The human gut microbiota, the vast community of microbes inhabiting the gastrointestinal tract, plays a pivotal role in maintaining health. Bacteria are the most abundant organism, and the composition of bacterial communities is strongly influenced by diet. Gut bacteria can degrade complex dietary carbohydrates to produce bioactive compounds such as short-chain fatty acids. Such products influence health, by acting on systemic metabolism, or by virtue of anti-inflammatory or anti-carcinogenic properties. The composition of gut bacteria can be altered through overgrowth of enteropathogens (e.g. Campylobacter, Salmonella spp.), leading to dysbiosis of the gut ecosystem, with some species thriving under the altered conditions whereas others decline. Various “biotics” strategies, including prebiotics, probiotics, synbiotics, and postbiotics, contribute to re-establishing balance within the gut microbial ecosystem conferring health benefits. Prebiotics enhance growth of beneficial members of the resident microbial community and can thus prevent pathogen growth by competitive exclusion. Specific probiotics can actively inhibit the growth of pathogens, either through the production of bacteriocins or simply by reducing the gastrointestinal pH making conditions less favorable for pathogen growth. This review discusses the importance of a balanced gut ecosystem, and strategies to maintain it that contribute to human health.

This study examined the prevalence of urovirulence genes in Uropathogenic Escherichia coli (UPEC) isolates obtained from Jordanian patients. In addition, antibiotic susceptibility profile of the isolates was also examined. Isolates (n=227) were subjected to PCR detection of vat, fyuA, chuA, yfcV, sivH, shiA, sisA, sisB and eco274 genes. The UPEC virulence genes prevalence rates were shiA (92%), sisA (72%), eco274 (44%), sivH (36%), vat (27%), yfcV (25%), sisB (25%), chuA (20%), and fyuA (18%). Approximately half and 82% of the isolates produced extended-spectrum beta-lactamases (ESBL) and were resistant to three or more antimicrobial classes, respectively. Among the isolates, highest resistance was for augmentin (83%) and nalidixic acid (78%). Modest resistance was for cefoxitin (21%) and cefixime (20%). Low resistance was for norfloxacin (5%), amikacin (3%), and ertapenem (0.4%). In conclusion, The UPEC virulence genes shiA and sisA are highly prevalent among the isolates. In addition, high resistance of UPEC to augmentin and nalidixic acid was reported. This may help in elucidating UPEC pathogenesis, and facilitate better treatment strategies for urinary tract infection patients.

Recent years have seen the development of high-accuracy and high-throughput genetic manipulation techniques, which have greatly improved our understanding of genetically tractable microbes. However, challenges remain in establishing genetic manipulation techniques in novel organisms, owing largely to exogenous DNA defence mechanisms, lack of selectable markers, lack of efficient methods to introduce exogenous DNA and an inability of genetic vectors to replicate in their new host. In this review, we describe some of the techniques that are available for genetic manipulation of novel microorganisms. While many reviews exist that focus on the final step in genetic manipulation, the editing of recipient DNA, we particularly focus on the first step in this process, the transfer of exogenous DNA into a strain of interest. Examples illustrating the use of these techniques are provided for a selection of human gut bacteria in which genetic tractability has been established, such as Bifidobacterium, Bacteroides and Roseburia. Ultimately, this review aims to provide an information source for researchers interested in developing genetic manipulation techniques for novel bacterial strains, particularly those of the human gut microbiota.

Background: Globally, community pharmacists worldwide have prescribed more over-the-counter systemic antibiotics, posing significant issues for international organizations tackling antibiotic-resistant bacteria, a major global threat, due to the accessibility in pharmacies. Objectives: This study aimed to examine the Jordanian pharmacists’ antibiotic selection and over-the-counter antibiotic prescriptions. Methods: A total of 244 community pharmacists participated in an online standardized survey, which examined five essential domains including sources and trust of pharmacy antibiotic prescription information, category and frequency of permitted antimicrobials, prescription-free antimicrobials, interactions, antimicrobial prescription issues for pharmacists, and pharmacy staff’s knowledge of non-prescription antimicrobial questions and answers. Results: This study found that 1—pharmacists are confident in prescribing antibiotics and they use various tools to improve their skills. 2—Antibiotics were the most sought antimicrobials without a prescription, followed by antifungals and antivirals. 3—Throat, urinary tract, chest, and otitis media are the most common infections that require antibiotics. Pharmacists prescribe penicillin for 75% of throat infections, Fluoroquinolones for 48.2% of urinary tract infections, and cephalosporins for 35.9%. Macrolides are the most prevalent otitis media treatment (43.2%). 4—Some people obtain antimicrobial prescriptions without a valid reason or diagnosis. 5—Many pharmacists (171/244, 70%) agree or strongly believe that antibiotic prescription information is difficult to obtain. 6—Many pharmacists (183/200, 91.5%) aimed to educate patients on the risks and correct use of antimicrobials without prescriptions. Conclusions: These results show that Jordanian community pharmacists follow clinical antibiotic prescribing guidelines and conduct antimicrobial stewardship, yet they demand antimicrobials without prescriptions and lack decision support tools. Antibiotic classes address most diseases, and pharmacists emphasize antimicrobial misuse.

