Background: Carbapenem-resistant K. pneumoniae (CRKP) has emerged as a critical global health threat due to limited therapeutic options and high rates of multidrug resistance. Novel β-lactamase inhibitors such as Nacubactam may enhance the activity of conventional agents against carbapenemase-producing strains. Methods: This experimental study investigated 200 CRKP isolates identified using the VITEK 2.0 system and subjected to antimicrobial susceptibility testing. Carbapenemase production was assessed phenotypically by mCIM and eCIM assays, and molecular detection of resistance genes (NDM-1, OXA-48, KPC, VIM, IMP) was performed by multiplex PCR. Synergistic antimicrobial properties displayed when nacubactam is administered together with meropenem (MRP) and cefepime (CFM) was evaluated using checkerboard microdilution and time-kill spot assays. Results: Of 200 isolates, 150 (75

OBJECTIVE:Bacterial infections caused by multidrug-resistant (MDR) strains pose a serious global health threat. This study aimed to evaluate the antibacterial efficacy of green-synthesized copper nanoparticles (G-CuNPs) against MDR strains of Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella spp., and Escherichia coli. SIGNIFICANCE:Emerging MDR pathogens necessitate the development of novel, eco-friendly alternatives. G-CuNPs synthesized using Citrus pseudolimon peel extract may offer a biocompatible and sustainable approach to combating MDR infections. METHODOLOGY:Clinical bacterial isolates were obtained from diagnostic specimens including urine, pus, wound swabs, sputum, and blood collected from hospitalized patients at a tertiary care hospital. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK 2 automated system. Phenotypic detection of metallo-β-lactamase (MBL) and extended-spectrum β-lactamase (ESBL) production was conducted. G-CuNPs were synthesized and characterized for physicochemical properties. Antibacterial activity was assessed using a CFU-based time-kill assay. Mechanistic studies included evaluation of cell membrane integrity, reactive oxygen species (ROS) generation, and DNA degradation. Interaction with bacterial enzymes was analyzed via molecular docking. Hemolytic and cytotoxicity assays were performed to assess biocompatibility. RESULTS:G-CuNPs (10 mg/mL) displayed potent antibacterial activity by disrupting cell membranes, inducing ROS accumulation, and degrading bacterial DNA. Molecular docking confirmed strong binding affinities to key bacterial enzymes. Compared to chemically synthesized CuNPs, G-CuNPs (Indian Patent No. 202111048797) exhibited minimal hemolytic and cytotoxic effects. CONCLUSION:G-CuNPs demonstrate promising antibacterial potential and biocompatibility, highlighting their applicability in biomedical domains such as implant coatings and wound care. Further in vivo studies are warranted to validate their clinical utility.

Introduction Dermatophytosis is a common superficial fungal infection affecting the skin, hair, and nails and is increasingly being recognized as a public health challenge. In recent years, there has been a noticeable increase in chronic and recurrent cases, possibly due to changing patterns of antifungal resistance, misuse of medications, and host-related factors. This study aimed to assess the demographic and clinical characteristics of patients with dermatophytosis, evaluate treatment history and recurrence, and analyze antifungal resistance patterns. Material and methods A total of 130 patients clinically diagnosed with dermatophytosis and attending the Dermatology Outpatient Department were included in this observational study. After obtaining informed consent, detailed data on demographic factors, clinical presentation using the Dermatophytosis Severity Score (DSS), treatment history, and recurrence were recorded. Fungal cultures and antifungal susceptibility testing were performed on positive isolates to evaluate resistance patterns. Results The most affected age group was 31-45 years (38; 42.2%), with a male predominance (52; 57.8%). Most patients were rural residents (72; 80%) and uneducated (58; 64.4%), with homemakers (32; 35.6%) and students (19; 21.1%) forming the major occupational groups. Disease duration was mostly one to two years (40; 44.4%), and recurrent infections were common (83; 92.2%), even with mild severity scores (DSS 1-10 in 79 individuals; 87.8%). Tinea corporis (79; 87.8%) was the most frequent clinical type. Poor hygiene correlated with higher DSS. Potassium hydroxide mount was positive in 115 (88.5%) patients, with culture showing Trichophyton mentagrophytes (87; 75.7%) as the predominant species. Resistance was seen to fluconazole (77; 85.6%) and terbinafine (54; 60%), while itraconazole, ketoconazole, and griseofulvin were sensitive. Conclusion Dermatophytosis continues to be a significant public health concern due to its chronicity and recurrence. Irrational use of medications and emerging resistance to commonly used antifungals highlight the need for better treatment compliance and periodic monitoring of resistance patterns.

