Synergistic Effect of Combined Antibiotics against Some Selected Multidrug Resistant Human Pathogenic Bacteria Isolated from Poultry Droppings in Akure, Nigeria

Antibiotic resistant bacteria pass between humans, between animals and between humans and animals in both directions, the use of antibiotics in poultry has contributed to multiple antibiotic resistant in pathogenic bacteria and use of two antibiotics might prevent the emergence of resistance to either. In this study, synergistic effect of combined antibiotics against multidrug resistant human pathogenic bacterial isolates from poultry droppings in Akure, Nigeria was examined. Collection of samples, isolation and identification of bacteria were carried out using standard microbiological method, antibiotic sensitivity test was performed by disc diffusion method and zone of inhibition was used to interpret the sensitivity test as resistant, susceptible or intermediate while combined effects of two antibiotics were investigated by macrobroth dilution and checkerboard assay methods while the synergetic effects of combined antibiotics were calculated using Fractional Inhibitory Concentration (FIC) and percentage synergistic interaction was calculated. All the ten (10) species of bacterial isolates were multidrug resistant and are less resistant to ofloxacin. The highest percentage synergistic interactions observed were Ofloxacin + Amoxicillin (90%), Ciprofloxacin + Amoxicillin (90%), Tetracycline + Amoxicillin (70%), Tetracycline + Augmentin (80%), Cotrimoxazol + Amoxicillin (50%), Cotrimoxazol + Augmentin (70%), Chloramphenicol + Amoxicillin (70%) and Chloramphenicol + Augmentin (80%). Poultry droppings is a potential source of human pathogenic bacteria, high frequency of multiple antibiotic resistance bacteria observed in this study is of great treat to man as this may cause the treatment of infection caused by these bacteria to be difficult. Combination of beta-lactam antibiotic with fluoroqunolones, tetracycline, Chloramphenicol and Cotrimoxazole was synergetic and this will reduce dose related toxicity and prevent resistance to single antibiotic.

Trifunctional Cu-Mesh/Cu_(2)O@FeO Nanoarrays for Highly Efficient Degradation of Antibiotic, Inactivation of Antibiotic-Resistant Bacteria, and Damage of Antibiotics Resistance Genes

Trifunctional Cu-mesh/Cu_(2)O@FeO nanoarrays heterostructure is designed and fabricated by integrating CuCu_(2)O@FeO nanoarrays onto Cu-mesh(CM)via an in situ growth and phase transformation process.It is successfully applied to efficiently mitigate the antibiotic pollution,including degradation of antibiotics,inactivation of antibiotic-resistant bacteria(ARB),and damage of antibiotics resistance genes(ARGs).Under visible-light irradiation,CM/CuCu_(2)O@FeO nanoarrays exhibit a superior degradation efficiency on antibiotics(e.g.,up to 99%in 25 min for tetracycline hydrochloride,TC),due to the generated reactive oxygen species(ROS),especially the dominant·O^(2−).It can fully inactivate E.coli(HB101)with initial number of~108 CFU mL^(−1) in 10 min,which is mainly attributed to the synergistic effects of 1D nanostructure,dissolved metal ions,and generated ROS.Meanwhile,it is able to damage ARGs after 180 min of photodegradation,including tetA(vs TC)of 3.3 log 10,aphA(vs kanamycin sulfate,KAN)of 3.4 log 10,and tnpA(vs ampicillin,AMP)of 4.4 log 10,respectively.This work explores a green way for treating antibiotic pollution under visible light.

