Microbiological Screening Research Articles

300. Disturbance of Gut Microbial Diversity in ICU Patients from Colombia is Driven by Multi-Drug Resistant Organisms (MDRO) Colonization

Abstract Background Gut microbiota plays a critical role in health, with essential functions in physiology, metabolism, immunity, regulation, and protection against pathogens. Critically-ill patients admitted on the ICU experience perturbation in the microbiota, with reduction in the phylogenetic diversity and composition. Here, we aimed to investigate the rectal microbiota in patients admitted on the ICU from Colombia, focused on MDRO colonization. Methods Microbiome analysis and microbiological screening for MDRO and WGS were performed in rectal swabs taken on admission day from 180 patients from 5 ICUs. Microbiome analysis was determined by 16S rRNA sequencing using Illumina Miseq platform. alpha-diversity metrics were calculated by Richness, Simpson, and Shannon indexes, and beta-diversity was determined using Similarity Percentages (SIMPER) analysis. Patients were grouped into 2 cohorts: MDRO-colonized and non-colonized. Clinical data was collected using REDCap. Results MDRO colonization was detected in 13 patients (7%), and Enterobacter cloacae complex was the most prevalent microorganism (38%), followed by K. pneumoniae (23%), and P. aeruginosa (15%). Of these MDRO, 23% and 15% harbored KPC-2 and KPC-3/OXA-9 combination, respectively. Prevotella and Bacteroides were the most abundant genus in the microbiota of all patients. Interestingly, microbiota of MDRO-colonized patients showed lower diversity (Shannon p:0.0025, Simpson p: 0.0031 and richness 0.012) and had less bacterial taxa than the observed in the non-colonized group (n=167), in which Bacteroides, Porphyromonas, Campylobacter, and Oscillospiraceae genus were exclusively detected. Moreover, Parabacteroides was a genus exclusively identified in the MDRO colonized group. Further, 14 genus including Oscillospiraceae, Lactobacillus, and Faecalibacterium related to beneficial functions were lower in abundance from MDRO-colonized patients, whereas some pathobionts were present in high abundance in this group. Most of patients were men (58%); median age was 59 y/o. Charlson comorbidity index 4 (IQR=1-6). Conclusion Loss in microbial diversity, with low abundance of beneficial microorganisms were associated with MDRO gut colonization in ICU patients from Colombia. Disclosures Karen Melissa Ordoñez, n/a, Pfizer: Advisor/Consultant|Pfizer: Honoraria

Detection of Clostridium perfringens in donor milk at a human breast milk bank: a case report

BackgroundThe breast milk bank is a professional organization that collects donor human milk (DHM) for special medical needs by recruiting qualified breast milk donors. Such organizations are also responsible for the disinfection, processing, testing, storage, distribution, and use of breast milk. As DHM is a biological product, it may get contaminated. Microbiological testing is the final step to determine microbial contamination of DHM. However, a universal method for the microbiological analysis of DHM in breast milk banks globally is lacking.DHM without strict screening may become a potential carrier of pathogens and seriously threaten the health of infants. Clostridium perfringens, a gram-positive anaerobic bacterium, is capable of causing wound infections, including gas gangrene, enteritis/enterocolitis, and enterotoxemia. Here, the first case of C. perfringens detected in DHM has been reported to facilitate the identification of such contamination in breast milk banks.Case presentationA breastfeeding mother donated 3000 mL of milk to the breast milk bank of the First Affiliated Hospital of the Army Medical University(over 2900 beds and patient receiving capacity of over 132,000), Chongqing, China. The milk sample was subjected to microbiological screening using liquid enrichment, followed by anaerobic and aerobic culturing. The results revealed the growth of C. perfringens in the anaerobic culture medium, but no bacteria or yeast-like fungi were observed in the aerobic culture medium. The donor did not exhibit any clinical symptoms, and her routine blood results and body temperature were normal. However, the infant fed with her milk had recurrent bloody stools. Breast milk bank infection control emergency handling as well as environmental sampling and investigation revealed that the cause was contamination of the donor’s home-use breast pump with C. perfringens. The infant no longer experienced bloody stool once the donor changed the breast pump.ConclusionsC. perfringens can enter breast milk from contaminated pumping environments or devices, thus causing illness in infants. The microbiological testing of DHM in breast milk banks can be accomplished using liquid enrichment, along with anaerobic and aerobic culture, which is of immense significance in improving the standards for microbiological screening, DHM safety, and infant health.

