Enhancing Staphyloxanthin Synthesis in Staphylococcus aureus Using Innovative Agar Media Formulations.

Background Staphyloxanthin, a carotenoid pigment found in Staphylococcus aureus, serves not only to impart color but also functions as a crucial antioxidant contributing to virulence. Traditionally, milk agar has been employed to enhance staphyloxanthin production, however, no alternative media have been explored. Objectives This study aims to enhance staphyloxanthin production in Staphylococcus aureus using beetroot and carrot formulations. Methods To assess the efficacy of the media, we utilized filter paper, slide spot tests, and microscopic visualization as preliminary identification techniques. Ultraviolet-visible (UV-Vis) spectroscopy and paper chromatography were employed for characterization. Pigment quantification was conducted using microtiter plate assays, and genotypical detection was performed using Reverse Transcriptase-quantitative Polymerase Chain Reaction (RT-qPCR). Results Beetroot agar exhibited the highest pigment intensity, followed by beetroot with carrot agar, milk agar, carrot agar, and nutrient agar with the lowest intensity. These novel media formulations increased staphyloxanthin synthesis yield, resulting in spectrum shifts ranging from 450 nm (yellow) of milk agar to 470 nm (carrot agar) /480 nm (orange) of beetroot agar. Conclusion This study demonstrates that beetroot and carrot agar can effectively enhance staphyloxanthin production in Staphylococcus aureus. Furthermore, we propose the potential for large-scale cultivation of these pigments in future studies for various industrial applications, such as integration into paints, fabrics, and sunscreen lotions, due to their antioxidant properties.

Malaria in newborn: A missed entity for primary care physician.

Neonatal malaria and congenital malaria, though thought to be a rare entity in non-endemic areas but incidences from epidemic countries are eye openers. It is still thought by primary care physicians that its existence among neonates is not common even in endemic areas due to a low index of suspicion. In order to attain the objective set out in the global technical strategy against malaria 2016-2030, it is important to have a gravity of this disease in all age groups, especially in children and neonates in which misconception of low burden of infection results in underestimation of its morbidity and mortality in these age groups. This disease is only the tip of the iceberg due to unidentified, underreported and neglected illness and being a pointer towards higher circulation among society and pregnant women. So this review article highlights pathophysiology, epidemiology, clinical features, complications, prognosis, treatment and prevention of malaria in newborns and intends to bring awareness among the caregivers to understand the need for attention towards this neglected disease of neonates so that they should be able to identify and manage the disease in this vulnerable age group.

Utility of IL-6 in the Diagnosis, Treatment and Prognosis of COVID-19 Patients: A Longitudinal Study.

COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of COVID-19-related cytokine storm. Patients with COVID-19 who were admitted at AIIMS Rishikesh from March to December 2020 were included in the study. Patients with no baseline IL-6 value at admission and for whom clinical data were not available were excluded. Clinical and laboratory data of these patients were collected from the e-hospital portal and entered in an excel sheet. Correlation was seen with other inflammatory markers and outcomes were assessed using MS Excel 2010 and SPSS software. A total of 131 patients were included in the study. Of these, 74.8% were males, with mean age 55.03 ± 13.57 years, and mean duration from symptom onset being 6.69 ± 6.3 days. A total of 82.4% had WHO severe category COVID-19, with 46.56% having severe hypoxia at presentation and 61.8% of them having some comorbidity. Spearman rank correlation coefficient of IL-6 with D-dimer was 0.203, with LDH was -0.005, with ferritin was 0.3, and with uric acid was 0.123. A total of 11 patients received Tocilizumab at a mean duration from symptom onset of 18.09 days, and 100% mortality was observed. Deaths were reported more in the group with IL-6 ≥ 40 pg/mL (57.1% vs. 40.2%, p = 0.06). ICU admissions and ventilator requirement were higher in the IL-6 ≥ 40 pg/mL group (95.9% vs. 91.4%, p = 0.32 and 55.1% vs. 37.8%, p = 0.05). The study showed that IL-6 can be used as a possible "thrombotic cytokine marker". Higher values of IL-6 (≥40 pg/mL) are associated with more deaths, ICU admissions, and ventilator requirement.

Pyogenic liver abscess: Clinical features and microbiological profiles in tertiary care center.

