Infectious Complications in Pediatric Patients with AML Demonstrate a Role for Antimicrobial Prophylaxis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4258-4258
Author(s):  
Carlie Stein ◽  
Jacob Kelley ◽  
Roger Berkow ◽  
Matthew A. Kutny
Keyword(s):  
Fungal Infection ◽  
Fungal Disease ◽  
Antifungal Prophylaxis ◽  
Severe Neutropenia ◽  
Fungal Culture ◽  
Gram Positive ◽  
Inpatient Hospitalization ◽  
Gram Negative ◽  
Skin Culture ◽  
Risk Of Death

Abstract Abstract 4258 Infection is a significant cause of morbidity and mortality in children receiving treatment for AML. Pediatric cancer centers vary widely in use of antibacterial and antifungal prophylaxis. Here we report on the incidence of bacteremia, fungal infections and associated outcomes of 76 children diagnosed with AML at our institution over a 12 year period. Further, we analyze the outcomes of patients diagnosed after 2010 when new policies were implemented requiring cefepime prophylaxis and inpatient hospitalization during count recovery. We retrospectively reviewed the medical charts of 76 children with AML treated at Children's Hospital of Alabama between January 2000 and March 2012. We examined in detail 101 episodes of bacteremia and 66 episodes of concern for fungal infection (defined as an episode of febrile illness where the patient received antifungal medication at treatment doses rather than only prophylaxis). Fifty-two patients (68%) had one or more episodes of bacteremia from time of diagnosis to an endpoint of bone marrow transplant, death, or end of therapy. There were a total of 101 episodes of bacteremia (68 gram-positive, 26 gram-negative, and 7 mixed gram-positive and gram-negative). Strep Viridans was the most common organism isolated, accounting for 33% of positive bacterial cultures. Eighty-six (85%) positive cultures occurred while the patient was severely neutropenic (ANC<200). Only nine (9%) positive cultures occurred in patients recovered from severe neutropenia. There was a 33% risk of PICU stay per episode of bacteremia. There was a 10% (10/101) risk of death per episode of bacteremia, and 13% (10/76) of patients in our cohort died of bacterial infection. Twenty-seven patients (36%) had 2 or more hospitalizations with bacteremia, and these patients had a disproportionate fraction of infection related complications. They accounted for 88% (29/33) of PICU stays and 80% (8/10) of patient deaths resulting from bacteremia. Seven of 76 (9%) AML patients received cefepime prophylaxis and inpatient hospitalization while severely neutropenic (ANC <200). Fifty seven percent (4/7) of these patients had one bacteremic episode which was similar to the 69% (48/69) rate of bacteremia in patients not receiving prophylaxis (p=0.67). However, there were no PICU stays or deaths associated with positive blood cultures in patients receiving cefepime prophylaxis. Comparing patients with bacteremia on cefepime prophylaxis (n=4) to patients with bacteremia not on a prophylaxis regimen (n=48), there were significantly less PICU stays in the patients receiving cefepime prophylaxis (p=0.014). All but one of the 76 patients in our cohort received antifungal prophylaxis (fluconazole 70%, voriconazole 11%, micafungin 5%, other/combination 14%). Fifty eight percent (44/76) of patients had at least one episode of clinical concern for fungal infection where they received an antifungal drug at treatment doses, and overall there were 66 episodes of fungal concern. Positive fungal cultures (from various sources including blood, lung biopsy, BAL, urine, trachea, skin, wound and stool cultures) were documented in 16% (12/76) of patients. Seven cultures were positive for Candida species (4 bloodstream, 1 wound, 1 stool, and 1 patient positive in both urine and trachea), 4 for Aspergillus (all lung biopsies), and 1 for Geotrichum (skin culture). Eleven episodes of positive fungal culture occurred during neutropenia with only the one skin culture occurring at ANC above 500. CT scans of the chest were used regularly to evaluate for fungal disease in 83% (55/66) of episodes of concern. Three (8%) chest CTs showed cavitary lesions highly suspicious for fungal disease, and 10 (27%) chest CTs had nodules. There was only one death attributed to fungal infection (Candida fungemia). In conclusion, AML patients have a high risk of infection. Bacteremia occurred in 68% of our cohort and resulted in a 13% mortality rate. However, patients receiving cefepime prophylaxis had significant decrease in PICU stays associated with bacteremia and did not account for any infection related deaths. Nearly all patients in our cohort received antifungal prophylaxis, and while 16% of patients had culture proven fungal disease, only one death was attributed to fungal infection. These results emphasize the importance of supportive care practices that prevent infection and monitor patients during times of increased risk. Disclosures: No relevant conflicts of interest to declare.

