Staphylococcus aureus is a frequent cause of microbial keratitis (MK), conjunctivitis and non-infectious contact lens related corneal infiltrative events (niCIEs). The aim of this study was to determine the rates of resistance of S. aureus isolates from different ocular conditions to commonly used antibiotics and niCIE strains to multi-purpose disinfecting solutions (MPDS). The minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) was used for susceptibility testing. 51 S. aureus strains from the USA and Australia were evaluated; 14 from niCIEs, 26 from conjunctivitis and 11 from microbial keratitis. 84% of the strains in this study were multi-drug resistant however all strains were susceptible to vancomycin (100%). All the MK strains from Australia were susceptible to ciprofloxacin and oxacillin, whereas only 11% of the MK strains from the USA were susceptible to these antibiotics (p = 0.107). Chloramphenicol susceptibility varied with the ocular condition in USA strains – 96% of conjunctivitis and 55% of MK strains were susceptible to this antibiotic (p = 0.0036). The MPDS OPTI-FREE PureMoist was the most active and Biotrue was least effective against the niCIE strains (p = 0.0231). Knowledge of the rates of resistance to antibiotics could help guide treatment of these diseases.

Biofilms exist naturally and contribute to antibiotic resistance significantly, making conventional treatments like antibiotics, phage therapy, quorum sensing (QS) inhibitors, and monoclonal antibody therapy inadequate to treat biofilm-associated diseases. Therefore, finding alternative treatment is urgent to cease biofilms. Andrographis paniculata (AP) is well known for demonstrating diverse pharmacological actions, including antibiofilm properties. Andrographolide, a secondary lead metabolite of AP, and its derivatives or analogues significantly inhibit biofilm formation. Despite having a sizeable list of antibacterial actions, there is no attempt to establish AP's mechanisms of actions in combatting biofilms through comprehensive analysis using the documented literature. Therefore, this systematic review aims to discuss this by considering various contributing factors to AP's anti-biofilm activity. This study conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and synthesized the studies conducted from 2011 to 2020. A total of 125 articles were obtained from the search, and antibiofilm characteristics data were extracted from 23 articles and pooled together. We revealed a total of ten biofilm-forming species of Pseudomonas aeruginosa (11), Escherichia coli (4), Staphylococcus epidermidis (2), Staphylococcus aureus, Vibrio harveyi, Serratia marcescens, Salmonella typhimurium, Klebsiella pneumoniae, Enterococcus faecalis, Proteus vulgaris. The biofilms were significantly inhibited by AP and its secondary metabolites up to 97% inhibition. AP or metabolites significantly disrupt the QS system, especially Las and Rhl systems, resulted in a significant reduction of extracellular polymeric substances and virulence factors. They decreased the expression of biofilm-forming genes as well. Additionally, AP showed synergistic activity with silver nanoparticles or standard antibiotics like gentamicin and azithromycin. In our opinion, AP or andrographolide is a great example of an anti-biofilm agent and is a strong candidate for future therapeutics to combat the unmet needs of virulence factor production, biofilm formation and antibiotic resistance.

Antibiotic resistance is growing health concerning issue in the present world. Misuse and overuse of antibiotics and lack of proper monitoring in the healthcare sector has caused a tremendous growth of antibiotic resistance (ABR) worldwide, especially in developing countries like Bangladesh. Staphylococcus aureus is still the prevalent cause of nosocomial infections, and it is becoming more of a community issue as more patients are treated outside of the hospital environment. Therefore, this systematic review was conducted to delineate the prevalence of ABR in S. aureus isolates in patients of various categories in Bangladesh. Bangladesh Journal Online, Scopus, PubMed and EBSCO databases were searched for studies conducted in the last 20 years following PRISMA guidelines. The literature search revealed 160 potentially relevant records were obtained from the database search. Through the screening process, 33 relevant studies investigated the resistance pattern of S. aureus from human isolates were included. The reported data produced a pooled prevalence of ABR (top ten resistant antibiotics) in S. aureus in Bangladesh from human sample: Penicillin (84.75%, interquartile range, IQR, 44.75), Ampicillin (83.75%, IQR 14.475), Oxacillin (77.5%, IQR 44.675), Cefoxitin (72%, IQR 24.55), Tetracycline (68%, IQR 34.3), Amoxicillin (67.375%, IQR 40.95), Ceftazidime (67%, IQR 16.125), Netilmicin (60.625%, IQR 20.625), Cefixime (60%, IQR 13.725), Cefuroxime (60%, IQR 9). A total of 64.52% of studies were conducted in the Dhaka district. The reported studies demonstrated the evidence of the high prevalence of ABR S. aureus in patients in Bangladesh. Even though this is limited data, this study's findings might help the policymakers developing the policy to contain the spread of ABR in Bangladesh to support the world One Health goal. Implementing nationwide surveillance and strict monitoring of antibiotic usage is highly recommended.

