Anti-fungal and anti-bacterial activities of ethanol extracts of selected traditional Chinese medicinal herbs

Objective:To evaluate in ritro antimicrobial activities of selected 58 ethno-medicinal plant extracts with a view to assess their therapeutic potential.Methods:A total of 58 traditional Chinese medicinal plants were carefully selected based on the literature review and their traditional use.The antimicrobial activities of ethanol extracts of these medicinal plants were tested against fungi(Aspergillus funigaius),yeast(Candida albicans),gram-negative(Acirelobacter haumannii and Pseudornnruis aeruginosa)and gram-positive bacteria(Staphglococcus aureus).The activities were tested at three different concentrations of 1.00,0.10 and 0.01 mg/mL.The data was analysed using Gene data Screener program.Results:The measured antimicrobial activities indicated that out of the 58 plant extracts,15 extracts showed anti-fungal activity and 23 extracts exhibited anti-bacterial activity.Eight plant extracts have exhibited both anti-bacterial and anti-fungal activities.For instance,Eucommia ulmoides,Pohgonum cuspidcrtum,Poria cocas and Uncaria rhineophylla showed activity against both bacterial and fungal strains,indicating their broad spectrum of activity.Conclusions:The results revealed that the ethanol extracts of 30 plants out of the selected 58 possess significant antimicrobial activities.It is interesting to note that the findings from the current study are consistent with the traditional use.A clear correlation has also been found between the antimicrobial activity and the flavonoid content of the plant extracts which is in agreement with the literature.Hence.the results presented here can be used to guide the selection of potential plant species for the isolation and structure elucidation of novel antimicrobial compounds in order to establish the structure-activity relationship.This in turn is expected to lead the way to the discovery of novel antimicrobial agents for therapeutic use.

Phytochemical and anti-bacterial activity of epidermal glands extract of Christella parasitica (L.) H. Lev.

Objective:To study the morphology,biochemistry and bioactivity of the epidermal glands of the glandular morphotype of Christella parasitica(C.parasitica)(L.) H.Lev.Methods: Morphological studies on epidermal glands were earned out by using light microscope and scanning electron microscope.To prepare the extract,the shade-dried fronds of glandular morphotype were soaked in acetone.For antibacterial studies paper disc method was followed by using various pathogenic bacteria.Results:Detailed micromorphological,phytochemical and bioactivity studies on a medicinal fern C.parasitica(L.) H.Lev.showed its inlraspecific variation in antibacterial activity.The presence or absence of the epidermal glands was the key factor for antibacterial activity in the morphovariants of this species.The epidermal glands were orange-coloured,stalked and elongated ones of about 84.2μm×45μm,and distributed on the undersurface of cosla,coslules and veins in croziers,young and mature leaves.Frequency of glands varied from 15/cm on costa in mature leaves to 140/cm on costules in croziers.The acetone extract of the glands showed antibacterial activities and also toxic effect against mosquito larvae and tadpoles of frog.Preliminary phytochemical analysis and HPLC studies of the gland extract showed the presence of various kinds of terpenoids,alkaloids,tannins,saponins and flavonoids in it.Conclusions:The present study shows that epidermal glands of the glandular morphotype of C. parasitica(L.) H.Lev.have several bioactive compounds and such rare moiphovariant should be conserved in nature.The next step is to isolate the pure compounds and to screen the bioactivity of individual compounds of the epidermal glands.

Anti-bacterial studies on Hemigraphis colorata(Blume) H.G.Hallier and Elephantopus scaber L.

