Multiple Drug-resistant Bacteria Research Articles

Identification of Bioactive Compounds from Alphonsea madraspatana Leaves against Multi Drug Resistance Bacteria

In this study, the antimicrobial compounds present in leaves of Alphonsea madraspatana was identified by using RP-HPLC, LC/MS and GC/MS and found to be active against multiple drug resistant (MDR) bacteria e.g. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. Extraction of dried plant leaves was performed by solvent gradient technique. Antimicrobial study was performed with each extract. n-Hexane and methanol extracts were further subjected to analysis for identification of potent antimicrobial compounds due to their better antimicrobial activity as compared to remaining extracts. The methanolic extract was more active than n-hexane extract. As n-hexane extract contains non-polar compounds, it was subjected to GC-MS analysis and methanol extract was subjected to RPHPLC followed by LC/MS due to presence of polar components. Among the isolated compounds, four compounds were identified as potent antimicrobial. RP-HPLC and LC/MS analysis of methanol extract also ensured the presence of four potent antimicrobial compounds as follows: (i) kaempferol-3-O-rotinoside-orhamnoside (m/z 748), (ii) 3-hydroxypropylglucosinolate (m/z 377), (iii) luteolin-7-O-glucoside (m/z 448) and (iv) genistein-7-O-glycoside (m/z 432). Leaves of this plant may be used as potent antibacterial agents due to presence of antimicrobial compounds.

Encapsulated virgin coconut oil as a nanoscale in vitro solution against multiple drug resistant Staphylococcus aureus

Niosomes are excellent nanoscale vehicular systems that can carry a variety of drugs and (bioactive) compounds entrapped inside them. Virgin coconut oil (VCO) is the finest grade of coconut oil that is highly enriched with phenolic content, antioxidant activity and also comprises medium chain triglycerides. In this work, niosomes were encapsulated with VCO synthesized by a simple chemical method. The electron microscopy confirmed that spherical nanostructured lipid carrier molecules with a diameter in the range of 180–190 nm were produced. A zeta potential value of −42 mV was a testimony that these nanovehicles were having good stability. The natural oil loaded nanocarrier spheres proved to be potent antibacterial nano-antibiotics against multiple drug resistant (MDR) bacteria. The antibacterial activity of these magic nano-spheres was found to be better than ZnO (metallic oxides) nanoparticles. The nano-antibiotics resulted in 17, 14 and 12 mm zones of inhibition against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA) and a (general) MDR strain of S. aureus in contrast to nanoparticles that resulted in zones of inhibitions 7, 8 and 6 mm for the same bacterial strains. Niosomes prove to be an excellent nanocarrier system that can encapsulate a number of bio-active compounds.

Isolation and characterization of multiple drug-resistant bacteria from the waste of hospital and non-hospital environment

Antibiotics used in hospitals for patient care which potentially growing antibiotic resistant bacteria in hospital waste and simultaneously transmitting to non-hospital environments by drainage system. Total 20 samples were collected randomly and examined with different bacteriological, biochemical and molecular tests. 55 bacterial isolates were isolated from all samples, among them 32 (58.2%) were from hospital environment and 23 (42.1%) were from non-hospital environment. The result of total viable count showed that maximum countable bacteria (2.20×1010) CFUs/ml that were from MARCH and the minimum number of countable bacteria (1.0×1010) CFUs/ml were isolated from the sample of Kalitola. Among the isolates, E. coli, Pseudomonas spp, Klebsiellaspp, Salmonella spp, Staphylococcus spp and Vibrio spp were identified 16 (29%), 12 (21.8%), 9 (16.4%), 8 (14.5%), 5 (9%) and 5 (9%) respectively. Multidrug resistant (MDR) Pseudomonas aeruginosawas characterized from hospital wastewater by polymerase chain reaction assays targeting the virulence gene and 16S rRNA gene region was amplified with the universal primers. PCR amplification band was found at 1399 bp. The antibiotic sensitivity study revealed that among the hospital isolates, about (83.3%) were resistant against Ampicillin, followed by Amikacin, Kanamycin and Penicillin (77.8%). On the other hand, non- hospital isolates were resistant against Amoxicillin and Penicillin (66.7%) followed by Ampicillin and Vancomycin (58.3%). Both hospital and non-hospital isolates were sensitive to Gentamycin respectively 72.5% and 75%. The findings of the experiment suggested that hospital wastewater contained more MDR bacteria than non-hospital wastewater which are released into receiving water bodies that may cause a serious threat to public health. Reducing indiscriminate use of antibiotics in both hospital and non-hospital settings and the use of wastewater treatment plant (WTP) in a hospital may reduce this problem.
 Asian J. Med. Biol. Res. September 2020, 6(3): 460-468

