Cefixime Research Articles

Antibiotic Susceptibility Pattern of Enterobacteriaceae Isolated from Raw Meat and Ghanaian Coin Currencies at Cape Coast Metropolis, Ghana: The Public Health Implication

Introduction: The emergence and upsurge of Multiple Antibiotic Resistant (MDR) Enterobacteriaceae in the environment is a cause of concern as this can result in an outbreak and spread to healthcare settings. MDR Enterobacteriaceae have been associated with high morbidity and mortality due to delay in selecting and delivering active therapy in time. Aims & Objectives: The study was conducted to investigate the level of contamination of raw meat and Ghanaian coins in circulation at Cape Coast Metropolis. In all, 10 raw meat were sampled each from chevron and beef from Kotokuraba market, and 400 Ghanaian coin currencies retrieved from food vendors, students, transport operators and banks were used in this study. Materials & Methods: The Enterobacteriaceae species isolated were tested for their susceptibility to Ampicillin, Tetracycline (TET), Gentamicin (GEN), Cotrimoxazole (COT), Cefuroxime (CRX), Cefixime (CXM), Cefotaxime (CTX), Penicillin (PEN), Cloxacillin (CXC), Erythromycin (ERY) and Amikacin (AMK) antibiotics using Mueller-Hinton agar antibiotic diffusion technique. Of the isolated Enterobacteriaceae, 30% and 62% from chevron and beef respectively and 14.17%, 13.75% and 10.63% from food vendors, students and transport operators respectively showed resistance to some of the antibiotics tested. Results & Discussion: 8.6% of the Escherichia coli (E. coli) isolated from chevon were resistant to CRXr-CHLr-AMPr-COTr-GEMr and 15.5% of CRXi-CHLi-AMPr-TETr-COTr from beef. 40.0% of E. coli isolated from coin currencies were resistant to CRXr-CHLr-AMPr-TETr-CTXr, 50.0% of Enterobacter spp to CRXr-CHLr-AMPr-TETr-CTXr, 16.67% of Proteus spp to CRXi-CHLi-AMPr-TETr-AMKi, 40% Pseudomonas spp to CRXr-AMPr-TETr-AMKi and 100% of Enterobacter spp to CRXr-AMPr-TETi-CTXr. Conclusion: The multidrug-resistant Enterobacteriaceae isolates from circulating Ghanaian coins and raw meats in the Cape Coast metropolis is an indication of an impending danger which requires immediate attention to prevent a possible outbreak and spread from the society to the hospital setting.

125. eGISP: Enhanced Surveillance of Neisseria gonorrhoeae Antimicrobial Susceptibility in the United States

BackgroundThe Gonococcal Isolate Surveillance Project (GISP), which monitors trends in N. gonorrhoeae susceptibility among men with gonococcal urethritis in sexually transmitted disease (STD) clinics, has informed treatment recommendations for 3 decades. However, it has been speculated that susceptibility patterns may differ in women, as well as in the pharynx and rectum. We describe preliminary findings from the enhanced GISP (eGISP), which expands surveillance to pharyngeal, rectal, and endocervical isolates.MethodsIn August 2017, select jurisdictions were funded to collect urogenital and extragenital specimens from men and women seen in participating STD clinics. Positive gonorrhea cultures were sent to regional laboratories for antimicrobial susceptibility testing (AST) by agar dilution. Isolates with elevated minimum inhibitory concentration (MIC) to azithromycin (AZI) (MIC ≥2.0 μg/mL), cefixime (CFX) (MIC ≥0.25 μg/mL), and/or ceftriaxone (CRO) (MIC ≥0.125 μg/mL) were designated as Alert isolates. Clinical and epidemiological data were linked to AST results.ResultsFrom August 2017 to February 2018, 4 clinics in 4 jurisdictions submitted 468 positive gonococcal specimens for AST; 36.1% were from men who have sex with men (MSM), 51.9% from men who have sex with women (MSW), and 12.0% from women. Overall, 71.8% were urethral, 7.9% endocervical, 7.1% rectal, and 13.2% pharyngeal. Seventy-two isolates (15.4%) were Alerts: 97.2% (N = 70) had elevated MICs to AZI, 2.8% (N = 2) had elevated MICs to CFX, and none had elevated MICs to CRO. No isolate had elevated MICs to both AZI and CFX. Among MSM, 15.9% of urogenital isolates and 16.1% of extragenital isolates had an elevated AZI MIC. Among MSW, 11.8% of urogenital isolates and 14.3% of pharyngeal isolates had an elevated AZI MIC. Among women, 24.3% of endocervical isolates and 26.3% of extragenital isolates had an elevated AZI MIC.ConclusionPreliminary eGISP data suggest that enhanced surveillance of pharyngeal, rectal, and endocervical isolates is feasible and that elevated MICs to azithromycin are common among males and females. Including isolates from extragenital anatomic sites and women may help strengthen N. gonorrhoeae surveillance capacity.Disclosures All authors: No reported disclosures.

