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Antibiotic resistance rate is rising worldwide. Silver nanoparticles (AgNPs) are potent for fighting antimicrobial resistance (AMR), independently or synergistically. The purpose of this study was to prepare AgNPs using wild ginger extracts and to evaluate the antibacterial efficacy of these AgNPs against multidrug-resistant (MDR) Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis. AgNPs were synthesized using wild ginger extracts at room temperature through different parameters for optimization, i.e., pH and variable molar concentration. Synthesis of AgNPs was confirmed by UV/visible spectroscopy and further characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy analysis (EDXA), and Fourier-transform infrared spectroscopy (FTIR). Disc and agar well diffusion techniques were utilized to determine the in vitro antibacterial activity of plant extracts and AgNPs. The surface plasmon resonance peaks in absorption spectra for silver suspension showed the absorption maxima in the range of 400–420 nm. Functional biomolecules such as N–H, C–H, O–H, C–O, and C–O–C were present in Zingiber zerumbet (Z. zerumbet) (aqueous and organic extracts) responsible for the AgNP formation characterized by FTIR. The crystalline structure of ZZAE-AgCl-NPs and ZZEE-AgCl-NPs was displayed in the XRD analysis. SEM analysis revealed the surface morphology. The EDXA analysis also confirmed the element of silver. It was revealed that AgNPs were seemingly spherical in morphology. The biosynthesized AgNPs exhibited complete antibacterial activity against the tested MDR bacterial strains. This study indicates that AgNPs of wild ginger extracts exhibit potent antibacterial activity against MDR bacterial strains.

Globally, antimicrobial resistance has grown at an alarming rate. To combat the multidrug-resistant (MDR) superbugs, silver nanoparticles (Ag NPs) were synthesized using an aqueous leaf extract of seasonal desert plant Sisymbrium irio obtained from the central region of Saudi Arabia by a simple one-step procedure. The physical and chemical properties of the Ag NPs were investigated through ultraviolet visisble analysis (UV-vis), Fourier-transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), scanning electron microscope (SEM), and transmission electron microscope (TEM) analysis. The UV-vis spectrum showed an absorption band at 426 nm. The XRD results showed a highly crystalline face-centered cubic structure. The surface morphology analyzed using SEM and TEM analyses showed the particle size to be in the range 24 nm to 50 nm. Various concentrations of Ag NPs were tested against MDR Pseudomonas aeruginosa and Acinetobacter baumanii that cause ventilator-associated pneumonia (VAP). American Type Culture Collection (ATCC) Escherichia coli-25922 was used as the reference control strain. The Ag NPs effectively inhibited tested pathogens, even at the lowest concentration (6.25 µg) used. The bacterial inhibitory zone ranged from 11–21 mm. In conclusion, the newly synthesized Ag NPs could be a potential alternative candidate in biomedical applications in controlling the spread of MDR pathogens.

Purpose High antibiotic and antifungal concentrations in wastewater from anti-infective drug production may exert selection pressure for multidrug-resistant (MDR) pathogens. We investigated the environmental presence of active pharmaceutical ingredients and their association with MDR Gram-negative bacteria in Hyderabad, South India, a major production area for the global bulk drug market. Methods From Nov 19 to 28, 2016, water samples were collected from the direct environment of bulk drug manufacturing facilities, the vicinity of two sewage treatment plants, the Musi River, and habitats in Hyderabad and nearby villages. Samples were analyzed for 25 anti-infective pharmaceuticals with liquid chromatography–tandem mass spectrometry and for MDR Gram-negative bacteria using chromogenic culture media. In addition, specimens were screened with PCR for bla VIM , bla KPC , bla NDM , bla IMP-1 , and bla OXA-48 resistance genes. Results All environmental specimens from 28 different sampling sites were contaminated with antimicrobials. High concentrations of moxifloxacin, voriconazole, and fluconazole (up to 694.1, 2500, and 236,950 µg/L, respectively) as well as increased concentrations of eight other antibiotics were found in sewers in the Patancheru–Bollaram industrial area. Corresponding microbiological analyses revealed an extensive presence of extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae and non-fermenters (carrying mainly bla OXA-48 , bla NDM , and bla KPC ) in more than 95% of the samples. Conclusions Insufficient wastewater management by bulk drug manufacturing facilities leads to unprecedented contamination of water resources with antimicrobial pharmaceuticals, which seems to be associated with the selection and dissemination of carbapenemase-producing pathogens. The development and global spread of antimicrobial resistance present a major challenge for pharmaceutical producers and regulatory agencies.