Clinical evidence based nano crystalline silver dressing rationality, efficacy and strategy in extensive burn patients survival

Extensive burns of more than 50% have high mortality and those over 90% have almost nil survival rate. All resuscitative measures fail as patient gets infected leading to burn wound sepsis causing septicemia and leading to mortality as the end clinical result. So we need clinically evidenced and rationally based burn dressing strategy to increase extensive burn patient survival. This is random retrospective selection of five patients in each two groups from second degree burn patients of more than 50 percent treated by collagen in one group and other by Nanocrystalline Silver dressings and observed for clinical evidence of patients survival keeping all resuscitative and treatment modalities as standard treatment protocol in all cases. The nano crystalline silver dressing is cost effective, rational and evidence based strategy. It is easy to use, has powerful anti bacterial effect, decreased frequency of dressing changes, shortened time of wound cleaning and painless dressing. It helps make the wound sterile for further treatment within a week. It is a great weapon in the hand of Burn Surgeon for rapid and better recovery of patients. This nano crystalline sustained release silver dressings are best suited to take care of burn wounds of more than 50%. Bacteriophages treatment is reserved for multiple drug resistant bacteria and had good recovery.

Graphene nanoplatelets/Cr2O3 nanocomposites as novel nanoantibiotics: Towards control of multiple drug resistant bacteria

Drug resistance resulting due to the abuse of antibiotics can possibly be fatal for human beings. It, therefore, is required to develop novel nanoantibiotics to fight with the bacterial infections. In this work, we report graphene nanoplatelets/Cr2O3 nanocomposites (GNPs/Cr2O3) as a potential nanomedicine. Antibacterial characteristics of GNPs/Cr2O3 nanocomposites have been investigated against Pseudomonas aeruginosa and Staphylococcus aureus. GCr2O3-II with the optimized GNPs’ content shows excellent antibacterial performance with 84.25% growth inhibition of S. aureus (Gram-positive bacteria) and 80.76% growth inhibition of -P. aeruginosa (Gram-negative bacteria). This can be attributed to the synergistic contribution of Cr2O3 nanoflakes and GNPs/Cr2O3 nanocomposites, towards bacterial membrane disruption, that may be caused by the sharp edges of GNPs and induction of the oxidative stress by Cr2O3 nanoflakes. Therefore, this study suggests that GNPs/Cr2O3 nanocomposites can be employed as an innovative nanoantibiotics for pathogen control.

In vitro antibacterial potential of acetone leaf extract of Otostegia integrifolia Benth against human selected bacterial pathogens

