Misuse Of Antimicrobial Agents Research Articles

Antimicrobial effects and phytochemical analysis of guava leaf extracts on selected microorganisms

The misuse of antimicrobial agents can lead to emergence of resistance to microbes which in turn can lead to the search for alternative therapy. The use of phytopharmaceuticals and herbal medicines have a positive impact and represents a promising alternative. Guava extract has been reported to have antimicrobial properties. However, the aim of this study was to determine the antimicrobial activities of methanol and ethanol extract of guava leave against some certain bacteria (Staphylococus aureus and Escherichia coli) and a fungus (Candida albicans). Qualitative phytochemical screening showed that phenols, tannins, saponins, terpenoids, flavonoids and glycosides are all present in the leaf extract; phenols and tannins are moderately present while others are present in minute quantities. Out of the different concentrations use (50, 100, 200 and 250), The highest concentration which is 250mg/ml showed the highest zone of inhibition for both methanolic and ethanolic extracts against the isolates. Minimum inhibitory concentration and Minimum Bactericidal Concentrations value for both S. aureus and E. coli are 200mg/ml and 250mg/ml respectively; while 50mg/ml and 100mg/ml are for Candida albicans.

Hybrids Diazine: Recent Advancements in Modern Antimicrobial Therapy.

Nowadays, antimicrobial therapies have become a very challenging issue because of a large diversity of reasons such as antimicrobial resistance, over consumption and misuse of antimicrobial agents, etc. A modern, actual and very useful approach in antimicrobial therapy is represented by the use of hybrid drugs, especially combined five and six-membered ring azaheterocycles. In this review, we present an overview of the recent advanced data from the last five years in the field of hybrid diazine compounds with antimicrobial activity. In this respect, we highlight here essential data concerning the synthesis and antimicrobial activity of the main classes of diazine hybrids: pyridazine, pyrimidine, pyrazine, and their fused derivatives.

Antimicrobial resistance of avian pathogenic Escherichia coli isolated from broiler, layer, and breeder chickens.

Antimicrobials are extensively used in poultry production for growth promotion as well as for the treatment and control of diseases, including avian pathogenic Escherichia coli (APEC). Poor selection, overuse, and misuse of antimicrobial agents may promote the emergence and dissemination of antimicrobial resistance (AMR) in APEC. This study aimed to assess antimicrobial susceptibility patterns and detect antibiotic resistance genes (ARGs) in APEC isolated from clinical cases of colibacillosis in commercial broiler, layer, and breeder chickens. A total of 487 APEC were isolated from 539 across 300 poultry farms in various regions of Nepal. Antimicrobial susceptibility patterns was determined using the Kirby-Bauer disk diffusion and broth microdilution methods. The index of AMR, such as multiple antibiotic resistance (MAR) index, resistance score (R-score), and multidrug resistance (MDR) profile, were determined. Polymerase chain reaction was employed to detect multiple ARGs and correlations between phenotypic and genotypic resistance were analyzed. The prevalence of APEC was 91% (487/539). All of these isolates were found resistant to at least one antimicrobial agent, and 41.7% of the isolates were resistant against 8-9 different antimicrobials. The antibiogram of APEC isolates overall showed the highest resistance against ampicillin (99.4%), whereas the highest intermediate resistance was observed in enrofloxacin (92%). The MAR index and R-score showed significant differences between broiler and layers, as well as between broiler breeder and layers. The number of isolates that were resistant to at least one agent in three or more antimicrobial categories tested was 446 (91.6%) and were classified as MDR-positive isolates. The ARGs were identified in 439 (90.1%) APEC isolates, including the most detected mobilized colistin resistance (mcr1) which was detected in the highest (52.6%) isolates. Overall, resistance gene of beta-lactam (blaTEM), mcr1, resistance gene of sulphonamide (sul1) and resistance gene of tetracycline (tetB) (in broiler), were detected in significantly higher than other tested genes (p < 0.001). When examining the pair-wise correlations, a significant phenotype-phenotype correlation (p < 0.001) was observed between levofloxacin and ciprofloxacin, chloramphenicol and tetracycline with doxycycline. Similarly, a significant phenotype-genotype correlation (p < 0.001) was observed between chloramphenicol and the tetB, and colistin with blaTEM and resistance gene of quinolone (qnrA). In this study, the current state of APEC AMR in commercial chickens is revealed for the first time in Nepal. We deciphered the complex nature of AMR in APEC populations. This information of molecular surveillance is useful to combat AMR in APEC and to contribute to manage APEC associated diseases and develop policies and guidelines to enhance the commercial chicken production.

