Assessment of Antibiotic Resistance Pattern of Bacteria Prevalent during COVID-19 Pandemic

Owing to disparities in the intensity of the breakouts, state and federal regulations, accessible means, cultural elements, and social consciousness, the global reaction to the COVID-19 pandemic has been varied. The COVID-19 pandemic, on the other hand, has had an impact on all parts of society, notably efforts to combat antimicrobial resistance (AMR). The pandemic has highlighted that a greater burden on medical infrastructure can contribute to higher, often unnecessary antibiotic usage and a de-prioritization of antimicrobial stewardship and surveillance (AMS). The focus of this research is to see if there is a growth in antibiotic resistance during the covid-19 pandemic in the King Salman Hospital in Riyadh, Saudi Arabia, and to investigate the subcomponent that leads to antibiotic resistance. This is a comprehensive review of patients hospitalized at the King Salman Hospital in Riyadh, Saudi Arabia, who were admitted to the Intensive Care Unit (ICU) during the first wave of the covid-19 pandemic, which occurred between March and August 2020. An analysis of the case dataset was performed to determine the rise in antibiotic resistance and relate it to resistant cases before the pandemic (September 2019 to February 2020). Before and throughout the pandemic, fifteen kinds of bacteria were found, with K. pneumonia being the most prevalent bacteria (49; 30.6%), and Ac. Baum/haem being the most removable bacteria during the pandemic (74; 37.3%). Cephalosporin antibiotics, in notably cefotaxime and ceftazidime (100%), cefazolin (96.3%), ceftriaxone (96%), cefuroxime and ceftazidime (95%), cefotaxime ((94.7%). These antibiotics also had the same amount of resistance during the pandemic. In pre-covid-19 and during covid-19, these findings were congruent with the penicillin antibiotics class, ampicillin, and piperacillin (96.3% and 92.1%), accordingly. It is presently uncertain if COVID-19 patients would develop new or growing antibiotic resistance in locations with low historical prevalence, but this should be investigated in retrospective and future clinical and microbiology research.

Ceftriaxone Mediated Synthesized Gold Nanoparticles: A Nano-Therapeutic Tool to Target Bacterial Resistance

Ceftriaxone has been a part of therapeutic regime for combating some of the most aggressive bacterial infections in the last few decades. However, increasing bacterial resistance towards ceftriaxone and other third generation cephalosporin antibiotics has raised serious clinical concerns especially due to their misuse in the COVID-19 era. Advancement in nanotechnology has converted nano-therapeutic vision into a plausible reality with better targeting and reduced drug consumption. Thus, in the present study, gold nanoparticles (GNPs) were synthesized by using ceftriaxone antibiotic that acts as a reducing as well as capping agent. Ceftriaxone-loaded GNPs (CGNPs) were initially characterized by UV-visible spectroscopy, DLS, Zeta potential, Electron microscopy and FT-IR. However, a TEM micrograph showed a uniform size of 21 ± 1 nm for the synthesized CGNPs. Further, both (CGNPs) and pure ceftriaxone were examined for their efficacy against Escherichia coli, Staphylococcus aureus, Salmonella abony and Klebsiella pneumoniae. CGNPs showed MIC50 as 1.39, 1.6, 1.1 and 0.9 µg/mL against E. coli, S. aureus, S. abony and K. pneumoniae, respectively. Interestingly, CGNPs showed two times better efficacy when compared with pure ceftriaxone against the tested bacterial strains. Restoring the potential of unresponsive or less efficient ceftriaxone via gold nanoformulations is the most alluring concept of the whole study. Moreover, applicability of the findings from bench to bedside needs further validation.

Polymicrobial native valve endocarditis due to Bacillus cereus and Cardiobacterium hominis

We present a case of polymicrobial subacute bacterial endocarditis and bacteremia with Bacillus cereus and Cardiobacterium hominis in a 72-year-old man with pre-existing mitral valve disease and prior mitral valve repair who presented with renal failure and glomerulonephritis. Bacillus is often a contaminant in blood cultures but has been rarely implicated in patients with invasive infections such as endocarditis. Intravenous drug use, prosthetic heart valves, valvular heart disease and venous catheters are the most frequently described risk factors for Bacillus bacteremia and endocarditis in the medical literature. Management is challenging as Bacillus is resistant to penicillin and cephalosporin antibiotics due to production of beta-lactamase. Polymicrobial endocarditis is uncommon and when it occurs typically involves Staphylococcal species. To our knowledge, this is the first reported case of polymicrobial endocarditis in which both Bacillus and a HACEK organism are implicated.

