Antibiotics

Listeria monocytogenes causes listeriosis in humans and animals and contaminates prepared food by attaching to food processing environments. Therefore, closer monitoring of how the organism adheres to surfaces will help identify ways to prevent it from colonising food-processing environments. To develop new attachment assays, clinical and environmental strains of L. monocytogenes were transformed by inserting a plasmid containing lux, gfp reporter genes and an erythromycin-resistant gene into the parent cells. Transformed cells were grown for 48 hours on brain heart infusion agar plates containing 1-5{micro}g/ml of erythromycin, after which the cells were viewed under a molecular light imager and luminometer. Fluorescent cells containing the gfp, lux, and erythromycin-resistant genes were visible, whereas control cells without the plasmid were not. Transformation efficiency was highest with the environmental strains, and subsequent growth and hydrophobicity tests carried out with the transformed cells in different growth conditions showed that they were able to attach well to solvents when compared to the parent cells. However, the growth rate of the transformed cells was poor, indicating a disruption of cell metabolism. Results show the possibility of real-time monitoring of how cells attach to different surfaces and could lead to a better understanding of the initial colonisation of a surface by the organism.

Probiotics produce antimicrobial peptides and small molecules that are secreted into the medium. Antimicrobial activity of cell-free supernatants can be tested using various qualitative and quantitative methods. Many of these techniques employ methods which introduce uncontrolled variables, impacting reproducibility and making comparison of reported results difficult. Here, we present a simple procedure for quantitative estimation of antimicrobial activity of cell-free supernatants which overcomes drawbacks of commonly used methods.

Antimicrobial resistance in Pseudomonas aeruginosa has emerged as a major clinical concern. Ciprofloxacin has potent intrinsic activity against P. aeruginosa, but resistance to this antibiotic is increasingly reported in clinical settings. In this study, P. aeruginosa ATCC 27853 strain was exposed to gradually increasing ciprofloxacin concentrations for 50 passages ([~]100 days). The final selected resistant strain (CIP-R) with 256-fold of minimum inhibitory concentration was studied further. Whole-genome sequencing revealed 12 genomic alterations, including known mutations in the quinolone resistance-determining genes gyrA (Thr83Ile), parC (Thr177Asn), parE (Glu459Lys). A duplication mutation in nfxB (Tyr153_Gly154dup) was also observed. In addition to these genes, we observed mutations in pilA, tadB, psdR, NP446_RS32055 (TRAP transporter permease), multiple dppA3 variants, and a prophage-associated hypothetical gene (NP446_RS24255), which have not been reported previously. The gyrA Thr83Ile substitution was conserved in 86.38% of ciprofloxacin-resistant clinical isolates retrieved from the NCBI database. Resistance acquisition was accompanied by slower growth, impaired swimming and swarming motility, diminished surface attachment, reduced biofilm formation. The resistant strain has enhanced {beta}-lactamase activity, and resistance to levofloxacin, cefepime, and meropenem together with sensitivity to piperacillin-tazobactam and aztreonam. This study highlights the gyrA Thr83Ile mutation as a key genomic marker for molecular screening of ciprofloxacin resistance and reveals secondary adaptive trade-offs that can be targeted for clinical diagnostic and therapeutic decision-making. In conclusion, achieving high-level ciprofloxacin resistance in P. aeruginosa involves non-target-site genomic adaptations and physiological trade-offs beyond classical target mutations.

