Prevalence and antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending Hargeisa Group Hospital, Hargeisa, Somaliland.

The aim of this study was to determine the prevalence, antimicrobial susceptibility pattern and associated factors of urinary tract infection (UTI) among pregnant women attending Hargeisa Group Hospital (HGH), Hargeisa, Somaliland. A cross-sectional study was conducted at HGH, Hargeisa, Somaliland and participants were selected by systematic random sampling technique. Clean catch midstream urine samples were collected from 422 participants and cultured and antimicrobial susceptibility pattern was determined for the isolates. Univariable and multivariable logistic regression analyses were utilized to identify the independent risk factors for UTI. The prevalence of UTI was 16.4% (95% CI 13.3-19.9). The predominant bacteria isolate was E. coli (43.5%) followed by Coagulase negative staphylococcus (CoNS) 11(16%), S. aureus 9(13%), K. pneumonia 6(8.7%), Pseudomonas aeruginosa 5(7.2%), Proteus mirabilis 4(5.8%), Citrobacter spp 3(4.4%) and M. morganii 1(1.5%) Gram negative bacilli were resistant to ampicillin (96%) and tetracycline (71.4%) and Gram-positive cocci were also resistant to ampicillin (90%), tetracycline (55%). Multidrug resistance was observed in 85.5% of bacterial isolated. No formal education participants, previous history of catheterization and previous history of UTI had 3.18, 3.22 and 3.73 times respectively more likely to develop UTI than their counterparts. Culture and susceptibility test is vital for appropriate management of UTI in the study area.

Antimicrobial susceptibility testing of Eggerthella lenta blood culture isolates at a university hospital in Belgium from 2004 to 2018.

OBJECTIVES: Eggerthella lenta is a Gram-positive anaerobic bacillus that is an important cause of bloodstream infections. This study aims to test the susceptibility of Eggerthella lenta blood culture isolates to commonly used antibiotics for the empirical treatment of anaerobic infections. METHODS: In total, 49 positive blood cultures for Eggerthella lenta were retrospectively included from patients hospitalised at the Universitair Ziekenhuis Brussel, Belgium, between 2004 and 2018. Identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Antimicrobial susceptibility testing was performed using the reference agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines with Brucella agar supplemented with 5 µg/mL hemin, 1 µg/mL vitamin K1 and 5% laked sheep blood. The minimal inhibitory concentrations were interpreted using the EUCAST breakpoints. Clinical characteristics were collected by reviewing the patient's medical records. RESULTS: All isolates were susceptible to amoxicillin-clavulanate, metronidazole and meropenem. Eighty-eight % of them were susceptible to clindamycin and 94% (20% S, 74% I) were susceptible to piperacillin-tazobactam. The mean age of the patients was 64 (±20) and they showed a 30-day mortality of 27%. The source of infection was in 65.3% of the cases abdominal, 20.4% were sacral pressure ulcers and 14.3% were unknown causes. While all isolates were fully susceptible at standard dosing regimen to amoxicillin-clavulanate, most were only susceptible at increased exposure or resistant to piperacillin-tazobactam. CONCLUSIONS: Our results suggest to be careful with the use of piperacillin-tazobactam and clindamycin in the empirical treatment of Eggerthella lenta infections.

Spectrum of Fungal Pathogens in Burn Wound Specimens: Data From a Tertiary Care Hospital Laboratory in Pakistan.

Burn patients are at great risk of developing fungal wound infections. Fungi are frequently cultured from burn tissue specimens alone or in combination with bacteria. However, the spectrum of fungi in burn patients from Pakistan has not been reported previously. A retrospective laboratory-based study was conducted and data on all positive cultures from burn wounds were included. During the study period, specimens were cultured on appropriate media and incubated for anaerobic and aerobic growth. Clinical and demographic information recorded during clinical reporting was also collected. Seventy tissue cultures were positive for microorganisms. Of these, 27 (39%) had growth of either filamentous mold (17 cases) or Candida species (14 cases). Two cases had growth of both mold and yeast. Aspergillus flavus was the most common mold (9) followed by Fusarium species (3). Candida tropicalis was the most common yeast (7) followed by Candida parapsilosis (4). There was concomitant bacterial growth in 19 cases, predominantly of Staphylococcus aureus (13), Pseudomonas aeruginosa (8), and other Gram-negative rods (6). Of the 35 patients in which treatment history was available, 33 were receiving broad-spectrum antibiotics. A high incidence of fungal isolation was seen in this study. Their findings are consistent with the global increase in fungal infections in burn wounds. High index of suspicion by clinicians and revision of culture protocols in burn patients may be warranted for optimal patient management.

Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections.

PURPOSE: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. METHODS: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. RESULTS: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. CONCLUSIONS: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.

Clinical and bacteriological profile of diabetic foot infections in a tertiary care.

BACKGROUND: Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice. This study was conducted to identify the microbiological profile and antibiotic sensitivity patterns of causative agents identified from diabetic foot infections (DFIs). In addition, the assessment included probable risk factors contributing to infection of ulcers that harbour multidrug-resistant organisms (MDROs) and their outcomes. METHODS: We carried out a prospective analysis based on the DFI samples collected from 2016 till 2018. Specimens were cultured with optimal techniques in addition to antibiotic susceptibility based on recommendations from The Clinical and Laboratory Standards Institute (CLSI). A total of 1040 pathogens were isolated with an average of 1.9 pathogens per lesion in 550 patients who were identified with having DFIs during this interval. RESULTS: A higher percentage of Gram-negative pathogens (54%) were identified as compared with Gram-positive pathogens (33%) or anaerobes (12%). A total of 85% of the patients were found to have polymicrobial infections. Pseudomonas aeruginosa (19%), Staphylococcus aureus (11%) and Bacteroides species (8%) appeared to be the predominant organisms isolated. In the management of Gram-positive bacteria, the most efficacious treatment was seen with the use of Vancomycin, while Imipenem and Amikacin proved to be effective in the treatment of Gram-negative bacteria. CONCLUSION: DFI's are common among Malaysians with diabetes, with a majority of cases displaying polymicrobial aetiology with multi-drug resistant isolates. The data obtained from this study will be valuable in aiding future empirical treatment guidelines in the treatment of DFIs. This study investigated the microbiology of DFIs and their resistance to antibiotics in patients with DFIs that were managed at a Tertiary Care Centre in Malaysia.

[ANALYSIS OF THE USE OF ANTIBIOTIC THERAPY IN PREMATURE INFANTS, TAKING INTO ACCOUNT THE CHARACTERISTICS OF THE NEONATAL PERIOD].

This article presents the results of sensitivity/resistance of microbial strains isolated from three biotopes, in premature infants: mucous membranes of the respiratory tract, urinary system and colon after 72 hours after birth, as well as on the 14th and 30th day of life. During the study, total 677 strains of various microorganism species were isolated of which gram-positive flora - 386 microbial strains, almost 1.5 times predominated over gram-negative (291 strains) flora. Determination of sensitivity/resistance to antibiotics was carried out by two methods - a disc diffusion and a dilution methods on a solid nutrient medium. In the process of study of specificities of neonatal period, the influence of duration of antibiotic therapy, which newborns received during hospitalization period, was assessed. As a result, the number of schemes varied from 4 to 17, and the duration of treatment was 22-19 days. The most frequently used drugs were: Carbapenems, Glycopeptide, as well as third generation Cephalosporin and Aminoglicosides.

Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections / Perfil microbiológico e de resistência bacteriana no pé diabético infectado

ABSTRACT Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. Results: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. Conclusions: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.

RESUMO Objetivo: identificar o perfil sociodemográfico, microbiológico e de resistência bacteriana em pacientes com pé diabético infectado. Métodos: tratou-se de estudo observacional, transversal que avaliou os perfis sóciodemográfico e microbiológico de pacientes portadores de pé diabético infectado internados em Pronto Socorro de referência. Os dados sociodemográficos foram coletados por meio de entrevista. Foram colhidos, durante os procedimentos cirúrgicos, fragmentos de tecidos das lesões podais infectadas para realização de cultura/antibiograma. Resultados: a amostra foi composta por 105 pacientes. O perfil sociodemográfico mais prevalente foi o de pacientes do sexo masculino, acima dos 50 anos, casados e com baixa escolaridade. Das 105 amostras de fragmentos de tecidos colhidos para realização de cultura e antibiograma, 95 foram positivas, com crescimento de um único germe em cada um dos exames. Houve predomínio de germes da família Enterobacteriaceae (51,5%). Germes Gram-negativos foram isolados em 60,0% das culturas e os espécimes mais isolados individualmente foram os cocos Gram-positivos, Staphylococcus aureus (20,0%) e Enterococcus faecalis (17,9%). Considerando-se os perfis de resistência bacteriana, verificou-se alta taxa de Staphylococcus aureus resistente à meticilina (63,0%) e à ciprofloxacino (55,5%); verificou-se, também, que 43,5% dos germes Gram-negativos eram resistentes à ciprofloxacino. Conclusões: o perfil sociodemográfico majoritário, foi o de homens, com mais de 50 anos e com baixa escolaridade. Concluímos que os germes mais prevalentes nas lesões podais dos pacientes diabéticos foram os Gram-negativos, resistentes ao ciprofloxacino e que o germe mais isolado individualmente foi o Staphylococcus aureus resistente à meticilina.