Objective:To examine the ethanol,aqueous,chloroform,benzene,acetone and petroleum ether extracts of Hemigraphis colorata(H.colorata) leaves and stem and Elephantopus scaber (E.scaber) leaves,root and flower for the presence of phyto-constituents and screened the antibacterial activity against the selected pathogens.Methods:The fresh materials were shade dried and powdered using the tissue blender.The dried and powered materials(50 g) were extracted successively with 200 mL of aqueous,acetone,benzene,chloroform,etganol.and petroleum ether by using Soxhlet extractor for 8 h at a temperature not exceeding the boiling point of the solvent.Aqueous,acetone,benzene,chloroform,ethanol.and petroleum ether extracts were prepared from powdered materials were used for preliminary phytnehemical and antimicrobial studies using standard methods.Results:The crude aqueous,acetone,benzene,chloroform, ethauol.and petroleum ether extracts E.scaber leaves,flower and root and H.colorata leaves and stem demonstrated that out of(5×6×12 = 360) tests for the presence or absence of the above compounds.188 tests gave positive results and the remaining 172 gave negative results. The results of the phvtochemical screening revealed that phenol(12/12).carbohydrates(9/12). steroids(8/12).saponins and coumarins(7/12).tannins(6/12),proteins(5/12).earboxylic acid and flavonoids(4/12).xanthoproteins(3/12) and alkaloids(2/12) presence in the crude aqueous, acetone,benzene,chloroform,ethanol.and petroleum ether extracts of H.colorata leaves and stem.The crude aqueous,acetone,benzene,chloroform,ethanol.and petroleum ether extracts E.scaber leaves,flower and root displayed the presence of phenol(18/18).tannin(17/18). carbohydrates(16/18).steroids(14/18),oarboxylic acid and coumarins(12/18).saponins(10/18), xanthoprotein(9/18).flavonoids(7/18).protein(4/18) and alkaloids(2/18).The root ethanolic extracts of E.scaber illustrated the highest zone of inhibition against three pathogens viz.. Staphylococcus aureus(S.aureus)(24 mm).Escherichia coli(E.coli)(16 mm) and Psemlomonas aeruginosa {P.aeruginosa)(13 mm).The chlorofrom extracts of E.scaber showed the highest zone of inhibition against Bacillus cereus(B.ceretus)(12 mm).The leaves ethanolic extracts of E.scaber demonstrated the highest zone of inhibition against three pathogens viz.,Enterococcus faecalis (E.faecalis)(18 mm).Proteus mirabilis(P.mirabilis)(17 mm).Salmonella Typhi(S.typhi)(14 mm) and Enterobacter sp.(11 mm) While the benzene extracts of H.colorata demonstrated maximum zone of inhibition against the pathogen Acinetobucter sp.(14 mm) and S.aureus (12 mm).Conclusions:It is hoped that this study would direct to the establishment of some compounds that could be used to invent new and more potent antimicrobial drugs of natural origin.

Effect of K1, K2 Anti-Bacterial Agents on Tobacco Ralstonia Solanacearum

The tobacco Ralstonia Solanacearum were both cultured on nutrient agar plates and inoculated in seedling stage of tobacco, then treated with K1 and K2, two anti-bacterial agents, at a serial con-centrations to study their inhibitory efficiency. The result indicated that K1 can inhibit R. Solanacearum growth entirely, at the concentration range from 1/50 to 1/5000. K2 can reach the same result at the concentration range from 1/50 to 1/50000. Compared with the control plates, K1, at the concentration 1/50000, had no significant differences, and the average number of colony per plate was 112-115. The immature tobacco shown wilt as soon as inoculated with R. Solanacearum, and recovered gradually after using K1, K2. The densities of microbial suspension, handled by K1, K2 within 10 hs, were both significantly lower than the controlled ones. The optical microscopy also shown that handled microbial body differed from the controlled, whose body was regular short, rod shape as opposed to the handled ones with irregular rod shape and damaged body. All the results indicated that K1 and K2 both had inhibitory effects on tobacco R. Solanacearum, and K2 was more efficient than K1.