IntroductionEnteric fever, being endemic with seasonal peaks in low- and middle-income countries, is a major health concern. Moreover, the rise in antibiotic resistance has exacerbated the situation. This study was undertaken to investigate the lytic bacteriophages against Salmonella Typhi with a potential for phage therapy. Materials and MethodsA hospital-based cross-sectional study was conducted from October 2023 to March 2024. Blood cultures were processed by the BACTEC automated culture system following standard microbiological techniques to isolate typhoidal Salmonella. Antibiotic susceptibility was tested by the modified Kirby-Bauer disc diffusion method. Lytic bacteriophages isolated by the double-layer agar method were assessed for their host range and lytic ability with spot and turbidimetric assays. ResultsOf the total 1054 blood specimens, 35 (3.2%) were positive for S. Typhi. All the isolates were susceptible to first-line antibiotics--ampicillin, chloramphenicol, and cotrimoxazole. The isolates were also sensitive to nalidixic acid (80%) as well as fluoroquinolones; ciprofloxacin (62.86%), levofloxacin (77.14%), and ofloxacin (80%). Fifteen lytic phages were isolated against S. Typhi Ty2 and CT18 strains. Four phages--vB_SaTy_ST2, vB_SaTy_ST7, vB_SaTy_ST17, and vB_SaTy_ST18--lysed all 35 clinical S. Typhi isolates. While vB_SaTy_ST17 and vB_SaTy_ST18 also lysed 7 out of 20 S. Paratyphi A isolates. Three phages (vB_SaTy_ST2, vB_SaTy_ST7, vB_SaTy_ST17) were tested against S. Typhi isolate S30. Individually, vB_SaTy_ST17 suppressed the growth for 13 hours, vB_SaTy_ST2 and vB_SaTy_ST7 for 10 hours. The phage cocktail vB_SaTy_ST2 + vB_SaTy_ST17 was the most effective, which extended the inhibition time to 15 hours. ConclusionThis study highlights the ongoing burden of enteric fever in Nepal and the increase in susceptibility of S. Typhi to nalidixic acid and fluoroquinolones. It also demonstrates the promising lytic potential of bacteriophages, particularly vB_SaTy_ST17 and the phage cocktail vB_SaTy_ST2 + vB_SaTy_ST17, against clinical S. Typhi, highlighting their potential as alternatives to antibiotics.

SynopsisO_ST_ABSBackgroundC_ST_ABSTime kill curve (TKC) assessments are an essential step in the study of an antimicrobials pharmacodynamic characteristics. Surprisingly TKCs have not be formally standardised, therefore there remain concerns that different testing centres/methodologies may produce different results. Six centres participating in Gram-negative-Antibiotics NOW (GNA-NOW) consortium measured a series of TKCs with meropenem against E. coli to establish: Same-day (SD) vs different-day (DD) replication per centre (intra-site), and centre to centre (inter-site) correlations. MethodsMeropenem was tested against three strains of E. coli (ATCC 25922; ESBL producer C1.55; OXA-48 producer C1.62). An inoculum of 1.5x106 CFU was specified with meropenem concentrations of x0, x1 to x16 MIC; and sampling assessment of bacterial density was determined at 0-24h. Experiments were performed in triplicate, aerobically at 37{degrees}C. Centre-specific methodology was collected. Meropenem, media, bacterial strains, were shipped from one central laboratory to participating laboratories. ANOVA and Friedman tests were used to assess SD, DD and between centre replications. ResultsAssessment of the methodologies between centres revealed many differences, including bacterial inoculum, meropenem preparation, volume of TKC vessel, vessel materials, agitation vs static cultures and sampling volumes. Intra-centre SD and DD analysis for all strains were generally associated with P>0.05 suggesting consistency. Inter-centre SD and DD comparisons resulted in P<0.05, indicating variable total bacterial load measurement between centres. ConclusionsTKC methodologies varied between different centres, and while intra-centre comparison of SD and DD were generally consistent, inter-centre comparisons were not. Standardisation of TKC methodologies is required.

