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BMC Infectious Diseases Feb 2024In Kenya, diarrhoeal disease is the third leading cause of child mortality after malaria and pneumonia, accounting for nearly 100 deaths daily. We conducted a...
BACKGROUND
In Kenya, diarrhoeal disease is the third leading cause of child mortality after malaria and pneumonia, accounting for nearly 100 deaths daily. We conducted a cross-sectional study in Mukuru informal settlements to determine the bacteria associated with diarrhea and their ASTs to provide data essential for implementing appropriate intervention measures.
METHODS
Diarrheagenic children (≤ 5 years) were purposively recruited from outpatient clinics of Municipal City Council, Mukuru kwa Reuben, Medical Missionaries of Mary, and Mama Lucy Kibaki Hospital, Nairobi. A total of 219 stool samples were collected between May 2021 and August 2021. Stool culture was done on MacConkey and Salmonella Shigella agar, while the recovered bacteria were identified using VITEK®2GNID and polymerase chain reaction (PCR) used for E. coli pathotyping. Antibiotic Susceptibility Testing was done using VITEK®2AST-GN83.
RESULTS
At least one bacterial organism was recovered from each of the 213 (97%) participants, with 115 (56%) participants having only one bacterial type isolated, 90 (43%) with two types of bacteria, and 2 (1%) with three types of bacteria recovered. The most predominant bacteria recovered was 85% (93/109) non-pathogenic E.coli and 15% (16/109)of pathogenic E.coli, with 2 (1%) were Enterohemorrhagic E.coli (EHEC), 6 (3%) were Enteroaggregative E.coli (EAEC), and 8 (4%) were Enteropathogenic E.coli (EPEC). Other potentially pathogenic bacteria included Enterobacter sp (27.8%), Klebsiella sp 33(11%), and Citrobacter sp 15(4.7%). Pathogenic isolates such as Salmonella 7 (2%), Proteus mirabilis 16 (6%), Providencia alcalifaciens 1 (0.3%), and Shigella 16 (4.7%) were detected. Isolates such as Pantoea spp 2(0.67%), Raoultella planticola 1(0.33%), and Kluyvera 6(2%) rarely reported but implicated with opportunistic diarrhoeal disease were also recovered. Ampicillin, cefazolin, and sulfamethoxazole-trimethoprim were the least effective antimicrobials at 64%, 57%, and 55% resistance, respectively, while meropenem (99%), amikacin (99%), tazobactam piperacillin (96%), and cefepime (95%) were the most effective. Overall, 33(21%) of all enterics recovered were multidrug-resistant.
CONCLUSION
The study documented different bacteria potentially implicated with childhood diarrhea that were not limited to E. coli, Shigella, and Salmonella, as previously observed in Kenya. The strains were resistant to the commonly used antibiotics, thus narrowing the treatment options for diarrheal disease.
Topics: Child; Humans; Child, Preschool; Kenya; Cross-Sectional Studies; Diarrhea; Anti-Infective Agents; Enteropathogenic Escherichia coli; Bacteria; Salmonella; Shigella
PubMed: 38388369
DOI: 10.1186/s12879-024-09114-5 -
BMC Urology Feb 2024This study comprehensively evaluates the distribution patterns and antimicrobial resistance profiles of urinary pathogens in Preoperative midstream urine cultures... (Meta-Analysis)
Meta-Analysis
Distribution and antimicrobial resistance patterns of urinary pathogens in preoperative midstream urine cultures from Chinese patients with urinary calculi: a meta-analysis.
BACKGROUND AND OBJECTIVE
This study comprehensively evaluates the distribution patterns and antimicrobial resistance profiles of urinary pathogens in Preoperative midstream urine cultures collected from patients with urinary calculi in China over the last two decades.
METHODS
A cross-sectional analysis of 41 studies was conducted. A systematic search across various databases, including Wanfang Data, CNKI, SinoMed, Embase, PubMed, and Web of Science, was carried out, covering the time period from 2002 to 2022. Using R 4.2.1 software, a meta-analysis was performed to assess heterogeneity using Cochran's Q test and the I statistic.
