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1.
Medical News of North Caucasus ; 17(2):202-204, 2022.
Article in English | EMBASE | ID: covidwho-2033430

ABSTRACT

The study determined the etiological structure and sensitivity to antibacterial agents of pathogens of uncomplicated and complicated forms of pneumonia in children treated in a multidisciplinary hospital. According to the study, that timely bacteriological diagnosis in the treatment of pneumonia in childhood with an adequate selection of effective antibacterial agents helps reduce hospitalizations and the development of complicated forms of pneumonia.

2.
Frontiers in Microbiology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-2009884

ABSTRACT

Invasive Staphylococcus aureus (S. aureus) infection is associated with high rates of mortality in children. No studies have been reported on invasive S. aureus infection among children in Kunming, China, and it remains unknown whether the COVID-19 epidemic has affected S. aureus prevalence in this region. Thus, this study investigated the changes in molecular characteristics and antimicrobial resistance of invasive S. aureus strains isolated from children in Kunming during 2019–2021. In total, 66 invasive S. aureus strains isolated from children were typed by multilocus sequence typing (MLST), spa, and Staphylococcal cassette chromosome mec (SCCmec), and antimicrobial resistance and virulence genes were analyzed. A total of 19 ST types, 31 spa types and 3 SCCmec types were identified. Thirty nine (59.09%) strains were methicillin-sensitive S. aureus (MSSA) and 27 (40.91%) strains were methicillin-resistant S. aureus (MRSA). The most common molecular type was ST22-t309 (22.73%, 15/66), followed by ST59-t437 (13.64%, 9/66). In 2019 and 2021, the dominant molecular type was ST22-t309, while in 2020, it was ST59-t437. After 2019, the dominant molecular type of MRSA changed from ST338-t437 to ST59-t437. All strains were susceptible to tigecycline, ciprofloxacin, moxifloxacin, vancomycin, quinopudine-dafoputin, linezolid, levofloxacin, and rifampicin. From 2019 to 2021, the resistance to penicillin and sulfamethoxazole initially decreased and then increased, a trend that contrasted with the observed resistance to oxacillin, cefoxitin, erythromycin, clindamycin, and tetracycline. Sixteen antimicrobial resistance profiles were identified, with penicillin-tetracycline-erythromycin-clindamycin-oxacillin-cefoxitin being the most common, and the antimicrobial resistance profiles varied by year. The carrier rates of virulence genes, icaA, icaD, hla, fnbA, fnbB, clfA, clfB, and cna were 100.00%. Furthermore, sak, pvl, icaC, icaR, fib, lip, hlb, hysA, sea, seb, and tsst-1 had carrier rates of 96.97, 92.42, 87.88, 69.70, 84.85, 62.12, 56.06, 50, 37.87, 30.30, and 7.58%, respectively. Since COVID-19 epidemic, the annual number of invasive S. aureus strains isolated from children in Kunming remained stable, but the molecular characteristics and antimicrobial resistance profiles of prevalent S. aureus strains have changed significantly. Thus, COVID-19 prevention and control should be supplemented by surveillance of common clinical pathogens, particularly vigilance against the prevalence of multidrug-resistant and high-virulence strains.

3.
Infection control and hospital epidemiology ; : 1-9, 2022.
Article in English | MEDLINE | ID: covidwho-2008228

ABSTRACT

BACKGROUND: Candida auris is an emerging fungal pathogen causing outbreaks in healthcare facilities. Five distinctive genomic clades exhibit clade-unique characteristics, highlighting the importance of real-time genomic surveillance and incorporating genotypic information to inform infection prevention practices and treatment algorithms. METHODS: Both active and passive surveillance were used to screen hospitalized patients. C. auris polymerase chain reaction (PCR) assay on inguinal-axillary swabs was performed on high-risk patients upon admission. All clinical yeast isolates were identified to the species level. C. auris isolates were characterized by both phenotypic antifungal susceptibility tests and whole-genome sequencing. RESULTS: From late 2019 to early 2022, we identified 45 patients with C. auris. Most had a tracheostomy or were from a facility with a known outbreak. Moreover, 7 patients (15%) were only identified through passive surveillance. Also, 8 (18%) of the patients had a history of severe COVID-19. The overall mortality was 18%. Invasive C. auris infections were identified in 13 patients (29%), 9 (69%) of whom had bloodstream infections. Patients with invasive infection were more likely to have a central line. All C. auris isolates were resistant to fluconazole but susceptible to echinocandins. Genomic analysis showed that 1 dominant clade-III lineage is circulating in Los Angeles, with very limited intrahost and interhost genetic diversity. CONCLUSIONS: We have demonstrated that a robust C. auris surveillance program can be established using both active and passive surveillance, with multidisciplinary efforts involving the microbiology laboratory and the hospital epidemiology team. In Los Angeles County, C. auris strains are highly related and echinocandins should be used for empiric therapy.

