Antimicrobial Resistance Patterns Research Articles

Stable antimicrobial resistance patterns of Mycobacterium abscessus complex antibiograms in Singapore from 2013 to 2022: a retrospective review.

Stable antimicrobial resistance patterns of Mycobacterium abscessus complex antibiograms in Singapore from 2013 to 2022: a retrospective review.

The global burden of enteric fever, 2017–2021: a systematic analysis from the global burden of disease study 2021

Enteric fever is a major public health challenge in developing countries. We conducted a systematic analysis from the Global Burden of Diseases 2021 Study to provide updated estimates of enteric fever's burden. We presented estimates for incident cases and deaths, age-standardized incidence and mortality rates, years of life lost (YLLs), and case-fatality rates spanning the study period of 2017-2021, stratified by region, country, socio-demographic index (SDI), and age group. Random-effects Poisson regression for longitudinal data was used to estimate the association between SDI and case-fatality rates, adjusting for antimicrobial resistance patterns. In 2021, there were 9.3 million global cases of enteric fever (95% uncertainty interval: 7.3-11.9) and 107.5 thousand deaths (56.1-180.8). The age-standardized incidence rate decreased from 152/100,000 person-years (118-195) in 2017 to 128/100,000 person-years (100-163) in 2021, and the mortality rate decreased from 1.87/100,000 person-years (0.95-3.18) to 1.50/100,000 person-years (0.78-2.54). There were wide geographical differences, with South Asia contributing the most cases and deaths. Age-standardized incidence exceeded the threshold for "high burden" of enteric fever (100/100,000 person-years) in 23 countries in2021.Children under five accounted for 40% of deaths and 47% of YLLs, with incidence and mortality peaking during the second year. Case-fatality was highest in low SDI countries and showed a global trend toward reduction, except among children aged 1-4 years. After adjusting for the prevalence of multidrug resistance, fluoroquinolone non-susceptibility, and third-generation cephalosporin resistance, a higher SDI was associated with a lower case-fatality rate, with a 1.1% (0.7-1.7) reduction for each percentage point increase in SDI. Despite notable improvements, several countries still showed a high burden of enteric fever, which remains a significant global health concern, especially among children under five. Although enhancing water and sanitation systems is crucial, the most significant reductions in the global disease burden are likely to be achieved through broader vaccine coverage. This includes the use of typhoid conjugate vaccines, which are effective in infants and young children and offer extended protection, along with improved data collection and surveillance to guide vaccine distribution efforts across high-incidence areas. This work was partially supported by "Ricerca Corrente" funding from Italian Ministry of Health to IRCCSHumanitas Research Hospital.

Virulence and Antimicrobial Resistance Patterns of Salmonella spp. Recovered From Migratory and Captive Wild Birds.

Salmonella spp., especially those are resistant to extended-spectrum β-lactamase (ESBL), are considered as major concern to global health due to their emergence and dissemination. The aim of this study was to investigate the virulence and antimicrobial resistance (AMR) profile of Salmonella spp. from migratory and captive wild birds. A total 262 faecal samples were collected, and the identification of Salmonella spp. was carried out using a standard culture and PCR as well as molecular detection of virulence and AMR genes. The overall prevalence of Salmonella was determined to be 30.92% (95% CI = 25.63-36.75). Migratory birds exhibited highest prevalence (38.10%), whereas wild birds in captivity showed a lower prevalence (23.40%). The agfA gene was detected at a higher rate at 24.69%. Salmonella spp. exhibited 100% resistance to tetracycline, followed by 58% ampicillin and 46% streptomycin. In addition, there was a resistance rate to ceftriaxone of 17% and to colistin sulphate of 25%. Interestingly, levofloxacin alone displayed 100% sensitivity across all isolates, while ciprofloxacin and azithromycin showed 73% and 64% sensitivity, respectively. The MAR index was 0.25 and 0.42, and 74.07% of all isolates showed multidrug resistance (MDR). It was shown that migratory and captive wild birds contained ESBL genes blaTEM (94.34% and 49.06%) and blaSHV (13.33% and 10%), respectively. Genes responsible for sulphonamide (sul1) resistance were detected in 13.33% and 79% of wild and migratory birds, respectively. Salmonella has been found in captive wild and migratory birds and could act as reservoirs for the transmission of MDR and ESBL bacteria.

