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Prevalence of Multi-Antibiotic Resistant Bacteria Isolated from Children with Urinary Tract Infection from Baghdad, Iraq

  • Salman, Hamzah Abdulrahman;Alhameedawi, Alaa kamil;Alsallameh, Sarah Mohammed Saeed;Muhamad, Ghofran;Taha, Zahraa
    • Microbiology and Biotechnology Letters
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    • v.50 no.1
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    • pp.147-156
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    • 2022
  • Urinary tract infections (UTIs) are one of the most common infections in different age groups, including children. Bacteria are the main etiological agents of UTIs. The aim of the present study was to isolate, identify, and determine the antibiotic susceptibility of bacteria isolated from children with UTIs from Baghdad, Iraq. Three hundred and two urine samples were collected from children aged 6 months to 12 years. The samples were cultured on blood agar and MacConkey agar. The selected colonies were subjected to biochemical tests and antibiotic susceptibility analysis using the Vitek® 2 Compact automated microbial identification system. In this sample, 299 bacteria were identified, of which, 267 were gram-negative bacteria, and 32 were gram-positive bacteria. Escherichia coli (56%) was the most commonly isolated gram-negative bacteria, followed by Pseudomonas aeruginosa (14%), Enterobacter spp. (10.48%), Klebsiella pneumoniae (9.36%), Proteus spp. (7.8%), Acinetobacter baumannii (1.5%), and Morganella morganii (0.37%). Enterococcus faecalis (62.5%) was the most commonly detected gram-positive bacteria, followed by Staphylococcus aureus (37.5%). E. coli and P. aeruginosa were the most antibiotic-resistant bacteria. Among the tested antibiotics, meropenem showed 100% sensitivity, followed by imipenem (97.4%), amikacin (91.8%), and tobramycin (83.5%). In contrast, the high frequencies of resistance were observed with cefixime (93.2%), cefotaxime (78.7%), and ceftriaxone/cefotaxime (71.2%). In conclusion, carbapenems and aminoglycosides are highly recommended for the empirical treatment of UTIs, while, Quinolones, penicillins, and cephalosporins are not suggested. Frequent antibiotics susceptibility testing are warranted to determine the resistance pattern of UTI bacteria.

Antimicrobial resistance of Escherichia coli isolated from wild birds in Daegu (대구지역 야생조류에서 분리된 대장균의 항생제 내성 조사)

  • Kim, Kyung-Hee;Lim, Hyun-Suk;Lee, Jung-Woo;Park, Dae-Hyun;Yang, Chang-Ryoul;Cho, Jae-Keun
    • Korean Journal of Veterinary Service
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    • v.44 no.4
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    • pp.209-216
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    • 2021
  • This study was aimed to investigate occurrence and the antimicrobial resistance of Escherichia coli isolates obtained from the feces of wild birds in Daegu. In total, 98 E. coli isolates (17.9%) were obtained from 547 fecal samples of wild birds. The E. coli carried by the birds showed a relatively high rate of antimicrobial resistance to tetracycline (27.6%) and ampicillin (21.4%). Drug resistance of the isolates to the others (penicillins, cephems, carbapenems, aminoglycosides, quinolones, sulfonamides and phenicols) resulted in the rates less than 20%, and all isolates were susceptible to imipenem, ciprofloxacin, cefotetan, and amikacin. Approximately, 45% E. coli among the isolates were resistant to one or more drugs tested. The higher rate of tetracycline resistance led us to determine the prevalence of the tet genes (tetA, tetB, tetC, tetD and tetE) in the tetracycline-resistant E. coli isolates by using PCR. All isolates of the tetracycline-resistant E. coli contained at least one or more of these tet genes examined. The most prevalent one was tetA (59.3%), and followed by tetB (7.4%) when tested with the selected 5 tet genes. Except tetA and tetB, however, the remaining tet genes (tetC, tetD, and tetE) tested were not found in this study. Nine isolates among the tetracycline-resistant E. coli contained the two (tetA and tetB) determinants of tetracycline resistance, simultaneously.