BACKGROUND:M. oleifera is the most adapted tree species in different medicinal eco-systems and has resilience against climate changes. This multiple-use tree provides healthy foods, snacks, honey, and fuel. Besides this, it has immense promising applications by offering antimicrobial and antibacterial activities for targeted uses. This validates the court of Hippocrates that let food be the medicine and medicine be the food for which moringa qualifies. OBJECTIVE:The objective of this study is to assess the antioxidant properties of M. oleifera, in vitro antibacterial activity of hydro-ethanolic extract, and further investigate in vivo healing potential of M. oleifera for corneal ulcers and in silico analysis. METHODS:To evaluate the antioxidant and in vitro antibacterial potency of the hydro-ethanolic extract of M. oleifera on clinically isolated multidrug-resistant strains of Staphylococcus aureus using agar well diffusion assay. Furthermore, in vivo, healing response of M. oleifera extract was analysed on corneal ulcers induced in rabbit eyes infected with methicillin-resistant Staphylococcus aureus. RESULTS:The M. oleifera extract exhibited exponential antioxidant activity. In-vitro antibacterial activity was evaluated by agar well diffusion assay showing zone of inhibition ranging from 11.05 ± 0.36 to 20 ± 0.40 mm at concentrations of 20, 40, 80, and 160 mg/ml, whereas, in our finding, no zone of inhibition was observed below 20 mg/ml concentration, which indicated that there is threshold limit below which the antibacterial activity of M. oleifera extract is not observed. Furthermore, continuous application of 3% and 5% M. oleifera extract (eye drop) four times a day for 14 consecutive days showed a significant healing response of the eyes of rabbits with corneal ulcers. CONCLUSION:These results suggest that M. oleifera extract could be a viable alternative or in combination could be used in existing antibacterial therapies for corneal ulcers. Additionally, there is a possibility of commercial formulation of M. oleifera extract in the form of deliverable pharmaceutical products; therefore, it should be explored further.

Numerous instances of pneumonia with uncertain cause were reported in December 2019 from small seafood market in Wuhan, China [1]. The World Health Organization's Institution (WHOI) then gave this unique virus, which is a member of the beta coronavirus family, the names severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and new coronavirus (nCoV) [2]. This disease spreads from China to 33 other nations within two months. At the end of February 2020, there were around 77658 confirmed cases, including 9126 severe cases and 2663 deaths in China and 23309 confirmed cases and 33 deaths abroad [3]. As the correct therapeutic alternatives have not yet been developed, early disease detection remains the only method for disease prevention. Methods for detecting nucleic acids point the way for a proper confirmation of COVID-19. Clinical signs displayed by patients infected with this virus are comparable to those seen in SARS-CoV and MERS-CoV cases. Both direct and indirect contact with an infected person as well as droplet transmission of the virus are possible. This method of transmission has the potential to harm the liver, nervous, and respiratory systems [4]. This comprehensive study gives an overview of the virology, molecular immunological pathogenesis, and established detection techniques for SARS-CoV2

Most healthy individuals usually have Staphylococcus aureus in their noses and on their skin. It is a coccus-shaped, gram-positive, non-motile, non-spore-forming bacterial species (Tigabu et al., 2018). It is a human pathogen in addition to being a commensal bacterium. Approximately thirty percent of people are infected with S. aureus. In addition to bacteremia and infective endocarditis, it is the main cause of infections associated with other body parts, including skin and soft tissue infections, pleuropulmonary infections, and osteoarticular disorders (Tong et al., 2015).

Antibiotics made long lasting impact on medicine as being one of the most important discoveries of 20th era. They have played a pivotal role in combating bacterial infections and have saved countless lives, making a substantial positive impact on society. But, rise of drug resistant pathogens is a major concern, and the major fear of inefficient treatment of infections has been an eminent concern from the beginning of the 21st century [1]. It facilitated advancements in various medical practices, including the successful outcomes of surgical procedures, the low use of immune suppressant drugs, and the enhanced utility of antimicrobial drugs for preventive steps and to control infectious complications. However, developing resistance against antimicrobials poses a major challenge to health care settings globally [2]. AMR is a natural consequence of evolution because all creatures undergo genomic alterations to evade deadly threats. Bacterial pathogens continuously enhanced their resistance mechanisms as frequently as antibacterial drugs were targeted at them. WHO reported (2019), 700,000 patients died due to the lack of efficient treatment available for drug