Phytochemical Analysis and Antimicrobial Activity of Pongamia Pinnata: A Comprehensive Study

Background: Antimicrobial resistance (AMR) poses a significant global health challenge, exacerbated by the misuse of antimicrobial agents. With the rising prevalence of AMR in various plant and animal pathogens, there is an urgent need to explore alternative therapeutic options. Plant extracts, historically utilized for disease treatment, offer a promising avenue. Pongamia pinnata, also known as Indian Karanja, is notable for its rich phytochemical content and has been the subject of recent scientific interest. Objective: The primary aim of this study is to investigate the antimicrobial efficacy of P. pinnata extracts, prepared using the Ultrasonic Assisted Extraction (UAE) method, against a range of bacterial and fungal species known to exhibit AMR. Methods: In this study, an experimental laboratory design was utilized to evaluate the antimicrobial properties of Pongamia pinnata. Aqueous and alcoholic extracts of P. pinnata were prepared and subjected to biochemical analysis to identify the spectrum of phytochemicals present. The antimicrobial activity of these extracts was then assessed using the well-diffusion method against selected bacterial and fungal pathogens. Results: Both aqueous and alcoholic extracts of P. pinnata demonstrated significant antimicrobial effects against the tested microbial species. The study highlights the potent antimicrobial properties of P. pinnata, attributed to its diverse phytochemical composition. Conclusion: The findings of this study underscore P. pinnata as a valuable source of natural antimicrobial agents. Its efficacy against AMR pathogens suggests its potential application in the development of new treatments for infectious diseases. P. pinnata holds promise for medicinal use, particularly in contexts where conventional antibiotics are ineffective.

Occurrence and Antimicrobial Resistance Profile of Escherichia coli in Poultry from Gusau metropolis, Nigeria

The increment in misuse of antimicrobial agents in the treatment of human and animal diseases has made bacterial organisms such as E. coli become resistant to many available antibiotics. This study investigates the presence of E. coli in chicken within the studied area. A cross-sectional study was conducted to determine the presence and antimicrobial resistance profile of E. coli in chicken within Gusau metropolis Zamfara state, Nigeria. A total of 289 cloacal swabs were collected from 40 broilers, 219 layers and 30 local chickens. Bacterial culture, phenotypic characterization, antibiotic susceptibility test were conducted. The overall prevalence of E. coli based on phenotypic identification was 22.1 % (64/289). The prevalence of E. coli based on the different chicken types was 20 % (8/40), 23.3 % (51/219) and 16.7 % (5/30) for broilers, layers and local chickens respectively. There was no statistically significant association between the isolate of E. coli and chicken type (p = 0.0987; df = 2). Antibiotic susceptibility test revealed 87.5% and 85.9 % resistance to Amoxicillin-clavulanate and Imipenem respectively, 76.6 % resistance to Cefuroxime, 60.9 % to Erythromycin, 51.6 % to Cefexime, 53.1% to Cefotaxime and 48.4 % Azithromycin. However, 31.3 % were resistant to Levofloxacin, 37.5 % to Ofloxacin, 42.2 % to Ceftriaxone, 45.3 % to Ciprofloxacin and 42.2 % to Gentamicin. In conclusion the study revealed the prevalence of E. coli in poultry from Gusau Metroplis to be 22.1 % (64/289) and antibiotic resistance awareness campaign is recommended to be employed by relevant agency.

