Identification of Bacterial Isolates and Their Antimicrobial Susceptibility Pattern from Wound/Pus Sample in a Tertiary Care Hospital, Gwalior, India

Objective: The goal of this investigation was to look at the frequency and dispersal of bacteria isolated from pus/wound, as well as their susceptibility patterns. Materials and Methods?A study was conducted on 175 patients who provided pus and/or wound discharge samples in different wards (outpatient department or inpatient department). MacConkey agar and blood agar plates were immediately inoculated with samples and incubated at 37°C for 24?hours. The Gram stain and biochemical tests were used to identify all isolates after incubation. Kirby–Bauer's disc diffusion method was used to perform sensitivity tests on Mueller–Hinton agar plates. Results?This study covered 175 patients, with a bacterial isolation rate of 102 (58.28%). Males outnumbered females in the samples (M:F?=?1.8:1), with a median age of 45 years as majority were in the age group of 40 to 60 years which was 41 (40.20%). Total 90.1% samples showed monomicrobial infection, whereas 9.8% showed polymicrobial infection, and total 112 bacterial strains were isolated. Conclusion?Escherichia coli was the most prevalent isolate in present investigation, followed by Pseudomonas aeruginosa. Chloramphenicol is the only antibiotic which is effective for both gram-negative bacilli and gram-positive cocci. This report's susceptibility statistic may be worth considering for developing empiric treatment regimens for pyogenic infections.

Rational use of Polymyxins against multi-drug resistant Gram-Negative bacteria

@#The current strategy in treating multi-drug resistant gram-negative bacterial (MDR-GNB) infections is salvage therapy by using polymyxins. However, the beginning emergence of polymyxin resistance should enforce strict antimicrobial stewardship programs to preserve polymyxin efficacy. Knowledge of structural characteristics, pharmacodynamic, and pharmacokinetic profiles of polymyxins, as well as consideration of efficacy, safety, suitability, and cost, will help in the choice of the appropriate polymyxin for therapy. Polymyxin B is the recommended polymyxin for systemic use, while colistin is recommended for lower urinary tract infections, intraventricular, and intrathecal use. Either polymyxin can be used for hospital-acquired and ventilator-associated pneumonia. Combination therapy over monotherapy remains to be advantageous due to synergism and decreased resistance development. The choice of the second drug to be used should be based on full susceptibility, or if unavailable, a drug with the least minimum inhibitory concentration relative to the breakpoint set by the Clinical and Laboratory Standards Institute. Using the mnemonic ESCAPE can also guide physicians in their polymyxin prescription process: (1) Checking if the pathogen is Extensively resistant or multi-drug resistant; (2) checking the patient’s clinical status if compatible with Significant infection; (3) using Combination therapy; (4) ensuring Adequate dosing; (5) Proper preparation and administration of drug; and (6) keeping an Eye for response and adverse effects.

Carbapenem-resistant bacilli in a hospital in southern Brazil: prevalence and therapeutic implications

Abstract Background Gram-negative bacilli (GNB), notably Acinetobacter spp., Pseudomonas spp., and Klebsiella spp., are becoming increasingly resistant to carbapenems and are associated with high health care costs and mortality, becoming a global concern. Objective To determine the prevalence rates of carbapenem resistance among Acinetobacter spp., Pseudomonas spp., and Klebsiella spp. in the main sites of nosocomial infection at a tertiary care hospital in southern Brazil and the consequent therapeutic implications. Methods Cultures processed at the institution's laboratory in 2017 were analyzed, and those positive for Acinetobacter spp., Pseudomonas spp., and Klebsiella spp. were identified. Antibiograms were evaluated for meropenem sensitivity following the Clinical Laboratory Standards Institute guidelines. Results Acinetobacter spp. had the lowest prevalence among the three GNB, and resistance of this pathogen to meropenem at different sites of infection ranged from 36% (blood) to 82% (respiratory tract). Pseudomonas spp. was highly prevalent at the respiratory tract (31%) and had a high resistance rate to meropenem in rectal swab samples (71%), but a relatively low frequency at infection sites (skin/soft tissue, 13%; blood, 25%). Klebsiella spp. was identified in 7.5% of the blood cultures and 15% of the urine cultures and was the chief colonizer among all pathogens, representing 54% of all rectal swab samples, of which 53% were meropenem resistant. At sites of infection, rates of Klebsiella spp. resistant to meropenem ranged from 19% (skin) to 55% (vascular catheter). Conclusions The prevalence of carbapenem-resistant GNB at our hospital was relatively low compared to national and international data; thus, meropenem remains a good therapeutic option against these bacteria. Other antibiotics effective against GNB, such as ceftazidime, cefepime, and piperacillin-tazobactam, can be used in most cases, while meropenem should be reserved for patients with sepsis. Strict contact precaution measures are still needed, given the high resistance rate observed at the colonizing site.

