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Background and Objectives: Urinary tract infections (UTIs), one of the most prevalent bacterial infections, are facing limited treatment options due to escalating concern of antibiotic resistance. Urine cultures significantly help in identification of etiological agents responsible for these infections. Assessment of antibiotic susceptibility patterns of these bacteria aids in tackling the emerging concern of antibiotic resistance and establishment of empirical therapy guidelines. Our aim was to determine various agents responsible for urinary tract infections and to assess their antibiotic susceptibility patterns. Materials and Methods: This cross-sectional study was performed over a period of six months from January 2023 to July 2023 in Department of Microbiology of Pakistan Institute of Medical Sciences (PIMS). Results: Out of 2957 positive samples, Gram negative bacteria were the most prevalent in 1939 (65.6%) samples followed by Gram positive bacteria in 418 (14.1%) and Candida spp. in 269 (9.1%) samples. In gram negative bacteria, Escherichia coli (E. coli) was the most prevalent bacteria isolated from 1070 samples (55.2%) followed by Klebsiella pneumoniae in 397 samples (20.5%). In Gram positive bacteria, Enterococcus spp. was the most common bacteria in 213 samples (51%) followed by Staphylococcus aureus in 120 samples (28.7%). Amikacin was the most sensitive drug (91%) for Gram negative bacteria. Gram positive bacteria were most susceptible to linezolid (97%-100%). Conclusion: The generation of a hospital tailored antibiogram is essential for the effective management of infections and countering antibiotic resistance. By adopting antimicrobial stewardship strategies by deeper understanding of sensitivity patterns, we can effectively combat antibiotic resistance. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal Sepsis (NS) is a major cause of morbidity and mortality worldwide, especially in developing countries like India. The role of antimicrobials is life-saving in NS. To achieve a good prognosis, early diagnosis and appropriate treatment are required. Data related to the irrational use of antimicrobials in neonates are limited. Aim: To evaluate the drug usage pattern and Adverse Drug Reactions (ADRs) of antimicrobials in NS. Materials and Methods: A prospective observational study was conducted among 350 neonates who were admitted and diagnosed with NS from January to December 2021 in the Neonatal Intensive Care Unit (NICU) of PDU Medical College and Civil Hospital, Rajkot, Gujarat, India. Demographic data such as age, sex, birth weight, and clinical data such as type of delivery, type of sepsis, culture-sensitivity status, and antimicrobials used were recorded. Suspected ADRs were reported in the pharmacovigilance database. Categorical data were analysed in percentage, whereas some clinical data were analysed with mean and median using Microsoft Office Excel-2019. Results: In the present study, 172 (49.15%) male and 178 (50.85%) female neonates were almost equally affected. The mean gestational age and birth weight were 35±3.6 weeks and 2±0.7 kg, respectively. Early-Onset Neonatal Sepsis (EONS) cases were more at 273 (78%) compared to Late-Onset Neonatal Sepsis (LONS). Seventeen different antimicrobials were used. The average number of antimicrobials used per case was 2.9. The Piperacillin Tazobactam was the most commonly used antimicrobial in 173 cases (49.43%) in early-onset sepsis, while Meropenem was used in 40 cases (11.43%) in late-onset sepsis. Coagulase-negative Staphylococcus was the most commonly isolated organism in 15 cases (4.2%), followed by Klebsiella Pneumoniae in 13 cases (3.7%). Twelve out of 17 antimicrobials (70.59%) were not included in the first list of essential medicines for children of India in 2011. Six ADRs were reported in the present study. Conclusion: In all admitted cases of sepsis, empirical therapy was given, but variations from standard recommendations were observed in dose and frequency. A periodic survey of antimicrobial use patterns in NS will be useful in the rational selection of empirical therapy.

Background and Objectives: Urinary tract infections (UTIs), one of the most prevalent bacterial infections, are facing limited treatment options due to escalating concern of antibiotic resistance. Urine cultures significantly help in identification of etiological agents responsible for these infections. Assessment of antibiotic susceptibility patterns of these bacteria aids in tackling the emerging concern of antibiotic resistance and establishment of empirical therapy guidelines. Our aim was to determine various agents responsible for urinary tract infections and to assess their antibiotic susceptibility patterns. Materials and Methods: This cross-sectional study was performed over a period of six months from January 2023 to July 2023 in Department of Microbiology of Pakistan Institute of Medical Sciences (PIMS). Results: Out of 2957 positive samples, Gram negative bacteria were the most prevalent in 1939 (65.6%) samples followed by Gram positive bacteria in 418 (14.1%) and Candida spp. in 269 (9.1%) samples. In gram negative bacteria, Escherichia coli (E. coli) was the most prevalent bacteria isolated from 1070 samples (55.2%) followed by Klebsiella pneumoniae in 397 samples (20.5%). In Gram positive bacteria, Enterococcus spp. was the most common bacteria in 213 samples (51%) followed by Staphylococcus aureus in 120 samples (28.7%). Amikacin was the most sensitive drug (91%) for Gram negative bacteria. Gram positive bacteria were most susceptible to linezolid (97%-100%). Conclusion: The generation of a hospital tailored antibiogram is essential for the effective management of infections and countering antibiotic resistance. By adopting antimicrobial stewardship strategies by deeper understanding of sensitivity patterns, we can effectively combat antibiotic resistance.

