Prevalence Of Multiple Drug Resistance Research Articles

Prevalence of multiple-drug resistance and identification of underlying antibiotic resistance genes in Escherichia coli isolated from ready-to-eat chicken salads being sold in restaurants in Delhi, India

Antibiotic resistance (AR) is a quintessential one-health concern. Unregulated usage of antibiotics in human clinical and veterinary sector has exacerbated the global figures of morbidity and mortality. One of the reasons behind clinical manifestation of AR is the farm-to-fork movement of AR bacteria (ARB), which necessitates a systematic evaluation of food products for AR-related threats. Due to easier availability, claimed high nutritional value and cost effectiveness, meat-based ready-to-eat (RTE) salads are gaining popularity among the consumers in low-and middle-income countries (LMICs) like India. Nevertheless, it has not yet been followed by a stern microbial evaluation concerning AR. Our study acknowledges this gap by performing a systematic evaluation of AR profile of a sentinel opportunist, Escherichia coli associated with chicken based RTE salads being served in popular restaurants in Delhi, India; and identifying the antibiotic resistance genes (ARGs) that drive the observed resistance. Results showed a significant degree of resistance in E. coli isolates to nalidixic-acid (35.89%), tetracycline (35.0%), β-lactams [ampicillin (28.3%), amoxicillin-clavulanic acid (26%), imipenem (25%)], and fluoroquinolones [ciprofloxacin (22.5%), norfloxacin (20.83%)], among others. Upon screening the isolates for the presence of 22 ARGs, genes like qnrS (42.5%), tetA (40.83%), strB (20%), aadA1(12.5%), qnrA (12.5%) and strA (11.66%) were prevalent. Multiple drug resistance (MDR) was showcased by 29.17% isolates while multiple ARGs were harboured by 25.83% of the screened isolates. Due to the well-known association of the prevalent ARGs with plasmids and mobile genetic elements (MGEs) in our study, our results present a concerning scenario where the manifestation of AR in humans is possible through meat-based RTE salads.

Variation of sensitivity of Trypanosoma evansi isolates from Isiolo and Marsabit counties of Kenya to locally available trypanocidal drugs.

Trypanocidal resistance is a major cause of treatment failure. This study evaluated the sensitivity of Trypanosoma evansi field isolates collected from Marsabit and Isiolo counties, Kenya. A total of 2,750 camels were screened using parasitological tests for trypanosomes. Of the screened camels, 113 tested positive from which 40 T. evansi isolates were tested using the single dose mice sensitivity test. Five treatment groups each comprising of 6 mice were inoculated intraperitoneally with 1x105 trypanosomes of each isolate and treated 24 hours later with isometamidium chloride at 1 mg/kg, homidium chloride at 1mg/kg, diminazene aceturate at 20 mg/kg and quinapyramine sulphate & chloride at 1 mg/kg. The fifth group was left untreated (positive control). The mice were monitored daily for 60 days. A survey on camel owners' practices that influence development of resistance to trypanocidal drugs was then conducted. Results indicated presence of drug resistance in all the 7 study sites that had infected camels. Seven of the isolates tested were resistant to diminazene aceturate whereas, 28, 33 and 34 were resistant to isometamidium chloride, quinapyramine sulphate & chloride and homidium chloride, respectively. Seven (17.5%) isolates of the 40 tested were sensitive to all 4 drugs, whereas, 7.5%, 10%,55% and 10% were resistant to 1,2,3 and 4 drugs, respectively. The prevalence of multiple drug resistance was 75%. Survey data indicated that camel management practices influenced the prevalence and degree of drug resistance. In conclusion, the multiple drug resistance observed in the two counties may not be an indication of total trypanocidal drug failure. Judicious treatment of confirmed trypanosomiasis cases with correct dosage would still be effective in controlling the disease since the observed resistance was at the population and not clonal level. However, integrated control of the disease and the vectors using available alternative methods is recommended to reduce drug use.

