Search

Background Tigecycline is an antimicrobial agent with a broad spectrum of activity against both Gram-positive and Gram-negative bacteria. However, mobile tigecycline resistance gene clusters, such as tnfxB-tmexCD-toprJ , have spread globally. The prevalence of tigecycline-resistant Enterobacterales in clinical settings in Japan is unknown. Objectives To investigate the tnfxB-tmexCD-toprJ gene cluster in the genome sequences of Enterobacterales clinical isolates in Japan. Methods We investigated the tnfxB-tmexCD-toprJ cluster from the genome sequences of 5143 Enterobacterales isolates collected from 175 hospitals around Japan between 2019 and 2020 as part of a national genomic surveillance program for antimicrobial-resistant bacteria. Results The tnfxB1-tmexCD1-toprJ1 cluster was detected in two Klebsiella pneumoniae isolates in 2019. One isolate possessed a 299.4 kb IncFIB(K) plasmid, pJBBGAAF19431, and the other possessed a 224.9 kb IncHI1B/IncFIB(K) hybrid plasmid, pJBEAACG19501, co-carrying multiple antimicrobial resistance genes, including extended-spectrum β-lactamase genes, bla OXA-1 and bla CTX-M-27, respectively, along with tnfxB1-tmexCD1-toprJ1. The genetic context of the tnfxB1-tmexCD1-toprJ1 -surrounding structure on pJBBGAAF19431 was similar to that of a K. pneumoniae plasmid pHNAH8I-1 from a chicken in China in 2017, and the cluster was embedded in an apparently intact mobile DNA element: strand-biased circularizing integrative element. The tnfxB1-tmexCD1-toprJ1 on pJBEAACG19501 was embedded in a Tn 3 family transposon related to Tn As1. The plasmid pJBEAACG19501 was highly similar to that of K. pneumoniae , isolated from humans in China in 2021. Conclusions tmexCD-toprJ was present in Japan as of 2019. Even in Japan, where the clinical use of tigecycline is significantly rare, tmexCD-toprJ -harbouring multidrug-resistant Enterobacterales is a public health threat and requires continuous monitoring. [ABSTRACT FROM AUTHOR]

AbstractTo promote the accurate administration of linezolid, this study aimed to evaluate its dosage regimens in critically ill patients with varying renal functions. This evaluation was based on a combined analysis of pharmacokinetic (PK), pharmacodynamic (PD), and toxicodynamic (TD) indices. The percentage of therapeutic target attainment (PTTA) was used as the index for PK/PD/TD, defined as simultaneously meeting two PK/PD criteria (AUC0-24h/MIC ≥ 100 and Css between 2.6–7.8 mg/L) and adjusted for toxicity probability, with MICs ranging from 0.5 to 8 mg/L. The recommended doses of linezolid for patients: 600 mg every 12 h for normal renal function or mild renal impairment, 300 mg every 12 h for severe renal impairment, 450 mg every 12 h for moderate renal impairment, and 600 mg every 8 h for supra-normal renal function. In conclusion, specific dosing regimens should be adopted for patients with varying renal functions, combined with therapeutic drug monitoring, to ensure the safety and efficacy of linezolid. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) strains circulating among populations and crossing borders constitute a major problem for health control and require a fast and simple genotypic approach. The objective of this study was to determine the prevalence, molecular types and drug resistance pattern of S. aureus isolated from Hospitalized Patients in teaching Hospitals of Ahvaz. This cross-sectional study was from April to September 2023, MRSA strains were identified by phenotypic and molecular methods. The antibiotics studied were), Cefoxitin (15 μg) Gentamicin (10 μg), Ciprofloxacin (5 μg), Erythromycin (15 μg), Clindamycin (2 μg), linzolide (10μg), azithromycin (5 μg). The tests were performed according to the guidelines of clinical and Laboratory Standards Institute (CLSI). It also detected the mecA gene of MSRA strains. 470 Staphylococcus aureus samples from patients hospitalized in different departments of Ahvaz Hospitals included 283 blood culture samples, 75 wound samples, 72 body fluid samples and 40 catheter samples, and 321 (68.3%) MRSA isolates were reported. All these 321 MRSA isolates were tested with ampicillin, ciprofloxacin, clindamycin, linezolid, gentamicin, erythromycin, and azithromycin antibiotics. Also, the results of molecular identification of the mec A gene in 321 strains of S. aureus showed that 312 strains carry the mec A gene. The high prevalence of S. aureus samples can be caused by long-term hospitalization of patients in the ward and excessive use of antibiotics to treat the infection and increased resistance in isolates. As a result, more monitoring of the hospital's infection control department, as well as the expansion of the correct use of antibiotics, seems necessary and important. [ABSTRACT FROM AUTHOR]

