Search Results (332)

The aim of this paper is to evaluate the performance of the Derma-SR-screen agar for accurate discrimination between susceptible and non-susceptible clinical Trichophyton isolates. Consecutive Trichophyton isolates, received for identification and susceptibility testing, were screened for terbinafine and itraconazole resistance using Liofilchem Derma-SR-screen 4-well panels alongside EUCAST reference testing (E.Def 11.0). EUCAST tentative ECOFFs (terbinafine: T. rubrum 0.03 mg/L; T. indotineae 0.125 mg/L; itraconazole: both species: 0.25 mg/L) were applied for wild-type/non-wild-type classification. Plates were evaluated after 5 days of incubation at 25 °C, with growth graded 0-+++. Faint growth (+) was disregarded. All isolates underwent sqle sequencing. Forty isolates were included; 25 were non-wild-type harbouring Sqle alterations (F397I (number (n) = 1), F397L (n = 17), L393F (n = 3), L393S (n = 1), and Q408L (n = 3)). On day 5, 21 isolates reached +++ growth in the control well; a further 10 reached this level on day 6. The remaining isolates reached a ++/+++ score after 5/6 days (n = 7/n = 2). The 0.125 mg/L terbinafine agar correctly identified 7/8 non-wild-type T. indotineae isolates (4/5 F397L and 3/3 Q408L alterations), all 17 non-wild-type and eight wild-type T. rubrum isolates, as well as the five wild-type isolates of other Trichophyton spp. The 0.016 mg/L agar correctly identified all 17 non-wild-type T. rubrum isolates, but misclassified 2/8 wild-type isolates as non-wild-type. All isolates were wild-type to itraconazole and correctly identified. The Derma-SR-screen agar resulted in correct classification of 24/25 (96%) sqle mutant T. indotineae and T. rubrum isolates. Two wild-type T. rubrum isolates grew at the 0.016 mg/L terbinafine agar suggesting possible reduced agar potency at this concentration. Full article

Background/Objectives: Escherichia coli is a ubiquitous commensal organism in humans, animals, and the environment, but certain strains harbour virulence and antimicrobial resistance (AMR) determinants that can cause significant disease. Food-producing animals, including dairy cattle, may act as reservoirs for AMR E. coli, and raw milk and raw milk products can serve as potential exposure pathways to humans. However, data on the prevalence and genomic characteristics of AMR E. coli in raw milk in Ireland are limited. This study aimed to describe the occurrence of commensal and clinically relevant AMR E. coli in raw milk and raw milk dairy products in Ireland and to characterise their antimicrobial susceptibility and genetic characteristics. Methods: A total of 139 raw milk and raw milk dairy product samples were collected and analysed for commensal E. coli and fluoroquinolone-resistant, extended-spectrum β-lactamase (ESBL)/AmpC β-lactamase and carbapenemase-producing E. coli. AMR patterns were determined in line with EU surveillance guidelines based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines which use minimum inhibitory concentration (MIC) breakpoints. Whole genome sequencing (WGS) was conducted on selected isolates to identify AMR genes (ARG), virulence factors, plasmid replicons, efflux pump, disinfectant resistance genes, multi-locus sequence types (MLSTs) and phylogenetic diversity. Results: A total of forty-seven E. coli isolates were recovered (33.8% isolation rate). Thirteen isolates exhibited resistance to between two and nine antimicrobials, with twelve classified as multidrug resistant (MDR). The highest resistance frequencies were to ampicillin, sulfamethoxazole, trimethoprim and tetracycline. Four fluoroquinolone-resistant isolates, one ESBL producer (bla_CTX-M-3), and one carrying a AmpC promoter mutation were identified; no carbapenemase producers were detected. WGS revealed diverse sequence types, multiple virulence determinants, plasmid replicons, intrinsic efflux pump genes, and limited presence of the disinfectant resistance gene qacEΔ1. Conclusions: Raw milk and raw milk dairy products in Ireland can harbour AMR E. coli, including MDR and potentially pathogenic strains, highlighting the need for ongoing surveillance within the dairy supply chain. Full article