G protein gene variants in schizophrenia

Abstract Background Various studies demonstrating enhanced vulnerability to apoptosis may contribute to the pathobiology of schizophrenia. Objective Thus, G proteins may provide an intriguing link between the signal transduction, and apoptotic hypotheses of schizophrenia. In the light of these findings, we investigated whether G protein gene polymorphisms (GNAS1-T393C and GNB3-C825T) accounted for an increased risk of schizophrenia. Methods The present analyses were based on 100 subjects diagnosed with schizophrenia, and on 100 unrelated healthy controls. The genotyping of GNAS1-T393C, and GNB3-C825T gene polymorphisms were performed using the polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP). Results: We demonstrated the positive association of GNB3-C825T gene variants with schizophrenia risk (p: 0.023). In our study, more prevalent CC genotype frequencies were detected in GNB3 in patients compared with the frequencies in the controls. The individuals with GNB3-C825T CC genotype had 2 fold increased risk for schizophrenia (p: 0.011, c2: 6.39, OR:2.14, 95% CI: 1.18-3.90). Discussion Our study results suggested that GNB3-C825T polymorphism might be associated with schizophrenia.

Bacteriological Profile and Antimicrobial Susceptibility Patterns of Bacteria Isolated from Surgical Site Infections of Patients Attending a Tertiary Care Hospital

Introduction: Surgical site infections (SSIs) are one of themajor causes of morbidity and mortality in developing countriesdespite recent advances in aseptic techniques. The SSIs dueto emerging multidrug resistance (MDR) bacteria isolates areconsidered as grave threats to the public health worldwide.Each hospital has specific type of microbial flora from whichinfection initiates. In such condition microorganism showsunique type of antibiotic susceptibility and resistance pattern.In this study we report on the microbiological spectrum ofSSIs and the antimicrobial susceptibility pattern with a viewto provide guide to the clinicians for making rational decisionover the choice of antibiotics in the management of surgicalsite infection.Material and Methods: This cross-sectional study wascarried out in a tertiary care hospital and the 560 sampleswere collected, processed in the microbiology laboratory andevaluated for the study.Results: Out of 376 growth positive samples, Gram NegativeBacilli (GNB) were isolated from 271 (72%) samples andGram Positive Cocci (GPC) were isolated from 105 (28%)samples. Among the isolated GNB, only 5 to 10% weresensitive to third generation Cephalosporins. Sensitivity toFluroquinolones (Ciprofloxacin and Levofloxacin) was alsolow (Only 5% to 10% were sensitive). Only 3 to 15% of theGNB were found sensitive to Co-amoxiclav and 6.5% to 23%were sensitive to Ampicillin-Sulbactam. About 60% of thePseudomonas aeruginosa and about 40% of the Klebsiellaspp and Acinetobacter baumanii were found resistant toMeropenem.Conclusion: Gram Negative Bacilli predominated overGram Positive Cocci in surgical site infections in our setup. Very low sensitivity to 3rd generation Cephalosporins,Ampicillin, Co-amoxiclav and Fluroquinolones was notedamong GNB isolates and an increasing pattern of resistanceto Aminoglycosides and Carbapenems was also noted amongMDR Pseudomonas aeruginosa and Acinetobacter baumaniiisolates. More than 50% of the MDR Acinetobacter spp.were was found sensitive to Ampicillin- Sulbactam andMinocycline.

