Presence Of Drug-resistant Bacteria Research Articles

In situ fabrication of co-coordinated TCPP-Cur donor-acceptor-type covalent organic framework-like photocatalytic hydrogel for rapid therapy of bacteria-infected wounds

Pathogenic bacterial infection and the presence of drug-resistant bacteria have been threatening the health of human. Phototherapy has attracted increasing attention for treating tissue infections because it is noninvasive and does not lead to drug resistance. Herein, we construct a Cu co-coordinated donor-acceptor type (D-A) covalent organic framework-like (COF-like) and sodium alginate (SA) hydrogel (CTCS hydrogel) with photocatalytic and anti-inflammatory properties for the treatment of wound infection. The COF-like (TCPP-Cur) can be photoexcited with 660 nm light to produce electron-hole pairs that would be separated by donor-acceptor pairs. The co-coordinated Cu can reduce the band gap of TCPP-Cur, increase the separation rate of photogenerated electron-hole pairs, and improve the photocatalytic performance of CTCS hydrogel. Under 660 nm irradiation, the CTCS hydrogel can achieve 99.95% and 98.5% bactericidal activity against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) within 20 min owing to the synergistic interactions of the photothermal and photocatalytic effects. In vivo tests have shown that CTCS hydrogel can reduce the expression of TNF-α and enhance the expression of IL-10 and VEGF to promote wound healing and tissue regeneration. This photocatalytic hydrogel provides a promising strategy for reconstructing bacterially infected tissues rapidly.

Identification and antibiotic susceptibility of microorganisms isolated from diabetic foot ulcers: A pathological aspect.

Diabetic foot ulcers infected with microorganisms increase the risk of amputation. The presence of drug-resistant bacteria in diabetic foot ulcers creates a big challenge during the treatment. The objective of the present study was to determine the bacterial prevalence and antibiotic resistance among bacteria isolated from Chinese patients with diabetic foot ulcers. The present study studied the microbial colonization of diabetic foot ulcers of patients from a single center in China. Wound swabs from 89 patients with diabetic foot ulcers were collected and the presence of microorganisms detected. The isolated microorganisms were subjected to antibiotic susceptibility testing by the disk diffusion method. Of 89 patients, 56 (62.9%) were male and 33 (37.1%) were female, the mean age of patients was 53.2±5.4 years, the mean duration of diabetes was 14.8±2.9 years, the mean random blood sugar was 301±87 mg/dl, mean HbA1c was 7.9±1.4%. Patients with Wanger ulcer grade III (36.0%; P=0.034) and patients within the weight range of 51-75 kg (59.6%; P=0.012) were significantly higher. The prevalence rate of diabetic foot ulcers was 11.3%. Among 153 microorganisms, gram-positive bacteria (52.3%) were more prevalent than gram-negative bacteria (44.4%). Most of the patients with polymicrobial infection were classified to have Wanger III ulcer grade diabetic foot ulcers. Staphylococcus aureus (38.2%) was the most predominant bacteria isolated followed by Staphylococcus epidermidis (29.2%) and Escherichia coli (28.1%). Most of the gram-positive and gram-negative bacteria were resistant to dicloxacillin (73.8%, P=0.021) and cefotaxime (50%), respectively and ~53.4% of the isolates were multi-drug resistance isolates, 61.8% of the Staphylococcus aureus were identified as methicillin-resistant Staphylococcus aureus and 61.8% of the gram-negative bacteria were extended-spectrum β-lactamase producers. Staphylococcus aureus and Escherichia coli were the predominant gram-positive and gram-negative bacteria isolated, respectively. Penicillin resistance was significantly higher among the gram-negative bacteria (P=0.019). Staphylococcus aureus and Escherichia coli were the predominant gram-positive and gram-negative bacteria isolated and levofloxacin and nitrofurantoin were the most effective antibiotics among the gram-positive and gram-negative bacterial isolates, respectively.

