Negative Organisms Research Articles

Microbial Aetiology and Risk Factors of Community-acquired Pneumonia in Security-challenged Communities in the Northeast Nigeria

Background: Community-acquired pneumonia is still a major cause of hospital admission in the sub-Saharan Africa. It is primarily due to gram positive organisms and atypical pathogens as well as gram negative organisms. Aim: The aim of the study was to identify the common risk factors of community-acquired pneumonia and the causative pathogens of community-acquired pneumonia among adults in the Northeastern States, Nigeria. Methods: This was a hospital-based cross-sectional analytical study conducted on adult patients seen at the general outpatient clinics and the medical outpatient clinics of a referral Teaching Hospital in Gombe, Northeast Nigeria between June 2017 and January 2018. Hundred patients with clinical and or radiological diagnosis of community-acquired pneumonia who presented to the General Outpatient Clinic and Medical Outpatient clinic of the hospital were recruited. A chest radiograph, sputum culture and multiplex PCR analysis was conducted on all the hundred sputa. Findings: 45(45%) of the patients had one or more identified risk factors of CAP. Of these, HIV 22 (22%), smoking 11(11%), alcohol consumption 2(2%) while 7 (7%) of these patients smoked cigarette and consumed alcohol. Culture diagnosis of CAP was negative in 58 (58%) of cases. The culture positive sputa included gram positive organisms 9 (9%) and gram-negative pathogens 33 (33%). However, with PCR analysis; Streptococcus pneumoniae 23 (23%) and Hemophilus influenzae 6(6%) were the typical pathogens detected, Legionella pneumophila 5 (5%), Chlamydia pneumoniae 3 (3%) and legionella/ chlamydia co-infection 1(1%) were the atypical pathogens identified. Conclusion: The risk factors of pneumonia identified among patients with community-acquired pneumonia in these insurgent facing communities were immunosuppressive illness, smoking and alcohol consumption. The identified microbial aetiologies were Streptococcus pneumoniae, Hemophilus influenzae, Staphylococcus aureus and gram-negative pathogens like Klebsiella pneumoniae, and Pseudomonas aeruginosa. Additionally, atypical pathogens such as the Legionella pneumophila and Chlamydia pneumoniae were also detected.

Green Synthesis of Silver Nanoparticles Using Allium cepa var. Aggregatum Natural Extract: Antibacterial and Cytotoxic Properties.

The chemical content of plant excerpts can be efficiently employed to reduce the metal ions to nanoparticles in the one-pot green production method. Here, green production of silver nanoparticles (AC-AgNPs) is performed by means of Allium cepa var. Aggregatum (shallot) extract as a stabilizer and reducer. The shape, size, and morphology of resultant AC-AgNPs are examined by optical spectroscopy analysis such as UV for nucleation and coalescence processes of the AC-AgNPs. Through FTIR functional group is determined and through DLS size is defined, it was confirmed that metallic AgNPs were successfully synthesized through the green synthesis route, and these results agreed well with the results obtained in the XRD pattern along with TEM spectroscopy, where the TEM images confirm the formation of sphere-like nanostructures along with SAED analysis. The chemical characterization is performed with XPS; the obtained molecular species in the materials are determined from the energy profile. Antioxidant activity of AC-AgNPs versus DPPH substrate is carried out. Antibacterial activity is well established against Gram-negative and Gram-positive organisms. Cell viability is accomplished, followed by an MTT assay, and a cytotoxicity assay of AC-AgNPs on MCF—7 cell lines is also carried out. Highlights: (1). This study highlights the eco-friendly synthesis of silver nanoparticles from Allium cepa var. Aggregatum Natural Extract. (2). The synthesized AC-AgNPs were characterized by UV-VIS, FT-IR, XRD, TEM, and XPS. (3). The synthesized nanoparticles were well dispersed in nature and the size range of 35 ± 8 nm. (4). The anti-candidal activity of biosynthesized silver nanoparticles was evaluated against the following Gram-Negative organisms: Escherichia coli (E. coli), and the following Gram-positive organisms: Staphylococcus aureus strains. The biosynthesized AC-AgNPs showed enhanced antiseptic features anti both Gram-positive and negative organisms. (5). Besides, the in vitro cytotoxic outcomes of AC-AgNPs were assessed versus MCF-7 cancerous cells, and the reduction in the feasibility of cancer cells was established via MTT assay, which suggests potential biomedical applications.