4.
Veterinary Record ; 2022.
Article in English | EMBASE | ID: covidwho-2007116

ABSTRACT

Background: The causes of respiratory disease in British gamebirds were investigated during 2016–2019 following concerns about poorer responses to antibiotic treatment. Emphasis was placed on Mycoplasma gallisepticum, but other possible bacterial and viral causes were included, along with gross and histopathological examination. Methods: Clinical respiratory disease outbreaks were investigated. Results: Mycoplasma gallisepticum was detected by PCR in 65 of 69 outbreaks in pheasants and partridges and isolated from 56 of these. Partial mgc2 gene sequences from 28 M. gallisepticum isolates were compared, and 26 proved identical, suggesting the prevalence of a dominant sequence type. Minimum inhibitory concentration values for tiamulin, tylosin, tylvalosin, doxycycline and tetracycline were significantly higher than the reference strain but could not be correlated with treatment failures. Other bacterial species were isolated from sinuses but were not consistently correlated with disease. RT-PCRs detected coronaviruses in 18% of 49 outbreaks and avian metapneumovirus in 8%. Histopathological lesions were typical of M. gallisepticum sinusitis and significantly associated with M. gallisepticum PCR outbreak positivity. Conclusion: Mycoplasma gallisepticum remains an important cause of respiratory disease in gamebirds. Synergism with other pathogens may have played a role in some outbreaks. Specific reasons for variable responses to antibacterial treatment were not identified.

5.
Indian Journal of Critical Care Medicine ; 26:S97, 2022.
Article in English | EMBASE | ID: covidwho-2006386

ABSTRACT

Aim and background: The COVID-19 pandemic has raised significant concerns over secondary infections because of the widespread use of steroids, immunomodulators, and empiric antimicrobials as part of the recommended treatment protocol. Various studies have shown that COVID-19 infection by itself predisposes to secondary infections. During the 2nd wave of the COVID-19 pandemic, there has been an unprecedented epidemic of secondary invasive fungal infections. This study analyses the prevalence, details, and outcomes of secondary infections in critical COVID-19 patients admitted to a tertiary intensive care unit (ICU) in India. Materials and methods: Retrospective study of secondary infections in ICU patients between April and June 2021. Demographic data, details of immunomodulator therapy, secondary bacterial and fungal infections, antimicrobial susceptibility data, and clinical outcomes of these patients were analyzed. Results: 71/238 (29.83%) ICU patients developed secondary bacterial and fungal infections. The mortality in patients with secondary infections was significantly higher [80.28% (p < 0.05)], compared to overall ICU mortality of 51.68%. In patients with secondary infections, 67.6% were referred from other hospitals after receiving initial treatment and 64.79% had received various immunomodulator therapies. Patients on prolonged mechanical ventilation (>7 days) and indwelling central venous (>7 days) and urinary catheters (>7.5 days) had higher secondary infection rates and higher mortality. There was positive significant growth in 80 respiratory samples, 34 blood samples, and 17 urine samples. Gram-negative bacteria were isolated in 85.91% and 32.39% had fungal isolates. Klebsiella pneumoniae followed by Acinetobacter baumannii were the predominant bacteria and Candida spp followed by Mucormycosis were the predominant fungal pathogens. Multi-drug resistant (MDR) infections were common among the isolates (70.59%). 49.3% of secondary infection patients had polymicrobial infections including fungal infections with higher mortality of 83%. Conclusion: There is a significantly high incidence of secondary MDR bacterial and fungal infection including Mucormycosis in critically ill COVID-19 patients, with an adverse impact on mortality. Risk factors included the use of steroids, immunomodulators, severe COVID-19 infection, empiric broad-spectrum antibiotics, invasive ventilation, and central venous and urinary catheterization, and prolonged ICU stay.

