Common Isolates Research Articles

Trends of Antimicrobial Sensitivity Among Common Isolates in a Tertiary Care Hospital, Rawalpindi

Objective: To evaluate the resistance patterns of frequently found pathogens to different antimicrobial agents, aiding physicians in choosing appropriate treatment strategies for patients within our locality. Materials and Method: This retrospective observational study took place at Pakistan Railway hospital (PRH) Rawalpindi; from January 2021 to December 2021. Data was obtained from the institute's database, the Hospital Information Management System (HIMS). Pathogens were identified in the laboratory through Gram staining and biochemical tests, and their antibiotic sensitivity profiles using disk diffusion method assessed following protocols established by the Clinical & Laboratory Standards Institute. Statistical analysis was conducted using SPSS version 24, and data entry was carried out accordingly. Results: Overall, 1128 positive cultures were reported in study period including urine, pus, HVS, sputum cultures, stool, blood, catheter tip, and others (tissue fluid, wound, and cannula tip etc.). They comprised 32.8 %, 30.9 %, 16.6%, 5.05 %, 3.81%, 3.72 %, 1.15%, 0.70 % and 0.08% of the other specimens respectively. Among the isolates, Escherichia coli revealed 31.4% resistance against one of the third-generation cephalosporin and 8% to imipenem while Klebsiella pneumoniae exhibited 58.7% resistance. Moreover 82% Staphylococcus aureus were resistant to oxacillin, and 6% to vancomycin. Conclusion: Moderate to reduced susceptibility to frequently utilized antimicrobials has been noted across diverse gram-positive and gram-negative species, apart from Penicillin. To address the escalating resistance to carbapenems and cephalosporins, it is essential to establish and enforce rigorous infection control measures.

Study of hygienic hand disinfection of staff and dental students at the Medical University – Plovdiv

<b>Introduction:</b> Transient microbial flora on the hands of medical personnel is a prerequisite for healthcare-associated infections. Unlike permanent this micro flora can be removed by washing and disinfection. The hands of the dental staff are factor number one in the transfer of microorganisms: from patient to patient as well as on objects from the dental environment.<br /> <b>The aim</b> of the present study was to microbiologically examine hand washes of 5th year dental students and medical staff before starting work with a patient in order to evaluate the quality of hygienic disinfection performed.<br /> <b>Methodology:</b> The hands of a total of 115 doctors and students from the Faculty of Dental Medicine of the Medical University of Plovdiv were wiped with a sterile swab after treatment with a disinfectant. Isolates were identified to species using Vitek MS and MALDI-TOF technology.<br />  <b>Results: </b>Coagulase-negative staphylococci with a microbial number of 10<sup>3</sup>-10<sup>4</sup> were found to have the highest microbial count (70%). 9% of the samples with coagulase-negative staphylococci had microbial count ≥10<sup>5</sup>. The most common isolates detected were: <i>Staphylococcus hominis</i>, <i>Staphylococcus epidermidis</i> and <i>Micrococcus luteus</i>.<br /> <b>Conclusion:</b> The presence of coagulase-negative staphylococci in a high microbial count, enterococci and representatives of <i>Bacillus simplex</i> is undesirable, especially in immunosuppressed patients. These results highlight the need to increase knowledge about hand disinfection and its actual application before working with a patient.

A ubiquitin-mediated post-translational degradation of Cyp51A contributes to a novel azole resistance mode in Aspergillus fumigatus

The airborne fungus Aspergillus fumigatus is a major pathogen that poses a serious health threat to humans by causing aspergillosis. Azole antifungals inhibit sterol 14-demethylase (encoded by cyp51A), an enzyme crucial for fungal cell survival. However, the most common mechanism of azole resistance in A. fumigatus is associated with the mutations in cyp51A and tandem repeats in its promoter, leading to reduced drug-enzyme interaction and overexpression of cyp51A. It remains unknown whether post-translational modifications of Cyp51A contribute to azole resistance. In this study, we report that the Cyp51A expression is highly induced upon exposure to itraconazole, while its ubiquitination level is significantly reduced by itraconazole. Loss of the ubiquitin-conjugating enzyme Ubc7 confers resistance to multiple azole antifungals but hinders hyphal growth, conidiation, and virulence. Western blot and immunoprecipitation assays show that deletion of ubc7 reduces Cyp51A degradation by impairing its ubiquitination, thereby leading to drug resistance. Most importantly, the overexpression of ubc7 in common environmental and clinical azole-resistant cyp51A isolates partially restores azole sensitivity. Our findings demonstrate a non-cyp51A mutation-based resistance mechanism and uncover a novel role of post-translational modification in contributing to azole resistance in A. fumigatus.

