Microbial, Physicochemical Profile and Sensory Perception of Dry-Aged Beef Quality: A Preliminary Portuguese Contribution to the Validation of the Dry Aging Process

Beef dry-aging consists of a selection of unpackaged prime cuts placed in a controlled environment cold room for several weeks. The goals are to concentrate flavors like nutty and beefy and to improve tenderness. The aim of this study was to verify the microbiological and physicochemical behavior and sensory perception of meat during a sample process example of meat dry-aging. Twelve beef loins were selected for 90 days of dry aging and placed in a cold room with average temperature, relative humidity and forced air 3.2 ± 0.7 °C, 60.7 ± 4.2% and 0.5-2 m/s, respectively. Samples of crust and lean meat were collected on days 1, 14, 21, 35, 60 and 90 of the dry aging process for microbiological, physicochemical (pH, aw, color L*a*b*) and sensory analysis. During drying, no pathogenic bacteria were detected, and the average counts were higher for the crust. The average values for water activity (aw) and pH were 0.98 ± 0.02 and 5.77 ± 0.015, respectively. A slight decrease in aw and an increase in pH were observed over the aging period (p < 0.05). The lower microbial counts on the lean meat and the overall assessment of freshness confirm the importance of good manufacturing and storage practices during dry aging.

Infectious Keratitis After Keratorefractive Surgery: Update and Review of the Literature

OBJECTIVES

To summarize the clinical manifestations, microbiological profile, treatment, and prognosis of corneal infections after different keratorefractive surgery.

METHODS

To obtain relevant studies, English-language databases, including PubMed, Ovid Embase, Web of Science, and CLNAHL, were searched from January 1979 to March 2022. The fundamentals of the literature, clinical characteristics, pathogens, and treatments were retrieved for each included article.

RESULTS

Eighty-four studies involving 306 infectious eyes were included in this review. Risk factors of potential infection included a history of blepharitis, contact lens usage, and contaminated surgical instruments. The mean onset time was 22.9±38.7 days (range: 1 day to 3 years). The most common organism isolated from infectious keratitis after keratorefractive surgery were Staphylococcus aureus , followed by Mycobacterium and coagulase-negative Staphylococcus . Most of the infections after refractive procedures were sensitive to medical treatment alone, and the ultimate best-corrected visual acuity after medical treatment was as follows: 20/20 or better in 82 cases (37.0%), 20/40 or better in 170 cases (76.5%), and worse than 20/40 in 52 cases (23.5%). Surgical interventions including flap lift, flap amputation, ring removal, and keratoplasty were performed in 120 eyes (44.5%).

CONCLUSIONS

Most infections after keratorefractive surgery occur within a week, whereas more than half of the cases after laser-assisted in situ keratomileusis happen after about a month. Gram-positive cocci and mycobacterium are the most common isolates. Infections after LASIK, intracorneal ring (ICR) implantation, and small incision lenticule extraction, which primarily occur between the cornea layers, require irrigation of the tunnels or pocket with antibiotics.

Microbial Profile, Peritoneal Fluid White Blood Cell Count, and Outcome of Peritoneal Dialysis-Related Peritonitis at Indonesian Tertiary Hospital

Introduction

Peritonitis caused by peritoneal dialysis (PD) remains a common complication of continuous ambulatory PD (CAPD). The purpose of this study is to determine the microbial profile in CAPD-related peritonitis, the optimal cutoff of white blood cell (WBC) count, and the percentage of polymorphonuclear (PMN) in CAPD fluid in the prediction of CAPD-related peritonitis, together with the outcome of CAPD-related peritonitis at an Indonesian tertiary hospital. This is a retrospective cohort study of CAPD-related peritonitis patients at Indonesian tertiary hospitals from November 2020 to October 2022.

Methods

Patients with suspected CAPD-related peritonitis who were tested for CAPD fluid culture and WBC count in CAPD fluid were eligible for this study. Patient's diagnosis and outcome obtained from medical records. Differences in clinical outcomes by category of microorganisms were analyzed with Fisher exact test. The Mann-Whitney test and receiver operating characteristic curve were used to determine optimal WBC and PMN cutoff.

Results

This study included 58 patients and 102 episodes of CAPD-related peritonitis. CAPD-related peritonitis was caused by 29.4% Gram-negative bacteria, 21.5% Gram-positive bacteria, 7.8% fungi, and 6.9% polymicrobial bacteria. CAPD fluid WBC count >79 cells/μL and PMN percentage >50% had a sensitivity of 76.4% and a specificity of 92.9% in predicting CAPD-related peritonitis. There was a significant difference in outcome between Gram-negative and Gram-positive bacterial peritonitis.

Conclusions

It is critical to understand the microbial profile in CAPD-related peritonitis. Lower WBC count cutoff points in CAPD fluids may improve sensitivity in predicting CAPD-related peritonitis.

Clinical and microbiological profile of otomycosis in Lagos, Nigeria

Introduction

Otomycosis is a global disease, common in the world's tropical and subtropical regions. The diagnosis is clinical, but mycological examination is required for its confirmation. There is a paucity of published data on otomycosis particularly the aetiologic agents in Nigeria. This study aims to fill in this gap by assessing the clinical presentations, risk factors and aetiologic agents of otomycosis in our setting.

Methods

This was a prospective study of 126 clinically diagnosed patients and 30 controls. Mycological analysis of debris and swab samples from their external auditory canal was carried out.

