Acinetobacter baumannii has become increasingly resistant to leading antimicrobial agents since the 1970s. Increased resistance appears linked to armed conflicts, notably since widespread media stories amplified clinical reports in the wake of the American invasion of Iraq in 2003. Antimicrobial resistance is usually assumed to arise through selection pressure exerted by antimicrobial treatment, particularly where treatment is inadequate, as in the case of low dosing, substandard antimicrobial agents, or shortened treatment course. Recently attention has focused on an emerging pathogen, multi-drug resistant A. baumannii (MDRAb). MDRAb gained media attention after being identified in American soldiers returning from Iraq and treated in US military facilities, where it was termed "Iraqibacter." However, MDRAb is strongly associated in the literature with war injuries that are heavily contaminated by both environmental debris and shrapnel from weapons. Both may harbor substantial amounts of toxic heavy metals. Interestingly, heavy metals are known to also select for antimicrobial resistance. In this review we highlight the potential causes of antimicrobial resistance by heavy metals, with a focus on its emergence in A. baumanni in war zones.
The current study dealt with patients with otitis media, where the fungus was isolated from different pathological conditions, and the patients were distributed according to age, sex, residence, and chronic diseases.The fungal species isolated from these patients were diagnosed, and the focus was on Mucor as it is dangerous and may cause black fungus disease, as it was diagnosed phenotypically and molecularly by polymerase chain reaction (PCR) and a drug sensitivity test was conducted. The results showed that men are more susceptible to infection than women, and adults are more susceptible than adolescents and children, and chronic diseases increased the incidence.The study showed an average ability of Mucor spp to produce hydrolytic enzymes, which makes it dangerous only for patients with low immunity. The study also showed that the fungus is resistant to antifungals except for fluconazole, amphotericin B, and ketoconazole, where the diameter of inhibition was 32, 14, and 10 mm, respectively.
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