The first year of the global Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) in Bangkok, Thailand, 2015-2016.

Antimicrobial-resistant Neisseria gonorrhoeae (NG) infection is a global public health threat, and there is a critical need to monitor patterns of resistance and risk factors. In collaboration with the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the Thailand Department of Disease Control (DDC), Ministry of Public Health (MoPH) implemented the first Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) in November 2015. Men presenting with urethritis at two clinical settings in Bangkok, Thailand (Bangrak Hospital [BH] and Silom Community Clinic @TropMed [SCC @TropMed]) provided demographic and behavioral information and had a urethral swab for Gram’s stain and NG culture collected. The NG isolates were evaluated for antimicrobial susceptibility by the Epsilometer test (Etest) to determine minimum inhibitory concentrations (MICs) for cefixime (CFM), ceftriaxone (CRO), azithromycin (AZI), gentamicin (GEN), and ciprofloxacin (CIP). From November 2015 –October 2016, 1,102 specimens were collected from 1,026 symptomatic men; 861 (78.1%) specimens were from BH and 241 (21.9%) specimens were from SCC @TropMed. Among the 1,102 specimens, 582 (52.8%) had intracellular Gram-negative diplococci and 591 (53.6%) had NG growth (i.e., NG infection); antimicrobial susceptibility testing (AST) was performed on 590 (99.8%) NG isolates. Among all symptomatic men, 293 (28.6%) had sex with men only, 430 (41.9%) were ages 18–29 years, 349 (34.0%) had antibiotic use in the last 2 weeks, and 564 (55.0%) had NG infection. Among 23 men with repeat NG infection during this first year of surveillance, 20 (87.0%) were infected twice, 2 (8.7%) were infected three times, and 1 (4.3%) was infected more than four times. All NG isolates were susceptible to CFM and CRO, and had MICs below 2 μg/mL for AZI and below 16 μg/mL for GEN. Overall, 545 (92.4%) isolates were resistant to CIP. This surveillance activity assessed individual patients, and included demographic and behavioral data linked to laboratory data. The inclusion of both individual and laboratory information in EGASP could help identify possible persistent infection and NG treatment failures. Expansion of EGASP to additional global settings is critical to assess trends and risk factors for NG, and to monitor for the emergence of resistance.

Enhanced HPLC-MS/MS method for the quantitative determination of the co-administered drugs ceftriaxone sodium and lidocaine hydrochloride in human plasma following an intramuscular injection and application to a pharmacokinetic study.