In vitro anti-biofilm and anti-bacterial activity of Junceella juncea for its biomedical application

Objective:To investigate the anti-biofilm and anti-bacterial activity of Junceella juncea(J.juncea)against biofilm forming pathogenic strains.Methods:Gorgonians were extraeted with methanol and analysed with fourier transform infrared spectroscopy.Biofilm forming pathogens were identified by Congo red agar supplemented with sucrose.A quantitative spectrophotometric method was used to monitor in vitro biofilm reduction by microtitre plate assay.Anti-bacterial activity of methanolic gorgonian extract(MGE)was carried out by disc diffusion method followed by calculating the percentage of increase with crude methanol(CM).Results:The presence of active functional group was exemplified by FT-IR spectroscopy.Dry,black,crystalline colonies confirm the production of extracellular polymeric substances responsible for biofilm formation in Congo red agar.MGE exhibited potential anti-biofilm activity against all tested bacterial strains.The anti-bacterial activity of methanolic extract was comparably higher in Salmonella typhii followed by Escherichia colt,Vibrio cholerae and Shigella flexneri.The overall percentage of increase was higher by 50.2%to CM.Conclusions:To conclude,anti-biofilm and anti-bacterial efficacy of J.juncea is impressive over biofilm producing pathogens and are good source for novel anti-bacterial compounds.

Biocompatible silver nanoparticles: An investigation into their protein binding efficacies, anti-bacterial effects and cell cytotoxicity studies

Green synthesis of silver nanoparticles(AgNPs)has garnered tremendous interest as conventional methods include the use and production of toxic chemicals,products,by-products and reagents.In this regard,the synthesis of AgNPs using green tea(GT)extract and two of its components,(-)-epigallocatechin gallate(EGCG)and(+)-catechin(Ct)as capping/stabilizing agents,is reported.The synthesized AgNPs showed antibacterial activity against the bacterial strains Staphylococcus aureus and Escherichia coli,along with anticancer activity against HeLa cells.After administering nanoparticles to the body,they come in contact with proteins and results in the formation of a protein corona;hence we studied the interactions of these biocompatible AgNPs with hen egg white lysozyme(HEWL)as a carrier protein.Static quenching mechanism was accountable for the quenching of HEWL fluorescence by the AgNPs.The binding constant(Kb)was found to be higher for EGCG-AgNPs((2.309±0.018)×104 M-1)than for GT-AgNPs and Ct-AgNPs towards HEWL.EGCG-AgNPs increased the polarity near the binding site while Ct-AgNPs caused the opposite effect,but GT-AgNPs had no such observable effects.Circular dichroism studies indicated that the AgNPs had no such appreciable impact on the secondary structure of HEWL.The key findings of this research included the synthesis of AgNPs using GT extract and its constituent polyphenols,and showed significant antibacterial,anticancer and protein-binding properties.The-OH groups of the polyphenols drive the in situ capping/stabilization of the AgNPs during synthesis,which might offer new opportunities having implications for nanomedicine and nanodiagnostics.

Cranberry cultivated in China:UPLC-Q-TOF-MS analysis of its acidic ethanol extract and assessment of its anti-bacterial and anti-tumor activities in vitro

Cranberry,the fruit of Vaccinium macrocarpon Aiton,is becoming popular all over the world,due to its pleasant taste,nutraceutical value and biological activities.For a long time,98%of its yield has been from America.Since being introduced to China as an import in recent decades,cranberry has become a rapid success in the food industry even with the high transportation cost.Recently,V.macrocarpon was cultivated in the Northeast of China,and the area of cultivation has increased dramatically.Therefore,it is important to systematically determine the useful compounds and their activity in this“Made-in-China”cranberry.In the present study,the content of total phenolics,anthocyanins,proanthocyanidins,sugars and organic acids was determined.Our results demonstrated that domestic cranberry is a rich source of phenolics,anthocyanins,proanthocyanidins,sugars and organic acids.Analysis of the chemical composition of an acidic ethanol extract by UPLC-QTOF-MS identified 21 compounds as well as the contents determination of catechin and cyanidin-3-O-glucoside using RPHPLC.Furthermore,cranberry extract was tested for its anti-bacterial activity against five clinically important pathogens,as well as its inhibitory effect on the proliferation and migration of cancer cells in vitro.Our results demonstrated that cranberry produced in Chinese cultivation areas is a rich source of bioactive compounds and exhibited in vitro anti-microbial and anti-tumor activities.Our work provides essential information about the quality of domestic cranberry and facilitates the development of related industries.

