Positive Bacterial Infections Research Articles

Rapid Determination of Positive-Negative Bacterial Infection Based on Micro-Hyperspectral Technology.

To meet the demand for rapid bacterial detection in clinical practice, this study proposed a joint determination model based on spectral database matching combined with a deep learning model for the determination of positive-negative bacterial infection in directly smeared urine samples. Based on a dataset of 8124 urine samples, a standard hyperspectral database of common bacteria and impurities was established. This database, combined with an automated single-target extraction, was used to perform spectral matching for single bacterial targets in directly smeared data. To address the multi-scale features and the need for the rapid analysis of directly smeared data, a multi-scale buffered convolutional neural network, MBNet, was introduced, which included three convolutional combination units and four buffer units to extract the spectral features of directly smeared data from different dimensions. The focus was on studying the differences in spectral features between positive and negative bacterial infection, as well as the temporal correlation between positive-negative determination and short-term cultivation. The experimental results demonstrate that the joint determination model achieved an accuracy of 97.29%, a Positive Predictive Value (PPV) of 97.17%, and a Negative Predictive Value (NPV) of 97.60% in the directly smeared urine dataset. This result outperformed the single MBNet model, indicating the effectiveness of the multi-scale buffered architecture for global and large-scale features of directly smeared data, as well as the high sensitivity of spectral database matching for single bacterial targets. The rapid determination solution of the whole process, which combines directly smeared sample preparation, joint determination model, and software analysis integration, can provide a preliminary report of bacterial infection within 10 min, and it is expected to become a powerful supplement to the existing technologies of rapid bacterial detection.

Evaluation of Antimicrobial Potential of a Gel loaded with Silver Nanoparticles of Argemone mexicana for Topical Application

Argemone mexicana is widely known for its antibacterial potential in the traditional system of medicine. With this background, the present study was designed to formulate a gel incorporated with nanoparticles synthesized from Argemon mexixana for topical application. Green synthesis of nanoparticles was carried out from the whole plant extract and latex of A. mexicana. The biosynthesized nanoparticles were characterized by SEM-EDAX, HR-TEM, SAED, XRD before it was incorporated into the gel. The biosynthesized nanoparticles were found to be stable, uniform, spherical, and ranged from 9.21nm to 14.03nm in size. The SAED pattern reveals the presence of a varying degree of crystallinity of nanoparticles. The physicochemical parameters of the gel such as pH, homogeneity, grittiness, viscosity, spreadability, and extrudability were characterized. Both the formulation showed the nanoparticles are well dispersed in the gel with pH (6.90, 6.92), viscosity (1542 scps, 1583 scps), spreadability (5.7 cm/sec, 5.90.1 cm/sec), and extrudability of 86% and 89% respectively. The gel loaded with nanoparticles exhibited strong antimicrobial potential against Escherichia coli, Bacillus subtilis, Staphylococcus aureus as compared to the crude form of the plant extract and latex. Among the two formulations, the highest zone of inhibition (22mm, 16mm, 13mm) was observed by the gel incorporated with methanol extract nanoparticles. Our result demonstrates the nanoparticulate gel of A. mexicana can be effectively used as topical gel for gram positive and negative bacterial infection.

Analysis of distribution and antibiotic resistance of Gram-positive bacteria isolated from a tertiary-care hospital in southern China: an 8-year retrospective study.