Otostegia integrifolia Benth (O. integrifolia) is the endogenous medicinal plant of Ethiopia mostly used for the treatment of Stomach ache, tonsillitis, hypertension, malaria, ascariasis, and lung diseases. The current study was focused on phytochemical analysis and evaluation of the antibacterial activity of O. integrifolia Benth leave extracts against selected human bacterial pathogen by the agar well diffusion and microtube broth dilution method. Plant leaves were extracted with less polar to high polar solvents such as petroleum ether, chloroform, acetone, and ethanol. Phytochemical investigation was carried out for the identification of secondary metabolites responsible for antibacterial activity. In vitro antibacterial potential of O.integrifolia Benth leaf organic extracts against human pathogenic gram-negative (E. coli, K. pneumonia, V. cholera) and positive bacteria (B.subtilis, E. faecalis, S.aureus) were assessed by agar well diffusion, and bacterial inhibitory concentration of effective plant extracts was determined by 96 well plate broth dilution assay. Among all the tested organic leaf extracts, the acetone leaf extract of O.integrifolia Benth exhibited a promising broad spectrum of in vitro antibacterial activity against all tested multiple drug-resistant bacteria pathogens with significant MIC values of K.pneumoniae (2.144µg/ml), V. cholera (2.025µg), B.substilis (2.604 µg), and S.aureus (3.028 µg), respectively. The significant antibacterial activity of acetone leaf extracts of O. integrifolia Benth was due to the existence of flavonoids and phenolic compounds. The current studies demonstrated that the broad-spectrum antibacterial activity of acetone leaf extracts of O.integrifolia Benth might be helpful for the isolation of novel potent antibacterial agents against infectious bacterial pathogens without any side effects.

The Application of Nucleic Acids and Nucleic Acid Materials in Antimicrobial Research.

Due to the misuse of antibiotics, multiple drug-resistant pathogenic bacteria have increasingly emerged. This has increased the difficulty of treatment as these bacteria directly affect public health by diminishing the potency of existing antibiotics. Developing alternative therapeutic strategies is the urgent need to reduce the mortality and morbidity related to drug-resistant bacterial infections. In the past 10 to 20 years, nanomedicines have been widely studied and applied as an antibacterial agent. They have become a novel tool for fighting resistant bacteria. The most common innovative substances, metal and metal oxide nanoparticles (NPs), have been widely reported. Until recently, DNA nanostructures were used alone or functionalized with specific DNA sequences by many scholars for antimicrobial purposes which were alternatively selected as therapy for severe bacterial infections. These are a potential candidate for treatments and have a considerable role in killing antibiotic-resistant bacteria. This review involves the dimensions of multidrug resistance and the mechanism of bacteria developing drug resistance. The importance of this article is that we summarized the current study of nano-materials based on nucleic acids in antimicrobial use. Meanwhile, the current progress and the present obstacles for their antibacterial and therapeutic use and special function of stem cells in this field are also discussed.

Impact of antibiotic de-escalation on hospitalized patients with urinary tract infections: A retrospective cohort single center study

BackgroundUrinary tract infections (UTIs) can be caused by multiple drug-resistant bacteria. Empirical broad-spectrum antibiotics help minimize the risk of disease progression. Although antibiotic de-escalation is important to reduce resistance, adverse drug effects, and costs, few studies have evaluated the impact of antibiotic de-escalation on complicated UTIs in hospitalized patients. MethodsIn this retrospective cohort single center observational study conducted over a period of 1 year at Prince Sultan Military Medical City (PSMMC), the rate of antibiotic de-escalation following reporting culture and sensitivity results, hospital length of stay (LOS), and factors associated with antibiotic de-escalation failure were determined. ResultsNinety-one patients were enrolled in this study. Baseline characteristics were comparable between groups. The rate of successful de-escalation was 29.7% (27 patients) while 70.3% (64 patients) failed to experience de-escalation. The median hospital LOS was significantly lower in successfully de-escalated patients, at 3 days interquartile range (IQR) (2–6), while in the failed group it was 10 days IQR (6–21) (p<0.001). However, the identified factor associated with failure was a multidrug-resistant (MDR) pathogen that was significantly higher in the failed group than in the successful group: 38 patients (59.4%) versus 6 patients (22.2%; p<0.001), respectively. ConclusionAntibiotic de-escalation is an essential antimicrobial stewardship strategy. The findings of this study showed that de-escalation was associated with better patient outcomes (i.e., reduced hospital LOS) in patients admitted due to UTIs. In this study's site hospital, there is a potential for improving the current de-escalation rate. MDR pathogens were the only significant reason identified for de-escalation failure. Further data are needed on the large scale to evaluate reasons for de-escalation failure.