The minimum inhibitory concentration (MIC) assay is the gold standard for evaluating antimicrobial activity1. However, conventional agar-based MIC methods often underestimate the potency of physicochemically complex compounds[1, 2]. Hydrophobic and adhesive molecules, such as lipoglycopeptide antibiotics, exhibit poor diffusion and non-specific binding to agar, leading to artificially elevated MIC values compared to broth-based methods[3]. This issue complicates accurate potency assessment and is particularly an issue when attempting resistance frequency (FOR) studies, which must be conducted on solid media. Here, we developed a modified miniaturised agar MIC assay using 1% agarose, 0.002% Tween 80-supplemented tryptic soy broth (TSB), and a 24-well plate format[4]. These modifications improved compound dispersion, reduced matrix interactions, and lowered compound requirements. The optimised assay was validated with vancomycin, oritavancin, and dalbavancin against Staphylococcus aureus ATCC 43300 (MRSA) and Streptococcus pneumoniae ATCC 700677. This efficient, cost-effective, high-throughput platform overcomes the limitations of traditional agar methods, enhancing reliability in evaluating challenging antimicrobials and supporting next-generation antibiotic development.

SynopsisO_ST_ABSBackgroundC_ST_ABSThe main advantages of Time Kill Curves (TKCs) in antimicrobial drug development are the ability to track bacterial kill and regrowth over time and with varying drug concentrations. Whilst there are guideline documents in place, such as M26-A in CLSI, there remains scope for individual laboratory differences in practice. Here we evaluated several factors which potentially influenced data generated in TKCs. MethodsFirstly, E. coli ATCC 25922 was used to determine optimum sampling volume, culture vessel volume, CFU enumeration variance factors and static versus agitated cultures in a single laboratory. Secondly, a ring test comprising of TKCs was performed by six laboratories focusing on: standardised inoculum, static culture and two culture vessel sizes 10 mL and 200 {micro}L. Data analysis was performed to determine consistency within centres and between them. ResultsConsistently accurate inocula could be achieved by use of: larger sampling volumes between 100 {micro}L > 20 mL; larger culture vessels volumes (10 mL > 100 {micro}L) and higher inocula (10 8 > 1.5x10 5 CFU). Culture agitation during the TKC experiment resulted in reduced killing compared to static cultures. Reproducibility of TKCs was best between centres when they were performed in 10 mL culture vessels. There was more variability per site when performing TKC in 96 well trays. ConclusionsTechnical factors such as preparation of inocula, agitation, vessel size and enumeration of cultures are important variables in performing TKCs that need to be standardised in drug development programmes involving multiple laboratory centres.

The global spread of antimicrobial-resistant (AMR) bacteria represents one of the greatest threats to modern medicine, making the development of novel therapeutic strategies increasingly urgent. Phage therapy, which exploits bacteriophages (phages, viruses that specifically infect and kill bacteria) has regained attention as a therapeutic approach for multidrug-resistant infections. One critical determinant of treatment outcome is the capacity of phages to sustain bacterial growth suppression; however, no metric has previously existed to directly quantify the duration of effective lytic activity. Here, we propose the Sustainability Index (SusI), a novel metric that quantifies both the duration and extent of phage-mediated bacterial growth suppression, which is restricted to the primary lysis period from lysis initiation to resistance emergence. Evaluation of individual phages and two-phage cocktails against both laboratory and clinical isolates of Escherichia coli demonstrated that SusI provides information independent of the Virulence Index, which primarily reflects bactericidal activity during the initial phase of infection, and serves as a complementary metric to the Suppression Index, which may incorporate behavior beyond primary lysis. Cocktails composed of phages targeting different receptors specificities consistently exhibited higher SusI values, consistent with the notion that multifaceted selective pressure delays resistance emergence. Furthermore, in a mouse model of systemic infection established by intraperitoneal administration, cocktails with higher SusI values demonstrated superior therapeutic efficacy. These results confirm SusI as a practical metric for rational phage cocktail design. As phage therapy advances toward clinical implementation, standardized quantitative metrics such as SusI are expected to facilitate evidence-based selection of therapeutic phages across diverse pathogens and infection conditions. ImportanceThe global spread of antimicrobial-resistant bacteria is making bacterial infections increasingly difficult to treat. Phage therapy, which uses bacteriophages (viruses that specifically infect bacteria), has re-emerged as a therapeutic alternative; however, reliable methods to determine in advance which phages will be therapeutically effective remain limited. Current evaluation metrics are well-suited for quantifying how rapidly phages kill bacteria but were not designed to directly measure how long lytic activity is sustained before resistant bacteria emerge. Here, we developed the Sustainability Index (SusI), a novel metric that specifically quantifies the duration of effective bacterial growth suppression. Evaluation of multiple phages and their combinations (cocktails) against both laboratory and clinical bacterial isolates demonstrated that SusI can distinguish phage combinations that existing metrics fail to differentiate. Moreover, in a mouse model of lethal bacterial infection, higher SusI values correlated with improved therapeutic outcomes. SusI has potential as a practical tool for selecting phages with greater likelihood of therapeutic success.

