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Amaç: Bu çalışmanın amacı bazı türleri geleneksel olarak nevroz, sıtma, skrofula, uyuz, ateş, eksternal kanserler, incinme ve yara tedavisinde kullanılan Vincetoxicum cinsine ait iki taksonun (Vincetoxicum canescens subsp. pedunculata (VC) ve Vincetoxicum fuscatum subsp. fuscatum (VF)) tohumlarının antimikrobiyal, antibiyofilm aktiviteleri ve sinerjik etkilerini incelemektir.Yöntem: Öğütülmüş tohumlardan elde edilmiş etanollü ekstrelerin antimikrobiyal etkinlikleri mikrodilüsyon yöntemiyle 5 referans bakteri suşu (Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae) ve 2 referans maya suşuna (Candida albicans and Candida parapsilosis) karşı test edilmiştir. Ayrıca ekstrelerin P. aeruginosa’nın biyofilm oluşumunu inhibe etme ve oluşmuş biyofilm üzerine etkisi kristal viyole yöntemi ile değerlendirilmiştir. Biyofilm testleri ile minimum biyofilm inhibisyon konsantrasyonu (MBIC50) ve minimum biyofilm azaltma konsantrasyonu (MBRC50) belirlenmiştir. E.coli'ye karşı iki ekstre arasındaki sinerjik etkiyi değerlendirmek için ise mikrodilüsyon dama tahtası yöntemi kullanılmıştır.Bulgu: Ekstreler, test edilen bakteri ve mayaları 62,5–250 µg/mL minimum inhibisyon konsantrasyonları (MİK) aralığında inhibe etmiştir. VF ve VC ekstrelerinin 0,5X ve 0,25X MİK'de biyofilm oluşumunu sırasıyla %47, %39 ve %50, %34 oranında inhibe ettiği ve iki ekstrenin MBIC50 değerinin 62,5 µg/mL olduğu belirlenmiştir. Ayrıca ekstrelerin önceden oluşmuş biyofilmi 1X ve 2X MİK'de sırasıyla %54, %62 ve %56, %61 oranında inhibe ettiği ve MBRC50 değerinin 125 µg/mL olduğu belirlenmiştir. Dahası ekstrelerin E.coli'ye karşı aditif etki (FİK=0,62) gösterdikleri de tespit edilmiştir.Sonuç: Test edilen ekstreler orta ve düşük antimikrobiyal etki göstermekle birlikte hem biyofilm oluşumunu engelleme hem de oluşmuş biyofilmi ortadan kaldırmada iyi etkinliğe sahiptir., Aim: The aim of this study is to examine the antimicrobial, antibiofilm activities, and synergistic effects of the seeds of two Vincetoxicum taxa [Vincetoxicum canescens subsp. pedunculata (VC) and Vincetoxicum fuscatum subsp. fuscatum (VP)] of which some species have been traditionally used to treat neurosis, malaria, scrofula, scabies, internal fever, external cancers, injuries, and wounds. Methods: Antimicrobial activities of ethanolic extracts obtained from seeds were determined by the microdilution method against 5 reference bacterial strains (Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae) and 2 reference fungal strains (Candida albicans and Candida parapsilosis). Effect of the extracts on inhibiting biofilm formation and on formed biofilm was determined by the crystal violet method. Minimum biofilm inhibition concentration (MBIC50) and minimum biofilm reduction concentration (MBRC50) were determined by biofilm tests. The microdilution checkerboard method was used to evaluate the synergistic effect between the two extracts against E.coli.Results: The extracts inhibited the tested bacteria and yeasts in the minimum inhibition concentrations (MIC) range of 62.5–250 µg/mL. It was determined that tested VF and VC extracts inhibited biofilm formation by 47%, 39%, 50%, and 34% at 0.5X and 0.25X MIC, respectively, and the MBIC50 value of both extracts was 62.5 µg/mL. In addition, it was determined that the extracts inhibited the preformed biofilm by 54%, 62%, and 56%, and 61% at 1X and 2X MIC, respectively, and the MBRC50 value was 125 µg/mL. It was determined that the extracts showed an additive effect (FIC=0.62) against E.coli.Conclusions: Although the tested extracts have moderate and low antimicrobial effects, they have well effects both in preventing the formation of biofilm and in removing the formed biofilm

