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Introduction/Objective Neisseria gonorrhoeae (NG) is the 2nd most common cause of sexually transmitted infection worldwide. WHO data from 2009-14 showed widespread resistance to ciprofloxacin (97%), azithromycin (81%), and oral cefixime and injectable ceftriaxone (66%). We have investigated local epidemiology of antimicrobial resistance in PCR-confirmed NG by chromosomal multi-locus sequence typing and analysis. Methods/Case Report Clinical specimens of 85 patients who tested positive for NG using automated PCR (COBAS 4800; Roche Diagnostics) were used in this study. The samples were amplified by PCR using 10 primers (Integrated DNA Technologies, USA) targeting seven antibiotic resistance-associated loci in the bacterial chromosome (penA, mtrR, ponA, porB, gyr, parC and 23s rRNA) and sequenced on a 48-channel ABI 3730 Sanger sequencer (Thermo Fisher). The resulting sequences were analyzed using the NG Sequence Typing for Antibiotic Resistance (NG-STAR) database for matching alleles, correlating to clinical resistance. Results were analyzed by Chi-square or Fisher’s exact tests. Results (if a Case Study enter NA) Most patients positive for NG were non-Hispanic Black males (60%), with mean age of 25 years (range: 14-53 years). 23.5% had Chlamydia trachomatis (CT) co-infection, and 29.4% had other sexually transmitted infections, such as syphilis, HIV and HPV. 15.0% had previous NG infection, and 12% had previous CT infection. Sixty-five samples (76.5%) yielded at least one gene locus with a DNA sequence with >95% similarity in the NG-STAR database. About half (50.6%) of these sample had confirmed resistance mutations, 5 of which indicated resistance to multiple antibiotics. All specimens with porB and gyr mutations were resistant to penicillins, ceftriaxone, cefixime, erythromycin, tetracycline and ciprofloxacin. Most of those with mtrR mutations were resistant to ciprofloxacin. Most of those with mutations (with or without resistance) had previous NG infection. Significant correlation was observed between those with at least 1 mutated gene locus and CT co-infection (p=0.0001). Conclusion A significant proportion of our patients tested positive for resistance mutations, a majority of whom had previous NG infection. There was significant correlation between the presence of mutations and CT co-infection. These findings warrant utilization of culture and sensitivity testing in patients with previous NG and CT co-infection.

The study reports the MDR, ESBL, and NDM producing Escherichia coli (CRE) isolated from the rescued sloth bear (Melursus ursinus), India. The faecal samples of adult rescued sloth bear (n=21) were collected from a rescue center located in India during 2015-2016 and processed for isolation and antibacterial susceptibility pattern of E. coli. 45E. coli isolates were recovered, and on phenotypic screening, 23 were MDR, 17 were ESBL producers, and five were carbapenem-resistant (CR). The MDR isolates carried beta-lactamase, chloramphenicol, aminoglycosides, tetracycline, fluroquinone, and sulphadimidine resistance genes. All the phenotypic ESBL producing isolates had blaCTX-M genes. On genotypic screening, three CRE (60.0 %, 3/5) were positive for blaNDM carbapenemase gene. Efflux pump-mediated carbapenem resistance was noticed in two CRE isolates (40.0 %, 2/5).The CRE also isolates co-harbored AMR genes like blaTEM-1, blaAmpC, qnrA, qnrB, qnrS, tetA, tetB and sulI. Virulence screening of the resistant isolates revealed the presence of Stx1, Stx2, eae, hlyA genes.Plasmid incompatibility (Inc) typesof three NDM positive isolates revealed that two isolates blaNDM-5 gene on Incl1 an one isolate on IncF plasmid. Apart from NDM genes, the plasmids also carried tetracycline, beta-lactamase and quinolone resistance genes. The plasmid multilocus sequence typing (pMLST) of the E. coli Incl1 plasmid showed the Sequence Type (ST) 297.This appears to be the first report of multi-drug resistant, extended spectrum beta-lactamase (ESBL) producing and blaNDM-5geneson Incl1 and IncF plasmids in rescued sloth bear.

Bacterial resistance to conventional antibiotics is a growing issue, and the development of novel antimicrobial compounds has not been able to keep pace with the emergence of multi drug resistant pathogens. Antimicrobial peptides are source of inspiration for the development of next generation antimicrobial drugs; however, there are key limitations to the use of natural antimicrobial peptides, owing in large part to common pharmacological features that preclude their use outside of topical applications. The development of novel antimicrobial peptides and peptidomimetics via strategic chemical alterations is a means of improving on the functionality of natural antimicrobial peptides while tuning their pharmacological properties and in some instances, imparting novel mechanisms of action and functions outside of bactericidal activity as well.

