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In recent years, the rapid growth in Antimicrobial resistance (AMR) has become a global concern. Essential oils derived from plants that include bioactive components with proven antioxidative and antibacterial activities could be a potential solution to arrest this problem. In this study, antibacterial activities of DoTERRA essential oils such as Onguard, Clove, Teatree, Lavender and Eucalyptus were evaluated with Indian essential oils against clinical pathogenic bacteria. The GC-MS study revealed that cineole, terpinene, eucalyptol, and eugenol were the most prevalent bioactive components in these essential oils. The purity of the essential oils was confirmed with zeta potential and white light absorption spectrophotometer and shows that the Zeta potential of all the essential oils ranges from -51.4 to 0 mV. Using agar well diffusion and Micro broth dilution procedures, the antimicrobial activity of essential oils of clove, lavender, tea tree, eucalyptus, and On-Guard (combined) was assessed against several multi-drug-resistant bacteria. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of essential oils in aqueous and micellar solutions were determined by Micro broth dilution techniques. The most effective antibacterial essential oils were clove, tea tree, and On guard (a blended essential oil with a predominance of Limonene and Eugenol). The current research could result in development of formulas that contain micelle or colloid suspensions of whole essential oils such as clove, On-Guard, or Tea-Tree oil to aid in antimicrobial treatment. [ABSTRACT FROM AUTHOR]

Most bacteria and fungi are capable of producing biofilms, enabling them to thrive in nature on distinct surfaces. Biofilm formation stands out as one of the most prominent virulence mechanisms that contribute to the infection's chronicity by functioning as a defense against antimicrobials and host immune systems. Microbial isolates capable of generating biofilms have been discovered to possess higher resistance to frequently administered antifungal drugs. In this research study, 91 Candida isolates from Vulvovaginal Candidiasis (VVC) patients were tested for biofilm development. Candida species were identified, and clinical isolates were tested for antifungal susceptibility (AST). Three methods were used to screen the isolates: the Congo agar method (CRA), the visual tube method (VT), and the Microtitre plate method (MTP). Nearly 60% of the 91 clinical isolates tested were recognized as Non-Albicans Candida (NCAC) species. Itraconazole resistance was shown to be the highest in clinical isolates, followed by Amphotericin B resistance. There were 11(12.09%) isolates that formed strong biofilms, 35(38.46%) isolates that formed moderate biofilms, and 45(49.45%) isolates that formed no biofilm. Because there is a growing incidence of NCAC in the study, it is critical to speciate the Candida species as NCAC are more resistant to routinely used azole medicines. Furthermore, a spike in the prevalence of biofilm producers has been reported, implying greater pathogenicity and antifungal resistance. [ABSTRACT FROM AUTHOR]

ImportanceThe ongoing pandemic of the novel Corona Virus Disease 2019 (COVID-19) is an unprecedented challenge to global health, never experienced before.ObjectiveThis study aims to describe the clinical characteristics and outcomes of patients with COVID-19 admitted to Mercy Hospitals.Design and methodsRetrospective, observational cohort study designed to include every COVID-19 subject aged 18 years or older admitted to Mercy Saint (St) Vincent, Mercy St Charles, and Mercy St Anne's hospital in Toledo, Ohio from January 1, 2020 through June 15th, 2020. Primary Outcome Measure was mortality in the emergency department or as an in-patient.Results470 subjects including 224 males and 246 females met the inclusion criteria for the study. Subjects with the following characteristics had higher odds (OR) of death: Older age [OR 8.3 (95% CI 1.1-63.1, p = 0.04)] for subjects age 70 or more compared to subjects age 18-29); Hypertension [OR 3.6 (95% CI 1.6-7.8, p = 0.001)]; Diabetes [OR 3.1 (95% CI 1.7-5.6, pConclusionAge and hypertension were associated with significant comorbidity and mortality in Covid-19 Positive patients. Furthermore, people who were older than 70, and had hypertension, diabetes, COPD, or CKD had higher odds of dying from the disease as compared to patients who hadn't. Subjects with hypertension also had significantly greater odds of other adverse outcomes.

