Vulvovaginitis is most common in reproductive-aged women, where candidal vulvovaginitis accounts for roughly one-third of cases. Because of the increased interest from doctors and patients, the use of probiotics in reproductive-related dysbiosis is an area of continuing growth. The purpose of this study was to explore the effect of a natural intimate gel based on Cyperus esculentus L. hydro-ethanolic extract and beads of Lacticaseibacillus rhamnosus SL42 on the treatment and prevention of recurrent vulvovaginitis induced by C. albicans (RVVC) in vivo. Wistar rats treated with œstrogenic substances were divided into 6 groups: 2 control groups (infected or not with two separate vulvovaginal infections of 5 × 10⁴ cells/mL of C. albicans), 2 treatment groups (Lactobacillus rhamnosus Lcr35 or Econazole), and 2 prevention groups (10⁸ CFU/g of L. rhamnosus SL42 in xanthan beads embedded or not in the intimate hydro-ethanolic plant gel). The fluctuation in microbial colonization and the change of bacterial flora in rat vaginal mucosa after sowing probiotic bacteria were investigated by colony-forming units (CFUs) and microflora analysis. Histological evaluation, myeloperoxidase (MPO) assay, and ELISA analysis for Prostaglandin E2 on vaginal tissues were also performed. The data obtained highlighted that the intimate gel based on tigernut extract and containing L. rhamnosus SL42 beads significantly preserved vaginal tissue architecture and prevented vaginal inflammation, proving its efficacy for the management of RVVC and reducing the adhesion of C. albicans, as did the probiotic bacteria Lcr35. Hence, L. rhamnosus SL42 was proven to be a potential probiotic for VVC treatment and prevention in vivo, and it may have potential application in RVVC prevention products.

Poultry products are essential to global food security, yet they can also harbor foodborne pathogens, such as Escherichia coli (E. coli). While E. coli is a common bacterium in human and animal intestines, certain strains can cause severe gastrointestinal illness if consumed. Given the widespread consumption of poultry in Nigeria, ensuring the safety of chicken products is crucial for public health. Increasing antimicrobial use and expanding reservoirs in food animals like chickens have been associated with the rise in the prevalence of Extended extended-spectrum beta-lactamase-producing E. coli (ESBL-EC). This study aimed to assess the prevalence and antibiotic resistance patterns of E. coli strains and determine the antibiogram of Extended Spectrum Beta-Lactamase-producing E. coli isolated from chicken processing plants in Ibadan, Nigeria.

A total of 100 swab samples were collected from the packaging stage of the processing line of five chicken processing plants across three local government areas: Oluyole, Lagelu, and Ibadan Southwest in Ibadan, Nigeria. Samples underwent standard microbiological techniques for E. coli isolation and identification, followed by antibiotic susceptibility testing using the Kirby–Bauer disk diffusion method. The obtained data were analysed using descriptive statistics.

The investigation revealed concerning results, with 45 out of 100 samples yielding E. coli isolates. Overall, 40 were identified as ESBL-producing strains, and 5 as non-ESBL E. coli. Prevalence rates varied among processing plants and local government areas, with Ibadan Southwest Local Government showing the highest prevalence at 60% and Plants B and D showing the highest prevalence per plant. High resistance rates were observed among the isolates against commonly used antibiotics, including 93.33% resistance to cefotaxime and 88.89% resistance to ceftazidime. Additionally, 77.78% and 75.56% resistance rates were recorded for tetracycline and pefloxacin, respectively. Multidrug resistance (MDR) was also prevalent among 84.45% of isolates, with 12.5% demonstrating extended-drug resistance (XDR).

Enterococci are the third to second most common pathogens in nosocomial infections. With their intrinsic resistance against cephalosporines and most other β-lactam antibiotics, the treatment of enterococcal infections remains challenging. With the rising resistance against last-resort antibiotics and the emergence of vancomycin-resistant enterococci (VRE), current therapy options are critically limited [1]. A promising way to overcome this burden is to re-sensitize resistant strains to modified approved antibiotics [2]. Therefore, we conjugated polycationic peptides to select β-lactam antibiotics using a bifunctional linker moiety. These conjugates were screened for their antimicrobial efficacy, pharmacokinetics and affinity to penicillin-binding proteins (PBPs). For the most promising ceftazidime-R6 conjugate, a broadened spectrum and up to 1000-fold-higher efficacy could be demonstrated against vancomycin-susceptible enterococci and VRE without increasing cytotoxicity. In vivo studies in rodents showed an altered way of excretion and demonstrated therapeutic efficacy against VRE. The altered PBP-binding profile as well as the faster killing mechanism of the conjugates compared to their parent β-lactam suggest an altered mode of action [3]. These findings go along with our previously reported findings on FU002, a vancomycin derivative, and represent a possible platform technology for cell-wall addressing antibiotics and particular against enterococci [4].

