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Aims: Ready-to-eat [RTE] animal products like ponmo are preferred by consumers due to its palatability and quality. However, foodborne pathogens particularly Staphylococcus aureus are sources of concern due to cross-contamination of raw and cooked cowhide. This study aimed to investigate the incidence of enterotoxigenic S. aureus in ready-to-eat locally processed cowhide. Methodology: Sixty (60) RTE cowhide samples were collected from different locations in Lagos, Nigeria and analyzed using conventional microbiological and molecular techniques for the detection of toxigenic S. aureus contamination. Suspected S. aureus isolates were confirmed by the presence of thermostable endonuclease [nuc] gene in their genome. Results: Result showed that 25 (41.67%) and 20 (33.50%) samples harbored coagulase-positive S. aureus and 20 other bacterial species different from S. aureus, respectively while 15 (24.83%) of the tested ponmo samples yielded no bacterial growth. Thirteen of the 15 randomly selected from the 25 suspected isolates were confirmed as S. aureus by the presence of thermostable endonuclease [nuc] gene in their genome. Enterotoxigenic genes were confirmed in all the 13 PCR detected S. aureus. Enterotoxin B gene is most prevalent in ponmo. Multiplex PCR detection of S. aureus enterotoxins [SE] genes revealed the molecular detection of different isolates carrying staphylococcal enterotoxin types A and B, mixed strain carrying both staphylococcal enterotoxins type A and type D. Antibiotic susceptibility of 20 S. aureus isolates revealed varying degrees of susceptibility patterns against the antimicrobial agents. Generally, gentamicin 70% (14/20), azithromycin 75% (15/20), co-trimoxazole 85% (17/20), levofloxacin 95% (19/20) were the most effective antibiotics to S. aureus. A low, ?50% susceptibility was recorded to chloramphenicol 55% (11/20) and nitrofurantoin 65% (13/20). A higher resistance to streptomycin (90%; 18/20) and ceftazidime (95%; 19/20) was identified, with resistance to ceftazidime being the highest (95%; 19/20). Conclusion: It can be concluded that RTE ponmo vended in the study sites is of low hygienic quality and may be of health risk to consumers. High level hygiene practice and good manufacturing practices are required during the production, distribution and marketing of ponmo to curb the potential health consequences of eating ponmo.
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Aims: Our proposal aimed to evaluate Acyl Homoserine Lactones (AHL) as a functional marker for Multi drug resistant (MDR) potential in clinical isolates of Acinetobacter baumannii. We investigated the AHL production potential of clinical isolates using a biosensor assay directly on a commonly used agar media. Place and Duration of Study: Department of Molecular Diagnostics and Biomarkers, Gleneagles Global Hospitals, Lakdikapul, Hyderabad-500004. Methodology: Antimicrobial drug sensitivity testing (AST) was performed on 72 clinical isolates of A. baumannii against two front-line antibiotics, Imipenem (10µg) and Meropenem (10µg), by Kirby-Bauer disk diffusion method. Production of long chain Acyl Homoserine lactone (AHLs) in the clinical isolates of A. baumannii was tested by cross streaking with the biosensor Chromobacterium violaceum mutant strain CV026 and Agrobacterium tumefaciens (NTL4pZLR4) by agar plate diffusion assay. Screening and identification of the quorum sensing mediator gene abaI was done by PCR to confirm its presence in all the 72 clinical isolates. Results: Out of the 72 clinical isolates, 58 were Carbapenem resistant Acinetobacter baumannii (CRAB) and 14 were Carbapenem sensitive Acinetobacter baumannii (CSAB) for AST by agar disc diffusion method. None of our isolates produced short chain AHLs whereas all the isolates could produce varying amounts of long chain AHLs. Genotypic confirmation of AHL gene was obtained by abaI gene PCR. Conclusion: Carbapenems are the front-line antibiotics used to treat gram negative bacterial infections in emergencies and in the critical care units of hospitals. Clinical isolates A. baumannii has innate resistance to several antibiotics due to various mechanisms, biofilms forming the first line of defense against antibiotics for the bacterium. Our study used AST to carbapenem as the leading marker for MDR, assuming the innate resistance of A. baumannii to other beta lactam antibiotics. Our study brought out certain important observations namely: a) All clinical isolates of A. baumannii produced Quorum Sensing signal molecules, the AHLs b) the clinical isolates of A. baumannii did not produce any short chain AHLs b) All the clinical isolates of A. baumannii produced long chain AHLs c) AHL production is not specific to carbapenem drug resistance because even CSAB isolates produced AHL d) AHL production is inherent to all clinical isolates of A. baumannii and it apparently indicates an underlying biofilm potential and MDR trait in these A. baumannii isolates. e) AHLs could be a universal marker for revealing MDR trait and biofilm potential in clinical microbiology AST profiling protocols.