Distribution and Antibiotic Resistance of Vibrio spp. Isolated from Fishery Products and Coastal Areas in Gyeongsangnam-do (경상남도 유통 어패류와 해양환경에서 분리된 비브리오균속 (Vibrio spp.) 분포 및 항생제 내성 특성)

  • Jin Yeong Tak;Jeong Gil Park;Ji-Young Um;Su Wan Choi;Na Lam Hwang;Mi Suk Kim;Jae Dong Kim
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.56 no.5
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    • pp.626-633
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    • 2023
  • Vibrio spp. are aquatic bacteria that are ubiquitous in warm estuarine and marine environments. Especially, V. vulnificus and V. cholerae are currently known to cause potentially fatal infections in humans. This study investigated the distribution and antibiotic resistance of V. vulnificus and V. cholerae isolated from coastal areas of Gyeongsangnam-do in 2022. A total of 252 samples of water, shellfish and coastal sediment were collected from 7 locations along the coast, and 124 samples of fishery products were collected from markets. Among the 252 samples, forty-four V. vulnificus (11.7%) and fourteen V. cholerae non-O1/non-O139 (3.7%), none of which carried the ctx gene, were isolated. Out of the 124 samples, 6 (4.8%) tested positive for V. vulnificus and V. cholerae was not detected. The isolation rates of V. vulnificus and V. cholerae showed a significant correlation with environmental factors such as seawater temperature and salinity. In an antibiotic resistance test, V. vulnificus was susceptible to amikacin, gentamicin, imipenem trimethoprim/sulfamethoxazole, and ciprofloxacin, but resistant to cefoxitin (100.0%), followed by tetracycline (9.1%). Multidrug resistance was also observed. Continuous monitoring of Vibrio pathogens with water temperature and salinity is expected to help reduce the outbreaks, and rational use of antibiotic agents is needed to prevent the accession of antibiotic-resistant microorganisms in aquatic ecosystems.

Antibiotic Reversal Activity of Piper longum Fruit Extracts against Staphylococcus aureus Multi-Drug Resistant Phenotype

  • Maryam Salah Ud Din;Umar Farooq Gohar;Hamid Mukhtar;Ibrar Khan;John Morris;Soisuda Pornpukdeewattana;Salvatore Massa
    • Microbiology and Biotechnology Letters
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    • v.51 no.4
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    • pp.432-440
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    • 2023
  • Irrational and injudicious use of antibiotics, easy availability of them as over-the-counter drugs in economically developing countries, and unavailability of regulatory policies governing antimicrobial use in agriculture, animals, and humans, has led to the development of multi-drug resistance (MDR) bacteria. The use of medicinal plants can be considered as an alternative, with a consequent impact on microbial resistance. We tested extracts of Piper longum fruits as new natural products as agents for reversing the resistance to antibiotics. Six crude extracts of P. longum fruits were utilized against a clinical isolate of multidrug-resistant Staphylococcus aureus.The antibiotic susceptibility testing disc method was used in the antibiotic resistance reversal analysis. Apart from cefoxitin and erythromycin, all other antibiotics used (lincosamides [clindamycin], quinolones [levofloxacin and ciprofloxacin], and aminoglycosides [amikacin and gentamicin]) were enhanced by P. longum extracts. The extracts that showed the greatest synergy with the antibiotics were EAPL (ethyl acetate [extract of] P. longum), n-BPL (n-butanol [extract of] P. longum), and MPL (methanolic [extract of] P. longum The results of this study suggest that P. longum extracts have the ability to increase the effectiveness of different classes of antibiotics and reverse their resistance. However, future studies are needed to elucidate the molecular mechanisms behind the synergy between antibiotic and phytocompound(s) and identify the active biomolecules of P. longum responsible for the synergy in S. aureus.

Study on antimicrobial resistance and detection of MRSA of Staphylococcus aureus isolated from carcass in Daegu slaughterhouses (대구지역 도축장 출하가축의 도체에서 분리한 Staphylococcus aureus의 항생제 내성과 MRSA 검출에 관한 연구)