Introduction: Bacteremia are emergencies that are life threatening to patients. Early initiation of adequate antibiotic therapy reduces mortality and morbidity. The purpose of this work was to evaluate the results obtained with the direct AST, carried out directly from positive blood cultures on Mueller-Hinton CHROMagar medium (CHROMagar 4, place du 18 Juin 1940 - 75006 Paris, France) and compare them with those obtained with the standard AST. Methods: To do this, 124 strains isolated from 124 bottles were tested against 21 antibiotics. The resulting diameters were read after 8h and 18h of incubation, interpreted using the CLSI breakpoints and compared to those obtained with the standard method. Results: It was found that, the results were extremely satisfactory at 18h (94.43% CA, 0.24% ME and 0.00% VME), compared to less conclusive results at 8h (87.32% CA). The best %CA were obtained with gentamicin, sulfamethoxazole+trimethoprim, levofloxacin, ampicillin and cefoxitin at 8h (all >93%) and 18h (all >97%). Also, non-fermenting GNB recorded the best results with 98.74%CA at 18h and Staphylococcus species the lowest ones with 90.70% CA at 18h. Conclusion: The encouraging results obtained during the present study suggest a possible future implementation of the direct-from-bloodculture AST as a routine technique. However, the standard AST remains the reference technique.

Methicillin-resistant Staphylococcus aureus (MRSA) is a worrisome microorganism resistant to almost all beta-lactams and it frequently carries resistance to other major antibiotic classes. In addition to humans, it has been reported that MRSA also colonizes and infects domestic animals, farm animals, wild, captive or free-living species. The increased prevalence of this microorganism in animals for consumption has been a concern, due to the high zoonotic risk. Thus, we isolated MRSA from quails and aimed to characterize their antimicrobial resistance.

One-hundred mouth and cloaca swabs were collected from quails at a slaughterhouse in Portugal. The swabs were incubated in BHI broth with 6.5% of NaCl for 24h at 37º C. The inoculum was seeded onto oxacillin resistance screening agar (ORSAB) plates supplemented with 2 mg/L of oxacillin and incubated at 37º C for 24-48h for MRSA isolation. One colony per plate was collected. The staphylococci specie and the presence of mecA genes were confirmed by maldi-tof and PCR, respectively. The antimicrobial resistance phenotype was evaluated by the Kirby Bauer disc diffusion method against 14 antibiotics.

From the 100 samples, 29 MRSA were recovered. All isolates were classified as multidrug-resistant since they were resistance to at least 3 different classes of antibiotics. All isolates were resistant to penicillin, cefoxitin, ciprofloxacin, erythromycin and clindamycin. All isolates expect one presented resistance to tetracycline and resistance to aminoglycosides (n=9), chloramphenicol (n=3) and fusidic acid (n=5) was also detected.

The indiscriminate use of antimicrobial agents in animal production and other agricultural activities has largely contributed to the distribution of MRSA among animals. Further studies will be carried out to investigate the antimicrobial resistance genes and clonal lineages of these isolates.

Glycosaminoglycans (GAGs) are complex unbranched polysaccharides widely found in intracellular compartments, at the cell surface, and in the extracellular environment in living organisms. This availability facilitates attachment of a wide variety of microbial pathogens, including viruses, bacteria, parasites, and fungi, to the host cells and invasion or evasion of host defence mechanisms. There are no doubt GAGs has a potential role in pathogenesis in infectious diseases, and at the same time, GAGs have multiple applications in the medical, veterinary, pharmaceutical, and cosmetic fields. However, little is known about the mechanistic role of GAGs as therapeutic agents, particularly antimicrobial agents. Several documented literature reported primary findings of the antibacterial, antiviral and antiparasitic role of GAGs in controlling infections. Heparin, one kind of GAGs, can prevent biofilm formation for a more extended period in ureteral stents. Desulfated heparins also reduced bacterial adhesion to different extents depending on the bacterium and the sulfated residue. Are GAGs valuable agents for the treatment of infectious diseases or only facilitator of the pathogenesis of infections? This perspective study aims to discuss the current understanding of how microbes co-opt GAGs activities to bypass host defence mechanisms and to propose the reverse role of GAGS as antimicrobial agents for the inhibition of infections or treatment of infectious diseases by considering the contributing mechanisms to the anti-infective pharmacology of GAGs alone or GAGs-based experimental studies.

Cystic fibrosis is an inherited, multi-system disease caused by malfunction of the Cystic Fibrosis Conductance Regulator (CFTR) gene/protein. The abnormal function of CFTR results in abnormalities of in sodium and water transport with abnormally viscous secretions. Lung disease, the main morbidity and mortality, is characterized by chronic bacterial endobronchial infection. The endobronchial microenvironment further shows neutrophilic inflammation, high protease activity and anaerobic conditions.

