Search Results (331)

Background: According to the literature, adverse drug reactions (ADRs) account for 5–10% of hospital admissions and affect 25–30% of hospitalized patients, but no data are available for Gabon. Objectives: To estimate the incidence of ADRs among hospitalized patients at the Libreville University Hospital Center (CHUL) and to classify them according to their frequency, severity, mechanism and preventability, while proposing appropriate risk minimization strategies. Patients and Methods: A 14-month, single-center, prospective study included all patients experiencing ADRs, excluding those without ADRs or with intentional overdoses. ADRs were analyzed using the World Health Organization (WHO) causality assessment, the ATC classification, and Rawlins and Thompson criteria. Data were actively collected from patients and hospital records. Results: Among 4999 patients, 105 experienced 177 adverse events (incidence: 3.5%, 95% CI: 1.7–2.5%). Among the identified ADRs, 42% were serious. Nausea and vomiting were the most frequent ADRs, mainly caused by analgesics (nefopam, tramadol) and antibiotics (amoxicillin–clavulanic acid). The gastrointestinal and nervous systems were the most affected. According to the Rawlins and Thompson classification, 90% of ADRs were type A, 8% type B, and 2% type E (withdrawal syndrome). Overall, 90% of ADRs were preventable. Conclusions: This study highlights the importance of pharmacovigilance at CHUL, Gabon, and emphasizes the role of healthcare professionals in ADR reporting and risk minimization. Full article

Respiratory diseases in poultry caused by Ornithobacterium rhinotracheale represent a significant challenge from both therapeutic and economic perspectives. Treatment of them, which uses antimicrobial agents, improperly contributes to the emergence and dissemination of multidrug-resistant strains within avian populations. The present study, based on O. rhinotracheale isolates (n = 733) obtained from the respiratory tract, joints, and organs of turkeys in Poland between 2016 and 2022, was conducted to assess the antimicrobial resistance of the strains and identify their serotypes. All O. rhinotracheale isolates were tested for antimicrobial susceptibility using the disk-diffusion method. The results of this study indicated that amoxicillin/clavulanic acid, doxycycline, florfenicol, and lincomycin/spectinomycin were the most effective agents against the isolates from turkeys. The findings showed that serotype I was the most prevalent among the tested turkey strains in Poland and was the serotype to which 29% of the O. rhinotracheale isolates affiliated. Full article

Raw meat can act as a reservoir and vehicle for antimicrobial-resistant foodborne Escherichia coli, particularly when sold under poor hygienic conditions, as is often the case in informal markets in many developing countries, thereby representing a significant public health risk. This study aimed to characterize the antibiotic resistance patterns and virulence of E. coli isolated from raw meat sold in informal markets in Luanda, Angola. A total of 99 E. coli isolates were recovered from fresh beef, pork and goat meat in five informal markets. DNA macrorestriction analysis by Pulsed-Field Gel Electrophoresis (PFGE) was used to evaluate the genetic diversity of isolates. Multiplex PCR was performed to detect virulent and antibiotic resistance genes. Antibiotic susceptibility was tested using the disk diffusion method. PFGE analysis showed high genotypic diversity. Virulence genes were found in 46% of the isolates, with astA (32.3%) being the most frequent. The results also showed high resistance to cefotaxime (67.7%), ampicillin (56.7%) and amoxicillin/clavulanic acid (56.6%). Resistance to imipenem, a last-resort antibiotic, was observed in 30.3% of the isolates. The most prevalent resistance genes were CTX-M group 1 (10.1%) and FOX variants (27.3%). The presence of multidrug-resistant and potentially pathogenic E. coli strains in raw meat sold in informal markets in Luanda represents a significant threat to public health. These findings underscore the urgent need to improve surveillance, hygiene practices, and antimicrobial use regulation policies in animal production in Angola. Full article

