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Background: Staphylococcus aureus infections are one of the most common and serious hospital-acquired infections seen in developing countries. Methicillin resistant Staphylococcus aureus (MRSA) is an important human pathogen and normally colonized in body parts including skin, nose, perineum and throat. MRSA is resistant not only to all ?-lactam groups but also other antibiotics including aminoglycosides, tetracycline and macrolides. In the present study the efficacy of agents used in the management of MRSA infections was determined by antibiotic gradient testing. Methods: A total of 60 clinical isolates of MRSA strains were collected from various diagnostic labs in central Kerala. Clinical isolates were reconfirmed as MRSA by gram staining, yellow-coloured colonies on mannitol salt Agar (MSA). Antibiotic susceptibility testing was done by disc diffusion method as recommended by CLSI guidelines. S. aureus isolates resistant to cefoxitin (30 µg) was identified as MRSA. Antibiotic gradient testing was performed to determine the MIC of vancomycin, tigecycline, linezolid, daptomycin, ceftaroline and mupirocin against MRSA isolates. Results: All the 60 MRSA isolates tested were sensitive to vancomycin, tigecycline, linezolid, daptomycin, ceftaroline and mupirocin (100%) and none of the MRSA isolates show resistance. Conclusions: Results of present study indicates that these agents may be used alongside vancomycin in management of infection caused by MRSA.
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Background: Antibiotic resistance is one of the greatest threats in human health. Extended spectrum ? lactamases mediated resistance is prevalent worldwide, Klebsiella pneumoniae and Escherichia coli leap out as this significant ESBL producers conferring resistance to the expanded spectrum cephalosporins. Colistin is being administered as last line therapy for patients that have failed to respond to other available antibiotics that are active against Gram-negative bacteria. Methods: The present study was conducted at school of medical education Kottayam, Kerala from January 2023 to November 2023.During the period of study 150 isolates of K. pneumoniae and 136 isolates of E. coli were collected from various diagnostic microbiology laboratories in Kerala. The colistin susceptibility pattern of ESBL producing isolates was detected by broth disc elution method recommended by CLSI. Results: In this study prevalence of multi-drug resistant is 6% and 9.6% and Extensively-drug resistant is 62% and 63.9% for K. pneumoniae and E. coli respectively. ESBL production was detected as 72% in K. pneumoniae and 79% in E. coli. The colistin susceptibility pattern of ESBL producing K. pneumoniae and E. coli was detected as 76.9% and 87.9% respectively Conclusions: Our result demonstrated that the recent use of colistin as last resort treatment for extensively drug resistant gram-negative bacilli, it is essential to know the prevalence of susceptibility pattern to this antibiotic.
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Background: Klebsiella pneumoniae are Gram-negative opportunistic pathogen, belonging to the family Enterobacteriaceae that can cause severe nosocomial infections particularly in immuno-compromised individuals. They exhibit co-resistance to multiple antibiotics which emphasize the need for non-antibiotic therapies. The goal of the presented study was to investigate the antimicrobial ability of probiotic Lactobacilli on clinical isolates of K. pneumoniae. Methods: In this cross-sectional study, antimicrobial activities of probiotic L. acidophilus and L. rhamnosus on K. pneumoniae were evaluated by Agar overlay interference technique. Clear zone around Lactobacilli were taken as positive inhibition. Antibiotic susceptibility profiles of K. pneumoniae were determined by Kirby-Bauer disk diffusion method, analyzed using interpretive standards of CLSI M100-S33 and categorized into MDR, XDR and Non MDR groups. Statistical analysis was done using descriptive statistics such as mean and standard error and inferential statistics such as ANOVA single factor. Results: K. pneumoniae exhibited positive inhibition with both the probiotic strain. On comparing the zone of inhibition of L. acidophilus and L. rhamnosus (both treated-pH adjusted and untreated), L. acidophilus had greater zone of inhibition against K. pneumoniae but concluded that statistically the values are insignificant (p>0.05). Based on antibiotic susceptibility pattern of K. pneumoniae, 63% of isolates were XDR, 3% were MDR and 34% were Non MDR Conclusions: It can be concluded that L. acidophilus and L. rhamnosus had significant inhibitory effect against K. pneumoniae in vitro and should be further studied for their human health benefit.
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Background: Candida species is a normal commensal flora of human body inhabiting the skin, mucous membrane and gastro intestinal tract but may be associated with superficial and deep-seated fungal infections. The switch of Candida species from commensal to a potent pathogen, is facilitated by various extracellular hydrolytic enzymes. The aim of this study was to estimate the phospholipase, proteinase, haemolysin and esterase activity of Candida species and to determine the antifungal susceptibility. Methods: Total 100 isolates of Candida spp. were collected from diagnostic microbiology laboratories in central Kerala. Phospholipase, proteinase, esterase and haemolytic activity was determined by early defined methods of Price et al, Aoki et al, Walter Rudek and Manns et al, respectively. Results: C. tropicalis exhibited highest phospholipase, proteinase and esterase activity followed by C. albicans and C. krusei. C.albicans shows highest haemolytic activity followed by C. tropicalis and C. krusei. Conclusions: Extracellular enzymes, phospholipase, proteinase, esterase and haemolysin was detected among Candida species in the present study.
