Pneumonia Strains Research Articles

Frequency of qnr and aac(6’)Ib-cr Genes Among ESBL-Producing Klebsiella pneumoniae Strains Isolated from Burn Patients in Kermanshah, Iran

Background: Assessment of bacteria such as Klebsiella pneumonia has shown that Plasmid-mediated quinolone resistance (PMQR) affects antibiotics resistance (e.g., quinolones). Objectives: We studied the prevalence of qnr and aac(6’)Ib-cr genes in extended-spectrum beta-lactamase (ESBL)-producing K. pneumonia strains isolated from burn wounds of patients in the city of Kermanshah, Iran. Methods: This descriptive-analytical study was conducted on 126 K. pneumonia strains isolated collected from burn wounds. Biochemical tests were used to detect the strains. The frequency of the ESBL-producing isolates was determined by phenotypic tests of the combination disk (CD) method after determining the antibiotic susceptibility pattern of the isolates through the Kirby-Bauer disc diffusion test. The prevalence of the qnr and aac(6’)-Ib-cr genes was determined using their special primers as well as polymerase chain reaction (PCR). Results: Of the 126 K. pneumonia isolates, 52 (41.3%) were identified as ESBL-producing strains. ESBL-producing isolates showed higher resistance against antibiotics than non-ESBL-producing ones. PMQR relevance and resistance to ciprofloxacin were, respectively, determined at 80.76% and 59.6%. The most frequent gene was aac(6’)-Ib-cr (n = 70, 55.6%), followed by the qnrB (n = 44, 34.9%). Conclusions: This study showed a high prevalence of qnr genes in ESBL-producing K. pneumonia isolates and antibiotic resistance. Given the horizontal transmission of antibiotic resistance genes among bacteria by mobile genetic elements, timely identification of infections caused by ESBL-producing and antimicrobial-resistant K. pneumonia strains is of paramount importance.

Adsorption, antimicrobial and wound healing activities of biosynthesised zinc oxide nanoparticles

Using plant extracts has been interesting as possible eco-friendly methods to synthesis and stabilize different types of nanoparticles. Zinc oxide nanoparticles (ZnO-NPs) can be used as effective adsorbent due to their high surface area to volume ratio and high spontaneous adsorption properties. In this research, ZnO-NPs were synthesized and stabilized to use as an effective adsorbent material for removing two carcinogenic azo dyes: Malachite green and Congo red. It is also used as an antibacterial active material to enhance mouse skin wound healing. The fabrication and stabilization of ZnO-NPs were performed using Aloe barbadensis leaf extract. The morphology and structure of the as-synthesized ZnO-NPs were investigated by X-ray diffraction, scanning electron microscopy, Fourier transforms infrared spectroscopy and UV–Vis spectroscopy. The fabricated ZnO-NPs were applied as an adsorbent for the removal of Malachite green, a cationic azo dye, and Congo red, an anionic azo dye. The ZnO-NPs achieved adsorption efficiency of 90.7% for Malachite green azo dye within 90 min at the maximum amount of 70 mg/ml. Congo red dye was adsorbed at the efficiency of 92.30% within 120 min at 80 mg/ml maximum concentration of ZnO-NPs. Using the batch process, different parameters (time, pH, amount of adsorbent) during the adsorption process were elucidated. The results confined the applicability of ZnO-NPs as an efficient adsorbent for Malachite green and Congo red dyes. Also, the synthesised ZnO-NPs demonstrated a powerful antimicrobial activity against four types of bacterial strains of Bacillus subtilis, Klebsiella pneumonia, Bacillus licheniformis and Escherichia coli, and two types of fungi strains of Aspergillus niger and Candida albicans. The healing efficiency of mouse wound was studied using ZnO-NP/silica gel (ZnO-NP/SG) dressings due to its extensive evidence on healing property. The microscopic investigations of the wound area are reduced significantly using ZnO-NP/SG-30 ppm dressings within 11 days of observation as compared to ZnO-NPs of the control sample. These findings elaborated that as-synthesized dressing enhanced the skin repairing on the wound surface and support its usage in the future.

