Best Practice for Colistin Susceptibility Testing: Methods and Evidence (Mini...Abdullatif Al-Rashed
Mini-Review presentation
Best Practice for Colistin Susceptibility Testing: Methods and Evidence
Clinical Microbiology Residency Program, King Fahd Hospital of the University
Al Khobar, Saudi Arabia
Best Practice for Colistin Susceptibility Testing: Methods and Evidence (Mini...Abdullatif Al-Rashed
Mini-Review presentation
Best Practice for Colistin Susceptibility Testing: Methods and Evidence
Clinical Microbiology Residency Program, King Fahd Hospital of the University
Al Khobar, Saudi Arabia
ESBL and mbl-method of detection-1.pptxAnanya147165
Beta lactamase diagnosis extended spectrum b lactamase and metallo b lactamase screening and confirmatory test disc diffusion test broth microdilution method molecular diagnosis and CLSI guidelines
ESBL and mbl-method of detection-1.pptxAnanya147165
Beta lactamase diagnosis extended spectrum b lactamase and metallo b lactamase screening and confirmatory test disc diffusion test broth microdilution method molecular diagnosis and CLSI guidelines
Drug development for neglected parasitic diseases. Group of the University of Barcelona offers expertise from the design and synthesis of new therapeutic membrane active peptide-based antibiotics (AMP, NCE) to in vivo proof-of-concept and MoA (TEM, AFM, flow cytometry, fluorescence...).
The occurrence of AmpC β-lactamase and ESBL producing Gram-negative bacteria ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
To study Prevalence, Pre-disposing factors and Prevention of the following MDRO’s – Klebsiella pneumoniae Carbapenemase Producer, Methicillin Resistant Staphylococcus aureus, Multi Drug Resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli.
ABSTRACT- This study was an attempt to estimate the prevalence of Antimicrobial resistance in patients attending the OPD and IPD of IIMS&R, hospital, Lucknow. Total 453 urine samples were included in this study. Urinary isolates from symptomatic UTI cases were identified by conventional methods. Of the 453 processed samples 166 samples showed significant colony count of pathogens among which the most prevalent were E. coli (49.39%) followed by Klebsiella species (7.83%). The majority of the isolates were from female (68.67%) while the remaining was from male (31.32%). Dysuria was the most common clinical presentation followed by fever and abdominal pain. Diabetes and urogenital instrumentation were the major risk factors for UTI. Among the 166 urine samples which showed significant colony count, 152 (91.56%) of specimen showed pus cells in wet film examination. Among the gram-negative enteric bacilli high prevalence of resistance was observed against Ampicillin, Cefotaxime, Ciprofloxacin, Nalidixic acid and co-trimoxazole. 44% of isolates were detected to produce ESBL among the gram negative bacteria. Carbapenemase production was seen in 13 (11.71%) isolates. Among the 32 Enterococcus isolates 14 (43.75%) were resistant to High level Gentamicin, 2 (6.25%) were resistant to High level Streptomycin while 12 (37.50%) of isolates were resistant to both of the antimicrobial drugs. Among the 16 Staphylococcus species, 8 (50%) were MRSA.
KEYWORDS- MRSA, Antimicrobial resistance, UTI, ESBL, Gram-negative bacteria
1 KEFLEX® CAPSULES CEPHALEXIN, USP To reduce.docxadkinspaige22
1
KEFLEX® CAPSULES
CEPHALEXIN, USP
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Keflex
and other antibacterial drugs, Keflex should be used only to treat or prevent infections that are
proven or strongly suspected to be caused by bacteria.
DESCRIPTION
Keflex® Capsules (Cephalexin, USP) is a semisynthetic cephalosporin antibiotic intended for
oral administration. It is 7-(D-α-Amino-α-phenylacetamido)-3-methyl-3-cephem-4-carboxylic
acid monohydrate. Cephalexin has the molecular formula C16H17N3O4S•H2O and the molecular
weight is 365.41.
Cephalexin has the following structural formula:
The nucleus of cephalexin is related to that of other cephalosporin antibiotics. The compound
is a zwitterion; i.e., the molecule contains both a basic and an acidic group. The isoelectric point
of cephalexin in water is approximately 4.5 to 5.
The crystalline form of cephalexin which is available is a monohydrate. It is a white crystalline
solid having a bitter taste. Solubility in water is low at room temperature; 1 or 2 mg/mL may be
dissolved readily, but higher concentrations are obtained with increasing difficulty.
