Microbiological profile of corneal ulcer cases diagnosed in a tertiary care ophthalmological institute in Nepal.

BACKGROUND: Corneal ulcer, a major cause of monocular blindness in developing countries has consistently been listed as the major cause of blindness and visual disability in many of the developing nations in Asia, Africa and the Middle East, ranking second only to cataract. This study was carried out to determine the microbiological profile of corneal ulcer cases diagnosed among patients visiting Tilganga Institute of Ophthalmology (TIO), Nepal. METHODS: A total of 101 corneal scrapping samples were tested for routine culture and antibiotic susceptibility at the pathology department of TIO Nepal from April to October 2014. Microorganisms were identified by using standard microbiological procedures following the manual of American Society for Microbiology (ASM) and their antibiotic susceptibility test, performed by Kirby-Bauer disc diffusion method in conformity with the CLSI guideline. RESULTS: Out of 101 samples analyzed, 44.6% (45/101) showed positive growth with bacterial isolates i.e., 56% (25/45), more prevalent than fungus i.e., 44% (20/45). Among bacteria Streptococcus pneumoniae (31.1%, N = 14) was isolated in highest number whereas Fusarium (13.4%, N = 6) was the most common fungus species. Pseudomonas aeruginosa was the only Gram negative bacteria isolated from corneal ulcer cases. All bacterial isolates were found to be susceptible to the quinolone group of antibiotics (moxifloxacin followed by ofloxacin and ciprofloxacin). CONCLUSIONS: These findings showcase the current trend in the microbiological etiology of corneal ulcer in Nepal, which have important public health implications for the treatment as well as prevention of corneal ulceration in the developing world.

Protective Effects of Bifidobacterial Strains Against Toxigenic Clostridium difficile.

Probiotics might offer an attractive alternative to prevent and control Clostridium difficile (C. difficile) infection (CDI). Limited information is available on the ability of commercially used bifidobacterial strains to inhibit C. difficile. This study examined the anti-clostridial effects of Bifidobacterium longum JDM301, a widely used commercial probiotic strain in China, in vitro and in vivo. In vitro evaluation revealed a significant reduction in C. difficile counts when JDM301 was co-cultured with C. difficile, which was correlated with the significant decrease in clostridial toxin titres (TcdA and TcdB). Furthermore, the cell-free culture supernatants (CFS) of JDM301 inhibited C. difficile growth and degraded TcdA and TcdB. Notably, the results showed that acid pH promoted the degradation of TcdA by CFS from JDM301. Furthermore, comparative studies among 10 B. longum strains were performed, which showed that the inhibitory effect of CFS from JDM301 was similar with the other 8 B. longum strains and higher than strain BLY1. However, when it was neutralized, the significant different was lost. When present together, it was suggested that the acid pH induced by probiotics not only played important roles in the growth inhibition against C. difficile resulting in the reduction of toxins titres, but also directly promoted the degradation of clostridial toxin. In vivo studies proved that JDM301 partially relieved damage to tissues caused by C. difficile and also decreased the number of C. difficile and toxin levels. In summary, our results demonstrated that the commercial strain, JDM301 could be considered a probiotic able to exert anti-toxin capability and most of the CFS from Bifidobacterium were able to inhibit the growth of C. difficile, depending on acid pH. These results highlighted a potential that JDM301 could be helpful in preventing CDI and that most of the bifidobacterial strains could (at least partially) exert protective effects by reducing toxin titres through growth inhibition against toxigenic C. difficile.

The Probiotic Effectiveness in Preventing Experimental Colitis Is Correlated With Host Gut Microbiota.

Current evidence to support extensive use of probiotics in inflammatory bowel disease is limited and factors that contribute to the inconsistent effectiveness of clinical probiotic therapy are not completely known. Here, we used Bifidobacterium longum JDM 301 as a model probiotic to study potential factors that may influence the effect of probiotics in experimental colitis. We found that the effect of B. longum JDM 301 in tempering experimental colitis varied across individual mice even with the same genetic background. The probiotic efficacy was highly correlated with the host gut microbial community features. Consumption of a diet rich in fat could exacerbate mucosal injury-induced colitis but could not change the host responsiveness to B. longum JDM 301 treatment, suggesting of potential mechanistic differences between regulating colitis pathogenesis, and modulating probiotic efficacies by the gut microbiota. Together, our results suggest that personalized microbiome features may modify the probiotic therapeutic effect and support the idea of personalized probiotic medicine in inflammatory bowel disease.