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To demonstrate efficacy and safety of an ophthalmic hydrogel formulation of netilmicin/dexamethasone, containing xanthan gum twice a day (b.i.d.) versus netilmicin/dexamethasone eye drops four times a day (q.i.d) to treat inflammation and prevention of infection after cataract surgery.Patients undergoing phacoemulsification with intraocular lens implantation (IOL) were randomised in two groups: group 1, twice daily (b.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) ophthalmic gel; group 2, four times daily (q.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) eye drops. Both treatments were administered for 14 days after surgery. Patients were evaluated before surgery, on the day of surgery and at 1, 7, 15 and 60 postoperative days. The primary efficacy endpoint was evaluation of cellularity and flare in the anterior chamber through slit-lamp biomicroscopy 7 days after surgery. Secondary endpoints included: presence of signs/symptoms of postoperative ocular inflammation and incidence of infection.One hundred seventy-three patients were randomised and 168 were evaluable. Flare and cellularity were resolved at day 7 in 92.5% of patients and almost completely by day 15. In both intent to treat (ITT) and per-protocol (PP) populations, the efficacy analysis demonstrated that the gel formulation administered twice a day was non-inferior to the eye drops administered four times a day. For ITT analysis, the lower limit of the 97.5% confidence interval (- 0.0535) was greater than the non-inferiority limit of -0.10. For the PP analysis, the lower limit of the 97.5% confidence interval (- 0.0526) was greater than the non-inferiority limit of - 0.10. The patient's global tolerability and reported symptoms were similar between treatment groups. No microbial load and no safety events were observed.Efficacy of the gel reduced posology (twice a day) is not inferior to four times a day eye drops. Both treatments were well tolerated and efficacious. The new reduced posology hydrogel formulation may improve patient compliance and quality of life.Eudract: 2016-0021138-63; ClinicalTrial.gov: NCT029738880.

A growing number of healthy dietary ingredients in fruits and vegetables have been shown to exhibit diverse biological activities. Phloretin, a dihydrochalcone flavonoid that is abundant in apples and pears, has anti-inflammatory effects on ulcerative colitis (UC) mice. The gut microbiota and metabolism are closely related to each other due to the existence of the food-gut axis in the human colon. To investigate the interplay of faecal metabolites and the microbiota in UC mice after phloretin treatment, phloretin (60 mg/kg) was administered by gavage to ameliorate dextran sulfate sodium (DSS)-induced UC in mice. Gut microbes and faecal metabolite profiles were detected by high-throughput sequencing and liquid chromatography mass spectrometry (LC-MS) analysis, respectively. The correlations between gut microbes and their metabolites were evaluated by Spearman correlation coefficients. The results indicated that phloretin reshaped the disturbed faecal metabolite profile in UC mice and improved the metabolic pathways by balancing the composition of faecal metabolites such as norepinephrine, mesalazine, tyrosine, 5-acetyl-2,4-dimethyloxazole, and 6-acetyl-2,3-dihydro-2-(hydroxymethyl)-4(1H)-pyridinone. Correlation analysis identified the relations between the gut microbes and their metabolites. Proteus was negatively related to many faecal metabolites, such as norepinephrine, L-tyrosine, laccarin, dopamine glucuronide, and 5-acetyl-2,4-dimethyloxazole. The abundance of unidentified Bacteriodales_S24-7_group was positively related to ecgonine, 15-KETE and 6-acetyl-2,3-dihydro-2-(hydroxymethyl)-4(1H)-pyridinone. The abundance of Christensenellaceae_R-7_group was negatively related to the levels of 15-KETE and netilmicin. Stenotrophomonas and 15-KETE were negatively related, while Intestinimonas and alanyl-serine were positively related. In conclusion, phloretin treatment had positive impacts on faecal metabolites in UC mice, and the changes in faecal metabolites were closely related to the gut microbiota.

Objetivo: A infeção no pós-operatório é considerada uma das mais importantes causas de morbi-mortalidade após transplante hepático. Poucos estudos analisam a incidência de culturas positivas do líquido de preservação do enxerto e o outcome dos respetivos recetores. Estudamos a incidência e o impacto clínico de infeção do líquido de preservação de orgão para transplante hepático. Métodos: Cultivamos o líquido de preservaãoo (Celsior®) em 225 transplantes de fígado durante quatro anos consecutivos; os recetores de alto risco foram submetidos a um protocolo de profilaxia antibiótica de infeção pós-transplante, durante 48 horas, que consistia numa cefalosporina de 3a geração e netilmicina. Resultados: Setenta líquidos de preservação foram considerados positivos com uma três patógenos identificados. Destes, 31% eram flora saprofítica da pele, porém, em 29 casos (41,1%), isolamos patógenos de alta virulência. Apenas oito doentes desenvolveram febre no pós-operatório devido ao microorganismo isolado no líquido de preservação. Conclusão: Foram identificadas culturas positivas em 31,1% dos casos, sendo que um terço corresponde a flora saprofítica da pele. Os nossos resultados não suportam a realização por rotina de cultura do líquido de preservação, desde que haja um regime profilático de antibióticos adequado.

The current study was carried out to investigate metabolic activities and main probiotic characteristics of two Latilactobacillus sakei strains (8.P1 and 28.P2) isolated from pastırma, a highly seasoned, air-dried cured beef. Both strains showed antimicrobial activity against important foodborne pathogens like Listeria monocytogenes, Staphylococcus aureus, Pseudomonas aeruginosa and so forth. For the characterization of antimicrobial activity, the effect of various enzymes, temperature and pH were tested. The results of the tests demonstrated that the antimicrobial activity of strains was based on the production of protein-structured compounds such as bacteriocin or bacteriocin like peptides. In metabolic activity studies, amounts of the lactic acid, proteolytic activity and hydrogen peroxide produced by the 8.P1 and 28.P2 were found to range between 16.09 and 17.32 mg/mL, 0.24 and 0.04 mg/mL and 0.98 and 0.04 µg/mL, respectively. It was also observed that neither strain could produce exopolysaccharide. Both strains were found susceptible to vancomycin, chloramphenicol, gentamicin, tetracycline, and netilmicin sulfate. When the strains are evaluated with respect to their probiotic potential, 28.P2 could tolerate acidic conditions, but 8.P1 showed sensitivity. The survival rate of the strains in the simulated gastric juice and their adhesion abilities were found suitable to stay alive in the gastrointestinal tract and to proliferate in the intestine. The evaluation of all the features of both strains demonstrated that both strains had the potential to be used as a protective culture. In addition, it was observed that 8.P1 and 28.P2 were more suitable as a starter culture and a probiotic candidate respectively.

Efficient monitoring of circulating purulent-septic infectious agents in a clinical setting and a study on antibiotic susceptibility of isolated strains of microorganisms allows identifying changes in the pathogen structure and trends in antibiotic resistance development, which helps to determine the tactics of antibacterial therapy and elaborate appropriate measures. The aim of the study. Retrospective analysis of the results of microbiological monitoring of purulent-septic infectious (PSI) agents in the Orthopedics and Traumatology Department (OTD) of the Zaporizhzhia Central Ambulance and Emergency Care Hospital over the period 2017–2020 to determine the main antibacterial drugs for empirical therapy. Materials and methods. We analyzed the bacteriological test results of 664 clinical material samples obtained from OTD patients using bacteriological examination statistical reporting and analytical data of the WHONET 5.6 software. Results. The main PSI pathogens in the OTD were from the ESKAPE group: E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa and S. epidermidis, P. mirabilis, C. amycolatum. Isolates of E. faecalis were sensitive to vancomycin, linezolid, S. aureus – to linezolid, tigecycline, netilmicin, A. baumannii – to tigecycline. All P. aeruginosa strains were resistant to ticarcillin/clavulanate, cefepime, chloramphenicol, imipenem, meropenem, aztreonam, ciprofloxacin. E. coli and K. pneumoniae were resistant to ampicillin, ticarcillin/clavulanate, aztreonam, ceftriaxone, cefepime. The number of isolates sensitive to piperacillin/tazobactam, carbapenems, levofloxacin, gentamicin, amikacin, chloramphenicol ranged from 37 % to 65 %. Conclusions. E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa, S. epidermidis, P. mirabilis, C. amycolatum play an important role in the structure of PSI pathogens in the Orthopedics and Traumatology Department of Zaporizhzhia Central Ambulance and Emergency Care Hospital. The antibiotics of choice as the antibacterial empirical therapy for enterococcal infections are vancomycin, linezolid, for staphylococcal infections – vancomycin, linezolid, tigecycline, netilmicin. PSI pathogens continually evolve developing antibiotic resistance, and it is of particular importance to monitor antibiotic susceptibility of microorganisms within the OTD.

Dogs are a potential reservoir for Escherichia coli and other zoonotic bacterial pathogens posing the risk of infection to humans and other animals. A crosssectional study was used to collect 438 rectal swab samples from apparently healthy dogs of Ambo, Gojo, and Bako towns of West Shewa Zone with the objectives of investigating the prevalence, risk factors and antibiogram of E. coli. A questionnaire survey was administered at the household level to collect data on potential risk factors to acquire E. coli infection. Prevalence was determined by using standard bacteriological culture techniques. Further confirmation and antimicrobial susceptibility testing of E. coli using the minimum inhibitory concentration (MIC) method were conducted using Automated Phoenix Machine. The overall prevalence of E. coli was found to be 24.2% (95% confidence interval [CI]:20.26-28.49%). The isolation rate of E. coli was the highest in Bako 31.01%, followed by Gojo 30.99% and Ambo 18.49% towns. Univariable and multivariable logistic regression analyses revealed that there was a significant association between E. coli prevalence and towns and Kebeles (P 0.05). E. coli isolates were pan-susceptible to amikacin, ertapenem, imipenem, piperacillin-tazobactam, netilmicin, ampicillin, piperacillin, cefoxitin, ciprofloxacin, levofloxacin, and meropenem. A low level of resistance was found to aztreonam, ceftriaxone, (each 13.95%), cefazolin (22.73%), gentamicin (11.90%), and trimethoprim-sulphamethoxazole (6.97%). E. coli isolates showed multidrug resistance to aztreonam, cefazolin, ceftriaxone, gentamicin, and trimethoprim-sulphamethoxazole (14.0%). This demonstrated E. coli prevalence and moderately low antimicrobial resistance suggests the possible risk of infection of humans. Therefore, raising public awareness about zoonotic canine disease prevention measures and good hygienic practices are essential.. Keywords: Antibiogram, Dog, Escherichia coli, Ethiopia, Prevalence, Risk factor

Antibiotic resistance in bacteria has become a worrying phenomenon in today's world, K. pneumoniae is a member of the Enterobacteriaceae family, which causes nosocomial infections as an opportunistic pathogen but inherently harbored as a part of the natural human microbiota this study aims to inform the sensitivity of bacteria to different antibiotics commonly used in the treatment against K. pneumoniae strains isolated from different infection sites and hospital environmental samples. Samples were collected from different sources (n = 886) were recorded from Diwaniyah hospitals during the period from August 2019 to January 2020, Among the 275 isolates positive for bacterial culture, only 70 isolates (40%) were identified as K.pneumoniae by standard microbiological techniques and antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion testing to 29 antibiotics using the tablet diffusion method according to CLSI 2020, The results susceptibility testing showed that frequency resistance of K. pneumoniae isolates to Pipercillin and Amoxicillin/ clavulanic acid was (100 %), Cefuroxime )97.14%) Cefoxitin (50%), Cefotaxime (74.28%), ceftriaxone (84.28%), aztreonam (52.85%), ceftazidime (81.42%), Tetracycline (70%), Nitrofurantoin (61.42%), Amikacin (57.14%), ciprofloxacin (50%). Also, the results showed the highest frequency of susceptibility among K.pneumoniae was associated withOfloxacin(78.57%), Netilmicin(74.28%), Gentamicin(75.71%), Meropenem(68.57%), Trimethoprim-Sulfamethoxazole(64.28%), Levofloxacin(72.85%).