Microbiological Screening of Donor Human Milk.

Mother's own milk is recognized as the optimal feeding not only for term but also for preterm infants. In addition to risk reduction for sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity in the early infancy, feeding preterm infants with mother's own milk is also associated with a better neurodevelopmental outcome; lower rates of otitis media, gastroenteritis, and respiratory infections; and a reduced risk of cardiovascular disease, obesity, and diabetes later in life. Donor human milk is the best alternative if mother's own milk is not available or with short supply. There is growing evidence that the benefits of human milk are mediated by the human milk microbiota and by human milk oligosaccharides through their influence on the infant's gut microbiota. Unfortunately, although human milk contains beneficial bacteria, it may also contain pathogenic bacteria. The antimicrobial properties of human milk protect those infants fed with their own mother's raw milk. In donor human milk, however, the antimicrobial activity is diminished due to storage and in particular by pasteurization, hereby lowering the resistance against bacterial infections. Subsequently, microbiological screening of donor human milk might enhance its safety for preterm infants. Up to date, a consensus on recommendations for the microbiological testing of donor human milk is lacking. Existing local and national guidelines for the microbiological screening vary significantly in terms of timing and frequency of testing as well as their specific acceptance and discard criteria. We reviewed the literature about microbiological testing of donor human milk to provide evidence-based recommendations for donor human milk.

Management and control of an outbreak of NDM-producing Klebsiella pneumoniae in a teaching hospital

Abstract Background Outbreaks caused by New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae are a major public health threat. We report an outbreak caused by NDM-producing Klebsiella pneumoniae (KP) in an Italian teaching hospital and describe the composite management approach that led to a successful containment. Methods On August 12 2022, a 39-year old Ukrainian patient with known colonization (rectal swab) by NDM-producing KP was admitted to the Hematology Unit of the University Hospital of Verona, Italy. Six days after, a second patient tested positive for carbapenem-resistant (CR) KP from rectal swab and 2 additional cases (rectal and pharyngeal swab respectively) were identified in the following 2 weeks. The 4 cases were identical strains. Results A multidisciplinary team coordinated the response actions. Isolation measures were ordered for positive patients, including use of dedicated instruments. Screening at admission and every 7 days was placed for all the ward patients. On-site inspections and microbiological screening of ward surfaces and devices were carried out. Infection prevention and control (IPC) measures were strengthened among personnel. Environmental cleaning was implemented by deep treatment of critical points (e.g. toilets) and reinforcement of routine cleaning. The Risk Manager developed an original checklist based on literature to review the implementation of IPC practices for CR Enterobacteriaceae. No new cases were identified from screening in the following weeks and the Unit returned to standard IPC measures. Given that environmental samples were negative and the cases had overlapping personnel, the hypothesis of contact transmission through caregivers was the most plausible. Reinforcement of training on hand hygiene and transmission-based precautions was planned. Conclusions It was possible to contain the hospital outbreak through rapid and diversified reaction capacity. Continuous IPC education is an essential control measure. Key messages • The spread of NDM-producing Enterobacteriaceae in the hospital setting must be countered with enhanced prevention and, in case of outbreak, rapid control. • Effective containment involves a mix of established measures (screening, hygiene, environmental controls) and innovative approaches (e.g. literature-based checklists).