Bacterial Profile, Susceptibility Patterns, and Factors Associated with Culture-Positive Sputum Among HIV Patients Presenting with a Cough in Northern Uganda.

Sub-Saharan Africa bears the highest burden of HIV/AIDS infections and constitutes 72% and 69% of AIDS-related deaths and people living with HIV worldwide, respectively. Due to the relationship between pulmonary infections and HIV/AIDS, it is biologically plausible that the surge in morbidity and mortality among HIV/AIDS patients could be attributed to an increase in pulmonary infections among this cohort of patients. This study determined the bacterial profile, susceptibility patterns, and factors associated with culture-positive sputum among HIV patients presenting with cough at the Lira Infectious Disease Centre in Northern Uganda. This prospective cross-sectional study recruited 180 participants. Culture and sensitivity of the sputum samples were done to determine the causative organism and its susceptibility. Blood agar, MacConkey's agar, and Chocolate agar were deployed for the culture media. Antimicrobial susceptibility testing was done using the Kirby-Bauer disc diffusion test. Data were analyzed using SPSS version 26. Out of the 180 enrolled patients, 113 were females with a mean age of 45. Bacterial growth was seen in 56 of the 180 samples. The most common isolate was Staphylococcus aureus at 35.7% of the 56 growths. The minority that accounted for 1.8% each were Citrobacter freundii, Salmonella species and Acinetobacter baumanii, respectively. A combination of ceftriaxone and gentamicin was effective against most organisms isolated in this study. At the multivariate level of analysis, an unsuppressed viral load and low peripheral oxygen saturation were independently associated with a sputum culture-positive cough. HIV patients at LIDC who present with productive cough with low oxygen saturation and an unsuppressed viral load may be screened for Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia, Klebsiella pneumonia, and Enterobacter species infection. A combination of ceftriaxone and gentamicin may be used as empiric therapy before the culture and sensitivity results are available.

Prevalence and antimicrobial resistance of bacterial meningitis in China from 2017 to 2021: a multicenter retrospective study.

This study aims to investigate the changing epidemiology and antimicrobial susceptibility of bacteria isolated from cerebrospinal fluid (CSF) in the Shandong region. We conducted a retrospective analysis of bacterial distribution and resistance patterns in CSF samples, utilizing data from the SPARSS network and analyzed with WHONET 5.6 software. A total of 3968 pathogenic bacterial strains were isolated, consisting of 70.6% Gram-positive bacteria, 27.2% Gram-negative bacteria, and 0.2% fungi. The six most commonly detected bacteria were coagulase-negative staphylococcus, Acinetobacter baumannii, Klebsiella pneumoniae, Streptococcus pneumoniae, Escherichia coli, and staphylococcus aureus. Analysis revealed gender and seasonal variations in the distribution of CSF pathogens, with a higher incidence observed in males and during autumn compared to other seasons. The susceptibility profiles of these bacterial species varied significantly, with many exhibiting multidrug resistances. A. baumannii showed a high resistance rate to cephalosporins and carbapenems but was sensitive to tigecycline and polymyxins. For treating multidrug-resistant A. baumannii infections, polymyxin-based combinations with tigecycline or sulbactam are recommended for adults, while tigecycline combined with meropenem is suggested for children. Enterobacteriaceae species were generally sensitive to carbapenems, such as meropenem and other carbapenems that can penetrate the blood-brain barrier can be recommended. Linezolid and vancomycin are the first choice for treating common gram-positive bacterial infections. The high resistance rates observed among common CSF isolates and their varied distributions across different demographics highlight the necessity for customized treatment strategies.