RESULTS
In the analysis of preoperative midstream urine cultures from Chinese patients with urinary calculi, gram-negative bacteria dominated at 69%, with Escherichia coli (43%), Klebsiella pneumoniae (8%), Proteus mirabilis (6%), Pseudomonas aeruginosa (5%), Acinetobacter baumannii (3%), and Enterobacter cloacae (4%) being prominent. Gram-positive organisms included Enterococcus faecalis (9%), Enterococcus faecium (5%), and Staphylococcus aureus (4%). Over time, proportions of Proteus mirabilis, Enterococcus faecalis, and Staphylococcus aureus decreased, while Klebsiella pneumoniae and Pseudomonas aeruginosa increased. Notably, Escherichia coli proportion reduced from 37 to 33% within the last two decades. Antimicrobial resistance analysis indicated declining resistance in E. coli (e.g., co-trimoxazole from 73 to 55%, gentamicin from 64 to 40%), but rising resistance in piperacillin and cefotaxime (34-60%). Enterococcus faecalis exhibited increasing resistance to ampicillin (5-69%), gentamicin (59-94%), and tetracycline (77-89%) over time, while resistance to levofloxacin and ciprofloxacin notably decreased (72-16% and 49-8%, respectively).
CONCLUSION
Over the past two decades, the proportion of gram-negative bacteria was declined, while the proportion of gram-positive bacteria increased. Escherichia coli remained the most common pathogen in the urine culture of patients with urinary calculi in China and the resistance of Escherichia coli to commonly used antibiotics increased. Clinicians should select appropriate antibiotics according to the results of urine culture and drug sensitivity test to reduce the occurrence of antibiotic resistance.
Topics: Humans; Anti-Bacterial Agents; Escherichia coli; Cross-Sectional Studies; Drug Resistance, Bacterial; Gram-Negative Bacteria; Staphylococcus aureus; Staphylococcal Infections; Pseudomonas aeruginosa; Gentamicins; Urinary Calculi; Microbial Sensitivity Tests; Urinary Tract Infections
PubMed: 38383429
DOI: 10.1186/s12894-024-01415-w -
Infection and Drug Resistance 2024() is known to cause various infections, most commonly urinary tract infections, and is a threat to hospitalized patients, especially in long-stay departments that...
BACKGROUND
() is known to cause various infections, most commonly urinary tract infections, and is a threat to hospitalized patients, especially in long-stay departments that utilize invasive devices. This study aims to fill the knowledge gap regarding epidemiology and antimicrobial resistance in Saudi Arabia. It investigates epidemiological patterns, resistance characteristics, and clinical outcomes among patients at King Fahad Medical City in Riyadh from 2019 to 2021.
METHODS
A total of 598 isolated from diverse clinical specimens, including the clinical information of 78 intensive care unit (ICU) patients, were included in the current study. The Phoenix BD instrument was used for complete identification and sensitivity testing of spp. Demographic, clinical, and outcome data were reported and compared using statistical analysis.
RESULTS
Pan-drug-resistant isolates were identified in 2019 (n = 6), although multi- and extensively drug-resistant isolate frequencies were greatest among all patients in 2019. The highest susceptibility levels were observed for piperacillin-tazobactam, carbapenems, and cephalosporins antibiotics. In contrast, Cephalothin, trimethoprim-sulfamethoxazole, and ampicillin had the lowest susceptibilities. Urine infections with a positive culture of were significantly higher in females and non-ICU patients ( <0.001), but respiratory infections were significantly higher in ICU patients ( <0.001). Moreover, ICU patients infected with and undergoing renal dialysis have a 7.2-fold ( 0.034) higher risk of death than those not receiving dialysis.
CONCLUSION
Hospitalized patients are at risk of fatal consequences due to infection. It is crucial to conduct further investigation to fully understand the severity of this issue and take necessary measures to prevent it.
PubMed: 38375102
DOI: 10.2147/IDR.S448335 -
Veterinary Medicine and Science Mar 2024Proteus mirabilis has been identified as an important zoonotic pathogen, causing several illnesses such as diarrhoea, keratitis and urinary tract infections.
BACKGROUND
Proteus mirabilis has been identified as an important zoonotic pathogen, causing several illnesses such as diarrhoea, keratitis and urinary tract infections.
OBJECTIVE
This study assessed the prevalence of P. mirabilis in broiler chickens, its antibiotic resistance (AR) patterns, ESBL-producing P. mirabilis and the presence of virulence genes.
METHODS
A total of 26 isolates were confirmed as P. mirabilis from 480 pooled broiler chicken faecal samples by polymerase chain reaction (PCR). The disk diffusion method was used to evaluate the antibacterial susceptibility test, while nine virulence genes and 26 AR genes were also screened by PCR.
RESULTS
All 26 P. mirabilis isolates harboured the ireA (siderophore receptors), ptA, and zapA (proteases), ucaA, pmfA, atfA, and mrpA (fimbriae), hlyA and hpmA (haemolysins) virulence genes. The P. mirabilis isolates were resistant to ciprofloxacin (62%) and levofloxacin (54%), while 8 (30.7%) of the isolates were classified as multidrug resistant (MDR). PCR analysis identified the bla gene (62%), bla (58%) and bla (38%). Further screening for AMR genes identified mcr-1, cat1, cat2, qnrA, qnrD and mecA, 12%, 19%, 12%, 54%, 27% and 8%, respectively for P. mirabilis isolates. The prevalence of the integron integrase intI1 and intI2 genes was 43% and 4%, respectively.
