Skin biopsies from 117 cases of acute and 23 cases of lupoid leishmaniasis were studied. Of the 117 acute cases, anergic macrophage response were seen in 44, diffuse necrosis in 9 and focalized necrosis in 11 biopsies; the remaining 53 biopsies showed scanty or no parasites with a few to abundant epithelioid cells probably representing post necrotic changes before complete healing of the lesions. The 23 biopsies of lupoid leishmaniasis showed rather well organized epithelioid granulomata surrounded by lymphocytes, inconspicuous plasma cells, no amastigotes and no necrosis. Lupoid cases showed strong delayed hypersensitivity with leishmanin and low serum antibody titres. It appears that the lesions of urban cutaneous leishmaniasis spend a long time in the anergic phase. Partial destruction of parasites by activated macrophages together with gradual elevation of antibody levels prepares the appropriate antigen-antibody ratio for optimum development of necrosis at PI3 leading to effective elimination of parasites. Plasma cells appear to be important in the induction of necrosis and inhibition of epithelioid granulomata. A significant inverse relationship has been found between plasma cells and epitheloid cells. The delayed hypersensitivity observed in lupoid leishmaniasis is probably the result of a poor humoral response evidenced by inconspicuous plasma cells and low serum antibody titres.

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Klebsiella pneumoniae is an important pathogen causing hospital-acquired infections in human beings. Samples from suspected patients of K pneumoniae associated with respiratory and urinary tract infections were collected at Bolan Medical Complex, Quetta, Balochistan. Clinical samples (n = 107) of urine and sputum were collected and processed for K pneumoniae isolation using selective culture media. Initially, 30 of 107 isolates resembling Klebsiella spp. were processed for biochemical profiling and molecular detection using gyrase A (gyrA) gene for conformation. The K pneumoniae isolates were analysed for the presence of drug resistance and virulence genes in their genomes. The 21 of 107 (19.6%) isolates were finally confirmed as K pneumoniae pathogens. An antibiogram study conducted against 17 different antibiotics showed that a majority of the isolates are multidrug resistant. All the isolates (100%) were resistant to amoxicillin, cefixime, amoxicillin-clavulanic acid, cefotaxime, and ceftriaxone followed by tetracycline (95.2%), ciprofloxacin and gentamicin (76.2%), sulphamethoxazol (66.7%), nalidixic acid (61.9%), norfloxacine (42.9%), piperacillin-tazobactam (23.8%), cefoperazone-sulbactam (19%), and cefotaxime-clavulanic acid (33.3%), whereas all the isolates showed sensitivity to amikacin, chloramphenicol, and imipenem. The presence of tetracycline, sulphamethoxazol-resistant genes, and extended-spectrum beta-lactamase was reconfirmed using different specific genes. The presence of virulence genes fimH1 and EntB responsible for adherence and enterobactin production was confirmed in the isolates. The high virulence and drug resistance potential of these Klebsiella isolates are of high public health concern. Multidrug resistance and virulence potential in K. pneumoniae are converting these nosocomial pathogens into superbugs and making its management harder.Sareeen Fatima and Faiza Liaqat contributed equally to the scientific work.

The aim of this study was to determine the prevalence and antimicrobial resistance of Campylobacter jejuni isolated from retail chicken meat. The identification of Campylobacter isolates and the presence of virulence factor were evaluated by polymerase chain reaction (PCR). Furthermore, clove oil, cinnamon, and turmeric extracts were evaluated for the antimicrobial potential against Campylobacter isolates. Out of 200 chicken meat samples, 80 (40%) samples were found contaminated with Campylobacter jejuni. Antibacterial susceptibility testing indicated that out of 80 isolates 60 (75%) were resistant to tetracycline followed by 31 (38.75%) to ciprofloxacin, 12 (15%) to ampicillin, 8 (10%) to erythromycin, and 2 (2.5%) were resistant to chloramphenicol. Clove oil and cinnamon extract showed antibacterial potential against Campylobacter isolates. Furthermore, all the 80 isolates (100%) were found positive for virulence genes (cadF, flaA, and dnaJ). The presence of antibacterial resistance and virulence factors in C. jejuni highlighted the risk associated with retail poultry meat. Practical applications Campylobacter jejuni is associated with foodborne illnesses such as gastrointestinal intestinal complications. This study demonstrated that raw chicken meat should be subjected to pretreatment to avoid the foodborne illnesses associated with multidrug‐resistant (MDR) Campylobacter jejuni. Moreover, the use of antibiotics should be strictly monitored in developing countries to avoid the emergence of multidrug‐resistant pathogens.