Results

One hundred and twenty-six patients were recruited, with 162 ear samples collected. There was mycological confirmation of otomycosis in 100 (79.4%) patients (subjects) and 127 (78.4%) specimens. The subjects' age range was 1-80 years, 30.89 ± 21.15 mean age, and 29-year median age. The peak prevalent age of 1-10 years was statistically significant, P = 0.022. The common symptoms in the subjects were itching 86 (86%), ear blockage 84 (84%) and otalgia 73 (73%). Regular ear cleaning 67 (67.0%) was the most common risk factor. Noted aetiologic agents were Aspergillus species 81 (63.8%), Candida species 42 (33.1%) and Yeast 4 (3.1%). Aspergillus flavus (40/127; 31.5%) was the most common fungus isolated. Unilateral otomycosis 73 (73%) was more common than bilateral otomycosis 27 (27%).

Conclusion

Otomycosis is common in all ages, and is a commonly unilateral disease. Regular ear cleaning is the most common risk factor. A. flavus was the most common aetiologic agent in this study.

Culture and sensitivity pattern of aerobic bacterial isolates in diabetic foot infections during 2018-2022 in Asian countries: a literature review study

The most prevalent consequence of diabetes mellitus is diabetic foot infections (DFIs). Prior to the final treatment established by the culture findings, the early identification of infections may be used as a prescription for an empirical therapy. This study examines the microbiological profile and antimicrobial susceptibility profile of the bacteria that cause DFI.

Methods

This research aims to determine the culture and sensitivity trend of aerobic bacterial isolates of DFI in Asian nations over a 5-year period. The article was searched using PubMed and Google Scholar with the keywords 'Diabetic Foot Infections', 'Antibiotic', 'Microbiological Profile', and their combinations. The author uses publications from 2018 to 2022 in Indonesian and English to select the appropriate journal.

Results

The author identified 11 relevant articles with microbiological profiles and sensitivity patterns in DFI. A total of 3097 isolates were found in 2498 patients with DFI. Gram-negative bacteria were the leading source of infection (n=1737; 56%). Totally, 1148 (or 37%) of all isolates were aerobic Gram-positive cocci. Staphylococcus aureus was the most commonly isolated aerobe (n=608, 20%), followed by Pseudomonas aeruginosa (n=451, 15%). Gram-positive bacteria showed good susceptibility to trimethoprim-sulfamethoxazole, chloramphenicol, doxycycline, vancomycin, and linezolid. Gram-negative bacteria displayed excellent susceptibility to aminoglycosides, piperacillin-tazobactam, and carbapenems.

Conclusions

Gram-negative microorganisms were the most prevalent cause of DFI. This study's findings will facilitate the development of future empirical therapeutic guidelines for the treatment of DFI.

Candida Genus Maximum Incidence in Boar Semen Even after Preservation, Is It Not a Risk for AI though?

There is little information in the literature about the fungal contamination of boar semen and its persistence during storage. The challenge of this study was to perform a mycological screening to identify the yeast in the raw semen at 12/24 h after dilution. The research was done in pig farms in the N-E area of Romania, with maximum biosecurity and state-of-the-art technology. All the examined ejaculates (101) were considered to be normal for each spermogram parameter, with microbiological determinations in T0 at the time of ejaculate collection, T1 at the time of dilution, and T2 at 24 h of storage. Microbiological determinations (mycological spermogram) were performed for quantitative (LogCFU/mL) and qualitative (typification of fungal genera) identification. Bacterial burden (×103 LogCFU/mL) after dilution (T1) decreased drastically (p < 0.0001) compared to the one in the raw semen (T0). After 24 h of storage at 17 °C, the mean value of the bacteriospermia remained constant at an average value of 0.44. Mycospermia had a constant trend at T0 (raw) and T1 (0.149 vs. 0.140) and was slightly higher at T2 (0.236). The difference between T1 vs. T2 (p = 0.0419) was close to the statistical reference value (p = 0.05). Of the total genera identified (24), the fungi had a proportion of 37.4% (9/15) and a ratio of 1:1.6. Regarding the total species (34), the fungi had a frequency of 29.42% (10/24) with a ratio between the fungi and bacteria of 1:2.4. A fertility rate of 86% was observed in the L1 group (50 AI sows with doses and mycospermia from T1), and an 82% rate was observed in the L2 group (50 AI sows with doses and mycospermia from T2). The litter size of L1 was 9.63 piglets and 9.56 for L2. Regarding the total number of piglets obtained between the two groups, there was a slight decrease of 22 piglets in group L2, without statistical differences (p > 0.05). The predominant genera persisted after dilution during a 12 h storage at 17 °C, where yeasts, such as Candida parapsilosis and C. sake were identified in more than 92% of AI doses.

Risk Factors for Development of Endophthalmitis after Open Globe Injury in Children: A Case-Control Study

AIM

To identify risk-factors for developing endophthalmitis following open globe injury (OGI) in children.

METHODS

Retrospective, single-center, case-control study of children aged <18 years who sustained OGI.

RESULTS

Our cohort of 93 eyes consisted of 30 cases (Group A- endophthalmitis) and 63 controls (Group B- no endophthalmitis). Twenty-four eyes (80%) diagnosed with endophthalmitis presented after 24 hours of injury. The presence of central corneal zone-1 injuries (Odd ratio [OR]: 6.64, p= 0.001) and vitreous in wound (OR: 3.53) were associated with the risk of developing endophthalmitis. (p= < 0.05) Additionally the presence of iris prolapse (OR: 4.76) and posterior capsular rupture (PCR) (OR: 5.80) increased the risk of developing endophthalmitis.(p <0.05) . Streptococci was isolated in 15 eyes, Pseudomonas in 3 eyes, and Candida in 1 eye. The visual outcomes at three months were significantly worse in Group A (LogMAR 1.77±1.06) compared to Group B (LogMAR 0.65±0.68)(p<0.05).