Methicillin-resistant S. aureus (MRSA) strains circulating among populations and crossing borders constitute a major problem for health control and require a fast and simple genotypic approach. The objective of this study was to determine the prevalence, molecular types and drug resistance pattern of S. aureus isolated from Hospitalized Patients in teaching Hospitals of Ahvaz. this cross-sectional study was from April to September 2023, MRSA strains were identified by phenotypic and molecular methods. The antibiotics studied were), Cefoxitin (15 μg) Gentamicin (10 μg), Ciprofloxacin (5 μg), Erythromycin (15 μg), Clindamycin (2 μg), linzolide(10μg), azithromycin(5 μg). The tests were performed according to the guidelines of clinical and Laboratory Standards Institute (CLSI). It also detected the mecA gene of Methicillin-resistant S. aureus strains (MRSA). 470 Staphylococcus aureus samples from patients hospitalized in different departments of Ahvaz Hospitals included 283 blood culture samples, 75 wound samples, 72 body fluid samples and 40 catheter samples, and 321 (68.3%) MRSA isolates were reported. All these 321 MRSA isolates were tested with ampicillin, ciprofloxacin, clindamycin, linezolid, gentamicin, erythromycin, and azithromycin antibiotics. Also, the results of molecular identification of the mec A gene in 321 strains of S. aureus showed that 312 strains carry the mec A gene. The high prevalence of S. aureus samples can be caused by long-term hospitalization of patients in the ward and excessive use of antibiotics to treat the infection and increased resistance in isolates. As a result, more monitoring of the hospital's infection control department, as well as the expansion of the correct use of antibiotics, seems necessary and important.

Methicillin-resistant Staphylococcus aureus (MRSA) bacteria is spreading in the community. It is a global threat that has caused serious infections in the community as well as health centers. This study was aimed to evaluate the pattern of antibiotic resistance and the prevalence of SCCmec types (I- IV) among community (CA-MRSA) and healthcare-associated (HA-MRSA) MRSA strains isolated from the clinical samples of hospitalized children. A total of 93 S. aureus isolates were collected from the clinical samples sent to Ahvaz Children's Medical Center Hospital, Ahvaz, Iran in a period of six months. The clinical samples of hospitalized children were used to determine the pattern of resistance to 8 different antibiotics including methicillin. Based on our results, out of 93 S. aureus isolates, 59 isolates were methicillin resistant. The presence of mec gene was indicated in 54 isolates, while 5 isolates were shown to lack this gene. Furthermore, assessment of the prevalence of SCCmec types (I- IV) among MRSA isolates showed type Ⅳ as the highest prevalent SCCmec type. The high prevalence of antibiotic resistant S. aureus samples can be attributed to long-term hospitalization of patients in the ward, the excessive use of antibiotics to treat infections and the increased occurrence of antibiotic resistance among clinical isolates. As a result, correct and appropriate use of antibiotics along with strict monitoring of the hospital's infection control department, seems both necessary and important.

Methicillin-resistant Staphylococcus aureus (MRSA) bacteria is spreading in the community. It is a global threat that has caused serious infections in the community as well as health centers. This study was aimed to evaluate the pattern of antibiotic resistance and the prevalence of SCCmec types (I- IV) among community (CAMRSA) and healthcare-associated (HA-MRSA) MRSA strains isolated from the clinical samples of hospitalized children. A total of 93 S. aureus isolates were collected from the clinical samples sent to Ahvaz Children's Medical Center Hospital, Ahvaz, Iran in a period of six months. The clinical samples of hospitalized children were used to determine the pattern of resistance to 8 different antibiotics including methicillin. Based on our results, out of 93 S. aureus isolates, 59 isolates were methicillin resistant. The presence of mec gene was indicated in 54 isolates, while 5 isolates were shown to lack this gene. Furthermore, assessment of the prevalence of SCCmec types (I-IV) among MRSA isolates showed type IV as the highest prevalent SCCmec type. The high prevalence of antibiotic resistant S. aureus samples can be attributed to long-term hospitalization of patients in the ward, the excessive use of antibiotics to treat infections and the increased occurrence of antibiotic resistance among clinical isolates. As a result, correct and appropriate use of antibiotics along with strict monitoring of the hospital's infection control department, seems both necessary and important. [ABSTRACT FROM AUTHOR]

Simple Summary: Streptococcus agalactiae, a significant pathogen affecting humans and aquatic species, is causing high morbidity and mortality in fish, particularly Nile tilapia (Oreochromis niloticus). This study focuses on S. agalactiae infection in cultured O. niloticus, examining transmission, sources, risk factors, clinical signs, pathogenesis, virulence factors, and methods for diagnosis, treatment, control, and prevention. Streptococcus agalactiae (Group B Lancefield) has emerged as a significant pathogen affecting both humans and animals, including aquatic species. Infections caused by S. agalactiae are becoming a growing concern in aquaculture and have been reported globally in various freshwater and marine fish species, particularly those inhabiting warm water environments. This has led to numerous outbreaks with high morbidity and mortality in fish. Nile tilapia (Oreochromis niloticus), a member of the Cichlid family, is one of the severely affected fish species by S. agalactiae. The current study aims to focus on S. agalactiae infection in cultured O. niloticus with reference to its transmission and sources of infection; risk factors influencing GBS infection, disease clinical signs, lesions, and pathogenesis; S. agalactiae virulence factors; and how to diagnose, treat, control, and prevent infection including vaccination and herbal extract medication. [ABSTRACT FROM AUTHOR]