Context Isepamicin is a new semisynthetic aminoglycoside derived from gentamicin B and it is effective against Gram negative bacteria. Antibiotic resistance is an emerging problem and new options need for the treatment of infections caused by Gram negative bacteria. Aims In this study we aimed to investigate the in vitro efficiency in carbapenem susceptible and nonsusceptible Enterobacterales and Pseudomonas aeruginosa. Methods and material A total of 214 isolates of Gram-negative bacteria (Enterobacterales n = 129 and P. aeruginosa n = 85). Identification of the bacteria was tested in Vitek MS (Biomeriux, France). Susceptibility of isepamicin, amikacin, gentamicin, tobramycin and netilmicin was determined by Kirby Bauer disc diffusion method. The breakpoints for susceptibility to isepamicin, amikacin, gentamicin, streptomycin, tobramycin and netilmicin were evaluated according to the Comite de l’Antibiogramme dela Societe Francaise de Microbiologie (CA-SFM) and EUCAST, respectively. Aminoglycoside modifying enzyme (AME) genes were investigated by multiplex PCR method. Results Isepamicin susceptibility was determined as 92.3% for Enterobacterales and 67% for P. aeruginosa and 94.4% for carbapenem resistant Enterobacterales. The most common AME gene was aac (6′)-Ib in both Enterobacterales (76%) and P. aeruginosa (14.1%). Seven of the isepamicin intermediate or resistant isolates were positive aac (6’)-Ib in Enterobacterales and P. aeruginosa. Conclusions In this study, isepamicin showed good efficiency against both susceptible and carbapenem nonsusceptible Enterobacterales. But amikacin was prior to isepamicin P. aeruginosa isolates. Isepamicin could be a therapeutic option for the infections caused by Enterobacterales.

Purpose To evaluate the effect of dexamethasone/netilmicin (dexa/net) fixed combination in the treatment of ocular inflammation after sutureless micro-incisional vitreoretinal surgery (MIVS). Patients and Methods This multicenter, open, randomized, active-controlled, parallel-group, clinical trial was run in 6 sites in Italy. Treatment started the day of surgery and continued 4 times daily for 14 days. Patients were 1:1 randomized to dexa/net (eyedrops solution and eye gel) or dexamethasone/tobramycin (dexa/tobra) eyedrops suspension and ointment. Viscous formulations (gel or ointment) were used alone during the early post-operative phase; afterwards, a combination of eye drops during daytime and viscous formulations at bedtime was adopted. The primary efficacy parameter evaluated was bulbar conjunctival hyperemia. Additional efficacy and safety parameters (palpebral conjunctival hyperemia, anterior chamber flare and cells, symptoms of ocular discomfort and ocular tolerance, adverse events and intraocular pressure) were also evaluated. Control visits were performed at day 1, day 4 and day 14 after surgery; the endpoint of the study was set at 14±2 days after surgery. Results A complete resolution of bulbar conjunctiva hyperaemia at the study end point was reached in 92.9% of patients treated with dexa/net and 75.0% of those treated with dexa/tobra (p=0.02, Fisher's exact test). No differences were observed between treatments for other efficacy parameters. Statistically significant differences in favour of dexa/net (p< 0.0001, ANOVA) were observed for most of subjective tolerance variables examined (blurred vision, foreign body sensation, stickiness, burning) starting day 1 after surgery when only the viscous formulations were used. No increase in intraocular pressure or adverse events was observed during the study. Conclusion The combination dexa/net is safe and effective in the treatment of post-operative inflammation following sutureless MIVS. In particular, the use of eye gel formulation is characterized by a great tolerability.

We studied possible otoprotective effect of drugs widely used for the correction of perinatal hypoxic brain damage in premature infants. The experiments were carried out on immature rabbits with an immature hearing organ. The auditory function was assessed by DPOAE and ABR methods in intact animals and rabbits treated with therapeutic doses of netromycin alone or in combination with the drugs that normalize metabolic processes in the brain (Cortexin, Cogitum, Elkar, vitamin B2, ATP, and cocarboxylase). It was found that the administered drugs produced an otoprotective effect and reduced the severity, but did not eliminate the ototoxic effect.

Netilmicin (NET) is an antibiotic widely used in healthcare and agriculture, but it can accumulate in the environment to threat human health. Netilmicin (NET) is an antibiotic used for veterinary purposes, for human therapy and for agricultural purposes. Therefore, there is a need to develop high-sensitive measuring methods to detect NET. Aptamer-based detecting methods are highly sensitive, inexpensive, and portable. In this study, we developed an aptamer-based fluorescence method to detect and quantify NET. NET was first conjugated to magnetic beads by amidation reaction and then NET-coated beads were used as the stationary phase to isolate aptamers by systematic evolution of ligands by exponential enrichment (SELEX) screening method. After ten rounds of SELEX screening, 32 aptamers with NET-binding affinity were obtained and the candidate aptamer APT-21 was finally chosen by comprehensively comparing their secondary structure characters and NET-binding affinity. APT-21 bound to NET with high affinity (Kd = 194.1 nmol/L) and high specificity that it displayed low cross-binding activities on 7 different structural analogs. We also developed a fluorometric assay using SYBR Green I (SG-I) and the APT-21. Key experimental parameters were optimized, including buffer system, SG-I and APT-21 reaction time, SG-I concentration, and aptamer concentration, to improve the detecting sensitivity. Our results suggest that the low limit of detection (LOD) of this method reached a low level of 1.95 nM and it also exhibited a good linear range up to 200 nM. Moreover, we successfully applied our method to detect the NET spiked in tap water and river water with good recoveries in the range from 97% to 111%. In conclusion, our current study isolated a NET-specific aptamer and developed an aptamer-based quantification method, which is promising to apply to detect NET in environmental samples.

Introduction Neonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths. Objective(s) To determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital. Methods We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P Results Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation. Conclusion Multi-drug resistant organisms were isolated. Therefore caution is required in selection of antibiotic therapy and avoid empirical treatment.

The samples isolated from blood were 250, out of these, 83 (33.2%) were positive, while 167 (66.8%) were negative. The organisms identified in the blood were Escherichia coli 22 (26.5%), Staphylococcus aureus 50 (60.2%), and Salmonella 11 (13.2%). According to our findings, the enteric pathogens occur in Peshawar are mainly resistant to oxacilin, doxycycline, and tetracycline, while these microbes are sensitive to kanamycin, cefoxitin, and netilmicin. In a similar study the researchers collected blood and they found similar results, i.e. S. aureus (35.9%) followed by E. coli (15.4%). Silver nanoparticles showed the zones of inhibitions against E. coli (11 mm), Salmonella (7 mm), and S. aureus (8 mm), while no inhibition against Shigella, Klebsiella, and Pseudomonas. In another report, silver nanoparticles showed the zone of inhibition against E. coli (13 mm) and S. aureus (11 mm). The synergistic effect of silver nanoparticles and oxacilin showed no zone of inhibition (ZOI) against Shigella, Salmonella, and Klebsiella, while the ZOI against E. coli, Pseudomonas, and S. aureus was 17, 20, 10 mm, respectively. Combined effect of AgNPs and tetracycline showed no ZOI against Shigella and Klebsiella, while the ZOI against E. coli, Pseudomonas, Salmonella, and S. aureus was 20, 20, 12, and 10 mm, respectively

Objective: This study focused on Acinetobacter spp. that were isolated from inpatients to determine the resistance rates to antibiotics and to monitor the resistance increase over the years.Method: To determine whether there was a clonal relationship between the strains using pulsed field gel electrophoresis (PFGE), to evaluate the epidemiological and clinical data of patients, and to determine the factors that may be effective in the formation and spread of infection, antibiotic susceptibilities of Acinetobacter strains were evaluated by the Kirby Bauer disk diffusion method. Molecular typing was studied with PFGE.Results: Netilmicin had the least resistance (7%) among the strains, while the highest resistance was found against piperacillin (92%), ceftriaxone (81%), and doxycycline (69%). When resistance profiles of strains were compared according to year (2005-2007), no significant changes were found for resistance rates to piperacillin, ceftriaxone, gentamicin, doxycycline, and trimethoprim / sulfamethoxazole. Of all the 131 tested Acinetobacter spp., 82 (62.6%) of the strains were clustered with the PFGE method and 72.3% of the strains were clonally related. The increase in MDR, XDR and PDR rates among the isolated Acinetobacter spp. is remarkable. It was determined that the degree of transmission of the strains was quite high among patients. The clone in the hospital was able to remain in the environment for long periods and the general patient mortality rates were higher than other studies. Conclusions: According to results and with the support of molecular typing studies, the need for more effective prevention and control measures in our hospital was demonstrated.

