Genotypic and phenotypic mechanisms underlying antimicrobial resistance and synergistic efficacy of rifampicin-based combinations against carbapenem-resistant Acinetobacter baumannii

Purpose

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an urgent concern to public health. This study focuses on exploring the resistance mechanisms and the in vitro results of using rifampicin in combination with conventional antibiotics for the management of CRAB.

Methods

The synergistic and bactericidal effects of rifampicin with conventional antibiotics were evaluated using chequerboard assay and time-kill assay, while the phenotypic and genotypic characteristics of resistant determinants were performed by efflux pump detection and whole genome sequencing on 29 isolates from ICU patients with underlying health diseases.

Results

The isolates showed multidrug resistance, with over 60% showing addictive responses to rifampicin-based combinations at FICI ranging from 0.6 to 0.8. The time-kill assay revealed 99 % killing for rifampicin and minocycline combination in one isolate at 1/4 MIC rifampicin plus 1/4 MIC minocycline, while a bacteriostatic effect was observed at 1/2 MIC rifampici plus 1/2 MIC for a second isolate. Combination with tigecycline resulted in a 99% killing in two out of three isolates with a 2.5-3 log reduction in CFU at 1/4 MIC rifampicin plus 1/4 MIC tigecycline. Rifampicin plus colistin exhibited bactericidal activity against three out of four isolates. The combinations of rifampicin with ciprofloxacin, chloramphenicol, and trimethoprim-sulfamethoxazole were ineffective against the isolates. In addition, a 4-fold reduction in rifampicin MIC was observed in 2 out of 14 isolates in the presence of an efflux pump inhibitor. The pan-genome study demonstrated a progressive evolution with an accessory genome estimated to cover 58% of the matrix. Seven of the ten sequenced isolates belong to sequence type 2 (ST2), while one isolate each was assigned to ST164, ST16, and ST25. Furthermore, 11 plasmids, 34 antimicrobial resistance (AMR) genes, and 65 virulence-associated genes were predicted from the whole genome data. The blaOXA-23blaADC-25, blaOXA-66, blaPER-7, aph(6)-Id, armA, and arr-3 were prevalent among the isolates. Sequence alignment of the bacteria genome to the reference strain revealed a deleterious mutation in the rpoB gene of 4 isolates.

Conclusion

The study suggests that rifampicin in combination with either minocycline, tigecycline, or colistin might be a treatment option for CRAB clinical isolates. In addition, genotypic analysis of the bacteria isolates may inform the clinician of the suitable drug regimen for the management of specific bacteria variants.

Synergistic effects of polymyxin and vancomycin combinations on carbapenem- and polymyxin-resistant Klebsiella pneumoniae and their molecular characteristics

IMPORTANCE

This study provides insights into the mechanisms of polymyxin resistance in K. pneumoniae clinical isolates and demonstrates potential strategies of polymyxin and vancomycin combinations for combating this resistance. We also identified possible mechanisms that might be associated with the treatment of these combinations against carbapenem- and polymyxin-resistant K. pneumoniae clinical isolates. The findings have significant implications for the development of alternative therapies and the effective management of infections caused by these pathogens.

Effectiveness of plant-based hand sanitizer incorporating Quercus infectoria gall extract

AIMS

Quercus infectoria (Qi), a traditional herbal plant with a broad spectrum of activities on multidrug-resistant bacteria, has been developed for hand sanitizer applications.

METHODS AND RESULTS

Antimicrobial activity was evaluated using agar-well diffusion and broth microdilution method. Bactericidal activity was determined following the European Standard 1276 antibacterial suspension test. Neutralization assay was performed to assess antirespiratory syncytial virus. Safety, stability, and skin permeation of Qi hand gel was investigated. Qi hand sanitizer gel inhibited microorganisms ranging from 99.9% to 99.999% against Enterococcus faecalis, Staphylococcus aureus, methicillin-resistant Staph. aureus, Staph. epidermidis, Staph. pseudintermedius, Staph. saprophyticus, Streptococcus pyogenes, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans. A significant reduction in main human dermatophytes including Microsporum canis, M. gypseum, and Talaromyces marneffei of ∼50% was observed (P < .05). Qi hand sanitizer gel inactivated >99% viral particles entering human laryngeal epidermoid carcinoma cells in a dose-dependent manner. Scanning electron micrographs further illustrated that Qi hand sanitizer gel disrupted microbial cell membrane after 1-min contact time resulting in cell death. Qi hand sanitizer gel delivered emollient compounds through simulated human skin layers and showed no cytotoxicity on fibroblast cells. Moreover, Qi hand sanitizer gel demonstrated stability under extreme conditions.