CONCLUSION

Central corneal involvement, vitreous/ iris incarceration and PCR were important risk factors for development of PTE in children.

Effect of Diet and Essential Oils on the Fatty Acid Composition, Oxidative Stability and Microbiological Profile of Marchigiana Burgers

The objective of this study is to evaluate the effects of including linseed (L) or linseed plus vitamin E (LE) in the diet of Marchigiana young bulls on the oxidative stability, color measurements, microbiological profile and fatty acid composition (FA) of burgers treated with and without a blend of essential oils (Rosmarinus officinalis and Origanum vulgare var. hirtum) (EOs). For this aim, the burgers were analysed for pH, thiobarbituric-acid-reactive substance (TBARS) content, Ferric Reducing/Antioxidant Power Assay (FRAP), vitamin E and colour measurements (L, a*, b) at 3, 6, 9, 12 days of storage: the TBARs were the highest in group L compared to C and LE after 12 days of storage (0.98, 0.73, and 0.63 mg MDA/kg, respectively). The TBARS content was also influenced by the use of EO compared to burgers not treated with EO (p < 0.05). The vitamin E content was influenced by the diet (p < 0.01), but not by the EO. The meat of the L group showed the lowest value of redness (a*) compared to C and LE (p < 0.01), while the use of EO did not affect colour parameters. The microbiological profile of the burgers showed a lower Pseudomonas count for L and LE at T0 (2.82 ± 0.30 and 2.30 ± 0.52 Log CFU/g, respectively) compared to C (3.90 ± 0.38 Log CFU/g), while the EO did not influence the microbiological profile. The FA composition was analysed at 0 and 12 days. The burgers from the LE group showed the highest value of polyunsaturated FA compared to the L and C groups (p < 0.05). Our findings suggest that the inclusion of vitamin E in a concentrate rich in polyunsaturated fatty acids is useful to limit intramuscular fat oxidation and to preserve the colour stability of burgers from young Marchigiana bulls enriched with healthy fatty acids. Moreover, linseed and vitamin E had a positive effect on microbial loads and growth dynamics, containing microbial development through time.

Microbiological Changes in Meat and Minced Meat from Beavers (Castor fiber L.) during Refrigerated and Frozen Storage

This study aims to evaluate the microbiological status, pH, and water activity of European beaver meat to establish its shelf-life and microbiological safety. In this study, the microbiological profiles of meat and minced meat obtained from the carcasses of beavers were investigated. Microbial evaluation of the chilled meat was performed within 24 h after hunting, on the 7th day and 14th day, and the evaluation of the frozen meat was made during the 11th week of storage. Meat samples were analysed for total viable count (TVC), psychrotrophic bacteria count (PBC), Enterobacteriaceae count (EBC), Escherichiacoli count (EC), total staphylococcal count (TSC), lactic acid bacteria count (LABC) and total yeast and mould counts (TYMC). Tests for the presence of pathogenic bacteria from the genus Salmonella and Listeria were also performed. Additionally, the pH and water activity were determined. The initial amount of TVC was 4.94 log CFU/g in meat samples and 4.80 log CFU/g in minced meat. After 14 days of storage, the TVC increased to 8.33 in meat samples and 8.08 log CFU/g in minced meat. Pathogenic bacteria such as Listeria and Salmonella were not found in the beaver meat tested. The microbiological state of meat stored frozen for 11 weeks was comparable to the state found in meat stored refrigerated for seven days regarding the number of microorganisms.

Microbiological Profile and Drug-Resistance Pattern of Pathogens Among Patients Who Visited the University of Gondar Comprehensive Specialized Hospital, Ethiopia

BACKGROUND

The emergence of antimicrobial resistance (AMR) is a public health threat in developing countries including Ethiopia; and there is a paucity of information regarding antimicrobial resistance patterns of commonly isolated pathogens, particularly in the study area. Hence, this study aimed to assess the microbiological profiles and resistance patterns of pathogens among patients who visited a tertiary hospital in the study setting.

METHODS

This study was based on secondary data sources from the hospital microbiology database and culture reports between September 2019 and August 2020 at the University of Gondar comprehensive specialized hospitals, Ethiopia. Data about socio-demographic characteristics and clinical parameters, types of specimens collected, culture results, and antibiotic resistance pattern were collected manually by using a data abstraction format from the department of clinical bacteriology registration book and electronic database.

RESULTS

A total of 5328 culture results were included in the final analysis. Bacterial growth was documented only in 803 (15.1%) samples. From the positive culture results documented, the highest positivity rate was reported from abscess (47.8%) followed by blood (26.2%) and urine (15.1%) samples. Among the bacterial isolates S. aureus (32.5%), Klebsiella species (17.9%), E. coli (14.8%) and Streptococcus species (7.4%) were the commonly identified organisms. Of the 803 bacterial isolates, about 672 (83.6%) isolates were resistant to at least one antibiotic and 19.7% isolates were MDR.

CONCLUSION

This study showed that Staphylococcus aureus, Klebsiella pneumonia species, and Escherichia coli were the commonest isolated pathogens. Antimicrobial resistance among common isolates was high for most routinely used antibiotics, and some reserved drugs like carbapenems and fourth-generation cephalosporin. Thus, this study may have implications on patient management, drug procurement, local treatment guideline development, and rational use of antibiotics. Furthermore, this finding could also help to facilitate the implementation of antimicrobial stewardship and infection prevention and control interventions within the hospital.

