Dalya Marwan Attallah

Introduction: Multidrug resistant (MDR) bacteria are one of the most important current threats to public health. Therefore, serious concerns were raised about the effectiveness of traditional antibiotics. Cisplatin, a chemotherapeutic agent that is used mainly in cancer treatment, has recently attracted attention and popularity for its potential antibacterial properties. Our study aim is to evaluate the antibacterial properties of cisplatin against several common MDR and non-MDR Gram-positive strains, including Methicillin-Resistant Staphylococcus aureus (MRSA), Methicillin-Susceptible Staphylococcus aureus (MSSA), Coagulase-Negative Staphylococcus (CoNS), and Vancomycin-Resistant Enterococcus (VRE). Methodology: Cisplatin's Minimum Inhibitory Concentration (MIC) was calculated through standard microdilution methods. Results: Our findings indicated that cisplatin had a minimum inhibitory concentration (MIC) of 256 µg/mL across all tested bacterial strains, reflecting its limited antibacterial efficacy in its currently available formulation. However, although the MIC values were high, this study explored cisplatin’s activity against these bacterial strains which uncovers a potential gap about cisplatin clinical effectiveness and indicates that further enhancement is required. Conclusions: These results confirm that cisplatin antibacterial activity has not been extensively explored against these resistant strains. Cisplatin alone shows limited efficacy based on the relatively high MIC values observed. However, combination therapy with other antibiotics may improve its therapeutic potential. Additionally, novel delivery systems—nanoparticle formulations, for instance—could enhance antibacterial activity while reducing toxicity. Future investigations should evaluate these approaches in more detail.

The rise in antimicrobial resistance and heavy metal contamination poses major risks to human health and the environment. This study reports the green synthesis of silver nanoparticles (AgNPs) using a polar extract of Geranium wallichianum D. Don ex Sweet. to evaluate antibacterial activity and Hg ²⁺ -sensing. This is the first reported use of G. wallichianum as a dual reducing and stabilizing agent, enabling a rapid sunlight-assisted synthesis completed within 15 min. Characterization confirmed successful formation of AgNPs: UV–Vis spectroscopy monitored stability, FT-IR verified functional group interactions, PXRD confirmed the crystalline phase, SEM revealed an average particle size of 26 nm, and hydrodynamic size and zeta potential were 39 nm and − 28 mV, respectively. Antibacterial activity was assessed using 30 µg/mL AgNPs, 30 µg/mL erythromycin as a positive control, 30 µg/mL plant extract, and DI water as a negative control. All tests were conducted in triplicate and analyzed using one-way ANOVA ( p < 0.05). The biogenic AgNPs exhibited strong antibacterial activity against Staphylococcus epidermidis (20 mm ZOI), Klebsiella pneumoniae (18 mm ZOI), and Escherichia coli (19 mm ZOI). The MIC and MBC values ranged from 15 to 30 µg/mL, confirming the dose-dependent antibacterial potency. Additionally, AgNPs showed excellent colorimetric response toward Hg ²⁺ , with a linear detection range of 1–100 µM and a limit of detection (LOD) of 6.68 µM. The sensor demonstrated high selectivity and practical applicability in real-water samples. Overall, the unique sunlight-driven synthesis strategy, coupled with the strong antibacterial potential and exceptional Hg ^{2 +} selectivity, underscores the novelty and sustainability of G. wallichianum -mediated AgNPs as a versatile nanoplatform for biomedical and environmental applications.

