OBJECTIVE: Beta-lactams resistance is a major clinical problem in treating pneumonia. This study aimed to detect the extended-spectrum beta-lactamases (ESBL) genes in Klebsiella pneumoniae among patients with community-acquired pneumonia (CAP) in Al-Najaf City, Iraq. METHODS: A total of 511 sputum samples were obtained from all suspected patients with CAP in Al-Najaf City, Iraq, from March 2020 to September 2020. Sputum samples were subjected to microbiological tests. The disk diffusion method was used to test antibiotic sensitivity. Production of ESBLs was identified using phenotypic and genotypic methods. RESULTS: The total prevalence of K. pneumoniae was 31.9% (163/511). Using CHROM agar, 41 (25.2%) isolates were ESBL producers. The imipenem 0.0% (n=0/41) and norfloxacin 0.0% (n=0/41) were the most effective antibiotics. The multiplex polymerase chain reaction showed that 46.3% (n=19/41) of isolates harbored ESBL genes. Out of 19 ESBL producers, 47.4% and 15.8% harbored bla(CTX-M) and bla(SHV), respectively. While bla(CTX-M) and bla(SHV)genes were detected in 7 (36.8%) isolates, simultaneously. CONCLUSIONS: The imipenem and norfloxacin can be used in empirical treatment of K. pneumoniae isolates in Iraq. The emergence of K. pneumoniae strains harboring ESBL resistance genes necessitates the development of a regular surveillance program to prevent the spreading of these isolates more in Iraqi health care systems.

The Food and Drug Administration (FDA) has licensed many antiretroviral medications to treat human immunodeficiency virus type 1 (HIV-1), however, treatment options for people with multi-drug resistant HIV remain limited. Medication resistance, undesirable effects, prior tolerance, and previous interlacement incapacity to deliver new drug classes all lead to the requirement for new medication classes and drug combination therapy. Fostemsavir (FTR) is a new CD-4 attachment inhibitor medicine that was recently authorized by the United States FDA to treat HIV-1. In individuals with multidrug-resistant (MDR) HIV-1, FTR is well tolerated and virologically active. According to recent investigations, drug combination therapy can positively affect MDR-HIV. The mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of FTR has been highlighted in this review.

Background: Postbiotics comprise soluble compounds freed from the structure of destroyed bacteria or created by living bacteria. Such byproducts provide the host with enhanced biological function as well as specific physiological consequences. This research aims to examine the characteristics and possible health advantages of Lacticaseibacillus (L.) casei-derived postbiotics. Methods: The antibacterial effects of postbiotics derived from L. casei were examined in vitro against various infectious gastrointestinal agents, as well as pasteurized milk and minced beef. Postbiotic activity potential was evaluated using disc-diffusion agar, minimum inhibitory concentration, minimum bactericidal concentration, and well-diffusion agar methods. Postbiotics were tested for antioxidant activity against 2,2-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) free radicals. Additionally, the total phenolic and flavonoid content of the postbiotics was determined. The colorimetric MTT was used to investigate the potential cytotoxicity of postbiotics. The chemical makeup of the postbiotics was also determined using gas chromatography/mass spectrometry. Results: The antibacterial capacity was mostly related to pyrrolo[1,2-a] pyrazine-1,4-dione, benzoic acid, and laurostearic acid. Gram-positive microbes were more influenced by microbial byproducts in vitro than Gram-negative bacteria (P<0.05). The minimum effective concentrations of postbiotics were found to be much greater in ground beef and milk in the Listeria monocytogenes-inoculated model than with other bacteria (P<0.05). Postbiotics also show high antioxidant activity. Postbiotics generated from L. casei had the greatest concentrations of phenolic (99.46 mg GAE/g) and flavonoid (17.46 mg QE/g) constituents. Postbiotics had no influence on the viability of human foreskin fibroblasts at any dose. Conclusion: Lactobacillus spp. postbiotics, particularly L. casei, were recommended for use as antioxidants, antimicrobials, and preservatives in both the food and pharmaceuticals sector for their beneficial effects and biological properties.

There are limited studies on the antibiotic resistance patterns of slowly growing mycobacteria (SGM) species and their related gene mutations in Iran. This study aimed to elucidate the antibiotic susceptibility profiles and the mutations in some genes that are associated with the antibiotic resistance among SGM isolates from Iran. The SGM strains were isolated from sputum samples of suspected tuberculosis (TB) patients. SGM species were identified by standard phenotypic tests and were assigned to species level by amplification and sequencing of the dnaK gene. The minimum inhibitory concentration (MIC) of eight antibiotics was determined using broth microdilution method. The mutations in rrl, rpoB, gyrA, and gyrB genes were investigated in clarithromycin, rifampin, and moxifloxacin resistant isolates using sequencing method. A total of 77 SGM isolates including 46 (59.7%) Mycobacterium kansasii, 21 (27.3%) Mycbacterium simiae, and 10 (13%) Mycobacterium avium complex (MAC) were detected. The amikacin and linezolid with the susceptibility rates of 97.4% and 1.3% were the most and the least effective antibiotics, respectively. All MAC and M. simiae isolates, and 32 (69.6%) M. kansasii strains had multiple-drug resistance (MDR) profiles. The rrl, rpoB, gyrA, and gyrB genes showed various mutations in resistant isolates. Although the current study showed an association among resistance to the clarithromycin, rifampin, and moxifloxacin with mutations in the relevant genes, further research using the whole-genome sequencing is needed to provide a clearer insight into the molecular origins of drug resistance in SGM isolates.