In-vitro susceptibility of multiple drug resistant Pseudomonas aeruginosa to organic acids

Objectives: Pseudomonas aeruginosa is a classic opportunistic pathogen with innate resistance to many antibiotics anddisinfectants. Resistance to antimicrobial agents makes it the most noxious organism to eliminate from infection site. Inview of its antimicrobial resistance, an attempt was made to study its susceptibility to various organic acids.Methods: Seven clinical isolates of P. aeruginosa resistant to multiple antibiotics were subjected to in vitro susceptibilityto various organic acids by broth dilution method to find out susceptibility to various organic acids.Results: The isolates of P. aeruginosa resistant to 14 antimicrobials were found susceptible to one percent oxalic acidand trichloroacetic acid, two percent lactic acid and citric acid, and three percent acetic acid. It is interesting to note thatstrains resistant to multiple antibiotics were also found susceptible to organic acids. Oxalic acid and trichloroacetic acidwere found highly effective.Conclusions: Clinical use of oxalic acid, trichloroacetic acid and lactic acid as topical agents to treat superficial pseudomonalinfections caused by difficult strains of P. aeruginosa may be recommended after confirmation of their toxicityand in vivo efficacy in animal models. J Microbiol Infect Dis 2013; 3(2): 67-70Key words: Pseudomonas aeruginosa, Multiple Antibiotic Resistance, Susceptibility to Organic Acid

Induction of In Vitro Resistance to Penicillin in Viridans Group Streptococci and Its Effect on Susceptibility Pattern of Other Antimicrobial Agents

Background: The development of resistance to penicillin in Viridans Group Streptococci (VGS) during therapy has been reported. However, the in vitro development of resistance to penicillin or other antimicrobial agents in VGS is mostly overlooked and rarely reported. Aim & Objectives: To induce in vitro resistance to penicillin in VGS and to study its effect on susceptibility pattern of other structurally related (Beta–lactams) and unrelated antimicrobial agents. Material and Methods: Four isolates of VGS susceptible to all antimicrobial agents were manipulated in vitro to induce resistance to penicillin by sequential exposure to increasing concentrations of penicillin. Results: Increase in MIC values of penicillin from 0.06-0.12 µg/ml to 2-32 µg/ml was observed indicating development of resistance to penicillin. A significant increase in Minimum Inhibitory Concentration (MIC) values of ampicillin and slight increase in MIC values of other antimicrobial agents in some isolates was also noted. Conclusions: Exposure to increasing concentrations of penicillin can promote the development of resistance to penicillin and cross-resistance to other antimicrobial agents suggesting its mutagenic role

A Comparative study of Triamcinolone acetonide with Methylprednisolone sodium succinate in the management of chronic low back pain

Background: Low back pain is the most common complaint of young adults in case of intervertebral disc herniation. Its incidence is high in India due to difficult working as well as living environment. Objectives: The present study was carried out to compare the efficacy of injecting epidural triamcinolone with methylprednisolone sodium succinate in the management of chronic low back pain. Patients and Methods: This study was carried on patients presenting with low back pain who had MRI proven lumbar disc prolapsed at different levels and were not responding to conservational management. The study was carried out on 50 subjects divided into 2 groups, Group A and Group B of 25 each. Group A was given injection triamcinolone 80 mg with 2 ml of 0.5%bupivacaine diluted in 8 ml of normal saline into the lumbar epidural space. Group B was given injection methylprednisolone sodium succinate 80 mg with 2 ml of 0.5% bupivacaine diluted in 8 ml of normal saline into the lumbar epidural space. Observations: The success rate in group A was found to be 68% and the success rate in group B was found to be 80%. The visual analog scale score in group A was decreased by 20% after one week and by 50 – 60% at the end of 6 months. However, in group B, the visual analog scale score decreased by 30% after one week and by 70-80% at the end of 6 months. Conclusion: Methylprednisolone sodium succinate was found to be more efficacious in the management of chronic low back pain than triamcinolone acetonide

Traumatic Fat Necrosis of Breast in Male: A Very Rare Clinical Entity

Fat necrosis is a benign condition that can occur anywhere in the breast and can affect women of any age. Although it is frequently seen in female breast, it is a very rare condition that occurs in a male breast, and a very few cases have been reported so far. We report a case of fat necrosis of the breast in a 22-year-old male. The case was referred for surgical excision. The excised tissue showed typical multiple areas of saponification and calcification. A diagnosis of fat necrosis was confirmed by histopathologic examination.

Susceptibility, Resistance and Treatment Strategy for Infections Caused by Viridans Group Streptococci - A Review

Viridans Group Streptococci (VGS) were considered to be commensal organisms of low virulence. Their major disease associations were formerly limited to dental caries and infective endocarditis. Over the last several years, these bacteria have emerged as significant pathogens associated with gingivitis, periodontitis, bacteremia, meningitis, pneumonia and a variety of infections in neonates. Although penicillin remains the drug of choice in the treatment of infections caused by VGS, drug tolerance and clinical therapeutic failures have been reported. Different studies in recent past show that there is an alarming increase in resistance in VGS to various antimicrobial agents. Increase in the incidence of VGS with multiple drug resistance to penicillin and other agents suggest for periodic surveillance of antimicrobial susceptibility among VGS in order to guide appropriate antimicrobial therapy and to develop an appropriate treatment strategy for various infections caused by VGS. The development of appropriate treatment strategy not only helps in effective management but also helps to monitor further spread of resistant pathogens

Stimulus-triggered Fate Conversion of Somatic Cells into Pluripotency in Chronic Wounds in Human Beings?

Bone-marrow derived stem cells are multi potential or totipotent and are able to differentiate into numerous cell types. Their application is indicated in various reconstructive and restorative surgeries for rapid healing. A technique for creating cells that have the embryonic ability to turn into almost any cell type in the mammalian body has been reported. Recently, an unexpected phenomenon of somatic cell reprogramming into pluripotent cells by exposing to sublethal stimuli such as citrate based acidic medium has been reported. With the concept of creating acidic environment in chronic infected wounds to make a condition unsuitable for growth and multiplication of bacteria using 3% citric acid has been reported. It would be interesting to study whether the phenomenon of pluripotency takes place in chronic infected wounds in human beings following the application of 3% citric acid and plays an important role in formation of healthy granulation tissue