Vancomycin Resistance Among Clinical Isolates of Staphylococcus aureus Obtained from Selected Hospitals in Sokoto Metropolis

The decreased vancomycin susceptibility and subsequent emergence of vancomycin resistant Staphylococcus aureus (VRSA) strains is a major public health problem. This study was aimed at detecting the prevalence of vancomycin resistant Staphylococcus aureus among clinical isolates obtained from patients attending Specialist Hospital Sokoto and Maryam Abacha Women and Children Hospital Sokoto. A total of 80 S. aureus clinical isolates were obtained from the medical microbiology laboratories of the selected hospitals. Antibiotic sensitivity testing of the isolates was carried out using the agar dilution method and isolates were screened for vancomycin resistance using vancomycin agar screen method. Of the 80 S. aureus isolates studied, 69 (86.0%) were identified as vancomycin susceptible S. aureus (VSSA) with MIC value of ≤2 µg/ml, 11 (13.8%) were identified as vancomycin intermediate S. aureus (VISA) and had MIC value of 4-8 µg/mL (VISA) and none of the isolates was identified as vancomycin resistant aureus (VRSA). The study detects high prevalence rate of VISA in the study area and identifies the need for increased public awareness on the danger associated with the presence of drug resistant bacteria. Emphasis should be directed at discouraging practices such as the use of over the counter medications which increase the rate of development of drug resistant organisms.

Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria

Rapidly progressing generalized perio­dontitis (RPGP) still remains an extremely important medical problem, despite certain achievements in solving most of the issues of etiology, pathogenesis and treatment. The study included 102 patients with rapidly progressing periodontitis of I-II and II-III degrees of severity, with ineffective and inconsistent results of previous treatment who were examined and treated in the clinic of the Department of Surgical Dentistry, Periodontics and Implantology of the SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine». On the basis of the diagnostic and therapeutic measures carried out, it was established that, in patients with rapidly progressing generalized periodontitis, the formation of various drug sensitivity in periodontopathogenic microorganisms to protocol antibacterial therapy is closely associated with immunological protocol diseases. The presence of drug-resistant bacteria in the periodontal tissues is combined with a more pronounced immunodeficiency in the mechanisms of systemic and local protection than when the lesions are colonized by drug-sensitive periodontal microorganisms. The revealed features of immunity disorders in patients with RPGP with drug-resistant infection to conventional antibiotic therapy are manifested by a decrease in CD3+ lymphocytes, cells with cytostatic activity (CD4+, CD16+) expressing receptors for the activation of lymphocytes CD25+, HLA-DR and apoptosis CD95+), against the background of a slight increase in CD20+, CD116+, CD54+, significant inhibition of the synthesis of SIgA, IgM, α-INF, γ-INF; a pronounced increase in the production of pro-inflammatory cytokines IL-1β and TNF-α. The need for a differentiated approach in the correction of immunological disorders in patients with RPGP depending on the detected sensitivity and resistance of periodontal pathogenic bacteria to the protocol generally accepted antibacterial therapy has been clearly proved; this provides a faster relief of the infectious and inflammatory process (on average on 3.6±0.2 day) in more than 90% of cases, normalization of the parameters of immunological reactivity in 93.3% of the observed and stable clinical remission of the disease.

Retrospective analysis of risk factors for deep infection in lower limb Gustilo\u2013Anderson type III fractures

BackgroundOpen fractures are among the most severe injuries observed in orthopedic patients. Treating open fractures is difficult because such patients with infections may require multiple operations and amputations. Furthermore, only a few studies have focused on antibiotic prophylaxis in open fractures and evaluated how to cover lost soft tissue to increase the success rate of reconstruction. We evaluated the risk factors for deep infection in lower limb Gustilo–Anderson (G–A) type III fractures.Materials and methodsThis retrospective study investigated patients who underwent surgical procedures for lower limb G–A type III fractures between January 2007 and January 2017 at our institution. We enrolled 110 patients with 114 lower limb G–A type III fractures (77 G–A type IIIA fractures and 37 G–A type IIIB fractures) who were followed up for at least 2 years. We compared patients presenting infections with those without infections by assessing the following factors: severe contamination, diabetes, smoking, Injury Severity Scale, segmental fracture, location of fracture, G–A classification, damage control surgery, methods of surgery, timing of fixation, combination of antibiotics used, duration of antibiotic prophylaxis, timing of wound closure, and soft-tissue reconstruction failure.ResultsEighteen fractures presented deep infections. Compared with patients without infections, patients developing infections differed significantly in terms of severe contamination (P < 0.01), G–A classification (P < 0.01), duration of antibiotic prophylaxis (P < 0.01), timing of wound closure (P < 0.01), and incidence of soft-tissue reconstruction failure (P < 0.01). Skin grafting was associated with significantly higher failure rates than muscle and free flap reconstructions (P = 0.04). Treatment with antibiotics was significantly longer in patients with drug-resistant bacterial infections than in those without infections (P < 0.01).ConclusionEarly flaps rather than skin grafting should be used to cover G–A type IIIB fractures, because skin grafting resulted in the highest failure rate among soft-tissue reconstructions in open fractures. Longer duration of antibiotic use had a significant impact not only on deep infection rates but also on the presence of drug-resistant bacteria. These findings suggest that prolonged use of antibiotics should be avoided in cases of open fractures.Level of evidenceLevel IV retrospective observational study.

