Resistance Patterns Research Articles

Periodic phenotypic profile analysis of Acinetobacter baumannii drug resistance characteristics showing the emergence of PDR.

Acinetobacter baumannii, one of the ESKAPE pathogens, is on the World Health Organization (WHO) list of priorities needing urgent new effective antimicrobial agents due to exhibited high resistance by the bacterium to currently available antibiotics. This study examines the periodic changes of clinical A. baumannii isolates and their antimicrobial resistance patterns and types in Southeastern region of Saudi Arabia. One hundred and seventy-seven randomly selected A. baumannii isolates were used for the investigation with bacterial identities (IDs) and antimicrobial assay ascertained with Gram-negative (GN) ID cards and antimicrobial susceptibility test (AST) cards of Vitek 2 Compact Automated System according to manufacturer's guidelines. Descriptive phenotypic types of isolates were compared using comparison proportion and Fisher extraction test, while Morpheus versatile matrix visualization and analysis software was used for the dendrogram of hierarchical clustering. A significantly higher proportion of samples were from males compared to females (p = 0.025), with 33.33% of samples originating from patients aged 51-70 years. Resistance was high for imipenem (93%), meropenem (94%), levofloxacin, ciprofloxacin (99%), and aztreonam (98%). There was less percentage resistance to colistin (18%), tigecycline (23%), and minocycline (23%). Multidrug resistance (MDR)/carbapenem-resistant Acinetobacter baumannii (CRAB) was observed consistently across all years. There was no extensive drug resistance (XDR) among isolates from 2013 to 2014, but it was present in the 2016 to 2018 and 2019 to 2020 periods, while pandrug resistance was seen only in the 2019 to 2020 isolates. The study shows a clear trend of the isolates changing from MDR to XDR and then to pandrug resistance over the study period. Also, it indicates that carbapenems might no longer be a treatment choice in this study region. Although colistin exhibited less resistance, the toxicity of the drug reduces its usefulness. The development of pandrug resistance is a critical concern.

Resistance pattern and profile of patients with drug-resistant tuberculosis at a tertiary care center

Abstract Background: Studies on resistance pattern and profile of patients with drug resistant tuberculosis (DRTB) are valuable as they provide insights into what are the rates of DRTB locally. Based on these data, treatment may be optimized. They also help in prevention of spread of DRTB elsewhere due to appropriate treatment. Objective: The objective is to study drug resistance pattern and profile of patients with DRTB. Materials and Methods: The present study was record-based study among records of 194 DRTB patients from December 2021 to May 2024. Their age, sex, height, and weight were recorded. From height and weight, body mass index was calculated. Patient status like pulmonary or extra-pulmonary tuberculosis (TB) was noted. Resistance pattern was also observed. Results: The incidence of DRTB was most common in 19–39 years (47.9%). Males were more affected (70.1%). Underweight was most common (78.3%). Pulmonary TB was most common form of TB (93.3%). Multidrug-resistant TB (MDR-TB) was most commonly seen (64.9%). Pre-extensively drug-resistant TB (XDR-TB) was next common (14.9%). XDR-TB was seen in only two cases. Majority (46.9%) were started on shorter oral regimen (Bedaquiline) followed by all oral longer regimen in 34%. All cases of extrapulmonary TB had MDR-TB and no one had XDR-TB or pre-XDR-TB. Conclusion: Thus, we conclude that young adults, males were commonly affected. Underweight is very common in these cases. Pulmonary TB is the leading form of TB in DRTB patients. XDR-TB is not so common form in DRTB cases. Pre-XDR-TB is more common than XDR-TB.