Screening and stability testing of commercially applicable Heliotropium crispum silver nanoparticle formulation with control over aging and biostability

Heliotropium crispum-mediated assembly of silver nanoparticles exhibit profound antibacterial and anti-biofilm effects against multiple drug-resistant bacteria, but its stability and biocompatibility remain a hurdle in commercialization. Herein, we adopted a surface chemistry-based steric repulsion approach to investigate the colloidal stability of H. crispum silver nanoparticles (HC-AgNPs) and determine its application as a commercial antibacterial formulation. Two primary silver nanoparticles (AgNPs) were synthesized, i.e., HC-AgNPs and citrate-HC-AgNPs initially, which were then modulated to assemble various derivatives of AgNPs using polyethylene glycol (PEG) and polyvinylpyrrolidone (PVP) as stabilizing agents. Various parameters were assessed to investigate the morphology, colloidal physio-chemistry, and surface capping using various analytical techniques, such as UV–Vis spectrophotometer, zeta–dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM, and transmission electron microscopy (TEM). Selective AgNPs were then screened on the basis of stability for up to 8 months, heat resistance at 100 °C, and bioactivity via MTT assay using HEP-2, MCF-7, and HCEC cell lines. The UV–Vis and electron microscope results revealed that HC-AgNPs confer near-spherical and slight triangular-shaped morphology and the size of all synthesized AgNPs is in the range of 400–450 nm. All AgNPs synthesized from HC-source have characteristic FTIR peaks recorded near 2931 cm−1, 1996 cm−1, and 825 cm−1. This study highlights promising evidence for the commercial application of HC-AgNPs as an antimicrobial agent. Additionally, it provides a methodology for modulating the surface capping of biological nanoparticles and assesses its corresponding effect on the stability.

Bacterial nanobiotic potential

AbstractAntibiotics are the chemicals responsible for killing pathogenic bacteria but inappropriate and extensive use of antibiotics is hazardous causing adverse impact on human health. Excessive use of antibiotics has led to the development of multiple-drug resistant bacteria posing health hazards to mankind. The study of nanoparticles has revolutionized the problem solving concerns regarding fields of agriculture, chemistry and medicine. Nanoparticles are smaller than atomic nuclei offering more surface area and greater reactivity. Bacterial silver nanoparticles (AgNPs) were studied for their antibacterial potential. AgNPs from Bacillus subtilus show the highest antibacterial activity. Nanoparticles exhibiting antibacterial activity can be helpful to reduce the toxic impact of synthetic antibiotics. Present work deals with the green production of silver nanoparticles by exploiting indigenous bacteria. These AgNPs were characterized through Fourier transform infrared spectroscopic (FTIR) analysis, transmission electron microscopy (TEM) and UV spectroscopic analysis and were also evaluated for their antibacterial and antifungal potential. The data suggested the extracellular biosynthesis method to be very effective for the biosynthesis of AgNPs in some bacterial strains. Keeping in view the antibacterial potential of studied AgNPs, the present work suggests green production of nanoparticles which can be effectively utilized as environment friendly antibacterial and antifungal agents.

Mikania cordata leaves extract promotes activity against pathogenic bacteria and anticancer activity in EAC cell-bearing swiss albino mice

Antibiotic resistance reversal of multiple drug resistant bacteria using Piper longum fruit extractVinay Kumar, Varsha Shriramand Javed Mulla

Partial implant retention in two-stage exchange for chronic infected total hip arthroplasty.