Background Development of rapid bacterial identification from blood cultures has been an area of intense study in diagnostic microbiology. Shortened turnaround time coupled with antimicrobial stewardship interventions have been shown to improve patient outcomes and decrease healthcare-associated costs. Objectives We report the validation of a short incubation method for Gram-positive and Gram-negative bacterial identification utilizing MALDI-TOF MS without additional instrumentation, processing or cost compared with current practice. Methods Prospective, observational, single-centre study in a quaternary care academic hospital encompassing 376 blood cultures subjected to bacterial identification after short incubation periods of 3–4 and 6–8 h. Results There was 97.5% species-level identification agreement with tests undertaken after 3–4 h incubation with 83.6% isolates identified, and 99.7% species-level identification agreement after 6–8 h incubation with 96.7% isolates identified. Conclusions The short incubation method provides a rapid MALDI-TOF MS bacterial identification method, reducing turnaround time by 10–18 h compared with standard practice without additional cost, processing or instrumentation. [ABSTRACT FROM AUTHOR]

We aimed to investigate the detection rate of causative organisms in stone-related pyelonephritis and to compare their distribution according to patient backgrounds. We retrospectively identified patients with stone-related pyelonephritis. Clinical data were collected between November 2012 and August 2020 at Wakayama Medical University Hospital, including on patient backgrounds and causative organisms. Patients were categorized by Eastern Cooperative Oncology Group performance status (PS) as the good PS group (0, 1) and the poor PS group (2–4). Bacteria were divided into Gram-positive cocci (GPC) or non-GPC groups and logistic regression analysis was used to examine factors that predict detection of GPC. Seventy-nine patients had stone-related pyelonephritis, 54 (68.4 %) in the good PS group and 25 (31.6 %) in the poor PS group. In the good PS group, Escherichia coli (67 %) was followed by Klebsiella species (9 %), while in the poor PS group, Escherichia coli (20 %) was followed by Enterococci and Staphylococci (12 %). GPC detection rate was significantly higher in the poor PS group than in the good PS group (40.0 % vs 14.8 %, p = 0.016), and multivariate logistic regression analysis showed that poor PS was an independent factor predicting detection of GPC (OR = 6.54, p = 0.02). The distribution of the causative organisms in stone pyelonephritis was similar to that in common complicated urinary tract infections. Poor PS may be an independent predictor of GPC detection in patients with stone pyelonephritis. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance is a serious concern and life threat in public health globally. Gram-positive clinical isolates are one of the leading etiological agents showing drug resistance traits. This study aimed to detect the antimicrobial resistance pattern of clinically isolated Gram-positive bacterial isolates collected from various renowned diagnostic centers of Dhaka city, Bangladesh. Methods: A laboratory-based cross-sectional study was conducted at the Microbiological Laboratory of the Department of Microbiology, Stamford University Bangladesh. A total of 104 clinical specimens (wound swab, pus, blood, urine, ear discharge, nasal swab, sputum, nipple discharge, breast milk, catheter tip, umbilical swab, and throat swab) from different age groups were collected from some renowned diagnostic centers of Dhaka city for analyzing the cultural and drug sensitivity patterns from January 2023 to April 2023. According to the study plan, only the Gram-positive bacteria were collected and transported to the laboratory of the Department of Microbiology, Stamford University Bangladesh following WHO guidelines, and the antimicrobial susceptibility tests were carried out by Kirby–Bauer disk diffusion method and the results were interpreted as per CLSI guidelines, 2022. Results: This study highlights the presence of Staphylococcus aureus (65.4%), Streptococcus spp. (23.1%), and Enterococcus spp. (11.5%) as causative agents of Gram-positive bacterial infections from overall 104 clinical specimens. Most of our isolates were found multidrug-resistant. For S. aureus isolates, cefixime (100%); for Streptococcus spp., doxycycline (95.83%); and for Enterococcus spp., amoxicillin (100%), cefixime (100%), colistin (100%), and cotrimoxazole (100%) were found to be the most ineffective drug when compared to other antibiotics. Conclusion: Our study portrayed the remarkable antibiotic resistance feature of Gram-positive bacterial isolates which is a matter of public health concern. It is necessary to carry out a continuous assessment of antibiotic sensitivity patterns of resistant Gram-positive bacteria; otherwise, it will become an uncontrollable problem not only in Bangladesh but also worldwide in the near future.

