Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern

Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.

Isolation, Serovar Identification, and Antimicrobial Susceptibility of Avibacterium paragallinarum from Chickens in China from 2019 to 2020

Infectious coryza is an acute infectious respiratory disease in chickens that is caused by Avibacterium paragallinarum (A. paragallinarum). Infectious coryza has major economic effects due to decreased egg production in growing birds and slowed growth in broilers. In this study, we isolated and identified 40 strains of A. paragallinarum from chickens that showed typical clinical signs of coryza in part of China from 2019 to 2020. Using a hemagglutination-inhibition test, 11 isolates were identified as serovar A, 10 isolates were identified as serovar B, and 19 isolates were identified as serovar C. Antimicrobial sensitivity tests showed that high minimum inhibitory concentration (MIC) values were encountered for compounds sulfamethoxine sodium and oxytetracycline hydrochloride. Especially, of the 40 A. paragallinarum isolates, 30% had an MIC value of compound sulfamethoxine sodium of 64 μg/mL, 10% of 128 μg/mL, and 15% of 256 μg/mL. For oxytetracycline hydrochloride, 85% of isolates showed MIC values of 64 μg/mL or more. Excitingly, the MIC values of β-lactamase (amoxicillin, ampicillin, and ceftiofur) were low, with 77.5%, 70%, and 92.5% of isolates having an MIC value of ≤1 μg/mL, respectively. Our results may provide a reference for the treatment of infectious coryza.

Genetic Characterization of mcr-1-Positive Multidrug-Resistant Salmonella enterica Serotype Typhimurium Isolated From Intestinal Infection in Children and Pork Offal in China

With the rapid emergence of plasmid-mediated colistin resistance gene mcr-1, the increased resistance of Salmonella has attracted extensive attention. This study reports on 11 multidrug-resistant Salmonella enterica serovar Typhimurium strains harboring mcr-1 in China. They all presented resistance to colistin, and additionally, one that was isolated from a child’s stool sample was also resistant to ceftriaxone and azithromycin. We screened 1454 strains of Salmonella for mcr-1 gene through PCR, and these strains are all preserved in our laboratory. Antimicrobial sensitivity analysis was carried out for the screened mcr-1 positive strains. Genetic polymorphism analysis of S. Typhimurium was performed by using the Pulsed-Field Gel Electrophoresis (PFGE). The plasmids harboring mcr-1 were identified by S1-PFGE and southern blotting. Plasmid conjugation assays were used to analyze the transferability of colistin resistance. The plasmids harboring mcr-1 were characterized by sequencing and bioinformatic analysis. Eleven S. Typhimurium strains harboring mcr-1 with colistin resistance (MICs 4μg/ml) were detected, which were isolated from children and pig offal in China. All of them were multidrug-resistant strains. PFGE results revealed that the strains isolated from different samples or locations have identical genotypes. S1-PFGE and southern blotting experiments showed that three plasmids of different sizes (33, 60, and 250 kb) all carried the mcr-1 gene. The plasmid conjugation assays revealed that Salmonella acquired mcr-1 harboring plasmids by horizontal transfer. Sequencing and plasmid type analysis revealed that these plasmids were types IncX4, IncI2, and IncHI2. Among them, IncX4 and IncI2 plasmids had extremely similar backbones and contained one resistant gene mcr-1. IncHI2 plasmid contained multiple resistant genes including blaCTX–M, oqxB, sul, aph, aadA, and blaTEM. We identified 11 mcr-1 harboring S. Typhimurium strains in China and described their characteristics. Our findings indicate that the mcr-1 gene can effectively spread among intestinal bacteria by horizontal transfer of three types of plasmids. Moreover, the IncHI2 plasmid can also mediate the transfer of other drug resistance genes. These results reveal that constant surveillance of mcr-1 harboring S Typhimurium is imperative to prevent the spread of colistin resistance.

Identification and antimicrobial susceptibility of microbial agents of otitis externa in dogs