Introduction: Burkholderia cepacia Complex (BCC) is a group of Gram negative betaproteobacteria with complex taxonomy that causes healthcare-associated infections and hospital outbreaks. BCC is the fourth most pathogenic non fermentative Gram negative bacilli worldwide, following Burkholderia cepacia, Acinetobacter baumannii, and Stenotrophomonas maltophilia, with a prevalence ranging between 10-20% for non fermentative Gram negative bacilli and 5-15% for BCC. Human infections are caused by 22 known species and 14 novel species. Pulmonary BCC infections lead to “Cepacia syndrome,” a fatal illness that results in progressive respiratory failure and necrotising pneumonia, leading to early death in 20% of cases. Aim: To emphasise the disease burden and clinical outcomes of BCC infections, as well as to assess the performance of various methods for BCC detection. Materials and Methods: A cross-sectional study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India. A total of 91,778 samples were received between April 2021 and December 2022, over a period of one year and nine months, to determine the disease burden of BCC. The identification of BCC was carried out using manual culture and sensitivity, VITEK®-2 ID/AST system, Matrix Assisted Laser Desorption Ionisation-Time of Flight Mass Spectrometry (MALDIToF-MS), recA gene virulence determinant by Polymerase Chain Reaction (PCR), and 16S Ribosomal ribonucleic acid (rRNA) sequencing. Out of 115 manually identified BCC isolates, 56 (48.70%) underwent automated Vitek® 2 ID/AST, MALDI-ToF-MS, recA gene PCR, and 16S rRNA sequencing for identification and characterisation. The results were entered into Microsoft Excel, and statistical analysis was performed using the International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 28.0. Results: Culture positivity was observed in 16,949 samples (18.47%), among which 3,387 (29.25%) were non fermentative gram negative bacilli. The incidence of Burkholderia spp. isolation was 115 (3.4%) out of 3,387 non fermentative gram negative bacilli. The prevalence of BCC among the study population was 115 (0.13%) out of 91,778. Conclusion: BCC, causing a wide array of infections, results in profound morbidity and mortality, especially in hospital settings. Early identification using Vitek-2 and MALDI-ToF-MS, along with molecular methods like PCR and 16S rRNA sequencing, could be the key to confirming the diagnosis and initiating appropriate management.

