Corrigendum to “Statistical Evaluation of Two Microbiological Diagnostic Methods of Pulmonary Tuberculosis After Implementation of a Directly Observed Treatment Short-course Program” Osong Public Health Res Perspect 2013;4(1):45–51

In the above-mentioned article, the authors want to update the source of Figure 1 both in Figure legend and in the Reference section, which was missing the original article.

Prevalence of dengue viral and malaria parasitic co-infections in an epidemic district, Angul of Odisha, India: An eco-epidemiological and cross-sectional study for the prospective aspects of public health

The co-existence of dengue and malaria infection in an individual and the primary and secondary dengue infection during co-infection were assessed. Over 1 year, 1980 blood samples were collected from suspected cases of dengue fever and analyzed by rapid diagnostic test [RDT], enzyme-linked immunosorbent assay [ELISA] and polymerase chain reaction [PCR] methods to detect dengue infection. RDT and microscopic methods were used to detect malaria. Of the 1980 samples, only 22 [3.0%] cases were identified as dengue-malaria co-infection cases, out of which 13 were male and 9 were female. The highest number of confirmed cases were found during the hot and humid months of September and October [7 cases, 31.8%] and within the over 15 years age group. Of the cases of co-infection, dengue primary infection [21 cases, 95.5%] was significantly more common than dengue secondary infection [1 case, 4.5%] among all of the age groups. There were 12 cases of Plasmodium falciparum and 10 cases of Plasmodium vivax infection among malarial cases. A high prevalence of concurrence of dengue and malaria infection was recorded in this ecosystem. In light of the severity of co-infection and overlapping symptoms, a multidimensional diagnostic approach is suggested

Prevalence of multidrug resistant uropathogenic bacteria in pediatric patients of a tertiary care hospital in eastern India

Today, because systemic infections such as urinary tract infection [UTI] affect even pediatric patients, antibiotic resistant bacteria have become a constant clinical challenge. In the present study, a total of 1054 urine samples were collected from pediatric patients over 18 months. From these samples, 510 isolates of pathogenic bacteria were collected using HiCrome UTI agar. Antibiotic sensitivity tests of isolates were performed using the Kirby-Bauer method. Two Gram-positive bacteria [Enterococcus faecalis and Staphylococcus aureus] and 7 Gram-negative bacteria [Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Kleb-siella oxytoca, K. pneumoniae, Proteus vulgaris and Pseudomonas aeruginosa] were isolated. Antibiograms of isolated bacteria were ascertained using antibiotics of 4 classes: aminoglycosides, p-lactams, fluoroquinolones and 2 stand-alones [co-trimoxazole and nitrofurantoin]. Based on percent values of antibiotic resistance, isolated bacteria were [in decreasing order of number of isolated isolates]: E. coli [109] > S. aureus [65] > E. faecalis [82] > E. aerogenes [64] > C. freundii [41] > P. aeruginosa [32] > K. pneumoniae [45] >K. oxytoca [50] >P. vulgaris [22]. Surveillance results show that MDR isolates of 9 pathogenic bacteria were prevalent in the environment around the hospital. Thus, revisions to the antimicrobial stewardship program in this area of the country are required to increase clinician confidence in empiric therapy, which is often used for UTI cases

Isolation of ESBL-producing gram-negative bacteria and in silico inhibition of ESBLs by flavonoids

Objective: To evaluate nosocomial accounts of 426 extended spectrum b-lactamase [ESBL]-producing strains from 705 isolates of 9 pathogenic gram-negative bacteria in vitro. We analysed the genetic divergence of ESBLs by constructing a phylogenetic tree and modelled flavonoid inhibition of ESBLs with in silico molecular docking to determine effective control options

Methods: Nine ESBL-producing bacteria were isolated from urine samples and their antibiograms were determined by the disc-diffusion method. Comparative models of the 9 ESBL enzymes were generated computationally using reference sequences, and validated by Ramachandran plots. Molecular docking with 11 flavonoids was conducted against the ESBL models