The efficacy of partial retention of well-fixed components during two-stage exchange for chronic total hip arthroplasty (THA) infection has remained unknown. A total of 14 patients with chronic infected THA were treated with damage control two-stage revision, including selective retention of the well-fixed femoral or acetabular component, aggressive debridement, antibiotic-laden cement spacer, antibiotic therapy, and delayed reimplantation. Indications for this treatment included chronic infected THAs with ingrown femoral or acetabular component and positive microbial growth with sensitive antibiotics. We excluded patients with acute infection; negative microbial growth; positive pathogen with high-virulence bacterial infections and multiple drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, fungi, and Mycobacterium tuberculosis; sinus formation; a prior failure for periprosthetic joint infection (PJI) treatment; and obvious bone resorption in both femoral and acetabulum side. During the study period, this represented 3.3% (14/425) of the patients treated for infected THA. Minimum follow-up was threeyears. None of the 14 patients in this series were lost to follow-up. Successful treatment was defined according to a modified Delphi-based international multidisciplinary consensus. No repeated debridement and recurrence of infection occurred during the study period; no patient need chronic antibiotic suppression. Successful treatment of chronic PJI was achieved in all patients. Despite the high peri-operative complication rate, no severe consequences were observed. The mean Harris Hip Score was 86 (range, 82-92; SD, 3.3). The selective partial implant retention two-stage revision for chronic PJI may be a treatment option in properly selected patients with low virulence bugs.

Multiple Drug Resistant Urinary Tract Infection in Kidney Transplant Recipients: A Retrospective Cohort Study.

Urinary tract infection (UTI) is the most common infectious disease in post-kidney transplantation patients. The objective of the study was to investigate the prevalence, impact and risk factors of multiple drug resistant (MDR) UTI in kidney transplant recipients. This retrospective cohort study recruited 72 kidney transplant recipients between March 2017 and February 2018. Urine cultures performed during the 1st year of posttransplantation with reference to clinical data were evaluated. Predesigned questionnaire was used to collect data regarding demographic, transplant related, and microbiological information. Multivariate analysis was performed to ascertain risk factors of MDR UTI. Out of 72 patients, 28 (38.9%) had culture guided clinical UTI. Overall, 59 UTI episodes were noted throughout the duration of this study. Eschericia coli were found to be the most frequent uropathogen of UTI among kidney transplant recipients (n = 32, 54.2%). MDR bacteria were responsible for 27.1% (n = 16) of the post-transplantation UTI episodes among patients, with E. coli (n = 9, 56.3%) being the predominant bacterial pathogen. Most of the MDR strains of E. coli (n = 7, 77.8%) were extended spectrum beta-lactamase positive. Female gender (P <0.001), prolonged Foley's catheterization (P = 0.002), coexisting diabetes mellitus (DM) (P <0.001) and induction of anti-thymocyte globulin (ATG) therapy (P <0.001) were independently associated with high risk of MDR UTI. The allograft rejection was found to be significantly higher in patients of posttransplantation UTI with MDR uropathogen (P = 0.009). In conclusion, E. coli were the most prominent uropathogen of UTI with and without MDR pathogen in the present study. Female gender, prolonged Foley's catheterization, coexisting DM, and induction of ATG therapy were the risk factors independently associated with MDR UTI in kidney transplant recipients. MDR organisms were significantly associated with allograft rejection.

A rapid, automatic and accurate assay for quantifying temocillin in human serum and CSF using turbulent flow liquid chromatography coupled to high-resolution mass spectrometry. Clinical application.

Temocillin is a β-lactamase-resistant penicillin used for the treatment of multiple drug-resistant Gram-negative bacteria. To maximize efficacy and avoid adverse effects, the dose regimen has to be quickly adjusted to the clinical situations. This necessitates the development of a rapid, reliable and accurate analytical method. Temocillin and the stable isotopically labeled internal standard ([13 C6 ]-amoxicillin) were extracted from either serum or cerebrospinal fluid by a turbulent flow liquid chromatographic method and eluted onto an octadecyl-silica phase with polar endcapping. Mass spectrometry was conducted using an exact mass determination method by electrospray positive ionization high-resolution mass spectrometry. The LLOQ and ULOQ of the present method were determined to be 0.4 and 200 μg/ml for serum and cerebrospinal fluid samples, respectively. The total analysis time was <7 min. The recovery ranged from 87.7 to 120.8%. Intra- and inter-day precision and trueness were tested at four concentration levels: 0.4, 8, 40 and 160 μg/ml. Values were 6.33 ± 1.53, 8.8 ± 1.3, 8.8 ± 0.36 and 2.1 ± 0.76%, and 5.0 ± 0.54, 9.9 ± 1.0, 5.8 ± 1.6 and 0.1 ± 1.1%, for inter- and intra-day analysis, respectively. Temocillin was found to be stable under all relevant laboratory conditions. The method was cross-validated with a microbiological assay. This method is suitable for accurate measurement of temocillin concentration in small volumes of serum or cerebrospinal fluid. Thanks to the online extraction procedure, the overall analytical time is compatible with high-throughput analysis for clinical application.