Design,synthesis and bioevaluation of N-hydroxyquinolinones as potential anti-plasmodial,anti-bacterial and iron(Ⅱ)-chelating agents

OBJECTIVE To establish a small compound library via a versatile synthetic route for the investigation of natural-inspiring compounds containing N-hydroxypyridones motif as potential anti-plasmodial,anti-bacterial and iron(Ⅱ)-chelating agents.METHODS An amidation/cyclization approach was adopted to synthesize a library of N-hydroxyquinolinones.The anti-plasmodial susceptibility of lab clone 3D7 P.falciparum was measured using aprotocol modified from the WHO microtest.The minimum bactericidal concentration(MBC)values were determined against Escherichia coli and Staphylococcus arueus.Nine compounds were selected to test their iron(Ⅱ)-chelating abilities.The iron(Ⅱ)-chelating ability was determined by measuring the absorbance of ferrozine-iron complex at 562 nm.RESULTS A new route for the facile synthesis of a library of N-hydroxyquinolinones based on one-pot palladium catalyzed C-N amidation/dehydrocyclizationsequence was implemented.Four compounds show anti-plasmodial activities with the range of 1.1-1.4μmol·L-1,50% chelation abilities of the nine selected compounds were shown to be 0.24-0.29mmol·L-1.CONCLUSION Alibrary of N-hydroxyquinolinones was synthesized via a novel synthetic route.The anti-plasmodial and anti-bacterial activities of these compounds were evaluated.Four compounds show potent anti-plasmodial activities Nine compounds were examined for their propensities to undergo iron chelation and these compounds were shown to be promising iron(Ⅱ)chelators as compared to EDTA.

An anti-bacterial porous shape memory self-adaptive stiffened polymer for alveolar bone regeneration after tooth extraction

The regeneration of alveolar bone after tooth extraction is critical for the placement of dental implants.Developing a rigid porous scaffold with defect shape adaptability is of great importance but challenging for alveolar bone regeneration.Herein,we design and synthesize a biocompatible poly(L-glutamic acid)-g-poly(ε-caprolactone)(PLGA-g-PCL)porous shape memory(SM)polymer.The PLGA-g-PCL is then copolymerized with acryloyl chloride grafted poly(ω-pentadecalactone)(PPDLDA)having a higher phase transition temperature than shape recovery temperature to maintain stiffness after shape recovery to resist chewing force.The hybrid pol-ydopamine/silver/hydroxyapatite(PDA/Ag/HA)is coated to the surface of(PLGA-g-PCL)-PPDL scaffold to afford the anti-bacterial activity.The porous SM scaffold can be deformed into a compact size and administered into the socket cavity in a minimally invasive mode,and recover its original shape with a high stiffness at body tem-perature,fitting well in the socket defect.The SM scaffold exhibits robust antibacterial activity against Staphy-lococcus aureus(S.aureus).The porous microstructure and cytocompatibility of PLGA allow for the ingrowth and proliferation of stem cells,thus facilitating osteogenic differentiation.The micro-CT and histological analyses demonstrate that the scaffold boosts efficient new bone regeneration in the socket of rabbit mandibular first premolar.This porous shape memory self-adaptive stiffened polymer opens up a new avenue for alveolar bone regeneration.