Multidrugresistant Klebsiella pneumoniae from clinical isolates at dr. Soeradji Tirtonegoro central hospital Klaten

Background: Klebsiella pneumoniae is a Gram-negative bacterium that often causes nosocomial infections. Use of broad-spectrum antibiotics as an empiric therapy has contributed to increases of K. Pneumoniae strains that are resistant to antibiotics. Therefore, a test on antibiotic susceptibility of K. pneumoniae is needed as a guide in treating a definitive therapy. Objective: This study aimed to measure the percentages of multidrug-resistant (MDR) of K. pneumoniae and its susceptibility at dr. Soeradji Tirtonegoro Central Hospital, Klaten, Central Java in 2017. Methods: This study was a descriptive study using secondary data at the Clinical Microbiology Laboratorium of dr. Soeradji Tirtonegoro Central Hospital, Klaten. The K. pneumoniae was isolated from patients hospitalized in the hospital from January 1, 2017, to December 31 2017. Identifications of the K. pneumoniae were conducted by a colony morphology observation, a gram staining, and a biochemical test. The test of antibiotics susceptibility used Kirby-Bauer method based on Clinical and Laboratory Standards Institute (CLSI). The data were analyzed by univariate analysis. Results: In 2017, there were 213 K. pneumoniae isolates from various clinical samples. Among them, 122 isolates were MDR K. pneumoniae (57.28%). The majority of MDR K. pneumoniae were resistant to a wide range of antibiotics. The MDR K. pneumoniae had only a good sensitivity to meropenem (98.43%), amikacin (93.75%), nitrofurantoin (88.89%), and fosfomycin (88.89%). In contrast, all non-MDR K. pneumoniae had good sensitivity to all tested antibiotics, except to ampicillin. Conclusion: The percentage of MDR K. pneumoniae isolates at the dr. Soeradji Tirtonegoro Cental in 2017 was 57%. Meropenem and amikacin could be considered as empirical therapies to cure an MDR K. pneumoniae infection.

Incidence of Beta-Lactamase Enzymes among Klebsiella pneumonia Isolates Causing Urinary Tract Infections in Aliabad, North-East Iran

AimsIn the past decade, drug resistance in Gram negative bacilli has become a serious problem. The production of extended spectrum beta-lactamase (ESBL), AmpC beta-lactamase, and metallo beta-lactamase (MBL) enzymes in Klebsiella pneumoniae strains is the mechanism of drug resistance among these commonly isolated Gram negative bacteria from clinical specimens. The aim of this study was to assess the frequency of β-lactamase enzymes, including extended spectrum β-lactamases (ESBLs), metallo-β-lactamases (MBLs), and AmpC beta-lactamases, in K. pneumonia strains isolated from urine samples referred to medical laboratories in Aliabad.Materials & MethodsA total of 780 urine samples were collected from patients suspected of having UTI from March to June 2017. In positive urine samples, K. pneumonia isolates were identified by biochemical tests. Antibiotic resistance pattern was determined by disk diffusion method, and phenotypic confirmatory test was performed for detecting ESBLs, MBLs, and AmpC BLs producers.FindingsOut of 378 positive samples for UTI, 97 K. pneumonia strains were isolated. Most of the isolates (more than 90%) were resistant to ampicillin and amoxicillin; however, imipenem and amikacin were effective antibiotics against the isolates. The frequency of ESBLs, MBLs, and AmpC BLs producers was determined as 33.3, 21.3, and 5.1%, respectively.ConclusionsIn this study, 14 isolates were simultaneously positive for ESBL and AmpC BL production, and 2 isolates were co-producer of ESBL and MBL. This finding could have a great impact on the management and treatment of UTI cases. Therefore, detection of beta‑lactamases is of great importance for controlling and reducing the spread of ESBL, AmpC BL, and MBL producing strains.

Evaluation of (GTG) 5-PCR for Genotyping of Klebsiella pneumonia Strains Isolated from Patients with Urinary Tract Infections

Klebsiella pneumonia is one of the common causes of pneumonia and bacteremia in intensive care patients. The present study was aimed to determine the capability of (GTG) 5-PCR assay for molecular typing of K. pneumonia strains isolated from patients with urinary tract infections. In this descriptive-sectional study, K. pneumoniae strains were collected from hospitalized patients with urinary tract infection in Baqiyatallah Hospital, Tehran, Iran during 2017-2018. Isolates were identified by conventional microbiological tests. Bacterial DNA was extracted using boiling method and (GTG) 5-PCR assay was used for subtyping of the isolates. For clustering of isolates, dendrogram was generated according to the un-weighted pair group method with arithmetic (UPGMA). Overall, 88 K. pneumoniae isolates were isolated and subjected to the molecular typing study. The (GTG) 5-PCR assay was able to differentiate the K. pneumoniae strains into 9 clusters including G1-G9. Genotype clusters G4 and G9 consist of highest (26) and lowest (1) number isolate, respectively. The K. pneumonia strains isolated under the study belonged to various clones and the (GTG) 5-PCR assay as simple and rapid method can be a powerful tool for molecular typing of K. pneumoniae strains.