Potential of Herbal Antibacterials as an Alternative to Antibiotics for Multiple Drug Resistant Bacteria: An Analysis

Potential of Herbal Antibacterials as an Alternative to Antibiotics for Multiple Drug Resistant Bacteria: An Analysis

Bacterial Profile and their Antibiogram Isolated from Cell Phones

Objectives: The present study aimed to identify bacteria profile of cell phones used by different people from different profession of Bhaktapur and to access their antimicrobial resistance.&#x0D; Methods: Forty-nine mobile swab samples were collected from 7 different profession category (7 samples each from student, butcher, cook, panipuri vendor, health workers, and dairy employee). Samples were cultured and processed by standard Microbiological procedures. All the isolates were further subjected to antibiotic susceptibility testing using modified Kirby Bauer disc diffusion method as describe in CLSI guidelines. The rate of multiple drug resistant (MDR) bacteria was also determined.&#x0D; Results: Out of 49 sample, Bacillus spp (20.4%) was the most predominant isolate, followed by Staphylococcus aureus (10.6%) and Pseudomonas spp (10.6%). Higher variety of bacterial isolates was found in the cell phones swabs from butcher followed by cook, farmer and panipuri vendor group. The data from the questionnaire showed that handkerchief or tissue paper were mostly used by respondents to clean their mobile. All Gram-positive and Gram-negative isolates were resistance to Cefoxitin (100%) except Micrococcus spp and Neisseria spp. Gram positive (18.2%) and Gram-negative (36.9%) isolates were identified as MDR. All S. aureus and Coagulase negative staphylococci were methicillin resistant&#x0D; Conclusion: The Cell phones of people from different profession were found to possess many different bacterial pathogens including multi drug resistant strains which could be the possible pathogens for food borne infections and opportunistic infections.

Computer-aided identification of lead compounds as Staphylococcal epidermidis FtsZ inhibitors using molecular docking, virtual screening, DFT analysis, and molecular dynamic simulation.

In an effort to face the multiple drug-resistant bacteria, various approaches have been discovered to design potent compounds and search new targets through computational design tools. With an aim to identify selective inhibitors against filamentous temperature-sensitive mutant Z (FtsZ), a library of Phase database compounds have been virtually screened. High-throughput virtual screening of compounds against Staphylococcal epidermidis FtsZ protein (4M8I) was performed using three sequential docking modes like high-throughput virtual screening, Glide standard precision, followed by Glide extra precision. Four top-ranked compounds were selected from molecular mechanics-generalized Born surface area (MM-GBSA) binding energy with better predicted free binding energies of - 89.309, - 54.382, - 53.667, and - 52.133 kcal/mol, respectively. It is also showed that the contribution of van der Waals and electrostatic solvation energy terms are playing a major part to make the hit molecule (T6288784) binding to S. epidermidis FtsZ protein. The result of highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) and energy gap analysis predicts the molecular reactivity and stability of hit molecules. Subsequently, Lipinski's rule of five and properties of absorption, distribution, metabolism, and excretion (ADME) were to calculate their bioavailability. The average binding energy - 9.67 kcal/mol of the best proposed hit molecule (T6288784) was found with half-maximal inhibitory concentration (IC50) value to be 75.53 nM. A 15-ns molecular dynamics simulation study revealed the stable conformation of hit molecule. On a wide-range research discipline, in silico studies of our proposed compound confirm promising results and can be successfully used towards the development of novel FtsZ inhibitor with better binding affinity. Graphical Abstract.