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Background: Antibiotic resistance being the critical issue faced by medical field, especially by Gram negative bacteria. It is a great threat in the case of both hospitals acquired and community acquired infections. They possess various mechanisms for their survival. The widespread resistance in Gram negative bacteria has necessitated evaluation of the use of older antimicrobials such as polymyxins. Polymyxins are disfavoured owing to their potential clinical toxicity, especially nephrotoxicity. Thus, they got abandoned in the sixties. But now they are re- emerged and used as last resort antibiotics. Methods: 274 isolates of Enterobacterales including Klebsiella pneumoniae, Escherichia coli, Citrobacter spp. Enterobacter spp. was collected from various diagnostic microbiology laboratories in Kerala. The polymyxin resistance among Enterobacterales by broth disk elution method recommended by CLSI. Results: In this study prevalence of multi drug resistant is 37% and extensively drug resistant strains is 25%. And the threatening fact is that the colistin also shows resistance among Enterobacterales (9.2%). Conclusions: Though the resistance to Polymyxin B is to the lesser side in the present study, increase in resistance to the agent is being documented globally elsewhere. So, rational use of Polymyxin B is warrantied as we could cherish polymyxin B as a 搇ife - saving drug� to avoid no drug available. Knowledge of antimicrobial resistance and development of new antimicrobial agents and improved treatments are essential in the current situation.
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Background: Candida spp. are intra-oral commensals in 40-60% of human subjects and the precise factors involved in the development of Candidiasis are still not clear. The adherence of Candida to epithelial cells is one of the main pathogenic characteristics of the genus. Studies have shown that there are variations in the adherence capabilities of different Candida spp., which may explain why some species colonize mucosal surfaces more frequently than others. The aim of this study was to estimate the adherence properties of Candida spp. to buccal epithelial cells and to determine the antifungal susceptibility. Methods: 87 isolates of Candida spp. from known non-diabetic patients with oral Candidiasis were collected from diagnostic microbiology laboratories in central Kerala. The method of Kimura and Pearsall et al was followed with minor modifications to test the adherence. Results: All the three species exhibited adherence with varying capacity. C. albicans was significantly more adherent to buccal epithelial cells than C. tropicalis and C. krusei. Resistance was not observed among the isolates against fluconazole, voriconazole and clotrimazole. Conclusions: In conclusion Candida spp. isolated from oral candidiasis patients exhibited a higher adherence capacity to normal human buccal epithelial cells considered an essential virulence property. As anticipated C. albicans displayed higher virulence activity than non-Candida albicans species.
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Background: Oral infections caused by microorganisms have led to increased risk of oral health problems like dental caries (DC). Streptococcus mutans and Candida albicans are the organisms responsible for DC. The goal of the presented study was to investigate the potential of probiotics to prevent and treat DC. An in vitro assay was developed to investigate several probiotic strains for their ability to inhibit the aforementioned oral pathogens. Methods: 40 oral isolates of Streptococcus mutans and 51 oral isolates of Candida albicans were tested for probiotic activity against Lactobacillus acidophilus and Lactobacillus rhamnosus using agar overlay interference technique as prescribed by Fleming et al. Results: The zone of inhibition shown by L. acidophilus was higher than L. rhamnosus against Streptococcus mutans and Candida albicans. Conclusions: In conclusion the two probiotic strains L. acidophilus and L. rhamnosus exhibited inhibitory activity on S. mutans and C. albicans respectively in vitro.
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Background: Oral infections caused by microorganisms have led to increased risk of oral health problems like dental caries (DC). Streptococcus mutans and Candida albicans are the organisms responsible for DC. The goal of the presented study was to investigate the potential of probiotics to prevent and treat DC. An in vitro assay was developed to investigate several probiotic strains for their ability to inhibit the aforementioned oral pathogens. Methods: 40 oral isolates of Streptococcus mutans and 51 oral isolates of Candida albicans were tested for probiotic activity against Lactobacillus acidophilus and Lactobacillus rhamnosus using agar overlay interference technique as prescribed by Fleming et al. Results: The zone of inhibition shown by L. acidophilus was higher than L. rhamnosus against Streptococcus mutans and Candida albicans. Conclusions: In conclusion the two probiotic strains L. acidophilus and L. rhamnosus exhibited inhibitory activity on S. mutans and C. albicans respectively in vitro.