A sensitive HPLC-MS/MS method was established for the quantification of ceftriaxone sodium (CFT) and lidocaine HCl (LDC) in human plasma utilizing cefixime (CFX) and tadalafil (TDA) as internal standards. The analytes were extracted from human plasma by protein precipitation using acetonitrile. Chromatographic separation was performed on Kinetex C18 (50.0 × 4.6 mm, 5 μm particle size) column with methanol-0.01M ammonium acetate pH 6.4 (70: 30, v/v) as mobile phase. Multiple reaction monitoring involving the transitions 555.10 → 396.20, 235.20 → 86.00, 454.20 → 284.80 and 390.20 → 268.20 was utilized to quantify CFT, LDC, CFX and TDA, respectively, using a triple quadrupole mass spectrometer which was operated in positive ion mode. The method revealed linearity in the concentration range of 3.0-300.0 μg/mL for CFT and 3.0-300.0 ng/mL for LDC. The validation of the method was achieved in accordance to the US Food and Drug Administration guidelines. A pharmacokinetic study was performed on healthy Egyptian volunteers after intramuscular injection of sterile ceftriaxone sodium (1 g CFT dissolved in 3.5 mL of 1% LDC) after approval from the ethics committee. The pharmacokinetic parameters were: Cmax 141.15 ± 39.84 (μg/mL) and 55.02 ± 9.36 (ng/mL); tmax (h) 2.50 ± 0.50 and 1.5 ± 0.50; t½ (h) 7.30 ± 2.98 and 4.23 ± 1.96; and Kel (h-1 ) 0.10 ± 0.04 and 0.20 ± 0.13 for CFT and LDC, respectively.

Cefixime in Acute Otitis Media

Cefixime in Acute Otitis Media

Molecular Analysis of Klebsiella Pneumoniae Isolated from UTI Patients in Erbil City

Fifty isolates of Klebsiella pneumoniae were identified using cultural, morphological and biochemical characteristics. Three-hundred and fifty urine samples were collected from patients with urinary tract infection admitted to Hawler Teaching, Rizgary, Raparin and West Emergency hospitals in Erbil city during the period of 2nd of June to 5th of October 2012. Antibiotic sensitivity testing performed for all isolates using amikacin (AK30), ampicillin (AMP10), aztreonam (ATM30), Cefixime (CFM5), Ceftriaxone (CI30), Ciprofloxacin (CIP30), Cefoxitin (CN30), Trimethoprim/sulfamethoxazole (COT25), Cefotaxime (CTX5), Gentamicin (GEN10), Imipenem (IPM10), Nalidixic acid (NA30), Nitrofurantoin (NIT300), Norfloxacin (NOR10) and Trimethoprim (TMP5). The resistance percentage of the isolates were (8, 100, 64, 52, 60, 20, 86, 50, 60, 34, 0, 24, 58, 24 and 60) %, respectively. Plasmid profiling was done for all isolates and it was revealed that 48% contained one plasmid, 44% possessed two plasmids, 6% had three plasmids and 2% of the isolates contained four plasmids. The process of transformation was done for the laboratory strain Escherichia coli DH5α by using purified plasmid of the most resistant isolate (K50) to determine the location of the genes which are responsible for resistance to antibiotics in that isolate. The transformed colonies appear to be resistant to the following antibiotics (AMP10, CFM5 and CTX5) which indicated that the genes encoding resistance to these antibiotics were located on transferrable plasmid.

Fluorescent Zn-PDC/Tb3+ Coordination Polymer Nanostructure: A Candidate for Highly Selective Detections of Cefixime Antibiotic and Acetone in Aqueous System.

Tb3+-doped zinc-based coordination polymer nanospindle bundles (Zn-PDC/Tb3+, or [Zn(2,5-PDC)(H2O)2]·H2O/Tb3+) were synthesized by a simple solution precipitation route at room temperature, employing Zn(NO3)2, Tb(NO3)3, and 2,5-Na2PDC as the initial reactants, and a mixture of water and ethanol with the volume ratio of 10:10 as the solvent. The as-obtained nanostructures presented strong fluorescent emission under the excitation of 298 nm light, which was attributed to the characteristic emission of the Tb3+ ion. It was found that the above-mentioned strong fluorescence of the nanostructures could be selectively quenched by cefixime (CFX) in aqueous solution. The other common antibiotics hardly interfered. Thus, as-obtained Zn-PDC/Tb3+ nanostructures could be prepared as a highly sensitive fluorescence probe for selective detection of CFX in an aqueous system. The corresponding detection limit reached 72 ppb. The theoretic calculation and UV-vis absorption experiments confirmed that the fluorescence quenching of Zn-PDC/Tb3+ nanostructures toward CFX should be attributed to the electron transfer and the fluorescence inner filter effect between the fluorescent matter and the analyte. In addition, the strong fluorescence of the nanostructures could also be selectively quenched by acetone in the water system.