Comprehensive 2D-Quantitative Structure-Activity Relationship Study on Monobactam Analogues Against Gram-Negative Bacteria.

Human health has been severely affected by infections resulting from multidrug-resistant (MDR) gram-negative bacteria (GNB). Monobactam antibiotics are known to be effective against such infections. This study aimed to construct a predictive two-dimensional quantitative structure-activity relationship (2D-QSAR) model for the rational design of new monobactams based on the 65 known monobactams against Escherichia coli (Eco) and Klebsiella pneumonia (Kpn) strains using the kernel partial least squares regression (KPLS) algorithm. The total performance of Eco and Kpn KPLS modes was shown as RMSE: 0.681/0.596, R²: 0.946/0.882, Q²: 0.922/0.877, and RMSU: 0.625/0.593. Thirty-four monobactams reported in our lab were chosen as external data to predict their activities against Eco and Kpn using the newly established models, by which the R² between the experimental and predicted values was 0.878 and 0.871, respectively. The models developed and verified in this study provide a powerful design strategy for novel monobactams that are effective against MDR gram-negative bacterial infections.

A computational subtractive genome analysis for the characterization of novel drug targets in Klebsiella pneumonia strain PittNDM01

The emergence of carbapenem-resistant Klebsiella Pneumoniae had been reported previously, which needs rapid attention. Currently, Pittsburgh University Hospital reported a new strain of carbapenem-resistant Klebsiella pneumoniae that was co-producing OXA-232 and NDM-1 named as PittNDM01. This strain is resistant to almost all beta-lactam antibiotics such as Carbapenem as well as to fluoroquinolones and aminoglycosides. Globally, failure to the wide-spread pathogenic strains had been observed due to the increased and antibiotic resistance, which leads to less antimicrobial drug efficacy. Since last decades, computational genomic approaches have been introduced to fight against resistant pathogens, which is an advanced approach for novel drug targets investigation. The current study emphasizes the utilization of the available genomic and proteomic data of Klebsiella pneumoniae PittNDM01 for the identification of novel drug targets for future drug developments. Comparative genomic analysis and molecular biological tools were applied, results in observing 582 non-human homologous-essential proteins of Klebsiella pneumoniae. Among the total 582 proteins, 66 were closely related to the pathogen-specific pathway. Out of all 66-targeted proteins, ten non-homologous essential proteins were found to have druggability potential. The subcellular localization of these proteins revealed; 6 proteins in the cytoplasm, 2 in the inner membrane, and one each in periplasmic space and outer membrane. All the above 10 proteins were compared to the proteins sequences of gut flora to eliminate the homologous proteins. In total, 6-novel non-human and non-gut flora essential drug targets of Klebsiella pneumoniae PittNDM01 strain were identified. Further, the 3D structures of the identified drug target proteins were developed, and protein-protein interaction network analysis was performed to know the functional annotation of the desire proteins. Therefore, these non-homologous essential targets ensure the survival of the pathogen and hence can be targeted for drug discovery.