Objective: To assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of time (2013–2017) with a special emphasis on ESBL-producing E. coli. Methods: This retrospective study was carried out in the Department of Microbiology, Kasturba Medical College, Ambedkar Circle, Mangalore. A retrospective time bound analysis of 500 samples/year was performed. The urine samples received from the suspected cases of urinary tract infection (UTI) were processed. Wet mount examinations of urine samples were done. The urine culture was done by a semi-quantitative method on Mac Conkey’s agar, Cysteine Lactose Electrolyte Deficient (CLED) medium, and UTI Chrome agar. Culture plates were incubated for 18–24 hours at 37°C. Urine samples with a colony count of ≥105 CFU/ml were considered significant. The uropathogens were identified by their biochemical reactions. The antibiotic susceptibility testing (AST) was carried out using a Vitek Compact 2 system and Modified Kirby Bauer disc diffusion method. Results: Antibiotic resistance of Uropathogenic E.coli to cephalosporins increased from 51 to 58%, Cotrimoxazole: 52 to 59%, Piperacillin tazobactam 9.4 to 23%, Carbapenems 0 to 5.9%. Antibiotic resistance to netilmicin has reduced from 8 to 6.5%, and norfloxacin 59 to 48%. The rates of ESBL production have increased from 45.2 to 59.6% in the 5 years. Conclusion: The increasing antibiotic resistance trends in UTI patients indicate that it is vitally important to use them conservatively. Proper guidelines, management of antibiotic usage, and constant information to the clinicians regarding the sensitivity pattern can help to prevent drug resistance.

Plesiomonas shigelloides, is an emerging and significant enteric pathogen in water having implication in both localised and gastrointestinal infections with characteristic of displaying high resistance against commonly used antibiotics. This study evaluated the prevalence of Plesiomonas shigelloides and their antibiogram fingerprints in water sample collected from four rivers in South-western Nigeria. In all, 148 presumptive Plesiomonas shigelloides isolates was recovered from the rivers out of which 66 (44.6%) were confirmed positive for the organism using polymerase chain reaction techniques. Confirmed isolates were evaluated for their antibiogram profiles against a panel of 20 antimicrobials using the disc diffusion method and further screened for relevant antibiotic resistance genes. Resistance of the isolates against the antimicrobials followed the order: sulphamethoxazole (100%), erythromycin (93%), ampicillin (90%), cephalotin (82%), streptomycin (64%), and chloramphenicol (58%), amoxicillin (53%), cefotaxime (50%), tetracycline (49%), neomycin (38%) and trimethoprim + sulphamethoxazole (38%). Conversely, all the isolates were susceptible against netilmicin, and susceptibility against the other antibiotics follows the order: meropenem (94%), gentamicin (88%), imipenem (79%), amikacin (70%), ciprofloxacin (70%), norfloxacin (59%), trimethoprim (56%) and ceftazidine (56%). The multiple antibiotic resistance indices of the organism were higher than the accepted threshold of 0.2. The incidence of 11 antimicrobial resistance determinants were obtained as follows: [sulphonamides; (sulI (18%), sulII (20%), dfr1 (70%), dfr(18) (5%)), [beta-lactams; (ampC 37%)], [tetracyclines; (tetA (78%), tetE (57%)], [phenicols; (catII (16%), cmlA1 (11%)] and [aminoglycosides; (aphA2 (36%) and strA (67%)]. Pearson chi-square exact test revealed positive associations among tetA, tetE, sullI and catII and tetA genes. To the best of our knowledge, this is the first report on the incidence and antibiogram fingerprint of P. shigelloides in these freshwater resources and we conclude that these rivers are important reservoirs of multiple antimicrobial resistant biotypes of this organism, and consequently a threat to public health.

Plazomicin is currently the only next-generation aminoglycoside approved for clinical use that has the potential of evading the effects of widespread enzymatic resistance factors. However, plazomicin is still susceptible to the action of the resistance enzyme AAC(2′)-Ia from Providencia stuartii. As the clinical use of plazomicin begins to increase, the spread of resistance factors will undoubtedly accelerate, rendering this aminoglycoside increasingly obsolete. Understanding resistance to plazomicin is an important step to ensure this aminoglycoside remains a viable treatment option for the foreseeable future. Here, we present three crystal structures of AAC(2′)-Ia from P. stuartii, two in complex with acetylated aminoglycosides tobramycin and netilmicin, and one in complex with a non-substrate aminoglycoside, amikacin. Together, with our previously reported AAC(2′)-Ia-acetylated plazomicin complex, these structures outline AAC(2′)-Ia’s specificity for a wide range of aminoglycosides. Additionally, our survey of AAC(2′)-I homologues highlights the conservation of residues predicted to be involved in aminoglycoside binding, and identifies the presence of plasmid-encoded enzymes in environmental strains that confer resistance to the latest next-generation aminoglycoside. These results forecast the likely spread of plazomicin resistance and highlight the urgency for advancements in next-generation aminoglycoside design.

Objective To describe clinical characteristics, complications, and the most prevalent microorganisms causing polymicrobial keratitis and their antibiotic sensitivities. Methods A cross-sectional study including a consecutive analysis of patient's records with a diagnosis of bacterial keratitis with a positive culture and antibiogram report were included. Patients were grouped into those having monomicrobial and polymicrobial infection. Features studied included demographic and clinical characteristics, risk factors, Gram stain, cultures, and antibiotic sensitivity. Results We included 656 patients; in 31.5% more than one microorganism was found. Seven hundred and twenty-three gram-positive bacteria were isolated, and 336 (46.5%) had polymicrobial keratitis. One hundred sixty-one gram-negative bacteria were isolated, and 99 (61.5%) from polymicrobial keratitis. Fourteen (0.60%) patients presented ring infiltrate, and 10 (71.42%) of those patients had polymicrobial keratitis (X2 10.654, P=0.001). Multivariate analysis showed that patients with history of contact lens use (odds ratio [OR] of 1.78, P=0.042), coexistent autoimmune disease (OR 4.64, P=0.03), irregular edges of the infiltrate (OR 2.06, P=0.005), and ring infiltrate (OR 6.034, P=0.005) have a higher risk for developing polymicrobial infection. In the polymicrobial group, gram-positive and gram-negative organisms showed a high sensitivity to Netilmicin. Conclusions We found a high incidence of polymicrobial keratitis. Our results suggest that it should be suspected in patients with a history of contact lens use, coexistent autoimmune disease, infiltrates with indistinct edges, and ring infiltrates. Sensitivities to moxifloxacin are lower than those reported in previous studies, but sensitivity to Netilmicin is higher.

Background Colistin is currently used as a last line antibiotic for the treatment of extensively drug-resistant Gram-negative bacteria. The widespread dissemination of ESBL-producing and carbapenem-resistant Gram-negative bacteria necessitated the re-introduction of colistin which was initially abandoned as a result of high toxicities. This study aimed at determining the epidemiology of Enterobacteriaceae isolates that are resistant to colistin, tigecycline, and netilmicin and the risk factors that may contribute to the resistance observed within Southeastern Nigeria. Methods A total of 400 participants who came to the hospitals for various reasons and suspected to have bacterial infections were enrolled in this study. Phenotypic resistance to colistin was detected using broth microdilution technique on cation - adjusted Mueller-Hinton broth while resistance to colistin and netilmicin was detected using the Kirby-Bauer disk diffusion method using tigecycline disk (10 µg) and netilmicin disk (30 µg). Risk factors were determined by the administration of questionnaires to the participants. Results Our study found an overall high prevalence of colistin - resistant Enterobacteriaceae (45.8%) and a high prevalence for colistin and tigecycline (22.2%) and colistin and netilmicin (31.7%) resistant isolates. Among the risk factors that contribute to colistin, non-completion of antibiotics was found to be more significant (p = 0.039 and an odds ratio of 0.324 - 0.972 at 95% confidence interval). Conclusions Our finding is significant in that colistin resistance was determined to be present among populations that have not been exposed to colistin therapy.

Context: Anti Tubercular drug resistance is a major contributor to microbial drug resistance. With the accelerated resistance of antibiotics to various pulmonary diseases, it is essential to prioritize effective use of antibiotics, by reserving Anti-Tubercular (Tb) drugs for tuberculosis and substituting other agents of the same class of antibiotics for any other pulmonary diseases. Aims: To discover the cross-sensitivity patterns of three aminoglycosides-gentamicin, amikacin, netilmicin and three fluoroquinolones-sparfloxacin, levofloxacin, ciprofloxacin with an intention to reserve levofloxacin and amikacin as antitubercular drugs and replace them with either of the other drugs for pulmonary infections other than TB. Settings and Design: A Prospective observational study conducted in Owaisi Group of Hospitals, Telangana, India. Methods and Material: A 8 months study was conducted on 100 patients of age group 12- 85 with various respiratory infections other than tuberculosis. Minimum Inhibitory Concentrations (MIC) technique was used to find out the sensitivity of bacteria from patient’s sensitivity reports of sputum isolate, endotracheal secretions and Bronchoalveolar Lavage to determine antibiotic sensitivity. Statistical Analysis: Mean averages of various samples, T-test. Results: For sensitivity of the three aminoglycosides-gentamicin, amikacin, netilmicin, 93% of the patients that showed sensitivity to amikacin were also sensitive to Gentamicin, and 86% of them also showed sensitivity to Netilmicin. For the three fluoroquinolones - sparfloxacin, levofloxacin, ciprofloxacin, Ciprofloxacin shows a sensitivity overlap of 78.8% and Sparfloxacin 80.1% to that of levofloxacin. Conclusions: A significant overlap between sensitivities of aminoglycosides and fluoroquinolones , is seen giving rise to substituting them with one another in order to prevent a future resistance of antitubercular antibiotics by saving and reserving the drug until the patient contacts tuberculosis. Funding Statement: None to declare. Declaration of Interests: None to declare. Ethics Approval Statement: Approved by the Institutional Ethics Committee of Owaisi hospital and research centre, Deccan College of Medical Sciences, Hyderabad. Informed consent was collected from all subjects who participated in the study.

The continual increase in resistance to antibacterial drugs has become a major public health problem, and their indiscriminate use in agriculture, aquaculture, and the treatment of human and animal diseases has severely contributed to the occurrence and spread of multidrug resistance genes. This study phylogenetically characterized multidrug-resistant bacteria isolated from seafood cocktails. Seafood cocktail dishes from 20 establishments on public roads were sampled. Samples were grown on TCBS agar and blood agar. Forty colonies with different macro- and microscopic characteristics were isolated. The 16S rRNA gene V4 and V6 hypervariable regions were amplified, sequenced and phylogenetically analyzed. Antibacterial drug resistance was determined by disk diffusion assay. Isolated bacteria were identical to species of the genera Enterococcus, Proteus, Vibrio, Staphylococcus, Lactococcus, Vagococcus, Micrococcus, Acinetobacter, Enterobacter, and Brevibacterium, with 75-100% presenting resistance or intermediate resistance to dicloxacillin, ampicillin, and penicillin; 50-70% to cephalosporins; 30-67.5% to amikacin, netilmicin and gentamicin; 40% to nitrofurantoin and other antibacterial drugs; 25% to chloramphenicol; and 2.5% to trimethoprim with sulfamethoxazole. In general, 80% of the bacteria showed resistance to multiple antibiotics. The high degree of bacterial resistance to antibacterial drugs indicates that their use in producing raw material for marine foods requires established guidelines and the implementation of good practices.

