The emergence of multi drug resistant bacterial infections has caused a critical problem with implication on hospitalization and mortality rates. This systematic review aims to review the combined antimicrobial effect of nanoparticles attached to the traditionally used antibiotics, to overcome the antibiotic resistance crisis. In this systematic search we focused on preclinical studies that have used animal models, to test and evaluate the effect of nanomaterials added to antibiotics against gram negative bacteria with carbapenem resistance. Where, this newly formed structure has led to significant decrease in bacterial load in animal model serum. Furthermore, by evaluating nanomaterial cytotoxicity and inflammatory markers, promising results were established, where low toxicity indices were presented, supporting the ability of this new pathway to be used as an alternative to abused antibiotics. Our research collected the various data and showed encouraging preclinical one for using nanomaterials with antibiotics. This undeniable route should be considered, due to its ability to contribute to the treatment of multi drug resistant bacterial infections. These findings provide base for future studies and reinforce the need for more evaluation and testing on the safety of nanomaterials against bacterial infections.

UNASSIGNED: Carbapenem-resistant bacteria (CRB) pose a major health risk to patients in intensive care units (ICU) across African hospitals. There are hardly any data about the role of hospital sinks as reservoirs of CRB in resource-poor African settings. Furthermore, the specific within-sink location of the highest concentration of pathogens and the role of splash back as a transmission mechanism remains poorly clarified.
UNASSIGNED: We swabbed ICU sluice room sinks in a tertiary hospital in Cape Town, South Africa. Swabs were taken from four different parts of the sluice room sinks (tap-opening, trap, below the trap, and u-bend). Dilutions were prepared and plated on carbapenem-infused agar. Colonies were identified and drug resistance profiles were determined using a biochemical analyser. To evaluate the potential transmission from the sink, similar plates were placed at fixed distances from the sink when the tap was turned on and off.
UNASSIGNED: CRB were isolated from the trap, water interface below the trap, and the u-bend (the latter harboured the highest density of CRB species). Five CRB, resistant to at least 7 antibiotic classes, were isolated including Pseudomonas, Klebsiella, Citrobacter, Serratia, and Providencia. CRB could be cultured from droplets that fell on agar-containing plates placed at a varying distance from the trap.
UNASSIGNED: There is a higher density of CRB in the u-bend of ICU sluice room sinks which can act as a potential source of transmission. The data inform targeted CRB transmission-interruption strategies in resource-poor settings.

The crude aqueous and ethanolic leaf extracts of Coccinia indica were screened for methicillin resistant Staphylococcus aureus (MRSA), multidrug resistant (MDR) Streptococcus pyogenes, Escherichia coli, Candida auris and Trichophyton rubrum. Antibacterial and antifungal activities were assessed by standard disc diffusion and tube dilution methods. The results showed that ethanolic extract inhibited MRSA, C. auris at 250 µg/mL and S. pyogenes at 200 µg/mL comparable to the susceptible antibiotics used as positive controls. There was no observable activity against T. rubrum, while a mild activity was observed with ethanolic extracts over E. coli at higher concentrations which did not turn out to be complete or significant inhibition. Aqueous extract did not exhibit any observable activity over the five organisms tested. Furthermore, the results showed clear cut concentration dependent antibacterial and antifungal activities with additional variation of specific activity over Gram positive and negative bacteria, yeast and filamentous fungi. So, it is evident that ethanolic extract of Coccinia indica could be further escalating for mechanistic studies in the era of multidrug resistance, indigenous preparations from herbs could be a safe choice over clinically challenging organisms.

OBJECTIVE: The objective is to identify the risk markers of multi-drug resistant bacteria (MDRB) related ventilator-associated pneumonia (VAP) in septic shock patients with previous MDRB carriage.
METHODS: This retrospective study was conducted in a medical ICU from 2010 to 2020. Consecutive patients with septic shock and still in the ICU after 48 h, were eligible. The following microorganisms were defined as MDRB: extended-spectrum beta-lactamase producing enterobacteriaceae, methicillin-resistant Staphylococcus aureus, multi-drug resistant Pseudomonas aeruginosa, imipenem-resistant Acinetobacter baumanii and Stenotrophomonas maltophilia. Screening for MDRB colonization was performed at ICU admission and during ICU stay. The determinants of MDRB-related VAP were assessed using a time-dependent cause-specific Cox model.
RESULTS: 643 patients were analyzed and 122 (18.9%) had at least one episode of VAP. The overall ICU mortality was 32.5%. The incidence of MDRB carriage was 31%, distributed into MDRB carriage at admission (14.3%) and MDRB acquired during ICU stay (16.7%). In multivariate analysis, MDRB colonization in ICU was independently associated with an increased risk of VAP (CSH: 1.85; 95% CI: 1.05-3.23; p = 0.03) whereas carriage prior to admission was not.
CONCLUSIONS: Imported and acquired MDRB carriage harbor different risks of subsequent MDRB-related VAP in patients with septic shock.