A retrospective longitudinal observational study of natural history of ESBL/MDR gram negative organisms in patients hospitalized in a tertiary hospital

Background: The IDSA recommends that when determining empiric treatment for a given patient, clinicians should consider previous organisms and associated antibiotic susceptibility data in the prior 6 months when multidrug-resistant/extended-spectrum β-lactamase gram-negative rods (MDR /ESBL GNR) is suspected. The presence of MDR GN in cultures on previous hospitalization or in surveillance cultures leads to use of broader-spectrum empiric antibiotic in subsequent admissions. We sought to determine whether the presence of an MDRO in 1 hospital admission dictates the need for broader-spectrum antibiotic use in subsequent hospitalizations when a different site is considered the source of infection. Methods: The study was conducted at a 700-bed tertiary-care level I trauma center. Infection control records were reviewed for patients aged 21–99 years admitted between July 1, 2013, through January 31, 2014, who had any ESBL or MDR GNR at any site including surveillance culture. The charts were surveyed until January 31, 2016, for ESBL or MDR gram-negative organisms at any site during subsequent hospitalizations. The CDC definition of MDR/ESBL was applied. Results: Of the 50 people followed, 34 patients (68%) had ESBL/MDR recovered at a single sentinel site, 6 patients (12%) had ESBL/MDR in multiple sites, and in 10 patients (20%) had ESBL/MDR only in surveillance cultures during their primary hospitalization. In 34 patients with a single sentinel site MDRO/ESBL in their primary hospitalization, 16 (47%) were identified in urine, 13 (38%) were identified by bronchoalveolar lavage (lung), 4 (12%) were identified on skin or MS, and 1 (3%) was identified at another site. When lung and urine were the sole sites of recovery of MDRO/ESBL in primary hospitalization, respectively, 3 patients (23%) and 2 patients (12.5%) subsequently developed MDROs in a secondary site on subsequent admissions. Overall, 10 bacteremia episodes occurred in 8 patients among 189 total admissions. MDRO/ESBL Klebsiella spp were identified in the cultures of 5 patients (50%), MDRO Acinetobacter spp were identified in the cultures of 3 patients (30%), and ESBL E. coli was identified in the cultures of 2 patients (20%). The organism causing bacteremia was present at a different sites during the same admission in only 3 (30%) of these cases: 2 were cultured from urine and 1 was cultured from a pulmonary source. Conclusions: The presence of MDRO at 1 site in a previous hospitalization may not be sufficient evidence to justify very broad antibiotics for patients during subsequent admissions, especially when another site is considered the source of infection. More studies are needed on natural history of MDRO in different patient populations with different risk factors.Funding: NoneDisclosures: None

Antimicrobial Potentials of Bacillus Subtilis Isolated from Soil and Water

In this study, an attempt was made to extract antimicrobial substance from the soil isolate of Bacillus subtilis and explore its antimicrobial activity on some selected bacteria. The bacteria were typed using RAPD-PCR method to identify organism to strain level, using 16sr RNA A1A13 specific primers. Results revealed bands of different sizes identical in both strains of Bacillus subtilis. The antimicrobial potential of the soil isolate was determined by disc diffusion assay. The production of antimicrobial compound was recorded maximum at the late exponential growth phase. The filtered concentrate of the crude extract was used to determine antimicrobial activity on some selected gram positive and gram – negative bacteria. Partial purification of the crude extract was carried out using High pressure Liquid chromatography (HPLC), Zymogram analysis and TLC were performed to determine the preliminary biochemical nature. The molecular weight of the antimicrobial peptide was determined to be less than 2.5k Da. The presence of antibiotic Bacilysocin was discovered from the extract. The minimum inhibitory concentration MIC of the purified fraction showed (MIC) ranging from 0.5 to 10µg/ml for Staphylococcus aureus and Streptococcus pyogenes. The MIC for the gram–negative was 0ug/ml. The crude extracts showed antimicrobial activity only on gram positive selected bacteria strains, while the purified extract showed antimicrobial activity on both the gram-positive and gram-negative with more activity on the gram-positive. The zones of inhibition for crude extract 1 on Staphylococcus auerus were 8.0mm, 5.0mm, 3.0mm, 1.0mm; extract 2: 15.0mm, 10.0mm, 9.0mm, 7.0mm, and 6.0mm, 4.0mm, 3.0mm, 1.0mm respectively for extract 3. for Streptococcus pyogenes the zones of inhibition range from 2.0mm to 9.0mm, for extracts 1 and 2:10.0mm to 3.0m and10.0mm to 1.0mm for extract 3.for the gram negative test organisms, the zones of inhibition were 0.0mm for all the extracts tested against it.

Do VAD Infections Predict Post-Heart Transplant Infections or Mortality?

