Multiresistant Microorganisms Research Articles

Nanoemulsions of essential oils against multi-resistant microorganisms: An integrative review

Microbial resistance to drugs continues to be a global public health issue that demands substantial investment in research and development of new antimicrobial agents. Essential oils (EO) have demonstrated satisfactory and safe antimicrobial action, being used in pharmaceutical, cosmetic, and food formulations. In order to improve solubility, availability, and biological action, EO have been converted into nanoemulsions (NE). This review identified scientific evidence corroborating the antimicrobial action of nanoemulsions of essential oils (NEEO) against antibiotic-resistant pathogens. Using integrative review methodology, eleven scientific articles evaluating the antibacterial or antifungal assessment of NEEO were selected. The synthesis of evidence indicates that NEEO are effective in combating multidrug-resistant microorganisms and in the formation of their biofilms. Factors such as NE droplet size, chemical composition of essential oils, and the association of NE with antibiotics are discussed. Furthermore, NEEO showed satisfactory results in vitro and in vivo evaluations against resistant clinical isolates, making them promising for the development of new antimicrobial and antivirulence drugs.

Structural and Functional Characterization of New Lipid Transfer Proteins with Chitin-Binding Properties: Insights from Protein Structure Prediction, Molecular Docking, and Antifungal Activity.

Faced with the emergence of multiresistant microorganisms that affect human health, microbial agents have become a serious global threat, affecting human health and plant crops. Antimicrobial peptides have attracted significant attention in research for the development of new microbial control agents. This work's goal was the structural characterization and analysis of antifungal activity of chitin-binding peptides from Capsicum baccatum and Capsicum frutescens seeds on the growth of Candida and Fusarium species. Proteins were initially submitted to extraction in phosphate buffer pH 5.4 and subjected to chitin column chromatography. Posteriorly, two fractions were obtained for each species, Cb-F1 and Cf-F1 and Cb-F2 and Cf-F2, respectively. The Cb-F1 (C. baccatum) and Cf-F1 (C. frutescens) fractions did not bind to the chitin column. The electrophoresis results obtained after chromatography showed two major protein bands between 3.4 and 14.2 kDa for Cb-F2. For Cf-F2, three major bands were identified between 6.5 and 14.2 kDa. One band from each species was subjected to mass spectrometry, and both bands showed similarity to nonspecific lipid transfer protein. Candida albicans and Candida tropicalis had their growth inhibited by Cb-F2. Cf-F2 inhibited the development of C. albicans but did not inhibit the growth of C. tropicalis. Both fractions were unable to inhibit the growth of Fusarium species. The toxicity of the fractions was tested in vivo on Galleria mellonella larvae, and both showed a low toxicity rate at high concentrations. As a result, the fractions have enormous promise for the creation of novel antifungal compounds.

Environmental microbial colistin resistance in an elderly south Brazilian long-term care facility

ABSTRACT Colistin resistance is a global health concern, with antibiotics being the last treatment for Gram-negative bacteria infections. We aimed to identify colistin-resistant enterobacteria on environmental surfaces of a long-term care facility (LTCF) for the elderly in southern Brazil. Samples were collected and screened on MacConkey agar plus colistin, followed by API20E identification and PCR. Two isolates were founded and identified as Klebsiella pneumoniae and Providencia stuartii harboring mcr-1 gene with MICs > 128 µg mL−1 for colistin. This is the first isolation of microorganisms resistant to colistin in the environment of a LTCF for the elderly in south Brazil, urging monitoring programs to reduce environmental contamination by multiresistant microorganisms.

Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023.

Pneumonia is a multifaceted illness with a wide range of clinical manifestations, degree of severity and multiple potential causing microorganisms. Despite the intensive research of recent decades, community-acquired pneumonia remains the third-highest cause of mortality in developed countries and the first due to infections; and hospital-acquired pneumonia is the main cause of death from nosocomial infection in critically ill patients. Guidelines for management of this disease are available world wide, but there are questions which generate controversy, and the latest advances make it difficult to stay them up to date. A multidisciplinary approach can overcome these limitations and can also aid to improve clinical results. Spanish medical societies involved in diagnosis and treatment of pneumonia have made a collaborative effort to actualize and integrate last expertise about this infection. The aim of this paper is to reflect this knowledge, communicated in Fifth Pneumonia Day in Spain. It reviews the most important questions about this disorder, such as microbiological diagnosis, advances in antibiotic and sequential therapy, management of beta-lactam allergic patient, preventive measures, management of unusual or multi-resistant microorganisms and adjuvant or advanced therapies in Intensive Care Unit.