  • Hyun-Sook Lim;Dong-Keun Suh;Hwan-Deuk Kim;Hye-Hwa Lee;Jeong-Mi Kim;MiHa Im;Jae-Keun Cho
    • Korean Journal of Veterinary Service
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    • v.47 no.1
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    • pp.27-33
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    • 2024
  • At the present study, it was aimed to explore the states of antimicrobial resistant Staphylococcus aureus isolates from 1,360 chickens, pigs and cattle carcass (400 chickens, 480 pigs and 480 cattle) in Daegu province from January 2022 to December 2022. Among 1,360 samples, 81 of S. aureus were isolated cattle (1.4%), pigs (7.7%) and chickens (9.2%). In antimicrobial susceptibility test, all of the isolates were demonstrated susceptibility to rifampin. But the isolates were showed resistance other antibiotics in order of tetracycline (62.9%), ciprofloxacin (62.9%), tobramycin (58.0%), gentamicin (51.8%), amikacin (40.7%), penicillin (39.5%), clindamycin (35.8%), enrofloxacin (33.3%), trimethoprim/sulfamethoxazole (30.8%), oxacillin (30.8%), minocycline (29.6%), erythromycin (25.9%), quinupristin/dalfopristin (20.9%), chloramphenicol (12.3%), cefoxitin (9.8%). Among the 81 S. aureus isolates, 25 (30.8%) methicillin-resistant staphylococcus aureus (MRSA) were observed. Seven (28.0%) of 25 MRSA harbored mecA gene. About 96% of MRSA were multidrug resistance to at least 3 more drugs. A continuous monitoring and surveillance program to prevent antimicrobial resistance in livestock products is demanded.

Prevalence and Characterization of Pathogenic Escherichia coli Isolated from the Livestock Environment in Chungcheongnam-do Province of South Korea (충남지역 농장환경에서 분리된 병원성대장균 분포 및 특성 분석)

  • Junhyuk Park;Kyung A Yun;Youngeun Ko;Mi Jang;Ok Kim
    • Journal of Environmental Health Sciences
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    • v.50 no.4
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    • pp.274-281
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    • 2024
  • Background: One of the major causes of pathogenic E. coli is the feces of infected livestock, and the management of the livestock environment is necessary to prevent pathogenic E. coli. Objectives: The prevalence of pathogenic E. coli was identified from livestock environments, and the molecular characteristics and antibiotic resistance profiles of the isolated pathogenic E. coli strains were analyzed. Methods: In 2022 and 2023, nine points of livestock houses at sites in Chungcheongnam-do Province were selected, and 100 cow feces or soil samples around the livestock houses were collected once per month. Pathogenic E. coli was isolated by selective culture and identified using multiplex PCR. Antibiotic resistance was tested on the isolated strains by using VITEK-2, and candidate strains were selected to perform 16s rRNA sequencing and phylogenetic analysis. Results: A total of 100 samples were tested, and 60 pathogenic E. coli strains were isolated. Of these, 45 and 15 isolates were determined to be single and hybrid pathogenic E. coli , respectively. Among the 15 hybrid pathogenic E. coli strains, eight, five, and two strains were respectively identified as EHEC/ETEC, EHEC/EPEC, and EHEC/ETEC/EPEC hybrids. All 45 isolates showed resistance to at least one antibiotic, and they were susceptible to cefotaxime, amikacin, nalidixic acid, and ciprofloxacin. The highest resistance was against cefalotin, tetracyclin, and ampicillin (20.0%~58.3%). The 16s rRNA sequences of candidate isolates revealed nucleotide sequence identities of 99.1% to 100%. Conclusions: In order to manage pathogenic E. coli from the One Health animal environment perspective, the characteristics of the occurrence of pathogenic E. coli from the livestock environment and molecular biology and antibiotic resistance to isolated strains were analyzed. In order to prevent and manage the occurrence of pathogenic E. coli, these monitoring studies must be continuously conducted.

Etiological agents isolated from blood in children with hemato-oncologic disease (2002-2005) (소아 혈액 종양 환자에서 발생한 균혈증의 원인균(2002-2005년))