Background and Objectives: Antimicrobial resistance has emerged as a significant global health threat. Infections caused by Multi Drug-Resistant (MDR) bacteria pose formidable challenges in terms of treatment options and patient outcomes. Pus cultures serve as crucial diagnostic tools in identifying the agents responsible for various infections, and their antimicrobial susceptibility patterns which help in establishment of empirical therapy guidelines. This study was conducted to determine the pathogen and its susceptibility pattern from pus cultures and to generate antibiogram in our tertiary care setting. Materials and Methods: It was a cross-sectional study, conducted for a period of six months, from July 2022 to December 2022, in the Pathology Department of Pakistan Institute of Medical Sciences (PIMS). Results: Out of total 2507 samples received, 1242 (49.5%) showed positive culture. Among the 1242 positive samples, 364 were Gram positive cocci (GPCs) and 878 were Gram negative rods (GNRs). Methicillin resistant Staphylococcus aureus (MRSA) was the most common isolate (23%) followed by Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (16.9%), Enterobacter spp. (15.5%) and Escherichia coli (14.2%). Vancomycin was found to be highly effective (100%) against MRSA. GPCs were highly susceptible to linezolid (98%) while GNRs showed high level of sensitivity to colistin (96%) and tigecycline (92%). Conclusion: The generation of a local antibiogram specific to the hospital setting is essential to effectively manage infections empirically and preserve the efficacy of existing antibiotics. By implementing antimicrobial stewardship practices based on a better understanding of antibiotic susceptibility patterns, we can contribute to the mitigation of antibiotic resistance and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Antimicrobial resistance has emerged as a significant global health threat. Infections caused by Multi Drug-Resistant (MDR) bacteria pose formidable challenges in terms of treatment options and patient outcomes. Pus cultures serve as crucial diagnostic tools in identifying the agents responsible for various infections, and their antimicrobial susceptibility patterns which help in establishment of empirical therapy guidelines. This study was conducted to determine the pathogen and its susceptibility pattern from pus cultures and to generate antibiogram in our tertiary care setting. Materials and Methods: It was a cross-sectional study, conducted for a period of six months, from July 2022 to December 2022, in the Pathology Department of Pakistan Institute of Medical Sciences (PIMS). Results: Out of total 2507 samples received, 1242 (49.5%) showed positive culture. Among the 1242 positive samples, 364 were Gram positive cocci (GPCs) and 878 were Gram negative rods (GNRs). Methicillin resistant Staphylococcus aureus (MRSA) was the most common isolate (23%) followed by Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (16.9%), Enterobacter spp. (15.5%) and Escherichia coli (14.2%). Vancomycin was found to be highly effective (100%) against MRSA. GPCs were highly susceptible to linezolid (98%) while GNRs showed high level of sensitivity to colistin (96%) and tigecycline (92%). Conclusion: The generation of a local antibiogram specific to the hospital setting is essential to effectively manage infections empirically and preserve the efficacy of existing antibiotics. By implementing antimicrobial stewardship practices based on a better understanding of antibiotic susceptibility patterns, we can contribute to the mitigation of antibiotic resistance and improve patient outcomes.

Introduction: Burkholderia cepacia Complex (BCC) is a group of Gram negative betaproteobacteria with complex taxonomy that causes healthcare-associated infections and hospital outbreaks. BCC is the fourth most pathogenic non fermentative Gram negative bacilli worldwide, following Burkholderia cepacia, Acinetobacter baumannii, and Stenotrophomonas maltophilia, with a prevalence ranging between 10-20% for non fermentative Gram negative bacilli and 5-15% for BCC. Human infections are caused by 22 known species and 14 novel species. Pulmonary BCC infections lead to "Cepacia syndrome," a fatal illness that results in progressive respiratory failure and necrotising pneumonia, leading to early death in 20% of cases. Aim: To emphasise the disease burden and clinical outcomes of BCC infections, as well as to assess the performance of various methods for BCC detection. Materials and Methods: A cross-sectional study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India. A total of 91,778 samples were received between April 2021 and December 2022, over a period of one year and nine months, to determine the disease burden of BCC. The identification of BCC was carried out using manual culture and sensitivity, VITEK®-2 ID/AST system, Matrix Assisted Laser Desorption Ionisation-Time of Flight Mass Spectrometry (MALDIToF-MS), recA gene virulence determinant by Polymerase Chain Reaction (PCR), and 16S Ribosomal ribonucleic acid (rRNA) sequencing. Out of 115 manually identified BCC isolates, 56 (48.70%) underwent automated Vitek® 2 ID/AST, MALDI-ToF-MS, recA gene PCR, and 16S rRNA sequencing for identification and characterisation. The results were entered into Microsoft Excel, and statistical analysis was performed using the International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 28.0. Results: Culture positivity was observed in 16,949 samples (18.47%), among which 3,387 (29.25%) were non fermentative gram negative bacilli. The incidence of Burkholderia spp. isolation was 115 (3.4%) out of 3,387 non fermentative gram negative bacilli. The prevalence of BCC among the study population was 115 (0.13%) out of 91,778. Conclusion: BCC, causing a wide array of infections, results in profound morbidity and mortality, especially in hospital settings. Early identification using Vitek-2 and MALDI-ToF-MS, along with molecular methods like PCR and 16S rRNA sequencing, could be the key to confirming the diagnosis and initiating appropriate management. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to evaluate the antibacterial and solubility properties of four luting cements in artificial saliva at varying pH and clarify the composition by chemical analysis. Samples of bioceramic (C1), two resin-modified glass ionomer (C2 and C3), and zinc phosphate (C4) cements were stored on media with Streptococcus mutans and artificial saliva (pH 4.6 and pH 6.5). The disc diffusion method was used to evaluate antibacterial activity. In the solubility test, cement discs were stored in artificial saliva (pH 4.6 and pH 6.5) and distilled water (pH 7). After 48 and 120 hours, the solubility of the cement specimens was determined. Chemical analysis was performed by X-ray fluorescence. The growth inhibition zones of S. mutans induced by C4 were the largest in any pH values tested (p