Fungal Colonization of the Airways of Patients with Cystic Fibrosis: the Role of the Environmental Reservoirs.

Filamentous fungi frequently colonize the airways of patients with cystic fibrosis and may cause severe diseases, such as the allergic bronchopulmonary aspergillosis. The most common filamentous fungi capable to chronically colonize the respiratory tract of the patients are Aspergillus fumigatus and Scedosporium species. Defining the treatment strategy may be challenging, the number of available drugs being limited and some of the causative agents being multiresistant microorganisms. The knowledge of the fungal niches in the outdoor and indoor environment is needed for understanding the origin of the contamination of the patients. In light of the abundance of some of the causative molds in compost, agricultural and flower fields, occupational activities related to such environments should be discouraged for patients with cystic fibrosis (CF). In addition, the microbiological monitoring of their indoor environment, including analysis of air and dust on surfaces, is essential to propose preventive measures aiming to reduce the exposure to environmental molds. Nevertheless, some specific niches were also identified in the indoor environment, in relation with humidity which favors the growth of thermotolerant molds. Potted plants were reported as indoor reservoirs for Scedosporium species. Likewise, Exophiala dermatitidis may be spread in the kitchen via dishwashers. However, genotype studies are still required to establish the link between dishwashers and colonization of the airways of CF patients by this black yeast. Moreover, as nothing is known regarding the other filamentous fungi associated with CF, further studies should be conducted to identify other potential specific niches in the habitat.

Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities.

The correct method of surface disinfection in hospitals is an essential tool in the fight against the spread of healthcare-associated infections caused by multi-resistant microorganisms. Currently, there are many disinfectants on the market that can be used against different microorganisms. However, the effectiveness of different active molecules is controversial in the literature. The aim of this study was to evaluate the effectiveness of wipes based on hydrogen peroxide (1.0 %) and highly specific plant-based surfactants, contained in H2O2TM (Hi-speed H2O2TM) products, against some hospital-associated microorganisms. The effectiveness of the wipes was tested against nosocomial and control strains of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae carbapenemase, Aspergillus fumigatus and Candida parapsilosis. Specifically, in vitro activity was assessed using three different techniques: stainless steel surface testing, surface diffusion testing and well diffusion test. The three different methods tested confirm the wipes' good effectiveness against the most common multi-resistant bacteria and against fungi. These data show that the tested wipes could be a valid adjunct to the disinfection process and could assist in the prevention of healthcare-associated infections.

Chemical Profiling, Antibacterial Efficacy, and Synergistic Actions of Ptychotis verticillata Duby Essential Oil in Combination with Conventional Antibiotics

Introduction: The primary aim of the current investigation is to assess the chemical composition and antibacterial efficacy of Ptychotis verticillata essential oil (PVEO) against three Gram-positive bacteria ( Staphylococcus aureus, Micrococcus luteus, and Bacillus subtilis) and three Gram-negative bacteria ( Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae). Furthermore, this research endeavors to investigate the potential synergistic effects of PVEO when combined with established antibiotics (Amoxicillin, Erythromycin, and Ampicillin), with a focus on discerning their interaction dynamics. Methods: The phytochemical profiling of PVEO was performed via the Gas Chromatography-Mass Spectrometry technique. The broth dilution test determined the interaction effect between PVEO and these three antibiotics. Results: Components γ-terpinene (38.96%), p-cymene (19.38%), thymol (18.07%), and carvacrol (6.99%) are the major bioactive moleculs composing this studied essential oil. PVEO demonstrated significant antibacterial activity with minimum inhibitory concentration (MIC) values ranging from 0.2 against E coli to 2 mg/mL against M luteus. The assessment of the synergistic activity between PVEO and antibiotics was accomplished through the utilization of the Fractional Inhibitory Concentration Index (FICI). The combination of PVEO and amoxicillin against M luteus demonstrated the best synergistic action with a FICI value of 0.43. Conclusion: Significant reductions, ranging from two to sevenfold, in the MIC values of PVEO, and antibiotics were observed. This noteworthy synergistic interaction between highly potent essential oils and synthetic antibiotics holds the potential to open avenues for novel combination therapies aimed at addressing infections caused by multiresistant microorganisms, even at notably reduced concentrations within the pharmaceutical sector.