CONCLUSIONS

Qi hand sanitizer gel was able to inhibit various microorganisms including bacteria, dermatophytes, and virus.

Rifampicin Enhanced Carbapenem Activity with Improved Antibacterial Effects and Eradicates Established Acinetobacter baumannii Biofilms

Biofilm-mediated infections are critical to public health and a leading cause of resistance among pathogens, amounting to a prolonged hospital stay and increased mortality rate in the intensive care unit. In this study, the antibacterial and antibiofilm activities of rifampicin or carbapenem monotherapies were compared with rifampicin and carbapenem combination therapies against rifampicin-resistant and carbapenem-resistant Acinetobacter baumannii isolates. Among 29 CRAB isolates, 24/29 (83%) were resistant to rifampicin, with MIC values between 2-256 µg/mL. Checkerboard assays disclosed that combination therapies at FICIs between 1/8 and 1/4 improved the activity of carbapenems at subinhibitory concentrations. Time-kill kinetics indicated a 2- to 4-log reduction at 1/2 MIC rifampicin + 1/4 MIC carbapenem and 1/4 MIC rifampicin + 1/4 MIC carbapenem against the isolates, with the MIC values ranging from 2-8 µg/mL. The MTT assay revealed a dose-dependent decrease of the cell viability of established bacterial biofilm at 4 MIC rifampicin + 2 MIC carbapenems, with a percentage reduction of 44-75%, compared with monotherapies at 16 MIC. Scanning electron microscopy further confirmed bacterial cell membrane disruption, suggesting a synergism between carbapenem and rifampicin against a representative isolate. The findings demonstrated that the combination of rifampicin with carbapenems could improve antibacterial activities and eradicate established Acinetobacter baumannii biofilm.

Interaction of lytic phage T1245 with antibiotics for enhancement of antibacterial and anti-biofilm efficacy against multidrug-resistant Acinetobacter baumannii

Biofilms associated with multidrug-resistant (MDR) Acinetobacter baumannii on medical devices remain a big clinical problem. Antibiotic susceptibility tests were performed with eight commonly employed antibiotics against clinical isolates. The effects of antibiotics in combination with well-characterized lytic phage T1245 were studied to assess their antibacterial and anti-biofilm efficacy. Ceftazidime, colistin, imipenem, and meropenem significantly reduced bacterial density up to approximately 80% when combined with phage T1245, compared with control. Phage T1245 in combination with ceftazidime, colistin, and meropenem at subinhibitory concentrations demonstrated significant reduction in biomass and bacterial viability of 3-day established biofilms, compared with antibiotic alone. In addition, electron microscopy further confirmed the disruption of biofilm structure and cell morphology upon treatment with phage T1245 and antibiotics, including ceftazidime, colistin, and meropenem. Combined treatment of phage T1245 with these antibiotics could be employed for the management of A. baumannii infections and eradication of the bacterial biofilms.

Toward in-process technology-aided automation for enhanced microbial food safety and quality assurance in milk and beverages processing

Ensuring the safety of food products is critical to food production and processing. In food processing and production, several standard guidelines are implemented to achieve acceptable food quality and safety. This notwithstanding, due to human limitations, processed foods are often contaminated either with microorganisms, microbial byproducts, or chemical agents, resulting in the compromise of product quality with far-reaching consequences including foodborne diseases, food intoxication, and food recall. Transitioning from manual food processing to automation-aided food processing (smart food processing) which is guided by artificial intelligence will guarantee the safety and quality of food. However, this will require huge investments in terms of resources, technologies, and expertise. This study reviews the potential of artificial intelligence in food processing. In addition, it presents the technologies and methods with potential applications in implementing automated technology-aided processing. A conceptual design for an automated food processing line comprised of various operational layers and processes targeted at enhancing the microbial safety and quality assurance of liquid foods such as milk and beverages is elaborated.

