Antibiotics Profile, Prevalence of Extended-Spectrum Beta-Lactamase (ESBL), and Multidrug-Resistant Enterobacteriaceae from Different Clinical Samples in Khartoum State, Sudan

One of the global requirements for controlling the occurrence of resistance to antimicrobial drugs is to understanding the resistivity profile of various clinical isolates. Therefore, this study aimed to deliver the indication of different resistant profiles of clinically isolated Enterobacteriaceae from different sources of samples from Khartoum state, Sudan, and to determine the prevalence rate of extended-spectrum beta-lactamase (ESBL), multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. A total of 144 Gram-negative bacteria were collected from different sources (vaginal swab, urine, catheter tip, sputum, blood, tracheal aspirate, pus, stool, pleural fluid, and throat swab). Samples were subcultured and identified according to their cultural characteristics and biochemical tests. Antimicrobial susceptibility test was performed for twenty-four antibiotics from eleven categories against all isolated Enterobacteriaceae according to the recommendation of Clinical and Laboratory Standards Institute (CLSI). The result showed that out of 144 isolates, Escherichia coli and Klebsiella pneumoniae were predominant isolates with the percentage of 47.9 and 25%, respectively. The prevalence of ESBL was higher in K. pneumonia (38.9%) than E. coli (34.8%). All isolated E. coli were sensitive to nitrofurantoin and tigecycline. There was a high prevalence of MDR Enterobacteriaceae, and only one isolate was XDR, while PDR was zero for all isolated bacteria. Active antimicrobial-resistant (AMR) observation through constant data sharing and management of all stakeholders is crucial to recognize and control the AMR global burden. Also, effective antibiotic stewardship procedures would be applied to limit the unreasonable expenditure of antibiotics in Sudan

Antimicrobial and antiquorum-sensing activity of Conocarpus lancifolius Engl. (Combretaceae)

Multidrug resistance to antimicrobial agents is a rapidly increasing problem. New strategies are required to reduce microbial resistance and pathogenicity. These include inhibiting microbial virulence factors, such as quorum-sensing (QS). In this study, the leaf and fruit extracts of Conocarpus lancifolius Engl. were investigated for their antimicrobial and QS inhibitory activities. The ethyl acetate extract of the leaf (EAL) recorded a remarkable inhibition of the Gram-negative bacteria; Escherichia coli and Klebsiella pneumonia (23 and 20 mm, respectively), using the agar well diffusion assay. Also, it showed the highest antifungal effect against Candida albicans (20 mm). Meanwhile, the ethyl acetate extract of the fruit (EAF) showed significant inhibition of the Gram-positive bacteria; Staphylococcus aureus and Bacillus cereus (20 and 21 mm, respectively). Measurement of the minimum inhibitory concentration (MIC) by the broth microdilution method indicated that Gram-positive bacteria were more susceptible to the antimicrobial effect of the investigated extracts. Particularly, EAL and EAF showed comparable activity to ampicillin against B. cereus (MIC, 312.5 µg/mL). The highest antifungal activity was recorded for the petroleum ether extract of the leaf (MIC, 625 µg/mL). Measurement of the inhibition diameter of pigment (PID) produced by the reporter strain, Chromobacterium violaceum indicated that EAL demonstrated higher QS inhibition (6 mm) compared to the standard, catechin (4.8 mm). In addition, the leaf and fruit extracts showed comparable activity to catechin (5 mm). The current study reported that C. lancifolius could be a promising antimicrobial and anti-quorum sensing drug candidate

Antimicrobial and antiquorum-sensing activity of Conocarpus lancifolius Engl. (Combretaceae)

