Rapid characterization of carbapenem-resistant Enterobacterales by multiplex lateral flow assay and detection of ceftazidime-avibactam-aztreonam synergy.

PURPOSE: The choice of antibiotics for treatment of Carbapenem-Resistant Enterobacterales (CRE) is increasing becoming limited due to co-expression of Metallo-beta-lactamases (MBL) along with other carbapenemases in these isolates. The study aimed to investigate the occurrence of CRE and to determine the in-vitro synergy and clinical outcomes of Ceftazidime-Avibactam and Aztreonam combination in CRE infections in adult Intensive Care Units (ICUs). METHODS: 79 CRE isolates recovered from adult ICUs during January to March 2023 were tested by O.K.N.V.I. RESIST-5, a lateral flow multiplex assay for rapid detection of OXA-48-like, NDM, IMP, VIM, and KPC carbapenemases. Ceftazidime-Avibactam MIC was determined by microbroth dilution method and in vitro synergy between Ceftazidime-Avibactam and Aztreonam was assessed by Modified E-test/disc diffusion method for these isolates. RESULTS: The study revealed 7.5 % occurrence of CRE in our hospital, with high occurrence of NDM (n = 42, 53.1 %) and OXA-48-like (n = 63, 79.7 %) carbapenemase. Production of more than one type of carbapenemases was found in 44 isolates. A total of 57 isolates (72 %) had Ceftazidime-Avibactam resistance and 44 of them displayed Ceftazidime-Avibactam and Aztreonam in-vitro synergy. Successful clinical outcome was observed in two patients who received Ceftazidime-Avibactam and Aztreonam combination therapy for 7 days or more. CONCLUSIONS: Despite the preponderance of Ceftazidime-Avibactam resistant CRE expressing NDM and OXA-48-like carbapenemase in our hospital, 77.2 % of them displayed in-vitro synergy of Ceftazidime-Avibactam with Aztreonam. It emphasizes the potential therapeutic utility of this combination in CRE strains showing coproduction of MBL and serine carbapenemases. Greater therapeutic potential of Ceftazidime-Avibactam and Aztreonam combination was observed with extended duration of therapy. However, further clinical evidence is needed to establish the efficacy of this combination and consider other factors that influence treatment outcomes.

Waste tire derived carbon as potential anode for lithium-ion batteries.

The uncontrolled accumulation of end-of-life tires every year leads to serious environmental concerns, rendering setback to the sustainable growth of the society. The most viable solution to overcome this environmental issue is to convert these hazardness waste tires into value added products. In the present investigation, carbonecous based anode materials has been developed by a novel chemical activation strategy involving aqua regia followed by controlled pyrolytic condition in the selective atmospheres. Raman spectroscopic study displayed a graphitic carbon with significant degree of disordered arrangements. The generation of the turbostratic carbon with higher content of broken crystal edges is corroborated using the structural characterization such as X-ray diffraction (XRD). This fact is further corroborated from surface energy results calculated using the contact angles measured by dynamic wicking method. The prepared turbostratic carbon, when used as lithium anode, renders excellent electrochemical performances with reversible specific capacity of 350 mAhg-1 (at 300 mAg-1) with 81% capacity retention after 500 cycles. The present research provides new roadmap in recycling the waste tires for energy storage applications.

COVID-19 Pandemic-Frontline Experiences and Lessons Learned From a Tertiary Care Teaching Hospital at a Suburban Location of Southeastern India.

