Search Results (1,529)

ESKAPE pathogens have become a major global health challenge. This study aimed to isolate and characterize LAB from fermented cacao and to evaluate their probiotic properties, preliminary antimicrobial activity against ESKAPE pathogens, safety profiles, and functional bioactivities. Each of P. acidilactici isolates exhibited antibacterial activity against ESKAPE pathogens, with inhibition zone diameters ranging from 10.00 ± 1.00 mm to 23.00 ± 0.00 mm, depending on the isolate and pathogens tested. CR05 was identified as the most promising probiotic candidate, showing the highest survival at pH 2 (69.65 ± 6.66%), strong tolerance to pancreatin (99.95 ± 0.10%), pepsin (89.11 ± 2.38%), bile salts (98.65 ± 0.33%), and favorable adhesion properties, including auto-aggregation, cell surface hydrophobicity, and adhesion to HT-29 intestinal epithelial cells. The safety assessment indicated a notable susceptibility to gentamicin, tetracycline, and chloramphenicol, with resistance to several other tested antibiotics. and showed no hemolytic activity. Three selected isolates were evaluated for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against ESKAPE pathogens, with MIC and MBC values ranging from 12.5 to 25 mg/mL and 25 to >50 mg/mL, respectively. The strongest inhibitory activity was observed against A. baumannii, P. aeruginosa, and E. aerogenes, with MIC values of 12.5 mg/mL, particularly for isolates CR05 and CR06. Whole-genome analysis identified genes related to stress response and gastrointestinal tolerance and predicted the enterolysin A gene. No acquired antimicrobial resistance genes were detected. These findings suggest that P. acidilactici isolates from fermented cacao are promising probiotic candidates for further investigation in functional food, probiotic, and postbiotic-related applications. Full article

Background: The COVID-19 pandemic disrupted healthcare systems and antimicrobial stewardship, potentially altering antimicrobial resistance patterns. This study characterized temporal changes in the proportions of multidrug-resistant organisms (MDROs) and identified associated factors before and during the pandemic at a tertiary care hospital in northeastern Thailand. Methods: A single-center retrospective observational study was conducted at Roi Et Hospital, including 5458 culture-confirmed MDRO cases (2017–2022), stratified into pre-pandemic (2017–2019) and pandemic (2020–2022) periods. Pathogen-specific resistance proportions were compared using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression identified independently associated factors within each period. Results: The proportion of MDRO cases classified as hospital-acquired increased from 40.71% to 57.41% (p < 0.001). Carbapenem-resistant Acinetobacter baumannii (CRAB) increased markedly (22.87% to 76.11%; OR 10.75, 95% CI 9.43–12.26), followed by carbapenem-resistant Enterobacterales (CRE) (4.05% to 21.61%; OR 6.54, 95% CI 5.84–7.32) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) (14.32% to 27.15%; OR 2.23, 95% CI 1.87–2.65; all p < 0.001). Vancomycin-resistant Enterococcus (VRE) declined significantly (OR 0.41, 95% CI 0.25–0.68; p < 0.001). Methicillin-resistant Staphylococcus aureus (MRSA) showed a higher proportion among clinical isolates (3.28% to 6.34%; OR 2.01, 95% CI 1.42–2.83), although without a consistent annual trend. In multivariable analyses, ICU admission was independently associated with lower odds of CRE (aOR 0.52) and CRPA (aOR 0.63) and with higher odds of CRAB (aOR 2.13; all p < 0.001). Conclusions: The COVID-19 pandemic was associated with a major proportional shift toward carbapenem-resistant Gram-negative pathogens, with distinct profiles of associated factors across CRAB, CRE, and CRPA. These findings highlight the need for pathogen-specific infection prevention and antimicrobial stewardship strategies during healthcare system disruptions. Full article

