scholarly journals Management of infections with Mycobacterium other than tuberculosis as a complication of surgical procedures

2020 ◽  
Vol 7 (7) ◽  
pp. 2275
Author(s):  
Bikash Naskar ◽  
Sabyasachi Bakshi ◽  
Tapas Mandal

Background: Atypical Mycobacterium other than tuberculosis (MOTT) have emerged as significant human pathogens, causing post-surgical wound infections. The aim of this study is to assess the causative organisms of such infection and their treatment response.Methods: After matching the criteria, 28 cases, were taken for this prospective, single center, observational study. The diagnosis was confirmed by bacterial culture.Results: Among 28 patients, 16 were females (median age of 45.5 year). Patients had undergone laparoscopic cholecystectomy (n=13), laparoscopic appendicectomy (n=3), laparoscopic hernioplasty (n=2), open appendicectomy (n=2), open mesh hernioplasty (n=7), exploratory laparotomy (n=1). No major comorbidities or immunosuppression was identified. All patients were initially treated with repeated incision and drainage and started conventional antibiotics until culture and sensitivity report was available. All except one patient had culture confirmed MOTT infection. Combination antibiotics (clarithromycin, linezolid and ofloxacin) given for initial 3 months. 12 well responded within 3 months. 9 required additional few months to get complete cure. 4 patients cured after 6 months of treatment and 3 patients did not come for follow up.Conclusions: Delayed onset chronic wound infection by atypical mycobacteria is preventable. These organisms are not responsive to conventional antitubercular drugs but to specific drug regimens.

2020 ◽  
Author(s):  
Bikash Naskar

Abstract BACKGROUND:Atypical mycobacteria (MOTT) have emerged as significant human pathogens, causing post-surgical wound infections.The aim of this study is to assess the causative organisms of such infection and their treatment response.METHODS:After matching the criteria, 28 cases, were taken for this prospective, single center, observational study.The diagnosis was confirmed by bacterial culture. RESULTS:Among 28 patients, 16 were females (median age of 45.5 year). Patients had undergone laparoscopic cholecystectomy ( n=13 ), laparoscopic appendicectomy ( n=3), laparoscopic hernioplasty ( n=2 ), open appendicectomy ( n=2 ), open mesh hernioplasty ( n= 7 ), exploratory laparotomy (n=1 ). No major comorbidities or immunosuppression was identified. All patients were initially treated with repeated incision and drainage and started conventional antibiotics until culture and sensitivity report was available.All except one patient had culture confirmed MOTT infection. Combination antibiotics (clarithromycin, linezolid and ofloxacin ) given for initial 3 months. 12 well responded within 3 months. 9 required additional few months to get complete cure. 4 patients cured after 6 months of treatment and 3 patients did not come for follow up.CONCLUSIONS:Delayed onset chronic wound infection by Atypical mycobacteria is preventable.These organisms are not responsive to conventional antitubercular drugs but to specific drug regimens.


2017 ◽  
Vol 4 (7) ◽  
pp. 2281
Author(s):  
Navdeep Garg ◽  
Pooja Batra ◽  
Sharadendu Bali

Background: Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Incidence of Incisional hernias is 60%. It is the most common complication after exploratory laparotomy followed by LSCS.Methods: Data was collected for 30 cases of incisional hernia according to the proforma which included detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted.Results: Incisional hernia was more common in females with the ratio 1.5:1. The incidence of incisional hernia was highest in the age group ranging from 30-50 years. Most of the patients presented with chief complaint of swelling (100%) followed by pain and swelling (24%). Incisional hernia was more common in patients of previous history of abdominal procedures (explorative laparotomy 53%) followed by gynaecological operations (23%). Out of 30 patients studied, 20 underwent only mesh hernioplasty (67%), 10 underwent sublay mesh hernioplasty (23%).Conclusions: With prosthetic mesh, defects of any size can be repaired without tension. The polypropylene mesh, by inducing inflammatory response sets up scaffolding that in turn induces the synthesis of collagen. Thus, the superiority of mesh repair over suture repair can be accounted for. 


2019 ◽  
Vol 5 (2) ◽  
pp. 89-98
Author(s):  
Ibtihal ALrawashdeh ◽  
Haitham Qaralleh ◽  
Muhamad Al-limoun ◽  
Khaled Khleifat

