Predominant Isolates Research Articles

Antimicrobial resistance and ESBL profile of Uropathogens among pregnant women at Edna Adan Hospital, Hargeisa, Somaliland.

The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum β-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland. Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30µg) and Cefotaxime (30µg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test. Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p<0.05). Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input.

English

The most common complication in open fractures is infection, which often escalates to sepsis, osteomyelitis, and amputations. The use of prophylactic antibiotics is one of the most effective strategies to prevent infection. The prevailing bacterial isolate patterns must guide the choice of antibiotics for both prophylactic and empiric therapy. This study aims to describe the bacterial isolate profiles in infected open fractures. A prospective cross-sectional study was carried out at Kenyatta National Hospital, Kenya, between October 2019 and January 2020. 66 infected open fractures were identified and pus swabs/infected tissue specimens taken for bacterial cultures. Other data were collected from patient interviews and their hospital records. Results revealed that the culture growth rate was 79%. Gram-negative isolates accounted for 73% while Gram-positive isolates were 27%. The most pre-dominant bacterial isolate was Pseudomonas aeruginosa (34%), followed by Staphylococcus aureus (27%), Escherichia coli (20%), Proteus mirabilis (16%) and Klebsiella pneumoniae (3%). There were more gram-negative than gram-positive bacterial isolates. The pre-dominant bacterial isolate was P. aeruginosa followed by S. aureus. The higher proportion of gram negative isolates is in variance with what is widely documented in the literature. The selection of antibiotics for both prophylaxis and empiric therapy should be tailored to the local patterns of bacterial isolates. &nbsp; Key words: Bacteria isolates profile infected open fractures.

Heavy Metal Tolerance Trend in Extended-Spectrum β-Lactamase Encoding Strains Recovered from Food Samples.

This study evaluates bacteriological profiles in ready-to-eat (RTE) foods and assesses antibiotic resistance, extended-spectrum β-lactamase (ESBL) production by gram-negative bacteria, and heavy metal tolerance. In total, 436 retail food samples were collected and cultured. The isolates were screened for ESBL production and molecular detection of ESBL-encoding genes. Furthermore, all isolates were evaluated for heavy metal tolerance. From 352 culture-positive samples, 406 g-negative bacteria were identified. Raw food samples were more often contaminated than refined food (84.71% vs. 76.32%). The predominant isolates were Klebsiella pneumoniae (n = 76), Enterobacter cloacae (n = 58), and Escherichia coli (n = 56). Overall, the percentage of ESBL producers was higher in raw food samples, although higher occurrences of ESBL-producing E. coli (p = 0.01) and Pseudomonas aeruginosa (p = 0.02) were observed in processed food samples. However, the prevalence of ESBL-producing Citrobacter freundii in raw food samples was high (p = 0.03). Among the isolates, 55% were blaCTX-M, 26% were blaSHV, and 19% were blaTEM. Notably, heavy metal resistance was highly prevalent in ESBL producers. These findings demonstrate that retail food samples are exposed to contaminants including antibiotics and heavy metals, endangering consumers.

Bacterial Profile and Antimicrobial Resistance Patterns of Infected Diabetic Foot Ulcers in Iran: A Systematic Review and Meta-Analysis of Cross-Sectional Studies.

