Background and Objective: Antimicrobial resistance (AMR) is a leading global public health concern as it resulted in more difficult-to-treat infections and fatalities. In the Philippines, drug-resistant E. coli, including multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL)-producing, carbapenemase-producing carbapenem-resistant (CP-CR) E. coli, have been isolated from common food animals, increasing the risk of cross-contamination between humans, animals, and the environment. However, there is a lack of data on the distribution of E. coli in chicken meat in public wet markets. This study aims to describe the AMR profile of E. coli in raw chicken meat from retail stalls in a selected wet market in Manila City. Methods: This quantitative descriptive study characterized the AMR profile of E. coli isolated from 25 raw chicken meat samples from a wet market in Manila City. Antimicrobial susceptibility was determined through disk diffusion method against 23 antimicrobial agents in 16 antimicrobial classes. MDR E. coli were identified based on the resistance patterns. ESBL- and carbapenemase-producing capacities of the bacteria were tested through double disk synergy test and modified carbapenem inactivation method, respectively. Results: Twenty-four out of 25 (96%) chicken samples contained E. coli isolates. Of these, 23 (96%) were classified as MDR. High resistance rates were observed against ampicillin (92%), tetracycline (88%), trimethoprim-sulfamethoxazole (83%), chloramphenicol (79%), ampicillin-sulbactam (75%), amoxicillin-clavulanic acid (67%), fosfomycin (67%), and streptomycin (54%). The majority of the E. coli isolates were still susceptible to a wide range of selected antimicrobial agents, including carbapenems (100%), ceftriaxone (100%), cefepime (100%), cefuroxime (96%), cefotaxime (96%), ceftazidime (96%), piperacillin-tazobactam (96%), aztreonam (96%), cefoxitin (92%), and nitrofurantoin (83%), among others. Meanwhile, none of the 24 isolated E. coli samples were classified as ESBL- and CP-CR E. coli. Conclusion Among the 25 chicken samples, 24 E. coli colonies were isolated that exhibited 0% to 92% resistance rates against selected antimicrobial agents. Most isolates were classified as MDR, but none were considered ESBLand CP-CR E. coli. This study suggests that chickens in wet markets can potentially serve as reservoir hosts for drugresistance genes, which could transfer to other bacteria and contaminate humans, animals, and the environment within the food production and supply chain. These findings emphasize the need for AMR surveillance and strategies to combat AMR in the Philippines through the One Health approach.
drug resistance ; multi-drug resistance ; drug resistance, multiple ; carbapenemase ; Escherichia coli

Adult ; Anti-Bacterial Agents/therapeutic use* ; COVID-19/drug therapy* ; Catheter-Related Infections/microbiology* ; China ; Drug Resistance, Multiple, Bacterial ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Intubation, Intratracheal ; Male ; Pneumonia, Viral/drug therapy* ; Prosthesis-Related Infections/microbiology* ; SARS-CoV-2

Aims: Antimicrobial resistance (AMR) is a significant public health concern of modern civilization. The potential risk of AMR is significant in terms of both human and animal health. This study aims to assess the antimicrobial resistance pattern of selected antimicrobials against Escherichia coli of animal, poultry and human origin in the Cumilla district of Bangladesh. Methodology and results: A total of 200 samples were collected from different sources. Isolation and identification of commensal E. coli were performed following standard bacteriological and molecular techniques. Antimicrobial susceptibility testing was performed following the Kirby-Bauer disc diffusion technique. Ampicillin, tetracycline and sulfamethoxazole-trimethoprim resistance genes were detected by polymerase chain reactions (PCR). A total of 152 (76%; 95% confidence interval (CI) 70-81%) E. coli were isolated from cattle, sheep, chicken and human, where 37.5% of isolates were found to be multidrug-resistant (MDR). In the cultural sensitivity test, E. coli showed the highest resistance to sulfamethoxazole-trimethoprim (71%), tetracycline (63%), ampicillin (62%), where gentamicin (23%) showed the lowest resistance, followed by ceftriaxone (26%). The prevalence of resistance genes like blaTEM, tetA, tetB, tetC, sul1 and sul2 were 100%, 95%, 11%, 8%, 58% and 52%, respectively. Conclusion, significance and impact of study The emergence of multidrug-resistant commensal E. coli and resistance genes circulating in animals, poultry and humans limit the treatment options for serious infections.
Escherichia coli ; Drug Resistance, Multiple, Bacterial