[Infections in diabetic foot. Choice of empirical antibiotic regimen]. / Infecciones en pie diabético. Elección del tratamiento antibiótico empírico.

Diabetic foot infections are related to severe complications and constitute the main reason for diabetes-related hospitalization and lower limb amputations. A diabetic foot infection requires prompt actions to avoid progression of the infected wound; a soft tissue sample has to be taken for microbiological culture and empiric antibiotic therapy must be started immediately. Empiric antibiotic schemes should be chosen based on the severity of the infection and the local prevalence of microbial causal agents. Therefore, it is important to monitor these indicators. The aim of this study was to determine which microorganisms were more prevalent in cultures of diabetic foot infections during 2018 and what antibiotic combination was better to cover local microbiology, compared with data available from 2015 for a similar cohort. A total of 68 positive cultures were obtained of 72 soft tissue specimens analyzed. The most frequent microorganisms were Gram negative (47.1%), and resulted significantly more frequent than in 2015 (24.6%) p = 0.01. These Gram negative germs also resulted more sensitive to ciprofloxacin than in 2015 (62.5% vs. 25.0%) p = 0.03. Amoxicillin-clavulanate plus ciprofloxacin was the optimal combination therapy in 2018, while in 2015 it was amoxicillin-clavulanate plus trimethoprim sulfamethoxazole. In agreement with these results, we recommend amoxicillin-clavulanate plus ciprofloxacin as the empiric antibiotic regimen of choice for soft tissue infections in diabetic foot. We consider surveillance of local microbiology to be an important tool in the management of diabetic foot infections.

Las infecciones del pie diabético se asocian a complicaciones graves y constituyen la principal causa de hospitalización relacionada con diabetes y amputación de miembros inferiores. Para evitar su progresión, se requiere una conducta inicial rápida y adecuada que incluye toma de muestras para cultivos e inicio inmediato de tratamiento antibiótico empírico, según las características de las lesiones y la prevalencia local de microorganismos. Por ello, es necesario conocer y vigilar la microbiología local y la resistencia a los antimicrobianos. El objetivo de este trabajo fue describir la frecuencia de gérmenes en infecciones de pie diabético en pacientes ambulatorios asistidos en nuestro hospital en 2018 e identificar el esquema antibiótico con mayor cobertura, en comparación con los resultados de un estudio similar realizado en 2015. Fueron analizadas 72 muestras tomadas mediante punción por piel sana de partes blandas. Entre los 68 gérmenes aislados, los Gram negativos fueron los más frecuentes (47.1%), lo que representa un aumento significativo en relación a la frecuencia observada en 2015 (24.6%) p = 0.01 y un aumento de la sensibilidad a ciprofloxacina de 25% a 62.5% (p=0.03). El esquema con mayor cobertura fue amoxicilina-clavulánico con ciprofloxacina (77.9%) mientras que en 2015 fue amoxicilina-clavulánico con trimetoprima sulfametoxazol. La vigilancia de la microbiología local es fundamental para la elección del antibiótico empírico en las infecciones de pie diabético. En nuestro hospital, cuando la infección es de partes blandas, se recomienda la combinación amoxicilina-clavulánico más ciprofloxacina como esquema antibiótico empírico según los hallazgos de este estudio.

Urinary tract infections, bacterial resistance and immunological status: a cross sectional study in pregnant and non-pregnant women at Mbouda Ad-Lucem Hospital.

