Journal of Antimicrobial Agents

Resistance to antibiotics is increasing dangerously worldwide. The emergence of antibiotic resistant bacteria is no more a local problem and calls for global action. It has become a leading challenge in infectious diseases management. The effectiveness of current drugs is restricted by emergence of multi-drug resistant bacterial strains and they have become the major reason for treatment failure of infections. Antimicrobial agents were initially highly successful in treating infections; however, their unsound use leads to rise in antimicrobial resistance frighteningly, especially in the developing countries. With the emergence of New Delhi Metallo-beta lactamase-1 and Extended Spectrum Beta Lactamase producing bacteria the clinicians are left with a very limited choice of treating the common infections. The recent situation calls for an urgent need for search of alternatives like herbal medicine which has shown potential in treating various other ailments. Because herbs are plants, they are often perceived as “natural” and therefore safe. Development of plant based compounds and combinational therapies using compounds may provide safer options for the community. Research should focus on scrutinizing compounds from plants for a target and bioactivity based drug discovery. However, the safety of using most herbs with drugs is not well established. Some herbs are known to interact with pharmaceutical drugs, although most of this information comes from case reports rather than systematic investigations. Because many herbs contain pharmacologically active compounds, some herbs may cause side effects through excessive biological effects. Unfortunately, the true frequency of side effects for most herbs is not known because most have not been tested in large clinical trials and because surveillance systems are much less extensive than those in place for pharmaceutical products. There is also a need for a strict regulations and policy in place for the use of herbal drugs or compounds of herbal origin in treatment of various common bacterial infections.

Antibiotics are widely prescribed therapeutic agents given as management for a range of bacterial infections. The development of antibiotic resistance is one of the most challenging problems in world. It occurs due to over use or inappropriate use of antibiotic. It occurs when the bacteria change in a way that reduces or stops the effectiveness of antibiotics, then the bacteria can survive and continue to grow and strengthen. Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps to reduce the impact and limit the spread of resistance such as education of health care professionals, patient counselling and maker policies.

Objective: In this study, antifungal substances were isolated from different soil bacteria like Clostridium species in the presence of different nitrogen sources. The isolated antifungal substances were then tested against Aspergillus and Trichoderma species to analyse their potential activity.
Methodology and Results: Antifungal substances were isolated from different soil bacterial species and it was observed that only Clostridium species was suitable to isolate active antifungal substances against Aspergillus and Trichoderma species in the presence of different nitrogen sources. Peptone and yeast extract were good nitrogen sources to isolate most active antifungal substances from Clostridium species. Agar well diffusion method was used to measure the zone of inhibitions and the maximum zone of inhibition was found up to 22 mm.
Conclusion: Yeast extract and Peptone were found to be good nitrogen sources for the growth of Clostridium sp. YLC and antibiotic production.

Objective: Chronic pulmonary aspergillosis (CPA) is a progressive infection that destroys lung tissue in immune competent patients. First-line therapies for CPA (itraconazole and/or voriconazole) are often curtailed due to toxicity or the development of drug resistance. Posaconazole is a potential alternative for these patients, but it is a high-cost medication.
Methods: Use of posaconazole was funded by the NHS Highly Specialised National Commissioners on an individual basis for patients who failed or did not tolerate first line therapy; those who met predefined criteria for improvement at 4 and 6 months (weight gain and/or improvement in St George’s Respiratory Questionnaire) continued posaconazole long-term. We recorded response, failure, discontinuation rates and adverse events.
Results: Seventy-eight patients received posaconazole as salvage therapy. Thirty-four (44%) achieved targets for continuation of therapy. Fourteen (18%) failed therapy; 5 (36%) patients did not achieve clinical targets at 4 or 6 months of assessment and 9 (64%) developed clinical and/or radiological failure. Twenty-eight (36%) discontinued their trial early; 8 (29%) died and 20 (71%) had significant side effects. One patient was non-compliant and another was lost to follow-up.
Conclusions: Establishing criteria for therapeutic success offered a clear, safe and sustainable method of identifying patients who benefit from additional therapy and minimised continuation of ineffective therapy in those who did not.