Evaluation of clarithromycin and levofloxacin resistance of Helicobacter pylori strains isolated from patients at the Hospital for Tropical Diseases, Ho Chi Minh City

Clarithromycin (CLA) and levofloxacin (LFX) have been recommended as the most effective antibiotics for treating Helicobacter pylori infection. However, the increase in H. pylori’s resistance to antibiotics is an alarming and growing challenge. The study aimed to determine the antimicrobial resistance profiles of H. pylori strains isolated from patients at the Hospital for Tropical Diseases and to detect point mutations in 23S ribosomal RNA (23S rRNA) and gyraseA (gyrA) genes. Point mutations in 23S rRNA and gyrA were detected using Sanger sequencing. Antibiotic resistance was tested by the microdilution method. Out of the 45 isolates, 44 (97.8%) were found to be resistant to at least one antibiotic, 38 (84.4%) resistant to metronidazole (MTZ), and all were sensitive to amoxicillin (AMX) and tetracycline (TET). Sixty percent of the isolated strains were resistant to 3-6 antibiotics; among them, multiple drug resistance (MDR) strains presented twenty percent resistance to more than two classes of antibiotics. Eleven strains (24.4%) carried two mutations associated with CLA and LFX but only nine of them were dual resistant to CLA and LFX, and twenty-four (53.3%) carried either CLA or LFX mutation. The point mutations A2143G in the 23S rRNA and N87K (Asn87Lys) in the gyrA were detected in the CLA and LFX resistant strains, respectively. The prevalence of MDR, especially CLA, MTZ, and LFX resistance, in the H. pylori isolates suggests that the use of these antibiotics need to be more considerable and cautious.

The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections.

BackgroundUrinary tract infections (UTIs) and bacterial resistance to antibiotics is global health problem and a threat to public health in many countries.AimsThe study aimed to determine the prevalence of MDR Escherichia coli and Klebsiella pneumoniae in UTI patients.Materials & methodsThe midstream urine samples of 120 patients were collected and cultured as described by the protocols at the respective sample collection sites on MacConkey Blood agar. Samples were tested by using the fully automated VITEK 2 Compact system for Gram‐negative identification and detection of antimicrobial susceptibility of microorganisms.ResultsThe most prevalent pathogen was E. coli, which was found in 82 (68.3%) urine samples, followed by K. pneumonia, found in 38 (31.7%) urine samples. As far as antibiotic resistance is concerned, E. coli isolates were found to be highly resistant for ceftriaxone (89.0% of the isolates), ampicillin (86.6%), levofloxacin (82.9%), cefotaxime (79.3%), aztreonam (74.4%), ceftazidime (68.3%) and gentamicin, piperacillin, and trimethoprim‐sulfamethoxazole, 54.9 and 53.7%, respectively. The E. coli isolates were found to be relatively less resistant to imipenem (2.4%), cefepime (34.1%), and ciprofloxacin (35.4%). For K. pneumonia isolates, high resistance rates were observed for piperacillin (81.6%), levofloxacin (78.9%), ampicillin (76.3%), cefotaxime (73.7%), trimethoprim‐sulfamethoxazole (71.1%), ceftazidime (65.8%), gentamicin (63.2%), cefepime (50.0%), and aztreonam (44.7%). However, moderate resistance rates were detected for these were found to be less resistant for imipenem (13.2%), ceftriaxone (31.6%), and ciprofloxacin (36.8%).Conclusion E. coli and K. pneumoniae from the clinical isolates displayed high resistance to many antibiotics in UTI patients.

In silico and in vitro study of Mycobacterium tuberculosisH37Rv uncharacterized protein (RipD): an insight on tuberculosis therapeutics.

