Use of Pistacia lentiscus mastic for sustained-release system of chlorocresol and benzoic acid for in vitro prevention of bacterial colonization of silicon urinary catheter

Urinary tract infections (UTI) are among the most common types of nosocomial infections. Patients with indwelling urinary catheters are at the highest risk of getting infections. A sustained-release method of chlorocresol and benzoic acid using a varnish of Pistacia lentiscus mastic was developed to prevent catheter colonization by Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa. Coatings of both antiseptics significantly reduced the number of colonizing bacteria on silicon urinary catheters for 72 h. Chlorocresol-coated catheters were significantly (P ≤ 0·05) more effective than benzoic acid. Except for the Pr. mirabilis, chlorocresol completely inhibited the colonization of catheters by the tested bacteria for 48 h. Nonetheless, the colonization of catheters by Pr. mirabilis was significantly reduced after 48 and 72 h by more than 3·5 logs. Although benzoic acid failed to completely inhibit bacterial growth, it significantly reduced the colonization of the catheters by all the tested bacteria by more than two logs for 72 h. The inhibition of colonization of catheters was confirmed by examining the tested catheters by scanning electron microscopy. The obtained results indicate the potential benefits of using mastic as a varnish for sustaining the release of chlorocresol and benzoic acid to prevent and reduce the colonization of urinary catheters by bacteria.

In vitro Effects of Punica granatum Ellagitannins on Adult Worms of Schistosoma mansoni

Schistosomiasis ranks second behind malaria in terms of overall morbidity and mortality. We evaluated the lethal effect of Punica granatum ellagitannins, extracted from the fruit rind, placenta and barks of the root and stem, on adult worms of Schistosoma mansoni (S. mansoni). All four ellagitannins were lethal to S. mansoni adult worms. However, while the rind ellagitannins were the most potent, placental ellagitannins were the least. Rind ellagitannins were capable of killing 40% of adult worms at a concentration of 25µg/mL after 5 days. The killing of 100% of the worms was achievable by rind ellagitannins at a concentration of 50µg/mL after 5 days. The LD_50S of the rind ellagitannins after 96h and 120h were 41.25 µg/mL and 28.73 respectively. Ellagitannins-treated worms suffered from erosions, wrinkles, swellings and losses, degenerations of the surface tubercles and tegument. In addition, ellagitannins induced deformation and degradation of oral and ventral suckers and degenerations in the muscles of worms. Ellagitannins also caused a separation of coupled worms and reduction of their motility. Data obtained suggest that ellagitannins of pomegranate could be considered as a cheap candidate for the treatment of schistosomiasis.

The First Egyptian Report Showing the Co-Existence of bla NDM-25, bla OXA-23, bla OXA-181, and bla GES-1 Among Carbapenem-Resistant K. pneumoniae Clinical Isolates Genotyped by BOX-PCR

Background and Objective

The emergence of carbapenem-resistant K. pneumoniae (CRKP) continues to escalate and is alarming because of the emergence of pan drug-resistant strains. The objective of this study was to investigate the existence of 12 carbapenemase genes among CRKP clinical isolates.

Methods

Ninety-six Klebsiella spp. clinical isolates were collected. The isolates were identified phenotypically and genotypically. These isolates were screened for susceptibility to 24 different antibiotics. The modified Hodge test (MHT) and the Carba Nordmann/Poirel (NP) test were used to phenotypically screen carbapenem-resistant strains for carbapenemase production. Phenotypic characterization of carbapenemases was performed using the combined disk synergy test (CDST). Additionally, the presence of 12 carbapenemase genes in CRKP isolates was investigated. The DNA sequence of bla _NDM and bla _GES genes was determined. The BOX-PCR technique was used to determine the clonal relationship between CRKP isolates.

Results

All carbapenem-resistant isolates were related to K. pneumoniae. Susceptibility testing showed that 19.79% (19/96) of the collected isolates were carbapenem-resistant. Of the CRKP isolates, 68.42% (13/19) tested positive for the MHT and Carba NP test. CDST showed that 42.11% (8/19), 63.16% (12/19), 47.37% (9/19), and 73.68% (14/19) of the CRKP isolates tested positive for the inhibitory effect of clavulanic acid, sulbactam, phenylboronic acid, and tazobactam, respectively, while 84.21% (16/19) and 68.42% (13/16) tested positive for the inhibitory effect of EDTA and mercaptopropionic acid, respectively. It was found that 10.53% (2/19) of the isolates tested positive for the inhibitory effect of sodium chloride. Molecular investigation of carbapenemases showed that 26.32% (5/19), 73.68% (14/19), 21.05% (4/19), 10.53% (2/19), and 5.26% (1/19) of the isolates tested positive for bla _NDM, bla _OXA-48, bla _OXA-181, bla _OXA-51, and bla _OXA-23, respectively. None of the isolates tested positive for bla _OXA-40 and bla _OXA-58. Two allelic variants of bla _NDM (bla _NDM-1 and bla _NDM-25) were detected. BOX-PCR revealed high clonal relatedness between CRKP isolates.