The genetic basis for medium‐dependent bacteriophage infection

While broad spectrum antibiotics have served a major role in combatting bacterial pathogens over the past decades, we are currently witnessing the rise of antibiotic‐resistant pathogenic strains. Moreover, the harmful effects of broad spectrum antibiotics on the natural human microbiome have been demonstrated in numerous cases. For these reasons, bacteriophages have been recently gaining attention as promising candidates for treatment of bacterial‐related diseases. Bacteriophages are natural viruses that infect and often kill specific bacterial strains; it is the phages’ high accuracy and specificity, alongside their natural origin, that highlights their value as an alternative treatment for diseases with bacterial involvement.However, a major challenge in screening for bacteriophages relevant for treatment of human diseases is the phages’ medium‐dependent infection trait. Several factors have been suggested to take a role in explaining this discrepancy, including the mechanism of infection, the spatial structure of the phage capsid, the biochemical characteristics of the bacterial cell wall, and other phage life‐cycle features. However, a comprehensive model for characterizing the media‐range for phage infection is still missing. This uncertainty often translates into multiple laborious screening rounds, since common practice in vitro assays are typically based on either liquid or solid medium infection, whereas the state of matter relevant for in vivo application is often hard to determine; thus, one must screen the same phages using multiple assays.In attempt to lay the groundwork for such a model, in this work we set out to determine the genetic‐basis for medium‐dependent infection of pathogenic Klebsiella pneumoniae phages. To this end we obtained 285 K. pneumonia strains, that span across the entire domain of known K. pneumonia genotypes. Subsequently we obtained 50 phages that were able to propagate on at least some of these hosts. For each phage‐host pair we determined whether infection occurs in two different assays: in liquid culture, and on solid agar plates. As expected, the results show that liquid medium enables more phage infections compared to solid; this is traditionally associated with the higher mobility enabled by the liquid. However, cases where a phage was able to infect its host in solid, but not in liquid, were observed as well. Finally, by analyzing genomic differences between the phages in the experiment we were able to discern several genetic features that correlate with the observed phenotype. Further exploration of these genetic features are the basis for a constructing a model for characterizing the media‐range for phage infection.

Whole genome sequencing of carbapenem-resistant Klebsiella pneumoniae: evolutionary analysis for outbreak investigation.

Aim: Carbapenemase-resistant Enterobacteriaceae represents a major concern in hospital setting. Materials & methods: The evolutionary history of carbapenem-resistant Klebsiella pneumonia strains was analyzed by core genome multilocus sequence typing and Bayesian phylogenesis by whole genomes sequencing. Results: A great increase carbapenem-resistant K.pneumoniae causing blood stream infection was observed in the years 2015-2016. At multilocus sequence typing (MLST), they were prevalently ST512 and ST101. ST512 were core genome (cg)MLST 53, while ST101 mainly cgMLST453. The minimum-spanning tree, based on cgMLST, showed strains clustering based on the different STs. By Bayesian phylogenetic analysis, maximum clade credibility tree showed that strains were introduced in the year 2005 with the most probable location in the ICU ward. Two outbreaks by ST101 and ST512 strains with Tower T8 as the probable location were evidenced. Conclusion: Molecular epidemiology is a powerful tool to track the way of transmission of resistant bacteria within the hospital setting.

Synovial Fluid Mediated Aggregation of Clinical Strains of Four Enterobacterial Species.

Septic arthritis and prosthetic joint infection (PJI) are conditions commonly associated with Gram-positive cocci, however, a drastic increase in cases derived from enterobacterial species has been observed. Recently it has been reported by multiple groups that staphylococci rapidly form free-floating aggregates in the presence of synovial fluid. These aggregates are comparatively more resistant to antimicrobial challenge than their planktonic counterparts, and thus may play a role in the pathogenesis of joint infection. While staphylococcal aggregates have been the primary focus of interest in the field, it is unclear just how widespread synovial fluid mediated aggregation (SFMA) is in Gram negative enterobacteria (GNE). Through this work we have evaluated SFMA in clinical GNE isolated from PJIs. Two PJI clinical strains each of Enterobacter cloacae, Escherichia coli, Klebsiella pneumonia and Proteus mirabilis strains representing a range of antibiotic susceptibilities were exposed to 10% bovine synovial fluid supernatant (BSF) using a relatively simple, quick semi-quantitative method using an imaging plate reader. BSF stimulated aggregation within 0.5h both strains of E. cloacae and P. mirabilis and one strain of E.coli. In one strain of P. mirabilis and E.coli, the size of the aggregates significantly increased from 0.5 to 2h exposure. In contrast, neither K. pneumoniae strain aggregated in BSF. These preliminary findings show that aggregation can occur quickly in GNE, but the extent appears strain and species specific. Further work is required to assess the impact of SFMA on antibiotic tolerance, host innate immunity and the establishment of biofilms.

A silent outbreak due to Klebsiella pneumoniae that co-produced NDM-1 and OXA-48 carbapenemases, and infection control measures.

