Management Of Bacterial Infections Research Articles

Prescription-Event Monitoring Study on Safety and Efficacy of Levonadifloxacin (Oral and I.V.) in Management of Bacterial Infections: Findings of Real-World Observational Study.

Background:Levonadifloxacin is a novel broad-spectrum antibiotic belonging to the benzoquinolizine subclass of quinolones. It is available in intravenous as well as oral formulation for the treatment of infections caused by common Gram-positive bacterial pathogens including methicillin-resistant Staphylococcus aureus (MRSA).Patients and Methods:This study retrospectively assessed the real-world safety and efficacy of levonadifloxacin (oral and/or IV) in the treatment of 1229 patients across various clinical conditions. Study outcomes were clinical and microbiological success at the end of therapy.Results:The mean duration of levonadifloxacin therapy was 7.2 days, with a time to clinical improvement averaging at 4 days. Three hundred and three patients received oral therapy, 875 received IV, and 51 received a combination of IV followed by oral therapy. Patients were prescribed levonadifloxacin for skin and soft-tissue infections, diabetic foot infections, septicemia, catheter-related bloodstream infections, bone and joint infections, febrile neutropenia, and respiratory infections including COVID-19 pneumonia. High clinical success rates of 98.3%, 93.7%, and 96.1% with oral, IV, and IV followed by oral levonadifloxacin, respectively, were obtained. Only 11 mild adverse events were reported in 9 patients which included constipation, diarrhea, hyperglycemia, nausea, fatigue, and vomiting. Overall, 96.3% and 97.3% of investigators rated the efficacy and safety of levonadifloxacin as “good to excellent.”Conclusions:An excellent safety and efficacy profile of levonadifloxacin was observed in this study making it a suitable treatment option for management of various bacterial infections, including those caused by resistant Gram-positive pathogens such as MRSA and quinolone-resistant S. aureus.

1343. Viral and Bacterial Pneumonia Hospitalizations — New York City, 2001–2016

Abstract Background This study was to investigate the burden and trend of viral and bacterial pneumonia hospitalization in New York City (NYC) from 2001 to 2016. Methods We analyzed hospital discharge data for NYC residents during 2001–2016 using Statewide Planning and Research Cooperative System. Annual crude hospitalization rate and percentage of in-hospital all causes death were calculated, using NYC population as denominator. Poisson regression was performed to assess temporal trends of pneumonia hospitalization rate and percentage of in-hospital death from 2001 to 2016. Results During 2001–2016, there were 122,324 pneumonia hospitalizations with identified viral or bacterial pathogen in NYC, of which 7,826 (6.4%) were influenza, 13,059 (10.7%) were other viruses, 11,847 (9.7%) were pneumococcus, and 89,592 (73.2%) were other bacteria. From 2001 to 2016, there was significantly increased viral and bacterial pneumonia hospitalization rate, except for pneumococcal pneumonia, and pneumococcal pneumonia had significantly decreased hospitalization rate (p< 0.0001). From 2001 to 2016, the percentage of in-hospital death for viral pneumonia except influenza significantly increased (p=0.0002), whereas decreased for bacterial pneumonia (p< 0.0001). Patients aged ≥65 years old had the highest percentage of in-hospital death among all ages for both viral and bacterial pneumonia, especially there was 19.5% of in-hospital death for pneumococcal pneumonia and 23.4% for other bacterial pneumonia. Conclusion While hospital discharge data are subject to limitations particularly for large amount of un-identified pathogens for pneumonia, our analysis showed increased viral activities considering the changes in hospitalization rate and percentage of in-hospital death in NYC during 2001–2016. There was a reduced pneumococcal pneumonia hospitalization rate and percentage of in-hospital death, likely related to the increased vaccine uptake, and a reduced percentage of in-hospital death for overall bacterial pneumonia, likely related to improved antibiotic treatment management. Further studies are warranted to evaluate the necessity of increasing the pneumococcal vaccine coverage in elderly, as well as reducing antimicrobial resistance to improve the management of bacterial infection. Disclosures All Authors: No reported disclosures

Evaluation of Antibacterial Potential of Ethanol Fruit Peel Extract of Mangifera indica against Isolated UTI Pathogens