Background/Objectives: Urinary tract infections (UTIs) are among the most common bacterial infections and represent a major source of antimicrobial use. Increasing antimicrobial resistance among uropathogens, particularly the emergence of extended-spectrum beta-lactamase (ESBL)-producing organisms, complicates empiric treatment strategies. ESBL-producing organisms are clinically relevant because they are frequently associated with multidrug resistance and significantly limit empiric antimicrobial treatment options in urinary tract infections. The study period starting in 2019 was selected to reflect contemporary resistance patterns and to ensure consistency with the updated EUCAST antimicrobial susceptibility interpretation criteria introduced at that time. This study aimed to characterize antimicrobial resistance patterns among uropathogens isolated from lower UTIs and to identify independent predictors of antimicrobial resistance using isolate-level analyses. Methods: This retrospective observational study included 1470 patients and isolates with clinically suspected lower UTIs who underwent urine culture and antimicrobial susceptibility testing between 2019 and 2024 at a single clinical center. Antimicrobial susceptibility was interpreted according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria, and ESBL production was assessed among Gram-negative (GN) isolates. Multivariable generalized estimating equation (GEE) logistic regression models accounting for patient clustering were used to identify predictors of resistance. Results: A total of 1470 patients and isolates were included. Escherichia coli was the most frequent uropathogen (66.0%), followed by Klebsiella pneumoniae and Enterococcus faecalis. Among Gram-negative isolates, 17.3% were ESBL-positive. Resistance rates were highest for ciprofloxacin (35.4%) and trimethoprim/sulfamethoxazole (31.7%), while fosfomycin and nitrofurantoin retained high activity against E. coli. In multivariable analyses, ESBL production was the strongest independent predictor of resistance to several antimicrobials, including ciprofloxacin (aOR 9.83), amoxicillin/clavulanic acid (aOR 3.22), trimethoprim/sulfamethoxazole (aOR 2.89), and cefotaxime (aOR 1337). Pathogen identity was also independently associated with resistance. Conclusions: Antimicrobial resistance among uropathogens was heterogeneous and predominantly driven by pathogen identity and ESBL production. ESBL status emerged as the most consistent and powerful predictor of resistance across multiple antimicrobials, underscoring its clinical relevance for empiric treatment decisions and antimicrobial stewardship in urinary tract infections. Full article

Urinary tract infections (UTIs) are the most frequent infections in hospitalized and outpatient settings, where Escherichia coli is the predominant pathogen. Conventional diagnostic and antimicrobial susceptibility testing (AST) methods are time-consuming, often requiring 48 h, leading to empirical antibiotic therapy and contributing to antimicrobial resistance (AMR). FASTinov^® developed a rapid phenotypic method that enables AST directly from urine samples within two hours using flow cytometry. In this study, 154 inoculated urine samples were analyzed to evaluate the performance of two diagnostic panels: FASTgramneg for Gram-negative bacteria and FASTgrampos for Gram-positive bacteria. Data analysis was performed using bioFAST^® software (version 3.0), providing results in accordance with EUCAST guidelines. The FASTgramneg panel allows detection of resistance mechanisms, including extended-spectrum β-lactamases (ESBLs), and screening of AmpC β-lactamases and carbapenemases; the FASTgrampos panel additionally determines the minimal inhibitory concentration (MIC) of vancomycin for Staphylococcus aureus. Overall agreement with conventional AST methods was 97.5% for Gram-negative bacteria and 95.0% for Gram-positive bacteria. All resistance mechanisms were correctly identified with no false positives. The essential agreement for vancomycin’s MIC was 95.2%, with a BIAS of +14.3%. Reproducibility was 99.5% for FASTgramneg and 95.0% for FASTgrampos. These results demonstrate that the FASTinov^® kit significantly reduces turnaround time while maintaining high accuracy, supporting improved UTI management and antimicrobial stewardship. Full article