The aim of this in vitro study was to evaluate the antibacterial and solubility properties of four luting cements in artificial saliva at varying pH and clarify the composition by chemical analysis. Samples of bioceramic (C1), two resin-modified glass ionomer (C2 and C3), and zinc phosphate (C4) cements were stored on media with Streptococcus mutans and artificial saliva (pH 4.6 and pH 6.5). The disc diffusion method was used to evaluate antibacterial activity. In the solubility test, cement discs were stored in artificial saliva (pH 4.6 and pH 6.5) and distilled water (pH 7). After 48 and 120 hours, the solubility of the cement specimens was determined. Chemical analysis was performed by X-ray fluorescence. The growth inhibition zones of S. mutans induced by C4 were the largest in any pH values tested (p < 0.05). The solubility of C4 was significantly higher than the solubility of other cements. C2 had the smallest inhibition zones and was least soluble in all media during the observation period, but without significant differences. After 48 hours, the solubility of C4 was significantly higher at pH 4.6 compared to control. The solubility of the cements, excluding C2, was significantly higher after 120 hours at pH 6.5. A significant association was found between larger amount of zinc oxide in cement composition and a larger zone of inhibition. Lower solubility was associated with higher amounts of aluminium and silicon oxides in the cement. Thus, cement containing higher amounts of zinc oxides had the highest antibacterial activity. In the solubility test, cements were more soluble in acidic media than in neutral media, and lower solubility was detected in cements containing more aluminium and silicon oxides. In clinical practice, C1 or C3 may be suggested when there is a higher risk of caries due to more desirable combination of antibacterial activity and lower solubility, for a lower caries risk C2 might be suggested. [ABSTRACT FROM AUTHOR]

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Objective: In this study, it was aimed to investigate the change of antibiotic susceptibility of Acinetobacter baumannii strains over the years and to help develop antibiotic use policy by determining the multiple antibiotic resistance rate. Methods: Acinetobacter species isolated from various clinical samples sent to Necip FazılCity Hospital Microbiology Laboratory between January 2013 and December 2018 were included. Vitek 2 Compact (bioMérieux-SE, France) automated systems were used for the identification and antibiotic susceptibility of the isolates. Results: Acinetobacter isolates were isolated at the most from tracheal aspirate samples (n=73; 35%) and samples sent from Anesthesia and Reanimation intensive care unit(n=160; 68%). The distribution of antibiotic sensitivity percentages (%) was given as yearly, three-year averages for 2013-2015, 2016-2018, and the total average for 2013-2018. In the study period, the highest sensitivity was determined to colistin at 97% and the lowest to ceftriaxone at 5%. When the antibiotic sensitivity rates of A. baumannii are evaluated roughly; In the period of 2016-2018, compared to 2013-2015, there was a decrease in sensitivity to amikacin, ampicillin-sulbactam, cefepime, ceftriaxone, colistin and tigecycline, while sensitivity to other antibiotics was observed. Multiple antibiotic resistance was examined in a total of 237 A. baumannii isolated. Multidrug resistant (MDR) resistance was 92%, Extensively Drug Resistant (XDR) resistance was 84% and Pan Drug Resistant(PDR) resistance was 3%. Conclusion: It is observed that resistance against some antibiotics has increased in A. baumannii over the years, and resistance to some antibiotics has decreased. It seems that our XDR resistance rate is very high. Our PDR resistance rate is higher than that of America, but lower than many European countries. In the other hand our result is lower than the average of Turkey. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the antibacterial activities of OrthoMTA, RetroMTA, and ProRoot MTA against Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi). Materials and Methods: Each material was mixed on a glass slab using a spatula and was placed in columns containing the filter membrane of the modified membrane-enclosed immersion test (MEIT) system. The materials were sterilized after setting. The columns containing the sterilized test materials were placed in microcentrifuge tubes containing 500 µl of bacterial suspension. The systems were then incubated at 37°C under anaerobic conditions. After 72 hours, the bacterial growth and concentration (colony-forming unit (CFU)/ml) were assessed. The results were analyzed using one-way analysis of variance (ANOVA) and Tukey's post-hoc test in SPSS 22 software. In all analyses, the differences were considered significant at P