Multidrug resistance to antimicrobial agents is a rapidly increasing problem. New strategies are required to reduce microbial resistance and pathogenicity. These include inhibiting microbial virulence factors, such as quorum-sensing (QS). In this study, the leaf and fruit extracts of Conocarpus lancifolius Engl. were investigated for their antimicrobial and QS inhibitory activities. The ethyl acetate extract of the leaf (EAL) recorded a remarkable inhibition of the Gram-negative bacteria; Escherichia coli and Klebsiella pneumonia (23 and 20 mm, respectively), using the agar well diffusion assay. Also, it showed the highest antifungal effect against Candida albicans (20 mm). Meanwhile, the ethyl acetate extract of the fruit (EAF) showed significant inhibition of the Gram-positive bacteria; Staphylococcus aureus and Bacillus cereus (20 and 21 mm, respectively). Measurement of the minimum inhibitory concentration (MIC) by the broth microdilution method indicated that Gram-positive bacteria were more susceptible to the antimicrobial effect of the investigated extracts. Particularly, EAL and EAF showed comparable activity to ampicillin against B. cereus (MIC, 312.5 µg/mL). The highest antifungal activity was recorded for the petroleum ether extract of the leaf (MIC, 625 µg/mL). Measurement of the inhibition diameter of pigment (PID) produced by the reporter strain, Chromobacterium violaceum indicated that EAL demonstrated higher QS inhibition (6 mm) compared to the standard, catechin (4.8 mm). In addition, the leaf and fruit extracts showed comparable activity to catechin (5 mm). The current study reported that C. lancifolius could be a promising antimicrobial and anti-quorum sensing drug candidate

Hepatitis B infection among hemodialysis patients in Al-Jazirah State: a seroepidemiological survey

Hemodialysis patients are more susceptible to HBV infection because they have low immunity and can be inflicted through an improperly sterilized machine or through a tainted blood transfusion. A cross-sectional study aimed to study the prevalence of HBV among hemodialysis patients in Aljazeera State, Hospital for Renal Disease and Surgery during the period between March and August 2018. A total of ninety-one blood samples were obtained randomly from hemodialysis patients. The plasma was examined for the presence of HBsAg using a sandwich Enzyme-Linked Immuno-Sorbent Assay (ELISA). Data collected by a structured questionnaire included sociodemographic data such as age, sex, marital status, education level, duration of dialysis, previous HBV vaccination, history of surgical operation, history of jaundice and history of blood transfusion. Detectable marker for HBV infections (HBsAg) were found in 21 (23.1%) patients, while the remaining 70 patients (76.9%) were negative. We noted that education level and a history of jaundice had a significant effect on the seroprevalence of HBV, with a P value <0.05

Formulation optimization, in vitro and in vivo evaluation of niosomal nanocarriers for enhanced topical delivery of cetirizine

Cetirizine hydrochloride (CTZ), a second-generation anti-histaminic drug, has been recently explored for its effectiveness in the treatment of alopecia. Niosomes are surfactant-based nanovesicular systems that have promising applications in both topical and transdermal drug delivery. The aim of this study was to design topical CTZ niosomes for management of alopecia. Thin film hydration technique was implemented for the fabrication of CTZ niosomes. The niosomes were examined for vesicle size, surface charge, and entrapment efficiency. The optimized niosomal formulation was incorporated into a hydrogel base (HPMC) and explored for physical characteristics, ex vivo permeation, and in vivo dermato-kinetic study. The optimized CTZ-loaded niosomal formulation showed an average size of 403.4 ± 15.6 nm, zeta potential of − 12.9 ± 1.7 mV, and entrapment efficiency percentage of 52.8 ± 1.9%. Compared to plain drug solution, entrapment of CTZ within niosomes significantly prolonged in vitro drug release up to 12 h. Most importantly, ex-vivo skin deposition studies and in vivo dermato-kinetic studies verified superior skin deposition/retention of CTZ from CTZ-loaded niosomal gels, compared to plain CTZ gel. CTZ-loaded niosomal gel permitted higher drug deposition percentage (19.2 ± 1.9%) and skin retention (AUC0-10h 1124.5 ± 87.9 μg/mL.h) of CTZ, compared to 7.52 ± 0.7% and 646.2 ± 44.6 μg/mL.h for plain CTZ gel, respectively. Collectively, niosomes might represent a promising carrier for the cutaneous delivery of cetirizine for the topical management of alopecia

Molecular Characterization and Antifungal Susceptibility of Aspergillus spp. among Patients with Underlying Lung Diseases