BACKGROUND: Urinary tract infections (UTI) are frequently encountered medical complications of pregnancy. OBJECTIVE: This study was aimed at analyzing the bacterial resistance in urogenital tract as well as the immunological profile amongst pregnant and non-pregnant women at Mbouda Ad-Lucem Hospital, Western Region of Cameroon. METHODS: A cross-sectional study was carried out from December 2015 to May 2016 at Mbouda Ad-Lucem hospital on 104 pregnant women and 24 non-pregnant women. The midstream urine from participants was analysed for the presence, isolation and identification of the uro-pathogens, using selective and specific bacterial culture media. An antibiotic susceptibility tests was carried out using disk diffusion method. Blood samples were collected for C-reactive protein (CRP) dosage, CD4 and CD8 lymphocytes count. RESULTS: Out of 128 participants in this study, a high prevalence of uro-pathogens and resistance strains was observed. The most prevalent urinary tract pathogens were Staphylococcus sp. with 45% and 38.89% respectively in pregnant and non-pregnant women. Staphylococcus sp. showed resistance to Amoxicillin (AMO; 55.56%) and Chloramphenicol (CHL; 100%) respectively in pregnant and non-pregnant women. Pregnant women had a significantly high average of granulocytes (p=0.009), monocytes (P=0.001), high ratio of CD4/CD8 (p< 0.0001) and significantly low CD8 lymphocytes (p< 0.0001) average compared to non-pregnant women. CONCLUSION: This study outlines high prevalence of Staphylococcus sp as the main urinary tract infectious pathogen in women at Mbouda Ad-Lucem hospital. It prevalence was accompanied with resistance to the routine antibiotics treatment, and a pronounced lymphocytosis and monocytosis.

Occurrence of Antibiotic-Resistant Bacteria in Therapy Pools and Surrounding Surfaces.

The number of patients colonized with antibiotic-resistant bacteria is increasing in health care facilities. Because transmission of antibiotic-resistant bacteria is feared, there exist reports that the affected patients are frequently excluded from hydrotherapy, which is a non-invasive and beneficial treatment used for patients with different diseases. Data from the literature suggest that deficient water disinfection measures exist, which are not always sufficient to kill all released bacteria. If the pool water is not disinfected properly, it may also infect the bathers. Immunocompromised patients are particularly susceptible to be infected with (antibiotic-resistant) bacteria. In order to determine the distribution of antibiotic-resistant bacteria in the pool water treatment system and the pool environment and to estimate the associated transmission risk we analyzed samples from eleven health care facilities. Antibiotic-resistant bacteria were found in the water and surface samples collected. One hundred and two antibiotic-resistant isolates from water samples and 307 isolates from surrounding surfaces were obtained, respectively. The majority of the isolates belonged to non-fermenting Gram-negative rods, like Pseudomonas spp. Some isolates were resistant to a wide range of the tested antibiotics. The results indicate a relation between the number of isolates in water samples and the number of patients using the pools in combination with deficiencies in water treatment. In the pool environment the highest number of isolates was obtained from barefoot areas and floor cleaning equipment.

Antimicrobial Activity of Gallium Compounds on ESKAPE Pathogens.

ESKAPE bacteria are a major cause of multidrug-resistant infections, and new drugs are urgently needed to combat these pathogens. Given the importance of iron in bacterial physiology and pathogenicity, iron uptake and metabolism have become attractive targets for the development of new antibacterial drugs. In this scenario, the FDA-approved iron mimetic metal Gallium [Ga(III)] has been successfully repurposed as an antimicrobial drug. Ga(III) disrupts ferric iron-dependent metabolic pathways, thereby inhibiting microbial growth. This work provides the first comparative assessment of the antibacterial activity of Ga(NO3)3 (GaN), Ga(III)-maltolate (GaM), and Ga(III)-protoporphyrin IX (GaPPIX), belonging to the first-, second- and third-generation of Ga(III) formulations, respectively, on ESKAPE species, including reference strains and multidrug-resistant (MDR) clinical isolates. In addition to the standard culture medium Mueller Hinton broth (MHB), iron-depleted MHB (DMHB) and RPMI-1640 supplemented with 10% human serum (HS) (RPMI-HS) were also included in Ga(III)-susceptibility tests, because of their different nutrient and iron contents. All ESKAPE species were resistant to all Ga(III) compounds in MHB and DMHB (MIC > 32 µM), except Staphylococcus aureus and Acinetobacter baumannii, which were susceptible to GaPPIX. Conversely, the antibacterial activity of GaN and GaM was very evident in RPMI-HS, in which the low iron content and the presence of HS better mimic the in vivo environment. In RPMI-HS about 50% of the strains were sensitive (MIC < 32) to GaN and GaM, both compounds showing a similar spectrum of activity, although GaM was more effective than GaN. In contrast, GaPPIX lost its antibacterial activity in RPMI-HS likely due to the presence of albumin, which binds GaPPIX and counteracts its inhibitory effect. We also demonstrated that the presence of multiple heme-uptake systems strongly influences GaPPIX susceptibility in A. baumannii. Interestingly, GaN and GaM showed only a bacteriostatic effect, whereas GaPPIX exerted a bactericidal activity on susceptible strains. Altogether, our findings raise hope for the future development of Ga(III)-based compounds in the treatment of infections caused by multidrug-resistant ESKAPE pathogens.