The increasing global threat of multi drug resistant pathogens is indicating that this is the time to put together our efforts to develop some approaches to turn down the spread of drug resistivity among the microbial world. The best way to reduce the evolution of antimicrobial resistance is to eliminate the heavy burden of antibiotics from our environment. The unfeasibility of elimination of antibiotics from our healthcare system directs us to develop some effective means to reduce their use at the least level. For this, we need to shift from completely antibiotic dependent therapeutic strategy to the multiple prophylactic and therapeutic approaches. Substantial efforts are being invested worldwide to find the sustainable line of defense against the rising pressure of antimicrobial resistance.

The global increase in infections by multi-drug resistant (MDR) pathogens is severely impacting our ability to successfully treat common infections. Herein, we report the antibacterial activity against S. aureus and E. faecalis (including some MDR strains) of a panel of adarotene-related synthetic retinoids. In many cases, these compounds showed, together with favorable MICs, a detectable bactericidal effect. We found that the pattern of substitution on adarotene could be modulated to obtain selectivity for antibacterial over the known anticancer activity of these compounds. NMR experiments allowed us to define the interaction between adarotene and a model of microorganism membrane. Biological assessment confirmed that the scaffold of adarotene is promising for further developments of non-toxic antimicrobials active on MDR strains.

BackgroundBacterial infections are a frequent cause of hospitalization and a leading cause of death, particularly with the emergence of antibiotics resistance. The emergence of Carbapenem resistance among gram-negative bacteria (GNB) is one of the evolving alerts as its use is considered the last resort of treatment [1]. Therefore, this urged studying the risk factors for the development of multi-drug resistant [2] GNB, identify the clinical outcomes and factors associated with mortality, especially among critically ill patients who are expected to have the worst outcomes.Materials/methodsThis is a retrospective observational study of critically ill patients who had an infection with Carbapenem-resistant Enterobacteriaceae (CRE), or MDR Pseudomonas aeruginosa, or MDR Acinetobacter spp. between May 2016- Nov 2018. Baseline demographics, co-morbidities, and clinical outcomes were collected and were evaluated for association with 28 days mortality. ResultsA total of 255 patients with MDR Gram-negative cultures were screened, 77 patients met the inclusion criteria. Pseudomonas aeruginosa was the most common index organism (53% of patients), followed by Acinetobacter spp. and CRE, respectively. The mortality rate at 28 days was (59.7%). Non-survivors were significantly older (mean age 64 vs. 44 years, P= 0.0001), had significantly worse disease severity scores on ICU admission, higher incidence of chronic kidney disease (CKD) (43% vs. 16%, P= 0.010), required more continuous renal replacement therapy (CRRT) (54% vs. 13% P= 0.0001), had longer hospital length of stay prior to infection (median 34 vs. 13 days, P= 0.018), and required longer inotropic and vasopressors support (median 19 vs. 8 days, P = 0.0001). In multivariate logistic regression the following factors were significantly associated with mortality; requirement of inotropic support [OR 10.01 (95% CI 1.55-64.77); P= 0.015], age [OR 1.05 (95% CI 1.0-1.1); P=0.01], APACHE IV score on ICU admission [OR 1.03 (95% CI 1.0- 1.06); P= 0.04], and ICU length of stay [OR 1.03 (95% CI 1.0- 1.06); P= 0.035].ConclusionMDR Gram-negative infection is associated with significant in-hospital mortality among critically ill patients. Old age, high APACHE IV score, higher ICU length of stay, and higher hemodynamic support are associated with higher mortality.Trial registrationretrospectively registered.