Background. Pulmonary aspergillosis is a lung infection caused by Aspergillus spp., which can cause severe illnesses in immunocompromised patients with underlying lung disease or who have asthma and inhale their spores. This study aimed to screen the antifungal susceptibility of Aspergillus spp. isolated from patients with underlying pulmonary infections and characterize the isolates using PCR and sequencing. Method. Three hundred and eighty-four sputum or bronchoalveolar lavage samples were collected and processed for the isolation and identification, and characterization of Aspergillus species and molecular amplification of the ITS1-5.8S-ITS2 region by the PCR and Sanger sequencing method. Antifungal susceptibility tests for itraconazole and voriconazole were performed using the E-test. Result. The overall results revealed that out of 384 patients, 32 (8.3%) were positive for fungal growth, including 28 (87.5%) Aspergillus spp. The highest resistance rate (100 and 44.4%) was obtained from itraconazole against A. niger and A. fumigatus. In contrast, voriconazole revealed the best activities against all tested fungi compared to itraconazole. All A. flavus were sensitive to voriconazole, while only 54.5% were sensitive to itraconazole. The MICs of E-test for Aspergillus spp were 1.6 &plusmn; 1.8 and 0.6 &plusmn; 0.93 for itraconazole and voriconazole, respectively. Conclusions. The prevalence of aspergillosis was high, with a significant association with underlying lung diseases. Voriconazole was the drug of choice for isolated fungi

Outlining the Phytoconstituents of Greek Clover Herb Extract and Assessment of Its Effect against Foodborne Infections Caused by <i>Salmonella typhimurium</i>

Owing to the spread of resistance between pathogenic bacteria, searching for novel compounds with antibacterial activity is essential. Here, we investigated the potential antibacterial activity of Greek clover or Trigonella foenum-graecum herb extract on Salmonella typhimurium clinical isolates. The chemical profile of the herb was initially determined using LC-ESI-MS/MS, which explored 36 different compounds. Interestingly, the fenugreek extract possessed antibacterial action in vitro with minimum inhibitory concentrations of 64 to 512 µg/mL. The potential mechanism of action was studied by elucidating the effect of the fenugreek extract on the membrane properties of S. typhimurium bacteria, including the inner and outer membrane permeability and membrane integrity. Remarkably, the fenugreek extract had detrimental effects on the membrane properties in 40–60% of the isolates. Moreover, the in vivo antibacterial action was studied using a gastrointestinal infection model with S. typhimurium bacteria. Interestingly, the fenugreek extract (200 mg/kg) improved the infection outcomes in the tested mice. This was represented by the noteworthy decrease (p S. typhimurium-infected group. Additionally, there was an improvement in the histological and immunohistochemical features of tumor necrosis factor-alpha. In addition, using an ELISA and qRT-PCR, there was an improvement in the proinflammatory and oxidative stress markers in the fenugreek-extract-treated group. Consequently, fenugreek extract should be investigated further on other food pathogens

Anti-Quorum Sensing and Anti-Biofilm Activity of <i>Pelargonium × hortorum</i> Root Extract against <i>Pseudomonas aeruginosa</i>: Combinatorial Effect of Catechin and Gallic Acid

HPLC-UV was used to compare the major constituents of two Pelargonium × hortorum cultivars and Pelargonium sidoides root extract. It revealed the presence of catechin and gallic acid in high concentrations and the absence of umckalin in P. × hortorum root extracts. The antibacterial activity of these extracts was screened against 19 Pseudomonas aeruginosa clinical isolates. P. × hortorum root extracts showed the lowest MIC values (512–1024 µg/mL). This activity was concluded to be attributable to the high concentrations of catechin and gallic acid. The anti-biofilm activity of catechin, gallic acid, and their combination was examined by a crystal violet assay. The combination reduced the percentage of strong and moderate biofilm-forming isolates from 52.63% to 5.26%. The impact on lasI and lasR genes expression using qRT-PCR and simultaneous docking against LasR protein was explored. The combination downregulated lasI and lasR gene expression in eight and six P. aeruginosa isolates, respectively, and showed the greatest docking score. Additionally, the in vivo protection capability of this combination in infected mice showed enhancement in the survival rate. Our study revealed the potential biofilm and quorum-sensing-inhibitory activity of the catechin and gallic acid combination as a novel alternative to inhibit bacterial pathogenicity