Background: Antimicrobial resistance (AMR) is one of the most significant current public health issues, which is driven crucially by the misuse and overuse of antibiotics. Antibiotics are still available without a prescription in many underdeveloped countries, including Jordan, allowing for self-medication and incorrect usage, which contributes to the establishment and spread of resistant bacteria. This cross-sectional study aimed to evaluate antibiotic-use practices and assess knowledge and awareness of antimicrobial resistance among the Jordanian population. Methods: We conducted a cross-sectional observational survey between September 2023 and January 2025, targeting males and females in Jordan. A QR code was used to distribute an online convenience sampling strategy with 57 questions across social media channels. The survey investigated a variety of aspects, including demographic traits, antibiotic knowledge and behaviour, and public awareness of resistance. The questionnaire was completed by 1031 people. The data was analysed using descriptive statistics. The chi-square test was performed to compare demographic groupings, and p < 0.05 was considered significant. Results: Among the 1031 participants, 61.3% were female and 37.8% were male. Recent utilization of antibiotics was prevalent, with 37.8% indicating usage in the preceding month and 26.4% within the last six months. It is noteworthy that 61% (n = 624) of participants indicated that they had consumed antibiotics without a prescription, while 33.6% (n = 345) reported acquiring antibiotics for children without a prescription. Furthermore, pharmacies constituted the predominant source of antibiotics, accounting for 90.4% of the total. Common misconceptions regarding the indications for antibiotics were observed, with a segment of participants under the impression that antibiotics are effective in treating symptoms such as fever (40.6%) and body pain (15%). Additionally, participants exhibited a moderate level of awareness regarding antimicrobial resistance, with 69.2% demonstrating familiarity with the concept, while 90% acknowledged the increased difficulty in treating infections caused by antimicrobial-resistant organisms. Nevertheless, major misconceptions persisted, including 84.8% incorrectly believing that antibiotic resistance occurs when the human body becomes resistant to antibiotics and then antibiotics cannot work properly. More than half of the respondents (n = 569; 57.1%) also believed that AMR only or mainly affects individuals who frequently take antibiotics and does not concern others. Conclusions: This study has identified that non-prescription antibiotic use remains prevalent in Jordan and is accompanied by substantial misconceptions regarding antimicrobial resistance. Although general awareness of the seriousness of AMR was relatively high, important knowledge gaps persisted. In the adjusted analysis, among the covariates, participants aged 51–60 years had higher odds of reporting non-prescription antibiotic use than those aged 18–30 years (aOR = 1.872, 95% CI 1.072–3.268; p = 0.028). Moreover, participants with a high-school education (aOR = 0.415, 95% CI 0.196–0.879; p = 0.022) and those with a master’s degree (aOR = 0.411, 95% CI 0.181–0.933; p = 0.034) had lower odds than the no-formal-education reference group. No other covariate was statistically significant. The findings clearly indicate the need for strengthened enforcement of prescription-only antibiotic dispensing regulations, targeted public education to address specific misconceptions, and expanded antimicrobial stewardship initiatives involving community pharmacists to promote responsible antibiotic use and lessen the growing threat of antimicrobial resistance.

Multidrug-resistant (MDR) bacteria have been isolated from a major wastewater pathway. These bacteria harbor several antimicrobial resistance genes that confer resistance to several antibiotics simultaneously. The main aim of this study was to investigate the antibiotic resistance profiles of lactose-fermenting gram-negative bacteria isolated from the main wastewater pathway in the Nablus area of the West Bank, Palestine. A total of 162 lactose-fermenting isolates belonging to the Enterobacteriaceae family were isolated from a sample obtained from the main wastewater pathway. Most of the isolates obtained were identified to the species level using the API-20 E identification system. The proportions of MDR strains among the obtained Escherichia coli and Citrobacter Koseri isolates were 19.1% and 10%, respectively. Among all isolates, six were found to be extended-spectrum beta-lactamase (ESBL) producers. These included three E. coli isolates, one Klebsiella pneumoniae isolate, and two C. Koseri isolates. Approximately 12.3% of the total isolates were MDR and 3.7% were identified as ESBL producers. The prevalence of MDR isolates in our study was concerning, indicating that immediate and decisive measures are needed to halt its escalation and promote its reduction.