Cytotoxicity evaluation, antibacterial effect, and degree of conversion of QAM-containing adhesives

Abstract The aim of this study was to evaluate the influence of adding quaternary ammonium methacrylates (QAMs) to experimental adhesives by assessing the degree of conversion (DC), cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. Two QAMs were added to an experimental adhesive: dimethylaminododecyl methacrylate bromododecane (DMADDM) or dimethylaminododecyl methacrylate bromohexadecane (DMAHDM) at three concentrations each: 1, 2.5, and 5 wt.%. Experimental adhesive without QAMs (control group) and commercially available Transbond XT Primer (3M Unitek, Monrovia, California, USA) were used for comparisons. The adhesives were tested for DC, cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. DC, cytotoxicity against fibroblasts, and antibacterial activity were analyzed using one-way ANOVA and Tukey's multiple comparisons. Cytotoxicity against keratinocytes was evaluated using the Kruskal Wallis and Dunn's post-hoc (α = 5%) tests. Transbond showed lower DC as compared to 5% DMAHDM, 1% DMADDM, and 5% DMADDM (p < 0.05). However, all groups presented proper DC when compared to commercial adhesives in the literature. In the evaluation of cytotoxicity against keratinocytes, Transbond induced higher viability than 2.5 wt.% groups (p < 0.05). Against fibroblasts, Transbond induced higher viability as compared to 5 wt.% groups (p < 0.05). DMAHDM at 5 wt.% reduced biofilm formation when compared to all the other groups (p < 0.05). Despite their cytotoxic effect against keratinocytes, gingival fibroblasts showed higher viability. DMAHDM at 5 wt.% decreased Streptococcus mutans viability. The incorporation of DMAHDM at 5 wt.% may be a strategy for reducing the development of white spot lesions.

Antibiotics prophylaxis at the time of catheter removal after radical prostatectomy: a systematic review of the literature and meta-analysis

Purpose: To conduct a systematic literature review with meta-analysis to identify whether antibiotic prophylaxis after removal of the indwelling urinary catheter reduces posterior infections. Methods: A systematic literature review was conducted in the databases PubMed, Embase, Cochrane, Google Scholar, and Latin American and Caribbean Health Sciences Literature, using the keywords "antibiotics" AND "prostatectomy" AND "urinary catheter." Results: Three articles were identified having the scope of our review, with 1,040 patients, which were subjected to our meta-analysis revealing a marginally significant decrease in the risk of urinary infection after indwelling urinary catheter removal (odds ratio-OR = 0.51; 95% confidence interval-95%CI 0.27-0.98; p = 0.04; I2 = 0%). No difference was found regarding the presence of bacteriuria (OR = 0.39; 95%CI 0.12-1.24; p = 0.11; I2 = 73%). Conclusions: In our meta-analysis, there was a significant decrease in urinary tract infection with antibiotic prophylaxis after indwelling urinary catheter removal following radical prostatectomy.

The impact of synthetic bone grafting for tissue regeneration: an in vivo study

Aims: This study aimed to examine the biological response of synthetic nanocomposite material on canine mandibular bone. Methods: Nine healthy adult male local breed dogs aged 12 to 18 months and weighing 10.2 to 15.2 kg were used in the study. Based on healing intervals of 1 and 2 months, the dogs were divided into 2 groups. Each group had 3 subgroups with 3 dogs each. The division was based on the grafting material used to fill the created defect: an empty defect (Control-ve), Beta-Tricalcium Phosphate, and nanocomposite (Beta-Tricalcium Phosphate and nanosilver 1%) . Surgery started after the dogs were anaesthetized. The surgical procedure began with a 5 cm parallel incision along the mandible's lower posterior border. After exposing the periosteum, a three 5mm-diameter, 5-mmdeep critical-size holes were made, 5mm between each one. Each group's grafting material had independent 3 holes. The defects were covered with resorbable collagen membranes followed by suturing of the mucoperiosteal flap. Results: Total densitometric analysis showed no significant differences between groups at 1-month intervals, with the nanocomposite group having a higher mean rank (165.66± 31.21) in comparison to other groups while at 2 months intervals that there was a highly significant difference between three groups as the P-value was (0.000) with the nanocomposite group having a higher mean rank (460.66± 26.40). Conclusions: In the current study, the use of nanocomposites improved osteoconductivity by accelerating new bone formation. Moreover, the encorporation of nanosilver enhanced growth factor activity. These attributes make nanocomposites a promising material for enhancing the bone healing process

Screening, biochemical characterization and antibiotics resistance/susceptibility of bacteria isolated from native soil and water samples / Triagem, caracterização bioquímica e resistência/suscetibilidade a antibióticos de bactérias isoladas de amostras nativas de solo e água

The present study was conducted to isolate and characterize bacteria from water and soil sample taken from the Lahore Canal at different sites i.e. Mall Road, Mohlanwal and Khera site. Isolated bacterial strains were identified on the basis of morphological and biochemical tests. Identification was confirmed by culturing bacteria on selective media. Antibiotic resistance test was also performed to observe the resistance of bacteria against different antibiotics. Blood agar test was performed for identification of different pathogenic bacteria. The result revealed that water and soil samples of Lahore Canal Lahore from different sites were contaminated with Escherichia coli, Salmonella sp., Vibrio sp., Bacillus spp., Enterococcus sp. and Staphylococcus spp. Due to presence of these pathogens, this water is not suitable for any domestic and irrigation use. Study also revealed that water of the Lahore Canal is harmful for human health as it is contaminated with bacteria that can cause severe disease e.g., Escherichia coli can cause gastroenteritis, Bacillus spp. can cause nausea and vomiting, Enterococcus may infect urinary tract, Salmonella sp. is responsible for Bacteremia, Staphylococcus spp. can cause mild fever and Vibrio sp. can be the reason of cholera. Thus it is rendered unfit for any kind of human use even other than drinking like swimming, bathing, washing etc., until and unless some remedial measures are employed to eradicate pathogenic microorganisms by WASA and LWMS according to standards of WHO. Similarly, it is quite harmful, when and where ever it is used for irrigation without proper treatment.

