In Vitro Susceptibility of Burkholderia pseudomallei Isolates to Cefiderocol and Ceftazidime/Avibactam from Odisha, India.

Introduction and Objectives The availability of a limited arsenal of antibacterial agents effective against Burkholderia pseudomallei, the causative agent of melioidosis, together with sporadic reports of emergence of resistance necessitates an evaluation of in vitro activity of new antimicrobials against clinical B. pseudomallei isolates. Cefiderocol (CFDC), a novel siderophore cephalosporin, and ceftazidime-avibactam (CZA), a new ß lactam combination agent, have shown promising results for the treatment of difficult-to-treat Gram-negative bacilli infections with limited treatment options. This study was conducted to determine the in vitro activity of CFDC and CZA against a contemporary collection of 60 B. pseudomallei clinical isolates. Materials and Methods Minimum inhibitory concentrations (MIC) of CFDC and CZA were determined by broth microdilution and E-test, respectively. The performance of disk diffusion was also evaluated for CFDC. Results All B. pseudomallei isolates were susceptible to CFDC and CZA with MIC range of 0.125 to 2 mg/L and 0.19 to 1 mg/L, respectively. Zone diameters for CFDC ranged from 31 to 40 mm. Conclusion CFDC and CZA exhibited excellent in vitro activity against 60 B. pseudomallei isolates. Further pharmacokinetic-pharmacodynamics studies and clinical trials are needed to prove the clinical efficacy of CFDC and CZA in the treatment of melioidosis.

Artificial Neural Network and Response Surface-Based Combined Approach to Optimize the Oil Content of Ocimum basilicum var. thyrsiflora (Thai Basil).

Ocimum basilicum var. thyrsiflora is valuable for its medicinal properties. The barriers to the commercialization of essential oil are the lack of requisite high oil-containing genotypes and variations in the quantity and quality of essential oils in different geographic areas. Thai basil's essential oil content is significantly influenced by soil and environmental factors. To optimize and predict the essential oil yield of Thai basil in various agroclimatic regions, the current study was conducted. The 93 datasets used to construct the model were collected from samples taken across 10 different agroclimatic regions of Odisha. Climate variables, soil parameters, and oil content were used to train the Artificial Neural Network (ANN) model. The outcome showed that a multilayer feed-forward neural network with an R squared value of 0.95 was the most suitable model. To understand how the variables interact and to determine the optimum value of each variable for the greatest response, the response surface curves were plotted. Garson's algorithm was used to discover the influential predictors. Soil potassium content was found to have a very strong influence on responses, followed by maximum relative humidity and average rainfall, respectively. The study reveals that by adjusting the changeable parameters for high commercial significance, the ANN-based prediction model with the response surface methodology technique is a new and promising way to estimate the oil yield at a new site and maximize the essential oil yield at a particular region. To our knowledge, this is the first report on an ANN-based prediction model for Ocimum basilicum var. thyrsiflora.

Developing a computational toolbased on an artificial neural network for predicting and optimizing propolis oil, an important natural product for drug discovery.

Propolis is a promising natural product that has been extensively researched and studied for its potential health and medical benefits. The lack of requisite high oil-containing propolis and existing variation in the quality and quantity of essential oil within agro-climatic regions pose a problem in the commercialization of essential oil. As a result, the current study was carried out to optimize and estimate the essential oil yield of propolis. The essential oil data of 62 propolis samples from ten agro-climatic areas of Odisha, as well as an investigation of their soil and environmental parameters, were used to construct an artificial neural network (ANN) based prediction model. The influential predictors were determined using Garson's algorithm. To understand how the variables interact and to determine the optimum value of each variable for the greatest response, the response surface curves were plotted. The results revealed that the most suited model was multilayer-feed-forward neural networks with an R2 value of 0.93. According to the model, altitude was found to have a very strong influence on response, followed by phosphorous & maximum average temperature. This research shows that using an ANN-based prediction model with a response surface methodology technique to estimate oil yield at a new site and maximize propolis oil yield at a specific site by adjusting variable parameters is a viable commercial option. To our knowledge, this is the first report on the development of a model to optimize and estimate the essential oil yield of propolis.

Analysis of In Vitro Activity of Cefiderocol Against Carbapenem-Resistant Gram-Negative Bacilli by Broth Microdilution and Disk Diffusion Method: A Single-Center Study in Odisha, India.

