In vitro and in vivo anti-Helicobacter pylori activity of selected medicinal plants employed for the management of gastrointestinal disorders.

Five medicinal plants Mentha piperita L., Trachyspermum ammi L., Viola odorata Linn., Matricaria chamomilla L. and Foeniculum vulgare Mill. were selected for their in vitro and in vivo evaluation of anti-Helicobacter pylori activity. In vitro evaluation was performed by using disk diffusion method and minimum inhibitory concentrations were noted while rat models were selected for in vivo activity against four Helicobacter pylori strains isolated form gastric mucosa. Mentha piperita showed largest zone of inhibition with 9 mm diameter among all other extracts. All the plants showed promising anti-Helicobacter pylori activity against four isolates and a reference strain at concentrations of 125, 250, 500 and 1000 µg/ml in comparison with Amoxicillin 1 µg/ml but least MIC was exhibited by Mentha piperita followed by in vivo testing where it competed Amoxicillin at 1000 mg/kg by achieving 80% eradication of Helicobacter pylori in mucosa of infected rats justified by histological examination of stomach. It was concluded that medicinal plants possess strong anti-Helicobacter pylori activity and can be considered a potential source of safe and effective alternative regimens for the eradication of Helicobacter pylori.

Molecular Characterisation of Carbapenem-Resistant Enterobacteriaceae from Intensive Care Units.

OBJECTIVE: To determine the molecular characterisation of carbapenem-resistant enterobacteriaceae (CRE) from patients admitted in intensive care units (ICUs) of a tertiary care hospital. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Pathology and Microbiology, Pakistan Institute of Medical Sciences (PIMS), SZABMU, Islamabad, Pakistan, from July 2015 to March 2016. METHODOLOGY: Fifty isolates of CRE from intensive care units samples were processed, collected through samples coming from ICUs. Specimens were cultured on blood and Mac Conkey agar, and organisms were identified. Resistant organisms to imipenem and meropenem were preserved in glycerol broth at -80oC. Their molecular characterisation was done using the conventional PCR targeting NDM, KPC, VIM and IMP genes. RESULTS: Out of 50 samples, 13 (26%) were from urine, 13 (26%) from endotracheal tube tip, 7 (14%) from blood, 7 (14%) from pus, 7 (14%) from tracheal secretions, 2 (4%) from fluids, and 1 (2%) from catheter tip. NDM genes was isolated in 56% isolates. VIM, KPC, and IMP genes were not found in any isolates. NDM positive isolates included 86% Klebsiella pneumonia, 10% Escherichia coli, and 4% Klebsiella oxytoca. CONCLUSION: NDM gene was present in 28 (56%) samples. Whereas, VIM gene, KPC gene, and IMP genes were not detected in the CRE samples.

Draft Genome Sequence of a bla NDM-1- and bla PME-1-Harboring Pseudomonas aeruginosa Clinical Isolate from Pakistan.

We performed Illumina whole-genome sequencing on a carbapenem-resistant Pseudomonas aeruginosa strain isolated from a cystic fibrosis patient with chronic airway colonization. The draft genome comprises 6,770,411 bp, including the carbapenemase bla NDM-1 and the extended-spectrum beta-lactamase bla PME-1 This isolate harbors 3 prophages, 14 antibiotic resistance genes, and 257 virulence genes.

Incidence of metallo-beta-lactamase-producing Klebsiella pneumoniae isolates from hospital setting in Pakistan.

The aim of this study was monitoring and surveillance in different wards of the PIMS hospital, Islamabad, to understand emerging challenges of antibiotic resistance in particular association with most virulent serotypes of Klebsiella pneumoniae. The study was conducted during March 2015 to September 2015. The study showed that rate of isolation of K. pneumoniae was 37% (103 positives out of a total of 277 clinical samples) and 7.7% (8) were phenotypically and genotypically confirmed to be metallo-ß-lactamase resistant (carbapenem resistant) and all of them were multidrug resistant (MDR). These carbapenem-resistant isolates were isolated from blood, endotracheal tubes, and pus. Molecular screening for the presence of integrons indicated that distribution of class I integrons (87.5% of carbapenem-resistant K. pneumoniae isolates) was higher than class II integrons (1.25%) among given isolates. The study indicated that exposure of metallo-beta-lactamase-producing strains through hospitalizations increases the chances of spread of MDR pathogens. There is an urgent need for effective surveillance and monitoring strategies to control the spread of extremely resistant K. pneumoniae implicated in nosocomial infections leading to the increased health burden and enforcement of policy guideline on appropriate antibiotics usage.

Prevalence and clinical burden of NDM-1 positive infections in pediatric and neonatal patients in Pakistan.

In a neonatal/pediatric Gram-negative infection study from Islamabad, 71/82 strains were carbapenem resistant with 12/82 positive for New Delhi Metallo-ß-lactamase and many being extensively antibiotic resistant. Burden and outcome analysis on 9 patients showed that 4/9 died after inadequate therapy regardless of organism type.