Tigecycline Resistant Pattern among Carbapenem Resistant Gram-negative Bacilli: Prospective Cross-sectional Study

Introduction: Tigecycline is a unique tetracycline class of semi-synthetic, last-line broad spectrum antibiotic against multi-drug-resistant bacteria. However, recently, resistance to this antibiotic is on the rise. Aims: This study was conducted to determine the prevalence of tigecycline resistance amongst carbapenem-resistant Gram-negative bacilli (GNB) isolated from clinical samples (pus and sputum) as well as to evaluate their antimicrobial susceptibility pattern. Study design: Prospective cross sectional Place and Duration of Study: Department of Microbiology at Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow, between January 2023 and December 2023. Methodology: Identification of GNB grown on culture was done by conventional biochemical tests and later validated by MALDI-TOF MS. The antimicrobial sensitivity testing of isolates was done using the E-test, and disk diffusion method. Minimum inhibitory concentration determination was done by Broth micro-dilution (BMD) method. Results: Amongst 8326 pus and respiratory samples, GNBs were recovered from 63.15% (5258/8326). Of 5258 GNB isolates, 50.74% (2668) were carbapenem-resistant, while 7.85% (413) demonstrated resistance to both tigecycline and carbapenem. Common isolates in this group were Klebsiella pneumoniae (37.04%), Acinetobacter spp. (25.18%), Enterobacter spp. (14.28%) and Escherichia coli (12.59%). BMD results demonstrated highest activity of tigecycline against carbapenem-resistant E. coli, followed by Citrobacter and Enterobacter. It works against resistant strains of Acinetobacter baumannii and K. pneumoniae as well, but in higher concentrations. Conclusion: High tigecycline resistance (one of the last-resort drugs) among carbapenem resistant GNB isolates is a matter of clinical concern, leaving physicians with limited options for treatment of such infections. Proper adherence to the policies of antimicrobial stewardship programs can reduce the emergence of resistance.

Temperature has a greater effect than salinity on microbial survival in saltwater from a single equine hydrotherapy unit.

To determine the ability of bacteria commonly isolated from equine limb wounds to survive in saltwater obtained from an equine hydrotherapy unit at different salinity concentrations and temperatures. Saltwater samples were obtained over a 2-week period (January 22, 2024 to February 2, 2024) from an equine hydrotherapy unit used for clinical patients, kept at either full salinity per manufacturer recommendations or diluted to half salinity to mimic the dilution that likely occurs in the clinical setting between cases when holding tanks are replenished with tap water only. Samples were then autoclaved to eliminate preexisting bacterial contamination before individual inoculation with Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus zooepidemicus. Each inoculated sample was maintained at 2, 22, or 44 °C to represent typical holding tank conditions. The bacterial concentration was determined at each condition every 24 hours up to and including 96 hours. The lower limit of detection was set at 1 CFU/mL. Salinity did not affect bacterial survival. Bacterial concentrations generally decreased with increasing temperature over time. Escherichia coli, S aureus, and S zooepidemicus concentrations decreased to the lower limit of detection at 44 °C by 24 to 48 hours, while P aeruginosa concentrations significantly decreased over 24 hours but remained well above the lower limit of detection. Common bacterial isolates of equine limb wounds can survive in typical saltwater hydrotherapy conditions. Further investigation is warranted to determine the clinical relevance of these findings including protocols for hydrotherapy unit disinfection, wastage of treatment water, and case inclusion/exclusion criteria.

Clinico-Mycological Study of Dermatophytosis among Diabetic and Non-Diabetic Patients in a Tertiary Level Hospital: A Comparative Study