Bifunctional Two-Dimensional Nanocomposite with Electromagnetic Wave Absorption and Anti-bacterial Performance

In current electronic information era,the complex application circumstance of 5G devices pursues the exploration of multi-functional electromagnetic wave(EMW)absorbent materials and it has become the crucial focus in industrial development.A two-dimensional(2D)graphite nanosheet decorated by nickel nanocapsules(2D graphite/Ni@C nanocomposite)was fabricated to possess the EMW absorption and the Escherichia coli(E.coli)anti-bacterial performance simultaneously.By adjusting the filling ratio and injecting nitrogen doping,the value of minimum reflection loss is−36.08 dB and the effective absorption bandwidth reaches to 5.12 GHz(from 11.4 to 16.52 GHz)with the mass ratio of 30 wt%and the absorber thickness of 2 mm.This 2D nanocomposite simultaneously gets an excellent anti-bacterial function expressing an E.coli anti-bacterial rate of 92%during 24 h which is significantly correlated to the interaction between the nanostructure of the 2D nanographite and the nickel ion released from Ni@C nanocapsules.This work provides a new approach to develop a promising 2D anti-bacterial EMW absorber.

Anti-bacterial and anti-viral effects of Fengreqing oral liquid(风热清口服液) in vitro and in vivo

OBJECTIVE:To investigate the anti-bacterial and anti-viral effects of Fengreqing oral liquid(风热清口服液,FRQ)in vitro and in vivo.METHODS:The minimum inhibitory concentrations of Fengreqing Oral Liquid against six gram-positive bacteria(Staphylococcus aureus,Streptococcus mutans,Peptostreptococcus anaerobius,Hemolytic streptococcus,Streptococcus pneumoniae,Klebsiella pneumoniae),seven gram-negative bacteria(Escherichia coli,Actinobacillus actinomycetemcomitans,Porphyromonas gingivalis,Haemophilus influenzae,Helicobacter pylori,Pseudomonas aeruginosa,Gardnerella vaginalis)and Candida albicans were detected by the paper disc diffusion method.The inhibition rate of A/Puerto Rico/8/34(H1N1)(PR8)influenza virus in different concentrations of Fengreqing oral solution was detected by chicken embryo method.CCK8 method was used to detect the half-cell infection of RSV,VSV and CVB3.The effect of FRQ on the survival curve of mice was detected by using co-infection model of Streptococcus pneumoniae and influenza virus.RESULTS:In vitro,FRQ can inhibit Actinobacillus actinomycetemcomitans,Helicobacter pylori,Gardnerella vaginalis,Staphylococcus aureus,Streptococcus mutans and Streptococcus pneumoniae and has an antiviral effect on the envelope virus H1N1.In vivo,Fengreqing oral solution had therapeutic effect on influenza-Streptococcus pneumoniae co-infection in mice,significantly improving the survival rate of mice.The medium dose and low dose FRQ significantly prolonged the survival time of mice.CONCLUSION:FRQ has good anti-bacterial and anti-viral effects in vivo and in vitro.

Study on Syntheses and Anti-bacterial Activities of Some New Transition Metal Complexes with Schiff Base Ligand Contain-ing Pyridine and Amide Moieties

Several new transition metal complexes using Schiff base containing pyridine and amide moieties (N, N'-bis(- salicylaliminoethyl)-2, 6-pyridinedicarboxylic amide, H4L) as the ligand have been prepared. Their compositions and structures are corroborated by elemental analysis, IR, UV, 1H NMR, DTA-TG and molar conductivity data. Their anti-bacterial activities have been studied by microcalorimetry. The result shows that the ligand and all com-plexes are potential anti-bacteria reagent and their inhibitory capacities are concentration-depended. The Mn com-plex has the strongest inhibitory capacity.