Tuberculosis caused byMycobacterium tuberculosis(Mtb)is responsible forthe highest global health problem, with the deaths of millions of people. With prevalence of multiple drug resistance (MDR) strains and extended therapeutic times, it is important to discover small molecule inhibitors against novel hypothetical proteins of the pathogen. In this study, a virtual screening protocol was carried out against MtbH37Rv hypothetical protein RipD (Rv1566c) for the identification of potential small molecule inhibitors. The 3D model of the protein structure binding site was used for virtual screening (VS) of inhibitors from the Pathogen Box, followed by its validation through a molecular docking study. The stability of the protein-ligand complex was assessed using a 150ns molecular dynamics simulation. MM-PBSA and MM-GBSA are the two approaches that were used to perform the trajectory analysis and determine the binding free energies, respectively. The ligand binding was observed to be stable across the entire time frame with an approximate binding free energy of -22.9916kcal/mol. The drug-likeness of the inhibitors along with a potential anti-tuberculosis compound was validated by ADMET prediction software. Furthermore, a CFU inhibition assay was used to validate the best hit compound's in vitro inhibitory efficacy against a non-pathogenic Mycobacterium smegmatis MC2155 under low nutrient culture conditions. The study reported that the compound proposed in our study (Pathogen Box ID: MMV687700) will be useful for the identification of potential inhibitors against Mtb in future.

The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections

The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections

Diverse Gene Cassette Arrays Prevail in Commensal Escherichia coli From Intensive Farming Swine in Four Provinces of China.

Multiple-drug resistance bacteria containing antimicrobial resistance genes (ARGs) are a concern for public health. Integrons are bacterial genetic elements that can capture, rearrange, and express mobile gene cassettes responsible for the spread of ARGs. Few studies link genotype and phenotype of swine-related ARGs in the context of mobile gene cassette arrays among commensal Escherichia coli (E. coli) in nonclinical livestock isolates from intensive farms. In the present study, a total of 264 isolates were obtained from 330 rectal swabs to determine the prevalence and characteristics of antibiotic-resistant gene being carried by commensal E. coli in the healthy swine from four intensive farms at Anhui, Hebei, Shanxi, and Shaanxi, in China. Antimicrobial resistance phenotypes of the recovered isolates were determined for 19 antimicrobials. The E. coli isolates were commonly nonsusceptible to doxycycline (75.8%), tetracycline (73.5%), sulfamethoxazole-trimethoprim (71.6%), amoxicillin (68.2%), sulfasalazine (67.1%), ampicillin (58.0%), florfenicol (56.1%), and streptomycin (53.0%), but all isolates were susceptible to imipenem (100%). Isolates [184 (69.7%)] exhibited multiple drug resistance with 11 patterns. Moreover, 197 isolates (74.6%) were detected carrying the integron-integrase gene (intI1) of class 1 integrons. A higher incidence of antimicrobial resistance was observed in the intI1-positive E. coli isolates than in the intI1-negative E. coli isolates. Furthermore, there were 17 kinds of gene cassette arrays in the 70 integrons as detected by sequencing amplicons of variable regions, with 66 isolates (94.3%) expressing their gene cassettes encoding for multiple drug resistance phenotypes for streptomycin, neomycin, gentamicin, kanamycin, amikacin, sulfamethoxazole-trimethoprim, sulfasalazine, and florfenicol. Notably, due to harboring multiple, hybrid, and recombination cassettes, complex cassette arrays were attributed to multiple drug resistance patterns than simple arrays. In conclusion, we demonstrated that the prevalence of multiple drug resistance and the incidence of class 1 integrons were 69.7 and 74.6% in commensal E. coli isolated from healthy swine, which were lower in frequency than that previously reported in China.

Prevalence of Multiple Drug Resistance among Avian Pathogenic E. coli Isolates from Commercial Poultry

