Respiratory tract infections caused by Klebsiella pneumoniae are frequently associated with high mortality and morbidity rates. Treatment of these infections is usually difficult due to the emergence of multiple resistances to antibiotics. Multidrug efflux pumps are greatly involved in antibiotic resistance in Gram-negative bacteria including Klebsiella pneumoniae. In the current study, efflux activity was observed in 93.75% of Klebsiella pneumoniae clinical isolates by the qualitative acridine orange agar method. This finding was further confirmed genotypically by polymerase chain reaction that showed the presence of efflux genes AcrA, AcrB, TolC and mdtk in these isolates. The ability of metformin to inhibit efflux activity was compared with the reference efflux pump inhibitors verapamil and ascorbic acid. Metformin was more active than ascorbic acid and less active than verapamil. Up to our knowledge, this is the first report that shows that metformin has an efflux pump-inhibiting activity in Klebsiella pneumoniae.

An increasing antimicrobial resistance among Klebsiella pneumoniae (K. pneumoniae) has been rapidly growing. The cross-sectional, analytical and descriptive study was conducted to investigate the multidrug resistance (MDR) of K. pneumoniae isolated from respiratory tract infection. One hundred and fifty-one K. pneumoniae isolates were recovered from 330 sputum specimens (45.75%). The isolates showed high levels of resistance to the most of antibiotics and intermediate resistance prevalence against imipenem and meropenem. Random and misuse of antibiotics lead to the emergence of superbugs. Prospective studies must focus on new strategies for facing of the tsunami of drug resistance.

Colorectal cancer (CRC) is a critical health problem. It is the second cause of death globally and the third world's most frequently diagnosed. Multiple evidences and suggestion imply the relationship of gut microbiota and colorectal cancer carcinogenesis. The different omics techniques like, metagenomic, metaproteomic and metabolomic approaches have led to important advances in the study of the intestinal microbiome, the host as well as the intestinal environment. Different bacterial species, proteins and metabolites have a crucial role in colorectal cancer screening, detection and recurrence. Integration of these three omics analysis in drawing attention to reveal taxonomic and functional structure of human gut microbiota in addition several protein and metabolites detection had helped in construction of microbial communities and their diversity in colorectal cancer patients and healthy controls besides that these bacterial species, metabolites and proteins could be used as a critical biomarkers candidate in colorectal cancer detection, prognosis and recurrence.