Five-year analysis of isolated pathogens and antibiotic resistance of ocular infections from two large tertiary comprehensive hospitals in east China

AIM:To analyze the spectrum of isolated pathogens and antibiotic resistance for ocular infections within 5y at two tertiary hospitals in east China.METHODS:Ocular specimen data were collected from January 2019 to October 2023.The pathogen spectrum and positive culture rate for different infection location,such as keratitis,endophthalmitis,and periocular infections,along with antibiotic resistance were analyzed.RESULTS:We included 2727 specimens,including 827(30.33%)positive cultures.A total of 871 strains were isolated,530(60.85%)bacterial and 341(39.15%)fungal strains were isolated.Gram-positive cocci(GPC)were the most common ocular pathogens.The most common bacterial isolates were Staphylococcus epidermidis(25.03%),Staphylococcus aureus(7.46%),Streptococcus pneumoniae(4.59%),Corynebacterium macginleyi(3.44%),and Pseudomonas aeruginosa(3.33%).The most common fungal genera were Fusarium spp.(12.74%),Aspergillus spp.(6.54%),and Scedosporium spp.(5.74%).Staphylococcus epidermidis strains showed more than 50%resistance to fluoroquinolones.Streptococcus pneumoniae and Corynebacterium macginleyi showed more than 90%resistance to erythromycin.The percentage of bacteria showing multidrug resistance(MDR)significantly decreased(χ^(2)=17.44,P=0.002).CONCLUSION:GPC are the most common ocular pathogens.Corynebacterium macginleyi,as the fourth common bacterium,may currently be the local microbiological feature of east China.Fusarium spp.is the most common fungus.More than 50%of the GPC are resistant to fluoroquinolones,penicillins,and macrolides.However,the proportion of MDR strains has been reduced over time.

Nature’s Pharmacy under Siege: Investigating Antibiotic Resistance Pattern in Endophytic Bacteria of Medicinal Plants

Antibiotic resistance poses a significant global health threat, necessitating a thorough understanding of its prevalence in various ecological contexts. Medicinal plants, renowned for their therapeutic properties, host endophytic bacteria that produce bioactive compounds. Understanding antibiotic resistance dynamics in these bacteria is vital for human health and antibiotic efficacy preservation. In this study, we investigated antibiotic resistance profiles in endophytic bacteria from five medicinal plants: Thankuni, Neem, Aparajita, Joba, and Snake plant. We isolated and characterized 113 endophytic bacteria, with varying resistance patterns observed against multiple antibiotics. Notably, 53 strains were multidrug-resistant (MDR), with 14 exhibiting extensive drug resistance (XDR). Thankuni-associated bacteria displayed 44% MDR and 11% XDR, while Neem-associated bacteria showed higher resistance (60% MDR, 13% XDR). Aparajita-associated bacteria had lower resistance (22% MDR, 6% XDR), whereas Joba-associated bacteria exhibited substantial resistance (54% MDR, 14% XDR). Snake plant-associated bacteria showed 7% MDR and 4% XDR. Genus-specific distribution revealed Bacillus (47%), Staphylococcus (21%), and Klebsiella (11%) as major contributors to MDR. Our findings highlight diverse drug resistance patterns among plant-associated bacteria and underscore the complexity of antibiotic resistance dynamics in diverse plant environments. Identification of XDR strains emphasizes the severity of the antibiotic resistance problem, warranting further investigation into contributing factors.

UV-Based Advanced Oxidation Processes for Antibiotic Resistance Control: Efficiency, Influencing Factors, and Energy Consumption

Antibiotic resistant bacteria(ARB)with antibiotic resistance genes(ARGs)can reduce or eliminate the effectiveness of antibiotics and thus threaten human health.The United Nations Environment Programme considers antibiotic resistance the first of six emerging issues of concern.Advanced oxidation processes(AOPs)that combine ultraviolet(UV)irradiation and chemical oxidation(primarily chlorine,hydrogen peroxide,and persulfate)have attracted increasing interest as advanced water and wastewater treatment technologies.These integrated technologies have been reported to significantly elevate the efficiencies of ARB inactivation and ARG degradation compared with direct UV irradiation or chemical oxidation alone due to the generation of multiple reactive species.In this study,the performance and underlying mechanisms of UV/chlorine,UV/hydrogen peroxide,and UV/persulfate processes for controlling ARB and ARGs were reviewed based on recent studies.Factors affecting the process-specific efficiency in controlling ARB and ARGs were discussed,including biotic factors,oxidant dose,UV fluence,pH,and water matrix properties.In addition,the cost-effectiveness of the UV-based AOPs was evaluated using the concept of electrical energy per order.The UV/chlorine process exhibited a higher efficiency with lower energy consumption than other UV-based AOPs in the wastewater matrix,indicating its potential for ARB inactivation and ARG degradation in wastewater treatment.Further studies are required to address the trade-off between toxic byproduct formation and the energy efficiency of the UV/chlorine process in real wastewater to facilitate its optimization and application in the control of ARB and ARGs.