Abstract Background: Dermatophytosis is a major public health concern in India, especially in recent years, with an alarmingly rising trend, particularly in relation to recurrent and chronic infection. The number of studies examining the relationship between an individual’s glycemic status and the development of dermatophytosis, and a comparison of the evolving species trend between diabetic and non-diabetic patients infected with dermatophytes, is limited. Aims and Objectives: To study and compare the clinical and mycological aspects of dermatophytosis among diabetic and non-diabetic patients and to compare the culture isolates in both groups. Materials and Methods: The study included 378 patients of clinically suspected dermatophytosis, divided into two groups of 189 known diabetics and non-diabetics each. We subsequently analysed and compared the demographics, clinical data, potassium hydroxide (KOH) mount, calcofluor white (CW) staining and fungal culture results of all patients in both groups. Results: Among the 378 patients, diabetic patients had a significantly greater extent of involvement and higher rates of recurrence when compared to non-diabetics. The overall positivity rate was higher in CW staining (77.8%) as compared to KOH (57.7%) in both non-diabetics and diabetics. Trichophyton mentagrophytes was the most common isolate (47.6%) in both diabetic (55.0%) and non-diabetic (61.4%) patients, followed by Trichophyton rubrum (31.8% and 29.6%, respectively). The positivity percentages of fungal culture, KOH and CW staining increased to 100%, 77.9% and 95.7%, respectively, when scrapings were taken from ≥2 sites. Conclusion: The pattern of dermatophytosis is comparatively more chronic and severe in diabetics compared to non-diabetics. T. mentagrophytes was the most common culture isolate in both groups. CW staining can potentially be used as the initial method of choice for the diagnosis of dermatophytosis as it has significantly outperformed the conventional KOH mount. Scrapings can regularly be taken from ≥2 sites to avoid false negative results.

Characterization of bean common mosaic virus isolates infecting three leguminous bean crops from South and Southeast Asia.

Bean common mosaic virus (BCMV) is causing economically important diseases in leguminous crops worldwide. In this study, BCMV isolates from country bean (CB, Lablab purpureus), yard-long bean (YLB, Vigna unguiculata) and rajma bean (RB, Phaseolus vulgaris) collected from Bangladesh, Nepal and Cambodia were characterized. Samples tested positive for BCMV in serological assays were subjected to high-throughput sequencing to generate near full-length genome sequences. In pair-wise comparisons of the polyprotein open reading frame, thirteen BCMV isolates from Bangladesh, Cambodia, and Nepal showed sequence identity of 92.1 to 98.8% at the nucleotide and 94.2 to 99% at the amino acid level among themselves and with corresponding sequences of BCMV reported previously. In phylogenetic analyses using the global BCMV sequences, they segregated into five distinct lineages, with RB isolates from Nepal clustering with US1/NL1-clade of common bean isolates from different countries, YLB isolates aligning with blackeye cowpea strain sequences reported from China, and CB isolates from Nepal and Bangladesh clustering with soybean isolates from China. One YLB isolate from Nepal was identified as a putative recombinant. None of the BCMV sequences aligned with isolates representing the RU1 or PStV clades. In grow-out tests, seed samples from local markets showed 14.3 to 38.1% transmission efficiency rate of BCMV with CB seed lots and from 9.5% to 33.3% with YLB seed lots.

In vitro elution of amikacin, cefazolin, gentamicin, ampicillin/sulbactam, and meropenem from a commercially available calcium sulfate delivery kit.

The use of implantable antibiotic beads has become a frequent treatment modality for the management of surgical site infections in human and veterinary medicine. The objective of this study is to describe the elution kinetics of five antibiotics from a commercially available calcium sulfate antibiotic delivery kit. A secondary goal was to compare elution concentrations with minimal inhibitory concentrations (MIC) for commonly encountered bacteria from the University of Florida's veterinary microbiology laboratory database. Calcium sulfate powder was combined with amikacin, cefazolin, gentamicin, ampicillin/sulbactam, and meropenem. Triplicates of three antibiotic-loaded beads were immersed in 5 mL of phosphate-buffered saline (PBS) and kept at 37°C under constant agitation. Antibiotic-conditioned PBS was sampled at 14 time points from 1-h to 30 days and analyzed by liquid chromatography to determine the antibiotic concentration. All beads eluted concentrations of antibiotics for the 30-day sampling period, except for ampicillin/sulbactam, with the most antibiotics being eluted within the first week. The concentration of antibiotics within the eluent within the first 3-9 days (3- and 5-mm beads, respectively) was greater than the MIC of common isolates. The 5 mm bead samples were superior in maintaining higher concentrations for a longer period, compared to the 3-mm beads. CSH beads eluted antibiotics over the 30-day course of the study. Most of the antibiotic elution occurred within the first week and was maintained above the MIC of commonly encountered isolates. This information may be useful for clinical decision making for treatment of local infections encountered in practice.