Study of microbiological and antibiotic sensitivity pattern of ventilator associated pneumonia (VAP) in ICU of a tertiary care hospital in Nepal

INTRODUCTION

Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU) acquired infection among patients receiving mechanical ventilation. Accurate clinical and microbiologic diagnosis of VAP is essential not only for selection of appropriate antimicrobials but also to prevent their misuse. As the organisms and their sensitivity pattern may differ in every ICU, the knowledge of the resident flora and their behaviour should be known for successful treatment.

METHODS

The study was conducted to evaluate the organisms responsible for VAP and their Antibiotic Sensitivity Pattern for the study setting. A prospective, open, epidemiological clinical study was performed in a tertiary care hospital in Nepal. 100 patients admitted to ICU and Mechanically Ventilated were evaluated about VAP. Clinical Pulmonary Infection Score (CPIS) was used to diagnose VAP.

RESULTS

Among 60 patients ventilated for more than 48 hours, 25 (41.6%) developed VAP. The VAP was caused predominantly by Klebsiella pneumonia in 34.5% of cases, followed by Acinetobacter calcoaceticus baumanni in 27.6%, Acinetobacter wolffi and Pseudomonas aeruginosa in 13.8% each and Escheresia coli in 10.3%. The most sensitive antibiotics were Colistin, followed by Polymyxin B and Amikacin with sensitivity rates of 67%, 60% and 58%, respectively.

CONCLUSION

Based on these results, an empiric approach to antibiotic treatment can be made tailored to the specific settings. Given the magnitude of drug resistance and its implicated financial and societal burden, there is an urgent need for broad implementation of Antibiotic Stewardship programs across all health care settings.

Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin, North Central, Nigeria

Background

The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality.

Objectives

To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria.

Methods

One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens.

Results

CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB – 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality.

Conclusion

CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment.

Clinical and Microbiological Profiles of Aggressive and Chronic Periodontitis in Congolese Patients: A Cross-sectional Study

Background:

Chronic and aggressive periodontitis were the main forms of periodontitis according to the 1999 classification of periodontal diseases and conditions. Their profile in Congolese patients is still undescribed.

Aim:

The aim of this study was to compare the profile of chronic periodontitis (ChP) with that of aggressive periodontitis (AgP) in Congolese patients.

Materials and Methods:

Thirty-two patients with ChP and 20 with AgP who consulted the dental services at any of the four medical centers in Kinshasa, from April 2017 to April 2018, were enrolled in the cross-sectional study. All patients underwent a full mouth examination, including assessment of the probing pocket depth and clinical attachment level at six sites per tooth. Microbial samples were collected in the deepest pocket in the maxilla and the deepest pocket in the mandible. A deoxyribonucleic acid (DNA) analysis was performed using DNA strip technology. Fisher exact test, the chi-square test, the t test, and the Mann–Whitney test were used for the statistical analysis.

Results:

Patients with AgP were significantly younger than those with ChP (P < 0.001). There was no significant difference in the prevalence of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, or Prevotella intermedia between the AgP and ChP groups (P > 0.05). Aggregatibacter actinomycetemcomitans was detected in 10% of cases in the AgP group and in none of those in the ChP group (P = 0.143).

Conclusion:

This study shows that the clinical profiles of ChP and AgP are similar in Congolese patients. There were no microbiological differences between these two forms of periodontitis.

Microbiological profile of chronic osteomyelitis with special reference to anaerobic osteomyelitis in a tertiary care hospital of coastal Karnataka

Chronic osteomyelitis is a relapsing, persistent, low-grade inflammation of bone caused by various infectious agents. The present study, conducted over a two-year period, on specimens received from cases of chronic osteomyelitis was, to determine the frequency of isolation of aerobic and anaerobic bacteria and to analyse their antimicrobial susceptibility pattern. Specimens were processed for Gram stain, aerobic and anaerobic culture, and were identified according to standard techniques. Significant growth was observed in 102/204 specimens, in which aerobic growth was observed in 62 (60.8%) and anaerobic in 40 (39.2%). Resistance to metronidazole and clindamycin was observed in 6.7% and 30% of the anaerobic isolates, respectively. None of these were resistant to meropenem. A significant proportion of anaerobic isolates were found to be resistant to commonly used empirical drugs, such as clindamycin, thus necessitating a need for routine anaerobic susceptibility testing.

Demographic details, risk factors, microbiological profile, and clinical outcomes of pediatric infectious keratitis cases in North India

Purpose:

To study the demographic details, risk factors, microbiological profile, and clinical outcomes of pediatric infectious keratitis cases in North India.

Methods:

This retrospective case series included review of medical records of pediatric patients (0–16 years) diagnosed with infectious keratitis in a tertiary care center of North India during December 2011 to January 2017 was done. Demographic details, predisposing factors, microbiological investigations, and clinical outcomes were analyzed.

Results:

In this time period, 104 eyes of 104 children had a diagnosis of infectious keratitis. Culture was obtained for all 104 eyes and was positive in eighty eight eyes (84.2%). The most common causative factor was trauma, seen in 77 eyes (74%). Bacteria was the most common agent isolated in culture (54.2%) followed by fungi (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical treatment occurred in 84 (80.7%) eyes, while 13 (12.5%) eyes required therapeutic keratoplasty. Of the 80 eyes with documentation of both preliminary and final visual acuity, improvement of two lines was seen in 35 eyes (43.7%), stayed the same in and worsened in 17 eyes (21%). Mean time to resolution of infection on medical treatment for bacteria was 23.65 ± 4.78 days, fungi 32 ± 5.19 days, and acanthamoeba 53.67 ± 4.78 days.