Resistance surveillance programmes are essential for choosing the most appropriate eradication therapy for the stomach pathogen Helicobacter pylori. This study aimed to determine H. pylori antimicrobial resistance rates in Ireland. H. pylori was cultured from patients attending four gastroenterology clinics from 2018 to 2023. Antimicrobial susceptibility testing (AST) was performed using Etests for metronidazole, clarithromycin, levofloxacin, amoxicillin, tetracycline and rifampicin and resistance classified using EUCAST guidelines. Resistance rates were compared between H. pylori treatment-naïve and previously treated patients (primary and secondary resistance, respectively). Samples from 138 culture-positive patients (mean age 49.4 ± 15.7 years, 47.1% female) were analysed. A total of 28.7% of isolates from treatment-naïve patients were susceptible to all antimicrobials tested. Primary resistance rates to metronidazole, clarithromycin, levofloxacin, amoxicillin, tetracycline and rifampicin were 44.3%, 36.5%, 18.3%, 14.6%, 9.6% and 9.6%, respectively. Primary dual resistance to clarithromycin and metronidazole was 22.6% and primary multidrug resistance was 13.0%. Secondary resistance rates were significantly higher than primary resistance rates for clarithromycin, metronidazole, dual resistance to clarithromycin and either amoxicillin, metronidazole or levofloxacin, and multidrug resistance. Female sex and older age were associated with increased risk of resistance. H. pylori resistance rates were high in our cohort. Clarithromycin-based triple therapy should no longer be used in Ireland in the absence of pre-treatment AST. Resistance to amoxicillin, tetracycline and rifampicin should be monitored closely. Full article

Background/Objectives: The increasing prevalence of antimicrobial-resistant bacteria highlights the need for improved methodologies to evaluate antimicrobial activity beyond conventional minimum inhibitory concentration testing. While resazurin-based assays are widely used for minimum inhibitory concentration determination due to their simplicity and sensitivity, minimum bactericidal concentration assessment still relies on labor-intensive colony-forming unit counting. The objective of this study was to develop and validate a resazurin-based microwell assay capable of determining both the minimum inhibitory concentration and the minimum bactericidal concentration without routine plate counting, thereby simplifying bactericidal evaluation. Methods: A two-step resazurin-based fluorescence assay was designed and performed in microplates. After determining the minimum inhibitory concentration using resazurin as a metabolic indicator, well-showing inhibited bacterial growths were subjected to a regrowth phase by transferring aliquots into fresh antimicrobial-free medium containing resazurin. This additional step allowed discrimination between reversible metabolic inhibition and irreversible bacterial death. The method was evaluated using ciprofloxacin and chloramphenicol against four bacterial species: Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa. Minimum bactericidal concentration values obtained using this assay were compared with those obtained through conventional colony counting on agar plates. Results: Minimum bactericidal concentration values obtained using the two-step fluorescence assay were fully concordant with the conventional colony-forming unit counting method for all tested antibiotics and bacterial species. Conclusions: The proposed two-step resazurin-based microwell assay represents a rapid, reliable, and less labor-intensive alternative for the determination of both the minimum inhibitory concentration and the minimum bactericidal concentration, with potential applications in clinical and industrial microbiology laboratories. Full article

