Tigecycline Susceptibility of Carbapenem Resistant Enterobacteriaceae and Acinetobacter spp. isolates from Respiratory Tract: A Tertiary Care Centre Study.

Background: Tigecycline is used as a last line ofdefence against Multidrug Resistant (MDR) strains,and increasing rates of resistance are a growing concernglobally. Tigecycline resistance has been reported invarious pathogens including Acinetobacter spp.,Klebsiella spp., Enterobacter spp., E. faecalis, S.aureus, S. pneumoniae and Serratia marcescens. Aimand Objectives: To study Tigecycline susceptibilitypattern of isolates of Enterobacteriaceae andAcinetobacter spp. from Respiratory Tract Infections(RTI) in a tertiary care hospital. Material and Methods:A total of 7573 respiratory samples were received inMicrobiology Department of Govind Ballabh PantInstitute of Postgraduate Medical Education andst st Research (GIPMER) from 1 January 2018 to 31December 2018. The samples were processed as perstandard techniques. Identification and antimicrobialsusceptibility testing was done by VITEK-2 Compactautomated system and Kirby – Bauer Disc DiffusionMethod as per CLSI Guidelines. Results: Out of total7573 respiratory samples received in laboratory, 1017(13.42%) were culture positive for pathogens.Klebsiella pneumoniae 420(41.29%) waspredominantly isolated microorganism followed byPseudomonas aeruginosa 206(20.25%) andAcinetobacter spp. 193(18.97%). Most of Gramnegative organisms were resistant to commonly usedantibiotics. Carbapenem resistance was observed as67.25%. Conclusion: Overall Tigecycline resistanceamong Carbapenem Resistant Enterobacteriaceae(CRE) and Carbapenem Resistant Acinetobacter(CRA) was found to be 15.50% and 10.69%respectively. Although Tigecycline is a promisingantibiotic for the treatment of infections caused by drugresistant problematic pathogens, Tigecycline resistanceis most frequently observed in A. baumannii andEnterobacteriaceae, especially in MDR strains. Hence,we advocate judicious use of Tigecycline in MDRinfections and it should be kept as reserve.

Prevalence of Gram-negative Septicemia in a Tertiary Care Center

Increased mortality due to sepsis and bacteremia impacts health-care activities severely. Administration of broad-spectrum antibiotics empirically may lead to failure of treatment. Toxic effects of non-susceptible drugs can be harmful for the patients and lead

To Evaluate The Antimicrobial Efficacy Of Green Coffee Bean Extract On Periopathogens- A Clinico-microbiological Study.

Aim - To evaluate the Antibacterial efficacy of three different dilution of green coffee bean extract on periopathogens. Objective- To achieve a dilution of green coffee bean extract which has the maximum inhibitory effect on P. gingivalis and A. actinomycetocomitans. Methods- The sterilised blood agar culture plate was prepared on which colonies of P. gingivalis and A. actinomycetocomitans were cultured by subgingival sample taken from Chronic Generalized Periodontitis cases. Three dilution of green coffee bean extract were prepared i.e 10 -8, 10 -9 and 10 -10 with the serial dilution method using Distilled water. Then streaking of colonies was done on three different areas of culture plate on which different dilution was added. Minimum inhibitory concentration (MIC) on culture plates was observed to see the inhibitory effect of Green Coffee Bean extract on periopathogens by Agar Diffusion Method.Result- 10-9 was found have maximum inhibitory effect on periopathogens especially P.Gingivalis Conclusion- P.Gingivalis is more susceptible to 10-9 concentration of Green Coffee Bean Extract [Sachin M NJIRM 2016; 7(5):56-59]

Impact Of Training On Knowledge And Practices Of Nurses Regarding Hospital Infection Control In A Tertiary Care Centre.

Background and objective:Nurses provide the first-hand bedside care to the patients in a hospital thus have a direct role in hospital infection control. Thus to improve hygiene behaviour of staff, training sessions on hospital infection control is necessary. The objective of this study was to assess the impact of training on knowledge and practices regarding hospital infection control amongst nursing staff working in tertiary care centre. Method: The study included 89 nurses from different wards and I.C.U. A pre-test and a post-test was conducted with a set of 20 self designed multiple choice questions in three days session of training covering important aspects of hospital infection control. Improvement in pre-test and post test for individual candidate was assessed and statistical data analysis was done. Results: Response rate of the questionnare was 100%.The mean pre-test score was 9(S.D 3.06) while mean post-test score was 14(S.D 6.34). The difference in pre-test and post-test was statistically significant(P< 0.00001) taking 95% confidence interval. Interpretation and conclusion: Training sessions and workshops for healthcare workers conducted regularly will help curbing nosocomial infections and providing a better patient care.

Comparative Evaluation Of C-Reactive Protein Levels And Leucocyte Counts In Patients With Sickle Cell Anemia, Chronic Generalized Periodontitis And Sickle Cell Anemia With Chronic Periodontitis: A Clinico-Biochemical Study.

