The rapid emergence of multidrug-resistant pathogens has become a major global health concern, highlighting the urgent need to discover new antimicrobial agents. Actinobacteria, particularly Streptomyces, are well known for their ability to produce diverse bioactive secondary metabolites with important pharmaceutical and agricultural applications. The purpose of this research was to isolate, characterize and evaluate the antimicrobial potential of actinobacteria isolated from tropical peat swamp forest soil. A total of 157 actinobacterial isolates were obtained and assigned to the genera Streptomyces, Microbispora, Microtetraspora, Micromonospora and Planosporangium. Preliminary antimicrobial screening revealed that 81 isolates (51.59%) exhibited inhibitory activity against at least one of the tested pathogens. Crude extracts from 17 selected isolates demonstrated antimicrobial activity with minimum inhibitory concentration (MIC) and minimum microbicidal concentration (MMC) values ranging from 0.024 to 12.50 mg mL-1. Several isolates exhibited strong antibacterial activity against Bacillus cereus TISTR 687 and Staphylococcus aureus ATCC 27853, while notable antifungal activity was observed against Candia albicans CBS 562. Molecular identification based on 16S rRNA gene sequencing revealed that all active isolates belonged to the genus Streptomyces, closely related to S. humi, S. yaanensis, S. bungoensis, S. murinus and S. malaysiense. These findings demonstrate that tropical peat swamp forest soils represent a valuable and underexplored reservoir of bioactive actinobacteria with promising antimicrobial potential. The study highlights the importance of peatland ecosystems as sources of novel microbial metabolites that may contribute to future pharmaceutical and biotechnological developments.
The creation and implementation of a system-wide frontline pharmacist antimicrobial stewardship (AS) competency curriculum are explained. Pharmacists are present throughout hospital environments and frequently play a pivotal role in optimizing infection management. However, frontline clinical pharmacists working across inpatient settings vary greatly in terms of training, expertise, years of experience, and background as they relate to infectious diseases (ID) and AS. Establishing a uniform level of ID and AS competency among pharmacists across all hospital departments and shifts is essential to optimizing the effectiveness of antimicrobial stewardship programs. Across a diverse 11-hospital health system, an innovative curriculum, "The Antimicrobial Resistance Fighter Curriculum," was implemented to help standardize care for patients with infections. Core modules incorporated gamified elements, case-based activities, knowledge checks, and visual learning aids. Tactics included system-wide automatic assignment, targeted onboarding for new hires, and strategic use of reminders to ensure completion. Annual feedback cycles and postimplementation surveys guided iterative improvements and module updates, focusing on engagement, efficiency, and practical application. An innovative, interactive curriculum successfully standardized AS competency across a diverse health system. Key implementation strategies including system leadership buy-in, modular design, interactive learning, and responsive updates enabled efficient dissemination, high engagement, and improvement of pharmacist competence in applying knowledge of AS topics to patient care.
The presence of multidrug-resistant extraintestinal pathogenic Escherichia coli (ExPEC) in pets poses a significant threat to animal health and represents a potential source of antimicrobial resistance with zoonotic transmission to humans. A total of 56 pyometra swab samples from dogs were analysed for the presence of E. coli using standard microbiological procedures. Phylogrouping of the E. coli isolates was performed using the quadruplex, and 12 virulence genes were detected by single polymerase chain reaction (PCR) method. Antimicrobial susceptibility testing was conducted against 12 antimicrobial agents in five different classes using the Kirby-Bauer disc diffusion method. E. coli was isolated from all 56 swab samples of pyometra cases using 5% ovine blood agar and MacConkey agar, and identified with Eosin Methylene Blue agar, Methyl Red and Voges-Proskauer tests. fimH was found in all strains. The most common virulence genes were fyuA (96.4%), usp (83.9%), sfa (73.2%), hlyA (69.6%), cnf1 (69.6%), papGIII (64.2%), and papC (58.9%). The least common virulence gene was iucD,while none of the strains carried afa and papG allelic variants (papGI and II). A total of 83.9% of isolates belonged to phylogenetic group B2. All isolates were resistant to amoxicillin/clavulanic acid, ampicillin and lincomycin but sensitive to amikacin. The multidrug resistance (MDR) rate was 58.9% (33/56 isolates). MDR and multiple antibiotic resistance index (MARI) scores were similar between the groups (p > 0.05). The phylogenetic analysis revealed that resistant isolates were found across all detected phylogroups, with strains from different phylogroups sharing the same virulence genes. E. coli from pyometra cases in companion animals is largely associated with resistance and possesses virulence genes enabling efficient colonization and carriage.
