Profile of Multidrug Resistant Bacteria in Bukavu Hospitals and Antimicrobial Susceptibility to Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus

Objective: To evaluate the spread of Multidrug-Resistant (MDR) bacterial infections in Bukavu hospitals and test antimicrobial susceptibility patterns of some isolates to usual marketed antibiotics. Methods: The prevalence of MDR strains was determined by using general antimicrobial susceptibility data collected from 3 hospital laboratories. The susceptibility of some isolates to usual antibiotics was processed by agar diffusion method with standard E. coli ATCC8739 and standard antibiotics discs as controls. The tested antibiotics were ampicillin, ceftriaxone, gentamicin, chloramphenicol and ciprofloxacin. Results: At the 3 hospitals, 758 tests were realized in urine, pus, stool, FCV, blood, LCR, split and FU specimens;46 strains were unidentified and 712 strains were identified. Of 712 identified strains, 223 (31.4%) were MDR or XDR strains including Escherichia coli, Klebsiella pneumoniae, Enterobacter, Proteus mirabilis, Salmonella enterica, Pseudomonas aeruginosa, Citrobacter freundii, Morganella morganii, Enterococcus faecalis and E. faecium, Neisseria gonorrohoae, Staphylococcus aureus, coagulase-negative, staphylococci, Streptococcus pneumoniae and Streptococcus pyogenes. Of the infected patients, 36 (21.5%) children were under 16 years and 188 (78.5%) adults were predominately women (58.5%). The susceptibility test showed that all strains but S. aureus were resistant to ampicillin and amoxicillin and ciprofloxacin. Gentamicin, ceftriaxone, and chloramphenicol remain partially active (27% - 80%) against P. mirabilis, E. coli and P. aeruginosa. The resistance is more likely related to strain mutation than to pharmaceutical quality of the antibiotics prescribed. Conclusion: Both data from hospital laboratories and in vitro post-testing findings confirmed the ongoing elevated prevalence of MDR strains in Bukavu. The causes of antibiotic misuse and socio-economic determinants of the phenomenon of resistance should be scrutinized in order to take adequate strategies in the prospective of establishing an effective control system against this threat to overall health. The results of this work on MDR profiles have various implications for the management of infectious diseases. It provides indicators for the surveillance of antimicrobial resistance, practical guidelines for antibiotic susceptibility testing in biomedical laboratories, and guidance for antibiotic therapy.

Microbiology of gallbladder bile in uncomplicated symptomatic cholelithiasis

BACKGROUND:Few studies have assessed microflora and their antibiotic sensitivity in normal bile and lithogenic bile with different types of gallstones. METHODS:We performed a case control study of 70 bile samples(35 cholesterol and 35 pigment stones from 51 females and 19 males,aged 21-72 years with a median age of 37 years)from patients who underwent laparoscopic cholecystectomy for uncomplicated cholelithiasis,and 20 controls(14 females and 6 males,aged 33-70 years with a median age of 38 years)who underwent laparotomy and had no gallbladder stone shown by ultrasound scan.The bile samples were aerobically cultured to assess microflora and their antibiotic susceptibility.The procedures were undertaken under sterile conditions. RESULTS:Thirty-eight(54%)of the 70 patients with gallstones had bacterial isolates.Nine isolates(26%)were from cholesterol stone-containing bile and 29 isolates (82%)from pigment stone-containing bile(P=0.01,t test). Twenty-eight of these 38(74%)bile samples were shown positive only after enrichment in brain heart infusion medium(BHI)(P=0.02,t test).The overall bacterial isolates from bile samples revealed E.coli predominantly,followed by P.aeruginosa,Enterococcus spp.,Klebsiella spp.and S. epidermidis.There were no bacterial isolates in the bile of controls after either direct inoculation or enrichment in BHI.CONCLUSIONS:Bacterial isolates were found in pigment stone-containing bile.Non-lithogenic bile revealed no bacteria,showing an association between gallstone formation and the presence of bacteria in bile.Antibiotic sensitivity patterns of isolated organisms were similar irrespective of the type of stone.