<h3>Purpose</h3> Infections are common after ventricular assist device (VAD) implantation but how these infections impact post-heart transplant (HT) course in patients (pts) supported with short-term (ST) VADs is not fully defined. We investigated whether VAD infections had any impact on post-HT outcomes, such as development of post-HT infections or mortality. <h3>Methods</h3> We performed a retrospective cohort study of 185 HT recipients (HTRs) supported with ST-VADs from 4/2006-10/2020. VAD-specific and -related infections were characterized according to 2011 ISHLT definitions. Statistics were performed using IBM® SPSS Statistics version 25.0. <h3>Results</h3> Prior to HT, 41 (22.2%) pts had VAD infections involving the bloodstream (n=17), pump (n=8), pocket (n=2) and driveline (n=22); gram-positive and -negative organisms were responsible for 55.3% and 44.7% of infections, respectively. Pts with VAD infections were predominantly male (68.2%, p=0.19), Caucasian (60.9 %, p=0.59), had non-ischemic cardiomyopathy (61%, p=0.67), and a mean age of 52.6 (p=0.351) at VAD implantation. Those with VAD infections had no significant difference in underlying lung disease (26.8% vs 22.9%, p=0.60), hypertension (41.5% vs 33.3%, p=0.33), diabetes mellitus (29.3% vs 21.5%, p=0.30), or chronic kidney disease (53.7% vs 62.5%, p=0.76). Pts with VAD infections had longer duration of VAD support (513.3 d vs. 290.7 d, p=0.001), but were similar to those without VAD infection in terms of HT hospitalization length of stay (26 d vs 24 d, p=0.28), need for re-operation (19.4% vs 16.7%, p=0.67), thymoglobulin induction (19.5% v. 21.5%, =0.78), cellular-rejection (12.2% vs 19.4%, p=0.29), and antibody-mediated rejection (31.7% vs 27.8%, p=0.62). HTRs with prior VAD infections had more post-HT infections, but this did not reach statistical significance (53.6% vs 43.1%, p=0.23), with more bacterial (43.9% v. 30.6%, p=0.11), fungal (14.6% vs 8.3%, p=0.23), and <i>C. difficile</i> (9.8% vs 3.5%, p=0.11) infections. In those with and without pre-HT VAD infections, 1-year all-cause mortality was 14.6% vs 6.9% (p=0.12), and 1-year infection-related mortality was 4.8% vs 3.5% (p=0.65). <h3>Conclusion</h3> In this single center study, there were non-significant increases in post-HT infections and mortality in HTRs with prior VAD infections. Larger studies are needed to further investigate the impact of VAD infections on post-HT outcomes.

PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF BACTERIAL ISOLATES CAUSING EAR INFECTION AMONG THE PATIENTS ATTENDING TERTIARY CARE HOSPITAL, PUDUCHERRY.

Ear infection can cause pain, discharge, hearing impairement ,deafness and its related complications . Ear infection affects both children and adults particularly in developing countries. Since the emergence of antibiotic resistant organisms increasing the risk of treatment failure. The prevalence and susceptibility of isolates to antibiotics is important for patient treatment. The aim of the study to assess the prevalence of isolated bacterial pathogen and their antimicrobial susceptibility prole among patient with ear infection attended SLIMS , puducherry between Febuary 2021 – January 2022 . Materials And Methods: Retrospective data was collected for analysis from ear samples subjected for bacterial culture and antimicrobial susceptibility pattern . Specimens such as ear swabs and aspirated fuild was collected and processed for microbiological diagnosis as per standard operating procedure (SOP) .Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standard Institute (CLSI) guidelines. Statistical Package for the social sciences (SPSS) was used to analyzed the data . Results: Gram positive and gram negative organisms were isolated from 109 ear samples . Gram positive cocci accounted for 75 (68.8 %) and Gram negative bacilli for 34 (31.2 %) . Staphylococcus aureus (33%) and pseudomonas spp (21.1%) were the most commonly isolated organisms. In drug susceptibility testing, gentamicin had coverage against 68(90.7%) of 75 gram positive cocci and 30(88.2 %) of 34 gram negative bacilli which were tested. Antimicrobial resistance were observed for penicillin , Erythromycin ,clindamycin whereas ciprooxacin, gentamicin, chloramphenicol and cotrimoxazole were found to be susceptible against the isolated bacteria. Conclusion: The predominant isolate was Staphylococcus aureus and Pseudomonas spp. The antibiotic with the greatest bacterial coverage in drug susceptibility pattern was Gentamicin. Gentamicin showed good coverage against gram positive cocci and Gram negative bacilli isolated from ear infections. Ciprooxacin showed the lowest resistance rates to all bacterial isolates.

