No abstract available.
Cholangitis ; Drug Resistance, Microbial

Aims: Bacteria on chicken egg surfaces can be potential sources of food borne diseases. The aim of this study was to determine the prevalence of E. coli, Salmonella and enterococci on the surface of conventional broiler eggs, “Kampung” chicken eggs and carrying trays and to determine the antimicrobial resistant profile of these isolates. Methodology and results: Conventional broiler eggs, “Kampung” chicken eggs and carrying trays were sampled randomly from nine wet markets in Selangor, Malaysia. The surface of the eggs and carrying trays were swabbed and E. coli, Salmonella and enterococci were isolated using selective agars. Antimicrobial susceptibility testing (AST) was performed on the isolates against different antimicrobials via disk diffusion test. A large proportion of E. coli isolates (>50% of isolates from conventional broiler eggs and “Kampung” chicken eggs) was resistant to chloramphenicol and tetracycline whereas enterococci (>60% of isolates from conventional broiler eggs and “Kampung” chicken eggs) isolates were resistant to tetracycline and erythromycin. Salmonella isolates were found to be susceptible to all of the antimicrobials tested except for tetracycline. There was also presence of isolates showing multiple resistances in this study. E. coli isolates (8.8%) from the surface of “Kampung” chicken eggs were resistant against 10 different antimicrobials whereas 17.8% of the enterococci isolates from the surface of “Kampung” chicken eggs were resistant to 11 different antimicrobials. Conclusion, significance and impact of study: The presence of multiple-antimicrobial resistant bacteria especially on the surface of “Kampung” chicken eggs that are ready to be sold to consumers is a serious concern. However, further study has to be conducted to determine the ultimate source of the bacterial contamination before specific food safety measures can be introduced.
Drug Resistance, Microbial ; Salmonella

Aims: Staphylococcus aureus is a Gram positive pathogen distributed worldwide and represents a rising problem for both hospitals and community. The aims of the study were to examine the antibiograms, toxin profiles as well as the genetic diversity of a set of S. aureus isolates from clinical and food samples. Methodology and results: To get some insights on the genetic heterogeneity and test for the presence of certain virulence genes, all isolates were subjected to different PCR amplifications and antibiotic sensitivity analysis. The mecA gene was detected in both clinical and food isolates. Resistance to penicillin and amoxicillin was observed in both clinical and food isolates. About 88% of both food and clinical isolates harbored the toxin gene sea, while 70% and 29% of clinical and food isolates respectively, harbored sec. The seb gene was detected in 59% and 18% of clinical and food isolates, respectively. Dendrograms prepared from the VNTR, antibiograms and toxin profiles, revealed 89, 52 and 12 clusters, respectively. Thus, suggesting a very high heterogeneity among the isolates. Conclusion, significance and impact of study: Strains used in this study showed high heterogeneity when examined by VNTR or antibiograms, while appeared less heterogeneous when dendrogram was generated based on toxin profiles. This study highlights the fact that methicillin resistance in S. aureus might be generated within the health institutions or the community. Obtained results also might help health authorities understand the origin of methicillin resistant clones within the study area.
Staphylococcus ; Drug Resistance, Microbial

Background: Extended-spectrum beta-lactamases (ESBLs), which allow bacteria to become resistant to commonly used antibiotics against common pathogens such as Klebsiella pneumoniae, are a significant public health concern as their presence severely limits treatment options. Discovery and development of new drug entities are critical to effectively combat infections with these increasingly common antibiotic-resistant variants. Objective: Computational approaches can accelerate and reduce the cost of the discovery phase by screening for inhibitors of “druggable” pathogen enzyme targets in silico. In this study, protein structures of the ESBL enzymes SHV-1 and CTX-M-15 were used as targets in molecular docking experiments to identify potential inhibitors for K. pneumoniae. Methodology: 5000 compounds from the Enamine Real HTS compound database were screened in silico for binding to SHV-1 and CTX-M-15. Twenty-six (26) compounds that were identified to have more favorable interactions compared to Avibactam, a known inhibitor of the target proteins, were tested for cytotoxic activities in vivo using Resazurin Microtiter Assay (REMA) against a K. pneumoniae clinical isolate containing both SHV-1 and CTX-M-15 resistance genes. Results and Conclusion Despite favorable binding energies in in silico screening, most of the compounds exhibited negligible inhibition on the growth of the K. pneumoniae clinical isolate in in vitro assays. This may be attributed to the fact that a phenotypic whole-cell assay, instead of an enzyme-targeted assay, was used for validation. Cell permeability requires a different set of molecular parameters which were not part of the study. Doxorubicin exhibited the highest in vitro bactericidal activity against this strain, which agrees with its known activity against many other bacterial pathogens and may be a promising compound for further lead optimization.
Drug Resistance, Microbial