The emergence of multiple drug resistant pathogenic bacteria has severely constricted the antimicrobial options of treating infectious diseases. One of the powerful mechanisms of antibacterial resistance employed by the antibiotic resistant bacteria is the active extrusion of antimicrobials with the help of membrane transporters known as efflux pumps. Efflux pumps effectively reduce the intracellular concentrations of antimicrobials by their antiporter activity in which antimicrobials are extruded outside the bacterial cell using energy derived from ionic gradient across the cell membrane. While a few efflux pumps are capable of conferring clinical levels of resistance to antibiotics, while many others only marginally increase the minimum inhibitory concentrations (MIC) of antibiotics. However, the role of efflux pumps in gradual development of antibiotic resistance by pathogenic bacteria due to mutations and other molecular mechanisms during the course of antimicrobial therapy is well recognized. The inhibition of active efflux can result in maintenance of an intracellular concentration of antibiotics necessary to inhibit or kill bacteria. Plant-derived compounds have historically been recognized as effective antimicrobial agents. Advances in analytical techniques have enabled purification of natural compounds responsible for efflux pump inhibition and these compounds and their derivatives can act as lead compounds for designing more effective efflux pump inhibitors. Efflux pump inhibition is promising as an effective method of confronting bacterial resistance to antimicrobials either alone or as adjuvants with antibiotics, and thereby restoring the antibacterial efficacy of antibiotics.

Tuberculosis (TB) is one of the greatest infectious killers worldwide for adult. In 2014, TB killed 1.5 million people (1.1 million HIV-negative and 0.4 million HIV-positive). Eighty percent of male patients with pulmonary TB are young men, and reproductive function is extremely important for them. The problem of the influence of pulmonary tuberculosis on the sexual function in men has been covered in medical literature insufficiently and most publications devoted to urogenital tuberculosis (UGTB) as well as for female genital tuberculosis (FGTB). Some articles demonstrates negative influence on reproductive function not only TB as infection disease, but as well anti-TB drugs.

Tuberculosis disturbs sexual function including reproductive one both in male and female patients-and not only TB of genitals, but also pulmonary TB. TB patients have to take not less than 4 anti-TB drugs simultaneously for a long time and anti-TB drugs negative influence on sexual function too. It is necessary to have high index of suspicion for in-time diagnosis of genital TB. Protective pathogenetic therapy is indicated for TB patients.

Background: Mobile devices and hand of Healthcare Workers may contaminate with bacteria and become a source of infection.
Objective: This study was conducted to identify the types of bacteria in mobile phones, ears, and hands of health workers (HCWs) in Kosti teaching hospital and to determine the frequency of MRSA among Staphylococcus auerus isolates from these specimens.
Materials and Methods: This was a cross-sectional, hospital and laboratory based study, was carried out in Kosti Teaching Hospital. A total of 120 swab samples were collected from mobile phone, hand and ear of healthcare workers. All the swabs were cultured directly on blood agar, MacConkey agar and chocolate agar. Identification of isolates was did base on colonial appearance, Gram stain, and conventional biochemical tests. All Staphylococcus auerus isolates were subjected to antibiotics susceptibility testing using disc diffusion technique. Data were analyzed by statistical package for social sciences (SPSS) software version 17 and presented in form of tables.
Results: The frequency of positive culture among mobile phone, ear, and hand swabs were were 95% (57/60), 100% (30/30) and 96.7% (29/30), respectively. The frequency of MRSA was 98.6%.
Conclusions: Mobile phone, ear and hand of Healthcare Workers were the source of nosocomial infections. Good basic hygiene measures are extremely important, not only for hospital staff but also for patients and visitors, and it has a positive impact in infection control.

The project, based on large studies in the context of the application nanoparticles in biological science and medicine. So, Firstly the magnetic nanoparticles (MNPs) Fe3O4 synthesized by a chemical Co-precipitation method with a cover layer of silica (to prevent excess oxidation and increases the sufficiency of the surface of the nanoparticles) that in the size of 20 nm were prepared. Then the core/shell structure of it detected by the analyses of the SEM, FT-IR. Purpose of this production was for using of the full performance level of nanoparticles in absorption of antibiotics, ampicillin (amp), thus that normal value is 100 μg.ml-1 of amp solved in 20 mg of MNPs on terms of room temperature and normal time 0.25 hr. The resulting sample was tested by the analysis UV-Vis spectrophotometer and the results obtained indicated that amp absorbed is stabilized 85% up on the surface of nanoparticles. The resulting link between those two, the kind of bond-electrostatic which was proved by the analysis of EDX. Eventually this combination to processing bactericidal was used. In this case, MNPs-amp combination in the normal value of 20 μl of a bacteria culture model was added during overnight (In-vitro). More, the results showed that 95% of the bacteria were killed. According to the results obtained, as antibacterial properties of MNPs-amp, became apparent. Lastly, MNPs was separated by magnet which controlled by external magnetic field. So it can be targeted to a system for the transfer between nanoparticles to bacteria for specification of quality antibacterial.