The microbiology of infected pancreatic necrosis.

BACKGROUND: Acute pancreatitis (AP) continues to cause significant morbidity and mortality, especially when it leads to infected pancreatic necrosis (IPN). Modern treatment of IPN frequently involves prolonged courses of antibiotics in combination with minimally invasive therapies. This study aimed to update the existing evidence base by identifying the pathogens causing IPN and therefore aid future selection of empirical antibiotics. METHODS: Clinical data, including microbiology results, of consecutive patients with IPN undergoing minimally invasive necrosectomy at our institution between January 2009 and July 2016 were retrospectively reviewed. RESULTS: The results of 40 patients (22 males and 18 females, median age 60 years) with IPN were reviewed. The etiology of AP was gallstones, alcohol, dyslipidemia and unknown in 31, 2, 2 and 5 patients, respectively. The most frequently identified microbes in microbiology cultures were Enterococcus faecalis and faecium (22.5% and 20.0%) and Escherichia coli (20.0%). In 19 cases the cultures grew multiple organisms. The antibiotics with the least resistance amongst the microbiota were teicoplanin (5.0%), linezolid (5.6%), ertapenem (6.5%), and meropenem (7.4%). CONCLUSION: The carbapenem antibiotics, ertapenem and meropenem provide good antimicrobial cover against the common, mainly enteral, microorganisms causing IPN. Culture and sensitivity results of acquired samples should be regularly reviewed to adjust prescribing and monitor for emergence of resistance.

Antibiotic susceptibility of wound swab isolates in a tertiary hospital in Southwest Nigeria.

Background: Wounds are commonly encountered in the clinical practice. Microbacterial colonization and infection negatively affect wound outcomes. With increasing emergence of antibiotic-resistant strains, it is essential to determine local patterns of wound microbiological profile and antibiotic susceptibility to guide rational empirical antibiotic use. Materials and Methods: Consecutive patients who presented to the plastic surgery unit were recruited to the study over a 6-month period. Wound swab cultures were performed at presentation using standard protocols and media. The wound swab was performed by the Levine technique and data were analyzed using a statistical software package. Results: Eighty-five microbial isolates were obtained from the eighty patients (55 males and 25 females) recruited. Gram-positive isolates were 35 (41.2%) and Gram-negative were 50 (58.8%). There was equal distribution of acute and chronic wounds. Pseudomonas aeruginosa was the most common isolate at 30.6%, followed by Staphylococcus aureus (27.1%), Escherichia coli (9.4%), Streptococcus species (8.2%), and Morganella morganii (7.1%). The isolates demonstrated resistance to amoxicillin-clavulanate, ampicillin, cloxacillin, cefuroxime, ceftazidime; low-to-moderate sensitivity to erythromycin, gentamicin, streptomycin, tetracycline, ciprofloxacin, and ofloxacin; and a moderate sensitivity to ceftriaxone and a high sensitivity to imipenem. There was significant difference in antibiotic resistance patterns between Gram-positive isolates from acute and chronic wound infections but not for acute and chronic wound Gram-negative isolates. Conclusion: Most of the microbial isolates, particularly the Gram-negative isolates demonstrated low sensitivity to commonly used antibiotics and moderate-to-high sensitivity to less commonly used newer antibiotics.