Due to the severe drug resistance situation of Gram-negative bacteria, especially Gram-negative enterobacter, relatively little attention has been paid to the changes in Gram-positive bacteria species and drug resistance. Therefore, this study analyzed the prevalence and drug resistance of Gram-positive bacteria in a general tertiary-care hospital from 2014 to 2021, in order to discover the changes in Gram-positive bacteria distribution and drug resistance that cannot be easily identified, inform clinicians in their respective regions when selecting antimicrobial agents, and to provide the basis for the diagnosis of Gram-positive bacterial infection, and for the comprehensive and multi-pronged prevention and control of drug-resistant bacteria. A retrospective study was conducted on Gram-positive bacteria isolated from patients presented to a general tertiary-care hospital from January 2014 to December 2021. A total of 15,217 Gram-positive strains were analyzed. During the 8-year period, the total number and the species of Gram-positive bacteria isolated from clinic increased continuously. The seven most common species were Streptococcus pneumoniae (21.2%), Staphylococcus aureus (15.9%), Enterococcus faecium (20.6%), Enterococcus faecalis (14.0%), and Staphylococcus epidermidis (7.8%), Staphylococcus haemolyticus (4.8%), Streptococcus agalactiae (3.6%). The isolation rates of Staphylococcus aureus and Streptococcus agalactiae increased, and the isolation rate of Enterococcus faecium decreased. The resistance rates of Staphylococcus aureus to erythromycin, clindamycin, tetracycline, rifampicin and furantoin decreased obviously. The resistance rates of Streptococcus pneumoniae to cefepime (non-meningitis) and ceftriaxone (meningitis) decreased significantly. The resistance rates of Enterococcus faecium to penicillin, ampicillin, erythromycin, levofloxacin, ciprofloxacin and furantoin rose rapidly from 50.3, 47.6, 71.5, 44.9, 52.3, and 37.5% in 2014 to 93.1, 91.6, 84.9, 86.8, 86.8, and 60.0% in 2021, respectively. The total number and the species of Gram-positive bacteria isolated during the 8-year period increased continuously. Streptococcus pneumoniae and Staphylococcus aureus are the main causes of positive bacterial infections in this hospital. The resistance rates of Enterococcus faecium to a variety of commonly used antibiotics increased significantly. Therefore, it is very important to monitor the distribution of bacteria and their resistance to antibiotics to timely evaluate and identify changes in drug resistance that are not easily detected.

A retrospective observational study on incidence and clinico-epidemiological features of COVID-19 associated pulmonary aspergillosis among cancer patients hospitalized with COVID-19 in a tertiary care cancer centre of India

Background: COVID-19 associated pulmonary aspergillosis (CAPA) is an emerging complication among patients with COVID-19 but hasn’t been well studied in cancer patients. This study, we try to find out important aspects associated with CAPA among cancer patients with regards to clinico-epidemiological factors. Methods: In this retrospective observational study, we included 198 consecutive patients COVID-19 between April 2020 and February 2021. CAPA cases were classified according to CAPA-European Confederation of Medical Mycology criteria (2020 ECMM/ISHAM consensus criteria). Results: The overall incidence of CAPA was found to be 10.1% in our study population. The incidence among hematological malignancies was 11.25% and solid tumors was 10%. In-hospital mortality was significantly high among patients with CAPA as compared to that among without CAPA (40% versus 16.85%; p<0.012695). Significant number of patients with CAPA had received chemotherapy in last 3 months before diagnosis of COVID-19 (50% versus 28.09%, p=0.043222) and had evidence of culture positive bacterial infection (30% versus 5.62; p=0.000888). Significantly more patients having CAPA were on steroids, required oxygen and/or ventilator support as compared to those without CAPA. Conclusions: CAPA is a significant cause of mortality and length of hospital stay (16 versus 7 days; p=0.00001) among cancer patients with COVID-19. Cancer patients with COVID-19 were at increased risk of CAPA as compared to non-cancer patients.

Linezolid Resistance against Gram Positive Bacteria Isolated from Blood Stream Infections: A Challenging Threat

The gradual rise of multidrug resistant micro-organisms is a national concern for all health care providers. Linezolid belongs to the oxazolidinone class of antimicrobials. it is a “last resort” used for the management of gram positive bacterial infections. Developing linezolid resistance creates a great challenge for treating bacterial infections. The objective of the current study is to determine the microbial profile and linezolid resistance in gram positive cocci isolated from blood stream infections. 1855 blood samples were analysed for microbial profile and antimicrobial sensitivity testing in our tertiary care centre over a 6 month period. In using Kirby-Bauer’s disk diffusion method for antimicrobial susceptibility testing, linezolid resistance was detected according to CLSI guidelines. Out of 1855 blood culture samples, 732 (39.4%) were identified to be culture positive. Amongst culture positive isolates mostly (83.3%) gram negative bacteria were isolated, and 16.7% were Gram positive bacterial isolates. Klebsiella species were the most prevalent among gram negative isolates. The linezolid resistance pattern was coagulase negative staph (CONS) was 25%, staphylococcus was 24% and streptococcus was 20%. This study reveals significant linezolid resistance in gram positive bacteria isolated from blood culture. The emergence of linezolid resistance is a major issue for clinicians treating the infection and it will require prompt monitoring of antibiotic policy and antimicrobial stewardship programs.