Antimicrobial resistance (AMR) in aquatic environments is an emerging public health concern, yet environmental surveillance remains underdeveloped compared to human and animal sector. A harmonized European approach to AMR monitoring in aquatic environments is urgently needed due to lack of standardized methods, suitable indicators, reference materials, reporting, and data sharing mechanisms. This perspective paper presents insights from a pilot study, coordinated by the European Environment Agency (EEA), Eionet, and the European Topic Centre Biodiversity and Ecosystems (ETC-BE), aimed at testing the feasibility of harmonized monitoring of AMR in surface waters within regulatory-authority-led water monitoring structures. Ten countries participated, applying harmonized protocols for sampling, culture-based detection, qPCR analysis of antimicrobial resistance genes, and data reporting. The collaboration helped to build capacity and overcome technical barriers. The study demonstrated that harmonized environmental AMR monitoring is feasible and can be implemented consistently across countries and institutions, offering a path to obtaining critical insights into AMR sources, spread, and mitigation strategies. The pilot generated harmonized baseline data, validated methodological choices, and identified key challenges for large-scale implementation. Remaining challenges include the lack of standardized methods, quality criteria, and data infrastructure. Future efforts should focus on defining clear objectives, selecting relevant indicators, establishing environmental thresholds, and building capacity through collaboration. A harmonized European framework would support One Health integration, align with EU water legislation, and contribute to global AMR efforts. The findings underscore the importance of transitioning from fragmented research and ad hoc initiatives to coordinated, routine surveillance of AMR in aquatic environments.
Antimicrobial drugs are fundamental to modern medicine. The rise and spread of drug-resistant microorganisms jeopardize our ability to manage common infections and perform critical medical interventions. The present work aimed to assess and analyze antimicrobial resistance and sensitivity in the neonatal intensive care unit of Alexandria University Children's Hospital to improve antibiotic choices in the neonatal intensive care unit. A medical record-based study of 1105 neonates with sepsis admitted to the NICU during the four-year study period (2019 to 2022) was conducted, with no exclusion criteria. The data were uploaded to the WHONET system after being collected. The results can be recorded as interpreted values: "R" (Resistant), "I" (Intermediate), and "S" (Sensitive). Interpretation guidelines for most standardized testing methodologies were built into the system. In addition, the program also permits retrieval and correction of clinical records. Among the 1105 neonates included in our study, Male patients accounted for 56.4%, with a mean gestational age of 32.67 ± 2.86 weeks. Early-onset neonatal sepsis (EOS) was detected in 329(29.7%), while late-onset neonatal sepsis (LOS) was detected in 776(70.2%) neonates. Klebsiella was the predominant pathogen, accounting for 554 (50.1%). This organism was responsible for 136(24.5%) neonates in 2019, 148(26.7%) neonates in 2020, 137(24.7%) neonates in 2021 and 133(24.0%) neonates in 2022. Candida species was the second most common pathogen in our NICU; 126 (11.4%) cases were distributed as follows: 31 (24.6%), 32 (25.4%), and 40 (31.7%). 23 (18.2%) cases occurred in 2019, 2020, 2021, and 2022, respectively. Across the 4 years of the study, 2020 had the highest sepsis frequency. Drug resistance was high in most of the isolates. It was maximum (94-80%) for Cefotaxime, Piperacillin, Amoxicillin/Clavulanic acid, and ceftriaxone. It varied between 60 and 80% for Piperacillin/Tazobactam, Imipenem, Ceftazidime, Cefoperazone/Sulbactam, Meropenem, Ampicillin/Sulbactam, and Ciprofloxacin. The current study found that neonatal sepsis had a nosocomial infection profile shared by both early-onset and late-onset sepsis. K. pneumoniae was the predominant pathogen in both EOS and LOS in our study, similar to other developing countries, and is totally different from developed countries.
