International Medical Publisher Journals (iMedPub)
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Impact of Antimicrobials use in chickens on emergence of drug-resistant Campylobacter organisms in humans
Get PDFThe objective of this review is to present the impact of uncontrolled use of antimicrobialagents in chicken husbandry on emergence of drug-resistant Campylobacterin humans. The absence of an Antimicrobial Resistance Monitoring System(ARMS) in most developing countries of the world, amidst trade’s globalization ofanimals and animal products, helped in the recent decade in spreading of drugresistantorganisms across the world’s food chains.The emergence of drug resistance in Campylobacter organisms was associated withtheir transmission from animals and their products to humans. This transmissionof drug-resistant Campylobacter resulted in serious failure of treatment regimensprescribed to infected humans
Antimicrobial efficacy of n-[3- chloro-(substituted aryl)-4-oxoazetidin- 1-yl] pyridine-4- carboxamides against resistant bacterial strains obtained from clinical isolates
Get PDFAbstract Background: The treatment of infectious diseases is still an important and challenging problem due to emerging infectious diseases and increasing number of multi-drug resistant microbial pathogens which cause a variety of illnesses ranging from hospital-acquired pneumonia, bloodstream infections, urinary tract infections from catheters, abdominal infections and even meningitis. Methods: The main objective of the present study was to evaluate the antimicrobial efficacy and β-lactamase inhibitory activity of the synthesized 2-azetidinones against resistant bacterial strains obtained from clinical isolates. Results: The tested 2-azetidinones exhibited antimicrobial efficacy comparable to the standard drugs Ampicillin and Griseofelvin. Among the tested compounds, N-[3-chloro-2-(2,5-dimethoxyphenyl)-4-oxoazetidin-1-yl]pyridine-4-carboxamide(5o) exhibited the highest activity with MIC of 6.25 µg/mL (Gram +ve and Gram –ve bacteria),1.56 µg/mL (A. niger) and 3.12 µg/mL(A. terrus and P. chrysogenum) respectively. Also all the screened compounds (5d, 5f, 5h,5j,5o) exhibited more pronounced activity (MIC: 125 µg/mL) against resistant K. pneumonia obtained from clinical isolates compared to standard antibiotic Amoxycillin. The compounds when tested as admixtures with the standard antibiotic amoxicillin (1:2) exhibited similar antibacterial spectra in comparison to the most widely employed clinical combination Augmentin. The 2-azetidinonescan prove to be a cheaper alternative with similar potential β-lactamase inhibitory activity thereby proving their utility and benefit towards the development of anti-infectives for the treatment of infections caused by drug resistant microorganisms
Azithromycin treatment of drug induced gingival hyperplasia in renal transplant patients
Get PDFObjectives: was to evaluate and compare the efficacy of azithromycin therapy inreducing drug-induced gingival hyperplasia as an adjunctive therapy in renaltransplant patients (RTP) under cyclosporine (CsA) and those under tacrolimus(Tac) therapyMaterial & Methods: Seventy five kidney transplant recipients (48men, 27 women) diagnosed to have early to moderate gingival overgrowth withstable allograft function entered the study. These patients had been takingeither CsA or Tac for more than 6 months .The patients were randomized equallyinto three groups. Two groups had received 500-mg azithromycin for 5-days givenat baseline only. While the control group received placebo in addition to theoral hygiene program .The clinical periodontal parameters were assessed and includethe plaque index, bleeding on probing index, the gingival overgrowth index, andthe probing depth. They were evaluated at the baseline and at flow up time (1,3, 6 months)Results: At the baseline time all groups were similar in the clinical parameterswith no statistically significant difference (P>0.05). At follow up timeintervals all groups showed improvement over baseline measurements however bothgroups who received AZI showed more favorable results manifested by reductionof gingival bleeding and the depth of gingival sulcus .However, thisimprovement was more in the (CsA) group than the (Tac) group and the differencewas statistically significant (P≥ 0.05)Conclusions: Azithromycin is an effective therapeutic tool in the management ofdrug-induced gingival overgrowth as it is conservative, well tolerated, andrapidly effective with minimal side effects; especially in renal transplantpatients under cyclosporine therapy
SOCIOECONOMIC FACTORS AFFECTING ANEMIC MOTHERS AND ITS EFFECT ON THEIR HEALTH: A SOCIOLOGICAL STUDY OF RANIKHET