Knowledge of the aetiological agents and its susceptibility to antimicrobial agents enables the clinician to initiate appropriate empirical antimicrobial therapy and guides diagnostic procedures. The aims of the study were to identify prevalence of bacterial pathogens causing sepsis and observe their antimicrobial resistance trends in hospitalized patients. A prospective cohort study was conducted on patients of sepsis admitted at a university hospital over a period of six months. Pathogens were identified by morphological, biochemical and serological tests as per the American Society for Microbiology. Antibacterial sensitivity of bacterial strains isolated from clinically diagnosed sepsis was carried out by Kirby-Bauer disk diffusion method and interpreted according Clinical and Laboratory Standards Institute guidelines. The data were analyzed by using Statistical Package for Social Sciences, version 16.0 (SPSS 16.0, Chicago, IL, USA). Coagulase negative Staphylococcus (63.5%) and Staphylococcus aureus (23.1%) were the most frequently isolated Gram positive bacteria. Acinetobacter species (31%) and Salmonella typhi (24.1%) were the most frequently isolated Gram negative bacteria. Coagulase negative Staphylococcus showed significant resistance to ciprofloxacin and tetracycline. Acinetobacter species showed significant resistance to ampicillin, amoxicillin and amoxiclav. Salmonella typhi showed significant resistance to ampicillin, amoxicillin, cefotaxime, netilmicin and, tetracycline. Escherichia coli showed significant resistance to ampicillin and netilmicin. All the stains of Staphylococcus aureus were resistant to amoxicillin. Coagulase negative Staphylococcus and Acinetobacter species were predominant Gram positive and Gram negative bacteria, respectively, causing sepsis. Increasing rates of bacterial resistance to commonly use antimicrobial agents were observed.

Isepamicin is a new semisynthetic aminoglycoside derived from gentamicin B and it is effective against Gram negative bacteria. Antibiotic resistance is an emerging problem and new options need for the treatment of infections caused by Gram negative bacteria.In this study we aimed to investigate the in vitro efficiency in carbapenem susceptible and nonsusceptible Enterobacterales and Pseudomonas aeruginosa.A total of 214 isolates of Gram-negative bacteria (Enterobacterales n = 129 and P. aeruginosa n = 85). Identification of the bacteria was tested in Vitek MS (Biomeriux, France). Susceptibility of isepamicin, amikacin, gentamicin, tobramycin and netilmicin was determined by Kirby Bauer disc diffusion method. The breakpoints for susceptibility to isepamicin, amikacin, gentamicin, streptomycin, tobramycin and netilmicin were evaluated according to the Comité de l'Antibiogramme dela Société Française de Microbiologie (CA-SFM) and EUCAST, respectively. Aminoglycoside modifying enzyme (AME) genes were investigated by multiplex PCR method.Isepamicin susceptibility was determined as 92.3% for Enterobacterales and 67% for P. aeruginosa and 94.4% for carbapenem resistant Enterobacterales. The most common AME gene was aac (6')-Ib in both Enterobacterales (76%) and P. aeruginosa (14.1%). Seven of the isepamicin intermediate or resistant isolates were positive aac (6')-Ib in Enterobacterales and P. aeruginosa.In this study, isepamicin showed good efficiency against both susceptible and carbapenem nonsusceptible Enterobacterales. But amikacin was prior to isepamicin P. aeruginosa isolates. Isepamicin could be a therapeutic option for the infections caused by Enterobacterales.

The emergence of infections caused by bacterial pathogens that are resistant to current antibiotic therapy is a critical healthcare challenge. Aminoglycosides are natural antibiotics with broad spectrum of activity; however, their clinical use is limited due to considerable nephrotoxicity. Moreover, drug-resistant bacteria that cause infections in human as well as livestock are less responsive to conventional antibiotics. Herein, we report the in vitro antibacterial evaluation of five different aminoglycosides, including ribostamycin, against a panel of Gram-positive and Gram-negative pathogens. Eight of the tested bacterial strains are linked to gastrointestinal (GI) infections. The minimum inhibitory concentration (MIC) of ribostamycin against three different Escherichia coli strains is in the range of 0.9–7.2 μM and against a strain of Haemophilus influenzae is 0.5 μM. We also found that the MIC of ribostamycin was considerably enhanced from 57.2 to 7.2 μM, an 8-fold improvement, when bacteria were treated with a combination of ribostamycin and ethylenediaminetetraacetic acid (EDTA). These findings demonstrate a promising approach to enhance the clinical potential of ribostamycin and provide a rational for its antibiotic reclassification from special level to non-restricted level.

Una caracteristica deseada de los probioticos es su sensibilidad a los antibioticos para descartar la transmision de resistencia en el ecosistema digestivo. Es importante conocer su susceptibilidad ya que se ingieren frecuentemente con la finalidad de reforzar la microflora intestinal. El objetivo de este trabajo fue analizar la susceptibilidad de probioticos aislados de productos comerciales a los principales antibioticos de uso clinico. La prueba de sensibilidad se realizo por el metodo de difusion en disco sobre agar MRS, empleando discos de antibioticos mixtos comerciales. Las bacterias Lactobacillus acidophilus, Lactobacillus casei y Bifidobacterium bifidum fueron sensibles a: penicilina, ampicilina, ceftriaxona y cefalotina (Betalactamicos), eritromicina (Macrolidos) y cloranfenicol (Anfenicoles). Resistentes a dicloxacilina (Betalactamicos), oxacilina (Fluoroquinolona), netilmicina, gentamicina y amikacina (Aminoglucosidos) y trimetoprimsulfametoxazol (Sulfonamidas). Los resultados muestran la importancia de valorar la susceptibilidad (sensibilidad y resistencia) de los probioticos a los antibioticos ya que, se consumen de forma intencionada con el proposito de mantener el equilibrio de la flora intestinal. A characteristic of probiotics istheir sensitivity to antibioticsto discard the transmission of resistance in the digestive ecosystem. It is important to know your susceptibility, which is often ingested for the purpose of strengthening intestinal microflora. The purpose of this work was to analyze the susceptibility of probiotics isolated from commercial products to the main antibiotics for clinical use. The sensitivity test was carried out by means of a disk diffusion method on MRS agar, using disks of mixed commercial antibiotics. The bacteria’s Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum were sensitive to: penicillin, ampicillin, ceftriaxone and cephalotin (Beta-lactam), erythromycin (Macrolides) and chloramphenicol (Amphenicoles). Resistant to dicloxacillin (Beta-lactam), enoxacillin (Fluoroquinolone), netilmicin, gentamicin and amikacin (Aminoglycosides) and trimethoprim-sulfamethoxazole (Sulfonamides). The results show the importance of assessing the susceptibility (sensitivity and resistance) of probiotics to antibiotics since they are consumed intentionally in order to maintain the balance of the intestinal flora.

La presencia de antibioticos en cuerpos de agua es un indicador de su mal uso. Se realizaron muestreos en seis sitios con marcada influencia antropogenica en la cuenca media del rio Usumacinta, Mexico, durante la estacion de seca, con la finalidad de estudiar la variacion espacial fisicoquimica del agua y la resistencia antimicrobiana de Salmonella spp. La identificacion bacteriana se realizo con pruebas bioquimicas convencionales. La resistencia bacteriana fue evaluada mediante la sensibilidad antibiotica a la amikacina (AK 30 μg), levofloxacina (LEV 5 μg), ceftriaxona (CRO μg 30), cloranfenicol (CLO 30 μg), trimetropina-sulfametoxazol (TRI-SXT 25 μg), ampicilina (AM 10 μg), (cefalotina CF 30 μg), gentamicina (GE 10 μg), (netilmicina NET 30 μg), nitrofurantoina (NF 300 μg), cefepime (FEP 30 μg) y cefotaxima (CTX 30 μg); con la tecnica de difusion estandarizada de Kirby Bauer. Los resultados detectaron 16 cepas correspondientes a Salmonella spp. Asi mismo, los diametros de los halos de inhibicion del crecimiento bacteriano fueron significativos, por efecto del tipo de antibiotico empleado para las pruebas. Asi como, por efecto del sitio de muestreo (p < 0.05). El 100% de las cepas de Salmonella spp fueron sensibles a los antibioticos AK, LEV, CRO, GE, NET, FEP y la CTX; mientras el 93.7% fueron resistentes a la AM. Finalmente, la resistencia de Salmonella spp, a antibioticos puede verse afectada por el grado de perturbacion antropogenica del sitio muestreado y segun el tipo de antibiotico presente en el agua. The presence of antibiotics in water bodies is an indicator of their misuse. Samples were conducted at six sites with marked anthropogenic influence in the middle basin of the Usumacinta River, Mexico, during the dry season. In order to study the physicochemical spatial variation of water and the antimicrobial resistance of Salmonella spp., bacterial identification was performed with conventional biochemical tests. Bacterial resistance was evaluated by the antibiotic sensitivity of amikacin (AK 30 μg), levofloxacin (LEV 5 μg), ceftriaxone (CRO μg 30), chloramphenicol (CLO 30 μg), trimetropin-sulfamethoxazole (TRI-SXT 25 μg), ampicillin (AM 10 μg), cephalothin (CF 30 μg), gentamicin (GE 10 μg), netilmicin (NET 30 μg), nitrofurantoin (NF 300 μg), cefepime (FEP 30 μg) and cefotaxime (CTX 30 μg); with the standardized diffusion technique of Kirby Bauer. The results showed the diameters of the bacterial growth inhibition halos were significant, due to the type of antibiotic used for the tests. In addition, the effect of the sampling site was significant (p