Prevalence incidence and clinical outcome of Klebsiella and Acinetobacter ventilator-associated pneumonia

Introduction: Antimicrobial resistance identification for each hospital has benefits in management of nosocomial infections. Objectives: The aim of this study was to determine antimicrobial susceptibility of meropenem against Acinetobacter and Klebsiella strains in samples obtained from hospitalized patients with ventilator-associated pneumonia (VAP). Patients and Methods: In this cross-sectional study, 100 patients with VAP were selected from the intensive care unit (ICU) of Amin hospital in Isfahan. Lung secretions were collected and tested for bacterial infections. In samples with the positive bacterial infection, E-test and agar diffusion test were used to determine and compare the susceptibility of Acinetobacter and Klebsiella strains to meropenem. Results: The two susceptibility testing methods – E-test and agar diffusion test – showed similar results in 87 cases (87%) therefore, 84 cases were resistant and three cases were susceptible to meropenem. However, in 13 cases, the result of the agar diffusion test was resistant and the result of E-test was sensitive. According to the Kappa test, the agreement between the two tests was 0.87 and statistically significant (P <0.001). Conclusion: Due to the high resistance of Klebsiella and Acinetobacter strains to meropenem, it should not be used as an experimental treatment in patients diagnosed with VAP caused by these strains. We recommend using meropenem for Acinetobacter and Klebsiella after susceptibility testing by E-test confirmed its efficacy.

Anti-Quorum Sensing Activities of Gliptins against Pseudomonas aeruginosa and Staphylococcus aureus.

The development of bacterial resistance to traditional antibiotics constitutes an emerging public health issue. Promising approaches have been innovated to conquer bacterial resistance, and targeting bacterial virulence is one of these approaches. Bacterial virulence mitigation offers several merits, as antivirulence agents do not affect the growth of bacteria and hence do not induce bacteria to develop resistance. In this direction, numerous drugs have been repurposed as antivirulence agents prior to their clinical use alone or in combination with traditional antibiotics. Quorum sensing (QS) plays a key role in controlling bacterial virulence. In the current study, dipeptidase inhibitor-4 (DPI-4) antidiabetic gliptins were screened for their antivirulence and anti-quorum sensing (anti-QS) activities against Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus. Upon assessing their antibiofilm activities, the ten tested gliptins significantly diminished biofilm formation. In particular, sitagliptin exhibited the most efficient antibiofilm activity, so it was chosen as a representative of all gliptins to further investigate its antivirulence activity. Sitagliptin significantly protected mice from P. aeruginosa and S. aureus pathogenesis. Furthermore, sitagliptin downregulated QS-encoding genes in P. aeruginosa and S. aureus. To test the anti-QS activities of gliptins, a detailed molecular docking study was conducted to evaluate the gliptins’ binding affinities to P. aeruginosa and S. aureus QS receptors, which helped explain the anti-QS activities of gliptins, particularly sitagliptin and omarigliptin. In conclusion, this study evaluates the possible antivirulence and anti-QS activities of gliptins that could be promising novel candidates for the treatment of aggressive Gram-negative or -positive bacterial infections either alone or as adjuvants to other antibiotics.

Medical Investigation and Clinical Changes in the Early Phases of Post Burn Adult Inpatients as Indicators for Prompt Infection Diagnosis, in the Hospital for Burn and Plastic Surgery, Sulaimanyah, Iraq