Nanoparticle therapy for antibiotic-resistant bacteria: current methods and prospects

Emerging diseases due to antibiotic-resistant bacteria cause severe health concerns while increasing their negative effects on human health. The overuse or misuse of antimicrobial agents has contributed to the evolution of bacterial resistance to current medications. Bacteria can develop resistance by altering drugs, changing their target sites, forming biofilms and spending more time in the intracellular environment. Due to this, efforts are being made to create novel, alternative nanoantibiotics as a promising strategy to treat bacteria that cause disease and have developed resistance to a variety of drugs. Utilizing their biocidal properties, nanoparticles can be directed for medication delivery to particular tissues and employed as antibacterial agents against a range of illnesses. Targeted medication delivery-related toxicity problems may be solved with the aid of nanoencapsulation technology. This review paper generally provides a conceptual foundation for understanding the complexity of the problem of the development of antibiotic-resistant bacteria, particularly for brand-new synthetic antibiotics. This information will allow researchers to explore the use of nanoparticles in the treatment of multidrug-resistant bacteria.

Novel Dietary Approach with Probiotics, Prebiotics, and Synbiotics to Mitigate Antimicrobial Resistance and Subsequent Out Marketplace of Antimicrobial Agents: A Review.

Antimicrobial resistance (AMR) is a significant public health concern worldwide. The continuous use and misuse of antimicrobial agents have led to the emergence and spread of resistant strains of bacteria, which can cause severe infections that are difficult to treat. One of the reasons for the constant development of new antimicrobial agents is the need to overcome the resistance that has developed against existing drugs. However, this approach is not sustainable in the long term, as bacteria can quickly develop resistance to new drugs as well. Additionally, the development of new drugs is costly and time-consuming, and there is no guarantee that new drugs will be effective or safe. An alternative approach to combat AMR is to focus on improving the body's natural defenses against infections by using probiotics, prebiotics, and synbiotics, which are helpful to restore and maintain a healthy balance of bacteria in the body. Probiotics are live microorganisms that can be consumed as food or supplements to promote gut health and improve the body's natural defenses against infections. Prebiotics are non-digestible fibers that stimulate the growth of beneficial bacteria in the gut, while synbiotics are a combination of probiotics and prebiotics that work together to improve gut health. By promoting a healthy balance of bacteria in the body, these can help to reduce the risk of infections and the need for antimicrobial agents. Additionally, these approaches are generally safe and well tolerated, and they do not contribute to the development of AMR. In conclusion, the continuous development of new antimicrobial agents is not a sustainable approach to combat AMR. Instead, alternative approaches such as probiotics, prebiotics, and synbiotics should be considered as they can help to promote a healthy balance of bacteria in the body and reduce the need for antibiotics.

A survey of knowledge, attitudes and use of antibiotics among Bulgarian population

Antimicrobial resistance occurs naturally but is enhanced by human activities related to the use of antibiotics (for example, excessive use and misuse of antimicrobial agents). Our study aimed to gain insight into the knowledge, attitudes and practice of the use of antibiotics among the general Bulgarian population. A cross-sectional survey was conducted during a 4-week period in April-May 2022. Our sample included 516 participants of whom 398 (77.1%) were females, mainly Bulgarians by ethnic group, with a university degree (master degree 58.9%; bachelor degree 17.2%) and living in big regional cities (91.5%). The main health reasons that respondents from all age groups share for taking antibiotics in the last year were bronchitis, sore throat, infections, including urinary tract infections, and pneumonia. Interestingly, about 14% of the respondents have treated the SARS-2-coronavirus infection with antibiotics. Our results highlighted existing attitudes toward antibiotic use in the surveyed sample. Overall, respondents from all age groups showed similarities in their attitudes toward treatment with antibiotics. People’s behavior and actions toward antibiotics play an important role in the spread of antimicrobial resistance. Our study provided some important insights concerning the knowledge and practices related to antibiotic use and antimicrobial resistance in the Bulgarian population. In general, good knowledge of antibiotic use and antimicrobial resistance was evident among the surveyed sample.