Introduction: This study aims to assess the in vitro activity of ceftazidime-avibactam (CZA) and ceftolozane-tazobactam (C/T) against the multi-drug resistant (MDR) Klebsiella pneumoniae. Furthermore, we aimed to determine the types of carbapenemase enzyme responsible for carbapenem resistance and compare the activity of ceftolozane-tazobactam and CZA according to the types of carbapenemase enzymes produced. Materials and Methods: Twenty-two MDR isolates were investigated in the study. The identification and antimicrobial susceptibilities of the isolates were performed by VITEK 2 (BioMérieux, France) automated system. The activity of C/T and CZA was determined by the gradient strip test (Liofilchem MIC strip test, Italy). In all K. pneumoniae isolates, blaIMP-1, blaKPC, blaNDM-1, blaOXA-48 and blaVIM gene regions encoding the carbapenemase enzyme were investigated by using Xpert CARBA-R test kits (Cepheid, Sunnyvale, CA, USA) of the Gene-Xpert® system. Results: Ceftolozane-tazobactam resistance was detected in 21 (95%) isolates, whereas CZA resistance was detected in six (27%) isolates. Among the 22 K. pneumoniae isolates, NDM-1 gene region was detected in three, NDM-1+OXA-48 gene region was detected in two, OXA-48 was detected in eight, and KPC gene region was detected in nine isolates. VIM and IMP-1 gene regions were not detected. Ceftolozane-tazobactam resistance was detected in seven isolates, whereas CZA resistance was not detected among the eight K. pneumoniae isolates producing only OXA-48. NDM-1 and OXA-48 co-producing isolates were detected resistant to C/T and CZA with high minimum inhibitory concentration (MIC) levels (MIC ≥256 µg/ml). All NDM-1 producing isolates had high MIC levels (MIC ≥256 µg/ml) to both C/T and CZA. Ceftazidime-avibactam resistance was detected in only one isolate, whereas C/T resistance was detected in all K. pneumoniae isolates producing KPC. Ceftolozane-tazobactam was detected inefficient whereas CZA was found very efficient in MDR K. pneumoniae isolates producing KPC. Conclusion: According to the obtained data, we detected the in vitro antibacterial activity of CZA against the MDR K. pneumoniae isolates was superior to that of C/T. Ceftolozane-tazobactam was found to be weakly efficient, whereas CZA was found to be highly efficient against the MDR K. pneumoniae isolates producing OXA-48 and KPC. Because avibactam can inhibit the activity of KPC-type carbapenemase, the combination drug CZA should be considered to be effective in the treatment of KPC-type carbapenemase-producing strains but noneffective against NDM-type carbapenemase-producing strains.

Background There is a global rise in multi-drug resistant (MDR) Gram-negative Enterobacteriaceae. Both maternal and neonatal gut colonization with pathogenic E. coli is associated with risk of invasive infection in infancy. Infections caused by MDR strains have delayed effective therapy and higher morbidity. Additionally, extended spectrum beta-lactamase producing (ESBL) E. coli are persistent gut colonizers. Perinatal transmission of ESBL E. coli could therefore have profound impact on the infant microbiota and health. Our aims were to 1) Determine the burden of ESBL Enterobacteriaceae (ESBL-E) colonization and rate of perinatal transmission among healthy mother-infant dyads in the Chicago area and 2) Compare rates of perinatal transmission among commensal, antibiotic-susceptible human E. coli strains versus ESBL E. coli strains in a mouse model. Methods This is an ongoing prospective study of healthy mothers and term infants born vaginally between 7/2020-11/2020. Maternal demographic and medical history data were collected, including age, race/ethnicity, international travel, and pregnancy/delivery information. Maternal rectal and vaginal swabs (n=62) were collected during labor. Clinical samples were initially grown in media supplemented with ampicillin and vancomycin to suppress growth of most susceptible commensal organisms. The sample was then plated on MacConkey agar (+/-ceftriaxone). We also developed a mouse model of perinatal transmission to determine the rate of transmission among ESBL E. coli compared to the commensal E. coli strain MG1655 and the pan-sensitive uropathogenic E. coli strain UTI89. Pups were sacrificed at 24–48 hours of life or 7 days of life, and presence of antibiotic resistant E. coli was noted. Results Human: Median maternal age was 32 years (IQR 30–35). Race was primarily white (84%), 11% Asian, and 10% were of Latina ethnicity. There were 30 (48%) female infants, and 42 (68%) infants received exclusive breastmilk. About half of the mothers reported international travel in the past 2 years (28/62, 45%), and 17/62 (27%) were born outside the USA. Ampicillin resistant (Amp-R) Enterobacteriaceae were recovered from rectal samples of 59/62 (95%) and vaginal samples of 16/62 (26%) mothers. Ten of 62 (16%) mothers were colonized with ESBL-E. Over half of infant stool samples (27/49, 55%) grew Amp-R Enterobacteriaceae. Of 6 mother-infant dyads with maternal ESBL-E colonization and infant stool available, 2 (33%) infants grew out ESBL-E. Murine We tested 4 ESBL E. coli strains and 2 control strains (MG1655 and UTI89) in our perinatal transmission model. We noted that while all strains adequately colonized the gut of the dams, only 2 (ST132 and ST511) of the 4 ESBL E. coli strains and none of the control strains were transmitted efficiently to the mouse pups (Figure 1). Conclusions There is notable community colonization of resistant Enterobacteriaceae among healthy mothers in Chicago with significant transmission to infants. Murine model data shows that human ESBL E. coli strains can colonize pregnant dams, and some ESBL E. coli strains appear to be perinatally transmitted more efficiently than non-drug resistant and commensal E. coli strains. Persistence of colonization, genomic factors related to transmission, and impact on the developing infant microbiome are future directions of study.