6.
Indian Journal of Critical Care Medicine ; 26:S49-S50, 2022.
Article in English | EMBASE | ID: covidwho-2006343

ABSTRACT

Aims and objectives: Gastrointestinal symptoms like abdominal pain can be atypical presentations associated with coronavirus disease. This case report describes the presentation of acute pancreatitis in a patient with moderate COVID-19 infection. Materials and methods: Data were collected from a patient who was admitted with acute pancreatitis as sequelae of COVID-19 infection in our intensive care unit in June 2021. Case presentation: A 25-year-old female with no comorbidities presented to our emergency department with complaints of fever and dry cough for 10 days for which she had taken treatment at home. COVID RTPCR was negative and CT severity was 10/25. She also complained of abdominal pain with vomiting for 2 days. So she was admitted to our hospital on the tenth day of her illness. Laboratory analysis showed >3 times elevation of serum lipase. CT abdomen showed acute pancreatitis with gallbladder sludge. Causes of pancreatitis like gallbladder stones, alcohol, hypercalcemia, and hypertriglyceridemia were excluded by history and investigations. She was diagnosed with acute pancreatitis due to COVID-19. C-reactive protein and D dimer was highly elevated. She was admitted in ICU and was started on conservative management with IV fluids and bowel rest. Oral intake was resumed gradually as tolerated. The patient was maintaining adequate oxygen saturation on room air. Her repeat COVID RTPCR was again negative. However, her CT severity had increased to 14/25. Her total antibody SARS-CoV-2 was highly reactive. She had severe pain which was not improving despite multimodal analgesia which included opioid infusion. She had bilateral minimal pleural effusion and consolidation and required 2-4 L oxygen support. Repeat CT abdomen after a week showed acute necrotizing pancreatitis with gross pancreatic ascites and partial splenic vein thrombosis (modified CT severity index 8). On day 7 of admission, she developed a fever. Blood and urine cultures were sent and empirical antibiotic was started. Urine culture showed Klebsiella pneumoniae and antibiotic was escalated as per sensitivity pattern. Her pain scores persisted to be high despite all measures. On day 14, she developed abdominal distension. Intra-abdominal pressures were normal and repeat CT abdomen showed extensive free fluid with dilated bowel loops which was likely paralytic ileus. A CT-guided pigtail was inserted for continuous drainage of fluid. The ascitic fluid culture showed no organism. Her abdominal distension gradually reduced. We tapered the requirement of opioids day by day and she got symptomatically better. She could tolerate oral feeds better, off oxygen support, and was shifted to wards with pigtail catheter in situ. She stayed in ICU for 26 days. She was doing better in wards and was discharged home after 5 days with oral anticoagulant and other symptomatic medications and was adviced for gastroenterology follow-up after 10 days. Results: A patient was diagnosed with acute pancreatitis associated with SARS-CoV-2 and was treated accordingly. Other causes of acute pancreatitis were excluded in the patient including alcohol, biliary obstruction/gall stones, drugs, trauma, hypertriglyceridemia, hypercalcemia, and hypotension. Conclusion: This case highlights acute pancreatitis as a complication associated with COVID-19 and underlines the importance of evaluating and treating patients with COVID-19 and abdominal pain.

7.
Indian Journal of Critical Care Medicine ; 26:S46-S47, 2022.
Article in English | EMBASE | ID: covidwho-2006342

ABSTRACT

Aim and objectives: To compare the microbiological profile, resistance pattern, and outcome in early- and late-onset ventilatorassociated pneumonia (VAP) among severe COVID-19 patients in a tertiary care ICU. Materials and methods: It is a retrospective study conducted in the Department of Critical Care Medicine, Fortis Hospitals Pvt ltd, Bangalore over a period of 15 months (April 2020 to June 2021). It included all patients who had a first episode of VAP confirmed by positive tracheal aspirate culture. Patients on mechanical ventilation for <4 days (48-96 hours) were included in the early-onset VAP group and 5 days or more were included in the late-onset VAP group. Data collected from case records including demographic and clinical characteristics of the patients at ICU admission, data related to the disease course, ICU treatments (prior antibiotic exposure and immunomodulatory therapy), mortality and, finally, data related to each VAP episode (date of sampling, implicated germs and their detailed biochemical testing identified any significant growth, and antibiotic sensitivity testing report). Results: We analysed a total of 404 patients, out of which 149 patients had VAP. The incidence of VAP was found to be 36.8%, out of which 59 (39.5%) had early-onset VAP and 90 (60.5%) had late-onset VAP. The most common organisms isolated from early- and late-onset VAP was Klebsiella pneumoniae. Among earlyonset VAP, 42% of Klebsiella pneumoniae were extended-spectrum beta-lactamase (ESBL) with carbapenemase-producing strains and in late-onset VAP 85% of Klebsiella pneumoniae strains were ESBL with carbapenemase-producing strains. The overall mortality in our study was 65.7%. Conclusion: VAP is one of the most common complications in critically ill mechanically ventilated COVID-19 patients. The underlying immune nature of the virus and the various immunomodulating therapies used for the same has contributed towards a high incidence of VAP in COVID-19 pneumonia patients. Knowledge of your local microbial flora can help in initiating the appropriate therapy at the correct time and hence improve clinical outcomes.