Surveillance of Antibiotic Susceptibility Patterns of Neisseria gonorrhoeae from 2013 to 2015 in Guangxi Province, China.

Neisseria gonorrhoeae is a sexually transmitted pathogen highly prevalent worldwide with an increasing trend of resistance to antimicrobial treatment. We conducted this study to trace the susceptibility of N. gonorrhoeae to penicillin (PC), spectinomycin (SPCM), ciprofloxacin (CPFX), azithromycin (AZM), cefixime (CFIX), and ceftriaxone (CTRX) in Guangxi province. In total, 303 N. gonorrhoeae isolates were obtained from patients infected with N. gonorrhoeae in 6 cities in Guangxi during 2013-2015, and the antibiotic susceptibility patterns were analyzed by an agar dilution assay. The results showed that N. gonorrhoeae was susceptible to treatment with cephalosporins, including CTRX (99.7% of isolates), CFIX (99%), SPCM (100%), and AZM (96.4%), and this is the first report of antibiotic susceptibility for AZM surveillance of N. gonorrhoeae in Guangxi. Penicillinase-producing N. gonorrhoeae (PPNG) isolates increased in prevalence from 37% in 2013 to 64% in 2015 (P = 0.068), and tetracycline-resistant N. gonorrhoeae (TRNG) prevalence increased from 23% in 2013 to 44% in 2015 (P = 0.071). High resistance of N. gonorrhoeae to PC was associated with infection in patients at ages 25 to 30 years (P ＜ 0.05), whereas PPNG positivity (P ＜ 0.01), and TRNG positivity were risk factors for CPFX resistance (P = 0.0407). Our study provides plausible evidence for therapeutic strategies and N. gonorrhoeae infection control and prevention in Guangxi, China.

Spectrophotometric Determination of Cefixime Following Simple Diazotization and Coupling with ?-Naphthol

Cefixime (CFX) was treated with sodium nitrite and hydrochloric acid for diazotization reaction followed by coupling with ?-Naphthol in alkaline medium to form, a yellow colored azo dye compound which exhibits maximum absorption (?max) at 412 nm where the concentration of (CFX) was determined spectrophotometrically. The optimum reaction conditions and other analytical parameters were evaluated. Beer’s law was obeyed in the concentration range of (1-20) ?g.mL-1 with a molar absorptivity of 34870.5 L.mol-1.cm-1. The limit of detection was found to be 0.1090 ?g.mL-1 and the Sandell's sensitivity value was 0.0130 ?g.cm-2. The proposed method could be successfully applied to the determination of (CFX) in pharmaceutical formulations.

Spectrophotometric Determination of Cefixime Following Simple Diazotization and Coupling with ?-Naphthol

Cefixime (CFX) was treated with sodium nitrite and hydrochloric acid for diazotization reaction followed by coupling with ?-Naphthol in alkaline medium to form, a yellow colored azo dye compound which exhibits maximum absorption (?max) at 412 nm where the concentration of (CFX) was determined spectrophotometrically. The optimum reaction conditions and other analytical parameters were evaluated. Beer’s law was obeyed in the concentration range of (1-20) ?g.mL-1 with a molar absorptivity of 34870.5 L.mol-1.cm-1. The limit of detection was found to be 0.1090 ?g.mL-1 and the Sandell's sensitivity value was 0.0130 ?g.cm-2. The proposed method could be successfully applied to the determination of (CFX) in pharmaceutical formulations.