Objective(s):Infections due to carbapenemase-producing Klebsiella pneumoniae are associated with high morbidity and mortality. In this study, we report a hospital outbreak due to co-producing OXA-48 and NDM-1 K. pneumoniae clone. The aim of the study is to investigate the clonal relationship of strains, risk factors of outbreak and infection control measures.Materials and Methods:Once an outbreak was suspected at the end of December 2017 in our intensive care unit (ICU), carbapenem resistance K. pneumoniae identified in patients’ specimens. An outbreak analysis was begun to determine the risk factors and dissemination of the cases. A case-control study was conducted to determine the risk factors. To control the outbreak; tight contact prevention, good clean-up the medical devices and hospital environment, were done. Staff training programs such as hand hygiene, disinfection, wearing aprons, good cleaning were created. Carbapenem resistance genes determined by PCR. Clonal relationships of strains investigated by PFGE.Results:We investigate 21 carbapenem-resistant K. pneumonia strains. Nine of them were found co-produced NDM-1 and OXA-48, 11 strains produced OXA-48, and one strain produced NDM-1. Seven strains of co-producing NDM-1 and OXA-48 were found clonally related with PFGE. We could not determine any risk factor except rectal colonization in the case-control study.Conclusion:The interventions that successfully controlled this outbreak were hand hygiene, tight contact prevention, good clean-up of the hospital environment and medical devices. As a result, we believe that it would be beneficial to take infection control measures to prevent the spread of these strains to the community and hospital settings.

Antimicrobial effect of different types of honey derived from Iraqi flora on clinical strains of Proteus mirabilis, Proteus vulgaris and Klebsiella pneumonia

Antimicrobial effect of different types of honey derived from Iraqi flora on clinical strains of Proteus mirabilis, Proteus vulgaris and Klebsiella pneumonia

ANTIBIOTIC RESISTANCE OF THE NASOPHARYNX MICROBIOTA IN PATIENTS WITH INFLAMMATORY PROCESSES

The aim: To study the species composition of microorganisms isolated from patients with inflammatory processes of different localization and to monitor the sensitivity of isolated microorganisms to the most commonly used antibiotics. Materials and methods: During 2017-2019, we examined 517 patients with acute inflammatory processes of the nasopharynx. To establish the etiological structure of pathogens of inflammatory processes, a microbiological study of nasopharyngeal washes was carried out using classical methods of isolation and identification of microorganisms. The sampling of the test material from patients was performed during the first visit to a doctor, before the appointment and implementation of etiopathogenetic therapy. To study the sensitivity of isolated microorganisms to antibacterial drugs, we used the method of paper disks (manufactured by "Pharmaktiv" Ltd. (Kyiv, Ukraine) and Himedia (India). Results and conclusions:The microflora of the mucous membranes of the nose and throat in patients with acute inflammatory processes of the nasopharynx is represented mainly by monoisolates of staphylococci and streptococci. The sensitivity of isolated microorganisms to antibiotics varied between different types of microorganisms and between different antibiotics.Cefazolin showed efficacy against all types of microorganisms. K. pneumonia strains showed the highest antibiotic resistance. Among the gram-positive cocci, 18 strains (4.2%) resistant to all antibiotics were isolated, which can be regarded as the circulation of hospital strains outside the medical institutions.

Synthesis, spectroscopic, structural and antimicrobial studies of a dimeric complex of copper(II) with trichloroacetic acid and metronidazole

In this work, we report the synthesis and characterization of a novel dimeric complex Cu2(μ-TCA)2(TCA)2(MET)4 [where TCA = trichloroacetic acid; MET = metronidazole]. The reaction was carried out at room temperature to obtain a blue crystalline compound. The complex was characterized by elemental analysis, electronic spectroscopy, FT-IR, High-Field EPR and X-ray crystallography. The complex crystallized in the triclinic system with a = 11.3749(6), b = 11.8752(7), c = 12.3307(7) Å, and space group P–1. Each Cu centre in the complex is in a square pyramidal environment. High-Field EPR investigations, combined with DFT calculations, revealed very weak interactions between the Cu2+ ions in the centrosymmetric dimer. The biological potency of the complex has been tested by using bacterial strains, Escherichia coli, Salmonella typhi, Klebsiella pneumonia, Micrococcus luteus, Staphylococcus aureus and yeast Candida albicans strain and compared with metronidazole and trichloroacetic acid. In vitro antibacterial activities of the complex and the parent ligands were examined using agar diffusion method. The newly synthesized copper complex showed some antibacterial activity against some strains compared to each parent ligands used. Moreover, a significant inhibition was observed in the action of the copper complex against yeast Candida albicans.