Causative Organisms in Neonatal Sepsis and Their Antibiotic Sensitivity and Resistance Pattern

Objective: To determine different causative organisms confirmed through blood culture in babies presenting with neonatal sepsis and their antibiotic sensitivity and resistance pattern. Methodology: This cross sectional observational study was conducted at The Department of Neonatology, Holy Family Hospital, Rawalpindi from Jan 2020 to Jan 2021. During the study period, a total of 241 neonates with positive blood culture were included. After following aseptic measures blood sample of 2.5ml was taken from neonate with features of sepsis. Samples were sent to microbiology sector while organism grown on culture media was noted and their sensitivity was checked for commonly used antibiotics. Results: There were 110(45.64%) female and 131(54.36%) male. Most common organism was staphylococcus aureus i.e. 29.88% (72/241) followed by klebsiella pneumonia and pseudomonas in 17.43% each, salmonella typhi 14.52% Acinetobacter 8.3%, E.coli 7.475 and enterococcus 4.98%. Drug sensitivity was assessed and found that drug Sulzone was 80% to 100% sensitive for pseudomonas, salmonella typhi and Acinetobacter organisms and 71.4% sensitive for klebsiella pneumonia negative organism while ciprofloxacin and Imipenem was sensitive for E.coli Conclusion: The most common causative organism of neonatal sepsis was staphylococcus aurues followed by klebsiella pneumonia and pseudomonas. Sulzone (cefoperazone/sulbactum) was found to be the most sensitive drug. Keywords: Blood culture and, klebsiella pneumonia, neonatal sepsis, staphylococcus aureus.

Metal–organic frameworks encapsulated with an anticancer compound as drug delivery system: Synthesis, characterization, antioxidant, anticancer, antibacterial, and molecular docking investigation

AbstractMetal organic framework (MOF) hybrid materials could be one of the answers in this investigation. We describe a simple and effective encapsulation of doxorubicin (DOX), an anticancer drug, inside Zr‐MOF, which have been little studied as drug delivery organizations. We investigated the measured release of the drug from Zr‐MOF in response to external incentives such as pH changes and interaction with biomimetic schemes. Zr‐MOF with encapsulated doxorubicin (DOX@Zr‐MOF) can be manufactured in one pot by addition the anticancer medication DOX to the reaction combination. They demonstrated pH‐responsive medication release and cancer cell killing capability. MOFs can be designed as multifunctional distribution vehicles for a diversity of loads, including medicinal and imaging agents, using our simple one‐pot approach. Fourier transform infrared (FTIR), X‐ray diffraction, scanning electron microscopy, and N2 sorption isotherm were used to analyze MOF and the developed drug delivery (DOX@Zr‐MOF) scheme. It investigated the effects of MOF and a bespoke drug delivery system on the feasibility of patient breast as well as liver tumor cell lines. At pH 5, the trapped drug can be released more quickly than at pH 7.4. Zr‐MOF nanoparticles had modest cytotoxicity; however, DOX@Zr‐MOF has higher cytotoxicity in MCF‐7 and HepG‐2 cells than DOX at concentrations greater than 31.25 μg ml−1. These results were discovered that DOX@Zr‐MOF could be a promising technique for delivering medicines to cancer cells. Furthermore, using the agar well dispersion technique, Zr‐MOF, DOX, and captured DOX@Zr‐MOF samples were assessed for their potential antibacterial activity against pathogenic bacteria in comparison to traditional antibiotics. In compared to the reference medication Gentamycin, the DOX@Zr‐MOF exhibits a large inhibitory zone against Gram negative organisms (Escherichia coli). The docking active place interactions were assessed to see if DOX might bind to the breast cancer 3hb5‐oxidoreductase receptor, prostate cancer protein 2q7k, and SARS‐CoV‐2 protease 6YB7 for anticancer and anticovid‐19 activities.

Evaluation of antioxidant, phytochemicals and antibacterial potential of Mormordica charantia (Linn) against pathogenic bacteria isolated from ready to eat food sold in Akure Metropolis, Nigeria

BackgroundFood hygiene and safety is of utmost importance for public health, as it helps to protect the health of consumers from foodborne illnesses. Although, hundreds of plant species have been screened and tested for antimicrobial properties, the vast majority of these plants have not been adequately screened and evaluated. Considering the vast potentiality of plants as sources for antimicrobial drugs, the present research aimed to evaluate antioxidant, phytochemicals and determine the antibacterial activity of M. charantia (Linn) on pathogenic organism from Ready-to-eat food sold in Akure metropolis.ResultsBacteria isolated from RTE food studied belong to the following genera; Staphylococcus, Streptococcus, Citrobacter, Pectobacterium, Klebsiella, Bacillus, Kocuria, Kluyveria, Serratia, Pantoea, Enterobacter and Salmonella. The antibiotic susceptibility pattern revealed that the Gram negative organisms were more susceptible to Gentamycin (30 µg) while Streptomycin (30 µg) was found to be more potent on Gram positive organisms. Water and ethanol extracts showed significant to moderate antibacterial activity toward all tested isolates except; Escherichia vulneris and Kluyveria intermedia which are both resistant to the aqueous extracts of M. charantia and the latter which was resistant to the ethanoic extract. The highest inhibitory activity was observed for Bacillus cereus with zone of inhibition of diameters 28 ± 0.29l (mm), followed by Escherichia vulneris 25 ± 0.29l (mm). DDPH% Inhibition has higher value in the water extract (69.21 ± 0.882a) while lower value was recorded in the ethanol extract (67.89 ± 0.155b). % Iron chelation has higher value in the ethanol extract (121.87 ± 0.882a) while lower value was recorded in the water extract (97.28 ± 0.155b). In all the concentration, vitamin C was higher in the ethanol extract than in the water extract.ConclusionsThe study revealed that all the Ready-to-eat food had a total bacterial count that are below potentially hazardous count although the presence of some microorganisms that are of health significance were observed. The study also confirmed that M. charantia (Linn) extracts had antibacterial effect against tested isolates from Ready-to-eat food sold in Akure metropolis. Based on the findings of this great research work, Mormordica charantia (Linn) possesses antioxidant activity that could prevent oxidative stress and degenerative diseases.