Infective endocarditis is a microbial infection of the endocardial surface of the heart. Antibiotics are the cornerstone of treatment, but due to the differences in presentation, populations affected, and the wide variety of micro-organisms that can be responsible, their use is not standardised. This is an update of a review previously published in 2016. Objectives: To assess the existing evidence about the clinical benefits and harms of different antibiotics regimens used to treat people with infective endocarditis. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase Classic and Embase, LILACS, CINAHL, and the Conference Proceedings Citation Index - Science on 6 January 2020. We also searched three trials registers and handsearched the reference lists of included papers. We applied no language restrictions. Selection criteria: We included randomised controlled trials (RCTs) assessing the effects of antibiotic regimens for treating definitive infective endocarditis diagnosed according to modified Duke's criteria. We considered all-cause mortality, cure rates, and adverse events as the primary outcomes. We excluded people with possible infective endocarditis and pregnant women. Data collection and analysis: Two review authors independently performed study selection, 'Risk of bias' assessment, and data extraction in duplicate. We constructed 'Summary of findings' tables and used GRADE methodology to assess the quality of the evidence. We described the included studies narratively. Main results: Six small RCTs involving 1143 allocated/632 analysed participants met the inclusion criteria of this first update. The included trials had a high risk of bias. Three trials were sponsored by drug companies. Due to heterogeneity in outcome definitions and different antibiotics used data could not be pooled. The included trials compared miscellaneous antibiotic schedules having uncertain effects for all of the prespecified outcomes in this review. Evidence was either low or very low quality due to high risk of bias and very low number of events and small sample size. The results for all-cause mortality were as follows: one trial compared quinolone (levofloxacin) plus standard treatment (antistaphylococcal penicillin (cloxacillin or dicloxacillin), aminoglycoside (tobramycin or netilmicin), and rifampicin) versus standard treatment alone and reported 8/31 (26%) with levofloxacin plus standard treatment versus 9/39 (23%) with standard treatment alone; risk ratio (RR) 1.12, 95% confidence interval (CI) 0.49 to 2.56. One trial compared fosfomycin plus imipenem 3/4 (75%) versus vancomycin 0/4 (0%) (RR 7.00, 95% CI 0.47 to 103.27), and one trial compared partial oral treatment 7/201 (3.5%) versus conventional intravenous treatment 13/199 (6.53%) (RR 0.53, 95% CI 0.22 to 1.31). The results for rates of cure with or without surgery were as follows: one trial compared daptomycin versus low-dose gentamicin plus an antistaphylococcal penicillin (nafcillin, oxacillin, or flucloxacillin) or vancomycin and reported 9/28 (32.1%) with daptomycin versus 9/25 (36%) with low-dose gentamicin plus antistaphylococcal penicillin or vancomycin; RR 0.89, 95% CI 0.42 to 1.89. One trial compared glycopeptide (vancomycin or teicoplanin) plus gentamicin with cloxacillin plus gentamicin (13/23 (56%) versus 11/11 (100%); RR 0.59, 95% CI 0.40 to 0.85). One trial compared ceftriaxone plus gentamicin versus ceftriaxone alone (15/34 (44%) versus 21/33 (64%); RR 0.69, 95% CI 0.44 to 1.10), and one trial compared fosfomycin plus imipenem versus vancomycin (1/4 (25%) versus 2/4 (50%); RR 0.50, 95% CI 0.07 to 3.55). The included trials reported adverse events, the need for cardiac surgical interventions, and rates of uncontrolled infection, congestive heart failure, relapse of endocarditis, and septic emboli, and found no conclusive differences between groups (very low-quality evidence). No trials assessed quality of life. Authors' conclusions: This first update confirms the findings of the original version of the review. Limited and low to very low-quality evidence suggests that the comparative effects of different antibiotic regimens in terms of cure rates or other relevant clinical outcomes are uncertain. The conclusions of this updated Cochrane Review were based on few RCTs with a high risk of bias. Accordingly, current evidence does not support or reject any regimen of antibiotic therapy for the treatment of infective endocarditis. post-print 876 KB

Halogenation of a suitably protected netilmicin derivative enables preparation of 4′-chloro-, bromo-, and iodo derivatives of netilmicin after deprotection. Suzuki coupling of a protected 4′-bromo derivative with phenylboronic acid or butyltrifluoroborate affords the corresponding 4′-phenyl and 4′-butyl derivatives of netilmicin. Sulfenylation of suitably protected netilmicin derivative with ethanesulfenyl chloride followed by deprotection affords 4′-ethylsulfanylnetilmicin. All netilmicin 4′-derivatives displayed reduced levels of inhibition for prokaryotic ribosomes and reduced antibacterial activity against typical Gram-positive and Gram-negative strains. None of the derivatives displayed enhanced target selectivity.

Existen escasos reportes de enfermedades bacterianas en el cultivo de chayote Sechium edule (Jacq.) Sw , casi todas se atribuyen a otros patógenos, principalmente hongos. El objetivo del proyecto fue Caracterizar e identificar bioquímicamente el aislado bacteriano pigmentado obtenido en Sechium edule (Jacq.) Sw (chayote). Se realizó una colecta de frutos de chayote en mercados de la región seleccionandolos de acuerdo a la sintomatología que consiste en la observación de manchas rojizas a nivel superficial del fruto. Se realizaron cortes que se desinfestaron con hipoclorito de sodio al 3% para eliminar organismos asociados a la infección ubicados superficialmente, se lavaron 5 veces con agua destilada estéril a fin de eliminar el hipoclorito. Las muestras desinfestadas se maceraron en un mortero estéril con un poco de agua destilada, posteriormente se sembraron por la técnica de extensión de placa con varilla acodada diluciones de 10-1 a la 10-7 en cajas con agar nutritivo y papa dextrosa agar. Posteriormente se incubaron a 28° C durante 24 horas. La purificación se llevó a cabo mediante resiembras sucesivas del primo aislamiento. El perfil exoenzimático realizado pone de manifiesto que este microorganismo posee 8 enzimas: Amilasa, esterasas, colagenasas, fosfolipasa, lipasa, caseínasa, DNAsa y quitinasa. De la prueba de sensibilidad bacteriana realizada con antibiograma se observó que la bacteria presentó alto grado de inhibición a los antibióticos: levofloxacina (LEV), netilmicina (NET), gentamicina (GE), trimetropim o sulfametoxazol (SXT), amikacina (Ak), y ceftriaxona (CRO). Con alto grado de resistencia a los antibióticos: cefeprime (FEP), cefotaxima (CTX), y amplicilina (AM). Las pruebas de identificación morfológica, microscópica y bioquímica, dieron como resultado, que el microorganismo problema corresponde a Serratia marcescens.

Objective of work was study of antibiotic resistance peculiarities and isolation localization of multi-resistant Pseudomonas aeruginosa strains. Materials and methods. The objects of investigation were multi-resistant P. aeruginosa strains isolated from pleural exudate, bronchial flushing fluid, blood, samples of wound surface and unaffected skin. Identification of the obtained cultures was carried out for morphological, tinctorial and cultural properties as well as using an automatic microbiological analyzer Vitek 32 (BioMerieux). The selected cultures were tested for sensitivity to a wide range of antibiotics using Vitek 32 (BioMerieux). Results. 18 cultures were selected among P. aeruginosa strains isolated from patients. Correspondingly to antibiotic resistance level, these strains were divided into three groups. The first group includes 7 strains (39%) with maximum resistance, representatives of the second group – 5 isolates (28%) were characterized by high resistance, and 6 cultures (33%) were referred to microorganisms with moderate resistance – the third group. Among 12 strains from the first and second groups, only two cultures were isolated in the intensive care unit. But, four cultures were isolated in the burn department, three – in orthopedics and traumatology, two – in surgery, and one – in proctology. It was found that in 50% of cases (9 strains) the cultures studied were isolated from the wound surface in patients with skin burns and after surgical intervention. At the same time, 3 strains (16% of all microorganisms) were localized in the composition of bronchial washings, as well as 2 strains (11% of all cultures) from pleural exudate and blood. From the abscess and skin of the ear, there was isolated one by one strain (6%). Conclusions. More often P. aeruginosa multi-resistant strains were isolated from the wound surface, however, the microorganisms isolated from pleural exudate were characterized the highest resistance to antibiotics, incl. to meropenem. All studied P. aeruginosa cultures retained sensitivity only to colistin and phosphomycin. The activity of other antibiotics was significantly limited, as only the netilmicin (43% of the sensitive strains), meropenem (41%), amikacin (33%), ciprofloxacin (28%) and norfloxacin (28%) influenced the isolated microorganisms.

Introduction Aminoglycoside resistance (AR) is common in health care-associated methicillin-resistant Staphylococcus aureus (HA-MRSA). AR is most often associated with the production of antibiotic modifying enzymes: bidomain AAC(6′)-Ie/APH(2″)-Ia acetyltransferase and phosphotransferase, ANT(4′)-Ia nucleotidyltransferase, and APH(3″)-IIIa phosphotransferase. Aim Determination of aminoglycoside sensitivity, presence of genes encoding enzymes, and molecular typing of HA-MRSA strains derived from patients hospitalized in surgical and transplantation wards. Materials and methods Fifty-four HA-MRSA strains, isolated from various materials from patients in the surgical and transplantation wards of Warsaw's clinical hospital, hospitalized between 1991 and 2007. The MIC values of gentamicin-GEN/tobramycin-TOB/amikacin-AK/netilmicin-NET were determined by the E-test (CLSI/EUCAST). Genes mecA/aacA-aphD/aadD/aph(3″)-IIIa were detected using PCR. SCCmec types were determined according to the Oliveira method and the sequence type (ST)/clonal complex (CC) by the MLST method. Results Of the isolates tested, 36 (66.7%) showed resistance to at least one aminoglycoside: TOB (57.4%), GEN (53.7%), AK (55.6%), NET (24.1%). The aacA-aphD gene was present in 29 MRSA-GEN-R (most often in combination with aadD, 15/29 or aph(3″)-IIIa, 10/29); the aacA-aphD gene was the only determinant of resistance in 1 isolate. The AR variants mainly belonged to the CC8 clonal complex (ST239/247/241/254/8) and most frequently contained SCCmec type III (3A) cassettes. Conclusions Resistance to at least one aminoglycoside was present in 66.7% of HA-MRSA and in more than 22% to all of them. The presence of the aacA-aphD gene was sufficient to express the resistance phenotype to GEN/TOB/AK/NET. Resistant isolates were closely related to each other.