In this study, a total of 277 unmedicated dogs with otitis externa were used. Overall, 413 agents were isolated from 277 ear swab samples; 52.7% of the cases were mono-infections (146 cases), and 37.1% of the cases were poly-infections (103 cases). In 10.1% (28) of the cases, neither bacteria nor yeasts were isolated. Coagulase-positive Staphylococcus spp. were the most frequently isolated bacteria and were found in 90 (21.8%) of the samples. Fifty-eight samples, (14%) were positive for Staphylococcus aureus, 51 (12.3%) for Pseudomonas aeruginosa, 27 (6.5%) for Proteus mirabilis, 27 (6.5%) for Malassezia pachydermatis, 21 (5%) for Corynebacterium spp., 21 (5%) for β-haemolytic Streptococcus spp., 15 (3.6%) for Staphylococcus pseudointermedius, 12 (2.9%) for Proteus spp., 12 (2.9%) for Escherichia coli, 9 (2.1%) for Acinetobacter calcoaceticus, 7 (1.6%) for Trichophyton mentagrophytes, 5 (1.2%) for Staphylococcus auricularis, and 46 (11.1%) for different bacteria and yeasts. A total of 14 different bacteria and yeasts were isolated and identified. Kirby-Bauer antibiotic susceptibility testing was carried out for 10 different antibiotics. The bacterial isolates were found to be resistant to amoxicillin-clavulanic acid (45%), gentamycin (28%), ampicillin/cloxacillin (69%), tobramycin (28%), amikacin (23%), enrofloxacin (47%), chloramphenicol (58%), doxycycline (65%), lincomycin/spectinomycin (58%) and polymyxin B (62%). In conclusion, it is important to test the antimicrobial sensitivity of aetiological agents of otitis externa before treatment so as to prevent the development of antibiotic resistance in bacteria and yeasts.

Isolation and Identification of Aerobic Bacterial Pathogens from Blood Culture of Cancer Patients in Al-Zara Hospital in Khartoum, Sudan

Patients with cancer are particularly under risk of many microbial infections and even septicaemia due to the weakened immune system induced by Chemotherapy. This study was done to identify and isolate aerobic bacterial septicaemic pathogens among cancer patients. This study was performed in Radiation and Isotopes national Centre of Khartoum Hospital (previously Alzarra) during the period from September to November 2019. One Hundred Fifty blood samples were collected from cancer patients suspected to have septicemia. All samples where inculated in blood culture media and incubated aerobically. Upon detection of growth signs the bacterial isolates were subcultured and identified according to the Standard known procedure. Antimicrobial sensitivity test was done following CLSI guidelines, The study showed that Twenty two (14%) of the investigated samples were showed growth signs, while One hundred Twenty eight (86%) were showed no growth. After subculture on Blood agar, MacConky agar and Chocolate agar, all isolated pathogens were subjected to essential bacteriological biochemical tests and identified as E.coli (57.1%) , Klebsiella pneumonia (19%) ,Staphylococcus aureus( 9.5%), Pseudomonas aeruginosa (4.8%) . Citrobacter Spp (4.8%) and Streptococcus pyogens (4.8%). Septicaemia in patients with cancer was mainly caused by E.coli in patients using chemotherapy. Further study with inclusion of more sample size and focusing on multidrug resistant isolates is essential to verify the current study results.

Escherichia coli antimicrobial resistance; Phenotypic and genotypic characterization

Improper use of the antimicrobials as E. coli giving the microorganism multi-resistance against many antimicrobials by gene mutation on integrons, transposons and plasmids. Therefore, our aim in this study is to 1)examine antibiotics resistance phenotype and genotype in Escherichia coli, 2) identifying the structure of bacterial resistance genes on whole-genome sequencing against multi-drug resistant of Escherichia coli in marketed poultry meat. Samples collected, prepared and Bacteriological examination, Antimicrobial sensitivity test performed, Serological identification of Escherichia coli isolates. Results declared that; the prevalence of E. coli from tested chicken meat samples of 100 chicken meat samples surveyed against E. coli the result declared that about 40%. Antimicrobial susceptibility was; antibiotics of choice against E. coli Sulfonamides, Cephalosporins,Tetracyclines, Quinolones. Serologically, STEC (O157:H7) 30%, ETEC (O142) 10%, EHEC (O26:H11). The subunit B of shiga-like toxin (SLT) gene appeared as a homogenous band. Heat-labile toxin (LT) gene was screened in both genomic DNA and plasmid preps in tested strains. Control STEC as it represents a danger to the poultry consumers. We recommended to increase the hygienic measures during slaughtering, processing and/or handling of chicken carcasses and avoidance unnecessary usage of any antimicrobials to avoid appearance of new antimicrobials resistant.

Characterization of upper respiratory tract isolates from children with recurrent tonsillitis

To analyze the profile of airway Upper Respiratory Tract isolates from children with recurrent tonsillitis. Samples were taken using nasal cavity, oropharynx and nasopharynx swabs from30 children called the test group before tonsillectomy. Counting, isolation, identification and sequencing of the 16S rRNA, biofilm production and antimicrobial sensitivity investigation were performed. Staphylococcus aureus (S. aureus) was the only microorganism recovered in 36.6% of patients, being more present in the oropharynx and with greater resistance to erythromycin 95%, penicillin 85% and cefoxitin 85%. All isolates were formed by biofilm, 20% formed by strongly adherent biofilm. S. aureus resistant and biofilm formed, were isolated in the three studied sites, suggesting that this species contributes to recurrent tonsillitis. Impact of the study: The ability of S. aureus to acquire resistance and its other associated factors such as biofilm formation, can make this microorganism recover more easily in the microbiota of patients, taking into account the other microorganisms present there after the use of antibacterial.

