Online ISSN: 2515-8260

Keywords : Antibiotic resistance

Antibiotic resistance- A review

Dr.Riddhi Tandon, Dr. Suresh Bhambhani .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 3, Pages 83-104

Background: Through the selection of resistant mutants, activation of latent resistance mechanisms, or acquisition of resistance determinants genes, bacteria may become more resistant after exposure. All of these processes may be sped up by antibiotic pressure.Objectives: To evaluate appropriate investigations and ascertain the condition of antibiotic resistance. Methods: After a thorough search of the online journals, 103 documents were found in total, and 54 of the papers were initially chosen. Then, 22 similar/duplicate articles were removed, leaving 41 investigations that were initially available. After reviewing the submissions' abstracts and titles, 17 more articles were disqualified. Finally, 21 papers that satisfied the inclusion and exclusion requirements were selected, including study articles and control trials.Results: All the 21 articles reported extensive antibiotic resistance to antimicrobial therapies, especially in cases of gram-negative bacterium. Conclusion: Finding strategies that can effectively lessen the burden of bacterial resistance towards antibiotics is the primary concern, whether they are applied in a variety of settings or are precisely tailored to the resources available and the most effective pathogen-drug combinations in a given environment.

Knowledge and awareness on the usage of antibiotics and analgesics among dental undergraduates

Nitinpreet Kaur, Gursimrat Kaur Brar, Sonu Gupta, S.P.S Sodhi

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 217-226

Antibiotics primarily used in treating the bacterial infections when administered unnecessarily can cause antibiotic resistance making the bacteria non responsive against antimicrobials. Analgesics that are used to relieve pain are one of the routinely used medications. Hence, the aim of this study was to check the knowledge and awareness regarding use of both antibiotics and analgesics amongst dental undergraduates. Total 324 participants from different profs and interns submitted their responses for the online questionnaire. A highly statistically significant difference was observed in the knowledge of participants for both analgesics and antibiotics. It can be concluded that the knowledge and awareness on the use of antibiotics and analgesics among dental undergraduates is low indicating lack of basic understanding of oral dose, indications and risks of both medications.

Prevalence of ESBL producing bacteria in recurrent UTI of diabetics: An Original Research

Dr Prathish Kumar, Dr Raveendran SR, Dr Saranya R, Dr Archana Mukunda

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2458-2467

Introduction: Many Gram negative bacteria are multi resistant as they produce ESBLs which breaks down the ring in the antibiotics there by rendering them ineffective. Infections caused by ESBL can be of great consequences even with common infections like urinary tract infections. Timely detection of drug resistant bacteria is of outmost importance as it plays a role in treatment approach and fatality. 
Materials and methods: 5ml of Clear midline stream urine was collected from 164 patients. The urine samples were careened for bacterial isolates and the presence of ESBL producers were confirmed by combination disc method and tested for antibiotic sensitivity and resistance.
Results: A total of 164 urine samples from 82 males and females were collected. We found that 58 females and 32 males had recurrent UTI. 43 and 38 isolates of ESBL producing bacteria were found by combination disc method in urine samples of females and males respectively. Out of 81 isolates of ESBL producers 43 were from E coli and 20 were from K pneumoniae.    
Conclusion: We found that E coli is the largest producer of ESBL in urine samples of patients with diabetes. ESBL isolates were found more in female urine samples than in males. There was a strong positive association of levels of diabetes with ESBL production. The ESBL were highly sensitive to amaikacin and nitrofurantoin but resistant to 3rd generation cephalosporin. 