Drug resistance pattern, prevalence and risk factors for resistance to second line anti-tuberculosis drugs in Balochistan, Pakistan

Background. Pakistan is high burden drug resistant tuberculosis (DR-TB) country. For devising a treatment regimen and optimizing empirical drug therapy, the local epidemiology and drug resistance patterns are needed to be considered. Objectives. To evaluate the drug resistance pattern, prevalence and risk factors for resistance to second line anti-tuberculosis drugs (SLD) among DR-TB patients in Balochistan, Pakistan. Design and setting. This cross-sectional study was carried out at the Fatimah Jinnah Chest and General Hospital in Quetta's programmatic management unit of the DR-TB (PMDT). Methods. This study included all DR-TB patients, regardless of their age, TB location, or medication resistance pattern. The sociodemographic, microbiological, and clinical data of the patients were gathered using a standard data collecting form. SPSS 20 was used to analyze the data. A statistically significant p-value was defined as less than 0.05. Results. A total of 354 patients were included in the final analysis. Among them majority were females (61.7%), belonged to the age group 19-30 years (36.7%), were previously treated for TB (95.8%) at public sector hospital (42.7%) and did not suffer from any other comorbidity(88.7%). The study participants were resistant to a median of three anti-TB drugs (range 1-8). The most common type of DR-TB was multi DR-TB (77.1%), followed by mono DR-TB (18.1%), extensive DR-TB(3.1%) and poly-DR (1.7%). A total of 147 (41.5%) patients were resistant to any second line anti-TB drug (SLD). Among SLD, the resistance was high for fluoroquinolones (38.4%), followed by ethionamide (4.8%) and injectable SLD(4.2%). Upon multivariate binary logistic regression analysis previous treatment of cat-II regimen had statistical significant association with resistance to any SLD (OR=5.273, 95%CI=1.098-25.316). Conclusion. It is concerning to see such a high level of SLD resistance, especially to fluoroquinolones. More stringent regulations are advised to regulate the non-prescription sale and indiscriminate use of fluoroquinolones, as well as testing for drug resistance in cat-I failures instead of placing patients on cat-II therapy.

Evaluation of bacteriophage effect against multidrug-resistant Proteus mirabilis isolated from different clinical samples

Proteus mirabilis is a Gram-negative bacterium that can cause a variety of infections including urinary tract infections, respiratory tract infections and wound infections. It is becoming increasingly resistant to antimicrobial agents, and new therapeutic options are urgently needed. Fifty samples were collected from different samples from hospitals in Baghdad city, thirty were found to be positive for Proteus mirabilis. The results showed that most of the Proteus mirabilis isolates were resistant to Cefotaxime (76.6%), Tobramycin and Amikacin (66.7%), Gentamicin (60%), Ciprofloxacin and Ceftazidime (40%). However, Norfloxacin, Amoxicillin / Clavulanic acid and Aztreonam had lower resistance rates of 33.3%, 30%, and 23.3% respectively. The isolates were also tested for multi-drug resistance. Eight different resistance patterns were identified with 24 (80%) of the isolates being resistant to more than three antibiotics. Eleven (36.7%) of the isolates produced β-lactamase enzymes while 8 (26.7%) were able to produce extended-spectrum β-lactamases. Four bacteriophages were isolated from bird droppings, sewage, Tigris river water and soil samples. These phages were able to infect four isolates of the multidrug-resistant bacteria P. mirabilis. A study of the effects of pH and temperature on bacteriophages found that they were able to eliminate bacteria with high efficiency in a pH range of 7 to 9 and at temperatures of 25 to 550C.

Prevalence of Metallo β-Lactamase Genes Among MDR Pseudomonas <i>Aeruginosa</i> Isolated from Different Sources in Baghdad

Background: Pseudomonas aeruginosa is a gram-negative apportunistic pathogen that has ability to couse different type of infections and charecterised by their high resistance to commonly used antibiotics via different stratiges. Objective: The objective of this study is to detect the prevalence rate of MβL gene among MDR Pseudomonas aeruginosa. Methods: Forty clinical isolates of Pseudomonas aeruginosa were obtained from different hospitials in Baghdad/Iraq. Their identification was confirmed by using 16s rDNA as a housekeeping gene (reference gene). Specific primers were used to detect 3 types of Metallo β-lactamase (MβL) genes vim, spm1, and imp1 genes followed by sequencing the amplified fragment which was analyzed by Geneious software. Antibiotic sensitivity test for 15 antimicrobial agents was done using the Kirby-Bauer disc diffusion method. Results: The revealed resistance pattern was as following: 100% for the combination of Trimethoprim/Sulphamethoxazole and Nitrofurantoin, 95% for Tigecycline, 82.5% for Ciprofloxacin, 67.5% for Cefepime, 60% for Levofloxacin, 57.5% for Carbenicillin, 55% for Piperacillin, 50% for Amikacin, 47.5% for Tobramycin, 45% for both Imipenem and Ceftazidime, 27.5% for piperacillin/tazobactam, 22.5% for Aztreonam and 7.5% for Colistin. More than half (55%) of isolates were positive for MβL enzymes production during phenotypically assessed by combined disc test. The MIC of meropenem ranged from 16µg/ml to 32 µg/ml. The percentage of MβL genes among the total isolates during conventional PCR was as follows: 95% for vim, 25% of the isolates harbored both vim and imp1, while spm 1 are negative in all isolates. The result of the study explained that 10 isolates from the antibiotic susceptibility test were resistant to 10-14 antimicrobial agents that harbored both vim and imp1 genes. Conclusions: MβL gene could be used as a genetic marker to determine the degree of resistance in MDR P. aeruginosa which are more resistant than other isolates that have one gene of MβL responsible for break the β-lactam ring then inactivating the β-lactam antibiotic.