References:

1. Kahn A. et al. (2022), Antimicrobial Susceptibility Testing for Enterococci. J. Clin Microbil., 60(9).

2. Narendrakumar L. et al. (2023), β-Lactam potentiators to re-sensitize resistant pathogens: Discovery, development, clinical use and the way forward. Front. Microbiol., 13.

3. Werner J. et al. (2024), Conjugation of Polycationic Peptides Extends the Efficacy Spectrum of β-Lactam Antibiotics. Adv. Sci. (Weinh), e2411406.

4. Umstätter F. et al. (2020), Vancomycin Resistance Is Overcome by Conjuagtion of Poylcationic Peptides. Angew Chem Int Ed Engl., 59(23).

Foodborne bacteria play an important role in the spread of antibiotic resistance and complicate treatment processes. Regarding antibiotic resistance, extended-spectrum beta-lactamase (ESBL)-producing E. coli and carbapenem-resistant Enterobacterales are among the issues highlighted by the WHO. In this study, 200 ready-to-eat stuffed mussels from Istanbul were collected from various sales points (street vendors, kiosks, and restaurants) in 2024, and the presence of ESBL-producing E. coli was investigated. A total of 3.5% (7/200) E. coli was confirmed by PCR with 16S rRNA-specific primer. Antibiotic susceptibilities of the isolates to cefotaxime, ceftazidime, amoxicillin-clavulanic acid, meropenem, and ampicillin were measured by disk diffusion method. ESBL production in E. coli isolates was investigated using a double disk synergy test for phenotypic confirmation and bla_OXA, bla_CTX-M, bla_SHV, and bla_TEM gene presence by mPCR, and one isolate was found to contain the bla_TEM gene. The disk diffusion test and PCR investigated related carbapenem resistance, and bla_NDM-1, bla_OXA-48, bla_VIM, and bla_IMP genes were not observed in any isolate. This study is the first report of ESBL-producing E. coli isolate from ready-to-eat stuffed mussels in Türkiye. The presence of foodborne ESBL-producing E. coli threatens public health. It is necessary for food safety and global health to report the threats detected, especially in ready-to-eat products, and to take necessary measures.

Antimicrobial resistance (AMR) is a pressing global health and development crisis. Low- and middle-income countries (LMICs), like Bangladesh, are disproportionately affected due to the weak enforcement of antibiotic regulations, pluralistic healthcare systems, and limited access to healthcare facilities in a predominantly rural population. Contemporary studies highlight the limited judicious use of antibiotics, despite a higher density of pharmacies in rural areas of Bangladesh.

This study investigates the field-level dynamics of antibiotic regulation in Bangladesh and its role in fostering sustainable stewardship practices, emphasizing a bottom-up approach to regulation to complement traditional top-down mechanisms.

Employing a qualitative, case-oriented design, this study relies on both primary and secondary data. Primary data were collected through key informant interviews, focus group discussions, and semi-structured interviews with district drug inspectors, community members, and local pharmacists, supplemented by official reports.

The findings reveal a gap between policy and practice, driven by institutional inefficiencies, power dynamics, limited stakeholder engagement, and inadequate public awareness at the field level. Among community respondents, 47.06% reported using antibiotics in the last six months, with almost half engaging in self-medication, and 52% were unaware of the legal restrictions on antibiotic sales.

This study advocates for an integrated regulatory approach that fosters stakeholder participation, strengthens district-level regulatory capacity, and aligns antibiotic regulation with broader public health goals. Strengthening field-level regulation and bridging the gap between policy and practice is crucial to promoting sustainable and effective antibiotic stewardship in Bangladesh.