Objective: To know the prevalence of NFGNB isolated from blood culture specimens and their antibiotic sensitivity pattern in intensive care units. Methods: A total of 3393 blood samples during 1 year were received from patients admitted in various ICUs. 5–7 mL blood was aseptically collected and added in BACTEC bottles and then subsequently incubated in BD BACTECTM (FX40) fluorescent series instrument for up to 5 days. After incubation period, positive samples were processed for gram stain and subsequently sub-cultured on blood agar and MacConkey agar. These plates were incubated at 37°C for 24 h. Further identification and antimicrobial susceptibility testing of NFGNB were carried out by Vitek-2 Compact (Biomerieux India) as per the standard operating procedures. Results: Out of 3393 samples 696 samples showed growth, out of which 96 (13.79%) were Gram-positive cocci, 36 (5.17%) were Candida spp., and 564 (81.03%) were Gram-negative bacilli (GNB). Among 564 GNB, 453(80.31%) were lactose fermenter and 111 (19.68%) were non-lactose fermenters. One (0.53%) isolate of Aeromonas hydrophila was excluded from this study. Among 110 NFGNB, Acinetobacter baumannii complex (41.66%) was the most predominant followed by Pseudomonas aeruginosa (32.72%). Amikacin was the most sensitive drug for all the NFGNB isolates followed by Piperacillin/Tazobactam. Stenotrophomonas maltophilia showed excellent susceptibility to minocycline (83.33%) followed by ceftazidime (66.66%). Burkholderia cepacia showed good susceptibility to Trimethoprim/Sulfamethoxazole. Conclusion: Increasing antimicrobial resistance in NFGNB and their intrinsic or acquired resistance to many antibiotics makes them more lethal. It is therefore recommended to have quality guidelines on the “rational use of antibiotics” which need to be implemented strictly

The quantitative nature of abiotic stresses makes the understanding of its molecular basis a demanding task. For developing a rational breeding and/or genetic engineering strategy—understanding the environmental signal perception, its transmission to cellular machinery and adaptive responses of the plant is critical. Here, subjecting sugarcane seedlings to salt and cold stresses resulted in chlorosis, wilting, leaf rolling and the drought stress led to decrease in relative water content. The LPO content accumulated during drought and salt stress indicate the stress responses of the plant. The proline content increased in response to drought and salt stress underscore the proline function as an important osmoprotectant in sugarcane. The differential gene expression under drought, salt and cold stress for abiotic stress responsive genes like p5CS1, APX, CAT, GST, HSP, LEA, NAC, SOD, NHX, NFY, NCED, ERA, SOS, and DREB in sugarcane seedlings indicates the molecular basis of stress response in this commercially important crop.

Background and Purpose:Emergence of fungi as a pathogenic threat presents a significant challenge to public health, notably in intensive care units (ICUs) and among immunocompromised patients. Various factors, including sepsis-induced barrier disruptions, immune system dysfunction, and extremes of age, contribute to increased susceptibility to fungal infections. Hospital practices, such as prolonged surgeries, broad-spectrum antibiotic use, and invasive procedures, further exacerbate the risk. Fungal bloodstream infections, particularly those caused by Candida albicans, rank among the most common hospital-acquired infections, leading to substantial morbidity and mortality. The global rise in invasive candidiasis, particularly due to non-albicans Candida species, presents challenges in the diagnosis and treatment due to nonspecific symptoms and emerging antifungal resistance. Nanotechnology interventions particularly by utilizing green synthesized copper nanoparticles could possibly provide a novel solution to combat microbial colonization, biofilm formation, and drug resistance. This study aimed to assess the prevalence of candidemia, identify the distribution of causative Candida species, and understand their susceptibility patterns to commonly used antifungal agents for effective management in ICU settings. Additionally, the study sought to explore the in vitro anti-Candida activity of green copper nanoparticles synthesized using Euphorbia milii des moul extract. Materials and Methods:This study was conducted at Microbiology Laboratory of Maharishi Markandeshwar Institute of Medical Sciences and Research from January to December 2022, focused on ICU patients suspected of bloodstream infections. Blood samples were collected aseptically and processed using BD BACTECTM culture vials. Identification of organisms was performed via the Vitek-2 system by confirming candidemia with positivity in both blood samples. After that antifungal susceptibility testing was also performed against Clinical and Laboratory Standards Institute recommended antifungal drug using Vitek 2 system. G-CuNPs were synthesized using E. milii Des moul extract and possessed for physiochemical characterization. The anti-Candida activity of G-CuNPs was evaluated through the MTT assay and time kill assay. After that generation of intracellular reactive oxygen species and DNA degradation were evaluated to understand its mechanism. Results:This study identified a candidemia rate of 7.3% (58/789). Age and gender analysis revealed higher Candida colonization rates in individuals above 60 years old and females. Antifungal sensitivity profiling indicated notable resistance to fluconazole (27.59%) and voriconazole (25.86%). Synthesizing G-CuNPs using E. milii des moul extract represents a novel approach exhibiting significant fungicidal potency against clinically isolated C. albicans, supporting potential therapeutic applications. Conclusion:the findings concluded that synthesized G-CuNPs have tremendous potential to battle against medical device-borne infections by surface coating.

