Antimicrobial peptides (AMPs) are short protein fragments that function as an innate immune response across diverse life forms. Structurally, AMPs exhibit diverse configurations, including α-helical, β-sheet, mixed, and random-coil forms, enabling a variety of mechanisms to combat pathogens. The mechanisms of action of AMPs encompass membrane disruption and inhibition of critical cellular processes, highlighting their broad-spectrum activity against bacteria, fungi, viruses, and parasites. AMP activity extends to anti-tumor and anti-HIV activities, further emphasizing their therapeutic potential. Purifying AMPs from natural sources can be challenging due to posttranslational processing. Fortunately, chemical synthesis has the advantage of producing high yield and pure AMPs, but the reaction efficiency diminishes as the molecular weight of peptides increases. Advances in computational tools and curated databases have further accelerated AMP discovery and engineering. While commercially available AMP-based antibiotics and in vivo efficacy against multidrug-resistant bacteria demonstrate their clinical relevance, several limitations still hinder the widespread use of AMPs such as low stability and toxicity to human cells. This review provides a comprehensive overview of AMP origins, characteristics, mechanisms, applications, and future prospects in combating infectious diseases with a particular focus on the clinical applicability of AMPs and their prospects as potent alternative to traditional antibiotics.

Background: Enterococcus faecalis and Enterococcus faecium are part of the human microbiota but pose significant risks in clinical settings due to increasing antimicrobial resistance. Vancomycin-resistant enterococci (VRE) are a growing concern, linked to high morbidity and mortality in hospitalized patients. Aim: This study is the first comprehensive investigation of VRE prevalence and associated risk factors at King Abdulaziz University Hospital (KAUH) from 2015 to 2022. Methods: Clinical samples were collected, and VRE isolates were identified using VRE Card GeneXpert, BioFire PCR, and the VITEK 2 system. Descriptive statistical analysis with Stata version 17 summarized patient characteristics, including demographics, comorbidities, hospital exposure, and laboratory findings. Categorical variables were reported as frequencies/percentages, while continuous variables were expressed as mean ± SD or median [IQR]. Results: Among 254 adult patients with VRE infections, the median age was 61 years. The most common comorbidities were diabetes, hypertension, and kidney disease. VRE infections peaked in 2021, with urine cultures being the most frequent source. Most patients had prior antibiotic exposure, particularly to vancomycin and carbapenems. Enterococcus faecium was the predominant species, with the VanA phenotype being most common. Alarmingly, 61.8% of VRE-infected patients died during the study period. Conclusion: These findings underscore the critical need for enhanced infection control measures and antimicrobial stewardship to combat VRE and improve patient outcomes.

Background: The rising global threat of antimicrobial resistance, particularly among multidrug-resistant pathogens like Pseudomonas aeruginosa, has prompted research into repurposing existing drugs with established safety profiles. Cisplatin, a well-known anticancer agent, has shown preliminary antimicrobial activity but its efficacy against P. aeruginosa has not been thoroughly explored. This study aims to evaluate the antimicrobial potential of cisplatin against clinical strains of P. aeruginosa by determining the minimum inhibitory concentration (MIC). Methodology: This study assessed whether cisplatin could serve as a novel therapeutic option for treating infections caused by P. aeruginosa via broth microdilution assay, especially as the pathogen shows increasing resistance to last-resort antibiotics such as meropenem, colistin, and tigecycline. Findings from this research could contribute to expanding the arsenal of treatments for resistant P. aeruginosa infections. Results: The study found that 54.9% of isolates had an MIC of 16 μg/mL, 26.8% had 32 μg/mL, 12.7% had 64 μg/mL, and 5.6% had 8 μg/mL. While cisplatin demonstrated antibacterial activity, no statistically significant difference (p = 0.089) was observed between sensitive and resistant strains. A key limitation of this study is the small number of both resistant and sensitive strains, which limits statistical power. Increasing the sample size in future studies will allow for a more robust assessment of cisplatin’s efficacy and validate the observed MIC similarities. Additionally, further studies including resistance assays, time-kill kinetics, and in vivo models are needed to explore its bactericidal potential and efficacy in combination with β-lactams. Conclusion: Although cisplatin exhibited activity against P. aeruginosa, its clinical potential remains uncertain, and further investigation is necessary to optimize its use and overcome resistance.

