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Background and Aim: There is an increasing rate of antibiotic resistance in Neisseria gonorrhoeae (N. gonorrhoeae). Several obstacles affect the culture and susceptibility testing of N. gonorrhoeae. This study was aimed to determine the antimicrobial susceptibility pattern and molecular characteristics in multidrug-resistant (MDR) N. gonorrhoeae in Jakarta, Indonesia. Materials and Methods: Forty-one endocervical specimens were streaked onto the chocolate agar and then gently rolled onto a glass object. The suspected colonies were identified by Gram staining, oxidase testing, and biochemical identification using VITEK® 2 NH cards. The antimicrobial susceptibility testing was performed using the disk diffusion or E-test method. Molecular detection of N. gonorrhoeae was carried out using the SYBR green real-time PCR targeting the opa gene. The multiplex real-time PCR with high-resolution melting (HRM) was also conducted to analyze the gene mutations in penA and 23S rRNA. DNA sequencing was used to confirm penA and 23S rRNA mutations. Results: SYBR green real-time PCR against the opa gene on direct specimens detected N. gonorrhoeae with higher positivity rate (49%) compared to the culture (34%). Susceptibility testing detected 11.1% N. gonorrhoeae resistant to cefixime, whereas resistance to azithromycin and ceftriaxone was 0%. The resistance of N. gonorrhoeae to levofloxacin and kanamycin was 33.3% and 88.9%, respectively. All isolates were resistant to penicillin, tetracycline and ciprofloxacin. There were no mutations in the penA genes Ala501, Gly545Ser, 23S rRNA A2059G and C2611T. Conclusion: Cefixime resistance was found in our samples. This resistence was not correlated with penA gene mutations. All isolates were still susceptiblle to azithromycin, which was in line with its molecular characteristics. The SYBR green real-time PCR targeting the opa gene successfully detected the DNA extracted from endocervical swabs as N. gonorrhoeae. [ABSTRACT FROM AUTHOR]

Background: The impact of antimicrobial resistance on children living in resource-limited countries has been underreported, despite its established global threat. Objective: This retrospective study aimed to describe the trend of antibiotic susceptibility in the paediatric age group. Methods: Sensitivity test report data consisting of 300 paediatric patients aged 18 hours to 192 months were retrieved from the microbiology laboratory records at a state-owned children’s hospital in Nigeria over a period of 4 months starting from December 2021 to March 2022. Five genera (Escherichia coli, Klebsiella spp., Pseudomonas spp., Staphylococcus aureus and Streptococcus spp.) were cultured as recommended by the Clinical Laboratory Standard Institute, using the Kirby Bauer disc diffusion method. Antimicrobial susceptibility testing was carried out on isolates using 15 different antibiotics. Results: Staphylococcus aureus was the most frequent pathogen isolated 32.1% (50/156) and Pseudomonas spp. was the least frequent pathogen isolated 7.1% (11/156) in all samples. The isolates with the highest rate of resistance to the tested antibiotics were S. aureus 32.1% (50/156), E. coli 28.2% (44/156) and Klebsiella spp. 20.5% (32/156). Isolates in all age groups were more resistant to ampicillin, amoxicillin + clavulanic acid, cefuroxime and cefepime. Conclusion: Antibiotic resistance is high, especially the younger Nigerian children. Strict antibiotic protocols should be adhered to especially in the use of empirical antibiotic therapy in hospitals. What this study adds: Our study reveals a higher trend of antibiotic resistance, especially in younger children. It further shows that the pathogens are most resistant to the most available empirical antibiotics in Nigeria.

Background: The impact of antimicrobial resistance on children living in resource-limited countries has been underreported, despite its established global threat. Objective: This retrospective study aimed to describe the trend of antibiotic susceptibility in the paediatric age group. Methods: Sensitivity test report data consisting of 300 paediatric patients aged 18 hours to 192 months were retrieved from the microbiology laboratory records at a state-owned children's hospital in Nigeria over a period of 4 months starting from December 2021 to March 2022. Five genera (Escherichia coli, Klebsiella spp., Pseudomonas spp., Staphylococcus aureus and Streptococcus spp.) were cultured as recommended by the Clinical Laboratory Standard Institute, using the Kirby Bauer disc diffusion method. Antimicrobial susceptibility testing was carried out on isolates using 15 different antibiotics. Results: Staphylococcus aureus was the most frequent pathogen isolated 32.1% (50/156) and Pseudomonas spp. was the least frequent pathogen isolated 7.1% (11/156) in all samples. The isolates with the highest rate of resistance to the tested antibiotics were S. aureus 32.1% (50/156), E. coli 28.2% (44/156) and Klebsiella spp. 20.5% (32/156). Isolates in all age groups were more resistant to ampicillin, amoxicillin + clavulanic acid, cefuroxime and cefepime. Conclusion: Antibiotic resistance is high, especially the younger Nigerian children. Strict antibiotic protocols should be adhered to especially in the use of empirical antibiotic therapy in hospitals. What this study adds: Our study reveals a higher trend of antibiotic resistance, especially in younger children. It further shows that the pathogens are most resistant to the most available empirical antibiotics in Nigeria. [ABSTRACT FROM AUTHOR]