O presente estudo foi realizado para isolar e caracterizar bactérias de amostras de água e solo retiradas do Canal Lahore, em Lahore, em diferentes locais, ou seja, Mall Road, Mohlanwal e Khera. As cepas bacterianas isoladas foram identificadas com base em testes morfológicos e bioquímicos. A identificação foi confirmada por cultura de bactérias em testes de meios seletivos. O teste de resistência aos antibióticos também foi realizado para observar a resistência das bactérias a diferentes antibióticos. Foi realizado o teste de ágar sangue para identificar diferentes bactérias patogênicas. O resultado revelou que amostras de água e solo do Canal Lahore, Lahore, de diferentes localidades estavam contaminadas com Escherichia coli, Salmonella sp., Vibrio sp., Bacillus spp., Enterococcus sp. e Staphylococcus spp. Por causa da presença desses patógenos, essa água não é adequada para qualquer uso doméstico e de irrigação. O estudo revelou que a água do Canal Lahore é prejudicial à saúde humana, pois está contaminada com bactérias que podem causar doenças graves, por exemplo: Escherichia coli pode ocasionar gastroenterite; Bacillus spp. pode causar náuseas e vômitos; Enterococcus sp. pode infectar o trato urinário; Salmonella sp. é responsável pela bacteremia; Staphylococcus spp. pode causar febre leve; e Vibrio sp. pode ser a razão da cólera. Assim, torna-se imprópria para uso humano, como natação, banho, lavagem etc., até que algumas medidas corretivas sejam empregadas para erradicar microrganismos patogênicos por WASA e LWMS de acordo com os padrões da OMS. Da mesma forma, é bastante prejudicial, quando usada para irrigação sem tratamento adequado.

Synthesis and antibacterial activities of phosphonate derivatives containing aminothiazoloxime fragment / 药学学报

Based on the principle of molecular hybridization, fifteen compounds were designed and synthesized through the combination of aminothiazoloxime and phosphonate fragment. The results showed that these compounds had better inhibitory effects on the tested bacteria. In particular, the activities of compounds Ⅲf and Ⅲi against S. aureus, E. coli, methicillin-resistant S. aureus (MRSA) and fluoroquinolone-resistant E. coli (FREC) were the most significant, the minimal inhibitory concentration (MIC) of Ⅲf was 1, 8, 4, 16 μg·mL-1 respectively, and the MIC of Ⅲi was 4, 4, 16, 8 μg·mL-1 respectively, which were slightly lower than that of the control drug oxacillin, and their anti-E. coli, MRSA and FREC activities were superior to that of the control drug oxacillin. Their activities to S. aureus were close to that of oxacillin, and to E. coli, MRSA and FREC were superior to that of oxacillin, which is worthy of further study.

Synthesis and antibacterial activity evaluation of octapeptin derivatives / 药学学报

Octapeptin has strong antibacterial activity against Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii, while it also has activity against some Gram-positive bacteria. This study used natural octapeptin A3 and B3 as lead compounds for structural modification. Twenty-one peptide derivatives (including A3 and B3) containing eight amino acid residues were prepared by solid-phase synthesis, and evaluated for antibacterial activity and renal cytotoxicity. Among them, three compounds 6, 7 and 17 exhibited broad-spectrum antibacterial activity and significantly enhanced the activity for Gram-positive bacteria while maintaining the activity of Gram-negative bacteria. Several compounds improved the activity for Pseudomonas aeruginosa. Compound 7 was active against all test strains and had relatively low renal cytotoxicity. The results provide a basis for the further development of novel polypeptide antibiotics.

An antimicrobial activity of oil extracted from Saara hardwickii / Atividade antimicrobiana do óleo extraído de Saara hardwickii

Present research work represents antiviral and antibacterial value of body fat of Saara hardwickii commonly called as spiny tailed lizard. Oil was extracted from body fats located in the ventral region of this animal using hydrocarbons e.g., n-hexane, methanol, butanol and ethyl acetate as a solvent. The antibacterial activity of lizard oil was tested against standard as well as multi-resistant lines ofEscherichia coli, Styphalococcus aureus, Pseudomonas aeruginosa and Proteus vulgaris alone and with antibiotic ampicillin. For antibacterial potential, Ethyl acetate and Butanol solvent extract showed best zone of inhibition (7mm) with P. aeruginosa and S. aureus respectively. For antiviral potential, Butanol and Methanol extract showed best HA (Hemagglutination) titer of 04 with NDV and IBV viral strain respectively. It is concluded that lizard oil has antimicrobial potential against different pathogens strains (virus, bacteria).