Chronic Dacryocystitis Clinico-Microbiological Study

Poulami Nandi, Suman Adhikari, Parikshit Nandi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2515-2520

Background: Chronic dacryocystitis is the most prevalent adnexal illness encountered in routine treatment and is a major cause of ocular morbidity in India.
Methodology: This cross-sectional study comprised 200 consecutive individuals with persistent dacryocystitis. All subjects had baseline examination after providing signed informed consent. By applying pressure to the lacrimal sac and allowing the regurgitant material to reflux via the lacrimal puncta, or by irrigating the lacrimal drainage system with sterile saline and collecting the sample from the refluxing material, sample fluid was collected. Gram staining and culture were performed on the samples, which were delivered to the microbiology department. The Kirby Baur disc diffusion test was used to assess antibiotic sensitivity in cultured bacterial growth.
Results: Chronic dacryocystitis is most common in the fifth decade of life. Females are more likely than males to develop chronic dacryocystitis. The left eye was more affected than the right. The majority of patients developed mucopurulent discharge. When compared to cases with serous discharge, the percentage of samples yielding positive growth on culture was higher in cases with mucopurulent and purulent discharge. On culture, the majority of patients with serous discharge exhibited no growth. The majority of individuals had epiphora with mucopurulent or purulent discharge. The most common nasal association was a deviated nasal septum. Microorganisms were found in 58.7% of the samples cultivated.
Conclusion: Knowledge of the bacteriology of chronic dacryocystitis aids in the selection of prophylactic antimicrobial drugs that act precisely on the pathogenic organism and also helps to prevent antibiotic resistance induced by injudicious antibiotic usage.

Clinico-bacteriological and antibiotic drug resistance profile of Chronic Otitis Media: Mucosal disease, at a tertiary care hospital in rural Haryana: A retrospective observational study

Garima Yadav, Mayank Yadav, Pooja Singla, Nisha Sharma, Sulabha M Naik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 648-655

Background: Objectives: To determine the microbiological profile and antimicrobial susceptibility pattern of bacterial isolates from aural swabs in patients with CSOM. Materials and Methods: A total of 142 patients of CSOM with unilateral or bilateral ear discharge who attended the outpatient department from March 2020 to November 2020 were included. Results: Among 142 patients included in the study, most common age group was 11-20 years. CSOM was found to be more common in females (56.33%) than in males (43.66%). The most common bacterial isolate was Pseudomonas aeruginosa (45.8%) followed by Staphylococcus aureus (30.5%), Proteus mirabilis (13.8%), Acinetobacter baumannii (2.7%), Klebsiella pneumonia, Micrococcus, E. Coli, Citrobacter and Providentia species. Pseudomonas aeruginosa was found to have maximum  sensitivity to Polymyxin B (87.8%) and least sensitive to amoxicillin (15.1%). Among Staphylococcus aureus (87% MRSA and 13% MSSA) maximum isolates were sensitive to piperacillin+tazobactam (90.9%) and least sensitive to amoxicillin (13.6%).

A Study of Pathogenic Bacteria Isolated from Blood Culture Samples and Their Antibiotic Sensitivity

Tiwari Palak, Mahi Ishani, Lal Darbari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 517-525

Background: To diagnose bacteremia blood culture still remains the gold standard despite its limitations. While collecting samples, focus must be given that there is strong association between timing of specimen collection at different time points during admission and their yield.
Methods: A retrospective observational study was carried out by analyzing 100 positive blood cultures from April 2021-April2022. All positive blood culture and sensitivity reports of males and females aged less than one month to 60years were included. A total of 100 positive blood culture cases were taken from the culture and sensitivity register from Microbiology department of Hindu Rao Hospital and details were tabulated using a questionnaire.
Results: The commonest organism found on cultures was Coagulase Positive Staphylococcus (CONS) 34% of the cultures, this was followed by Actinobacter in 17% and Klebsiella pneumoniae in 11% of the culture samples. The most common fungi were Candida in 3% and Budding Yeast which was found in 2% of the samples. The most sensitive antibiotic was Gentamycin (27) which was sensitive for Coagulase-positive SA (12), K. pneumoniae (5), Actinobacter (5), S. typhi (3), E. coli (1) and P. aeuroginosa (1). The second most sensitive antibiotic was Vancomycin (20), which was sensitive for Coagulase-positive SA (9), Enterococcus (4), Methicillin resistant coagulase-positive SA (2), Methicillin sensitive SA (2), Actinobacter (1), MRSA (1), and S. aureus (1).
Conclusion: Positive blood culture is a crucial parameter for both the diagnosis of the patient as well as the associated prognosis, the correct interpretation of the blood culture results is essential. While planning treatment the sensitivity and resistance pattern of pathogens found in blood culture to common antimicrobial agents must be taken into account.