Antimicrobial resistance dissemination associated with intensive animal production practices in Argentina: A systematic review and meta-analysis

Abuse and misuse of antimicrobial agents has accelerated the spread of antimicrobial-resistant bacteria. The association between antimicrobial-resistant infections in humans and antimicrobial use in agriculture is complex, but well-documented. This study provides a systematic review and meta-analysis of the dissemination of antimicrobial resistance (AMR) to antimicrobials defined as critically important by the WHO, in swine, chicken, and cattle from intensive and extensive production systems in Argentina. We conducted searches in electronic databases (MEDLINE-PubMed, Web of Science, SciELO, the National System of Digital Repositories from Argentina) as well as in the gray literature. Inclusion criteria were epidemiological studies on AMR in the main food-transmitted bacteria, Salmonella spp., Campylobacter spp., Escherichia coli and Enterococcus spp., and mastitis-causing bacteria, isolated from swine, chicken, dairy and beef cattle from Argentina. This study gives evidence for supporting the hypothesis that AMR of common food-transmitted bacteria in Argentina is reaching alarming levels. Meta-analyses followed by subgroup analyses confirmed the association between the prevalence of AMR and (a) animal species (p<0.01) for streptomycin, ampicillin and tetracycline or (b) the animal production system (p<0.05) for streptomycin, cefotaxime, nalidixic acid, ampicillin and tetracycline. Moreover, swine (0.47 [0.29; 0.66]) and intensive production (0.62 [0.34; 0.83]) showed the highest pooled prevalence of multidrug resistance while dairy (0.056 [0.003; 0.524]) and extensive production (0.107 [0.043; 0.240]) showed the lowest. A research gap regarding beef-cattle from feedlot was identified. Finally, there is an urgent need for political measures meant to coordinate and harmonize AMR surveillance and regulate antimicrobial use in animal production.

Extended spectrum beta lactamases-producing Escherichia coli in retail chicken meat from Khyber Pakhtunkhwa, Pakistan

In human diet, poultry meat is an important component due to the presence of vitamins, proteins and minerals. But poultry meat can be contaminated by pathogenic bacteria which are responsible for food borne infections. The current study was therefore aimed at identification of Escherichia coli, a common pathogen causing food borne infections, in chicken samples (n = 400) collected from three districts of KhyberPukhtunkhwa; Peshawar, Kohat and Nowshera. The isolates were identified by Gram staining, API strips and through PCR (Universal Stress Protein). A total of 174 samples were positive for E. coli among the collected chicken samples. The isolates were resistant to TE, NOR and NA while were sensitive to MEM, TZP and FOS. The results were statistically significant having value P ≤ 0.05 in ANOVA. The isolates showed different antibiotic resistance genes; OXA-1, CTX-M15, blaTEM, QnrS, TetA, AAC, AAD, sul1 and sul2 which is the molecular explanations of their antibiotic resistance pattern. The PCR products were sequenced by Next Generation Sequencing (NGS) and the results revealed mutations in AAC gene (M120T and R197T) and CTX-M15 (A85V, N122D, A148S and G247D).To prevent and treat pathogenic diseases, the use of antimicrobial agents in animal husbandry are of utmost concern. The over-use and misuse of antimicrobial agents has made pathogenic E. coli multi drugs resistant making it a causative agent for many diseases in human beings. The results of the current study may be helpful for the physicians the better management of the diseases caused by E. coli.

Characterization of Multidrug Resistance Patterns of Emerging Salmonella enterica Serovar Rissen along the Food Chain in China.

