Phenotypic and Molecular Characterization of β-Lactamases among Enterobacterial Uropathogens in Southeastern Nigeria

A Snapshot of Antimicrobial Resistance in Semi-Wild Oryx: Baseline Data from Qatar

Background/Objectives: The spread of antimicrobial resistance (AMR) is a growing global health concern. Wild animals can play an important role in the amplification and dissemination of AMR and in conservation efforts aiming at controlling diseases in vulnerable wild animal populations. These animals can serve as reservoirs for antibiotic resistance genes and are key in the spread of AMR across ecosystems and hosts. Therefore, monitoring AMR in wild animals is crucial in tackling the spread of resistance in the environment and human population. This study investigated the phenotypic and genotypic resistance of Escherichia coli (E. coli) isolated from semi-wild oryx (Oryx leucoryx) in Qatar. Methods: One hundred fecal samples were collected from oryx in diverse natural reserves across Qatar. A selective agar medium was used to isolate E. coli, and the identity of the isolates was further confirmed using the VITEK® 2 Compact system. The Kirby-Bauer disk diffusion method was used to test antibiotic susceptibility. Genetic resistance determinants were identified through polymerase chain reaction (PCR) analyses and sequencing using the Oxford Nanopore Technology (ONT). Results: The results revealed that 18% (n = 18) of the samples harbored E. coli with resistance to a single antibiotic, 28% (n = 28) were resistant to at least one antibiotic, and 2% (n = 2) were multidrug-resistant (MDR). No resistance was observed against colistin. tetA and tetB encode tetracycline resistance were the most frequently detected genes (57.7%). Whole genome sequencing (WGS) was used to expand on AMR gene-PCR analyses and analyze the resistome of 12E. coli isolates. WGS identified several important antibiotic resistance determinates, including blaCTX-M-encoding Extended Spectrum Beta-Lactamase (ESBL) resistance, soxR associated with tetracycline target alteration, and mdtE, emrB, AcrE, mdtF, and marA related to ciprofloxacin efflux pump resistance. Conclusions: This study provides essential information regarding AMR in Qatari semi-wild animals, which will guide conservation strategies and wildlife health management in a world experiencing increasing antibiotic-resistant infections. Furthermore, these findings can inform policies to mitigate AMR spread, improve ecosystems, and enhance public and environmental health while paving the way for future research on AMR dynamics in wildlife.

Pandemic Events Caused by Bacteria Throughout Human History and the Risks of Antimicrobial Resistance Today

During human history, many pandemic events have threatened and taken many human lives over the years. The deadliest outbreaks were caused by bacteria such as Yersinia pestis. Nowadays, antimicrobial resistance (AMR) in bacteria is a huge problem for the public worldwide, threatening and taking many lives each year. The present work aimed to gather current evidence published in scientific literature that addresses AMR risks. A literature review was conducted using the following descriptors: antimicrobial resistance, AMR, bacteria, and Boolean operators. The results showed that antimicrobial-resistant genes and antibiotic-resistant bacteria in organisms cause critical infectious diseases and are responsible for the infections caused by antibiotic-resistant bacteria (ARB). This review emphasizes the importance of this topic. It sheds light on the risk of reemerging infections and their relationship with AMR. In addition, it discusses the mechanisms and actions of antibiotics and the mechanisms behind the development of resistance by bacteria, focusing on demonstrating the importance of the search for new drugs, for which research involving peptides is fundamental.

Structure-based drug design of pre-clinical candidate nanopiperine: a direct target for CYP1A1 protein to mitigate hyperglycaemia and associated microbes

Diabetes is attributed to an increased vulnerability to bacterial infection linked to unregulated hyperglycaemia. The present study highlights the formulation of nanoparticles with phyto-compound piperine (PIP) encapsulated within non-toxic biodegradable polymer poly-lactide co-glycolide (PLGA) which showed a variety in surface functionality, biocompatibility, and the ability to tailor an optimized release rate from its polymeric enclosure. The observations revealed that nanopiperine (NPIP) pre-treatment in mice inhibited alteration in hepatic tissue architecture and hepato-biochemical parameters in diabetes and its associated bacterial infections. NPIP also decreased the propensity of lipids to undergo an oxidation process and stabilized the membrane lipids in vivo, thereby lowering oxidative stress and preventing enzymatic activation of CYP1A1. This result is corroborated with the in silico molecular docking study where PIP binding with CYP1A1 gave -11.32 Kcal/mol dock score value. The antibacterial activity of PIP was further demonstrated by the in silico PIP and Ef-Tu protein-binding efficacy revealing -6.48 Kcal/mol score value which was coupled with the results of in vitro studies where the zone of inhibition assay with NPIP against Staphylococcus aureus and Escherichia coli. Thus, NPIP could serve as a potential drug candidate in modulating targeted proteins to inhibit the progression of hyperglycaemia and its associated microbes.