Effective use of antimicrobial agents for treatment/management of infectious diseases is decreasing due to emergency of multi-drug and cross resistant strains of pathogenic microbes. Medicinal plants are now increasingly used alone or as an adjunct in the management of infectious diseases as a result of their claimed efficacy and safety. This research focused on evaluating the antimicrobial potential of ethanol fruit peel extract of Mangifera indica against isolated Urinary tract infection (UTI) pathogens. Urinary tract infection (UTI) bacterial strains (staphylococcus aureus, escherichia coli and pseudomonas aeruginosa) were isolated from midstream urine of infected students using standard procedures after which the isolated Urinary tract infection pathogens were subjected to antimicrobial susceptibility test by agar-well diffusion method (Cup plate method) and the mean diameter of growth inhibition zones (n=3) of the extract at different concentrations were compared against the controls (sterile water and ciprofloxacin). Ethanol fruit peel extract of Mangifera indica significantly and dose dependently inhibit the growth of all the isolated Urinary tract infection pathogens with E.coli exhibiting the highest inhibition zone ranging from 16.83 to 28.23 mm, this was followed by pseudomonas aeruginosa with inhibition zone of 24.33 mm and staphylococcus aureus least susceptible with 22.63 diameter of zone inhibition. Ethanol fruit peel extract of Mangifera indica demonstrated a dose dependent antimicrobial activity with more pronounced effect exhibited by E. coli suggesting that the extract is more effective against gram negative bacteria despite their permeability barrier, thus suggesting Mangifera indica fruit peel as a potential candidate for the management of bacterial infections especially those caused by gram negative organisms.

Virulence Potential and Treatment Options of Multidrug-Resistant (MDR) Acinetobacter baumannii.

Acinetobacter baumannii is an opportunistic pathogen which is undoubtedly known for a high rate of morbidity and mortality in hospital-acquired infections. A. baumannii causes life-threatening infections, including; ventilator-associated pneumonia (VAP), meningitis, bacteremia, and wound and urinary tract infections (UTI). In 2017, the World Health Organization listed A. baumannii as a priority-1 pathogen. The prevalence of A. baumannii infections and outbreaks emphasizes the direct need for the use of effective therapeutic agents for treating such infections. Available antimicrobials, such as; carbapenems, tigecycline, and colistins have insufficient effectiveness due to the appearance of multidrug-resistant strains, accentuating the need for alternative and novel therapeutic remedies. To understand and overcome this menace, the knowledge of recent discoveries on the virulence factors of A. baumannii is needed. Herein, we summarized the role of various virulence factors, including; outer membrane proteins, efflux pumps, biofilm, penicillin-binding proteins, and siderophores/iron acquisition systems. We reviewed the recent scientific literature on different A. baumannii virulence factors and the effective antimicrobial agents for the treatment and management of bacterial infections.

Filamentous fungi in the airway of patients with cystic fibrosis: Just spectators?

BackgroundThere are important advances in the management of bacterial infection in patients with cystic fibrosis (CF), but there are many gaps in the field of fungal infections. AimsThe aim of this study was to analyse whether chronic respiratory filamentous fungal colonization had clinical impact and whether antifungal treatment can change the disease. MethodsThe prospective, bicentric and descriptive study was carried out within a 3-year follow-up period, with four-month periodicity medical controls. Adult patients from two CF units of tertiary hospitals were included. Clinical, microbiological, analytical and spirometric variables were collected. Quality of life was evaluated in a subgroup, using the Spanish version of the Revised Cystic Fibrosis Quality of Life Questionnaire (CFQ-R). To statistically analyze the evolution of forced expiratory along time (volume of air blown out in 1 second -FEV1-) and the forced vital capacity (FVC), mixed linear models were carried out. ResultsFrom the ninety-eight patients under study, 40 suffered chronic filamentous fungal colonization. The presence of filamentous fungi in airway was associated to an annual fall of FEV1 and FVC of 0.029 and 0.017 litres, respectively (p<0.001). In addition, worse quality of life based on CFQ-R, significant when concerning physical condition and emotional state, was also linked with the fungal colonization. Protocolized antifungal therapy, nebulized or oral, improved FEV1 in 0.023 and 0.024 litres per year, respectively (p<0.001). ConclusionsChronic filamentous fungal colonization in patients with CF is associated with a significant annual decline of lung function that persists over time. Chronic antifungal therapy slows down this progression, mainly in the patient with more advanced disease.

