The current study aimed to determine the prevalence of class A genes in the Extended Spectrum of β-Lactamase producing E. coli and K. pneumoniae isolated from Patients Urine Samples in United Arab Emirates. A total of 3457 urine samples were collected from October 2018 to January 2019. ESBL screening and confirmatory test were done using MicroScan WalkAway automated bacterial identification system. The ESBL class A gene primers were used to detect the blaCTX-M, blaSHV & blaTEM. Out of the collected urine samples, 474 were reported positive for urinary tract infection. A total of 130 samples were identified as Gram negative ESBL producing species, Escherichia coli (n=107) and Klebsiella pneumoniae (n=23). Amid these 130 ESBL producers, the class A ESBL genes blaTEM, blaCTX-M & blaSHV were detected in 78 isolates of which 59 were E. coli and 19 K. pneumoniae. In the identified 59 E. coli isolates, the most predominant gene was blaTEM, followed by blaCTX-M and blaSHV, and these three genes were detected together in 02 E. coli. In 10 E. coli and 11 K. pneumoniae two class A genes were detected in combination of blaCTX-M + blaSHV, blaSHV + blaTEM and blaTEM + blaCTX-M.

Beta Lactamases is proven to be one of the leading cause of resistance to β-lactam antibiotics among gram-negative bacteria. Many up to date researches have shown increase in the incidence and prevalence of ESBL worldwide. This study aimed to determine the prevalence of ESBL strains of Klebsiella spp. and Escherichia coli species in urinary isolates from the patients admitted in Thumbay hospitals around United Arab Emirates. Furthermore, drug resistant genes (SHV and CTX-M) in the ESBL positive samples were detected. 237 urine samples were collected from November 2017 to January 2018. Based on the lactose utilization, colony morphology, and biochemical utilization of the gram negative bacilli were identified as E. coli (53), Klebsiella pneumoniae (10) and Citrobacter species (2). Antibiotic sensitivity test, double disc diffusion test and combination disc tests all confirmed that the 65 (27.4 %) out of 237 isolates were ESBL producing bacteria. There was high prevalence of bacteria in females than male and the number of E. coli strains is higher than Klebsiella spp. DNA isolation was performed on the 65 samples, out of which 50 samples were selected for PCR based on their concentration. The selected DNA samples were used to detect the presence of bla CTX-M and bla SHV genes. Only 24 DNA samples (48 %) contains blaCTX-M genes, bla SHV or both the genes. 14 samples had bla CTX-M gene, 2 bla SHV genes, and 8 with both bla SHV and bla CTX-M. At the rate at which ESBL is spreading, further research, close observation and cautious use of antibiotics is important.

Objective The aim of this study was to compare the clinical outcomes associated with different combinations of oral diabetic drugs among patients with type 2 diabetes mellitus. Method A prospective multicenter longitudinal, noninterventional observation study design was applied. At baseline (0 month), clinical parameters including glucose profile, renal function, lipid profile and risk assessment for cardiovascular risks were calculated. Mean Weighted difference (MWD) with heterogeneity and effect z was calculated to determine the risk reduction at the end of the study. Results A total of 1,657 were enrolled to different cohorts with response rate of 75.5%. The distribution of patients was based on prescribed drug. A total of 513 (30.9%) in G1 (metformin alone), 217 (13.09%) in G2 (metformin with Glimepiride), 231 (12.85%) in G3 (Metformin with Gliclazide), 384 (23.17%) in G4 (metformin with Sitagliptin) and 312 (18.89%) in G5 (Metformin with Saxagliptin). There was no significant different in all clinical and social variables at baseline. The Intergroup analysis showed significant differences with all the primary outcome variables except BMI (p = 0.217) and eGFR (p = 0.782) among patients using sulphonylurea (SU) combination (G2 & G3). Findings also showed significant high frequency of emergency visit and hospitalization in G1 (78.16% & 30.8%) as compared to SU (70.1% & 28.3%, p = 0.001) and DPP-4 (56.6% & 20.4%, p = 0.001). The overall reported effect was z = 2.58, p = 0.001 for ASCVD risk reduction assessment. Conclusion The study concluded that significant effect of Dipeptidyl peptidase-4 inhibitor on reduction of hospitalization, lipid profile and also ASCVD risk score of type-II diabetes mellitus patients regardless of clinical comorbidities. Also, sulfonylurea combinations have showed significant reduction in LDL and triglycerides values.

Forty-one aerotolerant subsurface bacterial colonies were isolated from terrestrial subsurface environment at various depth from 5 feet to 50 feet at 5 feet intervals. Out of 41 colonies, 32 morphologically distinct bacterial colonies were selected for gram staining reaction, various sugar utilization pattern and scanning electron microscopic studies. Most of the bacterial colonies were gram-positive rods; some are gram-negative rods, gram-positive cocci and coccobacilli, and gram-negative coccobacilli respectively. Seven bacterial colonies NTN33, NTN34, NTN35, NTN36, NTN01, NTN02 and NTN03 isolated from 40 to 50 feet depth were neither gram positive nor gram negative, and no distinct morphological shape but gigantic structure have identified in that bacteria. The bacterial size were identified on the bacteria NTN36, NTN35, NTN01, NTN30, NTN34, NTN02 as 4.5 µm, 4.1 µm, 3.5 µm, 3.4 µm, 3.2 µm and 2.2 µm. Gigantic rod surrounded by capsular sheath and gigantic rod with footprint like appearance were identified in the bacteria NTN02 and NTN36; those are isolated from 45 and 50 feet depth. Intracellular granules were also found in bacteria NTN34, NTN35 and NTN01. In total, 24 different sugars had used to analyse the sugar utilization pattern of that 32 bacteria. Most of the bacteria have utilized only 03 different types of sugars either maltose, galactose and glycerol or lactose, trehalose and mannose. However, the bacteria NTN16, NTN12, NTN06, NTN24, NTN27, NTN28, NTN34 and NTN02 had utilized 14 different sugars. Nevertheless, very few bacteria have utilized the l-arabinose, α-methyl-d-gluconate and inulin. None of the bacteria had utilized the sugar sodium gluconate, salicin, glucosamine and dulcitol.