Community-acquired multidrug-resistant pneumonia,bacteraemia,and infective endocarditis:A case report

BACKGROUND The prevalence of multidrug-resistant(MDR)bacteria has increased globally,with extensive drug-resistant(XDR)bacteria posing a threat to patients.CASE SUMMARY This case report describes a young man admitted for suspected tropical fever infections who experienced rapid deterioration in health.Despite negative results for tropical fever infections,he had neutrophilic leucocytosis,acute kidney injury,and chest imaging findings suggestive of bilateral consolidations.On day two,he was diagnosed with infective endocarditis with possible rheumatic heart disease and MDR methicillin-resistant Staphylococcus aureus bacteraemia,and communityacquired pneumonia.Despite treatment with broad-spectrum antibiotics,he did not respond and succumbed to death on day five.CONCLUSION This case highlights that clinicians/public should be aware of MDR communityacquired pneumonia,bacteraemia,and endocarditis which ultimately culminate in high rates of morbidity and mortality.Early identification of pathogenic strain and prompt antibiotic treatment are a mainstay for the management and prevention of early fatalities.Simultaneously,route cause analysis of communityacquired MDR/XDR pathogens is a global need.

The Carriage of Escherichia coli Resistant to Antibiotics in Healthy Populations in Shanghai

Healthy populations represent the largest reservoir of bacteria resistant to antibiotics.We investigated the resistance of Escherichta coli to 12 antibiotics in fecal samples from untreated healthy populations in Shanghai, China by using Kirby-Bauer (K-B) method. The results showed that: (i) All subjects carried resistant strains of Escherichta coli. (ii) The carriage rates of Escherichta coli resistant to various antibiotics were different, less than 10 % to amikacin and 30 % to 100% to others. (iii) In the elder children group aged 10-11 years, the percentages of stralns resistant to gentamicin, streptomycin, chloramphenicol, tetracycline, trimethoprim, and sulfamethoxazole were significantly lower than those in the younger group aged 5-6 years. In the adult group, the percentages of strains resistant to ampicillin, piperacillin, arnikacin, streptomycin, chloramphenicol, tetracycline, trimethoprim, and sulfamethoxarole were significantly lower than those in the elder children group. (iv) The number of strains resistant to five or more antibiotics accounted for 31. 8 % in the younger children group, 23. 7 % in the elder children group,and 12. 1 % in the adult group. These findings suggest that all healthy people in Shanghal carry resistant strains of Escherichta coli in the intestine. The younger the populations, the higher the level of resistance of fecal Escherichta coli to antibiotics. Improvement of health behaviors and environmental sanitation and rational use of antibiotics could remarkedly decrease the resistant level of bacteria

Mobile genetic elements facilitate the transmission of antibiotic resistance genes in multidrug-resistant Enterobacteriaceae from duck farms

Multidrug-resistant(MDR)Enterobacteriaceae critically threaten duck farming and public health.The phenotypes,genotypes,and associated mobile genetic elements(MGEs)of MDR Enterobacteriaceae isolated from 6 duck farms in Zhejiang Province,China,were investigated.A total of 215 isolates were identified as Escherichia coli(64.65%),Klebsiella pneumoniae(12.09%),Proteus mirabilis(10.23%),Salmonella(8.84%),and Enterobacter cloacae(4.19%).Meanwhile,all isolates were resistant to at least two antibiotics.Most isolates carried tet(A)(85.12%),blaTEM(78.60%)and sul1(67.44%)resistance genes.Gene co-occurrence analysis showed that the resistance genes were associated with IS26 and integrons.A conjugative IncFII plasmid pSDM004 containing all the above MGEs was detected in Proteus mirabilis isolate SDM004.This isolate was resistant to 18 antibiotics and carried the blaNDM-5 gene.MGEs,especially plasmids,are the primary antibiotic resistance gene transmission route in duck farms.These findings provide a theoretical basis for the rational use of antibiotics in farms which are substantial for evaluating public health and food safety.