Objectives: The aim of this study was to assess the antibacterial activities of OrthoMTA, RetroMTA, and ProRoot MTA against Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi). Materials and Methods: Each material was mixed on a glass slab using a spatula and was placed in columns containing the filter membrane of the modified membrane-enclosed immersion test (MEIT) system. The materials were sterilized after setting. The columns containing the sterilized test materials were placed in microcentrifuge tubes containing 500 μl of bacterial suspension. The systems were then incubated at 37°C under anaerobic conditions. After 72 hours, the bacterial growth and concentration (colony-forming unit (CFU)/ml) were assessed. The results were analyzed using one-way analysis of variance (ANOVA) and Tukey's post-hoc test in SPSS 22 software. In all analyses, the differences were considered significant at P<0.05. Results: OrthoMTA had the highest antibacterial activity against Pi. The mean number of CFU/ml of Fn in the presence of ProRoot MTA and RetroMTA was significantly lower than that in positive controls. There were significant differences between the antibacterial activities of ProRoot MTA and OrthoMTA against Pg compared to positive controls. Conclusions: ProRoot MTA, OrthoMTA, and RetroMTA had similar antibacterial activities against the three evaluated anaerobic endodontic bacteria, except RetroMTA against Pg. [ABSTRACT FROM AUTHOR]

Background and Objectives: Infection of pleural fluid is a common disease and because of antibiotic administration, the microbiology of this fluid has changed. The aim of this study was to determine the common bacteria and suitable antibiotics for treatment in pleural effusion (PE). Materials and Methods: In this cross sectional study, 1210 samples with exudative features were cultured for possible growth of microbial pathogens and then examined for antibiotics sensitivity. Samples' characteristics were then analyzed according to the age and sex difference. Results: Among 1210 exudative pleural effusions, 38.2% were obtained from females and 61.8% from males. Of 142 pleural fluid samples, 11.7% had a positive culture. Aerobic gram negative organism was the most common type among the other samples with a prevalence of 52% followed by aerobic gram positive (25.3%), non- aerobic gram negative (15.7%), non- aerobic gram positive (6.2%) and fungi (0.8%). E. coli, Staphylococcus Aureus and Acinetobacter baumannii were the most common types of organism among adult population. Conclusion: Aerobic gram positive bacteria had the highest prevalence among the pathogens, and cephalosporins, aminopenicillins and β-lactams were the most effective antibiotics for their treatment. [ABSTRACT FROM AUTHOR]

Background: Infections are the most common complications in patients with pemphigus vulgaris. The inappropriate use of antibiotics increases the morbidity and mortality of these patients. Objectives: To determine the most common bacteria associated with sepsis in hospitalized patients with pemphigus vulgaris, their antimicrobial susceptibility patterns and to assess their association with mortality. Patients and methods: A retrospective, analytical, descriptive and observational study was made. We had two groups, patients with pemphigus vulgaris (group 1) and a control group of patients without autoimmune disease who suffered sepsis (group 2) when were admitted to General Hospital of Mexico. To identify bacterial agents, we used routine microbiological methods. Results: In both groups, Gram-negative bacteria were the most common isolated. Pseudomonas aeruginosa was the most commonly isolated, being sensitive to ceftazidime (40%) and imipenem (40%), and resistant to ciprofloxacin (67%) and levofloxacin (21%). Conclusions: There is an increased frequency of infections by Gram-negative bacteria. It is important to select appropriate initial antimicrobial therapy according to local pathogens and to perform epidemiological strategies to decrease the risk of acquisition of pathogens responsible of severe sepsis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the antibacterial activities of OrthoMTA, RetroMTA, and ProRoot MTA against Fusobacterium nucleatum ( Fn ), Porphyromonas gingivalis ( Pg ), and Prevotella intermedia ( Pi ) ., Materials and Methods: Each material was mixed on a glass slab using a spatula and was placed in columns containing the filter membrane of the modified membrane-enclosed immersion test (MEIT) system. The materials were sterilized after setting. The columns containing the sterilized test materials were placed in microcentrifuge tubes containing 500 μl of bacterial suspension. The systems were then incubated at 37°C under anaerobic conditions. After 72 hours, the bacterial growth and concentration (colony-forming unit (CFU)/ml) were assessed. The results were analyzed using one-way analysis of variance (ANOVA) and Tukey's post-hoc test in SPSS 22 software. In all analyses, the differences were considered significant at P<0.05., Results: OrthoMTA had the highest antibacterial activity against Pi . The mean number of CFU/ml of Fn in the presence of ProRoot MTA and RetroMTA was significantly lower than that in positive controls. There were significant differences between the antibacterial activities of ProRoot MTA and OrthoMTA against Pg compared to positive controls ., Conclusions: ProRoot MTA, OrthoMTA, and RetroMTA had similar antibacterial activities against the three evaluated anaerobic endodontic bacteria, except RetroMTA against Pg .