Mastitis is a prevalent condition affecting small ruminants, leading to significant economic losses, attributed to decreased milk production and inferior milk quality at a global scale. This issue is particularly pronounced in the rural regions of the Mediterranean, where nearly two-thirds of the world's sheep and a quarter of the global goat milk supply is generated. The present study sought to explore the epidemiology, genetic diversity, antimicrobial resistance profiles, and virulence factors associated with Staphylococcus aureus isolated from sheep and goat suffering from clinical mastitis in Sardinia, Italy.

A total of thirty-four isolates obtained from clinical mastitis cases across 26 dairy farms were characterized through whole genome sequencing and phenotypic assessments of antibiotic resistance.

All isolates were confirmed to be phenotypically methicillin-sensitive S. aureus (MSSA). A small proportion of the isolates exhibited resistance to tetracycline (12.5%) and erythromycin (3.12%). The isolates were categorized into seven distinct sequence types, with ST133 (n = 15) and ST700 (n = 9) being the predominant types. All isolates that were resistant to tetracycline contained either the tetM or tetK gene.

The distribution of certain clusters across various regions demonstrates the ongoing presence of cluster-related infections. Despite all isolates being derived from clinical mastitis cases, they exhibited minimal resistance to the antimicrobials tested. This suggests that the farms surveyed have implemented highly effective hygiene practices, alongside routine antimicrobial resistance testing and the judicious use of antimicrobials to prevent the development of resistance. This approach aligns with the current agricultural regulations, particularly the enforcement of EU legislation. This could result in a reduction in the disease burden and an improvement in animal welfare.

Introduction: Infections involving bacteria in the bloodstream pose a significant public health risk, potentially progressing to sepsis, which is often fatal. Staphylococcus aureus and Escherichia coli are recurrent pathogens in these infections, and effective treatment depends on the proper choice of antibiotics due to the growing issue of antimicrobial resistance. Objectives: The aim of this study was to evaluate the clinical management of bacteremias caused by E. coli and S. aureus. Methodology: This is a literature review study that used the PubMed and Virtual Health Library (VHL) databases, employing the following descriptors: bacteremia AND antibiotics AND Staphylococcus aureus OR Escherichia coli. Results: The search yielded a total of 394 articles, and after applying the selection and exclusion criteria, 9 articles were deemed eligible. It was observed that the treatment for methicillin-sensitive S. aureus includes penicillinase-resistant semi-synthetic penicillins, first-generation cephalosporins, and daptomycin. Beta-lactam anti-staphylococcal therapy is effective for methicillin-sensitive S. aureus, but combining it with daptomycin did not show additional benefits, as it did not reduce mortality or recurrence. For methicillin-resistant S. aureus cases, vancomycin or daptomycin is recommended. The combination of daptomycin with fosfomycin showed a 12% higher success rate, but without statistical significance. Ceftobiprole showed efficacy similar to that of daptomycin in treating complicated S. aureus bacteremias, with a success rate of 69.8%, making it an effective alternative. In bacteremias caused by E. coli producing extended-spectrum β-lactamases, carbapenems such as meropenem are the standard treatment. Fosfomycin is an alternative, but it is not superior to meropenem. Piperacillin–tazobactam demonstrated comparable efficacy to carbapenems, provided that the co-production of OXA-1 by E. coli was rare. Conclusions: The management of bacteremias caused by S. aureus and E. coli requires continuous monitoring of antimicrobial resistance and therapeutic efficacy. New treatments and approaches are crucial to address the growing threat of these infections.

Introduction: Fosfomycin is a commonly prescribed antimicrobial for the prevention and treatment of urinary tract infections. The current study aimed to show the fosfomycin sensitivity among Enterobacterales and enterococci urinary isolates in communities in British Columbia (BC), Canada. The population data will help clinicians in predicting the effectiveness of fosfomycin when patients’ urine isolate susceptibility results are pending.

Methods: LifeLabs BC regional microbiology laboratories, connected with 129 collection centres in urban and rural communities in the province, provided the laboratory data. An audit was conducted on all urine cultures from October 2023 to September 2024. Antimicrobial susceptibility testing was performed and interpreted using the Clinical and Laboratory Standard Institute M100 guidance. Breakpoints for Enterococcus faecalis and Escherichia coli were extrapolated to all enterococci and Enterobacterales, respectively. Species with <30 isolates tested were excluded to reduce the risk of selection bias.