Antimicrobial resistance (AMR) is a major global health threat, yet public engagement remains limited because AMR is often perceived as distant and abstract. Digital storytelling (DST) may offer a more accessible approach by situating AMR within lived experience. In this qualitative study, eight members of the public participated in a facilitated screening discussion of five digital stories (short videos created by people depicting their experiences of resistant infection and antibiotic-related harm). Analysed using reflexive thematic analysis, three themes were generated from the data. First, DST made AMR visible, personal, and emotionally grounded through lived experience rather than information alone. Second, engagement was shaped by storytelling devices including metaphor, imagery, voice, and framing. Third, viewers interpreted stories through pre-existing beliefs, social norms, and personal experience. As an exploratory outcome, mapping themes to a behaviour change model suggested DST engagement may influence determinants of behaviour change including social opportunity, psychological capability, and reflective and automatic motivation.
Pseudomonas aeruginosa is a high-priority opportunistic pathogen of public health concern. Its large, complex genome, rich in transferable genetic elements, enables rapid acquisition of antibiotic resistance and contributes to its natural tolerance to antibiotics and disinfectants. Among fifty-two clinical isolates, shotgun whole-genome sequencing was conducted on four clinical isolates of P. aeruginosa from Erbil, Iraq (PA-1 to PA-4) and the laboratory strain PA-NCIMB 8626. The antibiotic susceptibilities of these strains were assessed using the Kirby-Bauer disk diffusion method. The clinical isolates selected for this study were PA-1 (multidrug-resistant, MDR), PA-2 (susceptible, S), PA-3 (extensively drug-resistant, XDR), and PA-4 (pan-drug-resistant, PDR), in addition to the standard strain NCIMB 8626. All strains underwent shotgun whole-genome sequencing and comprehensive bioinformatics analysis. Genomic DNA sequencing was performed on an MGI T7 platform using a unique DNA nanoball technology, followed by quality control, read assembly, gap closing, and annotation. Since the potential of Iraqi strains remains incompletely understood, whole-genome sequence (WGS) data from five P. aeruginosa strains were analyzed to compare genomic divergence in size, structure, and content, assess evolutionary relationships, and identify genes associated with antibiotic resistance and virulence. Virulence factor profiling identified key genes involved in adhesion, secretion, quorum sensing, iron acquisition, and biofilm formation, with isolate-specific differences. Gene analysis aligned efflux pump-related, β-lactam, and aminoglycoside resistance genes with phenotypic susceptibility profiles, except for one susceptible strain. Phylogenetic and evolutionary analyses indicated genomic diversity without sequence type clumping.
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Helicobacter pylori is one of the most widespread pathogens in humans and a strong predictor of gastric cancers. This systematic review and meta-analysis (PROSPERO: CRD420261375391) aimed at determining the extent, clinical impact, and antibiotic resistance profile of H. pylori infections in Cameroon. Six databases were exploited to identify relevant studies published between 2000 and 2026, as per PRISMA guidelines. Pooled proportions were computed using random effects models, while sensitivity analyses were performed to identify confounding factors. A total of 46 studies were included. The pooled proportion of H. pylori infection was 56.7% (95%CI 51.1 - 62.1%), with higher estimates found in i) clinical settings (57.0%), ii) the regions of Centre (62.2%) and Littoral (58.5%), iii) adults (59.7%), and individuals with gastrointestinal disorders (60.1%). The burden of H. pylori was positively correlated with gastric disease severity, with 64.5% of infection cases seen in gastric cancer. Infections have led to adverse clinical effects (e.g., anemia). H. pylori isolates were highly resistant to metronidazole (87.6%, 95%CI 62.4 - 96.8%), while the lowest resistant rates were found for levofloxacin (1.1%, 95%CI 0.4 - 3.2%) and rifampicin (0.6%, 95%CI 0.1 - 2.2%). An unusually high resistance rate to amoxicillin (93.4%; 95% CI 85.9-97.0%) was observed, warranting confirmatory studies. Multidrug-resistant isolates accounted for 77.6%. Several urgent challenges, including the lack of studies in four regions, in other at-risk groups (e.g., obese), limited clinical data, and resistance status vis-à-vis other commonly prescribed ATBs (i.e., amoxicillin), have been identified. This comprehensive study provides baseline data to improve therapeutic management and resistance stewardship in Cameroon.