O presente trabalho de pesquisa apresenta a importância antiviral e antibacteriana da gordura corporal de Saara hardwickii, comumente chamado de lagarto de cauda espinhosa. O óleo foi extraído de gorduras corporais localizadas na região ventral desse animal usando hidrocarbonetos, por exemplo, n-hexano, metanol, butanol e acetato de etila, como solvente. A atividade antibacteriana do óleo do lagarto foi testada em linhagens padrão e multirresistentes de Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa e Proteus vulgaris, de forma isolada e com antibiótico ampicilina. Para o potencial antibacteriano, acetato de etila e extrato de butanol apresentaram melhor zona de inibição (7 mm) com P. aeruginosa e S. aureus, respectivamente. Para o potencial antiviral, o extrato de butanol e o extrato de metanol apresentaram melhor título de hemaglutinação de 4 com as cepas virais NDV e IBV, respectivamente. Conclui-se que o óleo do lagarto possui potencial antimicrobiano contra diferentes cepas de patógenos (vírus e bactérias).

Antibacterial activity of Ricinus communis plant extract against antibiotic resistant Helicobacter pylori and Gluconobacter oxydans isolated from fresh apple juices samples

Abstract Bacteria were isolated from samples of Fresh Apple juices from shops of three different localities of Lahore. Analysis of samples from Liberty, Anarkali and Yateem khana Markets show different levels of contamination. There were pathogenic and non-pathogenic bacteria in all samples and were identified by the morphological and biochemical tests. Most of the plasmids of pathogenic bacteria were 4kb in their molecular size. Ribotyping of 16S ribosomal RNA gene sequencing was done to confirm Helicobacter pylori strain and Gluconobacter oxydans. The highest sensitivity of 210mm was shown by Enterobacter sp. against Aztheromysine disk (15µg) while Micrococcus sp. was highly resistant against all of the Antibiotics applied. The antibiotic resistance of pathogenic bacteria was also checked against Ricinus communis plant's extracts, all isolated bacterial pathogens were resistant but only, E.coli was inhibited at 300µl of the extracts. Presence of pathogenic bacteria in Apple juice samples was due to contamination of sewage water in drinking water while some of these pathogenic bacteria came from Apple's tree and other from store houses of fruits.

Resumo As bactérias foram isoladas de amostras de suco de maçã fresco de lojas de três diferentes localidades de Lahore. A análise de amostras dos mercados Liberty, Anarkali e Yateem khana mostram diferentes níveis de contaminação. Havia bactérias patogênicas e não patogênicas em todas as amostras e foram identificadas pelos testes morfológicos e bioquímicos. A maioria dos plasmídeos de bactérias patogênicas tinha 4 kb em seu tamanho molecular. A ribotipagem do sequenciamento do gene do RNA ribossômico 16S foi realizada para confirmar a cepa de Helicobacter pylori e Gluconobacter oxydans. A maior sensibilidade de 210 mm foi mostrada por Enterobacter sp. contra disco de azteromisina (15µg) enquanto Micrococcus sp. foi altamente resistente a todos os antibióticos aplicados. A resistência a antibióticos de bactérias patogênicas também foi verificada contra extratos de plantas de Ricinus communis, todos os patógenos bacterianos isolados foram resistentes, mas apenas E. coli foi inibida em 300µl dos extratos. A presença de bactérias patogênicas nas amostras de suco de maçã deveu-se à contaminação da água de esgoto na água potável, enquanto algumas dessas bactérias patogênicas vieram da árvore da maçã e outras de armazéns de frutas.

An antimicrobial activity of oil extracted from Saara hardwickii

Abstract Present research work represents antiviral and antibacterial value of body fat of Saara hardwickii commonly called as spiny tailed lizard. Oil was extracted from body fats located in the ventral region of this animal using hydrocarbons e.g., n-hexane, methanol, butanol and ethyl acetate as a solvent. The antibacterial activity of lizard oil was tested against standard as well as multi-resistant lines ofEscherichia coli, Styphalococcus aureus, Pseudomonas aeruginosa and Proteus vulgaris alone and with antibiotic ampicillin. For antibacterial potential, Ethyl acetate and Butanol solvent extract showed best zone of inhibition (7mm) with P. aeruginosa and S. aureus respectively. For antiviral potential, Butanol and Methanol extract showed best HA (Hemagglutination) titer of 04 with NDV and IBV viral strain respectively. It is concluded that lizard oil has antimicrobial potential against different pathogens strains (virus, bacteria).

Resumo O presente trabalho de pesquisa apresenta a importância antiviral e antibacteriana da gordura corporal de Saara hardwickii, comumente chamado de lagarto de cauda espinhosa. O óleo foi extraído de gorduras corporais localizadas na região ventral desse animal usando hidrocarbonetos, por exemplo, n-hexano, metanol, butanol e acetato de etila, como solvente. A atividade antibacteriana do óleo do lagarto foi testada em linhagens padrão e multirresistentes de Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa e Proteus vulgaris, de forma isolada e com antibiótico ampicilina. Para o potencial antibacteriano, acetato de etila e extrato de butanol apresentaram melhor zona de inibição (7 mm) com P. aeruginosa e S. aureus, respectivamente. Para o potencial antiviral, o extrato de butanol e o extrato de metanol apresentaram melhor título de hemaglutinação de 4 com as cepas virais NDV e IBV, respectivamente. Conclui-se que o óleo do lagarto possui potencial antimicrobiano contra diferentes cepas de patógenos (vírus e bactérias).