Background: Burn injury is one of the leading causes of morbidity and mortality worldwide. Burn related hospital acquired infections is one of the major problems in the management of these injuries. Aim of the study: To elaborate on the early laboratory and microbial culture changes in adult burn inpatients, and to make use of subtle changes in the laboratory investigations, to predict and detect infections in burn victims, in its early phases. Patients and Methods: A Clinical observational study included a random sample of one hundred adult burn inpatients from Sulaymaniyah Burn Hospital, admitted from April 2019 to January 2021, retrospectively and prospectively followed up during the course of the study. Results: thirty one (31%) patients were male and 69% were female, all patients were adults and aged ≥18 years. 51 % of them had mix II-III degree burns, while 38% second and 11% third degree burns. Hematocrit decreased, total WBC count increased while platelet in most of the patients was normal. Blood urea was increased, Serum creatinine levels were normal in most of the patient in first three weeks of their admission. Eleven patients (11%) died. Whereas 36% of the patients who died had Total Body Surface Area burn of more than 60%, while 72% of them had II and III degree burns. Also 90% of the patients had infections, majority of the isolate results were Gram-negative bacteria (66.8%), and (33.2%) were Gram-positive. Pseudomonas aeruginosa (32.5%) was the most common gram negative. The Staphylococcus aureus (33.2%) was the gram positive organism recovered. While 66.6% of patients had fever during the first week, 55.5% of patients had fever in second week. Most of the patients, who had fever, were infected with S.aureus and Pseudomonas aeruginosa throughout the second week post burn. Conclusion and recommendations; Many laboratories and microbial parameter changes occur in the early phases of post burning, of which Leukocytosis can be a good predictor for infection in burns, especially when it happens in the second week and beyond. Yet it cannot distinguish gram negative from gram positive bacterial infections. To detect any change in the back ground laboratory parameters, as soon as they happen, infections in burns can be detected or suspected

Molecular mechanisms of hepatotoxic cholestasis by clavulanic acid: Role of NRF2 and FXR pathways

Treatment of β-lactamase positive bacterial infections with a combination of amoxicillin (AMOX) and clavulanic acid (CLAV) causes idiosyncratic drug-induced liver injury (iDILI) in a relevant number of patients, often with features of intrahepatic cholestasis. This study aims to determine serum bile acid (BA) levels in amoxicillin/clavulanate (A+C)-iDILI patients and to investigate the mechanism of cholestasis by A+C in human in vitro hepatic models. In six A+C-iDILI patients, significant elevations of serum primary conjugated BA definitely demonstrated A+C-induced cholestasis. In cultured human Upcyte hepatocytes and HepG2 cells, CLAV was more cytotoxic than AMOX, and, at subcytotoxic concentrations, it altered the expression of more than 1,300 genes. CLAV, but not AMOX, downregulated the expression of key genes for BA transport (BSEP, NTCP, OSTα and MDR2) and synthesis (CYP7A1 and CYP8B1). CLAV also caused early oxidative stress, with reduced GSH/GSSG ratio, along with induction of antioxidant nuclear factor erythroid 2-related factor 2 (NRF2) target genes. Activation of NRF2 by sulforaphane also resulted in downregulation of NTCP, OSTα, ABCG5, CYP7A1 and CYP8B1. CLAV also inhibited the BA-sensor farnesoid X receptor (FXR), in agreement with the downregulation of FXR targets BSEP, OSTα and ABCG5. We conclude that CLAV, the culprit molecule in A+C, downregulates several key biliary transporters by modulating NRF2 and FXR signaling, thus likely promoting intrahepatic cholestasis. On top of that, increased ROS production and GSH depletion may aggravate the cholestatic injury by A+C.

CT-255: Progressive Substitution of Post-Transplant Cyclophosphamide with Bendamustine as GVHD Prophylaxis Reduces GVHD while Preserving GVL

Context Post-transplant cyclophosphamide (PTCy) is approved in haploidentical stem cell transplant setting. However, disease relapse and CMV or BK/JC viral reactivation veno-occlusive disease of the liver (VOD) remains a major challenge with the use of PTCy. Progressive substitution of PTCy with bendamustine (PT-BEN) may be a suitable option as evidenced by murine models. Objective To compare the outcomes for patients receiving PTCy with PT-BEN compared to historical cohorts receiving PTCy alone. Design This is a single arm, retrospective and prospective, single centre study in which all the patients undergoing allogeneic stem cell transplantation with a T-cell replete graft were recruited. Patients or Other Participants All patients received T-cell replete stem cells followed by PTCy 50mg/kg on day +3 and bendamustine 90mg/m2 on day +4. Calcineurin inhibitors with mycophenolate mofetil was given. Main Outcomes Measures The main outcome measures included myeloid and platelet engraftment, viral reactivations, disease status, incidence and severity of acute GVHD, incidence of veno-occlusive disease until D+28 post-transplant. Results Five patients have been recruited, all males, median age being 17 years. Two patients had relapsed/refractory (R/R) ALL after 2 lines of therapy, 1 had R/R AML, 1 had very severe aplastic anemia, 1 was high risk ALL in CR1. 3 fully matched a sibling, whereas 2 had haplomatched donors from mother. All the donors and recipients had seropositivity for CMV. Two patients received FluCyTBI, 2 received FluCyATG, and 1 received FluTreoTBI as conditioning. One patient expired due to neutropenic septic shock on D+8 and has been excluded from analysis. The median day for myeloid engraftment was 12 and platelet engraftment was 14. No patient had VOD, thrombotic microangiopathy, or culture positive bacterial infections. All the patients were in CR, 100% donor chimerism at D+28. Three patients had CMV reactivation, controlled with antivirals. One patient had Gr1 skin GVH and 1 patient had Gr1 gut GVH managed with topical and oral steroids respectively. Conclusions Progressive substitution of PT-BEN may ameliorate the toxicities associated with PT-Cy in post-transplant setting.