Doctor's Group Questions Anti-Bacterial Soaps

美国一个主要的医师组织最近说,消毒肥皂的抗菌效果也许并不比普通肥皂好,可能还是使细菌产生抗药性的危险征兆之一。但是一个行业组织对此进行了反驳,认为消毒类产品能杀灭或抑制导致皮肤感染,肠道疾病或其它常见传染病的细菌的生长。双方在这一问题上可谓是针锋相对,互不相让。读者诸君如何选择使用肥皂类物品,看来暂时只能凭你的"慧眼"了。

Study on the Antibacterial and Deodorization Effect of 4,4-Dichloro-2-Hydroxydiphenyl Ether in Laundry Gel Beads

In the formulation development of laundry gel beads,4,4-dichloro-2-hydroxydiphenyl ether(HP-100)was used as a bacteriostatic agent,and the effect of HP-100 dosage on the bacteriostatic rate of laundry gel bead samples with different formulation systems was examined by the suspension quantification method;the long-lasting bacteriostatic performance of laundry gel bead samples added with HP-100 was investigated by the absorption method for evaluating the antimicrobial performance of textiles;the effect of HP-100 on the odor control of laundry gel bead samples was investigated by filling out surveys and questionnaires using the actual measurement method.Questionnaire was used to investigate the effect of HP-100 on odor control.The test results showed that the antibacterial rate of the two laundry gel samples against S.aureus increased with the increase of HP-100 dosage,and the antibacterial rate of Formula 1 reached 99.9%when the dosage of HP-100 was 0.3%;the antibacterial rate of cotton cloth washed with the laundry gel sample of Formula 1+0.3%HP-100 was more than 50%after 24 h,and still had the antibacterial effect;the antibacterial rate of cotton cloth washed with the sample of laundry gel with HP-100 was more than 50%after 24 h,and still had the antibacterial effect;the antibacterial effect of the sample with HP-100 was more than 50%after 24 h,and still had the antibacterial effect.The fabrics washed with HP-100 added laundry gel beads had better odor control than those treated with laundry gel beads without HP-100,and the addition of HP-100 to laundry gel beads could have antibacterial and deodorizing effects.

Recent advances in endogenous and exogenous stimuli-responsive nanoplatforms for bacterial infection treatment

As drug-resistant bacterial infections escalate and antimicrobial resources become insufficient,new alternative therapies are critical.The emergence of nano drug delivery system,in addition to giving drugs sustained,targeted or longer half-life characteristics,also plays an important role in improving the therapeutic effect and reducing the toxic side effects of conventional drugs.Despite its potential benefits,the traditional nanomedical drug delivery system has some practical limitations,including incomplete and slow drug release,as well as insufficient accumulation at infection sites.Stimuli responsive nanoplatforms are hence developed to overcome the disadvantages of conventional nanoparticles,which can provide several advantages like:enhancing the pharmacokinetics and biodistribution of antimicrobial drugs,increasing their effective bioavailability,reducing their dosage frequency,and improving their antimicrobial efficacy against biofilm-related infections,while slowing down the development of antimicrobial resistance,which is expected to trigger a medical revolution in the field of human health,thus bringing huge clinical benefits.In this review,we provide an extensive review of the recent progress of endogenous and exogenous stimuli-responsive nanoplatforms in the antibacterial area.Using specific infectious microenvironments(pH,enzymes,reactive oxygen species and toxins),this review systematically presents the design principles of nano delivery systems and the mechanisms by which endogenous stimuli induce changes in the morphology or properties of delivery systems to achieve programmed drug release.Furthermore,exogenous stimuli such as light,heat,and magnetic fields can also control the release of drugs.Last but not least,we discussed the challenges and opportunities for future clinical translation of stimuli-responsive nanoplatforms in bacterial infections.