Since infectious foot ulcers represent one of the major causes of lower-limb amputation, it calls for an appropriate action for early detection and sufficient treatment of diabetic foot infection (DFI). The present study aimed at investigating the bacterial epidemiology and antimicrobial resistance (AMR) patterns of DFIs in Iran. We have conducted a systematic search in PubMed, Embase, Web of Science, Scopus, Google Scholar, and Scientific Information Database to identify all articles reporting the proportion of different kinds of bacteria isolated from Iranian DFI samples. Quality was assessed using Joanna Briggs Institute tool. A pooled estimate of proportion with a corresponding 95% confidence interval (95% CI) was calculated using the random effect method. Fifteen studies were eligible, of which 1970 bacterial isolates were obtained from 1316 patients. The most predominant isolates recovered from DFIs was Staphylococcus aureus with a pooled proportion of 24.29% (95% CI: 20.25%, 28.57%) from which 55% (95% CI: 38%, 72%) were methicillin-resistant S. aureus (MRSA). Among Gram-negative strains, Escherichia coli had the highest proportion (17.19%; 95% CI: 13.96%, 20.68%) followed by Pseudomonas aeruginosa, 7.54% (95% CI: 4.56%, 11.14%). The highest pooled estimates of resistance against cotrimoxazole and ciprofloxacin were found in S. aureus 66% (95% CI: 48%, 82%) and E coli isolates 68% (95% CI: 51%, 84%), respectively. Our study revealed that AMR is at a high level in Iran and clinicians should be aware of bacterial resistance patterns to prescribe appropriate antibiotic regimens.

Study of Aerobic Bacterial Etiology and Their Antibiogram from Pus Samples in a Tertiary Care Hospital

Introduction: The spread of multidrug resistant bacteria has added a new angel to the problem of wound infections which are a major cause of morbidity. To avoid difficulty in treatment of such infections it is mandatory for every pus sample to undergo Culture and sensitivity. Aim: To isolate and study the antibiogram of the aerobic bacteria from pus samples. Materials and Methods: A total of 426 pus samples received from various wards in the Microbiology department. Andhra Medical College, Visakhapatnam were processed as per standard guidelines in the laboratory. All the aerobic bacterial isolates obtained were kept for antibiogram by Kirby Bauer’s disc diffusion method as per CLSI Guidelines. Results: Out of 426 samples 394 (92.4%) were culture positive. Among culture positive samples 90.6% were pure cultures and 9.4% were mixed isolates. Gram negative bacilli were 72.8% of the total isolates and 27.2% were Gram positive cocci. Escherichia coli and Klebsiella pneumonia were the predominant isolates (30.3% and 28.9%) followed by Pseudomonas aeruginosa (24%), Proteus species (9.7%) and Acinetobacter species (6.9%). Among Gram positive cocci Staphylococcus aureus (62.6%), Enterococci (20.5%) and Coagulase Negative Staphylococcus (11.2%) and Streptococci (3.7%). GNB were more sensitive to Colistin (92%), Amikacin (86%), Imipenem and Meropenem (86% and 84.4%), Piperacillin Tazobactam (84%), Gentamycin (78%), Cefaperazone Sulbactam (76.2%) and Ciprofloxacin (56%). Gram positive cocci were sensitive to Linezolid and Teicoplanin (98% each), Vancomycin (96.2%), Clindamycin (84%), Gentamycin (79%), Azithromycin (76.4%), Ciprofloxacin (66%) and Amoxiclav (54%) out of 62.6% Staphylococcus aureus isolates 31.4% were MRSA and out of 72.8% of Gram negative bacilli 38.2% were ESBLS. Conclusion: As multidrug resistant bacterial strains are emerging in various infectious and pyogenic wound infection is most important cause of morbidity, it is important for a clinician to send all pus samples for microbiological analysis and their antibiogram before putting cases on antibiotics. Keywords: Pus samples, Multidrug resistance, Gram negative bacilli, Gram positive cocci, Antimicrobial sensitivity.

Prevalence of keratinophilic fungi in the garden soil samples in Western India and study of its clinical impact

Dermatophytosis has been a common contagious disease and remain an important public health problem among people worldwide and particularly in developing countries. This study was done in order to know prevalence of keratinophilic fungi in the soil samples of Ajmer region and its clinical correlation. Five samples (5gm each) of garden soil were collected from each of the randomly selected 10 sites of Ajmer region in sterile polythene bags &amp; pH of soil was recorded. All samples were processed in the laboratory using hair bait technique and incubated at 28 + 2◦C for 3-4 weeks. Fungi grown were subcultured onto Sabourauds Dextrose Agar (SDA) with chloramphenicol &amp; SDA with cycloheximide and identified using standard mycological procedures. Out of 50 soil samples cultured 28 (56%) samples were positive for keratinophilic fungi. 64.28% were dermatophytes and 12.8% were non-dermatophytic fungi. The predominant isolate among dermatophytes was spp. (64.28%) where as spp. (12.8%) was the commonest non-dermatophyte. : In our hospital, dermatophytic infection including Tinea corporis is one of the most common clinical presentations of skin infection. is commonest causative agent of Tinea corporis. Interestingly was the most commonly isolated dermatophyte in our study suggesting soil as a source of dermatophytic infections.