Background: The goal of this study was to characterize the microbial etiology, antimicrobial susceptibility, and temporal resistance trends of early-onset neonatal sepsis (EOS) pathogens in a tertiary neonatal intensive care unit over 10 years (2014–2023), assessing empirical therapy adequacy and mortality associations. Methods: Retrospective analysis was performed on the positive blood cultures of neonates with confirmed EOS, born between 1 January 2014 and 31 December 2023. Blood was aseptically collected into PEDS Plus/BC bottles, incubated using the BACTEC system, with pathogen identification by biochemical assays or MALDI-TOF MS. Susceptibility testing followed EUCAST disk-diffusion standards, with additional resistance assays. Results: Among 6631 NICU admissions, 39 neonates met EOS criteria (31 preterm, 8 term). In preterm infants, Gram-negative Enterobacterales—mainly E. coli (n = 20)—predominated, while GBS was most common in term infants. All GBS isolates (n = 7) were susceptible to benzylpenicillin and vancomycin. Although 90% of E. coli were ampicillin-resistant, 90–95% remained susceptible to third-generation cephalosporins, piperacillin–tazobactam, and aminoglycosides. Two E. coli isolates produced ESBL but remained susceptible to aminoglycosides and carbapenems. Mortality was higher in E. coli EOS (50%) than in GBS (0%) or other pathogens (25%), with borderline significance (p = 0.0547; adjusted RR 1.55, 95% CI 0.54–4.41). Ampicillin resistance was not associated with increased mortality. No annual resistance trends were observed. Conclusions: In this 10-year NICU cohort, the etiology of EOS differed markedly between preterm and term neonates. Recommended empirical ampicillin–aminoglycoside therapy demonstrated in vitro efficacy against most neonatal bloodstream isolates pending pathogen identification. However, the widespread ampicillin resistance, particularly among E. coli strains, supports consideration of cephalosporin–aminoglycoside combinations or meropenem monotherapy when rapid beta-lactam bactericidal activity is clinically essential. Mortality was higher in E. coli EOS, though not statistically significant, and unrelated to ampicillin resistance. Full article

Invasive infections attributed to rare yeasts are increasingly recognized and often exhibit resistance to echinocandins or fluconazole. Despite geographical variability, epidemiological data from Greece are limited. To bridge this gap, we conducted a 15-year retrospective study of rare yeast fungaemia at a tertiary teaching hospital in Athens. All microbiologically confirmed cases in hospitalized patients (2010–2024) were included. Demographic and clinical data were retrieved from medical records. Incidence was calculated per 1000 admissions and 10,000 bed days. Isolates were identified using Vitek 2 and, when available, further characterized by MALDI-TOF MS and tested for antifungal susceptibility based on EUCAST guidelines. A total of 29 episodes (3% of all fungaemias) were identified, with an incidence of 0.04/1000 admissions and 0.09/10,000 bed days. Hematological malignancies (31%) were the most common underlying condition. All patients had central venous catheters and were receiving antibiotics; 38% were non-neutropenic/non-immunosuppressed. The most frequently isolated species were Rhodotorula mucilaginosa (41%), Saccharomyces cerevisiae (31%) and Trichosporon asahii (21%), with single cases of Apiotrichum loubieri and Magnusiomyces capitatus. Amphotericin B exhibited good in vitro activity against all species; echinocandins were active only against S. cerevisiae, and azole activity was species dependent. The median time from hospital admission to fungaemia onset was 27 days; one-third of cases were breakthrough infections, and in 19%, diagnosis was established post-mortem. Despite antifungal therapy, crude mortality was 53%. Although infrequent, rare yeast fungaemia at our centre was associated with high breakthrough rates and substantial mortality. Regional epidemiological insight and heightened clinical awareness are key to optimizing outcomes. Full article