Evidence-based assessment of primary antifungal prophylaxis in patients with hematologic malignancies

Blood ◽  
2003 ◽  
Vol 101 (9) ◽  
pp. 3365-3372 ◽  
Author(s):  
Oliver A. Cornely ◽  
Andrew J. Ullmann ◽  
Meinolf Karthaus
Keyword(s):  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Fungal Infections ◽  
High Risk Patient ◽  
Risk Groups ◽  
Hematologic Malignancies ◽  
Antifungal Prophylaxis ◽  
Severe Neutropenia ◽  
Evidence Based ◽  
Cell Transplants

Invasive fungal infection is an increasing source of morbidity and mortality in patients with hematologic malignancies, particularly those with prolonged and severe neutropenia (absolute white blood cell count < 100/μL). Early diagnosis of invasive fungal infection is difficult, suggesting that antifungal prophylaxis could be the best approach for neutropenic patients undergoing intensive myelosuppressive chemotherapy. Consequently, antifungal prophylaxis has been extensively studied for more than 20 years. Nonabsorbable polyenes reduce superficial mycoses but are not effective in preventing or treating invasive fungal infections. Intravenous amphotericin B and the newer azoles were used in numerous clinical trials, but the value of antifungal prophylaxis in defined risk groups with cancer is still open to discussion. Recipients of allogeneic stem cell transplants and patients with a relapsed leukemia are high-risk patient populations. In addition, certain risk factors are well defined, for example, neutropenia more than 10 days, corticosteroid therapy, sustained immunosuppression, and graft-versus-host disease. In contrast to study efforts, evidence-based recommendations on the clinical use of antifungal prophylaxis according to risk groups are rare. The objective of this review of 50 studies accumulating more than 9000 patients is to assess evidence-based criteria with regard to the efficacy of antifungal prophylaxis in neutropenic cancer patients.

scholarly journals The Safety and Efficacy of Granulocyte Transfusions in Pediatric Recipients with Severe Neutropenia

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2148-2148
Author(s):  
Elysia R. Cohen ◽  
Madeline Miceli ◽  
Jibran Ahmed ◽  
Alexandra Jimenez ◽  
Bruce Sachais ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Stem Cell Transplant ◽  
Severe Neutropenia ◽  
Cell Transplant ◽  
Granulocyte Transfusion ◽  
Gram Positive ◽  
Advisory Committees ◽  
Gram Negative ◽  
Healthy Donors ◽  
Pediatric Recipients