Occurrence of drug resistant bacteria in household waste samples

Current study was carried out to investigate the presence of drug resistant bacterial isolates in the biodegradable household waste samples. In this respect, a total of six domestic waste samples including three kitchen waste samples and one sample each of home dust, dustbin waste and liquid waste were collected. Samples were analyzed for quantification of bacterial load and along with their drug susceptibility pattern. Huge array of total viable bacteria was present in all the samples (in average of 108 cfu/g or ml). Among the specific bacteria, Bacillus spp. was predominant and Vibrio spp. was found in almost all samples except liquid waste. Presence of Staphylococcus spp., E. coli, Klebsiella spp., Pseudomonas spp., Salmonella spp. and fecal coliform were evident in some samples. All isolates were found to be multidrug resistant. Notably, 100% resistance was documented against cefuroxime and amoxicillin. All the isolates showed sensitivity against meropenem, amikacin and ceftriaxone. Presence of drug resistant bacteria in household waste samples in present study critically raises the requirement for proper management and disposal of the accumulated domestic wastes by the municipal and government authorities.&#x0D; Stamford Journal of Microbiology, Vol.9(1) 2019: 15-18

OPTIMAL DOSING STRATEGIES AGAINST SUSCEPTIBLE AND RESISTANT BACTERIA

Mathematical models can be very useful in determining efficient and successful antibiotic dosing techniques against bacterial infections. There are several challenging issues involved, the presence of drug resistant bacteria being one. Recent rise in antibiotic resistant strains of bacteria is a grave public health hazard, hence there is a need to develop dosing protocols taking into account the presence of these resistant strains. In this study, we consider a model for antibiotic treatment of a bacterial infection where the bacteria are divided into two sub-populations: susceptible and resistant. The mechanism of acquisition of resistance by the susceptible bacteria considered is via the process of conjugation. We find the steady-state solutions under an antibiotic protocol of discrete periodic doses and analyze their stability. We also prove an extension of a result that pertains to the persistence of bacteria. In addition, we perform the bifurcation analysis under this dosing protocol and show that bi-stability exists for the bacterial population. Furthermore, efficient treatment strategies are devised that ensure bacterial elimination while minimizing the quantity of antibiotic used. Such treatments are necessary to decrease the chances of further development of resistance in bacteria and to minimize the overall treatment cost. We consider the cases of varying antibiotic costs, different initial bacterial densities and bacterial attachment to solid surfaces, and obtain the optimal strategies for all the cases. The results show that the optimal treatments ensure disinfection for a wide range of scenarios.

Prevalence of multidrug resistance, extensive drug resistance and pandrug resistance among multiple Gram-negative isolates: experience in a tertiary-care hospital ICU in North India

Antibiotic resistance is a major worldwide problem in the ICU [1]. The situation in developing countries like India is particularly serious. Since the presence of drug-resistant bacteria in the environment is a threat for public health, up-to-date information on local pathogens and the drug sensitivity pattern is very crucial to treat patients. This study was carried out to evaluate the prevalence of multidrug resistance (MDR), extensive drug resistance (XDR) and pandrug resistance (PDR) among multiple Gram-negative isolates in a medical-surgical ICU in a tertiary care hospital in North India.

