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Nedbal C, Mahobia N, Browning D, Somani BK. Variability in Profiles and Prevalences of Gram-Negative Bacteria in Urinary Tract Infections: A Population-Based Analysis. J Clin Med 2024; 13:5311. [PMID: 39274523 PMCID: PMC11396369 DOI: 10.3390/jcm13175311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 09/03/2024] [Accepted: 09/06/2024] [Indexed: 09/16/2024] Open
Abstract
Objective: An increase in antimicrobial resistance (AMR) is observed worldwide, partly due to the overuse and misuse of antibiotics, which are ineffective in certain population subgroups. This negatively impacts both the healthcare system and patients. Our study aimed to investigate the current AMR profiles for the most commonly used antibiotics in treating urinary tract infections (UTIs) caused by gram-negative bacteria (GNB) across different age and gender subpopulations. By doing so, we provide valuable information for doctors managing prophylactic and empiric therapeutic treatments. Materials and Methods: We retrospectively analysed over 650,000 urine cultures collected in the Microbiology Department of a referral university hospital in Southern England from January 2014 to December 2022. A population-based analysis for subgroups was performed to rule out differences in AMR patterns. Our report was recorded at UHS as an internal audit (UHS7670). Results: 146,867 cultures were found positive for GNB growth. Nitrofurantoin showed the best sensitivity patterns for all age subgroups (0.93% for patients aged ≤ 18; 1.22% for patients aged 19-40; 2.17% for patients aged 40-60; and 3.48% for patients aged > 60), regardless of gender (male: 6.37%, female: 2.59%). Ampicillin/amoxicillin and trimethoprim showed a poor AMR profile for all age groups (>55% and >28%, respectively) and genders (>60% and >28%, respectively). All the other tested antibiotics (cefalexin, cefotaxime, ceftazidime, ciprofloxacin, co-amoxiclav, gentamicin) showed an overall good profile for GNB resistance across all subgroups. For all antibiotics except trimethoprim, the risk of developing AMR was significantly higher in the male population. We also found that people aged over 60 had a higher risk of AMR compared to the other age groups for all antibiotics, with the exception of cefotaxime and co-amoxiclav. Conclusions: With an overall rise in resistance patterns for GNB-related UTIs, certain antibiotics-particularly ampicillin/amoxicillin and trimethoprim-now exhibit very poor sensitivity profiles. However, antibiotics such as nitrofurantoin and gentamicin remain excellent options for empirically treating UTIs. It is important to note that AMR can vary across different populations, with higher resistance often found in elderly and male patients. Clinicians must stay informed about current guidelines and research to provide the best treatment options while minimizing the risk of further AMR development.
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Affiliation(s)
- Carlotta Nedbal
- Department of Urology, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
- Urology Unit, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Nitin Mahobia
- Department of Infection, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - Dave Browning
- Department of Infection, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - Bhaskar Kumar Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
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Mekky AE, Saied E, Abdelmouty ES, Haggag MI, Khedr M, Khalel AF, Al-Habibi MM, Metwally SA, El Askary A, Mohammad AM, Alshehri WA, Sharahili AI, Khairy NM, Abdelaziz AEM, Mahmoud NN. Phytochemical Analysis of Centaurea calcitrapa L. Aerial Flowering Parts Serial Solvent Extracts and Its Antibacterial and Antioxidant Activities. Life (Basel) 2024; 14:900. [PMID: 39063653 PMCID: PMC11278314 DOI: 10.3390/life14070900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