Conclusion:

Gram positive organism is the most common etiological agent of keratitis in children in our study population which is in contrast to pediatric infective keratitis study conducted by Aruljyothi et al. in South India (2011--2013). Though less in number than bacterial keratitis, fungus also remains an important causative agent. Along with early diagnosis and immediate medical intervention, it is important to identify regional profile of organisms and risk factors for good visual and anatomical outcome.

Patients with cirrhosis and SBP: Increase in multidrug-resistant organisms and complications

BACKGROUND

Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with liver cirrhosis. In recent years, it has been postulated that the rate of multidrug-resistant organisms (MDROs) is increasing, especially in nosocomial SBP patients. Aim of the present work was to investigate this hypothesis and its possible clinical consequences.

MATERIALS AND METHODS

One hundred and three culture-positive patients between 2007 and 2014 were compared with 81 patients between 2015 and 2017, to study the change of microbiological profiles and their clinical consequences. The cirrhosis patients with bacterascites requiring treatment were included as well.

RESULTS

The most prevalent Gram-negative bacteria isolated from ascites were Enterobacterales (31.6%) and in Gram-positive pathogens Staphylococci (22.8%). There was a significant increase in MDROs (22.3% ICU 40.7%, P = .048), accompanied by an increased incidence of sepsis (from 21.4% to 37.0%, P = .021), hepatorenal syndrome (from 40.8% to 58.0%, P = .007) and the need of catecholamine therapy (from 21.4% to 38.8%, P = .036). Nosocomial origin correlated with higher MDRO proportion, more complications and lower antimicrobial susceptibility rates in 12 commonly used antibiotics. MDROs were confirmed as an isolated predictor for inpatient mortality and complications in multivariable logistic regression.

CONCLUSIONS

The feeling in clinical practice that MDROs have increased in the last 11 years could be confirmed in our study in Munich, Germany. Nosocomial SBP correlated with significantly higher MDRO rates (nearly 50%) and complication rates. In our opinion, an antibiotic combination with comprehensive effect should be taken into account in nosocomial SBP patients in this region.

Microbiological profile of septic arthritis in adults: Lessons learnt and treatment strategies

Objective

The aim of this study is to characterise the clinical and microbiological profile of adult patients treated at our orthopaedic unit with septic arthritic between 2006 and 2017.

Materials and Methods

A total of 70 patients who were admitted with a diagnosis of septic arthritis between 2006 and 2017 were included in the study. The patients' clinical and epidemiological characteristics were surveyed; microbiological profile and the complications relating to the patients' treatment were identified.

Results

Septic arthritis was more common among males (83%). About 75% of the patients presented with a history of fever. The knee was the most commonly affected joint (71%), followed by the hip. While C-reactive protein was found to be consistently >75, total blood white blood cell (WBC) counts were found not to be reflective of the presence of infection with a mean WBC count of only 13,561/cu.mm, and Gram stain examination had a poor sensitivity of 47%. Among the co-morbidities, the most prevalent association was with diabetes mellitus. The infectious agent most frequently isolated was Staphylococcus aureus(42.85%). The antibiotic sensitivity pattern has evolved since the early years, with resistant strains becoming increasingly prevalent. Unusually, high incidence of streptococci was noted (30%), contrary to the published literature. One-third of the patients had multi-resistant organisms. Septic arthritis left 70% of the patients with a significant residual disability at 6 months follow-up and had 4.25% mortality.

Conclusion

Changing sensitivity patterns of microbes in septic arthritis point to a need for reconsidering empirical antibiotic therapy. Joint damage following infection can lead to significant disability.

Comparison of epidemiological, clinical and microbiological characteristics of bloodstream infection in children with solid tumours and haematological malignancies

Bloodstream infection (BSI) is a serious complication in immunocompromised hosts. This study compares epidemiological, clinical and microbiological characteristics of BSI among children with haematological malignancies (HM) and solid tumours (ST). The study was conducted from October 2012 through to November 2015 at a referral hospital for cancer care and included the first BSI episode detected in 210 patients aged 18 years or less. BSI cases were prospectively detected by daily laboratory-based surveillance. The Centers for Disease Control and Prevention definitions for primary or secondary BSI were used. A higher proportion of use of corticosteroids (P = 0.02), chemotherapy (P = 0.01) and antibiotics (P = 0.05) before the BSI diagnosis; as well as of neutropenia (P < 0.001) and mucositis (P < 0.001) at the time of BSI diagnosis was observed in patients with HM than with ST. Previous surgical procedures (P = 0.03), mechanical ventilation (P = 0.01) and bed confinement (P < 0.001) were more frequent among children with ST. The frequency of use of temporary (P = 0.01) and implanted vascular lines (P < 0.01) was significantly higher in children with ST than with HM while the tunnelled line (P = 0.01) use was more frequent in children with HM as compared to ST. Most (n = 181) BSI cases were primary BSI. BSI associated with a tunnelled catheter was more frequent in children with HM (P < 0.01), whereas BSI associated with an implanted (P < 0.01) or temporary central line (P < 0.02) was more common in patients with ST. BSI associated with mucosal barrier injury was more frequent (P = 0.01) in children with HM. Indication for intensive care was more frequent in children (P = 0.05) with ST. Mortality ratio was similar in children with ST and HM, and length of hospital stay after BSI was higher in patients with HM than with ST (median of 19 vs. 13 days; P = 0.02). Infection caused by Gram-negative bacteria (P = 0.04) and polymicrobial infections (P = 0.05) due to Gram-positive cocci plus fungus was more common in patients with HM. These findings suggest that the characteristics of BSI acquisition and mortality can be cancer-specific.