8.
Jundishapur Journal of Microbiology ; 15(7), 2022.
Article in English | EMBASE | ID: covidwho-1997997

ABSTRACT

Background: Antimicrobial resistance in ESKAPEEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobac-ter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli) pathogens causing bloodstream infections is a growing threat to clinicians and public health. Objectives: Our purpose was to determine the prevalence and susceptibility of ESKAPEEcs causing bloodstream infection over five years (2016 to 2020) at a large tertiary hospital in Istanbul, Turkey. Methods: Of 2591 unique isolates obtained from blood culture specimens, 1.281 (49.4%) were positive for ESKAPEEc pathogens. The ESKAPEEc rates increased from 2016 to 2019 and decreased during the COVID-19 pandemic. Results: The most common pathogen was K. pneumoniae (34.3%). Carbapenem resistant K. pneumoniae was 61.8% and A. baumannii was 90.4%. The percentages of methicillin-resistant S. aureus and vancomycin-resistant E. faecium were 38.6% and 29.4%, respectively. Conclusions: Our findings showed a high incidence of ESKAPEEc and antimicrobial resistance in bloodstream infections. Antibiotic policies and restrictions in health care settings and the community will play an essential role in the solution in the future.

9.
JACCP Journal of the American College of Clinical Pharmacy ; 5(3):283-290, 2022.
Article in English | EMBASE | ID: covidwho-1995541

ABSTRACT

Introduction: Due to the high volume of outpatient antibiotic prescribing, the Joint Commission now requires antimicrobial stewardship program (ASP) expansion to ambulatory practice settings. Unfortunately, ASP resources in these settings are scarce. The purpose of this study was to determine whether the implementation of antibiotic order sentences alongside education would improve antibiotic prescribing for urinary tract infections (UTI) and skin and soft tissue infections (SSTI). Objectives: The primary objective was to compare the proportion of total guideline-concordant antibiotic prescribing before (pre-ASP) vs after (post-ASP) implementing order sentences. Guideline concordance was defined as antibiotic selection, dosing, and duration in accordance with the health system's empiric guidelines. Secondary objectives included comparing patient-centered outcomes, such as infection-related revisits and Clostridiodes difficile infections between groups. Methods: This retrospective, quasi-experimental study evaluated adult patients treated for uncomplicated UTI or SSTI at an outpatient Family Medicine office between 1 February 2020 and 1 January 2021. The institution's stewardship team provided in-person education and set prescribing order sentence “favorites” for providers. Patients were excluded who were diagnosed with a complicated UTI, treated only with topical antibiotics, were pregnant, or received care via telephone encounter. Results: Two hundred sixty patients were included in this study (pre-ASP n = 139, post-ASP n = 121). Total antibiotic appropriateness improved significantly from 24.5% to 39.7% after implementation of order sentences and education (P =.008). Significant improvement was seen for appropriate drug selection (52.5% vs 66.9%, P =.018) and duration (47.5% vs 68.6%, P =.001). There were no differences observed in patient-centered outcomes between groups. Conclusion: Implementing stewardship-focused order sentences significantly improved outpatient antibiotic prescribing for UTI and SSTI. Tailoring antibiotic order sentences may be a useful tool for ASP expansion into the outpatient setting with limited resources to allocate to stewardship efforts.

10.
Current Medical Mycology ; 8(1):32-38, 2022.
Article in English | EMBASE | ID: covidwho-1988710

ABSTRACT

Background and Purpose: Candidemia remained important in the intensive care units (ICU) during the COVID-19 pandemic. This study aimed to investigate the clinical and laboratory data on candidemia in COVID-19 patients. Materials and Methods: The baseline characteristics, as well as laboratory and clinical findings of candidemia and non-candidemia patients, were compared. Candidemia was defined as the isolation of Candida spp. from blood cultures. The isolates were identified by VITEK® 2 (bioMérieux, France) commercial method. Antifungal susceptibility was assessed using the E-test method. Univariate and multiple binary logistic regression analyses were performed to compare the variables. Results: In total, 126 patients with the COVID-19 disease were included. Candidemia was diagnosed in 44 (35%) of the patients. The number of patients with diabetes mellitus and chronic renal failure was higher in the candidemia group. In the candidemia group, the duration of ICU stay of patients, the 30-day mortality rate, mechanical ventilation therapy, and systemic corticosteroids (Prednisone) usage were significantly higher in candidemia patients. Moreover, the median white blood cell, neutrophils, and lactate dehydrogenase were higher in the candidemia group. Univariate and multiple binary logistic regression analyses were performed to compare the variables. Isolated species were identified as Candida albicans (n=12, 41%), Candida parapsilosis (n=7, 24%), Candida glabrata (n=6, 21%), Candida tropicalis (n=3, 10%), and Candida dublinensis (n=1, 3%). In total, three isolates of six C. glabrata species had dose-dependent sensitivity to fluconazole, and one C. parapsilosis was determined to be resistant. Conclusion: The COVID-19 patients who are admitted to ICU have many risk factors associated with candidemia. The most common risk factors for the development of candidemia were mechanical ventilation, diabetes mellitus, neutrophilia, and low hemoglobin level. The most frequently isolated species was C. albicans. Moreover, caspofungin was found to be the most effective drug in vitro. No significant resistance pattern was detected against the isolated species. It should be noted that risk-stratified antifungal prophylaxis in the ICU is possible.