Detection of Aflatoxigenic Fungi in Poultry Feed

Mycotoxins are poisonous biomolecules produced as secondary metabolites by some fungal species, as they grow on various substrates under suitable growth conditions. Approximately, 83% of these deaths occur in East Asia and sub-Saharan Africa. It has been estimated that more than five billion people in developing countries are at risk of chronic exposure to aflatoxins, through contaminated foods/feeds Several studies of revealed that A. flavus and A. parasiticus are of significant concern in poultry contamination, being the most common producers of aflatoxins. In the current study, a total of 120 samples of poultry feeds were collected from different localities of Beni-Suef Governorate. The samples were examined for the existence of Aspergillus species. Moreover, the capacity to produce aflatoxins by the Aspergillus flavus was determined. The results revealed that the most predominant Aspergillus isolates was A. flavus (n= 75; 62.5%) followed by A. niger (n= 31; 25.9%) and A. fumigatus (n= 19; 15.8%). Out of 75 A. flavus isolates, 43 strains (57.3%) produced aflatoxins. These results concluded the potential exists for the production of mycotoxins by the Aspergillus flavus. The present study was designed to investigate the existence of Aspergillus species in poultry feed as well as determining the capacity of Aspergillus flavus isolates to produce aflatoxins.

Prevalence, Clinical Characteristics and Changes of Antibiotic Resistance in Children with Nontyphoidal Salmonella Infections from 2009-2018 in Chongqing, China.

PurposeNontyphoidal Salmonella (NTS) is a leading bacterial cause for acute gastroenteritis in children. With the increasing use of antibiotics worldwide, antibiotic resistance has become a global problem. However, data on NTS infections and changes in antibiotic resistance among children remain limited in China. We aimed to characterize the prevalence, clinical feature, serotype and the changes of antibiotic resistance of NTS in children in Chongqing.Methods501 hospitalized children with NTS infections (confirmed by positive NTS culture) in Children’s Hospital of Chongqing Medical University from January 2009 to December 2018 were included. The clinical data and drug sensitivity test results were retrospectively reviewed and analyzed. Antibiotic resistance in NTS infections was compared between 2009–2013 and 2014–2018.ResultsA total of 501 isolates were detected. Most NTS infections occurred in children under three years old, which mainly occurred between July and October. The numbers of patients with diarrhea, fever, and vomiting were 472 (94.2%), 422 (84.2%) and 146 (29.1%), respectively. Serogroup B (67.5%) was the predominant serogroup isolates. And Salmonella Typhimurium was the most common serotype (79.2%). The study compared the drug resistance of NTS from 2009 to 2013 with that from 2014 to 2018. We found the drug resistance rates of NTS to cefazolin, cefotaxime, ciprofloxacin, levofloxacin and imipenem showed an upward trend. The drug resistance rates of NTS to chloramphenicol, ampicillin, ceftriaxone, cefepime and compound sulfamethoxazole decreased slightly, but still showed high drug resistance rates. And drug resistance rates of NTS to piperacillin/tazobactam and ceftazidime decreased significantly in the last ten years. Multi-drug resistance (MDR) isolates, were detected among 69 cases (13.7%) of 501 children with NTS infections.ConclusionThe overall antibiotic resistance rates remained at a high level in Chongqing. Continuous surveillance of antibiotic resistance in NTS and control measures such as avoiding unnecessary antibiotic therapy in general NTS gastroenteritis are important. For severe or invasive infections caused by NTS infection in Southwest China, the use of ceftazidime is recommended until antibiotic sensitivity test results are available. And the choice of antibiotics should be based on the curative effect and the antibiotics sensitivity results.

