No abstract

No abstract

No abstract

Global transmission of plasmid-mediated tigecycline resistance gene tet (X)-bearing Escherichia coli strains incurs a public health concern. However, the research focusing on the prevalence of tet (X)-positive isolates in clinical specimens is still rare, and to our knowledge, there is no such report from South Asia.

MicroRNA (miRNA) is a small section of ribonucleic acid (RNA) that reduces the protein formation by making the pair of the complementary piece of mRNA. The genes of miRNA are present as transcriptional or polycistronic units in the chromosomes. The cellular multiplication, separation and existence like the multitude of genetic functions are affected by miRNA. Nearly 50% of identified miRNA are located in the residence in the intronic part of the genes. The mature miRNA is yielded in two steps. Drosha and RNA-induced silencing complex are the catalysts that play an important role in miRNA synthesis. The miRNA may function by just hindering the translation or complete vitiation of miRNA that occurs to control the genes. The microRNA antagonists and miRNA mimics are therapeutics approaches for the treatment of abnormalities. The upregulation and downregulation of miRNAs are linked to a number of diseases as miR-122 is associated with viral hepatitis, and some members of let-7 and other miRNAs are concerned with various diseases. Overexpressed miRNAs may function as both oncogenes and regulator of cellular processes. The miRNA functions can be altered by single-point mutations in miRNA target and epigenetic silencing of transcription units. There are numerous molecular targets for miRNA as degradation by nuclease and phosphodiesterase. Thus, miRNA has potential applications in disease diagnosis along with therapy, but the mechanisms involved in miRNA systems and its targeted delivery of miRNA are much more important to achieve its therapeutic applications.

The human body harbors trillions of microbes collectively known as microbiota. The human gut microbiota is importantly involved in most of the human metabolic and regulatory pathways. The gut microbiota needs to be balanced for the health of the host. Several factors are involved in the distribution of microbiota in the human body, in most cases these microbiotas are commensals, but some circumstances lead to serious disorders and the development of infections from microbiota. When parasites colonize the gut, the balance between the host and the gut microbiota can be disturbed. Parasitic invasion in the gut is associated with unhygienic conditions including contaminated food and water. Parasitic invasion in the gut induces the immune response to recognize and eliminate pathogens. The current study highlights the immune system’s response to disruption of normal intestinal microbiota and parasitic infections.

Aims This study aims to quantify antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in tertiary care hospitals in Pakistan. Methods and results This observational study was conducted at two tertiary care hospitals of Pakistan over a 1-year period. The AMC and resistance patterns of Escherichia coli isolates collected from hospitals were observed and analysed using the pearson correlation coefficient. AMC in hospitals varied between 0.00186 and 0.72 (Mean = 0.12 ± 0.191) Defined Daily Dose (DDDs)/1000 patient-days. Fluoroquinolones were the most consumed antimicrobial followed by penicillins, cephalosporins, carbapenems, and aminoglycosides. Antimicrobial-resistant rates in hospitals varied between 92.2% and 34.6%. The highest resistance rate was observed for moxifloxacin, followed by ampicillin, cefotaxime, amoxicillin, ceftriaxone, ciprofloxacin, amoxiclav, and amikacin. Statistically significant association was found between AMC and resistance rate for ampicillin (r = 0.78, P = 0.032), cefotaxime (r = 0.87, P = 0.012), ceftriaxone (r = 0.67, P = 0.042), and ciprofloxacin (r = 0.63, P = 0.031). Additionally, there was a significant association between fluoroquinolone consumption and the resistance rate of third generation cephalosporins (r = 0.61, P = 0.032), and significance was also found when all antimicrobials were combined into 1 analysis (r = 0.721, P = 0.032). Conclusion This data documented a significant association between AMC and resistant rates for multiple antimicrobial agents.

Background: Urinary tract infection (UTI) is one of most common pediatric infections. The study was conducted with an aim to assess the etiological agents, antimicrobial resistance, their risk factors and clinical significance in pediatric UTI cases.Methods and materials: This is a cross-sectional study conducted at Department of Microbiology and Infectious Diseases for 1 year (January to December 2018). A total of 4020 pediatric patients <14 years old, suspected to have UTI, were included in the study. Clinical data was obtained from software and enquiry with patients whenever feasible; standard microbiological guidelines were followed for laboratory testing. Chi-square test was applied for comparison of categorical variables. P value less than 0.05 was considered as statistically significant.Results: Of the 4020 children with suspected UTI, 724 (18%) were culture positive. Escherichia coli was the most common etiological agent (55% n = 402), followed by Enterococcus faecalis (17%, n = 120), and Klebsiella pneumoniae (9%, n = 65). Among total isolates, 32% (n = 231) were multi-drug resistant (MDR) while 35% (192) of gram-negative bacilli were extended-spectrum b lactamase (ESBL) producers. Multidrug resistance and ESBL production occurred more frequently in previously hospitalized patients (p value 0.0001 and 0.02), patients with longer duration of fever (p value 0.03 and 0.01) and higher recurrence rate (p value 0.001 and 0.001). ESBL production was observed most commonly in neonates (40%), followed by infants (32%). Degree of antimicrobial resistance was significantly higher in ESBL producer isolates as compared to non-producers. Amikacin resistance was observed in 22% of ESBL producer isolates as compared to 14% in non-producers (p value 0.01). Similar pattern of resistance were observed for other antimicrobials.Conclusion: High-level antimicrobial resistance was observed in pediatric UTI with alarming incidence superbugs MDR and ESBL. Previous hospitalization, longer duration of fever and recurrence is significantly associated with increase in MDR and ESBL production. Regular antimicrobial surveillance should be carried out and judicial use of antimicrobials based on susceptibility reports when available and local antimicrobial resistance data should be encouraged for the optimal management of pediatric UTI.