Detection of Multidrug resistant cariogenic bacteria among Diabetic Patients attending a Tertiary Hospital in Ado Ekiti, South-Western, Nigeria

Microorganisms colonizing the oral cavity have a significant probability of spreading on epithelial surfaces to neighboring sites. Many reports have associated oral bacteria to oral infectious diseases as well as systemic diseases such as cardiovascular disease and diabetes. Oral care is usually neglected in the control of health problems linked with diabetes which may contribute to the increased morbidity and complications from oral health problems. The study aimed to identify the resident microbial flora and assess the possible carriage of cariogenic bacteria among people with diabetes in Ado- Ekiti, Nigeria. Oral swabs were collected from 306 consenting patients. Culture-based isolation was done using standard techniques on Mitis salivarius agar supplemented with 1% Potassium Tellurite, 10% chocolate agar and MacConkey agar at 37 oC for 18-48 hours. The susceptibility patterns of the isolates were detected using standard techniques as recommended by CLSI. Selected bacteria isolates were genomically identified using the bacterial universal primer 16S rRNA and STR-1 and STR 2 primers (partial tuf genes). Amplified genes were sequenced and phylogenetic analysis was carried out using MEGA 7 software. A total of 447 microbial isolates were identified among which were Staphylococcus spp (14.5%), Klebsiella pneumoniae (3.4%), Escherichia coli (2.5%), Candida spp (8%) while the streptococcal organisms such as Streptococcus pyogenes (35.2%), Streptococcus mitis (14%), Streptococcus mutans (7.3%) and Streptococcus salivarius (15.1%). Streptococcus mutans was susceptible to meropenem (71.4%) but highly resistant to Penicillin (100%), cefuroxime (71.4%) cefotaxime (68.6%). Streptococcus mitis was highly resistant to Amoxicillin/Clavulanate (100%), Cloxacillin (100%) and Cefuroxime (70.1%) but was found susceptible to Meropenem (77.3%). 16S ribosomal RNA gene amplification and subsequent sequencing of the isolates revealed twenty-six (26) de-novo bacterial strains. In conclusion, the study showed that diabetic individuals carry multidrug-resistant cariogenic bacteria that may predispose them to other oral diseases. There is a need to incorporate routine oral microbiological screening into routine care for diabetic patients in Nigeria.

Influence of a Structured Microbiological Endotracheal Monitoring Program on the Outcome of Critically Ill COVID-19 Patients: An Observational Study.

In past influenza pandemics and the current COVID-19 pandemic, bacterial endotracheal superinfections are a well-known risk factor for higher morbidity and mortality. The goal of this study was to investigate the influence of a structured, objective, microbiological monitoring program on the prognosis of COVID-19 patients with mechanical ventilation. A structured microbiological monitoring program (at intubation, then every 3 days) included collection of endotracheal material. Data analysis focused on the spectrum of bacterial pathogens, mortality, as well as intensive care unit (ICU), hospital, and mechanical ventilation duration. A total of 29% of the patients showed bacterial coinfection at the time of intubation, and within 48 h, 56% developed ventilator-associated pneumonia (VAP). Even though patients with VAP had significantly longer ICU, hospital, and mechanical ventilation durations, there was no significant difference in mortality between patients with VAP pneumonia and patients without bacterial infection. VAP is a common complication in COVID-19 patients. In contrast to already published studies, in our study implementing a structured microbiological monitoring program, COVID-19 patients with bacterial coinfection or VAP did not show higher mortality. Thus, a standardized, objective, microbiological screening can help detect coinfection and ventilator-associated infections, refining anti-infective therapy and positively influencing patient outcomes.

Label-Free Multiplex Proteotyping of Microbial Isolates.