Klebsiella aerogenes, a member of the Enterobacteriaceae, is a causative agent of healthcare-associated infections, and outbreaks caused by drug-resistant K. aerogenes have been reported worldwide. The range of antimicrobial agents available for treating infections caused by carbapenem-resistant K. aerogenes is limited. While in vivo animal experiments using clinical K. aerogenes isolates to evaluate antimicrobial therapy could facilitate selection of the most effective treatment, conducting infection experiments involving large numbers of mammals such as mice is challenging due to ethical concerns related to animal welfare. Silkworms are invertebrates increasingly used as experimental models for infectious disease research to evaluate antimicrobial efficacy. In this study, we aimed to establish a silkworm infection model using a clinical K. aerogenes isolate to evaluate its utility for determining effective antimicrobial doses. K. aerogenes strains were isolated from a patient at a Japanese hospital, and a silkworm infection model was established using the clinical isolate. The non-metallo-beta-lactamase-producing strain K. aerogenes TUM25562, isolated from a patient with a complicated urinary tract infection, was susceptible to meropenem (MEPM) and gentamicin (GM) in vitro. During treatment, additional isolates with increased resistance to MEPM and subsequently to both MEPM and GM emerged. K. aerogenes TUM25562 caused dose-dependent mortality in silkworms. Treatment with clinically equivalent weight-based doses of MEPM or GM did not cure the infected silkworms. The median effective (ED50) doses of MEPM and GM were therefore investigated using the silkworm infection model. Administration of higher doses corresponding to four times the ED50 significantly prolonged the survival of infected silkworms. These results suggest that a silkworm infection model using clinical K. aerogenes isolates may provide a practical approach for evaluating antimicrobial efficacy and determining effective antimicrobial doses.

The minimum inhibitory concentration (MIC) is a standard measure for describing the lowest effective dose concentration of an antimicrobial compound in clinical practice; yet, conventional assays often require a substantial amount of antimicrobial compound, limiting their use with scarce, purified agents. Here, we describe a simple and reproducible technique to evaluate the MIC for purified compounds with a limited sample size. The protocol describes the MIC steps against a bacterial strain while minimizing the use of reagents and materials. It is helpful for screening purified natural products as antimicrobial agents and in early-stage drug discovery. The protocol adapts standard microplate-based assays for two-fold dilution of the compound, ensuring their applicability in microbiological studies. The MIC value of the standard antibiotic kanamycin against Staphylococcus aureus, Vibrio fischeri, Klebsiella pneumoniae, and Escherichia coli was determined using our method, and was found to be consistent with the conventional broth microdilution method, validating its reliability. Therefore, this method offers a practical and viable solution for antimicrobial drug discovery, addressing the disparity between limited compound availability and comprehensive microbiological assessment of MIC.