The emergence of drug-resistant microbial pathogens is a matter of global concern and become more serious if they linked with healthcare-associated infections (HAIs). As per World Health Organization statistics, multidrug-resistant (MDR) bacterial pathogens account for between 7 and 12

Emergence of fungi as a pathogenic threat presents a significant challenge to public health, notably in intensive care units (ICUs) and among immunocompromised patients. Various factors, including sepsis-induced barrier disruptions, immune system dysfunction, and extremes of age, contribute to increased susceptibility to fungal infections. Hospital practices, such as prolonged surgeries, broad-spectrum antibiotic use, and invasive procedures, further exacerbate the risk. Fungal bloodstream infections, particularly those caused by

Non-fermenting gram-negative bacteria (NFGNB) endeavouring as major pathogen in infectious disease, predominantly in urinary tract infection (UTI) and increased resistance in NFGNB are matter of concern. This study aimed to evaluate the frequency of NFGNB, antibiotics resistance pattern, plasmid profiling, and antibacterial efficacy of Moringa oleifera against NFGNB. NFGNB were isolated from clinically suspected UTI patients. Identification of isolates and their antibiotics sensitivity pattern were analyzed according to conventional method, and Vitek 2 automated system. Moreover, NFGNB were evaluated for biofilm production and presence of plasmid. Furthermore, antibacterial activity of Moringa oleifera was evaluated against NFGNB. P. aeruginosa (86.0%), and A. baumannii (10.0%) were the most frequent NFGNB followed by Providencia rettgeri 2.0%, Stenotrophomonas maltophilia 1.0%, myroides species 1.0%. 68.6% P. aeruginosa and 60.0% A. baumannii were biofilm producers whereas imipenem and meropenem were the most effective antibiotics. Isolated NFGNB showed multiple bands of plasmid. Furthermore, Moringa oleifera leaves extract showed antibacterial activity against tested NFGNB. MDR-NFGNB presents challenges in treatment and Moringa oleifera leaf extract may be used as an alternative medicine. However, the therapeutic role of specific ingredients present in extract needs further investigation and purification.

Introduction: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age and is associated with adverse obstetric and gynecologic outcomes. Aim: To find out the diagnostic accuracy of Nugent's scoring when Amsel’s criteria considered as gold standard from the patients of reproductive age group suspected for bacterial vaginosis. Material and Methods: A total of 100 random samples were collected from the patients of reproductive age group having complaint of vaginal discharge suspected for vaginosis attending Obstetrics and Gynecology Out Patient Department (OPD). Bacterial vaginosis was diagnosed using Amsel's criteria and Nugent's method and Gardnerella vaginalis was isolated by inoculating on Columbia agar and identified by Hippurate hydrolysis test. Result: The sensitivity, specificity, positive predictive value, negative predictive value of Nugent's score when compared to Amsel's criteria was found to be 69.23%, 100%, 100%, 95.6% and 96% respectively. The rate of isolation Gardnerella vaginalis was found to be 15.3%. Conclusion: The Amsel's criterion has high sensitivity and was found to be highly efficient require lower cost, lesser time and have advantage of being done in outpatient department thus enabling precise and fast treatment for patient. Nugent scoring system can be as good as Amsel's criteria in terms of specificity and positive predictive value, however has lower sensitivity and negative predictive value at diagnosing bacterial vaginosis. Diagnosis of bacterial vaginosis by culture was least sensitive method.

Objective:This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions. Methodology:A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights. Main findings:Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress. Conclusion:The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.