Mobile genetic elements facilitate the transmission of antibiotic resistance genes in multidrug-resistant Enterobacteriaceae from duck farms

Multidrug-resistant(MDR)Enterobacteriaceae critically threaten duck farming and public health.The phenotypes,genotypes,and associated mobile genetic elements(MGEs)of MDR Enterobacteriaceae isolated from 6 duck farms in Zhejiang Province,China,were investigated.A total of 215 isolates were identified as Escherichia coli(64.65%),Klebsiella pneumoniae(12.09%),Proteus mirabilis(10.23%),Salmonella(8.84%),and Enterobacter cloacae(4.19%).Meanwhile,all isolates were resistant to at least two antibiotics.Most isolates carried tet(A)(85.12%),blaTEM(78.60%)and sul1(67.44%)resistance genes.Gene co-occurrence analysis showed that the resistance genes were associated with IS26 and integrons.A conjugative IncFII plasmid pSDM004 containing all the above MGEs was detected in Proteus mirabilis isolate SDM004.This isolate was resistant to 18 antibiotics and carried the blaNDM-5 gene.MGEs,especially plasmids,are the primary antibiotic resistance gene transmission route in duck farms.These findings provide a theoretical basis for the rational use of antibiotics in farms which are substantial for evaluating public health and food safety.

Resistance Profile of Urogenital Mycoplasmas to Antibiotics: Comparative Study between the Mycoplasma IST2 and Mycoplasma IST3

Acquired resistance of mycoplasmas to antibiotics constitutes a major health problem in the world in general and in Africa in particular. Despite the diversity of kits marketed, several of them evaluating the sensitivity of mycoplasmas to antibiotics continue to present resistance, in this case, the Mycoplasma IST2. In order to overcome this resistance, a new kit (Mycoplasma IST3) has been developed in accordance with the new Clinical and Laboratory Standard Institute (CLSI) recommendations. The objective of the study was to determine the resistance profile of urogenital Mycoplasmas to antibiotics using this new kit and to highlight cases of co-infections in comparison with the Mycoplasma IST2. Over a period of four mo nths, one hundred and one (101) samples of urogenital secretions were collected (from sexually active men and women) and analyzed. Culture and antibiotic susceptibility testing were performed in a liquid medium using the Mycoplasma IST2 and Mycoplasma IST3 Tests according to the manufacturer’s recommendations. Among the different samples analyzed, we noted a mycoplasma positivity rate of 71.29% with a predominance of infection in women, i.e. 86.12% compared to men 13.88%. Ureaplasma spp was the most encountered germ with a rate of 62.50% followed by cases of co-infections at 33.33% (Uspp/Mh) and the least encountered was Mycoplasma hominis with a rate of 2.79%. We analyzed 25 samples, among which we had 4 co-infections, simultaneously using the two kits in the same patients. The distribution of cases between the two kits was equivalent. We noted a significant rate of resistance to erythromycin 100% using Mycoplasma IST2. However, no resistance was observed in erythromycin with Mycoplasma IST3. Mycoplasma IST2 also showed resistance to fluoroquinolones, which was not the case for Mycoplasma IST3 which did not show any resistance to fluoroquinolones. Both kits showed resistance to tetracycline. The antibiotic sensitivity test using the Mycoplasma IST3 revealed a high rate of resistance to tetracycline, i.e. 57.14% and 91.67% for Ureaplasma spp and Mycoplasma hominis respectively. Resistance rates to other antibiotics were less than 25%. This study was able to demonstrate that Mycoplasma IST3 constitutes a better therapeutic choice compared to its predecessor Mycoplasma IST2, because it eliminated the biggest shortcoming of its predecessor.

Urinary Tract Infection in Pediatric Emergency Department of Mohamed VI Hospital in Marrakech: Epidemiological Profile and Antibiotic Resistance

Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University Hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.