Gastrointestinal manifestations of long-term effects after COVID-19 infection in patients with dialysis or kidney transplantation:An observational cohort study

BACKGROUND Prolonged symptoms after corona virus disease 2019(Long-COVID) in dialysisdependent patients and kidney transplant(KT) recipients are important as a possible risk factor for organ dysfunctions,especially gastrointestinal(GI)problems,during immunosuppressive therapy.AIM To identify the characteristics of GI manifestations of Long-COVID in patients with dialysis-dependent or KT status.METHODS This observational,prospective study included patients with COVID-19 infection,confirmed by reverse transcription polymerase chain reaction,with the onset of symptoms between 1 January 2022 and 31 July 2022 which was explored at 3 mo after the onset,either through the out-patient follow-up or by telephone interviews.RESULTS The 645 eligible participants consisted of 588 cases with hemodialysis(HD),38 patients with peritoneal dialysis(PD),and 19 KT recipients who were hospitalized with COVID-19 infection during the observation. Of these,577(89.5%) cases agreed to the interviews,while 64(10.9%)patients with HD and 4(10.5%) cases of PD were excluded. The mean age was 52 ± 11 years with 52% women. The median dialysis duration was 7 ± 3 and 5 ± 1 years for HD and PD groups,respectively,and the median time post-transplantation was 6 ± 2 years. Long-COVID was identified in 293/524(56%) and 21/34(62%) in HD and PD,respectively,and 7/19(37%) KT recipients. Fatigue was the most prevalent(96%) of the non-GI tract symptoms,whereas anorexia(90.9%),loss of taste(64.4%),and abdominal pain(62.5%) were the first three common GI manifestations of Long-COVID. Notably,there were 6 cases of mesenteric panniculitis from 19patients with GI symptoms in the KT group.CONCLUSION Different from patients with non-chronic kidney disease,there was a high prevalence of GI manifestations of Long-COVID in dialysis-dependent patients and KT recipients. An appropriate long-term follow-up in these vulnerable populations after COVID-19 infection is possibly necessary.

Assessment of Prevalence Group A Streptococci (GAS) Associated with Upper Respiratory Tract Infection among Hajj and Umrah Pilgrims

Background: Respiratory tract infection (RTI) is a prevalent infection across the world and is a major health concern linked to the crowding that occurs during the Hajj season. Objectives: To identify how prevalent Streptococcus pyogenes is among Umrah visitors and pilgrims by comparing its presence before and after the visitors perform Umrah and hajj. Methods: A cross-sectional study was carried out on Umrah visitors/pilgrims, for which their throat swabs were taken for assessing the upper respiratory tract infection’s carriage rate, particularly of Group A streptococci (GAS), after they arrived in Saudi Arabia for the Hajj and Umrah rituals and befor their leaving. After collecting the swabs, they were inoculated on Columbia agar using 5% sheep blood and then incubated at 37&#730C. VITEK 2 systems were used to identify the isolates. Results: Of the 979/613 Umrah visitors/pilgrims involved, before performing Umrah, their Streptococcus pyogenes percentage was 0.2% and it increased to 0.7 after performing Umrah. Further, the Streptococcus pyogenes percentage before and after performing Hajj was 0.3% and 1.1%, respectively. No statistical significance was found in the difference between the positive Streptococcus pyogenes found before and after performing Hajj and Umrah among Umrah visitors/pilgrims (p-value = 0.2). All bacterial isolates were found to be sensitive to Cefotaxime and Ceftriaxone antibiotics (100%). Conclusion: The Streptococcus pyogeneshigh resistance to antibiotics combined with the lack of a vaccine poses a serious risk concerning the resulting infection spread and emphasizes the necessity of ensuring greater global surveillance of such epidemics.