Introduction: Pneumonia is the most prevalent infection worldwide, leading to hospitalisation and contributing to mortality rates. Among the bacterial agents associated with CommunityAcquired Pneumonia (CAP), Streptococcus pneumoniae remains the most common. Conventional microbiological diagnostic tests have various limitations, including issues with sample collection, prior antibiotic administration, and delayed specimen transport. Urinary Antigen Testing (UAT) shows promise in rapidly identifying the causative agent of CAP, allowing for targeted therapy. Aim: To evaluate the diagnostic accuracy of the pneumococcal UAT in identifying CAP. Materials and Methods: A cross-sectional analytical study was conducted over a period of one year from June 2022 to May 2023 at SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India. A total of 38 patients (>18 years of age) with clinically suspected CAP and who satisfied the clinical criteria for CAP were recruited for the study. Respiratory specimens were subjected to bacterial culture, real-time Polymerase Chain Reaction (PCR), and UAT using the Fluorescent Immunoassay (FIA) to detect Streptococcus pneumoniae. The sensitivity, specificity, positive and negative predictive values, and accuracy of the pneumococcal UAT for detecting CAP were assessed. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software, version 21.0. Results: The study revealed a female predominance 22 (57.89%). Bacterial culture and real-time PCR identified 7 (18.42%) of patients with S. pneumoniae, while the UAT only detected 1 (2.63%). The pneumococcal UAT showed low sensitivity (14.29%), high specificity (100%), and satisfactory accuracy (84.21%). Conclusion: The pneumococcal UAT, with its straightforward technology, ease of use, rapid results, non invasive approach, cost-effectiveness, and high specificity and accuracy, could be favoured over bacterial culture and molecular techniques for ruling out CAP. [ABSTRACT FROM AUTHOR]

To study the correlation between quantitative Hepatitis B DNA and HBeAg positivity among HBsAg positive patients in a tertiary care hospital. To detect HBsAg, HBeAg levels by CMIA (Chemiluminescent microparticle immunoassay). To perform quantitative Hepatitis B virus DNA assay using Real Time Polymerase Chain Reaction. The study took place between July and December 2022 for 6 months. Sixty four patients were included in the study for whom HBsAg was positive by CMIA and for whom HBeAg (detected by CMIA) and Hepatitis B Virus DNA by quantitative Real Time PCR was performed. Of the 64 HBsAg reactive patients, the 'e' antigen of Hepatitis B virus was positive in six patients. In all the six HBeAg positive patients, HBV DNA was detected with a range of 78-10,288 IU/ml with 66% having levels more than 2000 IU/ml and requiring treatment. Among the 58 patients who were negative for the 'e' antigen of Hepatitis B virus, the Hepatitis B Viral DNA was detected in 27 patients with a range of 10-1,76,000 IU/ml, with 21% of patients having levels more than 2000 IU/ml. HBeAg is a good serological test to detect viral replication. However, it alone might not be sufficient as quantitative HBV DNA levels are more accurate and it does identify more patients who may require treatment. [ABSTRACT FROM AUTHOR]

Human leukocyte antigens (HLA) are genetically derived proteins in the major histocompatibility complex. They help distinguish “self” and “non-self” antigens and are essential in interacting with the immune cells inside the body. The present research work examines the prevalence of HLA-B27 among patients suspected of Spondyloarthritis (SpA), which has also been correlated with Interleukin-17/23 Inflammatory Markers and other clinical manifestations and was carried out between August 2017 to January 2021. The patient’s blood samples were collected and tested for HLA-B27 and Interleukin-17/23 inflammatory markers. Among 289 SpA patients, 60% (172) were males, and 40% (117) were females, with a ratio of 1.5:1. Ankylosing Spondylitis (65.1%) was found to be the most prevalent subgroup of SpA among the patients, closely followed by reactive arthritis (21%), psoriatic arthritis (10.7%), undifferentiated spondyloarthritis (2.1%), and inflammatory bowel disease with associated arthritis (1%). HLA-B27 was found to be positive in 54% (156) out of 289 patients. Normal IL-17 ranges were seen in 42% of HLA-B27- positive patients, while increased IL-17 was seen in 58% of the population with positive HLA-B27 cases. IL-23 was found within normal ranges in 40% of positive HLA-B27 cases, while it was found to be increased in 60% of the positive HLA-B27 positive subjects. We concluded that HLA-B27 was found to be positive among more than half of the patient population with SpA. The early detection of HLA-B27 may aid in changing lifestyle to prevent Spondyloarthritides. [ABSTRACT FROM AUTHOR]

UTI is one of the most common infections requiring antibiotic treatment and hospitalization. The rising trend in multidrug resistance to commonly used antibiotics has reduced the therapeutic options for treating these infections. Reexploring older antibiotics like nitrofurantoin and fosfomycin provide treatment options and help combat resistance. This prospective study was conducted in the Department of Microbiology, SRM Medical College Hospital and Research Center, from July 2021 to February 2022. The study included only clean catch midstream urine isolates of Escherichia coli and Klebsiella pneumonia from hospitalized patients and outpatients. Standard microbiological procedures were used to process the urine samples. Direct gram stain and conventional biochemical reactions were performed to identify the isolates. The antimicrobial susceptibility testing was carried out by the Kirby Bauer disk diffusion method and Minimum Inhibitory Concentration by E- test gradient method for fosfomycin. MIC for nitrofurantoin was determined by Micro Broth Well Dilution according to CLSI guidelines 2021. Among 150 urine samples, Escherichia coli 107 (71.3%) was higher than Klebsiella pneumonia 43 (29%). Carbapenemase production was seen in 58 (63.04%) isolates by the Kirby Bauer disc diffusion method. Among the 58 positive carbapenemase producers, E. coli was found to be 33 (56.8%), and Klebsiella pneumonia was 25 (43.1%). Fosfomycin susceptibility rates by E test were reported to be high in Escherichia coli, ranging from 0.5-1mg/L. Klebsiella pneumonia was less susceptible to fosfomycin ranging from 16-32mg/L. Only 7(21%) isolates of Escherichia coli showed MIC of 1-4µg/ml to nitrofurantoin by broth microdilution. 21 (63.63%) isolates of Escherichia coli and 11(44%) isolates of Klebsiella pneumonia were reported to have an intermediate category with MIC of 8-32µg/mL. A higher MIC of 64- > 256µg/ml was shown by 5 (15.15%) isolates of Escherichia coli and 14 (56%) isolates of Klebsiella pneumonia. Older medications may resurface as useful therapeutic choices as resistance to current treatment options grow. [ABSTRACT FROM AUTHOR]

