Antimicrobial-Resistant Bacteria and Prescription of Antibiotics at a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Purpose The purpose of the study was to assess the bacterial resistance and annual antibiotic consumption at a tertiary care hospital in Riyadh, Saudi Arabia over a two-year period. Methods This retrospective cohort study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia from January 1, 2016, to December 31, 2017. Results The results showed that there was no significant difference between 2016 and 2017 data regarding patient characteristics like bed occupancy rate, the average length of stay, and the number of admissions; the same was true for bacterial characteristics like the number of bacteria, percentage of isolates in the group, and multidrug resistance (MDR) percentage (p: >0.05). Between 2016 and 2017, there was a slight reduction in the sensitivity of Escherichia​​​ coli (E. coli) carbapenem-resistant Enterobacteriaceae (CRE) (97%, 86%) and Klebsiella pneumoniae (K. pneumoniae) CRE (80%, 76%) towards colistin. There was also a decrease in the sensitivity of Acinetobacter baumannii (A. baumannii) multidrug-resistant organism (MDRO) from 42% to 29% against tigecycline, but an increase in the sensitivity of K. pneumoniae CRE (33%, 50%) and E. coli CRE (76%, 82%). The percentage of MDR strains in gram-positive bacteria showed that more than half of Staphylococcus aureus (S. aureus) were methicillin-resistant (61%, 59%) in 2016 and 2017 respectively. There was a reduction in the percentage of MDR strains in some gram-negative bacteria like Pseudomonas aeruginosa (P. aeruginosa) MDRO (24%, 19%),E. coli extended-spectrum beta-lactamases (ESBL) (56%, 50%), E. coli CRE (4%, 1%), K. pneumoniae CRE (49%, 33%), A. baumannii CRE (90%, 76%), and Proteus mirabilis​​​​​​​ (P. mirabilis) ESBL (54%, 50%). Conclusion MDRO bacteria are very common in the hospital where the study was conducted. Immediate action is required to tackle this problem.

Pharmaceuticals safety practices-a comparative pilot study.

INTRODUCTION: The safety of medicine is essential for the safety of patients. Inappropriate drug storage, expiration dates, sharing prescription drugs, self medication habits and misuse of some drugs are contributing factors affecting medication safety. One or more of these factors may lead to serious health complications and even death. OBJECTIVES: The purpose of this study was to highlight the common errors and pharmaceutical malpractices that people usually engage in on a daily basis and to correlate these to culture, gender and educational levels. This may spread awareness in an easy and understandable manner and provide certain guidelines to drug consumers ensuring that pharmaceutical preparations are used correctly and safely. METHODS: Two hundred questionnaires were randomly distributed in two countries; Saudi Arabia and India. The collected data were statistically analyzed. OUTCOMES AND CONCLUSION: Results showed that alarming percentages of various participants were using pharmaceuticals inappropriately due to carelessness, unawareness or intentional mistakes. Therefore, active participation by health care professionals is essential for the prevention of drug misuse. Increasing population awareness about self medication, products expiration, pharmaceuticals labels and optimum storage conditions would minimize the adverse effects and may even be life saving.

Burkholdines from Burkholderia ambifaria: antifungal agents and possible virulence factors.

Burkholdines are cyclic lipopeptides with unusual antifungal potency, making them promising leads as a new class of antifungal agents. However, a recent report using knockout mutagenesis indicates that these and related compounds, such as occidiofungins, xylocandins, and cepacidines, may also be synonymous with the long-known hemolytic virulence factors found in diverse Burkholderia isolates. Because of their possible roles in causing Burkholderia infections or curing fungal infections, it is important to fully define their structures and biological activities using pure compounds. Here, we report the structures of three further burkholdines, Bk-1119, Bk-1213, and Bk-1215, which were elucidated using spectroscopic methods. The absolute configuration of this compound class was determined for the first time using a combination of spectroscopy and chemical degradation techniques. Antifungal and hemolytic activities were assessed for five pure burkholdines, representative of the structural diversity of this lipopeptide class. All of the burkholdines were potent antifungal and hemolytic agents, validating their probable role in virulence. However, one of the burkholdines (Bk-1119) exhibited a >30-fold selectivity for fungi versus sheep erythrocytes and was more than 25-fold more potent than amphotericin against some fungal strains. Therefore, burkholdines have potential to selectively target fungal infections.

Burkholdines 1097 and 1229, potent antifungal peptides from Burkholderia ambifaria 2.2N.

Potent antifungal cyclic lipopeptides, burkholdines (Bk), were isolated from a culture of Burkholderia ambifaria 2.2N. Bk-1229 (1) and Bk-1097 (2) are octapeptides comprised of nonproteinogenic amino acids, including beta-hydroxytyrosine, beta-hydroxyasparagine, and a new fatty acyl amino acid. 1 and 2 are fungicidal against a panel of fungi with potencies 2-60-fold better than amphotericin B control.

HPLC determination of certain flavonoids and terpene lactones in selected Ginkgo biloba L. phytopharmaceuticals.

The biologically active secondary metabolites of Ginkgo biloba extract EGb 761 in phytopharmaceuticals were analyzed using two simple, rapid, accurate and sensitive HPLC methods. The proposed methods were successfully applied in the determination of terpenes and flavonoids in four phytopharmaceutical preparations selected from the Egyptian market. The terpenes; ginkgolide A, ginkgolide B, and bilobalide were analyzed using RP 18 column with a mobile phase consisting of water/methanol/isopropanol (72.5:17.5:10, v/v) at a flow rate of 1 ml min-1 and UV detection at 220 nm. The flavonoids; quercetin and kaempferol were analyzed using RP 18 column in a step gradient elution with acetonitrile and water at pH 3.3 and flow rate of 1.5 ml min-1 with UV detection at 370 nm. The two HPLC methods were completely validated.