Is it safe to do a single-stage implant exit and primary hip replacement? clinical and microbiological profiling

Background

A single-stage implant revision for failed fixation of proximal femoral fractures is performed only when there is no evidence of infection. Else, a two-staged revision is preferred - where the definitive revision surgery is done a few months after the implant exit. This study aims to audit the safety and incidence of culture positivity in single-stage revisions.

Materials and Methods

Forty one of 284 patients that presented over the last 12 years for implant exchange of the hip, had a single stage revision surgery for failed fixation of a fracture of the hip, as there was no obvious evidence of infection at the time of implant exit.

Results

Micro-organisms were grown in 51% of the 41 hips. 76% were gram positive, of which 63% were Coagulase negative staphylococci (CoNS). 50% of CoNS and 75% of S. aureus were resistant to oxacillin, but susceptible to Vancomycin. Of the gram negative organisms, 2 (Enterobacter sp) were resistant to carbapenam, while others were susceptible. Preoperative ESR and CRP, individually, had low specificity - 50% for ESR >30mm at 1 hour and 62% for CRP>10. The combined use of ESR > 30mm and CRP>10 increased the specificity to 90%. 12% of the patients had immediate postoperative complications that required a wash out in theatre. The long term clinical follow up of these patients is limited.

Conclusion

This study suggests that implant exit and simultaneous arthroplasty for failed fracture fixation should be done with caution due to the high possibility of infection. It may be prudent to opt for a 2 stage revision.

Sarecycline Review

Objective: Sarecycline is a new oral tetracycline antibiotic recently approved by the US Food and Drug Administration. The aim of this article was to evaluate the data from published clinical trials of sarecycline in the treatment of acne, review the drug's pharmacology, and understand how this new medication may apply to clinical practice. Data Sources: A systematic literature review was performed using the terms sarecycline (Seysara), P005672, and WC-3035 in the MEDLINE and EMBASE databases. ClinicalTrials.gov was searched to identify ongoing or nonpublished studies. Study Selection and Data Extraction: Articles in English between January 2000 and April 2019 relating to clinical trials, pharmacology, safety, and microbiological profile were evaluated. Data Synthesis: In a phase 3 clinical trial (SC1401), absolute change from baseline in facial inflammatory lesion count at week 12 was -15.3 for the sarecycline arm and -10.1 for placebo (P < 0.01). In another phase 3 clinical trial (SC1402), the absolute change in this category was -15.7 for sarecycline and -10.7 for placebo (P < 0.01). Mean percentage change in facial inflammatory lesion count was higher in the sarecycline group than in the placebo group in both studies (P < 0.01). Relevance to Patient Care and Clinical Practice: The 1.5-mg/kg sarecycline dose has efficacy in reducing inflammatory lesions, is well tolerated, and has more targeted antimicrobial activity, which may help reduce the risk of developing antibiotic resistance. Conclusions: This novel, once-daily treatment may represent a useful treatment for patients with moderate to severe acne.

Microbiological profile and outcomes of two-stage revision hip arthroplasty

Background

Prosthetic joint infection (PJI) is one of the most challenging cases that confront modern orthopaedics. Two-stage revision, which is the standard of care for PJI, is the preferred mode of treatment for these infections.

Aims and Objectives

To study the microbiological profile of prosthetic joint infections (PJI) in the hip and to assess the efficacy of a two stage revision surgery for PJI. We also aimed to study the sensitivity and specificity of ESR and CRP in the diagnosis of PJI.

Materials and Methods

The microbiological profile, clinical and radiological outcomes of 22 patients who had a two-stage revision for PJI of the hip between 2013 and 2017 were retrospectively analysed. PJI was defined using the criteria provided by the International Consensus Statement on PJI 2013.

Results

Staphylococcus aureus was found to be the most common organism in PJI. Debridement was successful in removing the organism in 74% of PJI. At the time of re-implantation (second stage), six joints grew organisms that were different from that isolated at the index debridement - coagulase-negative staphylococci (3cases) and enterococci (3cases). Other infection parameters for these patients were negative. None of the patients who had two-stage revision surgery had clinical evidence of reinfection or radiological evidence of loosening at a mean of 2-year follow-up. An ESR cut off of >30mm/hr had a sensitivity of 75% and specificity of 88% in predicting PJI. A CRP >10mg/L had a sensitivity of 75% and specificity of 69%. The sensitivity and specificity of using both ESR and CRP cut-offs in the diagnosis of infection were 57% and 94%, respectively. The positive predictive value was 94% and negative predictive value was 56%.

Conclusion

The outcomes of the study justify a two-stage revision arthroplasty for PJI of the hip. The use of ESR and CRP as screening tests for the success of debridement has value - but should be interpreted with caution.

Microbiological profile and antibiotic susceptibility of scleral buckle infections in North India

Purpose:

The aim of this article to study causative organisms for scleral buckle (SB) infections in North India.

Methods:

A retrospective review of records was done for all patients who have undergone SB removal at our institute between January 2009 and December 2017. The records were analyzed for etiological agent of the infected buckle and its antibiotic sensitivity.

Results:

A total of 43 samples were analyzed and a positive culture was noted in 35 (81.40%) cases. The buckle infection rate at our institute was noted to be 2.53%. The commonest organism causing SB infections was Staphylococcus – 15 (42.6%) cases, followed by Pseudomonas – 6 (17.14%) cases and Fungi – 6 (17.14%) cases. The median interval between retinal detachment surgery and buckle explantation was 3 years.