Agastache foeniculum (Pursh) Kuntze, a member of the Lamiaceae family, is a phytochemically rich yet underexplored species with potential biomedical applications. This study aimed to provide an organ-specific chemical characterization of its secondary metabolites and to evaluate the antimicrobial potential of ethanolic extracts derived separately from its leaves and flowers. Using UHPLC-MS/MS, we identified a total of 54 compounds, including phenolic acids and flavonoids. In total, 35 compounds in the flower extract and 38 in the leaf extract were reported here for the first time. The antimicrobial activity of both extracts was tested against six multidrug-resistant (MDR) clinical bacterial isolates (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Citrobacter freundii, Achromobacter xylosoxidans, and Acinetobacter baumannii) using seven concentration levels (12.5–87.5%). While the leaf extract showed limited antibacterial effects, the flower extract demonstrated stronger, concentration-dependent inhibitory effects. At concentrations of 62.5% and above, it markedly reduced viable bacterial counts in all tested MDR strains. These findings highlight the importance of organ-specific phytochemical analysis in medicinal plants and suggest that A. foeniculum, particularly its flowers, may serve as a promising source of bioactive compounds for further antimicrobial research and development. Full article

Acinetobacter baumannii, a multidrug-resistant pathogen of critical priority within the ESKAPE group, poses a significant threat to global healthcare, particularly in the context of nosocomial infections. Its pathogenesis is mediated not only by antibiotic resistance determinants but also by a complex repertoire of secreted virulence factors. However, comprehensive characterization of the A. baumannii secretome remains methodologically challenging due to spectral overlap in complex biological matrices. In this study, we applied a hybrid approach integrating size-exclusion chromatography with Raman spectroscopy to deconvolute the cell-free supernatant of A. baumannii. Chromatographic fractionation into seven fractions reduced spectral complexity and enabled the identification of unique metabolic profiles. Fraction 3 exhibited a distinct composition, containing specific markers for phosphatidylserine (~1724 cm⁻¹), cysteine, phosphatidylinositol, and DNA (~770–806 cm⁻¹), as well as CH₂ groups of lipids and amino acids (~1450–1456 cm⁻¹), while lacking signals corresponding to methionine-containing compounds, nucleic acid backbones, and polypeptide backbones characteristic of other fractions. Analysis revealed distinct biochemical specialization across fractions: Fraction 2 was enriched in glutamine/asparagine-associated signals (~990, ~998 cm⁻¹), Fraction 4 contained a unique carotenoid marker (~1154 cm⁻¹), Fraction 6 exhibited a phenylalanine-specific peak (~1104 cm⁻¹), and Fraction 7 demonstrated the highest intensity of cysteine-containing protein, nucleotide, and phospholipid signals. These findings open new avenues for the discovery of biomarkers associated with virulence and antibiotic resistance in A. baumannii. Full article

This study aimed to investigate the marked increase in bla_NDM-1-positive Acinetobacter baumannii isolates (20% of all CRAB isolates) observed in a tertiary-care hospital in Central Greece during 2025. Thirty bla_NDM-1-producing carbapenem-resistant A. baumannii (CRAB) isolates were selected and subjected to whole-genome sequencing for molecular typing and characterization of antimicrobial resistance determinants and virulence-associated genes. The majority of the isolates (22/30) belonged to ST2^Pasteur (18 strains), ST85^Pasteur (2 strains) and ST2493^Pasteur (2 strains), all previously identified in 2023. The remaining eight strains belonged to newly detected STs, such as ST1^Pasteur (six strains) and ST2806^Pasteur (two strains). All strains carried the bla_NDM-1 gene on the Tn7382. The high prevalence of bla_NDM-1-positive CRAB represents not only a local threat but also a national concern, as patients from our hospital are frequently transferred to other healthcare facilities or long-term care centers across the country, creating a substantial risk for further dissemination of these strains. Routine molecular screening for bla_NDM-1-positive CRAB may represent a valuable strategy for limiting further dissemination. Full article