Background Urinary tract infections (UTIs) caused by bacteria occupy the second highest rank of common infectious diseases in the world. Empirical use of antibiotics may give rise to multidrug-resistant (MDR) bacteria because of irrational prescription. Choice of antibiotics to treat UTIs is limited because of MDR bacteria. Thus, this study was conducted to investigate the bacterial antibiotic susceptibility patterns in inpatients and outpatients in Jakarta and Tangerang. Methods Bacterial isolates were obtained from midstream urine specimens from 43 inpatients and 43 outpatients with UTIs in Jakarta and Tangerang. Bacteria were isolated on blood and MacConkey agar media using colony count method. Isolate identification and their susceptibility patterns were performed using VITEK2 compact system according to manufacturers’ instructions. Data were analyzed using Chi-square test. Results A total of 89 bacterial isolates consisting of 15 bacterial species were successfully isolated from 86 specimens. Gram-negative bacteria were the most common etiology of UTIs in inpatients and outpatients. MDR bacteria were found in 52 of the 89 isolates. ESBL-producing E. coli was the most common MDR bacteria. ESBL-producing E. coli and other MDR bacteria showed good susceptibility to ertapenem, meropenem, amikacin, and tigecycline. There were no significant differences regarding the MDR bacterial count in inpatients and outpatients (p=0.521). Conclusion E. coli was found to be the most common MDR bacteria causing UTIs in inpatients and outpatients in Jakarta and Tangerang. Higher resistance to many antibiotics was found in MDR bacterial isolates in inpatients compared to outpatients. MDR bacteria in outpatient UTIs were highly resistant to commonly used antibiotics.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA), Gram-positive bacteria causing infection in hospital-acquired infection, has increased worldwide, including in Indonesia. Currently, the updated data on MRSA in Indonesia is limited. Purpose: This study aims to explore the prevalence and susceptibility pattern of MRSA in Dr. Soetomo General Academic Hospital Surabaya, Indonesia. Methods: This study was a descriptive-analytic study with a retrospective design. All clinical isolates of Methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA from January to December 2017 were included. All inpatients included one MSSA or MRSA, and colonized bacteria were excluded. Data were analyzed using Chi-Square or Fisher’s Exact Test. Results: A total of 503 Staphylococcus aureus isolates were identified, of which 126 (25.05%) were MRSA. The highest prevalence of MRSA was from pus, wound swab, and tissue, 59 (28.37%) from 333, and the highest prevalence of the ward was in the intensive care unit (50%). MRSA were highly sensitive to daptomycin (n=95/95; 100%), linezolid (n=123/125; 98.40%), vancomycin (n=120/125; 96.00%), nitrofurantoin (n=43/45; 95.56%), quinupristin-dalfopristin (n=112/121; 92.56%), fosfomycin (n=87/97; 89.69%), and moxifloxacin (n=104/117; 88.89%). The susceptibility of the other antibiotics such as rifampicin, clindamycin, erythromycin, chloramphenicol, cotrimoxazole, levofloxacin, gentamicin, and tetracycline was less than 80%. Conclusion: The prevalence of MRSA among hospitalized patients in Dr. Soetomo General Academic Hospital, Surabaya, is 25.05% and tends to decrease from January to December 2017. Most MRSA was sensitive/intermediate to daptomycin, linezolid, vancomycin, nitrofurantoin, quinupristin-dalfopristin, fosfomycin, and moxifloxacin.

One of the most feared complications of diabetes is diabetic foot, which is also the main cause of hospitalisation in diabetic individuals. In order to pick the appropriate antibiotics for the effective management of these illnesses, it is essential to have a solid understanding of the prevalent microorganisms that have been isolated and their respective antibiograms. [ABSTRACT FROM AUTHOR]

Background: Macrolides are considered one of the oldest classes of antibiotics which have been regarded among the best-tolerated antibiotic for almost several years. They are characterized by their large lactone ring structures and by their growth-inhibiting (bacteriostatic) effects on bacteria. Aim: The potency of macrolide antibiotics were determined against enteric bacteria (E. coli, Shigella spp. and Salmonella spp.) isolated during the raining season between June to September in the year 2018 from locations in Ado Ekiti metropolis. The consequences of the presence of these bacteria can be fatal hence the need to investigate their susceptibility to macrolide antibiotics. Methods: The bacteria were isolated from well water, soil and drainage samples obtained at Erifun, Omisanjana, Fiyinfoluwa, Ajilosun areas using serial dilution method. Results: It was observed that the bacteria were susceptible to 250 µg/mL and 500 µg/mL concentration of Azithromycin, Erythromycin, and Clarithromycin though with varying degrees of susceptibility. Azithromycin showed the highest potency. Conclusion: The present study indicated samples of the well water, soil and drainage at Erifun, Omisanjana, Ajilosun and Fiyinfoluwa areas of Ado-Ekiti were severely contaminated with E. coli, Salmonella spp., and Shigella spp. this is due to the lack of adequate sanitary measures. However, unhygienic behaviour like indiscriminate disposal of waste and open defecation should be discouraged.

