UNASSIGNED: Recent reports have described the increasing predominance of Gram-negative organisms among invasive bacterial infections affecting preterm infants. This changing pattern of infections is concerning due to the spread of antibiotic resistance among Gram-negatives.
UNASSIGNED: We conducted a single-centre, retrospective cohort study involving very-low-birthweight (VLBW) (<1500 grams) infants born <32 weeks gestation, with culture-proven infections (blood, urine, cerebrospinal fluid [CSF]) in the neonatal intensive care unit from 1 January 2005 to 31 October 2017.
UNASSIGNED: A total of 278 out of 2431 (11.4%) VLBW infants born <32 weeks gestation developed 334 infections, i.e. 52 (15.6%) early-onset infections (EOIs) and 282 (84.4%) late-onset infections (LOIs). The overall incidence decreased from 247 to 68 infections per 1000 infants over the study period, corresponding to reductions in LOI (211 to 62 infections per 1000 infants). A total of 378 bacteria were isolated, i.e. Gram-negatives accounted for 70.9% (45 of 59 [76.3%] EOI; 223 of 319 [69.9%] LOI). Specific resistant organisms were noted, i.e. Methicillin-resistant Staphylococcus aureus (8 of 21 S. aureus infections [38.1%]); Cephalosporin-resistant Klebsiella (18 of 62 isolates [29.0%]) and multidrug-resistant [MDR] Acinetobacter (10 of 27 isolates [37.0%]). MDR organisms accounted for 85 of 195 (43.6%) Gram-negative infections from the bloodstream and CSF. Based on laboratory susceptibility testing, only 63.5% and 49.3% of infecting bacteria isolated in blood were susceptible to empiric antibiotic regimens used for suspected EOI and LOI, respectively.
UNASSIGNED: Gram-negative bacteria are the predominant causative organisms for EOI and LOI and are frequently MDR. Understanding the pattern of antimicrobial resistance is important in providing appropriate empiric coverage for neonatal infections.

UNASSIGNED: The aim of this study is to evaluate the etiological profile and antimicrobial resistance in breast abscess cultures from patients from the community, treated at a public hospital located in Porto Alegre, Brazil.
UNASSIGNED: This is an retrospective cross-sectional study that evaluated the medical records of patients with bacterial isolates in breast abscess secretion cultures and their antibiograms, from January 2010 to August 2022.
UNASSIGNED: Based on 129 positive cultures from women from the community diagnosed with breast abscesses and treated at Fêmina Hospital, 99 (76.7%) of the patients had positive cultures for Staphylococcus sp, 91 (92%) of which were cases of Staphylococcus aureus. Regarding the resistance profile of S. aureus, 32% of the strains were resistant to clindamycin, 26% to oxacillin and 5% to trimethoprim-sulfamethoxazole. The antimicrobials vancomycin, linezolid and tigecycline did not show resistance for S. aureus.
UNASSIGNED: Staphylococcus aureus was the most common pathogen found in the breast abscess isolates during the study period. Oxacillin remains a good option for hospitalized patients. The use of sulfamethoxazole plus trimethoprim should be considered as a good option for use at home, due to its low bacterial resistance, effectiveness and low cost.

During COVID-19 public health emergence, azithromycin was excessively used in Brazil, as part of a controversial \"early treatment\", recommended by former national health authorities. Excessive usage of macrolides may increase resistance rates among beta-hemolytic streptococci. Therefore, this study aimed to investigate the occurrence of resistance to erythromycin and clindamycin among Streptococcus agalactiae recovered from February 2020 to May 2023. Bacterial isolates (n = 116) were obtained from pregnant women and submitted to antimicrobial susceptibility testing, investigation of macrolide resistance phenotypes and genotypes, and identification of capsular type. The overall rate of erythromycin not susceptible (NS) isolates was 25.9%, while resistance to clindamycin was 5.2%. Drug efflux, associated with the M phenotype and mef(A) gene, was the prevalent mechanism of resistance (80%). Capsular type Ia was predominant (39.8%), followed by II, III, and V (17.7% each). A higher diversity of types was observed in the last years of the study. Type IV has had an increasing trend over time, being the fourth most common in 2023. The majority of the isolates that expressed the M phenotype presented capsular type Ia, while those with iMLS phenotype presented capsular type V. Despite no causal relationship can be established, azithromycin excessive usage may be a possible factor associated with this higher rate of erythromycin NS isolates, compared with most previous national studies. On the other hand, resistance to clindamycin has not changed significantly. Therefore, in the studied clinical setting, clindamycin remains a useful alternative to intrapartum prophylaxis among penicillin-allergic pregnant women.