Infections associated with Avian Pathogenic E. coli are responsible for huge economic losses for poultry industry worldwide. Particularly, its association with colibacillosis, a complex syndrome which is characterized by lesions of multiple organs i.e. peritonitis, pericarditis, air Sacculitis, osteomyelitis, salpingitis and yolk sac infections is responsible for high mortality and morbidity. Moreover, it causes respiratory tract infections among poultry birds, followed by septicaemia. Liver samples were collected from commercial poultry birds from the various retail shops located in Peshawar City. Bacteria were identified by biochemical and molecular methods. Out of all the tested isolates n=85, 98% were identified as Avian Pathogenic E. coli (APEC). Identified APEC samples were further tested against 23 different antibiotics including amoxicillin (89.40%), levofloxacin (62.40%), ciprofloxacin (71.80%), tobramycin (14.10%), gentamycin (34.10%),neomycin (53.00%), streptomycin (81.00%), tigecyclines (0.00%), oxytetracyclines (96.50%), doxycycline (61.20%), nitrofurantoin (1.00%), chloramphenicol (63.50%), cefixime (7%), cefepime (4.70%), ceftazidime (8.30%), cefotaxime (8.00%), cephalothin (43.50%), trimethoprim, sulfamethoxazole (77.60%), lincomycin (100%), augmentin (4.70%), carbapenem (4%) and polymyxin B (15%). Out of all n=85 isolates 99.9% were multi-drug resistant. Furthermore, ESBL encoding TEM, OXA, SHV were detected in following percentages 53.60%, 19.50%, 9.70% respectively genes.

Synthesis, Characterization, Biomedical Application, Molecular Dynamic Simulation and Molecular Docking of Schiff Base Complex of Cu(II) Supported on Fe3O4/SiO2/APTS.

IntroductionOver the past several years, nano-based therapeutics were an effective cancer drug candidate in order to overcome the persistence of deadliest diseases and prevalence of multiple drug resistance (MDR).MethodsThe main objective of our program was to design organosilane-modified Fe3O4/SiO2/APTS(~NH2) core magnetic nanocomposites with functionalized copper-Schiff base complex through the use of (3-aminopropyl)triethoxysilane linker as chemotherapeutics to cancer cells. The nanoparticles were characterized by Fourier transform infrared spectroscopy (FT-IR), X-ray powder diffraction (XRD), field emission scanning electron microscopy (FE-SEM), TEM, and vibrating sample magnetometer (VSM) techniques. All analyses corroborated the successful synthesis of the nanoparticles. In the second step, all compounds of magnetic nanoparticles were validated as antitumor drugs through the conventional MTT assay against K562 (myelogenous leukemia cancer) and apoptosis study by Annexin V/PI and AO/EB. The molecular dynamic simulations of nanoparticles were further carried out; afterwards, the optimization was performed using MM+, semi-empirical (AM1) and Ab Initio (STO-3G), ForciteGemo Opt, Forcite Dynamics, Forcite Energy and CASTEP in Materials studio 2017.ResultsThe results showed that the anti-cancer activity was barely reduced after modifying the surface of the Fe3O4/SiO2/APTS nanoparticles with 2-hydroxy-3-methoxybenzaldehyde as Schiff base and then Cu(II) complex. The apoptosis study by Annexin V/PI and AO/EB stained cell nuclei was performed that apoptosis percentage of the nanoparticles increased upon increasing the thickness of Fe3O4 shell on the magnetite core. The docking studies of the synthesized compounds were conducted towards the DNA and Topoisomerase II via AutoDock 1.5.6 (The Scripps Research Institute, La Jolla, CA, USA).ConclusionResults of biology activities and computational modeling demonstrate that nanoparticles were targeted drug delivery system in cancer treatment.

Phenotypic and molecular characterization of antimicrobial resistant Escherichia coli from urinary tract infections in Port-Harcourt, Nigeria.