Prevalence of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Ethiopia: A Systematic Review and Meta-Analysis.

Background Antimicrobial resistance especially caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has become a global public health concern. Globally, these isolates have remained the most important causes of several infections and associated mortality. Their rapid spread in Ethiopia is associated with a lack of regular surveillance and antibiotic stewardship programs. Isolates of ESBL-PE from different regions of Ethiopia were searched exhaustively. However, published data regarding the pooled estimate of ESBL-PE are not conducted in Ethiopia. For this reason, we systematically reviewed laboratory-based studies to summarize the overall pooled prevalence of the isolates recovered from various human specimens. Methods An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley Online Library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA follow diagram. Data extraction form was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at 95% confidence interval was performed using Der-Simonian-Laird's random-effects model. Finally, results were presented via text, figures, and tables. Results A comprehensive electronic database literature search has yielded a total of 86 articles. Among the total, 68 original articles were excluded after the review process. A total of 18 studies with 1191 bacterial isolates recovered from 7919 various clinical samples sizes were included for systematic review and meta-analysis. In this study, the pooled prevalence of ESBL-PE was 18% (95% CI: 9–26). Nine out of the total (50%) reviewed articles were studied using the combination disk test. Likewise, E. coli and K. pneumoniae (50% both) were the predominant isolates of ESBL-PE in addition to other isolates such as Salmonella spp. and Shigella spp. Conclusion This meta-analysis has shown a low pooled estimate of ESBL-PE in Ethiopia.

Species identification and antifungal susceptibility testing of Aspergillus strains isolated from patients with otomycosis in northern China

There are limited studies on species distribution and susceptibility profiles of Aspergillus strains isolated from patients with otomycosis in China. A total of 69 confirmed Aspergillus species isolates were obtained from ear swabs of patients diagnosed with otomycosis from 2017 to 2018 in northern China. Identification of these Aspergillus isolates at the species level was performed using conventional morphological methods and MALDI-TOF MS in combination with molecular sequencing, and invitro susceptibility to nine antifungal agents was evaluated using the Sensititre YeastOne system. The Aspergillus section Nigri had the greatest distribution of Aspergillus isolates. A. welwitschiae (n=25) was the most predominant isolate in section Nigri, followed by A. tubingensis (n=12) and A. niger (n=11). Other Aspergillus species were also isolated, including A. terreus (n=11), A. flavus/A. oryzae (n=8), and A. fumigatus (n=2). Amphotericin B, posaconazole, and echinocandins were highly invitro active against all the isolates tested. 2.9% (2/69) of the isolates were resistant to azoles in our study, including one A. niger isolate with a high MIC value for itraconazole (ITR) (16mg/L) and one A. tubingensis isolate cross-resistant to both voriconazole (VOR) (MIC >8mg/L) and ITR (MIC >16mg/L). One A. welwitschiae and one A. niger isolate both had increased MIC values of 4mg/L against VOR. A. welwitschiae was the most prevalent Aspergillus species isolated from patients with otomycosis. Our findings also indicated that the azole-resistant Aspergillus section Nigri should be utilized to guide clinical medication for Otomycosis.

Phenotypic Study on the Bacterial Isolates from Equine with Respiratory Disorders regarding Antimicrobial Drug Resistance