The key challenges to any health care setup during emergency situations, such as that of the COVID-19 pandemic would be to rapidly address hospital preparedness and response tailored to the local population, societal influences, political factors within the existing infrastructure, and workforce. Second, to adopt and moderate policies, standard operating procedures (SOPs) and guidelines issued by national and international agencies, such as WHO, CDC, and the Indian Council for Medical Research (ICMR) were tailor-made to the local conditions of the hospital and community. In this publication, we have discussed the challenges and experiences in preparation and responses to the ongoing COVID-19 pandemic at a tertiary teaching hospital situated at a suburban locale in a small union territory. Puducherry is located in the South Eastern Coromandel Coast of India. The core processes, such as hospital preparedness, adoption, and amendments to SOPs based on dynamic changes in guidelines released by the central and local government, training given to health care workers, setting up the in-house diagnostic facility, surge capacity, management of supplies during the lockdown, infection prevention, and control and patient care are discussed. We have also reinforced our experiences in translating COVID-related opportunities for research and innovation in the form of awards and research proposals for the faculty and students of our institute. The lessons learned in terms of strength and limitations on the ground level of public health during this process is worth sharing as it would provide guidance in preparing the health care setups for pre- and post-pandemic.

Chitosan mediated gold nanoparticles against pathogenic bacteria, fungal strains and MCF-7 cancer cells.

In the present study, we report cytotoxic and antimicrobial potential of gold nanoparticles (Au NPs) synthesized using chitosan derived from squilla shell wastes. Here we adopted ecofriendly approach for the synthesis of Au NPs and characterized them using UV-visible spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, atomic force microscopy, transmission electron microscopy (TEM) and dynamic light scattering (DLS) methods. The UV-visible spectroscopic analysis revealed an absorption peak at 529 nm, which represents the Surface Plasmon Resonance of Au NPs. TEM analysis showed that the biosynthesized Au NPs were spherical in shape with an average size of 80 to 82 nm. Interestingly, the biosynthesized Au NPs showed antimicrobial activity against selected Gram-positive and negative bacterial isolates and also showed activity against fungal pathogens. Further, the cytotoxic effect of the synthesized Au NPs against MCF-7 cell lines was assessed by MTT assay with IC50 value of 250 µg mL-1. In addition, double staining of treated MCF-7 cells with acridine orange and ethidium bromide shows that the Au NPs exert apoptosis mediated cytotoxicity.

Electrochemically Exfoliated Graphene for Nanosensor Applications.

Water dispersible graphene layer are the excellent nano materials used for wide range of electronic applications. High quality graphene was synthesized by an eco-friendly, easy and cost effective electrochemical exfoliation method. In this work, graphite rod was used both as an anode and cathode for the production of graphene. Potassium sulphate (K2SO4) was used as an intercalating agent. Electrochemically exfoliated graphene (EEG) was coated on glassy carbon electrode (GCE) and evaluated towards the electrochemical oxidation of vanillin and L-phenylalanine. The fabricated electrode was able to detect vanillin and L-Phenylalanine as low as 0.2 µM with signal to noise ratio of 3. A significant increase in the current was observed for the graphene coated electrode for both vanillin and L-phenylalanine when compared to bare Glassy electrode. The finding clearly demonstrated the higher detection capability, selectivity and reproducibility of EEG.

Long-range molecular dynamics show that inactive forms of Protein Kinase A are more dynamic than active forms.

Many protein kinases are characterized by at least two structural forms corresponding to the highest level of activity (active) and low or no activity, (inactive). Further, protein dynamics is an important consideration in understanding the molecular and mechanistic basis of enzyme function. In this work, we use protein kinase A (PKA) as the model system and perform microsecond range molecular dynamics (MD) simulations on six variants which differ from one another in terms of active and inactive form, with or without bound ligands, C-terminal tail and phosphorylation at the activation loop. We find that the root mean square fluctuations in the MD simulations are generally higher for the inactive forms than the active forms. This difference is statistically significant. The higher dynamics of inactive states has significant contributions from ATP binding loop, catalytic loop, and αG helix. Simulations with and without C-terminal tail show this differential dynamics as well, with lower dynamics both in the active and inactive forms if C-terminal tail is present. Similarly, the dynamics associated with the inactive form is higher irrespective of the phosphorylation status of Thr 197. A relatively stable stature of active kinases may be better suited for binding of substrates and detachment of the product. Also, phosphoryl group transfer from ATP to the phosphosite on the substrate requires precise transient coordination of chemical entities from three different molecules, which may be facilitated by the higher stability of the active state.