Aims: The objective of the present study is to evaluate the possibility of reversing the resistance of pathogens to antibiotics using phytochemicals from plant extracts as antibiotic-adjuvant. Methodology and results: Twenty-one plants were collected from Podhigai Hills, Tamil Nadu, India and tested in this study. The susceptibility of burn wound isolates (Pseudomonas aeruginosa and Staphylococcus aureus) to antibiotics and the adjuvant activity of the aqueous plant extracts were tested using well diffusion assay. The impact of the plant extracts on quorum sensing was assessed using Chromobacterium violaceum as the model organism. The antibiofilm activity of the adjuvant and antibiotics was determined by crystal violet assay. The isolates which were resistant to more than one class of antibiotics (aminoglycoside, cephalosporin, fluoroquinolone and penicillin) were designated as multidrug resistant bacteria. Combination of cefdinir-Citrullus colocynthis showed 17 mm inhibition zone which is greater than cefdinir (0 mm) against P. aeruginosa. The combination reduced quorum sensing with an inhibition zone of 30 mm. The same combination reduced 96% and 95% of the biofilm formed by P. aeruginosa and S. aureus, respectively at 16 h. Besides, cefdinir with Leucas aspera reduced quorum sensing with an inhibition zone of 28 mm. The combination reduced 94% and 95% of biofilm formed by P. aeruginosa and S. aureus, respectively at 16 h. The aqueous extract of C. colocynthis and L. aspera revealed the presence of flavonoids that possess adjuvant activity. Conclusion, significance and impact of study Cefdinir-C. colocynthis and cefdinir-L. aspera reversed the resistance of multi drug resistant bacteria to cefdinir. The flavonoids of C. colocynthis and L. aspera served as an adjuvant that potentiates the activity of cefdinir.
Drug Resistance, Microbial ; Phytochemicals

OBJECTIVES

The objectives of the study were to determine the antibiotic consumption of restricted antibiotics and to correlate this with resistance rate.

A retrospective review of pharmacy dispensing records was conducted in the adult internal medicine wards of a tertiary level teaching hospital in the Philippines between March 2019 to February 2020. Antibiotic consumption was determined using Defined Daily Dose (DDD) per 1000 patient-days (PD). Correlations between antibiotic consumption and antibiotic resistance of restricted antibiotics were done. Outcomes were compared between Ward 1 (with the presence of a unit-dose pharmacist) and Ward 3 (without a unit-dose pharmacist).

Both wards showed decreasing trends of piperacillin-tazobactam consumption and increasing trends of ceftazidime consumption from quarter 1 to quarter 4. It was observed that levofloxacin was the most prescribed fluoroquinolone with the highest consumption recorded from March to May 2019 in Ward 3 of 350.2 DDD/1000 PD as compared with ciprofloxacin which has the highest consumption (23.3 DDD/1000 PD) during the period June to August 2019 in Ward 1. Antibiotic resistance of Acinetobacter baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were statistically significantly different between the wards. In Ward 1, ciprofloxacin consumption was strongly positively correlated with Escherichia coli resistance (r = 0.90). In Ward 3, a significantly moderately positive association was observed for ceftazidime consumption and A. baumannii resistance (r = 0.61), positive correlation between piperacillin-tazobactam and E. coli resistance (r = 0.65), and a strong positive correlation in Ward 3 between levofloxacin and Pseudomonas aeruginosa resistance (r = 0.71).

The restriction and pre-authorization strategy of the AMS program has greatly contributed to the decrease in the consumption of almost all restricted antibiotics. This strategy has been helpful in minimizing unnecessary antibiotic use associated with inappropriate drug therapy. The success of the AMS program has been based on the collective efforts of the AMS team with the implementation of hospital policies, such as the AMS program, across the different sites in the hospital in order to achieve optimum patient health outcomes. It was noted that the resistance rates of A. baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were higher in Ward 3 compared to Ward 1 which makes infections very difficult to treat which may result to prolonged hospital stay, increased health-care costs and increased mortality rate. This study has supported the involvement of pharmacists in the AMS team by conducting auditing activities that promote safe compliance of restricted antibiotic use among patients. Pharmacists can greatly participate on either prospective or retrospective review of antibiotic utilization and analyze trends of antibiotic consumption data to provide feedback to prescribing physicians on prescribing patterns and possible correlation with occurrence of antibiotic resistance.