Background: Acinetobacter spp., particularly A. baumannii, is a major intensive care unit (ICU) pathogen frequently associated with carbapenem non-susceptibility and delayed initiation of receipt of therapy. Methods: We conducted a single-center retrospective ICU cohort study in Romania (January 2019–December 2024) of adults with clinical cultures positive for Acinetobacter spp. (first isolate per patient). Susceptibility was interpreted per EUCAST. We assessed species distribution, carbapenem non-susceptibility, receipt of at least one in vitro active empiric agent, time to active therapy (TTAT, from index culture collection), early inflammatory biomarkers [neutrophile-to-lymphocyte ratio (NLR) and C-reactive protein (CRP)], and 30-day mortality. Predictors of mortality were evaluated using multivariable logistic regression and receiver operating characteristic (ROC) analysis. Results: A total of 234 episodes were included; A. baumannii accounted for 87.6% (205/234). Carbapenem non-susceptibility among Acinetobacter spp. isolates was 89.3% (209/234). Empiric antibiotics were initiated within 24 h in 95.7% of patients (224/234), yet only 49.6% (116/234) received at least one empiric agent later confirmed to be active. TTAT was 6 days (IQR 4–7), and active therapy within 72 h occurred in 8.5% (20/234). Thirty-day mortality was 73.1% (171/234) and did not differ between carbapenem non-susceptible (EUCAST I + R) and carbapenem-susceptible (EUCAST S) A. baumannii episodes (73.2% vs. 72.0%, p = 1.00). In multivariable analysis, age was independently associated with mortality (OR 1.36 per 10-year increase, 95% CI 1.04–1.90), with acceptable model discrimination (area under the curve = 0.74). Early NLR and CRP did not differ between carbapenem non-susceptible and carbapenem-susceptible A. baumannii episodes. Conclusions: In this ICU cohort, A. baumannii was the predominant species, and carbapenem non-susceptibility was highly prevalent. Despite early empiric therapy, receipt of at least one in vitro active agent was often delayed, and early inflammatory biomarkers had limited discriminatory value. These findings support locally tailored empiric strategies informed by local epidemiology and reinforce the need for improved diagnostics and stewardship interventions in high-burden ICU settings. Full article

Background/Objectives: This article describes the results of an analysis of the sensitivity of dermatophytosis pathogens to terbinafine, conducted by the authors based on a review of available scientific publications and data from their own research. Currently, no information is available on the sensitivity of Kazakh isolates obtained from patients at dermatological clinics. The aim of this study was to compile data on the resistance of dermatophytes to terbinafine over the past decade worldwide and investigate the sensitivity of dermatophyte isolates collected from patients in Astana, Kazakhstan, to terbinafine. Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, utilizing the Pubmed and Cochrane Library databases with specific keywords. The sensitivity of the dermatophytes to terbinafine was assessed using EUCAST E.Def 11.0 method. Results: Screening of terbinafine susceptibility among Kazakh clinical isolates revealed that all Microsporum canis strains (57/57, 100%) were sensitive to the drug. Among 33 Trichophyton spp. isolates, 4 (12.1%) demonstrated resistance to terbinafine, with MIC values ranging from 0.125 to 1.5 µg/mL. The resistant isolates belonged to the species T. indotineae, T. interdigitale, and T. mentagrophytes. Conclusions: Terbinafine remains highly effective against Microsporum canis in Kazakhstan, while a small proportion of Trichophyton isolates show resistance. Continuous monitoring of dermatophyte susceptibility is warranted to guide effective treatment. Full article

Aim: Infections and multidrug-resistant (MDR) pathogens are concerns in pediatric palliative care (PPC) units, where children with life-limiting conditions undergo invasive procedures and prolonged hospitalization. This study evaluated clinical characteristics, microbiological profiles, and factors associated with MDR infections among pediatric patients hospitalized in a PPC unit. Methods: This retrospective observational study included 66 children aged 1 month to 18 years who were admitted to the PPC unit of our hospital due to infection between June 2023 and January 2024. Demographic data, comorbidities, device use, infection sites, and microbiological results were reviewed. Bacterial identification and antimicrobial susceptibility testing were performed using the Vitek2 system and interpreted according to EUCAST. Results: The median age was 48 months (IQR 19–106); 63.6% were male. Lower respiratory tract infection was most common (68.2%), followed by sepsis (13.6%) and urinary tract infection (12.1%). Pseudomonas aeruginosa (36.4%) and Klebsiella pneumoniae (27.3%) predominated. MDR organisms represented 15.2% of isolates. MDR infections were significantly associated with percutaneous endoscopic gastrostomy or mechanical ventilation use (p = 0.033). Prolonged hospitalization and multiple comorbidities tended to increase the MDR risk but did not reach statistical significance. Conclusions: Gram-negative MDR infections constitute an important problem in PPC units. Frequent exposure to invasive devices and antibiotics increases susceptibility to resistant pathogens. Reinforcing infection prevention, optimizing antimicrobial stewardship, and monitoring device-related infections are essential to reduce morbidity and improve care quality in pediatric palliative care. Full article

