Prevalence and Antibiotics Susceptibility Pattern of Urine Bacterial Isolates from Tripoli Medical Center (TMC), Tripoli, Libya / Prevalencia y patrón de susceptibilidad a los antibióticos de los aislados bacterianos en orina del centro médico de Trípoli (TMC), Trípoli, Libia

Introduction: Urinary tract infections (UTI) are one of the most common human bacterial infections encountered by physicians. The risk of resistant microbes is emerging as a result of the overuse of antibiotics treatments. The presence of pathogens with increased resistance to antimicrobial agents makes UTIs difficult to treat. This study was aimed at determining the prevalence of the pathogens that cause UTIs, as well as the antibiotic susceptibility of these isolates.Materials and methods: This prospective study was conducted from February 2020 to April 2020; a total number of 200 urine samples were collected from patients who daily attended TMC Libya. Bacterial pathogens were determined by bacteriological culture methods and Antimicrobial susceptibility testing was done by using the disc diffusion method.Results: Out of 200 samples, 110 cases had a positive culture. The dominant bacterial pathogens were Gram-negative that being with Escherichia coli (49, 55.68%), followed by Klebsiella pneumonia (18, 20.46%), Pseudomona aeruginosa (9, 10.23%), Proteus mirabilis (8, 9.09%), Enterobacter aerogenes (2, 2.27%), Citrobacter freundii (2, 2.27%). Gram-positive bacteria were Staphylococcus aureus 20 (90.91%) followed by S. saprophyticus (2, 9.01%) of the isolate’s strains. The isolated uropathogen showed increased levels of resistance to antibiotics. Where the Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus indicated the highest antibiotic resistance to Nitrofurantoin, Sulfamethoxazole/trimethoprim, Tetracycline, Ciprofloxacin, Metronidazole and also revealed the most sensitivity to Cefixime followed by doxycycline and ceftriaxone.Conclusions: The obtained results emphasized the emergence of highly resistant bacteria to most of the tested antimicrobials and propose the need for physicians to change their treatment pattern depending on antimicrobial susceptibility results.(AU)

Introducción: Las infecciones del tracto urinario (ITU) son una de las infecciones bacterianas humanas más comunes que encuentran los médicos. El riesgo de microbios resistentes está surgiendo como resultado del uso excesivo de tratamientos con antibióticos. La presencia de patógenos con mayor resistencia a los agentes antimicrobianos dificulta el tratamiento de las infecciones urinarias. Este estudio tuvo como objetivo determinar la prevalencia de los patógenos que causan las ITU, así como la susceptibilidad a los antibióticos de estos aislados.Materiales y métodos: Este estudio prospectivo se realizó desde febrero de 2020 hasta abril de 2020; Se recogió un total de 200 muestras de orina de pacientes que asistían diariamente a TMC Libia. Los patógenos bacterianos se determinaron mediante métodos de cultivo bacteriológico y las pruebas de susceptibilidad a los antimicrobianos se realizaron mediante el método de difusión en disco.Resultados: De 200 muestras, 110 casos tuvieron un cultivo positivo. Los patógenos bacterianos dominantes fueron Gram-negativos con Escherichia coli (49, 55.68%), seguidos de Klebsiella pneumonia (18, 20.46%), Pseudomonas aeruginosa (9, 10.23%), Proteus mirabilis (8, 9.09%), Enterobacter aerogenes (2, 2.27%). %), Citrobacter freundii (2, 2.27%). Las bacterias grampositivas fueron Staphylococcus aureus (20, 90.91%) seguido de S. saprophyticus, (2, 9.01%) de las cepas del aislado. El uropatógeno aislado mostró niveles aumentados de resistencia a los antibióticos. Donde Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus indicaron la mayor resistencia a los antibióticos a la nitrofurantoína, sulfametoxazol/trimetoprima, tetraciclina, ciprofloxacina, metronidazol y también revelaron la mayor sensibilidad a la cefixima seguida de la doxiciclina y la ceftriaxona.Conclusiones: Los resultados obtenidos enfatizan la aparición de bacterias altamente resistentes a la mayoría de los antimicrobianos probados...(AU)

The role of bacterial colonization of ventilator circuit in development of ventilator associated pneumonia in ICU of Medical Center Hospital in Tripoli, Libya