Microbial profiling, antimicrobial resistance surveillance, and molecular detection of MecA gene in Staphylococcal strains from donor human milk: Insights from a milk bank investigation

PurposeDonor human milk (DHM) from milk banks provides vital nutrition to vulnerable infants. Understanding its microbial profile and antimicrobial resistance patterns is crucial for ensuring its safety and efficacy. This study aimed to profile the microbial composition, detect antibiotic resistance, and identify the presence of mecA gene in Staphylococcal strains from DHM samples. Materials and methodA total of 151 DHM samples were collected from a regional human milk bank in North India. Microbial identification was performed using MALDI TOF MS, and antimicrobial susceptibility testing was conducted using the disc diffusion method. Molecular methods, including PCR, were employed for mecA gene detection. ResultsThe study revealed a diverse microbial profile, with Staphylococcus species being predominant. Acinetobacter and Pseudomonas species were also prevalent, raising concerns due to their association with healthcare-associated outbreaks. High rates of antibiotic resistance were observed across both Gram-positive and Gram-negative bacteria, with resistance to commonly used antibiotics such as penicillin, clindamycin, erythromycin, and ceftriaxone. The mecA gene, associated with methicillin resistance, was detected in a significant proportion of Staphylococcal isolates. ConclusionThe study underscores the importance of rigorous microbial analysis and antimicrobial susceptibility testing in assessing the safety of DHM. The presence of diverse microbial species, including antibiotic-resistant strains and the mecA gene in Staphylococcal strains, emphasizes the need for stringent hygiene practices and continuous surveillance in milk banks. Implementing comprehensive screening protocols and adhering to best practices in milk handling and pasteurization are crucial for safeguarding the health of vulnerable infants reliant on donor milk.

A Study of the Characteristics and Properties of P. aeruginosa Isolated from Different Sources and their Resistance to Antibiotics

Pseudomonas aeruginosa, a common opportunistic bacterium, is a major source of human surface infections. Infections with these bacteria are difficult to cure and cause significant economic implications. Objectives The current study looked at the antibiotic resistance patterns of P. aeruginosa isolated from burns, wound swabs, and urinary tract infections that were referred to Iraq Hospitals' emergency health care units. From October 2022 to May 2023, 180 swabs were collected from burn and wound patients (110 burns, 67 wounds, and 3 urinary tract infections) of both sexes, (80) males and (100) females, aged 1-72 years, at Baghdad government hospitals: Ghazi Al-Hariri Hospital, Central Laboratories, Specialized Burns Hospital, and Yarmouk Hospital. Results:(180) diagnostic swabs from patients with burns and wound infections of both sexes, (80) males and (100) females, aged 1–72 years. The current study found 25(31.25) more P. aeruginosa positive cases in males than females, with 29(29) out of 54 positive cases. The study discovered that the age group 21-30 years had the highest rate of bacterial infection, followed by the age groups 11-20 and 1-10, with 11 (20.37%), 10 (18.51%), and 10 (18.51%), respectively. According to the current study's findings, the antibiotics Amikacin, Gentamicin, Ceftazidime, Cefepime, Netilmicin, and Tobramycin showed the highest resistance rates (81.4%, 81.4%, 79.6%, 72.2%, 74%, and 79.6%, respectively).The test findings showed that 52 isolates (96%) produced pyrocyanin and hemolysins. Bacterial colonies were white to gray with a sticky feel. All isolates exhibited β-hemolysis.Alkaline protease production All isolates exhibited a translucent halo surrounding the bacterial colonies.Lipase production All isolates exhibited a hazy halo surrounding the development zone of P.aeruginosa colonies. The current study discovered that the antibiotics Amikacin, Gentamicin, Ceftazidime, Cefepime, Netilmicin, and Tobramycin were the most resistant in cases of burn and wound patients, as well as urinary tract infections in Iraq.