To meet clinical diagnostic needs and for general microbiological screening, it is essential to be able to accurately and rapidly identify any microorganisms from complex microbiota. To gain insight into the individual components of microbiota, culturomics has been proposed as a means to systematically test hundreds of possible cultivation conditions and generate numerous microbial isolates with very distinct characteristics. High-throughput identification methods must now be developed to quickly screen these isolates. Currently, most multiplexing methods involve labeling, which comes at a cost. In this paper, we present an innovative label-free multiplexing method for the identification of microorganisms using tandem mass spectrometry. The method is based on offline reversed-phase fractionation of individual peptidomes. Multiplexing is achieved by mixing fractions of staged hydrophobicity; thus, each sample is mapped to specific elution times. In this proof-of-concept study, multiplexed samples were analyzed by tandem mass spectrometry in a single run and microorganisms present in the mixture were resolved by phylopeptidomics proteotyping. Using this methodology, up to 21 microorganisms could be identified in a single 60 min run performed with a Q-Exactive HF high-resolution mass spectrometer, resulting in a rate of one microorganism identified per 3 min of mass spectrometry, without any need for the use of labeling reagents. This approach opens new perspectives for the application of high-throughput proteotyping of bacteria using tandem mass spectrometry in large culturomics projects.

Unexpected death involving the spleen - an overview.

The spleen is located in the left upper quadrant of the abdominal cavity and has both immunological and haematological functions. A variety of quite different entities may be associated with sudden death due to splenic involvement. These range from simple traumatic disruption of the parenchyma of a normal spleen with marked intra-abdominal haemorrhage, to conditions such as malaria and infectious mononucleosis where splenomegaly predisposes to rupture. Haematological diseases such as malignancies and haemoglobinopathies may causes sudden death due to haemorrhage or red cell sequestration. Asplenia or polysplenia may be associated with significant congenital heart disease. Hyposplenia, both structural and functional, may also result in rapid demise from sometimes unusual bacterial infections. Vascular abnormalities causing death include entities such as splenic artery aneurysms. Thus, deaths from splenic pathology may be due to localised issues or may be part of more generalised disease. For this reason the autopsy in cases of splenic-associated deaths must be comprehensive and include special testing such as microbiological screening and/or haematologic/genetic evaluation.

Colonization with drug-resistant pathogens among patients in long-term care facilities and under home hospice care - a cross-sectional study.

The spread of drug-resistant bacteria is deemed a worldwide threat. Patients in long-term care, including those under palliative care, are exposed to a high risk of colonization and infection with drug-resistant pathogens. This refers primarily to long-term care facilities as opposed to home care. A cross-sectional study was carried out between 1January 2018 - 30 June 2019. The study was approved by the Bioethics Committee at the Medical University of Warsaw (KB/222/2017). The aim of the study was to assess the frequency and type of colonization with drug-resistant pathogens among patients in long-term care facilities and those under home hospice care. An additional aim was evaluation the risk of pathogen transmission according to the type of provided long-term care. The study included 129 participants: 68 patients under the care of 3 long-term care facilities in Warsaw, Poland, 42 patients under home hospice care, and 19 household members of hospice patients. All included participants provided written informed consent. Oropharyngeal and rectal swabs were obtained from all participants for microbiological assessment. Colonization with pathogens was more common in long-term care facilities residents (82.4%)than in at-home hospice patients (42.9%). Risk of colonization was significantly lower in patients staying at home than in long-term care facilities patients (OR 0.16; 95% CI 0.06-0.38). Conclusions. Risk of colonization with drug-resistant pathogens depends on the type of care and is significantly higher in patients staying at long-term care facilities. Systemic measures, such as microbiological screening, are necessary to provide optimal patient care and to ensure epidemiological safety, both to patients and their caregivers.

N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues: prediction of toxicity and prospects for use as diuretics