IntroductionMultidrug resistance among Escherichia coli causing Urinary Tract Infections (UTIs) is a major public health problem, threatening the effective treatment of UTIs. This study investigated the phenotypic and molecular characteristics of E. coli associated with UTIs in Port-Harcourt, Nigeria.MethodsTwenty-five non-duplicate isolates of E. coli from UTIs patients at the University of Port-Harcourt Teaching Hospital, Nigeria were identified using Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry. The antimicrobial susceptibility patterns were determined using Kirby-Bauer disc diffusion technique. Phenotypic expression of Extended Spectrum Beta Lactamases (ESBLs) and AmpC beta-lactamase were determined using standard laboratory methods and polymerase chain reaction (PCR) was used to detect ESBLs, AmpC, Quinolones and Aminoglycosides resistance genes.ResultsThe isolates exhibited high rates of resistance to co-trimoxazole (76%), nalidixic acid (68%), ciprofloxacin (60%), gentamicin (44%) and low resistance to cefotaxime (20%) but were fully susceptible to cefoperazone/sulbactam, amikacin, nitrofurantoin, colistin and carbapenems. Phenotypic expression of ESBLs was recorded in 6(24%) isolates while genotypic detection revealed the highest prevalence of blaTEM 22(88%), followed by blaCTX-M-15 16(64%), blaSHV 7(28%) and blaOXA-1 6(24%) while AmpC (blaCMY-2) gene was detected in 8(32%) isolates. Amongst the quinolone resistant isolates, qnr variants (qnrB, qnrD and qnrS) and aac(6')-Ib genes were detected in 7(28%) and 3(12%) isolates respectively while all gentamicin resistant isolates possessed the aacC2 gene. The co-expression of blaCTX-M-15 with quinolones and aminoglycoside genes were 20% and 40% respectively. The prevalence of multiple drug resistance was 52%.ConclusionA high proportion of the studied E. coli isolates co-expressed ESBLs, quinolones and aminoglycosides resistance genes which call for prompt antibiotic stewardship and preventive strategies to limit the spread of these genes.

Prevalence, risk factors, and antimalarial resistance patterns of falciparum plasmodiasis among pregnant women in Kaduna metropolis, Nigeria.

Objective:Pregnant women infected with malaria represent a significant obstetric problem, especially in the face of antimalarial resistance. This cross-sectional study investigated the prevalence of malaria parasitemia, associated risk factors as well as the antimalarial resistance pattern of Plasmodium isolates from pregnant women attending four selected secondary health facilities in Kaduna State, Nigeria.Materials and Methods:Blood samples were collected from 353 pregnant women attending selected hospitals. Malaria microscopy and parasite density count were conducted based on standard protocols. Antimalarial susceptibility test (using chloroquine, artesunate, artether, and sulfadoxine-pyrimethamine), and hemoglobin concentrations were determined using schizont maturation assay and methemoglobin method, respectively. Multiple-drug resistance (MDR) was defined by resistance against ≥3 antimalarial drugs.Results:The overall prevalence of plasmodiasis was 22.4%. Out of those infected, 5.2% was found to be anemic. Malaria parasitemia was significantly associated with parity, residential area, age of women, and use of preventive measures against malaria (P < 0.05) but not with hemoglobin concentration, occupation, and trimester of pregnancy (P > 0.05). Malaria parasites from the pregnant women exhibited the highest resistance against chloroquine, 75 (94.9%) followed Artemether, 30 (37.9%) then sulfadoxine-pyrimethamine, 29 (36.7%) and least resistant to artesunate, 28 (35.4%). The prevalence of MDR was 40.5% (32/79).Conclusion:The prevalence of malaria was relatively high due to inadequate and/or ineffective preventive measures adopted by pregnant women. More so, significant isolates of Plasmodium falciparum exhibited MDR against antimalarial agents tested.

DISTRIBUTION AND MORTALITY PATTERNS IN PATIENTS CO-INFECTED WITH HIV AND TB IN KARELIA

The time course and distribution patterns of combined HIV/TB infection in the Republic of Karelia over the last eight years were studied. Additionally, 127 case histories of HIV/TB patients related to the period from 2001 to 2015 were examined. It is found that the high prevalence of multiple drug resistance of M. tuberculosis (primary MDR prevalence is 46,5%) is associated with delayed diagnoses of combined HIV/TB infection (stage 4-5 HIV in 70% of cases). This factor in combination with the significant input of HIV/TB patients from the Federal Penitentiary System promotes the rapid spread of HIV/TB infection over the whole territory of the Republic. These features make it expedient to develop dedicated programs aimed at close monitoring of risk groups and at the social support for homeless people and for convicts set free after imprisoning. With account of the high rate of other concomitant infections, the atypical clinical and roentgenologic manifestations of TB upon immunosuppression, and the high rate of MDR, speeding up of TB diagnosis requires the use of molecular diagnostic tools, such as Gene-X-Pert, when TB is suspected in HIV patients.