Klebsiella is a pathogen that causes a significantly high number of community-acquired and hospitalacquired infections, with infections being one of the leading causes of death in ICU patients worldwide due to increasing antibiotic-resistance and a lack of therapeutic options. A total of 230 Klebsiella spp. were collected from various clinical samples. After initial identification, the drug-resistant strain was subjected to standard Clinical laboratory and Standards institute methods such as Kirby--Bauer disc diffusion. All isolates were screened and confirmed for ESBL/AmpC β-lactamase/carbapenemase production. the isolated Klebsiella spp. were found to be K. pneumonia (89%), K. oxytoca (6.5%), and K. aerogenes (4.5%). Among the 230 isolates, 80 (34.7%) isolates were found to be eSBl producers via screening; of these, 53 (23.5%) were verified by a confirmatory test. Moreover, 115 isolates (50%) were screened as AmpC producers; of these, 23 isolates (10%) were verified by a confirmatory test. Carbapenemase producers accounted for 69 (30%) isolates, identified by screening; 25 (10.86%) were verified by a confirmatory test. ESBL producers accounted for the majority of Klebsiella spp. isolates, followed by carbapenem and AmpC producing strains. [ABSTRACT FROM AUTHOR]

The prevalence of multidrug-resistant gram-negative bacilli has increased worldwide. Critical care areas of most hospitals use carbapenem antibiotics for the empirical treatment of gram-negative bacterial (GNB) infections. In the last decade, there have been reports of the detection of carbapenem-resistant Enterobacterales (CRE). This rise in the spread of CRE presents a great challenge in the treatment of GNB infections and poses a serious threat to global health. To detect the burden of CRE and to characterize CRE, we used three phenotypic methods for the detection of carbapenemase enzymes. Using conventional aerobic bacterial culture methods, 150 Enterobacterales strains were isolated from various clinical samples. Identification of CRE was performed using multiple phenotypic detection methods, such as the Kirby Bauer disc diffusion method for meropenem (10 mcg) using the CLSI 2021 interpretation for meropenem, modified Hodge test (MHT), Carba NP test, and modified carbapenem inactivation method (mCIM) test. A total of 150 Enterobacterales strains were isolated over a period of 1 year. Among these, 66/150 (44%), 63/150 (43%), 64/150 (43%), and 65/150 (43%) were identified as CRE using the Kirby Bauer disc diffusion method, MHT, mCIM test, and Carba NP test, respectively. The sensitivity and specificity of MHT, mCIM, and Carba NP tests within 95% CI were 93.94%/100%, 96.97%/100%, and 98.48%/100%, respectively. The positive and negative predictive values of MHT, mCIM, and Carba NP tests were 100%/95.45%, 100%/97.67%, and 100%/98.82%, respectively. The accuracies of the MHT, mCIM, and Carba NP tests were 97.33%, 98.67%, and 99.33% respectively indicating a high burden of carbapenem resistance in Enterobacterales. Therefore, given the current statistics of carbapenem resistance, use of carbapenem as empiric treatment in the intensive care units of hospitals may not be beneficial. Identification of carbapenem resistance can help in the initiation of appropriate antimicrobial therapy. This study compares the accuracy and efficiency of Carba NP, mCIM, and MHT in detecting carbapenem-resistant Enterobacterales. [ABSTRACT FROM AUTHOR]