Antibiotic Susceptibility Patterns of Bacteria Associated with Sepsis among Hospitalized Patients in the Yaoundé University Teaching Hospital—Cameroon

Background and Objective: In developing countries, the steep increase in septicaemia cases is a major health problem that creates the biggest challenge for clinicians in the selection of appropriate antimicrobial agents. This is further complicated by the development of resistance in organisms to antimicrobial agents, which is the mainstay of treatment. The aim of this study was to determine the antimicrobial resistance patterns of bacterial isolates associated with sepsis among hospitalized patients including the detection of Methicillin Resistance Staphylococcus aureus (MRSA) and Extended Spectrum Beta lactamases (ESBLs). Methods: A cross-sectional study was carried out for 5 months at the Yaounde University Teaching Hospital. Bacterial species were isolated from 150 blood samples collected from hospitalized patients. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disc diffusion method. The isolates were tested for methicillin resistance and ESBLs. Results: The prevalence of septicaemia was 16% (24/150) among hospitalized patients. In our study, 75% (18/24) of infections were caused by Gram- negative and 25% (6/24) by Gram-positive bacteria. Klebsiella spp., Escherichia coli, and Staphylococcus aureus were the most common isolates. The antibiotic susceptibility patterns of the isolates showed that Gram-negative bacteria were highly resistant to Amoxicillin clavulanic acid and ceftriaxone while the Gram- positive bacteria were highly resistant to minocycline. Fifty percent (3/6) of the isolated S. aureus were methicillin-resistant and 27.8% (5/18) of the isolated Enterobacteriaceae were ESBLs producers. In multivariable logistic regression analysis, temperature above 37.9℃ (AOR = 4.455;95% Cl = 1.458 - 15.693;p = 0.033) and being under respiratory assistance (AOR = 4.311;95% Cl = 1.458 - 12.749;p = 0.008) were significantly associated with septicaemia. Conclusion: The Occurrence of multidrug-resistant strains in this study emphasizes the need for continuous surveillance in hospitals to detect resistant strains. Strict guidelines for antibiotic therapy and the implementation of infection control measures to reduce the increasing burden of antibiotic resistance are advocated.

Prevalence of primary Helicobacter pylori resistance to metronidazole and clarithromycin in Singapore

INTRODUCTIONEradication of Helicobacter pylori,a bacteriumresiding in stomach and causing peptic ulcer disease,can be achieved by using combination therapiesconsisting of one or two antibiotics with a protonpump inhibitor (PPI).The major antibiotics widelyused in the regimens to eradicate H.pylori aremetronidazole and clarithromycin.However,resistance to these antibiotics by H.pylori

Synergistic growth inhibitory effects of Phyllanthus emblica and Terminalia bellerica extracts with conventional cytotoxic agents:Doxorubicin and cisplatin against human hepatocellular carcinoma and lung cancer cells

AIM: To examine the growth inhibitory effects of Phyllanthus emblica (P. emblica) and Terminalia bellerica (T. bellerica) extracts on human hepatocellular carcinoma (HepG2), and lung carcinoma (A549) cells and their synergistic effect with doxorubicin or cisplatin. METHODS: HepG2 and A549 cells were treated with P. emblica and T. bellerica extracts either alone or in combination with doxorubicin or cisplatin and effects on cell growth were determined using the sulforhodamine B (SRB) assay. The isobologram and combination index (CI) method of Chou-Talalay were used to evaluate interactions between plant extracts and drugs. RESULTS: P. emblica and T. bellerica extracts demonstrated growth inhibitory activity, with a certain degree of selectivity against the two cancer cell lines tested. Synergistic effects (CI < 1) for P. emblica /doxorubicin or cisplatin at different dose levels were demonstrated in A549 and HepG2 cells. The T. bellerica/ cisplatin or doxorubicin also showed synergistic effects in A549 and HepG2 cells. In some instances, the combinations resulted in antagonistic effects. The dose reduction level was different and specific to each combination and cell line. CONCLUSION: The growth inhibitory activity of doxorubicin or cisplatin, as a single agent, may be modified by combinations of P. emblica or T. bellerica extracts and be synergistically enhanced in some cases. Depending on the combination ratio, the doses for each drug for a given degree of effect in the combination may be reduced. The mechanisms involved in this interaction between chemotherapeutic drugs and plant extracts remain unclear and should be further evaluated.