Get PDFThis study has identified factors of anemia, and its effect on anemic mother health. Themain objective was to investigate mother and child anemia conditions within sociocultural,demographic and nutritional context and effect of anemia on anemic mother and effect ontheir health. CrossSectionalstudy was conducted in urban areas of Ranikhet DistrictAlmora. Both quantitative and qualitative methods were used to get meaningful detailedinformation. For capturing maximum variation on sociocultural,demographic andnutritional aspects, the study was conducted city of the district Almora. This researchdesign enhances the scope of study regarding generalization of research findings. Datahas been selected random sample of 60 respondents. Respondent aged 1849years withat least one child (less than five year) was taken to explore the research objectives throughpredesignedinterviewing schedule with open and closed ended questions. In qualitativestudy detailed information through 8 focus group discussion of 412women were collected.A blood sample was obtained from mothers and their last child to determine hemoglobinlevels
Antibacterial agents and innate immunity
Get PDFOn their own, antibacterial agents cannot cure an infectious disease. They need help from the innate immune response followed by the adaptive immune response and inflammatory response. An overview of Toll-Like Receptors (TLR) as key players in the innate immune response is given followed by a review of published results obtained in the authors laboratory related to the effect of several antibacterial agents on the action of bacterial lipopolysaccharide (LPS), a ligand for TLR-4. The results indicated that the antibacterial agents tested were anti-inflammatory. Inflammation is a two edged sword; in moderation it is beneficial, but deleterious if in excess. It is suggested that infectious disease specialists monitor serum proinflammatory cytokine and/or nitric oxide levels of their patients on antibacterial therapy and when needed, treat with a cytokine, a TLR agonist or a TLR antagonist where indicated.Antibacterial agents on their own are not capable of eradicating infections efficiently. Help coming from the patient’s innate immune response followed by the adaptive immune response and inflammatory response is needed. This has been observed in patients with immunodeficiency diseases such as X-Linked Agammaglobulinemia, Chronic Granulomatous Disease and CD40 Ligand Deficiency (1). Treatment of these patients with antibacterial agents might temporarily control the infection. However, recurrences’ always occur
Case Study: Pseudomonas aeruginosa Blood Stream Infection showing Derepressed AmpC β-lactamase Hyper-producing Mutants
Get PDFHere we describe a middle aged-woman who had septic shock caused by a strain of Pseudomonas aeruginosa carrying derepressed AmpC hyper-producing genes. This was brought into view when the strain located in pipracillin/tazobactam area was exposed on agar plate to imipenem by diffusion causing “D-phenomenaâ€. Clinicians and microbiologists have to be aware of this phenomenon for a better choice of antimicrobials in treating their patients
Evaluation of Meropenem, Imipenem and Ertapenem Impregnated MacConkey Agar Plates for the Detection of Carbapenem Resistant Enterobacteriaceae
Get PDFBackground: Rapid detection of carbapenem resistant bacteria, in particular, members of the Enterobacteriaceae family (CRE), is of utmost importance for the management of infected or colonized patients. Methods: Three carbapenems; meropenem, imipenem and ertapenem, with two different concentrations (0.5 mg/ml and 1.0 mg/ml), were impregnated in MacConkey agar. The carbapenem impregnated MacConkey agar plates; ([Mac-Mem], [Mac-Imp] and [Mac-Ert]), were then evaluated for the detection of carbapenem resistant Gram-negative bacteria in particular the blaKPC producing Enterobacteriaceae. The Limit of Detection (LOD) of the plates was determined after counting the colonies that grew on the plates after serial logarithmic dilutions of ten. Carbapenem resistant Gram-negative bacteria were prepared in normal saline, inoculated on the different plates and incubated at 35oC for 18-24 hours. The specificity and the shelf-life of the plates were determined by challenging the plates with six ESBL positive members of the Enterobacteriaceae family (K. pneumoniae, Salmonella species, Shigella species, E. coli, Proteus species and Citrobacter species) and one Enterobacter species with the blaAmpC phenotype. Finally, the MacConkey agar plates impregnated with 0.5 mg/ml meropenem were further challenged by incorporating them in the routine Caritas Baby Hospital active surveillance program for the detection of carbapenem resistant bacteria. Results: Of the three carbapenems impregnated plates, Mac-Ert plates gave the lowest number of colony forming units (CFU’s) detected regardless of the concentration of the antibiotic used. This was followed by the Mac-Mem plates which showed an LOD of less than 200 CFU’s for most of the blaKPC positive bacteria tested at both antibiotic concentrations. The worst performance was noted for the Mac-Imp plate regardless of the antibiotic concentration used as a number of carbapenem resistant bacterial strains failed to grow on the plate. The Mac-Mem plates showed the best specificity as none of the ESBL and blaAmpC positive isolates grew on the plates at either antibiotic concentration tested after 18-24hours incubation in ambient air at 35oC. On the other hand, the Mac-Ert plates failed to inhibit the growth of the Citrobacter species tested at both antibiotic concentrations and the Proteus species tested at the 0.5µg/ml antibiotic concentration. The Mac-Imp plates showed poor specificity as both concentrations failed to inhibit the growth of the Proteus, Enterobacter and Citrobacter species evaluated after 18-24 hours incubation in ambient air at 35oC. Of all the plates tested, the 0.5 µg/ml Mac-Mem agar had the best shelf-life of up to one month at 4-8oC. Conclusions: The high specificity and the good selectivity, in addition to the long shelf-life allowed the 0.5µg/ml Mac-Mem agar to be used as a cost effective selective medium for the isolation of carbapenem resistant Gram-negative bacteria, in particular the blaKPC producing members of the Enterobacteriaceae family