Analysis of the Clinical Characteristics and Antibiotics Resistance of Community-acquired Methicillin-resistant Staphylococcus aureus

The purpose of this investigation is to study the clinical characteristics of infections by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and the condition of antibiotics resistance of the clinical isolates in order to guide for the rational use of antibiotics. With the clinical isolates from cases of hospital-acquired MRSA at the same period as controls, the clinical characteristics of infections by community-acquired MRSA in Hangzhou area and the pattern of non-β-lactamase antibiotics resistance were determined in this study. It was found that the average age of patients with community-acquired MRSA infections was 30.89±13.3, in comparison with those of the hospital-acquired patients of 56.0±11.8, appearing to be younger than those of the latter, and the former showing no any basic illness. Both of the former and the latter were sensitive to vancomycin (100% vs 100%), and they had the same degrees of sensitivity to rifampicin, fosfomycin, and STM/TMP (86.8% vs 88.1%, P >0.05; 81.6% vs 82.9%, P >0.05; and 52.6% vs 61.9%, P >0.05, respectively). The former was more sensitive to netimycin, clindamycin, erythromycin and minocycline than those of the latter (73.7% vs 50.5%, P <0.01; 60.5% vs 45.7%, P <0.05; 28.9% vs 11.4%, P <0.01; and 81.6% vs 58.6%, P <0.01 respectively). Meanwhile, the incidence of multi-resistant strain of isolates in the former was significantly lower than that of the latter (31.6% vs 81.0%, P <0.01). In conclusion, it appears that the strains of clinical isolates isolated from patients with the community-acquired MRSA infections show different clinical characteristics and antimicrobial susceptibility in comparison with those of the hospital-acquired cases of infection, and this necessitates an alteration in the chemotherapy of infections suspected to be caused by community-acquired MRSA.

Prevalence of Drug Resistant Uropathogenic Escherichia coli from Immunocompromised Diabetic Patients Attending Selected Health Facilities in Benue State

Escherichia coli is the commonest bacterial uropathogen of UTIs, the commonest infections in immunocompromised diabetic patients. Better understanding of their main resistance mechanisms to commonly used antibacterial agents will help to reduce the burden of this infection. The prevalence of drug resistant uropathogenic Escherichia coli isolates from immunocompromised diabetic patients attending selected health facilities in Benue State was investigated. Two hundred and ninety-six midstream urine samples were collected for both study and control diabetic patients. Bacterial isolation was done using semi-quantitative method. Drug resistant Escherichia coli were identified as multidrug resistant (MDR), extensive drug resistant (XDR) and pan-drug resistant organisms (PDR). Statistical significance was considered at p E. coli isolates from the study and control subjects with overall prevalence of 20.9% and 8.4% respectively. The isolates were highly resistant to penicillin (ampicillin), monobactam (aztreonam), older quinolone (nalidixic acid) whereas the majority of them showed high susceptibility to aminoglycoside (streptomycin), cephalosporin (cefotaxime) and carbapenem (imipenem). None showed complete susceptibility to all the tested antibiotics. Twenty-five E. coli were identified in this MDR, eight, XDR while 5 were PDR. High numbers of drug resistant E. coli isolates were identified in the study group of which 25 were MDR, 8 XDR while 5 were PDR isolates. High prevalence of UTI and drug resistant isolates occur in diabetic patients with hyperglycemic condition.

Performance Parameters:Demobilization Antibiotic Resistant Bacteria(ARB)and Carrying Genes(ARG)in Wastewater Disinfection

The UV irradiation is used for removing Antibiotic Resistant Bacteria(ARB)and Antibiotic Resistance Genes(ARG)from wastewater treatment.Bacteriophages are viruses that infect within bacteria,are recognized for bacterial control.The influence of some parameters in quantification and performance influencing of pathogen demobilization could be considered in disinfection of wastewater.The comparison of Polyvalent phage(NE1)versus Coliphage(NE4)in suppressing a bacterium Escherichia coli(NDM-1:b-lactam-resistant)with UV irradiation was observed the efficacy in reduction of cells in the disinfection and parameter process.The results with the effect of UV-C irradiation on NDM-1 infected with 1%of NE4 showed a decrease of cells from 8×10^(6)to 2×10^(5)in 60 min with UV-C dose.The NDM1(E.coli)was infected with 1%of NE4(Polyvalent Phage)under magnetic stirring for 1 h,the cells count was 8×10^(6).After 1 h in UV-C e×posure,the cells number reached 3×10^(5).The NDM1 that was e×posed in 1 h of UV-C irradiation and then was infected with 1%of NE4.Cells counting were done 24 h after this procedure.These cells were e×posed in UV-C and showed a reduction in the number of cells from 1×10^(8)to 4×10^(5)after 60 min.The results indicate that bacteriophages can mitigate bacteria species,and combined the conventional water disinfection technologies that can support the microbial safety control strategies.