Drug sensitivity and drug resistance profiles of human intrahepatic cholangiocarcinoma cell lines

AIM: To study the effect of a number of chemotherapeutic drugs on five human intrahepatic cholangiocarcinoma (CCA) cell lines. The expressions of genes that have been proposed to influence the resistance of chemotherapeutic drugs including thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), glutathione-S-transferase P1 (GSTP1), multidrug resistance protein (MDR1) and multidrug resistance-associated proteins (MRPs) were also determined.METHODS: Five human CCA cell lines (KKU-100, KKU M055, KKU-M156, KKU-M214 and KKU-OCA17) weretreated with various chemotherapeutic drugs and growth inhibition was determined by 3-(4,5-dimethylthiazol-2-yl)5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay. Semi-quantitative levels of gene expression were determined by a reverse transcriptase polymerase chain reaction (RT-PCR). Results of IC50 values and the ratios of gene expression were analyzed by linear regression to predict their relationship. RESULTS: Among five CCA cell lines, KKU-M055 was the most sensitive cell line towards all chemotherapeutic drugs investigated, particularly taxane derivatives with IC50 values of 0.02-3 nmol/L, whereas KKU-100 was apparently the least sensitive cell line. When compared to other chemotherapeutic agents, doxorubicin and pirarubicin showed the lowest IC50 values (＜5 μmol/L) in all five CCA cell lines. Results from RT-PCR showed that TS, MRP1, MRP3 and GSTP1 were highly expressed in these five CCA cell lines while DPD and MRP2 were only moderately expressed. It should be noted that MDR1 expression was detected only in KKU-OCA17 cell lines. A strong correlation was only found between the level of MRP3 expression and the IC50 values of etoposide, doxorubicin and pirarubicin (r = 0.86-0.98, ,P＜0.05). CONCLUSION: Sensitivity to chemotherapeutic agents is not associated with the histological type of CCA. Choosing of the appropriate chemotherapeutic regimen for the treatment of CCA requires knowledge of drug sensitivity. MRP3 was correlated with resistance of CCA cell lines to etoposide, doxorubicin and pirarubicin, whereas other chemotherapeutic drugs showed no association. The roleof this multidrug resistance-associated protein, MRP3, in chemotherapeutic resistance in CCA patients needs to be further investigated.

Mortality of therapeutic fish Garra rufa caused by Aeromonas sobria

Objective:To investigate a case of mass mortality of Garra rufa(G.rufa)from a fish hatchery farm in Slovakia.Methods:Causative bacterial agent was swabbing out of affected fish skin area and subsequently identified using commercial test system.Antibiotic susceptibility was determined by the disk diffusion method.Results:Infected G.rufa was characterized by abnormal swimming behaviour,bleeding of skin lesions and local haemorrhages.Despite of using recommended aquatic antibiotic treatment no improvement was achieved and Aeromonas sobria{A.sobria)was identified as a causative agent of fish mortality.Due to massive fish mortality,antibiotic susceptibility of pure isolated culture of A.sobria was evaluated employing eight antibiotics against human infections.A.sobria was resistant only against one antibiotic,namely ampicilin.Conclusions:These results indicate that A.sobria can act as a primary pathogen of G.rufa and may be a potential risk factor for immunodeficient or immunoincompetent patients during the ichthyotherapy.

Genetic variability of CYP2B6 polymorphisms in four southern Chinese populations

瞄准：在四张南部的中国人口调查遗传型和细胞色素 P450 2B6 多型性的突变而产生之遗传的频率。方法：DNA 从香港和三个少数从汉汉语从血样品被获得从在南部的中国的云南的组， Wa， Bulang 和拉枯族。Genotyping 用即时 PCR 被执行并且由直接定序证实了。结果：从南部的中国的 507 个题目的一个总数被学习。结果证明用与另外的亚洲人口和白种人上的文学报告相比的种族汉语有 516G 】 T (34.5%) 的高流行。516TT 遗传型的频率比在三个另外的种族少数组在汉多数(23.1%) 是更高的(即， 7.4% ， 9.1% 和 15.8%) 在南部的中国。结论：这是第一研究在一张南部的中国人口记录 CYP2B6 突变而产生之遗传的变体和遗传型的光谱。516G 】 T 等位基因与 efavirenz (EFV ) 的有缺点的新陈代谢被联系，它可以因此预先安排到药毒性。因为关键使人的免疫不全病毒(HIV ) 和海洛因嗜好产生代射变化酶的显著可变性，为的处理政体可以需要在不同人口被优化。