Infectious diseases are an important growing public health problem, which perspective has worsened due to the increasing number of drug-resistant strains in the last few years. Although diverse solutions have been proposed, one viable solution could be the use of immune system modulators. The induction of the immune response can be increased by histone deacetylase inhibitors (iHDAC), which in turn modulate the chromatin and increase the activation of different cellular pathways and nuclear factors such as STAT3, HIF-1α NF-kB, C/EBPα and, AP-1. These pathways are capable to promote several immune response-related molecules including those with antimicrobial properties such as antimicrobial peptides (AMPs) that lead to the elimination of pathogens including multi drug-resistant strains.

It is estimated that about 25% of humanity is infected with the bacterium Mycobacterium tuberculosis. Thatis about 2 billion people. Several new vaccines will pass Phase I clinical trials in the next few years. Thispaper briefly summarizes past and present challenges to developing a vaccine against tuberculosis as well astreating tuberculosis. TB is a pathogen that infects more individuals globally than any other communicabledisease. TB is particularly devastating in poor developing countries, notably in Africa and Southeast Asia.Despite the WHO’s efforts to overcome TB, Multi Drug Resistant (MDR) TB and Extremely Drug Resistant(XDR) TB are huge challenges.

A suspected outbreak of multi-drug resistant (MDR) Klebsiella pneumoniae in a Malawian neonatal unit was investigated using whole-genome sequencing. Strain-types, virulence and resistance genes of K. pneumoniae isolated from patients from the hospital over a four-year period were identified. A MDR ST340 clone was implicated as the likely outbreak cause.

Background Multiple infection outbreaks have been linked to contaminated duodenoscopes worldwide. However, the contamination rate of patient-ready duodenoscopes varies highly amongst published studies testing this subject. We aimed to estimate the contamination rate of reprocessed patient-ready duodenoscopes for endoscopic retrograde cholangio-pancreatography (ERCP) based on currently available data. Methods We searched the PubMed and Embase databases from January 1, 2010 until March 10, 2020, for citations investigating contamination rates of reprocessed patient-ready duodenoscopes. Studies not assessing other types of endoscopes than duodenoscopes were excluded from the analysis. Study eligibility and data extraction was evaluated by three reviewers independently. A random-effects model (REM) based on the proportion distribution was used to calculate the pooled total contamination rate of reprocessed patient-ready duodenoscopes. Subgroup analyses were carried out to assess contamination rates when using different reprocessing methods by comparing single high-level disinfection (HLD) with double HLD and ethylene oxide (EtO) gas sterilization. Additionally, we investigated the contamination rate between studies conducted following an outbreak compared to non-outbreak-initiated studies. Findings We identified 15 studies that fulfilled the inclusion, which included 925 contaminated duodenoscopes from 13,112 samples. The calculated total weighted contamination rate was 15.25% ± 0.018 (95% confidence interval [Cl]: 11.74% - 18.75%). The contamination rate after only using HLD was 16.14% ± 0.019 (95% Cl: 12.43% - 19.85%) and after using either dHLD or EtO the contamination rate decreased to 9.20% ± 0.025 (95% Cl: 4.30% - 14.10%). Studies conducted following an outbreak (n=4) showed a 5.72% ± 0.034 (95% Cl: 0.00% - 12.43%) contamination rate, and non-outbreak-initiated studies (n=11) revealed a contamination rate of 21.50% ± 0.031 (95% Cl: 15.35% - 27.64%). Interpretation This is the first meta-analysis to estimate the contamination rate of patient-ready duodenoscopes used for ERCP. Based on the available literature, our analysis demonstrates that there is a 15.25% contamination rate of reprocessed patient-ready duodenoscopes. Additionally, the analysis indicates that dHLD and EtO reprocessing methods are superior to single HLD but still not efficient in regards to cleaning the duodenoscopes properly. Furthermore, studies conducted following an outbreak did not entail a higher contamination rate compared to non-outbreak-initiated studies. Funding The authors received no financial support for the research, authorship, and/or publication of this article.