Background: Canine skin and ear infections are common in small-animal practice and increasingly complicated by multidrug resistance (MDR), yet data from Serbia are limited. This study aimed to describe the bacterial etiology and antimicrobial resistance patterns in canine otitis externa and pyoderma. Methods: We retrospectively reviewed laboratory records from the Clinical Bacteriology and Mycology Laboratory, Faculty of Veterinary Medicine, University of Belgrade (January 2017–August 2024). A total of 422 non-invasive swabs from clinically ill dogs were included (ears: n = 210; skin: n = 212). Bacterial identification used conventional methods and commercial systems, and disk-diffusion susceptibility testing followed CLSI/EUCAST guidance. Methicillin resistance in staphylococci was assessed by cefoxitin/oxacillin screening; MRSA was confirmed by PCR and PBP2a detection. Resistance trends were compared between 2017–2020 and 2021–2024. Results: The leading pathogens were Staphylococcus pseudintermedius (ears 48.1%; skin 79.7%) and Pseudomonas aeruginosa (ears 29.1%; skin 7.6%). Staphylococci showed high resistance to macrolides, clindamycin, tetracycline, and first-line β-lactams (amoxicillin–clavulanate, cephalexin), with the highest susceptibilities to amikacin, florfenicol, and rifampicin. P. aeruginosa remained most susceptible to amikacin, polymyxin B, and imipenem. Between the two periods, S. pseudintermedius resistance increased to amikacin, fusidic acid, and cephalexin, while resistance to florfenicol decreased. P. aeruginosa resistance to imipenem increased. The prevalence of methicillin-resistant S. pseudintermedius (MRSP) was 27.4% (74/270). MDR S. pseudintermedius and MDR P. aeruginosa were identified in 38.5% and 53.3% of isolates, respectively. One isolate of each species was resistant to all tested drugs. Conclusions: These findings confirm high levels of antimicrobial resistance in major canine skin and ear pathogens and emphasize the need for susceptibility-based therapy, rational antimicrobial use, and ongoing surveillance in small-animal practice. Full article

Background/Objectives: The emergence of hypervirulent Pseudomonas aeruginosa strains resistant to β-lactamase inhibitor antibiotics is a critical health problem as they impede the treatment of infections. The objective of this study was to determine the different molecular arrangements of the virulence genotype related to β-lactamase genotype and the resistance phenotype to a combination of β-lactam antibiotics and β-lactamase inhibitors, and the phylogroups in P. aeruginosa strains isolated from patients with healthcare-associated infections and community-acquired infections. Methods: P. aeruginosa, virulence genes, β-lactamase genes and phylogroups were identified using polymerase chain reaction. Resistance to β-lactam antibiotics and β-lactamase inhibitors was determined using the disk diffusion method. The MIC determination of ticarcillin/clavulanic acid and piperacillin/tazobactam was performed using the MIC test strip for antimicrobial susceptibility testing. Results: In total, 124 P. aeruginosa strains from patients with healthcare-associated (67/124) and community-acquired infections (57/124) were analyzed. Most strains from patients with healthcare-associated infections and community-acquired infections harbored genes for proteases (aprA), phospholipases (pIcH and pIcN), elastases (lasA and lasB), rhamnolipids (rhLA), quorum-sensing system (lasI and rhII), and β-lactamase (bla_oxa-4, bla_oxa-1, and bla_GES). In total, 100% (124/124) and 99.1% (123/124) of the strains isolated from patients with healthcare-associated and community-acquired infections were resistant to the β-lactamase inhibitor antibiotics, amoxicillin/clavulanic acid and ampicillin/sulbactam, respectively, while 54% (67/124) of the strains were resistant to piperacillin/tazobactam. Phylogroup 1 (22/124) was detected more frequently among the strains in relation to phylogroup 2 (8/12). Conclusions: We demonstrated different association profiles of virulence genotype related to the β-lactamase genotype, the β-lactamase inhibitor resistome, phylogroups, and clinical origin of the strains. Therefore, medical treatment regimens against infections caused by P. aeruginosa should be improved. Full article