The rapid emergence of antimicrobial resistance in major uropathogens has created a global threat especially in the developing countries. In Bangladesh, prescribers of different regions generally diagnose microbial infection on clinical judgment and select antimicrobial on empirical basis, which unfavorably affects the sensitivity pattern of microbes. The present study was designed to determine the prevalence of antimicrobial resistance of Escherichia coli and Klebsiella species isolated from patients with UTI in a tertiary care hospital. This was a cross sectional study conducted at Sylhet MAG Osmani Medical College Hospital, Sylhet from 1st January to 31st December 2016. A total of 200 clinically suspected urinary tract infection patients aged 16-85 years were included in this study. The isolated Escherichia coli and Klebsiella species were tested for antimicrobial susceptibility according to the guideline of Clinical and Laboratory Standards Institute (CLSI) 2011 using the modified Kirby- Bauer disc diffusion technique. Out of 107 pus cell positive ( 05/HPF) urine samples, 75 (70.1%) yielded significant bacteriuria of which 49 (65.3%) were Escherichia coli and 9 (12%) were Klebsiella species. The isolated Escherichia coli showed absolutely high resistance to ampicillin and cefuroxime (100%), moderately high resistance to ceftazidime (81.6%), ciprofloxacin (77.6%), cotrimoxazole (75.5%), cefotaxime (67.4%) and ceftriaxone (59.2%), moderate rate of resistance to amikacin 48.9% and imipenem 46.9% and least rate of resistance to gentamicin (22.5%), nitrofurantion (22.5%) and netilmicin (6.1%). In addition, Klebsiella species revealed completely resistance to ampicillin, cotrimoxazole, cefuroxime, cefotaxime, ceftriaxone, ceftazidime (100%), moderately high resistance to imipenem (88.9%), nitrofurantoin (77.8%), moderate resistance to ciprofloxacin (44.4%), amikacin (33.3%) and gentamicin (33.3%) and least resistance to netilmicin (11.1%). Hence very high resistance rates of 1st line drugs found in uropathigenic Escherichia coli & Klebsiella species, it is necessary to diagnose clinically followed by culture and sensitivity testing. Regular antibiotic surveillance of a particular geographical area is required to establish reliable information regarding susceptibility pattern of uropathogens in order to preserve the continued usefulness of most antimicrobial agents.Medicine Today 2018 Vol.30(2): 61-66

Introduction: Chromobacterium violaceum is a Gram-negative, facultative, anaerobic, non-sporing, fermentative and oxidase-positive coccobacillus. Human infections caused by Chromobacterium violaceum are infrequent. There are a few reported cases in several countries. Those infections appear after a skin contact with soil or contaminated water. Infections can progress to necrotizing metastatatic lesions and multiple abscesses of the lung, liver, skin, spleen, lymph nodes and brain with fatal septicemia. Infections caused by this bacterium have a high lethality rate, with a low recovery rate among survivors. It has been described that this bacterium is resistant to several antibiotics. Materials and methods: Chromobacterium violaceum was isolated, cultivated, and identified from oysters from thirteen different restaurants in Mexico City and antimicrobial susceptibility testing was performed. Results: Four isolations of Chromobacterium violaceum were obtained from oysters. Three of them corresponded to biotype 36 and all of them had a confidence factor of 0.987. All isolations were resistant to Carbencillin, Cephalothin and Cephotaxime. Two isolations were also resistant to Ampicillin and one was resistant to Amikacin. All isolations were sensitive to Ceftriaxone, Chloramphenicol, Gentamicin, Netilmicin, Nitrofurantoin, Pefloxacine and Trimethoprim-Sulfamethoxazole. Conclusions: The presence of Chromabacterium violaceum in food obtained from salt marshes that usually are eaten fresh (like oysters) means a high potential risk for human health because this bacterium has been associated with high morbidity and mortality. In our report, this bacterium showed resistance to several antibacterial agents. Patients should be cautions when eating fresh seafood, and healthcare personnel should suspect an infection caused by Chromobacterium violaceum if the patient presents with sepsis, enteritis or abscesses and they have risk factors for acquiring this bacterium in order to provide prompt treatment and reduce the morbidity and mortality associated with the infection. This work represents the first isolation, cultivation and identification of Chromobacterium violaceum in Mexico. Resumen: Introducción: Chromobacterium violaceum es un cocobacilo Gram negativo, facultativo, anaeróbico, no formador de esporas, fermentativo y oxidasa positivo. Las infecciones en humanos causadas por Chromobacterium violaceum son infrecuentes. Existen pocos reportes de casos en varios países. Estas infecciones aparecen después del contacto de la piel con el suelo o con agua contaminada. Las infecciones pueden progresar a lesiones necrotizantes metastásicas y múltiples abscesos en pulmón, hígado, piel, bazo, ganglios linfáticos y cerebro y septicemia letal. Las infecciones causadas por esta bacteria tienen una alta tasa de letalidad, con una baja tasa de recuperación entre los sobrevivientes. Se ha descrito que esta bacteria es resistente a varios antibióticos. Material y métodos: Se aisló, cultivó e identificó Chromobacterium violaceum en ostras de trece distintos restaurantes de la Ciudad de México y se realizaron estudios de susceptibilidad antimicrobiana. Resultados: Cuatro aislamientos de Chromobacterium violaceum fueron obtenidos de ostras. Tres de los aislamientos correspondieron al biotipo 36 y todos tuvieron un nivel de confianza de 0.987. Todos los aislamientos fueron resistentes a Carbenicilina, Cefalotina y Cefotaxima. Dos aislamientos fueron también resistentes a Ampicilina y uno fue resistente a Amikacina. Todos los aislamientos fueron sensibles a Ceftriaxona, Cloranfenicol, Gentamicina, Netilmicina, Nitrofurantoína, Pefloxacina y Trimetoprim-Sulfametoxazol. Conclusiones: La presencia de Chromobacterium violaceum en alimentos obtenidos de marismas los cuales son ingeridos frescos (como las ostras), representa un alto potencial de riesgo para la salud humana, ya que esta bacteria se ha asociado con enteritis aguda, septicemia y con la formación de abscesos diseminados. En nuestro reporte, esta bacteria demostró una resistencia a varios agentes antimicrobianos. Los pacientes deben de ser cuidadosos al ingerir pescados y mariscos frescos, y el personal de salud debe de sospechar una infección causada por Chromobacterium violaceum si el paciente se presenta con sepsis, enteritis o abscesos, y si tiene los factores de riesgo para adquirir esta bacteria, con el objetivo de dar un tratamiento oportuno y reducir la morbi-mortalidad asociada con esta infección. Este trabajo representa el primer aislamiento, cultivo e identificación de Chromobacterium violaceum en México. Keywords: Chromobacterium violaceum, Oyster, Enteritis, Septicemia, Abscess, Palabras clave: Chromobacterium violaceum, Ostra, Enteritis, Septicemia, Absceso

The quorum sensing (QS) inhibitory activity of hordenine from sprouting barley against foodborne pathogen Pseudomonas aeruginosa was evaluated for the first time here. At concentrations ranging from 0.5 to 1.0 mg mL–1, hordenine inhibited the levels of acyl-homoserine lactones. The enhanced susceptibility of hordenine with netilmicin on P. aeruginosa PAO1 biofilm formation as well as their efficiency in disrupting preformed biofilms was also evaluated using scanning electron microscopy and confocal laser scanning microscopy (CLSM). Hordenine treatment inhibited the production of QS-related extracellular virulence factors of P. aeruginosa PAO1. Additionally, quantitative real-time polymerase chain reaction analysis demonstrated that the expressions of QS-related genes, lasI, lasR, rhlI, and rhlR, were significantly suppressed. Our results indicated that hordenine can serve as a competitive inhibitor for signaling molecules and act as a novel QS-based agent to defend against foodborne pathogens.

One of the serious complications associated with diabetes is foot ulcer and this condition affects the quality of life in patients in all classes, races and ages. Chronic wounds are prone to colonization by wide array of microorganisms which could be extremely hazardous to patients if effective and timely therapeutic intervention is not made. This study was conducted to determine the antibiotic susceptibility profiles of bacteria from diabetic foot infections in southwestern Nigeria. Samples were collected from a total of 142 diabetic foot ulcer patients with moistened sterile cotton swabs. Nutrient agar, Mac-Conkey agar, blood agar and mannitol salt agar media were used for the isolation of total viable bacteria, Gram-negative non-spore forming lactose fermenters, fastidious bacteria and staphylococci, respectively. Morphological and biochemical characteristics of pure cultures were determined in accordance with standard laboratory criteria. API 20 E and API 20 NE were used for the confirmation of identity of the bacterial isolates. The disc diffusion technique was employed for the determination of antibiotic susceptibility of bacterial isolates in accordance with standard procedures. The antibiotics investigated included amikacin, amoxicillin, ampicillin, ceftazidime, cefazolin, ceftriaxone, chloramphenicol, ciprofloxacin, clindamycin, gentamicin, imipenem, linezolid, methicillin, netilmicin, ofloxacin, oxacillin, penicillin, piperacilin, sulfamethoxazole, trimethoprim and vancomycin. One hundred and seventy-seven isolates were encountered and these were characterized into eleven bacterial species. These included Staphylococcus aureus (22.03%), Pseudomonas aeruginosa (16.95%), Staphylococcus epidermidis (12.43%), Proteus mirabilis (8.48%), Klebsiella pneumoniae (7.91%), E. coli (7.35%), Staphylococcus saprophyticus (6.78%), Streptococcus pyogenes (5.65%), Morganella morganii (5.09%), Citrobacter freundii (4.52%) and Acinetobacter baumannii (2.83%). Gram-negative bacteria showed 76.99% susceptibility to the antibiotics while 22.85% was resistant. Gram-positive bacteria showed 93.75% susceptibility and 5.01% resistance to the antibiotics. This study revealed that there is no definite aetiologic bacterial agent for diabetic foot infections and many of the associated bacteria are sensitive to certain antibiotics.

Purpose/aim of the study: The purpose of this study was to measure the pre-corneal retention time of two marketed formulations (eye drops and eye gel) of a steroid-antibiotic fixed combination (FC) containing 0.1% dexamethasone and 0.3% netilmicin.Pre-corneal retention time was evaluated in 16 healthy subjects using an ultrahigh-resolution anterior segment spectral domain optical coherence tomography (OCT). All subjects randomly received both formulations of the FC (Netildex, SIFI, Italy). Central tear film thickness (CTFT) was measured before instillation (time 0) and then after 1, 10, 20, 30, 40 50, 60 and 120 min. The pre-corneal retention time was calculated by plotting CTFT as a function of time. Differences between time points and groups were analyzed by Student's t-test.CTFT increased significantly after the instillation of the eye gel formulation (p 0.001). CTFT reached its maximum value 1 min after instillation and returned to baseline after 60 min. No effect on CTFT was observed after the instillation of eye drops. The difference between the two formulations was statistically significant at time 1 min (p 0.0001), 10 min (p 0.001) and 20 min (p 0.01).The FC formulated as eye gel was retained on the ocular surface longer than the corresponding eye drop solution. Consequently, the use of the eye gel might extend the interval between instillations and decrease the frequency of administration.

