Osong Public Health and Research Perspectives

Environmental emergence and dissemination of clinically relevant multidrug-resistant bacteria and resistance genes in sewage and aquatic ecosystems: Smita Atara, Komal Antaliya, Nilam Vaghamshi, Ashaka Vansia, Anjana Ghelani, Rajesh Patel, Pravin Dudhagara; Received February 19, 2026 Accepted May 28, 2026 Published online July 23, 2026; DOI: https://doi.org/10.24171/j.phrp.2026.0186 [Epub ahead of print]

Objectives
This study characterized multidrug-resistant (MDR) bacteria in sewage, river, and marine ecosystems in South Gujarat, India.
Methods
Water samples were collected from 25 hospital drainage, sewage treatment/pumping, Tapi River, and coastal marine sites at multiple time points. From 270 screened colonies, 166 morphologically and biochemically distinct nonduplicate isolates were retained. Antimicrobial susceptibility was assessed, and isolates were classified as MDR, extensively drug-resistant (XDR), or pan-drug-resistant (PDR). Biofilm formation, metabolic activity, extracellular polymeric substance protein, heavy metal tolerance, extended-spectrum β-lactamase production, carbapenemase production, and metallo-β-lactamase activity were assessed phenotypically. Tapi River estuary water was used for taxonomic profiling and antibiotic resistance gene (ARG) detection.
Results
The 166 isolates comprised 45 bacterial species, with clinically significant Gram-negative pathogens predominating, including Pseudomonas aeruginosa (n=24, 14.5%), Ochrobactrum intermedium (n=16, 9.6%), Stenotrophomonas maltophilia (n=15, 9.0%), and Escherichia coli (n=12, 7.2%). MDR phenotypes were detected in 80.1% of isolates; 18.1% were XDR, and 1.8% were PDR, with PDR isolates confined to river water samples. Biofilm formation was observed in 86.1% (n=143) of isolates, including 28.3% (n=47) strong, 24.7% (n=41) moderate, and 32.5% (n=54) weak producers. Extended-spectrum β-lactamase production was confirmed in 13.4% of Gram-negative isolates, and carbapenemase activity was detected in 11 isolates. Zinc and copper tolerance were significantly higher in XDR than in MDR isolates (p<0.05). Metagenomics identified efflux pumps as the dominant ARG class (36.2%), followed by target-site mutations (21.3%) and β-lactamases (14.9%), and detected blaCTX-M-15, blaTEM-207, gyrA, and parC.
Conclusion
These interconnected aquatic systems represent important reservoirs for community-level antimicrobial resistance transmission.

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Genetic profiling of the tolC component of the acrAB-TolC efflux pump in clinical Klebsiella pneumoniae isolates: a cross-sectional study in Pontianak, Indonesia: Mardhia Mardhia, Delima Fajar Liana, Sari Eka Pratiwi, Mahyarudin Mahyarudin, Risa Agustina; Osong Public Health Res Perspect 2026;17(3):254-261.
Published online April 20, 2026; DOI: https://doi.org/10.24171/j.phrp.2025.0573

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Applying biotechnology to overcome cancer drug resistance and improve public health outcomes: Franklin Akwasi Adjei, Bernard Kwame Frempong, Augustine Afriyie; Osong Public Health Res Perspect 2026;17(1):4-16.
Published online February 4, 2026; DOI: https://doi.org/10.24171/j.phrp.2025.0336

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Prevalence, multidrug resistance, and biofilm formation of Vibrio parahaemolyticus isolated from fish mariculture environments in Cat Ba Island, Vietnam: Kim Cuc Thi Nguyen, Phuc Hung Truong, Hoa Truong Thi, Xuan Tuy Ho, Phu Van Nguyen; Osong Public Health Res Perspect 2024;15(1):56-67.
Published online February 19, 2024; DOI: https://doi.org/10.24171/j.phrp.2023.0181