Antibiotic Resistance in the Elderly: Mechanisms, Risk Factors, and Solutions.

Antibiotic resistance presents a critical challenge in healthcare, particularly among the elderly, where multidrug-resistant organisms (MDROs) contribute to increased morbidity, mortality, and healthcare costs. This review focuses on the mechanisms underlying resistance in key bacterial pathogens and highlights how aging-related factors like immunosenescence, frailty, and multimorbidity increase the burden of infections from MDROs in this population. Novel strategies to mitigate resistance include the development of next-generation antibiotics like teixobactin and cefiderocol, innovative therapies such as bacteriophage therapy and antivirulence treatments, and the implementation of antimicrobial stewardship programs to optimize antibiotic use. Furthermore, advanced molecular diagnostic techniques, including nucleic acid amplification tests and next-generation sequencing, allow for faster and more precise identification of resistant pathogens. Vaccine development, particularly through innovative approaches like multi-epitope vaccines and nanoparticle-based platforms, holds promise in preventing MDRO infections among the elderly. The role of machine learning (ML) in predicting resistance patterns and aiding in vaccine and antibiotic development is also explored, offering promising solutions for personalized treatment and prevention strategies in the elderly. By integrating cutting-edge diagnostics, therapeutic innovations, and ML-based approaches, this review underscores the importance of multidisciplinary efforts to address the global challenge of antibiotic resistance in aging populations.

Results of a 10-month Study on the Species Spectrum and Antimicrobial Resistance of Microorganisms in a Tertiary Care Hospital

Introduction. Antimicrobial resistance (AMR) remains a global issue requiring a comprehensive approach to address it. One of the methods to mitigate AMR is the microbiological monitoring of antibiotic-resistant strains of microorganisms within the framework of infection control with regular monitoring of resistance patterns. The aim of thе study. To determine the species diversity and antimicrobial resistance of microorganisms isolated in a tertiary care hospital over a 10-month period. Materials and methods. The study was conducted at the Clinical Bacteriology Laboratory of the Regional Center for Laboratory Diagnostics, Communal enterprise ″Yuri Semenyuk Rivne Regional Clinical Hospital″ of Rivne Regional Council (Rivne, Ukraine) over 10 months (July 2023 - April 2024). From 8.300 patients, 12.463 biological samples were collected, from which 16.618 strains of microorganisms were isolated and studied. Pure culture isolation was performed using bacteriological methods with nutrient media. Species identification and antimicrobial susceptibility testing were carried out using a semi-automated bacteriological analyzer ID/AST system D2mini with plates produced by Zhuhai DL Biotech Co. Ltd., in accordance with EUCAST 2023-2024 guidelines. Results. During the 10 months of observation, 16.618 strains of microorganisms were identified and their antimicrobial resistance levels were determined. Of these, 64.4 % were gram-negative bacteria, 32.5 % were gram-positive microorganisms, and 3.0 % were yeast fungi. The most common gram-negative bacteria were Klebsiella pneumoniae (40.8 %), Pseudomonas aeruginosa (18.2 %), and Acinetobacter baumannii (14.4 %). Among the gram-positive bacteria, Staphylococcus aureus (39.5 %), Staphylococcus epidermidis (15.5 %), and Staphylococcus haemolyticus (14.1 %) were predominant. The most common yeast fungi of the Candida genus were Candida albicans (60.5 %), Candida guilliermondii (12.5 %), and Candida tropicalis (8.9 %). High resistance was found to second-generation cephalosporins (81.4 % resistant strains to cefalexin) and fourth-generation cephalosporins (67.2 % resistant to cefepime), as well as aminopenicillins (amoxicillin-clavulanate – 76.1 %, ampicillin – 75.1 %). High sensitivity was noted to antibiotics of the tetracycline group (78.5 % to tetracycline), glycylcyclines (93.5 % to tigecycline), oxazolidinones (93.5 % to tigecycline), and lincosamides (80.8 % to clindamycin). Conclusions. A total of 16.618 strains of microorganisms were identified, with 64.4 % being gram-negative bacteria, 32.5 % gram-positive microorganisms, and 3.0 % yeast fungi. High resistance was found to second- and fourth-generation cephalosporins and aminopenicillins. High sensitivity was detected to antibiotics of the tetracycline, glycylcycline, oxazolidinone, and lincosamide groups.