Aeromonas hydrophila meningitis and fulminant sepsis in preterm newborn: A case report and review of literature.

Neonatal meningitis is a lethal infection occurring in the 1st month of life. The risk of developing permanent neurological sequels is high among the neonates who survive. Bacterial pathogens are commonly associated with this condition. Aeromonas is a Gram-negative bacteria of aquatic habitat. Although isolation of Aeromonas species from neonates with blood stream infection is infrequently reported, neonatal meningitis caused by Aeromonas is exceedingly rare. We present a case of fulminant sepsis and meningitis caused by Aeromonas hydrophila in a preterm newborn male. The bacteria was isolated in culture from blood and cerebrospinal fluid. In spite of targeted antibiotics and supportive therapy, the baby failed to respond and died on the 12th day of life.

Metallic silver nanoparticle: a therapeutic agent in combination with antifungal drug against human fungal pathogen.

Silver nanoparticles (Ag-NPs) are known to have inhibitory and fungicidal effects. Resistance against fungal infection has emerged as a major health problem in recent years, which needs great and immediate concern. Here, we report the extracellular biological synthesis of silver nanoparticles through a simple green route approach using a marine mangrove (Rhizophora mucronata) and silver nitrate. Aqueous extract of marine mangrove helped in reduction and was used as capping agent in biological synthesis. Nanoparticles were characterized using microscopy and spectroscopy techniques such as HRTEM, UV-Vis absorption spectroscopy and FTIR spectroscopy. X-ray diffraction analysis showed that the nanoparticles had face centered cubic structure with crystalline nature. FTIR spectroscopy showed the presence of different functional groups, such as hydroxyl and carbonyl, involved in the synthesis of nanoparticles. The antifungal activity of fluconazole and itraconazole was enhanced against the tested pathogenic fungi in the presence of Ag-NP and confirmed from increase in fold area of inhibition. This environmentally friendly method of biological synthesis can be easily integrated for various medical applications.

Fluorescence spectra of blood components for breast cancer diagnosis.

OBJECTIVE: To explore whether fluorescence emission spectroscopy of blood components can differentiate normal from early and advanced stages of breast cancer using stepwise discriminant analysis. MATERIALS AND METHODS: Fluorescence emission spectra were measured for blood components of three different groups: 35 normal controls, 28 with early-stage, and 18 with advanced-stage breast cancer. The data from the spectra were subjected to Fisher's linear discriminant analysis. Classification accuracy, specificity, and sensitivity of the technique were calculated for breast cancer diagnosis. RESULTS: Fluorescence emission spectra of blood components accurately distinguished normal from early-stage and advanced-stage breast cancer in 91.4% of original cases and 90.1% for cross-validated cases. The sensitivity and specificity were 80.4% and 100%, respectively, in distinguishing subjects with breast cancer from normal controls. CONCLUSION: Our statistical evaluation indicates that porphyrin in blood can be used as a reliable tumor marker. Fluorescence emission spectroscopy of blood components and statistical evaluations should be further investigated for a variety of tumors.

Comparison of morbidity among twins and triplets.

This study aims to compare morbidity indicators between twins and triplets. This was a retrospective, observational study, and involved a review of twins and triplets born in Basildon Hospital between 1991 and 2000. The main outcome measures were mean birth weight, gestational age at delivery, mode of delivery and length of stay in the intensive care unit. The mean birth weight is comparable between twins and triplets (1.877 kg at 33+4 weeks of gestation vs. 1.905 kg at 34+4 weeks of gestation). Triplets stayed a longer period in the intensive care baby unit. In this study birth weight in multiple pregnancies was as expected for gestational age. Triplets required longer neonatal intensive care.