Sokolova K.V., Podpletnia O.A., Konovalova S.O., Avdieienko A.P., Komarovska-Porokhniavets O.Z., Lubenets V.I., Kovalenko S.I. Continuing our research on compounds that affect urination, we have become interested in N-arylsulfonyl-2-aroylamino-1,4-quinone imines, which combine a quinone matrix with tolylsulfonamide and benzamide fragments with versatile biological activity in their structure, which has a promising value in preventing development of pathological processes in kidneys. Therefore, the search for low-toxic compounds with polyvector activity as a promising approach to the design of drug-like molecules has become an urgent aspect in this regard. The aim of this work was to investigate N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues as promising diuretic agents with antiradical and antibacterial activity using in silico, in vitro and in vivo methodologies. The virtual laboratory of the ProTox-II site is used to predict the toxicity of molecules. The study of compounds affecting the excretory function of the rat kidneys was carried out on 120 white Wistar rats according to the method of E.B. Berkhin under conditions of water stress and spontaneous urination. The interaction of the synthesised compounds with 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to study their antiradical activity in vitro. The antibacterial activity of the compounds was studied on test cultures of the bacteria Escherichia coli, Staphylococcus aureus, Mycobacterium luteum and the fungi Candida tenuis, Aspergillus niger by the method of serial dilutions in a liquid nutrient medium. Based on the results of the calculation, it was predicted that N-arylsulfonyl-2-aroylamino-1,4-quinone imines (2) and their hydrogenated analogues (3) have hepato-(immuno-, cyto-) toxicity, carcinogenicity (mutagenicity) similar to natural quinones and diuretics (toxicity class IV). This class of compounds has been shown to have both stimulatory and inhibitory effects on diuresis under condi­tions of water stress and spontaneous urination. At the same time, N-(5-methyl-6-oxo-3-(tosylimino)cyclohexa-1,4-dien-1-yl)benzamide (2.3) was revealed to increase daily diuresis by 67.1% compared with the control, exceeding the effect of «Furosemide» (22.2%). It was found that quinone imines (2.1-2.5) inhibited the formation of the DPPH radical by 25.99-40.09%, while their hydrogenated analogues (3.1 and 3.2) – by 61.56% and 68.28%, respectively, and are more effective acceptors of radicals. The microbiological screening revealed a number of promising compounds that inhibited the growth of S. aureus (compound 2.5, MIC 62.5 μg/ml, MBC 125.0 μg/ml), M. luteum (3.1 and 3.2, MIC 31.2 μg/ml, MBC 62.5 μg/ml) and A. niger (2.1, 2.4 and 3.2, MIC 31.2 μg/ml, MPC 62.5 μg/ml). According to the results of biological studies, among N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues, compound 2.3 has been iden­tified, which competes with «Furosemide» in potency and has high antibacterial activity against S. aureus. Other compounds show moderate antiradical activity, high antibacterial activity against M. luteum (2.1, 3.1) and antifungal activity against A. niger (2.1, 2.4, 3.2). The obtained results support the further research for diuretics with polyvector activity within this class of compounds.

Detection of antimicrobial residues in animal manure by a microbiological screening methodology: A non-invasive tool in animal production

Detection of antimicrobial residues in animal manure by a microbiological screening methodology: A non-invasive tool in animal production

Rapid identification of main antibacterial components from New Zealand ‘Hass’ avocado peel hexane extract

‘Hass’ avocado (Persea americana Mill) is a very popular tropical fruit that contains several nutrients, including vitamins, proteins, minerals, and unsaturated fatty acids. ‘Hass’ avocado peel is one of the by-products obtained from the New Zealand (NZ) avocado processing industry. The current study focused on the antibacterial components from hexane ‘Hass’ avocado peel extract. The aim was to perform microbiological screening of NZ hexane ‘Hass’ avocado peel extract using Staphylococcus aureus. We used thin- layer chromatography (TLC) with direct microbiological detection to isolate the individual components that showed antibacterial activity. Mass spectrometry (MS) analysis characterized the isolated components from hexane peel extract. (15Z)-9,12,13-Trihydroxy-15-octadecenoic acid, (±)9-HpODE, and NP-011548 are the three fatty acids that have been tentatively identified. Present findings provide new bioactive components from avocado peel and suggest potential applications for this extract as a natural antibacterial additive in soaps, and detergents.