Efecto Antibacteriano del Extracto Etanólico de Equisetum giganteum L. "Cola de Caballo" Frente al Fusobacterium nucleatum, Microorganismo Asociado a la Enfermedad Periodontal

La fitoterapia aplicada a la Odontología se presenta como una eficaz alternativa de tratamiento frente a las enfermedades periodontales (EP) porque busca utilizar los principios activos de las plantas medicinales que se encuentran en gran cantidad en la naturaleza, dándole así las características de ser más asequibles y de menor costo, para combatir los microorganismos patógenos causantes de las EP. El objetivo del estudio fue determinar el efecto antibacteriano in vitro del extracto etanólico de Equisetum giganteum L. frente a cepas ATCC de Fusobacterium nucleatum. El estudio fue de tipo experimental no probabilístico y estuvo constituido en total por 10 placas Petri sembradas con F. nucleatum. Se utilizó extracto etanólico de E. giganteum L. en las concentraciones de 100, 50, 25, 12.5 y 6.25 %. Se utilizó el método de difusión en agar y se incubaron 10 placas a 37 °C durante 07 días. Se midieron los halos de inhibición con un vernier digital, siendo estos datos posteriormente analizados. No se evidenciaron halos de inhibición significativos en ninguno de los discos embebidos con las diferentes concentraciones en las 10 placas Petri sembradas con F. nucleatum, pero sin con la clorhexidina, agente química utilizado como control positivo. En conclusión no se determinó un efecto antibacteriano in vitro del extracto etanólico de E. giganteum L. frente a F. nucleatum, en ninguna de sus concentraciones.

Phytotherapy applied to Dentistry is presented as an effective alternative treatment against periodontal diseases (PD) because it seeks to use the active ingredients of medicinal plants that are found in large quantities in nature, thus giving it the characteristics of being more affordable. and at a lower cost, to combat the pathogenic microorganisms that cause PE. Objective: to determine the in vitro antibacterial effect of the ethanolic extract of Equisetum giganteum L. against ATCC strains of Fusobacterium nucleatum. Material and methods: The study was of a non- probabilistic experimental type and consisted of a total of 10 Petri dishes seeded with F. nucleatum. Ethanolic extract of E. giganteum L. was used in concentrations of 100, 50, 25, 12.5 and 6.25 %. The agar diffusion method was used and 10 plates were incubated at 37 °C for 07 days. The inhibition halos were measured with a digital vernier, and these data were subsequently analyzed. Results: No significant inhibition halos were found in any of the embedded disks with the different concentrations in the 10 Petri dishes seeded with F. nucleatum, but without chlorhexidine, the chemical agent used as a positive control. Conclusions: an in vitro antibacterial effect of the ethanolic extract of E. giganteum L. was not determined against F. nucleatum, in any of its concentrations.

Clasificación de riesgo y tiempo puerta-antibiótico en pacientes con sospecha de sepsis / Risk classification and door-to-antibiotic time in patients with suspected sepsis / Classificação de risco e tempo porta-antibiótico no paciente com suspeita de sepse

Objetivo: evaluar la asociación entre la clasificación de riesgo y el tiempo puerta-antibiótico en pacientes con sospecha de sepsis. Método: estudio de cohorte retrospectivo, con una muestra de 232 pacientes con sospecha de sepsis atendidos en el departamento de emergencias. Se dividieron en 2 grupos: con y sin clasificación de riesgo. Una vez identificado el tiempo puerta-antibiótico, se realizó un análisis de varianza de un factor con la prueba post hoc de Bonferroni o la prueba t de Student independiente para variables cuantitativas continuas; pruebas de correlación de Pearson, correlación biserial puntual o correlación biserial para análisis de asociación; y procedimiento de bootstrap cuando no había distribución normal de variables. Para el análisis de los datos se utilizó el software Statistical Package for the Social Sciences. Resultados: el tiempo puerta-antibiótico no difirió entre el grupo que recibió clasificación de riesgo en comparación con el que no fue clasificado. El tiempo puerta-antibiótico fue significativamente más corto en el grupo que recibió una clasificación de riesgo de alta prioridad. Conclusión: no hubo asociación entre el tiempo puerta-antibiótico y si se realizó o no la clasificación de riesgo, ni con la hospitalización en enfermería y en unidad de cuidados intensivos, ni con la duración de la estancia hospitalaria. Se observó que cuanto mayor era la prioridad, más corto era el tiempo puerta-antibiótico.

Objective: to evaluate the association between risk classification and door-to-antibiotic time in patients with suspected sepsis. Method: retrospective cohort study, with a sample of 232 patients with suspected sepsis treated at the emergency department. They were divided into 2 groups: with and without risk classification. Once the door-to-antibiotic time was identified, one-way analysis of variance was performed with Bonferroni post hoc test or independent Student's t-test for continuous quantitative variables; Pearson correlation tests, point-biserial correlation or biserial correlation for association analyses; and bootstrap procedure when there was no normal distribution of variables. For data analysis, the Statistical Package for the Social Sciences software was used. Results: the door-to-antibiotic time did not differ between the group that received risk classification compared to the one that was not classified. Door-to-antibiotic time was significantly shorter in the group that received a high priority risk classification. Conclusion: there was no association between door-to-antibiotic time and whether or not the risk classification was performed, nor with hospitalization in infirmaries and intensive care units, or with the length of hospital stay. It was observed that the higher the priority, the shorter the door-to-antibiotic time.