Molecular Characterization and Antibiogram of <i>Pseudomonas aeruginosa</i> Isolated from Fish Sold in Markets of Tirupati, India

Pseudomonas aeruginosa is an emerging opportunistic pathogen and is one of the pathogens in the acronym ESKAPE representing a global threat to human health associated with antimicrobial resistance. The present study aimed for molecular characterization, virulence gene profiling and antimicrobial resistance studies of P. aeruginosa isolated from 200 fish samples collected from different fish markets in Tirupati, Andhra Pradesh, India. Of the 200 fish samples screened, 30.5% were confirmed as P. aeruginosa by PCR, targeting the 16S rRNA gene. Among the positive isolates, it was found that 70.4% and 75.4% of the isolates harbored toxA and exoS virulence markers, respectively. All 61 P. aeruginosa isolates recovered were phenotypically characterized for antimicrobial resistance patterns by the disc diffusion method. The study has found 100% resistance against erythromycin followed by 98.4% resistance to amoxicillin, 91.8% resistance against tetracycline, 88.5% resistance to vancomycin and cotrimoxazole, 45.9% resistance to ciprofloxacin, 44.2% resistance against cefepime and 9.9% resistance to gentamicin. The MAR indices were in the range from 0.5 to 1.0. The prevalence of multiple antibiotic resistance of P. aeruginosa harboringvirulence genes in fish can pose a serious threat and hazard to public health through the consumption of raw or undercooked fish.

Antimicrobial resistance trends in Italian hospitals: insights from two point prevalence surveys

Abstract Background Antimicrobial resistance (AMR) presents a critical challenge to global healthcare systems, necessitating vigilant surveillance efforts. The European Centre for Disease Prevention and Control (ECDC) conducts point prevalence surveys (PPSs) to monitor AMR trends across European hospitals. This study focuses on comparing AMR patterns in Italian hospitals using data from two surveys: PPS2 (2016-2017) and PPS3 (2022-2023). Methods A total of 140 hospitals enrolling 28991 patients participated in PPS2, while 325 hospitals with 58506 patients contributed data to PPS3. Microbiological samples were collected and tested for antimicrobial susceptibility. Prevalence ratios (PR) with corresponding 95% confidence intervals (CI) were calculated to assess changes in resistance patterns between PPS2 and PPS3. Statistical significance was determined with p-value <0.05. Results Staphylococcus aureus showed a trend towards decreased oxacillin resistance, (PR: 0.77, 95% CI: 0.60 - 0.99). Enterococcus faecalis exhibited a non-significant decrease in glycopeptide resistance. Pseudomonas aeruginosa and Acinetobacter baumannii maintained stable carbapenem resistance between the two surveys. Escherichia coli and Klebsiella pneumoniae showed a decreasing trend in resistance to carbapenems and third-generation cephalosporins, but only Klebsiella pneumoniae was found to be significant (PR: 0.69, 95% CI: 0.55 - 0.88, p 0.004 and PR: 0.78, 95% CI: 0.66 - 0.94, p 0.01, respectively). Conclusions These findings underscore the importance of surveillance in monitoring AMR trends. Observed decreases, especially in Klebsiella pneumoniae, suggest potential improvements. However, the overall stability of resistance highlights the ongoing challenge of combating AMR. A multifaceted approach, including antimicrobial stewardship and One Health initiatives, is crucial to address this global health threat effectively. Key messages • Surveillance efforts are crucial to understand antimicrobial resistance (AMR) trends, as demonstrated by comparing data from two surveys in Italian hospital. • Results highlight the need for data-driven interventions, guiding future strategies within a One Health framework to address antimicrobial resistance comprehensively.