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Background & objectives: This study was aimed at estimating the proportion among sputum smear-positive tuberculosis (TB) patients diagnosed at a tertiary care centre in India, who did not undergo universal drug-susceptibility testing (UDST), assessing the sociodemographic and morbidity-related factors associated with it, ascertaining the reasons for not getting tested and estimating the proportion with any drug resistance (DR). Methods: TB Notification Register and TB Laboratory Register, maintained in Designated Microscopy Centre and Intermediate Research Laboratory, respectively were used to obtain the patient details and information regarding UDST and DR-TB status. Under UDST, the TB patients had undergone rapid molecular tests to check for any DR. TB patients who dropped out of this strategy (those who did not submit a sputum sample for DR testing even after being instructed) were telephonically contacted and asked regarding reasons for not getting themselves tested. Results: Of the 215 patients, 74 [34.4%, 95% confidence interval (CI): 28.1-41.2] did not undergo UDST. Of these 74 participants, 60 per cent reported the reason that they were not informed regarding the drug-susceptibility test. Among the 141 patients who underwent UDST, six (4.3%, 95% CI: 1.58-9.03) had DR. Non-UDST patients were significantly more in percentage among TB patients who were aged <30 years (adjusted prevalence ratio 2.36; 95% CI: 1.19-4.68) compared to >60 years. Interpretation & conclusions: The present findings point towards a need to sensitize healthcare workers and TB patients to improve UDST.
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Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.
Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados para o isolamento completo do Mycobacterium tuberculosis.
Subject(s)
Humans , Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Multidrug-Resistant , Mycobacterium tuberculosis , Rifampin/therapeutic use , Rifampin/pharmacologyABSTRACT
BACKGROUND Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry (MALDI-TOF MS) allows rapid pathogen identification and potentially can be used for antifungal susceptibility testing (AFST). OBJECTIVES We evaluated the performance of the MALDI-TOF MS in assessing azole susceptibility, with reduced incubation time, by comparing the results with the reference method Broth Microdilution. METHODS Resistant and susceptible strains of Candida (n = 15) were evaluated against fluconazole and Aspergillus (n = 15) against itraconazole and voriconazole. Strains were exposed to serial dilutions of the antifungals for 15 h. Microorganisms' protein spectra against all drug concentrations were acquired and used to generate a composite correlation index (CCI) matrix. The comparison of autocorrelations and cross-correlations between spectra facilitated by CCI was used as a similarity parameter between them, enabling the inference of a minimum profile change concentration breakpoint. Results obtained with the different AFST methods were then compared. FINDINGS The overall agreement between methods was 91.11%. Full agreement (100%) was reached for Aspergillus against voriconazole and Candida against fluconazole, and 73.33% of agreement was obtained for Aspergillus against itraconazole. MAIN CONCLUSIONS This study demonstrates MALDI-TOF MS' potential as a reliable and faster alternative for AFST. More studies are necessary for method optimisation and standardisation for clinical routine application.
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Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.
A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados para o isolamento completo do Mycobacterium tuberculosis.
Subject(s)
Humans , Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Lymph Node/microbiology , Tuberculosis/diagnosis , Diagnostic Techniques and ProceduresABSTRACT
Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.
Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados para o isolamento completo do Mycobacterium tuberculosis.
