Drug resistance is a public health concern that threatens to undermine decades of medical progress. ESKAPE pathogens cause most nosocomial infections, and are frequently resistant to carbapenem antibiotics, usually leaving tigecycline and colistin as the last treatment options. However, increasing tigecycline resistance and colistin’s nephrotoxicity severely restrict use of these antibiotics. We have designed antimicrobial peptides using a maximum common subgraph approach. Our best peptide (Ω76) displayed high efficacy against carbapenem and tigecycline-resistant Acinetobacter baumannii in mice. Mice treated with repeated sublethal doses of Ω76 displayed no signs of chronic toxicity. Sublethal Ω76 doses co-administered alongside sublethal colistin doses displayed no additive toxicity. These results indicate that Ω76 can potentially supplement or replace colistin, especially where nephrotoxicity is a concern. To our knowledge, no other existing antibiotics occupy this clinical niche. Mechanistically, Ω76 adopts an α-helical structure in membranes, causing rapid membrane disruption, leakage, and bacterial death.
Introduction: Candida is most common fungal pathogen in the immunocompromised and medically ill patients. Higher prevalence of Candida albicans has been reported in tobacco users and oral squamous cell carcinoma (OSCC) patients which may be due to immunosuppression. Recently, emergence of nonalbicans candida (NAC) species resistant to conventional antifungal treatment has been observed that requires accurate identification of organisms at species level for reduction of progression of suspicious oral lesions toward malignancy. Aims and Objectives: To detect and compare the prevalence of C. albicans and NAC species smokeless tobacco chewers, histopathologically confirmed oral squamous cell carcinoma patients and the normal individuals. Effectiveness of automated Vitek 2 system in comparison to HiCrome agar color media in the identification of the candida species was also evaluated. Methodology: One hundred and fifty patients (90 males, 60 females) aged between 20 and 76 years were divided into three groups: Group I individuals with habit of chewing Gutka, and betel quid/pan masala with or without tobacco, Group II individuals with clinically and histopathologically confirmed oral squamous cell carcinoma and Group III comprised of controls. Salivary samples were cultured on HiCrome agar color media and results were compared with those of Vitek 2 system in the accurate identification of candida species. Data were statistically analyzed and Chi-square test was used to estimate the effectiveness of color and Vitek method in the identification of candida species in all the three groups. P < 0.05 was considered to be statistically significant. RESULTS: HiCrome agar color method identified six candida isolates C. albicans , Candida tropicalis, Candida krusei and Candida glabrata isolates in all the three groups, with 0.00 unidentified organisms ( P = 0.00001) whereas VITEK 2 system identified five isolates of candida; C. albicans , Candida famat, Candida ciferri, Candida gulleri, C. tropicalis , unidentified organisms were observed in 26% of subjects. Further confirmation by supplemental tests indicated the presence of two or three organisms of different species/or subspecies with low reactivity biopattern. Higher incidence of opportunistic infections was seen in Group II OSCC patients ( P = 0.00001). Conclusion: The results suggested that there is shift toward NAC species, with higher species diversity in OSCC patients followed by gutka, betel quid/pan masala with or without tobacco users. Conventional agar media culture methods of species identification should be used in conjunction with automated ...
Background: Infections caused due to injuries are due to microbial proliferation at the wound site following skin damage. Initial testing of micro-organisms in terms of culturing and sensitivity leads to appropriate antibiotic selection and prevents escalation of antimicrobial resistance. Aim: To evaluate the bacteriological profile and antibiotic susceptibility patterns of wound infections in this single-centered study. Materials and Methods: The study included 160 patients suspected to have wound infection. Pus or tissue samples collected from patients were subjected to microbiological processing including Gram staining, culture and antibiotic susceptibility testing. Their demographic data and wound related factors (duration, nature, type) were recorded. The isolated organisms were evaluated for β-lactamase production using Extended spectrum β-lactamase (ESBL) test, Modified Hodge test for Carbapenemase and AmpC βlactamase enzyme detection tests. Results: Most participants were 41-60 years old (45.63%). The majority had surgical site infections (SSI, 91.25%), early infected (91.1%) and clean (67.12%) wounds. The bacterial isolation rate was 80% and 45.27% (n=67) were Gram positive isolates, out of which 47 (70.14%) were multidrug resistant. Staphylococcus aureus was identified as the predominant organism (n=40), where 33 among 40 were methicillin sensitive, followed by Escherichia coli (n=30, 23.43%). Amongst the Gram negative isolates (n=81, 54.73%), 60 (74.07%) were multidrug resistant with majority being susceptible to imipenem, meropenem and amikacin. Conclusion:The most common pathogen associated with wound infection was Methicillin sensitive S. aureus with SSI being the most common type of wound infection.
Acinetobacter, Gram negative bacterium, has proven to be recently important to research due to multidrug resistance. Multidrug resistance is directed against antibiotics like Aminoglycosides, Carbapenems, Cephalosporins, Quinolones etc. The presence of efflux pump, primarily the Resistance-Nodulation-Cell Division (RND) type, is an active transport mechanism which allows it to efficiently reduce antibiotic levels within the cell. 1-(1-naphtylmethyl)-piperazine (NMP) is an efflux pump inhibitor (EPI) which mechanically inhibits the efflux pump in bacteria resulting in increased concentration of antibiotic intracellularly, thereby killing the cell. Objectives: To detect the efflux pumps phenotypically using NMP and to establish the cut-off zone diameter to detect efflux pump in Acinetobacter species. Materials and Methods: Acinetobacter species were isolated from patient samples using conventional techniques of inoculation, identification and antibiotic susceptibility testing. The efflux pump was detected phenotypically by disc diffusion method on Mueller Hinton agar with NMP and chloramphenicol, tetracycline discs as substrates. The zone diameters were recorded & values compared using t-test. Tipping analysis was done to determine the mean zone difference to identify the presence of efflux pump. Results and Conclusion: 61% of the Acinetobacter species were multidrug resistant of which 63% had efflux pump as detected by chloramphenicol substrate which is better than Tetracycline (p<0.05). A difference of 5 mm in the zone diameter can be used to detect efflux pump. The gene encoding for the efflux pump -AdeFGH was present in 72% of the isolates. NMP can be a potential adjuvant with common antibiotics to treat MDR Acinetobacter infections.
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