Prior to the Severe Acute Respiratory Syndrome Coronavirus Disease 2 (SARS-CoV-2) pandemic, the rise in antimicrobial resistance was a major source of concern in public health. However, due to the novelty of SARS-CoV-2 infection during the pandemic, antibiotics were administered prior to laboratory testing for secondary gram-negative bacteria (SGNB) in order to avoid or reduce the occurrence of SGNB infection. the purpose of this study was to investigate the etiology, prevalence, and antimicrobial susceptibility pattern of gram-negative bacteria (GNB) isolated from SARS-CoV-2 positive patients. Respiratory and blood samples were collected from confirmed SARS-CoV-2 positive patients. they were subsequently cultured and bacterial isolates identified according to standard microbiological protocols. Antimicrobial susceptibility testing (ASt) was performed and interpreted according to Clinical & laboratory Standards institute (ClSi) 2021 guidelines. A total of sixty-four non-repetitive GNB were isolated from respiratory samples and twenty-two GNB from blood samples. K. pneumoniae was the major cause of SGNB, followed by Acinetobacter species. K. pneumoniae had over 60% resistance to β-lactam combination agents, cephalosporin, and the carbapenem group of antibiotics. in the current study, we observed that K. pneumoniae was the major cause of SGNB and had high resistance to the antimicrobial agents. Hence, it is important that the epidemiology and susceptibility patterns of circulating organisms causing SGNB infection are always monitored to inform clinical treatment and decrease the occurrence of antibiotic-resistant bacteria. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance has emerged as a major danger to contemporary medicine around the world. Carbapenems are the highest class of B-lactam drugs which are considered as the most effective and safest antibiotics available. increasing spread of carbapenemases has been noted across the world which restricts treatment options. the aim of this study was to determine the incidence of carbapenem resistant genotypic pathways in a tertiary care hospital. 130 clinical strains of Enterobacteriaceae were subjected to Kirby-Bauer disk diffusion tests and genotypic methods (PCR) for the identification of the genes NDM, ViM, and OXA-48. Carbapenem resistance was detected in 30% of the isolates by phenotypic methods. these 37 isolates on being subject to PCR showed OXA-48 followed by ViM and NDM as the most frequently isolated genotypes. All isolates had multiple genes encoding carbapenem resistance. Carbapenemases resistance is on the rise and is associated with multi drug resistance pattern. to minimize spread and initiate early appropriate therapy, early detection of carbapenem resistance is essential. Molecular methods remain gold standard for detection. [ABSTRACT FROM AUTHOR]

Every country had to make several difficult decisions in the initial phase of the Coronavirus (COVID-19) pandemic to allocate resources for COVID testing. Decisions on who should be tested for COVID-19 testing are extremely vital for pandemic preparedness. In this article, we highlight the need for prioritization of testing resources including direct-to-consumer testing methods, ethical dilemmas involved in obligatory testing, and testing of refugees and immigrants. [ABSTRACT FROM AUTHOR]

Introduction: Streptococcus pyogenes is a medically significant member of the Streptococci. This bacterial illness affects the people frequently. It also results in toxin-related reactions, life-threatening soft tissue infections, and a range of suppurative diseases on the skin and in the respiratory system. The disease primarily affects children between 5 to 15 years old. Aim: To find the prevalence and antibiotic sensitivity pattern of Streptococcus pyogenes in upper respiratory tract infections in a tertiary health care centre. Materials and methods: A prospective study, it was carried out between August 2021 and March 2022. The research was carried out in a tertiary medical facility close to Chengalpattu, Tamil Nadu, India. The Institutional Scientific and Ethical Committees have given their prior consent. Throat swabs were collected from all age groups having upper respiratory tract infections as per standard protocols. Streptococcus pyogenes were isolated through throat swabs using conventional culture methods phenotypically and by resistance pattern were examined by using Statistical Package for the Social Sciences(SPSS) software version 24.0. Results: Out of 50 throat swabs from patients processed bacteriologically, 8 (40%) were Streptococcus pyogenes which shows the prevalence was relatively low in a period of the global covid 19 pandemic. A majority of cases occurred between 5 to 15 years of age, followed by 17(34%), 13(26%) between 16 to 30 and 31 to 45 years of age, and 5 (10%) between 46 to 60. Streptococcal infection was observed to harm men more frequently (58%) than women. Chloramphenicol and Erythromycin are 100% resistant, Cotrimoxazole is 37.5% resistant, Ofloxacin is 12.5% resistant and Bacitracin, Cefepime, Ceftriaxone, Cefazolin, Penicillin, Tetracycline, Linezolid, Vancomycin are found to be sensitive towards Streptococcus pyogenes. Conclusion: It was concluded that the prevalence of Streptococcus pyogenes is relatively low among the study population in a period of the global covid 19 pandemic. Antibiotics Chloramphenicol and Erythromycin were found to be resistant and Bacitracin, Cefepime, Ceftriaxone, Cefazolin, Penicillin, Tetracycline, Linezolid, Vancomycin were found to be sensitive for Streptococcus pyogenes. [ABSTRACT FROM AUTHOR]

Viridans streptococci are important causative organism of infective endocarditis, which is a disease having long-lasting effects among the patients who live with the disease as well as those who are cured. Infective endocarditis due to viridans streptococci generally usually affects persons with structural heart disease and is also associated with intravascular prosthetic devices. After the onset of bacteremia with the pathogenic viridans streptococci, vegetation is formed in one or more heart valves. The diagnosis of infective endocarditis due to viridans streptococci is difficult to establish in patients with underlying risk factors and it involves the correlation of microbiological (in-vitro growth of viridans streptococci), clinical, and echocardiography results (modified Duke criteria). The common microorganisms are Staphylococcus spp., Enterococcus spp followed by viridans streptococci. The details of viridans streptococci causing infective endocarditis were reviewed in detail. Viridans streptococci possess a challenge in identification up to its species level and which helps in the identification of the source of infection as well as treating the infection. [ABSTRACT FROM AUTHOR]