Biofabrication of Gold Nanoparticles Using Capsicum annuum Extract and Its Antiquorum Sensing and Antibiofilm Activity against Bacterial Pathogens.

The intensive use of antimicrobial agents has led to the emergence of multidrug resistance (MDR) among microbial pathogens. Such microbial (MDR) infections become more problematic in chronic diseases in which the efficacy of chemotherapeutic agents is highly reduced. To combat the problem of drug resistance, inhibition of bacterial quorum sensing (QS) and biofilms are considered as promising strategies in the development of anti-infective agents. In this study, gold nanoparticles (AuNPs-CA) were biofabricated using Capsicum annuum aqueous extract and characterized. The AuNPs-CA were tested against the QS-controlled virulence factors and biofilms of Pseudomonas aeruginosa PAO1 and Serratia marcescens MTCC 97. AuNPs-CA were found to be crystalline in nature with average particle size 19.97 nm. QS-mediated virulent traits of P. aeruginosa PAO1 such as pyocyanin, pyoverdin, exoprotease activity, elastase activity, rhamnolipids production, and swimming motility were reduced by 91.94, 72.16, 81.82, 65.72, 46.66, and 46.09%, respectively. Similarly, dose-dependent inhibition of virulence factors of S. marcescens MTCC 97 was recorded by the treatment of AuNPs-CA. The biofilm development and exopolysaccharide (EPS) production also decreased significantly. Microscopic analysis revealed that the adherence and colonization of the bacteria on solid support were reduced to a remarkable extent. The findings indicate the possibility of application of green synthesized gold nanoparticles in the management of bacterial infection after careful in vivo investigation.

Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases.

The blue blood of the horseshoe crab is a natural, irreplaceable, and precious resource that is highly valued by the biomedical industry. The Limulus amebocyte lysate (LAL) obtained from horseshoe crab blood cells functions as a surprisingly sophisticated sensing system that allows for the extremely sensitive detection of bacterial and fungal cell-wall components. Notably, LAL tests have markedly contributed to the quality control of pharmaceutical drugs and medical devices as successful alternatives to the rabbit pyrogen test. Furthermore, LAL-based endotoxin and (1→3)-β-D-glucan (β-glucan) assay techniques are expected to have optimal use as effective biomarkers, serving as adjuncts in the diagnosis of bacterial sepsis and fungal infections. The innovative β-glucan assay has substantially contributed to the early diagnosis and management of invasive fungal diseases; however, the clinical significance of the endotoxin assay remains unclear and is challenging to elucidate. Many obstacles need to be overcome to enhance the analytical sensitivity and clinical performance of the LAL assay in detecting circulating levels of endotoxin in human blood. Additionally, there are complex interactions between endotoxin molecules and blood components that are attributable to the unique physicochemical properties of lipopolysaccharide (LPS). In this regard, while exploring the potential of new LPS-sensing technologies, a novel platform for the ultrasensitive detection of blood endotoxin will enable a reappraisal of the LAL assay for the highly sensitive and reliable detection of endotoxemia.

Development and optimization of hot-melt extruded moxifloxacin hydrochloride inserts, for ocular applications, using the design of experiments

The current study sought to formulate sustained-release hot-melt extruded (HME) ocular inserts of moxifloxacin hydrochloride (MOX; MOX-HME) for the treatment of bacterial keratitis. The concentration of Eudragit™ FS-100 (FS) and propylene glycol (PG) used as polymer and plasticizer, respectively, in the inserts were optimized using the central composite design (CCD) to achieve sustained release. The inserts were characterized for weight, thickness, surface characteristics, pH, and in vitro release profile. The crystalline characteristics of MOX and surface morphology of the inserts were evaluated using differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). Furthermore, ex vivo permeation through rabbit cornea and stability of the optimized MOX-HME insert was investigated. The results demonstrate an inverse correlation between FS concentration and MOX release from the MOX-HME inserts, and a potential 24 h release. The optimized MOX-HME inserts were found to be stable at room temperature for four months, showing no significant change in drug content, pH and release profile. MOX converted into an amorphous form in the MOX-HME inserts and did not recrystallize during the study period. SEM analysis confirmed the smooth surface of the MOX-HME insert. The ex vivo studies revealed that the MOX-HME inserts provided a much prolonged transcorneal MOX flux as compared to the commercial ophthalmic solution and the immediate-release MOX-HME insert. The results indicate that MOX-HME inserts could potentially provide a once-a-day application, consequently reducing the dosing frequency and acting as an alternative delivery system in the management of bacterial infections.