Upper respiratory tract infection and pneumonia in foals are primarily caused by a bacterial infection. Gram-negative bacteria are commonly found in neonatal pneumonia although gram-positive and mixed infections could be accompanied. The current study aimed to detect the different pathogens causing respiratory disorders in the equine, describe the antimicrobial resistance in these pathogens, and determine the types of antimicrobial isolates. A total of 203 different samples were collected from 42 horse foals, 5 adult horses, and 4 donkey foals from June 2019 to April 2020. All samples were subjected to bacteriology analysis and isolated bacteria were analyzed using susceptibility test for different antibacterial agents. The findings indicated that 38 (74.5%) animals were positive for the isolation of bacteria causing respiratory disorders. The most predominant isolates were Klebsiella pneumoniae subsp. Pneumoniae followed by Staphylococcus aureus, Streptococcus equi, Pseudomonas aeruginosa, Streptococcus zooepidemicus, Proteus mirabilis, Rhodococcus equi, Stenotrophomonas maltophilia, and Streptococcus mitis. Stenotrophomonas maltophilia is isolated from all organs, including the lungs. All K. pneumoniae isolates were sensitive to lomefloxacin, cefotaxime, meropenem, enrofloxacin, neomycin, and chloramphenicol. The Pseudomonas aerugenosa (P. aeruginosa) is sensitive to aztreonam and 20% of isolates sensitive to Piperacillin-tazobactam. All Proteus mirabilis were sensitive to ampicillin-sulbactam, piperacillin-tazobactam, and cefoperazone. Stenotrophomonas maltophilia was only sensitive to oxytetracycline and lomefloxacin. Staphylococcus aureus was susceptible to Piperacillin-tazobactam (50%), 25% to lomefloxacin; Streptococcus equi were sensitive to vancomycin 33.3% while 16.7% to erythromycin and doxycycline, Streptococcus zooepidemicus (100%) were sensitive to cefotaxime, meropenem, and doxycycline. All isolates of Enterococcus species were sensitive to penicillin, piperacillin-tazobactam, and lomefloxacin. Moreover, Rhodococcus equi (one isolate) was only sensitive to clarithromycin. The antimicrobial susceptibility test illustrated the presence of multidrug-resistant and pan-drug resistant isolates which proved the indiscriminate and extensive use of antibiotics. In conclusion, resistance monitoring data and risk assessment identified several direct and/or indirect predisposing factors to be potentially associated with MDR development in the equine health sector of Egypt. The predisposing factors may be attributed to insufficient veterinary healthcare, monitoring, and regulatory services, in addition to the intervention of animal health service providers, and/ or farmers’ lack of knowledge about drugs. The misuse and overuse of antibiotics have led to the evolution of antibiotic-resistant bacteria in equine in Egypt.

English

BACKGROUND Urinary tract Infection (UTI) are the most common clinical conditions in general practice and gynaecological department. Men and women of all age groups are affected by UTI, but its overall prevalence is higher in women. The major causative agents are Escherichia coli and other Enterobacteriaceae. In majority of the cases, empirically treatment is started with antimicrobials before the urine culture and sensitivity reports become available. This has led to an increase in antibiotic resistance in urinary pathogens. Hence, the present study was undertaken to determine the antimicrobial susceptibility pattern of uropathogens to commonly used antimicrobials in treating UTIs. METHODS A total of 200 urine samples were obtained from patients with signs and symptoms suggestive of UTIs attending Bapuji and Chigateri General Hospital which are attached to Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davangere for a period of 3 months that is from May 2016 to July 2016. Urine samples were processed within 2 hours of reaching the laboratory. Semi quantitative urine culture was done. Isolation and identification were done by performing standard biochemical tests and the antimicrobial susceptibility testing was done using the standard disc diffusion method by Kirby-Bauer technique. RESULTS There were 170 urinary isolates from 200 samples. Children less than 10 years were more affected 54 (27 %). Female patients were more, 119 (59.5 %) compared to males 81 (40.5 %). Escherichia coli was the most predominant isolate, 71 (41.8 %) followed by Enterococcus species 22 (1.9 %). Organisms were resistant to commonly used antibiotics i.e., cotrimoxazole, ciprofloxacin, norfloxacin and amoxicillin. Both gram negative and gram-positive isolates were sensitive to amikacin and nitrofurantoin. CONCLUSIONS In present study Escherichia coli is the predominant pathogen. Uncomplicated UTIs can be empirically treated by nitrofurantoin. Occurrence of treatment failure with commonly used antimicrobials is more often in Indian setting. Hence, antimicrobial susceptibility testing must be employed routinely. KEY WORDS UTIs, Uropathogens, E. coli, Antimicrobial Susceptibility Pattern