Value-added materials recovered from waste bone biomass: technologies and applications

As the world population increases, the generation of waste bones will multiply exponentially, increasing landfill usage and posing health risks. This review aims to shed light on technologies for recovering valuable materials (e.g., alkaline earth material oxide such as CaO, hydroxyapatite, beta tri-calcium phosphate, phosphate and bone char) from waste bones, and discuss their potential applications as an adsorbent, catalyst and catalyst support, hydroxyapatite for tissue engineering, electrodes for energy storage, and phosphate source for soil remediation. Waste bone derived hydroxyapatite and bone char have found applications as a catalyst or catalyst support in organic synthesis, selective oxidation, biodiesel production, hydrocracking of heavy oil, selective hydrogenation and synthesis of bioactive compounds. With the help of this study, researchers can gather comprehensive data on studies regarding the recycling of waste bones, which will help them identify material recovery technologies and their applications in a single document. Furthermore, this work identifies areas for further research and development as well as areas for scaling-up, which will lead to reduced manufacturing costs and environmental impact. The idea behind this is to promote a sustainable environment and a circular economy concept in which waste bones are used as raw materials to produce new materials or for energy recovery.

Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July-September 2021

A veterinarian in Thailand was diagnosed with COVID-19 after being sneezed on by an infected cat owned by an infected patient. Genetic study supported the hypothesis of SARS-CoV-2 transmission from the owner to the cat, and then from the cat to the veterinarian.

A Cold Plasma Technology for Ensuring the Microbiological Safety and Quality of Foods

Changing consumers’ taste for chemical and thermally processed food and preference for perceived healthier minimally processed alternatives is a challenge to food industry. At present, several technologies have found usefulness as choice methods for ensuring that processed food remains unaltered while guaranteeing maximum safety and protection of consumers. However, the effectiveness of most green technology is limited due to the formation of resistant spores by certain foodborne microorganisms and the production of toxins. Cold plasma, a recent technology, has shown commendable superiority at both spore inactivation and enzymes and toxin deactivation. However, the exact mechanism behind the efficiency of cold plasma has remained unclear. In order to further optimize and apply cold plasma treatment in food processing, it is crucial to understand these mechanisms and possible factors that might limit or enhance their effectiveness and outcomes. As a novel non-thermal technology, cold plasma has emerged as a means to ensure the microbiological safety of food. Furthermore, this review presents the different design configurations for cold plasma applications, analysis the mechanisms of microbial spore and biofilm inactivation, and examines the impact of cold plasma on food compositional, organoleptic, and nutritional quality.

Characteristics, Influencing Factors, Predictive Scoring System, and Outcomes of the Patients with Nephrotoxicity Associated with Administration of Intravenous Colistin

Multidrug-resistant Gram-negative infection is a major global public health threat. Currently, colistin is considered the last-resort treatment despite its nephrotoxicity. The purpose of this study was to estimate the incidence, characteristics, and influencing factors and to develop a prediction model for colistin-associated nephrotoxicity. A retrospective study was conducted in the university hospital in the South of Thailand from December 2015 to June 2019. A total of 381 patients (median age (IQR) of 64 (51–62) years) were analyzed. Overall, 282 (74%) had nephrotoxicity according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification. In-hospital, 30-day mortality rates and cost of hospital admission were significantly higher among those with nephrotoxicity. Age > 60 years, comorbidities, serum albumin less than 3.5 g/dL, and concomitant nephrotoxic use were significantly associated with colistin-associated nephrotoxicity with adjusted OR (95% CI) 2.01 (1.23–2.45), 1.85 (1.18–3.6), 1.68 (1.09–2.99), and 1.77 (1.10–2.97), respectively. The prediction model for high-risk colistin-associated nephrotoxicity was identified with good overall performance (specificity of 79.6% (95% CI 70.3–87.1) and positive predictive value of 92.1% (95% CI 88.0–95.1)). In conclusion, the incidence of colistin-associated nephrotoxicity was high and incurred significant morbidity, mortality, and economic burden. Our predictive scoring system is relatively simple and useful for optimizing colistin therapy.