Introduction: Multi Drug Resistant Organisms (MDRO) are microorganisms that are resistant to one or more classes of antimicrobial agents, and these have become significant pathogens to contend with in the treatment of Healthcare Associated Infections. Objectives: This study aimed to determine the clinico-epidemiologic profile and outcome of pediatric patients with healthcare-associated multi-drug resistant gram-negative infections, and its antimicrobial susceptibility patterns. Methodology: This was a retrospective study done on pediatric patients with gram negative healthcare associated MDRO sepsis compared to non-MDRO sepsis admitted at the ICU and pediatric wards of a tertiary government hospital from July 2015 to June 2016. Descriptive statistics was used to summarize the clinical characteristics of patients. Odds ratio and the corresponding 95% confidence interval from binary logistic regression was computed to determine significant predictors for the development of multi drug resistance. Outcome of patients with MDRO gram-negative infection was noted, as well as its antimicrobial susceptibility patterns. Results: A total of 199 patients developed HAI, and 41% were identified to be gram negative MDR cases. Pediatric patients with healthcare associated infections due to MDR gram negative organisms had shorter hospital stay and a higher mortality rate of 78% compared to 41% among non MDR patients.The most commonly isolated gram negative organisms were Burkholderia cepacia, 38%; Klebsiella pneumoniae, 31%; and Acinetobacter baumanii, 18%; while the most common MDR gram negative isolates were Klebsiella pneumoniae, 65%; Acinetobacter aumanii, 22%; and Pseudomonas aeruginosa, 7%. Significant predictors for MDRO were age (0-28 days old), ICU admission, intravascular catheterization and use of total parenteral nutrition. Conclusion Profile of pediatric patients with healthcare-associated multidrug resistant gram-negative infections were neonates admitted in the ICU with a shorter hospital stay and a high mortality rate. The identified risk factors for developing Multi Drug Resistant Gram Negative sepsis were age of 0-28 days, admission to ICU, intravascular catheterization and parenteral nutrition. Patients with gram-negative MDR infections have a high mortality rate and isolates are susceptible mostly to Colistin.
Drug Resistance, Multiple ; Cross Infection ; Gram-Negative Bacterial Infections

Adult ; Base Sequence ; Drug Resistance, Multiple, Viral ; Genome, Viral ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Mutation ; Phylogeny

The distribution of minimal inhibitory concentrations (MIC) for amoxicillin, clarithromycin, metronidazole, tetracycline, azithromycin, and fluoroquinolone (ciprofloxacin, levofloxacin, and moxifloxacin) have shifted to higher concentrations from 1987 to 2003 in Helicobacter pylori (H. pylori) strains isolated from Korean patients. MIC values of secondary isolates were higher than those of primary isolates. Of treatment-failure patients, 16.4% showed mixed infections with both antibiotic-susceptible and -resistant H. pylori strains. A total of 89.6% of patients with treatment failure and 52.3% of patients without antibiotic treatment had H. pylori strains resistant to two or more antimicrobial agents (multi-drug resistance, MDR). The most common antibiotics showing MDR were clarithromycin, metronidazole, and azithromycin. The resistance rates to both amoxicillin and clarithromycin were 34.3% in secondary isolates and 6.2% in primary isolates. The resistance rates to both clarithromycin and metronidazole were 73.1% in secondary isolates and 7.7% in primary isolates. In addition, there was a significant difference in antibiotic resistance between two institutions located at Seoul and Gyeonggi provinces. To provide adequate informations about susceptible antibiotics to clinicians, continuous surveillance of antibiotic susceptibilities is needed in Korea.
*Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Helicobacter pylori/*drug effects/isolation & purification ; Humans ; Korea ; Microbial Sensitivity Tests

Acinetobacter baumannii ; drug effects ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Multiple, Bacterial ; Microbial Sensitivity Tests

OBJECTIVETo investigate the HIV-1 drug resistance associated mutations and examine the susceptibility of HIV-1 with these mutations to antiretroviral in treatment-naive individuals in Liaoning province from 2004 to 2008.

