This paper discusses the mechanisms of S. aureus drug resistance including: (1) introduction. (2) resistance to beta-lactam antibiotics, with particular emphasis on the mec genes found in the Staphylococcaceae family, the structure and occurrence of SCCmec cassettes, as well as differences in the presence of some virulence genes and its expression in major epidemiological types and clones of HA-MRSA, CA-MRSA, and LA-MRSA strains. Other mechanisms of resistance to beta-lactam antibiotics will also be discussed, such as mutations in the gdpP gene, BORSA or MODSA phenotypes, as well as resistance to ceftobiprole and ceftaroline. (3) Resistance to glycopeptides (VRSA, VISA, hVISA strains, vancomycin tolerance). (4) Resistance to oxazolidinones (mutational and enzymatic resistance to linezolid). (5) Resistance to MLS-B (macrolides, lincosamides, ketolides, and streptogramin B). (6) Aminoglycosides and spectinomicin, including resistance genes, their regulation and localization (plasmids, transposons, class I integrons, SCCmec), and types and spectrum of enzymes that inactivate aminoglycosides. (7). Fluoroquinolones (8) Tetracyclines, including the mechanisms of active protection of the drug target site and active efflux of the drug from the bacterial cell. (9) Mupirocin. (10) Fusidic acid. (11) Daptomycin. (12) Resistance to other antibiotics and chemioterapeutics (e.g., streptogramins A, quinupristin/dalfopristin, chloramphenicol, rifampicin, fosfomycin, trimethoprim) (13) Molecular epidemiology of MRSA.

The paper presents various issues related to the increasing drug resistance of Neisseria gonorrhoeae and the occurrence and spread of multidrug-resistant clones. One of the most important is the incidence and evolution of resistance mechanisms of N. gonorrhoeae to beta-lactam antibiotics. Chromosomal resistance to penicillins and oxyimino-cephalosporins and plasmid resistance to penicillins are discussed. Chromosomal resistance is associated with the presence of mutations in the PBP2 protein, containing mosaic variants and nonmosaic amino acid substitutions in the transpeptidase domain, and their correlation with mutations in the mtrR gene and its promoter regions (the MtrCDE membrane pump repressor) and in several other genes, which together determine reduced sensitivity or resistance to ceftriaxone and cefixime. Plasmid resistance to penicillins results from the production of beta-lactamases. There are different types of beta-lactamases as well as penicillinase plasmids. In addition to resistance to beta-lactam antibiotics, the paper covers the mechanisms and occurrence of resistance to macrolides (azithromycin), fluoroquinolones and some other antibiotics. Moreover, the most important epidemiological types of multidrug-resistant N. gonorrhoeae, prevalent in specific years and regions, are discussed. Epidemiological types are defined as sequence types, clonal complexes and genogroups obtained by various typing systems such as NG-STAR, NG-MAST and MLST. New perspectives on the treatment of N. gonorrhoeae infections are also presented, including new drugs active against multidrug-resistant strains.

Background: Primary care overload, limited access to physicians, and rising antimicrobial resistance highlight the role of pharmacists in managing minor ailments such as sore throats. We evaluated pharmacy-based counseling in Poland supported by point-of-care testing and symptomatic therapy. Methods: Multicenter, prospective observational study across 23 community pharmacies. Adults (≥18 years) with sore throat underwent group A streptococcus (GAS) rapid antigen testing. Patients with a positive test result were referred to physicians, while others received pharmacist counseling and ketoprofen throat spray. Standardized questionnaires captured symptom severity, perceived effectiveness, onset/duration, convenience, adherence, and patient-reported outcomes. Results: 142 patients were included. Among ketoprofen users, 98.4% reported improvement, and 75% rated relief ≥8/10. Compared with prior remedies, 88.3% judged ketoprofen more effective, and 86.7% reported faster onset. The spray was convenient for 91.4% of participants; no overdosing occurred. Qualitative feedback emphasized rapid relief, easier swallowing/speaking, and return to daily activities without physician consultation. Conclusions: Polish community pharmacy practice, an integrated sore throat pathway combining point-of-care RADT with structured pharmacist counseling and symptomatic treatment, was feasible, acceptable, and without notable safety concerns. As a pilot, these practice-based findings warrant larger comparative and economic studies to confirm clinical effects and assess potential impact on antibiotic use.

Introduction: Antibiotic resistance poses a significant threat to public health, that can lead to reduced effectiveness of many therapies, increased morbidity, longer hospitalization times, increased deaths, and additional costs for health care systems. Unreasonable use of antibiotics may result from a lack of adequate knowledge about antibiotic therapy and a lack of knowledge of the risks associated with antibiotic resistance, both among medical personnel and patients. Aim. The primary objective of the study was to verify the opinion of medical personnel on the risks associated with antibiotic resistance. Material and Methods: The study was conducted in 2023 among 605 Polish sanitary workers. An anonymous survey designed specifically for the purpose of the study was used. The survey was made available on the Internet through the Trade Unions of Pharmacy Workers and directly to hospitals with the support of local authorities. Results: The majority of respondents were women (77.36%). The largest group consisted of individuals over 40 years of age (55.04%). More than half of the respondents were nurses (56.20%), and every fourth of the respondents was a physician (23.64%). Most respondents consider antibiotic resistance to be a very serious (24.13%) or extremely serious (30.75%) problem. The problem of antibiotic resistance on a global scale was mentioned, especially in the opinions of physicians and nurses (p < 0.01), people working in the profession for over a year (p < 0.01), and people with a specialization or undergoing specialist training (p = 0.00). Similarly, these groups most often indicated that antibiotic resistance poses a problem in their workplace. The main problems of antibiotic resistance were the use of antibiotics in farm animals (36.69%), the pressure on patients to take antibiotics (38.84%), and the prophylactic use of antibiotics (43.15%). Conclusions: Medical personnel consider antibiotic resistance a somewhat serious problem, although not all agree in this regard. The risk of antibiotic resistance is much more seriously assessed by physicians and nurses, as well as by people with specializations or undergoing specialization training. Knowledge about antibiotic resistance should be further spread among all groups of medical personnel.

Gram-negative bacteria pose a significant threat as primary agents of infection in septic shock, a condition with high mortality rates in intensive care patients. To combat this, chemists develop antibiotic drugs fortified with protective agents, such as carbapenemase inhibitors, to counter bacterial resistance mechanisms. This study aims to evaluate the clinical efficacy of two antibiotic combinations, imipenem/cilastatin/relebactam (IMI/REL) and piperacillin/tazobactam (PIP/TAZ), in the treatment of septic shock caused by gram-negative bacteria. Seventeen patients diagnosed with septic shock were divided into Group 1 with IMI/REL and Group 2 with PIP/TAZ. All patients received antishock treatment, renal replacement therapy, and ventilation. Bacteriological detection identified four gram-negative pathogens in biological samples, with further phenotyping and genotyping confirming resistance mechanisms.