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Antibiotic resistance (ABR) has now become a major global public health issue. New legislation has recently been introduced in Northern Ireland from April 2017, requiring domestic households to recycle all domestic food waste items. Resulting increases in the volume of such waste which is collected by the local council has driven technologies for the safe recycling of such material including commercial composting. Little is known about the antimicrobial resistance (AMR) profile of such composted food waste materials and hence the purpose of this paper is to characterise total AMR in bacteria isolated from such composted domestic food waste and to consider the potential public health consequences of such material.

Finished compost containing food waste material was obtained in the Spring 2017 from a local authority recycling amenity site, which freely distributes such material to the public. Total culturable populations of bacteria were isolated from the composted material and antibiotic susceptibility to six classes of antibiotics, namely florfenicol, fluoroquinolone, aminoglycoside, lincosamide, tetracycline and β-lactam was examined.

ABR was greatest for lincomycin > tobramycin > minocycline/amoxycillin > ciprofloxacin > florfenicol. In this study, there was one compost, which showed complete resistance to all antibiotics tested. No compost displayed complete antibiotic sensitivity. Two composts were considered pan-resistant, whilst four were considered multi-resistant.

This study showed that the total ABR profile of food waste compost is significant, with bacterial populations within the compost having ABR to several classes of antibiotics, which are important and sometimes critical to human health. The application of such materials to enrich and fertilise garden soils in significant volumes inadvertently allows for the artifical and man-made transfer of AMR bacteria and their genes to new environments, which have been hitherto niave to the presence of such AMR properties. The application of such compost horticulturally to enrich soils used to cultivate flowers, fruits and vegetables may have important consequences for human and animal health. Urgent work is now needed to quantify the fate of such antibiotic resistant bacteria from compost to their new environment and risk assessments made to estimate the carriage through to human health.

Broad-spectrum cephalosporin resistance is rapidly increasing in Escherichia coli, representing a food safety problem. The purpose of this paper is to characterize eight extended-spectrum-ß-lactamase (ESBL) and acquired AmpC ß-lactamase-producing E. coli isolates and virotypes associated, obtained from chicken and pork food samples in Puebla, Mexico.

Samples (36 from chicken and 10 from pork) were cultured on Levine agar plates supplemented with cefotaxime (2 mg/L) for isolation of cefotaxime-resistant (CTXR) E. coli. CTXR-E. coli isolates were detected in 33 of 46 samples (72 percent), and one isolate/sample was characterized (28 from chicken and 5 from pork), for ESBL production, phylogenetic group, sequence typing, resistance and virulence genes by PCR and sequencing.

Results showed 16 ESBL-E. coli (35 percent) (12/16 belonging to phylogroup B1) and 8 CMY-2-E. coli (17 percent). ESBL detected were as follows (number of isolates): CTX-M-2 (8); CTX-M-1 (2); CTX-M-15 (1); SHV-2a (4) and TEM-52c (1). In total, 20 different sequence types (STs) were identified among the ESBL- or CMY-2-producing E. coli strains, which included four new ones. The CTX-M-15 β-lactamase was detected in one E. coli ST617-ST10 Cplx-B1 strain that also carried ibeA gene. One CMY-2-positive strain of lineage ST224-B2 was detected and it carried the qnrA1 gene.

In this study, a ST131-based virotyping scheme for strains from food of animal origin was established since this kind of strains constitutes an important vehicle of virulent ESBL- and CMY-2-producing E. coli isolates, which could be transmitted to humans by direct contact or through the food chain.

The purpose of this paper is to evaluate the frequency and antimicrobial susceptibility pattern of pathogens present in ready-to-eat salads available at a local market.

A 100 salad samples were collected aseptically. Each sample (25 g) was homogenized in 225 ml of sterile peptone water and was serially diluted up to 1×106. Dilutions were inoculated on nutrient agar by surface spread plate technique. Aerobic colony count (ACC) was estimated by counting the colonies. Bacterial isolates were cultured on blood and MacConkey agar and identified on the basis of their morphology, culture characteristics and confirmed by API 20E and 20NE. Antimicrobial susceptibility was determined as per CLSI 2014.