Indoor Aquaria and Offshore Cages Bacterial Disease of Cultivated Giant Clam

Giant clam marine culture is commonly influenced by a wide variety of pathogenic bacteria including Vibrio species, resulting in high losses. The current study was organized to investigate the bacterial infections, in the Hurghada area, between the culture of Tridacna maxima and Tridacna gigas in indoor aquaria and offshore cages. Eighty samples of T. maxima and T. gigas in both indoor aquaria and offshore cages were collected for bacteriological analysis. Samples were taken from gills, gut, mantels, and gonads of Tridacna. The results showed reduced motion followed by loss of attractive color pattern with 25 % and 20 % mortality rate among indoor cultured T. maxima and T. gigas, respectively. About forty-six bacterial isolates were identified, using phenotypic and biochemical testing. Most of those isolates were Vibrio logei, V. harveyi, and unidentified Vibrio. The pathogenicity and virulence of V. logei seem high with a 30% mortality rate. The current study would provide useful information for better management of bacterial infections in T. maxima and T. gigas.

High rates of antibiotic prescriptions in children with COVID-19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America.

AimThis study aims to assess rates of antibiotic prescriptions and its determinants in in children with COVID‐19 or Multisystem Inflammatory Syndrome (MIS‐C).MethodsChildren <18 years‐old assessed in five Latin Americas countries with a diagnosis of COVID‐19 or MIS‐C were enrolled. Antibiotic prescriptions and factors associated with their use were assessed.ResultsA total of 990 children were included: 921 (93%) with COVID‐19, 69 (7.0%) with MIS‐C. The prevalence of antibiotic use was 24.5% (n = 243). MIS‐C with (OR = 45.48) or without (OR = 10.35) cardiac involvement, provision of intensive care (OR = 9.60), need for hospital care (OR = 6.87), pneumonia and/or ARDS detected through chest X‐rays (OR = 4.40), administration of systemic corticosteroids (OR = 4.39), oxygen support, mechanical ventilation or CPAP (OR = 2.21), pyrexia (OR = 1.84), and female sex (OR = 1.50) were independently associated with increased use of antibiotics. There was significant variation in antibiotic use across the hospitals.ConclusionOur study showed a high rate of antibiotic prescriptions in children with COVID‐19, in particular in those with severe disease or MIS‐C. Prospective studies are needed to provide better evidence on the recognition and management of bacterial infections in COVID‐19 children.

Changes in the epidemiology and management of bacterial infections in cirrhosis.

Patients with cirrhosis are susceptible to develop infections because of immune dysfunction, changes in microbiome and increase in bacterial translocation from the gut to systemic circulation. Bacterial infections can worse the clinical course of the disease, triggering the development of complications such as acute kidney injury, hepatic encephalopathy, organ failures and acute on chronic liver failure. In recent years, the spread of multi drug resistant bacteria made more challenging the management of infections in patients with cirrhosis. Hence, the mortality rate associated to sepsis is increasing in these patients. Therefore, the optimization of the management of infections has a high priority in cirrhosis. Herein we reviewed the recent changes in the epidemiology and the management of bacterial infections in patients with liver cirrhosis.