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Carissa spinarum L. is traditionally valued for its medicinal properties, yet its bioactive potential remains insufficiently explored. In this study, stem and leaf extracts were evaluated for their total phenolic content (TPC), metabolite composition, and biological activities. TPC values were 87.13 and 89.90 mg GAE at concentrations of 217.83 mg/mL and 224.78 mg/mL for stem and leaf extracts, respectively. 1H-NMR analysis revealed several tentative bioactive metabolites including syringic acid, catechin, hiravanone, quinic acid, betulinic acid, and linoleic acid. Antibacterial activity tested against Escherichia coli, Staphylococcus aureus, Bacillus subtilis and MRSA showed strong inhibition of all pathogens except B. subtilis. Anticancer activity on HeLa cells and antioxidant evaluation using DPPH confirmed higher efficacy of the stem extract compared to the leaf extract. Overall, C. spinarum demonstrates promising antibacterial, anticancer, and antioxidant properties, supporting its potential as a source of natural therapeutic agents.
Vaginal infections are a major public health concern in sub-Saharan Africa, where antimicrobial resistance increasingly compromises clinical management. This study aimed to determine the prevalence of vaginal infections, describe their antimicrobial resistance profiles, and evaluate the probiotic potential of lactic acid bacteria (LAB) isolated from cervicovaginal samples of women consulting in Garoua, North Cameroon. A mixed retrospective-prospective and analytical study was conducted at three hospital facilities in Garoua (January 2023-December 2024). Microbial identification used the VITEK 2 system and API 50 CHL galleries. Antibacterial and antifungal susceptibility were interpreted per EUCAST guidelines (versions 13.1-14.0) and CLSI M60 breakpoints, respectively. LAB isolates were characterized for safety, physiological tolerance, aggregation capacity, and antimicrobial activity. Statistical analyses included chi-square tests, odds ratio, Shannon diversity index, MARI, and PCA. Among 877 records analyzed, overall prevalence was 60.55% (95% CI: 57.27%-63.73%), declining significantly from 69.60% in 2023 to 53.78% in 2024 (OR = 1.97; p < 0.0001). Women aged 15-35 years were most affected (62.55%), with a seasonal peak in August (69.31%). Gardnerella vaginalis predominated (52.02%), followed by Candida albicans (18.60%). Clotrimazole (85.50%) showed critical antifungal resistance, while econazole retained the greatest activity (82.11% sensitivity). All five bacterial species fulfilled multidrug resistance criteria, with resistance confirmed in ≥ 82% of antibiotic families tested per species. Six LAB isolates identified as Lacticaseibacillus paracasei, Lactobacillus acidophilus, Lactiplantibacillus plantarum, Lactiplantibacillus pentosus, and Lactococcus raffinolactis displayed satisfactory probiotic profiles, including absence of virulence factors, acid and bile stress tolerance, strong aggregation capacity, and antimicrobial activity against Staphylococcus aureus, Neisseria gonorrhoeae, and Escherichia coli. This study reveals a high burden of vaginal infections with alarming multidrug resistance in Garoua. The identified LAB isolates represent promising locally sourced candidates for vaginal probiotic development. Institutionalized antimicrobial surveillance, revised antifungal prescribing practices, and targeted prevention campaigns are urgently needed.