Abstract Background: Pediatric oncology and stem cell transplant patients are at high risk for severe bacterial and fungal infections due to the myelosuppressive effects of chemotherapy and conditioning, respectively. Febrile neutropenia is one of the most concerning complications of chemotherapy. Even with the rapid initiation of empiric antibiotics, morbidity and mortality in this patient population occur frequently. Prognosis is worse in patients with proven bacteremia, with mortality rates of 18% and 5% reported in patients with gram-negative and gram-positive bacteremia, respectively (de Naurois et al. Annals of Oncology, 2010). Although gram positive organisms are known to be the most common cause of bacteremia in neutropenic patients (Kibbler et al. Curr Opin in Infect Dis, 1999), recent studies within the last 5 years have reported gram-negative organisms as the most common cause of bacteremia in this patient population (Mert et al. J Infect Dev Ctries, 2019, Islas-Muñoz et al. Int J Infect Dis, 2018, Sierra et al. Medicina, 2020, Cattaneo et al. Ann Hematol, 2018, Parodi et al. PloS one, 2019). Granulocytes harvested from healthy donors can temporarily raise the functional neutrophil counts in transfusion recipients. Data in the adult population show that while these transfusions are safe, they may be of limited efficacy, with patients receiving more than 6 x10 8 having better outcomes (Price et al. Blood, 2015). However, there is a paucity of data in the pediatric population (Atallah et al. Curr Opin in Hematol, 2006, Price et al. Semin Hematol, 2007, Estcourt et al. Cochrane Database Syst Rev, 2015). Objective: To determine the safety of granulocyte transfusions in pediatric recipients with severe neutropenia. Methods: Following IRB approval, we completed a retrospective cohort study of neutropenic pediatric recipients with various infections who received granulocyte transfusions. We reviewed the records of 74 pediatric recipients at the Maria Fareri Children's Hospital at Westchester Medical Center who received granulocyte transfusions from 2011-2019. The medical record was reviewed for patient age, underlying medical condition, indication for granulocyte transfusion, duration of fever, time to resolution of infection, mortality, and adverse reactions to the granulocyte transfusion. Mobilized granulocytes (dexamethasone) were collected from healthy donors at the New York Blood Center, as we have previously reported (Sulis/Cairo et al, Blood 2002, Price et al, Blood 2015). Results: The average age was 11 years (&lt;1-20) with 38 male patients and 36 female patients. The majority of patients were either stem cell transplant recipients, patients with hematologic malignancies, or both. The most common indication for granulocyte transfusion was a documented bacterial infection (56.7%). Fifty-two percent had gram negative infection and 45.2% had gram positive infection. Nine percent were staph infections. Patients received granulocytes for a median of 7.5 days. 54% of the patients cleared their infection with antibiotics prior to receiving the granulocytes. In the remaining patients, infection resolved in 32.4% while receiving granulocyte transfusions in addition to antimicrobial therapy. In this subset of patients, 63.6% had bacterial infection with 71.4% having gram positive infection, all of which were staph infections. The infection cleared after a median of 4 days of granulocyte transfusions. Patients in this subset were on antibiotics for a median of 5 days prior to starting granulocytes. Adverse events related to the granulocyte infusion occurred in 6 patients, with 3 patients having a fever during the transfusion (CTCAE 1), 1 with hypothermia (CTCAE 2), and 1 with joint pain (CTCAE 1). 3 patients died during the period when they were receiving granulocytes. 2 due to infection complication and one due to seizure. 30 day survival was 86.5% and 100 day survival was 85.1%. Conclusions: Granulocyte transfusions can be safely administered to pediatric patients with severe neutropenia. 32.4% cleared the infection with granulocyte transfusion. 100 day survival is 85.1%. Adverse events had CTCAE scores of 1-2. A majority of patients had gram negative infections, but the majority of patients that had resolution of infection with granulocytes had staph infections. It is possible that granulocytes may have greater efficacy against staph infections than other types of infection. Figure 1 Figure 1. Disclosures Liu: Incyte: Honoraria; Pharmacyclics: Honoraria, Speakers Bureau; Astellas: Honoraria, Speakers Bureau; Pfizer: Research Funding; Beigene: Honoraria, Speakers Bureau; Celgene: Research Funding. Cairo: Jazz Pharmaceutical: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Speakers Bureau; Sanofi: Speakers Bureau; Servier: Speakers Bureau; Sobi: Speakers Bureau; Omeros: Membership on an entity's Board of Directors or advisory committees; Nektar: Membership on an entity's Board of Directors or advisory committees.

The effect of anthracene-based chalcone derivatives in the resazurin dye reduction assay mechanisms for the investigation of Gram-positive and Gram-negative bacterial and fungal infection

2018 ◽  
Vol 42 (2) ◽  
pp. 1037-1045 ◽  
Author(s):  
Gopi Prakash ◽  
Mani Boopathy ◽  
Ramasamy Selvam ◽  
Samuel Johnsanthosh Kumar ◽  
Kathavarayan Subramanian
Keyword(s):  
Fungal Infection ◽  
Gram Positive ◽  
Gram Negative ◽  
Antifungal Activities ◽  
Chalcone Derivatives ◽  
Antibacterial And Antifungal Activities ◽  
Reduction Assay ◽  
Dye Reduction ◽  
Antibacterial And Antifungal ◽  
Resazurin Dye

