European Journal of Molecular & Clinical Medicine

Background: To assess outcome of management of diabetic foot ulcer.
Materials and Methods: One hundred ten patients of diabetic foot ulcer of both genders were enrolled. Parameters such as Wagner's classification, type of operations performed were recorded. Previous history of diabetes, wound healing, ulcers and boils in other part of the body were recorded. D.
Results: Out of 110 patients, males were 65 (59%) and females were 45 (40%). Wagner classification grade 0 was seen in 6, grade 1 in 8, grade 2 in 14, grade 3 in 26, grade 4 in 30 and grade 5 in 26 patients. Clinical presentation was gangrene seen in 20, cellulitis in 30 and ulcer in 60 patients. Bacteria    isolated were staphylococcus aureus in 72, Beta haemolytic streptococci in 16, gram negative organisms in 20 and anaerobic cocci in 2 cases. The difference was significant (P< 0.05). Management performed was incision and drainage in 10, amputation in 52, debridement in 26, transmetatarsal in 8, below knee amputation in 4 and above knee amputation in 10 patients. The difference was significant (P< 0.05). Complete healing was observed in 68, outcome was unknown in 26 and patient death occurred in 2 cases. The difference was significant (P< 0.05).
Conclusion: The management of diabetic foot ulcers remains a major therapeutic challenge which implies an urgent need to review strategies and treatments in order to achieve the goals and reduce the burden of care in an efficient and cost-effective way. Grade 5, presence of ulcers and bacteria such as staphylococcus aureus and gram- negative organisms were major risk factors for the surgical management of diabetic foot ulcer.

Introduction. Dental Biofilm or plaque is an assembly of microbial cells attached to a surface encased in the extracellular polymeric substance, which plays a crucial role in infection persistence. Oral infections are caused by opportunistic pathogens that exist in normal balanced microflora of the oral cavity, but become pathogenic upon any alteration in the typical biological environment of the oral cavity giving them favorable conditions. The early colonizers such as Streptococci enhance the infectivity by remodeling the oral microbiome and the metabolome. This remodeling may allow other pathogenic Streptococcus strains such as  S.mitis, S.oralis, S.sanguia S. gordonii, S.mutans to colonize, which can potentially cause problems due to their inherent resistance to antibiotics and ability to form biofilms.
Methods. In this study, we performed mass spectrometry (MS) based metabolomic analysis of biofilm formation by Streptococcus mutans strains linked to dental caries and those present in the oral microbiome of healthy persons to screen Streptococcus strains that can cause caries. Five clinical specimens from individuals who had caries disease (Caries active, CA) were compared with two isolates from the healthy oral dental microbiota (Caries free, CF).
Results and Discussion. Metabolomic studies were performed to identify the mechanism of biofilm formation and adaptations of bacterial strains to the human buccal cavity environment, which can lead to better diagnostic strategies and antibiotic development for streptococcus. The finding revealed metabolic variations in bacterial cells obtained from non-caries and caries subjects. These signatures though very general or broad can still be used to characterize the caries causing propensities of the oral cavity resident bacteria

Inhospitalspyogenicinfectionisoneofthemajorcauseofmorbidity.Increasingmultidrugresistant strains has made treatment of such infection difficult. For correct antibiotic use, everypus samplesshouldundergocultureandsensitivity.
Aim:Toisolatebacteriafrompussamplesandantibioticsensitivitypatterninvariouspusisolates.
Objectives:
i) To study the distribution pattern and prevelance of bacteria causing pyogenic infection.
ii) TostudyAntibioticSensitivityPatternoforganism isolatedfrompus.
Methods: The study was conducted in the Department of Microbiology, T.S. MisraMedical College & Hospital, Lucknow, for a duration of 6 months. 256 pus samples fromvarious wards with suspected pyogenic infection were studied. Bacteria were isolated,identified and antibiotic profile was determined from pus samples using standard protocol.
Results: In our study, out of 256 pus samples studied, 159 (62.10%) samples werepositiveforgrowth. Grampositivebacteriaoutnumberedgramnegativeisolates.CommonestisolatewasStaphylococcusaureus,followedbyCoagulaseNegativeStaphylococcusand Pseudomonasaeruginosa.AllStaphylococcusaureusweresensitive to Vancomycin and Linezolid. All Pseudomonas aeruginosa were sensitive toColistin. In Enterobacteriaceae group most effective antibiotic were Colistin and Tigecyclin.
Conclusion:Itisimportantforacliniciantosendallthepussamplesformicrobiologicalanalysisandtheirantibiogrambeforeputtingcasesonantibioticsothatemergenceofdrugresistancecanbeminimized.