Bacterial, fungal pathogens, and antimicrobial resistance patterns in ocular infections: Insights from a tertiary care hospital, North Karnataka

Background: Ocular infections, including conjunctivitis, keratitis, and endophthalmitis, significantly impact eye health, leading to morbidity, visual impairment, and blindness if not treated. Aims and Objectives: This study focuses on reviewing and analyzing the prevalence of bacterial and fungal pathogens in ocular infections and assessing their antimicrobial susceptibility patterns at Vijayanagar Institute of Medical Sciences, Ballari. Materials and Methods: A cross-sectional study was conducted by collecting ocular infection samples from January 01, 2022, to December 31, 2022. Samples, including corneal scrapings and conjunctival swabs, underwent initial procedures such as Gram staining and were inoculated on various agars. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method. Results: Out of 404 evaluated samples, corneal scrapings were predominant, with a significant incidence of fungal and bacterial growth. Aspergillus spp. and Pseudomonas spp. were the most common fungal and bacterial isolates, respectively. Antimicrobial susceptibility testing revealed that Gram-negative bacilli showed more susceptibility to gentamycin, ceftriaxone, and ciprofloxacin, whereas Gram-positive cocci were more susceptible to tetracycline and doxycycline. Conclusion: The study highlights the cornea as the most common source of ocular infections, with Aspergillus and Pseudomonas spp. being the predominant fungal and bacterial pathogens, respectively. Identifying the prevalent species in this geographical area aids in early diagnosis and treatment, thereby preventing morbidity and improving patient outcomes. The antimicrobial susceptibility pattern observed suggests effective options for treatment, emphasizing the need for ongoing surveillance to adapt to resistance patterns.

Relationship of C-reactive Protein/Serum Albumin Ratio and qPitt Bacteremia Score With An All-Cause In-Hospital Mortality in Patients With Bloodstream Infections.

Bloodstream infections remain a major cause of morbidity and mortality despite notable advances in their diagnosis and treatment. C-reactive protein/serum albumin ratio and the quick Pitt bacteremia score are two useful tools for clinicians to assess severity and predict mortality risk in patients with sepsis attributable to bloodstream infections. This study examined the relationship between C-reactive protein/serum albumin ratio and Q Pitt bacteremia score with all-cause in-hospital mortality in patients with bloodstream infections. Hospitalized adult patients with bacteremic bloodstream infections between January 1, 2020, and December 31, 2021, were retrospectively reviewed. Patients' demographics and clinical and laboratory data were retrieved from patient electronic records. C-reactive protein/albumin ratio was calculated using CRP (mg/L) and serum albumin (g/L) values obtained within 24 hours of blood culture collection and quick Pitt bacteremia score was calculated for each patient with each of the five variables of the score determined within 24 hours of blood culture collection and each patient was assigned a numerical score of 0-5 accordingly. The relationship between C-reactive protein/albumin ratio and quick Pitt bacteremia score with all-cause in-hospital mortality was determined. A total of 187 hospitalized adult patients with non-repeat bacteremic bloodstream infections were identified.Escherichia coliwas the most common Gram-negative blood isolate whileStaphylococcus aureuswas the predominant Gram-positive isolate. One hundred and five (56.1%) patients were male with a cohort mean age of 56.9 ± 2.7 years. All-cause in-hospital mortality was 27.3%. The mean CRP/albumin ratio (8.6 ±1.7) and mean quick Pitt bacteremia score (2.8 ±0.4) were significantly higher in patients with bloodstream infections who died during their hospitalization compared to those who survived. The all-cause in-hospital mortality was 8%, 12%, 22%, 46%, 93%, and 100% for patients with quick Pitt scores of 0, 1, 2, 3, 4, and 5, respectively. In hospitalized patients with bacteremic bloodstream infections, an incremental increase in quick Pitt bacteremia score and mean C-reactive protein/albumin ratio of >8 was associated with higher mortality.

Clinical and Microbiological Profile of Gram-Negative Infections in Critically Ill Diabetic Patients.