Introduction: In mechanically ventilated patients, ventilator-associated pneumonia (VAP) is a major cause of prolonged hospitalization with increased morbidity and mortality. There is a lack of studies on the relationship between bacterial colonization of the ventilator circuit (VC) and VAP. This study aimed to investigate the role of bacterial colonization of VC in the development of VAP and identify antibiotic susceptibility trends for isolated strains. Methods: A prospective study of the bacterial culture has been performed between February 2021 to March 2021 on a total of 100 mechanically ventilated patients, (n =50) samples have been obtained from patient's lower respiratory tract (LRT) and (n =50) were taken from mechanical ventilator equipment VC. Paired samples of bacteria isolated from VC and LRT, where VC was colonized before LRT. Results: A total of 58 samples were cultured positively, while 42 specimens showed negative bacterial growth. However, there was no substantial difference in comparing between the bacterial colonization of the ventilator system and the patient samples. Most isolated organisms were gram-negative bacteria which were found in the ventilator circuit with 26 (68.4%), and 14 (70%) in patient's LRT. Gram-positive was detected in 12 (31.6%) and 6 (30%) of the ventilator circuit, and patient's LRT, respectively. The predominant bacterial type was Acinetobacter baumannii organism at the VC with 10 (26.3%) and LRT at 4 (20%) followed by Klebsiella pneumoniae (8 (21.1%) in VC and 4 (20%) in LRT). Moreover, A. baumannii showed a full resistance to amoxicillin and the first generation of cephalosporins, while the other bacterial types were resistant to the most antibiotics used in this research (AU)

A Low Prevalence of Inducible Macrolide, Lincosamide, and Streptogramin B Resistance Phenotype among Methicillin-Susceptible Staphylococcus aureus Isolated from Malaysian Patients and Healthy Individuals.

BACKGROUND: Antibiotic resistance among Staphylococcus aureus is of great concern worldwide. This resistance is further complicated by the ability of S. aureus to confer cross-resistance to other antibiotics due to the presence of resistance genes, such as erythromycin resistance methylase (erm) genes, which render the bacterium resistant to macrolide-lincosamide-streptogramin B (MLSB) antibiotics. Resistance to these antibiotics can lead to therapeutic failure, resulting in significant morbidity and mortality in patients with S. aureus infections. OBJECTIVES: This study was performed to examine the distribution of MLSB-resistant strains of methicillin-susceptible S. aureus (MSSA), which were obtained from hospitalized patients and normal healthy individuals (carriers) using phenotypic methods, such as the double-disk diffusion (D-test) and the genotypic method by polymerase chain reaction (PCR). METHODS: A total of 183 nonduplicative MSSA isolates obtained from hospitalized patients (133) and carriers (50) in our previous studies were randomly selected for the D-test. The guidelines of the Clinical and Laboratory Standards Institute (CLSI) were used for the interpretation of the results of this test. The detection of ermA, ermB, ermC and msrA genes by PCR was performed for isolates that had positive D-test results and that were resistant to erythromycin. RESULTS: Of the 183 MSSA isolates, 97.2% and 98.4% were highly susceptible to erythromycin and clindamycin, respectively. MSLB resistance was detected in four isolates (2.2%). Of the 133 MSSA isolated from hospitalized patients, only 3.0% (4/133) and 2.3% (3/133) exhibited resistance to erythromycin and clindamycin, respectively. With regard to the MLSB resistance phenotypes, only 1.6% and 0.6% exhibited inducible MLSB (iMLSB) and MS phenotypes, respectively. The ermC gene was detected in all three iMLSB phenotypes, and the msrA gene was detected in the MS phenotype. Surprisingly, all MSSA isolates (100%) from carriers exhibited extremely high susceptibility to both antibiotics. CONCLUSIONS: The prevalence rates of iMLSB MSSA isolates vary according to geographical locations and the local antibiotic policy. The low prevalence rate of iMLSB MSSA isolates could probably be related to the judicious use of antibiotics for treating S. aureus infections in our studied population. Nonetheless, continuous antibiotic surveillance is still necessary to control any emergence of resistance isolates so that targeted therapy and effective control can be implemented accordingly.