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AIM: To investigate the bacterial flora and antibiotic susceptibility testing of conjunctival sac in adolescents after wearing orthokeratology(OK)lens.METHODS:A total of 101 adolescents aged 8 to 14 who admitted to outpatient department of Xi'an No.1 Hospital from September 2021 to August 2022 were recruited in this cross-sectional observational study. There were 51 cases wearing OK Lens(wearing group)and 50 patients not wearing contact lens(non-lens group), the right eye of all patients was selected into the group. The culture of bacterial flora in conjunctival sac between the two groups were compared, the species were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the antibiotic susceptibility testing was carried out for the positive strains cultured in the wearing group.RESULTS:The positive rate of conjunctival sac bacterial cultured in the wearing group and the non-lens group was 68.6%(35/51)and 60.0%(30/50), respectively(P>0.05). In both groups, the bacteria with the highest detection rate were staphylococcus epidermidis and staphylococcus aureus. The sensitivity rates of the strains detected in the wearing group to drugs are as follows: Levofloxacin(98%), Moxifloxacin(98%), Gatifloxacin(98%), Cefuroxime(98%), Cefathiamidine(98%), Rifampicin(98%), Chloramphenicol(96%), Cefoxitin(95%), Clindamycin(80%), Gentamicin(74%), Fusidic acid(72%), Tobramycin(64%), Compound sulfamethoxazole(26%), Mezlocillin(10%), Azithromycin(6%), of which the sensitivity rate of Gram-positive cocci was 100% sensitive to Vancomycin.CONCLUSION:Gram-positive cocci are the main bacteria isolated from conjunctival sac of adolescents after wearing OK Lens. Wearing OK Lens will not significantly increase the positive rate of conjunctival sac bacterial flora. Results of antibiotic susceptibility testing may provide guidance for empirical medication in patients wearing OK lens after eye infection.
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Purpose: To study the antifungal susceptibility of common corneal pathogenic fungi to antifungal agents in the North Indian population. Methods: Prospective study of the antifungal sensitivity testing (natamycin, amphotericin B, voriconazole, itraconazole, fluconazole, posaconazole, caspofungin, micafungin) of fungal isolates from 50 cases of culture positive fungal keratitis by using E test method. Details noted included demographic data, visual acuity, clinical details, grade of keratitis, healing time, and success in medical management. Results: Of 50 patients with fungal keratitis (mean age: 40.28 ± 16.77 years), 12 eyes healed within 3 weeks, 14 had a delayed healing response, and 24 had chronic keratitis. Among the 15 cases of Fusarium isolates, 93.3% were sensitive to natamycin, while 40% to amphotericin B; 66.6% to voriconazole, 13.4% to itraconazole and fluconazole each. 80% of Fusarium cases (n = 12) showed susceptibility to posaconazole. Among Aspergillus flavus isolates, 53.4% (n = 8) were sensitive to natamycin, with only 40% (n = 7) showing sensitivity to amphotericin B and good susceptibility to azoles. MIC against susceptible Fusarium spp. for natamycin was 3–16 ?g/mL, amphotericin B: 1–8 ?g/mL, voriconazole: 0.5–1.5 ?g/ mL, itraconazole: 0.5–12 ?g/mL, posaconazole: 0.094–1.5 ?g/mL. MIC against Aspergillus flavus was natamycin: 8–32 ?g/mL, amphotericin B: 0.5–16 ?g/mL, voriconazole: 0.025–4 ?g/mL, itraconazole: 0.125–8 ?g/mL, posaconazole: 0.047–0.25 ?g/mL; against Aspergillus niger isolates, to natamycin was 6 ?g/mL (n=1), amphotericin B 8–12 ?g/mL (n = 3), voriconazole: 0.125–0.19 ?g/mL (n = 3), itraconazole: 0.38–0.75 ?g/mL, posaconazole: 0.064–0.19 ?g/mL and against Aspergillus fumigatus (n = 1), was natamycin4 ?g/ mL, amphotericin B ? 8 ?g/mL, voriconazole 0.25 ?g/mL, itraconazole 1 ?g/mL, and posaconazole 0.19 ?g/mL. MIC against susceptible Acremonium spp. for natamycin was 1.5–16 ?g/mL, amphotericin B: 0.5–8 ?g/mL, voriconazole: 0.19–3 ?g/mL, itraconazole: 0.125 ?g/mL, posaconazole: 0.125–0.5 ?g/mL and against susceptible Curvularia was natamycin 0.75–4 ?g/mL, amphotericin B 0.5–1 ?g/mL, voriconazole 0.125–0.19 ?g/mL, itraconazole 0.047–0.094 ?g/mL, posaconazole 0.047–0.094 ?g/mL. MIC against Mucor spp.+ Rhizopus spp. (n = 1) was natamycin: 8 ?g/mL, amphotericin B: 0.75 ?g/mL, posaconazole: 1.5 ?g/ mL. MIC against of Alternaria (n = 1) was voriconazole: 0.19 ?g/mL, posaconazole: 0.094 ?g/mL. MIC against Penicillium (n=1) was natamycin: 8 ?g/mL, voriconazole: 0.25 ?g/mL, itraconazole: 0.5 ?g/mL, and Posaconazole: 0.125 ?g/mL. Conclusion: Our observations highlight the variations in susceptibility to antifungal agents. Posaconazole seems to be effective with low MIC against common corneal pathogenic fungal isolates