CONCLUSIONS
The rise of ciprofloxacin and levofloxacin resistance, as well as MDR strains, is a public health threat that points to a challenge in the treatment of infections caused by these zoonotic bacteria. Furthermore, because ESBL-producing P. mirabilis has the potential to spread to humans, the presence of bla -producing P. mirabilis in broilers should be kept under control. This is the first study undertaken to isolate P. mirabilis from chicken faecal samples and investigate its antibiotic resistance status as well as virulence profiles in South Africa.
Topics: Animals; Humans; Chickens; Proteus mirabilis; Virulence; Levofloxacin; Abattoirs; South Africa; Drug Resistance, Multiple, Bacterial; Ciprofloxacin
PubMed: 38357843
DOI: 10.1002/vms3.1371 -
Clinical Practice and Cases in... Nov 2023Mycotic pseudoaneurysms are rare but severe sequelae of an arterial wall infection. If undiagnosed and untreated they can lead to significant morbidity and mortality...
INTRODUCTION
Mycotic pseudoaneurysms are rare but severe sequelae of an arterial wall infection. If undiagnosed and untreated they can lead to significant morbidity and mortality through complications such as arterial rupture or dissection.
CASE REPORT
This report details the case of a 64-year-old-male who developed a left common iliac artery mycotic pseudoaneurysm from , which was associated with a prevertebral abscess. The patient presented with isolated, left lower extremity edema and intermittent fevers. The case is unique in both the pathogen () and in its association with presumed direct arterial wall infection from an adjacent prevertebral abscess.
CONCLUSION
The obscure presentation highlights the need for a high clinical suspicion of such a diagnosis when a patient presents with a certain constellation of symptoms and the right predisposing risk factors in their history.
PubMed: 38353193
DOI: 10.5811/cpcem.1348 -
JCI Insight Feb 2024The gut and local esophageal microbiome progressively shift from healthy commensal bacteria to inflammation-linked pathogenic bacteria in patients with gastroesophageal...
The gut and local esophageal microbiome progressively shift from healthy commensal bacteria to inflammation-linked pathogenic bacteria in patients with gastroesophageal reflux disease, Barrett's esophagus, and esophageal adenocarcinoma (EAC). However, mechanisms by which microbial communities and metabolites contribute to reflux-driven EAC remain incompletely understood and challenging to target. Herein, we utilized a rat reflux-induced EAC model to investigate targeting the gut microbiome-esophageal metabolome axis with cranberry proanthocyanidins (C-PAC) to inhibit EAC progression. Sprague-Dawley rats, with or without reflux induction, received water or C-PAC ad libitum (700 μg/rat/day) for 25 or 40 weeks. C-PAC exerted prebiotic activity abrogating reflux-induced dysbiosis and mitigating bile acid metabolism and transport, culminating in significant inhibition of EAC through TLR/NF-κB/TP53 signaling cascades. At the species level, C-PAC mitigated reflux-induced pathogenic bacteria (Streptococcus parasanguinis, Escherichia coli, and Proteus mirabilis). C-PAC specifically reversed reflux-induced bacterial, inflammatory, and immune-implicated proteins and genes, including Ccl4, Cd14, Crp, Cxcl1, Il6, Il1b, Lbp, Lcn2, Myd88, Nfkb1, Tlr2, and Tlr4, aligning with changes in human EAC progression, as confirmed through public databases. C-PAC is a safe, promising dietary constituent that may be utilized alone or potentially as an adjuvant to current therapies to prevent EAC progression through ameliorating reflux-induced dysbiosis, inflammation, and cellular damage.
Topics: Humans; Rats; Animals; Proanthocyanidins; Gastrointestinal Microbiome; Dysbiosis; Bile Reflux; Rats, Sprague-Dawley; Adenocarcinoma; Gastroesophageal Reflux; Inflammation; Metabolome; Esophageal Neoplasms
PubMed: 38329812
DOI: 10.1172/jci.insight.168112 -
Frontiers in Medicine 2024Percutaneous nephrolithotomy is the gold standard treatment for staghorn calculi. However, this study reviews a case of an almost complete removal of staghorn calculi...