Detection of Stage I nasopharyngeal carcinoma by serologicscreening and clinical examination

In a prospective study, 42 048 adults residing in Zhongshan City, Guangdong, China, were followed for 16 years, and 171 of them developed nasopharyngeal carcinoma (NPC). Although Epstein-Barr virus (EBV) antibody levels of the cohort fluctuated, the antibody levels of 93% of the patients with NPC were raised and maintained at high levels for up to 10 years prior to diagnosis. This suggests that the serologic window affords an opportunity to monitor tumor progression during the preclinical stage of NPC development, facilitating early NPC detection. We reviewed the clinical records of the 171 patients with NPC in the prospective study to assess the efficacy of early NPC detection by serologic screening and clinical examination. Of the 171 patients, 51 had Stage I tumor (44 were among the 73 patients detected by clinical examination and 7 were among the 98 patients presented to outpatient department). Initial serologic screening predicted 58 (95.1%) of the 61 patients detected within 2 years. The risk of the screened population (58/3093) raised 13 times relative to cohort (61/42 048) during this period. Clinical examination detected all the 58 predicted cases, and 35 (60.3%) of which were diagnosed with Stage I tumor. The serologic prediction rate fell to 33.6% (37/110) 2 to 16 years after screening. The proportion of cases detected by clinical examination fell to 40.5% (15/37). The proportion of Stage I tumors among the cases detected by clinical examination during both periods remained at about 60%. We concluded that early detection of NPC can be accomplished by repeated serologic screening to maintain high prediction rates and by promptly examining screened subjects to detect tumors before the symptoms develop.

BINDING AND INTERACTION OF TRANSCRIPTIONAL REGULATOR HUMAN DAXX WITH ADENOVIRUS12 E1B 55 KILODALTON ONCOPROTEIN

Objective: To study the disruption of co- localization of human Daxx(hDaxx) with promyelocytic leukemia protein(PML) at the PML oncogenic domains (PODs) by the interaction of hDaxx with adenovirus(Ad) 12 E1B 55 Kilodalton Oncoprotein (Ad12 E1B 55kD). Methods: The direct binding reaction of hDaxx and Ad12 E1B 55kD was analyzed by coimmunoprecipitation and Western blotting in vivo or in vitro. The interaction of hDaxx with Ad12 E1B 55kD was studied using yeast two-hybrid assay. Results: hDaxx bounded directly to Ad12 E1B 55kD in vivo and in vitro. hDaxx interacted with full length Ad12 E1B 55kD. Conclusion: Transcriptional regulator hDaxx directly binds to and interacts with Ad12 E1B 55kD.

Antimicrobial Resistance Patterns and Molecular Characterization of <i>Klebsiella pneumoniae</i>in Clinical Isolates at Mbarara Regional Referral Hospital