Pounded yam is a staple food consumed in Makurdi, Benue State. The food is sold along major streets and roads in the town, as such; it is prone to bacterial contamination from different sources. The study was aimed at assessing the contamination and susceptibility pattern of bacteria isolated from pounded yam sold along major roads in Makurdi metropolis. One hundred and forty (140) samples of pounded yam were aseptically collected from seven food vending sites (Wurukum, Wadata, High level, Naka road, Otukpo road, Gboko road and North bank) and analyzed for bacterial contamination using standard microbiological procedures. The Kirby-Bauer disk diffusion method was used for the antibacterial susceptibility testing. The antibiotics tested were Septrin, Chloramphenicol, Sparfloxacin, Ciprofloxacin, Amoxicillin, Augmentin, Gentamycin, Pefloxacin, Tarivid and Streptomycin. If a bacterial isolate proved resistant to at least three of the tested antibiotics, it was deemed to be multi-drug resistant (MDR). A total of four species of bacteria which included Staphylococcus aureus (35.66%), Escherichia coli (18.18%), Klebsiella spp (11.20%) and Proteus spp (34.97%), were isolated from the pounded yam samples. The mean total viable count of all the samples; which ranges from 2.61x105cfu/g (Wadata) to 3.25x105cfu/g (Otukpo road) are within the acceptable limits for food. Staphylococcus spp, Escherichia coli and Proteus spp were multidrug resistant to four, six and three antibiotics respectively, according to the antibacterial susceptibility test. Staphylococcus spp showed 31.37% susceptibility to Septrin, 37.25% to Streptomycin and 33.33% of the Staphylococcus isolates were sensitive to Sparfloxacin and Amoxycillin. For Escherichia coli, more than 50% of the 26 Escherichia coli isolates showed resistance to Septrin (46.16%), Sparfloxacin (42.31%), Amoxicillin (42.31%), Gentamycin (38.46%), Perfloxacin ((46.15%) and Streptomycin (23.08%). Proteus spp showed 44.00% susceptibility to Chloramphenicol, 30.00% to Sparfloxacin and 40.00% to amoxicillin. Klebsiella spp showed 25.00% susceptibility to Amoxicillin only. The study identified that pounded yam sold along major roads in Makurdi metropolis are contaminated with bacteria of public health importance. Therefore hygienic way of food preparation is of utmost importance to prevent contamination of food with these organisms resulting to food borne diseases.

Background: Understanding the proportion of blood and blood products contamination during transfusion is important in developing infection control strategy in the health system. Therefore, this study was aimed to determine bacterial contamination and susceptibility patterns among blood and blood components at Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia. Methods: A cross-sectional study was done on blood and blood components collected with both diverging and none-diverging methods. Simple random sampling method was applied to select blood and blood product units from the record form and 10 mL of sample was drawn from each blood and blood product. Culturing from collected blood and blood products and antimicrobial sensitivity tests were done. The collected data were entered and analyzed by SPSS statistical software version 20. Binary and multiple logistic regression analysis were done to see different factors and p-values less than 0.05 were taken as statistically significant. Results: A total of three hundred seventy six (376) units of blood and blood product samples, 188 from non-diverging and 188 from diverging blood donor collection methods were included. Among different blood group types, O+ blood and the majority of components were stored from one to five days. The overall bacterial contamination among blood and blood components were n = 17 (4.5%). Among them, n = 14 (7.4%) and n = 3 (1.6%) were collected with a non-diverging and diverging method, respectively. Staphylococcus epidermidis was the most dominant isolate. Most bacterial isolates were susceptible to different antimicrobial agents; however, Pseudomonas aeruginosa showed resistance for gentamicin. The non-diverging collection units of blood and components were significantly associated with bacterial contamination. Of all, n = 5/17 (29.4%) isolated bacteria were multidrug resistant. Conclusion: The bacterial contamination of blood and blood components collected with diverging method was lower and recommended to use this collection method from donors. [ABSTRACT FROM AUTHOR]