Prevalence and antibiotic susceptibility patterns of uropathogens in men with prostate cancer and benign prostate hyperplasia from Southwestern Nigeria

BACKGROUND

Epidemiological investigations have revealed an important association between infection, inflammation and prostate cancer. Certain bacterial species, such as Klebsiella spp, Escherichia coli, Pseudomonas spp, Proteus mirabilis, Chlamydia trachomatis have been linked to prostate cancer. This study aimed to examine the microbiota; specifically bacterial species that have been linked to prostate infections in the urine of individuals diagnosed with prostate cancer.

RESULTS

Sixty-six prostate cancer patients and forty controls provided midstream urine samples. The urine samples were grown on suitable medium, and bacterial isolates were detected by standard microbiological methods. Additionally, the antibiotic sensitivity pattern of the bacterial isolates was analysed. A total of number of 72 bacterial isolates were obtained from the urine of study participants. The results showed the presence of Escherichia coli (50.0%), Pseudomonas aeruginosa (18.1%), Klebsiella spp (15.3%), Staphylococcus aureus (8.3%), Enterobacter spp (4.2%), and Proteus mirabilis (2.8%) in the urine. The most common bacterial species isolated from prostate cancer patients was Escherichia coli, which was susceptible to levofloxacin (100%), tobramycin (91.7%), and amikacin (62.5%).

CONCLUSIONS

This study's findings established the presence of bacteria previously linked to prostatitis. This report indicates a high prevalence of pro-inflammatory bacteria and uropathogens in the urinary tract of men diagnosed with prostate cancer.

Multidrug-Resistant Sepsis: A Critical Healthcare Challenge

Sepsis globally accounts for an alarming annual toll of 48.9 million cases, resulting in 11 million deaths, and inflicts an economic burden of approximately USD 38 billion on the United States healthcare system. The rise of multidrug-resistant organisms (MDROs) has elevated the urgency surrounding the management of multidrug-resistant (MDR) sepsis, evolving into a critical global health concern. This review aims to provide a comprehensive overview of the current epidemiology of (MDR) sepsis and its associated healthcare challenges, particularly in critically ill hospitalized patients. Highlighted findings demonstrated the complex nature of (MDR) sepsis pathophysiology and the resulting immune responses, which significantly hinder sepsis treatment. Studies also revealed that aging, antibiotic overuse or abuse, inadequate empiric antibiotic therapy, and underlying comorbidities contribute significantly to recurrent sepsis, thereby leading to septic shock, multi-organ failure, and ultimately immune paralysis, which all contribute to high mortality rates among sepsis patients. Moreover, studies confirmed a correlation between elevated readmission rates and an increased risk of cognitive and organ dysfunction among sepsis patients, amplifying hospital-associated costs. To mitigate the impact of sepsis burden, researchers have directed their efforts towards innovative diagnostic methods like point-of-care testing (POCT) devices for rapid, accurate, and particularly bedside detection of sepsis; however, these methods are currently limited to detecting only a few resistance biomarkers, thus warranting further exploration. Numerous interventions have also been introduced to treat MDR sepsis, including combination therapy with antibiotics from two different classes and precision therapy, which involves personalized treatment strategies tailored to individual needs. Finally, addressing MDR-associated healthcare challenges at regional levels based on local pathogen resistance patterns emerges as a critical strategy for effective sepsis treatment and minimizing adverse effects.

Evaluation of Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus respiratory tract superinfections among patients with COVID-19 at a tertiary-care hospital in Tehran, Iran

BACKGROUND

The emergence of healthcare-associated infections (HAIs) or superinfections in COVID-19 patients has resulted in poor prognosis and increased mortality.

METHODS

In a cross-sectional study, 101 respiratory samples were collected from ICU-admitted COVID-19 patients. The HAI rate, demographics, and antibiotic resistance were assessed.