Background: Klebsiella pneumoniae is one of the most frequent opportunistic pathogens causing a range of infections and being resistant for beta-lactamases (ESBL) and Carbapenemases. Aim: The aim of the present study was to determine the antimicrobial resistance patterns and molecular characterization establishing the phenotypes and genotypes associated with drug resistance, an antibiogram of genotypically positive isolates for resistance of Klebsiella pneumoniae in clinical isolates at MRRH. Materials and Methods: A laboratory-based descriptive cross-sectional study that was conducted from September 2018 to May 2019 at MRRH. Klebsiella pneumoniae was identified by cultural and biochemical methods. Antibiotic sensitivity test was performed by modified Kirby-Bauer disc diffusion technique. ESBL production in Klebsiella pneumoniae was tested by double-disc synergy test, Carbapenemase production by MHT, Boronic Acid or EDTA test using Meropenem phenotypically and both resistance confirmed genotypically by Multiplex PCR. Results: Out of 1055 clinical isolates, 298 (28.2%) were found positive for Klebsiella.spp, 175 isolates were subcultured among which 22 (12.57%) were K. pneumoniae based on API 20E. Overall Sensitivity patterns of these Klebsiella pneumoniae isolates to Ceftriaxone, (Amoxicillin/Clavulanate), Gentamicin, Cefepime, Ciprofloxacin, Cefoxitin, Nitrofurantoin, Cefuroxime, piperacillin/tazobactam, Meropenem, Ceftazidime and cefotaxime were 72.7%, 63.7%, 54.5%, 45.5%, 31.8%, 31.8%, 27.3%, 27.3%, 22.7%, 22.7%, 18.2%, 9.1%, 9.1% respectively. ESBL producing K. pneumoniae was found at 68.18% (15/22) phenotypically. Genotypically;the ESBL genes were blaCTX-M (100%), blaSHV (80%) and blaTEM (100;47%);8/15 (73.3%) had CTX-M, SHV, TEM, 4/15 (26.67%) CTX-M, TEM, 3/15 (20.00%) CTX-M and SHV. Carbapenemase producing K. pneumoniae was found at 31.82% (7/22) phenotypically;1/7 (14.28%) by MHT, 4/7 (57.14%) Boronic acid test and 2/7 (28.58%) EDTA test. Genotypically;3/4 [(75%) 42.86%] had OXA-48, 1/4 [(25%) 14.28%] OXA-48 and KPC gene, 1/2 [(50%) 14.28%] KPC and VIM, 1/2 [(50%) 14.28%] KPC and KPC gene [(100%) 14.28%]. Conclusion/Recommendations: DDS to be used for ESBL production, MHT, Boronic Acid test and EDTA tests using Meropenem/or Imipenem for Carbapenemase-production routinely.

Integron frequency of Escherichia coli strains from patients with urinary tract infection in Southwest of Iran

Objective: To investigate the frequency of integrase genes intI1, intI2 and intI3 of Escherichia coli strains, and their association with resistance to routinely used antibiotics. Methods: A total of 120 Escherichia coli strains were collected from patients with urinary tract infection in Ahvaz, Southwest of Iran. Antibiotic susceptibility testing was performed. The presence of intI1, intI2, and intI3 genes was determined by polymerase chain reaction. Results: Antibiotic susceptibility testing disclosed the highest resistance rate to ampicillin (91.7%) followed by trimethoprim/sulfamethoxazole (65.8%), and ceftazidime (56.7%). The imipenem susceptibility rate was 91.7%. IntI1 and intI2 were identified in 74 (61.6%) and 8 (6.6%) of Escherichia coli strains, respectively, but intI3 was not found in any isolates. The presence of integrons was significantly associated with resistance to ampicillin, trimethoprim/sulfamethoxazole, ceftazidime, and ciprofloxacin antibiotics (P<0.05). Conclusions: The high resistant Escherichia coli isolates harboring class 1 integrons (intI1) were detected in patients with urinary tract infection in our region. Therefore, preventive strategies are necessary to restrict further dissemination of resistant strains.

Chemical compositions and biological activities of essential oils obtained from some Apiaceous and Lamiaceous plants collected in Thailand

Objective: To determine the chemical composition, as well as the antioxidant, antityrosinase and antibacterial activities of essential oils obtained from some Apiaceous and Lamiaceous plants collected in Thailand. Methods: The essential oils of the specified spices and aromatic herbs were obtained by hydro-distillation, and their chemical constituents were analyzed by gas chromatography/mass spectrometry. Antioxidant assays were based on the scavenging effects of 2,2-Diphenyl-1-picrylhydrazyl(DPPH) and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulphonic acid)(ABTS) free radicals as well as the lipid oxidation inhibition of β-carotene bleaching by linoleic acid. Tyrosinase enzyme inhibition was evaluated by the dopachrome method. Broth microdilution technique was performed for the purposes of studying microbial growth inhibition against the isolated bacterial strains. Results: The essential oils of Elsholtzia stachyodes, Coleus amboinicus(I) and Trachyspermum ammi presented a high degree of potency in DPPH, ABTS and β-carotene bleaching assays. The Trachyspermum ammi oil, which mainly contained thymol(49.04%) and p-cymene(22.06%), proved to be the most effective in terms of antibacterial activity. The major compositions of Coleus amboinicus(I) were carvacrol(51.57%), γ-terpinene(18.04%) and p-cymene(7.81%); while thymol(43.76%) and γ-terpinene(24.61%) were identified as the major components of Elsholtzia stachyodes oil, with p-cymene(6.73%) being identified as a minor constituent. Moreover, Cuminum cyminum oil containing cuminaldehyde(49.07%) and Elsholtzia communis oil composed with geranial(44.74%) and neral(35.27%) as the major components displayed a specific ability for the inhibition of the mushroom tyrosinase enzyme. Conclusions: The results indicated that these bioactive essential oils obtained from indigenous herbs are of significant interest as alternative raw materials in food, cosmetic and medicinal products.