Antibacterial Mechanism of Nanosilvers

Due to antibiotic abuse, multiple drug-resistant bacteria have become the most threatening killers in the clinic. The alternative metal drugs, silver nanoparticles (AgNPs), thus exhibit huge antibacterial potential. Many studies have proved that the antibacterial efficacy of AgNPs depends on their concentration, size, surface charge, and coated material. In recent years, with the development of omics technology including genomics, proteomics, and transcriptomics, several antibacterial molecular mechanisms of AgNPs are proposed. Collapsing cell membrane/wall; inducing ROS, photocatalytic protein damage, and genotoxicity; inhibiting the respiration chain; and interfering with protein biosynthesis and folding are considered as the main molecular mechanisms till date. However, there are contradictions among these views and a lack of the complete theory. A global understanding of the antibacterial mechanisms of AgNPs is necessary for wider application of AgNPs to the clinic.

Application and effect evaluation of clohexidine wipes in patients with liver transplantation

Objective To investigate the application of clohexidine wipes in patients after liver transplantation and the effect of infection prevention. Methods A total of 279 patients who received orthotopic liver transplantation in the first affiliated hospital of sun yat-sen university from January 2017 to December 2018 and were transferred to the intensive care department of our hospital after the surgery were selected as subjects. Among them, 145 patients who received liver transplantation between January and December 2017 were selected as the control group. From January to December, 2018, 134 patients after liver transplantation were enrolled as the intervention group, and were treated with clohexidine 2% gluconate wet wipes, and the hospital infection rate, infection rate, multiple drug-resistant bacteria infection rate, bath time consumption, and adverse reaction rate were compared between the two groups. Results The hospital infection rate of the control group was 20.00% (29/145), the infection rate of patients was 37.93%(55/145), the infection rate of multiple drug-resistant bacteria was 25.52%(37/145), and the infection rate of the intervention group was 11.19% (15/134), 24.63% (33/134), 14.93% (20/134). The differences were statistically significant (χ2=4.065, 5.709, 4.806, P<0.05). The bath time of the control group was (16.70±1.42) minutes, and the intervention group was (14.07±1.53) minutes. Compared with the control group, the bath time of the intervention group was saved, and the difference was statistically significant (t=9.637, P<0.01).No discomfort symptoms such as disinfectant allergy were found in both groups. Conclusion The application of clohexidine 2% gluconate wet wipes in the wiping bath of patients after liver transplantation had a good effect, significantly reducing the hospital infection rate, saving the time of wiping bath. Key words: Clohexidine; Clean bath; Liver transplantation; Intensive care; Infection

Assessment of biological activities of chitosan Schiff base tagged with medicinal plants.

A chitosan Schiff base with an aromatic aldehyde was synthesized and characterized by FTIR and NMR spectroscopies. Furthermore, the degree of substitution was calculated based on the ratios of the area of the proton of the imine (Aimine ) and the area of the peak of the proton of the pyranose ring (AH-2 ). The antimicrobial activities were determined against bacterial and fungal strains, as well as multiple drug-resistant (MDR) bacteria. The chitosan Schiff base was also tagged with medicinal plants, for example, Curcuma longa, Peganum harmala, Lepidium sativam, and cruciferous vegetables, and the biological activities determined against pathogenic bacterial and fungal strains. The chitosan Schiff base showed maximum zone of inhibition of 22 mm against Staphylococcus aureus with a minimum zone of inhibition of 15 mm against Bacillus cereus. The chitosan Schiff base was fused with C longa, isothiocyanates and a combined mixture of P harmala and L sativam that has shown activities against Escherichia coli with a zone of inhibition of 28, 24, and 30 mm, respectively. The Schiff base of chitosan fused with medicinal plants also showed significant inhibitory activities against MDR bacteria.