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Purpose: To analyze the pattern of bacterial pathogens causing infective keratitis and their resistance to the recommended antibiotics over six years. Methods: It was a retrospective study of 9,357 cases of bacterial keratitis from January 2015 to December 2020, at a tertiary care ophthalmic center. A total of 9,547 corneal specimens were obtained from the study subjects. Demographic details of the patients, pathogenic bacteria isolated, and their antimicrobial susceptibility were noted and analyzed. Results: Bacterial pathogens were identified in 23.52% of the specimens. The most common isolates were coagulase?negative Staphylococci (60.75%), followed by Pseudomonas aeruginosa (14.23%), Staphylococcus aureus (13.92%), gram negative bacilli of the family Enterobacterales (8.64%), Streptococcus spp. (1.72%), Acinetobacter spp. (0.13%), and other non?fermenting gram?negative bacilli (0.57%). In Staphylococci, 55–80% of isolates were resistant to erythromycin, and 40–70% to fluoroquinolones, while no resistance was observed against vancomycin. 40–60% of isolates of P. aeruginosa were resistant to cephalosporins, 40–55% to fluoroquinolones, and 30–60% to aminoglycosides. Also, 40–80% of isolates of Enterobacterales were resistant to cephalosporins, and 50–60% to fluoroquinolones. Most gram?negative isolates were susceptible to carbapenems and polymyxin B. Conclusion: To the best of our knowledge, our study is the largest compilation of microbiological profile of bacterial keratitis from North India. It highlights the current trend of the bacterial pathogens that cause infectious keratitis. Staphylococci and Pseudomonas were found to be the most common pathogens. Increased resistance was seen against some of the commonly prescribed empirical antibiotics. Such evidence is useful for restructuring the empirical prescription practices from time to time.
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Schizophyllum commune is a basidiomycotic fungus that grows ubiquitously on trees and rotting wood. Human infections caused by it are of diverse presentation but are very rare. We present a case of sinusitis caused by S. commune in a 58-year-old female patient with post-COVID-19 infection along with a history of allergic rhinitis and diabetes mellitus type 2. Computed tomography scan findings established the clinical diagnosis of fungal maxillary sinusitis which was confirmed with culture report and polymerase chain reaction followed by sequencing. The patient underwent functional endoscopic sinus surgery. She was treated empirically with itraconazole after surgical excision
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Objective:To clarify the M protein ( emm gene) types and drug susceptibility characteristic variations of Group A Streptococcus (GAS) in children in Beijing. Methods:The GAS strains isolated from throat swab samples of children diagnosed with scarlet fever and pharyngeal infection in scarlet fever etiology surveillance sentinel hospitals in 16 districts of Beijing in 2018, 2019 and 2021 were analyzed retrospectively.PCR amplification and sequencing were used for emm genotyping, and the minimum inhibitory concentrations (MIC) of 10 antibiotics were determined by the broth microdilution method.The data were analyzed using χ2 test and Fisher′ s exact method between groups. Results:A total of 557 GAS strains were collected, and 11 emm genotypes ( emm1, emm3, emm4, emm6, emm11, emm12, emm22, emm75, emm89, emm128, and emm212) were detected.Of 557 strains, 238 trains were of emm1 type (42.73%), 271 strains were of emm12 type (48.65%) and 48 strains were of other emm types (8.62%). The detection rates of emm1, emm12 and other emm type genes in 2018, 2019, and 2021 were [37.50% (105/280 strains), 57.14% (160/280 strains), 5.36% (15/280 strains)], [49.05% (129/263 strains), 39.54% (104/263 strains), 11.41% (30/263 strains)], and [28.57% (4/14 strains), 50.00% (7/14 strains), 21.43% (3/14 strains)], respectively.In children infected with emm12 in 2018 and 2019, there were more children under 6 years old than children over 6 years old (62.50% vs.46.88%, 46.36% vs.30.36%) (χ 2=7.182, 6.973; all P<0.05). Drug susceptibility testing results suggested that 225 randomly selected GAS strains were all 100.00% sensitive to 7 antibiotics including Penicillin, Levofloxacin, Meropenem, Linezolid, Cefotaxime, Cefepime and Vancomycin.The rates of resistance to Erythromycin, Tetracycline and Clindamycin were [88.57% (93/105 strains), 87.62% (92/105 strains), 86.67% (91/105 strains)], and [94.34% (100/106 strains), 94.34% (100/106 strains), 87.74% (93/106 strains)] in 2018 and 2019, respectively.The test strains were 100.00% (14/14 strains) resistant to the above 3 antibiotics in 2021.MIC 50 and MIC 90 values of Penicillin in 2018, 2019, and 2021 were (0.03 mg/L, 0.03 mg/L), (0.03 mg/L, 0.06 mg/L), and (0.06 mg/L, 0.06 mg/L), respectively.Among 225 GAS strains, 207 strains had drug resistance and were resistant to more than one drug.Specifically, 94.69% (196/207 strains) were resistant to Erythromycin, Tetracycline and Clindamycin.About 4.35% (9/207 strains) were resistant to both Erythromycin and Clindamycin.A total of 0.97% (2/207 strains) were resistant to Erythromycin and Tetracycline. Conclusions:The emm genotypes of GAS in children in Beijing are diverse in 2018, 2019 and 2021.The dominant genotypes are emm12 and emm1, and emm12 is the main epidemiological type.GAS strains maintain highly resistant to Erythromycin, Clindamycin and Tetracycline, and sensitive to Penicillin and other antibiotics.However, MIC 50 and MIC 90 of Penicillin shows an ascending trend.