Knowledge and practices of dental students of Kashmir regarding antibiotic prescription and development of resistance : A cross sectional study

Dr. Iram Kahkashan; Dr. Sana Farooq; Dr. Nazia Lone

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2811-2818

As odontogenic infections have multimicrobial etiology like Gram-positive, Gram-negative, facultative anaerobes, and obligate anaerobic bacteria so major proportion of analgesics and antibiotics are prescribed by dentist. The aim of the study was to assess knowledge , practices and awareness of dentist of Kashmir regarding antibiotic prescription and development of resistance .75% of dentist agreed self medication as a prime reason of antibiotic resistance and abuse. As per the survey there was overprescription of antibiotic by the dentist and over the counter use of these medication by patients.

Molecular Characterization of Extended Spectrum Beta-Lactamase Producing Bacteria Isolated from a River Surface Water

Fazlul MKK; Mohamad Farouk Abdullah; Nomani Kabir; Saeid Reza Doustjalali; Negar Shafiei Sabet; Srikumar C; Rashid MA; Jassim M. SaadounMohammed A. KadhimSalah M. S. Al-Atab; Nazmul MHM

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1570-1580

The existence and prevalence of multi-drug resistant extended-spectrum βlactamase (ESBL)-producing bacteria in the river water is a major cause of numerous diseases worldwide. In this study, the molecular characterization of antimicrobial-resistant bacteria producing ESBL encoding genes was investigated for a better understanding of the risk factors and public health issues. The potential ESBL-producing bacterial species were detected using 16S ribose ribonucleic acid (rRNA) polymerase chain reaction (PCR). This served as a screening step to detect potential ESBLs encoding genes which were confirmed by phenotypes (DDST and E-test) and genotypes (PCR) assays with the presence of the bla genes; TEM, CTX-M, OXA-1 and SHV. Furthermore, all the confirmed bacterial isolates producing ESBL encoding genes were analysed for antibiotic susceptibility patterns against 10 different classes of antibiotics as a choice of therapy using antibiotic susceptibility testing (AST) by the disc diffusion method. The highest bacterial isolates were confirmed as Enterobacteriaceae (89.5%), predominantly Escherichia coli and Klebsiella pneumoniae. Among the 20 bacterial isolates, 12 (60 %) bacteria possessed one or more ESBLs encoding genes. Relatively high occurrence rates of β-lactamase genes; bla TEM 35%, bla SHV 20%, bla OXA-15% and bla CTX-M 10% were recorded. All the ESBLs encoding isolates showed high resistance to penicillin’s, third-generation cephalosporins, monobactams, cephamycins and carbapenems. High occurrences of ESBLs producing bacteria in the environment pose a threat to exposed communities. Therefore, early detection of MDR beta-lactamase mediated resistance genes are essential to avoid numerous diseases due to the dissemination of ESBLs producing strains.

Study Of Most Common Bacterial Isolates Causing Pyogenic Infections.

Gurinder Singh; Shubhi Taneja

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 4029-4041

Pyogenic infections are the challenges in the hospital patients invite to other nosocomial infections.It is also life threatening and required appropriate antibioticstotreatthesepyogenicbacterialinfections. Multi drug resistance is accountable to make chemotherapy more difficult to manage the bacterial pyogenic infections. Objective: To determine the antimicrobial susceptibility pattern of bacterial isolates from pyogenic infection. Methods:A study was conducted on samples collected differentwardsofthehospital.Pussamplewascollectedthroughaspirationandsterileswabs.The clinical specimens were processed immediately after collection to isolate and identification of the pyogenic bacteria Further AST was conducted by automated technique as well as Kirby-Bauer method by following the recommendedprocedures. Result: Overall 103 specimens were collectedand 44 samples were isolated out of them, showinganisolationrateof42.7%. Outof44positivesamples19weregrampositive(43.2)and25were gramnegative(56.2%).ThemajorbacteriaisolatedfrompuswasStaphylococcusaureus14(32%) , followedbyKlebsiellapneumonia6(13%)andEnterobacterspp6(13%),Escherichiacoli5(11%), Pseudomonas aeruginosa 4 (9%), Acinetobacter baumannii 2 (6%), Coagulase negative staphylococci 3 (8%), Enterococcus spp. 2 (4%). The remaining isolates were nonbacterial microbial infections. Conclusion: Emerging of MRbacterial strainsis the main focusfor thetreatment of pyogenic infections.Major challenges of pyogenic infections are due to Gramnegative bacteria which are followed by Gram positive bacteria such as Staphylococcus aureus. The change in antimicrobial pattern of antibioticsis tested by antibiotic sensitivity testing to treat the challenge in treating these conditions.