Background: This six-year retrospective study provides an in-depth analysis of the epidemiological and clinical patterns associated with Acinetobacter baumannii (A. baumannii) infections, focusing on age distribution, antibiotic resistance profiles, and specimen types. Aim: The research examines the incidence and characteristics of both non-Multi-Drug Resistant (non-MDR) and Multi-Drug Resistant (MDR) A. baumannii strains by reviewing patient records from January 2016 to December 2022. Methods: Through a statistical analysis, the study highlights the incidence rates across diverse age groups and explores the impact of antibiotic treatment regimens on infection outcomes. Additionally, it identifies the primary clinical specimen types for each strain, noting an association between non-MDR A. baumannii and midstream urine samples, while MDR A. baumannii strains were more frequently found in respiratory, wound, peripheral, and central line swaps/specimens. Results: The results indicate that in 2016, non-MDR A. baumannii infections were notably more frequent compared to MDR A. baumannii cases. However, a significant shift occurred in 2021 and 2022, with a marked decrease in non-MDR A. baumannii cases and an increase in MDR A. baumannii infections. Antibiotic susceptibility testing revealed that non-MDR strains were commonly tested against cefazolin, ceftazidime, ciprofloxacin, gentamicin, nitrofurantoin, oxacillin, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole. In contrast, MDR strains were frequently tested against amikacin, cefepime, colistin, meropenem, imipenem, and tigecycline. Conclusion: This study enhances the understanding of A. baumannii clinical behaviour and resistance patterns, offering valuable insights to support future research and inform strategies for infectious disease management and control.

Background: Tuberculosis (TB) is a major public health issue in Saudi Arabia, particularly impacting the elderly. Immunocompromising conditions, including comorbidities, malignancies, and the use of immunosuppressive agents, are major risk factors for active TB (ATB). Objective: To analyze clinical factors and estimate mortality in TB and drug-resistant cases. Methods: This retrospective study analyzed medical records of 12,494 patients at KAUH (2019– 2021), identifying 131 confirmed TB cases with comprehensive data on demographics, clinical features, comorbidities, diagnostics, and outcomes. Data were analyzed using SPSS, with chi-square and logistic regression identifying risk factors. Statistical significance was determined at a threshold of p < 0.05. In our study, logistic regression was employed to identify significant predictors of mortality among TB patients. The results were presented using beta coefficients (B) to quantify the relationship between predictors and the outcome, along with the adjusted odds ratio (AOR) to provide an interpretable measure of the strength of these associations. Results: Of the 131 TB patients involved in this paper, a higher incidence of pulmonary TB was observed among men under 30 years old. This group also showed a higher mortality rate due to comorbidities such as renal failure, human immunodeficiency virus (HIV), and autoimmune disease. The risk of mortality was heightened by 69.47% with drug susceptibility. Additionally, 19.85% of the patients had multidrug-resistant TB (MDR-TB), and 10.69% had extensively drug-resistant TB (XDR-TB). Patients undergoing hemodialysis, and those with respiratory comorbidities, cancer, diabetes, and smoking were found to have a higher mortality hazard, indicating these as significant risk factors for TB. Conclusion: This study highlights TB’s prevalence and drug resistance at KAUH, emphasizing high-risk groups, including males and young adults. Effective strategies, targeted interventions, and future research are vital for reducing mortality.This study examines the stability of tuberculosis (TB) disease presentation using dynamic models among patients treated at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Key findings include:This is the first study to analyze TB disease stability across different demographic groups.Males, elderly individuals, cancer patients, and those with pulmonary disease or other comorbidities were found to have a higher risk of death from TB.The results emphasize the need for healthcare practices to adopt the “equilibrium state” method for hazard assessment. Incorporating this gold-standard approach into treatment plans can help identify high-risk cases and improve control measures to reduce TB-related mortality. This study provides valuable insights for improving TB patient care and treatment outcomes, particularly for vulnerable groups.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing infections ranging from skin disorders to severe conditions like infective endocarditis. Its evolving resistance, including resistance to β-lactams and last-resort antibiotics, such as vancomycin, daptomycin, and linezolid, necessitates alternative therapies. This study investigates the synergistic efficacy of vancomycin and 3-hydrazinoquinoxaline-2-thiol (3HL) against 23 clinical MRSA isolates. Susceptibility testing was performed using broth microdilution and checkerboard assays, while in silico analyses assessed interactions between vancomycin and 3HL. Vancomycin exhibited minimum inhibitory concentrations (MICs) ranging from 0.25 to 1 µg/mL, whereas 3HL showed higher MICs of 16–32 µg/mL. Synergistic interactions were confirmed via checkerboard assays, with fractional inhibitory concentration index (FICI) values between 0.236 and 0.5, indicating enhanced vancomycin efficacy. Notably, vancomycin MICs decreased significantly when combined with 3HL. In silico docking revealed interactions with penicillin-binding protein 2a (PBP2a), suggesting promising therapeutic potential. Vancomycin exhibited superior docking scores (−8.9 kcal/mol) and stabilizing hydrogen bonds, effectively targeting key protein grooves. Both compounds demonstrated potential for overcoming PBP2a’s structural occlusions, suggesting their role in combating β-lactam-resistant strains through targeted protein inhibition and structural stabilization.