11.
Current Medical Mycology ; 8(1):26-31, 2022.
Article in English | EMBASE | ID: covidwho-1988709

ABSTRACT

Background and Purpose: Taurolidine is active against a wide variety of micro-organisms, including bacteria and fungi. Mucormycosis is one of the life-threatening opportunistic fungal infections, especially in immunocompromised patients. Currently, the emergence of Mucormycosis during the COVID-19 pandemic raises public health concerns regarding untoward morbidity and mortality among SARS-CoV-2 patients. It is well-known that delayed and inappropriate antifungal therapy leads to increased morbidity and mortality. This study aimed to investigate the in-vitro antifungal activity of taurolidine to evaluate its effects against clinical isolates of Mucorales. Materials and Methods: This study included previously collected clinical Mucorales isolates. The minimum in vitro inhibitory concentration (MIC) of amphotericin B, caspofungin, voriconazole, posaconazole, and itraconazole was determined using the broth microdilution method. Results: All clinical isolates showed full sensitivity to amphotericin B. Posaconazole MIC range from 8 μg/mL to 0.032 μg/mL. The MIC range of voriconazole and caspofungin were determined to be 2-8 μg/mL and 0.5-16 μg/mL, respectively. Growth of the isolates was entirely inhibited in 1000 μg/mL concentration of taurolidine. In microscopic observations, morphological effects on hyphal growth were observed at 500 μg/mL concentration. Conclusion: In conclusion, this is an updated experience of using taurolidine against Mucorales. However, our in-vitro findings need to be confirmed in well-designed clinical trials aimed at treating invasive Mucormycosis infections.

12.
Biochemical and Cellular Archives ; 22(1):2123-2131, 2022.
Article in English | EMBASE | ID: covidwho-1980344

ABSTRACT

This study was conducted in the College of Medicine, Wasit University Cooperation with the Al Zahraa Teaching Hospital, Al Kut Hospital laboratory in Wasit, Al-Karama hospital and private clinics of internal from the period of November 2020 to April 2021. It has been carried out on 150 samples of nasal and throat swabs from post COVID-19 patients who suffered from nasal and throat infection from both sex (male &female). The infections were in age group between (4-88) years. The results of throat swabs showed that 84(56%) were infected with bacteria and 66(44%) non-infected and the results of nasal swabs showed that 67(44.66%) were infected with bacteria and 83(55.33%) non-infected. The results of culture appeared that from 150 throat swab sample found that 66(44%) samples were no growth and 84(56%) were infected with bacteria. The results were Pseudomonas aeruginosa 12/150(8%), E. coli 9/150(6%), Enterobacter spp. 2/150(1.33), Pseudomonas spp. 2/ 150(1.33%), Klebsiella spp. 2/150(1.33%), Staphylococcus spp. 4/150(2.66%), Staphylococcus aureus 4/150(2.66%), Streptococcus viridans 43/150(28.66%) and mix of Staphylococcus spp. and Streptococcus viridans 6/150(4%). Out of 150 nasal swab sample found that 83/150(55.33%) sample were no growth and 67/150(44.67%) were infected with bacteria. The result were Pseudomonas aeruginosa 7/150(4.66%), E.coli 3/150(2%), Enterobacter spp. 2/150(1.33), Pseudomonas spp. 5/ 150(3.33%), Klebsiella spp. 6/150(4%), Staphylococcus spp. 12/150(8%), Staphylococcus aureus 3/150(2%), Streptococcus viridans 24/150(16%) and mix of Staphylococcus spp. and Streptococcus viridans 3/150(5.33%) and mix of E. coli and Pseudomonas spp. 2/150(1.33%). Antimicrobial sensitivity for Pseudomonas aeruginosa showed sensitivity to Amikacin (100%), levofloxacin (90%), Meropenem (90%), Cefipime (70%), Imipenem (60%), Aztreonam (30%), Chloramphenicol (5%), and don’t show sensitive to Tetracycline, Pipracillin, Ampicillin, Trimethoprim-Sulphamethoxazole and Clarithromycin. To facilitate species identification, used molecular methods (PCR analysis) by 16s rRNA primers gene for more predominant bacteria isolates (Pseudomonas aeruginosa) isolates studied were detected by 16S rRNA gene and there virulence factors based on multiplex polymerase chain reaction technique amplifying five virulence factors primer for Pseudomonas aeruginosa (aprA, filC, toxA, pilA, pslA). In this study, we concluded that the production of virulence factors genes in Pseudomonas aeruginosa is important to human infection especially (ToxA) gene and the PCR technique was very specific and fast method in detection virulence factor genes in Pseudomonas aeruginosa.

