Globally, Klebsiella pneumoniae (K. pneumoniae) has been identified as a serious source of infections. The objectives of our study were to investigate the prevalence of multidrug-resistant (MDR) K. pneumoniae in Tanta University Hospitals, Gharbia Governorate, Egypt; characterize their carbapenem resistance profiles; and identify their different capsular serotypes. We identified and isolated 160 (32%) K. pneumoniae from 500 different clinical samples, performed antimicrobial susceptibility testing, and then used multiplex PCR to detect carbapenemase genes and capsular serotypes K1, K2, K3, K5, K20, K54, and K57. We detected phenotypic carbapenem resistance in 31.3% (50/160) of the isolates; however, molecular assays revealed that 38.75% (62/160) of isolates were carrying carbapenemase-encoding genes. Generally, bla_OXA-48 was the prevalent gene (15.5%), followed by bla_VIM (15%), bla_IMP (7.5%), bla_KPC (4%), and bla_NDM (3.8%). Bla_VIM and bla_OXA-48 correlated with phenotypic resistance in 91.67% and 88% of the isolates that harbored them, respectively. Capsular typing showed that the most prevalent pathotype was K1 (30.6%), followed by K57 (24.2%), K54 (19.35%), K20 (9.67%), and K2 (6.45%). A critical risk to community health is posed by the high incidence of multidrug-resistant (MDR) virulent K. pneumoniae isolates from our hospital, and our study examines this pathogen’s public health and epidemiological risks.

Methicillin-resistant in Staphylococci is a serious public health issue. It is mostly encoded by the mecA gene. The mecC gene is a new mecA analog responsible for resistance to methicillin in some Staphylococcal clinical isolates. This mecC gene is still underestimated in Egypt. The aim of the current study was to detect mecA and mecC genes in clinical Staphylococci isolates from a tertiary care university hospital in Egypt compared to the different phenotypic methods. A total of 118 Staphylococcus aureus (S. aureus) and 43 coagulase-negative Staphylococci (CoNS) were identified from various hospital-acquired infections. Methicillin resistance was identified genotypically using the PCR technique and phenotypically using the cefoxitin disc diffusion test, oxacillin broth microdilution and the VITEK2 system in all Staphylococcal isolates. The mecA gene was detected in 82.2% of S. aureus and 95.3% of CoNS isolates, while all of the isolates tested negative for the mecC gene. Interestingly, 30.2% of CoNS isolates showed the unique character of inducible oxacillin resistance, being mecA-positive but oxacillin-susceptible (OS-CoNS). The dual use of genotypic and phenotypic methods is highly recommended to avoid missing any genetically divergent strains.

Hypervirulent Klebsiella pneumoniae is a highly pathogenic variant of Klebsiella pneumonae, which represents a global public health issue because it is very virulent and spreads easily. The objectives of this study were to assess the predominance of hvKp among health care-associated infections in intensive care units of Tanta University Hospital and to compare hvKp with classical K. pneumoniae (cKp) in terms of antibiotic resistance, virulence, and molecular features. The study included 300 patients suffering from HAIs from different ICUs of Tanta University Hospitals. K. pneumoniae isolates were identified and subjected to string testing and antibiotic susceptibility testing, and the tissue culture assay for biofilm formation and polymerase chain reaction (PCR) tests were performed for the identification of capsular genes (K1, K2, K57) and virulence genes (rmpA, rmpA2, iuc A). Fifty-seven K. pneumonaie isolates were isolated. A total of 21 (36.8%) of them were hvKp and 36 (63.15%) were cKp. Significantly higher antibiotic resistance was detected in the cKp group. There was a significant difference between biofilm formation between cKp and hvKp isolates (p < 0.004*). iucA, rmpA2, and K1 genes were significantly associated with hvKp. The string test shows 100% sensitivity and negative predictive value for the detection of hvKp. Consequently, using the string test alone for the screening of hvKp is required. However, combining aerobactin-positive with hypermucoviscous isolates while screening for hvKp is crucial.

Background: Acinetobacter baumannii, are involved in hospital- acquired infections and are increasingly developing resistance to fluoroquinolones, such as ciprofloxacin. The most common method of fluoroquinolone resistance is alteration in genes that encode DNA gyrase (gyrA) and topoisomerase IV (parC). Method: We sought to isolate fluoroquinolone- resistant A. baumannii and search for changes in gyrA (Ser83Leu) and parC (Ser80Leu) loci by polymerase chain reaction- restriction fragment length polymorphism (PCR- RFLP). Results: We found that all 68 A. baumannii isolates that were part of this research were multidrug resistant and harbored gyrA and parC loci. Most isolates had ciprofloxacin minimal inhibitory concentrations of >128 μg/mL (50.8%). Mutations in gyrA (Ser83Leu) were the most prevalent (47.45%), followed by parC (Ser80Leu) mutations (33.9%) and combined mutations in both genes (23.7%). Conclusion: Single mutations in either gyrA (Ser83Leu) and parC (Ser80Leu) genes may be attributed to fluroquinolone resistance in A. baumannii.Keywords: Acinetobacter baumannii; fluoroquinolone resistance; gyrA, parC; PCR-restriction fragment length polymorphism

Background: Biosynthesis of silver nanoparticles (AgNPs) by endophytic fungi is a potential biological nanomanufacturing technique. Endophytic fungus provides a cost-effective and environmentally friendly method for producing nanoparticles. Methods: In the current investigation, endophytic fungal isolates were identified as Fusarum proliferetum visually and genetically. The purified silver particles' crystalline structure, particle size distribution, and morphology were analyzed using UV-Vis, X-ray diffraction, and high-resolution transmission electron microscopy. Results: Fourier transform infrared spectroscopy (FT-IR) of the particles indicated the presence of many functional groups involved in the synthesis process, such as bio reducers and capping agents. Optimization of physio-chemical parameters for biosynthesis of silver nanoparticles was at pH 7, substate concentration 1mM, salinity value 0.1 NaCl and incubation period 72 hrs. silver nanoparticles were shown to have an antibacterial impact on multidrug resistant bacteria, as evidenced by an inhibitory zone that increased with nanoparticle concentration. furthermore, the effect of silver nanoparticles on gram negative bacteria was better than gram positive bacteria as evidence by MIC results. Scanning electron microscopy analysis revealed significant distortions caused by green produced silver nanoparticles on bacterial cell morphology. Conclusion: The research findings suggest that GS-AgNPs have significant efficacy as a safe and potent antibacterial agent against bacteria that are resistant to many antibiotics.

Background: There has been an expansion in antibiotic resistance among Enterobacteriaceae over the previous ten years raising serious questions about global health. Our objectives were to isolate the carbapenem-resistant Gram-negative bacilli that cause Blood stream infections and investigate the genetic relatedness between carbapenemase producing K. pneumoniae isolates. Methods: A total of 255 blood specimens were withdrawn into blood culture bottles and incubated, Pathogenic microorganisms were identified, Antibiotic susceptibility was done for Gram-negative isolates. carbapenemase producers were screened for Molecular detection of carbapenemase and extended spectrum β-lactamase genes. Results:133 pathogens were isolated, of these 77 Gram-negative isolates (including 32 K. pneumoniae,18 E. coli, 12 Acinetobacter, 9 pseudomonas and 6). Out of them, 55 were carbapenem resistant by phenotypic method. 23/55 of them were harboring carbapenemase genes by PCR. ERIC results showed that Anesthesia ICU isolates showed >90% genetic similarity while isolates from chest and internal medicine ICUs showed