Community-acquired pneumonia:The importance of the early detection of drug-resistant organisms

Pneumonia is a disease associated with significant healthcare burden with over 1.5 million hospitalizations annually and is the eighth leading cause of death in the United States.While community-acquired pneumonia(CAP)is generally considered an acute time-limited illness,it is associated with high long-term mortality,with nearly one-third of patients requiring hospitalization dying within one year.An increasing trend of detecting multidrug-resistant(MDR)organisms causing CAP has been observed,especially in the Western world.In this editorial,we discuss about a publication by Jatteppanavar et al which reported that a case of a MDR organism was the culprit in developing pneumonia,bacteremia,and infective endocarditis that led to the patient’s death.The early detection of these resistant organisms helps improve patient outcomes.Significant advances have been made in the biotechnological and research space,but preventive measures,diagnostic techniques,and treatment strategies need to be developed.

Isolation and Biological Characteristics of Bacteriophage of an Antibiotic-resistant Escherchia coli Strain

In this study, bacteriophage of an antibiotic-resistant Escherchia coil strain isolated from feces of chicken was isolated. Its host range was determined by the method of spotting sample on monolayer agar, and its lysis titer, optimal multiplicity of infection （MOI）, temperature tolerance and pH tolerance were determined by the double-layer agar plate method. The results showed that the bacteriophage had a broad host range. The biological assay demonstrated that two strains of E. coil were fully lysed and one strain of E. coil was weakly lysed by the bacteriophage. The lysis titer and MOI of the bacteriophage were 1.20×10^8 PFU/ml and 1, respec- tively. Under the optimum temperature of 40℃, the Jysis titer of the bacteriophage reached 8.90×10^9 PFU/ml; however, the bacteriophage lost its infectivity at the tem- perature of 80℃. In the pH range of 5-11, the lysis titer of the bacteriophage ranged from10^6 to 10^9 PFU/mI. Under the condition of pH 4 and 12, the bacterio- phage was invalid.

Resistance of Helicobacter pylori to antibiotics from 2000 to 2009 in Shanghai

AIM: To investigate the resistance of Helicobacter pylori (H. pylori ) to 6 commonly used antibiotics from 2000 to 2009 in Shanghai. METHODS: A total of 293 H. pylori strains were collected from 2000 to 2009 in Shanghai and tested for their susceptibility to metronidazole, clarithromycin, amoxicillin, furazolidone, levofloxacin and tetracycline using agar dilution. RESULTS: The resistant rates of H. pylori to clarithromycin (8.6%, 9.0% and 20.7%) and levofloxacin (10.3%, 24.0% and 32.5%) increased from 2000 to 2009 in Shanghai. The resistant rate of H. pylori to metronidazole remained stable (40%-50%). Only one strain of H. pylori isolated in 2005 was resistant to tetracycline. All strains were sensitive to amoxicillin and furazolidone.The resistant rate of H. pylori to antibiotics was not related with the sex, age and clinical outcome of patients. CONCLUSION: Resistance of H. pylori to antibiotics plays an important role in making treatment strategies against H. pylori -associated diseases.

Detection,isolation,and identification of cadmium-resistant bacteria based on PCR-DGGE

This study focused on the screening of cadmium-resistant bacterial strains from Pb-Zn tailing. We investigated the diversity of microbial community inhabiting Dong-san-cha Pb-Zn tailing in Beijing, China, by polymerase chain reaction-denaturing gradient gel electrophoresis （DGGE） of 16S rRNA gene of bacterial strain, and found two dominant strains in the DGGE profile. Using special culture media, we isolated two strong cadmium-resistant bacterial strains. On the basis of morphological, physiological, and biochemical characteristics, BIOLOG, and 16S rDNA sequencing, the two strains were identified as Bacillus cereus and Enterobacter cloacae. Minimal inhibitory concentrations （MICs） of heavy metals for the bacteria were determined. E. cloacae showed higher MIC values for heavy metals and a larger range of antibiotic resistance than B. cereus.