The cephalosporins differ from penicillins in the structure of the bicyclic ring system.
Cephalexin has a D-phenylglycyl group as substituent at the 7-amino position and an
unsubstituted methyl group at the 3-position.
Each capsule contains cephalexin monohydrate equivalent to 250 mg, 333 mg, 500 mg or
750 mg of cephalexin. The capsules also contain cellulose, D & C Yellow No. 10, F D & C
Blue No. 1, F D & C Yellow No. 6, gelatin, magnesium stearate, silicone, titanium dioxide, and
other inactive ingredients.
CLINICAL PHARMACOLOGY
Human Pharmacology
Keflex is acid stable and may be given without regard to meals. It is rapidly absorbed after oral
administration. Following doses of 250 mg, 500 mg, and 1 g, average peak serum levels of
approximately 9, 18, and 32 µg/mL respectively were obtained at 1 hour. Measurable levels were
present 6 hours after administration. Cephalexin is excreted in the urine by glomerular filtration
and tubular secretion. Studies showed that over 90% of the drug was excreted unchanged in the
urine within 8 hours. During this period, peak urine concentrations following the 250-mg,
500-mg, and 1-g doses were approximately 1000, 2200, and 5000 µg/mL respectively.
Microbiology
In vitro tests demonstrate that the cephalosporins are bactericidal because of their inhibition of
cell-wall synthesis. Cephalexin has been shown to be active against most strains of the following
O CH3N
H
N
H
• H2O
SHH2N H
O
OHO
2
microorganisms both in vitro and in clinical infections as described in the INDICATIONS AND
USAGE section.
Aerobes, Gram-positive:
Staphylococcus aureus (including penicillinase-producing strains)
Streptococcus pneumoniae (penicillin-susceptible strains)
Streptococcus pyogenes
Aerobes, Gram-negative:
Escheri.
Pippettes are an essential component in fetching the accurate lab results,.... maintaining the accuracy and precision while dipensing reamins the mainstay of valid results in any test performed whether ELISA, DNA extraction Vitek, MALDI-ToF
Procalcitonin in sepsis, LDH in sepsis, sample collection for LDH estimation, microbiological aspects of sepsis, ashraf, Lysis centrifugation technique, collection of samples for diagnosis of sepsis, surviving sepsis guidelines, lysis centrifugation technique,
Antibiotic policy and trends in antibiotic policy,
References
Infection control: Basic concepts and practices, 2nd edn.
www.cdc.org
Antibiotics guide: choices for common infections
Chennai Declaration
A sincere effort
A compilation of all the diagnostic methods for diagnosis of ToRCH gp of infections in Pregnant women..
Presentation is done in two parts-
part-1 includes Toxoplasmosis and Rubella virus infection
Part-2- Cytomegalovirus, HSV-1, HSV-2 are covered
microbiological, lab diagnosis of Torch complex, Laboratory diagnosis of TORCH complex, Cytomegalovirus, Herpes simplex type1, HSV-1, Herpes simplex type2, HSV-2,
Shell vial technique,
view after download for better understanding, or else it appears quite compact and jumbled..
TORCH complex, forms important set of PERINATAL (Vertically transmitted infections)
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. OUTLINE
A. Definition of Test / Report groups
B. Major deletions in CLSI 2017
C. Summary of antibiotic changes for
Individual bacteria
D. Addition of Supplemental tests
E. Changes in reporting for colistin
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3. A. ANTIBIOTIC TEST/REPORT GROUPS
Group A: Routine reporting against specific organism
Group B: Warrants primary testing and selective reporting.
Group C: Supplemental antimicrobial agents: institutional
endemic/epidemic resistant strains
Group U (“urine”): antimicrobials for treating UTIs.
Group O (“other”): clinical indication but are generally not
candidates for routine testing and reporting.
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4. Table 1A- Antimicrobial Agents :Testing
and Reporting on Nonfastidious
Organisms.
Table 1B – Fastidious organisms
Table 1C - Anaerobic Organisms
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11. B. MAJOR DELETIONS
1. Norfloxacin – Group U drug : Table 1A
2. Cefuroxime (parenteral) and
gemifloxacin from Table 1A, 1B and 1C.
3. Nalidixic acid breakpoints for
Salmonella spp
4. Telavancin disk diffusion breakpoints
for S.aureus.