Exploring the impact of rotavirus vaccination on antibiotic prescription and resistance:A comprehensive systematic review

BACKGROUND Rotavirus is a highly contagious virus responsible for a significant burden of acute gastroenteritis,particularly among infants and young children worldwide,however,vaccination against this viral agent is available.Several studies have hypothesized that rotavirus vaccination has been linked to lower rates of antibiotic resistance.AIM To assess the relationship between rotavirus vaccination and antibiotic resistance.METHODS The present systematic review was tailored based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Several electronic databases(PubMed/MEDLINE,Scopus and Web of Science)were searched independently by two investigators in order to retrieve relevant publications published until April 2023 that investigated the aforementioned research question.RESULTS The comprehensive database search identified a total of 91 records.After the duplicates were removed(n=75),we screened the titles and abstracts of 16 potentially eligible publications.After the irrelevant records were excluded(n=5),we screened the full texts of 11 manuscripts.Finally,5 studies were entered into the qualitative and quantitative analysis.CONCLUSION In conclusion,all the studies support the idea that vaccinations can reduce the need for antibiotic prescriptions which could potentially contribute to mitigating antibiotic resistance.However,to fully comprehend the mechanisms of antibiotic resistance,enhance treatment guidelines,and consider diverse demographic situations,further research is necessary to use evidence-based strategies to fight antibiotic misuse and resistance.

Beta-lactam antibiotic resistance among Escherichia coli isolates from patients with urinary tract infections in Vietnam:A systematic review and meta-analysis

Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.

Salmonella enterica and Escherichia coli Cohabitation among Factors Increasing Antibiotic Resistance in Bukavu City, Democratic Republic of the Congo

Food- and water-borne diseases exacerbate cases of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Since 2011, cases of enteric infections have been reported in Bukavu city, Democratic Republic of the Congo. The objectives of this study were to evaluate the rate of AMR and multidrug resistance (MDR) of Salmonella enterica and Escherichia coli, and to determine the effect of S. enterica and E. coli cohabitation on antibiotic resistance of S. enterica. Bacteria were isolated from 553 foods, milk, and water samples collected from restaurants, taps, tanks and wells in Bukavu. Microbial analyses involved bacterial culture, and morphological and biochemical characterization. Antibiotic susceptibility tests were performed before and after bacteria cohabitation of S. enterica and E. coli isolates in the same media. 152 (27.5%) and 27 (4.9%) of the samples tested positive for S. enterica and E. coli, respectively. Salmonella isolates were more susceptible to ciprofloxacin (75.7%) and co-trimoxazole (75.0%) and more resistant to ampicillin (82.2%). E. coli was more resistant to ciprofloxacin (59.3%). Overall, 90.5% of isolates (n = 179) were MDR. The origin (food, water) of S. enterica and E. coli isolates had no significant (p > 0.05) influence on their susceptibility to antibiotics. However, S. enterica isolates from milk were significantly (p = 0.00) antibiotic-resistant than those from food and water. The cohabitation between antibiotic-susceptible S. enterica and antibiotic-resistant E. coli significantly (p S. enterica from 30% to 89.5%, implying that interactions of antibiotic-resistant and antibiotic-susceptible bacteria in food and water could be among neglected factors promoting the spread of AMR, leading to increase AMR cases in Bukavu. Strong sanitation strategies and the operationalization of One Health approach could mitigate the spread of AMR in Bukavu city, DR Congo.

Beyond the desert sands:decoding the relationship between camels,gut microbiota,and antibiotic resistance through metagenomics

Background:Camels,known as the enduring“ships of the desert,”host a complex gut microbiota that plays a crucial role in their survival in extreme environments.However,amidst the fascinating discoveries about the camel gut microbiota,concerns about antibiotic resistance have emerged as a significant global challenge affecting both human and animal populations.Indeed,the continued use of antibiotics in veterinary medicine has led to the widespread emergence of antibiotic-resistant bacteria,which has worsened through gene transfer.Methods:This study offers a deeper examination of this pressing issue by harnessing the potent tools of metagenomics to explore the intricate interplay between the camel(Camelus ferus)gut microbiota and antibiotic resistance.Results:Samples from wild camels yielded varying amounts of raw and clean data,generating scaftigs and open reading frames.The camel fecal microbiome was dominated by bacteria(mainly Bacillota and Bacteriodota),followed by viruses,archaea,and eukaryota.The most abundant genera were the Bacteroides,Ruminococcus,and Clostridium.Functional annotation revealed enriched pathways in metabolism,genetic information processing,and cellular processes,with key pathways involving carbohydrate transport and metabolism,replication,and amino acid transport.CAZy database analysis showed high abundances of glycoside hydrolases and glycosyl transferases.Antibiotic resistance gene(ARG)analysis identified Bacillota and Bacteroidota as the main reservoirs,with vancomycin resistance genes being the most prevalent.This study identified three major resistance mechanisms:antibiotic target alteration,antibiotic target protection,and antibiotic efflux.Conclusion:These findings contribute to a broader understanding of antibiotic resistance within animal microbiomes and provide a foundation for further investigations of strategies to manage and mitigate antibiotic resistance.