Antibactrial activity of Asteriscus graveolens methanolic extract and its synergy effect with fungal mediated silver nanoparticles (AgNPs) against some enteric bacterial human pathogen was conducted. Silver nanoparticles were synthesized by the fungal strain namely Tritirachium oryzae W5H as reported early. In this study, MICs of AgNPs against E. aerogenes, Salmonella sp., E. coli and C. albicans in order were 2.13, 19.15, 0.08 and 6.38 µg/mL, respectively, while the MICs of A. graveolens ethanolic extract against the same bacteria were 4, 366, <3300 and 40 µg/mL, respectively. The MIC values at concentration less than 19.15 and 40 µg/ml indicating the potent bacteriostatic effect of AgNPs and A. graveolens ethanolic extract. Increasing in IFA was reported when Nitrofurantion and Trimethoprim were combined with Etoh extract with maximum increase in IFA by 6 and 12 folds for, respectively. Also, 10 folds increasing in IFA was reported when trimethoprim was combined with AgNPs: Etoh extract. But, there were no synergistic effect between the antifungal agents (Caspofungin and Micafungin) combined with AgNPs and or A. graveolens ethanolic extract against C. albicans. The potent synergistic effect of A. graveolens ethanolic extract and/or NPs with the conventional antibiotics is novel in inhibiting antibiotics resistant bacteria. In this study, remarkable increasing in the antibacterial activity, when the most resistant antibiotics combined with A. graveolens ethanolic extract and/or NPs was reported.


2021 ◽  
Author(s):  
Gulzar Ahmed Rather ◽  
Saqib Hassan ◽  
Surajit Pal ◽  
Mohd Hashim Khan ◽  
Heshu Sulaiman Rahman ◽  
...  

The emergence of biogenic nanomaterials as novel antimicrobials introduces a new paradigm in human health care. Based on the recent reports of the World Health Organization, infectious diseases pose one of the greatest health challenges. Increased multi-drug resistance prevalence among human pathogens, due to the inefficiency of commercially available antimicrobial drugs in the market is a great threat to humans. The poor solubility, stability and side effects of the antibacterial therapy prompted the researchers to explore new innovative strategies for developing new antimicrobials. Recently, biogenic nanoparticles have proven their effectiveness against multidrug-resistant (MDR) pathogens as an alternative to conventional antibiotics. Biogenic nanoparticles such as silver nanoparticles (AgNPs) and Zinc Oxide nanoparticles (ZnONPs) are easy to produce, biocompatible, provide enhanced uptake and are eco-friendly. Moreover, the capping of the biogenic nanocrystals provides an active surface for interaction with biological components, facilitated by free active surface functional groups to enhance their efficacy and delivery. Inorganic nanocrystals (AgNPs and ZnONPs) are effective both as nano-bactericides and as nanocarriers against sensitive and MDR) pathogens. The present chapter focuses on the utilization of the recent nanosystems to combat drug resistance in human pathogens. Nanomedicine represents a new generation of potiential antimicrobial candidates capable of combating the drug resistance in various pathogenic organisms.


2021 ◽  
Vol 29 (01) ◽  
pp. 13-18
Author(s):  
Ahsan Nasim ◽  
Pir Muneeb Rehman ◽  
Kamran Ali ◽  
Naila Jabbar

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty.


2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Dieudonné Lemuh Njimoh ◽  
Jules Clement N. Assob ◽  
Seraphine Ebenye Mokake ◽  
Dinga Jerome Nyhalah ◽  
Claude Kwe Yinda ◽  
...  

Microbial infections till date remain a scourge of humanity due to lack of vaccine against some infections, emergence of drug resistant phenotypes, and the resurgence of infections amongst others. Continuous quest for novel therapeutic approaches remains imperative. Here we (i) assessed the effects of extracts/hydrolates of some medicinal plants on pathogenic microorganisms and (ii) evaluated the inhibitory potential of the most active ones in combination with antibiotics. Extract E03 had the highest DZI (25 mm). Extracts E05 and E06 were active against all microorganisms tested. The MICs and MBCs of the methanol extracts ranged from 16.667 × 103 μg/mL to 2 μg/mL and hydrolates from 0.028 to 333333 ppm. Extract E30 had the highest activity especially againstS. saprophyticus(MIC of 6 ppm) andE. coli(MIC of 17 ppm). Combination with conventional antibiotics was shown to overcome resistance especially with E30. Analyses of the extracts revealed the presence of alkaloids, flavonoids, triterpenes, steroids, phenols, and saponins. These results justify the use of these plants in traditional medicine and the practice of supplementing decoctions/concoctions with conventional antibiotics.Nauclea pobeguinii (E30), the most active and synergistic of all these extracts, and some hydrolates with antimicrobial activity need further exploration for the development of novel antimicrobials.


mBio ◽  
2017 ◽  
Vol 8 (6) ◽  
Author(s):  
Wonsik Mun ◽  
Heeun Kwon ◽  
Hansol Im ◽  
Seong Yeol Choi ◽  
Ajay K. Monnappa ◽  
...  