Seasonality in testing and positive respiratory bacterial infections in the Australian Capital Territory, 1997-2007.

Chlamydia pneumoniae (Cp) and Mycoplasma pneumoniae (Myco) bacteria are atypical pathogens that can cause pneumonia and exacerbate underlying conditions such as asthma and chronic obstructive pulmonary disease. In the Australian Capital Territory, there is limited information on how seasonal patterns for positive infections and testing may vary, a gap that has implications for control strategies. We examined seasonal patterns of immunoassay results of patients from Canberra Hospital, Australia, who were tested for Cp and/or Myco. Pathology data, collected from August 1997 to March 2007 from 7,275 patients, were analysed with time series additive decomposition and time series regression. The proportion of positive Cp infections was highest in March and April (autumn) and lowest in June and August (winter). The proportion of positive Myco infections was highest in December and January (summer) and lowest in August (winter), even though testing for the pathogen peaked in winter with a low in summer. Models with a long-term trend and a variable for month were a better fit for the data than the null models for both infections. We found differences in seasonal patterns of testing and in the proportion of positive infections. These findings suggest that preventative measures for common infections need to account for seasonal testing practices so as to build an accurate picture of temporal changes in these infections.

A Review on Existing Tetracyclines Analogues and Their Pharmacologically Targeted SAR

Background: Tetracyclines belong to a class of broad spectrum antibiotics. Around the globe, they are prescribed to treat various gram negative and gram positive bacterial infections. Once in the cell, they reversibly bind to the receptors which are located on 30S subunit of bacterial ribosome. They act by averting the protein synthesis, in turn, halting the bacterial growth.
 Aim and Objectives: The aim of current review is to study tetracyclines, identifying potential activity against infections and highlighting the microbial resistance associated with various analogues.
 Material and Method: The data for this review is collected from various databases including Scopus, PubMed, Springer Link and Google Scholar. To ensure the credibility only indexed articles were used in current study.
 Result: The outcome of the study has suggested that tetracyclines and number of its analogues show selective bioactivity and strength to the biological targets. Through modification at certain positions, activity of drug is changed substantially. This not only affects therapeutic activity and safety profile but also has influence the bacterial resistance.
 Conclusion: As antibiotic resistance amongst bacteria is emerging tremendously, demanding more research. It is still needed to synthesize the novel analogues that would be helpful to cure infections caused by the resistant bacteria. Further these analogues can be tagged with radioisotopes that would be helpful for diagnosis and treatment of infectious diseases.

Procalcitonin as a biomarker of bacterial infection in critically ill patients admitted with suspected Sepsis in Intensive Care Unit of a tertiary care hospital.

Objective:To compare the diagnostic accuracy of procalcitonin (PCT), C- reactive protein (CRP), total leukocyte count (TLC) and lactate in critically ill patients admitted with suspicion of sepsis.Methods:It was a cross sectional study conducted at the department of Chemical Pathology and Endocrinology AFIP, Rawalpindi, in collaboration with Medical and surgical intensive care units (ICU) of CMH Rawalpindi from January 2019 to December 2019. A total of 126 patients of both genders with age above 18 years and fulfilling the inclusion criteria of systemic inflammatory response syndrome (SIRS) were inducted in the study.Results:Out of 126 patients 82 (65%) patients have positive blood culture results. Male predominance was noted in patients with positive blood culture. Out of 82 patients with positive blood culture results 69(84%) patients have positive PCT results as well whereas 13(15%) patients with positive blood culture results have negative PCT values. 57(69%) patients had Gram negative bacterial infection and 25(30%) patients had Gram positive bacterial infection. Significant difference was noted between the medians of PCT in blood culture positive and blood culture negative group (p value< 0.05) whereas no significant difference was found between medians of CRP, TLC and lactate between blood culture positive and blood culture negative patients (p value > 0.05). ROC curve analysis of PCT, CRP and TLC were done, keeping blood culture as reference standard, PCT showed largest area under the curve (AUC) and clearly outperformed TLC and CRP. PCT showed AUC of 0.781 as compared to CRP and TLC, which was 0.568 and 0.617 respectively. PCT showed sensitivity of 93.9%, specificity of 47.7%, positive predictive value (PPV) of 77% and negative predictive value (NPV) of 80.8%.Conclusion:Higher NPV makes it a reliable marker for screening out sepsis in suspected cases.