  • Kim, So-Hee;Lee, Young-Ah;Eun, Byung-Wook;Kim, Nam-Hee;Lee, Jin-A;Kang, Hyoung Jin;Choi, Eun-Hwa;Shin, Hee Young;Lee, Hoan-Jong;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.56-64
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    • 2007
  • Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : One hundred and ninety-seven episodes of bloodstream infections that developed in 128 pediatric cancer patients were analyzed, which were identified at the Seoul National University Children's Hospital during a 4 year-period from 2002 to 2005. Results : A total of 214 pathogens was isolated, of which 64.0 percent were gram-negative, 31.3 percent were gram-positive bacteria, and 4.7 percent were fungi. The most common pathogens were Klebsiella spp. (21 percent) and Escherichia coli (16.8 percent), and coagulase-negative staphylococci (CNS, 7.9 percent) and viridans streptococci (7.5 percent) emerged as important pathogens. Neutropenic patients were more often associated with gram-negative bacteria than non-neutropenic patients (67.5 percent vs. 51.1%, P=0.018) and patients with central venous catheters were more often associated with CNS and viridans streptococci than those without. Resistance rates of gram-positive bacteria to penicillin, oxacillin and vancomycin were 83.3 percent, 48.5 percent and 0.5 percent, respectively, and those of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin and amikacin were 24.1 percent, 17.2 percent, 6.6 percent, 21.6 percent, and 14.2 percent, respectively. Gram-negative bacteremias were more often associated with intensive care than gram-positive bacteremias (26.5 percent vs. 10.3 percent, P=0.016), and patients with catheters were more often associated with intensive care (34.4 percent vs. 10.8 percent, P<0.001) and higher fatality rate (16.7 percent vs. 4.8 percent, P=0.012) than those without. Conclusion : This study revealed that gram-negative bacteria are still a dominant organism in bloodstream infections, especially in neutropenic patients, and confirmed that gram-positive bacteria are emerging as important etiological agents in bloodstream infections of pediatric hemato-oncologic patients.

Prevalence and Risk Factors of Candida Sepsis in Neonatal Intensive Care Unit (신생아 중환자실에서 캔디다 패혈증의 발생 추이와 위험 인자)

  • Choi, Ic Sun;Lim, Suk Hwan;Cho, Chang Yee;Choi, Young Youn;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.836-846
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    • 2002
  • Purpose : With the development of neonatal intensive care and the increased use of systemic antibiotics, candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The purpose of this study was to investigate the prevalence rate and its associated risk factors. Methods : We retrospectively reviewed medical records of 28 cases with candida sepsis who were admitted in the neonatal intensive care unit(NICU) of Chonnam University Hospital from July 1995 to June 2001. Twenty-nine patients without candida sepsis were enrolled for the control group to verify the risk factors. Results : The overall incidence of candida sepsis was 0.61% for all NICU admissions and 3.68% for all very low birth weight infants with the gradual increase of the annual prevalance rate over time. The endotracheal intubation, percutaneous central vein catheter(PCVC), umbilical vein catheter, total parenteral nutrition, intralipid and dopamine were more applied than the control group (P<0.01 for all). The durations of mechanical ventilator care, central catheter appliance, nothing per os, and admission were also significantly longer than the control group(P<0.01 for all). Ampicillin/ sulbactam, ceftazidime, amikacin, netilmicin, teicoplanin and imipenem/cilastatin were significantly more used than the control group(P<0.05). The durations of ampicillin/sulbactam, ceftazidime, netilmicin and imipenem/cilastatin administration were also proved to be significant as the risk factors(P<0.01). Conclusion : The average annual prevalence rate of candida sepsis in NICU for six years was 0.61% with gradual increasing tendency over time. The elimination of the above risk factors is important in decreasing neonatal morbidity and mortality associated with candida sepsis.

Treatment and Prognosis according to Causative Organisms in Neonatal Bacterial Meningitis (신생아 세균성 뇌막염의 원인균에 따른 치료와 예후)