Isolation and Identification of Staphylococci and Pseudomonas from Diabetic Foot Ulcer in Perambalur District Hospitals in Tamil Nadu

Diabetic foot ulcers are still a problem for the health care system and are majorly influencing quality of life. Infected foot ulcer is one of the most feared complications of diabetes mellitus, leading to gangrene and it needs to be amputed. Diabetic foot lesions are major medical, social and economic problem and leading cause of hospitalization for patients with diabetes worldwide. The risk of a diabetic patient for developing a foot ulcer was estimated to be ~25%. Samples were collected from 65 infected patients of diabetic foot ulcer male and female. The mean age group was found to be 40-80 years with the clinical history such as age, sex, types of diabetes duration of diabetes, size of ulcer and duration of ulcer were observed and recorded. The Specific mediums were used for the isolation and identification using classical methods based on their morphology, Grams stain reaction, oxidase and catalase tests were performed to confirm the isolates were both gram-negative and gram-positive organisms Bergey’s manual of Determinative Bacteriology. Further, MALDI- TOF (Matrix-Assisted Laser Desorption/Ionization) was used to confirm the isolates identified in classical methods were Staphylococci (79%) and Pseudomonas (21%) In this study Among 68 isolates, identified in out of 41 isolates Pseudomonasaeruginosa (21%) Staphylococcus aureus (54%) Staphylococcus hominis (20%)and Staphylococcous hemolytic(5%). Although in gram positive organism Staphylococcus aureus (54%) was the most predominant isolate found in diabetic foot ulcer.

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

BackgroundThe existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile.MethodsA cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test.ResultsOut of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers.ConclusionMultidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

Asymptomatic Bacteriuria among Pregnant Women Attending Tertiary Care Hospital in Lucknow, India

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.

Antibiotic Susceptibility Patterns of Bacterial Isolates from Routine Clinical Specimens from Referral Hospitals in Tanzania: A Prospective Hospital-Based Observational Study.

IntroductionAntimicrobial resistance is one of the biggest threats of modern public health. Although sub-Saharan Africa is highly burdened with infectious diseases, current data on antimicrobial resistance are sparse.MethodsA prospective study was conducted between October 2018 and September 2019 to assess the antibiotic susceptibility patterns of clinical bacterial isolates obtained from four referral hospitals in Tanzania. We used standard media and Kirby-Bauer disc diffusion methods as per Clinical and Laboratory Standards Institute (CLSI) standards.ResultsWe processed a total of 2620 specimens of which 388 (14.8%) were culture-positive from patients with a median (IQR) age of 28 (12–44) years. Of the positive cultures, 52.3% (203) were from females. Most collected specimens were ear pus 28.6% (111), urine 24.0% (93), wound pus 20.6% (80), stool 14.9% (58), and blood 8.3% (32). Predominant isolates were S. aureus 28.4% (110), E. coli 15.2% (59), P. aeruginosa 10.6% (41), P. mirabilis 7.0% (27), V. cholerae 01 Ogawa 6.2% (24), Klebsiella spp. 5.2% (20) and Streptococcus spp. 4.6% (18). Generally, the isolates exhibited a high level of resistance to commonly used antibiotics such as Ampicillin, Amoxicillin-Clavulanic acid, Erythromycin, Gentamicin, Tetracycline, Trimethoprim, third-generation Cephalosporins (Ceftriaxone and Ceftazidime), and reserved drugs (Clindamycin and Meropenem). S. aureus isolates were resistant to most of the antibiotics tested; 66.7% were classified as MRSA infections.ConclusionAntibiotic resistance to commonly prescribed antibiotics was alarmingly high. Our findings emphasize the need for comprehensive national control programs to combat antibiotic resistance.