Phenotypic Detection and Susceptibility Pattern for the Detection of Extended Spectrum β-Lactamase-Producing <i>Klebsiella pneumonia </i>Isolates in Nairobi, Kenya

Klebsiella pneumoniae is an opportunistic pathogen that is an important cause of nosocomial infections. Detection of ESBL producers’ poses a special challenge for clinical microbiology laboratories, although ESBL producing pathogens are able to hydrolyze extended-spectrum penicillins, cephalosporins, and aztreonam, the minimum inhibitory concentrations (MIC) of some and perhaps even all of these agents may be within the susceptible range. The third generation cephalosporins have the reputation for being useful against a broad range of bacterial infections. However, resistance to these agents is something that must still be considered and creates obstacles for their clinical use. A total of 80 multi drug resistant clinical isolates of Klebsiella pneumoniae were obtained from a study on anaerobes associated with Pelvic Inflammatory disease (P.I.D), KEMRI S.S.C No.495. The isolates were identified by standard microbiological procedures. Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. Upon identification, the antibiogram profiles of the isolates were determined and those resistant to third-generation cephalosporins were tested for production of ESBL. ESBL production among the multi drug resistant isolates was detected using the phenotypic confirmatory disc diffusion test (PCDDT) and double disk synergy test (DDST). While using standard double disk synergy test (DDST) as screening method for identifying potential ESBL producers, ceftriaxone was the most efficient antimicrobial in screening isolates as potential ESBL producers followed by cefotaxime.

Results of gastroscope bacterial decontamination by enzymatic detergent compared to chlorhexidine

瞄准：比较功效酶与为胃的范围的 chlorhexidine 净化细菌的净化。方法：未来的使随机化的控制研究被承担评估这 2 个代理人的能力在一个胃的范围完成高级消毒。260 件样品的一个总数从 5 个不同胃的范围被收集。用手的清洗独立与这 2 个代理人为 10 min 被做(n = 130 各个) 。然后，所有标本经历了为 20 min 浸泡的 2% glutaraldehyde。在 70% 酒精被清洗以后，无菌的生理盐水被冲洗进每条胃的范围隧道，样品的 40 mL 是镇定的。样品被去请在膜以后的氧气的细菌的文化被过滤。比 200 cfu/mL 大的一个殖民地计数被认为重要。结果：积极文化率在酶的净化的手臂是 4.6% ， 3.1% 在 chlorhexidine 武装。假单胞菌属种类是从两个组(60%) 检测的主要有机体。多重有机体从 4 个标本被发现(酶的净化的手臂 = 1， chlorhexidine 手臂 = 3 ) 。结论：清洗答案的两种类型的污染率是相等的。

Agglutination of Helicobacter pylori coccoids by lectins

AIM To study the agglutination pattern ofHelicobacter pylori coccoid and spiral forms.METHODS Assays of agglutination andagglutination inhibition were applied usingfifteen commercial lectins.RESULTS Strong agglutination was observedwith mannose-specific Concanavalin A(Con A),fucose-specific Tetragonolobus purpureas(Lotus A)and N-acetyl glucosamine-specificTriticum vulgaris(WGA)lectins.Mannose andfucose specific lectins were reactive with allstrains of H.pylori coccoids as compared to thespirals.Specific carbohydrates,glycoproteinsand mucin were shown to inhibit H.pylorilectin-agglutination reactions.Pre-treatment ofthe bacterial cells with formalin and sulphuricacid did not alter the agglutination patterns withlectins.However,sodium periodate treatment ofbacterial cells were shown to inhibitagglutination reaction with Con A,Lotus A andWGA lectins.On the contrary,enzymatictreatment of coccoids and spirals did not showmarked inhibition of H.pylori-lectinagglutination.Interestingly,heating of H.pylori cells at 60℃ for 1 hour was shown toaugment the agglutination with all of the lectinstested.CONCLUSION The considerable differences inlectin agglutination patterns seen among the twodifferentiated forms of H.pylori might beattributable to the structural changes during theevents of morphological transformation,resulting in exposing or masking some of the sugar residues on the cell surface.Possibility ofvarious sugar residues on the cell wall of thecoccoids may allow them to bind to differentcarbohydrate receptors on gastric mucus andepithelial cells.The coccoids with adherencecharacteristics like the spirals could aid in thepathogenic process of Helicobacter infection.This may probably lead to different clinicaloutcome of H.pylori associated gastroduodenaldisease.