Multidrug-resistant (MDR) pathogens present a significant threat to hematopoietic stem cell transplant (HSCT) recipients; despite their critical implications, regional data on their infection patterns remain scarce. This study aimed to characterize the incidence, pathogen and antimicrobial resistance distribution of clinically confirmed bacterial infections among HSCT recipients. A retrospective analysis was conducted at King Hussein Cancer Center, Jordan (2018–2022). MDR pathogens were defined per CDC criteria. During the study period, 1157 HSCT procedures were performed. A total of 327 patients developed clinically documented bacterial infections, yielding an overall cumulative incidence of 28.3%, with a higher burden in the pediatric cohort (34.7%), including exclusive identification of Klebsiella oxytoca in pediatrics (2.3%). Gram-negative bacteria dominated, with Escherichia coli (50.5%) and Klebsiella pneumoniae (22.0%) being most common. Extended-spectrum beta-lactamase (ESBL) production was the dominant resistance mechanism (71.3%), followed by carbapenem-resistant Enterobacteriaceae (CRE; 14.1%), methicillin-resistant Staphylococcus aureus (MRSA; 8.6%), and carbapenem-resistant Pseudomonas aeruginosa (CRPA; 7.0%). The urogenital (39.1%) and bloodstream (31.2%) were the most infected sites. Significant site-specific associations were noted for ESBL production, MDR-Acinetobacter baumannii (p < 0.001) and MRSA (p = 0.007). Temporal analysis revealed a convergent MDR peak in 2021. Our findings offer critical insights into MDR pathogen incidence in HSCT recipients in the Middle East, informing improved infection management and intensified antimicrobial stewardship in this high-risk population. Full article

Antimicrobial resistance (AMR) has emerged as one of the foremost global threats to public health, with the veterinary sector, responsible for nearly three-quarters of global antimicrobial consumption, representing an underappreciated epicenter of this crisis. Despite the extensive literature on bacteriocins as antibiotic alternatives, most reviews focus on human medicine or food preservation, leaving a conspicuous gap in evidence specific to veterinary medicine. The present review addresses this gap by examining the molecular basis of bacteriocin activity (lipid II, bacterial RNA polymerase, cytoplasmic membrane), strategies for clinical deployment (topical therapy, antibiotic combinations, disruption of biofilm tolerance), and preclinical evidence relevant to bovine mastitis, canine pyoderma and otitis externa, and infections caused by multidrug-resistant pathogens (MRSA (Methicillin-Resistant Staphylococcus aureus), MRSP (Methicillin-Resistant Staphylococcus pseudintermedius), colistin-resistant P. aeruginosa, XDR (extensively drug-resistant) Acinetobacter baumannii). Translational barriers—pharmacokinetic, regulatory, and evidentiary—are critically appraised, alongside emerging directions including precision nanocarriers, biofilm-targeted therapies, and the animal microbiota as a reservoir of novel molecules. Bacteriocins represent a promising yet underexploited antibacterial class in response to the escalating AMR crisis in the animal sector. Full article

Background: Healthcare-associated infections (HAIs) and antimicrobial resistance are major burdens in tertiary care hospitals. Repeated point prevalence surveys (PPSs) offer a pragmatic approach to monitor temporal changes and guide infection prevention. Objectives: Characterize healthcare-associated infections (HAI) prevalence trends, microbiological profiles, antimicrobial resistance (AMR) patterns, and risk factors to refine prevention strategies and hospital policy. Methods: Four annual cross-sectional PPSs were conducted between 2022 and 2025 using the standardized ECDC protocol. Data from all eligible inpatients present at 08:00 on survey days were collected through systematic medical record review. Multivariable logistic regression was used to identify factors independently associated with HAI, with additional sensitivity analyses evaluating invasive device burden and hospital ward type. Results: Across the surveys, 3314 patients were included. Overall HAI prevalence was 11.3%. Infections were most frequent in intensive care units (31.2%), followed by medical (14.6%) and surgical (14.2%) wards. Bloodstream infections (25.7%) and lower respiratory tract infections (19.8%) were the most common. Multivariable analysis identified invasive device exposure as the strongest predictor, with central venous and urinary catheters showing robust independent associations and a clear dose–response relationship according to the number of devices. Pathogens were predominantly Gram-positive cocci (40.5%) and Enterobacterales (30.8%), with Klebsiella pneumoniae being the most frequent isolate (13.0%). Notably, 57.6% of K. pneumoniae isolates were resistant to third-generation cephalosporins. All tested Acinetobacter baumannii isolates were resistant to carbapenems. Conclusions: This repeated PPS reveals a persistently high HAI burden, associated with invasive device exposure and resistant pathogens. Because of the repeated cross-sectional design, causal inference cannot be established. Hospital-wide device stewardship and integrated surveillance are essential for guiding targeted prevention measures, refining antimicrobial policies, and adapting local responses to evolving resistance profiles. Full article