The off-target delivery as well as multi-drug resistance (MDR) are generally recognised as two keys difficulties responsible for the poor performance of chemotherapy in clinical treatment of cancer. With the aim to address the problems, we herein constructed iRGD modified and lipid-coated silica (LSC) nanoparticles co-delivering Ca2+ channel siRNA and adriamycin (Adr) to reverse the MDR in liver cancer (LSC/R-A). The iRGD decoration was suggested to elevate the tumour accumulation of the drug delivery system (DDS). In addition, the introduction of Ca2+ channel siRNA was proved to reverse the MDR within the cells of cancer by regulation the T-type Ca2+ channels. Our results showed that decreased expression of T-type Ca2+ channels resulted in lowered cytosolic Ca2+ level responsible for the cell cycle arrest (at G0/G1 phase) as well as elevated cellular drug retention in HepG2/Adr. B in vitro/in vivo experiments revealed that LSC/R-A exerted highly elevated therapeutic outcome on HepG2/Adr, than administration of single siRNA or Adr.

Tuberculosis is on increase worldwide. WHO estimates that nearly 1.7 Billions are infected with Mycobacterium Tuberculosis, out of which approximately 20 Millions are active cases. 3 Million die each year and 8 Million new cases occur in each year. [1] India is one of the 22 high burden countries. Here nearly 300 Million people are infected with Mycobacterium tuberculosis [2]. 12 to 14 Million have active disease and there are about 5 lakh deaths per year. [3],[4] The problem in India is on the verge of an explosion with the emergence of increasing HIV infection and spread of Multi drug Resistant TB.

Background: Rates of infections with multi-drug-resistant organisms (MDROs) are increasing among critically ill patients. Among non-surgical patients, MDROs increase directly the risk of adverse secondary events including death. However, similar effects do not appear to occur among surgical patients. Specifically, among critically injured trauma patients, it is unknown whether degree of injury versus the presence of an MDRO increases the risk of death. Methods: This is a retrospective chart review of admitted adult trauma patients. Data included demographics, medical comorbidities, injury severity score, infections, occurrence of pneumonia including microbiology sensitivity profile, hospital course, and outcomes. Results: Patients requiring adminission to the intensive care unit (ICU) were more severely injured with greater degree of thoracic and head trauma and had a greater burden of pre-trauma medical comorbidities. Among those admitted to the ICU, 93 patients developed pneumonia. Patients who developed pneumonia were younger and more severely injured, with higher rates of thoracic and head injuries and higher rates of smoking. Development of pneumonia was associated with worse outcomes. However, among patients with pneumonia, comparing MDRO to pan-sensitive (PanSens) infections, PanSens infection occurred earlier and were more likely associated with pre-trauma smoking status. There was no difference in injury patterns, medical comorbidities, or outcomes. Conclusion: The development of pneumonia among trauma patients reflects degree of injury and underlying medical status. However, development of MDRO versus PanSens pneumonia did not affect trauma-related outcomes further. This information will guide family discussions and critical care decisions better among vulnerable trauma patients.

Colonization pressure is a risk factor for intensive care unit (ICU)-acquired multi-drug-resistant organisms (MDROs).To measure the long-term respective impact of colonization pressure on ICU-acquired extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) and meticillin-resistant Staphylococcus aureus (MRSA).All patients admitted to two ICUs (medical and surgical) between January 1997 and December 2015 were included in this retrospective observational study. Rectal and nasal surveillance cultures were obtained at admission and weekly thereafter. Contact precautions were applied for colonized or infected patients. Colonization pressure was defined as the ratio of the number of MDRO-positive patient-days (PDs) of each MDRO to the total number of PDs. Single-level negative binomial regression models were used to evaluate the incidence of weekly MDRO acquisition.Among the 23,423 patients included, 2327 (10.0%) and 1422 (6.1%) were colonized with ESBL-PE and MRSA, respectively, including 660 (2.8%) and 351 (1.5%) acquisitions. ESBL-PE acquisition increased from 0.51/1000 patient-exposed days (PEDs) in 1997 to 6.06/1000 PEDs in 2015 (P0.001). In contrast, MRSA acquisition decreased steadily from 3.75 to 0.08/1000 PEDs (P0.001). Controlling for period-level covariates, colonization pressure in the previous week was associated with MDRO acquisition for ESBL-PE (P0.001 and P=0.04 for medical and surgical ICU, respectively), but not for MRSA (P=0.34 and P=0.37 for medical and surgical ICU, respectively). The increase in colonization pressure was significant above 100/1000 PDs for ESBL-PE.Colonization pressure contributed to the increasing incidence of ESBL-PE but not MRSA. This study suggests that preventive control measures should be customized to MDROs.