Literature on patients with HIV and Peripherally Inserted Central Catheter “PICC“ published on MEDLINE database in English and Spanish have thoroughly been studied, revised and updated. We reviewed the medical records of all Human Immunodeficiency Virus (HIV) infected patients with Peripherally Inserted Central Catheter “PICC” implanted from 2010 to 2016.
In view of changes over the past in the intravenous management of patients with AIDS and infectious disease, we performed at Policlinico Gemelli Hospital a retrospective study of the last six years, in which we had reviewed all HIV infected patients with PICCs. Retrospectively we have evaluated the clinical severity of patients enrolled using Charlson-Deyo comorbidity score.
Our hospital has 1500 beds. There are two departments of infectious diseases for a total of 40 beds. There is an outpatient service where HIV patients are followed and a Day Hospital where chemotherapy is administered.
All HIV- infected patients who had PICC were identified about the occurrence of one of the following events: catheter related complication, catheter requiring removal in all cases, or death. All statistical procedures were performed using the SPSS software package (SPSS Inc. Version 15.0, Chicago).

Recently, changes have been observed in the occurrence and clinical presentation of Pseudomonas endocarditis, with increasing incidence of nosocomial infections and involvement of the aortic and mitral valves.
Two cases of patients who had suffered cardiac surgery in the recent past, successfully treated for pseudomonal endocarditis, are presented here.

An ethno botanical survey of 40 individuals in the Wilaya of Mascara identified 40 medicinal plants used for the treatment of diabetes mellitus. Among these plants, Malva sylvestris, Olea europea sylvestris, Citrus aurantium have been selected. The objective of our work is the phytochemical study and the antioxidant activity of the 3 plants selected. The raw methanolic extracts of Malva sylvestris and their stems, Olea europea sylvestris and Citrus aurantium were obtained by the extraction method maceration. The quantitative determination of total polyphenols by the Folin Ciocaltieu method and the flavonoids in the presence of AlCl3, the total polyphenol content in Malva sylvestris and their stems, Olea europea sylvestris and Citrus aurantium represents 556.33 μg EAG/g MS and 443.33ug EAG/G Ms; 557.66 g EAG/g Ms 447.77 μg EAG/gMS. The content of flavonoids is 1032.33 μg EQer/g Ms 898.66ug EQer/g Ms 894.33, μg EQer/g Ms 1428.33 μgEQer/g MS. Antioxidant activity of the extracts prepared was measured by two methods. The first is the use of free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH) and the second reducing power of FRAP iron. These methods show that these plants have good antioxidant activity.

Bacillus thuringiensis is a microbial insecticide whose presence in the Fernandez Canyon State Park, a protected natural area in the north of Mexico, has not been reported. The objective of this work was to isolate Bacillus thuringiensis strains isolated from the Fernandez Canyon State Park with the capacity to synthesize antimicrobial peptides (bacteriocins). We showed the isolation and characterization of two native strains of Bacillus thuringiensis (CF13 and CF42) collected from soils of the protected area. Bacteria were identified based on its capacity to synthesize spherical crystals and by sequencing of the flagellin gene. Both strains produced bacteriocins with bactericial/bacteriolytic activity against Bacillus cereus, with molecular mass of 10 kDa and 15 kDa, susceptible to proteolytic treatment, thermotolerants and with activity to ten Gram-positive and eight Gram-negative bacteria that might affect human and animal health. The importance of this work is that it is reported for the first time the isolation and characterization of bacteriocinogenic strains of Bacillus thuringiensis native from the Fernandez Canyon State Park, a protected natural area in Mexico.