Results: Isolated strains were floridly multidrug-resistant. From the docking study, the predicted minimum energy value of amikacin was _8.108 kcal/mol against the wild type TEM-1 ESBL of Acinetobacter baumannii, while the docking value against the mutant type Escherichia coli was _7.388 kcal/mol. The docking scores obtained corroborated the in vitro results showing that the antibiotic was incapable of controlling the ESBL of the mutant strain. Among 11 flavonoids tested against the mutant ESBL of E. coli, epigallocatechin 3-gallate and eriodictyol, with docking scores of _9.448 and _8.161 kcal/ mol, respectively, were the most effective, with druglikeness scores of 0.39 and 1.37, respectively, compared to 1.03 for amikacin

Conclusion: Docking scores and drug-likeness scores indicated that flavonoids are compelling alternative antimicrobial agents that could serve as complementary therapy for newly arising ESBL-producing bacteria

Frontal recess polyp in a 14-year-old child resembling an antro-choanal polyp

A rare case of a unilateral single nasal polyp arising from a left frontal recess resembling an antro-choanal polyp in a 14-year-old girl is presented. A polypoidal mass completely occupying the left nasal cavity extending to the anterior nares was evident by anterior rhinoscopy. The mass was excised endoscopically, and its origin was found to be the frontal recess of the left nasal cavity, a rare occurrence in the paediatric age group

Antibacterial efficacy of five medicinal plants against multidrug-resistant enteropathogenic bacteria infecting under-5 hospitalized children / 中西医结合学报

<p><b>OBJECTIVE</b>To evaluate in vitro antibacterial effectiveness of five medicinal plants used by an Indian aborigine, against 8 multidrug-resistant (MDR) enteropathogenic bacteria isolated from clinical samples of under-5 hospitalized children.</p><p><b>METHODS</b>Antibiotic sensitivity patterns of eight clinically isolated strains of enteropathogenic bacteria, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Salmonella paratyphi, S. typhi, Shigella dysenteriae, S. sonnei and Vibrio cholerae were assessed by disc-diffusion method. Antibacterial activities of 8 solvent-extracts of leaves and bark of five medicinal plants were monitored by the agar-well diffusion method. The microbroth dilution method was used to assess minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Qualitative phytochemical analyses of active plant extracts were carried out.</p><p><b>RESULTS</b>Ethanol, ethyl acetate and methanol extracts of Holarrhena antidysenterica leaf tissue were most effective against 8 MDR pathogens in vitro. Similarly, acetone, ethanol and methanol extracts of Terminalia alata leaf tissue; chloroform, ethyl acetate and methanol extracts of Terminalia arjuna leaf tissue and ethyl acetate, ethanol and methanol extracts of Paederia foetida leaf tissue were most effective in inhibiting in vitro growth of the 8 MDR enteropathogens. Ethyl acetate and methanol extracts of H. antidysenterica bark tissue; acetone, ethanol and methanol extracts of T. alata bark tissue and acetone, ethanol and methanol extracts of T. arjuna bark tissue were most effective in controlling enteropathogen growth. The minimum inhibitory concentration and minimum bactericidal concentration values of the 3 most antimicrobial leaf and bark extracts from the five plants were in the range of 1.56 to 50 mg/mL.</p><p><b>CONCLUSION</b>These 5 plants exhibited in vitro control over a cohort of 8 enteropathogenic bacterial strains isolated from clinical samples.</p>

In vitro antibacterial efficacy of plants used by an Indian aboriginal tribe against pathogenic bacteria isolated from clinical samples

Objectives: To evaluate antibacterial efficacies of 21 medicinal plants used by an Indian aboriginal tribe against infectious diseases caused by bacteria isolated from clinical samples

Methods: Standard biochemical procedures were followed for identifying bacteria that were isolated from several clinical samples. All of the bacterial strains were subjected to antibiotic sensitivity tests by Kirby-Bauer's disc diffusion method. From antibiograms of isolated Gram-positive and Gram-negative bacteria, it was discernible that samples were multidrug resistant [MDR]. The methanol leaf-extract of Solanum xanthocarpum was subjected to thin layer chromatography [TLC] for phytochemical analysis. Molecular docking of Beta-lactamase enzyme of Escherichia coli with phytochemicals of S. xanthocarpum was performed to locate effective compounds