METHODSRNA was extracted from 20 plasma samples of diagnosed untreated HIV-1-infected treatment-naive patients by drawing method. After the viral loading (VL) test, the protease and nucleoside reverse transcriptase coding regions were amplified by RT-PCR, nested PCR and sequence analysis directly. Levels of resistance and prevalence were evaluated according to the Stanford University HIV Drug Resistance Database's algorithm (http://hivdb.stanford.edu).

RESULTSAmong the 20 plasma samples, 13 got PCR products because of their VL values higher than 1000 copies/ml.Meanwhile, the 13 samples got 65 sequences by using 5 primers each. Polymorphisms in subtype H and circulating recombinant forms (CRFs) CRF10_CD sequences were identified. An overall prevalence of 30.8% (4/13) resistance to NNRTIs, 7.7% (1/13) to PI and no NRTIs mutations were found. The most frequent substitutions (4/13) in the RT region at positions P225H, K238S, V179D, K238T and a major position I54S in PR implied to a multiple drug-resistance. A71V or L10V only, respectively, substitution in PR was found in 3 samples, but no any worse with drug sensitivity.

CONCLUSIONHIV-1 polymorphisms in subtype H and CRFs CRF10_CD sequences were identified circulating in Liaoning. A major mutation position I54S in PR implied that it would be the time to commence a higher level drug regimen.

Anti-HIV Agents ; pharmacology ; China ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Viral ; drug effects ; genetics ; Genotype ; HIV Infections ; drug therapy ; virology ; HIV-1 ; genetics ; Humans ; Mutation ; RNA, Viral ; genetics

OBJECTIVETo investigate HBV mutations in reverse transcriptase (RT) gene and precore/basal core promoter (PC/BCP) regions in a chronic hepatitis B patient and to analyze the link between the mutations and drug resistance or HBeAg sero-conversion.

METHODSEighteen serum samples were collected from a chronic hepatitis B patient during his 14 hospitalizations from June 2002 to September 2007. HBV DNA was extracted and nested PCR was employed for amplification of target gene fragments. Direct sequencing of PCR products was performed followed by analysis with NTI software. The significance of the results was analyzed in combination with the clinical data of the patient.

RESULTSSeveral mutations were identified in succession, including LAM-resistant mutations M204I/V and L180M+M204V, ETV-resistant mutation S202G, and HBeAg nonsense mutation G1896A. The results were in accordance with the disease progression of the patient.

CONCLUSIONSequencing of HBV RT and PC/BCP regions is valuable for comprehensively checking the viral mutations and thus it is helpful in the surveillance of patients in clinics as a way for adopting reasonable antiviral therapy.

Adult ; Antiviral Agents ; pharmacology ; DNA, Viral ; genetics ; Drug Resistance, Multiple, Viral ; genetics ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Male ; Mutation

The main factors influencing the bacterial ecology on burn wound are the selection of antibacterial agents and systemic antibiotic. Some antibacterial agents more active against P. aeruginosa were developed in 1960s, and the detection rate of P. aeruginosa on burn wound has been declined, and the detection rate of Enterobacteriaceae species and Acinetobacter SPP. has been raised since then. In 1990s, the third generation Cephalosporin was widely used in burn unit and the detection rate of staphylococcus aureus showed an increased trend. Especially, the positive rate of MRSA was increased significantly. Under the selection pressure of antibacterial agent, the resistant strains are rapidly increased and the antibiotics against opportunistic pathogen on burn wound should be selected continuously. Finally, the bacterial ecology pattern on burn wound is changing incessantly. The result is that the prevalence of infection of multi-drug resistance strains and opportunistic pathogen appears on burn wound. In order to optimize the antibiotic therapy, the bacterial ecology pattern on burn wound has to be investigated, and the dominant pathogen including invasive and currently prevailing strains in the burn unit also should always be surveyed. In addition, we also should know the mechanisms of bacterial resistance. The regular surveillance of antibiotic resistance in the clinical isolates is the most important and valuable for understanding the trend of bacterial resistance. The antibiotic therapy should be decided according to the result of susceptibility tests.
Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; drug therapy ; Burns ; drug therapy ; microbiology ; Drug Resistance, Multiple, Bacterial ; Humans