UNASSIGNED: Neonatal sepsis remains a major cause of morbidity and mortality. Therefore, early detection and initiation of appropriate empirical antibiotic therapy are crucial.
UNASSIGNED: The aim of this study was to describe the antibiogram of the neonatal intensive care unit at Grey\'s Hospital, a tertiary hospital in KwaZulu-Natal.
UNASSIGNED: This was a retrospective descriptive study, reviewing positive cultures from Grey\'s Hospital tertiary neonatal intensive care unit (NICU) in KwaZulu-Natal, South Africa for a 3-year period (01 January 2017 to 31 December 2019). All positive cultures from all sites were included.
UNASSIGNED: There were 1314 positive organisms cultured. Late-onset sepsis (89.3%) predominated over early-onset sepsis (10.7%). Blood was the source for 55.2% (725/1314) of positive cultures. Of the 1314 organisms cultured, 53.7% (706/1314) were Gram-positive, 45.7% (601/1314) were Gram-negative and 0.5% (7/1314) were Candida species. Klebsiella pneumoniae, 23.5% (313/1314) was the most frequent Gram-negative organism. It was noted to have high resistance to the unit\'s first-line antibiotic regimens; 99% were resistant to ampicillin and 92% resistant to gentamicin.
UNASSIGNED: Blood cultures yielded most positive results with a predominance of Gram-positive organisms and late-onset sepsis. A significant proportion of the cultured organisms were resistant to the first-line antimicrobials utilised in the unit, ampicillin and gentamicin.
UNASSIGNED: Ongoing surveillance on positive cultures is recommended to assess the effectiveness of the unit\'s current empirical antimicrobial guideline.

Staphylococcus lugdunensis endophthalmitis is an uncommon intraocular infection with potentially visually devastating consequences. S. lugdunensis endophthalmitis have been reported following cataract surgery, trauma, intravitreal injections of anti-vascular endothelial growth factor agents and dexamethasone implant. We report four cases of postoperative S. lugdunensis endophthalmitis after cataract extraction (three patients) and combined pars plana vitrectomy and cataract extraction (one patient). The onset of presentation of endophthalmitis was acute (within 2 weeks) in two patients, subacute (2 to 6 weeks) in one patient, and chronic (more than 6 weeks) in one patient. All patients had presenting visual acuity (VA) of hand motions or worse and were treated with pars plana vitrectomy with intravitreal antibiotics. The final VA was 20/50 in two patients, 4/200 in one patient with pre-existing myopic maculopathy, and no light perception in one patient with retinal detachment. In antibiotic susceptibility testing, S. lugdunensis isolates were resistant to penicillin (3/4, 75%), but all were susceptible to vancomycin, oxacillin, teicoplanin, tigecycline, and sulfamethoxazole-trimethoprim. S. lugdunensis may be associated with acute or chronic endophthalmitis. Favorable visual outcomes can be achieved with prompt diagnosis and management.

The rise of antimicrobial resistance at an alarming rate is outpacing the development of new antibiotics. The worrisome trends of multidrug-resistant Gram-negative bacteria have enormously diminished existing antibiotic activity. Antibiotic treatments may inhibit bacterial growth or lead to induce bacterial cell death through disruption of bacterial metabolism directly or indirectly. In light of this, it is imperative to have a thorough understanding of the relationship of bacterial metabolism with antimicrobial activity and leverage the underlying principle towards development of novel and effective antimicrobial therapies.
Herein, we explore studies on metabolic analyses of Gram-negative pathogens upon antibiotic treatment. Metabolomic studies revealed that antibiotic therapy caused changes of metabolites abundance and perturbed the bacterial metabolism. Following this line of thought, addition of exogenous metabolite has been employed in in vitro, in vivo and in silico studies to activate the bacterial metabolism and thus potentiate the antibiotic activity.
Exogenous metabolites were discovered to cause metabolic modulation through activation of central carbon metabolism and cellular respiration, stimulation of proton motive force, increase of membrane potential, improvement of host immune protection, alteration of gut microbiome, and eventually facilitating antibiotic killing. The use of metabolites as antimicrobial adjuvants may be a promising approach in the fight against multidrug-resistant pathogens.