A novel series of anthracene-based chalcone derivatives were synthesized and evaluated in terms of their antibacterial and antifungal activities.

scholarly journals CD4/CD8 ratio can predict the risk of septicemia in HIV infection

2020 ◽  
Author(s):  
YINGCHUN ZHU ◽  
Ping Zheng ◽  
Lin Cai ◽  
Ruifeng Zhou ◽  
Yin Wang ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Bacterial Infection ◽  
Fungal Infection ◽  
Fungal Infections ◽  
Multiple Infection ◽  
Aids Patients ◽  
Gram Positive ◽  
Gram Negative ◽  
Study Results ◽  
Significant Difference

Abstract Objectives There are few reports about the effect of CD4/CD8 ratio on the infection of HIV with sepsis. Here we analyze the correlation between the baseline CD4 / CD8 ratio and the pathogenic spectrum of AIDS patients with sepsis and the effect on the prognosis. Methods A retrospective analysis study(May 2010 to June 2017) was carried out using routinely colleted data from HIV with spesis at Chengdu Public Health Clinical Center. The values of clinical data, CD4/CD8 ratio and pathogenic spectrum were evaluated in the study. Results Among 322 positive blood culture HIV patients with septicemia, 208 (64.60%) were fungal infection, 64 (19.90%) were gram-negative bacterial infection, 47 (14.60%) were Gram-positive bacterial infection, and 3 (0.90%) were fungal and bacterial infection. Among the fungal infections, Cryptococcus was found in 152 cases (73.08%), followed by cyanobacteria marneffei in 53 cases (25.48%) and Candida in 3 cases (1.44%); Salmonella in 38 cases (59.38%) and Escherichia coli in 17 cases (26.56%); Staphylococcus in 28 cases (59.58%) were positive. When the CD4 / CD8 ratio≤0.3, the risk of sepsis infection was significantly higher than that of CD4 / CD8 > 0.3. The lower the ratio of CD4 / CD8 (< 0.1), the higher the risk (χ 2 =188.968,P = 0.00).When the ratio of CD4 / CD8 was less than or equal to 0.3, the incidence of fungal infection was significantly increased (67.14%), and the incidence of gram-negative bacterial infection (18.02%) was significantly higher than that of Gram-positive bacterial infection (13.78%), (χ 2 = 283.277, P = 0.00); when the ratio of CD4 / CD8 was greater than or equal to 0.3, the incidence of septicemia was significantly reduced, and there was no significant difference between the original spectrum of infection (χ 2 = 1.750, P=0.42)。 286 patients (88.82%) were discharged after treatment, 36 patients (11.18%) died after treatment. Conclusions In Chengdu of China, the main pathogens of septicemia in AIDS patients are fungi, including Cryptococcus and cyanobacteria marneffei, next are bacteria containing Salmonella and Staphylococcus. The lower the ratio of CD4 / CD8, the higher the risk of infection with sepsis, the higher the risk of multiple infection, and the higher the mortality. Therefore, we think that CD4 / CD8 ratio is an important risk factor for HIV infection with septicemia. We should pay more attention to role of the CD4 / CD8 ratio in clinical work, and it may be help us predicting progress of HIV disease.

Microbial Spectrum and Antibacterial Susceptibility of Endophthalmitis Cultures in a Tertiary Referral Center in the Midwestern United States: An Analysis From 295 Patients

2020 ◽  
pp. 247412642093645
Author(s):  
Michael Gemayel ◽  
Ashley Neiweem ◽  
Brent Aebi ◽  
Peter Bracha ◽  
Thomas Ciulla
Keyword(s):  
United States ◽  
Fungal Culture ◽  
Indiana University ◽  
Tertiary Referral ◽  
Gram Positive ◽  
Gram Negative ◽  
Midwestern United States ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Microbial Spectrum

