Prevalence of Antimicrobial Resistance and Respective Genes among Bacillus spp., a Versatile Bio-Fungicide.

The plant rhizosphere is not only a reservoir of microbes but also a hub of antimicrobial resistance genes. Rhizospheric Bacillus spp. are the potential bio-inoculants with a versatile application in agriculture as bio-fertilizer and bio-fungicide. In the current study, the potential bio-control agent that is the Bacillus species (n = 7) was screened for the antimicrobial resistance pattern to assess their risk before registering them as a bio-inoculant. All of the Bacillus spp. were categorized as multi-drug-resistant (MDR), bacteria but none of them was either pan-drug-resistant (PDR) or extensive-drug-resistant (XDR). The multiple antimicrobial resistance (MAR) index of Bacillus spp. was higher than the critical value (0.2). The Bacillus spp. showed resistance to antimicrobial classes such as ß lactam, macrolides, sulfonamides, tetracycline, aminoglycosides, and lincosamide. Various antimicrobial resistance genes, namely VmiR, ImrB, tetL, mphK, ant-6, penp, and bla OXA, associated with different mechanisms of resistance, were also detected in Bacillus spp. The Bacillus spp. also showed stress-tolerance traits such as ACC deaminase and EPS activity except the strains MAZ-117 and FZV-34, respectively. A significant correlation was observed between the PGPR and antimicrobial resistance, which shows that they may have adapted drug-resistance mechanisms to tolerate the environmental stress. These findings suggest that bio-fungicidal Bacillus spp. could be used very carefully on a commercial scale.

Baseline characteristics of infected foot ulcers in patients with diabetes at a tertiary care hospital in Pakistan.

OBJECTIVE:: Studies on diabetic foot ulcers (DFU) involving a representative sample of patients in Pakistan are scarce. This study aimed to determine baseline characteristics of infected DFUs in patients hospitalised at the Pakistan Institute of Medical Sciences Islamabad. METHOD:: In this cross-sectional study, carried out during May 2015 and June 2016, foot ulcer characteristics of patients with DFUs were investigated and documented. From infected DFUs, aerobic bacterial pathogens were isolated, identified and evaluated for antimicrobial susceptibility. RESULTS:: A total of 214 patients were recruited to the study, 62.6% of which were male, 90.2% were aged ≥40 years, 76.2% had type 1 diabetes and 78.5% had poor glycaemic control at time of presentation to hospital. Most patients had grade 3/moderate ulceration (based on the Wagner and International Working Group on the Diabetic Foot/Infectious Diseases Society of America criteria). Over half of the DFUs (57.9%) were of ≤3 months' duration and 70.1% were ≥3 cm2. Of the patients with deep infection grade ulcers, 26.6% underwent amputation, accounting for their prolonged hospital stay (≥20 days). Significant differences were observed between patients with type 1 and type 2 diabetes with DFUs in relation to gender (p≤0.0001), ulcer size (p=0.0421) and duration of hospital stay (p=0.0253). The most significant predictors for lower extremity amputation were osteomyelitis (p=0.0114), retinopathy (p=0.0001) and neuropathy (p=0.0001. Piperacillin/tazobactam was found to be an effective antibiotic against the most commonly isolated Staphylococcus non-aureus (35.48%), Pseudomonas aeruginosa (22.26%), and Staphylococcus aureus (20.96%) species indentified in the DFU infections. CONCLUSION:: The findings of this study may be helpful in the optimal management and appropriate treatment of patients with infected DFUs.