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Introduction@#One in every three preventable under-five deaths occur in the neonatal period and one of the leading causes of neonatal death in Low and Middle-Income Countries (LMIC) is sepsis. Organisms isolated varies between and within geographical locations, its trend changes with time. Each setting hence needs to have its antibiogram for susceptible isolates to optimize treatment outcome, the background on which this study was conducted. @*Methodology@#A retrospective study was done on neonates admitted to the Neonatal Intensive Care Unit of Bowen University Teaching Hospital, a missionary hospital in South West Nigeria, between January 2016 and December 2017. The medical records of these neonates were retrieved from the comprehensive electronic database for all neonates admitted into the unit. @*Result@#Of the 129 newborns eligible for the study, early-onset sepsis (56.6%) predominated. There were 79 (61%) males giving a M:F ratio of 1.6:1. The incidence rate of neonatal sepsis was 15 per 1,000 live births with a mortality rate of 24%. Gram-Negative Bacilli were mostly isolated in positive cultures. The likelihood of getting a positive culture was unrelated to the age and sex of patients at presentation. There was a varying resistance pattern of the isolates to commonly used empiric antibiotics. @*Conclusion and Recommendation@#Gram-Negative Bacilli was the commonest cause of neonatal sepsis in our center, associated with poor outcome. The high incidence of resistance to the commonly used empirical treatment calls for an urgent review of practice if the trend of high morbidity and mortality would be curtailed, as well as improved infection control practices.
Subject(s)
Neonatal Sepsis , Microbial Sensitivity TestsABSTRACT
Resumen Las Infecciones del Tracto Urinario (ITU), constituyen uno de los principales motivos de consulta en el ámbito de atención primaria, debido al aumento de la resistencia antibacteriana. Objetivo . Caracterizar la prevalencia de infección del tracto urinario y el perfil de susceptibilidad antimicrobiana in vitro en Enterobacterias en los pacientes de la provincia de Santa Elena - Ecuador. Método . Esta investigación fue descriptiva de diseño documental. La población fue de 827 registros de urocultivos, recopilados de la base de datos del laboratorio de microbiología del Centro de Especialidades IESS La Libertad, en el período comprendido desde agosto 2019 hasta marzo de 2020. Los datos fueron procesados mediante estadística descriptiva, análisis de frecuencia y chi cuadrado. Resultados . De este estudio indican que la prevalencia de ITU fue 22,1%; los principales agentes etiológicos fueron: E. coli (76,0%), Klebsiella oxytoca (6,5%), Klebsiella pneumoniae (5,8%) y Proteus mirabilis (3,9%). La ITU y la infección por E. coli fueron estadísticamente mayores en mujeres y adultos mayores. La mayor frecuencia de resistencia de E. coli fue para ácido nalidíxico (81,2%), ampicilina (79,9%), ciprofloxacina (72,6%) y sulfametoxazol trimetoprima (61,5%); en Klebsiella oxytoca fue ampicilina (80,0%), sulfametoxazol trimetoprima (70,0%), ácido nalidíxico (60,0%) y ciprofloxacina (40,0%). Mientras que en Klebsiella pneumoniae se halló una resistencia del (100%) para ampicilina y cefalotina, amoxicilina y ácido clavulánico (66,7%), ciprofloxacina (55,6%), ácido nalidíxico (44,4%), meropenem e imipenem (11,1%). Conclusiones. La E. coli continúa siendo el microorganismo más frecuente en ITU. El tratamiento empírico de ITU debería incluir amikacina, nitrofurantoina y piperacilina tazobactam.