The Impact of Recent Antibiotic Usage on Oropharyngeal Neisseria spp. in MSM of Hanoi, Vietnam

Background Neisseria gonorrhea (NG) has a long history of gaining resistance to nearly all antimicrobials used for treatment since the 1930s, which makes susceptibility to last-line cephalosporins of dire importance. Horizontal gene transmission is highly prevalent among the Neisseria genus, with genetic fragments from common commensal Neisseria having been found in resistant NG strains. Globally, NG disproportionately affects men-who-have-sex-with-men (MSM) and nearly all ceftriaxone-resistant cases have been reported from pharyngeal samples. Our study aims to assess the impact of antibiotic usage on the antimicrobial susceptibility of oropharyngeal Neisseria spp.Methods MSM from Hanoi, Vietnam, were surveyed regarding antibiotic usage. Pharyngeal swabs were collected and cultured on chocolate and modified-Thayer–Martin agar. Neisseria spp. were subcultured, identified using MALDI-TOF, and antimicrobial susceptibility determined by E-test using NG CLSI MIC breakpoints to ciprofloxacin (CIP), cefixime (CFM), ceftriaxone (CRO), and cefpodoxime (CPD).ResultsThe 225 MSM surveyed were young (mean age 23.9 years, std 4.4). In the past 6 months: 41.6% participants used any antibiotics, among whom 62.4% did not have a prescription; 6.6% used CFM (16.4% more were unsure), among whom 55.6% did not have a prescription; and 4.5% received CRO.From 72 swabs, 102 Neisseria isolates were obtained; N. flavescens (n = 59), N. perflava (n = 14), N. macacae (n = 8), N. sublfava (n = 7), N. gonorrhoeae (n = 5), N. mucosa (n = 3), N. meningitides (n = 3), N. cinerea (n = 2), and N. lactamica (n = 1). “Reduced susceptibility” status for any Neisseria spp. was 35.3, 10, 8, and 30% to CIP, CFM, CRO, and CPD, respectively; 61.8% were “resistant” to CIP. MSM who took any antibiotics in the past 6 months were almost twice as likely to have Neisseria spp. with reduced susceptibility to cephalosporins (CFM, CRO, or CPD), RR 1.8 (95% CI 1.1–3.2; P = 0.026) compared with non-antibiotic users.Conclusion Many MSM in Hanoi used antibiotics recently, often without a prescription. Antibiotic use was associated with antimicrobial “reduced susceptibility” of commensal Neisseria spp. to cephalosporins, possibly potentiating resistance acquisition by NG.Disclosures All authors: No reported disclosures.

Real-Time PCR Targeting Mosaic penA XXXIV for Prediction of Extended-Spectrum Cephalosporins Susceptibility in Clinical Neisseria Gonorrheae Isolates

BackgroundAntimicrobial-resistant Neisseria gonorrheae (NG) is a global public health problem, resulting in limited empirical treatment options. Due to increasing minimum inhibitory concentrations (MICs) of ESCs against NG in the US, it is critical that susceptibility to ESCs be monitored. Since few laboratories routinely perform culture and susceptibility testing for NG, there is a need for a rapid test to predict susceptibility to ESCs. More than 98% of isolates with decreased susceptibility to cefixime (CFM) in the US carry mosaic penA XXXIV. In this study, we developed a multiplex real-time PCR for mosaic penA XXXIV and previously validated gyrA to predict ESCs MICs and ciprofloxacin (CIP) susceptibility.Methods150 NG isolates with known cefpodoxime (CPD), CFM, ceftriaxone (CRO) and CIP MICs were obtained from Neisseria Reference Laboratory at University of Washington and CDC Antimicrobial Resistance Bank. DNA extracted from culture was used in multiplex HybProbe real-time PCR on Lightcycler 480. gyrA was genotyped by melt curve and served as internal control, while presence of mosaic penA XXXIV was detected by selective amplification.ResultsAll 32 (100%) CIP-susceptible and 118 (100%) CIP-resistant isolates, as determined by Clinical and Laboratory Standards Institute breakpoints, demonstrated wild-type and Ser91 mutant gyrA genotype, respectively. Melt curve genotyping demonstrated mosaic penA XXXIV melt patterns in 66/68 (97%) isolates with at least one ESC MIC above alert value set forth by the CDC (CPD and CFM MICs ≥0.25 µg/ml; CRO MIC ≥0.125), while all 82 (100%) isolates with ESC MICs under alert values did not amplify. The first of the 2 false-negative isolates had MICs above alert values for all ESCs tested and harbored IX mosaic type, while the second one had CRO MIC above alert value and harbored XII mosaic type. Both of these mosaic types did not share homology with mosaic penA XXXIV in the region targeted by the assay.ConclusionThe mosaic penA XXXIV assay demonstrated 97% sensitivity and 100% specificity in predicting alert ESCs MIC values among clinical isolates tested, and was successfully multiplexed with gyrA assay. Clinical utility of this assay may be limited due to false negativity in isolates with non-XXXIV mosaic types, but it could serve as a useful surveillance tool for XXXIV mosaic.Disclosure R. Humphries, Roche: Consultant, Consulting fee