Background: Diabetes mellitus is one of the most important underlying condition contributing to high morbidity and mortality globally leading to a number of cumbersome clinical conditions, of which a Diabetic Foot Ulcer ( DFU) is the most dreaded complication. A leading cause of hospitalization, in diabetic patients 36 the consequences are adverse leading to loss of a part of the lower limb or the whole limb. The risk of amputating a lower limb is 15 -46 times higher in a diabetic patient than in a non diabetic patient.
 
Aims and objectives: 1. To determine the genera of microorganisms found in diabetic foot ulcer. 2. To determine the antibiotic susceptibility pattern of organisms found in diabetic foot ulcer.
 

Introduction: A key diagnostic material for aerobic growth and susceptibility testing in the microbiology laboratory is pus. It is crucial to periodically conduct investigations to ascertain the evaluate the safety of microorganisms since the rate of emergence of resistance in bacterial isolates considerably outpaces the frequency of subsequent drug discovery and development.
Aim: This investigation was done to assess the evolving pattern of antibiotic resistance in different pus specimens.
Materials and Methods: Pus specimen was obtainedfrom several Department of Microbiology, MGM Medical college n Lion’s Seva Kendra, Kishanganjover the course of six months using an aseptic approach, and they were processed right away in the lab using conventional antimicrobial techniques. Motility tests, Gram staining, and biochemical processes were used to microbes. All specimens underwent Kirby Bauer's disc diffusion method antibiotics susceptibility testing on Muller Hinton agar, with results interpreted in accordance with CLSI recommendations.
Results: 120 pus specimens were analysed, and the results revealed that surgeries departments (32.42%) contributed the most to the 93.26% culture positive. One of most prevalent organism was Pseudomonas, followed by Staphylococcus aureus (22.51%). Gram negative bacilli were responsive to Imipenem (87.09%), Piperacillin (61.28%), and Gentamicin (48.38%) while Gram positive cocci were susceptible to Linezolid (94.86%), Vancomycin (92.30%), and Imipenem (92.30%).
Conclusions: As per regions and growing multi-resistant bacteria, the shifting patterns of antibiotic sensitivity in isolated strains from pus might be a useful tool for doctors to begin empiric therapy of patients as soon as possible

Background: Skin and soft tissue infections (SSTIs) are frequent forms of disease. In order
to define or improve empirical antibiotic therapy, it is necessary to generate data on the
current spectrum and susceptibility profile of bacteria associated with community-acquired
SSTIs.
Material and Methods: The clinicalsamples were obtained from 600 out-patients and the inpatientswith
community acquired skin and soft tissue infections.All clinical samples were
inoculated on the routine laboratorymedia. Antibiotic sensitivity testing was performed as per
standard guidelines.
Results:Out of 600 patients with community acquired skinand soft tissue infections, 258
(43%) were diagnosedwith abscess followed by cellulitis 145 (24.2%).Gram positive cocci
accounted for 92.27% of total isolates. Staph. aureus was the predominant pathogen
accounting for 78.75% of total isolates. Amongst the Gram negative isolates, P. aeruginosa
was predominant pathogen 7.72%.71 (19.34%)strains of MRSA were detected in the present
series.Sensitivity to other antimicrobials varied from 6.3% (penicillin G) to 97%
(clindamycin).All the strains of P. aeruginosa were found to be sensitive to the
antipseudomonal agent ceftazidime and to amikacin. The sensitivity of Pseudomonas strains
to other antimicrobials ranged from 52.8% to 97.22%.

Staphylococcus aureus is significant human pathogen which cause various kinds of infection ranging from minor skin diseases to life- threating endocarditis. It has acquired resistance to previously effective antimicrobials including the methicillin. Methicillin resistant Staphylococcus aureus (MRSA) is prototype of bacteria which is resistant and associated with long hospital stay, more mortality, raised costs & trouble-some to patient when compared with methicillin -sensitive Staphylococcus aureus (MSSA). The present study was prospective study conducted for a period 1 year 8 month (from Nov 2011-June 2013) all staphylococcal isolate in Microbiology Laboratory, Shri-Aurobindo Medical-college & P.G. institute Indore India. Gram staining of each specimen (except blood) was performed & findings noted. Each specimen was cultured on Blood agar & MacConkey’s agar aerobically incubated over-night at 37 ˚C. Staphylococcal isolate were identified by phenotyping methods like Gram stain, catalase test, slide &tube coagulase test growth on manitol-salt agar, VP test Phosphates test and bacitracin susceptibility test. The antimicrobial susceptibility testing was conducted by Kirby-Bauer disc diffusion method as per guidelines of CLSI. Sensitivity, specificity & Positive predictive valve of chromogenic-agar for identification of MRSA detection was 83.7%, 80.2% and 71.9% respectively. In our study out of 100 cefoxitin resistant strain 89 were mec a positive and 11 were mec a negative