Inappropriate and broad-spectrum antibiotic use contributes to antimicrobial resistance (AMR) and higher healthcare costs. In Saudi Arabia, despite ongoing antimicrobial stewardship efforts, comprehensive real-world evidence on antibiotic prescribing patterns remains limited. This study aimed to evaluate antibiotic prescribing among insured (Daman) beneficiaries in Saudi Arabia and benchmark against international standards. Retrospective analysis of deidentified health insurance claims from the National Platform for Health and Insurance Exchange Services (NPHIES), covering 1 November 2023-31 October 2024. Antibiotic prescriptions were identified within claims and linked to diagnostic codes using the International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) to determine clinical indications for use. Among 4.02 million claimants, 8.3 million antibiotic prescriptions were identified. Antibiotic claims were mapped to the Saudi Food and Drug Authority (SFDA) drug list. Hospital antibiotic consumption was expressed as defined daily doses (DDD) per 100 patient-days for five selected inpatient antibiotics, whereas overall antibiotic consumption (in both community and hospital settings) was expressed as DDD per 1000 insured persons per day. Treatment duration, prescriber specialty and patient demographics were measured. Appropriateness of antimicrobial prescribing for respiratory tract infections was assessed using Healthcare Effectiveness Data and Information Set (HEDIS) metrics. Age-stratified and sex-stratified antibiotic prescription rates showed disproportionately high use in male infants (509.6 prescriptions per 1000) and older males (641.9 prescriptions per 1000). General practitioners accounted for 80% of prescriptions. Broad-spectrum beta-lactams, particularly amoxicillin-clavulanate, predominated. Overall antibiotic consumption was 11.63 DDD per 1000 insured persons per day, comparable to European Surveillance of Antimicrobial Consumption Network (ESAC-Net) outpatient benchmarks. Mean treatment durations ranged 8-14 days, exceeding global stewardship recommendations. HEDIS indicators revealed overprescribing, particularly for upper respiratory tract infections. This is the first claim-based analysis of antibiotic prescribing patterns among Daman beneficiaries in Saudi Arabia. Decision support systems, artificial intelligence-driven audits and targeted education could optimise prescribing, reduce AMR and inform policy.
Staphylococcus pseudintermedius is the main etiological agent of canine pyoderma and exhibits increasing multidrug resistance. Due to the reduced efficacy of antimicrobials, topical combinations of antimicrobial agents-such as chlorhexidine (CHX) and clotrimazole (CLT)-have gained attention as an alternative. To evaluate the in vitro antibacterial activity and pharmacological interaction of a 2:1 CHX-CLT combination against S. pseudintermedius isolates from canine pyoderma. Sixteen isolates of S. pseudintermedius were obtained from canine pyoderma and identified by PCR detection of the nuc gene. Methicillin resistance was assessed both phenotypically, by oxacillin disk diffusion, and genotypically, through mecA detection. Minimum inhibitory concentrations for CHX, CLT and their 2:1 combination were determined by broth microdilution using resazurin. The fractional inhibitory concentration index was calculated to assess drug interaction. All isolates carried both nuc and mecA genes, while only 25% were phenotypically resistant to oxacillin. CHX exhibited MIC50 and MIC90 values of 0.781 and 1.562 µg/mL, respectively; CLT showed 6.25 and 12.5 µg/mL. In the 2:1 CHX-CLT combination, MICs were reduced up to 6-fold, with MIC50 and MIC90 values of 0.39-0.781 µg/mL (CHX) and 0.195-0.39 µg/mL (CLT). The interaction was additive in 81.25% of isolates and indifferent in the remainder. The CHX-CLT combination demonstrated enhanced in vitro antibacterial activity with predominantly additive interactions against S. pseudintermedius. The results support the rational use of CHX-CLT topical formulations as an effective therapeutic alternative for canine pyoderma in the context of growing antimicrobial resistance.