Phenotypic identification of Escherichia coli O157:H7 isolates from cattle at Suleja Abattoir, Nigeria

Escherichia coli O157:H7 is a well-known pathogen of man and animals and a very low infection dose is needed to propagate the infection and clinical disease. In this study, a total of 515 rectal swab samples were collected from cattle and subjected to conventional biochemical tests. Presumptive identification on Eosine Methylene Blue (EMB) yielded an overall prevalence of 83.1%. Cefixime, Tallurite, Sorbitol MacConkey Agar (CT-SMAC) test yielded 18(4.2) isolates while Indole test, Methyl Red, Voges Proskauer and Citrate utilization test (IMVIC) biochemical test showed prevalence rate of 11(61.1%) and MicrogenTM test performed on the 18 Isolates yielded a prevalence rate of 33.3%. A total of 6 of the isolates were subjected to latex agglutination test, in which 2(0.4%) were confirmed to be E. coli O157. The results of the somatic flagella antigen test performed on the 2 isolates revealed that 1(50%) belonged to E. coli O157:H7. Thus this study is therefore the first research work to confirm the presence of E. coli O157:H7 in cattle presented for slaughter in Suleja abattoir in Nigeria. Humans can contract the infection through exposure, handling and consumption of beef or animal products. Control measures are therefore necessary especially during processing and evisceration of beef, to ensure safety of cattle offal presented to the public for human consumption. Key words: Escherichia coli O157:H7, cattle, Microgen kit, flagella staining, phenotypic identification, cattle, latex agglutination test.

A capillary coated with a metal-organic framework for the capillary electrochromatographic determination of cephalosporins

The authors have developed a rapid and reliable method for the capillary electrochromatographic determination of cephalosporin antibiotics in environmental waters. An open-tubular capillary column was modified with the complex [Cu(mal)(bpy)], a copper(II) complex with malic acid and 4,4′-bipyridyl, by an amide coupling method to act as the stationary phase. The simultaneous determination of the cephalosporins formulations, namely cefapirin (CP), ceftiofur (EFT) and cefixime (CFM) in environmental water samples was accomplished in buffer of pH 5.0 by applying a voltage of 8 kV and with DAD detection. Detection limits typically are 0.1 μg⋅mL−1.The method was applied to the analysis of cephalosporins in spiked water samples from Kunming Lake to give recoveries betwen 88 and 106%.

Comparing the disk-diffusion and agar dilution tests for Neisseria gonorrhoeae antimicrobial susceptibility testing.