Background We examined the association between hypoglycemia and the occurrence of early onset sepsis (EOS) in premature infants admitted to the neonatal intensive care unit (NICU). Methods We included infants discharged from 358 NICUs between 1997 and 2020 with gestational age <34 weeks, ≥1 culture collected in the first 3 days of life, and ≥1 serum glucose value recorded on the day of or day prior to culture collection. We used multivariable logistic regression and inverse probability weighting (IPW) and constructed models for three definitions of hypoglycemia: American Academy of Pediatrics (AAP), Pediatric Endocrine Society, and a definition based on neurodevelopmental studies. We performed subgroup analysis in EOS episodes caused by Gram-negative and Gram-positive organisms. Results Of the 62,178 infants and 64,559 cultures that met study inclusion criteria, 739 (1%) cultures were positive. The median (25th, 75th percentile) glucose value was 75 mg/dL (50, 106) on the day of or day prior to a positive culture versus 70 mg/dL (50, 95) on the day of or day prior to a negative culture. We found that hypoglycemia was not associated with the occurrence of EOS for all organisms and Gram-positive organisms, whereas there was a small but significant association between the lower AAP glucose cutoff value and EOS due to Gram-negative organisms (logistic regression: risk difference [RD] 0.24% [95% CI, 0.01-0.47]; IPW: RD 0.22% [95% CI, 0.00-0.43]). Conclusions Hypoglycemia may be an early marker of EOS, particularly in episodes caused by Gram-negative organisms and when using a stricter definition of hypoglycemia. [ABSTRACT FROM AUTHOR]

Background Invasive infections caused by Streptococcus pyogenes (invasive group A streptococcus [iGAS]) and Streptococcus pneumoniae (invasive pneumococcal disease [IPD]) decreased substantially at the beginning of the COVID-19 pandemic. Our study sought to evaluate the extent of this decrease and the trends of these infections since reversion of societal adjustments incident to the pandemic. We also wanted to compare the frequency of these infections with invasive community-onset Staphylococcus aureus (I-CO-SA) infections and common respiratory viral infections in this period. Methods Cases of iGAS, IPD, and I-CO-SA infections were identified prospectively and retrospectively at 2 large US children's hospitals by positive cultures from July 2018 through December 2022. Admission data were used to estimate frequency. For comparison, rates of respiratory syncytial virus (RSV), influenza, and SARS-CoV-2 were estimated by the number of positive viral test results at each institution. Results I-CO-SA infections showed little variation in the study period. Rates of iGAS infection and IPD decreased by 46% and 44%, respectively, from 2019 to 2020, coinciding with a substantial decrease in RSV and influenza. In 2022, RSV and influenza infection rates increased to prepandemic winter season rates, coinciding with a return to prepandemic rates of IPD (225% increase from 2021 to 2022) and a surge above prepandemic rates of iGAS infections (543% increase from 2021 to 2022). Conclusions The COVID-19 pandemic had an unexpected influence on IPD and iGAS infections that was temporally related to changes in rates of viral infections. [ABSTRACT FROM AUTHOR]

Introduction The annual incidence of infective endocarditis (IE) is 3-9 cases per 100000 in developed countries and most cases are due to staphylococci and streptococci. IE due to Gram-positive anaerobic cocci (GPAC) is very rare. Case report We present a case of a 38-year-old female with Anaerococcus hydrogenalis bacteremia and infective endocarditis of the native mitral valve. She presented with fever, chills, and abdominal pain. A computed tomographic scan of the abdomen showed splenic abscesses. Blood cultures and broad-range PCR from the splenic abscess sample were negative. Transthoracic echocardiography showed a mobile filamentous structure on the atrial side of the anterior mitral leaflet which was suggestive for infective endocarditis. Karius test (cell-free microbial DNA testing) showed Gram-positive anaerobic cocci Anaerococcus hydrogenalis. She was successfully treated with antibiotics. Conclusions In cases of infection with fastidious organisms like GPACs, the use of next-generation sequencing (NGS) can allow the correct identification of culprit pathogens and streamlined treatment. [ABSTRACT FROM AUTHOR]

Leopard cat (Prionailurus bengalensis euptilurus) is a small wild cat assessed as an endangered wildlife in Korea. There have been very few reports of their diseases. Herein, we describe fibrinous pleuritis caused by Streptococcus canis infection with excessive pleural effusion, hydropericardium, mild ascites, and liver fibrosis in a leopard cat. S. canis is a commensal microflora in domestic cats and often affects the upper respiratory tract inducing chronic and severe respiratory diseases. However, there is no literature regarding the S. canis in leopard cats. Therefore, we first report fibrinous pleuritis associated with an S. canis infection in a leopard cat. [ABSTRACT FROM AUTHOR]

Abstract Streptococcus canis is a beta-haemolytic, Gram-positive cocci commonly identified on the canine ocular surface under both healthy and diseased conditions. The objective of the study was to determine the prevalence of S. canis on the normal and abnormal ocular surface of a canine ophthalmology referral population in Canada, and to investigate potential clinical aspects that may be associated with its presence. Included were 59 dogs (118 eyes) with unilateral or bilateral ocular disease diagnosed at the time of conjunctival sampling. A real-time PCR specific for S. canis was standardized for use with conjunctival swabs. Total DNA was extracted from 118 samples and used as template for the diagnostic assay. Samples were considered positive if amplification was detected and dissociation temperature matched a positive control. Signalment and other clinical data were also collected at the time of sampling. Of the 118 eyes sampled, 8 tested positive for S. canis (6.8%). No association between the detection of S. canis and breed, cephalic conformation, sex, age, use of ophthalmic antibiotics or other topical medications, ophthalmic diagnosis, use of systemic antibiotics or other systemic medications, or systemic diagnosis was identified. In conclusion, S. canis may be present on the ocular surface of dogs at a higher rate than previously reported. It is suggested that this may be linked to the use of PCR for pathogen detection instead of culture.