Background and aim Type 2 diabetes mellitus (T2DM) is associated with several infections due to hyperglycemia and impaired immunity. This study aims to analyze the clinical and microbiological profile of critically ill T2DM patients with sepsis due to gram-negative bacteria (GNB). Materials and methods A prospective cross-sectional observational study was conducted at Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, India, between December 2023 and May 2024, after ethics committee approval. A total of 100 patients (50 T2DM cases and 50 nondiabetic controls), diagnosed with sepsis due to GNB and admitted to the medical ICU, were included in the study. The clinical profile and laboratory investigations of these patients were studied. Cultures were obtained from peripheral/central venous samples, tracheal secretions, and urine samples. Cultures from other specimens, such as ascitic fluid, cerebrospinal fluid, and pus from skin and soft tissue infections, were also obtained. The statistical tests that were applied were two-tailed with a 95% CI, and a p-value of less than 0.05 was considered statistically significant. Results The mean age of critically ill T2DM cases was 60.52 ± 12.88 years. Of the 50 T2DM cases, 28 were males and 22 were females. The most common infection in critically ill T2DM patients was bloodstream infection (n = 21), followed by bronchopneumonia (n = 16) and urinary tract infections (n = 10). Escherichia coli (n = 15) and Klebsiella pneumoniae (n = 15) were the most common gram-negative pathogens isolated. The most common GNB isolated from the blood cultures of critically ill T2DM patients was Acinetobacter spp. (n = 6). The death rate was significantly higher in T2DM patients with GNB sepsis as compared to nondiabetic controls. Conclusion GNBs like E. coli, K. pneumoniae, and Acinetobacter spp. are commonly found in critically ill T2DM patients with sepsis. Bloodstream infection was the most common site of infection in critically ill T2DM cases. Acinetobacter spp. was the most common isolate found in the blood cultures of critically ill T2DM patients. It is important to identify the site of sepsis, isolate the organism, and treat it with appropriate antibiotics promptly in critically ill T2DM patients to improve the outcomes of these patients.

Technical-functional and surface properties of white common bean proteins (Phaseolus vulgaris L.): Effect of pH, protein concentration, and guar gum presence

Legumes are abundant sources of proteins, and white common bean proteins play an important role in air–water interface properties. This study aims to investigate the technical-functional properties of white common bean protein isolate (BPI) as a function of pH, protein concentration, and guar gum (GG) presence. BPI physicochemical properties were analyzed in terms of solubility, zeta potential, and mean particle diameter at pH ranging from 2 to 9, in addition to water-holding capacity (WHC), oil-holding capacity (OHC), and thermogravimetric analysis. Protein dispersions were evaluated in terms of dynamic, interfacial, and foam-forming properties. BPI showed higher solubility (>80 %) at pH 2 and above 7. Zeta potential and mean diameter ranged from 15.43 to −34.08 mV and from 129.55 to 139.90 nm, respectively. BPI exhibited WHC and OHC of 1.37 and 4.97 g/g, respectively. Thermograms indicated decomposition temperature (295.81 °C) and mass loss (64.73 %). Flow curves indicated pseudoplastic behavior, with higher η100 values observed in treatments containing guar gum. The behavior was predominantly viscous (tg δ > 1) at lower frequencies, at all pH levels, shifting to predominantly elastic at higher frequencies. Equilibrium surface tension (γeq) ranged from 43.87 to 41.95 mN.m−1 and did not decrease with increasing protein concentration under all pH conditions. All treatments exhibited ϕ < 15°, indicating predominantly elastic surface films. Foaming properties were influenced by higher protein concentration and guar gum addition, and the potential formation of protein-polysaccharide complexes favored the kinetic stability of the system.

Novel insights into acetylation kinetics in a continuous Flow milli-reactor for chemo-enzymatic separation of silybin A/B