Aim: The aim of this study is to compare the CRP levels and leucocyte counts in patients with Sickle cell anemia, Sickle cell anemia with chronic periodontitis, and chronic periodontitis. Material andMethods: A total of 90 subjects with an age range of 30-50 years having sickle cell anemia and chronic periodontitis with probing depth ≥5mm and clinical attachment level ≥ 5mm were included and three groups: Group I- Sickle cell anemia; Group II- Sickle Cell anemia with chronic periodontitis and Group III: Chronic severe periodontitis. Blood samples for CRP and leucocytes counts estimation were collected. All participants were subjected to quantitative CRP analysis. Results: Mean CRP levels and leucocyte counts were significantly greater in group II as compared to group I and group III. Conclusion: The present study indicates a positive correlation in CRP levels and leucocyte counts in patients with Sickle cell anemia, chronic periodontitis and both.

Experimental evaluation of analgesic property of bark skin of Saraca indica (Ashoka) and Shorea robusta (Shal).

The aqueous and alcoholic extracts of bark skin of Saraca indica (Ashoka) and Shorea robusta (Shal) were evaluated for their analgesic activity in Swiss albino rats by making use of different pain models such as, tail immersion test, tail clip method and writhing induced by 4% NaCl solution. The aqueous and alcoholic extract of Saraca indica and Shorea robusta showed significant analgesic activity at 300 mg/ Kg body weight in Swiss albino rats as compared with control rats from physical, thermal and chemical stimulus of evaluation techniques. The analgesic activity might have been attributed to the presence of alkaloids, steroids in these plants as revealed from phytochemical analysis. On the basis of these observations it was concluded that Ashoka and Shal has got analgesic property, however further experimental as well as clinical evaluations are necessary.

Obstetric hemorrhage: anesthetic implications and management

Obstetric hemorrhage, a preventable condition, is one of the leading causes of death in developing countries. The role of anesthesiologist in the management of obstetric hemorrhage is very critical. The crux of management of obstetric hemorrhage is a consensual planning with formation of a multidisciplinary team and formulating a logistic protocol that can be disseminated locally for managing catastrophes. This review highlights the optimum preoperative care to assess the risk factors and isolate the patients prone to develop peripartum hemorrhage and also deals with the most recent guidelines and management protocols including conservative and interventional modes of treatment. Details of anticipated and unanticipated obstetric hemorrhage, fluid and blood transfusion strategies are discussed

Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

Spinal anesthesia [SA] was combined with general anesthesia [GA] for achieving hemodynamic stability in laparoscopic hysterectomy. The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Patients were randomly assigned to receive SA with GA [group SGA] or plain GA [group GA]. Group SGA received 10 mg bupivacaine [heavy] for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance [ANOVA] was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate [HR], mean arterial pressure [MAP], SPO2, and etCO2 was done with Student's t-test or Mann-Whitney test, wherever applicable. Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant [P < 0.01]. Group GA showed additional requirement of metoprolol [53.33%] and higher concentration of isoflurane [P < 0.001] to combat the increased MAP. Recovery was early and quick in group SGA as against group GA [P = 0.000]. There were no adverse/residual effects of SA. The hemodynamic repercussions during pneumoperitoneum can be effectively attenuated by combining SA and GA, without any adverse effects

IgG AVIDITY WESTERN BLOT USING Toxoplasma gondii rGRA-7 CLONED FROM NUCLEOTIDES 39-711 FOR SERODIAGNOSIS OF ACUTE TOXOPLASMOSIS / Avidez do IgG pelo Western Blot usando o r GRA-7 do Toxoplasma gondii clonado de nucleotídeos 39-711 para sorodiagnóstico de toxoplasmose aguda

Toxoplasmosis is an important cause of congenital infection. The present study was performed to evaluate the usefulness of recombinant (r) GRA-7 cloned from nucleotides (n) 39-711 in discriminating between acute and chronic toxoplasmosis. First, commercial IgM, IgG and IgG avidity ELISAs were used to determine the serological profile of the sera. Serum samples were from 20 symptomatic patients with acute infection (low IgG avidity, IgM positive), 10 with chronic infection (high IgG avidity, IgM negative) and 10 with indeterminate IgG avidity (IgM positive) which were tested for IgG avidity status with an in-house developed IgG avidity Western blot using the rGRA-7 recombinant antigen. All 20 sera from cases of probable acute infection showed bands which either faded out completely or reduced significantly in intensity after treatment with 8 M urea, whereas the band intensities of the 10 serum samples from chronic cases remained the same. Of the 10 sera with indeterminate IgG avidity status, after treatment with 8 M urea the band intensities with six sera remained the same, two sera had completely faded bands and another two sera had significantly reduced band intensities. Discrimination between acute and chronic toxoplasmosis was successfully performed by the in-house IgG avidity Western blot.