Effects of vancomycin linoleic acid nanoparticles on male reproductive indices of Sprague–Dawley rats

The management of bacterial infections, especially trains of methicillin-resistant Staphylococcus aureus observe in health care settings, has markedly improved with the introduction of established drugs but using newer nano-based formulations. This study investigates the effects of vancomycin-linoleic acid nanoparticles on testicular tissue in an experimental animal model. Twenty-five adult male Sprague–Dawley rats maintained at the Animal House of the Biomedical Resources Unit were assigned to five groups namely E – solid lipid nanoparticles; F – vancomycin solid lipid nanoparticle; G – linoleic acid nanoparticle; H – vancomycin linoleic acid; and A – control. Perturbations in seminal fluid parameters showed a reduced sperm count in groups F & G which was statistically significant (p < .05) but motility and morphology were not significant when compared to controls (A). Reduced testosterone levels were found in groups E, F and H but were not statistically significant (p > .05). There was also increased luteinizing hormone (LH) and decreased in follicular stimulating hormone (FSH) levels was statistically significant (p < .05). Hypoplasia, tubular atrophy and shrinkage were observed in histologic sections of the treated groups with basement membrane thickening. Vancomycin solid lipid nanoparticle and its constituents SLN and LA disrupted testicular morphometry and the hormonal milieu sufficient to potentially induce altered reproductive function.

A global perspective on management of bacterial infections in pregnancy: a systematic review of international guidelines

Introduction Maternal sepsis is a leading cause of maternal and neonatal mortality. Despite the availability of management protocols, there is disparity in case fatality rates for pregnancy-related sepsis compared to other maternity-related complications. The main aim of this systematic review was to assess concordance between international evidence-based guidelines for the prevention and management of childbirth-related bacterial infections. Material and methods The PRISMA statement was followed during the conduct and reporting of this review. PubMed was searched electronically from 2009 to November 2019 for clinical guidelines covering the topic of childbirth-related infections and specific searches for relevant guidelines on the websites of the top five international professional bodies most commonly identified by our searches. We did not apply any language restrictions. Guidelines were included if they provided any information about the prevention or management of childbirth-related bacterial infections irrespective of whether the guideline stated a recommendation or not. Two independent reviewers undertook study selection, decisions about inclusion of selected guidelines and data extraction. Extracted information was synthesized under the following topics: Asymptomatic bacteriuria; group B streptococcal infection (GBS); preterm premature rupture of membranes (P-PROM); intrauterine infection; procedures; maternal sepsis; miscellaneous. Concordance was defined as absence of contradictory information between the different guidelines with regards to a specific topic, subtopic or recommendation. Quality of included guidelines was assessed against the AGREE II guideline reporting domains. Results A total of 43 guidelines were selected of which 11 were excluded leaving 32 guidelines that fulfilled our inclusion criteria. None of the guidelines fulfilled all the quality assessment domains and 11 (34%) of the guidelines satisfied 1−2 of domains only. Two guidelines covered the topic of asymptomatic bacteriuria, nine for GBS, five for P-PROM and three covered each of intra-amniotic infections maternal sepsis, obstetric procedures and interventions topics. The remaining guidelines covered miscellaneous topics. Conclusions There was concordance between guidelines with regards to several aspects in the prophylaxis and treatment of bacteriological infections in pregnancy. Nevertheless, there were several areas of discordance, some of which reached the extent of contradictory information as in the case of antenatal screening for GBS.

Antibacterial Activity Evaluation of Psidium guajava L. (Myrtaceae) Crude Extracts Against Selected Bacterial Pathogens

Methanol, ethanol, acetone, ethyl acetate and hot water extracts of different parts (leaves, seeds, fruits and twigs fractions) of Psidium guajava L. were investigated for their antibacterial activities against 8 bacterial isolates. Inhibitory effects of P. guajava L. extracts have been screened by disc- diffusion method (Zone of inhibition, ZI), activity index (AI) and minimum inhibitory concentration (MIC) determination. Ciprofloxacin antibiotic was used as standard for P. guajava L. antimicrobial activity comparison. From the ZI, AI and MIC values, methanolic and hot water extracts of twigs &lt; 1cm diameter were the most potent against all tested micro-organisms by showing the highest ZI and AI value and the lowest MIC values. Whereas, no inhibitory activity was recorded for both seeds and fruits extracts using all tested solvents. These observations make this plant a potential source that can be used in management of bacterial infections. Moreover, methanolic and hot water extracts of twigs &lt; 1cm required further in depth study.&#x0D; &#x0D; &#x0D;

Progress and prospects in the management of bacterial infections and developments in Phytotherapeutic modalities.