Epidemiology of antibacterial drug resistance in northern Ethiopia

Antibacterial drug resistance is a worldwide problem. The situation in developing countries like Ethiopia is particularly serious. Since the presence of drug resistant bacteria in the environment is a threat to public health, updated information on local bacterial isolates and drug sensitivity patterns is very crucial for evidence based treatment decisions. This cross-sectional retrospective survey on antibacterial drug resistance was, therefore, conducted to determine the extent of antibacterial drugs resistance in northern Ethiopia. The results of specimens collected and tested in Mekelle Regional Microbiological Laboratory from 2001 to 2005 were analyzed. The most commonly isolated Gram-negative bacteria were Escherichia coli 580 (52.7%) followed by Pseudomonas aeruginosa 139 (12.6%) and Pseudomonas mirabilis 77 (7.0%); while from Gram-positive bacteria, Staphylococcus saprophyticus 643 (63.8%) and Staphylococcus aureus 249 (24.9%) were predominant. The resistance rate of E. coli, S. aureus and S. saprophyticus to ampicillin were 89.0%, 89.0% and 92.3%, respectively. The same group of bacterial isolates showed resistance to cotrimoxazole at the rate of 76.0%, 82.3% and 89.0%, while for tetracycline it was 87.0%, 85.9% and 92.7%, respectively. This study indicated an alarmingly high rate of resistance among bacterial isolates to commonly used antibacterial drugs in the Region. Thus rational use of drugs should be practiced and modifications of empirical therapy should be done through periodic monitoring of the resistance profiles of bacterial isolates to antibacterial drugs.Keywords: epidemiology, antibacterial, resistance, Tigray, Northern Ethiopia

Factors associated with the presence of drug-resistant bacteria and recurrent acute otitis media in children – a study in a private clinic

Conclusions. The proportion of drug-resistant bacteria was lower than previous reports. In children with acute otitis media (AOM), lower age, presence of multiple bacteria, and otitis media with effusion (OME) represented significant factors for recurrent AOM and the presence of drug-resistant bacteria. Objective. Recently, the proportion of drug-resistant bacteria has been increasing in children with AOM. We studied the proportion of drug-resistant bacteria and background factors for detection of drug-resistant bacteria and recurrent AOM in a private clinic. Subjects and methods. Subjects comprised 170 patients <12 years old with AOM. Middle ear fluid was collected and pathogenic bacteria were identified. The following factors were considered: age, sex, use of antibiotics in the past 1 month, past history of recurrent AOM, presence of OME, and multiple bacteria of the three main strains (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis). Results. A total of 169 strains were detected in 77% of children with AOM. Drug-resistant bacteria comprised 44 of the 169 strains (26%). Lower age (p=0.001) and presence of multiple bacteria (p<0.001) represented significant factors for the presence of drug-resistant bacteria. OME was a significant factor for recurrent AOM (p<0.001).

Antimicrobial resistance of gram-negative bacteria isolated from foods in Mexico.

When trimethoprim-sulfamethoxazole was given to US travelers in Mexico to prevent diarrheal illness, high-level resistance to the drug emerged [2], although in previous studies such resistance had not been observed among enteric flora following administration of trimethoprim-sulfamethoxazole as prophylaxis against urinary tract infection [3]. Since food has been shown to be an important vehicle of transmission of travelers' diarrhea, food samples were examined for the presence of drug-resistant bacteria to explain the acquisition of high-level resistance among enteric flora of individuals taking antibiotics as prophylaxis against traveler's diarrhea. Of 34 strains of ETEC isolated from US students in Guadalajara, Mexico, who had acute gastroenteritis, one was resistant to trimethoprim and one was resistant to trimethoprim-sulfamethoxazole. Eight of the ETEC strains tested demonstrated multiple drug resistance. Twenty-two of 149 isolates from food produced enterotoxin. Only one isolate, which was nontoxigenic, was resistant to trimethoprim, and no coliforms were resistant to trimethoprim-sulfamethoxazole; however, 16 isolates demonstrated multiple drug resistance. Of 235 gram-negative organisms recovered from frozen food samples grown on antibiotic-containing media and tested for enterotoxin production, no isolates were enterotoxigenic. Thirty-four isolates were resistant to trimethoprim, 15 were resistant to trimethoprim-sulfamethoxazole, and 33 demonstrated multiple resistance. Multiple drug resistance was demonstrated among gram-negative organisms isolated from patients' stools and foods in Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)