PREVELANCE OF CARBAPENEMASE PRODUCING ORGANISMS AND MOLECULAR RAPID DETECTION OF DIFFERENT GENES FROM VARIOUS CLINICAL ISOLATES IN PATIENTS ADMITTED AT TERTIARY CARE HOSPITALS OF VADODARA

Introduction- Carbapenemase-producing organisms (CPO) have been identied as an urgent healthcare threat. The spread of carbapenemase-producing Enterobacterales (CPE) is a global health problem of great concern. Rapid detection of carbapenemase-producing organisms is clinically desirable for hospital infection control and antibiotic stewardship. Recently, an on-demand polymerase chain reaction (PCR) assay, namely, the Xpert Carba- R assay, that requires less than an hour of turnaround time, had been developed for CPO detection in clinical samples to identify and guide infection control programs to contain the spread of CPO within a hospital. Carba-R assay is a Objective- qualitative multiplex real-time PCR method that qualitatively detects and differentiates ve common carbapenemase genes (blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP) directly from clinical samples or puried colonies within approximately 1 hour. This benets hospitals and patients by facilitating timely Infection Prevention & Control measures, thereby reducing risk of exposure, transmission and bed-days lost. In this study, the Xpert Carba-R assay was evaluated for Materials & Methods- detection of the ve carbapenemase genes (blaKPC, blaNDM, blaIMP, blaOXA-48, and blaVIM) in total of 40 non duplicate various clinical samples of admitted patients in tertiary care hospitals of Vadodara. We performed Carba-R on 40Result- isolates: 18 blood samples, 06 urine, 05 rectal swabs, 03 Endotracheal secretion, 03 Pus, 02 wound discharge, 01 Bronchoalveolar lavage uid, 01 sputum, and 01 ERCP stent isolates. 36/40 (90%) isolates had one or more carbapenemase genes. They were as follows: 19/40 (47.5%) both OXA48 and NDM , 12/40 (30%) NDM and 05/40(12.5%) OXA-48. There were 04/40 (10 %) isolates which were Carbapenem resistant on disc diffusion & VITEK but none of the resistant genes were detected possibly due to other resistant mechanism like efux pump and porin channels. Klebsiella pneumoniae was the most common isolate with CR, 34/40 (85%). The most frequent genes encountered in Klebsiella pneumoniae were both OXA48 and NDM, 19/34 (55.88%), NDM 08/34 (23.53%) followed by OXA 48, 05/34 (14.71%) and Out of 34 Klebsiella isolates, 02 isolates failed to detect any of these ve carbapenemase genes. Xpert Carba-R assay provides good reliable results for detection and Conclusion- differentiation of ve carbapenemase genes in clinical isolates. Compared to bacterial culture followed by PCR identication of resistance genes from colonies, the Carba-R assay reduced turnaround time from 48 to 72 hours to less than 1 hour. Carbapenemase genes were detected by the Carba-R assay in Klebsiella pneumoniae (34/40), Escherichia coli (5/40), Acinetobacter spp (1/40). The Carba-R assay detected 19 both OXA48 and NDM (47.5%), 12 blaNDM (30% and 05 blaOXA-48 (12.5%) genes. Laboratory detection of these genes may help improve patient outcomes by tailoring therapy. This study was conducted for understanding the molecular epidemiology of Carbapenemase producing Enterobacteriaceae in a tertiary care hospital. The combined use of the Xpert Carba-R assay and culture produces rapid and reliable results for the active surveillance of CPO in patients

DETECTION OF CARBAPENEMASE PRODUCING ENTEROBACTERALES AMONG THE CLINICAL ISOLATES OF DIARRHOEAGENIC ESCHERICHIA COLI CAUSING ACUTE GASTROENTERITIS IN CHILDREN BELOW 2 YEARS IN TERTIARY CARE HOSPITAL OF NORTH EAST INDIA.