Salmonella spp. are recognized as important foodborne pathogens globally. Salmonella enterica serovar Rissen is one of the important Salmonella serovars linked with swine products in numerous countries and can transmit to humans by food chain contamination. Worldwide emerging S. Rissen is considered as one of the most common pathogens to cause human salmonellosis. The objective of this study was to determine the antimicrobial resistance properties and patterns of Salmonella Rissen isolates obtained from humans, animals, animal-derived food products, and the environment in China. Between 2016 and 2019, a total of 311 S. Rissen isolates from different provinces or province-level cities in China were included here. Bacterial isolates were characterized by serotyping and antimicrobial susceptibility testing. Minimum inhibitory concentration (MIC) values of 14 clinically relevant antimicrobials were obtained by broth microdilution method. S. Rissen isolates from humans were found dominant (67%; 208/311). S. Rissen isolates obtained from human patients were mostly found with diarrhea. Other S. Rissen isolates were acquired from food (22%; 69/311), animals (8%; 25/311), and the environment (3%; 9/311). Most of the isolates were resistant to tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, streptomycin, sulfisoxazole, and ampicillin. The S. Rissen isolates showed susceptibility against ceftriaxone, ceftiofur, gentamicin, nalidixic acid, ciprofloxacin, and azithromycin. In total, 92% of the S. Rissen isolates were multidrug-resistant and ASSuT (27%), ACT (25%), ACSSuT (22%), ACSSuTAmc (11%), and ACSSuTFox (7%) patterns were among the most prevalent antibiotic resistance patterns found in this study. The widespread dissemination of antimicrobial resistance could have emerged from misuse of antimicrobial agents in animal husbandry in China. These findings could be useful for rational antimicrobial usage against Salmonella Rissen infections.

Antimicrobial resistance, mechanisms and its clinical significance

Antimicrobial agents play a key role in controlling and curing infectious disease. Soon after the discovery of the first antibiotic, the challenge of antibiotic resistance commenced. Antimicrobial agents use different mechanisms against bacteria to prevent their pathogenesis and they can be classified as bactericidal or bacteriostatic. Antibiotics are one of the antimicrobial agents which has several classes, each with different targets. Consequently, bacteria are endlessly using methods to overcome the effectivity of the antibiotics by using distinct types of mechanisms. Comprehending the mechanisms of resistance is vital for better understanding and to continue use of current antibiotics. Which also helps to formulate synthetic antimicrobials to overcome the current mechanism of resistance. Also, encourage in prudent use and misuse of antimicrobial agents. Thus, decline in treatment costs and in the rate of morbidity and mortality.This review will be concentrating on the mechanism of actions of several antibiotics and how bacteria develop resistance to them, as well as the method of acquiring the resistance in several bacteria and how can a strain be resistant to several types of antibiotics. This review also analyzes the prevalence, major clinical implications, clinical causes of antibiotic resistance. Further, it evaluates the global burden of antimicrobial resistance, identifies various challenges and strategies in addressing the issue. Finally, put forward certain recommendations to prevent the spread and reduce the rate of resistance growth.

Impact of misuse of antimicrobial agents on egg bitterness

A hundred raw eggs samples randomly selected from Aswan university residence restaurant due to students' complain of bitter taste presence in the table eggs served to them during breakfast. The samples were examined physically and chemically for antibiotic residues and vitamins A, D3 levels concentration by Spectrophotometer. The result showed that all interior egg quality traits were normal except the presence of small blood spots in 5 eggs yolk, bitter taste were present in 18 eggs yolk, antimicrobial residues were detected in 19 eggs yolk and 4 eggs white. Antimicrobial residues positive samples were examined quantitatively by HPLC for Doxycycline (DC) residues presence. The results showed that 100% of examined samples having DC residues with means concentrations of 35±1.46 and 97±4.46 ppb for eggs white and yolk respectively. The mean levels of vitamin A and D3 in eggs yolk were 447±5.49 µg/100g and11±1.35 µg/100g respectively. The paper concludes that the high concentrations of Vitamins and Doxycycline may be the cause of bitter taste of egg.

Antibiotic utilization pattern in the emergency medicine ward of a tertiary health care centre: An observational study

Antibiotic utilization pattern in the emergency medicine ward of a tertiary health care centre: An observational study - IJCAAP- Print ISSN No: - 2581-5555 Online ISSN No:- 2456-9542 Article DOI No:- 10.18231/j.ijcaap.2019.006, IP International Journal of Comprehensive and Advanced Pharmacology-IP Int J Compr Adv Pharm

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea.