Actinobacillus pleuropneumoniae (APP) remains one of the most significant bacterial respiratory pathogens in swine production worldwide, causing porcine pleuropneumonia with substantial economic impact. Although recent reviews have summarized aspects of APP epidemiology, serotyping, surface-associated virulence determinants, and vaccine development strategies, several complementary research areas have advanced rapidly since the last DISease CONtrol TOOLS (DISCONTOOLS) 2017 report on this bacterium. These include antimicrobial resistance surveillance, chronic persistence mechanisms such as biofilm formation, refined experimental infection models, intracellular survival within host immune cells, and the immunopathological processes driving lung injury. This review focuses on these practical and mechanistic dimensions, emphasizing their relevance for herd-level control, outbreak management, and future therapeutic approaches. Recent genomic studies of multidrug-resistant strains, as well as the development of improved molecular diagnostic tools, are also discussed. Collectively, emerging evidence suggests that APP should not be viewed solely as an extracellular pathogen causing acute disease outbreaks, but rather as an adaptable organism capable of persistence, immune modulation, and endemic circulation in modern pig populations. Addressing these challenges will require integrated strategies that combine antimicrobial stewardship, improved surveillance, and a deeper understanding of host-pathogen interactions.
Metal-organic frameworks (MOFs) have emerged as promising materials for antimicrobial applications due to their tunable structure and chemical properties. In this work, the morphology of MIL-88A was systematically controlled by adjusting the molar proportion of the water relative to the iron precursor in a solvothermal synthesis approach, by ranging from the absence of water to a molar proportion of 1 : 9 from the salt to water. Increasing the water content induced a progressive morphological transition from rod-like to spindle-like and ultimately star-like architectures, as revealed in the SEM analysis. Structural characterization showed that the solvent composition influenced not only the morphology but also the crystallinity of MIL-88A, with changes in the dominant crystal planes observed by X-ray diffraction. Raman and FTIR analyses confirmed the formation of MIL-88A in all synthesized samples. Antibacterial assays against Escherichia coli and Staphylococcus aureus demonstrated that rod-like and spindle-like structures exhibit enhanced inhibitory activity, particularly at low concentrations (0.24-0.48 mg mL-1), suggesting that morphology plays a key role in antimicrobial capacity. At higher concentrations (1.2 mg mL-1), all morphologies displayed similar antibacterial performance, likely associated with iron-mediated oxidative damage to bacterial cells. These findings highlight the potential of MIL-88A as antibacterial agents by finely tuning morphology, suggesting its potential for applications requiring low material dosages, including antimicrobial coatings, food-contact materials, and biomedical-related systems.
The Little Book of Bad Wounds by Yvette Godwin is a concise field manual intended to guide civilian surgeons managing complex traumatic and wartime wounds in resource-limited environments. Written from the perspective of frontline surgical experience rather than tertiary academic practice, the text emphasizes practical wound stabilization strategies over definitive reconstruction and introduces the concept of the "delayed acute wound" (DAW), a wound that may present days after injury yet still requires acute management principles. This editorial evaluates the book's practicality, readability, and consistency with current wound care literature. Godwin work succeeds in presenting a highly accessible framework for the management of blast and ballistic injuries, particularly its "blueprint recipe" structure, which allows for rapid bedside reference. The text appropriately emphasizes repeated debridement, antimicrobial stewardship, preservation of reconstructive options, and the clinical significance of biofilm in delayed traumatic wounds. Additional strengths include pragmatic discussion of austere-resource solutions, realistic commentary on limb salvage versus amputation, and a writing style that remains engaging without sacrificing clinical utility. Several recommendations, however, differ from current guideline-supported practice and warrant contextualization. These include the use of high-concentration povidone-iodine solutions, broad rejection of pulse lavage, omission of negative pressure wound therapy, and selective recommendations regarding topical antimicrobials and antibiotic timing. While many of these viewpoints are grounded in extensive field experience, they should be interpreted as practice-based recommendations rather than universal standards of care. Despite these limitations, The Little Book of Bad Wounds provides a valuable and timely contribution to modern reconstructive and wartime wound literature. As civilian health care systems increasingly encounter injuries associated with armed conflict and mass trauma, this work offers surgeons a practical framework for stabilizing complex wounds in compromised circumstances. When used with appropriate clinical discernment, the book serves as an effective field guide for surgeons managing devastating injuries under austere conditions.