Subclinical mastitis is a major but often overlooked constraint to dairy productivity, causing economic losses through reduced milk yield and quality. In Romania, comprehensive data on the bacterial etiology and antimicrobial resistance (AMR) of subclinical mastitis are limited. This study aimed to characterize the etiological agents and antimicrobial susceptibility profiles of major bacterial pathogens isolated from subclinical mastitis cases in dairy cows from Western Romania. Between 2021 and 2022, milk samples were collected from 117 lactating cows diagnosed with subclinical mastitis on three dairy farms. Bacterial isolation and differentiation were performed on ChromID^® CPS^® Elite Agar, and isolates were confirmed by standard biochemical tests. Antimicrobial susceptibility testing of Staphylococcus aureus and Escherichia coli isolates was conducted using the automated Vitek^®2 system, interpreted according to CLSI veterinary standards. Multidrug resistance (MDR) was defined as resistance to at least one agent in three or more antimicrobial classes. Bacterial growth occurred in 51 of 117 samples (43.6%). S. aureus subsp. aureus predominated (28.2%), followed by E. coli (4.3%), Klebsiella pneumoniae subsp. pneumoniae (2.3%), and Streptococcus uberis (2.3%). Mixed infections occurred in 6.0% of positive samples. Among S. aureus, the highest resistance rates were to fosfomycin (58.3%), penicillin (44.4%), clindamycin (44.4%), and tetracycline (41.7%), with 47.2% MDR isolates. E. coli showed resistance to amoxicillin/clavulanic acid (88.9%), ampicillin (55.6%), and cefotaxime (55.6%), with 66.6% MDR. S. aureus remains the leading cause of subclinical mastitis in Western Romania. The high MDR rates highlight the need for targeted antimicrobial stewardship, culture-based therapy, and continuous AMR monitoring under the “One Health” framework. Full article

Background/Objectives: The global response to the COVID-19 pandemic included a notable shift in antibiotic prescribing patterns, with use declining and then rising again as restrictions were lifted. In Poland, point-of-care (POC) testing for infections such as influenza A/B, COVID-19, respiratory syncytial virus (RSV), and Group A Streptococcus was widely introduced in primary care in recent years. This study investigates the patterns of oral antibiotic prescription in Poland during the pandemic and post-pandemic periods. Methods: We analyzed Polish National Healthcare Fund data on reimbursed oral antibiotics—Anatomical Therapeutic Chemical (ATC) J01 class—sold between 2019 and 2024. We quantified antibiotic groups by the number of packages sold and individual agents using the defined daily dose per 1000 inhabitants per day (DDD/TID). Results: Total oral antibiotic reimbursements noted a significant fall from 2019 to 2020 (20.9 million vs. 14.5 million packages reimbursed) and subsequently surged from 16.3 million packages in 2021 to 20.9 million in 2024. The most prescribed groups were penicillins (J01C), macrolides (J01F), and other beta-lactams (J01D). Amoxicillin with clavulanic acid was the most commonly used individual antibiotic, with its DDD/TID rising from an average of 2.3 to 2.6 in 2024. Although the use of phenoxymethylpenicillin initially decreased after the introduction of “strep-tests” in 2022 (DID 0.18 in 2023 vs. 0.23 in 2022), it increased again to 0.26 in 2024. Conclusions: Our findings demonstrate a slight continuous increase in oral antibiotic use in Poland, despite the current widespread availability of POC testing. The persistent and growing preference for amoxicillin with clavulanic acid, an agent not typically recommended as first-line treatment for most infections, suggests that antibiotic stewardship efforts need to continue in order to curb inappropriate prescription. Full article