Strongyloidiasis is a neglected parasitic disease caused by the intestinal parasite, Strongyloides stercoralis. Most patients with strongyloidiasis are asymptomatic, but few present with varied clinical manifestations such as cutaneous, gastrointestinal, pulmonary, and disseminated disease. It creates a diagnostic dilemma and undue delay in the diagnosis of patients. We report the case of a 79-yearold male who presented with fever and abdominal pain due to strongyloidiasis with no history of immunosuppression. The infection resolved entirely on treatment with ivermectin. [ABSTRACT FROM AUTHOR]

Human leukocyte antigens (HLA) are gene products found in the major histocompatibility complex, aiding in differentiation of "self" from "non-self" antigens, and is crucial for the communication between immune cells of the human body. HLA-B27, in specific, has a strong interrelation with different types of Spondyloarthritis (SpA). The aim of this study is to study the frequency of HLA-B27 in suspected Spondyloarthritis patients presenting with axial and peripheral joint involvement, who attended our tertiary care centre from August-2017 to January-2021. Patients fulfilling Assessment of Spondyloarthritis International Society (ASAS) criteria for Spondyloarthritis were included in the study, and were further classified into Spondyloarthritis sub-groups. Blood samples were collected for CRP and ESR tests along with HLA-B27 detection by RT-PCR method. Magnetic resonance imaging was done for sacroiliac joints in patients with lower back pain. Analysis of 289 samples of SpA patients revealed 156 (54%) to be HLA-B27 positive and 133 (46%) to be HLA-B27 negative. There were 98 patients (63%) with Ankylosing spondylitis, 33 (21%) had Reactive arthritis, 19 (12%) had Psoriatic arthritis, 6 (4%) had Undifferentiated Spondyloarthritis, and inflammatory bowel disease was diagnosed in 0% in HLA-B27 positive Spondyloarthritis patients. The frequency of HLA-B27 among the Spondyloarthritis SpA) patients in our study was found to be 54% (156), more common clinical manifestation in men belonging to the age group of 16-25 years positive patients. Ankylosing spondylitis (AS) was found to be the most common sub-groups observed among the SpA patients. [ABSTRACT FROM AUTHOR]

The rise in antibiotic resistance has been a major source of public health concern. As a result, mortality and morbidity rates have risen significantly. This study was done to identify gram-negative organisms causing bacteremia/sepsis, study their prevalence rates, and antimicrobial resistance patterns, as evidence-based knowledge of gram-negative organisms causing sepsis and their resistance profiles is essential for effective hospital control and better management of infections caused by resistant bacteria. A retrospective study, conducted from January 2016 to December 2019, blood samples were collected using aseptic guidelines and cultured using automated blood culture methods. Biochemical tests were done according to microbiology standard procedures, while antimicrobial testing was done according to CLSI guidelines. A total of 13,808 blood samples were received within the study period of four years. Of the total, 2079 showed significant growth, with 765 being GNB isolates. The most common isolates were Escherichia coli (35.42%), Klebsiella pneumonia (19.74%), Acinetobacter species (9.67%), and other non-fermenting gram-negative bacilli (11.76%). Escherichia coli showed yearly resistance to aminoglycosides, cephalosporins, penicillin, fluoroquinolones, and B-lactam combination agents. Routine surveillance and awareness of the prevalence, etiological agents, and antibiotic resistance of gram-negative bacteria causing bacteremia/sepsis is critical for individual therapy, hospital control, and the effectiveness of preventive interventions. [ABSTRACT FROM AUTHOR]

Severe acute respiratory diseases caused by coronavirus disease 2019 (COVID-19) have caused infections around the world, and this disease has been declared a global pandemic by the World Health Organization. COVID-19 has severely impacted the world economy, and as it has multiple unnoticeable transmission routes, it can derail the health care system for a long time. Most states in India are affected by the COVID pandemic. As India is known for its seasonal infections such as dengue, leptospirosis, influenza, malaria, and enteric fever, it is expected that these infections may co-exist. Coinfection of these two viral infections causes challenges in diagnosis and treatment, especially in places with limited resources. Antibody-mediated enhancement of the immune response is a cause for concern in co-infection of COVID-19 and dengue. The present article discusses the clinical features, serological cross reactions, and antibody-dependent enhancement of COVID-19 coinfection with dengue infection. [ABSTRACT FROM AUTHOR]