The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive non-invasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

Antibacterial Efficacy of Polysaccharide Capped Silver Nanoparticles Is Not Compromised by AcrAB-TolC Efflux Pump.

Antibacterial therapy is of paramount importance in treatment of several acute and chronic infectious diseases caused by pathogens. Over the years extensive use and misuse of antimicrobial agents has led to emergence of multidrug resistant (MDR) and extensive drug resistant (XDR) pathogens. This drastic escalation in resistant phenotype has limited the efficacy of available therapeutic options. Thus, the need of the hour is to look for alternative therapeutic approaches to mitigate healthcare concerns caused due to MDR bacterial infections. Nanoparticles have gathered much attention as potential candidates for antibacterial therapy. Equipped with advantages of, wide spectrum bactericidal activity at very low dosage, inhibitor of biofilm formation and ease of permeability, nanoparticles have been considered as leading therapeutic candidates to curtail infections resulting from MDR bacteria. However, substrate non-specificity of efflux pumps, particularly those belonging to resistance nodulation division super family, have been reported to reduce efficacy of many potent antibacterial therapeutic drugs. Previously, we had reported antibacterial activity of polysaccharide-capped silver nanoparticles (AgNPs) toward MDR bacteria. We showed that AgNPs inhibits biofilm formation and alters expression of cytoskeletal proteins FtsZ and FtsA, with minimal cytotoxicity toward mammalian cells. In the present study, we report no reduction in antibacterial efficacy of silver nanoparticles in presence of AcrAB-TolC efflux pump proteins. Antibacterial tests were performed according to CLSI macrobroth dilution method, which revealed that both silver nanoparticles exhibited bactericidal activity at very low concentrations. Further, immunoblotting results indicated that both the nanoparticles modulate the transporter AcrB protein expression. However, expression of the membrane fusion protein AcrA did show a significant increase after exposure to AgNPs. Our results indicate that both silver nanoparticles are effective in eliminating MDR Enterobacter cloacae isolates and their action was not inhibited by AcrAB-TolC efflux protein expression. As such, the above nanoparticles have strong potential to be used as effective and alternate therapeutic candidates to combat MDR gram-negative Enterobacterial pathogens.

The Use of Procalcitonin (PCT) for Diagnosis of Sepsis in Burn Patients: A Meta-Analysis.

The continuous development of resuscitation techniques and intensive care reduced the mortality rate induced by the initial shock in burn patients and, currently, infections (especially sepsis) are the main causes of mortality of these patients. The misuse of antimicrobial agents is strongly related to antimicrobial and adverse patient outcomes, development of microbial resistance and increased healthcare-related costs. To overcome these risks, antimicrobial stewardship is mandatory and biomarkers are useful to avoid unnecessary medical prescription, to monitor antimicrobial therapy and to support the decision of its stop. Among a large array of laboratory tests, procalcitonin (PCT) emerged as the leading biomarker to accurately and time-effectively indicate the presence of systemic infection. In the presence of systemic infection, PCT blood levels undergo a sudden and dramatic increase, following the course of the infection, and quickly subside after the control of the septic process. This work is a meta-analysis on PCT performance as a biomarker for sepsis. This meta–analysis showed that overall pooled area under the curve (AUC) is 0.83 (95% CI = 0.76 to 0.90); the estimated cut-off is 1.47 ng/mL. The overall sepsis effect in PCT levels is significant and strong (Cohen's d is 2.1 and 95% CI = 1.1 to 3.2). This meta–analysis showed PCT may be considered as a biomarker with a strong diagnostic ability to discriminate between the septic from the non-septic burn patients. Thus, this work encourages the determination of PCT levels in clinical practice for the management of these patients, in order to timely identify the susceptibility to sepsis and to initiate the antimicrobial therapy, improving the patients’ outcomes.

Identification and characterization of Daldinia eschscholtzii isolated from skin scrapings, nails, and blood.