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Drug resistance and the genotypic characteristics of rpoB and katG in rifampicin- and/or isoniazid-resistant Mycobacterium tuberculosis isolates in central Vietnam: Thi Binh Nguyen Nguyen, Thi Kieu Diem Nguyen, Van Hue Trương, Thi Tuyet Ngoc Tran, van Bao Thang Phan, Thi Tuyen Nguyen, Hoang Bach Nguyen, Viet Quynh Tram Ngo, Van Tuan Mai, Paola Molicotti; Osong Public Health Res Perspect 2023;14(5):347-355.
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Analysis of Resistance to Macrolide–Lincosamide–Streptogramin B Among mecA-Positive Staphylococcus Aureus Isolates: Mahmoud Khodabandeh, Mohsen Mohammadi, Mohammad Reza Abdolsalehi, Azadeh Alvandimanesh, Mehrdad Gholami, Meysam Hasannejad Bibalan, Abazar Pournajaf, Ramin Kafshgari, Ramazan Rajabnia; Osong Public Health Res Perspect 2019;10(1):25-31.
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<sec> <title>Objectives</title> Genetic determinants conferring resistance to macrolide, lincosamide, and streptogramin B (MLSB) via ribosomal modification such as, <italic>erm</italic>, <italic>msrA/B</italic> and <italic>ereA/B</italic> genes are distributed in bacteria. The main goals of this work were to evaluate the dissemination of MLSB resistance phenotypes and genotypes in methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) isolates collected from clinical samples.</sec> <sec> <title>Methods</title> A total of 106 MRSA isolates were studied. Isolates were recovered from 3 hospitals in Tehran between May 2016 to July 2017. The prevalence of MLSB-resistant strains were determined by D-test, and then M-PCR was performed to identify genes encoding resistance to macrolides, lincosamides, and streptogramins in the tested isolates.</sec> <sec> <title>Results</title> The frequency of constitutive resistance MLSB, inducible resistance MLSB and MSB resistance were 56.2%, 22.9%, and 16.6%, respectively. Of 11 isolates with the inducible resistance MLSB phenotype, <italic>ermC</italic>, <italic>ermB</italic>, <italic>ermA</italic> and <italic>ereA</italic> were positive in 81.8%, 63.6%, 54.5% and 18.2% of these isolates, respectively. In isolates with the constitutive resistance MLSB phenotype, the prevalence of <italic>ermA</italic>, <italic>ermB</italic>, <italic>ermC</italic>, <italic>msrA</italic>, <italic>msrB</italic>, <italic>ereA</italic> and <italic>ereB</italic> were 25.9%, 18.5%, 44.4%, 0.0%, 0.0%, 11.1% and 0.0%, respectively.</sec> <sec> <title>Conclusion</title> Clindamycin is commonly administered in severe MRSA infections depending upon the antimicrobial susceptibility findings. This study showed that the D-test should be used as an obligatory method in routine disk diffusion assay to detect inducible clindamycin resistance in MRSA so that effective antibiotic treatment can be provided.</sec>

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In Vitro Antibacterial Efficacy of 21 Indian Timber-Yielding Plants Against Multidrug-Resistant Bacteria Causing Urinary Tract Infection: Monali P. Mishra, Rabindra N. Padhy; Osong Public Health Res Perspect 2013;4(6):347-357.
Published online December 31, 2013; DOI: https://doi.org/10.1016/j.phrp.2013.10.007

Objectives
To screen methanolic leaf extracts of 21 timber-yielding plants for antibacterial activity against nine species of uropathogenic bacteria isolated from clinical samples of a hospital (Enterococcus faecalis, Staphylococcus aureus, Acinetobacter baumannii, Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa).
Methods
Bacterial strains were subjected to antibiotic sensitivity tests by the Kirby–Bauer's disc diffusion method. The antibacterial potentiality of leaf extracts was monitored by the agar-well diffusion method with multidrug-resistant (MDR) strains of nine uropathogens.
Results
Two Gram-positive isolates, E. faecalis and S. aureus, were resistant to 14 of the 18 antibiotics used. Gram-negative isolates A. baumannii, C. freundii, E. aerogenes, E. coli, K. pneumoniae, P. mirabilis, and P. aeruginosa were resistant to 10, 12, 9, 11, 11, 10, and 11 antibiotics, respectively, of the 14 antibiotics used. Methanolic leaf extracts of Anogeissus acuminata had the maximum zone of inhibition size—29 mm against S. aureus and 28 mm against E. faecalis and P. aeruginosa. Cassia tora had 29 mm as the zone of inhibition size for E. faecalis, E. aerogenes, and P. aeruginosa. Based on the minimum inhibitory concentration and minimum bactericidal concentration values, the most effective 10 plants against uropathogens could be arranged in decreasing order as follows: C. tora > A. acuminata > Schleichera oleosa > Pterocarpus santalinus > Eugenia jambolana > Bridelia retusa > Mimusops elengi > Stereospermum kunthianum > Tectona grandis > Anthocephalus cadamba. The following eight plants had moderate control capacity: Artocarpus heterophyllus, Azadirachta indica, Dalbergia latifolia, Eucalyptus citriodora, Gmelina arborea, Pongamia pinnata, Pterocarpus marsupium, and Shorea robusta. E. coli, followed by A. baumannii, C. freundii, E. aerogenes, P. mirabilis, and P. aeruginosa were controlled by higher amounts/levels of leaf extracts. Phytochemicals of all plants were qualitatively estimated.
Conclusions
A majority of timber-yielding plants studied had in vitro control capacity against MDR uropathogenic bacteria.