Цель работы — изучить активность антимикробных препаратов в отношении клинических штаммов Acinetobacter spp., выделенных у пациентов, госпитализированных в хирургические стационары различных регионов Украины. Материалы и методы. Исследованы 1092 клинических штамма Acinetobacter spp., выделенные в 2009—2015 гг. у пациентов, госпитализированных в хирургические отделения многопрофильных стационаров различных регионов Украины. Чувствительность штаммов Acinetobacter изучена к основным группам антибиотиков, в том числе аминогликозидам, фторхинолонам, цефалоспоринам III—IV поколений и карбапенемам, диско-диффузионным методом в соответствии с рекомендациями Национального комитета по клиническим лабораторным стандартам США (NCCLS). Результаты и обсуждение. Штаммы A. baumannii более резистентны к антибиотикам, чем другие Acinetobacter spp. В 2015 г. цефалоспорины и ципрофлоксацин неактивны в отношении A. baumannii. Ма- лоактивны амикацин, гентамицин (30—35 %), пиперациллин-тазобактам, цефоперазон-сульбактам (50 %). Наиболее активны в отношении A. baumannii нетилмицин (80 %), имипенем (94 %), меропенем (64 %). Выводы. Наибольшей активностью к нозокомиальным штаммам Acinetobacter характеризуются нетилмицин, имипенем и меропенем. Учитывая постоянные изменения и существенные отличия уровней резистентности нозокомиальных штамов Acinetobacter, что наблюдается в разных регионах, необходимо проводить постоянный мониторинг антибиотикорезистентности в каждом хирургическом стационаре и на основании полученных локальных данных разработать больничный формуляр антибиотиков. Тактику применения антибиотиков в каждом хирургическом стационаре следует определить в зависимости от локальных данных резистентности к ним. Необходимо наладить систему эпидемиологи- ческого надзора за микробной резистентностью на локальном, региональном и национальном уровнях.

Мета роботи — вивчити антибіотикорезистентність клінічних штамів Pseudomonas aeruginosa, виді- лених у пацієнтів, госпіталізованих у хірургічні стаціонари у різних регіонах України. Матеріали і методи. Досліджено 279 620 клінічних штамів P. aeruginosa, виділених від пацієнтів, госпіталізованих у 2011—2015 рр. у хірургічні відділення 42 багатопрофільних стаціонарів у 24 областях України, а також у м. Києві. Вивчено чутливість штамів P. aeruginosa до 36 антибіотиків (пеніцилін, ампіцилін, амоксицилін, оксацилін, ампіцилін/сульбактам, амоксицилін/клавуланат, цефазолін, цефалексин, цефуроксим, цефоперазон, цефотаксим, цефтріаксон, цефтазидим, цефепім, іміпенем, меропенем, гентаміцин, амікацин, тобраміцин, нетилміцин, еритроміцин, кларитроміцин, азитроміцин, лінкоміцин, кліндаміцин, тетрациклін, доксициклін, ванкоміцин, рифампіцин, офлоксацин, левофлоксацин, ломеф- локсацин, гатифлоксацин, ципрофлоксацин, пефлоксацин, норфлоксацин) відповідно до рекомендацій Національного комітету США з клінічних лабораторних стандартів. Результати та обговорення. У хірургічних стаціонарах України 39,6 % штамів P. aeruginosa виявили резистентність до всіх досліджених антибіотиків. Найактивнішими щодо штамів P. aeruginosa були меропенем, тобраміцин, іміпенем та левофлоксацин. Високий рівень резистентності спостерігали до пеніциліну (66,6 %), еритроміцину (60,3 %), рифампіцину (58,2 %), тетрацикліну (56,8 %), азитроміцину (54,6 %), амоксициліну (53,8 %), цефалексину (52,4 %), ампіциліну/сульбактаму (51,2 %), кларитроміцину (51,0 %) та пефлоксацину (50,4 %). Висновки. Антибіотикорезистентність нозокоміальних штамів P. aeruginosa в досліджених стаціонарах є серйозною терапевтичною та епідеміологічною проблемою. Найбільшою активністю до нозокоміальних штамів P. aeruginosa характеризуються іміпенем та меропенем. З огляду на постійні зміни рівня резистентності нозокоміальних штамів P. aeruginosa в регіонах України необхідно у кожному стаціонарі здійснювати постійний моніторинг за резистентністю до дії антибіотиків і на підставі отриманих даних розробити лікарняний формуляр антибіотиків. Тактику використання антибіотиків у кожному хірургічному стаціонарі слід визначати залежно від локальних даних резистентності до протимікробних препаратів. Необхідно організувати систему епідеміологічного нагляду за мікробною резистентністю на локальному, регіональному та національному рівнях.

Background and rationale: Antibiotic resistance is a global problem. Many factors are complexly related to the issue in multiple dimensions. Bangladesh is right in the middle of this great calamity, and is seeing the rise in resistant strains of several bacteria. Very sadly, the prevalent malpractice of abusing antibiotics in Bangladesh contributes to add complexity to the danger which may prove to be possibly the greatest threat humans have ever faced. There is much scarcity of medical literature in Bangladesh, on the antibiotic sensitivity pattern and prevalent microorganisms. Moreover, antibiotic sensitivity pattern changes over time and place. Again, most of the studies done in Bangladesh, concentrate on a single disease, pathogen, or specimen. This study attempts to see the prevalent microorganisms and the antibiotic sensitivity pattern in multiple types of specimens collected from Dhaka Medical College Hospital. This study also attempts to establish a way of presentation of the relevant findings which can be used in future to ensure easy comparability and contrasting of findings.Methods: The specimens were collected from the adult patients (age >12 years) admitted in the Internal Medicine ward of Dhaka Medical College Hospital, Dhaka, over a period of 6 months. The sampling technique was consecutive sampling method. Specimens which were culture positive, were only included in the study for analysis. Multiple specimens were taken.Results: S. aureus was 100% sensitive to amikacin, moxifloxacin, imipenem, meropenem, piperacillin+tazobactum combination, vancomycin, doxycycline, tetracycline, tigecycline, nitrofurantoin, azactum, linezolid and 100% resistant to cefixime. Enterobacter was 100% sensitive to penicillin, amikacin, gentamicin, netilmicin, doxycycline, tetracycline, tigecycline and 100% resistant to cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, levofloxacin, vancomycin. E. coli was 100% sensitive to imipenem, meropenem, vancomycin, tigecycline and 100% resistant to mecillinam, aztreonam. Klebsiella was 100% sensitive to flucloxacillin, colistin, vancomycin, tigecycline, linezolid and 100% resistant to nalidixic acid. Proteus was 100% sensitive to cephradine, cefoxitin, cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, amikacin, ciprofloxacin, imipenem, meropenem, netilmicin, piperacillin+tazobactum combination, tetracycline, tigecycline, azithromycin, azactum and 100% resistant to doxycycline, tetracycline, chloramphenicol and cefuroxime. Pseudomonas was 100% sensitive only to amikacin, netilmicin, and 100% resistant to cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, gentamicin, ciprofloxacin, levofloxacin, imipenem, meropenem, doxycline, tetracycline, chloramphenicol. Salmonella typhi was 100% sensitive to amoxicillin, cefoxitin, cefixime, ceftriaxone, cefepime, cotrimoxazole, amikacin, netilmicin, azithromycin, chloramphenicol, azactum and 100% resistant to cephradine, doxycycline, tetracycline, nalidixic acid. MRSA was 100% sensitive to imipenem, vancomycin, teicoplanin, nitrofurantoin, linezolid and 100% resistant to cefpirome, cefoxitin, ceftazidime, cotrimoxazole, clindamycin, gentamicin, ciprofloxacin, netilmicin, tetracycline, clarithromycin. Acinetobacter was 100% sensitive to penicillin, cefuroxime, colistin, piperacillin+tazobactum combination, tigecycline, chloramphenicol and 100% resistant to cefixime, nalidixic acid. Citrobacter freundii was 100% sensitive to ceftazidime, ceftriaxone, cotrimoxazole, amikacin, gentamicin, ciprofloxacin, levofloxacin, imipenem, meropenem, netilmicin, nalidixic acid and 100% resistant to ampicillin, cefixime, nitrofurantoin.Conclusion: More and more antibiotics are becoming ineffective due to emergence of resistance. Serious actions should be taken. Awareness should be raised from the policy maker level to the physicians and patients.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 52-64

No orthodox practices disrupt the vaginal flora and expose it to pathogenic microorganisms including group B Streptococcus β hemolytic (GBS). The study aims to describe the bacterial profil and resistance of GBS to antibiotics. Retrospective study included 640 women at Cotonou suspected of vaginal infections or vaginal discharge during 1st January 2004 to 31st December 2015. Three swabs were collected and analyzed to identify the bacteria by standard biochemical reactions, diagnosis of bacterial vaginosis and identification of Trichomonas vaginalis, yeasts and leukocyte count. Antibiogram was performed according to the CA-SFM. Among 640 samples, 502 (78.4%) were positive. The most encountered microorganisms were Candida albicans (37.45%) and GBS (19.92%). GBS sensitivity ranged from 80-100% for augmentin, pefloxacin and nitrofuran. But resistance was observed to netilmicin, tetracyclin, cefoxitin, cephalotin, thiamphenicol, trimethoprim / sulfamethnoxazole between 80-100%. A high percentage of resistance is the result of uncontrolled access to antibiotics and improper antibiotic policy. Routine susceptibility testing will allow to take appropriate treatment of GBS in Benin.

Fever is the commonest symptom of infection in neutropenic children with malignancy, under chemotherapy. To avoid bacterial complications, it is necessary to diagnose infection early and to administer empirical antibiotic. The aim of this study was to find out the causative bacteria and their antimicrobial susceptibility pattern in febrile neutropenic children who were under chemotherapy. The study was conductedin a tertiarylevel hospital,Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Blood, urine and wound swab were collected for culture from 30 febrile neutropenic children, age 1-15 years. Out of 70 samples total 26(37.14%)yielded growth of bacteria among which 6(20%), 12(40%), and 8 (80%) were isolated from blood, urine and wound swab respectively. Among thebacteria Pseudomonas spp, Esche coli and Staph aureus weremost frequently isolated. Meropenem, imipenem and netilmicin were the most sensitive against gram negative bacteria and the entire isolated gram positive bacteria were 100% sensitive to vancomycin and linezolid. Bangladesh J Med Microbiol 2017; 11 (2): 5-8

Neonatal sepsis (NS) is a frequent problem in neonatal intensive care, especially in preterm and very low birthweight (VLBW) infants. The objective of the study was to characterize the cutaneous bacterial microbiome in VLBW infants treated in the neonatal intensive care unit (NICU). Non-invasive skin microbiome specimens were taken repeatedly from 12 VLBW infants during treatment in NICU starting on the first day of life. All infants received benzylpenicillin and netilmicin during the first 1-5 postnatal days. Samples were also collected from incubators. High cutaneous microbial diversity was present at birth in 11 of 12 of the infants, but the diversity decreased substantially after the first weeks of life in all infants regardless of their infection status. After the loss of diversity, one Staphylococcus operational taxonomic unit dominated the skin microbiome. Recovery of microbial diversity was seen in six of 12 neonates. The microbiome of incubators showed typical environmental bacterial genera. Maternal antibiotic treatment, the aetiology of the preterm birth or being born by C-section did not appear to affect the diversity of skin microbiota at birth, and no correlation was found between cutaneous microbiome and NS.