Günümüzde gram negatif bakterilerde karbapenem direncinin artması ile birlikte tedavilerde kolistin daha sık kullanılmaya başlanmıştır. Bunun bir sonucu olarak kolistine direnç giderek artmaktadır. Çalışmamızda, kolistin ve karbapenem dirençli Acinetobacter baumannii ve Klebsiella pneumoniae suşlarında akım sitometri tabanlı time kill ve dama tahtası sinerji testi yöntemleri ile kolistin ve meropenem kombinasyonunun in vitro etkinliğinin araştırılması amaçlandı. Kolistin ve karbapenem dirençli 10 adet A. baumannii ve 10 adet K. pneumoniae suşunda kolistin direnci broth mikrodilüsyon yöntemi ile doğrulandıktan sonra, kolistin ve meropenem kombinasyonu akım sitometri tabanlı time kill ve dama tahtası yöntemleri ile çalışıldı. Ek olarak suşlar, gradient difüzyon sinerji testi yöntemi ile de çalışıldı. Sonuçlar, dama tahtası ve GDY için fraksiyonel inhibitör konsantrasyonu, time kill için logaritma tabanında artış-azalış ile hesaplanarak değerlendirildi. Klebsiella pneumoniae suşlarında dama tahtası yöntemi ile %40 sinerjik, %50 aditif ve %10 indiferan etkinlik saptandı. A. baumannii suşlarında ise %70 sinerjik, %20 aditif, %10 indiferan etkinlik saptandı. Time kill yönteminde ise tüm suşlarda indiferan etkinlik saptandı. Akım sitometri tabanlı time kill ve dama tahtası yöntemleri arasında %10 uyum saptanırken, time kill ile GDY arasında %55 uyum saptandı. Literatürde akım sitometri tabanlı bir sinerji testi ile hasta izolatları kullanılarak antibiyotik kombinasyonu etkileşiminin incelendiği bir çalışmaya rastlamadık. Geleneksel yöntemi modernize etmesi, hızlı sonuç vermesi gibi yönleriyle çalışmamız dikkat çekicidir. Ancak sinerji testlerinin doğasında bulunan testler arası uyumsuzluk nedeniyle yeni çalışmalar ile testler arasındaki korelasyon iyileştirilmelidir. Nowadays, colistin has been used more frequently in treatments with the increase in carbapenem resistance in gram-negative bacteria. As a consequence, resistance to colistin is gradually increasing. It was aimed to investigate the in vitro efficacy of colistin and meropenem combination with both flow cytometry-based time-kill and checkerboard synergy test methods in colistin and carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae strains in this study. It was studied with both flow cytometry-based time-kill and checkerboard synergy test methods after colistin resistance was confirmed by broth microdilution method in ten different A. baumannii and ten different K. pneumoniae strains resistant to colistin and carbapenem. In addition, the strains also studied with the gradient diffusion synergy test method. The results were evaluated by calculating the fractional inhibitor concentration for the checkerboard and gradient diffusion synergy test method and the increase-decrease at the logarithm base for the time kill. It was found that the synergistic, additive, and indifference efficacy for Klebsiella pneumoniae strains were 40%, 50%, and 10%, and also for A. baumannii strains were 70%, 20%, and 10% respectively considering the checkerboard method. However, indifference activity was observed in all strains in the time-kill method. 55% agreement was found between flow cytometry-based time kill and gradient diffusion while it was meeting 10% of correlation between flow cytometry-based time-kill and checkerboard synergy test methods. We could not find any study about the interaction of antibiotic combinations using a flow cytometry-based synergy test on patient isolates in the literature. This study is remarkable considering modernizing the traditional method and taking quick results. However, the correlation between the tests should be improved because of the inconsistency between the tests inherent in synergy tests.

Objective: Combination therapy is needed to treat extensively drug-resistant (XDR) Acinetobacter baumannii infection. Colistin (Col) in combination with another drug is usually used for that purpose. The aim of this study was to determine the activity of antimicrobial combinations against XDR A. baumannii using both standard checkerboard (CB) method and E-test. E-test was also evaluated for application in a diagnostic bacteriology laboratory by comparing its efficacy with that of CB method. Methods: Eighty clinical isolates of XDR A. baumannii were used to determine the activity of the following antimicrobial combinations by CB method and E-test: Col+cefoperazone/sulbactam (Cps), Cps+moxifloxacin (Mox), and Col+Mox. Comparison of CB and E-test was also evaluated. Results: By CB method, Col+Cps yielded a synergistic effect rate (12.5%) higher than those of the other 2 combinations (CpS+Mox 5% and Col+Mox 0%). The majority of test results revealed additivity. Col+Cps, Cps+Mox, and Col+Mox exhibited additive effect against 78.75%, 85.0%, and 87.5% of isolates, respectively. Overall, E-test and CB yielded only 37.5% concordant rates. However, high concordant rates were specifically observed in additive effect of Col+Cps (73.8%) and Cps+Mox (80.4%). Conclusion: Col+Cps exhibited better activity than the other two combinations against XDR A. baumannii. E-test is the method that should be used, but its use is limited to the additive results of Col+Cps and Cps+Mox.