Summary Background Candida auris, a multi-drug-resistant fungal pathogen, has become an emerging threat in healthcare settings around the world. Reliable disinfection protocols specifically designed to inactivate C. auris are essential, as many chemical disinfectants commonly used in healthcare settings have been shown to have variable efficacy at inactivating C. auris. Aim Ultraviolet germicidal irradiation (UVGI) was investigated as a method to inactivate clinically relevant strains of C. auris. Methods Ten C. auris and two C. albicans isolates were exposed to ultraviolet (UV) energy to determine the UV dose required to inactivate each isolate. Using a UV reactor, each isolate (106 cells/mL) was exposed to 11 UV doses ranging from 10 to 150 mJ/cm2 and then cultured to assess cell viability. Findings An exponential decay model was applied to each dose–response curve to determine inactivation rate constants for each isolate, which ranged from 0.108 to 0.176 cm2/mJ for C. auris and from 0.239 to 0.292 cm2/mJ for C. albicans. As the model of exponential decay did not accurately estimate the dose beyond 99.9% inactivation, a logistic regression model was applied to better estimate the doses required for 99.999% inactivation. Using this model, significantly greater UV energy was required to inactivate C. auris (103–192 mJ/cm2) compared with C. albicans (78–80 mJ/cm2). Conclusion UVGI is a feasible approach for inactivating C. auris, although variable susceptibility among isolates must be taken into account. This dose–response data is critical for recommending UVGI dosing strategies to be tested in healthcare settings.

The object of the present study was to investigate the antioxidant, antimicrobial activity and phenolic compounds of fruit and seeds of Diospyros lotus L. The fruits consumed by humans as nutrients were harvested from the plants that grow naturally in the province of Trabzon-Akçaabat, Eastern Black Sea Region of Turkey. The antioxidant activities of fruit and seeds of Diospyros lotus were determined by using four methods (% DPPH radical scavenging activity, FRAP antioxidant power determination, CUPRAC reducing antioxidant activity and total phenolic content (TPC) in five different proportion of methanol-water extracts. All extracts of fruit and seeds of D. lotus analyzed through whole antioxidant analysis methods showed significant antioxidant activity. In addition, antimicrobial activity of fruit and seeds extracted with DMSO was determined against seven standard bacteria and three multi-drug resistance clinical strains. Although fruit extracts did not have the antimicrobial activity against bacteria, seeds showed antimicrobial effect to both standard strains (Gram-negative and Gram-positive) and antibiotic resistance clinical isolates (Klebsiella pneumoniae carrying blaKPC, Acinetobacter baumannii, harboring blaOXA-23 gene and resistance to colistin, and multi-drug resistant Pseudomonas aeruginosa). MICs’ value of plant seed extracts for standard strains was 0.75-25 mg/mL and antibiotic resistant clinical bacteria were 12.5 and 25 mg/mL. Additionally, phenolic compounds in methanol extracts of fruit and seeds were also determined in by HPLC using 19 standards. Gallic acid and chrysin phenolic compounds were the major phenolic compounds in fruit and seeds, respectively.

The extensive spread of antibiotic resistance among pathogens is critically challenging the healthcare system with treatment options. Often, the physicians are left with no choice but to use high doses of antibiotics to combat infectious diseases in spite of the associated toxicity. In an attempt to investigate plant sources as an alternative source of drugs, the current study evaluated the antibacterial activity of extracts obtained from six commonly available plants against 16 pathogens isolated from skin, respiratory and urinary tract. Among these, 14 multi drug resistant pathogens and 7 ESBL producers were identified. Also, 4 isolates showed both ESBL and carbapenemase production whereas 2S. aureusisolates showed ESBL production and resistance to Streptogramins. The plants used in our study included garlic, cinnamon, Indian borage, clove, green tea and onion. The qualitative analysis of antibacterial activity was carried out by well diffusion method for water and methanol extracts of these plants. The results indicated garlic and Indian borage water extracts to be active against both gram negative and gram positive test pathogens. The observed zones of inhibition were in the range of 11-27 mm (Indian borage) and 9-21 mm (garlic) against the test pathogens. However, no synergy was observed when these extracts were combined.&nbsp

Background: Acinetobacter species is an important hospital acquired pathogen. Rapid development of resistance to multiple drug and ability to form biofilm make these bacteria more adaptable to survive in health care facilities, thus posing a challenge for its effective management. This study was aimed to characterize clinical isolates of Acinetobacter spp, study their antimicrobial susceptibility pattern and ability to form biofilm. Resistant Acinetobacter was further analyzed for the detection of extended spectrum β-lactamases (ESBLs), metallo β-lactamases (MBLs) production and presence of blaNDM-1 (New Delhi metallo-beta-lactamase-1) gene.Results: A total of 324 Acinetobacter species isolated from various clinical specimens submitted to Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, were studied Antibiotic susceptibility testing, detection of ESBL and MBL production, and biofilm formation was performed by standard microbiological methods. PCR was done to determine the presence of blaNDM-1 gene.Predominant Acinetobacter species isolated was A calcoaceticus-baumannii Complex (Acb complex) 167 (51.5%). 13 (4.0%) were ESBL producers, 61.9% (70/113) were MBL, 10.6% (12/113) were carbapenemase producers. About 40% were Multi-drug resistant (MDR). Among MDR, producers of ESBL, MBL and carbapenemase were 1.6%, 57% and 9.6%, respectively. Thirty seven percent isolates formed biofilm. A significant proportion of biofilm producers were MDR (p