Objetivo: avaliar a associação entre a realização de classificação de risco e o tempo porta-antibiótico no paciente com suspeita de sepse. Método: estudo de coorte retrospectivo, com amostra de 232 pacientes com suspeita de sepse atendidos no pronto atendimento. Foram distribuídos em 2 grupos: com e sem classificação de risco. Identificado o tempo porta-antibiótico, realizou-se análise de variância de um fator com post hoc de Bonferroni ou teste T-Student independente para variáveis quantitativas contínuas; testes de correlação de Pearson, correlação bisserial por pontos ou correlação bisserial para análises de associação; e procedimento de bootstrap quando não havia distribuição normal de variáveis. Para a análise dos dados foi utilizado o software Statistical Package for the Social Sciences. Resultados: o tempo porta-antibiótico não diferiu entre o grupo que recebeu classificação de risco comparado ao que não foi classificado. O tempo porta-antibiótico foi significativamente menor no grupo que recebeu classificação de risco de alta prioridade. Conclusão: não houve associação entre o tempo porta-antibiótico e a realização ou não da classificação de risco, tampouco com internação em enfermaria e em unidade de terapia intensiva, ou com o tempo de internação hospitalar. Observou-se que quanto maior a prioridade, menor o tempo porta-antibiótico.

Terapia con antibióticos versus apendicectomía en la apendicitis aguda no complicada: Una revisión sistemática y metaanálisis

Introducción: Existe una controversia acerca del mejor enfoque para el tratamiento de la apendicitis aguda no complicada. Este metaanálisis buscó evaluar la eficacia, recurrencia de la patología, presencia de complicaciones mayores, y duración de la estancia hospitalaria en adultos con apendicitis aguda no complicada. Materiales y Método: Se realizó una búsqueda sistemática de ensayos clínicos aleatorizados en las bases de datos PubMed, Scopus, Web of Science, Embase y Cochrane Library hasta finales de octubre del 2022. El riesgo de sesgo y calidad de los estudios incluidos en el estudio fueron evaluados mediante la herramienta RoB 2.0. de la Colaboración Cochrane. La síntesis de datos fue realizada a través del software Cochrane Review Manager (RevMan; version 5.3). Resultados: 6 estudios fueron incluidos, con un total de 1.862 pacientes. La probabilidad de presentar una mejoría clínica definitiva en el grupo que recibió antibioticoterapia fue menor (RR 0,5; IC95% 0,92-0,98; p = 0,004; IC2 = 44%). La probabilidad de presentar una recurrencia de la apendicitis en el grupo que recibió antibioticoterapia fue notablemente superior (RR 94,86; IC95% 30,73-292,81; p < 0,00001; IC2 = 0%). El grupo conservador presentó un menor riesgo de presentar una complicación mayor (RR 0,55; IC95% 0,36-0,85; p = 0,007; IC2 = 0%). El tratamiento conservador presentó una duración de la estancia hospitalaria superior que la apendicectomía (MD 0,34; IC95% 0,25-0,42; p < 0,00001; IC2 = 64%). Conclusiones: Esta revisión sistemática demuestra que, en términos de eficacia, recurrencia del cuadro y duración de la estancia hospitalaria, la antibioticoterapia es inferior a la apendicectomía en adultos con apendicitis aguda no complicada y superior en evitar la presencia de complicaciones mayores.

Introduction: There is controversy about the best approach for the treatment of uncomplicated acute appendicitis. This meta-analysis sought to assess efficacy, disease recurrence, presence of major complications, and length of hospital stay in adults with uncomplicated acute appendicitis. Materials and Method: A systematic search for randomized clinical trials was performed in the PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases up to the end of October 2022. The risk of bias and quality of the studies included in the study were assessed. using the RoB 2.0 tool. of the Cochrane Collaboration. Data synthesis was performed using the Cochrane Review Manager software (RevMan; version 5.3). Results: 6 studies were included, with a total of 1.862 patients. The probability of presenting a definitive clinical improvement in the group that received antibiotic therapy was lower (RR 0.5; CI95% 0.92-0.98; p = 0.004; CI2 = 44%). The probability of presenting a recurrence of appendicitis in the group that received antibiotic therapy was notably higher (RR 94.86; 95%CI 30.73-292.81; p < 0.00001; CI2 = 0%). The conservative group presented a lower risk of presenting a major complication (RR 0.55; CI95% 0.36-0.85; p = 0.007; CI2 = 0%). Conservative treatment had a longer hospital stay than appendectomy (MD 0.34; 95%CI 0.250.42; p < 0.00001; CI2 = 64%). Conclusions: This systematic review shows that, in terms of efficacy, recurrence of the condition, and length of hospital stay, antibiotic therapy is inferior to appendectomy in adults with uncomplicated acute appendicitis, and superior in avoiding the presence of major complications.

Trends in the epidemiological and microbiological profiles of infectious keratitis in southeastern Brazil / Perfil epidemiológico e microbiológico das ceratites infecciosas no sudeste do Brasil

ABSTRACT Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients' (3.1% of the total) endophthalmitis evolving to evisceration. The patients' microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis.

RESUMO Objetivo: Investigar a susceptibilidade a antibió­ticos, o perfil clínico, epidemiológico e microbiológico das ce­ratites infecciosas. Métodos: Estudo retrospectivo longitu­dinal. Registros médicos e laboratoriais de 2015 a 2019 fo­ram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-po­sitivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente.