The separation of silybin A (SilA) and B (SilB) diastereomers in optically pure compounds is challenging due to their very similar physical and chemical properties. However, such separation is crucial for evaluating the biological activity of the diasteroisomers SilA and SilB, which show very different performance in pharmacological applications like treating prostate cancer, liver diseases, and Alzheimer’s disease. The most common isolation method is based on high-performance liquid chromatography, but it is slow and has a yield in pure SilB of hundreds of milligrams per day. An alternative chemo-enzymatic separation method, utilizing an immobilized lipase CALB catalyst to stereoselectively acetylate silybin B (1b), offers advantages in terms of higher productivity, selectivity, and scalability, particularly when applied in flow reactors. This study delves into the kinetics of Sil acetylation catalyzed by Novozym 435 in a continuous flow milli-reactor, investigated at various temperatures, volumetric flow rates, and Sil initial concentrations. It is noteworthy that, at the current state of the art, there is a lack of kinetic studies on this reaction, emphasizing the novelty and significance of this work. The kinetic and fluid dynamic parameters were estimated using a non-linear regression analysis of experimental data. The examined reaction showed a null apparent activation energy, explaining the temperature insensitivity of the final acetylated silybin B (1b) concentration. Furthermore, the decrease in steady-state concentrations of the acetylated products with increasing volumetric flow rates indicated that the reaction was occurring in a kinetic regime. Interestingly, a maximum starting Sil concentration was identified, above which there was no favorable impact on conversion.

Neonatal sepsis-a peek into our findings in Northwest Nigeria: a prospective study

BackgroundNeonatal sepsis is still a global health concern as it contributes to a high burden of neonatal morbidity and mortality especially in developing countries. The aim of the study is to give an insight into neonatal sepsis: risk factors, sepsis types, clinical features, pathogen burden with their antibiotic sensitivities, and outcome of admission in our facility. The study was a prospective hospital-based study conducted over 10 months, October 2018–July 2019.ResultOf the 248 term neonates with features of sepsis enrolled in the study 94 (37.9%) were confirmed to have sepsis. Late-onset sepsis LOS (68%) was found to be the most common, and most of the neonates were delivered elsewhere. Clinical features were non-specific for both early-onset (EOS) and LOS and include fever, jaundice, poor suck, and depressed primitive reflexes. Infections were mostly caused by gram-negative bacteria, and while Staphylococcus aureus was the single most common isolate for both EOS and LOS. Antibiotic sensitivity was highest with ciprofloxacin for both EOS and LOS. Mortality was high at 14.9% and was mostly contributed to by Staphylococcus aureus infection.ConclusionNeonatal sepsis is still a burden with mostly non-specific clinical features. The local prevalent organisms were Staphylococcus aureus, Enterobacter agglomerans and Klebsiella pneumonia with good antibiotic susceptibility to ciprofloxacin. Most presented with late-onset sepsis and therefore infection is likely to be community-acquired which to a great extent can be prevented with robust public health interventions.

Ventilator Associated Pneumonia in Tertiary Care Hospital, Maharajgunj, Kathmandu, Nepal

Introduction: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection among intensive care unit (ICU) patients and lack of much information in Nepal. So, the aim of this study was to determine prevalence and bacteriological profile of VAP with special reference to multi-drug resistant (MDR), Methicillin-resistant Staphylococcus aureus(MRSA), Metallo-β-Lactamase(MBL), Extended-Spectrum β-Lactamase(ESBL)-producing bacterial strains. Methods: A total 150 tracheal specimens were studied during June 2011 to May 2012 at Department of Microbiology, TUTH as described by American Society for Microbiology (ASM). Combination disk method was done for the detection of ESBL and MBL producing isolates. Results: Prevalence of VAP was found to be 34%. Acinetobactereal coaccticusbaumannii complex (44%) was the commonest isolate, followed by Klebsiellapneumoniae (22%), Pseudomonas aeruginosa (16%) and Staphylococcus aureus (12%). Among MDR Gram negative bacteria (GNB), 39% were MBL and 33% were ESBL-producers. All GNB (61) were sensitive to Polymyxin B and Colistinsulphate, whereas, 48% were found resistant to Carbapenems. Prevalence of MRSA was 75%, which were all sensitive to Vancomycin. Conclusion: High prevalence of VAP, MDR along with MRSA or ESBL or MBL producing strains was found in the study. Thus, suitable control measures must be adopted to cope up this alarming situation with genetic characterization.

