Fosphomycin: A ray of hope against multidrug resistant uropathogens

Aims@#Urinary Tract Infection (UTI) is one of the common infections in clinical practice. Increasing incidence of Multi Drug Resistant (MDR) uropathogens limited the therapeutic options; thereby prompted the interest in old drugs like Fosphomycin. The current study was undertaken for the comparative evaluation of vitro activity of Fosphomycin and Nitrofurantoin against ESBL producing and carbapenem resistant uropathogens. We also tried to compare the coexistence of resistance of both the drugs with another commonly used oral drug for UTI, i.e. Flouroquinolone. @*Methodology and results@#A total 101 MDR uropathogens were tested for ESBL production, carbapenem resistance, Fosphomycin susceptibility and Nitrofurantoin susceptibility as per the CLSI guidelines. Fosphomycin susceptibility testing was carried out by disc diffusion test. Klebsiella pneumoniae was the commonest MDR uropathogen followed by Pseudomonas aeruginosa and Escherichia coli. Susceptibility to Fosphomycin among the ESBL producer and carbapenem resistant uropathogen was found uniformly higher (91.8%, 90.1%) in comparison to Nitrofurantion (27.5%, 21.3%). Coexistence of resistance to Fosphomycin was much less than Nitrofurantoin in presence of resistance to Flouroquinolone. @*Conclusion, significance and impact of study@#Fosphomycin showed excellent in vitro susceptibility against both ESBL producing and carbapenem resistant MDR uropathogens. Fosphomycin has excellent in vitro action of Fosphomycin against ESBL producing and carbapenem resistance uropathogen in comparison to Nitrofurantoin, hence will be useful for the treatment of drug resistsant uropathogens.

Hemozoin Pigment: An Important Tool for Low Parasitemic Malarial Diagnosis

Low parasitemic condition in malaria remains a diagnostic challenge; as the available diagnostic methods failed to detect. Currently, hemozoin (Hz) pigment is gaining attention in the diagnosis of malaria. The major drawback is ease of detection of Hz in routine practice. A pilot study was conducted to evaluate the role of Hz pigment and to compare the performance of quantitative buffy coat assay (QBC) and PCR in such conditions. Clinically suspected cases of malaria were examined by both Giemsa stain and immunochromatographic test (ICT). Samples positive by ICT and negative by Giemsa stain were further examined by nested PCR targeting 18S rRNA and QBC for the presence of malaria parasites and pigments. Thirty blood samples fulfilled the inclusion criteria out of which 23 were Plasmodium vivax (Pv), 4 Plasmodium falciparum (Pf), and 3 mixed (Pv and Pf) by immunochromatographic test. Twenty-one out of 30 (70%) were positive by nested PCR in comparison to 25/30 (83%) by QBC. Samples containing both malaria parasites and Hz pigment by QBC completely showed concordance with the PCR result. However, 61% of total samples containing only Hz pigment were observed positive by PCR. Hz pigment remains an important tool for malaria diagnosis. Identification of leukocytes containing pigments by QBC not only indicates recent malarial infections but also puts light on severity of the disease. QBC assay is a rapid, highly sensitive, and cost-effective method to detect malaria parasites and Hz pigment especially in low parasitemic conditions.