BACKGROUND: Pyogenic liver abscess (PLA) is the end result of a number of pathologic processes that cause a suppurative infection of the liver parenchyma. MATERIALS AND METHODS: Sixty-five patients of age more than 18 years and radiologically confirmed cases of liver abscess were included in this study. Pus and blood samples were collected. Pus was processed for microscopy of trophozoite of Entamoeba histolytica and aerobic and anaerobic bacterial culture. Blood was processed for antibody ELISA for Entamoeba histolytica and aerobic bacterial culture. Identification of aerobic and anaerobic isolates was done by Vitek2 and antibiotic sensitivity test for aerobic bacterial isolates was done by Vitek2. RESULT: Out of sixty five, twenty five were confirmed as PLA. All patients were male with mean age 37.9 years. Fever and upper abdominal pain were the most common symptoms. Right lobe comprised 80% of the abscess. Pus sample was more sensitive than blood sample for diagnosis. There were a total of 33 isolates in our study. Klebsiella pneumoniae (6/33) was the most common aerobic isolate and Clostridium spp. (7/33) was the anaerobic isolate. All gram-negative bacteria were showing good sensitivity for 3rd and 4th generation cephalosporins, fluoroquinolones, amikacin, gentamicin, piperacillin-tazobactam, imipenem and meropenem. Abscess >5 cm was treated with percutaneous drainage while abscess <5 cm was treated with antibiotics only. CONCLUSION: Diagnosis should be made with the combination of clinical suspicion, radiology, and microbiology. Empirical therapy should include anaerobic coverage too. Only antibiotic therapy can be given under consideration of size of abscess, persistence of fever after giving antibiotics, and any suspected complications.

Diphtheria: The Patch Still Remains-A Case Report From the State of Uttarakhand.

Diphtheria is a potentially fatal acute infectious disease caused by toxigenic strains of Corynebacterium diphtheriae. It is rare in most developed countries due to routine childhood vaccination. Although Universal Immunization Programme is fully functional in India, several hospital-based surveillance studies over the recent years indicate that cases of this infection do occur among school-going children and adolescents. Poor immunization coverage, failure to take booster doses, and absence of data regarding coverage of booster doses of Diphtheria, Pertussis, and Tetanus vaccine are some of the factors responsible for persistence or possible reemergence of this infection in our country. There are no published reports of diphtheria from the state of Uttarakhand, India, in the recent years. We hereby report a confirmed case of diphtheria from this region.

Emerging Biocide Resistance among Multidrug-Resistant Bacteria: Myth or Reality? A Pilot Study.

CONTEXT: Possible linkage between biocide and antibiotic resistance in bacteria is a major area of concern. AIM: To evaluate the susceptibility of multidrug-resistant (MDR) bacteria to four commonly used biocides. SETTINGS AND DESIGN: A pilot study was conducted in a tertiary care hospital from April to November 2017. MATERIALS AND METHODS: Fifty-four MDR bacterial isolates, namely Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus, were obtained from various clinical samples of inpatients. These isolates were subjected to tube dilution method for determining minimum inhibitory concentration (MIC) of four commonly used biocides in our hospital, namely 5% w/v povidone iodine, absolute ethanol (99.9%), sodium hypochlorite (4% available chlorine), and quaternary ammonium compounds (QACs) (3.39%). Minimum bactericidal concentration (MBC) of these biocides was determined as per standard guidelines. Similar tests were also performed on corresponding American Type Culture Collection (ATCC) bacterial strains. STATISTICAL ANALYSIS: The Fisher exact test. RESULTS: Twenty-two MDR bacterial isolates had higher MIC values for QACs than their corresponding ATCC strains. Statistically significant difference in proportion of test isolates exhibiting higher MIC values for QACs and absolute ethanol was observed (P-value = 0.02). Twenty-four MDR bacterial isolates exhibited higher MBC values for sodium hypochlorite than their corresponding ATCC strains. The difference in proportion of test isolates exhibiting higher MBC values for sodium hypochlorite and absolute ethanol, respectively, was statistically significant (P-value <0.0001). The difference in proportion of test isolates exhibiting higher MBC values for absolute ethanol versus QACs and povidone iodine, respectively, was statistically significant (P-values = 0.0003 and 0.0076). Statistically significant differences in susceptibility to biocides among test isolates were also observed. CONCLUSION: Emergence of biocide resistance among MDR bacteria poses a serious threat to our efforts in containing outbreaks of nosocomial infections.