Rice is the most important staple food crop feeding more than 50% of the world’s population. Rice blast is the most devastating fungal disease, caused by Magnaporthe oryzae (M. oryzae) which is widespread in rice growing fields causing a significant reduction in the yield. The present study was initiated to evaluate the effect of green synthesized silver nanoparticles (AgNPs) on the biochemical constituents of rice plants infected with blast. AgNPs were synthesized by using Azadirachta indica leaf extract and their characterization was performed using UV-visible spectroscopy, particle size analyser (PSA), scanning electron microscope (SEM), and X-ray diffraction (XRD) which confirmed the presence of crystalline, spherical shaped silver nanoparticles with an average size of 58.9 nm. After 45 days of sowing, artificial inoculation of rice blast disease was performed. After the onset of disease symptoms, the plants were treated with AgNPs with different concentrations. Application of nanoparticles elevated the activity of antioxidative enzymes such as superoxide dismutase, catalase, peroxidase, glutathione reductase, and phenylalanine ammonia-lyase compared to control plants, and total phenol and reducing sugars were also elevated. The outcome of this study showed that an increase in all biochemical constituents was recorded for A. indica silver nanoparticles-treated plants. The highest values were recorded in 30 ppm and 50 ppm AgNPs-treated plants, which showed the highest resistance towards the pathogen. Green synthesized AgNPs can be used in future for disease control in susceptible varieties of rice. The synthesized AgNPs using A. indica leaf extract have shown promising antibacterial activity when tested against 14 multidrug-resistant (MDR) bacteria comprising Gram-negative bacteria Escherichia coli (n = 6) and Klebsiella pneumoniae (n = 7) with a good zone of inhibition diameter, tested with the disc diffusion method. Based on these findings, it appears that A. indica AgNPs have promise as an antibacterial agent effective against MDR pathogens.

Background Little is known on the burden of co-infections and superinfections in a specific setting such as the respiratory COVID-19 sub-intensive care unit. This study aims to (i) assess the prevalence of concurrent and superinfections in a respiratory sub-intensive care unit, (ii) evaluate the risk factors for superinfections development and (iii) assess the impact of superinfections on in-hospital mortality. Methods Single-center retrospective analysis of prospectively collected data including COVID-19 patients hospitalized in a newly established respiratory sub-intensive care unit managed by pneumologists which has been set up from September 2020 at a large (1200 beds) University Hospital in Rome. Inclusion criteria were: (i) COVID-19 respiratory failure and/or ARDS; (ii) hospitalization in respiratory sub-intensive care unit and (iii) age > 18 years. Survival was analyzed by Kaplan–Meier curves and the statistical significance of the differences between the two groups was assessed using the log-rank test. Multivariable logistic regression and Cox regression model were performed to tease out the independent predictors for superinfections’ development and for mortality, respectively. Results A total of 201 patients were included. The majority (106, 52%) presented severe COVID-19. Co-infections were 4 (1.9%), whereas 46 patients (22%) developed superinfections, mostly primary bloodstream infections and pneumonia. In 40.6% of cases, multi-drug resistant pathogens were detected, with carbapenem-resistant Acinetobacter baumannii (CR-Ab) isolated in 47%. Overall mortality rate was 30%. Prior (30-d) infection and exposure to antibiotic therapy were independent risk factors for superinfection development whereas the development of superinfections was an independent risk factors for in-hospital mortality. CR-Ab resulted independently associated with 14-d mortality. Conclusion In a COVID-19 respiratory sub-intensive care unit, superinfections were common and represented an independent predictor of mortality. CR-Ab infections occurred in almost half of patients and were associated with high mortality. Infection control rules and antimicrobial stewardship are crucial in this specific setting to limit the spread of multi-drug resistant organisms.

Introduction Urinary tract infections (UTIs) are among the most common bacterial infections in children. This study aimed to investigate the distribution of bacterial uropathogens and their antimicrobial resistance patterns among hospitalized pediatric patients with UTIs in governmental hospitals across the West Bank, Palestine. The findings are intended to support evidence-based empirical treatment strategies and inform local antimicrobial stewardship efforts. Methods This is a cross-sectional study, analyzed urine culture results from pediatric patients with UTI symptoms admitted to governmental hospitals across three regions of the West Bank in 2021–2022, using data from the Ministry of Health’s electronic database. Results 3,949 positive urine culture results were analyzed; 58.5% of the total were aged ≥ 2 years, and 2883 were females (73%), with Gram-negative bacteria accounting for 87.1%. The most common pathogen was Escherichia coli (61.7%). The prevalence of multidrug-resistant (MDR) bacteria was 34.3%. Among Gram-negative isolates, 34.5% were MDR, 33.1% were extended-spectrum beta-lactamase (ESBL) producers, and 3.3% were carbapenem-resistant Enterobacterales (CRE). The highest MDR percentage was in Proteus spp. (50.6%) followed by Klebsiella spp. (45.4%), and E. coli (32.6%). According to matching with the empirical antibiotics, Ampicillin shows 16.8%, Ceftriaxone shows 49.5%, and Cefotaxime shows 51.9%. Conclusion Our findings highlight the high prevalence of MDR bacteria among pediatric UTI patients in the West Bank. E. coli and Klebsiella spp. were the predominant pathogens, showing considerable resistance to commonly used antibiotics. These results underscore the need to reassess empirical UTI treatment regimens, conduct routine antibiogram monitoring, and implement coordinated infection control and antibiotic stewardship programs across the West Bank, Palestine.