Background and Objectives: The study conducted involves reviewing the current scenario of antimicrobial resistance in the community by obtaining collected data from patients suffering from ongoing infective disorders andanalyzing their culture and sensitivity reports. Methods: We have collected the samples from 56 patients with infective disorders such as cellulitis, wound infection, pneumonia, cultured the samples and checked for the sensitivity of various different antibiotics using the disc diffusion methods according to CLSI standards. We have also checked for the morphology of the organism by routine microscopy using gram stain. Results: We have noted that the Gram-positive Cocci infections are more prevalent in our community settings and there was also a high level of resistance seen in both gram-negative and gram-positive organisms, towards the standard empirical antibiotic Cefotaxime used in such patients. Hence, we had to switch to a more effective antibiotic according to the patterns of resistance. The presence of resistance to other antibiotics was also noted. Interpretation & Conclusion: There is an increased level of resistance towards once considered highly effective broad-spectrum antibiotics in the community. This may be a result of inappropriate and overzealous usage of antibiotics by patients. This may be a result of improper supervision or no strict guidelines when it comes to the prescription of antibiotics. Hence many different strategies must be deployed in order to tackle the development of resistance to useful antibiotics. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance in methicillin-resistant Staphylococcus aureus and beta-lactamase-producing Gram-negative bacteria is a global health concern necessitating research and the development of effective antimicrobial agents. This study, conducted in May 2020 in Mwanza, Tanzania, aimed to determine the antibacterial activity of metabolites from soil-isolated Bacillus species against clinical bacterial pathogens. One soil-isolated Bacillus species, identified as Bacillus altitudinis/pumilus complex, showed antibacterial activity against Gram-positive cocci, including a methicillin-resistant S. aureus strain with inducible clindamycin resistance, previously isolated from a patient with osteomyelitis. Bacillus altitudinis/pumilus complex metabolites may be a potential source of antimicrobial agents against multidrug-resistant bacteria. What this study adds: The study supports existing research on the discovery and development of new antimicrobial agents against multi-drug-resistant bacteria. We report the antimicrobial activity of metabolites extracted from soil-isolated Bacillus altitudinis/pumilus complex strains against Gram-positive bacteria, including a methicillin-resistant Staphylococcus aureus strain with inducible clindamycin resistance

Streptococcus canis is a beta-haemolytic, Gram-positive cocci commonly identified on the canine ocular surface under both healthy and diseased conditions. The objective of the study was to determine the prevalence of S. canis on the normal and abnormal ocular surface of a canine ophthalmology referral population in Canada, and to investigate potential clinical aspects that may be associated with its presence. Included were 59 dogs (118 eyes) with unilateral or bilateral ocular disease diagnosed at the time of conjunctival sampling. A real-time PCR specific for S. canis was standardized for use with conjunctival swabs. Total DNA was extracted from 118 samples and used as template for the diagnostic assay. Samples were considered positive if amplification was detected and dissociation temperature matched a positive control. Signalment and other clinical data were also collected at the time of sampling. Of the 118 eyes sampled, 8 tested positive for S. canis (6.8%). No association between the detection of S. canis and breed, cephalic conformation, sex, age, use of ophthalmic antibiotics or other topical medications, ophthalmic diagnosis, use of systemic antibiotics or other systemic medications, or systemic diagnosis was identified. In conclusion, S. canis may be present on the ocular surface of dogs at a higher rate than previously reported. It is suggested that this may be linked to the use of PCR for pathogen detection instead of culture. [ABSTRACT FROM AUTHOR]