Introduction: Enterobacterales that test resistant to at least one of the carbapenem antibiotics (ertapenem, meropenem, doripenem, or imipenem) are called Carbapenem resistant Enterobacterales (CRE) and if they produce a carbapenemase (an enzyme that can make them resistant to carbapenem antibiotics) they are called Carpenemase producing Enterobacterales (CPE). Children with CRE strains in fecal samples are considered as a high risk group by World Health Organization (WHO), which can spread CRE by intimate contact and travel. This cross-sectional study was conducted in the Departm Methods: ent of Microbiology, RIMS, Imphal, Manipur, India from Jan 2020 to Feb 2022. A total of 157 children under 2 years of age whose stool culture was positive for diarrhoeagenic Escherichia coli were included in the study. The modified carbapenem inactivation method (mCIM) has been done for detection of carbapenemase producers and the addition of EDTA in eCIM to further differentiate between serine and metallo-?-lactamase producers. Out of 157 Result and Discussion: Diarrhoegenic E.coli (DEC) ,Carbapenem resistance was seen in 9 isolates i.e 5.7 %. Out of these 9 isolates, 3 were MBL producers tested by the phenotypic test mCIM and eCIM. All the three MBL producers carried bla NDM-1 gene. mCIM/eCIM assay is designed to simultaneously detect and distinguish the different types of carbapenemases. Carbapenemase genes are often located on plasmids that can be exchanged between Enterobacteriaceae and other Gram-negative bacteria. Carbapenem-resistant K. pneumoniae are currently more frequent and more likely to cause healthcareassociated outbreaks, carbapenem-resistant E. coli pose a greater risk for spread in the community. Conclusion: Screening for carbapenemase producer using mCIM and eCIM essay is important along with infection control measure such as active surveillance through rectal screening for CRE carriage on hospital admission, contact precautions, hand hygiene, patient isolation, environmental sanitation, case notification/fiagging, antibiotic restriction.

Caracterización de carbapenemasas en enterobacterias de muestras de pacientes que acudieron al Hospital General San Juan de Dios de la ciudad de Guatemala durante 2014 y 2015 / Characterization of carbapenemases in Enterobacteriaceae of samples of patients who attended the San Juan de Dios General Hospital in Guatemala City during 2014 and 2015

En salud pública a nivel mundial, la producción de carbapenemasas es actualmente el mayor problema de resistencia antimicrobiana. El objetivo de este estudio fue caracterizar las carbapenemasas en enterobacterias en pacientes que acudieron al Hospital General San Juan de Dios de la ciudad de Guatemala y determinar servicios hospitalarios y tipos de muestras más frecuentes. Se usaron datos de 2014 y 2015 del área de bacteriología del hospital; se realizó una revisión sistemática, selección, ordenamiento y cálculo de frecuencias y porcentajes. En 2014, 165/165 (100 %) de las carbapenemasas fueron de tipo metalo-ß-lactamasas (MBL); en 2015, 90/118 (76 %) MBL y 28/118 (24 %) Klebsiella pneumoniae carbapenemasa (KPC). Klebsiella pneumoniae fue la enterobacteria productora de carbapenemasas (CPE) aislada con más frecuencia, 134/165 (81 %) en 2014 y 82/118 (69 %) en 2015. En 2014 la unidad de cuidados intensivos de neonatos obtuvo el mayor porcentaje de aislamientos de CPE, 30/165 (18 %); en 2015, medicina de hombres fue el servicio con el mayor porcentaje de CPE, 13/118 (11 %). El tipo de muestra más frecuente en 2014 fue sangre, 67/165 (41 %); en el 2015 fue orina, 31/118 (26 %). Los resultados evidencian la persistencia de carbapenemasas tipo MBL y la aparición de nuevos tipos, específicamente carbapenemasas tipo KPC, que destacan la necesidad de actuar urgentemente ante el riesgo que suponen para la salud de la población.