ABSTRACT Predation of Chromobacterium piscinae by Bdellovibrio bacteriovorus HD100 was inhibited in dilute nutrient broth (DNB) but not in HEPES. Experiments showed that the effector responsible was present in the medium, as cell-free supernatants retained the ability to inhibit predation, and that the effector was not toxic to B. bacteriovorus. Violacein, a bisindole secondary metabolite produced by C. piscinae, was not responsible. Further characterization of C. piscinae found that this species produces sufficient concentrations of cyanide (202 µM) when grown in DNB to inhibit the predatory activity of B. bacteriovorus, but that in HEPES, the cyanide concentrations were negligible (19 µM). The antagonistic role of cyanide was further confirmed, as the addition of hydroxocobalamin, which chelates cyanide, allowed predation to proceed. The activity of cyanide against B. bacteriovorus was found to be twofold, depending on the life cycle stage of this predator. For the attack-phase predatory cells, cyanide caused the cells to lose motility and tumble, while for intraperiplasmic predators, development and lysis of the prey cell were halted. These findings suggest that cyanogenesis in nature may be employed by the bacterial strains that produce this compound to prevent and reduce their predation by B. bacteriovorus. IMPORTANCE Bacterial predators actively attack, kill, and enter the periplasm of susceptible Gram-negative bacteria, where they consume the prey cell components. To date, the activity of B. bacteriovorus HD100 has been demonstrated against more than 100 human pathogens. As such, this strain and others are being considered as potential alternatives or supplements to conventional antibiotics. However, the production of secondary metabolites by prey bacteria is known to mitigate, and even abolish, predation by bacterivorous nematodes and protists. With the exception of indole, which was shown to inhibit predation, the effects of bacterial secondary metabolites on B. bacteriovorus and its activities have not been considered. Consequently, we undertook this study to better understand the mechanisms that bacterial strains employ to inhibit predation by B. bacteriovorus HD100. We report here that cyanogenic bacterial strains can inhibit predation and show that cyanide affects both attack-phase predators and those within prey, i.e., in the bdelloplast. IMPORTANCE Bacterial predators actively attack, kill, and enter the periplasm of susceptible Gram-negative bacteria, where they consume the prey cell components. To date, the activity of B. bacteriovorus HD100 has been demonstrated against more than 100 human pathogens. As such, this strain and others are being considered as potential alternatives or supplements to conventional antibiotics. However, the production of secondary metabolites by prey bacteria is known to mitigate, and even abolish, predation by bacterivorous nematodes and protists. With the exception of indole, which was shown to inhibit predation, the effects of bacterial secondary metabolites on B. bacteriovorus and its activities have not been considered. Consequently, we undertook this study to better understand the mechanisms that bacterial strains employ to inhibit predation by B. bacteriovorus HD100. We report here that cyanogenic bacterial strains can inhibit predation and show that cyanide affects both attack-phase predators and those within prey, i.e., in the bdelloplast.


2019 ◽  
Vol 27 (1) ◽  
pp. 41-47
Author(s):  
Abbas Tanhaeian ◽  
Marjan Azghandi ◽  
Zahra Mousavi ◽  
Ali Javadmanesh

Background: Thanatin is the smallest member of Beta-hairpin class of cationic peptide derived from insects with vast activities against various pathogens. Objective: n this study, the antimicrobial activity of this peptide against some species of human bacterial pathogens as well as its toxicity on NIH cells were evaluated. Method: Thanatin DNA sequence was cloned into pcDNA3.1+ vector and transformed into a DH5α bacterial strain. Then the recombinant plasmids were transfected into HEK-293 cells by calcium phosphate co-precipitation. After applying antibiotic treatment, the supernatant medium containing thanatin was collected. The peptide quantity was estimated by SDS-PAGE and GelQuant software. The antimicrobial activity of this peptide was performed with Minimum Inhibitory Concentration (MIC) method. In addition, its toxicity on NIH cells were evaluated by MTT assay. Results: The peptide quantity was estimated approximately 164.21 µmolL-1. The antibacterial activity of thanatin was estimated between 0.99 and 31.58 µmolL-1 using MIC method. The result of cytotoxicity test on NIH cell line showed that the peptide toxicity up to the concentration of 394.10 µmolL-1 and for 48 hours, was not statistically significant from negative control cells (P>0.05). The antimicrobial assay demonstrated that thanatin had an antibacterial effect on some tested microorganisms. The results obtained in this study also showed that thanatin had no toxicity on mammalian cell lines including HEK293 and NIH. Conclusion: Antimicrobial peptides such as thanatin are considered to be appropriate alternatives to conventional antibiotics in treating various human pathological diseases bacteria.


Author(s):  
Laurence Van Moll ◽  
Jeroen De Smet ◽  
Anne Paas ◽  
Dorothee Tegtmeier ◽  
Andreas Vilcinskas ◽  
...  

With the ever growing antimicrobial resistance, finding new candidates for antimicrobial drug development is indispensable. Antimicrobial peptides have steadily gained attention as alternatives for conventional antibiotics, due to some highly desirable characteristics, such as their low propensity for resistance development.


1997 ◽  
Vol 77 (01) ◽  
pp. 001-010 ◽  
Author(s):  
Michael D P Boyle ◽  
Richard Lottenberg

SummaryIn this review the interaction between invasive human pathogens expressing plasmin(ogen) receptors and/or producing plasminogen activators with the human plasmin(ogen) system is described. Evidence is presented for multiple mechanisms by which human pathogens can acquire a surface bound form of plasmin that cannot be regulated by host serpins. The potential importance of these pathways in providing the organisms with the ability to cross tissue barriers is discussed.


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