Background: Macrolides are considered one of the oldest classes of antibiotics which have been regarded among the best-tolerated antibiotic for almost several years. They are characterized by their large lactone ring structures and by their growth-inhibiting (bacteriostatic) effects on bacteria. Aim: The potency of macrolide antibiotics were determined against enteric bacteria (E. coli, Shigella spp. and Salmonella spp.) isolated during the raining season between June to September in the year 2018 from locations in Ado Ekiti metropolis. The consequences of the presence of these bacteria can be fatal hence the need to investigate their susceptibility to macrolide antibiotics. Methods: The bacteria were isolated from well water, soil and drainage samples obtained at Erifun, Omisanjana, Fiyinfoluwa, Ajilosun areas using serial dilution method. Results: It was observed that the bacteria were susceptible to 250 µg/mL and 500 µg/mL concentration of azithromycin, erythromycin, and clarithromycin though with varying degrees of susceptibility. Azithromycin showed the highest potency. Conclusion: The present study indicated samples of the well water, soil and drainage at Erifun, Omisanjana, Ajilosun and Fiyinfoluwa areas of Ado-Ekiti were severely contaminated with E. coli, Salmonella spp., and Shigella spp. this is due to the lack of adequate sanitary measures. However, unhygienic behaviour like indiscriminate disposal of waste and open defecation should be discouraged. [ABSTRACT FROM AUTHOR]

Wigilya P Mikomangwa,1,* George M Bwire,2,* Manase Kilonzi,1,* Hamu Mlyuka,1 Ritah F Mutagonda,1 Wema Kibanga,1 Alphonce Ignace Marealle,1 Omary Minzi,1 Kennedy D Mwambete2 1Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania; 2Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania*These authors contributed equally to this workCorrespondence: Wigilya P Mikomangwa Email wpad.miko@gmail.comBackground: Antibiotic resistance poses burden to the community and health-care services. Efforts are being made at local, national and global level to combat the rise of antibiotic resistance including antibiotic stewardship. Surveillance to antibiotic resistance is of importance to aid in planning and implementing infection prevention and control measures. The study was conducted to assess the resistance pattern to cefepime, clindamycin and meropenem, which are reserved antibiotics for use at tertiary hospitals in Tanzania.Methods: A hospital-based antibiotic resistance surveillance was conducted between July and November 2019 at Muhimbili National Hospital and Bugando Medical Center, Tanzania. All organisms isolated were identified based on colony morphology, Gram staining and relevant biochemical tests. Antibiotic susceptibility testing was performed on Muller-Hinton agar using Kirby-Bauer disc diffusion method. Antibiotic susceptibility was performed according to the protocol by National Committee for Clinical Laboratory Standards.Results: A total of 201 clinical samples were tested in this study. Urine (39.8%, n=80) and blood (35.3%, n=71) accounted for most of the collected samples followed by pus (16.9%, n=34). The bacterial resistance to clindamycin, cefepime and meropenem was 68.9%, 73.2% and 8.5%, respectively. About 68.4% Staphylococcus aureus isolates were resistant to clindamycin whereby 56.3%, 75.6%, 93.8% and 100% of the tested Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa and Enterobacter cloacae, respectively, were cefepime resistant. About 8.5% of isolated Klebsiella spp were resistant and 6.4% had intermediate susceptibility to meropenem. Also, Pseudomonas aeruginosa was resistant by 31.2% and 25% had intermediate susceptibility to meropenem.Conclusion: The bacterial resistance to clindamycin and cefepime is high and low in meropenem. Henceforth, culture and susceptibility results should be used to guide the use of these antibiotics. Antibiotics with low resistance rate should be introduced to the reserve category and continuous antibiotic surveillance is warranted.Keywords: antibiotic resistance, clindamycin, cefepime, meropenem, reserved antibiotics, bacteria, susceptibility pattern

Abstract Background Diphtheria has been reported as an outbreak in some regions in Indonesia, most especially in East Java Province. Resistance to penicillin, erythromycin, and other antibiotics, single or multiple, has been reported in several studies. This study aims to evaluate the first-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae isolates. Methods This descriptive observational study was performed from August to November 2018. C. diphtheriae isolates were collected from diphtheria patients and carriers in East Java from 2012 to 2017 and kept at the Balai Besar Laboratorium Kesehatan Daerah Surabaya or the Public Health Laboratory of Surabaya. Sample selection was done by random cluster sampling. The sensitivity test by E-test®of the five antibiotics (penicillin, oxacillin, erythromycin, azithromycin, and clarithromycin) was done to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute M45A (2015) Corynebacterium spp. for penicillin and erythromycin was used as standard. Results From 114 targeted isolates, 108 were viable and toxigenic. The E-test was performed on the viable isolates. The majority of the hosts were male (58.3%), with median (range) age of 6.5 (1–14) years. Half of the samples were from the 1 to 5-year-old age group. The isolates were acquired much more from patients (78.7%) than carriers (21.3%) and from pharyngeal swab (74.1%). Most of these isolates were from Madura Island (47.2%) and the northern and eastern parts of the province (horseshoe area). Mitis isolates were the major variant (76.9%). The susceptibility pattern of C. diphtheriae to erythromycin was better than that to penicillin. The E-test result for penicillin was 68.52% susceptible, 31.48% intermediate, and 0% resistant (MIC range, 256 μg/L) was 85.2% susceptible, 12% intermediate, and 2.8% resistant The MIC range for oxacillin was 1 to 96 μg/L, while for both azithromycin and clarithromycin were 256 μg/L. Conclusion The susceptibility rate of C. diphtheriae to erythromycin is higher than that to penicillin. The regular update of antibiotic selection to the national guidelines is recommended. The MIC reference standard to azithromycin and clarithromycin is also needed.