ACC range was 1.1×103 cfu/g to 5.8×109 cfu/g. Among these the highest ACC was found in channa chat (4.9×104 to 5.8×109 cfu/g). A total of 127 microorganisms were identified; 73 were gram negative rods (GNRs) and 24 were gram positive cocci (GPC). Among GNRs; Klebsiella spp. (n=18) was the predominant whereas among GPC, Staphylococcus aureus (n=6) were the chief pathogen. Klebsiella spp. showed 100 percent resistance to ampicillin, 89-78 percent to amoxicillin/clavulanic acid and 33 percent to imipenem, however, Enterobacter spp. were resistant to ampicillin (100 percent) amoxicillin/clavulanic acid (77 percent) and imipenem (23 percent). Staphylococcus aureus showed resistance to co-amoxiclav (83 percent) and penicillin (75 percent).

This study revealed that effective control measures must been implemented and respected by throughout the entire food chain and better surveillance studies should be performed at national level to reduce the spread of bacteria by fresh salads.

This paper explore the high prevalence of multidrug-resistant pathogens in different salads and most of the salads were found to be unhygienic for consumption.

The objective of this study was to determine Salmonella prevalence, antimicrobial-resistant phenotypes, and their genetic relatedness in frozen organic chicken collected at retail level in Turkey.

Retail packs (n = 348) of cut-up chicken parts (breast, leg quarter and drumstick) and whole chicken carcasses were purchased from a central hypermarket in Diyarbakir (Southeast Anatolia Region in Turkey) and from a large online retailer in Turkey. The retail packs were paired by part type, brand, production date, and sell-by date. The chicken samples were analyzed for the presence of Salmonella spp., and then isolates were screened for antibiotic susceptibility, class I integron, and genetic similarity.

Salmonella prevalence in retail frozen organic chicken samples was 6.3 percent; however, the prevalence by parts, leg quarter, drumstick, breast, and whole chicken was 2.1 percent, 10.4 percent, 10.4 percent, and 0 percent, respectively. Salmonella prevalence was significantly higher in samples obtained from the hypermarket (9.2 percent) compared to online retailer (3.8 percent). All the isolates were serotype Infantis, genetically similar (highly clonal), and 68.2 percent harbored class I integron. All isolates were resistant to ciprofloxacin (drug of choice to treat salmonellosis in human), and 86.3 percent of the isolates were multidrug-resistant.

Salmonella prevalence in organic chicken meat, regardless of the retail market source in Turkey, may pose a health risk to consumers especially with the high prevalence of multi-drug resistant phenotypes. Findings inform researchers and the public about the safety of organically produced chicken and the potential health risk to consumers.

The purpose of this paper is to assess the occurrence of the extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamase genes in 144 Escherichia coli isolates recovered from 160 vegetable salad samples.

Among the 144 E. coli isolates recovered from 160 vegetable salads, 17 (12 percent) ceftazidime-resistant isolates were screened for ESBL production with the double disk-diffusion test. The ESBL-producing isolates were characterized for antimicrobial resistance, the presence of virulence genes and plasmid-mediated quinolone resistance (PMQR) determinants. The isolates were also subjected to phylogenetic group typing. The existence of plasmid AmpC genes and mutations in the regulatory region of the chromosomal AmpC gene was assessed using polymerase chain reaction (PCR) and sequencing. All β-lactamase isolates were further characterized by pulsed-field gel electrophoresis to determine the genetic relatedness.

Overall, 17 (12 percent) of the 144 E. coli isolates studied were ceftazidime resistant. Among the 17 isolates, 13 (77 percent) were multidrug resistant and four (23.5 percent) were ESBL producers. The bla CTX-M14 was the only gene detected. Of the 12 AmpC-producing isolates, three (18 percent) harbored plasmid-encoded AmpC and sequencing analysis of the chromosomal AmpC genes revealed mutations in the promoter/attenuator region. PMQR determinants were detected in 9 (52 percent) isolates. A was the most prevalent phylogenetic group (56 percent), followed by groups B1 (31 percent), D (6 percent), and B2 (6 percent). PCR showed that six (50 percent) ESBL/AmpC-producing E. coli isolates carried one and/or two virulence genes. Pulsed-field gel electrophoresis showed no epidemiological relationship between these isolates.

This study places vegetable salads within the spectrum of ecological niches that may be vehicles for antibiotic-resistant bacteria/genes with clinical interest and these findings are worthy of attention as their spread to humans by ingestion cannot be dismissed.

The purpose of this paper is to provide an overview of the context for strategies to overcome antimicrobial resistance in Australia, which may provide valuable learnings for other jurisdictions.

Non-systematic review of literature from websites of national, state and territory health departments and interviews with key stakeholders for Australian strategies to reduce antimicrobial resistance.