The rapid aminoglycoside NP (Nordmann/Poirel) test was developed to rapidly identify multiple aminoglycoside (AG) resistance in Enterobacteriaceae . It is based on the detection of the glucose metabolism related to enterobacterial growth in the presence of a defined concentration of amikacin plus gentamicin. Formation of acid metabolites was evidenced by a color change (orange to yellow) of the red phenol pH indicator. The rapid aminoglycoside NP test was evaluated by using bacterial colonies of 18 AG-resistant isolates producing 16S rRNA methylases, 20 AG-resistant isolates expressing AG-modifying enzymes (acetyl-, adenyl-, and phosphotransferases), and 10 isolates susceptible to AG. Its sensitivity and specificity were 100% and 97%, respectively, compared to the broth dilution method, which was taken as the gold standard for determining aminoglycoside resistance. The test is inexpensive, rapid (

The present study was designed to analyze the difference of the adeB gene expression levels under conditions of induced resistance and to verify the significance of the AdeABC efflux pump in the in vitro induction of Acinetobacter baumannii (A. baumannii). Strains were isolated from blood or drainage samples in the First Hospital of China Medical University. The minimum inhibitory concentration (MIC) was determined by a broth microdilution method. In addition, an in vitro induction of drug-resistance tests was confirmed with the three drugs. The expression level of the adeB was determined by quantitative polymerase chain reaction (qPCR), and there were 19, 17 and 25 strains isolated from this test that were susceptible to amikacin, netilmicin and imipenem, respectively. Furthermore, 11, 15 and 8 stably resistant strains generated against amikacin, netilmicin and imipenem, respectively, by in vitro induction. The MIC values of all the imipenem-sensitive and imipenem-resistant strains decreased by no more than 2-fold under carbonyl cyanide 3-chlorophenylhydrazone (CCCP)-containing conditions. The MIC values of 10 amikacin-resistant and 14 netilmicin-resistant strains decreased 4-fold or more under CCCP-containing conditions. Furthermore, qPCR revealed that none of the imipenem-sensitive or the imipenem-resistant strains expressed the adeB gene, but there were 10 amikacin-resistant and 5 netilmicin-resistant strains that expressed the adeB gene. In conclusion, the present study confirmed that in vitro induction of drug-resistance tests in sensitive A. baumannii strains could produce drug-resistance following long-term exposure to low doses of antibacterial drugs. In addition, amikacin and netilmicin are more prone to producing drug-resistance compared to imipenem in vitro. The results of the efflux phenotype indicate the possible application of CCCP in the inhibition of the efflux system in some drugs. The inconsistency between efflux phenotype and qPCR of adeB indicates that other mechanisms may also be included in the induction of drug-resistance that work with the active mechanism in order to increase drug resistance to common clinically-used antimicrobial drugs.

The aim of the present study was to determine biocide tolerance and antibiotic resistance in Salmonella isolates from hen eggshells. A total of 39 isolates from hen eggshells, identified as either Salmonella spp. or Salmonella enterica according to 16S rDNA sequencing, were selected for biocide tolerance. Isolates with minimum inhibitory concentrations (MICs) above the wild-type MICs were considered to be biocide tolerant: benzalkonium chloride (BC, 7.7%), cetrimide (CT, 7.7%), hexadecylpyridinium chloride (HDP, 10.3%), triclosan (TC, 17.9%), hexachlorophene (CF, 30.8%), and P3-oxonia (OX, 25.6%). The resulting 21 biocide-tolerant isolates were further characterized. Most isolates (95.2%) were resistant to ampicillin, but only 9.5% were resistant to cefotaxime as well as to ceftazidime. Resistance to chloramphenicol (61.9%), tetracycline (47.6%), streptomycin (19.0%), nalidixic acid (28.6%), ciprofloxacin (9.5%), netilmicin (14.3%), and trimethoprim-sulfamethoxazole (38.1%) was also detected. Considering only antibiotics, 66.7% of isolates were multiresistant; furthermore, 90.5% were multiresistant considering antibiotics and biocides combined. Efflux pump and biocide tolerance genetic determinants detected included acrB (95.2%), oqxA (14.3%), mdfA (9.5%), qacA/B (4.8%), and qacE (9.5%). Antibiotic resistance genes detected included bla

Therapeutic resistance towards most of the current treatment regime by Acinetobacter baumannii has reduced the prescribing antibiotic pattern and option is being re-shifted towards more toxic agents including aminoglycosides. The present investigation aimed at to study various mechanisms towards aminoglycoside non-susceptibility in clinical isolates of A. baumannii. The bacteria were subjected to genetic basis assessment for the presence of aminoglycoside modifying enzymes (AME), 16S rRNA methylase encoding genes and relative expression of AdeABC and AbeM efflux pumps in relation to their susceptibility to five aminoglycosides. When isolates were subjected to typing by repetitive extragenic palindromic (REP) PCR, isolates could be separated into thirteen definite clones. The majority of isolates (94%) were positive for AME encoding genes. Possession of ant(2′)-Ia correlated with non-susceptibility towards gentamicin, amikacin, kanamycin, tobramycin; while, presence of aph(3′)-VIa attributed to resistance towards amikacin, kanamycin; possession of aac(3′)-Ia allied with non-susceptibility to amikacin, tobramycin and presence of aac(3′)IIa correlated with kanamycin non-susceptibility. Presence of armA was detected in 34.4%, 34.2%, 29.2%, 40.3%, and 64.2% of isolates showing non-susceptibility to gentamicin, amikacin, kanamycin, tobramycin and netilmicin, respectively. No isolates were found to carry rmtB or rmtC. Amikacin non-susceptibility in comparison to other aminoglycosides correlated with over production of adeB. Overall, the results represented a definitive correlation between presence of AME encoding genes as well as armA and resistance of A. baumannii towards aminoglycosides. On the other hand, the up-regulation of AdeABC and AbeM systems was found to have only the partial role in development of aminoglycoside resistance.

Antimicrobial resistance became a growing public health problem in the world and Escherichia coli (E. coli) appeared as one of nine bacteria commonly causing infections in community and hospitals. It prevalence and it resistance to antibiotics were evaluated in Benin throughout an eleven year period. In this retrospective study, routine urine samples from patients collected at the National Laboratory (NL) of Health Ministry during the period 2005-2015 were analyzed. Samples higher than 103 CFU/mL bacterial growth were considered positive and for these cases, the bacteria were identified and Antimicrobial Susceptibility Test (AST) was performed. From the 4467 samples analyzed, 1455 (32.6%) were positive with E. coli preponderance (38.3%) of all isolated germs and (58.5%) of enterobacteriaceae. Most of the isolates were susceptibility to netilmicin (80%), gentamycin (93%), chloramphenicol (70%), pipemidic acid (60%), nalidixic acid (75%), ciprofloxacin (75%), amoxicillin/clavulanic acid (80%) and nitrofurantoin (100%). Susceptibility rates increased for cefotaxim (78-100%), ceftriaxon (71-100%) and aztreonam (67-100%). Resistances were observed for minocyclin (70%), Trimethoprim/Sulfamethoxazole (TMP-SMX) (60%), ampicillin (67%), amoxicillin (75%), carbenicillin (86%), cephalothin and cephalexin (50 and 80% respectively). The use of drugs such as minocyclin, ampicillin, amoxicillin, carbenicillin, cephalothin, cephalexin and trimethoprim/sulfamethoxazole does not seem appropriate for empirical treatment of UTI in Benin.

The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9 % bromfenac, 0.1 % nepafenac, 0.5 % indomethacin, or 0.1 % diclofenac) in addition to topical steroidal treatment with 0.1 % dexamethasone and 0.3 % netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation. Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy. A retrospective 6-month single center study. Patients were divided into groups according to treatment with topical drugs for 2 weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac). Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (−1.3 %, p = 0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3 %, p = 0.04), and did not change in the groups treated with bromfenac (−1.1 %, p = 0.3), indomethacin (+0.1 %, p = 0.19), or diclofenac (+1.2 %, p = 0.74). There were no side effects in any group. Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.

This study investigated the changes in antibiotic resistance in recurrent Pseudomonas aeruginosa infections in chronic suppurative otitis media (CSOM). Its aim was to provide a treatment strategy for P aeruginosa infections in CSOM for the prevention of multidrug resistance. A case-control study was conducted in tertiary teaching hospitals in Korea. The experimental group included patients with recurrent P aeruginosa infection who had relapsed within 2 months after the successful control of a previous P aeruginosa infection. The control group consisted of patients with a P aeruginosa infection who had no history of such an infection. An antibiotic sensitivity test was performed for each culture. The proportion of recurrent P aeruginosa infection was 22.69% (98 of 432 cases). Drug resistance to amikacin, tobramycin, netilmicin, ciprofloxacin, and levofloxacin was significantly changed after recurrent infection. The fluoroquinolone strains seen in recurrent P aeruginosa showed high cross-resistance to other drugs. Antibiotic resistance of P aeruginosa in CSOM changed with recurrent infection.

This study was designed to compare the activity of piperacillin/tazobactam (TZP) in combination with either netilmicin (NET) or aztreonam (ATM) against metallo-β lactamases (MβL) Pseudomonas aeruginosa. Out of 46 nosocomial Ps. aeruginosa isolates, 38 (82.6%) isolates were carbapenem-resistant by disc diffusion susceptibility testing. These were then screened by imipenem + EDTA combined disc test for MβL production. Thirty (78.9%) MβL-producing isolates detected were further tested for antibiotic synergy against NET-TZP and ATM-TZP combinations by Etest synergy and Etest/agar dilution tests. Neither combination showed antagonism. The synergistic effect of NET-TZP combination was detected in (27 (90%) and 28 (93.3%), respectively) and ATM-TZP combination in (24 (80%) and 25 (83.3%), respectively) of the tested isolates by Etest synergy and Etest/agar dilution tests, respectively. Thus, we have determined the synergistic effect of these two combinations for treating MβL-producing Ps. aeruginosa. Significance and Impact of the Study: The present study has shown valuable information on the combination treatment of Ps. aeruginosa and recommends their use for treatment of resistant Ps. aeruginosa.