Introduction: The Proteus species are vulnerable to cause community-acquired and Healthcare Acquired Infections (HCAI). This organism is grouped under opportunistic pathogen and implicates a wide range of infection in humans. The emergence of antimicrobial resistance in this species is alarming and life threatening. Aim: To evaluate the prevalence and the resistance pattern of Proteus species isolated from various clinical samples by conventional culture methods. Materials and Methods: This was a cross-sectional study conducted from May 2020 to April 2021. The study was conducted at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, after approval from the Institutional Ethical Committee. Proteus isolates from various clinical samples like wound swab, pus, urine, Cerebrospinal Fluid (CSF), tracheal swabs, endotracheal aspirate, vaginal swabs, blood, body fluids, ear swab, tissue were collected as per standard protocols. The phenotypic characterisation and resistance pattern of Proteus isolates were done by conventional culture methods. The analysis was done using Statistical Package for the Social Sciences (SPSS) software version 24.0. Results: Out of 100 isolates, the higher number of Proteus species was isolated from pus sample (35%), wound swab (22%) and urine sample (25%). Males were found to have a higher prevalence (65%) of infections by Proteus species than females. Proteus mirabilis was the most common isolated species (89%) in this study. The Extended Spectrum Beta Lactamase (ESBL) producers among Proteus species were found to be 39%, AmpC producers to be 20% and carbapenemase producer 1%. Proteus species had the highest sensitivity to piperacillin tazobactam (100%), tigecycline (100%), meropenem and imipenem (98%) in this study. Conclusion: It was concluded that there was an increasing occurrence of drug resistance Proteus species. Their resistance is contributed by production of ESBL, AmpC and carbapenemase enzymes. The screening test alone is sufficient for detection of antibiotic resistance. Hence, there is a need for reliable phenotypic confirmatory test to identify the resistance among Proteus species. [ABSTRACT FROM AUTHOR]

Sepsis, the second leading cause of death is due to infections. Intensive care units (ICUs) are having the highest burden of treating the patients with sepsis and nosocomial infections compared to other areas of hospitals. Our objective was to identify the bacteriological profile and their antibiogram of sepsis cases in all ICUs. A sum of 102 blood samples were collected from patients with clinically suspected sepsis with elevated CRP. Processed by an automated method using Bact/Alert & growth were identified by Standard guidelines. Out of 102 samples, 54 (53%) were shown positive by culture. Gram-negative bacilli were the predominant and their number were 33 (61.1%) and the commonest organisms were from the Enterobacteriaceae family. Escherichia coli was the highest number with 15 (27.7%) followed by Klebsiella pneumoniae 10 (18.51%), & the rest were single isolates of Salmonella typhi, Proteus mirabilis and Citrobacter koseri. Nonfermenter isolated were Acinetobacter baumanii 3 (5.6%), Pseudomonas aeruginosa 2 (3.7%). The Gram-positive cocci were 17 & 32.4% of culture positivity. Coagulase-negative Staphylococcus was the highest isolated accounting for 9 (16.6%) followed by Staphylococcus aureus 6 (11.1%) and Enterococcus faecalis (3.7%). Culture positivity will be more when CRP is also included in the selection of samples for sepsis and Gram-negative bacilli are the leading cause in septicemia and organisms belonging to the Enterobacteriaceae family still dominate in septicemia infections in ICUs and a real challenge for treatment are MDRs which needs to be detected regularly by using screening tests. [ABSTRACT FROM AUTHOR]

Candida spp. is one among the major causes of nosocomial infection, with candidemia gaining increasing prevalence worldwide in parallel with mortality rates ranging from 10-49%. Epidemiology and predisposing factors of candidemia have changed since the number of patients receiving transplants and immunosuppressive therapy, the use of broadspectrum antimicrobials, and the number of AIDS patients have increased. Candidemia is more common among patients with subcutaneous and cutaneous candida infections, through percutaneous inoculation. Major predisposing factors for invasive candidiasis includes neutropenia, haematological malignancies, bone marrow transplantation, total parenteral nutrition, chemotherapy, invasive procedures, and immune-suppressive agents. This study analyses the risk factors of immunocompromised patients with candidemia and antibiogram of Candida spp. isolated from ICU patients. To evaluate the prevalence, distribution and antibiogram of Candida spp., associated risk factors, and outcome in candidemia patients. Blood samples received from patients with clinically suspected fungal infections were subjected to gram staining, culture, sugar assimilation & fermentation, Candida Chrome agar (CCA) & Corn meal agar for identification and speciation. Antifungal susceptibility tests were performed by disk-diffusion tests. Among a total of 337 samples received, 22 (6.5%) samples were positive for candida infections, of which Candida tropicalis 9 (41%) was the predominant isolate followed by C. albicans 5 (23%), Candida glabrata 4 (18%), Candida parapsilosis 2 (9%), and Candida krusei 2 (9%). Male patients had a higher prevalence of candidemia 15 (68.2%). Among the age group of 51-70 years, uncontrolled DM(Diabetes mellitus) and CKD(chronic kidney disease) were found to be the predominant co-morbidities with candidemia. [ABSTRACT FROM AUTHOR]