SynopsisO_ST_ABSBackgroundC_ST_ABSThe complexity of diagnosing and treating biofilm-associated infections necessitates a comprehensive strategy to mitigate the rising rates of antimicrobial resistance (AMR). Microtiter plate methods are used globally for determination of biofilm eradication concentrations (MBEC) but few have been adapted to observe pharmacodynamic observations. Here, we describe a method which allows for both static and pharmacodynamic assays of biofilm evaluation. MethodsA total of 150 clinical isolates from Southmead Hospital were assessed, representing five bacterial species (N=30 per bacterial species): Pseudomonas aeruginosa, Escherichia coli, Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae. MBECs were determined using a developed method using 96 well plates and glass beads. MBECs of seven different antibiotics were compared to those determined using the established Calgary biofilm device (CBD). Dynamic pharmacodynamic evaluations to produce Biofilm Time Kill curve (BTKC) based on published planktonic time kill curve (TKC) data and ISO recommendations were carried out using the glass bead model for K. pneumoniae and ciprofloxacin, S. aureus and levofloxacin and S. pneumoniae and vancomycin. Quantification of biofilm biomass was assessed at 0, 2, 4, 8 and 24 hours and compared to planktonic culture survival under comparable challenge conditions. ResultsComparing MBEC results for all bacterial strains and antibiotic challenges showed no statistical difference between the glass bead and CBD methods (P <0.05). Biofilm BTKC AUBKC were inferior to planktonic equivalents but demonstrated specific pharmacodynamic patterns of biofilm reduction efficacy. MBEC correlated with biofilm BTKC penetration in line with clinical observations for S. aureus vs vancomycin and S. pneumoniae vs levofloxacin. ConclusionsThe glass bead biofilm models provide robust, reproducible alternatives to the traditional methods of determining MBEC and bridge the gap with biofilm pharmacodynamic evaluations. These methods also provide a low-cost option to current methods as only standard laboratory equipment is required, allowing for the generation of comprehensive data sets. This ensures greater translatability to complex in vitro models and clinical scenarios.

Mathematical models, e.g. differential equations and stochastic processes, have gained considerable attention for understanding evolution of antibiotic resistance. However, most existing models assume standing genetic variation and do not consider the possibility of random or drug-induced mutation of reference bacterial strains. Therefore, we propose a pharmacokinetics/pharmacodynamics (PK/PD)-based continuous-time Markov chain considering the competition and mutation between sensitive and resistant bacterial within an infected host during treatment. The proposed model is approximated as a generalized birth-death process with immigration, allowing for explicit derivation of the probability resistant population establishes during treatment. Besides capturing the stochasticity of de novo emergence of a resistant bacterial strain, we explore the effects of different antibiotic modes of action, horizontal gene transfer, nutrient availability and drug pharmacokinetics on antibiotic resistance. We find that replication-targeting (biostatic) drugs suppress resistance more than death-targeting (biocidal) drugs. Like prior works, we obtain maximized resistance at intermediate drug concentrations, however the consideration of de novo mutation magnifies the superiority of higher doses in preventing resistance emergence.

The vancomycin-resistant Enterococcus faecium (VREfm) has been declared as a high priority pathogen by World Health Organisation (WHO). It presents a major therapeutic challenge to healthcare, remaining with limited antibiotic options. Bacteriophage therapy has emerged as a promising alternative for combating antimicrobial-resistant pathogens. This study reports the isolation and characterization of bacteriophages active against VREfm and MDR E. faecium clinical isolates from India. Two bacteriophages, NIMS_EF375_N69_P9 ({Phi}1) and NIMS_EF375_N74_P12 ({Phi}2), were isolated from sewage by enrichment using MDR E. faecium strain EF375 as the propagation host. Lytic activity was confirmed by spot assay and double-layer soft agar plaque assay; both phages produced clear plaques of 1.5-2.0 mm. Transmission electron microscopy showed icosahedral heads with long non-contractile tails, presenting siphovirus-like morphotype within the class Caudoviricetes. Host range was assessed against 10 MDR E. faecium isolates (including the propagation host), 2 of which were VREfm. {Phi}1 lysed 5 of 10 isolates, including the VanA-type VREfm, whereas {Phi}2 lysed 7 of 10, including both VanA- and VanB-type VREfm. In time-kill assays against EF375 at an MOI of 1, {Phi}1 produced effective decline in optical density sustained through 24 h (~80% reduction relative to the untreated control), whereas {Phi}2 suppressed bacterial growth with only ~50% reduction. To the best of our knowledge, this study represents the first report from India on the isolation and characterization of bacteriophages active against clinical VREfm isolates. The broader host range of {Phi}2 and the stronger killing kinetics of {Phi}1 suggest complementary roles in a phage cocktail, warranting genomic characterization and in vivo evaluation.