Background: The inappropriate and empirical use of antibiotics in early childhood remains a major global public health concern, contributing significantly to the rise of antimicrobial resistance (AMR). In Kosovo, the COVID-19 pandemic further influenced prescribing behaviors in primary care, increasing the reliance on symptom-based treatment in the absence of laboratory confirmation and age-appropriate formulations. Aim: This study aimed to assess the prevalence and patterns of antibiotic prescribing among children aged 1–7 years in primary health care centers in Prishtina and Ferizaj from January 2022 to December 2025, and to compare regional differences in prescribing practices and guideline adherence. Methods: A retrospective observational study was conducted using data from the national electronic health record system and protocol books. All pediatric visits for children aged 1–7 years with infectious diagnoses were included. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used to evaluate prescribing prevalence, demographic and seasonal variations, and independent predictors of antibiotic use, including assessment of appropriateness based on international pediatric guidelines. Results: Of 4320 pediatric visits, 1328 (30.7%) resulted in an antibiotic prescription. Prescribing prevalence was higher in Ferizaj (34.2%) than in Prishtina (28.5%, p < 0.01). Amoxicillin–clavulanic acid (42.9%) and amoxicillin (21.5%) were the most frequently prescribed agents, while macrolides (11.7% vs. 6.2%) and cephalosporins (7.9% vs. 3.4%) were more common in Ferizaj. Only 61.4% of prescriptions were fully guideline-concordant. Younger age (1–3 years), winter season, and residence in Ferizaj were independently associated with higher odds of receiving an antibiotic. Conclusions: Pediatric antibiotic prescribing in Kosovo remains high and predominantly empirical, reflecting real-world limitations in diagnostic capacity and formulation availability. Significant proportions of partially appropriate and inappropriate prescriptions highlight the need for standardized pediatric guidelines, improved diagnostic support, and strengthened stewardship initiatives within primary care. Full article

Background/Objectives: Although several studies have reported antibiotic protocols for the prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients receiving antiresorptive and/or antiangiogenic therapy following tooth extraction, it remains unclear which protocol is the most effective. Accordingly, this scoping review analyzed antibiotic use in dental extractions in these patients, focusing on whether antibiotic duration influences MRONJ occurrence. Methods: Two authors independently searched PubMed, Scopus, and Web of Science (2003–2025). Out of the 770 studies screened, 36 were included. Descriptive statistics, a meta-analysis comparing MRONJ incidence in patients treated with high-dose (HD) and low-dose (LD) antiresorptive treatment according to the therapeutic indication and generalized linear mixed models on antibiotic duration were obtained (α = 0.05). Results: Amoxicillin, alone or with clavulanic acid, was the most used antibiotic, and in 8 studies it was combined with metronidazole. Seven studies reported parenteral antibiotic administration. Median antibiotic duration was 1.5 days pre-extraction, 5.5 days post-extraction, and 7 days overall. MRONJ risk was significantly higher in HD than LD patients (95% CI: 1.46–5.43; p = 0.002), and antibiotic duration was positively associated with reduced MRONJ risk in HD patients (β = –0.15, p = 0.026; OR = 0.86, 95% CI: 0.75–0.98). Conclusions: The literature shows heterogeneous antibiotic protocols for MRONJ prevention. The increased MRONJ risk and greater protective effect of antibiotics in HD patients suggest that patient risk profile may be more relevant than the antibiotic regimen. Full article

The One Health approach emphasizes the importance of zoonoses due to their pandemic potential, highlighting the need to characterize emerging bacterial pathogens across animal reservoirs. Non-typhoidal Salmonella (NTS) species are among the most common zoonotic agents and can be transmitted by various reservoirs, including reptiles. Both direct and indirect contact with reptiles may result in Reptile-Associated Salmonellosis (RAS), which mainly affects children, immunocompromised individuals, pregnant women, and the elderly. This study aimed to isolate and characterize the Gram-negative intestinal microbiota from free-living snakes in Poland (Natrix natrix, Natrix tessellata, Coronella austriaca, Zamenis longissimus, and Elaphe dione) and to determine the prevalence and virulence potential of Salmonella. Using MALDI-TOF Mass Spectrometry, 432 isolates were identified. Serological analysis of 62 Salmonella isolates revealed 10 distinct O-antigen groups, and rare serovars O:38, O:48, O:57 and others were confirmed. Salmonella isolates were tested for antibiotic susceptibility and resistance to Human Serum; most isolates survived exposure to serum while remaining susceptible to antibiotics. One isolate was classified as multidrug-resistant (MDR), showing resistance to amoxicillin/clavulanic acid, ampicillin, cefuroxime, cephalexin, tigecycline, and fosfomycin. These findings demonstrate that wild snakes in Poland can act as reservoirs of pathogenic and zoonotic Salmonella, emphasizing their epidemiological significance in natural ecosystems. Full article