Staphylococcus aureus Pneumonia: Preceding Influenza Infection Paves the Way for Low-Virulent Strains.

Staphylococcus aureus is a facultative pathogenic bacterium that colonizes the nasopharyngeal area of healthy individuals, but can also induce severe infection, such as pneumonia. Pneumonia caused by mono- or superinfected S. aureus leads to high mortality rates. To establish an infection, S. aureus disposes of a wide variety of virulence factors, which can vary between clinical isolates. Our study aimed to characterize pneumonia isolates for their virulent capacity. For this, we analyzed isolates from colonization, pneumonia due to S. aureus, and pneumonia due to S. aureus/influenza virus co-infection. A total of 70 strains were analyzed for their virulence genes and the host–pathogen interaction was analyzed through functional assays in cell culture systems. Strains from pneumonia due to S. aureus mono-infection showed enhanced invasion and cytotoxicity against professional phagocytes than colonizing and co-infecting strains. This corresponded to the high presence of cytotoxic components in pneumonia strains. By contrast, strains obtained from co-infection did not exhibit these virulence characteristics and resembled strains from colonization, although they caused the highest mortality rate in patients. Taken together, our results underline the requirement of invasion and toxins to cause pneumonia due to S. aureus mono-infection, whereas in co-infection even low-virulent strains can severely aggravate pneumonia.

Diversity and frequency of resistance and virulence genes in bla KPC and bla NDM co-producing Klebsiella pneumoniae strains from China.

BackgroundEmergence of blaKPC and blaNDM co-producing Klebsiella pneumoniae strains have led to the limited therapeutic options for clinical treatment. Understanding the diversity and frequency of resistance and virulence genes of these isolates is of great significance.PurposeThe aim of this study is to research the diversity and frequency of resistance and virulence genes in the blaKPC and blaNDM co-producing Klebsiella pneumoniae strains.Methods and ResultsIn this study, 117 K. pneumonia strains were isolated from China, and among of which, 24 were found to be blaKPC and blaNDM co-producing with significant resistance against almost all the commonly used antibiotics. Additionally, 4 strains were hypermucoviscous and 8 showed high serum resistance. Overall, blaSHV, blaCTX-M, tetA and sul1 resistance genes found in 100% of the isolates, followed by blaTEM (95.8%), oqxA/B (91.7%), qnrB (87.5%), aac(6’)Ib-cr (83.3%), blaDHA (79.2%), rmtB (66.7%), qnrS (54.2%), cat(54.2%), floR (50.0%), sul2 (45.8%) cmlA (20.8%)andblaCMY (8.33%), respectively. What’ more, seven blaCTX-M subtypes [blaCTX-M-14 (n=18), blaCTX-M-3(n=11), blaCTX-M-65 (n=4), blaCTX-M-15 (n=3), blaCTX-M-28 (n=2), blaCTX-M-55 (n=2), blaCTX-M-22 (n=1)] and six blaSHV subtypes [blaSHV-12(n=16), blaSHV-11 (n=4), blaSHV-2a(n=1), blaSHV-1(n=1), blaSHV-38(n=1) and blaSHV-28(n=1)] were detected. The frequency of virulence genes was as follows: 100% for entB, ybtS and irp, 95.8% for mrkD, 91.66% for fimH, 79.2% for iutA, 62.5% for iroBCDE, aerobactin and kfu, 66.7% for allS, 45.8% for wcaG, 37.5% for rmpA, 20.8% for pagO and 16.7% for magA.ConclusionFrom this study, we concluded that the blaKPC and blaNDM co-producing Klebsiella pneumoniae strains have a high diversity and frequency of resistance and virulence genes. This study may offer hospitals important information about the control of infections caused by blaKPC and blaNDM co-producing Klebsiella pneumoniae.