Uropathogenic Bacterial Detection and Surveillance of Antimicrobial Resistance Pattern in Urine Specimens Referred to Al anbar Province

For clinicians treating patients, antimicrobial resistance is becoming a significant concern. This brief study was therefore conducted to find out how common it is for bacterial isolates that are resistant to multiple drugs (MDR), XDR, and PDR, as well as extensively drug-resistant (XDR), in Anbar hospital. The microbiology department cultivated the clinical samples and identified the bacterial strains. The detection of MDR, XDR, and PDR microorganisms was accomplished by analyzing the antibiotic susceptibility profile of various bacterial isolates. 257 children and adult patients from both sexes were included in this study. The total number of urine samples that gave positive bacterial culture results were 114 (44.4%) and the number of samples that gave negative results was 143(55.6%) . The antibiotic susceptibility profile of 114 bacterial strains was studied. 90(78.9) of gram-negative bacteria strains were MDR, (8.9%) (72.2%) XDR, and (18.9%) PDR was isolated. 24 (21.1%) Gram positive bacterial egative bacteria strains were MDR, (33.3%) (54.2%) XDR, and (12.5%) PDR was isolated. To effectively combat the threat of antibiotic resistance, all clinical microbiology laboratories need to closely monitor MDR, XDR, and PDR.

Uropathogenic Bacterial Detection and Surveillance of Antimicrobial Resistance Pattern in Urine Specimens Referred to Al anbar Province

For clinicians treating patients, antimicrobial resistance is becoming a significant concern. This brief study was therefore conducted to find out how common it is for bacterial isolates that are resistant to multiple drugs (MDR), XDR, and PDR, as well as extensively drug-resistant (XDR), in Anbar hospital. The microbiology department cultivated the clinical samples and identified the bacterial strains. The detection of MDR, XDR, and PDR microorganisms was accomplished by analyzing the antibiotic susceptibility profile of various bacterial isolates. 257 children and adult patients from both sexes were included in this study. The total number of urine samples that gave positive bacterial culture results were 114 (44.4%) and the number of samples that gave negative results was 143(55.6%) . The antibiotic susceptibility profile of 114 bacterial strains was studied. 90(78.9) of gram negative bacteria strains were MDR, (8.9%) ,(72.2%) XDR, and (18.9%)PDR was isolated. 24 (21.1%)Gram positive bacterial egative bacteria strains were MDR, (33.3%) ,(54.2%) XDR, and (12.5%) PDR was isolated. To effectively combat the threat of antibiotic resistance, all clinical microbiology laboratories need to closely monitor MDR, XDR, and PDR.

Surveillance of Antibiotic Resistant Klebsiella pneumoniae in Tertiary Care Hospital of Nepal