Characterization of Staphylococcus aureus isolated from milk samples for their virulence, biofilm, and antimicrobial resistance

The Staphylococcus aureus (S. aureus) one of the important food borne pathogen from milk, which was investigated in this study. The isolates were screened for antimicrobial resistance, enterotoxin genes, biofilm formation, spa typing, coagulase gene polymorphism and accessory gene regulator types. The prevalence of S. aureus in milk samples was 34.4% (89/259). Methicillin resistant S. aureus (MRSA) was found at 27% (24/89) of the isolates, were classified as community acquired based on SCCmec typing. The 24.71% (22/89) isolates demonstrated multiple antimicrobial resistance (MAR) pattern. However, none of the isolates carried vancomycin and mupirocin resistance genes. The isolates were positive for sea and sed enterotoxin genes and exhibited high frequency of biofilm formation. The High-Resolution Melting and conventional spa typing revealed that the isolates had both animal and community-associated S. aureus clustered origins. Coagulase gene polymorphism and agr typing demonstrated variable genotypic patterns. The finding of this study establishes the prevalence of community associated, enterotoxigenic, biofilm forming and antimicrobial resistance among S. aureus from milk in Chennai city. This emphasizing a potential threat to public health which needs a continuous monitoring system and strategies to mitigate their spread across the food chain and achieve food safety.

Prevalence and Antimicrobial Susceptibility of Foodborne Pathogens from Raw Livestock Meat in China, 2021

The rising prevalence of pathogenic bacteria in livestock meat poses a growing public health concern in China. The determination of antimicrobial resistance (AMR) is critical for the clinical management of foodborne infections stemming from livestock meat consumption. This study aimed to assess the prevalence of pathogenic bacteria in livestock meat (pork, beef, and mutton) sampled in China in 2021 and to identify the most common AMR patterns among the isolated pathogens. A total of 2515 raw livestock meat samples were collected across 15 provinces in China during 2021. Pathogen detection, including Listeria monocytogenes, Salmonella, and diarrheagenic Escherichia coli (DEC), followed China’s national food safety standards. All Salmonella isolates underwent serotyping via slide agglutination. Antimicrobial susceptibility of Salmonella and DEC isolates was assessed using the broth dilution method. The detection rates for L. monocytogenes, Salmonella, and DEC in raw livestock meat were 9.06% (228/2, 515), 10.54% (265/2, 515), and 6.16% (155/2, 515), respectively. Pork showed the highest contamination rates for Salmonella and DEC, with prevalence rates of 17.60% (214/1, 216, χ2 = 124.62, p < 0.05) and 7.89% (96/1, 216, χ2 = 14.466, p < 0.05), respectively. L. monocytogenes contamination was notably higher in chilled (14.43%, 84/582) and frozen (12.39%, 55/444) meat than in fresh meat (χ2 = 43.510, p < 0.05). In contrast, Salmonella (12.09%, 180/1489, χ2 = 15.173, p < 0.05) and DEC (7.25%, 108/1489, χ2 = 12.275, p < 0.05) were more prevalent in fresh meat than in chilled or frozen samples. The predominant Salmonella serotypes identified were Salmonella enterica subsp. enterica serovar Typhimurium, followed by Salmonella enterica serovar Derby, Salmonella enterica serovar Rissen, Salmonella enterica serovar London, and Salmonella enterica serotype Enteritidis. Enteroaggregative E. coli was the most frequent pathotype among DEC (84.7%, 133/157), followed by enteropathogenic E. coli (8.3%, 13/157) and enterohemorrhagic E. coli (5.1%, 8/157). Among the 14 tested antimicrobial agents, Salmonella isolates demonstrated an overall resistance rate of 87.50%, while DEC exhibited a resistance rate of 84.70%. Ampicillin and tetracycline showed the highest resistance rates in both pathogens. Multi-drug resistance (MDR) was observed in 67.53% of Salmonella isolates (183 isolates) and 57.96% of DEC isolates (91 isolates). This study highlights the significant contamination of retail raw livestock meat in China by L. monocytogenes, Salmonella, and DEC. The high resistance of MDR in both pathogens poses serious public health risks. Chinese food safety and veterinary authorities should implement stricter measures to control pathogen contamination and regulate the use of antimicrobials in livestock to mitigate these risks.