In July 2015 all states and territories in Australia adopted the National Antimicrobial Resistance Strategy 2015-2019, which is built on the World Health Organization policy package to combat antimicrobial resistance. This strategy represents “the collective, expert views of stakeholders on how best to combat antimicrobial resistance in Australia. It will also support global and regional efforts, recognising that no single country can manage the threat of antimicrobial resistance alone”. It combines quantitative and qualitative monitoring strategies with frameworks and guidelines to improve management of the use of antimicrobial resistant drugs. Prior to this, health services and states developed and implemented initiatives aimed at monitoring and improving prescribing practices. Development of the national strategy has encouraged and fostered debate within the Australian health system and a raft of new policy initiatives.

Surveillance strategies are in place to monitor impact and trends at jurisdictional and sector levels. However, actual impact on antimicrobial resistance and prescribing practices remains to be seen as existing initiatives are expanded and new initiatives implemented.

This overview of key Australian initiatives balancing quantitative and qualitative surveillance, accreditation, research, education, community awareness and price signals on antibiotic prescribing practices may be valuable to health systems in developing local strategies.

The authors provide an up to date overview of the context, strategies and aims of antimicrobial stewardship in Australia.

Staphylococcus aureus (S. aureus), Klebsiella pneumoniae (K. pneumoniae) and Streptococcus pneumoniae (S. pneumoniae) are among the pathogens detected during Hajj pilgrimage known to cause pneumonia. This study aims to evaluate the antibacterial activity of activated carbon cloth (ACC) with Ag⁺ impregnated with zinc oxide nanoparticles (ZnO NPs) against these pathogens.

ZnO NPs were impregnated into ACC-Ag⁺ via layer-by-layer (LbL) self-assembly. Scanning electron microscope (SEM) was used to observe the fine surface morphological details of the ACC-Ag⁺-ZnO sheets. Antibacterial activity of the ACC-Ag⁺-ZnO sheets was evaluated using the disk-diffusion susceptibility assay. Allergy patch test was done to evaluate allergic reactions of the ACC-Ag⁺-ZnO sheets on human skin.

SEM micrographs showed successful impregnation of ZnO NPs into the ACC-Ag⁺ sheets. Disk-diffusion susceptibility assay results of ACC-Ag⁺-ZnO sheets against S. aureus, K. pneumoniae and S. pneumoniae showed good antibacterial activity; with 1.82 ± 0.13 mm zone of inhibition for S. pneumoniae, at a ZnO concentration of 0.78 mg mL^-1. No signs of human skin irritation were observed throughout the allergy patch test.

Results indicate that ACC-Ag⁺-ZnO sheets could potentially be embedded within surgical face masks (pilgrims’ preferred) to reduce the risks involved with the transmission of respiratory tract infections during and after mass gatherings (e.g. Hajj/Umrah, Olympics).

Severe bacterial infection is a major cause of neonatal morbidity and mortality worldwide. Geographical-based demographic laboratory and clinical data are required to get a conclusion about the bacterial infection and their antibiotic susceptibility for the empiric antibiotic treatment in infants who presented with suspected infection. This study was aimed to find the most prevalent bacterial infection and antibiotic sensitivity among infants in the post-neonatal period presented at a tertiary care centre in South India.

A cross-sectional study was designed among infants (29 days to 1 year old) presented with suspected infection in the paediatric department. Infants with positive culture report were analysed for the bacteriological and antibiotic profile from the medical records. Antibiotic sensitivity was determined for the isolated bacteria according to standard procedure and data statically analysed.

Total of 218 samples (138 male and 80 female) were analysed. Most of the samples (171/218, 78.4%) were throat swab (p = 0.0247). Only one sample was cerebrospinal fluid from case of meningitis. Sample from upper RTI was major (162/218, 74.3%) with male dominance followed by stool samples from cases of diarrhoea (22/218, 10.0%). Staphylococcus aureus was the major organism identified in 46/171 (26.9 %) throat swabs. The most sensitive antibiotic against bacteria isolated from throat swab and CSF was gentamicin and cloxacillin. Netilmicin and piperacillin plus tazobactam were the sensitive antibiotics against bacteria isolated from stool, ear secretion and urine samples.