In public health worldwide, carbapenemase production is currently the biggest problem of antimicrobial resistance. The objective of this study was to characterize carbapenemases in Enterobacteriaceae of patients who attended the San Juan de Dios General Hospital in Guatemala City and to determine hospital services and types of samples more frequent. Data from 2014 and 2015 of the bacteriology department of the hospital were used; a systematic review, selection, ordering and calculation of frequencies and percentages was conducted. In 2014, 165/165 (100 %) of the carbapenemases were metallo-ß-lactamases (MBL); in 2015, 90/118 (76 %) MBL and 28/118 (24 %) Klebsiella pneumoniae carbapenemase (KPC). Klebsiella pneumoniae was the carbapenemases-producing Enterobacteriaceae (CPE) most frequently isolated, 134/165 (81 %) in 2014 and 82/118 (69 %) in 2015. In 2014 the neonatal intensive care unit obtained the highest percentage in CPE, 30/165 (18 %); in 2015, men's medicine was the service with the highest percentage of carbapenemases, 11/138 (11 %). The most frequent type of sample in 2014 was blood, 67/165 (41 %). In 2015 it was urine, 31/118 (26 %). The results obtained highlight the persistence of MBL-type carbapenemases and the appearance of new types of carbapenemases, specifically KPC. These results underline the need to act urgently in Guatemala in the face of the problems that carbapenemases-producing Enterobacteriaceae pose for the health of the population.

Quality microbiological diagnostics and antimicrobial susceptibility testing, an essential component of antimicrobial resistance surveillance and control efforts in Pacific island nations

Problem@#Emerging bacterial antimicrobial (antibiotic) resistance (AMR) is a global threat to human health. However, a majority of lower income countries do not have microbiological diagnostic testing for prompt, reliable confirmation of bloodstream infection and identification of AMR.@*Context@#Clinicians in Pacific island nations are increasingly challenged by patients who have infection due to antimicrobialresistant bacteria. Treatment of infection remains empirical because of a lack of diagnostic testing capacity and may follow guidelines that were formulated without reference to local measures of AMR prevalence. There is limited understanding among clinicians of microbiology testing and test interpretation.@*Action@#Examine the lessons learnt from pilot laboratory development programmes in two Pacific island nations that focused on establishing standard procedures for micrological diagnostics and antimicrobial susceptibility testing (AST) and on improving the training of clinicians to increase their use of laboratory services.@*Outcome@#The pilot programmes addressed a range of logistical difficulties and evaluated two blood culture systems. They also examined and improved internal QC implementation and evaluated the prevalence of AMR.@*Discussion@#Continued development of microbiological diagnostic capability in the Pacific region is paramount. Pacific Island nations need to develop the capability of at least one central laboratory to culture AMR pathogens and subject them to quality-controlled AST or arrange for suitable referral to a nearby country.

Factors Associated with the Occurrence of Canine Parvoviral Enteritis in Dogs

A prospective study was conducted to identify the risk factors associated with the incidence of Canine Parvoviral Enteritis (CPE) in dogs. Total of 120 animals screened using PCR assay, 72.50 percentage of animal were found positive for Canine Parvo Virus (CPV). Incidence in history of unvaccinated and vaccinated dogs was 79.69 and 64.29 per cent respectively. Age-wise predisposition of CPE indicated that the highest incidence was observed in both less than 3 months (78.08 %) and 3 to 6 months of age group (77.42 %) followed by 6 to 12 months of age group (34.50 %). Incidence of CPE in scheduled and unscheduled vaccination was 30.00 and 83.33 per cent respectively. In this study, unvaccinated status, unscheduled vaccination and young age groups are found to be significant risk factors associated with the occurrence of CPE

Pesquisa de Clostridium perfringens em carnes bovinas embaladas a vácuo comercializadas no Distrito Federal e entorno / Clostridium perfringens research on vacuum packed beef commercialized on Distrito Federal and in the surrounding area

