Background: Surveillance of antimicrobial resistance (AMR) is of great importance. Pseudomonas aeruginosa and Acinetobacter baumannii are important pathogens and emergence of resistance in these have ...increased the morbidity and mortality rates. This surveillance study was initiated by the Government of India - Indian Council of Medical Research. The aim of this study is to determine the antimicrobial susceptibility profile and to characterise the enzyme mediated antimicrobial resistance such as extended spectrum beta-lactamases (ESBLs) and carbapenemases among multidrug-resistant (MDR) P. aeruginosa and A. baumannii. Materials and Methods: A multi-centric study was conducted from January 2014 to December 2015 with a total number of 240 MDR P. aeruginosa and 312 MDR A. baumannii isolated from blood, cerebrospinal fluid, respiratory, pus, urine and intra-abdominal infections. Kirby–Bauer disc diffusion was done to determine the antimicrobial susceptibility profile. Further, MDR isolates were characterised by multiplex polymerase chain reaction to determine the resistance genes for ESBLs and carbapenemases. Results: Among the ESBLs, blaVEB (23%), blaTEM (5%) and blaSHV (0.4%) in P. aeruginosa and blaPER (54%), blaTEM (16%) and blaSHV (1%) in A. baumannii were the most prevalent. Likewise, blaVIM (37%), blaNDM (14%), blaGES (8%) and blaIMP (2%) in P. aeruginosa and blaOXA-23like (98%), blaOXA-58like (2%), blaNDM (22%) and blaVIM (3%) in A. baumannii were found to be the most prevalent carbapenemases. blaOXA-51like gene, intrinsic to A. baumannii was present in all the isolates tested. Conclusion: The data shown highlight the wide difference in the molecular mechanisms of AMR profile between P. aeruginosa and A. baumannii. In P. aeruginosa, plasmid-mediated mechanisms are much lesser than the chromosomal mediated mechanisms. In A. baumannii, class D oxacillinases are more common than other mechanisms. Continuous surveillance to monitor the trends in AMR among MDR pathogens is important for implementation of infection control and to guide appropriate empirical antimicrobial therapy.
The effect of preparation method on the photocatalytic degradation of phenol using zinc oxides under solar radiation was studied in batch reactors. Zinc oxide was prepared by different methods by ...varying precipitating agents and the source of precursors and microwave irradiation time and characterized by XRD, surface area, acid sites and crystallite sizes. The photocatalytic reactions were carried out by varying the reaction conditions such as preparation methods, microwave irradiation time, activation temperature, solar irradiation time, catalyst amount, substrate concentration etc. Under optimization conditions, it was found that 15
min microwave irradiated sample shows 88% phenol (0.6
g/l dose) degradation at pH 5.0 and 4
h reaction time under sunlight. Zinc oxide samples prepared by microwave irradiation and calcined at 573
K exhibit highest surface area, acid sites and lowest crystallite sizes and show highest activity towards photocatalytic oxidation of phenol.
Plasmid mediated AmpC β-lactamase (PMABL) resistance in Escherichia coli and Klebsiella spp. is an emerging problem worldwide. Phenotypic methods are commonly used for detection of PMABL production ...in Gram-negative isolates, but molecular data about the prevalence of plasmid-mediated AmpC-type resistance at the national level are needed. Hence, a prospective study was undertaken to determine the occurrence of PMABL gene and its types among clinical isolates of E. coli and K. pneumoniae obtained from six different hospitals in India.
A total of 241 nosocomial isolates of K. pneumoniae (n=109) and E.coli (n=132) from six geographically distant hospitals in India were included. These were screened for cefoxitin resistance. AmpC disk test and modified three dimensional extraction test were used for phenotypic detection of PMABL production. Molecular types were determined by a multiplex PCR.
Among the 241 isolates, 187 (77.5%) were found to be cefoxitin resistant (K. pneumoniae n=83, E. coli n=104). AmpC activity was detectable in 153 (63.4%) isolates, (K. pneumoniae n=69, E. coli n=84). By PCR, the plasmid encoded AmpC genes were found in 92 (38.1%) isolates and the molecular types of the genes detected predominantly were DHA, CIT followed by MOX and ACC types.
A high percentage of plasmid-encoded AmpC enzymes was noted in E. coli and K. pneumonia isolates obtained from different parts of the country. Phenotypic methods alone may not reflect the true number of PMABL producers. Genotypic methods need to be employed in national surveillance studies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The degree of mechanical reinforcement that could be obtained by the introduction of glass fibres in biofibre (pineapple leaf fibre/sisal fibre) reinforced polyester composites has been assessed ...experimentally. Addition of relatively small amount of glass fibre to the pineapple leaf fibre and sisal fibre-reinforced polyester matrix enhanced the mechanical properties of the resulting hybrid composites. Different chemically modified sisal fibres have been used in addition to glass fibers as reinforcements in polyester matrix to enhance the mechanical properties of the resulting hybrid composites. The surface modification of sisal fibres such as alkali treatment produced optimum tensile and impact strengths, while cyanoethylation resulted in the maximum increase in flexural strength of the hybrid composites. It has been observed that water uptakes of hybrid composites are less than that of unhybridized composites. Scanning electron microscopic studies have been carried out to study the fibre-matrix adhesion.
