Prevalence of silver resistance determinants and extended-spectrum β-lactamases in bacterial species causing wound infection: First report from Bangladesh

Background: The use of silver is rapidly rising in wound care and silver-containing dressings are widely used along with other antibiotics, particularly β-lactams. Consequently, concerns are being raised regarding the emergence of silver-resistance and cross-resistance to β-lactams. Therefore, this study aimed to determine the phenotypic and genotypic profiles of silver-resistance and extended-spectrum β-lactamases in isolates from chronic wounds. Methods: 317 wound swab specimens were collected from tertiary hospitals of Dhaka city and analysed for the microbial identification. The antibiotic resistance/susceptibility profiles were determined and phenotypes of silver resistant isolates were examined. The presence of silver-resistance (sil) genes (silE, silP, and silS) and extended-spectrum β-lactamases (ESBL) (CTX-M-1, NDM-1, KPC, OXA-48, and VIM-1) were explored in isolated microorganisms. Results: A total of 501 strains were isolated with Staphylococcus aureus (24%) as the predominant organism. In 29% of the samples, polymicrobial infections were observed. A large proportion of Enterobacterales (59%) was resistant to carbapenems and a significantly high multiple antibiotic-resistance indexes (>0.2) were seen for 53% of organisms (P ​< ​0.001). According to molecular analysis, the most prevalent types of ESBL and sil gene were CTX-M-1 (47%) and silE (42%), respectively. Furthermore, phenotypic silver-nitrate susceptibility testing showed significant minimum-inhibitory-concentration patterns between sil-negative and sil-positive isolates. We further observed co-occurrence of silver-resistance determinants and ESBLs (65%). Conclusions: Notably, this is the first-time detection of silver-resistance along with its co-detection with ESBLs in Bangladesh. This research highlights the need for selecting appropriate treatment strategies and developing new alternative therapies to minimize microbial infection in wounds

Impaired acylcarnitine profile in transfusion-dependent beta-thalassemia major patients in Bangladesh

Patients with beta-thalassemia major (BTM) suffer from fatigue, poor physical fitness, muscle weakness, lethargy, and cardiac complications which are related to an energy crisis. Carnitine and acylcarnitine derivatives play important roles in fatty acid oxidation, and deregulation of carnitine and acylcarnitine metabolism may lead to an energy crisis. The present study aimed to investigate carnitine and acylcarnitine metabolites to gain an insight into the pathophysiology of BTM. Dried blood spots of 45 patients with BTM and 96 age-matched healthy controls were analyzed for free carnitine and 24 acylcarnitines by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Although medium chain acylcarnitine levels were similar in the patients with BTM and healthy controls, free carnitine, short chain acylcarnitines, long chain acylcarnitines, and total acylcarnitine levels were significantly lower in patients with BTM than in the healthy controls (P < 0.05). Moreover, an impaired fatty acid oxidation rate was observed in the patients with BTM, as manifested by decreased fatty acid oxidation indicator ratios, namely C2/C0 and (C2 + C3)/C0. Furthermore, an increase in the C0/(C16 + C18) ratio indicated reduced carnitine palmitoyltransferase-1 (CPT-1) activity in the patients with BTM compared with that in the healthy controls. Thus, a low level of free carnitine and acylcarnitines together with impaired CPT-1 activity contribute to energy crisis-related complications in the patients with BTM. Keywords: Beta-thalassemia major, Carnitine-acylcarnitine levels, Impairment in fatty acid oxidation, Carnitine Palmitoyltransferase-1 activit

Civil society, corporate power, and food security: counter-revolutionary efforts that limit social change

Food is produced, processed, packaged, transported, and sold in a stable, organized system or food regime. The current food regime is focused on calories empty of substantial nutrition designed primarily for the growth of capital and corporate power, fostered through the lax, often corporate-designed, regulatory environment of neoliberalism. The neoliberal food regime is responsible for systemic malnutrition and erosion of the ecological preconditions for food production, as a regularity of the system itself. Consequently, a main line of food vulnerability is the political system that insulates the current food regime from social forces demanding change. This insecurity is contrary to the public or larger human interest, but this unsustainable system remains in place through a stable arrangement of government prescriptions that follow corporate-elite interests. To understand this structural problem, this essay examines the power of the food industry which requires the manufactured consent of civil society. The paper finds that counter-revolutionary efforts, which are anticipatory and reactive efforts that defend and protect capitalist elite from social change, stabilize the neoliberal food regime through covert tactics meant to undermine public interest critics and activists. As a result of these elite-led interventions, true civil society has become less powerful to articulate a public interest that might otherwise intercede in the operation and structure of the food regime. Thus, one leverage point in this political problem is the capacity of civil society, once it is independent of corporate interests, to remove consent to an abusive system and to debate and demand a food system that neither systematically starves whole groups of people nor destroys the ecological systems that make food possible. Building food security, then, requires recapturing a semi-autonomous civil society and eliminating domination of the corporate elite and replacing it with politics aligned with a public and ecological affinity. Scholars, educators, and the public can reduce the food vulnerability by becoming aware of corporate interests and creating strategic alliances to form a new system with more humane and ecological priorities