Conclusion:

A large variety of organisms may cause SB infections. The commonest organism found to cause buckle infections in our study was Staphylococcus sp.

Microbiological Profile of Sarecycline, a Novel Targeted Spectrum Tetracycline for the Treatment of Acne Vulgaris

Sarecycline is the first narrow-spectrum tetracycline-class antibiotic being developed for acne treatment. In addition to exhibiting activity against important skin/soft tissue pathogens, sarecycline exhibits targeted antibacterial activity against clinical isolates of Cutibacterium acnes.

Sarecycline is the first narrow-spectrum tetracycline-class antibiotic being developed for acne treatment. In addition to exhibiting activity against important skin/soft tissue pathogens, sarecycline exhibits targeted antibacterial activity against clinical isolates of Cutibacterium acnes. In the current study, sarecycline was 16- to 32-fold less active than broad-spectrum tetracyclines—such as minocycline and doxycycline—against aerobic Gram-negative bacilli associated with the normal human intestinal microbiome. Also, reduced activity against Escherichia coli was observed in vivo in a murine septicemia model, with the 50% protective doses, or the doses required to achieve 50% survival, being >40 mg/kg of body weight and 5.72 mg/kg for sarecycline and doxycycline, respectively. Sarecycline was also 4- to 8-fold less active than doxycycline against representative anaerobic bacteria that also comprise the normal human intestinal microbiome. Additionally, C. acnes strains displayed a low propensity for the development of resistance to sarecycline, with spontaneous mutation frequencies being 10⁻¹⁰ at 4 to 8 times the MIC, similar to those for minocycline and vancomycin. When tested against Gram-positive pathogens with defined tetracycline resistance mechanisms, sarecycline was more active than tetracycline against tet(K) and tet(M) strains, with MICs ranging from 0.125 to 1.0 μl/ml and 8 μl/ml, respectively, compared with MICs of 16 to 64 μl/ml and 64 μl/ml for tetracycline, respectively. However, sarecycline activity against the tet(K) and tet(M) strains was decreased compared to that against the wild type, which demonstrated MICs ranging from 0.06 to 0.25 μl/ml, though the decrease in the activity of sarecycline against the tet(K) and tet(M) strains was not as pronounced as that of tetracycline. These findings support sarecycline as a narrow-spectrum tetracycline-class antibiotic that is effective for the treatment of acne, and further investigation into the potential reduced effects on the gut microbiome compared with those of other agents is warranted.

Changing prevalence and antibiotic drug resistance pattern of pathogens seen in community-acquired pediatric urinary tract infections at a tertiary care hospital of North India

AIMS AND OBJECTIVES

The aim and objective of this study was to assess the temporal changes in the microbiological profiles and antimicrobial resistance patterns of uropathogens in pediatric community-acquired UTI.

MATERIALS AND METHODS

This is a retrospective analysis of data collected over a Scattered period of 5 years. The baseline data collected were from January to December 2009, and the second period considered for comparison was from January to December 2014. Urine specimens from children (<17 years) suspected of UTI were cultured by a semi-quantitative method on cysteine lactose electrolyte-deficient medium. Antibiotic sensitivity was put up by Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standard Institute guidelines.

RESULTS

In the year 2009, 340 of 2104 (16.15%) urine specimens yielded significant colony count, whereas in 2014, it was 407 of 2212 (18.39%) (P = 0.051). Escherichia coli was the predominant pathogen and was significantly more prevalent in girls than in boys (P < 0.0001) during both periods. There was a significant overall increase in resistance to ampicillin (from 40.29% to 58.72%), amoxyclav (from 26.17% to 40.54%), nitrofurantoin (from 28.82% to 39.06%), and norfloxacin (from 30% to 41.42%). However, the maximum increase in the resistance was noted for co-trimoxazole from 35.58% in 2009 to 63.39% in 2014 (P = 0.0000058). The prevalence of extended-spectrum beta-lactamases (ESBLs) has also significantly increased from 21.7% to 33.16% (P = 0.0045).

CONCLUSION

Although E. coli remains the prime pathogen in pediatric UTI, the prevalence of resistance has dramatically increased over the 5-year study period. Our study highlights the emergence of community-acquired ESBL-producing uropathogens in children proclaiming treatment challenges.

Differences in sheep and goats milk microbiological profile between conventional and organic farming systems in Greece

The aim of this study was to examine differences in the microbiological profile and antimicrobial resistance of bacteria isolated from milk from organic and conventional sheep and goat farms. Twenty-five organic and 25 conventional sheep and goat farms in the region of Thessaly, Greece participated in this study. A standardised detailed questionnaire was used to describe farming practices. A total of 50 samples were collected and analysed for total viable count (TVC), total coliform count (TCC) and somatic cell count (SCC), while Staphylococcus aureus and Escherichia coli were isolated using standard methods. Isolates were identified at species level by Api-test and Matrix-Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS). Susceptibility to a panel of 20 for E. coli and 16 for S. aureus antimicrobials was determined by the agar dilution method. Pulsed Field Gel Electrophoresis (PFGE) was performed for S. aureus and E. coli isolates to determine predominant clones. Lower counts of TVC, TCC and SCC were identified in milk from the organic farms, possibly due to differences in the hygienic farming practices found on those farms. API-tests and MALDI-TOF MS showed no significant differences in the S. aureus and E. coli isolates. Overall, antimicrobial resistance rates were low, while a statistically higher percentage was estimated among strains originating from conventional farms in comparison with organic farms, possibly due to the restriction of antibiotic use in organic farming. PFGE revealed diversity among S. aureus and E. coli populations in both organic and conventional farms indicating circulation of 2-3 main clones changing slightly during their evolution. Consequently, there is evidence that milk from the organic farms presents a better microbiological profile when compared with milk from conventional farms.