The emergence and global dissemination of pandrug-resistant (PDR) Acinetobacter baumannii represents a critical public health crisis. This One Health study provides comprehensive surveillance and molecular characterization of carbapenem-resistant, extensively drug-resistant (XDR), and PDR A. baumannii isolates isolated from hospitalized patients and diseased chickens/environment in Egypt. We investigated cross-species clinical and pathological impacts, characterized resistance genes, and analyzed potential transmission links. Of 145 samples, 48 A. baumannii isolates were identified. Resistance profiling revealed an alarming prevalence, with PDR (56.3%) being the dominant phenotype, followed by XDR (43.7%), all exhibiting high multiple antibiotic resistance (MAR) indices (≥0.67). Chickens and humans infected with PDR A. baumannii suffered from increased neutrophilia, anemia, elevated inflammatory markers (CRP and procalcitonin), renal and liver impairment, and upregulation of MMP-9 and IL-8 response genes. Molecular analysis showed that all PDR isolates co-harbored multiple carbapenemase genes, including Class D beta-lactamases (bla_OXA-23 (most prevalent), bla_OXA-48, bla_OXA-58, bla_OXA-24) and Class B metallo-beta lactamase (bla_VIM, bla_IMP, bla_NDM). A substantial proportion also carried bla_KPC (44.4%) and the carO gene (81.48%). Genotyping using ERIC PCR and Multilocus Sequence Typing (MLST) identified a high diversity (23 ERIC types, DI = 0.986). Significantly, two ERIC types (ET19 and ET20) contained isolates from both human and chicken sources. MLST confirmed this interspecies correlation, with isolates from both hosts clustering into Sequence Types (STs) ST1410 and ST1828. These findings confirm the rapid and alarming spread of highly virulent, multi-carbapenemase-producing PDR A. baumannii strains across the human–animal interface in Egypt. The detection of shared STs between clinical and poultry isolates underscores a potential zoonotic or environmental transmission route, necessitating integrated One Health surveillance and urgent infection control interventions. Full article

Background: The coronavirus disease 2019 (COVID-19) pandemic coincided with substantial changes in healthcare delivery and antimicrobial resistance (AMR) patterns worldwide, particularly in intensive care units (ICUs), where invasive procedures and broad-spectrum antibiotics are commonly used. Data from Türkiye remains limited. Methods: This retrospective observational study evaluated bacterial and fungal isolates from adult ICU patients at a tertiary hospital from 2016 to 2025. Microorganisms were identified, and antimicrobial susceptibility testing was performed using standardized methods. Resistance patterns were compared between the pre-pandemic (January 2016–February 2020) and post-pandemic (March 2020–May 2025) periods. Results: A total of 2666 patients and 5433 isolates were analyzed. Gram-negative pathogens showed marked increases in resistance: carbapenem and colistin resistance in Klebsiella pneumoniae were significantly higher in the post-pandemic period (69.6% vs. 44.4% and 60.5% vs. 22.5%, respectively; p < 0.001). Resistance rates to multiple antimicrobial agents also increased in Acinetobacter baumannii and Pseudomonas aeruginosa (p < 0.05). Among Gram-positive bacteria, vancomycin-resistant Enterococcus faecium increased from 10% to 47.1%. Candida auris emerged only in the post-pandemic period, showing high resistance to fluconazole (75%) and amphotericin B (36.7%). Conclusions: Significant differences in AMR patterns were observed between the pre- and post-pandemic periods in this ICU population. Higher resistance rates were observed among several clinically important bacterial pathogens, and Candida auris emerged exclusively during the post-pandemic period. Given the study’s observational design, these findings should be interpreted as temporal associations rather than evidence of a causal effect of the COVID-19 pandemic. Continued antimicrobial stewardship and infection-control measures remain essential to address the growing burden of AMR. Full article