Distribution of gyrA mutations in fluoroquinolone-resistant Helicobacter pylori strains

AIM:To investigate the resistance of Helicobacter pylori(H.pylori) to ciprofloxacin(CIP),levofloxacin(LVX) and moxifloxacin(MOX) in the Beijing area and to elucidate the resistance mechanisms.METHODS:Seventy-nine H.pylori clinical strains,isolated from patients who had undergone upper gastrointestinal endoscopy in Peking University First Hospital from 2007 to 2009,were tested for their susceptibility to CIP,LVX and MOX using the E-test method.H.pylori strain 26695 was included in the susceptibility testing as a control strain.According to the minimal inhibitory concentration(MIC) values,a strain was classified as resistant to CIP,LVX or MOX when the MIC was > 1 μg/mL.We amplified by polymerase chain reaction(PCR) and sequenced the quinolone resistance-determining regions of the gyrA and gyrB genes from 29 quinolone-resistant and 16 quinolone-susceptible H.pylori strains selected at random.RESULTS:In this study,the resistance rates of H.pylori to CIP,LVX or MOX were 55.7%(44/79),and the primary resistance rates were 26.6%(21/79).Patients with secondary resistance had received LVX in previous eradication treatments,but not MOX or CIP.Forty-five strains,including 29 CIP,LVX or MOX-resistant strains(MIC:1.5-32 μg/mL) and 16 susceptible strains,were selected randomly from the 79 strains and used in PCR analysis.Among these 45 strains,27 resistant strains had mutations in the gyrA gene,including 11 strains with mutations corresponding to Asp-91(MIC:2-32 μg/mL),one of which also had a mutation corresponding to Val-150,and 16 strains had mutations at Asn-87(MIC:4-32 μg/mL),three of which also had mutations corresponding to Arg-140 or Val-150.In addition,Arg-140,Val-150 or Ala-97 mutations were separately detected in three susceptible strains.Analysis of the gyrB gene showed that one strain of low resistance had a mutation corresponding to Ser-457 that coexisted with an Asp-91 mutation.There was a significant difference in the occurrence of mutations in the gyrA gene between CIP,LVX and MOX-resistant and-susceptible strains(P < 0.05),but 2 resistant strains were found to possess no quinolone resistance-determining region mutations.CONCLUSION:Resistance is primarily mediated through point mutations in gyrA.Whether other mechanisms are responsible for resistance in strains without mutations in the QRDR should be detected.

Phage therapy: An alternative to antibiotics in the age of multi-drug resistance

The practice of phage therapy, which uses bacterial viruses(phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnological advances have further expanded the repertoire of potential phage therapeutics to include novel strategies using bioengineered phages and purified phage lytic proteins. Current research on the use of phages and their lytic proteins against multidrug-resistant bacterial infections, suggests phage therapy has the potential to be used as either an alternative or a supplement to antibiotic treatments. Antibacterial therapies, whether phage-or antibiotic-based, each have relative advantages and disadvantages; accordingly, many considerations must be taken into account when designing novel therapeutic approaches for preventing and treating bacterial infection. Although much about phages and human health is still being discovered, the time to take phage therapy serious again seems to be rapidly approaching.