Gender-specific changes of the gut microbiome correlate with tumor development in murine models of pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with a dismal outcome. To improve understanding of sequential microbiome changes during PDAC development we analyzed mouse models of pancreatic carcinogenesis (KC mice recapitulating pre-invasive PanIN formation, as well as KPC mice recapitulating invasive PDAC) during early tumor development and subsequent tumor progression. Diversity and community composition were analyzed depending on genotype, age, and gender. Both mouse models demonstrated concordant abundance changes of several genera influenced by one or more of the investigated factors. Abundance was significantly impacted by gender, highlighting the need to further elucidate the impact of gender differences. The findings underline the importance of the microbiome in PDAC development and indicate that microbiological screening of patients at risk and targeting the microbiome in PDAC development may be feasible in future.

Microbiological screening of compounds with potential anti-lep activity among new synthesis compounds of the pyrimidine series

Aim. To study the effect of new synthesized pyrimidine derivatives on the growth of Mycobacterium lufu (M. lufu) and Mycobacterium tuberculosis (M. tuberculosis) when cultivated on Shkolnikova's medium.Materials and methods. The objects of research were new synthesized derivatives of 6 samples of derivatives of pyrimidine - 5-(arylmethylidene)-2,4,6-pyrimidine-2,4,6(1H,3H,5H)-trions under laboratory codes TAG1, TAG2, TAG3, TAG4, TAG5, TAG6 and 7 samples of 5-(getarylmethylidene)-2,4,6-pyrimidine-2,4,6(1H, 3H, 5H)-trions under the laboratory codes TAG7, TAG8, TAG9, TAG10, TAG11, TAG12, TAG13. M. lufu and M. tuberculosisH37Rv strains were used as test cultures. The antimycobacterial activity of the studied compounds was studied by the method of serial dilutions.Research results. All studied compounds were found to exhibit antimycobacterial activity. The greatest inhibitory effect against M. lufu was noted for TAG1, TAG4, TAG7, TAG12, and TAG13, which was comparable to that of the reference drug dapsone. By the nature of the inhibitory effect on the growth of M. tuberculosis, the compounds under the laboratory codes TAG 1, TAG 4, TAG 7 and TAG13 were comparable to isoniazid, and the effect of the TAG3 compound was even slightly superior to the reference drug.Conclusion. Among the studied new synthesized pyrimidine derivatives, compounds under the laboratory codes TAG1, TAG4, TAG 7 and TAG13 have the most pronounced antimicrobial activity both against M. lufu and M. tuberculosis, which allows us to consider them as the most promising substances for further research on the search for antimycobacterial, including antileprosy drugs.

Microbiological screening of compounds with potential anti-lep activity among new synthesis compounds of the pyrimidine series

Aim: To study the effect of new synthesized pyrimidine derivatives on the growth of Mycobacterium lufu (M. lufu) and Mycobacterium tuberculosis (M. tuberculosis) when cultivated on Shkolnikova’s medium.Materials and methods. The objects of research were new synthesized derivatives of 6 samples of derivatives of pyrimidine - 5-(arylmethylidene)-2,4,6-pyrimidine-2,4,6(1H,3H,5H)-trions under laboratory codes TAG1, TAG2, TAG3, TAG4, TAG5, TAG6 and 7 samples of 5-(getarylmethylidene)-2,4,6-pyrimidine-2,4,6(1H, 3H, 5H)-trions under the laboratory codes TAG7, TAG8, TAG9, TAG10, TAG11, TAG12, TAG13. M. lufu and M. tuberculosisH37Rv strains were used as test cultures. The antimycobacterial activity of the studied compounds was studied by the method of serial dilutions.Research results. All studied compounds were found to exhibit antimycobacterial activity. The greatest inhibitory effect against M. lufu was noted for TAG1, TAG4, TAG7, TAG12, and TAG13, which was comparable to that of the reference drug dapsone. By the nature of the inhibitory effect on the growth of M. tuberculosis, the compounds under the laboratory codes TAG 1, TAG 4, TAG 7 and TAG13 were comparable to isoniazid, and the effect of the TAG3 compound was even slightly superior to the reference drug.Conclusion. Among the studied new synthesized pyrimidine derivatives, compounds under the laboratory codes TAG1, TAG4, TAG 7 and TAG13 have the most pronounced antimicrobial activity both against M. lufu and M. tuberculosis, which allows us to consider them as the most promising substances for further research on the search for antimycobacterial, including antileprosy drugs.