Garlic (Allium sativum) is widely known for its cardiovascular, antimicrobial, and potential anticancer properties. Despite these benefits, topical application may lead to adverse effects, including allergic reactions, anticoagulant effects, and chemical skin burns. Such burns are rare and under-recognized. This systematic review synthesizes the available clinical evidence on garlic-induced skin burns and complements it with an illustrative case to support clinical decision-making. A systematic PubMed search was conducted to identify clinical reports of garlic-induced skin burns with documented treatment and outcomes. Inclusion criteria comprised case reports or clinical studies on cutaneous garlic burns with available clinical intervention and outcome data. Exclusion criteria included studies published before 2000, non-English publications, mucosal or oral burns, animal or in vitro studies, review articles and editorial texts without patient data. In total, 45 studies were screened and 18 studies met the inclusion criteria. Extracted variables included patients' demographics, burn depth, treatment modality, and healing course. Additionally, a case of a woman with deep dermal, circumferential burns of the knee following the self-application of crushed garlic under occlusion is presented. Most reported cases involved superficial to deep dermal burns caused by prolonged or occlusive garlic application. Conservative treatment-topical antimicrobials, corticosteroids, and advanced dressings-was effective for superficial burns. However, deeper injuries often required surgical intervention including debridement, and in selected cases, split-thickness skin grafting. Healing times ranged from 7 to>56 days, with surgical management associated with faster recovery in deep lesions. Garlic-induced burns represent an uncommon but clinically relevant chemical injury. Prolonged occlusion increases risk for deep dermal necrosis. Early recognition and appropriate surgical management may optimize outcomes and prevent complications. Increased clinician awareness and patient education are essential. Due to heterogeneous case-based evidence, further research is warranted to inform standardized treatment guidelines. Knoblauch (Allium sativum) ist für seine kardiovaskulären, antimikrobiellen und potenziell antikanzerogenen Eigenschaften bekannt. Trotz dieser positiven Effekte kann die topische Anwendung mit unerwünschten Wirkungen wie allergischen Reaktionen, gerinnungshemmenden Effekten und chemischen Verätzungen einhergehen. Solche Verbrennungen sind selten und werden klinisch häufig unterschätzt. Diese systematische Übersichtsarbeit fasst die verfügbare klinische Evidenz zu knoblauchinduzierten Verätzungen zusammen und ergänzt diese durch einen illustrativen Fall zur Unterstützung der klinischen Entscheidungsfindung.Es wurde eine systematische PubMed-Recherche durchgeführt, um klinische Berichte über knoblauchinduzierte Verätzungen mit dokumentierter Therapie und Verlauf zu identifizieren. Die Einschlusskriterien umfassten Fallberichte oder klinische Studien zu kutanen Knoblauchverbrennungen mit verfügbaren Angaben zu Intervention und Outcome. Ausgeschlossen wurden Studien vor dem Jahr 2000, nicht englischsprachige Publikationen, mukosale oder orale Verbrennungen, tierexperimentelle oder In-vitro-Studien sowie Übersichtsarbeiten und editoriale Beiträge ohne Patientendaten. Insgesamt wurden 45 Studien gescreent, von denen 18 die Einschlusskriterien erfüllten. Erfasst wurden Patientendemografie, Verbrennungstiefe, Behandlungsmodalität und Heilungsverlauf. Zusätzlich wird der Fall einer Frau mit zirkulären IIb° Verbrennungen am Knie nach okklusiver Selbstapplikation von zerdrücktem Knoblauch dargestellt.Die meisten berichteten Fälle betrafen IIa° bis IIb° Verbrennungen infolge prolongierter oder okklusiver Knoblauchapplikation. Eine konservative Behandlung mit topischen antimikrobiellen Substanzen, Kortikosteroiden und modernen Wundauflagen war bei oberflächlichen Verbrennungen wirksam. Tiefere Läsionen erforderten hingegen häufig eine operative Therapie einschließlich Débridement und in ausgewählten Fällen eine Spalthauttransplantation. Die Heilungsdauer lag zwischen 7 und über 56 Tagen, wobei operative Verfahren bei tiefen Läsionen mit einer schnelleren Rekonvaleszenz assoziiert waren.Knoblauchinduzierte Verbrennungen stellen eine seltene, jedoch klinisch relevante Form chemischer Hautschädigung dar. Eine prolongierte Okklusion erhöht das Risiko tief dermaler Nekrosen. Die frühzeitige Diagnose und eine adäquate chirurgische Therapie können das Behandlungsergebnis verbessern und Komplikationen vermeiden. Eine erhöhte Sensibilisierung von Behandelnden sowie Patientinnen und Patienten ist essenziell. Aufgrund der heterogenen, überwiegend fallbasierten Evidenz sind weitere Untersuchungen erforderlich, um standardisierte Therapieempfehlungen abzuleiten.