RESULTS

The HAI rate was 83.16% (76.62% bacterial and 6.54% fungal). The prevalence of 3 major HAI-causing organisms included Klebsiella pneumoniae (41.5%), Acinetobacter baumannii (20.8%), and Staphylococcus aureus (4.9%). Mortality and intubation ventilation proportions of 90% (p = 0.027) and 92.2% (p = 0.02) were significant among patients with superinfection, respectively. Multiple logistic regression analysis showed SpO2 pressure (odds ratio 0.842; 95% CI 0.750-0.945; p = 0.004) as a predictive factor in the association between antibiotic usage and mortality. More than 50% of patients received carbapenems. The resistance rates to at least one antibiotic of third-generation cephalosporins, aminoglycosides, quinolones/fluoroquinolones, tetracyclines, and β-lactam inhibitors were 95.2%, 95.2%, 90%, 57.1%, and 100% among A. baumannii isolates and 71.4%, 55%, 69%, 61.9%, and 59.5% among K. pneumoniae isolates, respectively. A proportion of 60% was recorded for methicillin-resistant S. aureus isolates.

CONCLUSION

As a result, antibiotic treatment should be administered following the microbial resistance profile. Contact isolation and infection control measures should be implemented as needed.

Antibiotic Resistance: Challenges and Strategies in Combating Infections

From a broader perspective, antibiotic or antimicrobial resistance is still evolving and spreading internationally. Infectious diseases have become more complex and often impossible to cure, increasing morbidity and mortality. Despite the failure of conventional, standard antimicrobial therapy, no new class of antibiotics has been developed in the last 20 years, which results in various cutting-edge and other tactics that can be used to encounter these disease-causing microorganisms with antibiotic resistance. In the continued fight against bacterial infections, there is an urgent requirement for new antibiotics and other antimicrobials. Antibiotic resistance is inevitable, and pharmaceutical companies consistently show little interest in funding novel antibiotic research. Some methods are being used as a possible replacement for conventional antibiotics. Combination therapy, methods that target the proteins or enzymes that cause antimicrobial resistance and bacterial resistance, systems for delivery of the drug, physicochemical approaches, and informal ways, such as the CRISPR-Cas system, are some of these approaches. These various approaches influence how multi-drug-resistant organisms are handled in human clinical settings.

Respiratory Bacterial and Fungal Superinfections During the Third Surge of the COVID-19 Pandemic in Iran

Objective: We characterized bacterial and fungal superinfection and evaluated the antimicrobial resistance profile against the most common superinfection-causing pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus). Methods: In a cross-sectional study, 192 respiratory samples were collected from patients with and without SARS-COV-2 admitted to a teaching hospital in Tehran. Superinfection proportions and the antibiotic resistance profile were assessed and compared with demographic, comorbidities, and other clinical factors. Results: Superinfection rate was 60% among COVID-19 patients (p = 0.629). Intensive care unit admission (p = 0.017), mortality rate (p ≤ 0.001), and antiviral and corticosteroid therapy (p ≤ 0.001) were significantly more common among patients with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). The most common superinfections were caused by K. pneumoniae (42.7%, 82/192), A. baumannii (14.6%, 28/192), and S. aureus (13%, 25/192). A. baumannii isolates exhibited greater antibiotic resistance. Forty-four percent (11/25) of S. aureus isolates were cefoxitin resistant and also confirmed as methicillin-resistant S. aureus by PCR. Conclusion: The rise of difficult-to-treat infections with a high burden of antibiotic resistance, coupled with an increase in mortality rate of SARS-COV-2 superinfected individuals, illustrates the impact of the COVID-19 pandemic on antimicrobial resistance. Post-pandemic antimicrobial resistance crisis management requires precise microbiological diagnosis, drug susceptibility testing, and prescription of antimicrobials appropriate for the patient's condition.

Antibiotic resistance: The challenges and some emerging strategies for tackling a global menace

Background

Antibiotic resistance is currently the most serious global threat to the effective treatment of bacterial infections. Antibiotic resistance has been established to adversely affect both clinical and therapeutic outcomes, with consequences ranging from treatment failures and the need for expensive and safer alternative drugs to the cost of higher rates of morbidity and mortality, longer hospitalization, and high‐healthcare costs. The search for new antibiotics and other antimicrobials continues to be a pressing need in humanity's battle against bacterial infections. Antibiotic resistance appears inevitable, and there is a continuous lack of interest in investing in new antibiotic research by pharmaceutical industries. This review summarized some new strategies for tackling antibiotic resistance in bacteria.

Methods

To provide an overview of the recent research, we look at some new strategies for preventing resistance and/or reviving bacteria's susceptibility to already existing antibiotics.

Results

Substantial pieces of evidence suggest that antimicrobials interact with host immunity, leading to potent indirect effects that improve antibacterial activities and may result in more swift and complete bactericidal effects. A new class of antibiotics referred to as immuno‐antibiotics and the targeting of some biochemical resistance pathway components including inhibition of SOS response and hydrogen sulfide as biochemical underlying networks of bacteria can be considered as new emerging strategies to combat antibiotic resistance in bacteria.

