Rabindra N. Padhy

Surveillance of infection status of drug resistant Staphylococcus aureus in an Indian teaching hospital

Objective To access nosocomial and community accounts of multidrug resistant strains of Staphylococcus aureus (S. aureus) isolated by surveillance in a teaching hospital, over a period of 30 months.

Surveillance of multidrug resistance of two Gram-positive pathogenic bacteria in a teaching hospital and in vitro efficacy of 30 ethnomedicinal plants used by an aborigine of India

Abstract Objective To record hospital- and community-acquired accounts of multidrug resistance (MDR) of two Gram-positive pathogens, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), by surveillance, and to evaluate antibacterial potencies of 30 plants with information on ethnomedicinal uses for infectious ailments by the aborigine Kandha tribe of Kalahandi district, Odisha (India), against both pathogens. Methods Over a period of 6 months bacteria/ strains of S. aureus and E. faecalis were isolated from clinical samples in a teaching hospital and their antibiograms were ascertained using 17 antibiotics of 9 different groups. S. aureus strains were further tested for confirmation if they were methicillin and vancomycin resistant, similarly, E. faecalis strains for vancomycin resistance. Concentrated aqueous and ethanolic extracts of leaves/barks of 30 plants were used for monitoring their antimicrobial potencies, by the agar-well diffusion method, along with qualitative phytochemical analyses. Results From the surveillance, both pathogens were found MDR and it was evident that the distribution of MDR strains was more in hospital-acquired than community-acquired samples. Both aqueous and ethanolic extracts of plants, Diospyrous melanoxylon, Woodfordia fruticosa (W. fruticosa), Oroxylum indicum (O. indicum), Dalbergia paniculata and Lantana camara had the most significant in vitro controlling capacity against MDR strains of both bacteria. Further, extracts of Holarrhena antidysenterica, Aspidopterys tomentosa and Argyreia speciosa had moderate antibacterial activities. Ethanolic extracts of L. camara, O. indicum and W. fruticosa contained all the phytochemicals, alkaloids, glycosides, terpenoids, reducing sugars, saponins, tannins, flavonoids and steroids, which could be attributed to the recorded significant antibacterial activity. Conclusion S. aureus strains have been found as the most widely prevailing pathogens in nosocomial settings, than in community. Plants, L. camara. W. fruticosa, O. indicum and P. santalinus, particularly could be useful for a use as complementary/ supplementary/alternative therapeutic agents against Gram-positive pathogens.

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

OBJECTIVE To record surveillance, antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months. METHODS Urine samples from wards and cabins were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests; and their antibiograms were ascertained by Kirby-Bauers disc diffusion method, in each 6-month interval of the study period, using 18 antibiotics of five different classes. RESULTS From wards and cabins, 1 245 samples were collected, from which 996 strains of bacteria belonging to 11 species were isolated, during April 2011 to September 2012. Two Gram-positive, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), and nine Gram-negative bacteria, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI. CONCLUSIONS Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and S. aureus. Moreover, vancomycin resistance in strains of S. aureus and E. faecalis is a matter of concern.

In vitro antibacterial potency of Butea monosperma Lam. against 12 clinically isolated multidrug resistant bacteria

Objective To investigate the antibacterial activity, using cold and hot extraction procedures with five solvents, petroleum ether, acetone, ethanol, methanol and water to validate medicinal uses of Butea monosperma Lam (B. monosperma) in controlling infections; and to qualitatively estimate phytochemical constituents of leaf-extracts of the plant.

Antimicrobial activity of medicinal plants used by aborigines of Kalahandi, Orissa, India against multidrug resistant bacteria