Effect of biofilm formation by clinical isolates of Helicobacter pylori on the efflux-mediated resistance to commonly used antibiotics

To evaluate the role of biofilm formation on the resistance of Helicobacter pylori (H. pylori) to commonly prescribed antibiotics, the expression rates of resistance genes in biofilm-forming and planktonic cells were compared.METHODSA collection of 33 H. pylori isolates from children and adult patients with chronic infection were taken for the present study. The isolates were screened for biofilm formation ability, as well as for polymerase chain reaction (PCR) reaction with HP1165 and hp1165 efflux pump genes. Susceptibilities of the selected strains to antibiotic and differences between susceptibilities of planktonic and biofilm-forming cell populations were determined. Quantitative real-time PCR (qPCR) analysis was performed using 16S rRNA gene as a H. pylori-specific primer, and two efflux pumps-specific primers, hp1165 and hefA.RESULTSThe strains were resistant to amoxicillin, metronidazole, and erythromycin, except for one strain, but they were all susceptible to tetracycline. Minimum bactericidal concentrations of antibiotics in the biofilm-forming cells were significantly higher than those of planktonic cells. qPCR demonstrated that the expression of efflux pump genes was significantly higher in the biofilm-forming cells as compared to the planktonic ones.CONCLUSIONThe present work demonstrated an association between H. pylori biofilm formation and decreased susceptibility to all the antibiotics tested. This decreased susceptibility to antibiotics was associated with enhanced functional activity of two efflux pumps: hp1165 and hefA.

Selection of appropriate analytical tools to determine the potency and bioactivity of antibiotics and antibiotic resistance

Antibiotics are the chemotherapeutic agents that kill or inhibit the pathogenic microorganisms.Resistance of microorganism to antibiotics is a growing problem around the world due to indiscriminate and irrational use of antibiotics.In order to overcome the resistance problem and to safely use antibiotics,the correct measurement of potency and bioactivity of antibiotics is essential.Microbiological assay and high performance liquid chromatography（HPLC） method are used to quantify the potency of antibiotics.HPLC method is commonly used for the quantification of potency of antibiotics,but unable to determine the bioactivity;whereas microbiological assay estimates both potency and bioactivity of antibiotics.Additionally,bioassay is used to estimate the effective dose against antibiotic resistant microbes.Simultaneously,microbiological assay addresses the several parameters such as minimal inhibitory concentration（MIC）,minimum bactericidal concentration（MBC）,mutation prevention concentration（MPC） and critical concentration（Ccr） which are used to describe the potency in a more informative way.Microbiological assay is a simple,sensitive,precise and cost effective method which gives reproducible results similar to HPLC.However,the HPLC cannot be a complete substitute for microbiological assay and both methods have their own significance to obtain more realistic and precise results.

Cloning and Sequence Analysis of Mutant OmpF from Antibiotic Resistant Escherichia coli

[Objective]This study aimed to investigate the mutations of OmpF from an isolated antibiotic resistant Escherichia coli strain.[Methods]The mutant OmpF（mOmpF）from antibiotic resistant E.coli was amplified by PCR with Pfu DNA polymerase and ligated into the expression vector pET28a.Subsequently,the expression vector pET28-mOmpF was sequenced and analyzed by DNAMAN software and Swiss-Model online.[Result]Sequence analysis revealed that the open reading fragment of mOmpF was 903 bp long,which was mutated dramatically compared to that of the 1 020 bp long model OmpF.The DNA sequence shared only54.5%homology with OmpF.mOmpF was 44.6%identical to that of OmpF.Protein structure predication and analysis through Swiss-Model online suggested that the structure of mOmpF changed dramatically compared to OmpF.[Conclusion]The present study provided basis for further analyzing the relationships between the structure and functions of mOmpF from antibiotic resistant E.coli.

Gonorrhoea among Sex Workers in China: Prevalence, Risk Factors, and Resistance to Antibiotics

Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were recruited into a sexually transmitted diseases (STD) care and prevention programme through various outreach activities. Data collection was standardized. Cervical samples were tested for the presence of Neisseria (N.) gonorrhoea by culture. The agar dilution method was performed to determine susceptibilities of 85 isolates to penicillin, ciprofloxacin, spectinomycin and ceftriaxone. The production of B-lactamase was determined by paper acidometric testing. Results The prevalence of gonorrhoea was 9%. Independent predictors for the disease were inconsistent condom use, lack of regular salary, absence of a previous STD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamydial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent discharge at genital examination were also independently associated with gonorrhoea. Of the 85 N. gonorrhoea isolates, 3.5% was penicillinase producing (PPNG) and 7% plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% was insensitive to penicillin, while 52% and 47% were resistant or less susceptible to ciprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriaxone. All strains were susceptible to spectinomycin. Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, but strains were sensitive to ceftriaxone and spectinomycin. Several personal or medical characteristics were independently associated with the presence of gonorrhoea. Women diagnosed with gonorrhoea should receive concurrent treatment for chlamydial infection.