Evaluation of Structurally Related 3-Substituted 4-Amino-2-arylquinolines and 2-Aryl-4-methoxyquinolines for Potential Antimycobacterial Activity
Get PDFSeries of structurally related 2-aryl-4-(amino/methoxy)quinoline derivatives were evaluated for potential antimycobacterial activity against Mycobacterium tuberculosis strain H37Rv. A complete inhibition of a drug sensitive strain of M. tuberculosis was observed at 20.0 µg/ml for 4-amino-2-(4-chlorophenyl)quinoline 3b, 4-amino-3-iodo-2-(4-methoxyphenyl)quinoline 5d, 4-amino-2,3-diphenylquinoline 6a, 4-amino-2-(4-fluorophenyl)-3-phenylquinoline 6b and 4-amino-2-(4-methoxyphenyl)-3-phenylquinoline 6d. These derivatives were further evaluated for activity against a multidrug resistant strain of M. tuberculosis. The minimum inhibitory concentration (MIC) against a two drug-resistant strain was found to be ≥5.0≤20.0 µg/ml. Systems 6a and 6b were, in turn, subjected to cytotoxicity assay using U937 human macrophages and their intracellular antimycobacterial activity was also determined. Moreover, these two 4-amino-2,3-diarylquinoline derivatives were also investigated for their immune modulatory effect according to Th1 and Th2-subset cytokines
Comparative Study of Wound Healing After Treatment With Crude Date Extract and Silver Sulphadiazine
Get PDFCrude date extract in comparison with silver sulphadiazine was tested to evaluate their effects on wound healing and their antimicrobial activities against the growth of Staphylococcus aureus. Crude date extract 5% (w/v) and silver sulphadiazine 20% (w/v) inhibited the growth of Staphylococcus aureus by 67% and 87% respectively. However,10% and 20% (w/v) date extract showed 100% inhibition. Date extract was fractionated using different solvents with different polarities; all fractions were tested for their antimicrobial activities. Ethyl acetate fraction was found to have inhibitory activity against the growth of Staphylococcus aureus. Preparative TLC was done for ethyl acetate fraction which was further identified to be terpenoidal compound. The histological changes in healing wounds have also been investigated after treatment with 20% and 40% crude date extract ,and silver sulphadiazine and amoxicillin by light microscopy. The results obtained from 20% CDE treatment as compared to untreated control indicated that, this treatment promotes the process of wound healing and stimulates fibroblast, collagen and epithelialization significantly. This effect was comparable with the effect of silver sulphadiazine treatment
Characterization of Cephalosporinases Produced by Clinical Isolates of Enterobacteriacae in North Lebanon
Get PDFBackground: The problem of Enterobacteriacae resistance to β-Lactamase drugsis of growing concern in hospitals. Enterobacteria have developed multiple mechanismsof resistance to antibiotics, the main one is the enzymatic resistance mediatedby the beta-lactamases. This study aims to characterize the occurrence ofcephalosporinases in clinical isolates of Enterobacteriacae isolates in North Lebanon.Methods. Twenty two strains of Enterobacteriacae producing high level of cephalosporinaseshave been studied. The antibiotic susceptibility of each strain wastested on Mueller Hinton agar contains cloxacilline (250 mg/L) and by using E-testaccording the guidelines of the Antibiogram Committee of the French Society forMicrobiology. The search for plasmid-mediated cephalosporinases was performedusing PCR and primers for plasmid-mediated cephalosporinases genes (CMY-2,DHA-1, ACT-1, ACC-1, FOX-1 and MOX-1).Results: Thirteen positive strains were detected, of these 9 strains produced theplasmid-mediated cephalosporinase (CMY-2) and one strain produced the plasmidmediatedcephalosporinase (DHA-1). The remaining 9 strains were high-level chromosomalcephalosporinase producers since they belong to group-three Enterobacteria.They did neither produce plasmid-mediated cephalosporinase, nor did theyhave resistance to third generation cephalosporins except for cefepim. Two strains(CMUL E. coli 021) and CMUL E. coli 255) which were not susceptible for cefepim byE-test produced plasmid-mediated cephalosporinase The sequencing result of these2 E.coli strains did not show any mutation in the promoter that is responsible forhigh expression level of the chromosomal cephalosporinase. All examined strainsproducing plasmid-mediated cephalosporinase CMY-2 were analyzed by ERIC-PCRtechnique. The results showed that two of these strains had the same pattern (C4and C5) and three others had another pattern (C10, C12 and C13).Conclusion: This study shows the variations of cephalosporinases produced byclinical isolates of Enterobacteriacae in North Lebanon