Effectiveness and adverse effects of Intravenous Colistin In Neonates with Multi-Drug Resistant Gram-Negative Bacterial Infections

Background@#The global burden of multi-drug resistant gram-negative bacterial (MDR-GNB) infections has been increasing. Neonates are at a particularly high-risk and there is limited treatment option. The use of colistin has been re-introduced for this population. However, data on its use in neonates is scarce. @*Objectives@#To determine the effectiveness and adverse effects of intravenous colistin in neonates with multidrug-resistant gram-negative infections. @*Design@#This is a retrospective cohort study of the clinical profile and outcome of neonates with MDR-GNB infections given colistin for a minimum of 3 days conducted from April 2015 to April 2019. @*Results@#A total of 175 pediatric patients had MDR-GNB infections. 75 (43%) neonates met the inclusion criteri a and received intravenous colistin. Of the 75 patients with MDRGNB infections- that included sepsis, pneumonia, urinary tract infection and abscess, 37 (49.3%) were alive and 38 (50.7%) patients died. Nephrotoxicity was seen in 4% if patients and 2.6% patients had hypersensitivity reaction. MDROs isolated were Acinetobacter baumanii, Klebsiella pneumoniae and Pseudomonas aeruginosa. @*Conclusions@#Intravenous colistin is 50% effective and is relatively safe to use in neonates.

Association of G-Protein β3 Subunit C825T Polymorphism with Seasonal Variations in Mood and Behavior

OBJECTIVE: Seasonal affective disorder and seasonal changes in mood and behavior are associated with several genes that regulate circadian rhythms. In this study, we investigated the relationship between the C825T polymorphism of the G-protein β3 subunit and seasonal variations in mood and behavior in a young healthy Korean population. METHODS: A total of 507 young Korean participants were recruited through a newspaper advertisement, and their seasonality was evaluated by the Korean version of the Seasonal Pattern Assessment Questionnaire to assess the global seasonality score (GSS). We analyzed the CC, CT, and TT genotypes and their association with the GSS score and subscales. RESULTS: T allele carriers of the GNB3 C825T polymorphism were more likely to score higher on body weight and GSS. In the female group, the T allele carriers obtained significantly high total GSS and its subscale scores for mood, body weight, energy level, and appetite; however, differences in genotypes and allele carriers were also observed in the male participants. CONCLUSION: These results suggested that GNB3 C825T polymorphism plays a role in seasonal variations in mood, body weight, energy level, and appetite in a Korean population, particularly in females.

Increased store-operated Ca²⁺ entry mediated by GNB5 and STIM1

Recent human genetic studies have shown that Gβ5 is related to various clinical symptoms, such as sinus bradycardia, cognitive disability, and attention deficit hyperactivity disorder. Although the calcium signaling cascade is closely associated with a heterotrimeric G-protein, the function of Gβ5 in calcium signaling and its relevance to clinical symptoms remain unknown. In this study, we investigated the in vitro changes of store-operated calcium entry (SOCE) with exogenous expression of Gβ5. The cells expressing Gβ5 had enhanced SOCE after depletion of calcium ion inside the endoplasmic reticulum. Gβ5 also augmented Stim1- and Orai1-dependent SOCE. An ORAI1 loss-of-function mutant did not show inhibition of Gβ5-induced SOCE, and a STIM1-ERM truncation mutant showed no enhancement of SOCE. These results suggested a novel role of GNB5 and Stim1, and provided insight into the regulatory mechanism of SOCE.