Molecular identification and antimicrobial resistance patterns of enterobacterales in community urinary tract infections among indigenous women in Ecuador: addressing microbiological misidentification

BackgroundAntibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the “gold standard” for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador.MethodsA facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test.ResultsThis study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively.ConclusionsCommunity-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.

Further Evidence of Anthropogenic Impact: High Levels of Multiple-Antimicrobial-Resistant Bacteria Found in Neritic-Stage Sea Turtles

Background/Objectives: Marine turtles are globally threatened and face daily anthropogenic threats, including pollution. Water pollution from emerging contaminants such as antimicrobials is a major and current environmental concern. Methods: This study investigated the phenotypic antimicrobial resistance and heavy metal resistance genes of 47 Vibrio isolates from different stages of sea turtles (oceanic stage vs neritic stage) from the Taiwanese coast. Results: The results show that a high proportion (48.9%; 23/47) of the Vibrio species isolated from sea turtles in our study had a multiple antimicrobial resistance (MAR) pattern. It was found that Vibrio spp. isolates with a MAR pattern and those with a MAR index value greater than 0.2 were both more likely to be observed in neritic-stage sea turtles. Furthermore, isolates from neritic-stage sea turtles exhibited greater resistance to the majority of antimicrobials tested (with the exception of beta-lactams and macrolides) than isolates from the oceanic-stage groups. Isolates from neritic sea turtles were found to be more resistant to nitrofurans and aminoglycosides than isolates from oceanic sea turtles. Furthermore, isolates with a MAR pattern (p = 0.010) and those with a MAR index value greater than 0.2 (p = 0.027) were both found to be significantly positively associated with the mercury reductase (merA) gene. Conclusions: The findings of our study indicate that co-selection of heavy metals and antimicrobial resistance may occur in aquatic bacteria in the coastal foraging habitats of sea turtles in Taiwan.

Investigation of the Antimicrobial Resistance of Important Pathogens Isolated from Poultry from 2015 to 2023 in the United States

Foodborne pathogens cause around 47.8 million illnesses in the U.S. annually, with antimicrobial misuse in food production, particularly in poultry processing, contributing significantly to this public health challenge. Misuse of antimicrobials can contribute to antimicrobial resistance (AMR) and make the treatment of pathogens increasingly difficult. This emphasizes the need to investigate antimicrobial resistance in U.S. poultry. This study analyzes data from the NCBI Pathogen Isolates Browser (2015–2023) to explore the relationships between antimicrobial-resistant pathogens, AMR genes, and antimicrobials detected with resistance in pathogens isolated from chicken and turkey. Using principal component analysis and hierarchical clustering, we mapped and profiled regional and temporal patterns of antimicrobial resistance. Salmonella enterica was the most prevalent antimicrobial-resistant pathogen across both chicken and turkey, with notable outbreaks, particularly in the Northeast. Antimicrobial-resistant Campylobacter jejuni was more prevalent in chicken, particularly in California and Georgia, while Escherichia coli and Shigella were more prominent in turkey, with concentrated antimicrobial resistance in Texas for pathogen samples isolated from chicken. Resistance to tetracycline and streptomycin was widespread, with distinct regional clusters: antimicrobial resistance was concentrated in states like Minnesota for pathogens isolated from chicken, while AMR found in pathogens isolated from turkey was more evenly distributed across the Midwest. Key AMR genes, such as tet(A), mdsA, and mdsB, also followed similar patterns, peaking in 2019 and significantly declining by 2022. The observed decline in AMR cases may be linked to improved biosecurity measures and disruptions in detection due to the COVID-19 pandemic. This comprehensive study of antimicrobial resistance in U.S. poultry provides valuable insights into resistance trends, which provide useful information to inform targeted interventions and policies to mitigate AMR threats in the poultry production industry. For consumers, these findings emphasize the importance of proper food handling and cooking practices to reduce the risk of exposure to resistant pathogens. Regulatory authorities should focus on enforcing stricter antimicrobial usage policies and enhancing surveillance systems to sustain the reduction in AMR cases.