Background Klebsiella pneumoniae is a ubiquitous Gram-negative, non-motile, encapsulated bacterium that resides in the mucosal surfaces of mammals and the environment such as soil, water, etc. Clinically, it is also associated with many infections and conditions that are aggravated by the acquisition of multidrug-resistant genes. MethodsThis descriptive study was conducted to find out the incidence of Klebsiella pneumoniae in different clinical samples and their antibiotic susceptibility pattern at B & B Hospital, Lalitpur from 12 June 2022 to 11 September 2022. The samples were cultured on MacConkey agar, and standard microbiological techniques were used to confirm the presence of K. pneumoniae. Antimicrobial susceptibility tests were performed using the Kirby-Bauer Disk Diffusion method.ResultsOf the 1967 different clinical samples, culture positivity was observed in 361 samples. Among these, total number of Klebsiella pneumoniae was 150 (41.55%) and from the urine samples exclusively, 63 (42%) Klebsiella pneumoniae were isolated. The most susceptible and resistant antibiotics were gentamicin and ciprofloxacin respectively. Among the isolates, 85 (56.66%) isolates were multi-drug resistant in which 69 (87.34%) isolates were resistant to carbapenem.Conclusions The diversified infections with a growing number of multi-drug resistant Klebsiella pneumoniae present a major public health concern. The limited availability of effective antibiotics emphasizes the prudent use of available antibiotics and the importance of regular national-wide surveillance of multi-drug resistance patterns.

Antibiotic Resistance Patterns of Pseudomonas aeruginosa Bacterial Species Isolated from Various Clinical Samples

Pseudomonas aeruginosa infections have become a real burden in healthcare settings, contributing substantially to nosocomial infections. The emergence of several drug-resistant strains was the major issue causing massive mortality. Multiple-drug resistant Pseudomonas aeruginosa isolates containing beta-lactamase were becoming more prevalent. Objective: To investigate and characterize the antibiotic resistance patterns of Pseudomonas aeruginosa isolated from different clinical samples. Methods: A total of 618 different clinical samples including blood, pus and urine samples were collected from the patients visiting Indus Medical College Hospital Tando Muhammad Khan, Sindh, Pakistan. All the clinical samples were processed for the isolation of bacterial species using specific culture media. The identification of Pseudomonas aeruginosa strains was achieved based on Gram’s staining and certain biochemical tests including Cetrimide test. Moreover, antibiotic susceptibility testing was determined by Kirby-Bauer disc diffusion method. Results: A total of 452 bacterial strains were isolated and pure cultured from different clinical samples. Among these, 60.62% were Gram-negative and 25% of the total isolates were found to be Pseudomonas aeruginosa strains. Antibiotic sensitivity testing results revealed the highest resistance ratio of Pseudomonas aeruginosa strains against Ticarcillin (46.02%), while Colistin showed the lowest resistance (3.54%). Overall, 14.15% of the isolates of Pseudomonas aeruginosa strains were found to be multi-drug-resistant bacteria. Conclusion: The results of the present study reveal an increased ratio of antibiotic resistance particularly of Ticarcillin, piperacillin and imipenem in Pseudomonas aeruginosa isolated from various clinical samples.

Increasing Antimicrobial Resistance Pattern in Enterococcus species. Isolated from Different Clinical Samples at North West General Hospital, KP Pakistan

Increasing Antimicrobial Resistance Pattern in Enterococcus species. Isolated from Different Clinical Samples at North West General Hospital, KP Pakistan

Escherichia coli, an important Uropathogen: Characteristics and antimicrobial susceptibility pattern at Prof. Dr. I.G.N.G. Ngoerah General Hospital, period January 2020 – December, 2021

Background: Urinary tract infections (UTIs) are among the most common infections globally, often treated empirically with broad-spectrum antibiotics without prior culture and sensitivity testing. This practice has contributed to the rise in antibiotic resistance. Escherichia coli (E. coli) is the primary pathogen in uncomplicated UTIs, accounting for 70–90% of cases. However, other bacteria such as Klebsiella pneumoniae, Proteus mirabilis, and Enterococcus faecalis are also significant, especially in complicated or healthcare-associated UTIs. This study examines the resistance patterns of E. coli in UTI cases. Method: A descriptive cross-sectional study was conducted using secondary data from medical records of UTI patients treated at Prof. Dr. I.G.N.G. Ngoerah General Hospital from January 2020 to December 2021. E. coli isolates were identified, and antibiotic sensitivity tests were performed using the VITEK® 2 compact automatic system, with antimicrobial sensitivity and resistance determined according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Result: Analysis of 639 UTI patients revealed that E. coli exhibited high resistance to cefixime (13.3%), ciprofloxacin (23.8%), and trimethoprim-sulfamethoxazole (35.2%). The highest levels of susceptibility were observed with Tigecycline, Meropenem, and Ertapenem, with rates ranging from 99.2% to 99.8%. The demographic data showed a higher incidence of UTIs in female patients (70.9%) compared to males (29.1%), with the majority of cases occurring in adults (94.52%). Additionally, 52.26% of the E. coli isolates were ESBL-producing strains, complicating treatment options. Conclusion: The study underscores the urgent need for judicious antibiotic use, guided by culture and sensitivity testing, to combat the rising threat of antibiotic-resistant UTIs. Tigecycline, Meropenem, and Ertapenem should be prioritized in treatment protocols for multidrug-resistant cases. Continuous surveillance and the development of new antimicrobial agents are essential to address this escalating public health challenge