The potential of the antiplatelet agent ticagrelor as a new antibacterial agent

The number of deaths caused by drug-resistant bacteria is expected to increase in the future, and there is a need to develop new antimicrobial agents. Recently, the antiplatelet drug ticagrelor has been reported to have promising antibacterial properties. The purpose of this review is to analyze articles and case reports that describe the antimicrobial action of ticagrelor. Ticagrelor was found to have antibacterial reactions against Gram-positive bacteria, including drug-resistant and spore-forming bacteria, while no effect was observed against Gram-negative bacteria. In this paper we discuss a new potential antimicrobial agent, ticagrelor.

Description of changes in clinical outcomes following the implementation of an antibiotic stewardship program in a level IV hospital / Descripción del cambio en desenlaces clínicos posteriores a la implementación de un programa de gestión de antibióticos en un hospital de cuarto nivel de atención en salud

Introduction. Inadequate prescription of antibiotics has been recognized as a public health problem by the World Health Organization. In this context, antibiotic stewardship programs have been implemented as a tool to mitigate its impact. Objective. To describe the changes in clinical outcomes after the implementation of an antibiotic stewardship program in a level IV hospital. Materials and methods. We conducted a unique cohort study of patients hospitalized for infectious pathologies that were treated with antibiotics in an advanced medical facility. We collected the clinical history before the implementation of the antibiotic stewardship program (2013 to 2015) and then we compared it to the records from 2018 to 2019 collected after the implementation of the program. We evaluated changes in clinical outcomes such as overall mortality, and hospital stay, among others. Results. We analyzed 1,066 patients: 266 from the preimplementation group and 800 from the post-implementation group. The average age was 59.2 years and 62% of the population was male. Statistically significant differences were found in overall mortality (29% vs 15%; p<0.001), mortality due to infectious causes (25% vs 9%; p<0.001), and average hospital stay (45 days vs 21 days; p<0.001); we also observed a tendency to decrease hospital re- admission at 30 days for infectious causes (14% vs 10%; p=0.085). Conclusions. The antibiotic stewardship program implemented was associated with a decrease in overall mortality and mortality due to infectious causes, as well as in average hospital stay. Our results evidenced the importance of interventions aimed at mitigating the impact of inadequate prescription of antibiotics.

Introducción. La inadecuada prescripción de antibióticos es un problema de salud pública, reconocido por la Organización Mundial de la Salud. Los programas de gestión de antibióticos son implementados como una herramienta para mitigar su impacto. Objetivo. Describir los cambios observados en los desenlaces clínicos después de la implementación de un programa de gestión de antibióticos en un hospital de IV nivel de atención. Materiales y métodos. Se llevó a cabo un estudio de cohorte única de pacientes hospitalizados por patologías infecciosas y tratados con antibióticos en una institución médica de alta complejidad. Inicialmente, se recolectaron las historias clínicas anteriores a la implementación del programa de gestión de antibióticos (2013 a 2015) y luego se compararon con los datos obtenidos después de la implementación del programa de gestión de antibióticos de 2018 a 2019. Se evaluaron los cambios en los desenlaces clínicos como mortalidad y estancia hospitalaria, entre otros. Resultados. Se analizaron las historias clínicas de 1.066 pacientes: 266 con historia previa a la implementación del programa y 800 con historia posterior a la implementación. El promedio de edad fue 59,2 años y 62 % de la población era masculina. Se encontraron diferencias estadísticamente significativas en mortalidad global (29 Vs. 15 %; p<0,001), mortalidad por causa infecciosa (25 % Vs. 9 %; p<0,001) y promedio de estancia hospitalaria (45 Vs.21 días; p<0,001), con tendencia a disminuir nuevas hospitalizaciones en 30 días por patología infecciosa (14 Vs.10 %; p=0,085). Conclusiones. El desarrollo del programa de gestión de antibióticos se asoció con a una disminución en la mortalidad global, la mortalidad por causa infecciosa y la estancia hospitalaria. Esto demuestra la importancia de desarrollar intervenciones dirigidas a mitigar el impacto de la prescripción inadecuada de antibióticos.

Phytochemical Screening and Antibacterial Activity of Chrysophyllum albidum Collected in Nsukka, South East Nigeria

Background: Chrysophyllum albidum is widely used by African people for the treatment of various types of diseases such as ear infection, sore throat, typhoid, cellulites, septicaemia, bactericemia, abscesses and tooth infections. Aim: The study was conducted to investigate the chemical components and antibacterial activity of the extract and fractions from the root bark of Chrysophyllum albidum from Nsukka, South-east Nigeria. Methodology: The fresh roots were collected, washed, cut into small pieces, air dried and pulverized to powder using mechanical grinder. Extraction and fractionation were done by cold maceration method and technique of liquid–liquid extraction respectively. The phytochemical analysis of the methanol extract and, n-hexane, butanol, aqueous and ethylacetate fractions of the plant part was carried out using standard method. The antibacterial activities were determined using cup-plate agar diffusion and agar dilution methods. Results: The phytochemical screening of the extract revealed the presence of tannins, flavonoids, saponins, terpenoids, alkaloids, reducing sugar and cardiac glycosides. The inhibition zone diameter (IZD) produced by the agents against some selected Gram positive bacteria (GPB) and Gram negative bacteria (GNB) pathogens ranged from 6 – 25 mm and 6 – 12 mm respectively. The MIC and MBC values produced by the extract and fractions of the plant’s part against the GPB ranged from 1.25 – 40 mg/ml and 5 – 80 mg/ml respectively Many of the GNB were not sensitive to the agents tested except Pseudomonas aeruginosa and Klebsiella spp that exhibited mild to moderate sensitivity to the agents. Conclusion: These agents, therefore, exhibited a potent antibacterial activity against all the GPB and a few GNB pathogens tested due to their potent phytochemicals. The results of this work have corroborated the trado-medical use of root of Chrysophyllum albidum for treating ear infection, sore throat, typhoid, cellulites, septicaemia, bactericemia, boils and tooth infection/decay.