Facile deposition of biogenic silver nanoparticles on porous alumina discs, an efficient antimicrobial, antibiofilm, and antifouling strategy for functional contact surfaces

Surface modification is an emerging strategy for the design of contact materials. Fabricated alumina discs were functionalized by deposition of biogenic silver nanoparticles. The surfaces were characterized for physico-chemical, antibacterial and antibiofilm properties against microbial pathogens. The surface demonstrated improved hydrophobicity and a surface silver nanoparticle content of 6.4 w%. A reduction of more than 99.9% in CFU mL^-i was observed against the Gram-positive and Gram-negative bacteria tested, with >90% reduction of the fungal isolate. After 4 h, microbial adhesion was reduced by >99.9 and 90% for Escherichia coli and Staphylococcus aureus, respectively. Scanning electron micrographs further revealed a biofilm reduction. Cell viability tests indicated a bioincompatibility higher than 80% with Caco-2 and HaCaT cell lines after 48 h contact. The results suggest that deposition of biogenic silver nanoparticles on the surface of contact materials could be employed as a strategy to prevent biofilm formation.

Chitosan-poly(vinyl alcohol) intelligent films fortified with anthocyanins isolated from Clitoria ternatea and Carissa carandas for monitoring beverage freshness

Biodegradable chitosan-poly(vinyl alcohol) films containing natural anthocyanin-rich extracts were prepared using solvent casting method and employed as intelligent indicators for monitoring beverages freshness. The surface and cross-sectional scanning electron micrograph indicated a compact structure for the intelligent films, whereas the atomic force micrograph indicated a 16.22 and 20.31 nm increase in surface roughness for Clitoria ternatea and Carissa carandas extract incorporated films, respectively. Moreover, the test films demonstrated enhanced radical scavenging efficacy. The extracts and anthocyanin incorporated films presented excellent colorimetric changes at pH 2 to 8. In addition, the C. ternatea test films showed changes in color for juice stored at 25 °C after 72 h. Photo-degradability results indicated stability of test films stored in dark at 4 °C and 25 °C, whereas leaching study indicated the release of ≤2.0% anthocyanin after 24 h. The cytocompatibilty assay showed that the test and control films were biocompatible with a viability of >80% on HaCat cells. The results demonstrated that the incorporation of anthocyanins-rich extracts into chitosan-poly(vinyl alcohol) did not significantly interfere with the films properties (p > 0.05). The natural anthocyanin incorporated films demonstrated good pH sensing property that could be further explored for monitoring of beverages freshness.

Chemical characterization, release, and bioactivity of Eucalyptus camaldulensis polyphenols from freeze-dried sodium alginate and sodium carboxymethyl cellulose matrix

Crude ethanolic extract of Eucalyptus camaldulensis was encapsulated with sodium alginate–sodium carboxymethyl cellulose (CMC) using freeze-drying techniques. The microcapsules were characterized for particle size, morphology, physicochemical parameters, and micromeritics properties. Antioxidant and antimicrobial activities of the microcapsules were also demonstrated. Results revealed an irregular-shaped microparticles with a mean diameter ranging from 6.7 to 26.6 µm. Zeta potential and polydispersity index ranged from −17.01 to 2.23 mV and 0.34 to 0.49, respectively. Percentage yield ranged between 70.4 and 81.5 per cent whereas encapsulation efficiency ranged between 74.2 ± 0.011 and 82.43 ± 0.77 per cent. Swelling index and solubility varied inversely with extract concentration, with a range of 54.4%–84.0% and 18.8%–22.2%, respectively. Antioxidant activities varied directly with the concentration of the extract. Minimum inhibitory and minimum bactericidal concentrations of the microcapsules against Gram-positive foodborne pathogens ranged from 0.19 to 3.12 and 0.19–12.25 mg/ml, respectively. The Higuchi model indicated a time-dependent, delayed, and regulated release of polyphenols at 37°C. The results suggested that alginate–CMC possessed good encapsulant properties that preserved the bioactive extract, thus might be employed for application of natural products in food systems.