Background/Objectives: Acinetobacter baumannii is a leading cause of healthcare-associated infections and is frequently associated with multidrug resistance, severely limiting therapeutic options. The increasing prevalence of carbapenem-resistant A. baumannii (CRAB) has intensified interest in novel antimicrobial agents such as cefiderocol, eravacycline, and imipenem–relebactam. Methods: A total of 80 multidrug-resistant (MDR) A. baumannii isolates recovered from various clinical specimens between April 2019 and October 2023 were included. Antimicrobial susceptibility testing was performed using disk diffusion, gradient test, and broth microdilution methods in accordance with EUCAST and CLSI recommendations. The minimum inhibitory concentrations (MIC’s) for cefiderocol were evaluated with broth microdilution using iron-depleted cation-adjusted Mueller–Hinton broth as the reference method. The presence of carbapenem resistance–associated genes (blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, blaIMP, and tetA) was investigated by polymerase chain reaction. Results: All isolates were resistant to imipenem and meropenem. Colistin resistance was detected in 7.5% of isolates. According to EUCAST criteria, cefiderocol susceptibility was observed in 77.5% of isolates by microdilution and in 81.25% by disk diffusion. Eravacycline demonstrated low MIC values, with MIC₅₀ and MIC₉₀ of 0.25 mg/L and 0.75 mg/L, respectively. In contrast, all isolates were resistant to imipenem–relebactam. The blaOXA-23 gene was detected in 82.5% and blaOXA-24 in 17.5% of isolates, while no blaOXA-58, blaIMP, or tetA genes were identified. No statistically significant association was found between cefiderocol resistance and OXA-type carbapenemase genes. Conclusions: Cefiderocol and eravacycline demonstrated promising in vitro activity against MDR A. baumannii, including colistin-resistant isolates, whereas imipenem–relebactam showed no activity. These findings support the potential role of cefiderocol and eravacycline as alternative treatment options for CRAB infections and highlight the multifactorial nature of cefiderocol resistance beyond OXA-type carbapenemase production. Full article

(1) Background: The oral cavity is a complex ecological environment that integrates elements of both the digestive and respiratory systems, contributing to its extensive microbial diversity. Despite its effectiveness, chlorhexidine is associated with undesirable effects, such as mucosal irritation and tooth staining, which have prompted research into natural alternatives. This study aimed to compare the antimicrobial activity of mouthwashes containing tea tree oil (TTO) alone and in combination with cannabidiol (CBD) and spilanthol with that of a chlorhexidine digluconate-based mouthwash (CHX) against selected oral bacterial and fungal strains. (2) Methods: To assess the antimicrobial effects of the tested mouthwashes on reference microbial strains, the agar diffusion method was applied in accordance with the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). In addition, the microdilution method using 96-well microtiter plates was employed to determine the minimum inhibitory concentration (MIC) of the tested substances. Microbial viability was further evaluated using the WST-based colorimetric Microbial Viability Assay Kit, in which the intensity of the produced WST-formazan dye is directly proportional to the number of viable cells. (3) Results: In the disc diffusion assay, inhibition zones measured after 24 h varied among the tested microorganisms, with the largest zones observed for CHX against Candida parapsilosis (19.63 mm) and Streptococcus pyogenes (16.7 mm). In the microdilution assay against Candida albicans, the MIC₅₀ was achieved for preparations A and B at the highest tested concentrations (column 1), whereas for chlorhexidine (CHX), it was reached at lower concentrations (column 9). (4) Conclusions: ① All tested mouthwashes containing tea tree oil (TTO), either as a single active ingredient or in combination with cannabidiol (CBD) and spilanthol, demonstrated limited bacteriostatic and antifungal activity under the experimental conditions of this study. ② The chlorhexidine digluconate-based mouthwash exhibited significantly higher antibacterial and antifungal activity against all tested microbial strains compared to both the TTO-only mouthwashes and the formulation containing TTO combined with CBD and spilanthol. Full article