The advent of antibiotics revolutionized medical care resulting in significantly reduced mortality and morbidity caused by infectious diseases. However, excessive use of antibiotics has led to the development of antibiotic resistance and indeed, the incidence of multidrug-resistant pathogens is considered as a major disadvantage in medication strategy, which has led the scholar's attention towards innovative antibiotic sources in recent years. Medicinal plants contain a variety of secondary metabolites with a wide range of therapeutic potential against the resistant microbes. Therefore, the aim of this review is to explore the antibacterial potential of traditional herbal medicine against bacterial infections. More than 200 published research articles reporting the therapeutic potential of medicinal plants against drug-resistant microbial infections were searched using different databases such as Google Scholar, Science Direct, PubMed and the Directory of Open Access Journals (DOAJ), etc., with various keywords like medicinal plants having antibacterial activities, antimicrobial potentials, phytotherapy of bacterial infection, etc. Articles were selected related to the efficacious herbs easily available to local populations addressing common pathogens. Various plants such as Artocarpus communis, Rheum emodi, Gentiana lutea L., Cassia fistula L., Rosemarinus officinalis, Argemone maxicana L, Hydrastis canadensis, Citrus aurantifolia, Cymbopogon citrates, Carica papaya, Euphorbia hirta, etc, were found to have significant antibacterial activities. Although herbal preparations have promising potential in the treatment of multidrug-resistant bacterial infection, still more research is required to isolate phytoconstituents, their mechanism of action as well as to find their impacts on the human body.

Factors Associated With Length of Hospital Stay Following Liver Transplant Surgery.

Length of stay is considered an important surrogate for transplant survival rate and resource utilization. Therefore, in the present study, our aim was to determine factors affecting length of hospital stay. We retrospectively analyzed records of patients who underwent liver transplant at the Tehran University of Medical Sciences Liver Transplantation Center from March 2014 to March 2016. For our final analyses, there were 161 adult recipients, including 106 males (65.8%) and 55 females (34.1%). Univariate analyses showed that body mass index, Modelfor End-Stage Liver Disease score, duration of surgery, number of administered packed red blood cells and fibrinogen during surgery, reoperation, retransplant, bacterial infection, pleural effusion, ascites, renal failure that required dialysis, and wound infection were risk factors for length of hospital stay. After multivariate linear regression analysis, only body mass index (β = 0.016; P = .028), Model for End-Stage Liver Disease score (β = 0.017; P = .002), surgical duration (β = 0.002; P = .001), reoperation (β = 0.016; P < .001), presence of pleural effusion (β = 0.212; P = .042), and management of bacterial infection (β = 0.21; P = .03) and psychiatric problems after liver transplant (β = 0.213; P = .025) were independent risk factors for length of hospital stay. The present study showed that multiple preoperative, intraoperative, and postoperative variables could have an impact on length of hospitalization. Therefore, methods for assessing these factors could improve patient outcomes and resource savings in liver transplant centers.

Phytochemical Investigation and Antimicrobial Activity of Root Extracts of &lt;i&gt;Withania Somnifera&lt;/i&gt; (L.) Dunal. against Drug- Resistant Bacterial Pathogens

With the emergence of multidrug resistance among clinical bacterial pathogens there is a growing need for the development of herbal alternatives for the effective therapeutic management of bacterial infections. Plants and plants products have long been used in traditional folk medicine worldwide. Hence this study was designed to test the antimicrobial efficacy of Withania somnifera L. Dunal. (root) against drug resistant bacterial pathogens. Extracts of W. somnifera (L.) Dunal (root) was prepared by cold percolation method. Antimicrobial activity of different solvent extracts of W. somnifera (L.) Dunal. (root) was studied against drug-resistant clinical isolates of Gram-positive cocci (vancomycin resistant Enterococcus faecalis and Methicillin resistant Staphylococcus aureus) and Gram-negative bacilli (ESBL Escherichia coli and Pseudomonas aeruginosa). The standard strains of ATCC 25922 E. coli, ATCC 25923 S. aureus, ATCC 27853 P. aeruginosa, and ATCC 29212 E. faecalis were used as controls. Antibacterial activities of extracts were evaluated using agar well diffusion method. Minimum inhibitory concentration was determined by microbroth dilution method. All the extracts (methanol, ethanol, acetone and chloroform) were inhibitory to gram positive bacteria tested. Nevertheless, inhibitory effect waspronounced in the methanol and ethanol extract, against gram negative bacteria (Both ATCC and clinical strains).Further based on the phytochemical and GC-MS analysis, it could be speculated that the antibacterial activity exhibited by the methanol extract of W. somnifera root could be attributed to the presence of phenolic compounds, flavonoids, steroids and terpenes.

