Biofilm formation by bacteria isolated from intensive care units of a tertiary care hospital, with special relevance to its risk factors

Background: The purpose of this study was to detect biofilm formation by bacterial isolates from patients with device associated infection admitted in intensive care units (ICUs), to compare the three methods used for detection of bioiflm, to compare the antimicrobial susceptibility pattern of the biofilm producers with the non-producers and to study the risk factors associated with biofilm formation.Methods: A total of 115 bacterial isolates from patients with device associated infection admitted in different ICU for a period of one year was included in the study. These clinical isolates were detected for biofilm formation by tissue culture plate method, tube method and Congo red agar method. Kirby-Bauer disc diffusion method of antibiotic susceptibility was performed on all isolates.Results: Out of the 115 bacterial isolates, 71 were biofilm producers. Tissue culture plate method detected the maximum number of biofilm producers (61.7%). The maximum number of biofilm producers were isolated from tracheal aspirate and endotracheal tubes (52.1%) followed by blood (17%) and urine (12.6%) respectively. The predominant biofilm producing isolates were Klebsiella pneumoniae (39.4%), Staphylococcus aureus (19.7%) and Pseudomonas aeruginosa (16.9%). Multi drug resistance among the biofilm producers was significantly higher than the non-biofilm producers (p value=0.0125). The risk of biofilm formation was seen to increase with the increase in duration of hospital stay (p value=0.0092, statistically very significant).Conclusions: From this study it was found that a high degree of biofilm producers were isolated from patients on indwelling devices. Tissue culture plate was found to be the most accurate method. The degree of multidrug resistance among the bioiflm producers was significantly higher than the non-producers

Staphylococcal scalded skin syndrome caused by methicillin-resistant Staphylococcus aureus with superadded fungal infection in a neonate

Staphylococcal scalded skin syndrome (SSSS) or acute staphylococcal epidermolysis is an exfoliative skin disease and a toxin mediated staphylococcal infection affecting mostly neonates and adolescents. We describe here a case of 10-day old full term, vaginally delivered baby weighing 1530gms presenting with erythematous lesions first developing on the face and later spreading to the entire body for the last 6 days. The mucosal areas were spared. Blood culture of the patient revealed growth of Methicllin Resistant Staphylococcus aureus (MRSA). Culture from the skin lesions also revealed growth of MRSA with similar antibiotic sensitivity pattern. Fungal culture from the skin lesions revealed growth of Candida tropicalis. The diagnosis of SSSS was based on clinical criteria and microbiological findings.

Seroprevalence of Japanese encephalitis amongst cases of acute encephalitis syndrome in a tertiary care centre of north east India: a four year retrospective study

Background: The present study was undertaken to investigate the trend of JE and the different parameters associated with it.Methods: It was a hospital-based retrospective study conducted from January 2014 to December 2017. A total of 3531 consecutive non-repetitive patients, satisfying the clinical case definition of AES as per the WHO guidelines, were included in the study. Cerebrospinal fluid (CSF) and serum samples were tested for JEV-specific IgM antibodies by the NIV JE IgM Capture ELISA Kit.Results: Of the 3531 patients admitted, 838(23.7%) cases were positive for JE IgM antibodies. There was a significant reduction in the JE positivity rate from 32.9% in 2014 to 13.3% in 2017. The male-to-female ratio was 1.6:1. JE positivity rate was significantly higher in adults as compared to children. The majority of cases occurred during the monsoon and post-monsoon season. Fever (100%), change in mental status (87.8%), headache (70.5%), neck rigidity (32.4%), unconsciousness (35.4%), seizure (43.9%) and paralysis (5%) were the major clinical symptoms. JE positivity was seen to be higher in the rural areas of Assam.Conclusions: A declining trend of JE was seen in this study, however further research work needs to be done to look for non-JE causes of AES

Alterations in urine, serum and brain metabolomic profiles exhibit sexual dimorphism during malaria disease progression