BACKGROUND: Recent years, multi drug resistant pathogens and their pathogenicity were increased worldwide due to unauthorized consumption of antibiotics. In addition, correlation between multi drug resistant bacteria and biofilm formation is heightened due to the production of more virulence behavior. There is no better identification methods are available for detection of biofilm producing gram negative bacteria.
METHODS: In this research work, multi drug resistant strains of Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae) were identified based on the specific antibiotics and third generation cephalosporin discs by disc diffusion assay. Subsequently, biofilm forming ability of selected pathogens were identified tissue culture plate and tube test. Based on the multi-drug resistant ability and biofilm production, the molecular identification of P. aeruginosa and K. pneumoniae were confirmed by PCR using universal primers.
CONCLUSIONS: No zone of inhibition present around the discs of muller hinton agar plates were confirm, selected P. aeruginosa and K. pneumoniae strains were multi drug resistant pathogens. Performed third generation cephalosporin antibiotics were also highly sensitive to selected pathogens of P. aeruginosa and K. pneumoniae. Further, biofilm forming ability of selected P. aeruginosa and K. pneumoniae was confirmed by tissue culture plate and tube methods. Finally, molecular identification of P. aeruginosa and K. pneumoniae was named as P. aeruginosa and K. pneumoniae. Our result was conclude, selected P. aeruginosa and K. pneumoniae as biofilm producing pathogens and also highly resistant to current antibiotics.

Water pollution is a major global problem that has been the leading cause of morbidity and mortality. This study was carried out to assess the microbiological quality of popular domestic brands of bottled water available in the Kathmandu Valley in Nepal. For the study of bottled water, a total of 50 samples each of different volumes (20 and 1 L) were selected. The samples were processed at the Microbiology laboratory at St. Xavier\'s College, Maitighar, Kathmandu. The microbiological assessments were performed as per the methods described in the American Public Health Association, 2005. Out of 100 samples, 48% of samples were found to be contaminated with total coliform. Escherichia coli was the predominant strain among the coliforms. Multidrug-resistant E. coli, Enterobacter aerogenes, and Pseudomonas aeruginosa were isolated from the 48 bottled water. Treat assessment test revealed that 88.23% of the isolated E. coli produced β hemolytic colonies, while 11.77% did not show hemolytic colonies, 100% E. aerogenes colonies were not able to develop hemolytic colonies and 100%, P. aeruginosa colonies gave β hemolytic colonies, respectively. Chi-square test shows that there is a significant association (p ≤ .05) between fecal coliform and volume of the vessel (i.e., 20 and 1 L), bottle type (i.e., unscratched and undented and scratched and/or dented), season (i.e., monsoon and postmonsoon), and total coliform. Chi-square test shows that there is no significant (p > .05) association between Pseudomonas spp and season (i.e., monsoon and postmonsoon). Out of 100 samples, 48% of samples were found to be contaminated with total coliform. Microorganisms survive in bottled water as they have many nutrients required for the microorganism in ionic form. Surveillance is lacking by the license-providing organizations followed by governmental organizations.

In this study graphene/chitosan nanoparticles (GR/CS NCs) were developed. The homogenous combination of GR and CS was confirmed by FTIR spectroscopy. The combination of CS with GR sheets reduced the XRD intensity of the GR peak in GR/CS NCs, while TEM images revealed the immobile CS coating of GR sheets. Further, the anti-biofilm activity of GR/CS NCs was tested. The tests showed that the formation of biofilm by Pseudomonas aeruginosa and Klebsiella pneumoniae was inhibited at 40□g/mL GR/CS NCs up to 94 and 92 %, respectively. The intracellular and cell surface damage of the bacteria was observed by CLSM and SEM. Also, GR/CS NCs produced a toxic effect of 90 % on Artemia franciscana at 70□g/mL upon 24 h incubation. The recorded properties of the synthesized GR/CS NCs qualify them as potential agents against multi-drug resistant bacteria.