RésuméContexte: Les plaies sont généralement rencontrés dans la pratique clinique. La colonisation et l'infection Microbacterial négatif sur blessure Les résultats. Avec l'augmentation de l'émergence de souches résistantes aux antibiotiques, il est essentiel de déterminer les tendances locales de plaie profil microbiologique Sensibilité aux antibiotiques et de guider l'utilisation d'antibiotiques empiriques rationnelle. Matériel et méthodes: Patients consécutifs qui ont présenté à la Unité de chirurgie en plastique ont été recrutés pour l'étude sur une période de 6 mois. Écouvillon blessure cultures ont été effectuées à la présentation en utilisant des protocoles standard et des médias. L'écouvillonnage de la plaie a été effectuée par la technique de Levine et les données ont été analysées à l'aide d'un logiciel statistique. Résultats: Quatre-vingt-cinq isolats microbiens ont été obtenues à partir de 80 patients (55 hommes et 25 femmes) recrutés. Les isolats Gram-positives ont été 35 (41,2%) et Gram-négatives sont 50 (58,8%). Il y a égalité de répartition des blessures aiguës et chroniques. Pseudomonas aeruginosa est le plus fréquent d'isoler à 30,6%, suivi de Staphylococcus aureus (27,1%), Escherichia coli (9,4%), streptocoques (8,2%), et de Morganella morganii (7,1%). Les isolats présentaient une résistance à l'amoxicilline-clavulanate, ampicilline, cloxacillin, céfuroxime, ceftazidime, faible à modérée de la sensibilité à l'érythromycine, la gentamicine, la streptomycine, la tétracycline, la ciprofloxacine, l'ofloxacine et; et une sensibilité modérée à la ceftriaxone et une forte sensibilité à l'imipénème. Il y avait une différence dans les profils d'antibiorésistance entre les isolats de Gram-positives des infections de plaies aiguës et chroniques mais pas pour les plaies aiguës et chroniques des isolats de bactéries Gram-négatives. Conclusion: La plupart des isolats microbiens, en particulier les bactéries Gram-négatives isolats présentaient une faible sensibilité aux antibiotiques couramment utilisés et l'effet d'une grande sensibilité aux antibiotiques plus récents moins fréquemment utilisés.

Clinical pattern and antibiotic sensitivity of bacterial corneal ulcers in Kano, Northern Nigeria.

Purpose: The purpose of this study is to determine predisposing factors, common bacterial causes, and antibiotic sensitivity of corneal ulcers in Murtala Muhammad Specialist Hospital. Materials and Methods: A prospective, cross-sectional, observational study was carried out on patients with corneal ulcers. Information on relevant clinical, sociodemographic profile was obtained. Examination includes visual acuity test and slit-lamp biomicroscopy, especially fluorescein staining. Corneal scrapings from the ulcer were inoculated onto the selected solid culture media plates. Gram staining for microscopic examination was done. Antibiotic sensitivity test on different antibiograms was done using modified Kirby-Bauer technique, determining bacterial isolate sensitivity or resistance to relevant antibiotics (chloramphenicol, ciprofloxacin, ofloxacin, gentamicin, tetracycline, ceftazidime, ceftriaxone, cefotaxime, and penicillin). Results: A total of 77 patients with corneal ulcer were examined. Ocular trauma, application of harmful traditional eye medication, and use of unspecified topical medication before presentation were among the predisposing factors. Bacterial growth was seen in 46.8% of the samples, of which 28.6% of the growth were Gram-positive. The common bacteria isolated were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Proteus species, and Klebsiella pneumoniae. Isolates were sensitive to ciprofloxacin and ofloxacin while an intermediate sensitivity was seen with chloramphenicol and gentamicin. Isolates were resistant to tetracycline, ceftazidime, ceftriaxone, cefotaxime, and penicillin. Conclusion: Ocular trauma was the major predisposing factor to corneal ulcer, and Staphylococcus species was the major bacterial organism isolated. Isolates were found to be sensitive to ciprofloxacin and ofloxacin, while an intermediate sensitivity was seen with chloramphenicol and gentamicin.