Candida species are the most common causative agents responsible for the majority of morbidity as well as mortality rates due to invasive fungal infections worldwide. In this study, a green approach was developed to control the pathogenic Candida spp. isolated from clinical samples, and prior data collections, ethics approval was obtained. Sixty candida isolates were obtained from the different device-associated infections and identified as Candida albicans, Candida tropicalis, Candida krusei, Candida parapsilosis, and Candida glabrata with prevalence rates 41.6, 38.3, 8.3, 6.6, and 5%, respectively. On the other hand, silver nanoparticles (Ag-NPs) were extra-cellular synthesized by biomass filtrate of previously identified Penicillium chrysogenum strain F9. The physico-chemical characterizations of biosynthesized Ag-NPs were assessed by using UV-Vis spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD) patterns, transmission electron microscope (TEM), dynamic light scattering (DIS), and zeta potential (ζ) analysis. Data revealed successful synthesis of crystallographic spherical Ag-NPs with average size 18 to 60 nm at maximum absorption peak 415 nm. FT-IR analysis confirmed the presence of functional groups related to reduction, capping, and stabilizing Ag-NPs. The DLS analysis showed that NPs were homogenous and stable with poly-dispersity index (PDI) and ζ value 0.008 and − 21 mV, respectively. Susceptibility pattern analysis revealed that sixty Candida isolates (100%) were susceptible to Ag-NPs as compared to 25 isolates (41.6%), and 30 isolates (50%) were susceptible to fluconazole and amphotericin B, respectively. Interestingly, 30 Candida isolates (50%) were resistant to amphotericin B, which are more than those recorded for fluconazole (17 isolates with percent 28.3%), while 18 candida isolates (30%) were susceptible dose-dependent to fluconazole. The recorded minimum inhibitory concentration 50/90 (MIC50/90) was 62.5/125, 16/64, and 1/4 for Ag-NPs, fluconazole, and amphotericin B, respectively. However, green synthesized Ag-NPs can be used to overcome the resistance pattern of Candida spp., and recommended as an anti-candida agent. [ABSTRACT FROM AUTHOR]

Early onset Ventilator associated pneumonia (VAP) is usually less severe, associated with a better prognosis, and is more likely caused by antibiotic- sensitive bacteria. Late-onset VAP, is usually caused by multidrug resistant (MDR) pathogens and is associated with increased morbidity and mortality. Therefore, the local microbial flora causing VAP needs to be studied and appropriate therapy based on the early endotracheal (ET) aspirate culture report can help managing this group of patients. The present study was carried out in the department of Microbiology, JSS Hospital, Mysore from January 2017 to December 2017. Bacterial pathogens and antibiotic resistance pattern of isolates from ET aspirates of patients on mechanical ventilation in Intensive care units were source of data. A total number of 1432 samples were received in the lab for ET aspirate culture. Among these 1432 samples, 1055 showed growth ranging from 10 2 to 106 colony forming units/ml (CFU/ml), 124 had no growth at all and 253 had no significant growth (

Background: Increased rates of Staphylococcus aureus resistance and its morbidity and mortality have raised concern about the strategy of antibiotic use. Objectives: This study aimed to determine the prevalence of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) isolates among Thai patients with S. aureus infection and to identify risk factors and appropriate antibiotics for these resistant strains. Methods: Data of culture-proven S. aureus isolates from clinical specimens during 2017 in King Chulalongkorn Memorial Hospital, Thailand, were retrospectively collected and classified as methicillin-sensitive S. aureus or MRSA by cefoxitin screening and oxacillin minimum inhibitory concentration by the Vitek 2 system. Each isolate was also tested for susceptibility to teicoplanin, erythromycin, clindamycin, linezolid, trimethoprim/sulfamethoxazole, ciprofloxacin, moxifloxacin, tetracycline, doxycycline, and vancomycin by Vitek 2. Demographic information and comorbidities from medical records were reviewed to identify risk factors for S. aureus infection. Results: MRSA isolates were identified in 147 (17%) of 890 patients with no different ratio in adults or children. A higher proportion of MRSA in hospital-acquired settings was observed (27% vs. 12%; p < 0.001). Comorbidities significantly associated with MRSA were chronic lung, cardiovascular, and neurological diseases. Atrial fibrillation, dementia, and benign prostatic hyperplasia were independently associated with MRSA isolation. Vancomycin was still susceptible to all kinds of infection. One VRSA isolate was from colonization. Conclusion: The prevalence of MRSA in our facility seemed to be comparatively low. Vancomycin is still an appropriate option for MRSA coverage since all S. aureus isolates in our center were sensitive to vancomycin. However, careful attention is warranted since one colonization isolate was VRSA. [ABSTRACT FROM AUTHOR]