Prevalence of atypical pathogens in patients with severe pneumonia: a systematic review and meta-analysis

ObjectivesWe aimed to summarise the prevalence of atypical pathogens in patients with severe pneumonia to understand the prevalence of severe pneumonia caused by atypical pathogens, improve clinical decision-making and guide...

Formation of Various Antimicrobial Peptide Emericellipsin Isoforms in Emericellopsos alkalina under Different Cultivation Conditions

Microbiological screening of the target component of emericellipsin A of the Emericellopsis alkalina E101 strain has been carried out in various biotechnological systems at various pHs. The content of emericellipsin A was quantified under these conditions. It has been established that the new approved membrane-liquid cultivation method at pH 10 contributes to an increase in the yield of the main component of emericellipsin A. It has been shown that the new method of cultivating the strain E. alkalina E101 also promotes the synthesis of various isoforms of the main component of emericellipsin A. Some comparative analysis has been carried out.

Prophylactic Antibiotics After Cleft Lip and Palate Reconstruction: A Review From a Global Health Perspective.

Orofacial clefts are common congenital deformities. Global initiatives have increased access to cleft care and reconstruction surgeries for cleft lip with or without cleft palate (CL/P), but there is no consensus on the use of postoperative prophylactic antibiotics. We conducted a narrative review using PubMed on the use of postoperative prophylactic antibiotics in CL/P surgery. A search of PubMed identified 30 potentially relevant articles, of which 15 were reviewed. There was no consensus among surgeons on prescribing patterns, but there was limited evidence that postoperative antibiotics reduce palatal fistulas. Notably, microbiological screening is not used to guide the choice of antimicrobial or to predict postoperative complications. Based on limited available data, we cannot make any strong evidence-based recommendations on prescribing postoperative antibiotics; however, we recommend that each cleft surgeon performing these procedures in lower-income countries without access to tertiary care centersconsider the cost-benefit analysis of prescribing antimicrobials postoperatively, without antimicrobial screening, which showed no benefit.

Prevalence of Multidrug-Resistant Organisms in Healthy Adults in Shenzhen, China.

Public health problems caused by the high transmission of multidrug-resistant organisms (MDROs) have attracted widespread international attention. However, studies on healthy adults in this field are scarce. In this article, we report the microbiological screening results of 180 healthy adults recruited from 1,222 participants between 2019 and 2022 in Shenzhen, China. Findings show a high MDRO carriage rate of 26.7% in those individuals who did not use any antibiotics in the past 6 months and had not been hospitalized within the past year. MDROs were mainly extended-spectrum β-lactamase-producing Escherichia coli with high resistance to cephalosporin. With the assistance of metagenomic sequencing technology, we also performed long-term observations of several participants and found that drug-resistant gene fragments were prevalent even when MDROs were not detected by drug sensitivity testing. Based on our findings, we suggest that healthcare regulators limit the medical overuse of antibiotics and enact measures to limit its nonmedical use.

Formation of Various Antimicrobial Peptide Emericellipsin Isoforms in <i>Emericellopsis alkalina</i> under Different Cultivation Conditions

A microbiological screening of the target component of emericellipsin A of the Emericellopsis alkalina E101 strain was carried out in various biotechnological systems at various pH. The content of emericellipsin A was quantified under these conditions.It has been established that the new approved membrane-liquid cultivation method at pH 10 contributes to an increase in the yield of the main component of emericellipsin A. It was shown that the new method of cultivating the strain E. alkalina E101 also promotes the synthesis of various isoforms of the main component of emericellipsin A. Some comparative analysis of them was carried out.