Background: Antibiotic resistance is a rising problem in Malaysia. For instance, high antibiotic prescribing rate for upper respiratory tract infection and inappropriate choice of antibiotic is a significant healthcare concern in Malaysia. Our main objective was to study knowledge, attitude and practice of antibiotic prescribing among medical officers in Kedah, Malaysia. Methods: A cross sectional study was conducted in outpatient departments of health clinics and hospitals in Kedah from June 2013 until December 2013. Sample size was 118 and systematic sampling was conducted. Research tool used was a validated questionnaire from studies conducted in Congo and Peru. Results: Response rate was 84.8%. Majority of our respondents were female doctors (71.0%), local graduates (63.0%), and practiced for 4 years or less (61.0%). 52.0% of the respondents prescribed antibiotics more than once daily. Mean knowledge score on antibiotics was 5.31 ±1.19 (95% CI: 5.06; 5.54). More than half (62.0%) of our respondents were confident in antibiotic prescribing and there were merely 18.0% of them consulted any colleagues prior to prescription. There was a significant difference in frequency of antibiotic prescribing between junior doctors and senior doctors (P-value: 0.036). In addition, there was also a significant association between frequency of antibiotic prescribing and awareness of antibiotic resistance in their daily practice. (P-value: 0.002). Conclusion: Knowledge on antibiotic was moderate among our medical officers and antibiotic prescribing was frequent. Training and courses on appropriate antibiotic prescribing should be emphasized to ensure the best practice in antibiotic prescription.
Drug Prescriptions ; Drug Resistance, Microbial

No abstract available.
Drug Resistance, Microbial* ; Plasmids* ; Pneumonia*

Background: the selection of appropriate antibiotics decided success in healing stomach-duodenum lesions. Regimens were recommended over the world today in treatment of stomach-duodenal ulcers were combination ofthree drugs, including an anti-gastric acid secretion agent and two of three antibiotics were amoxicillin (Amox), clarithromycin (Clar) and metronidazole (Metro). In Vietnam, a recent study showed that 76% of HP strains resistant to Metro and 1% resistant to Clar. Objectives: to describe prevalence and trend of primary antibiotics resistance of H.pylori to metronidazole, clarithromycin and amoxicillin over 10 years (1993-2002). Subjectives and Method: A retrospective study was about the susceptibility of 434 HP isolates derived from 281 children and 153 adults to Metro, Clar and Amox for 10 years (1993-2002) by using E-test. Results: no isolates resistant to Amox had been identified. Overall resistance rates of HP isolates to Metro, Clar and to both of them were 48.9%, 31.5% and 17.1% (51.7%, 28.4% and 17.6% in children and 43.7%, 36.6% and 16.3% in adults). Metro resistance rate in children aged from 10 to 18 was higher than that in adults and younger children (p<0.04). Clar resistance rate of children under 10 was lower than that of older children and adults (p<0.02). Both MICs of dual resistant isolates to Metro and Clar were higher than that of single resistant isolates (p<0.02 with Metro and p<0.01 with Clar). Conclusions: resistance rates of HP isolates to Metro, Clar and to both of them were relatively high. No isolates resistant to Amox had been identified. Antibiotics resistance rates in children were difference between the ages.
Helicobacter pylori ; Drug Resistance ; Microbial ;

In order to prevent the use of antibiotics from the errors, it should test the minimal inhibitory concentration (MIC) of antibiotics for some causative strains of microbe. From which to determine the MIC 90 of antibiotics for antibiotic resistance or sensitivity strains. A study evaluated the sensitivity and resistance of 23 strains of S. Pneumoniae, 34 strains of staphylococcus, 15 strains of H. influenzae, and 24 strains of M. catarrhalis for penicilline and chloramphenicol which are two antibiotics had a high rate of resistance by microbials causing the respiratory tract infections. The MIC90 of these 2 antibiotics for the above strains was higher 2-8 times than MIC.
Drug Resistance ; Microbial Sensitivity Tests