Multidrug-resistant Proteus mirabilis has emerged as an important healthcare-associated pathogen; however, genomic epidemiological data from sub-Saharan Africa remain limited, particularly in military hospital settings. This study aimed to characterize the phenotypic and genomic resistance profiles of P. mirabilis isolates recovered from a military referral hospital in Ethiopia between May 2024 and May 2025. A total of 99 non-duplicate clinical isolates were analyzed using antimicrobial susceptibility testing according to Clinical and Laboratory Standards Institute (CLSI) guidelines, with phenotypic detection of extended-spectrum β-lactamase (ESBL) and carbapenemase production. Whole-genome sequencing was performed on a selected subset of 25 representative ESBL- and/or carbapenemase-associated P. mirabilis isolates to identify resistance genes, determine multilocus sequence types (MLST), analyze plasmid replicons, and reconstruct core-genome phylogeny. Using phenotypic detection, 96.0% of isolates were found to be resistant to at least one third- or fourth-generation cephalosporin, and 99.0% were classified as multidrug-resistant. ESBL production was confirmed in 60.6% (60/99) of isolates, while 6.1% (6/99) demonstrated carbapenemase activity. Genomic analysis revealed diverse ESBL determinants dominated by blaPER-13 (40.0%) and blaVEB-6 (28.0%), with additional detection of blaCTX-M-65. MLST analysis identified nine sequence types, with ST135 predominating (32.0%). Phylogenetic analysis demonstrated moderate genetic heterogeneity, with evidence of multiple lineages circulating within the hospital setting; however, transmission dynamics could not be definitively determined. Plasmid analysis showed a structured replicon distribution dominated by IncQ1 (36.0%) and several Col-type plasmids. These findings demonstrate extensive multidrug resistance associated with diverse ESBL determinants and multiple plasmid replicon types among P. mirabilis isolates in a military healthcare setting. The results highlight the need for strengthened antimicrobial stewardship, improved infection prevention strategies, and integration of genomic surveillance in comparable healthcare environments.
The increasing severity of antibiotic-resistant bacterial infections necessitates the development of next-generation wound dressings capable of both potent antimicrobial activity and effective tissue repair. Porous organic framework materials possess stable structural connectivity, large specific surface areas, and well-ordered pore architectures, making them promising platforms for applications in infectious wound healing. In this study, metal-organic framework (MOF) and hydrogen-bonded organic framework (HOF) nanofilms (MOF-on-HOF) were successfully integrated onto medical gauze through van der Waals heterojunction interactions, enabling a synergistic cascade effect that enhances both antibacterial activity and wound regeneration. The MOF-on-HOF composite was uniformly loaded on gauze by utilizing the solution processability of HOF and the interfacial film-forming ability of MOF. The resulting MOF-on-HOF dressing rapidly and efficiently eliminated Gram-positive pathogens, thus demonstrating excellent antibacterial efficacy against Staphylococcus aureus (≥99%). Meanwhile, it facilitated hemostasis, scavenges reactive oxygen species (ROS), and accelerates cell migration. In a methicillin-resistant Staphylococcus aureus (MRSA)-infected wound model, treatment with MOF-on-HOF@guaze eradicated bacterial load on the wound surface, hence reduces the expression of pro-inflammatory cytokines, and significantly promotes wound closure, achieving a wound healing rate of 98%. These results highlight the MOF-on-HOF@guaze as a promising platform for managing acutely infected wounds and combating antimicrobial resistance.