Upper RTI was the prevalent bacterial infection followed by diarrhoea in infants in the post-neonatal period. Klebsiella pneumoniae was the common organism identified in the overall report followed by E. coli and S. aureus. Community-based awareness should be provided to follow good hygiene regularly in child care. Furthermore, avoid delay in seeking treatment and provide the medicine prescribed at the right time and in the right dose to limit the morbidity and bacterial resistance.

The purpose of this paper is to evaluate the prevalence and antibiograms of bacteria isolated from various fresh fruit juices at a local market in Faisalabad.

Fresh fruit juice samples (n=125) were randomly collected using aseptic technique. Each sample (10 mL) was serially diluted with 90 mL of sterile peptone water, from 1×10⁻¹ to 1×10⁻⁵. Each dilution was then used to inoculate nutrient agar by surface spread plating. Aerobic colony counts (ACCs) were determined by colony counting. The isolates were sub-cultured on blood and MacConkey agar. Preliminary identification was achieved on the basis of colony morphology and culture characteristic, and confirmed by API® 20E, 20NE, and API® Staph testing. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disk diffusion assay, per CLSI 2015 guidelines.

The mean ACC ranged from 2.0×10⁶ CFU/mL to 4.93×10⁶ CFU/mL, with the highest ACC determined for orange juice. Overall, 153 polymicrobial were identified in 125 samples; 103 of these were Gram-negative rods (GNR) and 28 were Gram-positive cocci (GPC). Escherichia coli (n=38), Klebsiella pneumoniae (n=32) and Pseudomonas aeruginosa (n=24) were the predominant GNR; Staphylococcus aureus (n=28) was the predominant GPC. Antibiogram analysis revealed that all GNR were resistant to ampicillin. However, most E. coli isolates were resistant to ceftazidime (72.4 percent of isolates), and ceftriaxone and cefepime (68.9 percent), while most K. pneumoniae isolates were resistant to cefepime (72 percent) and ceftriaxone (64 percent). All S. aureus isolates were resistant to penicillin, while most (64 percent) were resistant to piperacillin; the most effective drugs against bacteria were vancomycin and imipenem.

The findings suggest that the local government regulatory food and public health authorities should take immediate emergency measures. Appropriate surveillance studies and periodic monitoring of food items should be regularly performed to safeguard public health.

The current study revealed the prevalence of multidrug-resistant bacteria in freshly prepared fruit juices sold by local street vendors.

Bacterial vaginosis (BV) is quite common and linked with serious public health issues such as premature delivery and spread of sexually transmitted infections. The study aims to identify different genital mycoplasmas (GM) in high vaginal swabs (HVS) from adult females in Bahrain.

In total, 401 HVS were collected and cultured on MYCOFAST^® RevolutioN 2 test for identification and antibiotic susceptibility. Polymerase chain reaction (PCR) was performed for detection of Mycoplasma genitalium (Mg), Mycoplasma hominis (Mh) and Ureaplasma species. DNA-probe based detection for Gardnerella, Candida and Trichomonas was performed by BD Affirm Assay. Representative PCR amplicons were sequenced by Sanger sequencing.

In PCR, Ureaplasma sp. was the most common GM, followed by Mg and Mh; the prevalence being 21.2, 5.2 and 1.5%, respectively. On the contrary, 10.7% samples showed positivity for Ureaplasma urealyticum (Uu) and 1.7% for Mh in MYCOFAST^® RevolutioN 2. The concordance rates between MYCOFAST^® RevolutioN 2 and PCR for Mh and Ureaplasma sp. were 97.7 and 84%, respectively. Considering PCR as gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of MYCOFAST^® RevolutioN 2 were 33.3, 98.8, 28.6, 98.9 and 37.7, 96.5, 74.4, 85.2% for Mh and Ureaplasma sp., respectively. The Uu and Mh isolates showed antibiotic-resistance ranging from 53%–58% and 71%–86%, respectively.

The prevalence of Ureaplasma sp. was high. Significant co-occurrence of GM was noticed with BV. MYCOFAST^® RevolutioN 2 had lower detection-rate than PCR, so a combination is suggested for wider diagnostic coverage.

The research reflects on status of prevalence of GM in adult females in Bahrain, and their co-occurrence with bacterial vaginosis. Diagnostic approach with combination of tests is suggested for wider coverage. The research has epidemiologic, diagnostic, and therapeutic implications.

This is the first report from the Kingdom of Bahrain reflecting on burden of GM from this geographic location. The diagnostic efficacy of MYCOFAST^® RevolutionN 2 test and polymerase chain reaction was evaluated for GM detection.