BackgroundWe assessed the validity of testing for antimicrobial susceptibility of clinical and mutant Neisseria gonorrhoeae (GC) isolates by disk diffusion in comparison to agar dilution, and Etest® (bioMerieux, France), respectively, for three third generation extended spectrum cephalosporins (ESC): ceftriaxone (CRO), cefixime (CFX), and cefpodoxime (CPD).MethodsOne hundred and five clinical isolates and ten laboratory-mutants were tested following Clinical Laboratory Standard Institute (CLSI) and manufacturer’s standards for each of the three methods. The measured diameters by the disk diffusion method were tested for correlation with the MIC values by agar dilution. In addition, comparisons with the Etest® were made. Categorical results for concordance, based on standard CLSI cutoffs, between the disk diffusion and the other two methods, respectively, were tested using the Chi-square statistics. Reproducibility was tested for CFX across a 6-month interval by repeated disk tests.ResultsAcross all 115 specimens, the disk diffusion tests produced good categorical agreements, exhibiting concordance of 93.1%, 92.1%, and 90.4% with agar dilution and 93.0%, 92.1%, and 90.4% with Etest®, for CRO, CFX, and CPD, respectively. Pearson correlations between disk-diffusion diameters and agar dilution MIC’s were -0.59, -0.67, and -0.81 for CRO, CFX, and CPD, respectively. The correlations between disk diffusion and Etest® were -0.58, -0.73, and -0.49. Pearson correlation between the CFX disk readings over a 6-month interval was 91%.ConclusionsDisk diffusion tests remain to be a useful, reliable and fast screening method for qualitative antimicrobial susceptibility testing for ceftriaxone, cefixime, and cefpodoxime.

In vitro activity of tigecycline alone and antimicrobial combinations against clinical Neisseria gonorrhoeae isolates

In this study, we determined the in vitro activity of various combinations of antimicrobial agents against 54 Neisseria gonorrhoeae isolates. The combined activity of ceftriaxone (CRO) and azithromycin (AZM), CRO and doxycycline (DOX), CRO and spectinomycin (SPT), cefixime (CFX) and AZM, CFX and DOX, and CFX and SPT was determined using a checkerboard method. The fractional inhibitory concentration index (FICI) values for all combinations were either additive or indifferent, and no synergistic or antagonistic effects were found. The FICI comparison in each combination did not show any difference according to the N.gonorrhoeae-resistant phenotypes and genotypic characteristics, including penicillinase-producing N. gonorrhoeae, tetracycline-resistant N. gonorrhoeae, stratified MIC of all antibiotics, and N. gonorrhoeae multiantigen sequence typing. MIC50 and MIC90 of tigecycline by agar dilution were 0.5 mg/L and 0.5 mg/L, respectively, which were lower than that of tetracycline and DOX. Additive/indifference results could suggest that combinations that include CRO may be used safely without a significant likelihood of generating resistance.

Genetic Resistance Determinants for Cefixime and Molecular Analysis of Gonococci Isolated in Italy.

A strictly defined subset of gonococci (n = 65) isolated in Italy from 2011 to 2014 was characterized by antimicrobial susceptibility for cefixime (CFM) and ceftriaxone (CRO) and by sequencing of resistance determinant genes (penA, mtrR, porB1b, ponA) for extended-spectrum cephalosporins and Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST). The penA mosaic alleles XXXIV and XXXV were found in all resistant (R) and decreased susceptibility (DS) gonococci to CFM, except for one. They were associated with an adenine deletion in the mtrR promoter plus amino acid substitutions, H105Y or G45D, in the coding region and ponA L421P. The penA mosaic allele XXXIV, and one variant, was found exclusively among genogroup (G) 1407 and its closely related sequence types (STs), as in CFM-DS as well as in CFM-R isolates. Single or combined mutation patterns in penA, mtrR, porB1b, and ponA genes were associated with different CFM susceptibility patterns and NG-MAST STs. Genotyping and antimicrobial resistance (AMR) determinant analyses can be valuable to enhance the gonococcal AMR surveillance.