Clinical and microbiological characteristics of urinary tract infections in the first year after renal transplantation

Urinary tract infections (UTI) are the most frequent infection in kidney transplant (KT) patients. The main objective was to determine the clinical and microbiological characteristics of UTIs that occur during the first year after KT. Retrospective cohort study that included patients over 18 years of age who received KT between 2009-2020 in two hospitals in Córdoba city, Argentina. Patients were followed up during the first year after the transplant by recording them in the medical records, and those who presented at least one episode of UTI were analyzed. During the study period, 568 KTs were performed, of which 207 (36.4%) had at least one episode of UTI. In total, there were 419 UTI episodes, 6 (1.4%) polymicrobial UTI episodes, so a total of 426 microorganisms were identified in the urine cultures. Of the total number of episodes, 206 (49.2%) occurred between 31 and 180 days post-transplant. The main etiological agent was E. coli with 225 isolates (52.8%) followed by Klebsiella sp. with 94 (22.1%). 52.1% of all episodes were caused by multi-resistant microorganisms (MRM). Among the E. coli isolates, 94 (41.8%) were MRM. In the multivariate analysis, the risk factors associated with UTI due to MRM were a history of recurrent UTI (Odds ratio 2.43; 95% CI: 1.37-4.30) and induction with basiliximab (Odds ratio 1.53; 95% CI: 1.029-2.29). UTIs occurred in more than a third of kidney transplant patients, being slightly more than half caused by MOR.

Evaluation of the Antibacterial and Anti-Adherent Activities of Eucalyptus globulus and Eucalyptus citriodora Essential Oils against Pseudomonas aeruginosa Strains

Biofilm can be defined as a complex sessile microbiological ecosystem formed by one or more species of bacteria, fungi or protozoa. Among the microorganisms capable of forming biofilms is Pseudomonas aeruginosa, a gram-negative bacterium with extensive virulence factors and high resistance to antimicrobials, making it difficult to treat infections caused by it. In this sense, phytotherapy and essential oils are promising therapeutic alternatives to multi-resistant microorganisms. The aim of this study was to evaluate the antibacterial and anti-adherent activities of Eucalyptus globulus and Eucalyptus citriodora essential oils against clinical strains of P. aeruginosa, and to compare their antibiofilm effects with 0.12% chlorhexidine digluconate. To determine the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the oils, the broth microdilution technique was used in 96-well plates. To determine the Minimum Adherence Inhibitory Concentration (MAIC), the inclined glass tube technique was used in the presence of 5% sucrose, using proportions corresponding to the pure essential oil up to a dilution of 1:1024, and its positive control was 0.12% chlorhexidine digluconate. It was therefore concluded that the essential oils under study had an antibacterial effect against the strains tested, varying between bactericidal and bacteriostatic action, as well as demonstrating an effective anti-adherence effect that was superior to the positive control.

Antimicrobial Activity of Silver Nanoparticles Stabilized by Liposoluble Extract of Artemisia terrae-albae

The global spread of multi-resistant pathogenic microorganisms has significantly complicated the treatment of chronic wounds. The development of novel drugs requires a substantial time investment. Hybrid materials such as nanoparticles stabilized by plant extracts are considered the best for creating efficient antiseptic substances. This paper is the first to discuss quantitative and qualitative analyses of the phytochemical constituents of the medicinal plant Artemisia terrae-albae, collected in Kazakhstan. The antimicrobial activity of the extracts, as well as of silver nanoparticles (AgNPs) stabilized by Artemisia terrae-albae extract, were evaluated. AgNPs were characterized by an average size of 82 nm or larger with a negative surface charge. TEM analysis of the obtained suspension showed a nonuniform structure of particles synthesized at a low concentration of ethyl acetate solvent in water. The SPR peak of AgNPs@Art aq. extract was detected at 420 nm, while any clear SPR peak was observed for AgNPs@Art ethylacetate extract. Diluted Artemisia terrae-albae extracts did not exhibit pronounced antimicrobial activity due to the poor solubility of compounds in water. Nevertheless, the AgNPs@Art aq. and AgNPs@Art EtAc. extracts possessed antimicrobial activity against the Pseudomonas aeruginosa ATCC 9027, Staphylococcus aureus ATCC 6538, Escherichia coli (ATCC 8739), and Candida albicans ATCC 10231 strains.