This study evaluated how graded dietary nucleotide supplementation (0, 0.25, 0.5, 0.75, 1.0, and 2.0 g/kg) affects growth performance, antioxidant capacity, intestinal morphology, and gut microbiota in swamp eel (Monopterus albus) (initial body weight 10.07 ± 0.92 g). Three hundred sixty fish were randomly assigned to six diets, each in triplicate, for eight weeks. Compared with the control, nucleotide addition significantly increased final body weight, weight gain rate, and specific growth rate, and decreased feed conversion ratio (p < 0.05), with optimal results at 0.75 g/kg (HS3). Survival was 100% in all groups. Supplemented fish showed lower serum and intestinal malondialdehyde levels and higher superoxide dismutase and catalase activities (p < 0.05). Serum total protein, albumin, and triglycerides increased, whereas alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase decreased (p < 0.05), pointing to improved hepatic and lipid metabolism. Intestinal trypsin, lipase, and amylase activities also rose markedly (p < 0.05), peaking in HS3. Histological examination revealed greater mucosal thickness and villus height (p < 0.05); in HS3, these values reached approximately 0.95 mm and 0.87 mm, respectively. Metagenomic analysis showed that 0.75–1.0 g/kg nucleotides increased alpha diversity and restructured the microbial community, enriching Bacteroidetes- and Prevotella-related taxa while reducing Proteobacteria, including Acinetobacter baumannii and Escherichia coli. LEfSe identified dose-specific discriminant taxa, and refined KEGG Level 3 pathway analysis predicted enhanced butyrate and propanoate biosynthesis, starch utilization, and purine/pyrimidine interconversion at moderate doses. Genus-level abundances of Prevotella and Bacteroides correlated inversely with serum oxidative and hepatic stress markers. Quadratic regression estimated the optimal dietary nucleotide level at 764 mg/kg (0.76 g/kg), consistent with the best-performing 0.75 g/kg group. Collectively, 0.75–0.76 g/kg dietary nucleotides optimize growth and intestinal health in M. albus through coordinated improvements in antioxidant status, digestive function, mucosal architecture, and beneficial gut microbiota remodeling. Full article

Antimicrobial resistance (AMR) is a growing global public health challenge. Its development is strongly associated with the inappropriate and excessive use of antimicrobial agents, leading to reduced treatment effectiveness, limited availability of therapeutic options, constraints on medical procedures, and an increasing economic burden. This narrative review synthesizes current knowledge on antibiotic-resistant bacteria detected in airborne samples from healthcare environments and examines their reported resistance profiles. The review focused on the bacterial species identified, methods used for antimicrobial susceptibility assessment, types of healthcare facilities investigated, and environmental and behavioral factors influencing the occurrence and dissemination of airborne antibiotic-resistant bacteria. The clinical relevance of the reported pathogens was discussed in the context of the WHO Bacterial Priority Pathogens List (BPPL), while the WHO AWaRe classification and TrACSS framework were used as complementary interpretative tools to contextualize resistance patterns and their implications for antimicrobial stewardship and AMR surveillance. The reviewed studies showed that airborne bacterial communities in healthcare settings were dominated by Gram-positive bacteria, particularly Staphylococcus spp. and Bacillus spp., while clinically relevant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Acinetobacter baumannii were also frequently detected. Resistance to β-lactam antibiotics was the most frequently reported resistance pattern. Considerable heterogeneity in sampling strategies, antimicrobial susceptibility testing methods, and interpretive criteria limited direct comparison among studies. The findings highlight the need for standardized monitoring methods, long-term surveillance, and integrated environmental and clinical research to support infection prevention strategies and mitigate antimicrobial resistance. Full article