The present study aims to determine the spectrum of etiological agents and to screen HLA-B27 and, related inflammatory markers in patients presenting with symptoms of Spondyloarthritis(SpA) post diarrhea, which can aid in prompt diagnosis of reactive arthritis (ReA). A total of 903 stool samples of patients presenting with diarrhea were collected and screened with microscopic and culture techniques to identify the etiological agents. Blood samples of patients presenting with both diarrhea and arthritis were collected and subjected to C- reactive protein(CRP), Erythrocyte sedimentation rate(ESR) and Human Leukocyte Antigen B27(HLA-B27) detection tests. Among the total of 903 patients, 20 Salmonella species were isolated. Othergut microbes identified included Escherichia coli 572(63%), Klebsiella species 126(14%), Proteus vulgaris 43(5%), Proteus mirabilis 27(3%), Citrobacter species and Enterococcus species 8(1%), while some of these organisms(3.2%) caused inflammation resulting in ReA. Parasitic etiology was found in 99 patients, among which the most common parasites include Entamoeba histolytica and hookworm, identified through microscopy. Among the total, 29 patients were found to have symptoms of joint pain with articular and extra articular manifestations, and some associated with HLA-B27. [ABSTRACT FROM AUTHOR]

Background and Objectives: The emergence of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β– lactamases (ESBLs) in neonatal intensive care unit patients is increasing. This study aims to find out the bacteriological profile in neonatal sepsis and study their antimicrobial susceptibility pattern including detection of MRSA and ESBLs. Materials and Methods: This study was conducted for a period of one and a half years from January 2010 to June 2011 in a tertiary care hospital in Chennai. A total of 182 blood samples were collected using sterile precautions. They were processed following standard laboratory protocol. Antibiogram was done using appropriate antibiotics by Kirby-Bauer disc diffusion method. Isolated Staphylococcus aureus were tested for methicillin resistance using Cefoxitin disc (30μg), ESBL was detected using combined disc method, MIC reduction and Polymerase chain reaction, metallobetalactamases using EDTA and Amp-C beta lactamases using AmpC disc test. C-reactive protein (CRP) was estimated for all the cases. Results: Out of the 182 cases, 110 (60.4%) were culture positive. Fifty five (63.9 %) of early onset sepsis cases had Gram negative bacteria (GNB) and 19 (79.1%) of late onset sepsis cases had Gram positive bacteria. Out of the total pathogens, 31 (28.1%) were Klebsiella pneumoniae and 30 (27%) were Staphylococcus aureus. 17 (56.6 %) of Staphylococcus aureus were found to be MRSA and they were 100% sensitive to Vancomycin. 33 (67.3%) of Enterobacteriaceae were ESBL producers. ESBL isolates were 100% sensitive to Imipenem. Three (6.1%) of Enterobacteriaceae were AmpC producers and 3 (27.2%) of Pseudomonas aeruginosa were MBL producers. CRP was positive in 99 (54.3%) cases, out of which 94 (94.9%) were culture positive. Conclusion: Klebsiella spp. and Staphylococcus aureus were the commonest bacteria causing neonatal sepsis in this centre. Multidrug resistance among the isolates was common. Early diagnosis and institution of specific antibiotics after studying the sensitivity pattern will help in reducing neonatal morbidity and mortality and prevent emergence of drug resistant strains. [ABSTRACT FROM AUTHOR]