Prevalence of urinary tract infection and sensitivity pattern in febrile children less than 5 years of age

Background: Fever has long been considered as an important clinical finding in children with urinary tract infections (UTIs), it is often ignored in children in whom the symptoms are fuzzy. UTI in children is alarming because of the acute and chronic complications not seen routinely in adults. The study emphasizes that UTI should be strongly suspected in febrile children to prevent future complications. This study was undertaken to determine the prevalence of UTI and sensitivity pattern in febrile children and to assess the validity of microscopic urine analysis against urine culture in the diagnosis of UTI.Methods: A descriptive study was undertaken in the department of pediatrics, NMCTH, Birgunj. Data related to age, sex, nutritional status, socioeconomic status were noted. Physical examinations with relevant investigations were carried out in all those patients.Results: Out of 1074 children 147 showed significant pyuria (13.7%) and 44 showed significant bacterial growth making an overall prevalence of 4.1%. Urine cultures were done in all the cases and showed positive culture in 29.93%. Among culture positive cases gram negative organisms were commonly isolated. E. coli (70.45%) commonly isolated in the culture was found highly sensitive to cefotaxime and sulphamethoxazole /trimethoprim (32.14%) and was highly resistance to cefepime, cefuroxime, cefixime.Conclusions: Overall prevalence of UTI in our study was low (4.1%). The &gt;5 pus cells/hpf in centrifuged sample should be considered as significant pyuria and further evaluation should be done promptly to initiate treatment and to prevent long term sequalae.

Bacterial profile of diabetic foot infection in a tertiary care centre

Diabetes foot infections are one of the most dangerous and common drawbacks of diabetes. Amputations are resulting from other atherosclerosis of the arteries. Furthermore, intrinsic traumas are also understood without any complication as they result from foot deformities and also associated with modified foot biomachenisms. To study bacterial profile of diabetic foot infection. To find the possible aerobic bacterial pathogens in diabetic foot infection. To observe the antibiogram of isolated microorganisms. In our observational study the isolates were identified by standard biochemical tests and antibiotic performed by Kirby-Bauer disc diffusion method and interpreted as per the clinical and laboratory Standards Institutes (CLSI) guidelines. A total of 82 cases with 50 males and 32 females were included. 64 specimens yielded positive growth with total 87 isolates. 73.43% showed single isolate and rest 2 or 3 isolates. Gram negative organisms were more predominant than gram positive organisms. Proper use of drugs based on antibiotic pattern helps the medical practitioner to reduce the risk of diabetic foot and ulcer. It will ultimately decrease the rate of amputations. Vancomycin, Linezolid and colistin are more susceptible drugs.

Empyema Thoracis Caused by Klebsiella Spp and Escherichia coli Co-Infection - An Uncommon Isolation with Atypical Presentation

Empyema thoracis is the collection of pus in the pleural space. A 9-year-old boy presented with a 3-day history of high grade continuous fever, a day history of abdominal pain, distension and fast breathing. Examination findings: acutely ill child, febrile, in respiratory distress. Chest findings: tachypnea, dull percussion note and decreased air entry on the right hemithorax. Chest radiograph: massive fluid collection in the right hemithorax. A pleural tap yielded frank pus that was sent for microscopy, culture and sensitivity (MCS). Escherichia coli was cultured which was sensitive to fluoroquinolones. Klebsiella spp was also cultured from the blood sample taken for MCS and yielded the same sensitivity. Patient responded well to tube thoracostomy drainage and administration of antibiotics. Empyema thoracis with the isolation of two-gram negative organisms in a previously healthy child is rare.

Clinical and Current Microbiological Profile with Changing Antibiotic Sensitivity in Malignant Otitis Externa.