Percutaneous nephrolithotomy is the gold standard treatment for staghorn calculi. However, this study reviews a case of an almost complete removal of staghorn calculi following one session of retrograde intrarenal surgery with intelligent control of renal pelvic pressure (RIRS-ICP). A 45 years-old female patient with an 8.3 × 4.5 cm complete staghorn stone was infected with . Two sensitive antibiotics, piperacillin tazobactam and etimicin, were administered for 3 days. Semirigid 7/8.4 Fr ureteroscope was used to treat the renal pelvis and upper calyceal calculi for 57 min. A 550 μm holmium laser fiber with 2.0 J × 30 Hz was set. Next, a disposable flexible ureteroscope of 8.4 Fr was used to address residual middle and lower calyx stones for 94 min. A 200 μm holmium laser fiber with 1.0 J × 30 Hz was set. The renal pelvis pressure was controlled within 15 mmHg. A 2 mm CT scan on the first postoperative day showed inferior caliceal residue of approximately 1.0 × 0.6 cm. No complications occurred. This suggests that RIRS-ICP is a safe and effective treatment for staghorn calculi.
PubMed: 38327711
DOI: 10.3389/fmed.2024.1321184 -
BMC Research Notes Jan 2024Proteus mirabilis is related to serious infections. The present study was designed to investigate the minimum inhibitory concentration (MIC) of silver nanoparticles...
Determining the cytotoxicity of the Minimum Inhibitory Concentration (MIC) of silver and zinc oxide nanoparticles in ESBL and carbapenemase producing Proteus mirabilis isolated from clinical samples in Shiraz, Southwest Iran.
OBJECTIVE
Proteus mirabilis is related to serious infections. The present study was designed to investigate the minimum inhibitory concentration (MIC) of silver nanoparticles (AgNPs) and zinc oxide nanoparticles (ZnONPs) and cytotoxicity among P. mirabilis isolates recovered from clinical samples in Shiraz.
RESULTS
A total of 100 P. mirabilis isolates were screened by biochemical tests and polymerase chain reaction (PCR). Also, 25 (25%) and 7 (7%) isolates were positive for extended-spectrum beta-lactamase (ESBLs) and carbapenemase, respectively. Synthesized nanoparticles were characterized by UV-vis spectrum, X-ray diffraction (XRD), and electron microscopy. The average size of AgNPs and ZnONPs in the present study is 48 and < 70 nm, respectively. The MIC and the MBC of the ZnONPs were in the range of 31.25 µg/ml and 62.5 µg/mL, respectively. Also, for AgNPs, the MIC and the MBC were in the range of 7.8 µg/mL and 15.6 µg/mL, respectively. MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay in a primary culture of fibroblast L929 cells for this MIC indicated biocompatibility and low cytotoxicity of Ag NPs and for ZnONPs indicated significant cytotoxicity. Also, a MIC of AgNPs can be used as a therapeutic concentration without the effect of cytotoxicity in human cells.
Topics: Humans; Silver; Anti-Bacterial Agents; Zinc Oxide; Proteus mirabilis; Metal Nanoparticles; Iran; Microbial Sensitivity Tests; Bacterial Proteins; beta-Lactamases
PubMed: 38287416
DOI: 10.1186/s13104-023-06402-2 -
Foods (Basel, Switzerland) Jan 2024The bioactive properties of the combination of microencapsulated cell-free supernatant (CFS) from and thyme extract on food-related bacteria (, ATCC29213, ATCC29212,...
The bioactive properties of the combination of microencapsulated cell-free supernatant (CFS) from and thyme extract on food-related bacteria (, ATCC29213, ATCC29212, and Paratyphi A NCTC13) were investigated. The microencapsulated CFS of in combination with ethanolic thyme extract, had a particle size in the range of 1.11 to 11.39 µm. The microencapsulated CFS of had a wrinkled, spherical form. In the supernatant, especially at 2% (), the thyme extract additive caused a decrease in the wrinkled form and a completely spherical structure. A total of 11 compounds were determined in the cell-free supernatant of , and acetic acid (39.64%) and methyl-d3 1-dideuterio-2-propenyl ether (10.87%) were the main components. Thyme extract contained seven components, the main component being carvacrol at 67.96% and 1,2,3-propanetriol at 25.77%. Significant differences ( < 0.05) were observed in the inhibition zones of the extracts on bacteria. The inhibitory effect of thyme extract on bacteria varied between 25.00 () and 41.67 mm (). Less antibacterial activity was shown by the microencapsulated CFS from compared to their pure form. ( < 0.05). As a result, it was found that microencapsulated forms of CFS from especially those prepared in combination with 2% (/) thyme extract, generally showed higher bioactive effects on bacteria.
PubMed: 38275696
DOI: 10.3390/foods13020329