Antioxidant Properties and Antibacterial Effects of Eucalyptus camaldulensis Ethanolic Leaf Extract on Biofilm Formation, Motility, Hemolysin Production, and Cell Membrane of the Foodborne Pathogen Listeria monocytogenes

Consumer concerns toward chemical preservatives have resulted in increased search for healthy green alternative. In this study, the antioxidant activity and antibacterial effects of Eucalyptus camaldulensis ethanolic leaf extract against Listeria monocytogenes, a serious foodborne pathogen, was evaluated. Total phenolic and flavonoid contents of the extract were 11.10 mg garlic acid equivalent/mg extract and 15.05 mg quercetin equivalent/mg extract, respectively. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration of the extract was 64-128 μg/mL and 256-512 μg/mL, respectively. Time-kill assay revealed growth inhibitory effects after 4-h treatment of the bacteria with the extract. A reduction of ≈2-3 log colony-forming units per milliliter was observed against the tested food and environmental isolates after challenging the pathogens with the extract at MIC for 6 h. Sub-MICs of the extract significantly inhibited motility and listeriolysin O production up to 80%, with 60% inhibition of biofilm formation (p < 0.05). Antioxidant assay revealed free radical scavenging activity with 50% inhibitory concentration (IC₅₀) of 57.07 μg/mL for 2,2-diphenyl-1-picrylhydrazyl and 29.01 μg/mL for ABTS [2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)] assay. Ferric reducing antioxidant power assay further showed a total antioxidant power equivalent to 92.93 μM ascorbic acid equivalent/mg extract. As the extract exhibited profound antilisterial activity and good radical scavenging ability, it might serve as a potential alternative source of biopreservative agent against L. monocytogenes.

Centella asiatica phenolic extract-mediated bio-fabrication of silver nanoparticles: characterization, reduction of industrially relevant dyes in water and antimicrobial activities against foodborne pathogens

In this article, we have reported an environmentally benign and cost-effective method for the synthesis of monodispersed silver nanoparticles (AgNPs), based on Centella asiatica phenolic extracts (CAPE). The presence of phenolics was confirmed by ultra high-performance liquid chromatography coupled with electrospray ionization quadrupole time of flight mass spectrometry (UHPLC-ESI-qTOF-MS). Colloidal AgNPs synthesized under different concentrations of silver nitrate were monitored with a UV-vis spectrophotometer. Maximum absorption spectra intensity was found to range between 430–440 nm, during a synthesis time of 90 minutes at room temperature. The as-synthesized CAPE-AgNPs, was subjected to various instrumental characterizations such as, transmission electron microscopy (TEM), X-ray powder diffraction (XRD), energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared (FTIR) spectroscopy, dynamic light scattering (DLS) and zeta potential. At the optimized synthesis conditions, spherical and monodispersed CAPE-AgNPs were obtained, with an absorption maximum at 430 nm. The crystalline CAPE-AgNPs had a face-centered-cubic (fcc) crystallographic structure, possessing average sizes estimated from TEM, to be between 20–25 nm diameter, a hydrodynamic diameter from DLS of about 90 nm and a zeta potential value of −28.7 mV. FTIR results validated the presence of phenolics on the surfaces of CAPE-AgNPs. The anti-microbial capacity of CAPE-AgNPs was further demonstrated on different pathogenic bacterial strains with satisfactory performances. As a result of the high surface area to volume ratio of CAPE-AgNPs, it was investigated as a catalyst towards the reduction of prominent environmental pollutants, 4 nitrophenol (4 NP), Congo red (CR) and methylene blue (MB). Pseudo first order kinetics were obtained with rate constants of 3.9 × 10⁻³ s⁻¹ for 4 NP, 54.7 × 10⁻³ min⁻¹ for MB and 5.6 × 10⁻³ s⁻¹ for CR. The catalytic performance and antimicrobial activities of CAPE-AgNPs suggest its potential application in wastewater treatment and control of pathogenic microbes.

Illustration of biogenic synthesis of AgNPs based on Centella asiatica phenolic extract and applications.