Background: Diphtheria has been reported as an outbreak in some regions in Indonesia, most especially in East Java Province. Resistance to penicillin, erythromycin, and other antibiotics, single or multiple, has been reported in several studies. This study aims to evaluate the first-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae isolates.Methods: This descriptive observational study was performed from August to November 2018. C. diphtheriae isolates were collected from diphtheria patients and carriers in East Java from 2012 to 2017 and kept at the Balai Besar Laboratorium Kesehatan Daerah Surabaya or the Public Health Laboratory of Surabaya. Sample selection was done by random cluster sampling. The sensitivity test by E-test®of the five antibiotics (penicillin, oxacillin, erythromycin, azithromycin, and clarithromycin) was done to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute M45A (2015) Corynebacterium spp. for penicillin and erythromycin was used as standard.Results: From 114 targeted isolates, 108 were viable and toxigenic. The E-test was performed on the viable isolates. The majority of the hosts were male (58.3%), with median (range) age of 6.5 (1-14) years. Half of the samples were from the 1 to 5-year-old age group. The isolates were acquired much more from patients (78.7%) than carriers (21.3%) and from pharyngeal swab (74.1%). Most of these isolates were from Madura Island (47.2%) and the northern and eastern parts of the province (horseshoe area). Mitis isolates were the major variant (76.9%). The susceptibility pattern of C. diphtheriae to erythromycin was better than that to penicillin. The E-test result for penicillin was 68.52% susceptible, 31.48% intermediate, and 0% resistant (MIC range, < 0.016 to 2 μg/L) and for erythromycin (MIC range, < 0.016 to > 256 μg/L) was 85.2% susceptible, 12% intermediate, and 2.8% resistant The MIC range for oxacillin was 1 to 96 μg/L, while for both azithromycin and clarithromycin were <  0.016 to > 256 μg/L.Conclusion: The susceptibility rate of C. diphtheriae to erythromycin is higher than that to penicillin. The regular update of antibiotic selection to the national guidelines is recommended. The MIC reference standard to azithromycin and clarithromycin is also needed. [ABSTRACT FROM AUTHOR]

Background: Streptococcus pneumoniae may colonize the upper respiratory tract without causing any symptoms. Medical students may be inhabited by these bacteria and transmit them to patients who were prone to infections. Streptococcus pneumoniae resistance to antibiotics was recently reported. This study was conducted to determine whether there was Streptococcus pneumoniae colonization among Medical Students of the Faculty of Medicine Universitas Padjadjaran Batch 2011 and analyze its susceptibility patterns towards several antibiotics. Methods: A descriptive study was conducted involving 75 Medical Students of the Faculty of Medicine Universitas Padjadjaran Batch 2011 that met the selection criteria. After informed consent, oropharyngeal throat swab was taken and further identification was carried out. Once Streptococcus pneumoniae colony was identified, susceptibility testing would be performed. Results: The identification results indicate that 7 students (9%) were colonized by Streptococcus pneumoniae. The susceptibility test showed that out of 7 isolates, 2 were resistant to 1 antibiotic, 1 was resistant to 2 antibiotics, and 4 were resistant to 3 antibiotics. Meanwhile, Streptococcus pneumoniae was resistant to trimethoprim-sulfamethoxazole (71%), oxacillin (71%), erythromycin (57%), and levofloxacin (14%). Conclusions: Streptococcus pneumoniae colonization is found among medical students. All Streptococcus pneumoniae are resistant to one or more antibiotics, mostly to trimethoprim-sulfamethoxazole and oxacillin.

Objective: There is an increased prevalence of extended-spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) worldwide including India, which is a major concern for the clinicians, especially in intensive care units and pediatric patients. This study aims to determine the prevalence of ESBL-KP and antimicrobial sensitivity profile to plan a proper hospital infection control program to prevent the spread of resistant strains. Methods: KP isolates obtained from various clinical samples were evaluated to detect the production of ESBL by phenotypic methods. Antimicrobial susceptibility profile was also determined of all the isolates. Findings: Of 223 nonduplicate isolates of K. pneumoniae, 114 (51.1%) were ESBL producer and antimicrobial susceptibility profile showed the isolates were uniformly sensitive to imipenem and highly susceptible to beta-lactamase inhibitor combination drugs (67–81%) and aminoglycosides (62–76%), but less susceptible to third generation cephalosporins (14–24%) and non-β-lactam antibiotics such as nitrofurantoin (57%), fluoroquinolones (29–57%), piperacillin (19–23%), and aztreonam (15–24%). Conclusion: This study found that beta-lactamase inhibitor combinations are effective in treatment of such infections due to ESBL-KP thus these drugs should be a part of the empirical therapy and carbapenems should be used when the antimicrobial susceptibility tests report resistance against inhibitors combinations.