The Synergistic effect of non-steroidal anti inflammatory drugs on antibacterial activity of ceftriaxone against streptococcus pyogenes Isolated from patients with pharyngitis

Suaad Traiji Zamil; Raad Abdulameer Alasady; Rana Talib AlNafakh

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4483-4488

Background: Streptococcus pyogenes cause major infectious problems including pharyngitis, scarlet fever, and rheumatic fever Emergence of resistant strains make such infections and relevant complications (e.g., rheumatic valvular disease and glomerulonephritis) a serious clinical challenge especially in children. Aims and objectives: In a maneuver of overcoming the resistance developed by S. pyogenes and improving the ability of antibiotics to fight such bacteria, a nonsteroidal anti-inflammatory drug NSAID is repurposed as antimicrobial against S. pyogenes, in objective to be united with the usual antibiotic mentioned by WHO principle of care. The combination was evaluated for its MIC and combination index versus S. pyogenes. Materials and Methods: From patients, suffering pharyngitis a multidrug-resistant strain of S. pyogenes was insulated. The maximum dangerous isolate was cultivated for MIC determination ceftriaxonemefenamic acid combination in comparison with each alone to establish the combination index. Results and conclusions: There were a pointed synergism concerning ceftriaxonemefenamic acid (index ˂ 1) at P= 0.012 and Z score= 2.3 additional validation of MIC folds of dilutions are to be evaluated to achieve rational evidence. Recommendations: We suggested to additional validate the antistreptococcal effect of the combined ceftriaxonemefenamic acid on more dilutions of MIC assay and to identify the benefit of this combination in patients developed pharyngitis induced by S. pyogenes.


V.A Muralidharan; Sindhu Ramesh; Dr.Gheena. S

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 169-185

Endodontic infection is the infection of the root canal system and the microorganisms play a tremendous role in pulpal and periapical disease. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system. This can be achieved by a combination of local and systemic use of antibiotics. The use of antibiotics in dentistry especially in endodontics has become a practice towards inappropriate prescription and overdose leads to adverse side effects and bacterial resistance. An undergraduate student will have only limited knowledge in this regard. The aim of this study was to determine the knowledge, attitude and perception on usage of antibiotics among undergraduate students for endodontic therapy.This present study is a cross-sectional, descriptive questionnaire study conducted among dental undergraduate students in Chennai, India. The study was conducted from March to April 2020. A descriptive questionnaire study was conducted among 320 dental students in the city. A structured questionnaire was prepared focussing on antibiotics indication in dentistry particularly in endodontic treatment. Assessment of subjects awareness and attitude towards use of antibiotics for patients after endodontics procedures included in the questions relating to the knowledge of the basic antibiotics regime and its course. The subjects were requested to respond to each item in the specific format given. All the participants were allowed to choose one of the given three to four choices for each item in the questionnaire.A large population of students of 320 were familiar with this antibiotic resistance. Compared with the juniors, the senior students have a wider knowledge for prescribing antibiotics for various endodontic procedures.Most of the students prescribed Amoxicillin (30.82%)for any endodontic treatment for a duration of three days (26.42%) compared to other antibiotics.This study concludes that undergraduate dental students may prescribe antibiotics inappropriately and hence a proper and extensive guideline must be given to them to be followed . A thorough knowledge and awareness must be there on the antibiotic regime and its usage to all students before entering their clinics.