Results:

Microorganisms (Susceptible Isolates/Total Number of Isolates = % Susceptible)

Enterobacter cloacae complex (16/65= 25%)

Enterococcus faecalis (249 / 266 = 94%)

Escherichia coli (49272/ 50329 = 98%)

Klebsiella oxytoca (32 / 62 = 52%)

Klebsiella pneumoniae (333 / 522 = 64%)

Proteus mirabilis (107 / 139 = 77%)

Vancomycin-resistant Enterococcus faecium (35 / 60 = 58%)

Vancomycin-sensitive Enterococcus faecium (55 / 112 = 49%)

Conclusion: Based on population data in BC, fosfomycin is likely effective against Enterococcus faecalis and Escherichia coli in urine (sensitivity >80%). Fosfomycin effectiveness is questionable against Klebsiella pneumoniae and Proteus mirabilis in urine (sensitivity 60-80%). It is likely ineffective against the Enterobacter cloacae complex, Klebsiella oxytoca, and Enterococcus faecium in urine (sensitivity <60%).

Introduction:

Hospital-acquired infections are relatively common in hospitalized patients, especially those who are critically ill or with invasive devices. Vancomycin is an antibiotic that is widely used to treat methicillin-resistant staphylococcus-aureus; an organism that is usually could be the causative of the hospital-acquired infections especially among critically ill patients. As vancomycin is mainly eliminated from the body through the kidney, the renal function plays an important role in the dosing of vancomycin. Augmented renal function is a common condition among neurocritical ill patients. The aim of this study is to observe the pharmacokinetics and optimize the dosing of vancomycin in neurocritical ill patients.

Methods:

A prospective observational study of neurocritical ill patients received vancomycin at University of Alberta Hospital. Population pharmacokinetics of vancomycin were conducted using Monolix software. Moreover, non-compartmental analysis was conducted to observe the vancomycin pharmacokinetics differences among patients. Monte Carlo simulations were performed to predict the percentage of patients reaching the target concentrations following different doses.

Results:

A total of 55 patients with 149 observations were included in this study. The population clearance was 0.083 L/kg.hr, and the volume of distribution was 1.02 L/kg. The model which best fitted the population was one compartment model with creatinine clearance (CrCl) and body mass index added as covariates on vancomycin clearance. In the non-compartmental analysis, there were 7 out of 11 patients with augmented renal function. There was a positive correlation between the vancomycin clearance and CrCl (r² = 0.3346, P=0.04), and a negative correlation between area under the curve-to-dose ratio and CrCl (r² = 0.5778, P=0.003).

Conclusion:

Vancomycin clearance is affected by changes in CrCl observed in patients with augmented renal function. Therefore, dosing optimization in such population is essential to reach the target concentrations.

Studies on multidrug-resistant microorganisms, especially Escherichia coli (E. coli) strains, continue worldwide. In addition to the discovery of new antibiotics, there is also significant research on resistance mechanisms. One such mechanism is the efflux pump, which rapidly expels substances (antibiotics) from the bacterial cell or reduces their concentration. Therefore, the effectiveness of antibiotics can be restored by preventing this mechanism, and studies on potential inhibitors in this direction are ongoing.

In this study, the potential inhibitory effect of acetone extract obtained from Phellinus hartigii (P. hartigii) against drug-resistant E. coli strains was investigated. This was done by using the extract in combination with the antibiotics aztreonam (ATM 30 µg), cefixime (CFM 5 µg), amoxicillin–clavulanate (AMC 30 µg), piperacillin–tazobactam (TZP 36 µg), and ceftriaxone (CRO 30 µg) (Oxoid, UK).

For the first stage of inhibition, the Ethidium Bromide (EtBr) test was used with P. hartigii acetone extract. After observing inhibition according to the test results, antibiotic disks were applied together with the extract, antibiotic, and resistant strains. As a result of this study, it was observed that activities against E. coli#3 strain ATM (MIC 4), E. coli#10 strain ATM (MIC 8), E. coli#7 strain TZP (MIC >16/4), and E. coli#8 strain TZP (MIC >16/4) were restored. Based on these findings, P. hartigii acetone extract may have a potential efflux pump inhibitory effect, but further studies are required to explain this effect more broadly.

Acknowledgement: This study was supported by the Kastamonu University Scientific Research Project
(KUBAP-01-2021-47).