Phenotypic and Genomic Characterization of Streptomyces pakalii sp. nov., a Novel Species with Anti-Biofilm and Anti-Quorum Sensing Activity in ESKAPE Bacteria.

The increasing number of infections caused by antimicrobial multi-resistant microorganisms has led to the search for new microorganisms capable of producing novel antibiotics. This work proposes Streptomyces pakalii sp. nov. as a new member of the Streptomycetaceae family. The strain ENCB-J15 was isolated from the jungle soil in Palenque National Park, Chiapas, Mexico. The strain formed pale brown, dry, tough, and buried colonies in the agar with no diffusible pigment in GAE (glucose-asparagine-yeast extract) medium. Scanning electron micrographs showed typical mycelium with long chains of smooth and oval-shaped spores (3-10 m). The strain grew in all of the International Streptomyces Project (ISP)'s media at 28-37 °C with a pH of 6-9 and 0-10% NaCl. S. pakalii ENCB-J15 assimilated diverse carbon as well as organic and inorganic nitrogen sources. The strain also exhibited significant inhibitory activity against the prodigiosin synthesis of Serratia marcescens and the inhibition of the formation and destruction of biofilms of ESKAPE strains of Acinetobacter baumannii and Klebsiella pneumoniae. The draft genome sequencing of ENCB-J15 revealed a 7.6 Mb genome with a high G + C content (71.6%), 6833 total genes, and 6746 genes encoding putative proteins. A total of 26 accessory clusters of proteins associated with carbon sources and amino acid catabolism, DNA modification, and the antibiotic biosynthetic process were annotated. The 16S rRNA gene phylogeny, core-proteome phylogenomic tree, and virtual genome fingerprints support that S. pakalii ENCB-J15 is a new species related to Streptomyces badius and Streptomyces globisporus. Similarly, its average nucleotide identity (ANI) (96.4%), average amino acid identity (AAI) (96.06%), and virtual DNA-DNA hybridization (67.3%) provide evidence to recognize it as a new species. Comparative genomics revealed that S. pakalli and its closest related species maintain a well-conserved genomic synteny. This work proposes Streptomyces pakalii sp. nov. as a novel species that expresses anti-biofilm and anti-quorum sensing activities.

Surgical Challenges in Infective Endocarditis: State of the Art.

Infective endocarditis (IE) is still a life-threatening disease with frequent lethal outcomes despite the profound changes in its clinical, microbiological, imaging, and therapeutic profiles. Nowadays, the scenario for IE has changed since rheumatic fever has declined, but on the other hand, multiple aspects, such as elderly populations, cardiovascular device implantation procedures, and better use of multiple imaging modalities and multidisciplinary care, have increased, leading to escalations in diagnosis. Since the ESC and AHA Guidelines have been released, specific aspects of diagnostic and therapeutic management have been clarified to provide better and faster diagnosis and prognosis. Surgical treatment is required in approximately half of patients with IE in order to avoid progressive heart failure, irreversible structural damage in the case of uncontrolled infection, and the prevention of embolism. The timing of surgery has been one of the main aspects discussed, identifying cases in which surgery needs to be performed on an emergency (within 24 h) or urgent (within 7 days) basis, irrespective of the duration of antibiotic treatment, or cases where surgery can be postponed to allow a brief period of antibiotic treatment under careful clinical and echocardiographic observation. Mainly, guidelines put emphasis on the importance of an endocarditis team in the handling of systemic complications and how they affect the timing of surgery and perioperative management. Neurological complications, acute renal failure, splenic or musculoskeletal manifestations, or infections determined by multiresistant microorganisms or fungi can affect long-term prognosis and survival. Not to be outdone, anatomical and surgical factors, such as the presence of native or prosthetic valve endocarditis, a repair strategy when feasible, anatomical extension and disruption in the case of an annular abscess (mitral valve annulus, aortic mitral curtain, aortic root, and annulus), and the choice of prosthesis and conduits, can be equally crucial. It can be hard for surgeons to maneuver between correct pre-operative planning and facing unexpected obstacles during intraoperative management. The aim of this review is to provide an overview and analysis of a broad spectrum of specific surgical scenarios and how their challenging management can be essential to ensure better outcomes and prognoses.