Acinetobacter baumannii is a significant pathogen of hospital-acquired infections, and its multidrug resistance (MDR) and extended drug resistance (XDR) have become increasingly severe, posing a global public health challenge. This article provides a narrative review of the major resistance mechanisms of Acinetobacter baumannii, including β-lactamase production, efflux pump overexpression, target site modification, reduced membrane permeability, and biofilm formation. Additionally, it summarizes the current main drugs and their target sites for treating MDR Acinetobacter baumannii infections, with a focus on the mechanism of action, antibacterial activity, and clinical research progress of the novel fully synthetic fluorocycline antibiotic—eravacycline. Eravacycline inhibits protein synthesis by high-affinity binding to the bacterial ribosomal 30S subunit and demonstrates activity against multidrug-resistant Acinetobacter baumannii (excluding Pseudomonas aeruginosa), providing a potential novel therapeutic option for MDR/XDR Acinetobacter baumannii infections. Finally, the article outlines future research directions and treatment strategies. Due to the narrative nature of this review, no systematic methodology (e.g., PRISMA) was applied, and the available clinical evidence, particularly for CRAB infections, remains limited. Full article

The global dissemination of carbapenem resistance is predominantly facilitated by plasmid-mediated carbapenemase genes, notably blaOXA-48-like genes. A comprehensive understanding of their evolutionary relationships and structural conservation is essential for monitoring their spread and informing therapeutic strategies. This study aimed to investigate the phylogenetic relationships and structural conservation of blaOXA-48-like carbapenemase genes in multiple Gram-negative bacterial species. We analysed blaOXA-48-like carbapenemase sequences obtained from a hospital in Pakistan and compared them with globally reported variants retrieved from GenBank. Carbapenemase gene sequences (blaOXA-48-like, blaNDM, and blaVIM) were analyzed using maximum-likelihood phylogenetics (MEGA11, Tamura–Nei model, 1000 bootstrap replicates). Comparative global sequences were retrieved from GenBank. Structural modeling of blaOXA-48-like genes was performed using SWISS-MODEL Workspace with the template PDB 3HBR, followed by validation using GMQE, QMEANDisCo, and Ramachandran plot analyses. Phylogenetic analysis revealed a tight clustering of blaOXA-48-like genes across A. baumannii, K. pneumoniae, and E. meningoseptica, showing high similarity to globally distributed plasmid-associated sequences. Structural modeling demonstrated strong conservation of the enzyme, with preserved catalytic residues (Ser70, Lys73, Ser118, Trp157, and Tyr211) and minimal structural deviation (RMSD < 0.3 Å). blaOXA-48-like carbapenemases exhibit strong phylogenetic conservation and structural stability across species and regions, consistent with the horizontal dissemination of blaOXA-48-like genes across bacterial hosts. These findings indicate that blaOXA-48-like carbapenemases have high evolutionary stability. Full article

To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of direct-from-specimen multiplex lateral flow immunoassay (LFIA) across diverse raw clinical specimens and pathogen types from critically sick patients. A total of 300 non-duplicate samples were tested to detect CR-GNB. Five major Carbapenemase genes were detected directly from the specimen using carbapenem-resistant K.N.I.V.O. detection K-Set and from culture using culture-enhanced multiplex PCR. Turnaround time (TAT) of each method was calculated. The direct LFIA revealed 100% specificity for NDM, KPC, and IMP enzymes in all tested clinical matrices (blood, urine, and respiratory samples). The study demonstrated 100% sensitivity and specificity with perfect categorical agreement (κ = 1.000) for the blaKPC in the Klebsiella pneumoniae and for blaOXA-48 and blaIMP in the Acinetobacter baumannii; however, sensitivity of blaVIM was significantly diminished across all isolates and samples. TAT decreased significantly (p < 0.001) from 30 to 70 h to about 50 min. The tested direct LFIA facilitates the prompt enhancement of lifesaving tailored antibiotic treatment for severe illnesses. Full article