<p>Abstract</p> <p>Background</p> <p>Metabolic changes in the host in response to <it>Plasmodium </it>infection play a crucial role in the pathogenesis of malaria. Alterations in metabolism of male and female mice infected with <it>Plasmodium berghei </it>ANKA are reported here.</p> <p>Methods</p> <p>¹H NMR spectra of urine, sera and brain extracts of these mice were analysed over disease progression using Principle Component Analysis and Orthogonal Partial Least Square Discriminant Analysis.</p> <p>Results</p> <p>Analyses of overall changes in urinary profiles during disease progression demonstrate that females show a significant early post-infection shift in metabolism as compared to males. In contrast, serum profiles of female mice remain unaltered in the early infection stages; whereas that of the male mice changed. Brain metabolite profiles do not show global changes in the early stages of infection in either sex. By the late stages urine, serum and brain profiles of both sexes are severely affected. Analyses of individual metabolites show significant increase in lactate, alanine and lysine, kynurenic acid and quinolinic acid in sera of both males and females at this stage. Early changes in female urine are marked by an increase of ureidopropionate, lowering of carnitine and transient enhancement of asparagine and dimethylglycine. Several metabolites when analysed individually in sera and brain reveal significant changes in their levels in the early phase of infection mainly in female mice. Asparagine and dimethylglycine levels decrease and quinolinic acid increases early in sera of infected females. In brain extracts of females, an early rise in levels is also observed for lactate, alanine and glycerol, kynurenic acid, ureidopropionate and 2-hydroxy-2-methylbutyrate.</p> <p>Conclusions</p> <p>These results suggest that <it>P. berghei </it>infection leads to impairment of glycolysis, lipid metabolism, metabolism of tryptophan and degradation of uracil. Characterization of early changes along these pathways may be crucial for prognosis and better disease management. Additionally, the distinct sexual dimorphism exhibited in these responses has a bearing on the understanding of the pathophysiology of malaria.</p

Biomedical Waste Management Need of the hour - A Review Article

Biomedical Waste (BMW) means any waste, which is generated during diagnosis, treatment or immunization of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camp. Majority of waste generated in HCF maybe non-infectious (85%). The infections hazardous waste only contributes to about to 15% of the total waste generated by HCF. Inappropriate disposal of biomedical waste is a potential threat to not only humans but also to the safety of environment. There is a need to handle BMW by safe and reliable method in order to prevent it as a public health problem. This is a review article which highlights BMW guidelines 2016 with recent Amendments 2018

Analytical Study of Graphene as a Novel Piezoresistive Material for MEMS Pressure Sensor Application

The one-atom thick layer of carbon has been investigated with its unique exclusive property such as high thermal conductivity due to the high velocity of electron and exceptional electrical conductivity as well as mechanical strength. Due to its extraordinary properties; graphene put back many conventional materials to due smart, sensitive applications. As graphene has no band gap (Eg ~0 eV) but there is one method to induce a band gap by applying strain and each specific strain direction will create a unique band gap structure, in return it give signals which can be sensed by the device. The device can be operated either optically or electrically at different pressure levels up to Tera Pascal range thereby providing designers and engineers with a versatile sensing solution. To fabricate MEMS sensor based on a single layer of graphene, the piezoresistive pressure is becoming the most devastating problem up to nanoscale without damaging and high quality, defect free graphene. In this paper, we discussed the issues and cost effective solutions to integrate MEMS/NEMS pressure sensor device. We also compared the sensor performance with traditional piezoresistive materials

Fabrication, Characterization and Assessment of Polymeric Nanoparticles as a Nanomedicine Approach for Paclitaxel Delivery for Enhanced Cancer Treatment

The effectiveness of paclitaxel as a cancer treatment is widely recognized. However, its solubility issue can be addressed by blending it with ethanol and Cremophor EL, a product marketed under the trade name Taxol. Nevertheless, to enhance the anticancer efficacy of Cremophor EL and reduce adverse effects, alternative delivery methods and strategies must be explored. The objective of this work was to synthesize PLGA nanoparticles (PNF) loaded with paclitaxel and evaluate a number of characteristics, including in vitro drug release, drug loading, polydispersity index, zeta potential, and particle size. Finding the best formulation, PNF4, based on its in vitro drug release properties, was the main goal of the study. The surface morphology of PNF4 was then investigated by means of scanning and transmission electron microscopy after that (SEM and TEM). The delivery method follows the Korsmeyer-Peppas model, according to analysis of the in vitro drug release kinetics, indicating a "Fickian diffusion" mechanism. Furthermore, the in vitro cytotoxicity assessment demonstrated that the PNF4 formulation exhibited superior cytotoxicity compared to free paclitaxel