Presence and Resistance Profile of Staphylococcus spp. Isolated from Slaughtered Pigs.

Background: The objective of this study was to isolate Staphylococcus spp. and to characterize the resistance profile in nasal samples from pigs slaughtered for consumption. Material and Methods: Intranasal swabs were collected from 100 pigs immediately after bleeding in a slaughterhouse located in the largest pork production region in Brazil, these samples were cultured and isolated to identify Staphylococcus spp. in coagulase positive (CoPS) and coagulase negative (CoNS) and molecular identification of Staphylococcus aureus and then subjected to the disk-diffusion test to identify the bacterial resistance profile and search for the mecA gene. Results: Of the 100 samples collected, it was possible to isolate 79 Staphylococcus spp., of these, 72.15% were classified as CoNS and 27.85% of the isolates classified as CoPS. Among the CoPS isolates, 77.27% were identified as S. aureus. Through the disk-diffusion test, it was possible to verify isolates resistant to clindamycin and erythromycin (98.73%), chloramphenicol (93.67%), and doxycycline (89.87%). There was amplification of the mecA gene in 30.38% of Staphylococcus spp. Conclusion: The results of this study highlight the need for the careful use of antibiotics in swine production, in addition to aiming at continuous surveillance in relation to the rate of multiresistant microorganisms within these environments, focused on large industrial centers; such results also indicate the importance of understanding, through future studies, possible pathways to transmission of these microorganisms directly, or indirectly, through meat products derived from these pigs, which can be considered neglected diffusers of variants of Staphylococcus spp. resistant to antibiotics or carriers of important resistance genes related to One Health.

147 Pre-Operative Urine Culture for Endourology Surgeries

Abstract Aim Our aim was to reduce post-operative endourology infection rates by screening all patient pre-operatively with urine culture. Our local guidelines recommend single dose Gentamicin for prophylaxis prior to endourology procedures. Pre-operative urine culture can identify patients with positive cultures to be treated prior to surgery and to identify multi-resistant microorganisms to aid alternative antibiotic prophylaxis choice. Method We identified patients that underwent elective endourological surgeries in a 3-month period (July-September2021). We identified if pre-operative urine cultures were performed, if the cultures were positive and were they treated appropriately. We identified if any patients had re-admissions postoperatively within 30 days of their procedure with UTI. We identified if the microorganism grown in the culture was resistant to Gentamicin and if an alternative prophylaxis was given pre-operatively. Results 104 patients were identified. 65 had pre-operative cultures done. Of the 39 patients that did not have cultures done, 2 were re-admitted within 30 days with UTI. 14 pre-operative cultures were positive (21.5%) and was treated with a course of antibiotics per sensitivities and Gentamicin pre-operatively. 4 were resistant to Gentamicin (6.2%). An alternative prophylactic antibiotic was used per microbiologist’s advice for those resistant. No one was re-admitted with a UTI within 30 days in the group that had pre-operative cultures done. Conclusions Around 1 in 5 urine cultures done was positive for growth. Almost a third of this was resistant to Gentamicin and this aided our choice of alternative prophylactic treatment. By performing pre-operative cultures, we reduced our postoperative infection complication and re-admission rates.