To analyze the microbiological profile and in vitro antibiotic susceptibility patterns of bacterial isolates in canaliculitis, an infection of the lacrimal drainage system of the eye.
The laboratory records of patients presenting with canaliculitis from whom specimens were obtained for microbiological investigations at our tertiary eye care centre in South India from January 2010 to December 2020, were reviewed.
A total of 130 canalicular pus samples were collected from 112 patients and submitted for microbiological studies during the study period. A total of 183 micro-organisms were isolated from 115 culture-positive specimens. The micro-organisms isolated were predominantly aerobic Gram-positive bacteria (83.44%), with Coagulase-negative Staphylococci (CoNS/Other Staphylococcus spp) (31.69%), Corynebacterium spp (15.3%), Staphylococcus aureus (9.84%) and Viridans Streptococci (9.84%) accounting for a majority of the isolates. Actinomycesspp (6.56%) was the most common anaerobic bacterium isolated. Our study revealed several bacteria not previously associated with canaliculitis namely Ottowia spp, Elizabethkingiameningoseptica, Aeromonassalmonicida, Capnocytophagaochracea and Campylobacter gracilis. Polymicrobial aetiology was observed in 39.13% of culture-positive samples. Analysis of antibiotic susceptibility patterns of the isolates revealed a high proportion of Gram-positive bacteria susceptible to chloramphenicol (90.16%) compared to fluoroquinolones including ciprofloxacin (74.42%), norfloxacin (64.15%) and gatifloxacin (60.49%).
This study represents the largest series of canaliculitis reporting the microbiological profile and antibiotic susceptibilities of the isolated micro-organisms, till date. Gram-positive bacteria accounted for a majority of isolates, predominated by Staphylococcus spp. The increasing resistance of Gram-positive bacteria to fluoroquinolones warrants antibiotic treatment in canaliculitis is based on in vitro antimicrobial susceptibility patterns.

To investigate the microbial spectrum isolated from foot ulcers among diabetic patients in China, which was conducted to help clinicians choose optimal antibiotics empirically.
The PubMed, MEDLINE, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases were searched for studies published between 2015 to 2019, that report primary data on diabetic foot infection (DFI) and antibiotic susceptibility in China.
A total of 63 articles about DFI and antibiotic susceptibility tests among diabetic patients in China were included. There were 11,483 patients with an average age of 60.2 ± 10.1 years and a mean course of 10.6 ± 5.0 years between 2010 and 2019, covering most geographical regions of China. The prevalence of Gram-positive (GP) bacteria (43.4%) was lower than that of Gram-negative (GN) (52.4%). The most prevalent pathogens isolated were Staphylococcus aureus (17.7%), Escherichia coli (10.9%), Pseudomonas aeruginosa (10.5%), Klebsiella pneumoniae (6.2%), Staphylococcus epidermidis (5.3%), Enterococcus faecalis (4.9%), and fungus (3.7%). The prevalence of polymicrobial infection was 22.8%. GP bacteria were sensitive to linezolid, vancomycin, and teicoplanin. More than 50% of GN bacteria were resistant to third-generation cephalosporins, while the resistance rates of piperacillin/tazobactam, amikacin, meropenem, and imipenem were relatively low. Among the 6017 strains of the isolated organisms, 20% had multi-drug resistance (MDR). Staphylococcus aureus (30.4%) was the most predominant MDR bacteria, followed by extended-spectrum β-lactamase (ESBL) (19.1%).
The microbial infection of foot ulcers among diabetic patients in China is diverse. The microbial spectrum is different in different geographic regions and Staphylococcus aureus is the predominant bacteria. Polymicrobial and MDR bacterial infections on the foot ulcers are common. This study could be valuable in guiding the empirical use of antibiotics for diabetic foot infections.

Maternal Group B Streptococcus (GBS) recto-vaginal colonization is the most common route for early onset neonatal GBS diseases. A good understanding of the rate of maternal GBS colonization, vertical transmission rate, and antibiotic susceptibility profiles is needed to formulate a broad protection mechanism, like vaccine preparation. For that reason, this meta-analysis aimed at determining the pooled prevalence of GBS recto-vaginal colonization, vertical transmission rate, and antibiotic susceptibility profiles in Ethiopia.
Both published and unpublished studies were searched from MEDLINE/PubMed, CINAHL (EBSCO), Embase, Cochrane Library, SCOPUS, Web of Sciences databases, and Google Scholar. Independent selection was then carried out by the authors based on the eligibility criteria and data extraction using Microsoft excel. The authors then used STATA version 14.1 software for further cleaning and analysis. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Using the random-effect model, the prevalence with a 95% confidence interval (CI) and forest plot were used to present the findings. Besides, the studies\' heterogeneity was assessed using Cochrane chi-square (I2) statistics, while Egger intercept was used to assess publication bias.
This review included nineteen studies. The pooled prevalence of recto-vaginal colonization was 15% (95% CI: 11, 19), while the prevalence of vertical transmission was 51% (95% CI: 45, 58) and highest-level susceptibility to vancomycin was 99% (95% CI: 98, 100). However, the GBS susceptibility to tetracycline was 23% (95% CI: 9, 36).
Nearly one out of seven pregnant women in Ethiopia had recto-vaginal colonization of GBS. As a result, half of the pregnancies end with vertical transmission of GBS. Hence, the review emphasizes that policy and programs should consider planning and implementing prophylactic programs.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.