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12. ORGANISMS IN TABLE 1A
Staphylococcus spp and Enterococcus spp. :
Norfloxacin – deleted
Moved ortivancin and telavancin to Test Group C
Enterobacteriaceae (except Salmonella sp) :
Gemifloxacin, norfloxacin – deleted
Enoxacin – moved to Test Group C
Nalidixic acid – Moved to Test group O (Enterobacteriaceae
except Salmonella)
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13. Salmonella spp.
Nalidixic acid disc diffusion breakpoints deleted for
Salmonella spp.
Preferred test for assessing fluoroquinolone susceptibility
or resistance is a ciprofloxacin MIC test
Pefloxacin disk diffusion test – surrogate test to predict
ciprofloxacin susceptibility
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14. Epidemiological Cutoff Values (ECVs)
for Enterobacteriaceae
not to be used as clinical breakpoints
Antimicrobial
agent
MIC ECV Comments
WT NWT
Colistin ≤ 2 ≥ 4 For use with E. aerogenes, E. cloacae,
E.coli, K. pneumoniae and R. ornitholytica
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15. Pseudomonas aeruginosa
Deleted colistin disk diffusion breakpoints.
Deleted polymyxin B disk diffusion breakpoints.
Moved norfloxacin to Test/Report group O and clarified
reporting.
Revised colistin MIC breakpoints.
Acinetobacter spp
No changes
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16. Other Non-Enterobacteriaceae
Deleted colistin and polymyxin B.
Deleted urinary tract infection (UTI) restriction for
gatifloxacin, lomefloxacin and ofloxacin.
Staphylococcus spp :
No changes
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17. ORGANISMS IN TABLE 1B
H.Influenzae and H.parainfluenzae :
Moved ciprofloxacin, levofloxacin and moxifloxacin to
Test Group B.
Moved trimethoprim-sulfamethoxazole to Test Group C.
Moved cefuroxime (parenteral) to Test Group C.
Moved gemifloxacin to Test Group C.
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18. Epidemiological Cutoff Values (ECVs)
for Neisseria gonorrhoeae :
Antimicrobial
agent
MIC ECV Comments
WT NWT
Azithromycin ≤ 1 ≥ 2 For use with N.gonorrhoeae
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19. ORGANISMS IN TABLE 1C
Epidemiological Cutoff Values (ECVs)
for Propionibacterium acnes
Antimicrobial
agent
MIC ECV Comments
WT NWT
Vancomycin ≤ 2 ≥ 4 For use with P.acnes
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20. 4. Changes in reporting for Colistin
Colistin, Polymyxin B not to be reported in Non-Enterobacteriaceae
In P.aeruginosa,
Colistin and PB not to be reported by disc diffusion.
Revised colistin MIC breakpoints
LIPOPEPTIDES
S I R
Colistin (10µg) ≤ 2 --- ≥ 4
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21. E. ADDITIONAL TESTS
modified carbapenem inactivation method (mCIM) for suspected
carbapenemase production : Enterobacteriaceae only
Test mCIM
When to do? For epidemiological, not for routine use
Method Meropenem disk inactivation
Test Reagents and
materials
• TSB (2mL aliquots)
• Meropenem disks (10mcg)
• 1mcL and 10mcL inoculation loops
• Normal saline (3-5mL)
• MHA plates (100mm or 150mm)
• Meropenem susceptible indicator strain E.coli
(ATCC 29522)
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22. Procedure:
1. One loopful (1mcL loop) bacteria + 2mL TSB
2. Vortex 10-15s
3. 10mcg meropenem disk added to it
4. Incubate at 35 ± 2ºC for 4 hrs
5. Simultaneously 0.5McFarland suspension of E.coli
ATCC 25922 prepared in NS.
6. E.coli ATCC inoculated on MHA (lawn culture)
7. Meropenem disk is removed from TSB by 10mL loop
and placed on above MHA plate: Incubate at 35 ± 2ºC
for 18-24hrs
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25. Test Interpretation
Carbapenemase positive: Zone size of 6-15mm or
presence of colonies within 16-18mm zone
Carbapenemase negative: Zone size ≥ 19mm
Indeterminate: 16-18mm
Reporting:
Positive to be reported as “Carbapenemase detected”
Control strains
K.pneumoniae ATCC BAA1705 : Carbapenemase positive
K.pneumoniae ATCC BAA1706 : Negative
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