Gram-Positive Bacterial Infections and Antibiotics Resistance in Jordan: Current Status and Future Perspective

Abstract

Background: Antibiotic resistance is expanding worldwide at alarming rates. Middle East countries including Jordan have high prevalence of antibiotic resistance.
 Aims: The main aims of this review are to summarize the situation with Gram-positive bacterial infections and antibiotic resistance in Jordan, identify areas where further investigation is required, and suggest strategies to combat antibiotic resistance.
 Methods: A systematic literature search was conducted by two independent researchers using general and specific combinations of MeSH search terms using Embase, PubMed, Web of Science, and Google Scholar databases.
 Results: Staphylococci and Streptococci were commonly isolated from environmental, animal, and human samples, while Staphylococci, Enterococci, and Listeria were commonly isolated from food. Staphylococci, Streptococci, and Enterococci human colonization were documented at variable but high rates. Methicillin-resistant S. aureus (MRSA) and methicillin-resistance coagulase-negative Staphylococci (MR-CoNS) infections were common with high rates of antibiotic resistance. S. pneumoniae showed increased resistance rates to most antimicrobials. Enterococci and C. difficile resistance rates were moderate, while group B Streptococci (GBS), viridans group streptococci (VGS), C. perfringens and L. monocytogenes antibiotic susceptibility patterns were not reported. All MRSA and vancomycin-resistant Enterococci (VRE) isolates were mec-A positive, while resistance genes among CoNS, S. pneumoniae, S. pyogenes, S. agalactia, C. perfringens, and L. monocytogenes were not investigated.
 Conclusions: Gram-positive bacterial infections and antibiotic resistance rates were high in Jordan. Molecular epidemiology studies, a nationwide surveillance program, and action plans are urgently required to combat antibiotic resistance.

Anti-Infection of Oral Microorganisms from Herbal Medicine of Piper crocatum Ruiz & Pav

“…According to clinical indications, antifungal drugs are classified into two groups, the first group is antifungals for systemic infections, including: amphotericin B (1), flucytosine (2), ketoconazole (3), fluconazole (4), miconazole (5) 6), 27 the structure of the compounds are as shown in Figure 1. The second group of antifungals for dermatophyte and mucocutaneous infections includes griseofulvin (7), clotrimazole (8), econazole (9), isoconazole (10), tioconazole (11), bifonazole (12), nystatin (13), tolnaftate (14) and other topical antifungals candicidin (15), undecylenic acid (16) and natamycin (17), 37 the structure of the compounds is shown in Figures 2-3.…”

“…However, the use of synthetic anti-infectives has been reported to cause side effects and resistance, such as resistance to the antibiotics ampicillin, amoxicillin, penicillin, cefotaxime, cefazolin, methicillin, erythromycin, lincomycin, clindamycin and vancomycin against S. mutans, with the greatest resistance in 87 adults being to amoxicillin (14.8%) and lincomycin (28.7%), and the greatest resistance in 87 children being to penicillin (27.6%) and vancomycin (42.5%). [7][8][9] With regard to the resistance of several antifungal agents to C. albicans, it has been reported that C. albicans has a relatively high level of resistance to several antifungal agents, such as nystatin, fluconazole, flucytosine and echinocandin. [10][11][12][13] The ongoing development of anti-infective drugs underscores the paramount importance of efficacy and safety in identifying compounds with no adverse effects.…”

Emergence and Genomic Characterization of a spa Type t4407 ST6-SCCmec Type IVa Methicillin-Resistant Staphylococcus aureus Strain Isolated from Al-Karak Hospital, Jordan

“…Despite enhanced preventive measures and surveillance, MRSA remains an enduring challenge in Jordanian healthcare settings. Limited published reports exist to unveil the genotypes of MRSA in Jordan, indicating a significant gap in our understanding of the specific genetic characteristics of circulating strains [6][7][8][9][10][11][12][13][14][15][16][17]. Alzoubi et al (2014) investigated 210 nasal swabs from children aged 6-11 years and predominantly identified SCCmec type IV, with t223 as the primary spa type [18].…”