Listeria monocytogenes causes listeriosis with a high mortality rate. This study systematically reviewed the antibiotic susceptibility of L. monocytogenes in the world. A literature search was done and the data of 33 studies that matched with the inclusion criteria, were used for meta-analysis. The random-effect model meta-analysis was applied to determine the frequency of overall L. monocytogenes and its antibiotic non-sensitive isolates. The frequency of L. monocytogenes contamination in non-human sources was 10.3%. The most frequent serotypes were 4b and 4ab in human and non-human isolates, respectively. The resistance of L. monocytogenes isolates to the first-line antibiotics namely penicillin, ampicillin/amoxicillin, gentamicin, and trimethoprim-sulfamethoxazole has been increased in recent years. Altogether, the results indicated a concern for the antibiotic resistance in L. monocytogenes isolates over time. The implement of the registry and surveillance systems is required to improve the insight of L. monocytogenes antibiotic susceptibility and its treatment choices.

BACKGROUND: Over the decades, new antibacterial agents have been developed in an attempt to combat drug resistance, but they remain unsuccessful. Recently, a novel class of bacterial gene expression regulators, bacterial small RNAs (sRNAs), has received increasing attention toward their involvement in antibiotic resistance. This systematic review aimed to discuss the potential of these small molecules as antibacterial drug targets.
METHODS: Two investigators performed a comprehensive search of MEDLINE, EmBase, and ISI Web of Knowledge from inception to October 2016, without restriction on language. We included all in vitro and in vivo studies investigating the role of bacterial sRNA in antibiotic resistance. Risk of bias of the included studies was assessed by a modified guideline of Systematic Review Center for Laboratory Animal Experimentation (SYRCLE).
RESULTS: Initial search yielded 432 articles. After exclusion of non-original articles, 20 were included in this review. Of these, all studies examined bacterial-type strains only. There were neither relevant in vivo nor clinical studies. The SYRCLE scores ranged from to 5 to 7, with an average of 5.9. This implies a moderate risk of bias. sRNAs influenced the antibiotics susceptibility through modulation of gene expression relevant to efflux pumps, cell wall synthesis, and membrane proteins.
CONCLUSIONS: Preclinical studies on bacterial-type strains suggest that modulation of sRNAs could enhance bacterial susceptibility to antibiotics. Further studies on clinical isolates and in vivo models are needed to elucidate the therapeutic value of sRNA modulation on treatment of multidrug-resistant bacterial infection.

To review the microbiological spectrum and antibiotic sensitivities of the pathogens that cause culture-proven endophthalmitis and to understand the status and trends of antibiotic susceptibility at a public hospital over a 10-year period.
The data of 577 culture-proven endophthalmitis isolates collected between April 2004 and April 2014 were reviewed retrospectively. The antibiotic sensitivities were determined according to the criteria of the Clinical and Laboratory Standards Institute. The changes in antibiotic susceptibility over the 10 years were subjected to χ2 tests for trends.
Among these isolates, 65% were gram-positive organisms (375), 16.6% were gram-negative organisms (96), and 18.4% were fungi (106). The predominant pathogens were Staphylococcal species (Staphylococcus epidermidis in 175, other coagulase-negative Staphylococci in 41, and Staphylococcus aureus in 54 cases), followed by Bacillus cereus isolates. The Aspergillus species was the most frequently isolated fungus, and Pseudomonas aeruginosa was the most frequently isolated gram-negative bacteria. The antibiotic susceptibilities of gram-positive bacteria were as follows: vancomycin, 97.6%; levofloxacin, 85.1%; gentamicin, 78.7%; rifampin, 77.2%; ofloxacin, 77.2%; chloramphenicol, 76.4%; and ciprofloxacin, 73.7%. The antibiotic susceptibilities of gram-negative isolates were as follows: ceftazidime, 50.5%; ciprofloxacin, 82.2%; amikacin, 81.3%; tobramycin, 80.2%; imipenem, 79.7%; and gentamicin, 78%. Over the 10-year study, there were significant changes in the antibiotic susceptibilities to the following five antibiotics: vancomycin, imipenem, penicillin G, amikacin, and trimethoprim-sulfamethoxazole (TMP-SMX).
Vancomycin remains the most appropriate empirical antibiotic for gram-positive bacteria. The susceptibilities of the gram-negative organisms to ciprofloxacin and amikacin were greater than that to ceftazidime. Trends toward increases in the susceptibilities to the following five antibiotics were observed: vancomycin, imipenem, penicillin G, amikacin, and TMP-SMX.

Bovine respiratory disease (BRD) remains a major disease from an economic and an animal welfare standpoint in beef production systems. Antimicrobial administration is a mainstay in the control of and therapeutic treatment of acute BRD. Judicious use of antimicrobials remains paramount to ensure efficacy of treatment remains acceptable. A systemic review was conducted in the scientific literature, the objective of which was to present a cumulative review of the data from published randomized clinical trials using a negative control in the treatment and control of BRD and using the number needed to treat as a means to effectively convey this information to bovine practitioners.