13.
Jundishapur Journal of Microbiology ; 15(5), 2022.
Article in English | EMBASE | ID: covidwho-1979586

ABSTRACT

Background: Clostridium spp. spores are resistant to many factors, including alcohol-based disinfectants. The presence of clostridial spores in a hospital environment may lead to infection outbreaks among patients and health care workers. Objective: This study is aimed to detect clostridial spores in the aurology hospital using C diff Banana Broth™ and assess the antibiotic sensitivity and toxinotypes of isolates. Methods: After diagnosing COVID-19 in medical staff and closing an 86-bed urology hospital in 2020 for H2O2 fogging, 58 swabs from the hospital environment were inoculated to C diff Banana Broth™, incubated at 37°C for 14 days, checked daily, and positive broths were sub-cultured anaerobically for 48 h at 37°C. After identification, multiplex PCR (mPCR) was performed for Clostridium perfringens, C. difficile toxin genes, and minimum inhibitory concentration (MIC) determination. Results: In this study, 16 out of 58 (~ 28%) strains of Clostridium spp. were cultured: 11-C. perfringens, 2-C. baratii, and 1 each of C. paraputrificum, C. difficile, and C. clostridioforme. 11 C. perfringens were positive for the cpa, 7-the cpb2, 2 – cpiA, and 1 – cpb toxin genes. All isolates were sensitive to metronidazole, vancomycin, moxifloxacin, penicillin/tazobactam, and rifampicin. Two out of the 11 C. perfringens strains were resistant to erythromycin and clindamycin. Conclusions: Regardless of the performed H2O2 fogging, antibiotic-resistant, toxigenic strains of C. perfringens (69%) obtained from the urology hospital environment were cultured using C diff Banana Broth™, indicating the need to develop the necessary sanitary and epidemiological procedures in this hospital.

14.
FEBS Open Bio ; 12:168, 2022.
Article in English | EMBASE | ID: covidwho-1976639

ABSTRACT

Antimicrobial resistance (AMR) is among the top 10 global public health threats. Antimicrobial overuse in part because of the overload of ICU departments in the context of the COVID-19 pandemic facilitates the phenomenon. Designing novel effective antimicrobial strategies necessitates the development of new methodologies of antimicrobial susceptibility testing (AST) instead of routinely used laboratory approaches that do not consider recent findings concerning the crucial impact of structural complexity inherent for macroorganism tissues, and physical characteristics of the environment on microbial population behavior and biological properties. Liquid crystal (LC) materials combining properties of both the liquid and the solid phase offer tremendous potential for the development of various spatially structured liquid model environments and solid surfaces for studying tripartite system bacterium-antibiotic-bacteriophage. Our pilot study was aimed to examine the behavior of the population of Proteus vulgaris ? the representative of the third most common etiological factor of nosocomial and catheter-associated urinary tract infections ? in different microcosms based on a lyotropic nematic liquid crystal. The study design included examining the bacterial growth, motility, and morphology under the transition of pre-grown population from different isotropic nutrient media to anisotropic microcosms based on LC. Growth kinetics, motility pattern as well as morphotype conversion from swimmers to swarmers changed significantly after the transition of the bacterial population to different microcosms based on LC as compared to those in isotropic conditions. The significance of swarming motility and swarming-specific induction of the virulence factors of Proteus for its pathogenicity and AMR has been debated widely yet remains unclear. Our findings indicate the attractiveness of artificial spatially structured microcosms based on LC for the study of these phenomena.

15.
Global Journal of Medical Pharmaceutical and Biomedical Update ; 17(6):1-5, 2022.
Article in English | EMBASE | ID: covidwho-1969977

ABSTRACT

Objective: The study aimed to assess the antibiotic resistance pattern before and after the pandemic to provide the physicians with general guidance for antibiotic prescribing. Material and Methods: The yearly antibiograms of different tertiary care hospitals were extracted from Pakistan Antimicrobial Resistance (AMR) Network. The data timeline observed was from January 2016 to December 2020. The data were scrutinized to the most common organism studied with the most recurring antimicrobial used. Results: Among the Gram-positive organisms, increased resistivity against penicillin was observed against both the organism, while a good susceptibility was observed against vancomycin. Among the Gram-negative organisms, the highest resistance was observed in Ceftriaxone, Ciprofloxacin, and Cotrimoxazole. Staphylococcus aureus and Escherichia coli are the most prevalent organisms in tertiary care hospitals. Conclusion: While satisfactory susceptibility was observed in Amikacin and Piperacillin/Tazobactam. The post-pandemic era resulted in a decrease in AMR due to significant changes in antibiotic prescribing patterns. This report may guide future antibiotic prescribing.