Low-Level Antibiotic Resistance among Staphylococcus aureus and Gram-Negative Pathogens from Infected Skin and Soft Tissues in Rural Kenya

Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.

Tangled web: Animal-human interaction and the rise of antibiotic resistance

Introduction Egypt is a Low-Middle Income Country(LMIC)with a population of 106,472,382 people in August 2022(Worldometers&Department of Economic and Social Affairs,2022).Available evidence suggests that there are misuse/overuse of antibiotic in Egypt[1].On recognizing the global threat of antibiotic resistance(AMR),Egypt launched the National Action Plan(NAP)in 2018.This comprehensive plan,inspired by the Global Action Plan(GAP),united diverse stakeholders like ministries,universities,and international organizations.The NAP tackled AMR through four key strategies:boosting public understanding of antibiotics,optimizing their use across humans and animals,embracing a“One Health”approach,and implementing effective infection prevention practices[2].

Enhancing Accumulation and Penetration Efficiency of Next-Generation Antibiotics to Mitigate Antibiotic Resistance in Pseudomonas aeruginosa PAO1

This study explores the efficacy of advanced antibiotic compounds against P. aeruginosa, focusing on Antibiotic B, an enhanced derivative of Ceftriaxone. The study measured the intracellular uptake of Antibiotic B and introduced a novel adjuvant, Influximax, which augmented its antibacterial activity. Results showed a diminished potential for resistance emergence with Antibiotic B, particularly when used in combination with Influximax. The study suggests that optimizing antibiotic delivery into bacterial cells and leveraging syner-gistic adjuvant combinations can enhance drug resistance combat. .

Breath and string test: A diagnostic package for the identification of treatment failure and antibiotic resistance of Helicobacter pylori without the necessity of upper gastrointestinal endoscopy

AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13C-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of H pylori. METHODS: The UBT was routinely performed 4 to 6 wk after H pylori eradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed. Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under micro-aerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture. RESULTS: H pylori was successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. H py/oriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%). CONCLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of H pylori with little inconvenience to the patient. Upper Gl-endoscopy can be avoided in several cases by applying consequently this diagnostic package.

Screening for Streptomyces Hygroscopicus Strains with High Production of Agricultural Antibiotics by Streptomycin Resistance

[Objective] The research aimed to screen Streptomyces hygroscopicus strains with high production of agricultural antibiotics. [ Method] A strain of S. hygroscopicus was screened from the soil of Hainan Island. After natural screening and consecutive ultraviolet induced mutation twice, S6-7 strain was obtained as the original strain then treated by UV irradiation and streptomycin resistance screening, and finally rescreened through shake-flask fermentation. [Result] 7 better strains were selected by primary screening from 62 single colonies which were picked out randomly. After 3 generations of consecutive cultivation on slant media and rescreening, 5 strains presented obvious forward mutation. The forward mutation rate reached 8.06%, and the largest production increasing rate came up to 25.11%. [Conclusion] By combining streptomycin resistance screening and conventional ultraviolet induced mutation, both the antibiotic-producing capacity and forward mutation screening efficiency of the original strain were greatly enhanced.

Phage therapy: An alternative to antibiotics in the age of multi-drug resistance

The practice of phage therapy, which uses bacterial viruses(phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnological advances have further expanded the repertoire of potential phage therapeutics to include novel strategies using bioengineered phages and purified phage lytic proteins. Current research on the use of phages and their lytic proteins against multidrug-resistant bacterial infections, suggests phage therapy has the potential to be used as either an alternative or a supplement to antibiotic treatments. Antibacterial therapies, whether phage-or antibiotic-based, each have relative advantages and disadvantages; accordingly, many considerations must be taken into account when designing novel therapeutic approaches for preventing and treating bacterial infection. Although much about phages and human health is still being discovered, the time to take phage therapy serious again seems to be rapidly approaching.

