Articles

An Adaptive Approach to Recurrent Pseudomonas Cellulitis and Bacteremia in Patients with Comorbid Complexities

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Pseudomonas aeruginosa has become increasingly difficult to manage due to its acquired antibiotic resistance and patient specific complications. The objective of this case study was to help guide management of resistant Pseudomonas in patients with complex comorbidities such as chronic kidney disease, recurrent cellulitis, venous insufficiency and more. Initial measures for treatment included Ciprofloxacin, Doxycycline, Levofloxacin and Vancomycin, but the patient either responded poorly with recurrent infections or did not respond at all to the treatment regiments. The patient felt relief and held the longest period of resolution when the treatment regimen included Daptomycin and Meropenem.

Identification of Listeria spp. with Antibiotic Resistance in Wastewater from Hospitals in Libreville, Gabon

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This study focuses on the use of Gram staining in the identification of Listeria monocytogenes in hospital wastewater in Libreville. The study aims to highlight the presence of this bacterium, which can cause illness and mortality in these wastewater systems. The study was conducted on 27 samples, of which 14 were identified as green colonies and 13 as white colonies after culture and isolation. Gram staining revealed that these were Gram-positive bacteria, with respective prevalence rates of 51.85% and 48.15%. Phenotypic identification of these colonies confirmed that they were Listeria monocytogenes. Antibiotic susceptibility testing showed that these bacteria exhibited an overall resistance rate of 36.4% (59/162) and an overall sensitivity rate of 63.6% (103/162) to the tested antibiotics. Resistance to amoxicillin was the highest at 63.6% (103/162), followed by cefotaxime (37%, 10/27), gentamicin (29.6%, 8/27), kanamycin (25.9%, 7/27), ofloxacin (14.8%, 4/27), and tetracycline (11.11%, 3/27). These results demonstrate that this bacterium, widespread in our environment, requires particular attention due to the risk of epidemics associated with multidrug-resistant Listeria monocytogenes. Hospital wastewater could be a source of human listeriosis resistant to antibiotics. This poses a significant risk to human health, as hospital wastewater can infiltrate the soil and contaminate groundwater. Additionally, it may pollute nearby effluents, thereby exposing human and animal populations that use these waters to potential contamination.

Treatment Challenges and Prevalence of Antibiotic Resistance Stenotrophomonas maltophilia an Emerging Pathogen Isolated from Leafy Greens and Clinical Samples

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Stenotrophomonas maltophilia is a commensal and an emerging pathogen earlier noted in broad-spectrum life-threatening infections among the vulnerable, but more recently as a pathogen in immunocompetent individuals. In the current study, S. maltophilia was identified from 78% of vegetable samples. Bacterial population count ranged from 5.50 × 10-1to 4.3 × 10-4 cfu/g (mean 8.9 × 105 cfu/g, median 7.75 × 103 cfu/g). Based on a cross-sectional study performed during 2015-2016 n=35 and 2016-2017 n=55 S. maltophilia was isolated from clinical samples. The occurrence of S. maltophilia from clinical samples increased during 2016-2017 with a significant value of P=.0008. Out of the total of n=90 S. maltophilia, clinical isolates (35.28%) were from tracheal aspirates, followed by cerebrospinal fluid (CSF) (17.70%), sputum (15.20%), blood (16.82%), and urine (15.0%).  Sample sources were taken from different age groups of patients between 0-75 years. Almost all the isolates > 97% confirmed multiple drug resistance (MDR). Above 95% of the isolates are biofilm formers and the resistance rate increases among the biofilm formers.