RHA™ anti-vancomycin monoclonal antibody, clone VM

Introduction Antimicrobial resistance (AMR) has become a challenge in modern-day medical practice. The pace at which microbes are becoming resistant to antibiotics is greater than the discovery of novel antimicrobial agents. There is a need to study these antimicrobial patterns and, for this purpose, antibiograms should be developed at the levels of wards and hospitals and studied to guide us better on how to choose suitable empirical therapy for our patients. Methods and materials A total of 286 reports were studied, which contained the culture and sensitivity data of all the patients admitted under the care of Surgical Unit-1 in Lahore General Hospital between April 1, 2019, and October 31, 2019. All the samples for culture and sensitivity were sent to the in-house laboratory of the hospital where the reporting was done by the pathology department. They were inoculated and then intubated, and gram staining was performed. Antibiotic resistance and susceptibility were measured by the disk diffusion method according to the Clinical and Laboratory standards institute (CSLI) guidelines. Results The most common isolated organism was Escherichia coli (E. coli) in 65 (24%) patients, the next most common was Acinetobacter species in 62 (23%), followed by Pseudomonas species 52(19%), Klebsiella species 32 (13%), Staphylococcus aureus 30 (11%), Coagulase-negative Staphylococci 20 (7%), Enterobacter species (2%), and Citrobacter species (1%). The antimicrobial susceptibility of E. coli was highest for aminoglycosides and carbapenems like amikacin (78%), meropenem (71%), and imipenem (63%). Acinetobacter was most sensitive to colistin (100%), amikacin (31%), meropenem (21%), and cefoperazone + sulbactam (21%). Pseudomonas was also most sensitive to colistin (93%) and after that amikacin (52%), meropenem (52%), and imipenem (44%). Klebsiella was most sensitive to colistin (86%), imipenem (60%), and aminoglycosides (50%). Among gram-positive organisms, Staphylococcus aureus was sensitive to linezolid (100%) and vancomycin (100%). Conclusion The vast majority of isolated organisms in this study were gram-negative bacteria, and most were showing high antimicrobial resistance. The antibiograms should be developed and regularly updated at every ward and hospital. There is a need to bring more awareness about the proper use of antimicrobials among healthcare workers, and antimicrobial stewardship programs can help in this matter.

Traditionally fermented food generally has unique sensorial aspects due to its high microbial diversity, being broadly consumed worldwide. Despite this, some Vancomycin-Resistant-Enterococci (VRE) can occur in these products, which raises questions about their safety. Thus, this study tries to assess information about the occurrence of Enterococcus strains in traditional Brazilian cheese samples collected from the five main regions as well as the characterization of their phenotypic (proteolytic, lipolytic and bacteriogenic potential) and safety (hemolysin activity and growth at commercial VRE selecting media) aspects. A total of 1669 lactic acid bacteria were isolated, of which 605 (36.2%) were identified as Enterococcus by 16sRNA sequencing. Out of these, E. faecium (58.7%) was identified as the dominant species, followed by Enterococcus faecalis (31.8%), Enterococcus durans (4.8%), Enterococcus hermanniensis (1.6%) and Enterococcus gilvus (1.6%). All the data were analyzed by multivariate statistics, and the findings highlighted the presence of Enterococcus as a naturally component of indigenous microbiota of Brazilian artisanal cheeses, mostly in the cheeses of Marajo, Coalho, and Manteiga, possibly as a consequence of their heat resistance and the curd cooking step applied during the process in these regions. The majority of the identified Enterococcus (63.1%) did not produce beta-hemolysin and were not resistant to vancomycin. Interestingly some of these strains (21.4%) were able to inhibit Listeria monocytogenes ATCC 35152, mostly isolates from Serrano, Colonial, and Minas artisanal (from Cerrado microregion) cheeses. Also, 10.2 and 11.8% of them have shown moderate to high proteolytic and lipolytic activity, respectively. Antilisterial activity is of most interest as it can contribute to reduce risk of listeriosis due to dairy products consumption, while proteolysis and lipolysis are responsible for some remarkable features (e. g. flavor, taste, and texture) of fermented foods. In summary, this study represents a contribution towards revealing some phenotypic and safety traits of a large set of strains of Enterococcus strains through the use of multivariate statistics combined with high throughput tools.