Misuse and overuse of antibiotics results in widespread multi-drug resistance. The major cause of increased mortality and morbidity rates is Multi-drug resistance to antibiotics and it becomes a global heath challenges now a days, therefore it becomes a necessity and need for researchers to seek for alternative and natural sources of antimicrobials. In the present study an experimental trial (In-vitro and In-vivo) was undertaken to examine the antibacterial activity of extracts of Swertia chirata leaf against multi drug resistant (MDR) E.coli and S.aureus. Broth dilution test for MIC and Disc diffusion method for antimicrobial susceptibility test were applied to investigate Antibacterial activity of plant methanolic extracts. Twenty five albino mice weighted between 180-200g were used for bacterial inhibitory activity (In- Vivo). Plant extract showed broad spectrum of antibacterial activity against S.aureus in comparison to E.coli and showed MIC values of 20µg/ml. Swertia chirata plant extract contains lesser inhibition zone against E. coli (8.7±0.80) and showed highest zone of inhibition against S.aureus (16.2±0.60). It can be concluded that Swertia chirata plant extract was significantly better (P<0.05) against S.aureus than E. coli. The number of bacteria in treated groups was very low, These findings have cleared demonstrated that the clearance of bacteria from the blood of infected mice by sub-MIC of plant extract was significant. the findings of present study provide a suitable evidences for the use of a drug composed of plant extract as a new generation of drugs to attack the antibiotic resistance of bacteria.

Background: Staphylococcus aureus infections are one of the major infections in hospitals and the drug-resistant strain of S. aureus caused mortality and morbidity throughout the globe. In this study, we evaluated the S. aureus infection and their drug sensitivity patterns at Medicine department for 5 years.
Methods: The patients admitted at medicine word were participated in this study. All clinical samples were taken for bacteriological study. After identification of bacteria, the drug sensitivity patterns were carried out by disc diffusion methods.
Results: A total of 944 S. aureus isolates were analyzed. High sensitivity of S. aureus was observed for quinupristin/dalfopristin (100%), tigecycline (98.2), imipenem (98%), nitrofurantoin (97.6%), linezolid (97.3%), teicoplanin (97.1%) and vancomycin (95.1%). High resistance was recorded against penicillin G (91.9%), trimethoprim/sulfamethoxazole (56.9%) and tetracycline (33.2%). MRSA prevalence among the patients at IMS and SUM Hospital, Bhubaneswar was 27.8%. Highest proportion (80%) of MRSA was in burns unit.
Conclusions: Both MRSA and MSSA were highly susceptible to quinupristin/dalfopristin, tigecycline, linezolid, nitrofurantoin, ampicillin/sulbactam and vancomycin and showed high resistance to commonly used antibiotics such as gentamycin, erythromycin, levofloxacin and tetracycline. A majority of isolates were from pus specimen (68%).

Staphylococcus aureus is an important infectious pathogen in health sector and communities. S. aureus was first described by the Scottish surgeon Alexander Ogaston in surgical abscess in 1881. It causes various infections ranged between simple to life threating infections. Owing potent toxins and other virulence factors enabled the bacteria to be very virulent. Additionally, acquisition of antimicrobial resistant genes increased the challenge in treating the infections caused by bacteria especially methicillin resistant S. aureus strains (MRSA) that are often multidrug resistant strains. The circulation of MRSA between health settings and communities resulted in changing even the genetic map for the strains in both places. Vancomycin was used for years and still acts as the drug of choice for treating MRSA infections but recently the resistance to vancomycin has risen and vancomycin resistant S. aureus were recorded. Consequently, different regimes were used like combination of antibiotics to reduce the resistance rate to antibiotics if they were used as a single drug and practiced the control measures at health settings to reduce the spread of MRSA strains. At last, global health organizations call for research and finding new antibiotics agents and put MRSA on the top list of infectious agents that need more antibiotics.