Nuhamin Melaku Gebremariam,1 Adane Bitew,2 Estifanos Tsige,3 Daniel Woldesenbet,4 Mekdes Alemu Tola5 1Ethiopian National Accreditation Office, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Clinical Bacteriology and Mycology National Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 4Mailman School of Public Health, Columbia University ICAP in Ethiopia, Addis Ababa, Ethiopia; 5Armauer Hansen Research Institute, Addis Ababa, EthiopiaCorrespondence: Mekdes Alemu Tola, Email mekdesalemu1@gmail.comBackground: Gram-positive cocci are clinically important pathogens that cause infections and their development of antibiotic resistance continues to pose a severe threat to public health. Therefore, this study aims to investigate the level of antimicrobial resistance among Gram-positive cocci isolated from different clinical samples among patients referred to Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia.Methods: From January to April 2018, a cross-sectional study was conducted at Arsho Advanced Medical Laboratory. Seven hundred ninety-two (792) different clinical samples were obtained from 792 individuals and inoculated into blood culture bottles and Blood Agar base. Bacterial identification was done using the number, type, and morphology of colonies, as well as Gram staining, catalase testing, and coagulase test after isolation of pure growth on culture media using the standard operating procedure. VITEK 2 compact system was used for bacterial identification and drug susceptibility testing. The information entry and analysis were performed by using SPSS version 20.Results: Out of 792 clinical samples cultured, the prevalence of Gram-positive cocci was 12.6% (n=100/792). The most frequent one is S. aureus 54% (n=54/100) followed by coagulase-negative Staphylococcus species 42% (n=42/100), S. agalactiae 1% (n=1/100) and E. faecalis 3% (n=3/100). Penicillin showed the highest resistance rate 85% (n=85/100), followed by sulfamethoxazole/trimethoprim (47%), and oxacillin (38%); however, highest sensitivity was seen towards linezolid 97% (n=97/100) and vancomycin 94% (n=94/100). The total multi-drug resistance (MDR) Gram-positive cocci were 44% (n=44/100).Conclusion: This study demonstrated high antimicrobial resistance and multi-drug resistance. This suggests that the importance of continuous monitoring of antimicrobial resistance patterns is crucial for selecting the suitable drug for treatment and infection prevention.Keywords: antimicrobial resistance, Gram-positive cocci, multi-drug resistance

Healthcare-Associated Infections (HAIs) are of global concern in this present era and white coats play an important role in the transmission of HAIs. The most common healthcare-associated bacteria are Enterococcus species, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa and Enterobacter species (ESKAPE bugs). These healthcare-associated bacteria are capable of surviving on white coats which could act as fomites in the transmission of HAIs. The purpose of this study was to compare the duration of survival of healthcare-associated bacteria on different materials used for making white coats. Materials like pure cotton, artificial cotton, cotton silk, spun and crepe were cut into swatches of 1cm2 size and sterilized by autoclaving. Five different bacteria isolated from clinical specimens were grown on 5 % sheep blood agar and bacterial suspensions were made in sterile physiological saline. The swatches were immersed in bacterial suspension and kept in petri plates at 25°C. The viable counts of bacteria were determined at definite time intervals by surface plate method. The present study shows that among the healthcare-associated bacteria, S.aureus survived the maximum up to 52 days. The duration of survival of S.aureus was significantly longer than P.aeruginosa and A.baumannii (p

Introduction: Enterococci are considered less virulent organisms, but have incurred recognition for being notorious for their acquisition and transfer of resistance. The greatest potential threat posed by enterococci is vancomycin resistance. The transfer of enterococcal vancomycin resistance to Staphylococcus aureus has been achieved making scientists apprehensive of its consequences. Aim: To find the prevalence of Vancomycin-Resistant Enterococci (VRE) and to determine the antimicrobial resistance pattern in enterococcal urinary isolates. Materials and Methods: A cross-sectional study was carried out on all urinary samples suspected of Urinary Tract Infection (UTI) received for duration of one year from April 2021 to March 2022 in the Department of Microbiology at Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh. Enterococci were isolated and identified with a VITEK-2® COMPACT (bioMérieux) automated system. The antibiotic susceptibility pattern was determined by Kirby-Bauer disc diffusion method. Further, confirmation of VRE was done by Minimum Inhibitory Concentration (MIC) E-test. Results: A total of 128 urinary enterococcal isolates were identified with the male-to-female ratio 1.37:1 and mean age of patients was 37.18±22.64 years. Out of total, 71.87% were identified as Enterococcus faecalis followed by 24.21% Enterococcus faecium and the rare species (4%) including E.durans, E.hirae, E.raffinosus. The prevalence of VRE was found to be 8.6%. Maximum resistance by isolates has been shown against ampicillin, erythromycin, ciprofloxacin, and doxycycline. All isolates were sensitive to linezolid. Nitrofurantoin resistance was observed in 4.34% and 25.80% of E.faecalis and E.faecium isolates respectively. Conclusion: In this study, it was revealed that the emergence of VRE in urinary isolates with antimicrobial resistance was higher among E. faecium. All this puts pressure on strict compliance with a multidimensional approach with collaboration of antibiotic stewardship, educational and surveillance programs.