鼻窦炎病原菌和抗菌治疗的临床药理学

急、慢性鼻窦炎是耳鼻咽喉头颈外科的常见病。多数急性细菌性鼻窦炎为单个病原菌感染,少数为两个种属病原菌联合感染。主要的病原菌是肺炎链球菌和流感嗜血杆菌,由细菌感染导致的鼻窦慢性炎症病程一般在90天以上。由于在培养方法、取材部位和消毒方法、是否应用抗菌药,以及病例选择等方面存在诸多差异,因此,不同的研究者报告的病原菌有较大差异。有关儿童急性鼻窦炎的研究数据并不多见。病原菌是导致急性细菌性鼻窦炎的直接致病因素,抗菌药的治疗至关重要,根据来源的不同,可将抗菌药分为:①来源于微生物代谢产物的抗生素,其中又可分为天然抗生素和人工半合成抗生素;②人工合成抗菌药,如磺胺和喹诺酮类。临床应参考患者的年龄和其他相关因素合理选择抗菌药。

解读“美国感染性疾病学会儿童和成人急性细菌性鼻及鼻窦炎临床指南”

2012-03-20美国感染性疾病学会在官方网站http://cid.oxfo rdjournals.org发表了儿童和成人急性细菌性鼻及鼻窦炎临床指南。该指南由多学科专家(包括临床和实验学专家、急诊医学专家、耳鼻咽喉科专家、公共健康专家、流行病专家、成人和儿童感染疾病专家)在收集分析相关文献的基础上,对数据类型和推荐等级分别进行了分类和分级,充分反映了所依赖数据的可靠程度。指南重点突出临床实用性,主要针对社区全科医师、家庭医师、实习医师、儿科医师、急诊医师和变态反应科医师。

Risk of transmission of carbapenem-resistant Enterobacteriaceae and related “superbugs” during gastrointestinal endoscopy

To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospi-tal X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including broncho-scopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endos-copy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind andnear the forceps elevator located at the distal end othe ERCP endoscope, are recommended. If the ERCPendoscope features a narrow and exposed channel thathouses a wire connecting the GI endoscope's controhead to this forceps elevator, then this channel's com-plete reprocessing, including its flushing with a deter-gent using a procedure validated for effectiveness, is also emphasized.

Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma

AIM: To investigate treatment outcome of Helicobacter pylori (H.pylori )-negative low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma.METHODS: In this study,we retrospectively reviewed the clinical outcome and clinicopathologic factors of stage Ⅰ E H.pylori -negative low-grade gastric MALT lymphoma cases from August 1998 to June 2009.RESULTS: A total of eleven patients with H.pylori -negative low-grade gastric MALT lymphoma were enrolled in the study and received anti-H.pylori eradication treatment and/or radiotherapy or excisional therapy.Complete remission (CR) of gastric MALT lymphoma was achieved in all patients.The time to CR was 1-66 mo (median,1 mo).CONCLUSION: Eradication therapy may be offered as an initial treatment option even in cases of localized H.pylori -negative gastric MALT lymphoma.

Nutrition status and Helicobacter pylori infection in patients receiving hemodialysis

Chronic kidney disease(CKD) patients receiving hemodialysis(HD) often develop gastrointestinal abnormalities over their long treatment period. In general, prognosis in such patients is poor due to the development of protein-energy wasting(PEW). Therefore, it is important to clarify the etiology of PEW and to establish better strategies to deal with this condition. Chronic Helicobacter pylori(H. pylori) infection in the gastric mucosa has a close association with not only the development of peptic ulcer disease and gastric cancer, but is also associated with abnormal plasma and gastric mucosal ghrelin levels that are seen in malnutrition. It is unclear whether H. pylori infection of the gastric mucosa is directly associated with prognosis in HD patients by affecting ghrelin levels. Recent studies show that the prevalence of H. pylori infection in HD patients is significantly lower than in subjects with normal renal function. In the natural history of H. pylori infection in HD patients, the prevalence of infection decreases as the length of time on HD increases. The severity of gastric mucosal atrophy has been suggested as the major determinant of ghrelin levels in these patients, and eradication therapy of H. pylori improves nutritional status by increasing serum cholinesterase and cholesterol levels, especially in patients with mildto-moderate gastric mucosal atrophy. Prompt H. pylori eradication to inhibit the progress of gastric atrophy may be required to prevent this decrease in ghrelin levels and subsequent PEW and improve the prognosis of HD patients by improving their nutritional status.