Key bacteria in CF include Staphylococcus aureus (SA), Pseudomonas aeruginosa (PA), and also other gram-negatives e.g. Achromobacter and Stenotrophomonas. SA is the earliest organism and in the U.S. 25% of the infections are due to methicillin resistant SA (MRSA). Chronic infection of MRSA and PA is associated with worse clinical outcomes. Bacterial adaptations present for both organisms or in mixed infections include biofilm formation, mucoidity and slow growing phenotypes. Data is shown on details of these findings for each bacterium from studies using bacteria from sputum from people with CF.

Multi-drug resistance of PA is a clinical problem yet data from in vitro susceptibility is not accurate in predicting in vivo response. The adaptive bacterial growth modes and heterogeneity of isolates within the same sputum contribute to these discrepant findings.

In summary, in chronic bacterial CF lung infections in vitro testing is often not helpful and clinical acumen for selection of antibiotics is recommended.

Gram-negative bacteria have the ability to sense damage inflicted to the cell wall by beta-lactam antibiotics. The process involves chemical signaling, which will be a subject of my presentation. A primary mechanism for this sensing and signaling involves the events of cell-wall recycling. The cell wall is degraded for recycling and then it is resynthesized de novo for the repair function. The recycling events get initiated by the functions of a family of lytic transglycosylases, which generate the signaling factors that influence transcriptional events in the cytoplasm. The structures and mechanisms of these enzymes and those of the early cytoplasmic steps of recycling have been the subject of study in my lab, which I will disclose in my presentation.

Introduction :
The use of broad-spectrum antibiotics, including an anti-anaerobic spectrum, is associated with the emergence of multi-resistant bacteria. However, all the new molecules on the market targeting GNB are very broad-spectrum, implying a strong ecological impact. Particularly in resuscitation, the volume of antibiotic prescriptions is very high. It is necessary to limit the pressure of antibiotic selection by using molecules with a narrower spectrum and less ecological impact. We propose to use in the existing pharmacopoeia the narrow spectrum molecules whose optmisation of PK/PD parameters would allow them to be used as an alternative to Carbapenems, third and fourth generation Cephalosporins or fluroquinolones.

Methods :
Systematic review of the literature allowing in a first step to select antibiotics active against GNB with a low ecological impact. In a second step, a literature review will allow to define the modalities of use of the selected molecules for the optimization of the PK/PD parameters integrating dosage, stability data and infusion modalities.

Results and Discussion :
Cefoxitin, temocillin, Amoxicillin ac clavulanic, aztreonam, piperacillin, piperacillin tazobactam, cotrimoxazole were selected for their lower ecological impact and their possible integration in an antibiotic stewardship program in intensive care. We propose continuous infusion administration methods to optimize the PK/PD parameters of its time-dependent molecules at maximum doses. Under the conditions of use in intensive care, the stability data allow the use of electric syringes for the infusion of temocillin, aztreonam and cefoxitin, the other molecules will have to be used with a volumetric pump.

Conclusions :
An antibiotic stewardship policy in resuscitation can integrate alternatives to molecules with high ecological impact with the use of Cefoxitin, temocillin, piperacillin, aztreonam and cotrimoxazole in continuous infusion using electric syringes or volumetric pumps.

The spread of antibiotic resistance is regarded as one of the most important factors affecting healthcare. Historically the spread of antibiotic resistance genes has been considered to be due to the spread of plasmids from one bacterial cell to another via conjugation. The possibility of inter-specific conjugation events, together with possible transmission through transformation by environmental DNA, has made this an even greater concern. However, it is becoming clear that it is also possible for antibiotic resistance genes to be found in bacteriophage, suggesting that transduction may also provide a route for their spread.

In the current work we investigate the putative origins of all antibiotic resistance genes which are reported in the GenBank database as having been isolated from bacteriophages. All candidate sequences including examples of resistance genes for tetracycline [tetO], macrolides [mefA], and aminoglycoside [aadE]) were downloaded from the database and compared to other sequences within the database to identify related sequences from both the bacterium infected by the relevant phage, and also from other species harbouring a related resistance gene. Based on this information dendrograms were constructed to examine the relationship between these sequences. In addition, codon usage patterns were compared between the antibiotic resistance genes from the phages, any other genes present in the phages and the genes from the other organisms identified for dendrogram construction, to assay the level of any codon amelioration patterns which have taken place.

Most phage antibiotic resistance genes were most similar to genes previously described in the genus Streptococcus, although the position of these genes within the phylogenetic trees suggested that there had been multiple acquisition events.