(1) Background: Meyerozyma guilliermondii is a yeast species widely distributed in the natural environment and one of the rare emerging pathogens capable of causing difficult to treat, severe infections. The species’ susceptibility profile is not fully defined; however, the species could be more prone to develop resistance than other Candida species. The objective of this research was to determine the susceptibility of a local collection of Meyerozyma guilliermondii clinical isolates to classical antifungal drugs as well as a new one—manogepix. (2) Methods: The study included 20 clinical isolates identified using the MALDI–TOF method followed with sequencing of ITS1-2 region of DNA. Overall, the susceptibility to 12 antifungal drugs was tested. Nine drugs (amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin) were assessed using the MICRONAUT–AT test. The susceptibility to the new drug, manogepix, as well as isavuconazole, clotrimazole and anidulafungin, was determined using the microdilution method recommended by EUCAST. Additionally, anidulafungin and voriconazole MIC was also examined with commercial gradient tests. (3) Results: Overall, the isolates showed low MIC values for amphotericin B (0.125 to 1 mg/L) and for flucytosine (≤0.06 to 32 mg/L), with the exception of one isolate with a high MIC value. The MIC ranges for azoles were 2–64 mg/L (fluconazole), 0.008–0.5 mg/L (voriconazole), ≤0.03–≥4 mg/L (itraconazole) and 0.008–0.5 mg/L (posaconazole). One isolate showed non-WT phenotype to all tested azoles. For anidulafungin, the MIC values ranged from ≤0.06 to 0.25 mg/L; however, in the reference method, higher values were observed, but they did not exceed 2 mg/L (ECOFF value). For manogepix, the MIC values ranged from 0.002 to 0.125 mg/L. Finally, the comparison of the obtained and published susceptibility data was conducted. (4) Conclusions: The data obtained in this study are consistent with reports by other authors and indicate that resistance to azoles or 5-fluorocytosine among clinical isolates of Meyerozyma guilliermondii should be considered. The low MIC values of manogepix suggest the potentially good efficacy of this drug against Meyerozyma guilliermondii species. Full article

Background. Antibiotic resistance is a growing global health challenge, complicating the management of infections. Aminoglycosides are increasingly associated with resistance, raising the risk of clinical complications and mortality in severe infections. This study aimed to characterize the epidemiological profile of 135 aminoglycoside-resistant clinical strains collected in Setif between 2021 and 2023. Methods. Antibiotic susceptibility testing was performed according to EUCAST guidelines, and phenotypic assays were conducted to assess key virulence traits, including biofilm formation and enzyme production. Results. Aminoglycoside resistance was more frequently observed in female patients (55.6%) and was found to be predominant among adults (68.1%). Urinary tract infections represented the main clinical presentation (76.3%), with Escherichia coli being the most common isolate (40.7%). High resistance rates were detected for amoxicillin (83%), amoxicillin–clavulanic acid (80%), cephalexin (74.8%), cefixime (71.1%), trimethoprim–sulfamethoxazole (74.8%), and gentamicin (72.6%). Conversely, chloramphenicol (53.3%), imipenem (47.4%), amikacin (47.4%), and piperacillin–tazobactam (31.1%) remained comparatively more effective. Multidrug resistance involving seven antibiotics occurred in 25.6% of isolates, with notable cross-resistance patterns between gentamicin and β-lactam antibiotics (5 out of 22). Genotypic analysis showed that 43% of isolates carried at least one β-lactamase gene, whereas 9.6% harbored a qnr determinant. Regarding virulence factors, isolates with low biofilm-forming ability were found to be the most common (62.96%). Conclusion. In conclusion, this study revealed substantial variations in aminoglycoside resistance in Setif, shaped by demographic, clinical, and bacteriological factors. Full article