Detection OF β- lactamase genes in clinical Klebsiella pneumonia strains isolated from hilla hospitals

This study aimed for isolation and identification of Klebsiella pneumonia, from clinical sample and from different hospitals in Hilla city. during the period from April to October 2017. 122/1056 (12%) isolates were belonged to Klebsiella pneumonia were collected. Growth on blood agar, MacConkey agar and Eosin methylene blue agar was identified by cultural, morphological and biochemical tests and confirmed by VITEK 2 system. The results showed that all the tested isolates were resistant to Ampicillin and Amoxicillin 122(100%), while 119(98%) for penicillin, whereas 100(82%) for piperacillin. Resistance to other drug classes varied among the isolates, a higher resistance was also detected with 95(78 %) to cefotaxime 99(81%) ceftazidime, 94(77%) to ceftriaxone and 92(75%) to ceftriaxone, The resistance to quinolones, nalidixic acid, ciprofloxacin and levofloxacin was detected 57(47%), 39(32%), 35(29%), respectively.majority of isolates 42 (34.4%) were obtained from sputum samples this result, 34 (27.8%) from urine, 17 (14 %) from stool, 15 (12.2 %) from burn, 8 ( 6.6 %) from vagina, 4 (3.3%) from wound, 1 (0.8%) from blood, 1 (0.8%) from ear and 0 (0 %) from both eye and throat. High prevalence rate for MDR, XDR and PDR in Merjan Teaching Hospital. The proportion of the patients from Merjan Teaching Hospital 27 (35.5%), 16 (44.4%) and 1 (50%) respectively. Detection of β - lactamase genes (blaCTX-M-9, blaCTX-M-10, and blaNDM-1) was performed by the conventional PCR technique. The results revealed that 36 isolates analyzed, blaCTX-M-9 12 (33.3%), blaCTX-M-10 14 (38.9%), and blaNDM-1 (0%).

Study on the distribution of pathogenic bacteria in chronic bacterial prostatitis and the mechanism of prostatic inflammation, vascular cell adhesion molecule-1 and vasoactive intestinal peptide expression

Objective To investigate the distribution of pathogenic bacteria in chronic bacterial prostatitis, the inflammatory mechanism of prostatic fluid, the expression of vascular cell adhesion molecule-1 (VCAM-1) and vasoactive intestinal peptide (VIP). Methods A total of 412 chronic bacterial prostatitis (CBP) patients who were admitted to the hospital in January 2012-2017 December were selected as the research group, and the other 120 in the December January 2012-2017 were selected as the control group. The distribution and drug resistance of pathogenic bacteria in CBP patients and the expression of two groups of inflammatory factors, VCAM-1 and VIP were analyzed. Results The 412 cases of CBP were isolated from 368 bacterial strains, including 212 strains of gram positive bacteria, 144 strains of gram negative bacteria, 12 strains of fungi; gram positive bacteria, mainly for 92 strains of Staphylococcus aureus accounted for 25.00%, 60 strains of Staphylococcus haemolyticus accounted for 16.30%; gram negative bacteria, mainly for 68 strains of Escherichia coli accounted for 18.48%, 48 strains of Klebsiella pneumonia accounted for 13.04%. Among the main Gram-positive bacteria, the high resistance rate of Staphylococcus aureus to penicillin was 78.26%, and the high rate of erythromycin resistant Staphylococcus was 80.00%. Among the main gram negative bacteria, Escherichia coli had higher resistance rates to ampicillin and ceftazidime, accounting for 88.24% and 76.47% respectively, and Klebsiella pneumoniae had a higher resistance rate to cefepime and ampicillin, accounting for 83.33% and 75.00% respectively. The levels of IL-8 [(4.72±1.27) μg/L], IL-10 [(159.84±24.36) ng/L] and TNF-α [(65.41±8.97) ng/L] in prostatic fluid of the study group were higher than those of the control group [(1.39±0.42) μg/L, (84.21±12.39) ng/L] and[ (10.20±1.42) ng/L], with significant differences (t=28.260, 32.782, P<0.05). The levels of VCAM-1 [(84.21±16.59) μg/L] and VIP [(46.32±8.24) ng/L] in prostatic fluid of the study group were higher than those of the control group [(46.13±8.35) μg/L] and [(23.81±3.46) ng/L], with significant difference (t=24.377, 29.170, P<0.05). Conclusion Gram positive bacteria were the main pathogens in CBP patients. There were obvious inflammatory reactions, and VCAM-1 and VIP were highly expressed. They should be rationally applied according to drug resistance. Key words: Chronic bacterial prostatitis; Pathogenic bacteria; Inflammatory mechanism; Vascular cell adhesion molecule-1; Vasoactive intestinal peptide