Abstract Urinary Tract Infections (UTI) are one of the main reasons for consultation in the primary care setting, due to the increase in antibacterial resistance. Objective . To characterize the prevalence of urinary tract infection and the in vitro antimicrobial susceptibility profile of Enterobacteriaceae in patients in the province of Santa Elena - Ecuador. Method. This was a descriptive research of documentary design. The population was 827 urine culture records, collected from the database of the microbiology laboratory of the Centro de Especialidades IESS La Libertad, in the period from August 2019 to March 2020. The data were processed using descriptive statistics, frequency analysis and chi-square. Results . From this study indicate that the prevalence of UTI was 22.1%; the main etiological agents were: E. coli (76.0%), Klebsiella oxytoca (6.5%), Klebsiella pneumoniae (5.8%) and Proteus mirabilis (3.9%). UTI and E. coli infection were statistically higher in women and older adults. The highest frequency of E. coli resistance was for nalidixic acid (81.2%), ampicillin (79.9%), ciprofloxacin (72.6%) and trimethoprim sulfamethoxazole (61.5%); in Klebsiella oxytoca it was ampicillin (80.0%), trimethoprim sulfamethoxazole (70.0%), nalidixic acid (60.0%) and ciprofloxacin (40.0%). While in Klebsiella pneumoniae, 100% resistance was found for ampicillin and cephalothin, amoxicillin and clavulanic acid (66.7%), ciprofloxacin (55.6%), nalidixic acid (44.4%), meropenem and imipenem (11.1%). Conclusions . E. coli continues to be the most frequent microorganism in UTI. Empirical treatment of UTI should include amikacin, nitrofurantoin and piperacillin tazobactam.
Resumo As infecções do trato urinário (IU) são um dos principais motivos de consulta no âmbito dos cuidados primários, devido ao aumento da resistência antibacteriana. Objetivo . Caracterizar a prevalência da infecção do trato urinário e o perfil de suscetibilidade antimicrobiana in vitro de Enterobacteriaceae em pacientes da província de Santa Elena - Equador. Método . Esta foi uma pesquisa descritiva do projeto documental. A população era de 827 registros de cultura de urina, coletados do banco de dados do laboratório de microbiologia do Centro de Especialidades IESS La Libertad, no período de agosto de 2019 a março de 2020. Os dados foram processados utilizando estatísticas descritivas, análise de freqüência e qui-quadrado. Resultados. Deste estudo indicam que a prevalência de UTI foi de 22,1%; os principais agentes etiológicos foram: E. coli (76,0%), Klebsiella oxytoca (6,5%), Klebsiella pneumoniae (5,8%) e Proteus mirabilis (3,9%). A infecção por UTI e E. coli foi estatisticamente maior nas mulheres e nos adultos mais velhos. A maior freqüência de resistência do E. coli foi para o ácido nalidíxico (81,2%), ampicilina (79,9%), ciprofloxacina (72,6%) e trimetoprim sulfametoxazol (61,5%); em Klebsiella oxytoca era ampicilina (80,0%), trimetoprim sulfametoxazol (70,0%), ácido nalidíxico (60,0%) e ciprofloxacina (40,0%). Enquanto em Klebsiella pneumoniae, foi encontrada 100% de resistência para ampicilina e cefalotina, amoxicilina e ácido clavulânico (66,7%), ciprofloxacina (55,6%), ácido nalidíxico (44,4%), meropenem e imipenem (11,1%). Conclusões . A E. coli continua sendo o microorganismo mais freqüente na UTI. O tratamento empírico da UTI deve incluir amikacina, nitrofurantoína e piperacilina tazobactam.