Background A number of methods have been used to study the in-vitro synergy between antibiotics with the checker board titration and E-test being the most widely described. Aim of the Study The aim of the present study is to determine the prevelence of Multi-Drug Resistance (MDR) among Enterobacteriacae and to compare between the E-test and the checkerboard titration method as rapid in-vitro diagnostic tests that can help to determine the synergy between selected antimicrobial combinations thought to be active against multi-drug resistant Enterobacteriacae. Materials and Methods The present study was conducted during the period between May 2017 and December 2017. A total number of 34 MDR Enterobacteriacae isolates were recovered from different clinical specimens submitted to the Main Microbiology Laboratory, Ain Shams University Hospitals. The isolates were tested using checkerboard titration method and E-test to determine the synergistic activity of selected antimicrobial combinations thought to be active against the MDR organisms. Results Out of 46 Enterobacteriacae isolates 34(74%) were MDR. According to antibiotic combination the combinations of Amikacin/Ceftazidime, Amikacin/Meropenem and Amikacin/Ampicillin+Sulbactam have synergistic effect against MDR Enterobacteriacae by E-test and checkerboard method. A statistically poor agreement was observed between the checkerboard BMD method and the E-test method regarding the results of the studied antibiotic combinations Conclusion The Checkerboard method, being the reference method for assessing antimicrobial synery, showed that the highest synergic activity belongs to Meropenem and Amikacin (40%).

Despite highly specialized international interventions and policies in place today, the rapid emergence and dissemination of resistant bacterial species continue to occur globally, threatening the longevity of antibiotics in the medical sector. In particular, problematic nosocomial infections caused by multidrug resistant Gram-negative pathogens present as a major burden to both patients and healthcare systems, with annual mortality rates incrementally rising. Bacteriocins, peptidic toxins produced by bacteria, offer promising potential as substitutes or conjugates to current therapeutic compounds. These non-toxic peptides exhibit significant potency against certain bacteria (including multidrug-resistant species), while producer strains remain insusceptible to the bactericidal peptides. The selectivity and safety profile of bacteriocins have been highlighted as superior advantages over traditional antibiotics; however, many aspects regarding their efficacy are still unknown. Although active at low concentrations, bacteriocins typically have low in vivo stability, being susceptible to degradation by proteolytic enzymes. Another major drawback lies in the feasibility of large-scale production, with these key features collectively limiting their current clinical application. Though such limitations require extensive research, the concept of expanding bacteriocins from food preservation to human health opens many fascinating doors, including novel drug delivery systems and anticancer treatment applications.

The alternative approaches for antibacterial drug discovery have a huge potential to develop novel antibacterial agents against multi drug resistant human pathogenic bacteria that are much needed to tackle the urgent threats of multi drug resistant human pathogenic bacteria. We may be able to develop much faster novel antibiotics against multi drug resistant human pathogenic bacteria using these alternative methods than that based on small molecule drug discovery. The alternative methods for antibacterial drug discovery can be used to target new molecules in pathogenic bacteria such as bacterial riboswitches. The combination of novel mechanisms of antibacterial drug action, with novel molecules targets, can result in the development of novel antibiotics against which bacteria have yet not developed any kind of resistance.

Diabetes Mellitus (DM) and its associated complications including neuropathy, retinopathy, nephropathy, diabetic wound etc. are major problems all around the globe. Triphala, an ayurvedic formulation consists of fruit powders of Emblica officinalis, Terminalia belerica, and Terminalia chebula. The Triphala nanoparticles (TNp) was formulated, characterized and screened for its antioxidant, anti-diabetic, and antimicrobial potential. TNp was incorporated into medical fabrics and evaluated for its antibacterial potential against E. coli ATCC (25922) and multi drug resistant (MDR) E. coli isolated from diabetic wound. The results suggest that TNp possess antioxidant, antidiabetic and antibacterial activities. In future, TNp incorporated nano biomaterial might be an effective alternate to control diabetes related infection.