Spectrum of Antimicrobial Susceptibility ofE. coliandStaphylococcus aureusIsolates from Clinical Samples

Background and objectives: Resistance of antibiotics is increasing the public health threat and serious clinical problems in treatment. Aim: To determine the antibiogram of E.coli and Staphylococcus aureus isolates and to discuss sensitivity and resistance pattern. Methodology: The Kirby Bauer method was used to evaluate the susceptibility of 120 isolates each of E.coli and Staphylococcus aureus to various antibiotic drugs on Mueller-Hinton agar. Results: The prevalence of multiple drug resistance as determined on Mueller Hinton agar was 87.8% for E.coli and 90.55% for Staphylococcus aureus. For E.coli, resistance ranged from 7.5% (gentamicin and amikacin) to 89.16% (cotrimoxazole, ampicillin). In the case of Staphylococcus aureus resistance ranged from 15.83% (erythromycin and gentamicin) to 94.16% (penicillin). Conclusion: High levels of resistance seen in this present study. And an attempt was done to find out the most resistant antibacterial drug for routine infections.

Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili National Hospital, Tanzania.

BackgroundSurgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania.MethodsThis descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18–24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion.ResultsOf the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18 S. aureus , 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics.ConclusionA high proportion (63%) of the isolates causing SSIs in this tertiary hospital were MDR, of which (90%) were resistant to more than four classes of antibiotics. In the light of these findings, an urgent and significant change in antibiotic prescription policy is required at this National hospital.

Pattern of Antimicrobial Resistance of Escherichia coli from Healthy Adults in Amassoma, South-South Nigeria

Aim: To investigate the antimicrobial resistance profile of faecal Escherichia coli to common antimicrobial agents in healthy adults in Amassoma, South Southern Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pharmaceutical Microbiology and Biotechnology, Niger Delta University, Bayelsa State, between February and June 2010. Original Research Article International Journal of TROPICAL DISEASE & Health, 4(12): 1245-1253, 2014 1246 Methodology: The stool samples collected were inoculated and screened for E. coli using standard microbiological protocols. The antimicrobial susceptibility test of the isolates was done using disc diffusion technique. Results: A total of 110 (84.6%) E. coli isolates were obtained from all the samples comprising 38 (34.5%) from the villagers and 72 (65.5%) from the University students. The overall resistance profiles of all the isolates were: ampicillin-95.5%, tetracycline72.7%, augmentin-70.9%, co-trimoxazole-54.5%, cefuroxime-44.5%, chloramphenicol39.1%, nalidixic acid-30.0%, nitrofurantoin-28.2%, ceftazidime-15.5%, ciprofloxacin14.5%, gentamicin-10.0% and ofloxacin-4.5%. The isolates from the villagers exhibited significantly higher resistances to some of the antibiotics than those from the students (P<0.05). The prevalence of multiple drug resistance among all the isolates was 76 (69.1%). Conclusion: The observed high level of multiple drug resistance among the flora of healthy individuals call for measures to control the sales of antimicrobial agents in this country as a strategy toward the containment of antibiotic resistance.

Isolation and characterization of multiple drug resistance bacterial pathogens from waste water in hospital and non-hospital environments, Northwest Ethiopia