The bidirectional link between HDL and COVID-19 infections

It is well recognized that gram positive and negative bacterial infections, tuberculosis, fungal infections, and parasitic infections result in changes in plasma lipid levels (1–12). Of note, viral infections, such as HIV, Epstein-Barr virus, and Dengue fever, also similarly alter plasma lipid levels (13–15). Typically, infections decrease total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels with either elevated triglyceride or inappropriately normal triglyceride levels for the decreased nutritional status that characteristically occurs with infections.

Nosocomial infections in in-hospital cardiac arrest patients who undergo extracorporeal cardiopulmonary resuscitation.

BackgroundLittle is known of nosocomial infections (NI) in patients who suffer from in-hospital cardiac arrest who undergoing extracorporeal cardiopulmonary resuscitation. This study aimed to investigate clinical pictures of NI, and the association of NIs with clinical outcomes in in-hospital cardiac arrest patients who undergoing extracorporeal cardiopulmonary resuscitation.MethodsTo evaluate the incidence and clinical characteristics of NI in patients who undergoing extracorporeal cardiopulmonary resuscitation, a retrospective cohort study was conducted in a single tertiary referral center between January 2010 and December 2018. We included adult patients who undergoing extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest and excluded patients who were out-of-hospital cardiac arrest or failed ECMO implantation. Clinical characteristics and outcomes were compared between NI and Non-NI patients, or multidrug-resistant (MDR) and non-MDR. The independent risk factors associated with NIs were also analyzed using multivariable logistic regression model.ResultsThirty-five (23.3%) patients developed a NI. These cases included 21 patients with a gram negative (G-) infection, 12 patients with a gram positive (G+) bacterial infection, and two patients with fungal infection. Pneumonia was the most common type of NIs, followed by catheter-related infection. The in-hospital mortality and neurologic outcomes at discharge were not different between the NI and non-NI groups. Multidrug-resistant (MDR) pathogens were detected in 10 cases (28.6%). The MDR NI patients had a higher ICU mortality than did those with non-MDR NI (80% vs. 32%, p = 0.028). Following multivariable adjustment, body mass index (adjusted OR 0.87, 95% CI, 0.77–0.97, p = 0.016) and cardiopulmonary resuscitation to pump on time (adjusted OR 1.04, 95% CI, 1.01–1.06, p = 0.001) were independent predictors of NI development.ConclusionsIn patients who received extracorporeal cardiopulmonary resuscitation, NIs were not associated with an increase in in-hospital mortality. However, NIs with MDR organisms do increase the risk of in-hospital mortality. Lower body mass index and longer low flow time were significant predictors of NI development.

Fatty acids as novel treatment options for Pseudomonad and Staphylococcal infection

Pseudomonas aeruginosa and Staphylococcus aureus are bacteria pathogens that cause a myriad of infections affecting various sites in the body including the eyes, ears, lungs, skin, heart, bones, and blood amongst others. These bacteria can be disseminated via the blood to other parts of the body away from the primary site of infection and consequences vary from mild to severe with death occurring in certain instances. Both bacterial infections can occur individually, as well as in co-infection resulting in even worse outcomes. P. aeruginosa and S. aureus exhibit multidrug resistance against current antibiotic treatment regimens, which accentuates the challenge in managing the infections caused by these bacteria. To prevent the looming era of untreatable bacterial infections, alternative treatment regimens that are cost effective and accessible are needed. To explore novel treatment options, twenty-five organic compounds comprising fatty acids and their derivatives were screened for antibacterial activity in broth microdilution assay to determine the minimum inhibitory concentration and minimum bactericidal concentration against both P. aeruginosa and S. aureus. Five candidates (N–nonanoic acid, butyric acid, heptanoic acid, palmitoleic acid, and isopropyl myristate) were effective against P. aeruginosa. Seven candidates (N–nonanoic acid, palmitoleic acid, tridecanoic acid, sebaic acid, undecanoic acid, monolaurin, and monocaprin) were effective against S. aureus. Candidates such as N–nonanoic acid and palmitoleic acid were effective against both P. aeruginosa and S. aureus, demonstrating that the same fatty acids show potential to be used against both Gram negative and Gram positive bacterial infections.