Malignant otitis externa (MOE) is a rare and fatal condition affecting temporal bone. It is also known as skull base osteomyelitis and is a rapidly progressive condition. This retrospective study evaluates the clinical, haematological, microbiological profile and management of malignant otitis externa in a tertiary care hospital and literature review. A retrospective review of 79 patients diagnosed with Malignant Otitis Externa from January 2015 to June 2021 was analyzed. History and Clinical findings, Imaging, Bacteriology, Random blood sugar on admission, Erythrocyte Sedimentation rate, HbA1C level, Biopsy of the granulation tissue from Externa auditory canal, cranial nerve involvement, duration of hospital stay, and treatment outcomes were analyzed. Out of 79 patients, otorrhea, otalgia, EAC oedema, and granulation were the most common findings. Facial nerve paralysis was found in 20 patients (25.3%) and multiple cranial nerve paralysis in 5 patients (6.3%). Uncontrolled diabetes mellitus and older age have increased duration of hospital stay, while cranial nerve paralysis did not affect this duration. Six different microorganisms were isolated. Pseudomonas aeruginosa was the most common organism cultured. Ciprofloxacin resistance was detected in 79% of cases. Amikacin, Cefaperazone-Sulbactam, and Piperacillin were the most sensitive antibiotics for gram negative organisms in our study. This study reviews the current microbiological profile and shows the need for higher-end antibiotics to treat MOE in present times. Early diagnosis, aggressive control of diabetes mellitus, and long duration culture-sensitive antibiotic therapy with regular monitoring are essential to reducing morbidity and mortality due to MOE.

Studies on Production and In Vitro Antibacterial Potentials of Violacein from Chromobacterium Violaceum Isolated from Otamiri River in Owerri, Imo State

Chromobacterium violaceum was isolated from Otammiri River in Owerri, Imo State. The organism was isolated using nutrient agar and identified based on cultural and biochemical characteristics. The isolate produced violacein pigment on nutrient broth and the violacein produced was quantified and extracted with ethanol. The effects of different temperatures (4°C, 25°C, 30°C, 37°C, 40°C, 52°C), pH (4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0), incubation period (12hr, 24hr, 36hr, 48hr, 60hr, 72hr, 84hr, 96hr), carbon sources (dextrose, fructose, glucose, maltose, lactose, sucrose, starch), nitrogen sources (ammonium nitrate, ammonium chloride, yeast extract, beef extract, peptone) on violacein production by C violaceum isolated were examined. Antibacterial activity of gram negative and gram positive organisms was done and the MIC of violacein was determined. The amount of violacein produced by C violaceum was 34.98mg/l. The production of violacein was increased with increase in temperature reaching its maximum value at 37°C. The optimum pH and incubation time for the production of violacein from the isolate were pH 6.5 and 72hr. Glucose and yeast extracts were most efficient carbon and nitrogen sources for the violacein production from C violaceum isolated. The violacein was highly sensitive to S aureus and Escherichia coli with inhibition zone of 15mm resistant to Klebsiella aerogenes and Pseudomonas aeruginosa with no inhibition zone. This study revealed that violacein has antibacterial activity against Gram positive and Gram negative organisms and provides knowledge of factors influencing the production of violacein. It also revealed the MIC of violacein and the MBC against different bacteria. The findings from this work could be of interest and suggest the need for further investigations in terms of toxicological studies and purification of active components with a view to using violacein in novel drug development.

Bacteriological Profile of Gram-Negative Organisms from Cases of Septicemia and Their Antibiotic Sensitivity Pattern with Special Reference to Beta-Lactamase and Carbapenemase Production

Background: Blood stream infections are amongst the most important causes of morbidity and mortality throughout the world. Septicemia is a serious bloodstream infection and a biggest challenge for the clinicians in selection of appropriate antimicrobial agents. Presence of intravascular catheters, immunosuppression and use of cytotoxic drugs are some precipitating factors for antibiotic resistance which is a global problem. Reports of multi-resistant bacteria causing septicemia in developing countries are increasing. Extended-spectrum beta-lactamases (ESBL) and Carbapenemase-producing Enterobacteriaceae (CRE) has caused a major public health concern. Aim and Objectives: To determine the bacteriological profile of septicemia and their antibiotic susceptibility profile with special references to β-lactamase and carbapemase productionin gram negative bacilli. Material and Method: During the 3 month period of study total 100 blood samples from suspected cases of septicaemia are collected. Isolates were processed and identified by standard protocols. Detection of extended spectrum β-lactamase (ESBL), inducible AmpC and MBL (Metallo β-lactamases) was done by using screening test and then confirmatory tests. Results: Out of 100 samples 68 gram negative organisms were isolated. Maximum growth was of Pseudomonas aeruginosa i.e. 34, followed by Klebsiella pnemoniae i.e. 19 and Acinetobacter sps and E.coli. From all isolates 4.4% were ESBL, Metallo –beta-lactamases (MBL) production were seen in 5.9 %. 40% and 10.5% were MBL-E.coli and MBL-Klebseilla pnuemoniae respectively. Conclusion: Many of the isolates from cases of septicaemia were resistant to most of the recently used antibiotics. So, Detection of the etiological agents and their antibiotic sensitivity will definitely help in effective prophylactic measures, prompt and accurate diagnosis of septicaemia. Simple methods like disc potentiation test for ESBL, disk antagonism test for inducible AmpC producers and Combined disk potentiation test for MBL production are relatively inexpensive and less cumbersome, so it can also be performed as a part of routine sensitivity testing. High degree of antibiotic resistance is an alarming sign for development of antibiotic policies and protocols for treatment of septicaemia.