Antimicrobial resistance (AMR) has emerged as a significant global concern. To combat this growing threat, various strategies have been employed, including the use of plant extracts and the biosynthesis of nanoparticles (NPs). The current study was designed to evaluate the phytochemical analysis of ginger ( ) extracts, characterize the silver nanoparticles (AgNPs) and to see their antibacterial potentials against multi-drug resistant (MDR) bacterial strains. The extracts were prepared and initially assessed for their phytochemical composition and antibacterial activity. Then, AgNPs were synthesized from these extracts at room temperature, and various analytical techniques, including UV-visible spectroscopy, X-ray diffraction (XRD), ATIR-FTIR, zeta sizer, scanning electron microscopy (SEM), and energy-dispersive X-ray analysis (EDXA), were used to characterize the NPs. After confirmation of prepared NPs, they were subjected to their antibacterial activity. HPLC analysis demonstrated the presence of eight phytoconstituents in organic ginger extracts. The absorption spectra of the silver suspension exhibited surface plasmon resonance peaks with maxima between 420 and 448 nm. Functional groups like C-H, N-H, OH, C-O-C, C=O, and C-O were identified in both the organic and aqueous extracts of , playing a key role in the formation of AgNPs, as characterized by ATR-FTIR analysis. Both ginger organic and aqueous extract synthesized AgNPs crystalline structure was shown in XRD analysis and the particle size distribution showed average diameter of 200.5 nm of AgNPs from aqueous extracts. Scanning Electron Microscopy displayed spherical structure and EDA results showed the percentage of elements in synthesized AgNPs using plant extracts. Most promising antibacterial activity was obtained against 20.83±0.53 for 100 µg/mL. The results of the current study showed that AgNPs synthesized from different ginger extracts have promising antibacterial properties and can be potential candidates for alternative treatment options for bacterial infections.

Objectives: Acute obstructive pyelonephritis (AOP) is a urological emergency that combines bacterial infection with upper urinary tract obstruction. This retrospective study focuses on the microbial etiology and causes of obstruction, clinical manifestations, antibacterial therapy, drainage type, and outcomes in patients diagnosed with AOP at a tertiary urology center between 1 January 2020 and 30 December 2024. Methods: One hundred patients with a mean age of 61.30 years were included in this retrospective study, which examines demographic data, comorbidities, clinical features, pathogens involved, antimicrobial regimens, and hospital outcomes. Results: Urolithiasis was the most frequent cause of obstruction (62%), followed by ureteral stenosis (14%) and tumors (11%). AOPs were mainly produced by Escherichia coli (58%), followed by Klebsiella spp. (21%); 18% of all identified bacteria were ESBL-producing Gram-negative bacilli, and 29% were MDR bacteria. The most used IV antibiotics were fluoroquinolones (52%), followed by cephalosporins (19%) and carbapenems (18%). Carbapenems were administered to all patients with AOP caused by ESBL-producing pathogens and to 62% of those with MDR bacteria. The duration of antibiotic therapy was individualized based on clinical response. Switch to oral administration was made after 4.3 ± 1.5 days, and the antibiotic treatment lasted 10.8 ± 3.2 days. Conclusions: The results of the present study support integrating evidence-based guidelines with regional patterns of bacterial susceptibility to optimize therapeutic approaches and reduce severe outcomes in patients with AOP, most of whom have multiple comorbidities.

Antimicrobial resistance poses a major threat to human health worldwide and the implementation of antimicrobial stewardship programs (ASPs), including antimicrobial de-escalation (ADE), is a multifaceted tool for minimizing unnecessary or inappropriate antibiotic exposure. This was a prospective observational study of 142 non-Intensive Care Unit (ICU) patients with microbiologically documented infection who were initially administered empirical antimicrobial therapy and admitted to the medical wards of 6 tertiary-care hospitals in Greece from January 2017 to December 2018. Patients were divided into two groups, the ADE and non-ADE group, based on whether ADE was applied or not, respectively. Exploratory end-points were ADE feasibility, safety and efficacy. ADE was applied in 76 patients at a median time of 4 days (IQR: 3, 5). An increased likelihood of ADE was observed in patients with urinary tract (OR: 10.04, 95% CI: 2.91, 34.57; p < 0.001), skin and soft tissue (OR: 16.28, 95% CI: 1.68, 158.08; p = 0.016) and bloodstream infections (OR: 2.52, 95% CI: 1, 6.36; p = 0.05). Factors significantly associated with higher rates of ADE were clarithromycin administration, diagnosis of urinary tract infection (UTI), isolation of E. coli, age and symptoms type on admission. Mortality was lower in the ADE group (18.4% vs. 30.3% p < 0.1) and ADE was not significantly associated with the probability of death (p = 0.432). ADE was associated with favorable clinical outcomes and can be performed even in settings with high prevalence of multi-drug resistant (MDR) pathogens without compromising safety.