Results: The most effective 5 plants, which caused the size of the zone of inhibition to range from 21 to 27 mm, were Buchanania latifolia, Careya arborea, Ocimum tenuiflorum, Senna alata and S. xanthocarpum, for MDR bacteria. S. xanthocarpum had the lowest MIC value of 0.67 mg/ml and the lowest MBC value of 1.51 mg/ml against E. coli. In the TLC study, 9 spots of methanol leaf-extract of S. xanthocarpum were recorded with two solvent systems. The phytochemicals of S. xanthocarpum, solasodine and stigmasterol glucoside had the highest docking score values, -10.868 kcal/mol and ?10.439 kcal/mol, respectively, against Beta-lactamase

Conclusion: This study could prove in vitro antimicrobial efficacy of 5 uncommon plants against MDR pathogenic bacteria. Solasodine and stigmasterol glucoside were computationally recorded as the best controlling chemicals from the plant S. xanthocarpum

Prevalence of fluoroquinolone resistance in Escherichia coli in an Indian teaching hospital and adjoining communities

Multidrug resistant [MDR] strains of the Gram-negative pathogenic bacterium, Escherichia coli, particularly fluoroquinolone-resistant strains, are the major causative agents for hospital acquired [HA] infections, as well as epidemics linked to gastrointestinal [GI] and urinary tracts in the non-hygienic communities of most developing countries. The prevalence of multidrug resistance among 1642 strains of E. coli, isolated from clinical samples of patients with GI infections in a hospital over 39 months [November 2009-January 2013] is recorded, along with sensitivity patterns to 23 currently used antibiotics, including third-generation cephalosporins and fluoroquinolones with disc-diffusion method. A total of 1642 strains of E. coli were isolated from the clinical samples, of which 810 isolates were from CA samples and 832 isolates were from hospitalized patients during the study period. Of the 810 CA isolates, 567 strains were resistant to fluoroquinolone antibiotics; of the 832 HA isolates, 575 strains were fluoroquinolone-resistant, independently. Minimum inhibitory concentration values of fluoroquinolones [ciprofloxacin and levofloxacin] against the isolated E. coli strains confirmed the resistance in the current/coveted treatment options. Patients with other bacterial infections had relatively higher chances of becoming infected with fluoroquinolone-resistant E. coli strains. The data presented epitomize the daunting state of the infection-dynamics of fluoroquinolone-resistant E. coli in hospitals and adjoining communities

Prevalence of two multidrug-resistant Klebsiella species in an Indian teaching hospital and adjoining community

The Gram-negative pathogenic bacteria Klebsiella oxytoca and Klebsiella pneumoniae produce the extended spectrum beta -lactamase [ESBL] and cephalosporinase enzymes and are the major causes of hospital acquired [HA] infections and epidemics in non-hygienic communities in the majority of developing countries. The prevalence of multidrug resistance among 445 strains of K. oxytoca and K. pneumoniae isolated from clinical samples of patients with gastrointestinal infections over a period of 42 months in the hospital was recorded, along with the sensitivity patterns to 23 antibiotics, including third-generation cephalosporin and fluoroquinolone antibiotics, using the disk-diffusion method. Of 175 K. oxytoca isolates, 143 were ESBL positive and 117 were fluoroquinolone resistant. Of 270 K. pneumoniaeisolates, 200 were ESBL positive and 195 were independently fluoroquinolone resistant. The HA samples yielded more isolates than the community acquired [CA] samples for each species. The K. oxytoca strains were resistant to cefepime, gatifloxacin, ciprofloxacin, ceftazidime, levofloxacin and imipenem, whereas the K. pneumoniae strains were highly resistant to ampicillin, norfloxacin, ciprofloxacin, gatifloxacin, ofloxacin, amoxyclav, ceftazidime, cefepime, cefixime, piperacillin and imipenem. The ESBL-producing and fluoroquinolone-resistant K. pneumoniae strains were more prevalent than the K. oxytoca strains in the HA/CA samples. The minimum inhibitory concentration values of the third-generation cephalosporins: cefotaxime and ceftazidime and the fluoroquinolones: ciprofloxacin and levofloxacin against both species of Klebsiella confirmed the resistance in the current/coveted treatment options. Patients with other bacterial infections had a relatively higher probability of infection with ESBL-producing and fluoroquinolone-resistant Klebsiella strains. The data presented here highlight the alarming state of Klebsiellainfection dynamics in the hospital and adjoining communities

Surveillance of extended-spectrum beta-lactamase producing bacteria in an Indian teaching hospital