The global emergence of multidrug-resistant (MDR) ESKAPE pathogens has significantly reduced the effectiveness of existing antibiotics, highlighting the urgent need for new strategies to restore antimicrobial susceptibility. Here, we report the discovery and mechanism of BMM_1567, a peptide potentiator that enhances aminoglycoside efficacy against MDR pathogens. A genetically defined reporter-based screen identified BMM_1567 as a potent inhibitor of aminoglycoside resistance, potentiating spectinomycin activity against MDR Gram-negative ESKAPE isolates at low micromolar concentrations. Structural modeling and molecular dynamics simulations indicated that BMM_1567 interacts with residues lining the antibiotic-binding groove of aminoglycoside-modifying enzymes (ANT, APH, AAC), with highest affinity for ANT ({Delta}G_bind = -62.25 kcal/mol), suggesting competitive inhibition of substrate binding. Site-directed mutagenesis of key ANT residues identified critical amino acids involved in BMM_1567 binding, confirming their role in mediating spectinomycin potentiation. In murine abscess model using XDR E. coli, BMM_1567 in combination with spectinomycin significantly reduced bacterial burden and pro-inflammatory cytokine levels, comparable to colistin. Collectively, these findings establish BMM_1567 as a promising aminoglycoside potentiator that restores antibiotic activity against MDR pathogens through direct inhibition of resistance enzymes, while exhibiting in vivo efficacy and a remarkably low propensity for resistance development.

IntroductionIn sub-Saharan Africa, and more specifically in Cameroon, antimicrobial resistance (AMR) represents a major public health threat. This is underlined by the increasing appearance of multidrug-resistant bacteria. Extended-spectrum {beta}-lactamase producing Escherichia coli (ESBL-Ec), a critical priority bacterium, is increasingly implicated in life-threatening infections in hospital and community settings in Cameroon. Data on the genetic composition of ciprofloxacin-resistant Escherichia coli are limited in Cameroon. This study aimed to investigate the prevalence, genetic diversity, resistance mechanisms in multidrug-resistant Escherichia coli organisms isolated from clinical samples in two hospitals in Yaounde, Cameroon. MethodA cross-sectional study was conducted from February to June 2025 in two healthcare facilities in Yaounde, Cameroon. All clinical samples from in- and out-patients were analysed. After culturing, identification was performed using API20E as per the manufacturers instructions and ESBL production was screened in CHROMagarTM ESBL. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Polymerase chain reaction (PCR) was used to detect ESBL and plasmid mediated quinolone resistance (PMQR)genes, as well as mutations in quinolone resistance-determining region (QRDR) (gyrA/parC) Horizontal. plasmid transfer was also investigated. Finally, phylogroup analysis was assessed. ResultThe prevalence of MDR E. coli was 50.7% (n=33/65), all of which (100%) were ESBL producers and 91% were ciprofloxacin-resistant. Highest resistance rates were observed for cefotaxime (100%), ceftriaxone (100%), and ciprofloxacin (91%). The most frequent ESBL genes were blaTEM (36.3%; n=12/33). Among PMQR genes, qnrB was detected in 16.6% (n=5/30) of isolates. Only the ESBL genes were carried by plasmids; the most prevalent plasmid-borne gene was blaTEM (40%), followed by blaCTX-M (26.7%). Mutations within the topoisomerase QRDR (parC gene) were identified in 36.6% (n=11/30) of ciprofloxacin-resistant strains. Phylogroup analysis revealed a predominance of phylogroup A, followed by group B. ConclusionThis study reveals a high prevalence of multidrug-resistance, ESBL (blaTEM dominant) and fluoroquinolone resistance in E. coli in Yaounde, with plasmid dissemination of ESBL genes and chromosomal stabilization of PMQR determinants. The predominance of commensal phylogroups in clinical samples underlines the role of the community reservoir. It is urgent to reinforce " real-time One Health" genomic surveillance in Cameroon.

