Globally, cephalosporin therapy failure is a serious problem for infection control. One causative agent of cephalosporin-resistant infections is multidrug-resistant (MDR) E. coli producing extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases. We evaluated the occurrence of ESBL/pAmpC genetic determinants in phenotypically MDR E. coli isolated from clinical samples of blood, faeces, ear effusion, urine and sputum from a UK hospital. Phenotypic resistance profiling for 18 antibiotics (from seven classes) showed that 32/35 isolates were MDR, with resistance to 4–16 of the tested antibiotics. Of the isolates, 97.1% showed resistance to ampicillin, 71.4% showed resistance to co-amoxiclav, cefotaxime, ceftazidime and ceftiofur, and 68.5% showed resistance to cefquinome. bla_CTX-M, bla_TEM and bla_OXA-1 genes were detected in 23, 13 and 12 strains, respectively, and Intl1 was detected in 17 isolates. The most common subtypes among the definite sequence types were CTX-M-15 (40%) and TEM-1 (75%). No E. coli isolates carried pAmpC genes. Significant correlations were seen between CTX-M carriage and cefotaxime, ceftiofur, aztreonam, ceftazidime and cefquinome resistance; between bla_CTX-M, bla_TEM and bla_OXA-1 carriage and ciprofloxacin resistance; and between Intl1 carriage and trimethoprim/sulfamethoxazole resistance. Thus, MDR phenotypes may be conferred by a relatively small number of genes. The level and pattern of antibiotic resistance highlight the need for better antibiotic therapy guidelines, including reduced use and improved surveillance.

Excessive use of antibiotics (such as fluoroquinolone) and inadequate infection control practices have turned antibiotics resistance (AMR) into a global, public health peril. The current study emphasizes on the prevalence of qnrA, qnrB, and qnrS plasmid in fluroquinolone (FQ) resistant Escherichia coli (E. coli) isolates from urinary tract samples and their correlation with the burden of resistance in these isolates. In this research, several E. coli strains were isolated from outpatients having urinary tract infections (UTIs) from Duhok province, Kurdistan Region of Iraq. Biochemical and Molecular confirmations were performed to confirm the isolates. Antibiotics susceptibility test was performed to detect the isolates antibiogram. Furthermore, polymerase chain reaction (PCR) amplification was used to detect the qnrA, B and S genes. Bioinformatics tools were used to perform the analysis of the results and data visualization. Forty isolates (out of 55) have been confirmed as E. coli. Antibiograms revealed that 70%, 65% and 63% of the isolates were resistant to Ciprofloxacin, Enrofloxacin and Levofloxacin, respectively. While there was variation in resistance to other antibiotics tested. The FQ resistant genes were detected in 17 (42.5%) isolates, with some isolates carrying more than one gene. The variant qnrS was the most predominant, as it has been detected in 14 isolates. The increasing rates of multidrug resistance E. coli isolates from UTIs, including FQ antibiotics, emphasizes the importance of carefully monitoring their use for UTI treatment.

Introduction: Sepsis is a life-threatening complication in pediatric patients. This study primarily aimed to investigate sepsis-causing bacteria and their antimicrobial resistance profile and check the change in the antimicrobial resistance trend for some selected bacteria. In addition, we evaluated the incidence of sepsis, the related mortality rate, and the effectiveness and outcome of the treatment regimes in sepsis pediatric patients.Methods: A retrospective analysis was conducted on 4-year data (2018–2021) collected from three intensive care units at the Hevi Pediatric Teaching Hospital. Sepsis screening involved clinical detection and confirmation by blood culture.Results: A total of 520 out of 1,098 (47.35%) blood samples showed positive microbial growth. A decrease in sepsis rate was observed during the COVID-19 pandemic. Coagulase-negative Staphylococci (CoNS) and Klebsiella pneumonia were the most commonly isolated bacteria. A notable variation in the antimicrobial resistance trend was observed among sepsis-causing bacteria. The empirical sepsis treatment recommended by the WHO was ineffective, as certain bacteria exhibited 100% resistance to every antibiotic tested. The mortality rate significantly increased from 1.3% in 2018 to 16.5% in 2021.Discussion: The antimicrobial resistance profile of sepsis causing bacteria is of concerns, indicating a potentially serious situation. Thus, to avoid treatment failure, the monitoring of antimicrobial resistance in pediatric patients is essential.