Factores asociados a nefrotoxicidad por polimixina B en un hospital universitario de Neiva, Colombia. 2011-2015 / Risk factors for acute kidney injury in patients treated with polymyxin B experience from 139 cases at a tertiary university hospital in Colombia

Background: The rise of infections caused by multidrug-resistant Gram negative bacilli (MDR-GNB), added to paucity of newer therapy, have led to increase polymyxin B use, despite adverse renal toxicity profile. Aim: To determine the incidence and risk factors associated to acute kidney injury (AKI) and polymyxin B use, in patients with infections caused by MDR-GNB. Methods: A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed. AKI was defined by AKIN criteria. Results: Of 139 patients included in our study, 102 were male with median age of 49 years (IQR:28-64). Sixty-one patients (44%) developed AKI. Independent risk factors for development of AKI included: total polymyxin B daily dose (OR = 2.19, 95% CI, 1.04-4.64); length of stay at ICU (OR = 1.03, 95% CI, 1.00-1.06); nosocomial infection (OR = 6.43, 95% CI, 2.12, -19.47); and vasopressor use (OR = 5.38, 95% CI, 2.40-12.07). Mortality was higher among AKI-patients (58.6%) compared with non-AKI patients (25.6%) (p = 0.001). Conclusion: In this study, the rate of AKI associated to polymyxin B use was greater than reported in studies from last decade, and associated with increased mortality. AKI associated to polymyxin B use is likely multifactorial and aggravated by the critically ill state of patients suffering nosocomial infections caused by mdr-gnb.

Introducción: El surgimiento de infecciones graves causadas por bacilos gramnegativos multi-resistentes (BGN-MR), sumado a la carencia de nuevas opciones terapéuticas efectivas, ha llevado a retomar el uso de polimixina B, a pesar de su perfil de nefrotoxicidad. Objetivo: Determinar la incidencia y factores relacionados con el desarrollo de nefrotoxicidad asociada al uso de polimixina B, en pacientes adultos con infecciones causadas por BGN-MR. Materiales y Métodos: Estudio observacional, analítico, tipo cohorte histórica, con un análisis de casos y controles anidado, realizado en un hospital universitario de tercer nivel de Colombia entre 2011 y 2015, en pacientes que recibieron polimixina B intravenosa por más de 48 h. Resultados: De 139 pacientes incluidos en el estudio, 61 (44%) desarrollaron falla renal aguda por criterios AKIN. Los factores de riesgo independientes para nefrotoxicidad fueron: dosis diaria de polimixina B (OR 2,19; IC 95% 1,04-4,64), días de estancia en UCI (OR 1,03; IC 95% 1,00-1,06), presencia de infección nosocomial (OR 6,43; IC 95% 2,12-19,47) y requerimiento de fármacos vasopresores (OR 5,38; IC 95%: 2,40-12,07). Conclusión: La tasa de nefrotoxicidad observada en pacientes que recibieron polimixina B es considerable; su origen probablemente multifactorial y agravada por estado crítico de pacientes con infecciones nosocomiales por BGN-MR.

Validation of G-protein beta-3 subunit gene C825T polymorphism as predictor of obesogenic epidemics in overweight/obese Korean children / 한국영양학회지

PURPOSE: We investigated the potential interaction between the G-protein beta-3 subunit gene (GNB3) C825T polymorphism, a risk factor for chronic disease in various ethnicities, and obesogenic environments in overweight/obese Korean children. METHODS: The present study was conducted as a cross-sectional study using measures of anthropometry, blood pressure (BP), and fasting blood samples as well as 3-day food records. Subjects were recruited from seven elementary schools in an urban district in Seoul, South Korea, between 2007 and 2008. A total of 1,260 children aged 8-9 years were recruited in the study, including 633 boys (50.3%) and 627 girls (49.7%). RESULTS: The allele frequencies of the GNB3 polymorphism were C allele = 49.7% and T allele = 50.3% in subjects. In general, boys with T allele had higher BMI, systolic BP (SBP), and triglycerides, although their energy intake was not significantly different from boys with C allele. In contrast to boys, girls with T allele had lower BMI but higher SBP and energy intake than those with C allele. The girls with T allele had a significantly lower BMI and waist circumference in both the normal weight group and obese group (OB). T allele carriers in both genders had significantly higher TC than C allele carriers in the OB group. At last, girls with T allele in OB appeared to have significantly lower HOMA-IR than those with C allele. CONCLUSION: Unlike higher risk for negative health outcomes by the GNB3 polymorphism in various ethnicities, GNB3 polymorphism did not influence obesogenic environments in overweight/obese Korean children.