O objetivo deste trabalho foi detectar a presença de Clostridium perfringens em 54 amostras de carne bovina embaladas a vácuo comercializadas na região do Distrito Federal, bem como detectar a presença da toxina cpe por PCR, ainda avaliar os meios de cultivo ágar SPS® e ágar TSC®, com e sem etapa de pré-enriquecimento das amostras em caldo infusão de cérebro e coração (BHI) na câmara de anaerobiose, e posterior incubação das placas de SPS® e TSC® tanto em jarra de anaerobiose, como em câmara de anaerobiose. Na análise da incubação das placas em ágar SPS® e TSC®, sem a etapa de pré-enriquecimento em caldo BHI na câmara de anaerobiose, observou-se o crescimento em apenas uma (1,85%) das 54 amostras analisadas, em ambos os meios de cultivo e formas de incubação. Com a etapa de pré-enriquecimento com caldo BHI em câmara de anaerobiose, observou-se crescimento em todas as 54 amostras (100%), em ambos os meios de cultivo e formas de incubação. Na reação em cadeia de polimerase (PCR) nenhuma das cepas oriundas das amostras analisadas apresentaram a amplificação de fragmento do gene da toxina cpe. Os resultados evidenciam a presença de C. perfringens em carnes embaladas a vácuo comercializadas no Distrito Federal e Entorno, porém não foi detectada a toxina cpe em nenhuma cepa isolada analisada. Na comparação estatística aplicando o teste qui-quadrado de McNemar, observou-se que houve diferença significativa (p<0,001) entre as análises sem e com a etapa de pré-enriquecimento em caldo BHI, verificando-se a influencia positiva do meio na recuperação de esporos, destacando desta forma a importância do enriquecimento prévio em meio BHI e a incubação em câmara de anaerobiose, na recuperação de esporos deste microrganismo.

The aim of this work was to detect Clostridium perfringens in 54 samples of vacuum packed beef sold at the Federal District area, and to detect the presence of the cpe toxin gene by Polymerase chain reaction (PCR), also evaluate the culture medium SPS® agar and TSC® agar, with and without pre-enrichment step of the samples in Brain Heart Infusion (BHI) broth in the anaerobic chamber, and to promote the incubation of the plates in anaerobic jar and anaerobic chamber. The results of the incubation on SPS® agar and TSC® agar, without the pre-enrichment step in BHI, growth was observed in only one (1,85%) of the 54 analyzed samples, in both culture media and incubation methods. With the pre-enrichment step with BHI broth in the anaerobic chamber, growth was observed in all 54 samples (100%), in both culture media and incubation methods. At the PCR, In the polymerase chain reaction (PCR), none of the strains from the analyzed samples showed fragment amplification of the toxin cpe gene. The results showed the presence of C. perfringens in vacuum packed beef samples commercialized at the Distrito Federal area and surroundings, however the cpe toxin was not detected in any isolated strain analyzed. In the statistical test using the McNemar chi-square test, a significant difference (p<0,001) was observed between the analysis with and without pre-enrichment step in BHI broth, verifying the positive influence of the medium in spore recovery, therefore to enhance the importance of the pre-enrichment stage in BHI broth and the incubation in anaerobic chamber in spore recovery for this microorganism.