Epidemiology of <i>Salmonella</i> and <i>Salmonellosis</i>

The prevalence of enteritis and its accompanying diarrheal and other health challenges linked to infections with Salmonella has continuously plagued sub Saharan Africa. In Nigeria, typhoid fever is among the major widespread diseases affecting both young and old as a result of many interrelated factors such as inadequate sanitaion, indiscriminate use of antibiotics and fecal contamination of water sources. Morbidity associated with illness due to Salmonella continues to increase with untold fatal consequences, often resulting in death. An accurate figure of cases is difficult to arrive at because only large outbreaks are mostly investigated whereas sporadic cases are under-reported. A vast majority of rural dwellers in Africa often resort to self-medication or seek no treatment at all, hence serving as carries of this disease. Non typhoidal cases of salmonellosis account for about 1.3 billion cases with 3 million deaths annually. Given the magnitude of the economic losses incurred by African nations in the battle against salmonella and salmonellosis, this article takes a critical look at the genus Salmonella, its morphology, isolation, physiological and biochemical characteristics, typing methods, methods of detection, virulence factor, epidemiology and methods of spread within the environment.

Anopheline Mosquitoes and the Malaria Scourge

The high prevalence of malaria in Africa has defiled many strategies aimed at its eradication. Researchers from various fields have tried without success in this fight against mosquito and its malaria disease. Annually billions of dollars are spent in the design of programs which are aimed at combating this dreaded disease. However all this spending seems to go down the drain as malaria and its vector mosquitoes celebrate their unflinching victory. Current control measures focusing on ways of preventing the disease vis-a-vis, protect man from the vectors “anopheline mosquito” are the mainstay of malaria prevention and control. Many of these control measures are operational with each contributing in its little way. The use of Long Lasting Insecticide Treated Nets (LLITN) and Indoor Residual Sprays (IRS) are well established strategies with global recognition and currently ongoing in Africa. However, as a result of shortcomings in these major control measures, new strategies with hopes of blissful success are been sought after. Larviciding (abortion of metamorphosis) and constant and adequate environmental sanitation seems to be the next option available for use. This article therefore takes a look at the vector-anopheline mosquito, its ecology, productivity and distribution. It also considers malaria and the various control and preventive measures currently targeted at its eradication.

Epidemiology of Salmonella and Salmonellosis

The prevalence of enteritis and its accompanying diarrheal and other health challenges linked to infections with Salmonella has continuously plagued sub Saharan Africa. In Nigeria, typhoid fever is among the major widespread diseases affecting both young and old as a result of many interrelated factors such as inadequate sanitaion, indiscriminate use of antibiotics and fecal contamination of water sources. Morbidity associated with illness due to Salmonella continues to increase with untold fatal consequences, often resulting in death. An accurate figure of cases is difficult to arrive at because only large outbreaks are mostly investigated whereas sporadic cases are under-reported. A vast majority of rural dwellers in Africa often resort to self-medication or seek no treatment at all, hence serving as carries of this disease. Non typhoidal cases of salmonellosis account for about 1.3 billion cases with 3 million deaths annually. Given the magnitude of the economic losses incurred by African nations in the battle against salmonella and salmonellosis, this article takes a critical look at the genus Salmonella, its morphology, isolation, physiological and biochemical characteristics, typing methods, methods of detection, virulence factor, epidemiology and methods of spread within the environment.

Anopheline Mosquitoes and the Malaria Scourge

The high prevalence of malaria in Africa has defiled many strategies aimed at its eradication. Researchers from various fields have tried without success in this fight against mosquito and its malaria disease. Annually billions of dollars are spent in the design of programs which are aimed at combating this dreaded disease. However all this spending seems to go down the drain as malaria and its vector mosquitoes celebrate their unflinching victory. Current control measures focusing on ways of preventing the disease vis-a-vis, protect man from the vectors “anopheline mosquito” are the mainstay of malaria prevention and control. Many of these control measures are operational with each contributing in its little way. The use of Long Lasting Insecticide Treated Nets (LLITN) and Indoor Residual Sprays (IRS) are well established strategies with global recognition and currently ongoing in Africa. However, as a result of shortcomings in these major control measures, new strategies with hopes of blissful success are been sought after. Larviciding (abortion of metamorphosis) and constant and adequate environmental sanitation seems to be the next option available for use. This article therefore takes a look at the vector-anopheline mosquito, its ecology, productivity and distribution. It also considers malaria and the various control and preventive measures currently targeted at its eradication.