. It has raised both mortality and morbidity. Resistance to antibiotics due to irrational use has further added to the severity of the problem. Aims and Objectives: The current study was designed with the aim of determining the incidence of SSIs among patients operated on a tertiary care hospital, along with their antibiogram. Materials and Methods: An observational study with a cross-sectional design was conducted on 150 patients with suspected SSI were included in this study over a period of 1 year, from August 2021 to July 2022. An adult patient with pus, serous, or seropurulent discharge from the surgical wound was included in the study. Information was obtained using a pre-designed and pre-tested schedule. Identification of the colony was done by gram staining and inoculation on 5% sheep blood agar and Mac Conkey agar plates. Antimicrobial sensitivity testing was done. The data was analyzed using Microsoft Excel. Results: A total of 152 patients were included in the study. The incidence of SSI was found to be 38.2%. The mean age of the participants was 47.7 ± 21.6 years. The maximum incidence of SSI was noted in the 5th decade of life. Among the 58 patients’ samples, 65 aerobic bacterial colonies were isolated. Out of which Staphylococcus aureus and Escherichia coli were the commonest organisms. On performing an antibiogram, a higher degree of resistance was observed among Gram-negative organisms. Conclusion: SSI adds to the mortality as well as the morbidity of the patients. Not only this, but it also adds to the expenses. A more stringent surveillance system and reinforcement of the guidelines was the need of the hour to overcome this problem of hospital-acquired infections.

Detection of volatile organic compounds in headspace of Klebsiella pneumoniae and Klebsiella oxytoca colonies

IntroductionEarly diagnosis of infections and sepsis is essential as adequate therapy improves the outcome. Unfortunately, current diagnostics are invasive and time-consuming, making diagnosis difficult, especially in neonatology. Novel non-invasive analytical methods might be suitable to detect an infection at an early stage and might even allow identification of the pathogen. Our aim is to identify specific profiles of volatile organic compounds (VOCs) of bacterial species.MethodsUsing multicapillary column-coupled ion mobility spectrometry (MCC/IMS), we performed headspace measurements of bacterial cultures from skin and anal swabs of premature infants obtained during weekly screening for bacterial colonization according to KRINKO. We analyzed 25 Klebsiella pneumoniae (KP) cultures on MacConkey (MC) agar plates, 25 Klebsiella oxytoca (KO) cultures on MC agar and 25 bare MC agar plates as a control group.ResultsUsing MCC/IMS, we identified a total of 159 VOC peaks. 85 peaks allowed discriminating KP and bare MC agar plates, and 51 peaks comparing KO and bare MC agar plates and 6 peaks between KP and KO (significance level of p &amp;lt; 0.05 after Bonferroni post hoc analysis), respectively. Peaks P51 (n-Decane) and P158 (Phenylethyl Alcohol), showed the best sensitivity/specificity/ positive predictive value/negative predictive value of 99.9% each (p &amp;lt; 0.001) for KP. P158 showed the best sensitivity/specificity/positive predictive value/negative predictive value of 99.9% each (p &amp;lt; 0.001) for KO. Comparing KP and KO, best differentiation was enabled using peaks P72, P97 and P16 with sensitivity/specificity/positive predictive value/negative predictive value of 76.0%, 84.0%, 82.6%, 77.8%, respectively (p &amp;lt; 0.05).DiscussionWe developed a method for the analysis of VOC profiles of bacteria. Using MCC/IMS, we demonstrated that VOCs derived from bacteria are clearly distinguishable from a bare agar plate. Characteristic peaks obtained by MCC/IMS are particularly suitable for the species-specific identification and differentiation of KP and KO. Thus, MCC/IMS might be a useful tool for in vitro diagnostics. Future studies must clarify whether similar patterns of VOCs can be detected in vivo in patients that are colonized or infected with KP or KO to enable rapid and accurate diagnosis of bacterial colonization.

Occurrence and temporal distribution of extended-spectrum β-lactamase-producing Escherichia coli in clams from the Central Adriatic, Italy.

