BACKGROUND Monitoring emerging trends in antimicrobial resistance at local levels is a very important aspect for clinical decision making and infection control interventions in this era of rising superbugs. The hospital antibiogram constructed by standardized methods is a summary of antimicrobial susceptibilities of local bacterial isolates, with periodic review. METHODS This antibiogram was prepared based on the Clinical and Laboratory Standards Institute (CLSI) M39-A4 guidelines. The data was collected for a period of three years from May 2016 to April 2019. All the samples which were received in the microbiology laboratory for aerobic bacterial culture and sensitivity testing were considered. Antibiotic susceptibility data of the bacterial isolates processed by VITEK2 system was considered. A hospital antibiotic policy was formulated and implemented. RESULTS A total of 15,135 samples were analysed from different clinical departments for a period of three years, of which 5,638 were culture positive. A comparative analysis of the three years' data during the introduction of antibiotic protocol showed a gradual decrease in the rate of infection with multidrug resistant organisms. The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) showed a decrease from 15% to 7%. Extended spectrum beta-lactamase (ESBL) producing Escherichia coli in urine decreased from 42.4% to 27%. CONCLUSIONS Prompt antimicrobial therapy in case of an infection makes a lot of difference between recovery and death and most of the time prevents long term disability. Hence, antibiotic policy is one of the mandatory requirements, and making an antibiogram is the first step before framing antibiotic policy.
BACKGROUND Acinetobacter species are important infectious agents worldwide especially in healthcare settings. It has the ability to develop various resistance mechanisms to various antibiotics. We wanted to study the role of tigecycline and minocycline in the treatment of multidrug resistant Acinetobacter species. METHODS 254 non-repetitive isolates of Acinetobacter species from various clinical samples like exudates, blood, sputum, urine were retrospectively studied. Antibiotic susceptibility testing was done by Vitek 2 compact system. Susceptibility of the carbapenem resistant isolates towards tigecycline and minocycline were analysed. RESULTS 205 (80.7 %) isolates were resistant to either of the carbapenem drugs and 49 (19.3 %) were sensitive to all the 3 carbapenems, namely imipenem, meropenem and doripenem. 54.1 % isolates were sensitive to tigecycline while sensitivity towards minocycline was 40.5 %. The degree of sensitive concordance in the susceptibility to minocycline and tigecycline against Acinetobacter species was 31.1 %, which indicated fair agreement statistically. 21.1 % isolates were resistant / intermediate to minocycline but sensitive to tigecycline. Only 9.4 % isolates which were resistant to tigecycline were sensitive to minocycline. CONCLUSIONS The results of the present study have demonstrated that minocycline and tigecycline are effective against the carbapenem resistant Acinetobacter species. Tigecycline can be considered as a therapeutic agent for the treatment of multidrug resistant Acinetobacter which are otherwise difficult to inhibit using other antibiotics. KEY WORDS Carbapenem Resistance, Tigecycline, Minocycline, Antimicrobial Resistance
In the present investigation, preliminary phytochemical screening of Ficus racemosa leaves has been done in methanol and aqueous extract, showed the presence of phytoconstituents namely carbohydrates, flavonoids, saponins, steroids, tannins and the absence of alkaloids and amino acids. Silver nanoparticles are synthesized using the leaf extract of F. racemosa by mixing dried leaves powder with aqueous solution of 1mM silver nitrate and by incubating it at 95°C for 15 min. The colour change in the solution from colorless to dark brown indicates naoparticle synthesis which was later characterized. Maximum absorption peak was observed at 400 nm and synthesized nanoparticles are cubic shaped with a diameter varies from 2.04µm-3.64µm. The antimicrobial activity of the aqueous, methanol and AgNO3 leaf extracts were tested against 5 bacterial species viz., Salmonella typhi, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Bacillus subtilis by agar well diffusion method with amoxicillin as a positive control. Methanol extract were found to be more active against all the organisms than the aqueous and AgNO3 extract. The present study included the bioreduction of silver ions through medicinal plants extracts and testing for their antibacterial activity. The aqueous silver ions exposed to the extract the synthesis of silver nanoparticles were confirmed by the change of color of plant extracts. These environmentally benign silver nanoparticles were further confirmed by using UV-Vis spectroscopy and FTIR analysis. The results indicated that silver nanoparticles have good antibacterial activity against different microorganisms. Nanotechnology is creating a growing sense of excitement in the life sciences especially biomedical devices and biotechnology. Nanoparticles exhibit completely new or improved properties based on specific characteristics such as size, distribution and morphology. Silver ion has been known to be effective against a broad range of new microorganisms. Silver nanoparticles are well known as one of the most universal antimicrobial substances in the field of biology and medicine also reported to possess antifungal, anti-inflammatory, anti-viral, anti-angiogenesis and anti-platelet activity. Thus various formulations have varied levels of medicinal properties and can be used to cure diseases caused by different pathogens.
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