Selection of appropriate analytical tools to determine the potency and bioactivity of antibiotics and antibiotic resistance

Antibiotics are the chemotherapeutic agents that kill or inhibit the pathogenic microorganisms.Resistance of microorganism to antibiotics is a growing problem around the world due to indiscriminate and irrational use of antibiotics.In order to overcome the resistance problem and to safely use antibiotics,the correct measurement of potency and bioactivity of antibiotics is essential.Microbiological assay and high performance liquid chromatography（HPLC） method are used to quantify the potency of antibiotics.HPLC method is commonly used for the quantification of potency of antibiotics,but unable to determine the bioactivity;whereas microbiological assay estimates both potency and bioactivity of antibiotics.Additionally,bioassay is used to estimate the effective dose against antibiotic resistant microbes.Simultaneously,microbiological assay addresses the several parameters such as minimal inhibitory concentration（MIC）,minimum bactericidal concentration（MBC）,mutation prevention concentration（MPC） and critical concentration（Ccr） which are used to describe the potency in a more informative way.Microbiological assay is a simple,sensitive,precise and cost effective method which gives reproducible results similar to HPLC.However,the HPLC cannot be a complete substitute for microbiological assay and both methods have their own significance to obtain more realistic and precise results.

Gonorrhoea among Sex Workers in China: Prevalence, Risk Factors, and Resistance to Antibiotics

Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were recruited into a sexually transmitted diseases (STD) care and prevention programme through various outreach activities. Data collection was standardized. Cervical samples were tested for the presence of Neisseria (N.) gonorrhoea by culture. The agar dilution method was performed to determine susceptibilities of 85 isolates to penicillin, ciprofloxacin, spectinomycin and ceftriaxone. The production of B-lactamase was determined by paper acidometric testing. Results The prevalence of gonorrhoea was 9%. Independent predictors for the disease were inconsistent condom use, lack of regular salary, absence of a previous STD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamydial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent discharge at genital examination were also independently associated with gonorrhoea. Of the 85 N. gonorrhoea isolates, 3.5% was penicillinase producing (PPNG) and 7% plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% was insensitive to penicillin, while 52% and 47% were resistant or less susceptible to ciprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriaxone. All strains were susceptible to spectinomycin. Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, but strains were sensitive to ceftriaxone and spectinomycin. Several personal or medical characteristics were independently associated with the presence of gonorrhoea. Women diagnosed with gonorrhoea should receive concurrent treatment for chlamydial infection.

Is the Potential Interconnection between Antibiotic Susceptibility and Disinfectant Resistance a Threat to Food Safety?

The prevalence of antibiotic susceptibility and disinfectant resistance in bacterial pathogens causes a serious problem not only to food safety but also to public health, which directly or indirectly leads to treatment and disinfection failures. In this review, multidrug resistance, the mechanism of disinfectant resistance, the methods for detecting disinfectant resistance and the cross-resistance between an- tibiotics and disinfectants are summarized. More efforts should be devoted to explor- ing the professional guidance of using antibiotics and disinfectants, and to develop- ing the comprehensive detection with genetic and molecular methods is highly ex- pected.

Extended role for insertion sequence elements in the antibiotic resistance of Bacteroides

The Bacteroides species are important micro-organisms, both in the normal physiology of the intestines and as frequent opportunistic anaerobic pathogens, with a deeply-rooted phylogenetic origin endowing them with some interesting biological features. Their prevalence in anaerobic clinical specimens is around 60%-80%, and they display the most numerous and highest rates of antibiotic resistance among all pathogenic anaerobes. In these antibiotic resistance mechanisms there is a noteworthy role for the insertion sequence(IS) elements, which are usually regarded as representatives of ‘selfish' genes; the IS elements of Bacteroides are usually capable of up-regulating the antibiotic resistance genes. These include the cep A(penicillin and cephalosporin), cfx A(cephamycin), cfi A(carbapenem), nim(metronidazole) and erm F(clindamycin) resistance genes. This is achieved by outwardoriented promoter sequences on the ISs. Although some representatives are well characterized, e.g., the resistance gene-IS element pairs in certain resistant strains, open questions remain in this field concerning a better understanding of the molecular biology of theantibiotic resistance mechanisms of Bacteroides, which will have clinical implications.