Surveillance of Food and Waterborne Pathogens in North-East India: Protocol for a Laboratory-Based Sentinel Surveillance Study.

Food safety is a global concern, which is often underestimated owing to challenges in investigating foodborne diseases. These challenges arise from the increased globalization of the food trade, advancements in agricultural practices, and shifts in environmental factors. In North-East India, common diarrheal outbreaks from fermented foods pose significant health risks. Despite these challenges, systematic data on foodborne pathogens is lacking in India, highlighting a crucial gap in understanding food safety issues. The aim of this research protocol is to establish an integrated surveillance system to identify enteric pathogens circulating within humans, food animals, and the environment through a health approach in North-East India, and to conduct outbreak investigations. The Indian Council of Medical Research (ICMR) initiated a surveillance study across all 8 North-East states in India, employing a centralized digital database for data collation. The project aims to enhance theinfrastructure for microbial culture, antibiotic sensitivity testing, and molecular epidemiological studies. The study involves laboratory-based surveillance of foodborne pathogens in market foods, hospitalized diarrheal patients, poultry and animal farms, slaughterhouses, butcher shops, and diarrheal outbreaks. A standardized case report form ensures consistent data collection of age, sex, signs, symptoms, and admission dates for diarrheal cases. Stool and rectal swabs will undergo testing for pathogen identification and antimicrobial resistance. Similarly, samples of market foods, food animals, and the environment will be collected. Outbreaks confirmed by the Integrated Disease Surveillance Project (IDSP) will be thoroughly investigated following standardized guidelines. In phase I, 5 surveillance centers were established across 4 states (ie, Assam [Dibrugarh and Guwahati], Tripura, Sikkim, and Arunachal Pradesh) in 2020. Following an interim phase I data assessment and the successful establishment of a streamlined system for data procurement, investigation, recording, and analysis, along with the implementation of regular training and monitoring programs, phase II expansion was initiated in 2023-24. This includes the addition of 7 more centers (including 3 veterinary centers) in the remaining 4 states (ie, Manipur, Meghalaya, Mizoram, and Nagaland), eventually covering the entire North-Eastern Region of India. Food and waterborne diseases are a constant public health problem in many countries. Key challenges to the enhancement of food safety policy include the paucity of systematic data and awareness. With this background, ICMR's initiative is the first systematic surveillance study in the country to adopt a single health approach. Data obtained from this project will help to understand the risk of acquiring food and waterborne pathogens, their transmission pathways, and antimicrobial resistance patterns. The scientific evidence generated through this project will be helpful in formulating and strengthening food safety policy and in initiating government programs to protect the health of the nation. DERR1-10.2196/56469.

Microbial Isolates and Antimicrobial Resistance Patterns in Adults with Inborn Errors of Immunity: A Retrospective Longitudinal Analysis of Sputum Cultures