ABSTRACT
With increasing use of antibacterial and cytotoxic drugs, lethal invasive Candidiasis is on the rise, with almost half of the cases being caused by non albicans Candida species (NAC). Frequent use of azoles for empirical therapy has also led to their increased resistance. We wanted to characterise Candida species isolated from various clinical specimens and assess their susceptibility pattern to Fluconazole and Voriconazole.METHODSA total of 100 consecutive Candida species isolated from various clinical specimens in our institute from January 2016 to December 2016 were included in the study. Standard yeast identification protocol and CHROM agar were used for speciation and their antifungal susceptibility pattern was found by disc diffusion method.RESULTSOut of the 100 isolates, C. tropicalis was the predominant isolate (47%), followed by C. albicans (31%), C. parapsilosis (16%) and C. krusei (6%). Females (57%) were more affected and maximum number of patients was above 60 years (24%). Diabetes mellitus (21%) was the major predisposing factor for Candida, followed by broad spectrum antibiotic therapy (14%). Isolates were more susceptible to Voriconazole (99%) than Fluconazole (87%). NAC spp. showed more resistance to Fluconazole (17.4%) than C. albicans (3.3%). Only one isolate of C. krusei (16.6%) showed resistance to Voriconazole.CONCLUSIONSDue to the increasing incidence of azole resistant NAC spp., the species level identification of Candida species, along with their anti-fungal susceptibility patterns can help the clinicians in formulating a treatment protocol and can help in decreasing the mortality and morbidity.
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Uno de los principales fracasos de los tratamientos antibióticos de las infecciones por P. aeruginosa, es debido a la producción de biopelículas. El objetivo de este trabajo fue estudiar la inhibición de formación de biopelículas en cepas de Pseudomonas aeruginosa en presencia de própolis. A todas las cepas se les determinó el perfil de susceptibilidad y se hicieron pruebas de sinergismo. Se detectó el nivel de producción de biopelículas sobre membranas de nitrocelulosa y por microscopía electrónica de transmisión. Se estudió la inhibición de las biopelículas por própolis por dilución en placas. En el hospital de Cumaná, "Dr. Julio Rodríguez", se aislaron cepas de P. aeruginosa, de diferentes procesos infecciosos, principalmente, pie diabético. Todas las cepas produjeron biopelículas a diferentes niveles (leve 60%, moderado 24% e intenso 16%). Sesenta por ciento de las cepas son productoras de MBL y 49% de AmpC. El antibiotipo predominante fue la resistencia a aminoglucósidos y fluoroquinolonas (XII). Siete cepas fueron resistentes a colistin. Las biopelículas tratadas con própolis (10 µg/ml), fueron inhibidas con éxito en su casi totalidad. En conclusión, el própolis logró erradicar la formación de biopelículas in vitro, rompiendo las barreras de los diferentes mecanismos de resistencia a los antibióticos expresados por las cepas de P. aeruginosa estudiadas en este trabajo
One of the main failures of antibiotics treatments of P. aeruginosa infections is due to the production of biofilms. The objective of this work was to study the inhibition of biofilm production in Pseudomonas aeruginosa strains in the presence of propolis. Susceptibility testing and synergism were performed in all strains. Biofilm production level was determined onto nitrocellulose membranes and transmission electronic microscopy. Biofilm inhibition propolis was did on plate dilution. "Dr. Julio Rodríguez" hospital, in Cumaná, P. aeruginosa strains were isolated from different infectious processes, mainly diabetic foot. All the strains produced biofilm at different levels (60% mild, 24% moderate and 16% high). Sixty percent of the strains are producers of MBL, and 49% of AmpC. The predominant antibiotype was resistance to aminoglycosides and fluoroquinolones (XII). Seven strains were resistant's to colistin. Biofilms treated with propolis (10 µg/ml) were almost completely inhibited. In conclusion, the propolis achieved to eradicate the in vitro biofilm production, breaking the barriers of the different mechanisms of resistance to the antibiotics expressed by the P. aeruginosa strains studied in this work
ABSTRACT
Problem@#Emerging bacterial antimicrobial (antibiotic) resistance (AMR) is a global threat to human health. However, a majority of lower income countries do not have microbiological diagnostic testing for prompt, reliable confirmation of bloodstream infection and identification of AMR.@*Context@#Clinicians in Pacific island nations are increasingly challenged by patients who have infection due to antimicrobialresistant bacteria. Treatment of infection remains empirical because of a lack of diagnostic testing capacity and may follow guidelines that were formulated without reference to local measures of AMR prevalence. There is limited understanding among clinicians of microbiology testing and test interpretation.@*Action@#Examine the lessons learnt from pilot laboratory development programmes in two Pacific island nations that focused on establishing standard procedures for micrological diagnostics and antimicrobial susceptibility testing (AST) and on improving the training of clinicians to increase their use of laboratory services.@*Outcome@#The pilot programmes addressed a range of logistical difficulties and evaluated two blood culture systems. They also examined and improved internal QC implementation and evaluated the prevalence of AMR.@*Discussion@#Continued development of microbiological diagnostic capability in the Pacific region is paramount. Pacific Island nations need to develop the capability of at least one central laboratory to culture AMR pathogens and subject them to quality-controlled AST or arrange for suitable referral to a nearby country.