BackgroundThe importance of bacterial isolates from waste water environment as a reservoir of antibiotic resistance and a potential source of novel resistance genes to clinical pathogens is underestimated. This study is aimed at to isolate and characterize public health important bacteria from waste water in hospital and non- hospital environments and evaluate the distribution of multiple drug resistance bacteria in the study area.MethodsA cross-sectional study was conducted at Gondar from January-June 2012. The hospital waste water was taken from different sections of the Gondar University Teaching Hospital. Non- hospital environment samples were taken at different sites of the university campuses, Gondar College of Teachers education, and soft drink factory in Gondar. Samples were aseptically collected, transported and processed with in two hours following standard procedure. Identified organisms were assessed for different antibiotics following Kirby-Bauer disk diffusion method. All data was registered and entered in to SPSS version 16 computer program. P-values less than 0.05 were taken as statistically significant.ResultA total of 60 waste water samples were processed for the presence of drug resistance pathogens. Among the total samples 113 bacterial isolates were recovered and of these 65 (57.5%) were from hospital environment and 48 (42.5%) were from non-hospital environment. The most frequently identified bacterium was Klebsiella spp. 30 (26.6%) followed by Pseudomonas spp. 19(16.8%), E. coli (11.5%) and Citrobacter spp (11.5%), and Staphylococcus aureus (8.2%). The over all prevalence of multiple drug resistance (MDR) in this study was 79/113 (69.9%). MDR in hospital environment was found to be 53/68 (81.5%) while in non hospital environment was found to be 26/48 (54.2%).ConclusionsMultiple drug resistance to the commonly used antibiotics is high in the study area. The contamination of waste water by antibiotics or other pollutants lead to the rise of resistance due to selection pressure. The presence of antibiotic resistance organisms in this waste water should not be overlooked. Since this organisms may be vital to the safety and well-being of patients who are hospitalized and individual susceptible to infection. Therefore, proper waste water treatment plant should be established and improved sanitary measure should be practice.

Detection of SHV type extended-spectrum B-lactamase and risk factors in pseudomonas aeruginosa clinical isolates

Pseudomonas aeruginosa is one of the most important causes of nosocomial infections and can acquire resistant to many antimicrobials, including β-lactams. The aim of this study was to detect the prevalence of SHV type extended-spectrum beta-lactamase (ESBL), antimicrobial resistance patterns of the P. aeroginusa and risk factors in hospitalized patients in two teaching hospitals in Sanandaj, Iran. 123 P. aeruginosa were isolated from various clinical specimens. All samples were prepared for double-disk synergy test on the isolates for detection of ESBL. SHV was confirmed by PCR method. Risk factors were evaluated for infection due to P. aeruginosa. The incidence of multiple drug resistance (MDR) in P. aeroginusa isolates was 3.85%. The prevalence of ESBL-SHV gene was 10.57%. Days of hospitalization (OR=14.34 CI95% 2.87-25.8), ICU hospitalization (OR=3.4 CI95% 1.24- 9.29), presence of catheter (OR=3.63 CI 95% 1.34-9.84), use of antimicrobials within previous two weeks (OR=5.51 CI95% 1.85-16.43) and use of ventilator (OR=3.7557 CI95%1.29-9) were risk factors for Pseudomonas nosocomial infection SHV positive ESBL. In this study Prevalence of ESBL, SHV gene and MDR in P. aeroginosa infection was lower than the prevalence reported from other studies in Iran and this indicated appropriate antimicrobial managements strategies and infection control. In addition, our research data indicate that risk factors such as use of ventilator, use of antimicrobials and ICU hospitalization can be effective in managing Pseudomonas infection.

Epidemiological aspects of non‐human antibiotic usage and resistance: implications for the control of antibiotic resistance in Ghana

To provide insights into the epidemiology of antibiotic usage in animal husbandry in Ghana and its effect on resistance. Three hundred and ninety-five randomly sampled commercial livestock keepers who practised intensive or extensive farming were interviewed about their antibiotic usage practices using a structured questionnaire. Escherichia coli isolated from stool specimens of farmers and their animals were tested against eight antibiotics using the Kirby Bauer method. Ninety-eight percent (387) of the farmers used antibiotics on animals and the main purpose was to prevent infections in animals; 41% applied antibiotics monthly. The overall prevalence of multiple drug resistance among the E. coli isolates was 91.6%; rates in human and animal isolates were 70.6% and 97.7%, respectively. The prevalence of resistance in animal isolates to the various drugs ranged from 60.8% (amikacin) to 95.7% (ampicillin); the prevalence of resistance in human isolates to the drugs ranged from 2% (cefuroxime) to 94.1% (gentamicin). Animal E. coli isolates showed higher resistance than that of human isolates for five of eight drugs tested. It is concluded that antibiotic usage in animal husbandry in Ghana is more driven by the interest of livestock keepers to prevent and treat animal infections than growth enhancement. Both animal and human E. coli showed high levels of antibiotic resistance, although resistance of animal isolates appeared to be higher than that of humans. There is the need for the development of an antibiotic-resistance management programme in Ghana that will focus simultaneously on human and animal use of antibiotics.