Prevalence And Antibiotic Resistance Patterns of Urinary Tract Infections in Menopausal Women

Prevalence And Antibiotic Resistance Patterns of Urinary Tract Infections in Menopausal Women

Tracking Candidemia Trends and Antifungal Resistance Patterns across Europe: An In-Depth Analysis of Surveillance Systems and Surveillance Studies.

The WHO fungal priority list classifies Candida species as critical and high-priority pathogens, and the WHO GLASS fungi initiative seeks to establish a standardised global framework for antifungal resistance monitoring. We aimed to review resistance rates and antifungal resistance patterns across European surveillance systems and studies in response to these recent calls for action. A systematic review of national and international surveillance systems and peer-reviewed surveillance studies available up to June 2024 was conducted. Descriptive and trend analyses were performed on surveillance data reporting resistance to different antifungals in Candida spp. In total, 6 national surveillance systems and 28 studies from 13 countries provided candidemia resistance data, mostly about the C. albicans, C. glabrata and C. parapsilosis complex. Azole resistance was most frequently reported (6/6 surveillance systems and 27/28 studies) with the highest resistance rate, especially for C. glabrata, in Croatia (100%, 28/28 isolates) and Slovenia (85.7%, 82/96) and C. parapsilosis in Croatia (80.6%, 54/67) and Italy (72.6%, 106/146). Echinocandin and polyene resistance rates were nearly zero. The number of isolates included in the surveillance systems increased over the years, particularly for C. albicans (+40-60 isolates/year), C. glabrata, and C. parapsilosis (+15-30 isolates/year). No surveillance system or study reported resistance data for C. auris. Pooled data from national surveillance revealed a decreasing trend in azole resistance in C. albicans and C. glabrata. The increasing azole-resistance trend in C. parapsilosis disappeared after adjusting for between-country heterogeneity. Overall, echinocandin and polyene resistance trends appeared relatively stable. Awareness of antifungal resistance is growing, but further actions are needed to strengthen surveillance capacity and knowledge-sharing networks across Europe.

SPECTRUM OF BACTERIAL CULTURE AND ANTIBIOGRAM IN PCNL PUNCTURE URINE SAMPLE

Percutaneous nephrolithotripsy (PCNL) is the standard treatment for high-volume renal stones, stones resistant to extracorporeal shockwave lithotripsy (ESWL), and multiple and inferior calyx renal stones. Objective: The study's main objective is to find bacterial culture and antibiogram spectrum in PCNL puncture urine samples. Methods: This retrospective observational study was conducted at CMH, Lahore, from April 2024 to July 2024. Data were collected from 185 patients. Urine samples were collected directly from the renal pelvis through the PCNL puncture site during the surgical procedure. This method ensures that the samples accurately represent the microbial environment of the kidney. Results: Data were collected from 185 patients according to the study's criteria. The gender distribution comprised 110 males (59.5%) and 75 females (40.5%). The age of the patients ranged from 25 to 70 years, with a mean age of 48.23±3.54 years. Among the positive cultures, Escherichia coli was the most prevalent species, found in 46.2% of cases, followed by Klebsiella pneumoniae (23.1%), Pseudomonas aeruginosa (15.4%), Enterococcus faecalis (7.7%), and Proteus mirabilis (3.8%). Additionally, 3.8% of the samples included other bacteria, including mixed infections. Conclusion: It is concluded that the bacterial spectrum in PCNL urine samples is diverse, with significant antibiotic resistance patterns observed among isolated pathogens.