Introduction: Individuals with inborn errors of immunity (IEI) are at increased risk of respiratory infection and frequently receive prolonged broad-spectrum antibiotics, leading to antibiotic resistance. The aim of this study was to identify respiratory pathogens and antibiotic resistance patterns in IEI patients. Methods: We retrospectively studied 36 IEI patients with positive bacterial growth in sputum cultures between 2014 and 2023. Data covered hospitalizations, respiratory infections, yearly antibiotic prescriptions, past sputum cultures, and antibiotic sensitivities. Patients with primary ciliary dyskinesia (PCD) and bronchiectasis served as a control group. Results: A total of 314 sputum cultures were analyzed from patients with IEI, alongside 585 cultures from individuals with PCD and 113 cultures from patients with bronchiectasis. Patients with IEI had a median age of 23.5 years, with 61% male participants. The study compared the differences in bacterial isolates from sputum cultures and antibiotic resistance between patients with IEI and the control groups. The most common bacterial isolates across all groups were Haemophilus influenzae (159 isolates in IEI vs. 314 in PCD and 26 in bronchiectasis), Pseudomonas aeruginosa, and Streptococcus pneumoniae. In IEI patients, 992 symptomatic respiratory exacerbations and 43 pneumonia-related hospitalizations were recorded. Notably, H. influenzae in IEI patients showed high resistance rates to cefuroxime (82%), amoxicillin/clavulanic acid (66%), trimethoprim/sulfamethoxazole (59%), and ampicillin/sulbactam (49%). P. aeruginosa in IEI patients displayed significant resistance to ciprofloxacin (85%), ceftazidime (42%), and aminoglycosides (23–33%). Additionally, all S. pneumoniae isolates in IEI patients were tetracycline resistant, with high resistance rates to penicillin, clindamycin, and erythromycin. It is essential to highlight the substantial resistance of common pathogens to oral antibiotics. In contrast, the control groups exhibited lower resistance rates across all bacterial isolates. Conclusion: Antimicrobial resistance is a growing concern among vulnerable IEI patients. We suggest conducting similar investigations in other regions to address this issue. The findings should inform future infection management guidelines for IEIs.

Antimicrobial resistance and clonal relationships of Salmonella enterica Serovar Gallinarum biovar pullorum strains isolated in China based on whole genome sequencing

BackgroundPullorum disease is a serious problem in many countries. Caused by Salmonella enterica serovar Gallinarum biovar Pullorum (S. Pullorum), it creates huge economic losses in the poultry industry. Although pullorum disease has been well-controlled in many developed countries, it is still a critical problem in developing countries. However, there is still a lack of information on S. Pullorum strains isolated from different regions and sources in China. The objective of this study was to supply the antimicrobial resistance patterns and clonal relationships of S. Pullorum from breeder chicken farms.MethodsIn this study, a total of 114 S. Pullorum strains recovered from 11 provinces and municipalities in China between 2020 and 2021 were selected. These 114 S. Pullorum strains were analyzed using whole genome sequencing (WGS). Antimicrobial resistance (AMR) was tested both by genotypic prediction using the WGS method and using disc diffusion to assess phenotypic AMR.ResultsThese 114 sequenced S. Pullorum strains were divided into three sequence types (STs), the dominant STs was ST92 (104/114). Further core genome multi-locus sequence typing analysis indicated that 114 S. Pullorum strains may have a close relationship, which could be clonally transmitted among different provinces and municipalities. Our results showed a close relationship between the S. Pullorum strains found in different regions, indicating these strains may have been transmitted in China a long time ago. Nearly all S. Pullorum strains 94.74% (n = 108) were resistant to at least one antimicrobial class, and 35.96% of the examined Salmonella strains were considered multiple drug resistant.ConclusionOverall, this study showed that S. Pullorum strains in China have a close genetic relationship in terms of antimicrobial resistance, suggesting widespread clonal transmission.

Assessment of Antimicrobial Resistance and Susceptibility Pattern of UTI-causing Microorganisms in Southern Punjab, Pakistan