This study evaluated the microbiological quality, presence of virulence genes, and antimicrobial resistance of Staphylococcus aureus and Escherichia coli in sheep and goat milk and traditional Romanian dairy products (Telemea and Burduf cheeses). Raw milk contained high levels of coagulase-positive staphylococci (CPS; 5.2 log CFU/mL) and E. coli (4.3 log CFU/mL), with several samples exceeding legal limits. Sour cream exhibited moderate CPS (1.2–1.9 log CFU/g) and E. coli (0.4–3.12 log CFU/g) counts, with occasional non-compliance. Cheeses had low CPS (0.52–0.84 log CFU/g) and E. coli (0.37–0.89 log CFU/g) levels, all within permissible limits. Molecular analysis detected the nuc gene in 21 sheep milk samples, of which 85.7% also carried the sea gene and 14.3% carried seb. Additionally, two goat milk samples tested positive for both nuc and sea. Three Telemea cheese samples were also sea-positive. Among raw milk samples, 10 E. coli isolates carried stx1, and two additionally harbored hly, while dairy products were negative for E. coli virulence genes. Antimicrobial susceptibility testing showed high resistance of S. aureus to penicillin (90.5%) and ampicillin (85.7%), with multidrug resistance among sea- and seb-positive isolates. STEC isolates showed resistance to ampicillin (70%), tetracycline (50%), and trimethoprim–sulfamethoxazole (40%), but remained susceptible to amoxicillin–clavulanic acid. Full article

Serratia species are opportunistic human pathogens found in diverse environmental habitats. Here, we report the first isolation of Serratia nevei from food samples in Nigeria. During a two-month epidemiological surveillance at a local food market in Dutsin-Ma, Katsina State, Nigeria, a total of 180 food samples were collected, and isolation and species identification were performed using chromogenic agar and MicroScan autoSCAN-4, respectively. Antimicrobial susceptibility and minimum inhibitory concentrations (MICs) were determined using the MicroScan autoSCAN-4 system. Strain F129B, recovered from a fresh, unprocessed beef sample, was initially identified as Klebsiella pneumoniae by chromogenic agar and MicroScan autoSCAN-4, and subsequently as Serratia marcescens by MALDI-TOF MS. Only Whole Genome Sequencing (WGS) and bioinformatics analyses confirmed its identity as S. nevei. The strain was then selected for further characterization by Whole Genome Sequencing (WGS) and bioinformatics analyses to confirm its identity. The strain was phenotypically resistant to amoxicillin/clavulanic acid and colistin, with elevated MICs for aztreonam (4 mg/L) and cefuroxime (16 mg/L). In silico analyses of its genome confirmed the isolate as S. nevei, harboring genes conferring resistance to β-lactams (blaSTR-2), aminoglycosides (aac (6′)-Ic), fosfomycin (fosA), streptomycin (satA), and tetracycline (tet (41)). Its virulence repertoire comprises genes associated with adhesion (yidE, yidR, yidQ), colicin tolerance (creA and creD), and heavy metal resistance (czcD, chrBACF operon). These findings underscore the need for genomic characterization for accurate species identification within the Serratia genus. Our findings revealed the emergence of S. nevei in the food supply chain and highlighted its potential for zoonotic transmission. Robust surveillance of the local food supply chain is urgently needed in north-western Nigeria. Full article