The Challenges of Treating a Helicobacter pylori Infection following the COVID-19 Pandemic in Croatia: A Review.

Background:Helicobacter pylori (H. pylori) is a prevalent bacterial pathogen implicated in different stomach and duodenal diseases, including chronic gastritis, gastric and duodenal ulcer, and stomach cancer. The COVID-19 pandemic has significantly influenced antibiotic prescription practices, potentially exacerbating antibiotic resistance in H. pylori. Objective: This study aims to investigate antibiotic prescription during the COVID-19 pandemic in Croatia and its possible impact on H. pylori antibiotic resistance, with a focus on Croatia. Methods: An extensive literature search was conducted to identify relevant studies from March 2020 to June 2024. The search strategy included terms related to COVID-19, antibiotic prescription, and Croatia. Studies were selected based on predefined eligibility criteria, focusing on observational research addressing antibiotic use during the pandemic. Results: The COVID-19 pandemic has led to significant fluctuations in community antibiotic consumption within the European Union/European Economic Area. In Croatia, antibiotic use in 2022 surpassed 2019 levels, driven by increased consumption of macrolides and other antibiotics. This surge, influenced by early pandemic treatment claims and penicillin shortages, contributed to rising antibiotic resistance in H. pylori. Resistance rates to clarithromycin and levofloxacin were notably high, driven by mutations in the 23S rRNA, gyrA, and gyrB genes. Discussion: The increased antibiotic use during the COVID-19 pandemic has highly likely complicated H. pylori eradication efforts, highlighting the necessity of judicious antibiotic use and robust antimicrobial stewardship. The pandemic underscored the need for new therapeutic strategies, optimized eradication regimens, and advanced diagnostic methods to manage bacterial infections effectively. Conclusions: The COVID-19 pandemic has significantly affected antibiotic use and resistance patterns, posing new challenges for H. pylori eradication. Addressing these challenges requires a multifaceted approach, including the development of new drugs and advanced diagnostics, coupled with sustained efforts in antimicrobial stewardship to combat emerging resistance threats.

Trends in Antimicrobial Resistance of Uropathogens Isolated from Urinary Tract Infections in a Tertiary Care Hospital in Dhaka, Bangladesh.

Background/Objectives: Urinary tract infection (UTI) is a prevalent microbial infection in medical practise, leading to significant patient morbidity and increased treatment costs, particularly in developing countries. This retrospective study, conducted at a tertiary care hospital in Dhaka, Bangladesh, aims to examine the antimicrobial resistance (AMR) patterns of uropathogens and evaluate whether these patterns are influenced by demographic factors such as gender, age, or patient status. Methods: Standard microbiological techniques were used to identify uropathogens, and AMR patterns were determined using the Kirby-Bauer disc diffusion method. Results: Out of 6549 urine samples, 1001 cultures were positive. The infection was more prevalent in females compared to males. The incidence of UTIs in children aged 0-10 years accounted for 12.59% of the total cases, with this age group also exhibiting the highest rate of polymicrobial infections. Among the bacterial uropathogens, 71.19% of isolates were multidrug resistant (MDR) and 84.27% were resistant to at least one antibiotic. Escherichia coli (n = 544, 73.90% MDR) and Klebsiella species (n = 143, 48.95% MDR) were the most common Gram-negative uropathogens, while Enterococcus species (n = 78, 94.87% MDR) was the predominant Gram-positive isolate in this study. Our results indicate that most uropathogens showed resistance against ceftazidime, followed by cefuroxime, trimethoprim-sulfamethoxazole, amoxicillin-clavulanate, and netilmicin. Moderate levels of resistance were observed against ciprofloxacin, levofloxacin, aztreonam, and cefpodoxime. Conclusions: Amikacin was observed to be effective against Gram-negative uropathogens, whereas cefixime was more active against Gram-positive microorganisms, such as Enterococcus species. Moreover, a principal coordinate analysis (PCoA) depicted no significant influence of gender, patient status, or age on AMR patterns. For the continued usefulness of most antibiotics, periodic analysis of the AMR patterns of uropathogens can help assess the rise of MDR bacteria, and therefore guide the selection of appropriate antibiotic treatment strategies.