Prevalence of Drug-Resistant Tuberculosis in Mainland China: Systematic Review and Meta-Analysis

BackgroundThe spread of drug-resistant tuberculosis (TB) is one of the major public health problems in the world. Surveillance of anti-TB drug resistance is important for monitoring TB control strategies. However, the status of drug-resistant TB in China has been reported inconsistently.MethodsWe systematically reviewed published studies on drug-resistant TB in China until March 31, 2011, and quantitatively summarized prevalence and patterns of anti-TB drug resistance among new cases and previously treated cases, respectively.ResultsNinety-five eligible articles, published during 1993–2011, were included in this review. The meta-analyses showed that the prevalence of drug-resistant TB in new cases was 27.9% (95% CI, 25.6%–30.2%) (n/N = 27360/104356) and in previously treated cases was 60.3% (95% CI, 56.2%–64.2%) (n/N = 30350/45858). Furthermore, in these two study populations, the prevalence of multiple drug resistance was found to be 5.3% (95% CI, 4.4%–6.4%) (n/N = 8810/101718) and 27.4% (95% CI, 24.1%–30.9%) (n/N = 10486/44530) respectively. However, the results were found to be frequently heterogeneous (p for Q tests <0.001). The most common resistance was observed for isoniazid among both study populations. Different patterns of drug resistance were observed in the subgroup analysis with respect to geographic areas, drug susceptibility testing methods and subject enrollment time.ConclusionsResults of meta-analyses indicated a severe status of drug-resistant TB in China, which attaches an importance to strength TB prevention and control.

Prevalence of multiple drug resistance and screening of enterotoxin ( stn) gene in Salmonella enterica serovars from water sources in Lagos, Nigeria

To determine the prevalence, antibiotic resistance and carriage of enterotoxin (stn) gene among strains of Salmonella isolated from water sources in Lagos. A total of 200 samples (60 well water, 60 pipe-borne water and 80 different brands of sachet water) were collected at random from various locations in Lagos. The samples were evaluated bacteriologically using standard methods. The identified isolates were subjected to antimicrobial susceptibility tests and were further screened for the presence of stn gene using standard procedures. Thirty-seven of the samples analysed were positive for Salmonella isolates. Seven serotypes were found -Salmonella typhi (n=3, 8.1%), Salmonella typhimurium (n=8, 21.6%), Salmonella choleraesuis (n=5, 13.5%), Salmonella enteritidis (n=9, 24.3%), Salmonella paratyphi (n=8, 21.6%) and Salmonella arizonae (n=4, 10.8%) - with at least one serotype present in all water sources. Over 60% of Salmonella isolates carried stn gene and the risk was higher in pipe-borne water. There was no relationship (P>0.05) between enterotoxin-producing gene and antibiotic resistance in Salmonella isolates. Thirteen resistance patterns wereexhibited by the isolates, with Str. Amp.Tet.Chl.Amo.Gen, Str. Amp.Tet.Amo.Chl.Amo.Nal.Nit, Str.Tet and Str. Amp.Tet.Chl.Amo being the most notable resistance patterns observed. Isolates that carried stn gene developed resistance to more antibiotics. Although reduced susceptibility to ciproflocacin was observed in two strains, none of the isolates developed resistance to ofloxacin. Emerging multidrug-resistant Salmonella serotypes with stn gene were found in the water samples, which may pose a threat to public health. Constant monitoring of pipe leakages, the quality of various wells and the quality of sachet water is advocated to avoid possible future outbreaks of salmonellosis due to consumption of contaminated water.