To evaluate the phytochemical composition, antibacterial, and antioxidant activity of successive extracts of Centaurea calcitrapa L. (C. calcitrapa) aerial flowering parts, they were assessed in vitro. Using a spectrophotometer, the sample absorbance at 517 nm was used to quantify the scavenging activity. The negative control was DPPH. In the current study, the diffusion using agar wells technique was adapted to measure antimicrobial activity. Phytochemical analysis was performed using the recommended standard procedures. The methanol extract of C. calcitrapa exhibited high levels of total phenolic acids expressed as gallic acid (GA), measured as (97.25 ± 0.73 mg GAE/g) content compared to the chloroform, acetyl acetate, and aqueous extracts (27.42 ± 0.29, 64.25 ± 0.96, and 17.25 ± 0.73 mg GAE/g), respectively. Additionally, the methanol extract had a higher total tannin (27.52 ± 0.53 mg TAE/g) content compared to the chloroform, ethyl acetate, and aqueous extracts (12.02 ± 0.55, 26.01 ± 0.81, and 7.35 ± 0.56 mg TAE/g), respectively, while the aqueous extract contains a lower percentage of flavonoids (141.10 ± 1.31 mg RTE/g) compared to the higher content achieved by the methanol extract (425.93 ± 1.27 mg RTE/g). The hydroxyl groups of the flavonoid and the phenolic compounds found in C. calcitrapa are essentially scavenging free radicals. Radical scavenging activity was highest in the methanol extract (IC50 = 2.82 μg/mL), aqueous extract (IC50 = 8.03 μg/mL), ethyl acetate extract (IC50 = 4.79 μg/mL), and chloroform extract (IC50 = 6.33 μg/mL), as compared to the standard scavenging activity (IC50 = 2.52 μg/mL). The antibacterial properties of C. calcitrapa against Gram-negative bacterial strains Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, and Acinetobacter baumanii, in addition to Gram-positive strains Staphylococcus haemolyticus, Enterococcus faecalis, and Staphylococcus aureus, revealed inhibition zone diameter. The findings of this investigation establish that the aerial flowering parts of C. calcitrapa have substantial antibacterial action against human infections, and the plant can serve as a significant antioxidant that can be employed to prevent and treat severe degenerative diseases brought on by oxidative stress. qPCR showed that C. calcitrapa extracts elevate both SOD1 and SOD2 (cellular oxidation markers) with remarkable folds (1.8-fold for SOD1 and SOD2) with ethyl acetate plant extract against ascorbic acid as a control. This result reflects that C. calcitrapa extracts have remarkable antioxidant activity.
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Affiliation(s)
- Alsayed E. Mekky
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
| | - Ebrahim Saied
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
| | - Eslam S. Abdelmouty
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
| | - Muhammad I. Haggag
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
| | - Mohamed Khedr
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
| | - Ashjan F. Khalel
- Biology Department, Al-Darb University College, Jazan University, Jazan 45142, Saudi Arabia; (A.F.K.); (A.M.M.)
| | - Mahmoud M. Al-Habibi
- Microbiology and Immunology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo 11884, Egypt;
| | - Shimaa A. Metwally
- Microbiology and Immunology Department, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo 11884, Egypt;
| | - Ahmad El Askary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Abeer Mahmoud Mohammad
- Biology Department, Al-Darb University College, Jazan University, Jazan 45142, Saudi Arabia; (A.F.K.); (A.M.M.)
| | - Wafa A. Alshehri
- Department of Biological Sciences, College of Science, University of Jeddah, Jeddah 23890, Saudi Arabia;
| | - Ahmed I. Sharahili
- Department of Clinical Laboratories, Medical Biochemistry Unit, Najran General Hospital, Najran 66277, Saudi Arabia;
- Ministry of Health, Riyadh 12613, Saudi Arabia
| | - Nehal M. Khairy
- Department of Microbiology and Immunology, Egypt Drug Authority (EDA), (Formerly NODCAR), Giza 12654, Egypt;
- Department of Microbiology and Immunology, Faculty of Pharmacy, Sinai University—East Kantara Branch, Ismailia 41636, Egypt
| | - Ahmed E. M. Abdelaziz
- Botany and Microbiology Department, Faculty of Science, Port-Said University, 23 December Street, P.O. Box 42522, Port-Said 42522, Egypt;
| | - Nashaat N. Mahmoud
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo 11884, Egypt; (E.S.); (E.S.A.); (M.I.H.); (M.K.); (N.N.M.)
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