Catheter-associated urinary tract infection (CAUTI) is defined as a urinary tract infection associated with catheter placement for more than two consecutive days. Hence, antibiotic resistance in the context of CAUTIs represents a substantial challenge. The aim of this study was to present the characteristics of patients with CAUTI and the susceptibility pattern of CAUTI bacteria in the national reference hospital of the Sumatra region of Indonesia. A cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, Indonesia, from 2020 to 2021, using a total sampling. All CAUTI patients included were on catheterization and diagnosed based on the Centers for Disease Control and Prevention (CDC) guidelines. The patient's urine culture and antibiotic susceptibility test were carried out on the patient's admitted urine sample for further assessment. Identification of bacteria, antibiotic susceptibility test, and the extended-spectrum beta-lactamase (ESBL) test for Escherichia coli and Klebsiella pneumoniae were conducted using the VITEK-2 Compact. A total of 74 CAUTI patients were included in the study, 59.5% were female, 54.1% were 46-65 years old, and a third had cardiovascular disease comorbidities (33.8%). A total of 83 CAUTI-associated bacteria were isolated. The majority were Gram-negative bacteria (74.7%), and the most bacteria isolated was E. coli (31.3%), followed by K. pneumoniae, Enterococcus faecalis, Acinetobacter baumannii , and Enterococcus faecium . The ESBL test was positive mostly in K. pneumoniae (100%) and E. coli (76.9%). CAUTI-associated E. coli was susceptible to tigecycline, meropenem, ertapenem, nitrofurantoin, and gentamicin. The isolated K. pneumoniae was susceptible to tigecycline, meropenem, ertapenem, and amikacin. While E. faecalis showed susceptibility to tigecycline, nitrofurantoin, vancomycin, imipenem, linezolid, ampicillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, ampicillin/sulbactam, and piperacillin., Competing Interests: The authors declare no conflict of interest., (© 2023 The Author(s).)

Early onset Ventilator associated pneumonia (VAP) is usually less severe, associated with a better prognosis, and is more likely caused by antibiotic- sensitive bacteria. Late-onset VAP, is usually caused by multidrug resistant (MDR) pathogens and is associated with increased morbidity and mortality. Therefore, the local microbial flora causing VAP needs to be studied and appropriate therapy based on the early endotracheal (ET) aspirate culture report can help managing this group of patients. The present study was carried out in the department of Microbiology, JSS Hospital, Mysore from January 2017 to December 2017. Bacterial pathogens and antibiotic resistance pattern of isolates from ET aspirates of patients on mechanical ventilation in Intensive care units were source of data. A total number of 1432 samples were received in the lab for ET aspirate culture. Among these 1432 samples, 1055 showed growth ranging from 10 ²to 106 colony forming units/ml (CFU/ml), 124 had no growth at all and 253 had no significant growth (<10² CFU/ml) Out of 1055 isolates,1023 were Gram negative bacteria and 32 were Gram positive cocci . Acinetobacter, Pseudomonas and Klebsiella were the major pathogens in our study. Majority of them being MDR, maximum sensitivity was observed for Tigecycline and colistin in these isolates. Knowledge of causative microbial flora of VAP along with information on the susceptibility patterns will help in selection of the appropriate antibiotic for therapeutic use for better outcome. [ABSTRACT FROM AUTHOR]

ntroduction: Neonatal sepsis is a major cause of neonatal mortality and treated with antibiotics. The antibiotic susceptibility pattern varies from place to place at any point of time. Antimicrobial resistance, a burning problem globally, is due to irrational use of antibiotics. Drug utilization study is a strong tool for evaluating rational use of antibiotics. Aim: To evaluate the antimicrobial use pattern, to identify problems associated with rational drug utilization and to know the clinical outcomes of neonates under treatment with various antimicrobial regimens in neonatal sepsis. Also to suggest any steps can be taken for possible improvement in rational antimicrobials use in this condition. Materials and Methods: This was a descriptive observational study conducted from June, 2015 to September, 2016 in a Tertiary Care Teaching Hospital, Odisha, India. The consecutive neonatal sepsis cases, admitted to SNCU, Paediatrics Department, were included. The protocol was approved by IEC and written informed consents were obtained from the parents/guardians prior to the study. Total 204 diagnosed, screen positive neonatal sepsis cases of 0 -28 weeks old and both the sexes were enrolled. Demographic data like age, sex, place of delivery, gestational age and birth weight and antibiotic use data as per WHO guide line for drug utilization study were recorded in a case record form. The categorical data were expressed in percentage and mortality data was analyzed using GraphPad Prism ver.0.7 by Chi square test and p