Degradable antimicrobial polycarbonates with unexpected activity and selectivity for treating multidrug-resistant Klebsiella pneumoniae lung infection in mice

Multidrug resistant (MDR) Klebsiella pneumoniae is a major cause of healthcare-associated infections around the world, with attendant high rates of morbidity and mortality. Progressive reduction in potency of antibiotics capable of treating MDR K. pneumoniae infections – including lung infection – as a consequence of escalating drug resistance provides the motivation to develop drug candidates targeting MDR K. pneumoniae. We recently reported degradable broad-spectrum antimicrobial guanidinium-functionalized polycarbonates with unique antimicrobial mechanism – membrane translocation followed by precipitation of cytosolic materials. These polymers exhibited high potency against bacteria with negligible toxicity. The polymer with ethyl spacer between the quanidinium group and the polymer backbone (pEt_20) showed excellent in vivo efficacy for treating MDR K. pneumoniae-caused peritonitis in mice. In this study, the structures of the polymers were optimized for the treatment of MDR Klebsiella pneumoniae lung infection. Specifically, in vitro antimicrobial activity and selectivity of guanidinium-functionalized polycarbonates containing the same number of guanidinium groups but of a shorter chain length and a structural analogue containing a thiouronium moiety as the pendent cationic group were evaluated. The polymers with optimal compositions and varying hydrophobicity were assessed against 25 clinically isolated K. pneumonia strains for antimicrobial activity and killing kinetics. The results showed that the polymers killed the bacteria more efficiently than clinically used antibiotics, and repeated use of the polymers did not cause drug resistance in K. pneumonia. Particularly, the polymer with butyl spacer (pBut_20) self-assembled into micelles at high concentrations, where the hydrophobic component was shielded in the micellar core, preventing interacting with mammalian cells. A subtle change in the hydrophobicity increased the antimicrobial activity while reducing in vivo toxicity. The in vivo efficacy studies showed that pBut_20 alleviated K. pneumonia lung infection without inducing damage to major organs. Taken together, pBut_20 is promising for treating MDR Klebsiella pneumoniae lung infection in vivo. Statement of SignificanceMultidrug resistant (MDR) Klebsiella pneumoniae is a major cause of healthcare-associated infections, with attendant high rates of morbidity and mortality. The progressive reduction in antibiotics capable of treating MDR K. pneumoniae infections – including lung infection – as a consequence of escalating drug resistance rates provides the motivation to develop drug candidates. In this study, we report a degradable guanidinium-functionalized polycarbonate with unexpected antimicrobial activity and selectivity towards MDR Klebsiella pneumoniae. A subtle change in polymer hydrophobicity increases antimicrobial activity while reducing in vivo toxicity due to self-assembly at high concentrations. The polymer with optimal composition alleviates Klebsiella pneumonia lung infection without inducing damage to major organs. The polymer is promising for treating MDR Klebsiella pneumoniae lung infection in vivo.

Etiological structure and antibiotic resistance of the nosocomial strains of microorganisms in the department of anaesthesiology and resuscitation

Due to the formation and wide spread of strains of microorganisms that are multiresistant to modern antimicrobial drugs, the problem of healthcare associated infections (HAIs) is relevant for all healthcare organizations. Most often HAIs are related to intravascular catheter use, mechanical ventilation, bladder catheterization, surgery and enteral feeding. Knowledge of the etiological structure of the nosocomial strains of microorganisms, regular microbiological monitoring, monitoring of antibiotic resistance are necessary to control HAIs and timely implementation of sanitary and anti-epidemic measures. The purpose of the study is to analysis of the etiological structure and determination of antibiotic resistance of the nosocomial strains isolated from patients and environmental objects in the Department of anesthesiology and resuscitation № 1 of City Clinical Hospital № 7. Materials and methods . We used conventional microbiological methods for isolating a pure culture of the pathogen with determining the sensitivity to antibiotics by the diffusimetric method (Kirby-Bauer), including the presence methicillin resistance of staphylococcal strains and extended-spectrum β-lactamases. Results and conclusion . Multiresistant strains of Acinetobacter baumannii, Proteus mirabilis and Klebsiella pneumonia were isolated in the department of anesthesiology and resuscitation. It will allow to conduct adequate antibiotic therapy, and as a result, reduce the incidence of complications, the risk of death and substantial economic losses.