Enterococcus faecalis is a leading cause of infective endocarditis, particularly in older and hospitalized patients. Treatment is challenging due to the intrinsic resistance of E. faecalis to many clinically important antibiotics and the increasing prevalence of multidrug-resistant strains. Bacteriophage (phage)-based therapies, including phage cocktails and phage-antibiotic combinations, offer a promising approach for treating resistant bacterial infections. In this study, we isolated ten novel phages from wastewater by screening on E. faecalis clinical isolates and tested phage activity both individually and in phage-phage and phage-antibiotic combinations against 18 E. faecalis clinical isolates collected from patients with infective endocarditis. We found that 15/18 (83%) isolates were susceptible to at least one phage tested, and that the same proportion of isolates were susceptible to a cocktail of three phages with complementary activities. We also observed improved bacterial growth inhibition and increased killing when phages were combined with ampicillin or daptomycin, two antibiotics commonly used to treat E. faecalis infections. Finally, we found that treatment with the three-phage cocktail improved the survival of Galleria mellonella infected with a pathogenic E. faecalis endocarditis isolate. Overall, these findings suggest that phages could be a helpful addition to the therapeutic repertoire for treating E. faecalis infective endocarditis. ImportanceNew approaches are needed for treating infective endocarditis, a life-threatening heart infection. Here we focus on Enterococcus faecalis, a resilient bacterium that is increasingly resistant to standard-of care antibiotic regimens, and explore the use of phage therapy for treating E. faecalis endocarditis. We found that combining phages together in a cocktail or pairing them with existing antibiotics can effectively kill E. faecalis clinical isolates from patients with infective endocarditis, and that treatment of infected waxworm moth larvae with a phage cocktail improved their survival. The results of this study contribute to the development of phage-based therapeutic approaches for E. faecalis endocarditis, which could ultimately lead to improved outcomes for patients facing this severe infection.

Clinically relevant pathogens are often tested for antimicrobial susceptibility using standard laboratory media that poorly reflect the in vivo environments in which they cause infections, leading to poor clinical outcomes. In this study, we aim to understand the impact of media on the global transcriptome, biofilm formation, and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus USA300 when cultivated in a physiologically relevant wound medium, such as simulated wound fluid (SWF), compared to cation-adjusted Mueller-Hinton broth (caMHB), a general-purpose medium. The transcriptomics analysis showed upregulation of 865 genes and downregulation of 792 in SWF compared to caMHB. Upregulated genes in SWF are associated with virulence, such as genes coding for fibronectin-binding proteins (fnaAB), serine proteases (splABCDE), as well as genes involved in antimicrobial resistance, such as multidrug efflux pump genes (norB, norC). Conversely, genes associated with transmembrane ion transport, including phosphate transport (pstSCAB, phoU) and potassium intake (kdpABCF), were significantly downregulated in SWF, as further confirmed by increased membrane disruption upon exposure to a membrane-potential-sensitive dye (DiSC3). Biofilm assay showed reduced surface attached biofilm but increased cell-to-cell attachement in SWF compared to caMHB. Antimicrobial susceptibility testing revealed a 2- to 4-fold increase in tolerance to clinically relevant antibiotics in SWF compared to caMHB. Overall, our findings revealed that media affects gene expression, membrane physiology, virulence, and antibiotic tolerance in MRSA, underscoring the need to use physiologically relevant media in routine antimicrobial susceptibility testing and the drug development pipelines.