West Nile virus methyltransferase domain interacts with protein kinase G

Background: The flaviviral nonstructural protein 5 (NS5) is a phosphoprotein, though the precise identities and roles of many specific phosphorylations remain unknown. Protein kinase G (PKG), a cGMP-dependent protein kinase, has previously been shown to phosphorylate dengue virus NS5. Methods: We used mass spectrometry to specifically identify NS5 phosphosites. Co-immunoprecipitation assays were used to study protein-protein interactions. Effects on viral replication were measured via replicon system and plaque assay titering. Results: We identified multiple sites in West Nile virus (WNV) NS5 that are phosphorylated during a WNV infection, and showed that the N-terminal methyltransferase domain of WNV NS5 can be specifically phosphorylated by PKG in vitro. Expressing PKG in cell culture led to an enhancement of WNV viral production. We hypothesized this effect on replication could be caused by factors beyond the specific phosphorylations of NS5. Here we show for the first time that PKG is also able to stably interact with a viral substrate, WNV NS5, in cell culture and in vitro. While the mosquito-borne WNV NS5 interacted with PKG, tick-borne Langat virus NS5 did not. The methyltransferase domain of NS5 is able to mediate the interaction between NS5 and PKG, and mutating positive residues in the αE region of the methyltransferase interrupts the interaction. These same mutations completely inhibited WNV replication. Conclusions: PKG is not required for WNV replication, but does make a stable interaction with NS5. While the consequence of the NS5:PKG interaction when it occurs is unclear, mutational data demonstrates that this interaction occurs in a region of NS5 that is otherwise necessary for replication. Overall, the results identify an interaction between virus and a cellular kinase and suggest a role for a host kinase in enhancing flaviviral replication

West Nile Virus Methyltransferase Domain Interacts with Protein Kinase

Background The flaviviral nonstructural protein 5 (NS5) is a phosphoprotein, though the precise identities and roles of many specific phosphorylations remain unknown. Protein kinase G (PKG), a cGMP-dependent protein kinase, has previously been shown to phosphorylate dengue virus NS5. Methods We used mass spectrometry to specifically identify NS5 phosphosites. Co-immunoprecipitation assays were used to study protein-protein interactions. Effects on viral replication were measured via replicon system and plaque assay titering. Results We identified multiple sites in West Nile virus (WNV) NS5 that are phosphorylated during a WNV infection, and showed that the N-terminal methyltransferase domain of WNV NS5 can be specifically phosphorylated by PKG in vitro. Expressing PKG in cell culture led to an enhancement of WNV viral production. We hypothesized this effect on replication could be caused by factors beyond the specific phosphorylations of NS5. Here we show for the first time that PKG is also able to stably interact with a viral substrate, WNV NS5, in cell culture and in vitro. While the mosquito-borne WNV NS5 interacted with PKG, tick-borne Langat virus NS5 did not. The methyltransferase domain of NS5 is able to mediate the interaction between NS5 and PKG, and mutating positive residues in the αE region of the methyltransferase interrupts the interaction. These same mutations completely inhibited WNV replication. Conclusions PKG is not required for WNV replication, but does make a stable interaction with NS5. While the consequence of the NS5:PKG interaction when it occurs is unclear, mutational data demonstrates that this interaction occurs in a region of NS5 that is otherwise necessary for replication. Overall, the results identify an interaction between virus and a cellular kinase and suggest a role for a host kinase in enhancing flaviviral replication

Usage Pattern of Glimepiride/Metformin Fixed-dose Combination in Type 2 Diabetes Patients with CVD or at Risk of CVD: An Experience in Indian Setting

Background: Diabetes is associated with almost twofold increased risk of cardiovascular diseases (CVD). The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals in prescribing glimepiride/metformin fixed-dose combination (FDC) to type 2 diabetes mellitus (T2DM) patients with CVD or those patients who are at risk of CVD in the Indian settings. Material and methods: A retrospective, multicenter, observational, case-based questionnaire survey was conducted in Indian healthcare centers using medical records of patients having T2DM, with CVD or are at risk of CVD, who were prescribed any strength of glimepiride/metformin FDC. Data was collected from the patients’ medical records and was analyzed using statistical tests. Results: A total of 680 patients with T2DM with CVD or at risk of CVD were included in this study. Mean duration of diabetes in the patients was 5.7 ± 4.8 years. About 68.5% patients had hypertension, 47.9% had dyslipidemia, 25.4% had coronary artery disease (CAD), 3.6% had transient ischemic attack (TIA), 4.8% had peripheral arterial disease (PAD) and 2.9% had heart failure. Around 18.1% patients had CVD after diabetes was diagnosed, while 81.9% presented with cardiovascular (CV) issues at the time of diabetes diagnosis. All patients received glimepiride/metformin FDC as first-line therapy. About 68.2% patients on glimepiride/metformin FDC had blood pressure within optimal limits. A large proportion of patients had improvement in glycemic parameters. Weight change was noted in 18.4% of the patients overall. Of these, 59.2% had reduction in weight. There were no major adverse events and treatment efficacy and tolerability were reported as good to excellent for 94.6% and 92.9% patients, respectively. Conclusion: This case-based questionnaire survey demonstrates the usage pattern of various strengths of glimepiride/metformin FDC and the clinicians’ practice approach regarding early initiation of this combination in Indian patients with diabetes who have or are at risk of CVD