To conduct surveillance of a teaching hospital in a period of 15 months, clinical samples from patients were used for the isolation of pathogenic bacteria. Bacterial isolates were isolated and identifies by standard biochemical procedures. Antibiotic sensitivity test were conducted for each isolates by Kirby-Bauer's/disc diffusion method. Extended spectrum beta lactamase [ESBL] producers were determined by double disc diffusion synergy test [DDST] and iodometric test. 2547 bacterial isolates were found belonging to 12 species namely: Escherichia coli [954], Staphylococcus aureus [661], Klebsiella pneumoniae [301], Enterococcus faecalis [175], Pseudomonas aeruginosa [121],Acinetobacter sp. [110], Citrobacter sp. [69], Klebsiella oxytoca [51], Proteus vulgaris [43], Proteus mirabilis[31], Enterobacter sp. [27], Morganella sp. [4], in descending order. The isolated bacterial strains were further tested for monitoring resistance to cefepime ceftazidime, cefotaxime, ceftriaxone [all 30 micro g/disc] and cefoperazone [75 micro g/disc] of the third generation cephalosporins [3GCs]. Numbers of resistant isolates were in descending order: Proteus vulgaris [76.7%], Morganella sp. [75.0%], Enterococcus faecalis [71.4%],Pseudomonas aeruginosa [68.6%], Proteus mirabilis [67.7%], Klebsiella oxytoca [62.6%] and Citrobactersp. [52.1%] cefepime [30 micro g/disc] and the rest other bacteria were of lesser resistant values with the least percent value, Escherichia coli [7.7%]. Similarly, Citrobacter sp. [91.3%] showed resistance to ceftazidime [30 micro g/disc] and 76.8% resistant to cefotaxime [30 micro g/disc]. Proteus mirabilis showed the highest resistance over all other isolates as 90.3% to ceftriaxone [30 micro g/disc] and 80.6% to cefoperazone [75 micro g/disc]. The resistance values to the tested 3GC antibiotics ranged from 43 to 51%. Antibiotics inhibiting beta -lactamase production were used with a blithesome control over 12 ESBL bacteria. The 3GC antibiotic group was significantly effective in controlling the GN bacterial strains in this study

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

<p><b>OBJECTIVE</b>To investigate the infection of hospital- and community-acquired "erythromycin-induced clindamycin resistant" strains or D-test positives of clinical isolates of Staphylococcus aureus (S. aureus) (with and without methicillin resistance) in a hospital.</p><p><b>METHODS</b>Strains of S. aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling.</p><p><b>RESULTS</b>Of the total 278 isolates, 140 (50.35%) were D-test positives and the rest were D-test negatives. Further, of 140 (100%) positives, 87 (62.14%) and 53 (37.85%) strains were from males and females, respectively. Of 140 (100%) positives, 117 (83.57%) were methicillin resistant S. aureus and 23 (16.42%) were methicillin sensitive S. aureus; of 140 strains, 103 (73.57%) strains from persons with and 37 (26.42%) were without related infections; of 140 strains, 91 (65%) and 49 (35%) were from hospital- and community-acquired samples, respectively. In 140 strains, 118 (84.28%) with comorbidities and 22 (15.71%) without comorbidities cases were recorded; similarly, persons with prior antibiotic uses contributed 108 (77.14%) and without 32 (22.85%) positive strains. These binary data of surveillance were analyzed by a univariate analysis. It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity, corroborated by low P values, P=0.001 1 and 0.002 4, respectively. All isolates (278) were resistant to 17 antibiotics of nine groups, in varying degrees; the minimum of 28% resistance for vancomycin and the maximum of 97% resistance for gentamicin were recorded. Further, of 278 strains, only 42 (15.1%) strains were resistant constitutively to both antibiotics, erythromycin resistant and clindamycin resistant, while 45 (16.2%) strains were constitutively sensitive to both antibiotics (erythromycin sensitive and clindamycin sensitive). Further, of the rest 191 (68.7%) strains were with erythromycin resistant and clindamycin resistant, of which only 140 (50.35%) strains were D-test positives, while the rest 51 (18.34%) strains were D-test negatives.</p><p><b>CONCLUSIONS</b>In view of high prevalence of D-test positive S. aureus strains, and equally high prevalence of multidrug resistant strains both in community and hospital sectors, undertaking of D-test may be routinely conducted for suppurative infections.</p>