The study presents a thorough examination of immune responses in pediatric populations within slum areas, specifically addressing respiratory infections. It explores the impact of slum conditions on respiratory health, detailing the epidemiology of infections, including common pathogens and environmental factors. The review delves into the etiology, clinical manifestations, and challenges associated with viral respiratory infections, co-infections, and complications in slum environments. The discussion extends to immune responses in pediatric respiratory infections, emphasizing unique challenges in diagnosis and treatment within slum areas. Prevention and intervention strategies are highlighted, encompassing vaccination programs, health education, and improving living conditions. It underscores the importance of targeted interventions, accounting for socio-economic factors, community-based strategies, and culturally sensitive approaches. It proposes the exploration of novel approaches and the development of vaccines tailored to prevalent respiratory pathogens in slum settings. Furthermore, the feasibility and impact of routine immunization programs, emphasizing accessibility, acceptance, and long-term sustainability are explored. It advocates strengthening primary healthcare systems, investing in healthcare workforce training, and improving diagnostic facilities. The potential of digital health technologies in enhancing surveillance, early detection, and the development of mobile applications or telemedicine platforms is discussed. In conclusion, the study emphasizes the multifaceted challenges faced by children in slum areas regarding respiratory infections, necessitating informed, interdisciplinary interventions. Addressing healthcare disparities, improving living conditions, and enhancing vaccination coverage are deemed crucial for mitigating the burden of respiratory infections. This review calls for collaborative efforts among researchers, healthcare professionals, policymakers, and community stakeholders to develop sustainable solutions for enhanced respiratory health in slum-dwelling pediatric populations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Carbapenem resistant Enterobacteriaceae are unaffected by most used antibiotics. Carbapenem resistance in Gram-negative bacterial isolates poses a concern. Eravacycline is a potent new therapy option to treat organisms that exhibit extended-spectrum -lactamases and carbapenem-resistant Enterobacteriaceae. The chequerboard microdilution panel method was used to evaluate the effectiveness of eravacycline when combined with other antibiotics. Most effective against Escherichia coli isolates was the combination of eravacycline and polymyxin B, with 60% synergism and eravacycline-Ceftazidime combination was the most potent combination against Acinetobacter baumannii with 80% synergism. Eravacycline is having synergistic benefits against carbapenem-resistant isolates when combined with cephalosporins or polymyxin B., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: The health-related information-seeking through internet sources has drastically increased throughout the world. This study aimed to analyze the Global public interest on "antibiotics" and "antibiotic resistance"., Methods: The worldwide internet trend for the search terms "antibiotics" and "antibiotic resistance" from February 2017 to February 2022 was obtained using Google trends. The seasonal variation of interest was analyzed using the Seasonal Decomposition of Time Series by Loess., Results: The mean interest for the search term "antibiotics" and "antibiotic resistance" is found to be 78.02 ± 7.5 and 2.3 ± 0.8, which will increase at 2.56 % and 16 % per year. It was observed that there was a significant relationship between antibiotic consumption, the number of physicians, and individuals using the internet in the countries with the search term "antibiotics". The study also indicates that there is a peak in search volume for the term during the COVID-19 Pandemic., Conclusion: Our study observed, that antibiotics related search questions on google by the public indicate the chances of antibiotic misuse. The study data suggest the need to raise public awareness about antibiotic use and antibiotic resistance, as well as there is need for intensive monitoring of dispensing and procurement patterns of antibiotics in developing countries., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Dysregulated inflammatory response plays a crucial role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and Non-Small cell lung cancer (NSCLC). Hence, the purpose of this research is to uncover the link between alterations in inflammatory cytokine levels and disease progression in CD4 + T cells of patients suffering from COPD and lung cancer. We also investigated the epigenetic regulation of mtTFA to delineate the role of oxidative stress-mediated inflammation in Lung cancer and COPD. The RT 2 Profiler PCR array was used to examine the differential expression pattern of inflammatory genes in CD4 + T helper (Th) cells from COPD, NSCLC, and control subjects. Candidate inflammatory gene loci were selected and the enrichment of transcriptional factor and histone modifiers was analysed using ChIP-qPCR. In comparison to control subjects, a set of genes (e.g., BMP2, CCL2, IL5, VEGFA, etc.) are over-expressed whereas another set of genes (e.g., AIMP1, IFNG, LTA, LTB, TNF, etc.) are under-expressed in both COPD and NSCLC patients. The increased percent enrichment of inflammation-associated transcription factors including NF-kB, CREB, HIF1, and MYC at the loci of inflammatory genes was revealed by our chromatin immunoprecipitation (ChIP) data. H3K4me3, H3K9me3, H3K14Ac, HDAC1, 2, 3, 6 all showed dysregulated enrichment at the VEGFA gene locus. One of the epigenetic modifications, histone methylation, was found to be abnormal in the mtTFA complex in COPD and NSCLC patients in comparison to controls. Although there is mounting evidence of several links between these disorders, therapeutic options remain inadequate. Our findings contribute to the body of knowledge about therapeutic techniques that use inflammatory cytokines as a prognostic marker and highlight the need for epigenetic therapy for these debilitating lung diseases., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: India introduced BBV152/Covaxin and AZD1222/Covishield vaccines in January 2021. We estimated the effectiveness of these vaccines against severe COVID-19 among individuals aged ≥45 years., Methods: We did a multi-centric, hospital-based, case-control study between May and July 2021. Cases were severe COVID-19 patients, and controls were COVID-19 negative individuals from 11 hospitals. Vaccine effectiveness (VE) was estimated for complete (2 doses ≥ 14 days) and partial (1 dose ≥ 21 days) vaccination; interval between two vaccine doses and vaccination against the Delta variant. We used the random effects logistic regression model to calculate the adjusted odds ratios (aOR) with a 95% confidence interval (CI) after adjusting for relevant known confounders., Results: We enrolled 1143 cases and 2541 control patients. The VE of complete vaccination was 85% (95% CI: 79-89%) with AZD1222/Covishield and 71% (95% CI: 57-81%) with BBV152/Covaxin. The VE was highest for 6-8 weeks between two doses of AZD1222/Covishield (94%, 95% CI: 86-97%) and BBV152/Covaxin (93%, 95% CI: 34-99%). The VE estimates were similar against the Delta strain and sub-lineages., Conclusion: BBV152/Covaxin and AZD1222/Covishield were effective against severe COVID-19 among the Indian population during the period of dominance of the highly transmissible Delta variant in the second wave of the pandemic. An escalation of two-dose coverage with COVID-19 vaccines is critical to reduce severe COVID-19 and further mitigate the pandemic in the country., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)