This paper is devoted to the analysis of advanced scientific research about the role of
superlow intensity EHF effects on biological objects, including people. In this
investigation was utilized Gunn diode with the flow of electromagnetic radiation
superlow intensity of 10 μW and frequency 40-43 GHz. The estimation of the influence
of the millimeter radiation on staphylococcus aureus, E.coli, and the native blood has
been performed. It was shown the death of staphylococcus is associated with the
frequency of modulation signals of the radiation. The EHF irradiation of bacterial
suspension for one minute leads to the short-term disorders of motor function of
E.coli. Exposure by EHF of the super weak intensity causes inhibition of red blood cell
function, which manifests itself in a decrease in their ability to aggregate. Our
experimental data also prove that intake of water activated by means of EHF radiation
modifies the functional status of patients.

Aim: To investigate the antimicrobial properties of calcium hydroxide when mixed with three vehicles namely Zamzam water, Normal saline and 2% Chlorhexidine.
Materials & Method: 6 plates of nutrient broth and S. aureus culture were prepared. 2 (5*3 mm) wells were prepared in one plate and is used as control. 3 wells each were prepared in the remaining 5 plates and filled with freshly prepared mix of calcium hydroxide with the three vehicles (5 wells were filled with each mix). The same process was repeated using 6 plates containing nutrient broth and B. subtilis culture. The plates were then incubated for 24 hours and the Zone of inhibition (ZOI) was measured. The pH of each mixture was also measured by using a pH meter. The data was analyzed by ANNOVA test and compared by using Tukey HSD test.
Result: The mean value of ZOI for Ca(OH2) and Zamzam was statistically significant when tested against both the bacteria. The pH of 12.26, 11.90 and 12.10 was achieved for Ca(OH2) and Zamzam, Ca(OH2) and Normal saline and 2% Chlorhexidine and Ca(OH2).
Conclusion: Calcium hydroxide powder mixed with Zamzam water exhibited the highest pH of 12.26 and showed statistical significant antimicrobial difference when compared to other medicaments. However further in depth scientific investigations regarding the properties and safety of Zamzam water and World health organization (WHO) approval would be required before considering its clinical use.

From prehistoric era, the plants are used as a healing for many alarming disease due to the presence of therapeutic value. Even in contemporary invention, many herbal plants are intent in research field to concise about the efficacy of plant in curing disease with fewer side effects in long term exposure. Physalis minima Linn is generally used in the indigenous system of medicine for various diseases like diuretic, fevers, etc. In the present study, an attempt was made to evaluate the phytochemical substances and bioactive compound of the aqueous methanol extract of unripe fruit of Physalis minima Linn. The crude extract was separated by soxhlet using methanol as solvent followed by the phytochemical screening to identify the presence of secondary metabolites. Volatile components present in the methanol extract were separated and identified using GC/MS. The Gas chromatography - mass spectrometry chromatogram result showed the presence of total of 18 bioactive compounds in crude extract of physalis minima Linn which are exhibiting different biological functions such as antioxidant, anti-inflammation, anticancer, antidiuretics etc. Antibacterial activity of Physalis minima Linn extracts were also studied using disc diffusion method. The activities of methanol extracts were tested and had showed good inhibition zone against Staphylococcus aureus.

This study aimed to isolate, purified and identified staphylococcal enterotoxin A from Staphy-lococcus aureus. 200 clinical urine samples were collected from pregnant women with urinary tract infection aged from ( 20-40 years).Then, these isolated were identified as Staphylococcus aureus by biochemical and molecular methods. The percentage of positive culture of Staphy-lococcus aureus was 47%. One strain was selected to produce of Staphylococcal enterotoxin A and this enterotoxin was purified by chromatography technique such as ion exchange and gel filtration. All purified fractions were collected and measured at 280 nm and then presence of enterotoxin A was detected by ELISA kit. Finally ,50 mg\ml of SEA was extracted from 15 liters of brain heart infusion broth.

The present prospective study has been carried out in the Department of General Surgery, KIMS Karad, out of 200 cases that had undergone other surgical procedures. The rate of infection of the surgical site and the frequency of various pathogens caused surgical site infection in general surgery units with their antibiotic resistance patterns. Aim of the study is to prevent or reduce the incidence of surgical site infection in clean, hygienic and contaminated cases.Surgical site infection (SSI) is both the most frequently studied healthcare-associated infection and the most common healthcare-associated infection. Incidence of General Surgical Site Infection is 5.5%. Older age group is commonly involved. Risk factors like anemia, diabetes mellitus, hypoproteinemia, and hypertension are associated with increased Surgical Site Infection rate. Contaminated cases had more SSI rate (23.33%) as compared to clean- contaminated cases (4.82%). Most of the bacterial isolates were multidrug resistant.