Isolation, Identification, and Antibiotics Resistance of Aeromonas spp. from Lakes of Udaipur (Rajasthan), India

Aim: Aeromonas spp. are commonly found in freshwater ecosystems. Aeromonas is Gram-negative, facultative anaerobes which causes aeromonasis in humans and are also pathogenic for aquatic and terrestrial animals. In this study, an attempt has been made to isolate Aeromonas spp. from lakes of Udaipur, namely, Fateh Sagar and Pichhola and to test their antibiotic resistance. Materials and Methods: The isolates were recovered on nutrient agar medium and screened for their growth on Aeromonas selective agar medium. Selected isolates were subjected to biochemical characterization. For molecular characterization, genomic DNA of all the isolates was amplified using universal primers 27 F and 1492 R, and amplified products were subjected for sequencing to confirm their identification. The isolates were tested for antibiotic resistance against 15 commonly used antibiotics, i.e., gentamycin, kanamycin, tetracycline, erythromycin, ampicillin, penicillin, polymyxin B, amikacin, ciprofloxacin, vancomycin, rifampicin, chloramphenicol, streptomycin, cefixime, and trimethoprim by disc diffusion method. Results and Discussion: Out of 116 isolates, a total of 14 strains able to grow on Aeromonas selective agar medium were selected. They were identified and grouped into 2 species as Aeromonas veronii and Aeromonas hydrophila according to their biochemical and molecular characteristics. All the strains, which were identified as A. veronii, were found resistant to 8 antibiotics, namely, AMP, penicillin, VA, kanamycin, polymyxin B, rifampicin, erythromycin, and streptomycin. All the strains, which were identified as A. hydrophila, were found resistant to 10 antibiotics, namely, ampicillin, penicillin, vancomycin, kanamycin, polymyxin B, rifampicin, erythromycin, streptomycin amikacin, and trimethoprim out of 15 antibiotics used in the study. Conclusion: The results indicated that the water of both the lakes was contaminated with multi-antibiotic-resistant enteric pathogenic bacteria. This study thus provides valuable information for making policy decisions aimed at reducing microbial contamination of lake water and the indiscriminate use of antibiotics.

Isolation and Identification the Fungus Trichophyton violaceum from Human Skin Specimens in Iraq and Study Efficiency Antibacterial and some Plant Essential Oils

This study was aimed to isolate and identify the fungus Trichophyton violaceum from human skin specimens and evaluate the activity of antibacterial and plant essential oils. The results showed of direct microscopy by using KOH examination and morphological identification, nine samples from skin were positive in KOH test. Microscopical examination appeared that colonies of T. violaceum were coarse with abundant aerial mycelium on SDA, growth rates 6-8cm/14 days. The color changes with age from white in the middle to brownish yellow at the edges which was more intense on the reverse side. Susceptibility test to antibacterial showed that 100% of T.Violaceum T2 isolate was resistant to TE (Tetracycline), AK (Amikacin), CTX (Cefotaxime), CFM (Cefixime), CIP (Ciprofloxacin), ERY (Erythromycin) and STR (Streptomycin). Also results showed that all plant essential oils at different concentrations significantly inhibit growth of T. violaceum T2. However, the peppermint oil, Myrrh oil, Cardamom oil, Chamomile oil and Castor oil at highest concentration (25mg / ml) caused highest reduction of mycelia growth (100%) followed by Olive oil (67.3%) and Clove oil (64%) at the same concentration, compared with the control treatment.
 

Preparation of amorphous drug nanoparticles by high-gravity reactive precipitation technique

For many water insoluble acidic or alkaline drugs, amorphization and nanonization represent an effective bioavailability enhancement strategy. Cefixime (CFX) was chosen as a model drug, and amorphous nanoparticles were prepared via a typical process intensification technology: high-gravity reactive precipitation (HGRP). The effects of temperature, rotating speed, overall flow rate, and drug concentration on the particle size and size distribution were investigated. Under the optimum conditions, spherical nanoparticles with a mean size of 45nm could be precipitated. After filtration, redispersion and spray-drying processes, the obtained CFX nano-powder showed a good stability and exhibited a tremendously enhanced saturation solubility, reaching ∼11 times higher than that of raw CFX. Furthermore, CFX nano-powder achieved 100% drug dissolution within 2min while raw CFX did not dissolve completely after 45min. Since the production capacity of lab-scale RPB reached 2.3kg/h, HGRP method might offer a general platform for mass production of drug nanoparticles without the use of organic solvents and pharmaceutical additives.