Inhibitory effect of geniposide against influenza A/H1N1 virus / 中国药科大学学报

@#The aim of this study was to explore the protective effects of geniposide against Influenza A(H1N1)pdm09 virus in vitro and in vivo. In vitro, geniposide was administered as a precaution drug, a direct deactivation drug or a treatment drug at different doses. Peramivir was applied as a positive control. The quantitative colorimetric MTT assay was applied to test both the cytotoxicity of geniposide on Madin-Darby Canine Kidney(MDCK)cells and the cytopathogenic effect(CPE)of geniposide on MDCK cells infected by influenza A(H1N1)virus. The viral inhibitory rate of geniposide on NT0901 was also calculated. In vivo, we presented a mouse model of influenza A(H1N1)pdm09 virus infection. Geniposide(5, 10, or 20 mg/kg)or peramivir(30mg/kg)were used as treatment procedures. Lung index and the survival rate were calculated to evaluate the therapeutic effects of geniposide or peramivir on NT0901-infected mice. Haematoxylin and eosin(H&E)stain was used to access the pathological alterations of lung tissues. The study in vitro demonstrated that the TD50(median toxic dose)of geniposide was higher than 1 040 μmol/L. Besides, the EC50(concentration for 50% of maximal effect)of geniposide administered for precaution, direct deactivation and therapy were 91. 90, 96. 25, 87. 68 μmol/L, respectively. These results suggested that geniposide could block the damage of NT0901 on MDCK cells in a dose-dependent manner. The results in vivo showed that geniposide could significantly alleviate the lung index elevation and inflammatory responses in lung tissues induced by NT0901, reduce the mortality of infected mice and extend their survival time. In conclusion, our investigation indicates that geniposide is highly effective in inhibiting cytopathogenic effect and acute lung injury caused by influenza A(H1N1)pdm09 virus. Geniposide may be a potential therapeutic agent for the suppression of influenza virus.

Prediction of brain atrophy using three drug scores in neuroasymptomatic HIV-infected patients with controlled viremia

ABSTRACTBACKGROUND: Despite potent antiretroviral therapy, HIV still causes brain damage. Better penetration into the CNS and efficient elimination of monocyte/macrophages reservoirs are two main characteristics of an antiretroviral drug that could prevent brain damage. The aim of our study was to assess efficacy of three antiretroviral drug scores to predict brain atrophy in HIV-infected patients.METHODS:A cross sectional study consisting of 56 HIV-infected patients with controlled viremia, who had no clinically evident neurocognitive impairment. All patients had MRI of the head. A typical T2 transversal slice was analyzed and ventricles-brain ratio (VBr) as an overall brain atrophy index was calculated. Three antiretroviral drug scores were used and correlated with VBr: 2008 and 2010 CNS penetration effectiveness scores (SCPE2008 and SCPE2010) and the recently established monocyte efficacy (SME) score. A p-value <0.05 was considered significant.RESULTS:SCPE2010 was significantly associated with VBr in both univariate (r = -0.285, p = 0.033) and multivariate (ß = -0.299, p = 0.016) regression models, while SCPE2008 was not (r = -0.141, p = 0.300 and ß = -0.156,p = 0.214). SME was associated with VBr in multivariate model only (r = -0.297, p = 0.111 andß = -0.406, p = 0.029). Age and reported duration of HIV infection were also significant predictors of overall brain atrophy in multivariate regression models.CONCLUSIONS:Although based on similar type of research, SCPE2010 is a superior drug score compared to SCPE2008. SME is an efficient drug score in determining brain damage. Both SCPE2010 and SME scores should be taken into account in preventive strategies of brain atrophy and neurocognitive impairment in HIV-infected patients.

The antiviral effect of jiadifenoic acids C against coxsackievirus B3

Coxsackievirus B type 3 (CVB3) is one of the major causative pathogens associated with viral meningitis and myocarditis, which are widespread in the human population and especially prevalent in neonates and children. These infections can result in dilated cardiomyopathy (DCM) and other severe clinical complications. There are no vaccines or drugs approved for the prevention or therapy of CVB3-induced diseases. During screening for anti-CVB3 candidates in our previous studies, we found that jiadifenoic acids C exhibited strong antiviral activities against CVB3 as well as other strains of Coxsackie B viruses (CVBs). The present studies were carried out to evaluate the antiviral activities of jiadifenoic acids C. Results showed that jiadifenoic acids C could reduce CVB3 RNA and proteins synthesis in a dose-dependent manner. Jiadifenoic acids C also had a similar antiviral effect on the pleconaril-resistant variant of CVB3. We further examined the impact of jiadifenoic acids C on the synthesis of viral structural and non-structural proteins, finding that jiadifenoic acids C could reduce VP1 and 3D protein production. A time-course study with Vero cells showed that jiadifenoic acids C displayed significant antiviral activities at 0-6 h after CVB3 inoculation, indicating that jiadifenoic acids C functioned at an early step of CVB3 replication. However, jiadifenoic acids C had no prophylactic effect against CVB3. Taken together, we show that jiadifenoic acids C exhibit strong antiviral activities against all strains of CVB, including the pleconaril-resistant variant. Our study could provide a significant lead for anti-CVB3 drug development.