Purpose: This work evaluates the microbial spectrum and antibiotic susceptibility pattern of endophthalmitis cases in a large tertiary referral center in the Midwestern United States. Methods: This retrospective case series included patients with clinically diagnosed endophthalmitis between April 14, 2006 and April 14, 2016, in whom ocular samples were submitted to the Microbiology Department at Indiana University. The patients were assessed by 11 vitreoretinal surgeons from 6 different sites in Indianapolis, including Indiana University and private practices, who receive patients from urban, suburban, and rural agricultural areas. Submitted specimens were cultured with the following media: blood agar, chocolate agar, MacConkey agar, and thioglycolate broth. Results: A total of 327 specimens from 295 patients were analyzed, with 96 (32.5%) samples from 90 (30.5%) patients meeting the criteria of confirmed growth. Of these 96 positive specimens, 83 (86.5%) organisms were identified as bacterial, and 13 (13.5%) were identified as fungal. Coagulase-negative Staphylococcus was the most common isolate (37.5%). Fifty gram-positive isolates and 10 gram-negative isolates underwent susceptibility testing. All 40 of the gram-positive isolates tested for vancomycin sensitivity were susceptible, whereas all 7 of the gram-negative isolates tested for ceftazidime sensitivity were susceptible. Conclusions: Empiric treatment with vancomycin and ceftazidime remains appropriate in most cases of endophthalmitis in the Midwestern United States, with 100% susceptibility of bacterial organisms tested with these antibiotics in this series. The high fungal culture rates in this study highlight the utility of obtaining vitreous cultures and potential need for antifungal agents in suspicious cases.

scholarly journals Bacteriological Profile and Drug Resistance Patterns of Blood Culture Isolates in a Tertiary Care Nephrourology Teaching Institute

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kalpesh Gohel ◽  
Amit Jojera ◽  
Shailesh Soni ◽  
Sishir Gang ◽  
Ravindra Sabnis ◽  
...  
Keyword(s):  
Blood Culture ◽  
Tertiary Care ◽  
Blood Stream ◽  
Antimicrobial Treatment ◽  
Biochemical Tests ◽  
Gram Positive ◽  
Gram Negative ◽  
Risk Of Death ◽  
Resistance Patterns ◽  
Life Threatening

Blood stream infections can lead to life threatening sepsis and require rapid antimicrobial treatment. The organisms implicated in these infections vary with the geographical alteration. Infections caused by MDR organisms are more likely to increase the risk of death in these patients. The present study was aimed to study the profile of organisms causing bacteremia and understand antibiotic resistance patterns in our hospital. 1440 blood samples collected over a year from clinically suspected cases of bacteremia were studied. The isolates were identified by standard biochemical tests and antimicrobial resistance patterns were determined by CLSI guidelines. Positive blood cultures were obtained in 9.2% of cases of which Gram-positive bacteria accounted for 58.3% of cases with staph aureus predominance; gram negative bacteria accounted for 40.2% with enterobactereciea predominence; and 1.5% were fungal isolates. The most sensitive drugs for Gram-positive isolates were vancomycin, teicoplanin, daptomycin, linezolid, and tigecycline and for Gram-negative were carbapenems, colistin, aminoglycosides, and tigecycline. The prevalence of MRSA and vancomycin resistance was 70.6% and 21.6%, respectively. ESBL prevalence was 39.6%. Overall low positive rates of blood culture were observed.

Microanatomy of the Periplasm of Bacillus Licheniformis

1971 ◽  
Vol 29 ◽  
pp. 262-263
Author(s):  
B.K. Ghosh
Keyword(s):  
Cell Wall ◽  
Plasma Membrane ◽  
Bacillus Licheniformis ◽  
External Environment ◽  
Permeability Barrier ◽  
Periplasmic Space ◽  
Modified Technique ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Periplasm of bacteria is the space outside the permeability barrier of plasma membrane but enclosed by the cell wall. The contents of this special milieu exterior could be regulated by the plasma membrane from the internal, and by the cell wall from the external environment of the cell. Unlike the gram-negative organism, the presence of this space in gram-positive bacteria is still controversial because it cannot be clearly demonstrated. We have shown the importance of some periplasmic bodies in the secretion of penicillinase from Bacillus licheniformis.In negatively stained specimens prepared by a modified technique (Figs. 1 and 2), periplasmic space (PS) contained two kinds of structures: (i) fibrils (F, 100 Å) running perpendicular to the cell wall from the protoplast and (ii) an array of vesicles of various sizes (V), which seem to have evaginated from the protoplast.