Conclusion

MHT was more sensitive than Carba NP test for evaluating carbapenemase production and class D carbapenemase genes were the most prevalent of the 12 carbapenemase genes that were evaluated.

Characterization of phenotypic and genotypic traits of carbapenem-resistant Acinetobacter baumannii clinical isolates recovered from a tertiary care hospital in Taif, Saudi Arabia

BACKGROUND AND OBJECTIVE

Acinetobacter baumannii (A. baumannii) is a common nosocomial pathogen, which developed multi-drug-resistance to different classes of antibiotics including carbapenems. This study examined ten common carbapenemase genes among 32 carbapenem-resistant A. baumannii clinical isolates recovered from Taif, Saudi Arabia.

METHODS

Isolates were phenotypically identified to the genus level by Vitek^®2 and API 20NE^®. The species level was confirmed by the amplification of bla _OXA-51. The susceptibility for 21 different antibiotics was performed by Vitek 2 and modified Kirby-Bauer method. Isolates were genetically screened for 10 carbapenemases. Phylogenetic relatedness between isolates was determined by ERIC-PCR.

RESULTS

Genotypically identified A. baumannii represented 100% of the total phenotypically identified Acinetobacter spp. All the carbapenem-resistant isolates were sensitive to polymyxin B and colistin. Among the other antibiotics, ampicillin/sulbactam and tigecycline were the most effective agents. 90.8% of the isolates were resistant to all ten investigated β-lactams. bla _OXA-51, bla _IPM, bla _NDM and bla _OXA-23 were detected in 100%, 87.5%, 62.5% and 59.4% of isolates, respectively. Also, bla _VIM and bla _OXA-40 were less prevalent and were detected in 9.3% and 3.1% of the isolates, respectively. In addition, bla _KPC, bla _OXA-48, bla _OXA-58, bla _OXA-181 were not detected in any isolate. The A. baumannii isolates were categorised into ten genotypes on the basis of the detected carbapenemase genes and ERIC-PCR revealed a remarkable clonal diversity among these isolates.

CONCLUSION

Class A and class D carbapenemase genes were the most commonly detected among carbapenem resistant A. baumannii (CRAB) clinical isolates.

Investigation of six plasmid-mediated quinolone resistance genes among clinical isolates of pseudomonas: a genotypic study in Saudi Arabia

Background: Quinolones are among the most effective antibiotics against Pseudomonas spp. Several chromosomal and/or plasmid-mediated quinolone-resistance mechanisms have been found in Pseudomonas.  Plasmid-mediated quinolone-resistance (PMQR) is mediated by quinolone-resistance (QNR) proteins, modifying enzymes or efflux pumps. Only a few previous studies examined the prevalence of quinolone-resistance in the Kingdom of Saudi Arabia (KSA) and showed it is increasing. Mechanisms of quinolone-resistance among Pseudomonas spp. in the KSA; examined herein; have not been extensively studied. Methods: Ninety-two Pseudomonas isolates were collected and their resistance to seven different types of quinolones was determined by the microbroth dilution method. PMQR mechanisms were examined using a PCR screen to identify six PMQR genes including qnrA, qnrB, qnrD, qnrS, aac(6´)-Ib-cr, and qepA. Clonal relatedness of the quinolone-resistant isolates was determined by ERIC-PCR. Results: Of the isolates, 42.4% (39/92) were resistant to 1-7 of the tested quinolones. Gemifloxacin resistance was the lowest (28.3%) while resistance to the other six quinolones were ≥ 35%. The most common biotype among the 39 quinolone-resistant isolates was resistance to the seven tested quinolones (26/39; 66.7%). qnrD, qnrS, and aac(6´)-Ib-cr were found in 31 (79.5%), 31 (79.5%) and 28 (71.8%) of the 39 isolates, respectively, and all three genes together were found in 22 of the 39 isolates (56.4%). qnrA, qnrB, and qepA were not detected in any of the isolates and two isolates did not harbor any of the six tested genes. The isolates showed 38 different ERIC profiles and only two isolates (Pa16 and Pa17) had an identical profile. Conclusion: This is the first description of PMQR mechanisms among clinical Pseudomonas isolates from the KSA, which appears to be mainly mediated by qnrD, qnrS, and aac(6´)-Ib-cr.