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Comparison of Antimicrobial Resistance in Escherichia coli Strains Isolated From Healthy Poultry and Swine Farm Workers Using Antibiotics in Korea: Seung-Hak Cho, Yeong-Sik Lim, Yeon-Ho Kang; Osong Public Health Res Perspect 2012;3(3):151-155.
Published online June 30, 2012; DOI: https://doi.org/10.1016/j.phrp.2012.07.002

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The Emergence of Oseltamivir-Resistant Seasonal Influenza A (H1N1) Virus in Korea During the 2008-2009 Season: Woo-Young Choi, Inseok Yang, Sujin Kim, Namjoo Lee, Meehwa Kwon, Joo-Yeon Lee, Chun Kang; Osong Public Health Res Perspect 2011;2(3):178-185.
Published online December 31, 2011; DOI: https://doi.org/10.1016/j.phrp.2011.11.042

Objectives
To monitor antiviral drug resistance among seasonal influenza viruses isolated in Korea during the 2008-2009 influenza season, we examined influenza isolates collected through Korea Influenza Surveillance Scheme for antiviral drug susceptibility.
Methods
For genetic analysis of antiviral drug resistance, the matrix (M2) and neuraminidase (NA) genes of each isolate were amplified by reverse transcription-polymerase chain reaction and followed by nucleotide sequencing. For phylogenetic analyses, the sequences of hemagglutinin (HA) and NA genes of each isolate were aligned using multiple alignment program. For phenotypic analysis of antiviral drug resistance, drug susceptibilities against M2 inhibitor (amantadine) and NA inhibitors (oseltavimir and zanamivir) were determined by virus yield reduction assay and fluorometric NA inhibition assay, respectively.
Results
In Korea, the resistant influenza viruses against oseltamivir were first detected in sealsonal influenza A(H1N1) viruses on Week 48 of 2008. Since then, the number of oseltamivir-resistant A(H1N1) viruses was continuously increased and had reached the highest peak on Week 52 of 2008. 533 (99.8%) of 534 A(H1N1) viruses were resistant to oseltamivir and all of them harbored the H275Y mutation in the NA gene during the 2008-2009 season. The oseltamivir resistance identified by sequencing was confirmed by NA inhibition assay. Genetic analysis based on HA gene of the resistant A(H1N1) viruses revealed that the viruses were identified as A/Brisbane/10/2007-like strain which was vaccine strain for the 2008-2009 season.
Conclusions
The oseltamivir-resistant A(H1N1) viruses were first emerged in Europe in November 2007 and then circulated globally. One year later, the oseltamivir-resistant A(H1N1) viruses were first detected in Korea in November 2008 and continued circulating until the Week 7 of 2009 during the 2008-2009 season. Considering the pandemic preparedness, it should be continued to monitor the emergence and the characterization of antiviral drug resistant influenza viruses.

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Prevalence of Antibiotic Resistance in Escherichia coli Fecal Isolates From Healthy Persons and Patients With Diarrhea: Seung-Hak Cho, Yeong-Sik Lim, Mi-Sun Park, Seong-Han Kim, Yeon-Ho Kang; Osong Public Health Res Perspect 2011;2(1):41-45.
Published online June 30, 2011; DOI: https://doi.org/10.1016/j.phrp.2011.05.003

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