16.
Russian Journal of Infection and Immunity ; 12(3):563-568, 2022.
Article in Russian | EMBASE | ID: covidwho-1969869

ABSTRACT

Multidrug-resistant K. pneumoniae bacterial strains producing extended range of beta-lactamases or carbapenemases are of serious clinical concern. The aim of the study was to determine the resistance factors of K. pneumoniae strains isolated from the lower respiratory tract of patients diagnosed with community-acquired pneumonia during the COVID-19 pandemic. Materials and methods. The study of resistance to antimicrobial drugs included 138 strains of K. pneumoniae isolated from the sputum of patients treated in infectious diseases monohospitals in the city of Tyumen and the Tyumen region within the period from May 2020 to June 2021. Among the strains examined, 51.4% of them were isolated from SARS-CoV-2 positive patients. The presence of resistance genes was determined by PCR in 71 strains of K. pneumoniae (34 strains from COVID-19-positive and 37 strains from COVID-19-negative patients). Identification of isolated bacterial strains was carried out according to the protein spectra by using a desktop time-of-flight mass spectrometer with matrix laser desorption MALDI-TOF MS (Bruker, Germany). The belonging of the strains to the hypermucoid phenotype was determined using the string test. Sensitivity to antimicrobial drugs was assessed in the disk diffusion method on Muller-Hinton medium. The sensitivity of culture strains to bacteriophage preparations was determined by the drop method (spot-test). In the study, we used “Polyvalent Sextaphage Pyobacteriophage” and “Purified Polyvalent Klebsiella Bacteriophage”, JSC NPO Microgen, Russia. Detection of resistance genes to beta-lactam antibiotics by real-time PCR was carried out using the BakRezista kit (OOO DNA-technology, Russia). The results of the study evidence that K. pneumoniae bacteria isolated from COVID-19-positive and COVID-19-negative patients diagnosed with community-acquired pneumonia displayed a high resistance to antimicrobial drugs and commercial phage-containing drugs. Resistance of K. pneumoniae strains was recorded from 50% (to aminoglycosides and carbapenems) to 90% (to inhibitor-protected penicillins). Sensitivity to bacteriophages was noted on average in no more than 20% of strains. It is important to emphasize that strains isolated from COVID-19-positive patients more often showed a hypermucoid phenotype, suggesting a high bacterial virulence, and also showed greater resistance to all groups of antibacterial drugs examined in the study, which is confirmed by the presence of resistance genes of the ESBL group and carbapenemase. The results of the study suggest that the high level of resistance of K. pneumoniae strains isolated from COVID-19-positive patients is associated with immunosuppression provoked by the SARS-CoV-2 virus, which contributes to their colonization by more virulent strains.

17.
Sexually Transmitted Infections ; 98:A40, 2022.
Article in English | EMBASE | ID: covidwho-1956913

ABSTRACT

Introduction Obtaining samples of Neisseria gonorrhoeae for antibiotic sensitivity testing is important for purposes of antimicrobial stewardship. While urethral and cervical gonorrhoea culture samples are usually taken by a healthcare professional, the Covid-19 pandemic necessitated a reduction in direct patient contact. In our service, patients with confirmed gonorrhoea who did not otherwise require examination were asked to take their own urethral or vaginal culture swabs. Methods GUMCAD coding was used to identify cases of cervical or male urethral Neisseria gonorrhoeae infection diagnosed on nucleic acid amplification testing, where the gonococcal culture result and the identity of the swab-taker (patient/healthcare professional) were recorded in the notes. 50 cases were selected in 2019, and 50 in 2020, after the onset of the Covid-19 pandemic. Proportions of patients taking their own swabs were calculated for the two periods. Culture positivity rates were compared between self-taken and healthcare professional-taken swabs. Results During the pandemic, use of self-taken culture samples increased ten-fold. Although positivity for Neisseria gonorrhoeae was lower for self-taken swabs, 38% of male self-taken urethral samples tested positive for gonorrhoea, and the organism was successfully cultured from a self-taken vaginal swab on one occasion. Discussion Although self-taken gonorrhoea cultures were less likely to grow Neisseria gonorrhoeae than those taken by healthcare professionals, they proved a useful tool in gathering sensitivity data in a time of restricted patient contact. The lower positivity rate of self-taken cultures may be partially attributable to their use in patients with fewer symptoms, and hence a lower bacterial load. (Table Presented).