Duración de la antibioticoterapia en pacientes con colecistitis aguda manejados con colecistostomía. ¿Afecta los desenlaces clínicos? / Duration of antibiotic therapy in patients with acute cholecystitis managed with cholecystostomy. Does it affect clinical outcomes?

Introducción. En pacientes con diagnóstico de colecistitis aguda tratados con colecistostomía, el tiempo óptimo de duración de la terapia antibiótica es desconocido. El objetivo de este trabajo fue comparar los resultados clínicos en pacientes con diagnóstico de colecistitis aguda manejados inicialmente con colecistostomía y que recibieron cursos cortos de antibióticos (7 días o menos) versus cursos largos (más de 7 días). Métodos. Se llevó a cabo un estudio de cohorte observacional, retrospectivo, que incluyó pacientes con diagnóstico de colecistitis aguda manejados con colecistostomía, que recibieron tratamiento antibiótico. Se hizo un análisis univariado y de regresión logística para evaluar la asociación de variables clínicas con la duración del tratamiento antibiótico. El desenlace primario por evaluar fue la mortalidad a 30 días. Resultados. Se incluyeron 72 pacientes. El 25 % (n=18) recibieron terapia antibiótica por 7 días o menos y el 75 % (n=54) recibieron más de 7 días. No hubo diferencias significativas en la mortalidad a 30 días entre los dos grupos ni en las demás variables estudiadas. La duración de la antibioticoterapia no influyó en la mortalidad a 30 días (OR 0,956; IC95% 0,797 - 1,146). Conclusión. No hay diferencias significativas en los desenlaces clínicos de los pacientes con colecistitis aguda que son sometidos a colecistostomía y que reciben cursos cortos de antibióticos en comparación con cursos largos

Introduction.In patients with acute cholecystitis who receive treatment with cholecystostomy, the optimal duration of antibiotic therapy is unknown. The objective of this study is to compare short courses of antibiotics (7 days or less) with long courses (more than 7 days) in this population. Methods. We performed a retrospective observational cohort study which included patients diagnosed with acute cholecystitis, who received antibiotic therapy and were taken to cholecystostomy. Univariate analysis and logistic regression were performed to evaluate the association between clinical variables and the duration. The main outcome evaluated was 30-day mortality. Results. Seventy-two patients were included, 25% (n=18) were given 7 or fewer days of antibiotics while 75% (n=54) were given them for more than 7 days. Demographic data between both groups were similar (age, severity of cholecystitis, comorbidities). There were no significant differences in 30-day mortality between both groups. Antibiotic duration did not influence mortality at 30 days (OR 0.956, 95% CI 0.797 - 1.146). Conclusion. There are no significant differences in the clinical outcomes of patients with acute cholecystitis who undergo cholecystostomy and receive short courses of antibiotics compared to long courses

One week pre-operative oral antibiotics for percutaneous nephrolithotomy reduce risk of infection: a systematic review and meta-analysis

ABSTRACT Purpose The aim of this meta-analysis is to assess the efficacy of extended dose of preoperative antibiotics to reduce infectious risk in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods A literature search for prospective case-control studies or randomized controlled trials was done. PICO framework was used. Population: adult patients that underwent to PCNL; Intervention: extended dose preoperative antibiotic prophylaxis before PCNL; Control: short dose preoperative antibiotic prophylaxis before PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fever after PCNL and positive intraoperative urine and stone culture. This meta-analysis was registered in PROSPERO database under the number: CRD42022359589. Results Three RCT and two prospective studies (475 patients) were included. SIRS/sepsis outcome was retrieved from all studies included. Seven days preoperative oral antibiotics for PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234 - 0.527, p < 0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147 - 2.388, p = 0.462). Patients who received seven days preoperative antibiotics had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120 - 0.674, p = 0.004) and stone culture (OR 0.351, 95% CI 0.185 - 0.663, p = 0.001) than the control group. Conclusion one week of prophylactic oral antibiotics based on local bacterial sensitivity pattern plus a dose of intravenous antibiotics at the time of surgery in patients undergoing PCNL reduces the risk of infection.

Evaluation of Phytochemical and HPLC analysis of Crotalaria angulata , Momordica cymbalaria , Senna hirsuta and Indigofera linnaei and it’s biological applications