Abstract Objective To evaluate the antimicrobial potency of 20 non-edible and/or poisonous plants used by an aborigine tribe (Kandha) of Kalahandi district for infectious diseases. Methods Over a period of 5 months from two hospitals, 10 pathogenic bacteria ( Staphylococcus aureus ( S. aureus ), Acinetobacter sp., Citrobacter freundii ( C. freundii ), Chromobacterium violeceum ( C. violeceum ), Escherichia coli ( E. coli ), Klebsiella sp., Proteus sp., Pseudomonas aeruginosa (P. aeruginosa ), Salmonella typhi ( S. typhi ) and Vibrio cholerae ( V. cholerae ) were isolated to pure axenic cultures from clinical samples. Water and ethanolic extracts of leaves and barks were concentrated before monitoring antimicrobial activity by agar-well diffusion method. Results All bacterial strains isolated were multidrug resistant. Ethanolic extract of most plants had effective antimicrobial activity against all the isolated multidrug resistant bacteria. Plants, Anthocephalus cadamba ( A. cadamba ) and Pterocarpus santalinus ( P. santalinus ) had antibacterial effect on all used bacteria. Water extract of several plants too had effective antimicrobial activity for all bacteria used. Effective in vitro control of MDR strains of Acinetobacter sp., C. freundii, Proteus sp . and P. aeruginosa , the most potential urinary tract infection causing organisms by plant extracts of all major plant used herein is recorded. MDR C. violaceum isolated from skin lesions was found to be resistant to imipenem, piperacillin-tazobactam and amoxyclav and was found sensitive to 13 plant extracts. Conclusion Effective in vitro control of MDR strains of Acinetobacter sp., C. freundii, Proteus sp. and P. aeruginosa ; enteropathogenic bacteria, E. coli, S. typhi, Klebsiella s p. and V. cholerae were found to be well controlled by all plant extracts used.

Status of multidrug resistance in tubercle bacillus and phytochemicals for the control

AimThe purpose of this study is to present the possibility of the control of the appalling tubercle bacillus (TB) strains of the present time with pure phytochemicals as a complementary or palpable source of drugs.Present problemMultidrug resistant (MDR) strains of TB for the current first-line drugs have emerged independently in several countries. The second-line or the reserve-line drugs are less often used for more side effects.PossibilityExtracts and pure phytochemicals of several plants are reported from many laboratories to have control over TB in vitro, which indicated that phytochemicals could be the suitable complementary candidates in the control of the range of MDR-TB strains, along with an ongoing treatment regimen. Extracts from plants, Lantana hispida, Eremophila, Galenia africana, Dodonea angustifolia, Bridelia micrantha, Achyrocline alata and Swinglea glutinosa, specifically phytochemicals, 5,7,2′-trihydroxyflavone, carvacrol, thymol, p-cymene, 1,8-cineole and limonene have been reported to have promising antitubercular activity in vitro. Pure phytochemicals should have the coveted credibility as complementary medicines and those could lend themselves for further manipulation before the use against TB.ConclusionSome avant-garde drug is the need of the day for TB, and pure phytochemicals could be considered.

Surveillance of multidrug resistance of 6 uropathogens in a teaching hospital and in vitro control by 25 ethnomedicinal plants used by an aborigine of India

Abstract Objective To evaluate antimicrobial potencies of 25 plants with reports on ethnomedicinal uses for infectious ailments by the aborigine Kandha tribe of Kalahandi district, Odisha state, India for urinary tract infections. Methods Over a period of 6 months, multidrug resistant (MDR) strains of 6 uropathogenic bacteria Acinetobacter baumannii (A. baumannii), Citrobacter freundii (C. freundii), Klebsiella oxytoca (K. oxytoca), Proteus mirabilis (P. mirabilis), Proteus vulgaris (P. vulgaris) and Pseudomonas aeruginosa (P. aeruginosa) were isolated from clinical samples in a teaching hospital; their antibiograms were ascertained. Concentrated aqueous and ethanolic extracts of leaves and barks of plants were used for monitoring their antimicrobial potencies, by the agar-well diffusion method. Phytochemical analyses of plant parts were done. Results All isolated bacterial strains were resistant to 15 antibiotics of 6 groups including β-lactams. From a surveillance of bacterial isolates, it was evident that the distribution of MDR strains of each was more in hospital acquired isolates than the community acquired ones. Both aqueous and ethanolic extracts of plants, Aegle marmelos (A. marmelos), Azadirachta indica (A. indica) and Withania somnifera (W. somnifera) were highly effective against MDR isolates of all these pathogens. Several plants were moderately effective during in vitro control of the pathogens. Plants, Anthocephalus cadamba (A. cadamba), Cleistanthus collinus (C. collinus) and Oroxylum indicum (O. indicum) were totally ineffective in the control of isolated MDR uropathogen. A. indica, T. arjuna and T. alata contained the full range of phytochemicals (alkaloids, glycosides, terpenoids, reducing sugars, saponins, tannins, flavonoids and steroids), which could be attributed to the significant anti-uropathogenic activities. Conclusion Plants, A. indica, A. marmelos, Cassia fistula (C. fistula), T. arjuna, Salvadora persica (S. persica), W. somnifera and Vitex negundo (V. negundo), particularly could be useful for an use as complementary/supplementary medicines for MDR uropathogens.