Drug resistance in malaria Parija, SC; Praharaj, I
Indian journal of medical microbiology,
07/2011, Letnik:
29, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Antimalarial chemotherapy is an important component of all malaria control programmes throughout the world. This is especially so in light of the fact that there are no antimalarial vaccines which ...are available for clinical use at present. Emergence and spread of malaria parasites which are resistant to many of the available antimalarials today is, therefore, a major cause for concern. Till date, resistance to all groups of antimalarials excluding artemisinin has been reported. In recent years, in vitro resistance to even artemisinin has been described. While resistance to antibacterial agents has come to prominence as a clinical problem in recent years, antiparasitic resistance in general and antimalarial resistance in particular has not received much attention, especially in the Indian scenario. The present review deals with commonly used antimalarial drugs and the mechanisms of resistance to them. Various methods of detecting antimalarial resistance and avoiding the same have also been dealt with. Newer parasite targets which can be used in developing newer antimalarial agents and antimalarials obtained from plants have also been mentioned.
Systems approach provides a logical and scientific basis for explaining the functioning of a system in a holistic manner. The health sciences university is a system with its three major operations – ...education, research, and patient care, which can be conceived as inputs, process, and output, respectively. The system is aided by a feedback loop to inform and correct the system. Systems thinking enable us to identify the deficiencies existing in each of the components so that appropriate remedial action can be taken. In this article, we have identified deficiencies in the health sciences system. Further, we have suggested a five-point formula to achieve connection among education, research, and patient care. We need to Form consortia and networks to create a mass movement, Uniform regulations to remove bottlenecks, Reform curricula to make them credit linked and competency based, Inform all through a faculty development initiative, and finally, Transform the system by setting examples and demonstrating success. The initiative taken by the Medical Council of India in introducing a competency-based curriculum for MBBS, and the revised accreditation manual introduced by the National Assessment and Accreditation Council can provide a lot of opportunities to explore the potentiality educational research to answer many questions that can help us in connecting research with education and patient care.
The important risk factors include the use of immunosuppressive drugs, and/or broad-spectrum antibiotic therapy, abdominal surgery, parenteral nutrition, haemodialysis, haematological disorders, HIV ...infections, solid tumours, mucosal or cutaneous barrier disruption, extremes of age, prolonged ICU stay and central venous catheter use 1,2,3,4,5 . Antifungal susceptibility of the isolated Candida species was tested by disc diffusion method against amphotericin B (10 U) and fluconazole (25 μg) on Mueller-Hinton Agar supplemented with 2 per cent glucose and methylene blue (5 μg/ml). Of the 31 isolates, 19 (61.3%) were isolated from females and 12 (38.7%) from males; 80.6 per cent (n=25) were isolated from patients admitted in intensive care units (ICU); 61.3 per cent (n=19) isolates were obtained from patients with age ≤10 yr, 12.9 per cent (n=4) from ≥51 yr, 6.5 per cent (n=2) each from 21-30 and 41-50 yr, and 9.7 per cent (n=3) from 31-40 yr. Species identified by morphology on corn meal agar (CMA) and Hichrom candida agar were the same.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Systems approach is a time tested, method of trying to understand the reality holistically, and resolving the issues by problem-solving method. It has resulted in enormous applications in almost ...every field of knowledge, science, technology, industries, agriculture, and health or education. The main essence of systems thinking lies in minimizing the inputs, optimizing the process to maximize the outputs through continuous feedback, and monitoring. Medical education has been greatly benefitted as the systems approach has influenced all aspects, from delineating the competencies of doctors, designing curriculum that includes comprehensive assessment. However, of late, there has been a debate as to whether the systems approach can really contribute to resolve complex issues such as bringing curricular reforms, or promote policy changes in patient care, education, or research. This involves a paradigm shift from problem-solving approach to “pattern recognition” and adaptive action to correct the system. This review based on critical appreciation, begins with a thesis that systems approach is a great tool. It then exposes its inadequacy to address complex systems. This is antithesis. In the end, a synthesis of both the contradictory views has been proposed as a take home.
A total of 200 subjects were screened for carriage of
methicillin-resistant Staphylococcus aureus (MRSA) at different sites
using oxacillin blood agar and mannitol salt agar with oxacillin.
Overall ...carriage rate was 8.5%, with the highest rate in inpatients
(15.6%) while the lowest was seen in health care workers (1.8%). The
commonest site of colonization was the anterior nares. Oxacillin blood
agar was found to be superior to mannitol salt agar with oxacillin for
the isolation of MRSA. Male sex and prolonged hospital stay were found
to be the major risk factors for MRSA colonization.
Context:Campylobacter is an undetected cause of diarrhoea especially under 5 years of age in most of the countries. Isolation of this organism is difficult, expensive and cumbersome. Aims: Our ...objective of this study was to isolate this pathogen from the stool specimens on routinely available blood containing laboratory media using the candle jar for creating the microaerophilic atmosphere in our setup. Settings and Designs: A descriptive study. Materials and Methods: A total of 50 stool samples were inoculated onto selective and non-selective media with and without filtration using a 0.45 μm membrane. The inoculated media were simultaneously incubated in microaerophilic conditions using the Anoxomat as well as in candle jars at temperatures 37°C and 42°C. The culture isolates were confirmed by standard phenotypic tests. A simplex polymerase chain reaction (PCR) targeting the 16S ribosomal deoxyribonucleic acid of Campylobacter was performed on the deoxyribonucleic acid (DNA) of the culture isolates as well as on the DNA extracted from the stool filtrates. Statistical Analysis: Data was expressed as a proportion. Results:Campylobacter could be isolated in 5 out of 50 stool samples using both the Anoxomat as well as the candle jar. Furthermore, we did not find any difference between the isolation using the selective and blood containing media as well as the different incubation temperatures. All the five were confirmed phenotypically and genotypically to be Campylobacter jejuni. The PCR results corroborated with that of the culture. Conclusions: Isolation by culture was as sensitive as that of the PCR.
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