BackgroundDaldinia eschscholtzii is a filamentous wood-inhabiting endophyte commonly found in woody plants. Here, we report the identification and characterization of nine D. eschscholtzii isolates from skin scrapings, nail clippings, and blood.MethodsThe nine isolates were identified based on colony morphology, light microscopy, and internal transcribed spacer (ITS)-based phylogeny. In vitro antifungal susceptibility of the fungal isolates was evaluated by the Etest to determine the minimum inhibitory concentration (MIC).ResultsThe nine isolates examined were confirmed as D. eschscholtzii. They exhibited typical features of Daldinia sp. on Sabouraud Dextrose Agar, with white felty colonies and black-gray coloration on the reverse side. Septate hyphae, branching conidiophore with conidiogenous cells budding from its terminus, and nodulisporium-like conidiophores were observed under the microscope. Phylogenetic analysis revealed that the nine isolates were clustered within the D. eschscholtzii species complex. All the isolates exhibited low MICs against azole agents (voriconazole, posaconazole, itraconazole, and ketoconazole), as well as amphotericin B, with MIC of less than 1 µg/ml.DiscussionEarly and definitive identification of D. eschscholtzii is vital to reducing misuse of antimicrobial agents. Detailed morphological and molecular characterization as well as antifungal profiling of D. eschscholtzii provide the basis for future studies on its biology, pathogenicity, and medicinal potential.

Emerging Antibiotic Resistance in Honey as a Hazard for Human Health

Overtime, intensive use or misuse of antimicrobial agents is considered as the most important factor for the emergence, selection and dissemination of antibiotic resistant bacteria under selective pressure. In this vein, in order to investigate the antibiotic resistance extent, samples from different untreated and unpasteurized honey samples from different botanical sources purchased in bulk from village open markets in Greece were studied. Antibiotic resistance in bacteria isolated from honeys is on the rise. A multiresistance antibiotic profile was effective for most bacterial strains, and pronounced resistance profiles were observed for the commonly used antibiotics. All strains demonstrate resistance to Vancomycin, Ampicillin, Oxacillin and Ceftiofur. High prevalence of S. Aureus, sub. aureus and B. subtilis resistant strains was observed. Metronidazole, Chloramphenicol and Tylosin conserved an almost absent resistance. Systematically monitoring and surveillance of the microbiological quality of selected ecosystems by implementation of a public education campaign must be done, in order to preserve food quality, optimizing sewage treatment and safeguard the public health.

Patterns of Antimicrobial Prescribing in a Tertiary Care Hospital in Oman.

Antimicrobial stewardship programs have been designed to measure and improve the use of antimicrobials to achieve optimal clinical outcomes and reduce bacterial resistance. The aim of this study was to review patterns of antimicrobial prescribing for hospitalized patients in the acute care setting and assess the appropriateness of antimicrobial use among prescribers in a tertiary care hospital in Oman. We conducted a retrospective audit of the appropriateness of antimicrobial prescribing in patients admitted to acute care settings in a tertiary care hospital in Oman over a four-week period (1 November to 28 November 2012). The data of all discharged patients were retrieved from the department databases. Patient records and prescriptions were reviewed by an infectious disease consultant. The rationality of antimicrobial use was evaluated, analyzed, and judged based on local standard guidelines and the experience of the evaluating consultant. There were 178 patients discharged from acute medical teams over the study period. Sixty-four percent of the patients received a total of 287 antimicrobial agents during admission. The average number of antimicrobials prescribed per patient in those prescribed antimicrobials was 2.5±1.1. The most commonly prescribed antimicrobial agent was piperacillin/tazobactam. Most patients had infections from gram-negative organisms, and high rates of extended spectrum beta-lactamase producing organisms were observed. Cultures were obtained before antimicrobial initiation in 25% of patients. Variability in antimicrobial selection for common infections was observed. National guidelines for the management of common infections are needed to minimize the overuse and misuse of antimicrobial agents in tertiary care hospitals. A large surveillance study on antimicrobial prescribing appropriateness in different hospital settings is warranted.