Efficacy of Nitrofurantoin and Fosfomycin against Extended Spectrum Beta Lactamase Producing Uropathogens in the Era of Antibiotic Resistance: A Cross-sectional Study

Background: Urinary Tract Infection (UTI) is one of the most common bacterial infections that require medical care. It accounts for 25% of all infections. Limited number of antibiotics are available for the treatment of UTI due to increased resistance among uropathogens. Aim of the study is to determine the causative agents of UTI and to evaluate the action of nitrofurantoin and fosfomycin against Enterobacteriaceae in ESBL (Extended spectrum beta-lactamase) producing strains. Material and Methods: It is a retrospective study carried out in the department of Microbiology, MAMC, Agroha. Data related to urine culture and antibiotic susceptibility pattern from January 2023 to December 2023 was taken from the records and analysed. Results: Out of 1648 urine samples processed, 569 showed significant bacterial growth. Escherichia coli (45.3%) was the most common isolate followed by Klebsiella pneumoniae (20.5%), Enterococcus (17.2%), Staphylococcus aureus (5%). Among the gram negative bacilli, 40% were ESBL producers. These ESBL producing strains were 99% sensitive to Fosfomycin and 75% sensitive to Nitrofurantoin. Conclusion: The study revealed that Nitrofurantoin and Fosfomycin are very effective oral drugs for empirical treatment against gram negative uropathogens causing UTI, especially multi drug resistant strains.

Bacteriological profile of bloodstream infections in pediatric age group in a tertiary care centre, Solapur

Bloodstream infections (BSI) due to multidrug-resistant organisms from paediatric setup have become increasingly common. BSI can be transient and be rapidly cleared out by the host defence mechanism or be associated with high morbidity and mortality if it becomes persistent.Blood samples were collected from 1112 children within a 1-year study period (July 2022 to June 2023) which included all children admitted with complaint of fever and suspected of having sepsis in Paediatric department of Shri Chhatrapati Shivaji Maharaj Sarvopchar Rugnalaya (SCSMSR), Solapur. Blood volume was collected depending upon age and body weight of the patient with aseptic precautions and inoculated in Brain Heart Infusion broth (BHI) which was incubated at 37°C for 7 days. Subcultures were made on blood agar and MacConkey agar plates. Organisms were identified by biochemical reactions and antibiotic susceptibility test of the isolates were performed by disk diffusion. Out of 1112 suspected cases, 175 (15.74%) were culture positive. (27.43%) was the most common isolate followed by (16.57%) Most common Gram positive isolate was (11.43%) followed by (6.86%). Total Multidrug resistant (MDR) isolates in Gram negative and Gram positive were 50.35% and 31.25% respectively.High rates of antibiotic resistance are observed in both gram positive and gram negative organisms. Thus, there is an urgent need for proper implementation of antibiotic stewardship programme and infection prevention and control measures.

An updated description of bacterial pneumonia in adult horses and factors associated with death.

Available descriptive studies on equine pneumonia are outdated or focus on specific horse or bacterial populations. To describe the clinical presentation and bacterial isolates of adult horses with bacterial pneumonia and identify factors associated with death. One hundred sixteen horses >2 years old with bacterial pneumonia. Retrospective case series. Data regarding history, physical examination, clinicopathologic features, treatment, bacterial culture and sensitivity, and outcome were collected and analyzed retrospectively. Historical risk factors were present for 60% of cases, whereas abnormal vital signs on intake were present for <50%. Most horses (58%) underwent at least 1 change of antimicrobial treatment, and 67% received the highest-priority critically important antimicrobials. Streptococcus zooepidemicus was the most isolated bacteria (44%), followed by Escherichia coli (19%), Klebsiella spp. (18%), other Streptococcus species (17%), and Bacillus spp. (13%). Fusobacterium spp. were the most common anaerobic isolates (11%). Antimicrobial susceptibility varied widely. Survival to discharge was 73%. Heart rate at presentation (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.008-1.17, P = .03) and higher creatinine (OR 14.1, 95% CI 1.56-127.6, P = .02) increased the risk of death. Higher lymphocyte count (OR 0.27, 95% CI 0.08-0.94, P = .04) reduced risk. Contrasting older literature, Fusobacterium spp. were the most common anaerobes. Streptococcus zooepidemicus remained the most common isolate and was predictably susceptible to penicillin. Antimicrobial susceptibility was otherwise variable and broad applicability is limited as this was a single-center study. Increased risk of death associated with tachycardia and abnormally high serum creatinine concentration is consistent with previous studies.