Conservation of cis-Regulatory Element Controlling Timely Translation in the 3'-UTR of Selected Mammalian Maternal Transcripts

The earliest stages of mammalian embryogenesis are governed by the activity of maternally inherited transcripts and proteins. Cytoplasmic polyadenylation of selected maternal mRNA has been reported to be a major control mechanism of delayed translation during preimplantation embryogenesis in mice. The presence of cis-elements required for cytoplasmic polyadenylation (e.g., CPE) can serve as a useful tag in the screening of maternal genes partaking in key functions in the transcriptionally dormant egg and early embryo. However, due to its relative simplicity, UA-rich sequences satisfying the canonical rule of known CPE consensus sequences are often found in the 3'-UTR of maternal transcripts that do not actually undergo cytoplasmic polyadenylation. In this study, we developed a method to confirm the validity of candidate CPE sequences in a given gene by a multiplex comparison of 3'-UTR sequences between mammalian homologs. We found that genes undergoing cytoplasmic polyadenylation tend to create a conserved block around the CPE, while CPE-like sequences in the 3'-UTR of genes lacking cytoplasmic polyadenylation do not exhibit such conservation between species. Through this cross-species comparison, we also identified an alternative CPE in the 3'-UTR of tissue-type plasminogen activator (tPA), which is more likely to serve as a functional element. We suggest that verification of CPEs based on sequence conservation can provide a convenient tool for mass screening of factors governing the earliest processes of mammalian embryogenesis.

Study on the antiviral effects of Stichopus japonicus Selenka glycosaminoglycans (SJ-GAG) on HSV-Ⅰ / 中国海洋药物

Objective To study the antiviral effects of SJ-GAG on herpes simplex virus Ⅰ(HSV-Ⅰ) in vitro as well as its protective effect on infected mice.Methods The Vero cells were exposed to HSV-Ⅰ SM44 and different concentrations of SJ-GAG,respectively.Cytopathic effect(CPE) was observed and qunatitative PCR was used to evaluate the antiviral effect of SJ-GAG.In vivo experiment,the mice were infected with HSV1 intracranial vaccination and followed SJ-GAG intragastric administration 4h later to test the protection of SJ-GAG on HSV1 infected mice.Results When the concentration of SJ-GAG was above 1.6mg?mL-1,it showed cytotoxicity.When the concentration was among 0.25～0.2mg?mL-1,it expressed marked antiviral effect without cytotoxicity.SJ-GAG could prolong the survival duration of infected mice and decrease the mortality rate significantly.The protection of SJ-GAG showed a dose-effect relationship.Conclusion SJ-GAG has antiviral effect and shows some protective effect on HSV-1 infected mice.

Experimental Study of RIP to Resist Virus in vitro / 微生物学通报

Ribosome inactivating protein(RIP) is a kind of toxin plant pr ot ein in which extensively lives in the body of higher plants and controls ribosom e's function. Beside it can control protein's combination,it has lots of biolog ical reactivity as resisting giving birth and tumor and controlling HIV. At fir st, RIP is isolated from seeds of bitter melon.The result of SDS-PAGE indicate s that there are lots of RIP in the abstraction liquid.Then we study the antivi ral action of RIP through the cell of CEF and SPF chicken embryos.The results s how that RIP can resist NDVF_48E_8,MDVCVI_988 and FPV-SD4 to so me extent.