RésuméBut: Le but de cette étude est de déterminer les facteurs de prédisposition, les causes bactériennes courantes, et la sensibilité aux antibiotiques des ulcères de la cornée à l'hôpital Murtala Mohammed Specialist. Matériels et méthodes: une étude prospective, transversales, l'étude d'observation a été effectuée sur des patients atteints d'ulcères de la cornée. Des informations sur les caractéristiques sociodémographiques, cliniques a été obtenue profi l. Examen comprend test d'acuité visuelle et lampe à fente biomicroscopie, surtout fl uorescein la coloration. À partir de l'ulcère cornéen raclures ont été inoculées sur la plaque de culture solide. La coloration de Gram pour l'examen microscopique a été fait. Essai sur la sensibilité aux antibiotiques a été effectuée à l'aide d antibiograms différentes modifi Ed Kirby-Bauer technique, déterminer la sensibilité ou la résistance d'isoler des bactéries aux antibiotiques correspondants (chloramphénicol, oxacin oxacin ciprofl, ofl, la gentamicine, la tétracycline, la ceftazidime, la ceftriaxone, céfotaxime, et la pénicilline). Résultats: Un total de 77 patients atteints d' ulcère cornéen ont été examinés. Un traumatisme oculaire, l'application de médicament traditionnel des nuisibles, et l'utilisation d'unspecifi ed médicament topique avant la présentation ont été parmi les facteurs de prédisposition. La croissance bactérienne a été observée dans 46,8 % des échantillons, dont 28,6 % de la croissance des bactéries Gram-positives ont été. Les bactéries communes isolées étaient Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, espèces de Proteus et Klebsiella pneumoniae. Les isolats étaient sensibles à l'oxacin oxacin ciprofl et ofl tandis qu'une sensibilité intermédiaire a été vu par le chloramphénicol et la gentamicine. Isolats étaient résistants à la tétracycline, la ceftazidime, la ceftriaxone, céfotaxime, et la pénicilline. Conclusion: un traumatisme oculaire a été le principal facteur prédisposant à l'ulcère cornéen, et Staphylococcus espèce a été le principal organisme bactérien isolé. Les isolats ont été trouvés à être sensibles à l'oxacin oxacin ciprofl et ofl, tandis qu'une sensibilité intermédiaire a été vu par le chloramphénicol et la gentamicine.

Bacteriological relevance of linezolid vs. vancomycin in postoperative empirical treatment of osteoarticular infections: a retrospective single-center study.

BACKGROUND: In 2015, our center replaced vancomycin with linezolid for the postoperative empirical treatment of osteoarticular infections (OAI). OBJECTIVES: To assess the bacteriological relevance of linezolid for orthopedic postoperative probabilistic antibiotic therapy. METHODS: Analysis of an observational cohort of patients empirically treated with a combination of linezolid and piperacillin/tazobactam during the immediate postoperative stage for an OAI between July 1st 2015 and July 1st 2016, in a French reference center. RESULTS: Seventy-seven of 126 patients who received a probabilistic postoperative combination of linezolid with piperacillin/tazobactam had microbiological proof of infection. Sixty-six of 77 OAI involved material, including an osteosynthesis in 45 cases (68%) and prosthesis in 21 cases (32%). Infection was due to Gram-positive bacteria in 62 cases (80.5%), mostly S. aureus (n=32, 41.6%), and S. epidermidis (n=14, 18.2%) accounting for 74.2% of Gram-positive bacteria. Among 14 OAI due to S. epidermidis, 11 (78.6%) were due to methicillin-resistant strains. All the S. aureus and S. epidermidis strains were susceptible to linezolid (MICs ≤ 4 mg/L), except in one patient previously treated with linezolid who was infected with a linezolid-resistant S. epidermidis strain (MIC > 256 mg/L). CONCLUSION: Linezolid can be used empirically in postoperative antibiotic therapy of OAI before obtaining definitive microbial results. Although linezolid resistance is rare in this population, previous oxazolidinone treatment should be documented before initiation of probabilistic postoperative treatment to highlight potential linezolid resistance.

Application of prickly pear fruit extract to improve domestic shelf life, quality and microbial safety of sliced beef.

The research aimed to expand the knowledge on the use of natural bioactive compounds for food preservation. First-crop fruit of prickly pear were subjected to water extraction and evaluated for total polyphenol content, antioxidant activity, in vitro antimicrobial performance against food spoilage and pathogenic bacteria, and betacyanin and betaxanthin content. The extract was then applied by dipping technique to packed sliced beef, to evaluate its effect on physical and chemical parameters, color and texture maintenance, as well as on microbial growth during shelf life at domestic storage conditions. The in vitro antimicrobial assay of prickly pear fruit extract evidenced a wide spectrum activity, since it inhibited the growth of all Gram positive and negative targeted strains. In vivo application of extract effectively reduced microbial growth during refrigerated storage; total mesophilic count was maintained below the limit established by Commission Regulation (EC) No 2073/2005 of 5 × 106 log CFU/g of beef up to 8 d, in comparison to control sample that reached the mentioned limit after 4 d. Moreover, extract addition preserved beef color and texture over the considered storage period, supporting the potential prospect to utilize the extract to improve overall quality and to prolong domestic shelf life of sliced beef.

