<abstract> <p>Over decades, sulfur has been employed for treatment of many dermatological diseases, several skin and soft tissue, and <italic>Staphylococcus</italic> infections. Because of its abuse, resistant bacterial strains have emerged. Nanotechnology has presented a new horizon to overcome abundant problems including drug resistance. Nano-sized sulfur has proven to retain bactericidal activity. Consequently, the specific aims of this study are exclusively directed to produce various sulfur nanoparticles formulations with control of particle size and morphology and investigate the antibacterial activity response specifically classified by the category of responses of different formulations, for the treatment of acne vulgaris resistant to conventional antibiotics. In this study, we produced uncoated sulfur nanoparticles (SNPs), sulfur nano-composite with chitosan (CS-SNPs), and sulfur nanoparticles coated with polyethylene glycol (PEG-SNPs) and evaluate their bactericidal impact against <italic>Staphylococcus aureus</italic> and <italic>Staphylococcus epidermidis</italic> isolated from 173 patients clinically diagnosed acne vulgaris. Accompanied with molecular investigations of <italic>erm</italic>B and <italic>mec</italic>A resistance genes distribution among the isolates. Sulfur nanoparticles were synthesized using acid precipitation method and were characterized by scanning electron microscope (SEM), transmission electron microscopy (TEM), energy dispersed x-ray spectroscopy (EDX), and Fourier transform infrared spectroscopy (FTIR). Moreover, agar diffusion and broth micro-dilution methods were applied to determine their antibacterial activity and their minimum inhibitory concentration. PCR analysis for virulence factors detection. Results: TEM analysis showed particle size of SNPs (11.7 nm), PEG-SNPs (27 nm) and CS-SNPs (33 nm). Significant antibacterial activity from nanoparticles formulations in 100% dimethyl sulfoxide (DMSO) with inhibition zone 30 mm and MIC at 5.5 µg/mL. Furthermore, the prevalence of <italic>mecA</italic> gene was the most abundant among the isolates while <italic>ermB</italic> gene was infrequent. Conclusions: sulfur nanoparticles preparations are an effective treatment for most <italic>Staphylococcus</italic> bacteria causing acne vulgaris harboring multi-drug resistance virulence factors.</p> </abstract>

The aim of the study is to isolate and characterize Pseudomonas aeruginosa  recovered from different clinical specimens and then study the susceptibility of the isolated strains to different antibiotics, screening for heteroresistant isolates and detecting the metalloβ-lactamase genes in these isolates. A total of two hundred and fifty clinical isolates were collected, from which one hundred forty five isolates revealed Pseudomonas aeruginosa. They were collected from different clinical specimens applied for bacteriological testing from hospitalized in-patients admitted to Kasr Al Aini Hospital and Al-Demerdash Hospital, Egypt, in the period from February 2016 to December 2017. Antibiotic susceptibility testing was done using ten antibiotics. The study covered the heteroresistance of P.aeruginosa  towards several classes of antibiotics to make the statistical analysis convenient and to overview the significance of this resistance. The minimum inhibitory concentration was detected for the heteroresistant P.aeruginosa  resistant isolates.  The polymerase chain reaction of the heteroresistant strains was performed to detect the metallo-β-lactamase genes SIM, IMP and SPM and then sequencing was done consequently. SIM, IMP and SPM metalloβ-lactam e genes were detected in the heteroresistant isolates. The isolates showed a high resistance pattern to ampicillin (98.62%) and a high sensitivity rate to imipenem (96.55%) and the IMP gene was the highly significant gene.

Background: Heteroresistance described infections with bacterial strains which causes infections with different levels of resistance to an antibiotic and differs with age and gender. Objectives: This work determined the variations in the heteroresistance pattern for the age, gender and site of infection and the statistical analysis was done using (SPSS version 20.0) for test of significance. Methodology: Out of two hundred and fifty clinical specimens isolated from different sites from Inpatients admitted to Kasr Al-Aini hospital and Al-Demerdash hospital from different genders with different ages in the period from February 2016 to December 2017, Egypt, one hundred and forty five specimens revealed P.aeruginosa after passing several conventional microbiological methods, the antimicrobial susceptibility testing and the screening of nht4heteroresistant specimens were performed. Results: The obtained results showed that the hetesroresistance was very high in the urine specimens and very high in males more than females. Conclusion: From the statistical analysis we recommend the use of imipenem, levofloxacin and ciprofloxacin in the treatment of heteroresistant P.aeruginosa, since they were the highly significant, effective antibiotics.