ПЕРСПЕКТИВЫ ЭФФЕКТИВНОЙ ЭРАДИКАЦИИ МУЛЬТИРЕЗИСТЕНТНЫХ МИКРООРГАНИЗМОВ: РЕЗУЛЬТАТЫ МИКРОБИОЛОГИЧЕСКОГО МОНИТОРИНГА В ГРОДНЕНСКОЙ УНИВЕРСИТЕТСКОЙ КЛИНИКЕ

Background. Monitoring sensitivity to antibacterial drugs of various groups of microorganisms allows us to provide an optimal approach to the prevention and treatment of bacterial infection. In this regard, it is important to analyze the composition and resistance of the bacterial flora in order to select the most effective drugs for its eradication. Purpose of the study. Our aim is to identify the most common microorganisms in intensive care unit (ICU) and analyze their sensitivity to antibacterial drugs, and determine the general patterns and main directions in the development of antibiotic resistance. Materials and methods. The data of microbiological studies in 107 patients of the ICU of a therapeutic profile with various diseases were analyzed. Results. The most frequently detected microorganisms were Staphylococcus epidermidis (30 patients, 28.03% of cases), Staphylococcus hominis (15 patients, 14.01% of cases) and Klebsiella pneumoniae ssp. pneumoniae (17 patients, 15.8% of cases). The most common carriers were patients with community-acquired bilateral interstitial pneumonia (62.9% of cases). Low sensitivity of bacteria to carbapenems and colistin, complete resistance of most microorganisms to penicillins, cephalosporins and fluoroquinolones, as well as unexpectedly high sensitivity to tetracycline were revealed. Conclusions. In clinical practice, the range of effective drugs against isolated multi-resistant microorganisms is narrowing, it is necessary to avoid the unreasonable use of antibiotics and, as soon as possible, move from the empirical prescription of broad-spectrum drugs to targeted antimicrobial therapy according to microbiological control data. It is recommended to consider the possibility of a wider use of tetracycline in ICU.

"Prevention of the Dramatic Increase of Multi Resistant Microorganisms. In Situ Generated Biocides Provided by Catalysts Show Fast and Strong Antimicrobial Activity on Surfaces"

"Prevention of the Dramatic Increase of Multi Resistant Microorganisms. In Situ Generated Biocides Provided by Catalysts Show Fast and Strong Antimicrobial Activity on Surfaces"

Modern view on the etiology and immunological aspects of pneumonia

Pneumonia is the most common and deadly nosology among all respiratory diseases associated with microorganisms. Despite advances in antibacterial and antiviral therapy, mortality due to pneumonia is not decreasing. It should be noted that the problem of infectious pathology has always been discussed only in narrow circles of specialists, which led to its underestimation, including during the pandemic of a new coronavirus infection. At present, scientific possibilities have not reached their perfection in the etiological diagnosis of pneumonia. Of no small concern is the lack of sections on immunology in the training program for general practitioners and pulmonologists and, as a result, the lack of knowledge by most medical specialists of the basics of the immune response in various infectious diseases, in particular, the differences in the immune response of a macroorganism in viral and bacterial infections, the stages of the immune response, differences between innate and adaptive immune responses, possibilities of immunocorrective therapy. Being followers of the scientific school of pulmonology of academician N.S. Molchanov, in this review, we evaluated the features of etiological factors and immune characteristics of the body on the course and out-comes of pneumonia, taking into account modern scientific knowledge. The current definition of pneumonia is formulated, the issues of the etiology of pneumonia from the perspective of the lung microbiome, the features of the immune response of the macroorganism in viral and bacterial pneumonia, the inconsistency of immune protection and the impact of comorbidity on this are covered in detail. Understanding the processes that lead to the disruption of the respiratory microbiome, the multiplication of pathobionts, the attachment of multiresistant microorganisms and the reactivity of the macroorganism will contribute to the development of new therapeutic approaches in the treatment of pneumonia.

Impacts of combination of onion bulb, holy basil and turmeric rhizome on shelf- life, flesh and microbial quality of smoked Clarias gariepinus