Antibacterial activity of Ilex paraguariensis (Yerba Mate) against Gram-positive and Gram-negative bacteria.

INTRODUCTION: The stems and leaves of Ilex paraguariensis are popularly used for tea infusions in South America and the Middle East. The health benefits have been previously studied, revealing anti-mutagenic, anti-oxidant, hepatoprotective, hypocholesteremic and glycemic improvement. Limited research was performed on the antibacterial activity of the aqueous extract of Yerba Mate on standard and clinical isolates of Gram-positive and Gram-negative bacteria. METHODOLOGY: Commercial Ilex paraguariensis stems and leaves were ground and extracted with sterile deionized water at 70°C. Four ATCC bacterial strains and twenty-five bacterial clinical strains were used for testing. To obtain the minimal inhibitory concentration (MIC), the Yerba Mate aqueous solution was serially diluted according to the microdilution method. For the minimal bactericidal concentration (MBC), the tubes with clear broth were sub-cultured. To identify the types of ESBLs present in the clinical isolates, a multiplex PCR was performed. RESULTS: An antibacterial activity was observed against most of tested strains, with a greater activity against Gram-positive bacteria. MIC and MBC values ranged between 0.468 mg/mL and 15 mg/mL of aqueous extract of Yerba Mate. CONCLUSION: The aqueous extract of the stems and leaves of Ilex paraguariensis extracted at 70°C showed a significant antibacterial activity. There was no correlation found between the different molecular resistance profiles and the antibacterial activity range.

[Late onset neonatal sepsis in an intensive care neonatal unit: etiological agents and most frequent location]. / Sepsis neonatal tardía nosocomial en una unidad de terapia intensiva: agentes etiológicos y localización más frecuente.

INTRODUCTION: Nosocomial neonatal sepsis (NNS) is a frequent entity in intensive care units, causing great morbidity and mortality. The most frequent site is blood, followed by lungs and urine. OBJECTIVE: To know the etiology and most frequent localization of infection in the NNS. POPULATION, MATERIAL AND METHODS: Cross sectional study, from January to December 2015, performed in a teaching hospital. All newborns infants were included. RESULTS: 70 patients were included, 88 episodes of NNS were analyzed. The most frequent localization was bacteremia in 40% of cases, followed by urinary tract infection and VAP in 25% respectively. The bacteria most frequently isolated were staphylococci of different types, followed by multiresistant Acinetobacter. The CNS involvement was 32%. Mortality was 34%, rising up to 50% with a second episode of NNS. The empirical therapy of choice was vancomycin and carbapenem, adjusting to antibiogram. CONCLUSIONS: The most frequent infection was bacteremia, mainly by staphylococci resistant to methicillin. CNS involvement was elevated, as well as mortality.

Aqueous chlorine dioxide treatment of horticultural produce: Effects on microbial safety and produce quality-A review.

Microbial load on fresh fruit and vegetables causes decay and losses after harvest and may lead to foodborne illness in case of contamination with human pathogens on raw consumed produces. Washing with tap water only marginally reduces microorganisms attached to produce surfaces. Chlorine is widely used for decontamination on fresh horticultural produces. However, due to harmful by-products and the questionable efficacy it has become increasingly challenged. During the last 20 years, the interest to study ClO2 treatments as an alternative sanitation agent for industrially prepared fresh produce has largely increased. For a wide range of commodities, the application of gaseous ClO2 has meanwhile been investigated. In addition, since several years, the interest in aqueous ClO2 treatments has further risen because of the better manageability in postharvest processing lines compared to gaseous application. This article critically evaluated the effects of postharvest application of aqueous ClO2, either alone or in combination with other treatments, on microbial loads for various horticultural produces. In laboratory investigations, application of aqueous ClO2 at concentrations between 3 and 100 ppm effectively reduced counts of natural or inoculated microorganisms (bacteria, yeasts, and mold) in the range of 1 and 5 log. However, various effects of ClO2 treatments on produce quality have been described. These mainly comprise implication on sensory and visual attributes. In this context, there is increasing focus on the potential impacts of aqueous ClO2 on relevant nutritional components of produces such as organic acids or phenolic substances.