Conclusion

This review highlighted and discussed immuno‐antibiotics and inhibition of SOS response and hydrogen sulfide as biochemical underlying networks of bacteria as new weapons against antibiotic resistance in bacteria.

Antibacterial kinetics and phylogenetic analysis of Aloe vera plants

Uncontrolled use of antibiotics has resulted in the emergence of resistant bacteria. It has necessitated the evaluation of antibacterial activities and phylo-diversity of Aloe vera (also called Aloe barbadensis) plants as antimicrobial agent in Nigeria. Biotyped enteric bacilli of 251 strains obtained from fecal samples of patients with various gastro-intestinal complications are profiled for antibiogram. Resistant biotypes were assayed for susceptibility to Aloe vera latex and further evaluated for time-kill kinetics and phylo-diversity. More than 30% of enteric bacilli, including Citrobacter freundii, Escherichia coli and Proteus mirabilis were resistant to cotrimoxazole, ciprofloxacin, and tetracycline respectively at MIC >16 µg/ml (p=0.004). Aloe vera latex significantly inhibited 39.5% resistant enteric biotypes with a significant average reduction of the viable count at 1xMIC and 2xMIC to less than 3.0 Log10CFU/mL after 24 hours. Flavonoids, alkaloids, terpenoids and anthraquinine in anti-enteric sap significantly correlated and regressed with antibacterial activity (p<0.05), while two of the antimicrobial Aloe vera plants showed phylogenetic relatedness with other homologous. Anti-bacteria efficacy of some Nigerian Aloe vera latex could provide alternative therapy, while its phylo-diversity and genomic profiling would offer a promising avenue for identification and development of antimicrobial agents as drug candidates for natural antibiotics.

Antibiotic resistance and ESBL production in Escherichia coli from various sources in Aba metropolis, Nigeria

BACKGROUND

The increase in multidrug resistance (MDR) among pathogenic bacteria responsible for infectious diseases has led to lack of effectiveness of some antibiotics. The ability of Escherichia coli to harbor resistant genes has made the treatment of infections a major challenge. This study was carried out to assess antibiotic resistance and extended-spectrum beta-lactamase (ESBL) production of E. coli from various sources in Aba metropolis, Nigeria.

RESULTS

From a total of 350 samples collected from clinical and non-clinical sources, 137 were presumptively identified as E. coli by standard phenotypic methods and 83 were confirmed as E. coli by the detection of E. coli specific 16S rRNA gene fragments. The majority of these isolates (52, 62.7%) were from non-clinical sources. The clinical isolates, however, exhibited a higher level of resistance against 62.5% of tested antibiotics. Both group of isolates exhibited similar levels (58.1% vs 53.9%) of MDR, though. A low rate of ESBL production was observed (1.2%) following phenotypic detection of ESBL-producing abilities using the double-disc synergy test. An assessment of the presence of three beta-lactamase gene genotypes (bla_TEM, bla_SHV and bla_CTX-M) revealed that none of the three predominant ESBL genotypes was identified in this study.

CONCLUSIONS

This study reports high levels of antibiotic resistance in both clinical and non-clinical E. coli isolates. Though higher rates of resistance were observed among the non-clinical isolates, both group of organisms had similar levels of MDR. Strikingly, however, was the low level of ESBL producers detected in this study and the absence of the three main genotypes associated with ESBL production in this study.

Prevalence of Transferable OXA-1 β-Lactamase Associated with Carbapenem-Resistant Klebsiella pneumoniae Isolates in Iraq

This study was designed to explore the incidence of blaOXA-1 amongst Klebsiella pneumoniae isolates with resistant to carbapenem. Between December 2014 and April 2015, one hundred samples were taken from two hospitals: Babylon Teaching Hospital for Maternity and Pediatric / Babylon Province (clinical, umbilical infections, n= 40; environmental, n=20) and Karbala Hospital for Pediatric / Karbala Province (40 stool samples). All patients were hospitalized or attended these hospitals, all under 1 year of age. Seventeenth (17%) isolates were identified as Klebsiella pneumoniae. The antibiotic resistance profile of isolates was tested using disk diffusion method. High-level of resistance was recorded with ampicillin (94.1%) and piperacillin (88.2%) antibiotics. Resistance to carbapenem was reported in two K.pneumoniae isolates, these were investigated for the existence of OXA-1β-lactamase using Polymerase Chain Reaction (PCR) technique. Two (100%) isolates gave positive result. Transference of this gene was studied by conjugation experiment. The blaOXA-1 gene conjugated successfully in 1 (50%) isolate only.