  • Kim, Dong Joon;Lee, Gwang Hoon;Lee, Hyung Won;Kim, Gil Hyun;Lee, Hak Soo
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.79-89
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    • 1997
  • Purpose : Neonatal bacterial meningitis is the disease which clinical manifestations are nonspecific and several neurologic complications may occur. We studied neonatal bacterial meningitis, particularly in treatment and prognosis according to causative organisms -gram positive and gram negative bacteria- to assist in treatment of neonatal bacterial meningitis. Methods : We analysed twenty-four cases retrospectively who had been admitted in NICU or pediatric ward in Chung-ang Gil hospital from Jan. 1991 to Jun. 1996, and who had proven causative organisms in culture or latex agglutination[n test in CSF. Results : 1) The ratio of male to female was 2.4: 1. The mean birth weight and gestational age in cases with gram positive bacterial meningitis were $2.91{\pm}0.79kg$ and $38.4{\pm}2.74$ weeks and those in cases with yam negative bacterial meningitis were $3.30{\pm}0.90kg$ and $37.7{\pm}3.33$weeks respectively. There was no significant difference between the two groups. 2) The perinatal predisposing factors were pematurity, mecoinium staining amnionic fluid, matemal diabetes and pregnancy-induced hypertension, etc. The clinical manifestations Were fever, seizure, poor oral intake and fontanel bulging, etc. There were eleven cases with early onset bacterial meningitis(four cases by gram positive bacteria, seven cases by gram negative bacteria), and thirteen cases with late onset bacterial meningitis(seven cases by gram positive bacteria, six cases by gram negative bacteria). There was no significant difference between the two groups in terms of onset. 3) There were eleven cases with yam positive bacterial meningitis and they were coagulase-negative staphylococci(three cases), group B streptococci(three cases), Staphylococcus aureus(two cases), Streptococcus viridans(two cases), and enterococci(one case). And there were thirteen cases with gram negative bacterial menir gitis and they were Escherichia coli(seven cases), Klevsiella pneumoniae(three cases), Pseudomonas aeruginosa(one case), Acinetobactor(one case) and Enterobacter(one case). 4) The initial CSF WBC counts in cases with yam negative bacterial meningitis were significantly higher than those in cases with gram positive bacterial meningitis but the CSF protein and glucose levels were no significant difference in the two groups statistically. 5) The number of cases with abnormal findings in brain ultrasonography was seven in gram positive bacterial meningitis and ten in gram negative bacterial meningitis. 6) There were relatively high sensitivity to penicillin derivatives, the first generation cephalosporin and vancomycin in gram positive bacteria and to the third generation cephalosporin and amikacin in gram negative bacteria. 7) The mortality rate was 20.8%(5 cases were expired or discharged hopelessly). There was no significant difference between the two groups in prognosis. Conclusions : We recommend active treatment in noenatal bacterial meningitis to improve prognosis because the prognosis is poor.

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Etiological Agents in Bacteremia of Children with Hemato-oncologic Diseases (2006-2010): A Single Center Study (최근 5년(2006-2010)간 소아 혈액 종양 환자에서 발생한 균혈증의 원인균 및 임상 양상: 단일기관 연구)

  • Kang, Ji Eun;Seok, Joon Young;Yun, Ki Wook;Kang, Hyoung Jin;Choi, Eun Hwa;Park, Kyung Duk;Shin, Hee Young;Lee, Hoan Jong;Ahn, Hyo Seop
    • Pediatric Infection and Vaccine
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    • v.19 no.3
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    • pp.131-140
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    • 2012
  • Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : A 5-year retrospective study of pediatric hemato-oncologic patients with bacteremia in Seoul National University Children's Hospital, from 2006 to 2010 was conducted. Results : A total of 246 pathogens were isolated, of which 63.4% (n=156) were gram-negative, bacteria 34.6% (n=85) were gram-positive bacteria, and 2.0% (n=5) were fungi. The most common pathogens were Klebsiella spp. (n=61, 24.8%) followed by Escherichia coli (n=31, 12.6%), coagulase-negative staphylococci (n=23, 9.3%), and Staphylococcus aureus (n=22, 8.9 %). Resistance rates of gram-positive bacteria to penicillin, oxacillin, and vancomycin were 85.7%, 65.9%, and 9.5%, respectively. Resistance rates of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin were 37.2%, 17.1%, 6.2%, 32.2%, and 13.7%, respectively. Overall fatality rate was 12.7%. Gram-negative bacteremia was more often associated with shock (48.4% vs. 11.9%, P<0.01) and had higher fatality rate than gram-positive bacteremia (12.1% vs. 3.0%, P=0.03). Neutropenic patients were more often associated with shock than non-neutropenic patients (39.6 % vs. 22.0%, P=0.04). Conclusion : This study revealed that gram-negative bacteria were still dominant organisms of bloodstream infections in children with hemato-oncologic diseases, and patients with gram-negative bacteremia showed fatal course more frequently than those with gram-positive bacteremia.

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