Clinico–mycological correlation of onychomycosis: emphasizing the role of non-dermatophytes in a tertiary care hospital from Karnataka, India

Background: Onychomycosis is a widespread problem in the clinical practice of dermatology, caused by dermatophytes, yeasts, and non-dermatophyte molds. In India, relatively little work has been done on this problem. It is a known fact that the geographical distribution of the fungi may change from time to time. Hence, through this study, an attempt was made to identify the clinical patterns and causative agents of onychomycosis. Methods: This study was conducted on 100 clinically suspected onychomycosis patients. The necessary clinical details were noted with their consent. Nail clippings were collected from the most severely affected parts and were subjected to direct microscopy in 40% potassium hydroxide before being inoculated into Sabouraud’s dextrose agar with and without cycloheximide at 25 °C and 37 °C for up to four weeks. Growth was identified following the standard protocols by assessing the rate of growth, colony character, lactophenol cotton blue mount, slide culture, urease test, germ tube test, etc. Results: Among the 100 patients, the mean age was 40.8 years. The male/female ratio was 1.28:1. Fingernail (49%) involvement was more common than toenail involvement (32%). Distal lateral subungual onychomycosis (52%) comprised the predominant clinical pattern. KOH mount was positive in 46%, while the culture was positive in 44% of patients. The causative agents isolated were non-dermatophyte molds (63.6%), dermatophytes (18.2%), and yeasts (18.2%). Conclusion: This work shows the broad spectrum of causative agents of onychomycosis with non-dermatophyte molds as the predominant isolates.

Microbes on the Mobile Phones of Healthcare Workers in Palestine: Identification, Characterization, and Comparison.

Background Healthcare workers (HCWs) may be using their mobile phones (MPs) to carry microbes that cause hospital-acquired and community infections in general. With antibiotic resistance problem emergence, these infections can be challenging to eradicate. Hence, this study aimed to determine the microbial contamination of HCW MPs and identify and classify bacterial isolates in Palestine. Methods This was a 7-month comparative cross-sectional analysis of 200 HCW MPs from 2 hospitals and 100 MPs from university students (non-HCWs). Data collection was done using a self-administrated questionnaire, and a swab sample from both HCW and non-HCW MPs was obtained and transferred to An-Najah National University (NNU) microbiology lab for bacterial identification and antibiotic susceptibility. Data were analyzed using Social Sciences Statistical Package (SPSS) version 22.0. Result Among HCWs, the microbial contamination was 87.5%. Coagulase-negative staphylococci (CoNS; 67.3%), methicillin-sensitive Staphylococcus aureus (MSSA; 17.5%), Gram-positive bacilli (4.1%), methicillin-resistant Staphylococcus aureus (MRSA; 1.6%), and Gram-negative species (1.6%) were the most predominant bacterial isolates. More than half of staphylococci isolates were resistant to penicillin and erythromycin. Male gender, using a mobile phone in the bathroom, and entry to the operating theatre were associated with mobile phone contamination and increased resistance against specific antibiotics. Among non-HCWs, the contamination was 86%. The most predominant bacterial isolates were CoNS, MSSA, and Gram-positive bacilli, with a contamination of 66.8%, 28.5%, and 2.6%, respectively. No MRSA or Gram-negative species were detected in this group. Antibiotic resistance percentage of staphylococci was nearly half of that yielded in the HCW group against each antibiotic. Conclusion Significant numbers of bacteria have been isolated from HCW MPs. Working in a hospital environment frequently raises the probability of presence of antibiotic-resistant bacteria on a MP. Therefore, infection control teams should discuss methods to prevent the transmission of drug-resistant pathogens from HCW MPs.

Magnitude of Multidrug Resistance among Bacterial Isolates from Surgical Site Infections in Two National Referral Hospitals in Asmara, Eritrea.