Antimicrobial resistance in methicillin-resistant Staphylococcus aureus and beta-lactamase-producing Gram-negative bacteria is a global health concern necessitating research and the development of effective antimicrobial agents. This study, conducted in May 2020 in Mwanza, Tanzania, aimed to determine the antibacterial activity of metabolites from soil-isolated Bacillus species against clinical bacterial pathogens. One soil-isolated Bacillus species, identified as Bacillus altitudinis/pumilus complex, showed antibacterial activity against Gram-positive cocci, including a methicillin-resistant S. aureus strain with inducible clindamycin resistance, previously isolated from a patient with osteomyelitis. Bacillus altitudinis/pumilus complex metabolites may be a potential source of antimicrobial agents against multidrug-resistant bacteria. What this study adds: The study supports existing research on the discovery and development of new antimicrobial agents against multi-drug-resistant bacteria. We report the antimicrobial activity of metabolites extracted from soil-isolated Bacillus altitudinis/pumilus complex strains against Gram-positive bacteria, including a methicillin-resistant Staphylococcus aureus strain with inducible clindamycin resistance. [ABSTRACT FROM AUTHOR]

The genus Aerococcus spp. comprise microaerophilic, catalase-negative, Gram-positive cocci that show alpha-haemolytic growth on blood agar. They have a tendency to divide on two planes at a 90° angle, and rapid multiplication leads to the formation of Grampositive cocci in tetrads and irregular clusters. Aerococcus spp. are capable of causing invasive and fatal systemic illnesses, such as endocarditis, bactereamia, arthritis, and meningitis. Due to evolving diagnostic tools, it is now identified as a pathogen in a variety of disorders instead of being considered a contaminant. Most isolates are susceptible to penicillins, but there is increasing resistance to cephalosporins, ciprofloxacin, cotrimoxazole, clindamycin, vancomycin, and tetracycline. Here, authors present a rare case of Aerococcus viridans meningitis in a patient who underwent surgical excision of a left trigeminal Schwannoma, along with the drug susceptibility pattern resistant to most first-line antibiotics used against isolates from Streptococci spp., except doxycycline.

Introduction One of the most severe complications of diabetes is the diabetic foot syndrome. Left untreated, it may result in the loss of a limb, and patients who have undergone a high-level amputation are at an extremely high risk of mortality. Diabetic neuropathy presents as three main concurrent clinical manifestations - sensory neuropathy, motor neuropathy and autonomic neuropathy. Together, these phenomena account for the development of the neuropathic ulceration. Infection represents the main factor complicating the healing process, thus, leading to the amputation of the extremity. Aim The objective of this study was to analyse the microbial species composition of infection-causing microorganisms in patients treated due to a diabetic foot wound infection at the Laboratory of Wound Healing in Łódź (Pracownia Leczenia Ran, Łódź). Material and methods A retrospective analysis of the randomly selected medical histories of 27 patients aged 36-80 years was performed. The study involved patients with neuropathic, or neuropathic and ischaemic foot lesions, who were clinically diagnosed with a wound infection according to the criteria provided in the guidelines of the IWGDF (Inter-national Working Group on Diabetic Foot). The material for the study included microbiological specimens collected from the infected diabetic foot wounds. Testing was performed for aerobic and anaerobic bacteria, following the culture method. Results In the study group, the most common type of diabetic foot was the neuropathic foot, diagnosed in 16 subjects, including 10 patients of mature age and 6 patients of senile age. Diabetic neuropathic-ischaemic foot was found in 11 participants, including 2 patients of mature age and 9 patients of senile age. In patients over 60 years of age, a mixed diabetic foot was more frequently observed than in the younger subjects. The most common pathogen isolated from wound infections was Staphylococcus aureus, present in 48.1% of isolates. In terms of multispecies infections (13 isolations), Staphylococcus aureus was also most frequently isolated, and was present in 7 patients, whereas Enterococcus faecalis was found in 6 participants. Discussion The lack of correlation between diabetes type one or two and the diabetic foot type stems from the similar progression of complications, although the pathomechanism leading to the development of diabetes itself is different. Furthermore, no correlation was found between the number of bacterial species isolated and the diagnosis of the diabetic foot type. In diabetic foot infections developing in temperate climates, Gram-positive cocci are the most commonly identified pathogens. Conclusions The results of the microbiological tests provide the basis for the most favourable local empirical antibiotic therapy, which needs to be initiated immediately after the infection diagnosis, even before the objective identification of the aetiological agent. The therapeutic decision should also be based on the clinical status evaluation and on the outcome of the empirical treatment to date. [ABSTRACT FROM AUTHOR]

Introduction: Urinary tract infections (UTIs) are one of the widespread human microbial disorders affecting all the age groups, which may involve the whole part of the urinary tract from the urethra to kidneys and are associated with a significant burden of mortality and morbidity. Although various microorganisms, including viruses, fungi, and parasites, are responsible for UTIs, bacteria are the leading cause. The prevalence of uropathogens in cases of UTI varies according to demographic features, community or hospital-based and also due to the use of different antibiotics in the community and hospital settings. Aim of the Study: To determine the prevalence of uropathogens and their antibiotic susceptibility pattern in rural populations. Study Design: This is a cross-sectional observational study conducted at the Department of Microbiology, Dr.PSIMS & RF, Chinaoutapalli, Andhra Pradesh. Materials and Methods: A total of 1378 clean-catch midstream urine samples from clinically suspected cases of UTI which were received from outpatient and inpatient set-up of various clinical departments were processed according to standard protocol and guidelines and the isolated pathogens were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method and interpreted according to CLSI guidelines. Results: In the present study, the prevalence of UTI is 29.53%, where Escherichia coli is the predominant isolate (56.06), followed by Klebsiella spp (16.95%) and among Gram-positives, Enterococcus faecalis is the predominant isolate (10.81%) followed by Staphylococcus aureus (2.70%). Conclusion: As the prevalence of bacterial uropathogens as well as their antibiotic sensitivity pattern varies in different geographical locations and time to time it is important that the diagnosis of UTI is not only dependent on the clinical signs and symptoms, it should be correlated with the positive urine culture and the antibiotic susceptibility pattern of the uropathogen isolated. Without having knowledge about the prevalence of uropathogens in that particular area and their susceptibility pattern, starting empirical antibiotic therapy will not only prolong the disease and lead to complications in the patients, and a negative consequence will also be added in the form of the development of multidrug resistance (MDR). [ABSTRACT FROM AUTHOR]