Isolation and Antibiotic-Resistant Pattern of Opportunistic Infectious Microbes from the Infected Sites of Oral Cancer Patients Compared to That of Healthy People Oral Microbiota

Introduction: Oral cancer is the third most prominent type of cancer in Bangladesh. During or after oral cancer treatment, immune-compromised cancer patients may be susceptible to an infection by multi-drug-resistant opportunistic microbes. This study aims to identify the prevalent microorganisms from the infected site of oral cancer patients and observe their antibiotic susceptibility pattern. Materials and Methods: Clinical samples were collected from the infected sites of oral cancer patients and healthy people. The swabs collected were placed on nutrient agar slant, then incubated for 24 hours at 37ºC. Bacteria from the slant were inoculated in several selective media (Mannitol Salt Agar Media, KF Streptococcus Agar media, Cetrimide Agar, Eosin Methylene Blue Agar). Several biochemical tests identified opportunistic microorganisms. Finally, the antibiotic susceptibility test was performed by the Kirby Bauer disc diffusion method. Results: The study found that 65.4% of microbes isolated from the patients’ oral cavities were Gram-negative bacteria, and 34.6% were Gram-positive bacteria. Among the patient group isolates (n = 55), the most prevalent organism was Pseudomonas spp. (30;54.54%). Others were Klebsiella spp. (27;49.09%), Staphylococcus spp. (24;43.63%), E. coli (14;25.45%), Streptococcus spp. (14;25.45%), Proteus spp. (12;21.8%) and Enterococcus spp. (6;10.90%). Both Gram-positive and Gram-negative microbes from the patient group have shown high resistance to the commonly used antibiotics. In the control group (n = 50), the most prevalent organism was Staphylococcus spp. (15;30%). Other organisms were Streptococcus spp. (6;12%), Klebsiella spp. (11;22%), E. coli (3;6%), Streptococcus spp. (14;25.45%), Pseudomonas spp. (8;16%). The microbes of the control group showed less resistance to the antibiotics and rather showed sensitivity to them. Conclusion: The study revealed a high prevalence of multi-drug-resistant opportunistic microbes on immune-compromised oral cancer patients compared to microbes isolated from healthy people’s oral cavity.

Reversal of Tetracycline Resistance by Cepharanthine,Cinchonidine,Ellagic Acid and Propyl Gallate in a Multi-drug Resistant Escherichia coli

Bacterial resistance to antibiotics is an increasing threat to global healthcare systems.We therefore sought compounds with potential to reverse antibiotic resistance in a clinically relevant multi-drug resistant isolate of Escherichia coli(NCTC 13400).200 natural compounds with a history of either safe oral use in man,or as a component of a traditional herb or medicine,were screened.Four compounds;ellagic acid,propyl gallate,cinchonidine and cepharanthine,lowered the minimum inhibi-tory concentrations(MICs)of tetracycline,chloramphenicol and tobramycin by up to fourfold,and when combined up to eightfold.These compounds had no impact on the MICs of ampicillin,erythromycin or trimethoprim.Mechanistic studies revealed that while cepharanthine potently suppressed efflux of the marker Nile red from bacterial cells,the other hit com-pounds slowed cellular accumulation of this marker,and/or slowed bacterial growth in the absence of antibiotic.Although cepharanthine showed some toxicity in a cultured HEK-293 mammalian cell-line model,the other hit compounds exhibited no toxicity at concentrations where they are active against E.coli NCTC 13400.The results suggest that phytochemicals with capacity to reverse antibiotic resistance may be more common in traditional medicines than previously appreciated,and may offer useful scaffolds for the development of antibiotic-sensitising drugs.