18.
Journal of Clinical Periodontology ; 49:225-226, 2022.
Article in English | EMBASE | ID: covidwho-1956764

ABSTRACT

Background and Aim: Many obstacles have risen during the lockdown period due to the COVID-19 pandemic, including the provision of urgent dental care. The Rothschild hospital had to establish a balance between providing a core service and limiting patient admission through a fair sorting system. This study aims to assess the efficacy of the dental emergency protocol implemented during the first lockdown. Methods: The protocol was applied for patients who arrived at the hospital between March 18 and May 11, 2020. First, they underwent a sorting diagnosis (A) based on self-reported symptoms. If deemed as urgent, they were oriented towards dental professionals, who performed an intraoral examination leading to a clinical diagnosis (B). Diagnoses (A and B) were categorized into four groups: infectious, prosthetic, traumatic, and other emergencies. The agreement between diagnoses A and B was tested (Cohen's Kappa score). Positive predictive value, negative predictive value, sensitivity and specificity among diagnostic categories were assessed to evaluate the performance and efficacy of the sorting diagnosis. Results: Out of 1651 dental visits, 1064 were included for this analysis. The most frequent reported symptom at the sorting diagnosis was pain (40%), whereas the most frequent clinical diagnosis was endodontic emergency (30%). Periodontal emergency concerned 6% of patients. Tooth extraction was required in 32% of cases;systemic antibiotics were prescribed for 49.2% of patients. Infectious emergency diagnosis had the higher sensitivity (94.2%), whereas prosthetic emergency diagnosis had the higher specificity (99.1%). The level of agreement was substantial (kappa > 0.6) for the majority of diagnoses. No Covid-19 contamination occurred. Conclusions: This study demonstrates that the implemented protocol during the first COVID-19 lockdown to manage dental emergencies was effective, establishing an appropriate patient orientation prior to clinical examination to minimize the risk of COVID-19 exposure whilst safeguarding professionals and patients.

19.
Asian Journal of Microbiology, Biotechnology and Environmental Sciences ; 24(2):224-227, 2022.
Article in English | EMBASE | ID: covidwho-1939799

ABSTRACT

Many COVID-19 studies are about epidemiological and clinical features but information about secondary bacterial infections is limited. The present study was conducted to determine the prevalence and characteristics of bloodstream infections in COVID-19 patients admitted to a tertiary care academic health care organization. All blood samples were obtained from patients with COVID-19 admitted were included in the study. Blood cultures were performed using BD BACTEC ™ FX40, and the diagnosis and bacterial identification and antimicrobial sensitivity was performed by manual method. 2200 patients with COVID-19 were hospitalized during a 6-month study period in which 315 blood cultures were performed. Of these, 24 (7.61%) were positive. The median age of patients with positive blood culture was 38 years and included 13 males and 11 females. Seventeen patients (70.83%) needed intensive care in the ICU. Significant correlations with blood culture positivity have been noted with parameters such as admission to the ICU, availability of accommodation, basic illness and adverse clinical outcomes. Bloodstream infections prevalence in COVID-19 patients is low. However, antibiotic prophylaxis needs to be used with caution, and immediate discontinuation should be made based on clinical judgment.

20.
Journal of Pure and Applied Microbiology ; 16(2):867-875, 2022.
Article in English | EMBASE | ID: covidwho-1939573

ABSTRACT

Klebsiella pneumoniae is a common bacterial pathogen causes wide range of infections all over the world. The antimicrobial resistance of K. pneumoniae is a global concern and expresses several virulence factors contributing to the pathogenesis. The incidences of bacterial co-infection in viral pneumonia are common. Increased risk of K. pneumoniae co-infection in viral respiratory tract infection should be alerted in COVID-19 pandemic period. The study aims to detect the association between antimicrobial resistance and factors causing pathogenicity of K. pneumoniae. For the current study, 108 K. pneumoniae clinical isolates were included. Antimicrobial susceptibility test was done by Kirby-Bauer disc diffusion method according to CLSI guidelines. Virulence factors such as biofilm formation, haemagglutination, haemolysins, hypermucoviscocity, siderophore, amylase, and gelatinase production were determined by phenotypic method. In this study K. pneumoniae showed high level of antimicrobial resistance towards ampicillin (92.59%) followed by amoxicillin-clavulanic acid (67.59%) and cotrimoxazole (47,22%). An important association between biofilm formation and antimicrobial resistance was found to be statistically significant for cotrimoxazole (P-value 0.036) and amoxicillin-clavulanic acid (P-value 0.037). Other virulence factors like hypermucoviscocity, haemagglutination, amylase, and siderophore production were also showed a statistically significant relation (P-value <0.05) with antimicrobial resistance. Further molecular studies are necessary for the identification of virulence and antimicrobial resistance genes, for the effective control of drug-resistant bacteria.

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