Background: Bacterial resistance against antibiotics has become a global challenge and measures are needed to stop this. The aim of this study is to highlight this problem and to determine the antibiotic susceptibility pattern of organisms in Southern Punjab, Pakistan. Method: This descriptive cross-sectional study was conducted in Sheikh Zayed Medical Hospital, Rahim Yar Khan. The urine samples obtained from 4 different wards were sent for culture and sensitivity analysis. 9 antibiotics (Nitrofurantoin, Fosfomycin, Ciprofloxacin, Ceftriaxone, Trimethoprim-Sulfamethoxazole, Norfloxacin, Linezolid, Amoxicillin, and Imipenem) were tested against 5 isolated strains of uropathogens using Kirby Bauer disk diffusion test. The sensitivity reports were obtained, and data points were entered into a spreadsheet and analysed using SPSS. Results: Out of 101 samples of uropathogens that showed positive growths (42.08%), 53 (52.4%) were from male patients and 48 (47.5%) positive growths were from females. Escherichia Coli had the highest positive growths (58%) followed by Pseudomonas (19%) Klebsiella (13%), Staphylococcus Aureus (7%) and Coagulase-negative staphylococci (3%). Imipenem was the most sensitive drug whereas the highest resistance by organisms was developed against TMP-SMX. No significant association(p>0.05) was found between any of the anti-microbial drugs and Escherichia coli, gram-positive uropathogens, and gram negative uropathogens. Conclusion: The high increasing rate of broad-spectrum antibiotics resistance suggests that diagnostic and culture tests should be encouraged in hospitals. Based on these test results, appropriate antibiotics should be prescribed. The limitations include the inability to distinguish between nosocomial and community-acquired urinary tract infections and also did not consider other demographic factors like age.

Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis.

Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent. The review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines. The reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30-55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17-32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce. Despite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa.

Surveillance on antimicrobial Resistance pattern of Third Generation Cephalosporins at the Benjamin Mkapa Tertiary Hospital in Tanzania

Abstract Background Antimicrobial resistance is a burden in Tanzania and the world economy, resulting in financial losses from lower production brought on by illness due to greater treatment expenses and death. Second- and third-line antibiotics like third generations of cephalosporins should be used rather than first-line, which is an expensive option, due to AMR. The direct effects of AMR include severe prolonged illnesses, prolonged hospital stays death, and (Global Action Plan on Antimicrobial Resistance., 2015) Methodology The retrospective study design was used to review AST to assess the AMR patterns from 2020-2022 for urine, pus, and blood samples as stated in the National Action Plan-Antimicrobial Resistance 2017. Results Three years (2020, 2021, and 2022) of antibiograms based on priority samples, priority pathogens and third generations of cephalosporins for both gram-negative and gram-positive bacteria see Tables 1 and 2. The surveillance identified sensitive (S), intermediate(I), and resistance(R) for tested bacteria. The N is the isolate number. Our antibiograms for third-generation cephalosporins were represented by cefotaxime, ceftazidime and ceftriaxone. The antimicrobial resistance to ceftriaxone for Acinetobacter species was 62.5% while 76% for Citrobacter. E. coli at 60.26%, Enterobacter aerogenes at 67.86%, Klebsiella species at 73.48% at 22.73%, Morganella morganii 65.75% and Staphylococcus aureus at 62.5%, Serratia marcescens 64.56%. Similar resistance trends have been observed in cefotaxime and ceftazidime. Conclusion Antimicrobial susceptibility surveillance, antimicrobial rotation and presentation of findings to clinicians for increased awareness and the promotion of a multi-disciplinary approach to successful AMS programmers is essential. Evidence found will optimize the use of antibiotics. Clinicians, pharmacists, and scientists will use obtained evidence in the development of guidelines and protocols for surgical prophylaxis, setting IPC programs, management of bacterial blood infections (septicemia and sepsis) and managing urinary tract infections by focusing on red flags antibiotics and bacteria such E. coli and K. pneumoniae. Avoiding delay of AST results by enough resources, and technology advancement. This enable identification of the causative pathogens facilitated the correct diagnosis, de-escalation, and use of targeted agents, which are necessary to promote the prudent use of antimicrobials. Antibiograms Table 1: Antibiogram of gram-negative bacteria Table 2: Antibiogram of gram-positive bacteria

Genotyping and antimicrobial resistance patterns of Klebsiella pneumoniae clinical isolates in Suez Canal University Hospitals

Genotyping and antimicrobial resistance patterns of Klebsiella pneumoniae clinical isolates in Suez Canal University Hospitals

Prevalence of colistin resistance in clinical isolates of Pseudomonas aeruginosa: a systematic review and meta-analysis.