Rapid demonstration of septic or infectious arthritis due to Gram-negative bacteria

1992 ◽  
Vol 50 (1) ◽  
pp. 686-687
Author(s):  
Jacob S. Hanker ◽  
Paul R. Gross ◽  
Beverly L. Giammara
Keyword(s):  
Chronic Arthritis ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Infectious Arthritis ◽  
Bacterial Arthritis ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Blood cultures are positive in approximately only 50 per cent of the patients with nongonococcal bacterial infectious arthritis and about 20 per cent of those with gonococcal arthritis. But the concept that gram-negative bacteria could be involved even in chronic arthritis is well-supported. Gram stains are more definitive in staphylococcal arthritis caused by gram-positive bacteria than in bacterial arthritis due to gram-negative bacteria. In the latter situation where gram-negative bacilli are the problem, Gram stains are helpful for 50% of the patients; they are only helpful for 25% of the patients, however, where gram-negative gonococci are the problem. In arthritis due to gram-positive Staphylococci. Gramstained smears are positive for 75% of the patients.

In-vitro Antioxidant and Antibacterial Activity of Methanolic Extract of Shorea robusta Gaertn. F. Resin

2016 ◽  
Vol 6 (4) ◽  
pp. 68
Author(s):  
Sushma Vashisht ◽  
Manish Pal Singh ◽  
Viney Chawla
Keyword(s):  
Antibacterial Activity ◽  
Methanolic Extract ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Gram Positive ◽  
Gram Negative ◽  
Shorea Robusta ◽  
Dose Dependent ◽  
Resin Extract

The methanolic extract of the resin of Shorea robusta was subjected to investigate its antioxidant and antibacterial properties its utility in free radical mediated diseases including diabetic, cardiovascular, cancer etc. The methanol extract of the resin was tested for antioxidant activity using scavenging activity of DPPH (1,1-diphenyl-2-picrylhydrazil) radical method, reducing power by FeCl3 and antibacterial activity against gram positive and gram negative bacteria using disc diffusion method. The phytochemical screening considered the presence of triterpenoids, tannins and flavoniods. Overall, the plant extract is a source of natural antioxidants which might be helpful in preventing the progress of various oxidative stress mediated diseases including aging. The half inhibition concentration (IC50) of resin extract of Shorea robusta and ascorbic acid were 35.60 µg/ml and 31.91 µg/ml respectively. The resin extract exhibit a significant dose dependent inhibition of DPPH activity. Antibacterial activity was observed against gram positive and gram negative bacteria in dose dependent manner.Key Words: Shorea robusta, antioxidant, antibacterial, Disc-diffusion, DPPH.

Antibacterial activity of magnesium oxide nanoparticles prepared by Calcination method

2019 ◽  
Vol 10 (03) ◽  
Author(s):  
Elaf Ayad Kadhem ◽  
Miaad Hamzah Zghair ◽  
Sarah , Hussam H. Tizkam, Shoeb Alahmad Salih Mahdi ◽  
Hussam H. Tizkam ◽  
Shoeb Alahmad
Keyword(s):  
Antibacterial Activity ◽  
Magnesium Oxide ◽  
Diffusion Method ◽  
Oxide Nanoparticles ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Magnesium Oxide Nanoparticles ◽  
Agar Disc

magnesium oxide nanoparticles (MgO NPs) were prepared by simple wet chemical method using different calcination temperatures. The prepared NPs were characterized by Electrostatic Discharge (ESD), Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD). It demonstrates sharp intensive peak with the increase of crystallinty and increase of the size with varying morphologies with respect to increase of calcination temperature. Antibacterial studies were done on gram negative bacteria (E.coli) and gram positive bacteria (S.aureus) by agar disc diffusion method. The zones of inhibitions were found larger for gram positive bacteria than gram negative bacteria, this mean, antibacterial MgO NPs activity more active on gram positive bacteria than gram negative bacteria because of the structural differences. It was found that antibacterial activity of MgO NPs was found it has directly proportional with their concentration.

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