The results from the phase 3 study that evaluated the efficacy and safety of tedizolid phosphate, an oxazolidinone drug, for the treatment of gram-positive ventilated hospital-acquired bacterial pneumonia (vHABP)/ventilator-associated bacterial pneumonia (VABP) compared with linezolid (VITAL study), have been previously reported. We conducted a subgroup analysis to report the data obtained from Japanese patients enrolled in this study. Patients aged ≥18 years with vHABP/VABP likely to be caused by gram-positive cocci were randomized 1:1 to tedizolid phosphate 200 mg once daily for 7 days or linezolid 600 mg twice daily for 10 days. In both treatment groups, patients with concurrent gram-positive bacteremia were treated for 14 days. Primary efficacy endpoints were day 28 all-cause mortality (ACM) and investigator-assessed clinical response at test-of-cure (TOC) in the intention-to-treat population. Safety outcomes included assessment of treatment-emergent adverse events. Fifty-three Japanese patients were randomized at received study drug (tedizolid, n = 28; linezolid, n = 25). Demographics and characteristics were generally similar between treatment groups. Rates of day 28 ACM were 10.7% and 20.0% with tedizolid and linezolid, respectively (difference, 9.3%; 95% CI, −10.1 to 28.7). Rates of investigator-assessed clinical cure at TOC were 78.6% and 72.0% with tedizolid and linezolid, respectively (difference, 6.6%; 95% CI, −16.7 to 29.8). Tedizolid phosphate was generally well tolerated and no new safety concerns were observed in the Japanese subgroup. The results from this subgroup analysis suggest generally favorable efficacy and safety of tedizolid in adult Japanese patients with vHABP/VABP. (ClinicalTrials.gov identifier: NCT02019420). [ABSTRACT FROM AUTHOR]

Background: Spontaneous bacterial peritonitis (SBP) is defined as a bacterial infection of the ascitic fluid without a surgically treatable intra-abdominal infection source. SBP is a common, severe complication in cirrhosis patients with ascites, and if left untreated, in-hospital mortality may exceed 90%. However, the incidence of SBP has been lowered to approx. 20% through early diagnosis and antibiotic therapy. Clinical awareness, prompt diagnosis, and immediate treatment are advised when caring for these patients to reduce mortality and morbidity. Aim: To discuss important issues comprising types of SBP, pathogenesis, bacteriology, including the emergence of multidrug-resistant (MDR) microorganisms, prompt diagnosis, risk factors, prognosis, treatment strategies, as well as recurrence prevention through antibiotic prophylaxis until liver transplantation and future trends in treating and preventing SBP in detail. Methods: This article is a literature review and appraisal of guidelines, randomized controlled trials, meta-analyses, and other review articles found on PubMed from between 1977 and 2022. Results: There are three types of SBP. Bacterial translocation from GI tract is the most common source of SBP. Therefore, two thirds of SBP cases were caused by Gram-negative bacilli, of which Escherichia coli is the most frequently isolated pathogen. However, a trend of Gram-positive cocci associated SBP has been demonstrated in recent years, possibly related to more invasive procedures and long-term quinolone prophylaxis. A diagnostic paracentesis should be performed in all patients with cirrhosis and ascites who require emergency room care or hospitalization, who demonstrate or report consistent signs/symptoms in order to confirm evidence of SBP. Distinguishing SBP from secondary bacterial peritonitis is essential because the conditions require different therapeutic strategies. The standard treatment for SBP is prompt broad-spectrum antibiotic administration and should be tailored according to community-acquired SBP, healthcare-associated or nosocomial SBP infections and local resistance profile. Albumin supplementation, especially in patients with renal impairment, is also beneficial. Selective intestinal decontamination is associated with a reduced risk of bacterial infection and mortality in high-risk group. Conclusions: The standard treatment for SBP is prompt broad-spectrum antibiotic administration and should be tailored according to community-acquired SBP, healthcare-associated or nosocomial SBP infections and local resistance profile. Since the one-year overall mortality rates for SBP range from 53.9 to 78%, liver transplantation should be seriously considered for SBP survivors who are good candidates for transplantation. Further development of non-antibiotic strategies based on pathogenic mechanisms are also urgently needed. [ABSTRACT FROM AUTHOR]