Aims: We analysed the prevalence of plasmid mediated multidrug resistance among Proteus spp isolated from wound infection patients attending healthcare centers in Maiduguri. Methodology: 320 wound swab samples were collected from August 2016 to June 2017, and investigated via microscopy, cultured on Blood agar and MacConkey agar. Suspected Proteus spp isolates were further confirmed using biochemical tests. Kirby bauer disc diffusion test was used to determine the antimicrobial susceptibility pattern. Isolates confirmed to be multidrug resistant (MDR) were subjected to gel electrophoresis for the determination of plasmid profile. Results: Twenty eight (28) samples yielded Proteus spp, giving a prevalence rate of 8.75%. Proteus mirabilis was the most significant specie isolated (32.14%). Isolates were most sensitive/least resistant to Ciprofloxacin (85.71%/14.29%) and most resistant/least sensitive to Augmentin (10.71%/89.29%). 64.28% of isolates observed were MDR strains and were quite significant among patients between the ages of 21-30years (21.43%). MDR Proteus mirabilis was most the significant and highly prevalent among patients suffering from wound sepsis and burns (10.71% respectively). The association between MDR Proteus spp and wound types was statistically not significant (X2 =7.342, p>0.01). Plasmid profile analysis revealed that 72.22% of the MDR isolates harbour plasmids with a DNA fragment size of 100 bp and a molecular weight of 31ng/10µl. An average of 7.22% of MDR isolates were cured of their plasmids while an average of 56.67% of MDR isolates resisted curing. Conclusion: Here, we report a high prevalence of multidrug resistance and a high rate of plasmid carrying strains of Proteus spp in wounds of hospitalised patients. We suggest that there is a role played by plasmid in the mediation of multidrug resistance among the MDR Proteus spp isolated, where the majority of the MDR isolates observed carry plasmids.

Multidrug resistant Klebsiella pneumoniae was resistant to various antibiotics which are commonly used to treat against the bacterial infections, and is now emerged as a great risk. Antibiotic susceptibility tests were performed to determine the scope of drug resistance of the bacteria. Further studies regarding the responsible genetic material were performed by Polymerase Chain Reaction and RFLP techniques. The remedial measures for treating these bacteria were studied with the help of metabolites obtained from various strains.Int. J. Appl. Sci. Biotechnol. Vol 6(3): 279-284

Aims: This study was carried out to analyze the plasmid profile of multidrug resistant Pseudomonas aeruginosa isolated among catheterized patients attending the University of Maiduguri Teaching Hospital. Place of Study: Department of Medical Microbiology (Laboratory Section), University of Maiduguri Teaching Hospital and Department of Biological Sciences, Abubakar Tafawa Balewa University, Nigeria. Methodology: 244 samples (catheter tip, urethral swab, urine) were collected from catheterised patients and investigated via microscopy and culture on Blood agar and MacConkey agar. Suspect Pseudomonas aeruginosa isolates were further confirmed using biochemical tests. Kirby bauer disc diffusion test was used to determine the antimicrobial susceptibility pattern. Isolates confirmed to be multidrug resistant (MDR) were subjected to plasmid profile analysis using agarose gel electrophoresis. Results: 21 yielded Pseudomonas aeruginosa which gives a recovery rate of 8.6%. A significant proportion was isolated from catheter tip samples collected from male patients (33.33%). The association between sex of patient and sample type in the isolation of Pseudomonas aeruginosa was statistically significant (X2 = 10.76, df = 2, P

Objectives: In order to investigate alternate therapeutic option, this study was carried out to assess the in vitro antibacterial activity of gel extract of Aloe barbadensis against multiple antibiotic resistant Pseudomonas aeruginosa isolated from wound specimens. Methods: A total of 180 different wound specimens collected in a hospital, were subjected to isolate and identify P. aeruginosa by cultural methods. Antibiotic susceptibility testing was done by Kirby- Bauer disc diffusion method to screen multidrug resistant isolates. A. barbadensis extracts were prepared using aqueous and organic solvents and their in vitro inhibitory action was evaluated by agar well diffusion methods. Results: Out of total, 38 (21.1%) of the wound specimens showed the occurrence of P. aeruginosa, among which 15 (39%) isolates were multi-drug resistant. Organic extracts of various concentrations (0.2 - 0.8 v/v %) inhibited 66.7% of MDR and all non-MDR (n = 23) P. aeruginosa with zone of inhibition ranging from 9.5 ±1.0 to 21.3 ± 2.2 mm but not by aqueous extract. A positive Pearson’s correlation (r=0.983) was found between antibacterial effect and concentrations of the extracts. The antibacterial activity of organic extracts was statistically associated with antibiotic resistance profile of the organism (p