Clinical case of associative course of panleukopenia and intestinal yersiniosis in cats

The study of the course and manifestation of mixed infections is an important modern problem of both humane and veterinary medicine because their diagnosis is quite complex and time-consuming. The clinical manifestation of double and sometimes triple infection has its characteristics, which depend on various biotic and abiotic factors. To date, it has been proven that the associative course of several infectious diseases is registered more and more often, which confirms the case of simultaneous manifestation of panleukopenia and intestinal yersiniosis in domestic outbred cats. Diagnosis of mixed infection was comprehensive through general clinical and laboratory studies, the use of rapid test systems to confirm the diagnosis of panleukopenia and RNGA with specific yersinia antigens to determine the status of intestinal yersiniosis in cats. The latter was caused by serovar Y. enterocolitica O: 9 with a diagnostic titer of 1: 400. Thanks to microbiological studies, the causative agent of intestinal yersiniosis Y. enterocolitica was isolated. Its biological properties were determined, and antimicrobial sensitivity to enrofloxacin and doxycycline was established against the background of polyresistance to ceftriaxone and tetracycline. During treatment, it was found that the clinical case of intestinal yersiniosis was also due to the simultaneous infection of Y. enterocolitica with two types of serotypes O: 3 and O: 9. Which also have their own specific features. But in most cases, we have different sensitivity to antibacterial drugs, in contrast to the case we described. Clinical signs of the associated course of panleukopenia and intestinal yersiniosis in domestic outbred cats were characterized by prolonged diarrhea, streaks of blood and mucus, apathy, refusal to feed, general weakness. Therapeutic measures containing antibacterial drugs, energy sources, crystalloids, buffer infusions which were aimed at reducing dehydration and maintaining water-salt balance in the complex, were effective, clinical signs of the disease disappeared on the eighth day of treatment, and complete isolation of the pathogen in the environment ceased on the thirteenth day, which indicated the complete recovery of the animal. However, to prevent re-infection, it was recommended to treat disinfectants with care items and utensils. And also to avoid direct contact with animals that have pronounced clinical signs of disease. To prevent the occurrence of panleukopenia, scheduled mass vaccinations with mandatory observance of time limits.

Aerobic bacterial profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge

Background: The average prevalence of Chronic suppurative otitis media (CSOM) in India is 5.2%. It is more prevalent due to various predisposing factors such as malnutrition, overcrowding, poor hygiene, inadequate health care, and recurrent upper respiratory tract infection. In recent years, there is increased preponderance of multi drug resistant organisms due to the irrational use of antibiotics, making treatment of CSOM more difficult.Methods: Samples from 100 subjects of uncomplicated CSOM who presented to the Oto-Rhino-Laryngology outpatient department of our hospital were collected. Aerobic bacterial profile and its Antimicrobial susceptibility were studied by conventional methods. Results were compiled and evaluated by descriptive statistics and inferential statistics.Results: Pseudomonas aeruginosa (50.7%) and Staphylococcus aureus (19.04%) were the predominant isolates in our study. Aminoglycosides and Fluoroquinolones were found to be effective first line drugs, followed by Carbapenems.Conclusions: These antibiotics can be used to prevent the life-long complications of CSOM. Timely culture and sensitivity helps in the management of these cases.

MRSA REMAINS A GREAT PRIORITY DUE TO THE TREMENDOUS MORTALITY --- A BIRD'S EYE VIEW

Methicillin-resistant Staphylococcus aureus (MRSA) is difcult to treat with methicillin, amoxicillin, penicillin, oxacillin, and other commonly used antibiotics because of its resistance. Staphylococcus organisms rapidly develop drug resistance as many as 50% of the domiciliary and 80% of the hospital strains are now penicillin resistant. Staphylococcus aureus also show multiple drug resistance. Therefore, Staphylococcal isolates should always be tested for antimicrobial sensitivity and chronic infection should be treated by more than one drug. Before 1960,when methicillin, is the rst penicillin's-resistant penicillin's, was brought into use, about 1%of the strains of the Staphylococcus aureus were "methicillin resistant" and by 1970 in Britain their proportion has risen to about 5%.These strains are tolerant of, low therapeutic concentrations of methicillin, cloxacillin, benzyl penicillin and ampicillin.They do not destroy methicillin and cloxacillin, but most of them are penicillinase-producing as well as being "methicillin resistant" and therefore inactivate benzyl penicillin and ampicillin. Its resistance is uncertain since infections may be cured with a high dose of methicillin.