Avian pathogenic Escherichia coli (APEC) causes avian colibacillosis, a disease responsible for high morbidity and mortality in commercial poultry flocks, leading to devastating economic losses to the poultry industry worldwide. APEC may also act as a source of virulence and antibiotic resistance genes that can be transferred to other Escherichia coli pathotypes. Therefore, this study aimed to determine the serotypes, phylogenetic background, virulence genes, and antibiotic resistance profiles of APEC in Algeria. A total of 98 APEC strains were isolated from chicken samples with characteristic colibacillosis signs between 2019 and 2020. O-serotyping identified O157 (20.41%) and O78 (11.22%) as the predominant serotypes. The isolates were classified into groups B1 (43.87%), C (29.59%), A (12.24%), E (7.14%), F (5.10%), and B2 (2.04%). Virulence gene analysis revealed that among the 31 genes investigated, a high occurrence of mat, crlA (100% each), yijP (98.98%), fimC, ibeB, ompA (97.96% each), iucD (89.80%), iroN (81.63%), iss (80.61%), and eae (79.59%) was observed. The highest resistance rates were found for ampicillin (97.96%), amoxicillin–clavulanic acid (96.94%), nalidixic acid (94.90%), tetracycline (90.82%), and ciprofloxacin (79.59%). Additionally, 92.86% of APEC isolates were resistant to three or more antibiotics, reflecting extensive antimicrobial use in Algerian poultry farms and highlighting a major challenge for animal health management and a potential risk of zoonotic transmission. Our data provide valuable insights into the characteristics of the APEC populations in broiler chickens in Algeria. This may assist in understanding APEC pathogenesis and in developing effective control strategies. Full article

Canine otitis externa is a common and recurrent ear infection in dogs, often caused by bacterial pathogens, and complicated by increasing antimicrobial resistance. The analysis of bacterial isolates from dogs with otitis externa revealed a predominance of Staphylococcus pseudintermedius, representing 41% of all cases, followed by Staphylococcus aureus (23%), and Pseudomonas aeruginosa (19%). Other less frequently isolated organisms included Escherichia coli, Streptococcus canis, and Proteus mirabilis. These results highlight the significant role of S. pseudintermedius in the pathogenesis of otitis externa in dogs, as well as the relevance of Gram-negative opportunistic pathogens like P. aeruginosa, which exhibits the highest recurrence rate, with 90% of the cases associated with highly resistant to β-lactams (93% for amoxicillin–clavulanic acid; >70% for third-generation cephalosporins). P. mirabilis showed complete resistance to tetracycline, partial resistance to doxycycline, and reduced susceptibility to carbapenems, nitrofurantoin, and polymyxin B. S. canis exhibited limited resistance to erythromycin and clindamycin, while S. epidermidis displayed extensive multidrug resistance, including β-lactams, fluoroquinolones, sulfonamides, and polymyxins. These findings highlight the high prevalence of multidrug-resistant pathogens in canine otitis externa, emphasizing the need for culture-guided therapy and raising concerns regarding One Health, due to potential zoonotic transmission and dissemination of genetic determinants of antimicrobial resistance. Full article

Background: Antibiotic drug resistance is a serious global health problem that threatens therapeutics against infectious diseases. As antibiotics become less effective every year, our objective was to evaluate the adjuvant activity of methanolic extracts of Moringa oleifera seed combined with antibiotics of clinical use against multidrug-resistant Escherichia coli isolated from street food samples searching for a new alternative to treat infectious diseases commonly treated with antibiotics. Methods: Secondary metabolites of M. oleifera seeds were obtained through maceration (methanol 80%) and detected following qualitative phytochemical assays. MIC, MBC and tolerance level were determined using microdilution tests. Antimicrobial activity was tested by sensitivity analysis, and the adjuvant activity was explored in combination with twelve antibiotics against the E. coli samples. Results: Alkaloids, phenolic compounds, flavonoids, and polyphenols were detected. MIC and MBC values ranged from 31.3 to 62 mg/mL and 62–125 mg/mL, respectively. The extract showed low antimicrobial activity against the multidrug-resistant E. coli, but the inhibitory capacity of ampicillin, cephalexin, and amoxicillin/clavulanic acid was significantly increased when combined with the plant extract. In contrast, the activity of ciprofloxacin, levofloxacin, tetracycline, polymyxin, and nalidixic acid decreased with the extract. Conclusion: Methanolic extracts of M. oleifera seeds represent a potential adjuvant for beta-lactams in the face of the growing problem of global antimicrobial resistance. This study represents the first steps in exploring the adjuvant capacity of plants against resistant environmental pathogens in Mexico. Full article