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BACKGROUND: Colistin has become a last-resort antibiotic for the management of multidrug-resistant gram-negative bacteria. The disk diffusion test is cheap and easy to perform but may be unreliable for colistin susceptibility testing due to poor diffusion of the large colistin molecule. An improved agar diffusion test would increase the reliability of colistin susceptibility testing. This study aimed to modify Muller-Hinton agar (MHA) to improve colistin diffusion in agar.METHODS: MHA was modified by reducing the agar concentration from 100% to 30% and supplementing with protamine. We tested 60 gram-negative clinical isolates of Pseudomonas aeruginosa (N=27) and Acinetobacter calcoaceticus-baumannii complex (N=33). Disk diffusion test results were interpreted based on minimum inhibitory concentrations determined by broth microdilution.RESULTS: The modified MHA yielded the best performance metrics, including 94.7% sensitivity, 100% specificity, and an area under the curve of 0.995 (95% confidence interval, 0.982–1.000), P<0.001, at a cut-off point of 13 mm.CONCLUSIONS: A reduction of the agar concentration from 100% to 30% and the addition of protamine improved colistin diffusion in agar and allowed routine colistin susceptibility testing in a clinical microbiology laboratory, but should be handled with caution.
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@#Aims: Tuberculosis and other mycobacterial infections occur worldwide especially in patients with immunodeficiency. Typically, an empirical treatment for disseminated disease is required for initial therapy due to slow growing nature of most mycobacterial species. Therefore, species distribution and average time to positivity of blood culture is crucial. However, such information is limited for blood culture and, therefore, were determined. Methodology and results: The blood culture data using the BACTEC FX system and drugs susceptibility testing (DST) pattern was recovered during 2012-2017 from a large teaching hospital in Bangkok, Thailand. Overall, 7.8% of 4,838 blood and 6.4% of 1,056 bone marrow (BM) samples were positive for mycobacterial growth. Mycobacterium tuberculosis complex (MTBC), M. avium, and M. abscessus, were the most three common species to be isolated from blood (3.8%, 2.1%, and 0.9%, respectively) and BM (2.4%, 2.4%, and 0.9%, respectively). The average time to positivity for MTBC, M. avium, and M. abscessus was 25.7, 16.1, and 3.8 days, respectively. From 209 antimycobacterial susceptibility testing (AST)-available MTBC strains, 6 (2.87%) strains were multi-drugs resistant (MDR-TB). From 35 AST-available M. avium complex (MAC) isolates, 6 (17.14%), 33 (94.29%), and 28 (80%) isolates were resistant to clarithromycin, moxifloxacin, and linezolid, respectively. BM MAC isolates were significantly more resistant to clarithromycin than the blood isolates (44.5% vs 7.69%; p= 0.027). Conclusion, significance and impact of study: In summary, an emergence of M. abscessus and unusually high moxifloxacin and linezolid resistance of MAC isolates were reported in this study. Additional information of this study benefits physicians for anti-mycobacterial drug selection for initial treatment of mycobacteremia while blood and BM culture is pending.
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The Kumbh Mela is considered the world’s largest mass gathering event (MGE). It represents a unique anthropogenicburden on the river ecosystem and may confer antimicrobial resistance among microbial communities. The present studyexplains the characterization of microbial isolates associated with Godavari River under the advent of the mass bathingevent using culture dependent approach. The isolates were identified by sequencing of 16S rRNA gene and ITS region.Further, the isolates were screened for antibiotic susceptibility against 22 antibiotics using disc diffusion method. A total of63 bacterial and 21 fungal isolates were isolated under the temporal variation of the event. Kocuria and Staphylococcuswere the most prevalent bacterial genera in the samples collected before and during the event, while Meyerozyma andCandida predominate among fungal communities. A group of antibiotics impeding the bacterial protein synthesis werefound to be most effective against C67% of bacterial isolates. However, C37–67% of isolates could escape the action ofinhibitors of bacterial cell wall synthesis. Moreover, bacterial isolates belonging to genera Acinetobacter, Corynebacteriumand Brevibacterium showed higher resistance towards the antibiotics. Observations from the current study suggest likelymicrobial taxa as targets to mitigate the waterborne infections during the MGE.