This review addresses the escalating challenge posed by antibiotic resistance, highlighting its profound impact on global public health, including increased mortality rates and healthcare expenditures. The review focuses on the need to adopt the One Health approach to effectively manage antibiotic usage across human, animal, and environmental domains. Antimicrobial stewardship programs (ASPs) are considered as comprehensive strategies that encompass both core and supplementary initiatives aimed at enhancing prudent antibiotic use. The 2021 \"Guidelines on Implementing ASP in Korea\" introduced such strategies, with a strong emphasis on fostering multidisciplinary and collaborative efforts. Furthermore, the \"Core Elements for Implementing ASPs in Korean General Hospitals,\" established in 2022, provide a structured framework for ASPs, delineating leadership responsibilities, the composition of interdisciplinary ASP teams, a range of interventions, and continuous monitoring and reporting mechanisms. In addition, this review examines patient-centric campaigns such as \"Speak Up, Get Smart\" and emphasizes the pivotal role of a multidisciplinary approach and international cooperation in addressing the multifaceted challenges associated with antibiotic resistance.

BACKGROUND: Treatment of Helicobacter pylori gastric infection is complex and associated with increased rates of therapeutic failure. This research aimed to characterize the H. pylori infection status, strain resistance to antimicrobial agents, and the predominant lesion pattern in the gastroduodenal mucosa of patients with clinical suspicion of refractoriness to first- and second-line treatment who were diagnosed and treated in a health center in Guayaquil, Ecuador.
METHODS: A total of 374 patients with upper gastrointestinal symptoms and H. pylori infection were preselected and prescribed one of three triple therapy regimens for primary infection, as judged by the treating physician. Subsequently, 121 patients who returned to the follow-up visit with persistent symptoms after treatment were studied.
RESULTS: All patients had H. pylori infection. Histopathological examination diagnosed chronic active gastritis in 91.7% of cases; premalignant lesions were observed in 15.8%. The three triple therapy schemes applied showed suboptimal efficacy (between 47.6% and 77.2%), with the best performance corresponding to the scheme consisting of a proton pump inhibitor + amoxicillin + levofloxacin. Bacterial strains showed very high phenotypic resistance to all five antimicrobials tested: clarithromycin, 82.9%; metronidazole, 69.7%; amoxicillin and levofloxacin, almost 50%; tetracycline, 38.2%. Concurrent resistance to clarithromycin-amoxicillin was 43.4%, to tetracycline-metronidazole 30.3%, to amoxicillin-levofloxacin 27.6%, and to clarithromycin-metronidazole 59.2%.
CONCLUSIONS: In vitro testing revealed resistance to all five antibiotics, indicating that H. pylori exhibited resistance phenotypes to these antibiotics. Consequently, the effectiveness of triple treatments may be compromised, and further studies are needed to assess refractoriness in quadruple and concomitant therapies.

The current study aimed to determine the occurrence and antimicrobial resistance of oral Aerococcus viridans in stray dogs and cats in Algeria. Oral swabs from 200 stray animals (100 dogs and 100 cats) were collected and cultured on Columbia agar medium supplemented with 5% defibrinated sheep blood. Isolates were identified using analytical profile index Rapid 20 Strep commercial kits, and antibiotic susceptibility was determined using the disk diffusion method. Of the 200 animals sampled, 34 carried A. viridans in their oral cavities, with 26 isolates (76.47%) resistant to at least 2 drugs. Multidrug resistance profiles (to more than three different antimicrobials) were observed only in cats (26.08% of isolates). More isolates were resistant to erythromycin and tetracycline (71% and 65%, respectively) than to other antimicrobials. This is the first research study in Algeria detecting antimicrobial resistance in oral A. viridans isolated from dogs and cats and highlights potential public health concerns. Clinical trials registration number: 01/2018.

Open reduction with internal fixation (ORIF) for facial fractures has frequently been associated with the occurrence of surgical site infections (SSIs). Perioperative antibiotic prophylaxis is customarily recommended for ORIF. Thus, the comparison of two different antibiotic regimens (i.e., single-dose and prolonged antibiotic prophylaxis) concerning the rate and severity of SSIs in facial fracture patients undergoing ORIF was the main purpose of this study. This retrospective analysis included patients who underwent ORIF for facial fractures. They were distributed into two groups. The single-dose antibiotic prophylaxis group (SDAP) received single-dose perioperative antibiotic prophylaxis, whereas the prolonged antibiotic prophylaxis group (PAP) were administered prophylactic antibiosis over a course of 5 days. 122 patients were included in the study. Nine patients in the SDAP group and 15 patients in the PAP group were affected by SSIs; no significant difference in the incidence of SSIs was found (p = 0.218). Moreover, the severity of SSIs did not significantly differ between the two groups (p = 0.982).