Introduction:the emergence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (E-ESBLs) is currently a major public health problem in the world and, in particular, in developing countries. In Cameroon, data on E-ESBLs are rare, especially in Garoua and in the northern region of the country. The objective of this study is to document the epidemiology of E-ESBL infections in small children and to explore their associations with possible risk factors. Methods:this was a cross-sectional, descriptive study conducted from June 14 to September 30, 2018, including small children with suspected urinary tract infections (UTI) attending the outpatient pediatric departments of two health facilities in the city of Garoua. Urine samples were analyzed at the Bacteriology Laboratory of the Pasteur Center of Cameroon, Annex Garoua. Bacterial culture was carried out on Bio-Rad UriSelect® chromogenic agar and the identification was confirmed by bioMérieux API 20E. The antibiotic susceptibility was determined using the bioMérieux ATB UR gallery and the ESBL phenotype was detected by the double disk synergy method according to the CA-SFM 2013 recommendations. The data was analyzed with the R Statistical Software version 2.15.2. Results:a total of 57 urine samples were collected from children aged from one month to two years, 37 boys and 20 girls. Bacteria were detected by culture in 20 samples:Escherichia coliwas the most frequently (75 %) isolated species followed byKlebsiella pneumoniae(25%). More than half of the infected samples (55%) contained E-ESBL. The presence of an ESBL was significantly associated with previous antibiotic intake up to 3 months prior current UTI (p=0.01664). The E-ESBL strains showed co-resistance to different antibiotics. Conclusion:this study reveals the important dissemination of E-ESBLs among small children in the community and a high rate of co-resistance to the different antibiotic families commonly used.

Infections due Scedosporium spp. in lung transplant recipients are associated with disseminated disease with high mortality rates. The adjunctive local antifungal therapy may be a useful option when systemic treatment is insufficient and/or surgery is not feasible. We present a case of mixed disseminated infection due Scedosporium apiospermum and S. prolificans in a lung transplant recipient. Combined local and systemic antifungal therapy provided an unusual long-term survival in the intensive care unit. Sí

非顯而易知性的判斷標準，一直是美國專利法實務與學界想要嘗試解決的問題之一。本文認為，由於客觀證據與時間因素，可呈現出發明當時的狀態，因此，符合美國專利法第103 條的文義要求，而應被優先考量。因此，本文嘗試將最高法院於Graham 案中提出的「輔助性判斷因素」，加入美國學界所提出之「時間判斷法」判斷架構中，主張若有客觀證據可證明，同業與發明人面臨相同的發明條件，卻只有發明人成功解決他人無法克服的需求，則發明即可合理被認為非顯而易知。本研究之最大貢獻在於克服先前判斷標準之判斷困境，特別是在KSR 案中仍未解決的後見偏差問題。 The test of obviousness has long been a problem which the courts and scholars in U.S. are trying to resolve. This Article argues the objective indicia and the timing of invention should have priority when considering nonobviousness, because these factors can demonstrate the conditions at the time the invention was made and therefore fit the requirement of Section 103 of Patent Law. Hence, this Article tries to merge “Secondary Consideration” mentioned in Graham case by Supreme Court with “the Timing Approach” raised by scholar, and argues if there are objective evidences to prove that the person having ordinary skill in the art faces the same conditions of invention, only the inventor can resolve the problem successfully while others cannot, then the invention can be reasonably seen as nonobvious. The most contribution of this research is overcoming problems of previous tests of nonobviousness, especially the hindsight problem which was still not solved in KSR case. solved in KSR case.

The Vitek-2 extended-spectrum β-lactamase (ESBL) test was assessed using a collection of 94 ESBL-positive and 71 ESBL-negative non-duplicate isolates of Enterobacteriaceae. These isolates produced a wide diversity of well-characterised β-lactamases, including 61 different ESBLs, two class A carbapenemases and various species-specific β-lactamases. ESBL detection was performed using (i) the conventional synergy test as recommended by the Comite de l'Antibiogramme de la Societe Francaise de Microbiologie, (ii) the CLSI phenotypic confirmatory test for ESBLs, and (iii) the Vitek-2 ESBL test. For Escherichia coli and klebsiellae, the sensitivity/specificity values were 97.3%/96.9% for the synergy test, 91.8%/100% for the CLSI phenotypic confirmatory test, and 91.8%/100% for the Vitek-2 ESBL test. For other organisms, the sensitivity/specificity values were 100%/97.4% for the synergy test, 90.5%/100% for the CLSI phenotypic confirmatory test, and 90.5%/100% for the Vitek-2 ESBL test. The Vitek-2 ESBL test seemed to be an efficient method for routine detection of ESBL-producing isolates of Enterobacteriaceae, including isolates producing AmpC-type enzymes.