Background The World Health Organization has emphasized the importance of understanding the epidemiology of MDR organisms from a local standpoint. Here, we report on a spectrum of bacteria associated with surgical site infections in two referral hospitals in Eritrea and the associated antibiotic susceptibility patterns. Methods This survey was conducted between February and May 2017. A total of 83 patients receiving treatment for various surgical conditions were included. Swabs from infected surgical sites were collected using Levine technique and processed using standard microbiological procedures. In vitro antimicrobial susceptibility testing was performed on Mueller–Hinton Agar by the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. The data were analyzed using SPSS version 20. Results A total of 116 isolates were recovered from 83 patients. In total, 67 (58%) and 49 (42%) of the isolates were Gram-positive and Gram-negative bacteria, respectively. The most common isolates included Citrobacter spp., Klebsiella spp., Escherichia coli, Proteus spp., Pseudomonas aeruginosa, Salmonella spp., Enterobacter spp., and Acinetobacter spp. In contrast, Staphylococcus aureus, CONS, and Streptococcus viridians were the predominant Gram-positive isolates. All the Staphylococcus aureus isolates were resistant to penicillin. MRSA phenotype was observed in 70% of the isolates. Vancomycin, clindamycin, and erythromycin resistance were observed in 60%, 25%, and 25% of the isolates, respectively. Furthermore, a high proportion (91%) of the Gram-negative bacteria were resistant to ampicillin and 100% of the Pseudomonas aeruginosa and Escherichia coli isolates were resistant to >5 of the tested antibiotics. The two Acinetobacter isolates were resistant to >7 antimicrobial agents. We also noted that 4 (60%) of the Klebsiella isolates were resistant to >5 antimicrobial agents. Possible pan-drug-resistant (PDR) strains were also isolated. Conclusion Due to the high frequency of MDR isolates reported in this study, the development and implementation of suitable infection control policies and guidelines is imperative.

Bioremediation of heavy metals from artisanal crude oil refinery (Kpo-Fire) impacted soil using Bacillus flexus and Pseudomonas aeruginosa in Ngie Community, Degema Local Government Area, Rivers State, Nigeria

The existence of heavy metals in “kpo-fire” impacted soil creates significant risks to human health and the ecosystem. In this study, the efficacy of the elimination of heavy metal from “kpo-fire” impacted soil was evaluated using bacterial treatments. The organisms (Bacillus flexus and Pseudomonas aeruginosa) used in the bioremediation setup were isolated from the impacted soil. Heavy metal analysis was carried out using an Atomic Absorption Spectrophotometer. The experimental setup involved the recreation of the contaminated soil sample in three (3) vessels labeled as: Flask A containing 300g of un-amended sample (control) to monitor natural process; Flask B containing 300g of sterilized sample; Flask C containing 300g of sample with Pseudomonas aeruginosa and Bacillus flexus. Soil baseline physicochemical composition was determined to have a pH of 6.18, Temperature of 29.2oC, Total Organic Carbon 7.58 mg/kg and Phosphate concentration 37.56 mg/kg. At the end of the investigation, experimental setup C, containing bacterial inocula was observed to possess the best bio-removal rates for Mercury (99.32%), Cadmium (77.59%), Boron (72.84%) and Arsenic (93.43%) after a 42-day period of study. Also, the concentrations declined from 1.05264mg/kg to 0.00621mg/kg for Mercury; Cadmium declined from 5.93mg/kg to 1.16mg/kg; Boron declined from 3.61mg/kg to 0.82mmg/kg and Arsenic declined from 2.78mg/kg to 0.16mg/kg. Molecular characterization revealed the contaminated soil had predominance of isolates with genomic molecular weight of 1,500 bp and the phylogenetic construct showed the bacterial isolates were Pseudomonas aeruginosa (MT023359), Bacillus flexus (MT023375) and Lysinibacillus macroides (MT023377). Statistical analysis revealed a strong positive correlation between the bacterial biomass and heavy metal removal. The synergistic parts played by bacterial consortia in the bio-removal of heavy metals from the polluted soil have been established and these potentials can be harnessed as a roadmap for eco-recovery of impacted environment in the Niger Delta. Bacillus flexus and Pseudomonas aeruginosa in consortium are efficient in remediation of kpo-fire contaminated soil.