Background: Extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases are enzymes produced by a variety of Gram-negative bacteria which confer an increased resistance to commonly used antibiotics and represent a substantial clinical threat. Several phenotypic tests have been recommended for screening and confirmation of ESBL-and AmpC-producing organisms. However, a comprehensive diagnostic algorithm integrating both screening and confirmation has not been established. Objectives: This study aimed to detect ESBL and/or AmpC production by using MastD68C ESBL and AmpC detection set as a single phenotypic method and to study its sensitivity and specificity comparing to other methods. Evaluate the effect of novel antibiotics namely tigecycline and doripenem, as well as the efficacy of old reviving antibiotics as colistin and temocillin against ESBL-and AmpC-producing Enterobacteriaecae. Methodology: Hundred Enterobacteriaceae isolates were screened for ESBL production using disc diffusion method and confirmed by combination disc diffusion test. Screening of AmpC production was done by cefoxitin disc test, disc approximation test and confirmation was done by AmpC disc test. Isolates screened positive for ESBL were investigated for their susceptibility to temocillin, tigecycline, colistin and doripenem by E-test. Results: Among the 100 Enterobacteriaceae isolates, 45 were screened positive for ESBL-production using the disc diffusion test and 36 were confirmed by the combination disc test. Nine isolates were screened for AmpCproduction using the cefoxitin disc test and 5 isolates were confirmed as AmpC producers by AmpC disc test. Using MAST D68C set, 35 isolates were ESBL producers, 2 were AmpC producers, one isolate was both ESBL and AmpC producer. All isolates were sensitive to tigecycline and doripenem. Forty-three isolates were sensitive to colistin, while, thirty-seven isolates were sensitive to temocillin. Conclusion: MAST D68C test appears to be a promising way to detect isolates producing ESBL and/or AmpC. Tigecycline, doripenem, temocillin and colistin revealed excellent activity against ESBL-and AmpC-producing Enterobacteriaceae.

Background Corneal ulcer is a potentially sight threatening ocular condition and the leading cause of monocular blindness in developing countries. Knowing the predisposing factors and etiologic microorganism can help prompt diagnosis and treatment to prevent devastating outcomes The aim of this study was to detect the prevalence of bacteria and fungi in infectious keratitis. And to detect the antimicrobial susceptibility pattern against these causative bacterial and fungal pathogens using antibacterial and antifungal disces. Results Out of 50 cases (= 50 eyes), fungal growth was predominant 23/50 representing 46% with Aspergillus flavus being the most prevalent 14/23(61%). Bacterial growth was 7/50 (14%), 4/7 was gram-positive cocci (Staphylococcus aureus and Streptococcus pneumonie) and 3/7 was pseudomonas spp. While twenty out of 50 cases (40%) showed no growth. Conclusion Ocular trauma was the major cause of infectious keratitis, more in rural population. Fungal growth; mainly Aspergillus spp. was the most prevalent pathogen encountered in all cases. Voriconazole proved to be the first choice in the treatment of mould keratitis with 100% susceptibility. While alarmingly, fluconazole should no longer be used for the empirical therapy as it showed resistance to all the fungal isolates.

Nitrofurantoin represents an attractive choice for empirical treatment of acute uncomplicated cystitis, and for long term prophylaxis against recurrent urinary tract infections. However, rather rare but severe adverse effects related to cumulative drug doses may occur. Bioactive compounds of plant origin combined with antibiotics can increase the sensitivity of microbial cells to such antibiotics. Garlic has antimicrobial effects against a wide range of microorganisms. The minimum inhibitory concentrations (MICs) of each of nitrofurantoin and garlic alone, and in combination were determined against 17 extended spectrum β-lactamase (ESBL) producing Escherichia coli and 24 Enterococcus spp. urinary isolates. When grown as planktonic cells, none of the E. coli isolates demonstrated resistance towards nitrofurantoin, whereas only one (4.2%) Enterococcus isolate was resistant. Garlic showed an inhibitory effect on planktonically grown ESBL producing E. coli and Enterococcus spp. with varying MICs. Each of nitrofurantoin and garlic tested alone showed an increase in the MICs for biofilm grown isolates compared to their planktonic counterparts. However, the combination of both agents led to significant decline of the MICs, whether for planktonic or biofilm forms, resulting in either synergy or addition. In conclusion, garlic enhanced the antibacterial activity of nitrofurantoin towards the tested urinary isolates.