Surveillance of multidrug resistance of 10 enteropathogens in a teaching hospital and in vitro efficacy of 25 ethnomedicinal plants used by an Indian aborigine

Abstract Objective To have an antibiogram of hospital acquired (HA) and community acquired (CA) enteropathogens against 16 antibiotics to assess the infection dynamics for plausible help to the antimicrobial stewardship. To check extracts of 25 lesser-known plants used by an Indian aborigine, for antimicrobial efficacy in vitro and as complementary and alternate medicines against resistant pathogens. Methods Ten strains of enteric bacteria ( Enterobacter aerogenes, Escherichia coli, Klebsiella sp. , Salmonella paratyphi, S. typhi, Shigella boydii, S. dysenteriae, S. flexneri, S. sonnei and Vibrio cholerae ) were isolated from clinical samples in 6 months and their antibiotic sensitivity was assessed by the disc-diffusion method. Concentrated aqueous and ethanolic extracts of leaves and barks of plants were used for monitoring their antibacterial potencies, by the agar-well diffusion method. Results Isolated bacterial strains were invariably multidrug resistant (MDR). E. coli was the most frequently isolated organism from HA and CA samples, followed next by Klebsiella sp. From the surveillance, it was evident that the distribution of MDR strains of each was more in HA than CA isolates. Aqueous and ethanolic extracts of Aegle marmelos, Azadirachta indica, Cassia fistula, Holarrhena antidysenterica, Salvadora persica and Terminalia arjuna were highly effective against the all isolated enteropathogenic strains. From the preliminary phytochemical analysis, it was confirmed that both extracts of A. indica, T. arjuna and T. alata contained all the detected phytochemicals (alkaloids, glycosides, terpenoids, reducing sugars, saponins, tannins, flavonoids and steroids), which plausibly attributed to their significant antibacterial activity. Conclusions Phytoextracts were highly effective against the all enteropathogenic bacterial isolates, in vitro . These 25 plants could be used further for the isolation of pure compounds for use as complementary medicines.

Surveillance of ESBL producing multidrug resistant Escherichia coli in a teaching hospital in India.

Objective To record nosocomial and community-acquired accounts of antibiotic resistance in Escherichia coli (E. coli) strains, isolated from clinical samples of a teaching hospital by surveillance, over a period of 39 months (November 2009-January 2013).

In Vitro Antibacterial Efficacy of 21 Indian Timber-Yielding Plants Against Multidrug-Resistant Bacteria Causing Urinary Tract Infection

Objectives To screen methanolic leaf extracts of 21 timber-yielding plants for antibacterial activity against nine species of uropathogenic bacteria isolated from clinical samples of a hospital (Enterococcus faecalis, Staphylococcus aureus, Acinetobacter baumannii, Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa). Methods Bacterial strains were subjected to antibiotic sensitivity tests by the Kirby–Bauers disc diffusion method. The antibacterial potentiality of leaf extracts was monitored by the agar-well diffusion method with multidrug-resistant (MDR) strains of nine uropathogens. Results Two Gram-positive isolates, E. faecalis and S. aureus, were resistant to 14 of the 18 antibiotics used. Gram-negative isolates A. baumannii, C. freundii, E. aerogenes, E. coli, K. pneumoniae, P. mirabilis, and P. aeruginosa were resistant to 10, 12, 9, 11, 11, 10, and 11 antibiotics, respectively, of the 14 antibiotics used. Methanolic leaf extracts of Anogeissus acuminata had the maximum zone of inhibition size—29 mm against S. aureus and 28 mm against E. faecalis and P. aeruginosa. Cassia tora had 29 mm as the zone of inhibition size for E. faecalis, E. aerogenes, and P. aeruginosa. Based on the minimum inhibitory concentration and minimum bactericidal concentration values, the most effective 10 plants against uropathogens could be arranged in decreasing order as follows: C. tora > A. acuminata > Schleichera oleosa > Pterocarpus santalinus > Eugenia jambolana > Bridelia retusa > Mimusops elengi > Stereospermum kunthianum > Tectona grandis > Anthocephalus cadamba. The following eight plants had moderate control capacity: Artocarpus heterophyllus, Azadirachta indica, Dalbergia latifolia, Eucalyptus citriodora, Gmelina arborea, Pongamia pinnata, Pterocarpus marsupium, and Shorea robusta. E. coli, followed by A. baumannii, C. freundii, E. aerogenes, P. mirabilis, and P. aeruginosa were controlled by higher amounts/levels of leaf extracts. Phytochemicals of all plants were qualitatively estimated. Conclusions A majority of timber-yielding plants studied had in vitro control capacity against MDR uropathogenic bacteria.