The emergence of resistance to colistin, the last resort for treating severe infections caused by Pseudomonas aeruginosa, poses a significant threat to public health. This meta-analysis aimed to investigate the prevalence of colistin resistance in clinical isolates of P. aeruginosa. A comprehensive search of MEDLINE (PubMed), Web of Science, and Scopus databases was conducted to identify relevant articles published until December 2023. Subsequently, a meta-analysis was performed using Stata software to examine the pooled prevalence of colistin resistance and to conduct subgroup analyses. A total of 619 studies were included in the meta-analysis, revealing a global prevalence of colistin resistance of 1% among all P. aeruginosa isolates. Furthermore, cystic fibrosis patients exhibited the highest resistance to colistin, with a prevalence of 7% among the examined diseases. The increase in colistin resistance in P. aeruginosa in recent years from 2% (in the period of 2006-2010) to 5% (in the period of 2020-2023) underscores the need for implementing infection prevention programs, using appropriate treatment regimens, and disseminating comprehensive information on antimicrobial resistance patterns. These measures are crucial for addressing this growing public health concern.

Hazard Characterization of Antibiotic-resistant Aeromonas spp. Isolated from Mussel and Oyster Shellstock Available for Retail Purchase in Canada

Surveillance and monitoring of foods for the presence of antimicrobial-resistant (AMR) bacteria are required to assess the risks these bacteria pose to human health. Frequently consumed raw or lightly cooked, live bivalve shellfish such as mussels and oysters can be a source of exposure to AMR bacteria. This study sought to determine the prevalence of third-generation cephalosporin (3GC) and carbapenem-resistant bacteria in live mussel and oyster shellstock available for retail purchase through the course of one calendar year. Just over half of the 180 samples (52%) tested positive for the presence of 3GC-resistant bacteria belonging to thirty distinct bacterial species. Speciation of the isolates was carried out using the Bruker MALDI Biotyper. Serratia spp., Aeromonas spp., and Rahnella spp. were the most frequently isolated groups of bacteria. Antibiotic resistance testing confirmed reduced susceptibility for 3GCs and/or carbapenems in 15 of the 29 Aeromonas isolates. Based on AMR patterns, and species identity, a subset of ten Aeromonas strains was chosen for further characterization by whole genome sequence analysis. Genomic analysis revealed the presence of multiple antibiotic resistance and virulence genes. A number of mobile genetic elements were also identified indicating the potential for horizontal gene transfer. Differences in gene detection by the bioinformatic tools and databases used (ResFinder. CARD RGI, PlasmidFinder, and MobSuite) are discussed. This study highlights the strengths and limitations of using genomics tools to perform hazard characterization of diverse foodborne bacterial species.

Genomics and Bioinformatics in One Health: Transdisciplinary Approaches for Health Promotion and Disease Prevention.

The One Health concept underscores the interconnectedness of human, animal, and environmental health, necessitating an integrated, transdisciplinary approach to tackle contemporary health challenges. This perspective paper explores the pivotal role of genomics and bioinformatics in advancing One Health initiatives. By leveraging genomic technologies and bioinformatics tools, researchers can decode complex biological data, enabling comprehensive insights into pathogen evolution, transmission dynamics, and host-pathogen interactions across species and environments (or ecosystems). These insights are crucial for predicting and mitigating zoonotic disease outbreaks, understanding antimicrobial resistance patterns, and developing targeted interventions for health promotion and disease prevention. Furthermore, integrating genomic data with environmental and epidemiological information enhances the precision of public health responses. Here we discuss case studies demonstrating successful applications of genomics and bioinformatics in One Health contexts, such as including data integration, standardization, and ethical considerations in genomic research. By fostering collaboration among geneticists, bioinformaticians, epidemiologists, zoologists, and data scientists, the One Health approach can harness the full potential of genomics and bioinformatics to safeguard global health. This perspective underscores the necessity of continued investment in interdisciplinary education, research infrastructure, and policy frameworks to effectively employ these technologies in the service of a healthier planet.