Introduction: Chronic Suppurative Otitis Media (CSOM) still is a common health care problem in developing countries like India with its potential for serious local damage and complications. Knowledge of causative microorganisms and their antimicrobial sensitivity pattern is essential so that early and effective therapeutic measures can be initiated for better patient outcome. Aim: The study was carried out to determine the clinicomicrobiological spectrum of CSOM from this geographical area and to evaluate the susceptibility pattern of aerobic bacterial isolates. Materials and Methods: The prospective study was carried out for a period of one year from December 2013 to November 2014 in Chhatrapati Shivaji Subharti Hospital, a Tertiary Care Hospital in Meerut city. A total of 113 ear discharge was collected from clinically suspected cases of CSOM. The discharge was cultured on blood agar and Mac Conkey’s agar plates for isolation of bacterial pathogen and Sabourauds Dextrose Agar (SDA) slants for isolation of fungal pathogens. Identification of the bacterial and fungal isolates was done using standard bacteriological and mycological methods respectively. Antimicrobial susceptibility testing of the bacterial isolates was performed by Kirby-Bauer’s disc diffusion method as per the Clinical Laboratory Standards Institute (CLSI) guidelines. Further, detection of Metallo Beta Lactamase (MBL) production, Methicillin Resistance in Staphylococcus aureus (MRSA) and Extended Spectrum Beta –Lactamase (ESBL) production was carried out by phenotypic methods. Result: A total of 73.45% cases were culture positive. Pure bacterial pathogen was isolated from 67.46 % followed by pure fungal pathogen 22.89% and mixed pathogen (bacteria and fungus) from 9.63% of cases. Pseudomonas aeruginosa and Staphylococcus aureus were the predominant bacterial pathogen and Aspergillus spp. and Candida species were the predominant fungal pathogens isolated. Overall the rate of MBL producers, MRSA and ESBL producers were 18.18%, 52.94% and 62.5% respectively. Conclusion: High level of resistance was observed in cases of CSOM from our hospital. Therefore, knowledge of the causative microorganisms and its susceptibility pattern is required and this data may contribute to an effective management of cases of CSOM.

AbstrakAcinetobacter baumannii merupakan spesies Acinetobacter spp. tersering diisolasi darimanusia, dan lebih sering dijumpai pada infeksi nosokomial dibandingkan dengan infeksi dikomunitas. Eksistensi bakteri ini di lingkungan terkait dengan keragaman reservoir, kemampuanmemperoleh gen pembawa sifat resisten antimikroba, dan sifat resisten terhadap pengeringan.Infeksi disebabkan strain A.baumannii yang resisten terhadap banyak antibiotik tidak mudahdikendalikan dan menjadi permasalahan di berbagai negara. Penelitian ini bertujuan untukmengetahui prevalensi A.baumannii dari spesimen klinis di instalasi mikrobiologi klinik RSUPHaji Adam Malik serta pola kepekaannya terhadap berbagai antibiotik. Identifikasi dan ujikepekaan menggunakan mesin otomatis Vitek 2 dengan Advanced Expert System (AES).Penelitian ini menemukan 644/3693 (17,44%) isolat A.baumannii dari berbagai spesimen klinis.A.baumannii paling banyak diisolasi dari spesimen dahak. Penelitian ini menemukan 147/644(23%) bahwa isolat carbapenem-resistent A.baumannii (imipenem dan meropenem). Sebagianbesar isolat sensitif terhadap colistin, amikacin dan tigecycline. Prevalensi A.baumanni yangditemukan pada penelitian ini adalah rendah namun resistensinya tinggi terhadap antibiotikterutama golongan penicillin, cephalosporin dan fluoroquinolon.AbstractAcinetobacter baumannii is the most frequent species of Acinetobacter spp. isolated fromhumans and more common in nosocomial infection than it is in community acquired infection.A.baumannii existence in environment is associated with the diversity of its reservoirs, itscapacity to accumulate genes of antimicrobial resistence, and its resistence to desiccation.Infection of Multidrug resistent (MDR) strain of A.baumannii is not easy to manage and it hasbecome a problem in many countries. The aim of this retrospective study was to investigatethe prevalence of A.baumannii from routine clinical specimens sent to clinical microbiologylaboratory RSUP HAM Medan and its susceptibility pattern to various antibiotics. Identificationand susceptibility testing of A. baumannii was performed by Vitek 2 with Advanced ExpertSystem (AES). A total of 644/3693 (17.44%) A.baumannii isolates were identified from variousclinical specimens. From those isolates, there were 147 (23%) isolates of carbapenemresistentA.baumannii (imipenem and meropenem). A.baumannii mainly isolated from sputumspecimens, and most isolates were highly sensitive to colistin, amikacin and tigecycline.Low prevalence of A.baumannii was found in this study. However, the isolates showed highresistence level to antibiotics, particularly penicillin, cephalosporin and fluoroquinolones.