Diagnostic value of serum procalcitonin for diagnosis of bacterial infection in patients with chronic kidney disease under hemodialysis

Introduction: Bacterial infections are common causes of mortality and morbidity among chronic kidney disease (CKD) patients under hemodialysis. Objectives: In this study the diagnostic value of serum procalcitonin for diagnosis of bacterial infections in patients with CKD under hemodialysis was assessed. Patients and Methods: In this cross-sectional comparative investigation, 47 patients with CKD under hemodialysis were enrolled to the study. We studied the relationship of serum procalcitonin (PTC) and C-reactive protein (CRP) levels (before and after dialysis) with "positive bacterial culture" and "systemic inflammatory response syndrome (SIRS)" results. Sensitivity and specificity were determined by ROC test. Results: Serum PTC before and after dialysis as well as the CRP before dialysis had no significant association with positive bacterial culture (P=0.492, P=0.1 and P=0.268 respectively), however after-dialysis CRP had a significant association with positive bacterial culture (P=0.032). Conclusion: According to the obtained results, it may be concluded that the diagnostic value of serum PTC for diagnosis of positive culture bacterial infections in hemodialysis patients is not satisfactory since the serum CRP level especially after dialysis is more useful.

Acute Respiratory Infections Epidemiology and Etiology in Hospitalized Moroccan Children under 15 Years

Introduction: Acute respiratory infections (ARIs) are serious infections with multiple etiologies. Viral etiology is most common worldwide, especially in pediatric patients.Materials and methods: This study aims to describe the epidemiology and etiology of ARIs in Moroccan children under 15 years old, through patients’ clinical features analysis and genetic detection of pathogens within 84 patients admitted to Hassan II regional hospital of Agadir, Morocco, from September 2015 to September 2016. Detection of pathogens was carried out using Multiplex real-time reverse transcription-polymerase chain reaction (RRT-PCR) with Fast Track Diagnostic kit respiratory pathogens 21 plus.Results: Results gave 61.9% of positive viral and bacterial infections and 19.23% of co-infections by at least two pathogens. Males were mainly infected and the respiratory syncytial virus (RSV) was the most common in 53.8% of patients. Children aged less than 2 years were the most infected by ARIs pathogens, and especially by the RSV virus. Concerning seasonality pattern, all ARIs pathogens showed a seasonal spreading mainly in winter.Conclusion: This study summarizes a great insight into the epidemiology and etiology of ARIs among children under 15 years in Morocco. We observed that ARIs constituted a real health problem in infancy and viruses are the commonest cause.

Pulmonary actinomycosis presenting as a pleural tumour

Pulmonary actinomycosis is a rare gram positive higher prokaryotic bacterial infection. We hereby present a case of 78-year old male presented with non-specific symptoms like cough, shortness of breath (SOB) and chest pain mimicking as pulmonary tuberculosis, fungal infection and lung cancer but was diagnosed to have pulmonary actinomycosis. From this, we want to emphasize that pulmonary actinomycosis should be evaluated in all patients that are not responding to anti-tubercular and lung cancer treatment.

Nocardiosis Associated with Novel Agents at Relapsed Multiple Myeloma: Case Series

Nocardiosis is a gram positive bacterial infection caused by aerobicactinomycetes. It’s nonspesific presentation and radiographic findings usually make it undiagnosed with highly fatal outcomes. The patients with intracelluler defects are prone to nocardiosis. Multiplemyelom(MM) itself is a mainly humoral deficiency disorder because of defective antibodies but recent drugs such as proteasome inhibitors and immuno modulatory drugs also cause cellular deficiency. Here we presented two definite and oneprobable pulmonary nocardiosis patients who have a diagnosis of MM, autologou shematopoetic stem cell transplant history in their past and anti myeloma therapy presently.