In-vitro Activity of Tigecycline versus Daptomycin against Clinical Isolates of Enterococcus Species

Introduction: Tigecycline is a potential therapeutic agent for multidrug resistant gram positive and gram negative organisms. The clinical efficacy of synergic combination of daptomycin with betalactam antibiotics have been described against various species of Enterococcus isolates. Aim: To detect the in-vitro activity of tigecycline and daptomycin against Enterococcus species and their antimicrobial activity with Vitek 2 automated system. Materials and Methods: This was a cross-sectional study conducted at Department of Microbiology, Vinayaka Mission’s Kirupananda Variyar (VMKV) Medical College and Hospitals, Salem, Tamil Nadu, India. Isolates of Enterococcus obtained over a period of two years from March 2016 - March 2018 from various clinical samples were identified by standard biochemical method and their antimicrobial susceptibility pattern was determined. Minimum Inhibitory Concentration (MIC) of tigecycline and daptomycin was determined by Vitek 2 automated system. Analysis of data was done by using frequency distribution and percentage. Results: Out of 211 Enterococcus isolates studied, 23 (10.90%) isolates showed decreased susceptibility to daptomycin with MIC of ≥8 µg/mL. All isolates showed 100% susceptibility to tigecycline. Conclusion: The present study showed potent antimicrobial activity of tigecycline against various species of Enterococcus. Decreased susceptibility to daptomycin has been observed among the study isolates. Further clinical investigations are required to know the potential benefits of these agents in therapy.

Xanthomonadin mediated synthesis of biocidal and photo-protective silver nanoparticles (XP-AgNPs)

Nanoparticles have drawn significant attention in recent years, owing to their unique electrical, optical, biocidal, and catalytic properties. The present study reports an environment friendly, green approach for silver nanoparticles (AgNPs) synthesis using bacterial yellow color pigment, xanthomonadin (XP) derived from Xanthomonas sp. After exposing the reaction mixture to sunlight, a visible colour shift and spectrophotometric measurement proved that nanosized silver particles (XP-AgNPs) were being synthesized by xanthomonadin. The size of XP–AgNPs was in the range between 30 and 100 nm, with the spherical shaped particles. The XP–AgNPs showed excellent biocidal activity against representative Gram positive and Gram negative organisms i.e. Staphylococcus aureus, B. subtilis and Pseudomonas aeruginosa, Escherichia coli. In addition, using standard assays, the photo-protecting/SPF enhancement of commercial sunscreens and DPPH radical scavenging activity of XP, and XP-AgNPs were evaluated. As a result, adding 4 % w/w xanthomonadin in commercial sunscreens have original SPFs 4 and 10 increases by 271 % and 85.2 %, respectively. XP and XP-AgNPs showed significant antioxidant activities with the IC50 values of 46.21 µg/mL and 21.62 µg/mL, respectively. In conclusion, xanthomonadin mediated silver nanomaterial with photo protecting, antioxidant and biocidal potential has been reported.

Staged Hindfoot Fusion for Osteomyelitis of the Distal Tibia and Talus

Category:Ankle; Diabetes; Hindfoot; TraumaIntroduction/Purpose:Management of hindfoot osteomyelitis involves eradication of infection, deformity correction, and bony stabilization in the setting of bone loss and poor bone quality. In this case series of 12 patients, we present a two-stage technique; debridement, deformity correction, joint surface preparation, and intramedullary reaming with placement of antibiotic rod and ring external fixation followed by a second stage of external fixator removal and exchange of antibiotic rod for definitive hindfoot rod. The purpose of this poster is to highlight techniques that can improve the success of obtaining stable fixation, remission of infection, and ultimately fusion. Techniques highlighted are ring fixator placement, preparation of the antibiotic rod, intramedullary canal preparation, rod exchange, and use of blocking screws to enhance compression and axial loading of the fusion.Methods:Twelve patients were treated with this two-stage protocol. The most common indication was post-traumatic osteomyelitis followed by neuropathic (Charcot) joint. All were treated in a staged manner with an initial debridement of nonviable tissue including osteomyelitic bone. The tibiotalar and talocalcaneal joints were resected and prepared for fusion at the initial debridement. Provisional stabilization and compression were obtained through the use of a ring external fixator. An intramedullary antibiotic impregnated cement coated rod was introduced through the calcaneus, talus, and the intramedullary space of the tibia. The patients were kept in the fixator until the skin was healed and all incisions were dry. At this point, the fixator was removed, and the antibiotic rod was exchanged for the definitive hindfoot fusion rod.Results:Cultures were positive for Staphylococcal or Streptococcal species in 58% of cases, fungal in 8%, and Gram negative organisms in 33%. On average patients spent 93 days in the fixator while wounds were healing, and they were receiving systemic antibiotics. One patient died while in the frame. There have been no amputations in the series. Of the patients that have completed the protocol, all have gone on to either bony fusion or stable fibrous union. All are able to walk unaided. And thus far, all are free of active infection. Secondary procedures are described.Conclusion:This technique of staged fusion for hindfoot osteomyelitis offers the following advantages. the first stage involves thorough debridement and deformity correction. Oftentimes there is extensive scarring and the soft tissue envelope is not conducive to internal fixation. This technique allows the soft tissues to heal before placing the definitive internal fixation. It also allows for graduated compression at the fusion site with the ring fixator. The antibiotic rod not only delivers high concentration of local antibiotics, but it prevents deformity recurrence during the compression phase. The definitive rod provides support of pathologic bone and maintains deformity correction.