Toxoplasmose é uma causa importante de infecção congênita. O presente estudo foi feito para avaliar o uso do recombinante (r) GRA-7 clonado de nucleotídeos (n) 30-711 para discriminar entre toxoplasmose aguda e crônica. Inicialmente IgM, IgG e ELISA avidez IgG comerciais foram usados para determinar o perfil sorológico do soro. Amostras de soro de 20 pacientes sintomáticos com infecção aguda (IgG avidez baixa, IgM positivo), 10 com infecção crônica (alta avidez IgG, IgM negativo) e 10 com avidez IgG indeterminada (IgM positivo) que foram testados para o status de avidez IgG com um doméstico Western Blot desenvolvendo avidez IgG usando o rGRA-7 antígeno recombinante. Todos os 20 soros de provável infecção aguda mostraram bandas que ou se apagaram completamente ou tiveram a sua intensidade significantemente reduzida após tratamento com uréia 8 M, enquanto as intensidades das bandas das 10 amostras de soros de casos crônicos permaneceram iguais. Dos 10 soros com status indeterminado de avidez de IgG, após tratamento com uréia 8 M a intensidade das bandas em seis soros permaneceram iguais, dois soros tiveram bandas apagadas completamente e dois outros tiveram significante redução da intensidade das bandas. Discriminação entre toxoplasmose aguda e crônica foi feita com sucesso através do IgG avidez Western blot doméstico.

Molecular analysis of gut microbiota in obesity among Indian individuals.

Obesity is a consequence of a complex interplay between the host genome and the prevalent obesogenic factors among the modern communities. The role of gut microbiota in the pathogenesis of the disorder was recently discovered; however, 16S-rRNA-based surveys revealed compelling but community-specific data. Considering this, despite unique diets, dietary habits and an uprising trend in obesity, the Indian counterparts are poorly studied. Here, we report a comparative analysis and quantification of dominant gut microbiota of lean, normal, obese and surgically treated obese individuals of Indian origin. Representative gut microbial diversity was assessed by sequencing fecal 16S rRNA libraries for each group (n=5) with a total of over 3000 sequences. We detected no evident trend in the distribution of the predominant bacterial phyla, Bacteroidetes and Firmicutes. At the genus level, the bacteria of genus Bacteroides were prominent among the obese individuals, which was further confirmed by qPCR (P<0.05). In addition, a remarkably high archaeal density with elevated fecal SCFA levels was also noted in the obese group. On the contrary, the treated-obese individuals exhibited comparatively reduced Bacteroides and archaeal counts along with reduced fecal SCFAs. In conclusion, the study successfully identified a representative microbial diversity in the Indian subjects and demonstrated the prominence of certain bacterial groups in obese individuals; nevertheless, further studies are essential to understand their role in obesity.

Composition, antioxidant and chemotherapeutic properties of the essential oils from two Origanum species growing in Pakistan

The GC-MS analyses of Origanum majorana L. (OME) and Origanum vulgare L. (OVE), Lamiaceae, essential oils helped identification of 39 (96.4 percent of the total oils) and 43 (92.9 percent of the total oils) components, respectively. The major constituents of OME were terpinene-4-ol (20.9 percent), linalool (15.7 percent), linalyl-acetate (13.9 percent), limonene (13.4 percent) and α-terpineol (8.57 percent), whereas, thymol (21.6 percent), carvacrol (18.8 percent), o-cymene (13.5 percent) and α-terpineol (8.57 percent) were the main components of OVE. In the disc diffusion and the resazurin microtitre assays, OME showed better antibacterial activity than OVE with larger zones of inhibition (16.5-27.0 mm) and smaller MIC (40.9-1250.3 μg/mL) against the tested bacterial strains. Only OVE displayed anti-heme biocrystallization activity with an IC50 at 0.04 mg/mL. In the DPPH assay, OVE showed better radical-scavenging activity than OME (IC50=65.5 versus 89.2 μg/mL) and both OME and OVE inhibited lionleic acid oxidation. However, in the bleaching β-carotene assay, OVE exhibited better antioxidant activity than OME. In the MTT assay, OME was more cytotoxic than OVE against different cancer cell types, such as MCF-7, LNCaP and NIH-3T3, with IC50s of 70.0, 85.3 and 300.5 μg/mL, respectively. Overall, some components of OME and OVE may have antiparasitic and chemotherapeutic activity.

Oviposition Attractancy of Bacterial Culture Filtrates: response of Culex quinquefasciatus

Oviposition attractants could be used for monitoring as well as controlling mosquitoes by attracting them to lay eggs at chosen sites. In the present study, culture filtrates of seven bacterial species were tested for their attractancy against gravid females of Culex quinquefasciatus. When their oviposition active indices (OAI) were studied, the culture filtrates of Bacillus cereus and Pseudomonas fluorescens exhibited oviposition attractancy (OAI = >0.3) at 100 ppm and the OAI were respectively 0.70 and 0.47. Culture filtrates of B. thuringiensis var. israelensis (wild type), B. t. var. israelensis (mutant) and B. sphaericus showed attractancy at 2000 ppm with OAI of respectively 0.71, 0.59 and 0.68. However, the OAI of B. megaterium as well as Azospirillum brasilense was 0.13 (at 2000 ppm), which was less than 0.3 required to be considered them as attractants. When the oviposition attractancy of the bacterial culture filtrates were compared with that of a known oviposition attractant, p-cresol (at 10 ppm), the culture filtrates of B. t. var. israelensis (wild type) and B. cereus were found to be more active than p-cresol, respectively with 64.2 and 54.3 percent oviposition