Background: Retail red meat may act as a source of foodborne pathogens, antimicrobial resistant bacteria, and antibiotic residues, posing a significant public health concern in Bangladesh. Objectives: This study aimed to isolate and identify major bacterial pathogens from retail red meat, determine their antimicrobial susceptibility patterns, assess the prevalence of antibiotic resistant bacteria, and detect antibiotic residues in meat samples. Methods: A cross-sectional study was conducted from January to June 2019 using 60 retail red meat samples (20 cattle, 20 goat, and 20 buffalo) collected from Rajshahi and Naogaon districts. Bacterial isolates were identified using standard cultural, morphological, staining, and biochemical techniques. Antimicrobial susceptibility was evaluated by the Kirby Bauer disc diffusion method according to CLSI guidelines. Antibiotic residues were screened in 15 representative samples using thin layer chromatography (TLC). Results: Overall prevalence of Escherichia coli, Salmonella spp., and Staphylococcus aureus was 10.0%, 13.3%, and 28.3%, respectively. E. coli showed complete resistance to penicillin (100%) and high resistance to amoxicillin (83.3%), while remaining highly susceptible to ciprofloxacin (83.3%) and gentamicin (66.7%). Salmonella spp. exhibited highest resistance to penicillin (87.5%) and tetracycline (75.0%), whereas gentamicin (87.5%) and ciprofloxacin (75.0%) remained the most effective agents. S. aureus demonstrated marked resistance to penicillin (94.1%), ampicillin (58.8%), tetracycline (47.1%), and amoxicillin (47.1%), but high susceptibility to gentamicin (88.2%) and ceftriaxone (70.6%). TLC detected ciprofloxacin and oxytetracycline residues in one cattle meat sample each (6.7%). Conclusions: Retail red meat marketed in the study areas harbored multidrug-resistant bacterial pathogens and detectable antibiotic residues, highlighting potential risks to food safety and public health. Continuous surveillance, prudent antimicrobial use, improved slaughterhouse hygiene, and strict compliance with antibiotic withdrawal periods are essential to minimize antimicrobial resistance and residue contamination.

To prevent antimicrobial resistance (AMR), antibiotic courses are traditionally prescribed to completion, overlooking their collateral impact on the commensal microbiota. We developed a deterministic within-host model linking pathogen growth, immune responses, antibiotic action, and commensal dynamics to explore how treatment duration influences resistance development. Simulations across community-acquired infection parameters showed that 71% of cases successfully treated with a standard 7-day regimen could also be cured with shorter "Stop When Better" (SWB) courses, where treatment cessation was triggered by a predefined threshold in pathogen abundance, and 97% by SWB plus 1 day. Compared with standard treatment, SWB+1 approaches reduced overall antibiotic exposure and resistance emergence in commensal niches while preserving efficacy. While this threshold-based definition of "feeling better" offers a clear theoretical framework, it would require translation into clinical cues. Therefore, although these findings suggest that response-based antibiotic stopping rules could inform future adaptive prescribing strategies, further empirical validation is essential.

Pseudomonas aeruginosa remains one of the most important clinical pathogens for which new drugs are needed, due to its resistance machinery. Consequently, there is an increasing effort to develop new and effective treatments against this pathogen. We recently showed that tetrasodium ethylenediaminetetraacetic acid (tEDTA) exhibits promising antibacterial and antibiofilm activity against P. aeruginosa in advanced biofilm models. tEDTA is known to chelate divalent cations, with predicted effects on the outer membrane; however, a full understanding of how this kills P. aeruginosa is lacking. Also, it is currently not clear how slowly or rapidly P. aeruginosa will evolve resistance to this treatment. Using membrane disruption assays and RNA-seq, we showed that tEDTA disrupts bacterial membrane potential and permeabilises P. aeruginosa membranes. RNA-seq revealed the significant upregulation of genes involved in the transport of iron, phosphate, potassium, and magnesium ion. The arnABCD operon which is involved in lipid A biosynthesis was also upregulated. Using a 7-day evolutionary ramp approach, we showed that P. aeruginosa could not evolve resistance to tEDTA under strong selection. Lastly, we carried out a cytotoxicity assay with Human Epithelial type 2 (HEp-2) cells and showed that there was reduced cytotoxicity of tEDTA compared to meropenem. This study provides good insight into the mechanism of action of tEDTA and further evidence of its potential as an alternative to antibiotics for P. aeruginosa infections.