Introduction: Cefiderocol (CFDC), a novel semi-synthetic siderophore cephalosporin has been developed to combat the menace of infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) including Carbapenem-resistant Enterobacterales (CRE) and Carbapenem-resistant Nonfermenting Gram-negative bacilli (CR-NFGNB). Methods: We determined the in vitro activity of CFDC against a contemporary collection of 503 CR-GNB isolates by the reference broth microdilution method (BMD) using Iron depleted cation adjusted Mueller-Hinton broth (ID-CAMHB). Performance of CFDC disk diffusion (DD) was evaluated against the reference BMD, as an alternative convenient testing method. Molecular characterization of carbapenemase in CR-GNB was performed by PCR targeting bla NDM-1, bla OXA-48like alleles, bla KPC, bla IMP, and, bla VIM. Minimum inhibitory concentration (MIC) distribution of CFDC in CR-GNB harbouring different carbapenemase enzymes was also analyzed. Results: In our study, 81.7% (411/503) of CR-GNB isolates [81.3%, (278/342) CRE and 82.6% (133/161) CR-NFGNB] were susceptible to CFDC (p>0.05). Categorical agreement (CA) of DD ranged from 79.8% to 87.5%, Minor error (mE) ranged from 0 to 14%, Major error (ME) ranged from 0 to 3.5%, and Very Major error (VME) ranged from 0 to 12.5% with variations by species tested. Overall CFDC MIC50 and MIC90 values of CR-GNB isolates without any carbapenemase genes were higher as compared to those with the presence of carbapenemase genes (4 µg/mL and 128 µg/mL versus 2 µg/mL and 16 µg/mL respectively). Discussion: CFDC is not yet available for clinical use in India. Hence, multicentric studies are the need of the hour in India for standardization of CFDC susceptibility using disks and CAMHB from different manufacturers as well as understanding mechanisms of high MIC values.

Molecular Detection of Carbapenemase Enzymes Directly from Positive Blood Cultures Using Xpert Carba-R.

Objective The performance of Xpert Carba-R assay for the direct identification of carbapenemases directly from positive blood culture vials was evaluated. Materials and Methods In total, 176 positively flagged blood culture vials, yielding carbapenem-resistant GNB (CR-GNB), were enrolled for the detection and differentiation of blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP using Xpert Carba-R. Results Klebsiella pneumoniae (76/176, 43.1%), Acinetobacter baumannii complex (67/176, 38%), and Escherichia coli (29/176,16.4%) were the predominant isolates. Overall, NDM production was the commonest (61/176, 34.6%), followed by the co-production of NDM + OXA-48 and the absence of any CR gene (44/176, 25%), followed by OXA-48 (27/176, 15.3%). In CR K. pneumoniae , the co-production of NDM + OXA-48 was most frequent (34/76, 44.7%), whereas in the A. baumannii complex , no CR gene was detected in the majority of isolates (38/67, 56.7%). bla NDM was the commonest gene in E. coli (18/29, 62%) and A. baumannii complex (26/67, 38.8%). Conclusion Xpert Carba-R can identify the molecular mechanism of CR within hours after a blood culture turns positive and, thus, has the potential for optimization of antimicrobial therapy, choosing appropriate novel ß-lactam combination agents, as well as infection control interventions.

Intractable diarrhoea due to co-infection with Cystoisospora belli and Trichuris trichiura unraveling a severely compromised host immune status.

Cystoisospora belli is an obligate intracellular coccidian parasite known to cause chronic persistent diarrhoea in immunocompromised individuals such as human immunodeficiency virus (HIV) infection, long term corticosteroid therapy, cancer chemotherapy and solid organ transplant recipients. Trichuris trichiura is a soil transmitted helminth, which predominantly causes asymptomatic or mild infections but heavy worm load can sometimes lead to chronic diarrhoea, tenesmus or rectal prolapse. We report a case of co-infection with Cystoisospora belli and Trichuris trichiura in an adult patient causing intractable diarrhea, which led to the unraveling of a severely compromised immune status in the patient enabling an appropriate therapeutic approach and further management.

Global emergence of Enterovirus 71: a systematic review.

Background: Hand, foot, and mouth disease (HFMD) is a viral infection caused by a virus from the enterovirus genus of picornavirus family that majorly affects children. Though most cases of HFMD do not cause major problems, the outbreaks of Enterovirus 71 (EV71) can produce a high risk of neurological sequelae, including meningoencephalitis, lung difficulties, and mortality. In Asia, HFMD caused by EV71 has emerged as an acutely infectious disease of highly pathogenic potential, which demands the attention of the international medical community. Main body of the abstract: Some online databases including NCBI, PubMed, Google Scholar, ProQuest, Scopus, and EBSCO were also accessed using keywords relating to the topic for data mining. The paid articles were accessed through the Centre Library facility of Siksha O Anusandhan University. This work describes the structure, outbreak, molecular epidemiology of Enterovirus 71 along with different EV71 vaccines. Many vaccines have been developed such as inactivated whole-virus live attenuated, subviral particles, and DNA vaccines to cure the patients. In Asia-Pacific nations, inactivated EV71 vaccination still confronts considerable obstacles in terms of vaccine standardization, registration, price, and harmonization of pathogen surveillance and measurements. Short conclusion: HFMD has emerged as a severe health hazard in Asia-Pacific countries in recent decades. In Mainland China and other countries with high HFMD prevalence, the inactivated EV71 vaccination will be a vital tool in safeguarding children's health. When creating inactivated EV71 vaccines, Mainland China ensured maintaining high standards of vaccine quality. The Phase III clinical studies were used to confirm the safety and effectiveness of vaccinations.