The present study was designed to identify the potential bioactive compound from endophytic actinomycetes (EA) Nocardiopsis sp. GRG 2 (KT 235641) against selected extended spectrum beta lactamase (ESBL) producing Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae). Initially, the multi drug resistance (MDR) effect of selected uropathogens was confirmed by respective UTI panel of Hexa antibiotics disc methods. The zone of inhibition ≤22 mm for ceftazidime, ≤ 27 mm for cefotaxime and ≤8 mm zone of MIC stripe against both the uropathogens of phenotypic methods confirmed, the selected strains were ESBL producer. Among the various EA extracts, GRG 2 extract showed excellent antibacterial activity against both ESBL producing P. aeruginosa and K. pneumonia by agar well diffution method. The molecular identification of selected GRG 2 strain was named as Nocardiopsis sp. GRG 2 (KT235641). The antibacterial metabolites present in the TLC elution was exhibited at 274 nm by UV visible spectrometer. The partial purification of preparative HPLC fraction 3 showed 14, 16 mm against P. aeruginosa and K. pneumoniae, respectively. Based on the antibacterial effect, the FT-IR, GC-MS and LC-MS analysis of fraction 3 was confirmed as 1, 4-diaza-2, 5-dioxo-3-isobutyl bicyclo[4.3.0]nonane (DDIBN). Further, the dose dependent inhibition of DDIBN against both ESBL producing pathogens was observed at 75 μg/mL by minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC). The increased cell death and disrupted cell membrane integrity were observed at MIC of DDIBN by confocal laser scanning electron microscope (CLSM) and scanning electron microscope (SEM). The results were proved that the DDIBN has potential antibacterial metabolites against ESBL producing pathogens and it can be applied for various other biomedical fields.

The aim of the current study is to identify bioactive compound from marine endophytic actinomycetes (MEA) isolated from Gulf of Mannar region, Southeast coast of India. Among the isolated actinomycetes, strain GRG 4 exhibited excellent ability to inhibit isolated colistin resistant (CR) Pseudomonas aeruginosa (P. aeruginosa) and Klebsiella pneumoniae (K. pneumoniae), which is a emerging threat to the world. The strain was identified as Streptomyces coeruleorubidus GRG 4 (KY457708), based on morphological, biochemical, phenotypic and genotypic characters. The bioactive metabolites present in the methanolic extract were partially purified by TLC and preparative HPLC. The active HPLC fraction 2 showed 15, 20 mm zone of inhibition against both CR P. aeruginosa and K. pneumoniae respectively. Analytical HPLC and FT-IR results of fraction 2 showed with carbonyl group. Both GC-MS and LC-MS results confirmed that the fraction 2 contained chemical constituents of Bis (2-Ethylhexyl) Phthalate (BEP). The compromised structure with loosely integrated and ruptured cell wall of BEP treated CR bacteria were observed by confocal laser scanning microscope (CLSM) and scanning electron microscope (SEM) at 75 μg/mL of minimum inhibitory concentration (MIC) dose. Further, cytotoxic effect of BEP against A549 human lung cancer cells revealed complete inhibition by cell proliferation and apoptosis was observed at 100 μg/mL in 24 h treatment. In addition, irreversible ROS dependent oxidative damage was clearly observed at the IC50 concentration of BEP. The toxicity of BEP was also studied against Vibrio fischeri (V. fischeri) and found to be highly toxic after 15 and 30 min of treatment. Based on the results it could be concluded that the identified compound BEP is a potent inhibitor for CR bacteria and A549 lung cancer cells.

In this study, monodispersed, highly biocompatible and substantially stable glucose encapsulated CdO nanoparticles (G-CdO NPs) of uniform sizes were synthesized using a sol-gel route. In addition, naked CdO (n-CdO) NPs without any capping or surface functionalization were synthesized using the same method. These NPs were uniformly dispersed in an aqueous solution. The synthesis of G-CdO and n-CdO NP was confirmed by UV-Vis spectroscopy, transmission electron microscopy (TEM), zeta potential, and dynamic light scattering analyses. The average size of G-CdO and n-CdO NP was found to be 17±1and 27 ± 1 nm, under TEM, respectively. X-ray diffraction analysis of G-CdO and n-CdO NPs confirmed their sizes to be 18.83 and 28.41 nm, respectively, and revealed their cubic crystal structures with no impurity. The surface functionalization of G-CdO NPs with glucose was confirmed by Nuclear Magnetic Resonance and Fourier-transform infrared spectroscopy analyses. As per our knowledge, this is the first report to investigate the potencies of G-CdO and n-CdO NPs against gram-negative and gram-positive multi-drug resistant (MDR) bacteria. The minimum inhibitory concentrations of G-CdO and n-CdO NPs were6.42 and 16.29 μg/ml, respectively, against Escherichia coli (NCIM 2571-MDR), whereas 7.5 μg/ml & 11.6 μg/ml, respectively against S. aureus (NCIM- 2079) as determined by the double dilution method. The minimum bactericidal concentration was determined at the concentration for which no growth was observed. TEM analysis of E. coli cells treated with G-CdO NPs revealed cell shrinkage and degraded cell membranes, while the cell surfaces of untreated viable cells were smooth.