Euphorbia milii Des Moul is a deciduous bush indigenous to Madagascar. The present study aims to investigate the presence of the phytochemical, in-vitro antioxidant and antimicrobial potency, and in-silico computational analysis of ethanolic and aqueous preparations of E. milii leaves and flowers. The ethanolic and aqueous extracts were tested for in-vitro antioxidant activity by DPPH, H2O2, TAC, and FRAP assay. In addition, antimicrobial potentials were assayed by agar well diffusion technique against Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans for various clinical isolates. The qualitative phytochemical analysis results confirmed the existence of alkaloids, flavonoids, phenolics, and tannins. The quantitative analysis elicits the availability of a magnificent number of alkaloids, flavonoids, phenolics, flavonols, and tannins. Among all the extracts, aqueous extracts of leaves exhibited potent antioxidant activity in DPPH, FRAP, and H2O2 assay with the IC50 value of 30.70, 60.05, and 82.92µg/mL, respectively. In agar well diffusion assay, all extracts displayed zone of inhibition varies from 2-24mm at different concentrations ranging from 10-320 mg/mL, whereas no activity was observed against Candida albicans. Furthermore, docking-based computational analysis has revealed that beta-sitosterol and taraxerol are the plant's active constituents responsible for their antimicrobial and antioxidant activities. Research findings suggest that the E. milii plant has an excellent prospect for further study for its extended antioxidative and antimicrobial potential. It could be a natural source of various ailments and can be utilized to develop new drugs.

In developing countries, infectious keratitis being the probable cause of preventable blindness, also have a varied epidemiological profile. This study was conducted to know the microbiological profile, risk factors, epidemiology and antimicrobial susceptibility pattern of bacteria isolated from patients with a corneal ulcers. A total of 193 patients who were clinically diagnosed with cases of infective keratitis in the Department of Ophthalmology were included in the study. The sample collected by an ophthalmologist was received in the Microbiology department. All the demographic details and relevant clinical data were noted. The bacterial identification and antimicrobial susceptibility were done using automated methods while the fungal identification was done using the conventional method (Vitek2 Compact system, BioMerieux). Out of 193 patients, 69% were male and 31% % were females. The Majority of cases were from the age group 41- 50 years. Of 193 cases, 83 (43%) showed microbial etiology in culture. Of 83 culture positive cases, 55 (66.3%) were fungal and 28 (33.7%) were bacterial. The most common isolated fungus was Fusarium species detected in 24 (28.9%) cases followed by Aspergillus species in 14 (16.8%) cases. Gram positive bacteria were predominantly isolated from cases of infective keratitis. Staphylococcus aureus was the most common isolated bacteria in 12 (14.4%) out of 83 positive cases followed by Coagulase negative Staphylococcus. Pseudomonas aeruginosa was the most common Gram negative bacteria isolated from the cases. Among the topical antimicrobials, both Gram positive bacteria as well as Gram negative bacteria showed maximum sensitivity to levofloxacin. Proper knowledge of the clinical presentation and etiological agents aided with microbiological examination is necessary in order to effectively treat corneal ulcers and prevent further complications that can lead to blindness.

Introduction:Bloodstream infections in the intensive care unit have always been a global healthcare challenge. The present study was conducted with the aim to evaluate the yearly trend of antibiotic resistance in non-fermenting Gram-negative bacilli (NFGNB) causing septicemia in intensive care units.Methods:Blood samples were collected from the patients admitted in various intensive care units and processed for isolation and identification of non-fermenting Gram-negative bacilli. The isolated bacterial strains were subjected to antibiotic susceptibility testing as per standard operating procedures.Results:Out of 3632 blood samples, 977 (26.9%) samples showed microbial growth, of which 10.1% were Gram positive cocci, 8.7% were Gram negative bacilli (Enterobacterales), 7% were NFGNB and 1% were Candida spp. Increasing resistance among Acinetobacter baumannii complex was observed to ceftazidime, cefepime, amikacin, ciprofloxacin, levofloxacin, meropenem and trimethoprim-sulfamethoxazole. Moreover, Pseudomonas aeruginosa strains were found to be associated with increased resistance to ciprofloxacin, levofloxacin, ceftazidime and meropenem. A substantial increase in resistance levels was observed among Stenotrophomonas maltophilia and Sphingomonas paucimobilis as well.Conclusions:An increasing trend of antimicrobial resistance in NFGNB envisages the worst consequences in ICUs in the coming years. Therefore, reviewing and strict implementation of the antimicrobial policies including 'rational use of antibiotics' is recommended.