The rise of multidrug-resistant pathogens has intensified the need for eco-friendly antimicrobial alternatives. In this study, silver nanoparticles (AgNPs) were synthesized using extract of Fumaria indica , an ethnomedicinal plant rich in bioactive compounds. The successful synthesis of FI@AgNPs was confirmed by a color change and a characteristic UV–Vis absorption peak at 409 nm. XRD analysis revealed a face-centered cubic (fcc) crystalline structure with an average crystallite size of 22.09 nm, while SEM and EDX confirmed spherical morphology and high silver content. The synthesized nanoparticles (NPs) exhibited good antibacterial activity against both Gram-positive and Gram-negative bacteria, with maximum inhibition observed against Streptococcus mutans and Staphylococcus epidermidis . Sensitivity was shown by minimum inhibitory concentration (MIC) values for the Gram-positive strain getting as low as 20 µg/mL. Significant antifungal activity was also noted against Candida albicans and Aspergillus flavus . Furthermore, FI@AgNPs demonstrated enhanced antioxidant potential in both DPPH and FRAP assays, exceeding the activity of the crude extract. These findings suggest that FI@AgNPs possess broad-spectrum antimicrobial and antioxidant properties, making them promising candidates for biomedical and pharmaceutical applications. This study reinforces the value of plant-based nanotechnology in developing effective alternatives to conventional therapeutics.

Background: Candidemia, a bloodstream infection caused by Candida species, poses a significant clinical challenge, especially in immunocompromised individuals and intensive care unit (ICU) patients. Prompt diagnosis and treatment are crucial, as delayed antifungal therapy is associated with higher mortality rates. This study, conducted at King Abdulaziz University Hospital (KAUH) in Saudi Arabia, aimed to investigate the clinical and microbiological aspects of candidemia. Methods: This study is a retrospective analysis, KAUH in Saudi Arabia, using data from January 2017 to March 2021. Advanced fungal diagnostic technologies, including MALDI-TOF MS, BioFire, and Vitek 2 systems, were utilized. Patient demographics, clinical characteristics, Candida species distribution, and antifungal susceptibility were assessed. Univariate, bivariate, and multivariate statistical analyses were conducted. Results: Among 418 patients, Candida albicans was the most prevalent species (32.1%), followed by C. tropicalis (23.4%) and C. parapsilosis (18.4%). Various Candida species exhibited different antifungal susceptibility patterns, with high sensitivity to Amphotericin B (95%) and Fluconazole (94%). Sensitivity to Caspofungin varied significantly among species (p = 0.023), with C. parapsilosis showing the highest sensitivity (95%). The overall mortality rate was 67%. None of Candida Species exhibited a statistically significant association with death, however other factors including age, autoimmune diseases, and dialysis were associated with increased mortality risk. Conclusion: This study provides valuable insights into the epidemiology and clinical characteristics of candidemia at KAUH, highlighting the importance of species identification and tailored antifungal therapy. These findings can inform strategies to improve patient care and infection control in Saudi Arabian healthcare settings, contributing to global efforts to mitigate the impact of invasive fungal infections.

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: 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.

Most surveillance studies in Saudi Arabia have been single-centered or did not use the gold standard broth microdilution (BMD) antimicrobial susceptibility test. This is the first study from Saudi Arabia to evaluate the resistance profiles of Acinetobacter baumannii by using BMD on a national level. Between November 2022 and April 2023, isolates from several infection sites were collected from seven hospitals in seven regions of Saudi Arabia. On testing days, BMD was done following Clinical Laboratory Standards Institute standards. Antibiotic susceptibility percentages and MIC₅₀ and MIC₉₀ were calculated. One hundred A. baumannii isolates were included. The highest susceptibility was to tigecycline (39%) and aminoglycosides (22–25%). The MIC₉₀ of all antibiotics were higher than the resistance breakpoint. All isolates (100%) were multidrug-resistant, of which 52% were classified as extensive-drug-resistant, and 42% were identified as pandrug-resistant. The isolates collected from the ear, peritoneal fluid, and the cerebrospinal fluid were all XDR, while 2/3 of the urine isolates (10/15; 66.7%), more than 1/2 of the skin/soft tissue and respiratory isolates (9/16; 56.3% and 22/43; 51.7%, respectively), and 3/8 (37.5%) of the blood isolates met this definition. Conversely, PDR isolates made up 5/8 of blood isolates (62.5%), 8/15 of body fluid isolates (57.14%), and 19/43 (44.2%) of respiratory isolates. A. baumannii showed a surprisingly high resistance to multiple commonly used antibiotics. Infection control policies and antimicrobial stewardship should be implemented by hospitals throughout the country to improve treatment, track resistance trends with local antibiograms, and prevent the development of resistant strains.

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.

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.