Assessment of Drug Sensitivity of Different Urinary Isolates to Nitrofurantoin and its Comparison with Other DrugsA Retrospective Study

Introduction: Uncomplicated Urinary Tract Infection (UTI) is one of the most common indications for antibiotic use in the community. However, gram negative organisms that are predominant cause of UTI are becoming increasingly resistant to commonly used antibiotics. Consequently, empiric therapy is likely to fail resulting in increasing number of patients with uncomplicated UTI requiring hospitalisation for intravenous antibiotics as there are no oral treatment options left. Aim: To assess the susceptibility trends of urinary isolates to panel of antibiotics with particular reference to nitrofurantoin. Materials and Methods: The present study was a retrospective study conducted at Adesh Hospital Bathinda, Punjab, India for a period of one year from April 2020-April 2021. Kass criteria was followed for interpretation of significant bacteriuria according to which significant growth is considered if number of colony is more than 105 Colony Forming Unit (CFU)/mL. Culture positive were analysed by Gram staining and on the basis of colony characteristics, gram staining, final identification was done using Vitek 2 compact system. Statistical analysis was done using Chi-square test. Results: A total of 392 urinary isolates were identified during the study period. Out of the 392 isolates 316 (80.6%) were gram negative isolates and 76 (19.4%) were gram positive isolates. Maximum sensitivity was shown to nitrofurantoin, 88% in case of gram negative isolates and 76% in case of gram positive isolates. Conclusion: Nitrofurantoin is an effective therapeutic agent in the treatment of UTI. It has been used for a long time, but the emergence of antibiotic resistance and the decline in newly developed antibiotics has increased interest in the treatment of bacterial UTI with this antibiotic

Audit to optimize antibiotics use in neonatal septicemia.

Objectives:To assess appropriate antibiotics use in neonatal sepsis and to highlight the need for developing an Antibiotic stewardship program at local levels.Methods:A clinical audit was conducted in the neonatal ward of the tertiary care hospital of Lahore for one year from May 2019 to May 2020. Reports of blood culture and drugs susceptibility were gathered from the microbiology department, and clinical records were evaluated about the choice of the antimicrobials, dosage, frequency, and clinical prognosis. The statistics were applied using SPSS software.Results:Eighty five neonates with the mean age of five days were treated in tertiary care hospital for septicemia. Every patient received more than one antibiotic empirically. The most prescribed drug combination (90.6%) was Cefotaxime and Amikacin. Optimum antibiotics dose was prescribed in only 70.2% of cases. Blood isolates showed gram-negative bacilli in 69 (81.2%) cases, gram positive cocci in 14 (16.5%) cases, two (2.3%) culture susceptibility reports showed growth of candida. Gram negative organisms were most susceptible to Imipenem (54%), Piperacillin-Tazobactam (48%) and Gentamicin (48%). Gram-positive organisms showed the most susceptibility to Vancomycin (100%), Amikacin (92%), and Co-amoxiclav (85%). Meropenem (39%), Linezolid (28%), and Vancomycin (27%) were the most commonly given alternate antibiotics. All the patients (n=10, 11.8%) whose culture sensitivity reporting showed susceptibility to empirical therapy survived.Conclusion:Due to poor availability of latest data about local antibacterial resistance pattern and lack of knowledge among pediatricians about latest antibiotic prescribing protocols, many inconsistencies were noted in the use of antibiotics in neonatal sepsis which resulted in a poor outcome hence, reflecting in international key health indicators (neonatal mortality rate) of country. Concerning the change in the resistance pattern of microorganisms to antimicrobials, it is high time to collect local data about antibacterial susceptibility and develop an antibiotic stewardship program to stop inappropriate use of antibiotics.