Shakti Rath

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.

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).

Which value should be used as the lethal concentration 50 (LC(50)) with bacteria

Computations of lethal concentration 50 (LC50) of a data-set of a toxicity study on an herbicide against a cyanobacterium were performed by general linear regression, Spearman-Karber and probit transformation methods, for evaluation of the methods used. It is shown that the linear regression method yields some faulty LC50 value, while both of Spearman-Karber and probit methods yield similar and statistically respectable LC50 values. In the Spearman-Karber method, a prerequisite of some uniform dose-interval of test-chemical and tiring calculations were involved. But, the probit method is less tiring and additionally computed LC25 and LC75 values help assess the solicited accuracy of the LC50 value and other test-statistics, including minimum inhibitory concentration (MIC), highest-permissive concentration (HPC), and a few more with respect to lethal concentration 100 (LC100) without prerequisite of any uniform dose-interval of test-chemical. Further, the redundancy of computations of standard error (SE) and 95% confidence limits (CL) of the LC50 value is suggested, as CL values are so wide to spoil LC50 accuracy that is solicited in toxicology.

Antagonism at combined effects of chemical fertilizers and carbamate insecticides on the rice-field N2-fixing cyanobacterium Cylindrospermum sp. in vitro

Abstract Effects of chemical fertilizers (urea, super phosphate and potash) on toxicities of two carbamate insecticides, carbaryl and carbofuran, individually to the N2-fixing cyanobacterium, Cylindrospermum sp. were studied in vitro at partially lethal levels (below highest permissive concentrations) of each insecticide. The average number of vegetative cells between two polar heterocysts was 16.3 in control cultures, while the mean value of filament length increased in the presence of chemical fertilizers, individually. Urea at the 10 ppm level was growth stimulatory and at the 50 ppm level it was growth inhibitory in control cultures, while at 100 ppm it was antagonistic, i.e. toxicity-enhancing along with carbaryl, individually to the cyanobacterium, antagonism was recorded. Urea at 50 ppm had toxicity reducing effect with carbaryl or carbofuran. At 100 and 250 ppm carbofuran levels, 50 ppm urea only had a progressive growth enhancing effect, which was marked well at 250 ppm carbofuran level, a situation of synergism. Super phosphate at the 10 ppm level only was growth promoting in control cultures, but it was antagonistic at its higher levels (50 and 100 ppm) along with both insecticides, individually. Potash (100, 200, 300 and 400 ppm) reduced toxicity due to carbaryl 20 and carbofuran 250 ppm levels, but potash was antagonistic at the other insecticide levels. The data clearly showed that the chemical fertilizers used were antagonistic with both the insecticides during toxicity to Cylindrospermum sp.

Antibacterial efficacy of five medicinal plants against multidrug-resistant enteropathogenic bacteria infecting under-5 hospitalized children

OBJECTIVE To evaluate in vitro antibacterial effectiveness of five medicinal plants used by an Indian aborigine, against 8 multidrug-resistant (MDR) enteropathogenic bacteria isolated from clinical samples of under-5 hospitalized children. METHODS Antibiotic sensitivity patterns of eight clinically isolated strains of enteropathogenic bacteria, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Salmonella paratyphi, S. typhi, Shigella dysenteriae, S. sonnei and Vibrio cholerae were assessed by disc-diffusion method. Antibacterial activities of 8 solvent-extracts of leaves and bark of five medicinal plants were monitored by the agar-well diffusion method. The microbroth dilution method was used to assess minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Qualitative phytochemical analyses of active plant extracts were carried out. RESULTS Ethanol, ethyl acetate and methanol extracts of Holarrhena antidysenterica leaf tissue were most effective against 8 MDR pathogens in vitro. Similarly, acetone, ethanol and methanol extracts of Terminalia alata leaf tissue; chloroform, ethyl acetate and methanol extracts of Terminalia arjuna leaf tissue and ethyl acetate, ethanol and methanol extracts of Paederia foetida leaf tissue were most effective in inhibiting in vitro growth of the 8 MDR enteropathogens. Ethyl acetate and methanol extracts of H. antidysenterica bark tissue; acetone, ethanol and methanol extracts of T. alata bark tissue and acetone, ethanol and methanol extracts of T. arjuna bark tissue were most effective in controlling enteropathogen growth. The minimum inhibitory concentration and minimum bactericidal concentration values of the 3 most antimicrobial leaf and bark extracts from the five plants were in the range of 1.56 to 50 mg/mL. CONCLUSION These 5 plants exhibited in vitro control over a cohort of 8 enteropathogenic bacterial strains isolated from clinical samples.

Prevalence of two multidrug-resistant Klebsiella species in an Indian teaching hospital and adjoining community.

BACKGROUND The Gram-negative pathogenic bacteria Klebsiella oxytoca and Klebsiella pneumoniae produce the extended spectrum β-lactamase (ESBL) and cephalosporinase enzymes and are the major causes of hospital acquired (HA) infections and epidemics in non-hygienic communities in the majority of developing countries. METHODS The prevalence of multidrug resistance among 445 strains of K. oxytoca and K. pneumoniae isolated from clinical samples of patients with gastrointestinal infections over a period of 42 months in the hospital was recorded, along with the sensitivity patterns to 23 antibiotics, including third-generation cephalosporin and fluoroquinolone antibiotics, using the disk-diffusion method. RESULTS Of 175 K. oxytoca isolates, 143 were ESBL positive and 117 were fluoroquinolone resistant. Of 270 K. pneumoniae isolates, 200 were ESBL positive and 195 were independently fluoroquinolone resistant. The HA samples yielded more isolates than the community acquired (CA) samples for each species. The K. oxytoca strains were resistant to cefepime, gatifloxacin, ciprofloxacin, ceftazidime, levofloxacin and imipenem, whereas the K. pneumoniae strains were highly resistant to ampicillin, norfloxacin, ciprofloxacin, gatifloxacin, ofloxacin, amoxyclav, ceftazidime, cefepime, cefixime, piperacillin and imipenem. The ESBL-producing and fluoroquinolone-resistant K. pneumoniae strains were more prevalent than the K. oxytoca strains in the HA/CA samples. The minimum inhibitory concentration values of the third-generation cephalosporins: cefotaxime and ceftazidime and the fluoroquinolones: ciprofloxacin and levofloxacin against both species of Klebsiella confirmed the resistance in the current/coveted treatment options. CONCLUSIONS Patients with other bacterial infections had a relatively higher probability of infection with ESBL-producing and fluoroquinolone-resistant Klebsiella strains. The data presented here highlight the alarming state of Klebsiella infection dynamics in the hospital and adjoining communities.