The spread of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is a major public health issue. Bivalves are filter-feeder animals capable of bioaccumulating the microorganisms present in water. This physiological characteristic makes them both good indicators of environmental contamination and possible carriers of pathogenic bacteria, including those resistant to antimicrobials. The aim of this study was to investigate the occurrence of ESBL-producing E. coli in clams (n = 308) collected from harvesting areas of the Central Adriatic Sea between 2018 and 2019. ESBL- /class C β-lactamase (AmpC)- producing E. coli and Escherichia spp. were isolated by streaking over the surface of MacConkey agar plates supplemented with cefotaxime enriched broths of the initial shellfish suspension. E. coli and Escherichia spp. resistant to cefotaxime were screened for ESBL production by using the double disk synergy test. Susceptibility to different antimicrobials and confirmation of ESBL-production were determined by the minimum inhibitory concentration (MIC) test. Isolates were further characterized by whole genome sequencing (WGS) and bioinformatic analysis of genomes with different tools. Overall, ESBL-producing E. coli were isolated from 3% of the samples. Of 13 ESBL- and ESBL-/AmpC-producing Escherichia spp. (n = 11 E. coli, n = 1 E. marmotae, n = 1 E. ruysiae) isolates, 13 were resistant to ampicillin and cefotaxime, 9 to sulfamethoxazole, 6 to tetracycline and nalidixic acid, 4 to trimethoprim, and 3 to ceftazidime, cefoxitin, ciprofloxacin, and chloramphenicol. Moreover, the majority (8/11) of the ESBL-producing E. coli isolates were multidrug-resistant. WGS showed that the isolates predominantly carried the blaCTX-M-15 gene (3/11) and blaCTX-M-14 and blaCTX-M-1 (2/11 each). The AmpC β-lactamase CMY-2 was found in two isolates. Phylogroup A was the most prevalent (5/11), followed by phylogroups D (4/11), F (1/11), and B2 (1/11). Ten different sequence types (STs) were identified. Occurrence at sampling sites ranged between 0 and 27%. To identify associations between the occurrence of ESBL-producing E. coli and E. coli levels, samples were divided into two groups, with E. coli at >230 MPN/100 g and E. coli at ≤230 MPN/100 g. ESBL-producing E. coli isolates were significantly more commonly recovered in samples with higher E. coli levels (14%) than in those with lower levels of E. coli (2%). Moreover, the majority (3/4) of the potentially pathogenic strains were isolated in samples with higher E. coli levels. These findings provided evidence for the bacterial indicator of fecal contamination, E. coli, as an index organism for ESBL-producing E. coli isolates in bivalves.

Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae in pediatric inpatients in South China.

Carbapenem-resistant Enterobacteriaceae (CRE) are a substantial health burden. Existing management guidelines are primarily based on clonal evidence. Therefore, epidemiological data are required. We evaluated the risk factors for CRE colonization and described the molecular and clinical characteristics of CRE colonization in pediatric inpatients in Guangzhou, China. Pediatric inpatients from three hospitals in Guangzhou, China, between July 2019 and January 2021 were included. Fecal samples were collected and screened for CRE. Microbiological cultures were grown on MacConkey agar plates, and bacteria were identified with a mass spectrometry microbial identification system. Antimicrobial susceptibility was tested with a VITEK2 system, and carbapenemase genes were amplified. A case-control study was conducted to evaluate the risk factors for fecal CRE colonization in pediatric inpatients. Of 4,033 patients screened, 158 (3.92%) were positive for CRE, including Escherichia coli (51.27%), Klebsiella pneumoniae (37.97%), and Enterobacter cloacae (6.96%). The most common carbapenemase genes were blaNDM-5 (51.89%), blaNDM-1 (15.19%), and blaIMP-4 (7.60%) and blaKPC-2 (3.80%). Hematological malignancies, respiratory diseases, otolaryngological diseases, nervous system diseases, oral administration of third-generation cephalosporins, and the combined use of two or more antibiotics were independently associated with CRE colonization. The most prevalent carbapenem-resistant K. pneumoniae sequence types (STs) were ST11 (8.06%), ST37 (8.06%), and ST76 (8.06%), and the most prevalent carbapenem-resistant E. coli STs were ST10 (9.88%), ST48 (13.58%), and ST58 (8.64%). Pediatric inpatients were colonized by a diversity of CRE strains. Infection control and prevention measures should be implemented to reduce CRE colonization. IMPORTANCE This study assessed the clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae in pediatric inpatients at three hospitals in South China by means of screening stool samples for carbapenem-resistant genes and a nested case-control study to determine risk factors for carriage of carbapenem-resistant Enterobacteriaceae. Of 4,033 fecal samples screened, 158 (3.92%) were positive for CRE, including Escherichia coli (51.27 %), Klebsiella pneumoniae (37.97%), and Enterobacter cloacae (6.96%). The most common carbapenemase genes harbored by gastrointestinal CRE strains were blaNDM-5, blaNDM-1, and blaIMP-4. Hematological malignancies, respiratory diseases, otolaryngological diseases, nervous system diseases, oral administration of third-generation cephalosporins, and the combined use of two or more antibiotics were independently associated with CRE colonization.