Beta-Lactam Antibiotic Discrimination Using a Macromolecular Sensor in Water at Neutral pH

Penicillins and cephalosporins belong to the β-lactam antibiotic family, which accounts for more than half of the world market for antibiotics. Misuse of antibiotics harms human health and the environment. Here, we describe an easy, fast, and sensitive optical method for the sensing and discrimination of two penicillin and five cephalosporin antibiotics in buffered water at pH 7.4, using fifth-generation poly (amidoamine) (PAMAM) dendrimers and calcein, a commercially available macromolecular polyelectrolyte and a fluorescent dye, respectively. In aqueous solution at pH 7.4, the dendrimer and dye self-assemble to form a sensor that interacts with carboxylate-containing antibiotics through electrostatic interaction, monitored through changes in the dye’s spectroscopic properties. This response was captured through absorbance, fluorescence emission, and fluorescence anisotropy. The resulting data set was processed through linear discriminant analysis (LDA), a common pattern-base recognition method, for the differentiation of cephalosporins and penicillins. By pre-hydrolysis of the β-lactam rings under basic conditions, we were able to increase the charge density of the analytes, allowing us to discriminate the seven analytes at a concentration of 5 mM, with a limit of discrimination of 1 mM.

CHARACTERISTICS OF USING 3RD AND 4TH GENERATION CEPHALOSPORIN AT THONG NHAT HOSPITAL

Objective: Describing characteristics of using 3rd and 4th generation Cephalosporin antibiotics at Thong Nhat Hospital in the period of 2019 - 2020.Subjects and methods: cross-sectional descriptive study on 158 medical records of patients discharged from hospital from February 20th, 2020 to February 24th, 2020 (5 days) was kept at themedical records store, Department of general planning, Thong Nhat hospital.Results: The majority of patients had no diagnosis of infection but had signs of infection, accounting for 69.92%. Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22± 2.79 days. Cefotaxim was used the most, accounting for 26.58%. The majority of indications for the use of antibiotics C3G/C4G for patients were appropriate or partly appropriate, accounting for 74.05%. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results, accounting for 39.24%. Most of the cases diagnosed or showed signs of infection after using antibiotics C3G/C4G obtained treatment efficacy, accounting for 75%. The majority of patients using C3G/C4G antibiotics achieved effectiveness in preventing wound infection in the patient with no signs of infection, accounting for 77.78%. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.Conclusion: Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22 ± 2.79 days. Cefotaxim were used the most. Most of indications to use antibiotics C3G/C4G were appropriate or partially appropriate. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.

Arrays of solid contact potentiometric sensors for separate determination of some cephalosporin antibiotics

Arrays of potentiometric sensors including developed solid-contact unmodified and modified sensors based on tetradecylammonium associates with complex compounds of silver (1) and some β-lactam antibiotics (cefazoline, cefuroxime, cefotaxime (n = 3 – 6)) are proposed; polyaniline and copper oxide being modifiers. The main electroanalytic properties of the sensors are determined (the range of the determined concentrations in antibiotic solutions 1 × 10–4 – 0.1 M, 46.3 < S < 48, Cmin = n × 10–5 М, response time 4 – 10 sec, potential drift 4 – 6 mV/day, service life — 2 months). It is shown that modification of the membrane surfaces brings the steepness of the electrode functions to Nernst-values for single-charged ions of the antibiotics under study; reduces the response time and the detection limits, the linearity intervals of the electrode functions being the same. The potentiometric selectivity coefficients of unmodified and modified sensors based on different electrode active components (EAC) to the studied cephalosporins in the presence of interfering antibiotics are close to unity; cross sensitivity parameters for the considered sensors (the average slope of the electrode function of the sensor Sav, the unselectivity factor F, and the reproducibility factor K) are 46.3 < S (mV/pC) < 48; 0.85 < F < 0.90; 144 < K < 170, respectively. Application of sensors in the multisensory analysis of model mixtures of cephalosporin antibiotics is shown. Method of artificial neural networks (ANN) is used for processing of analytical signals. The correctness of the determination is carried out using «spike tests» on the reference model mixtures (the relative error of the determination does not exceed 12 %).

Development of TLC Chromatographic-Densitometric Procedure for Qualitative and Quantitative Analysis of Ceftobiprole

Currently, there is still a need for broad-spectrum antibiotics. The new cephalosporin antibiotics include, among others, ceftobiprole, a fifth-generation gram-positive cephalosporin, active against Staphylococcus aureus methicillin agonist (MRSA). The main focus of the work was to optimize the conditions of ceftobiprole qualitative determination and to validate the developed procedure according to ICH guidelines. As a result of the optimization process, HPTLC Cellulose chromatographic plates as a stationary phase and a mixture consisting of ethanol:2-propanol: glacial acetic acid: water (4:4:1:3, v/v/v/v) as a mobile phase were chosen. The densitometric detection was carried out at maximum absorbance of ceftobiprole (λ = 232 nm). Next, the validation process of the developed procedure was carried out. The relative standard deviation (RSD) for precision was less than 1.65%, which proves the high compatibility of the results, as well as the LOD = 0.0257 µg/spot and LOQ = 0.0779 µg/spot values, which also confirm the high sensitivity of the procedure. The usefulness of the developed method for the stability studies of ceftobiprole was analyzed. Study was carried out under stress conditions, i.e., acid and alkaline environments, exposure to radiation imitating sunlight and high temperature (40–60 °C). It was found that cefotbiprole is unstable in an alkaline environment and during exposure to UV-VIS radiation. Moreover, the lipophilicity parameter, as a main physicochemical property of the biologically active compound, was determined using experimental and computational methods.