Ventilator-associated pneumonia: A persistent healthcare problem in Indian Intensive Care Units!

Background:

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection acquired by patients in the Intensive Care Unit (ICU). However, there are scarce clinical data, particularly from Indian ICUs on the occurrence of this infection.

Aims:

To collect data on the incidence, microbiological profile, and outcomes of patients with VAP.

Settings and Design:

Tertiary level, medical-surgical ICU; prospective, observational study.

Subjects and Methods:

All patients who were mechanically ventilated for >48 h in the ICU during the study were enrolled. VAP was diagnosed according to the Centre for Disease Control (CDC) criteria.

Results:

A total of 95 (38%) patients developed VAP infections, an incidence of 40.1 VAP infections/1000 mechanical ventilation days. These were predominantly caused by Gram-negative organisms, especially the Acinetobacter species (58 isolates, 53.2%). Many of the VAP-causing isolates (27.3%) demonstrated multidrug resistance. Patients with VAP infections experienced a significantly longer ICU stay (13 days [Interquartile Range (IQ) range = 10–21] vs. 6 days [IQ = 4–8], P < 0.0001) and total hospital stay (21 days [IQ = 14–33] vs. 11 days [IQ = 6–18], P < 0.0001). While the overall mortality rates were similar between patients with or without VAP infections, (68.4% vs. 61.3%, P = 0.200), on subgroup analysis, elderly patients (>60 years) and those with higher Acute Physiology and Chronic Health Evaluation II scores at admission had significantly greater mortality rates if they acquired a VAP infection (P = 0.010).

Conclusions:

VAP continues to be a major threat to patients who are admitted for mechanical ventilation into the critical care unit, emphasizing the urgent need for infection control measures.

essential oil effect on biogenic amines formation and microbiological profile in Gouda cheese

The effect of Zataria multiflora Boiss. (Z. multiflora) essential oils (EO) on biogenic amines (BAs) production and microbial counts in Gouda cheese has been investigated. Zataria multiflora was added to milk in different concentrations (0·05, 0·1, 0·2 and 0·4% (v/v)). The BAs (tyramine and histamine) were measured by RP-HPLC, following extraction from the cheese. Various microbiological analyses (aerobic mesophilic bacteria, enterococci, mesophilic lactobacilli, Enterobacteriaceae, lactococci and yeasts) were performed during ripening using the viable plate count method on specific culture media. The overall acceptability of cheeses was investigated by seven panellists. All the samples containing different concentrations of EO were acceptable to the panellists. Also, Gouda cheeses with 0·2% Z. multiflora EO showed the highest acceptability among all the samples. At the end of maturation period, 0·1, 0·2 and 0·4% Z. multiflora EO reduced tyramine and histamine significantly to 5%, 22% and 44% for tyramine and 14%, 29% and 46% for histamine, respectively, when compared to the control group. The increase of Z. multiflora EO concentrations led to further decrease in BAs content and microbial counts. The maximum microbiological reduction was observed in yeasts, and minimum microbiological reduction was seen in Enterobacteriaceae counts. Zataria multiflora EO could be used for reduction of BAs and also as a flavouring agent in Gouda cheese and could contribute to consumers' health.

SIGNIFICANCE AND IMPACT OF THE STUDY

The presence of biogenic amines in cheese has a serious impact on public health. Besides, there is growing concern about the use of chemical preservatives and the food industry is looking for new natural preservation methods. Zataria multiflora Boiss. essential oil is well known for its antimicrobial effects, and we attempted to reduce biogenic amines formation in Gouda cheese using Z. multiflora Boiss. essential oil as a natural additive. Furthermore, the desirable organoleptic qualities such as flavour, odour, texture and colour were achieved by adding Z. multiflora Boiss. to cheese.

Microbiological profile of bacterial conjunctivitis in ibadan, Nigeria

OBJECTIVE

In bacterial conjunctivitis, clinical presentations are not diagnostic of the causative agent, therefore, microbiological analysis is mandatory for specific treatment option. This study was undertaken to determine the microbiology profile of bacterial conjunctivitis in our environment.

METHODOLOGY

This is a laboratory-based study carried out in the Medical Microbiology Laboratory of University College Hospital, Ibadan, Nigeria. Conjunctival swabs collected from 365 patients with clinically diagnosed conjunctivitis, were analysed by standard bacteriological methods.

RESULTS

Bacterial pathogens were detected in 342 (93.7%) conjunctival samples while 23(6.3%) were sterile. Of the pathogens, 256 (74.9%) were Staphylococcus aureus, 35(10.2%) Coagulase- negative staphylococci, 22 (6.4%) Pseudomonas aeruginosa , 11(3.2%) Escherichia coli, 7(2.1%) Klebsiella species, 5(1.5%) Streptococcus pneumoniae , 4(1.2%) Haemophilus influenzae, 1(0.3%) Proteus mirabilis, and 1(0.3%)Neisseria gonorrhoeae. The highest rate of conjunctivitis 96(26.3%) was found among infants and children (0-10years).Resistance rates to most of the tested antibiotics were high. However, 67% of them were susceptible to ceftriaxone while only 39.2% were susceptible to chloramphenicol.

CONCLUSION

This study has recorded high antibiotic resistance in bacterial pathogens of conjunctivitis in this environment; therefore, determining the susceptibility pattern of these pathogens to available antibiotics is crucial to effective management of bacterial conjunctivitis.