Roscovitine synergizes with conventional chemo-therapeutic drugs to induce efficient apoptosis of human colorectal cancer cells

AIM: To examine the ability of cyclin-dependent kinase inhibitor (CDKI) roscovitine (Rosco) to enhance the antitumor effects of conventional chemotherapeutic agents acting by different mechanisms against human colorectal cancer. METHODS: Human colorectal cancer cells were treat-ed, individually and in combination, with Rosco, taxol, 5-Fluorouracil (5-FU), doxorubicine or vinblastine. The antiproliferative effects and the type of interaction of Rosco with tested chemotherapeutic drugs were de-termined. Cell cycle alterations were investigated by fluorescence-activated cell sorter FACS analysis. Apop-tosis was determined by DNA fragmentation assay. RESULTS: Rosco inhibited the proliferation of tumor cells in a time-and dose-dependent manner. The ef-ficacies of all tested chemotherapeutic drugs were markedly enhanced 3.0-8.42 × 103 and 130-5.28 × 103 fold in combination with 5 and 10 μg/mL Rosco, re-spectively. The combination of Rosco and chemothera-peutic drugs inhibited the growth of human colorectal cancer cells in an additive or synergistic fashion, and in a time and dose dependent manner. Rosco induced apoptosis and synergized with tested chemothera-peutic drugs to induce efficient apoptosis in human colorectal cancer cells. Sequential, inverted sequential and simultaneous treatment of cancer cells with combi-nations of chemotherapeutic drugs and Rosco arrested the growth of human colorectal cancer cells at various phases of the cell cycle as follows: Taxol/Rosco (G2/M-and S-phases), 5-FU/Rosco (S-phase), Dox/Rosco (S-phase) and Vinb/Rosco (G2/M-and S-phases). CONCLUSION: Since the eff icacy of many anticancer drugs depends on their ability to induce apoptotic cell death, modulation of this parameter by cell cycle inhibi-tors may provide a novel chemo-preventive and chemo-therapeutic strategy for human colorectal cancer.

Effects of histamine HlR-H4R-agonist on the airway epithelium of rabbits

Objective:To explore the exact role of histamine receptors in respiratory system.Methods: The cohort comprised of six groups(group I control and groupⅡ—Ⅳtreated) containing five rabbits in each group.Control-group received vehicle(sterile distilled water) and treated groups received subcutaneous histamine(100μg/kg,b.i.d.),and H1R-agonist(HTMT),H2R-agonist (amthamine),H3R-agonist(R-(-)-α-methylhistamine) and H4R-agonist(clobenpropit) each in a dose of 10μg/kg,b.i.d.for 30 subsequent days.After completion of treatment,animals were euthanized and perfused with 10% buffered formalin.Small tissue blocks of trachea and lungs were processed for paraffin embedding.Observations were recorded in sample photomicrographs taken from 10μm thick.Haematoxylin and eosin stained sections.Results:It was observed that trachea and bronchi from histamine,H1R and H4R groups had only patches of hyperplastic and hypertrophied epithelium and in general,cells in the affected region were taller heaped up. The bronchiolar epithelia from all treated groups showed hypertrophy and hyperplasia throughout with most of the cells having rounded profile and appeared to bud out from the basal cells. Conclusions:It is concluded that histamine receptors on induction via its specific agonist can induce hypertrophy,hyperplasia of respiratory tract epithelia suggesting its role akin to growth stimulating factor and warranting further long-term study.