The increasing use of synthetic antimicrobials has created a situation leading to a pond ecological imbalance and enrichment of multiple multi-resistant pathogenic microorganisms. This study was conducted to investigate the impact of spices and natural preservatives using a mixture of Onion Bulb (OB), Holy Basil (HB) and Turmeric Rhizome (TR) on shelf–life, flesh and microbial quality of smoked Clarias gariepinus during 56 days storage. Spices were added at the point of processing with five treatments of 8 fresh C. gariepinus (1.2-2kg) were distributed into experimental containers; the control (without Onion Bulb, Holy Basil and Turmeric Rhizome), (TR + OB)2, (TR+ HB)3, (OB +HB)4, (TR + OB + HB)5 and the experiment were carried out in triplicates. Clarias gariepinus were smoked in a smoking kiln at 40ºC- 60ºC and 120-150ºC for 6 and 18 hours respectively. Proximate composition, biochemical parameters, organoleptic assessment, and microbial analysis were carried out using standard methods. The result showed that the crude protein of C. gariepinus was higher in the treated groups compared to the control. Also, the result shows that the biochemical parameters, organoleptic assessment and the microbial loads in smoked C. gariepinus were reduced in the treated groups than in the control at 1 day, 28 days and 56 days storage respectively. The results indicated that using onion bulb, holy basil, and turmeric rhizome in combination may be useful in improving the shelf life, consumer acceptability of smoked C. gariepinus and preventing bacteria pathogens in smoked C. gariepinus.Keywords: Catfish, Onion Bulb, Holy Basil, Microbial Loads, Turmeric Rhizome

Transrectal vs. transperineal fusion biopsy of the prostate : Time to switch to the perineal technique-comparison of methods and description of the transperineal procedure under local anesthesia

The clinical and histological diagnosis of prostate cancer is acrucial aspect of the routine work of aurologist. The high prevalence of multiresistant microorganisms leads to an increased incidence of sepsis after transrectal prostate biopsy. It requires a switch from the still gold-standard method to the transperineal fusion biopsy procedure after multiparametric prostate magnetic resonance imaging (MRI). This article provides an overview of the most important differences between the two methods and gives adetailed methodological description of transperineal fusion biopsy under local anesthesia.

The Soaring Increase of Resistant Microorganisms Demands Immediate Action Solutions are Available

Clinical environments provide an ideal reservoir for the growth, proliferation, and transmission of pathogenic organisms. Surfaces in hospitals e.g. hospital furniture, ECG lead wires and other cables, push buttons of infusion pumps, control knobs of ventilation machines, textiles as well as implantable biomaterials like central venous catheters, urologic catheters, endotracheal tubes are contaminated increasingly frequent with multiresistant microorganisms. These microorganisms are distributed by the hands of the nursing personnel throughout the hospital with serious, life threatening consequences. 1.8 million patients suffer from a nosocomial infection per year in Europe; approximately 180,000 deaths are attributed to these infections. The Centers for Disease Control (CDC) estimates that 2 million U.S. patients per year acquire a hospital-related infection. These infections cause 90,000 deaths each year and cost an average of $47,000 per patient to treat. The added cost to hospitals is $4.8 billion anually for extended care treatment. Microorganisms show an increasing rate of resistance against the majority of antibiotics including carbapenems as last available antibiotic. 700,000 deaths have been rеρorted worldwide, 30 000 deaths alone in Europe during the last year due to infections where no effective antimicrobial substance was available. The use of disinfectants is ostensibly intended to remove/kill pathogens on surfaces. However studies have shown that more than one-half the time, surfaces are not adequately cleaned or are re-contaminated within minutes. Much emphasis has been put therefore on hand disinfection. However there are also rеρorts of the emergence of alcohol tolerant/insensitive microorganisms e.g., vancomycin resistant enterococci. This phenomenon has the potential to undermine the effectiveness of alcohol based disinfectant standard precautions. The reason for this dramatic development of resistant microorganisms is still in debate. The indiscriminate use of antibiotics for prevention of a bacterial superinfections e.g. sinusitis, otitis media after a viral infections is frequently incriminated, however this seems to have little impact on the occurrence of multi-resistant hospital pathogens in general. However individual patients are seriously affected by the selection of multi-resistant pathogens. In contrast there is increasing evidence that the widespread use of disinfectants is responsible: disinfectants - analogous to antibiotics - must be incorporated into the metabolism of microorganisms. This is inevitably associated with induction of resistance by transfer of resistance plasmids e.g. induction of efflux pumps. 10 167 рublications (PUBMed Jan. 2023) are available in the international literature which document the resistance of microorganisms against disinfectants; 649 рublications describe the cross resistance with antibiotics, at the same time there are 11 237 publications on the toxicity of disinfectants.