Bacterial keratitis (bacterial infection of the cornea) is a major cause of vision loss worldwide. Given the rapid and aggressive nature of the disease, immediate broad-spectrum antibiotics are essential to adequately treat this disease. However, rising antibiotic resistance continues to accelerate, rendering many commonly used therapeutics increasingly ineffective. As such, there is a significant effort to understand the basic pathogenesis of common causative organisms implicated in keratitis in part, to fuel the development of novel therapies to treat this blinding disease. This review explores two common causes of bacterial keratitis, Staphylococcus aureus and Pseudomonas aeruginosa, with regards to the bacterial mediators of virulence as well as novel therapies on the horizon.

OBJECTIVE: To juxtapose the microbiological efficacy of standard and targeted antibiotic therapy (ABT) based on the comparison of the results of extended bacteriology of biomaterial in patients suffering chronic bacterial prostatitis (CBP) before and after treatment.
METHODS:
METHODS: single-centre observational comparative study. Sixty patients with CBP aged 20 to 45 years were included in the study. All patients underwent an initial examination: questioning, Meares-Stamey 4-glass test, extended bacteriology of biomaterial samples, and determination of antibacterial susceptibility (ABS). After the initial examination, the patients were randomly assigned to two groups (30/30 patients). In group (G) 1, antibacterial drugs were prescribed following the EAU guidelines on Urological Infections (monotherapy), in G2, focusing on the results of ABS (mono or combination therapy). Evaluation of the treatment effectiveness and control bacteriology were carried out three months after therapy.
RESULTS: In G1 vs G2, nine vs ten aerobes and eight vs nine anaerobes were identified in the expressed prostate secretion, respectively. The microbial load of the samples in more or equal 103 CFU / ml was established in G1 vs G2 for five vs ten aerobes and seven vs eight anaerobes, respectively. The highest ABS of bacteria was determined to moxifloxacin, ofloxacin, and levofloxacin. Cefixime was the most active against anaerobes. After treatment, no significant changes in the bacterial spectrum were observed in both groups. A more reliable decrease in the frequency of microorganism identification and the microbial load of the samples was observed in patients with G2 after the targeted ABT.
CONCLUSIONS: Targeted ABT based on extended bacteriology can be considered an effective alternative to standard guideline-approved ABT for the treatment of CBP.

Urinary tract infections (UTIs) are among the most common bacterial infections. The clinical phenotypes of UTIs are heterogeneous, ranging from rather benign uncomplicated infections to complicated UTIs and pyelonephritis to severe urosepsis. Antibiotics have become indispensable in modern medicine, but the development of resistance is threatening clinical effectiveness. Antimicrobial resistance rates are locally high in UTIs, however can vary significantly depending on the population studied and the type of study. In addition, between 1990 and 2010, there was a discovery void in the development of new antibiotics that is still having an impact today. In recent years, UTIs have emerged as an infection model for research into novel antibiotics. In the last 10 years, novel gram-negative active drugs have been explored in these groups. On the one hand, novel beta-lactam/beta-lactamase inhibitor combinations were investigated, and there has also been further development of cephalosporins and aminoglycosides.
UNASSIGNED: Harnwegsinfektionen (HWI) gehören zu den häufigsten bakteriellen Infektionen. Die klinischen Phänotypen der HWI sind heterogen und reichen von eher gutartigen unkomplizierten Infektionen über komplizierte HWI und Pyelonephritis bis hin zu schwerer Urosepsis. Antibiotika sind aus der modernen Medizin nicht mehr wegzudenken, aber Resistenzentwicklung bedroht die klinische Effektivität. Antimikrobielle Resistenzraten sind bei HWI stellenweise hoch, können sich jedoch erheblich unterscheiden, je nach untersuchter Population und Studienart. Zusätzlich manifestierte sich in den Jahren 1990 bis 2010 eine Antibiotikaentwicklungslücke, die auch heute noch nachwirkt. HWI haben sich in den letzten Jahren als Infektionsmodell für die Erforschung neuartiger Antibiotika herausgestellt. In den letzten 10 Jahren wurden neuartige gramnegative Wirkstoffe in diesen Gruppen beforscht. Zum einen wurden neuartige Beta-Laktam/Beta-Laktamasehemmerkombinationen untersucht sowie Weiterentwicklungen von Cephalosporinen und Aminoglykosiden.