Streptococcus pyogenes [Group A Streptococcus (GAS)] is one of the most important human pathogens, responsible for numerous diseases with diverse clinical manifestations. As the epidemiology of GAS infections evolves, a rapid and reliable characterization of the isolates remains essential for epidemiological analysis and infection control. This study investigated the epidemiological patterns and genetic characteristics of 150 GAS isolates from a tertiary hospital in Lebanon by emm typing, superantigens (SAgs) detection, PFGE and antibiotic profiling. The results revealed 41 distinct emm types, the most prevalent of which were emm89 (16 %), emm12 (10 %), emm2 (9 %) and emm1 (8 %). Testing for the presence of superantigens showed that speB (87 %), ssa (36 %) and speG (30 %) were predominant. PFGE detected 39 pulsotypes when a similarity cut-off value of 80 % was implemented. Antibiotic-susceptibility testing against seven different classes of antibiotics showed that 9 % of the isolates were resistant to clindamycin, 23 % were resistant to erythromycin and 4 % showed the macrolide-lincosamidestreptogramin B (MLS B ) phenotype. The emergence of tetracycline-resistant strains (37 %) was high when compared with previous reports from Lebanon. This study provided comprehensive evidence of the epidemiology of GAS in Lebanon, highlighting the association between emm types and toxin genes, and providing valuable information about the origin and dissemination of this pathogen.

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Burn infections caused by Pseudomonas aeruginosa pose a major complication in wound healing. This study aimed to determine the antimicrobial effect of metal ions, graphene (Gr), and graphene oxide (GO), individually and in combination, against the planktonic and biofilm states of two antimicrobially resistant clinical strains of P. aeruginosa each with different antibiotic resistance profiles. Minimum inhibitory, minimum bactericidal, and fractional inhibitory concentrations were performed to determine the efficacy of the metal ions and graphene composites individually and their synergy in combination. Crystal violet biofilm and XTT assays measured the biofilm inhibition and metabolic activity, respectively. Molybdenum, platinum, tin, gold, and palladium ions exhibited the greatest antimicrobial activity (MIC = 7.8–26.0 mg/L), whilst GO and Gr demonstrated moderate-to-no effect against the planktonic bacterial cells, irrespective of their antibiograms. Biofilms were inhibited by zinc, palladium, silver, and graphene. In combination, silver–graphene and molybdenum–graphene inhibited both the planktonic and biofilm forms of the bacteria making them potential candidates for development into topical antimicrobials for burns patients infected with antibiotic-resistant P. aeruginosa.

Due to the ever-increasing burden of antimicrobial-resistant (AMR) bacteria, the development of novel antimicrobial agents and biomaterials to act as carriers and/or potentiate antimicrobial activity is essential. This study assessed the antimicrobial efficacy of the following ionic metals, silver, gold, palladium, platinum, zinc, and gallium alone and in combination with graphene matrices (which were coated via a drop casting coating method). The graphene foam was utilized as a carrier for the ionic metals against both, antibiotic susceptible and resistant bacterial strains of Acinetobacter baumannii,Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa. Ionic gold, palladium and platinum demonstrated the greatest antimicrobial activity against the susceptible and resistant strains. Scanning electron microscopy (SEM) visualized cellular ultrastructure damage, when the bacteria were incubated upon the graphene foam alone. This study suggests that specific metal ions applied in combination with graphene foam could present a potential therapeutic option to treat AMR bacterial infections. The application of the graphene foam as a potential carrier could promote antimicrobial activity, provide a sustained release approach and reduce possible resistance acquisition. In light of this study, the graphene foam and ionic metal combinations could potentially be further developed as part of a wound dressing.