To encompass a quantitative evaluation of phytochemical analysis and HPLC analysis of ethanol extracts of Senna hirsuta ; Indigofera linnaei; Crotalaria angulata and Momordica cymbalaria leaves were experimented to have broad analysis on presence of bioactive components. The phytochemical tests showed the bioactive compounds in Senna hirsuta ethanolic extracts with Steroids, Glycosides, Anthraquinones, Saponins Glycosides, Flavonoids and Terpenoids. In Indigofera linnaei, ethanolic extracts of this plant contain Steroids, Glycosides, Saponins, Glycosides and Terpenoids, Anthraquinones, Tannins, Flavonoids and Saponins are absent for this plant. Test for Steroids, Anthraquinones, Tannins and Terpenoids are strongly present in the plant of Crotalaria angulata . The strong presence of Steroids, Glycosides, Tannins, Terpenoids, Saponins foam in the plant of Momordica cymbalaria . The effects of ethanolic extracts of Anti-Bacterial activity of S.hirsuta and Indigofera linnaei with some of bacteria pathogenic strains such as Shigella dysenteriae, Escherichia coli, Salmonella typhi, Proteus vulgaris, Klebsiella pneumoniae and Bacillus subtilis were experimented . The antibacterial activities of the ethanolic extracts were compared favorably with that standard antibiotic (Chloramphenicol). The Ethanolic extract of leaf showed a maximum zone of inhibition (11 mm) against Escherichia coli, a Gram negative bacteria. In Indigofera linnaei, the ethanolic extract, show a maximum zone of inhibition (19 mm) to Salmonella typhi . In chromatographic technique, the separation and movements of biomolecules has been investigated. Hence, these bio-techniques play a significant role in finding of important material for pharmaceutical industry and have substances that induce a great interest due to their versatile applications . The paper chromatographic technique showed the Rf value at chlorophyll ‘a’ is 0.569 and ‘b’ value 0.123 present in plant Crotalaria angulata . The Rf value at chlorophyll’a’0.569, and ‘b’ value is 0.353 present in the plant Momordica cymbalaria . HPLC analyses allow for the identification of samples of Momordica cymbalaria with peak value of 1676436 and Retention time is 4.092. This particular study revealed the strong quantitative phytochemicals in Crotalaria angulata and Momordica cymbalaria and the same has been found to be the most effective free radical quencher. As a culmination, these plant extracts can be a safe alternative to chemical drugs.

Efecto antibacteriano del extracto hidroalcohólico de Solanum sessiliflorum Dunal (cocona) sobre Streptococcus mutans

Introducción: La búsqueda de nuevos extractos de origen vegetal con propiedades antibacterianas para mantener la salud bucal, es fundamental para el óptimo desempeño del personal militar. Objetivos: Evaluar el efecto antibacteriano del extracto hidroalcohólico de Solanum sessiliflorum Dunal (cocona) sobre Streptococcus mutans. Métodos: Estudio experimental in vitro y comparativo. Se realizó un ensayo fitoquímico preliminar del extracto hidroalcohólico de Solanum sessiliflorum Dunal. Se emplearon 48 placas de agar Müller-Hinton (Merck®), distribuidas en 6 grupos (n= 8): grupo I (agua destilada), grupo II (etanol al 70 %), grupo III (clorhexidina al 0,12 %), grupo IV (Solanum sessiliflorum Dunal al 25 %), grupo V (Solanum sessiliflorum Dunal al 50 %) y grupo VI (Solanum sessiliflorum Dunal al 75 %). Se utilizó la técnica de difusión con discos descrita por Bauer y Kirby; la cepa empleada fue Streptococcus mutans ATCC 25175 y las mediciones de los halos de inhibición se realizaron a las 24 horas, para determinar la actividad antibacteriana. Resultados: En el ensayo fitoquímico se detectaron compuestos fenólicos, antocianinas, quinonas y glicósidos cardiotónicos. Se comprobó el efecto antibacteriano del grupo VI (Solanum sessiliflorum Dunal al 75 %) con 19,831 ± 0,0553 mm (99,37 %), comparable con el de clorhexidina al 0,12 % (grupo III) 19,956 ± 0,0431 mm (100 %) sobre Streptococcus mutans ATCC 25175. Conclusiones: El extracto hidroalcohólico de Solanum sessiliflorum Dunal al 75 % presenta efecto antibacteriano in vitro sobre cepas de Streptococcus mutans ATCC 25175 con valores similares a clorhexidina al 0,12 % .

Introduction: The search for new extracts of plant origin with antibacterial properties to maintain oral health is essential for the optimal performance of military personnel. Objectives: To evaluate the antibacterial effect of the hydroalcoholic extract of Solanum sessiliflorum Dunal (cocona) on Streptococcus mutans. Methods: In vitro and comparative experimental study. A preliminary phytochemical assay of the hydroalcoholic extract of Solanum sessiliflorum Dunal was performed. Forty-eight Müller-Hinton agar plates (Merck®) were used, distributed in 6 groups (n= 8). Group I (distilled water), group II (70% ethanol), group III (0.12% chlorhexidine), group IV (25% Solanum sessiliflorum Dunal), group V (50% Solanum sessiliflorum Dunal) and group VI (75% Solanum sessiliflorum Dunal); the disc diffusion technique described by Bauer and Kirby was used; the strain used was Streptococcus mutans ATCC 25175 and the inhibition halos were measured at 24 hours to determine the antibacterial activity. Results: Phenolic compounds, anthocyanins, quinones and cardiotonic glycosides were detected in the phytochemical assay. The antibacterial effect of group VI (Solanum sessiliflorum Dunal 75%) was proven with 19,831 ± 0,0553 mm (99,37%), comparable to that of 0,12% chlorhexidine (group III) 19,956 ± 0,0431 mm (100%) on Streptococcus mutans ATCC 25175. Conclusions: The 75% hydroalcoholic extract of Solanum sessiliflorum Dunal shows in vitro antibacterial effect on Streptococcus mutans ATCC 25175 strains with values similar to 0,12% chlorhexidine.