Association of GNB3 C825T polymorphism with plasma electrolyte balance and susceptibility to hypertension

The role of G-protein activation in cardiovascular disorders is well-known. G-protein β3 subunit (GNB3) C825T polymorphism is associated with increased intracellular signal transduction. We investigated the role of the variant in plasma sodium and potassium concentrations and association with hypertension. 345 healthy controls and 455 patients with essential hypertension were enrolled. Plasma renin activity and aldosterone concentration were measured. The variant, typed by SNaPshot, was analyzed on an ABI Prism 3100 Genetic Analyzer and GeneScan. The TT genotype and T allele were over-represented in the patients (p < 0.001, p < 0.0001). Multiple-logistic regression disclosed that the risk of hypertension was significantly greater for TT (p < 0.0001, OR = 6.1, CI = 2.9-12.7). One-way ANOVA revealed that hypertensive T-allele carriers (CT+TT), compared to non-carriers (CC), had a greater body mass index (BMI), mean arterial pressure (MAP) and PAC (p = 0.01, p = 0.01, p < 0.0001, respectively); while the patients with 825TT risk genotype showed higher plasma sodium and lower potassium (p < 0.0001, each). The results strongly emphasize, not only the role of C825T polymorphism by the induction of increased G-protein activity and enhancement of Na/h exchangers, but also the association with higher plasma sodium and lower potassium levels, high BMI and susceptibility to hypertension.

Genetic analysis of ?-ADDUCIN and GNB3 in essential hypertension patient / 基础医学与临床

Objective To explore the polymorphism at position G460W of ?-ADDUCIN and at position C825T of GNB3,and the genetic interaction between ?-ADDUCIN and GNB3 genes in a QiQihr essential hypetension population.Methods Three hundreds and thirty-one patients with EH and two hundreds and ninety-three healthy controls were enrolled.Genotyping was performed using PCR-RFLP technique.Results(1)genotype distributions of ?-ADDUCIN G460W(GG 0.177 vs 0.160,GW 0.580 vs 0.481,WW 0.242 vs 0.359,P=0.006) and GNB3(CC0.177 vs 0.353,CT 0.468 vs 0.541,TT 0.355 vs 0.106,P

The C825T polymorphism of GNB3 gene effects the response to 15-days-treatment of adalat / 中国药理学通报

AIM To study the relationship between the response of hypertension patients to Adalat and the C825T polymorphism of the GNB3 gene. METHODS 554 hypertension subjects were treated with Adalat. Epidemiological and clinical data were collected. Genotypes of the GNB3 gene were measured by the PCR RFLP method. Linear and logistic regression were used to analyze the association between GNB3 genotypes and the response to Adalat. RESULTS The frequency of the 825T allele in our hypertensive group (48 4%) was slightly higher than that of the normal Chinese reported previously by Siffert W et al. (42%). The average SBP decrease after 15 days of Adalat treatment of subjects with the T allele was significantly less than that of the subjects with the CC genotype (?=-3 3, P= 0 03). Using logistic regression, the subjects with the T allele were less likely to reach good treatment result compared to those with the CC genotype (OR=0 33, P =0 02). CONCLUSION The GNB3 gene C825T polymorphism is related to the response to Adalat.