Immunosuppression reduction in kidney transplant recipients during bacterial infection-A retrospective study.

Immunosuppression reduction is a common practice in the management of bacterial infection among kidney transplant recipients (KTRs). This practice, however, is based on limited evidence. Retrospective study comparing clinical outcomes of KTRs whose antimetabolite was discontinued vs continued during hospitalization due to bacterial infection, considering calcineurin inhibitors (CNI) levels. Primary outcome was a composite of clinical failure at day 5; all-cause mortality; and/or re-hospitalization at 90days. Multivariable analysis of risk factors for the primary outcome was performed using a propensity-matched cohort. We included 183 KTRs hospitalized with bacterial infection. Neither discontinuation of antimetabolites nor lower levels of CNI at infection onset were associated with a significant decrease the composite primary outcome. No significant difference in graft loss or rejection was demonstrated between patients with low vs high CNI levels or discontinuation vs continuation of antimetabolite. In multivariable analysis, CNI levels and management of antimetabolite were not significantly associated with adverse outcome. Immunosuppression reduction in hospitalized KTRs with bacterial infection did not offer a clinical advantage in terms of mortality, re-hospitalization, or clinical success. An interventional study evaluating continuation of immunosuppression vs reduction should be considered.

In-vitro Screening of Antimicrobial Activities of Ocimum gratissimum on Clinical Isolates

This study was undertaken to evaluate the antimicrobial activities of crude ethanol and methanol extracts of the leaves of Ocimum gratissimum L. (scent leaf) on Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus auerus and Candida albicans.The antimicrobial activities were carried out using agar well diffusion method. The Minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC) of the plant extracts on the test isolates were determined by the agar dilution method. Ciprofloxacin and fluconazole (positive controls) were used in comparison with crude extract of O. gratissimum leaves and also, Dimethyl sulfoxide (DMSO) was used as the negative control. The ethanolic extract of O. gratissimum showed antibacterial activity with the mean inhibitory zone diameter of 3 -7mm against S. auerus, 2 mm against E. coli, 2 – 12 mm against K. pneumoniae, 2 mm against P.aeruginosa. Ethanol and methanol crude extracts of O. gratissimum leaves showed no effect on C.albicans. O. gratissimum extracts showed the lower antimicrobial activity than the commercially available antibiotics (ciprofloxacin and fluconazole). The minimum Inhibitory Concentration and Minimum Bactericidal Concentration of the extracts on the test organisms also increased in the following order; methanol &lt; ethanol. Hence, this extract could only serve as antibacterial agent in the management of bacterial infection because it has no antifungal activities on Candida isolates used in this study.

Current Challenges and Perspectives for the Use of Aqueous Plant Extracts in the Management of Bacterial Infections: The Case-Study of Salmonella enterica Serovars.

Worldwide, foodborne diseases are a growing public health problem. Among the infectious bacteria, non-typhoidal Salmonella enterica serovars (NTS) are the major cause of hospitalization and death, and the emergence and spread of their antibiotic-resistance is becoming a worldwide health issue. This, coupled with the restrictions of antibiotics use in agriculture and animal production, calls for alternative approaches to solve this problem. Plant-derived aqueous extracts compounds could provide novel straightforward approaches to control pathogenic bacteria. This review discusses the antimicrobial activity of aqueous plant extracts against Salmonella serovars, the possible mechanisms of action involved, which components/structures might be responsible for such activity, and the current challenges for the use of these extracts/components in Salmonella infection management and their application perspectives.