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Papers by Dr. Sakshita Agnihotri
GLOBAL JOURNAL FOR RESEARCH ANALYSIS
Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it ... more Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it has an implication in the control of tuberculosis. The terms used to describe resistance to antituberculosis drugs are resistance among new cases (or primary resistance) and resistance among previously treated patients. The resistance among previously treated patients may be due to faulty treatment like prescription of inadequate treatment regimens, interrupted availability or poor quality of drugs, or incomplete treatment adherence while subsequent transmission of these resistant organisms to others will lead to development of disease which is resistant from the beginning called primary resistance. Pakistan is ranked eighth in terms of global estimated burden of tuberculosis cases. Multi-Drug Resistant (MDR) tuberculosis among new cases and MDR among previously treated patients is 3.2% and 35% respectively. Material and methods: - AFB smear examination and grading: - AFB smear examinati...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, Feb 1, 2022
The objective of this study was to isolate, identify, and explore the in-vitro antifungal suscept... more The objective of this study was to isolate, identify, and explore the in-vitro antifungal susceptibility pattern of dermatophytes isolated from clinically suspected cases of dermatophytosis (tinea infections) attending the Dermatology Outpatient Clinic. Methods: This study was conducted at Sohag University Hospital from December 2014 to December 2015. Clinical samples (e.g., skin scrapings and hair stumps) were collected under aseptic precautions. The identification of dermatophytes was performed through microscopic examination using 10% potassium hydroxide (KOH) with 40% dimethyl sulphoxide (DMSO) mounts and culture on Sabouraud dextrose agar (SDA) and on Dermasel agar base media, both supplemented with chloramphenicol and cycloheximide. All dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion (ABDD) method against Clotrimazole, Miconazole, Fluconazole, and Griseofulvin. Data were analyzed via SPSS 16, using Chi square and a screening test (cross-tabulation method). Results: A total of 110 patients of dermatophytosis were studied. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis (49), tinea corporis (30), tinea pedis (16), tinea cruris (9), or tinea barbae (6). The dermatophytes isolates belonged to 4 species: Microsporum canis 58 (52.7%), Microsporum gypseum 23 (20.9%), Trichophyton mentagrophytes 18 (16.4%), and Microsporum audouinii 11 (10%). The most effective antifungal drugs tested were Clotrimazole, followed by Miconazole (95.5% and 84.5% of isolates were susceptible, respectively). Conclusion: Every patient with a tinea infection should be properly studied for a mycological examination and should be treated accordingly. Dermasel agar is more useful as an identification medium in the isolation of dermatophytes. The ABDD method appears to be a simple, cost-effective, and promising method for the evaluation of antifungal susceptibility of dermatophytes.
GLOBAL JOURNAL FOR RESEARCH ANALYSIS, Jul 15, 2022
Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it ... more Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it has an implication in the control of tuberculosis. The terms used to describe resistance to antituberculosis drugs are resistance among new cases (or primary resistance) and resistance among previously treated patients. The resistance among previously treated patients may be due to faulty treatment like prescription of inadequate treatment regimens, interrupted availability or poor quality of drugs, or incomplete treatment adherence while subsequent transmission of these resistant organisms to others will lead to development of disease which is resistant from the beginning called primary resistance. Pakistan is ranked eighth in terms of global estimated burden of tuberculosis cases. Multi-Drug Resistant (MDR) tuberculosis among new cases and MDR among previously treated patients is 3.2% and 35% respectively. Material and methods: - AFB smear examination and grading: - AFB smear examination was carried out by direct microscopy using the Ziehl Neelsen (ZN) method. Sputum smear result was examined and interpreted according to the AFB grading. AFB culture and drug susceptibility test: - Culture examinations were done on all diagnostic specimens of AFB smear positivity. Sputum specimens from each patient were processed with sodium hydroxide (NaOH) method-Modied Petroff 's procedure and cultured on Lowenstein-Jensen (LJ) slopes.10 All inoculated LJ drug and control media were incubated at 37ºC. All cultures were examined 48-72 hours after inoculation to detect gross contaminants. Thereafter, cultures were examined weekly, up to eight weeks on a specied day of the week. Typical colonies of M. tuberculosis were rough, crumbly, waxy, non-pigmented (buff coloured) and slow-growers, i.e., only appeared two to three weeks after inoculation. The colony was conrmed by ZN staining. Detection time for MOTT was 25 days. M. tuberculosis positive strains were culture negative when they grew on p-nitro benzoate (PNB) containing medium. Only a few colonies of non-tuberculosis Mycobacteria (NTM – often pigmented, with smooth morphology or PNB positive) were grown as visible colonies on PNB containing medium. Anti-TB drug susceptibility testing: - anti-susceptibility testing perform on pre-formed LJ media with antitubercular drugs Tuberculosis First Line Kit (Total 7 slants) Containing ve antitubercular agent (Isoniazid, Streptomycin, Ethambutol, Rifampicin and Pyrazinamide) 2 controls without any antimicrobial agent. Results: out of 119 samples antitubercular testing against rst line antitubercular drugs such as Pyrazinamide were shows 12 (10.08%) sample were resistance which accounts maximum resistance among rst line antitubercular another rst line antitubercular drugs shows resistance as follows Streptomycin (9.24%), Ethambutol (8.40%), Isoniazid (7.56%), Rifampicin (6.72%), drugs out of 119 samples in which 107 samples were susceptible to the Pyrazinamide drug in in-vitro antitubercular susceptibility testing. Antitubercular resistance against second line antitubercular drugs were shows as follows out of 119 samples antitubercular testing Ethionamide were shows 9 (8.18%) sample were resistance which accounts maximum resistance among second line antitubercular another second line antitubercular drugs shows resistance as follows Clarithromycin (6.72%), Ciprooxacin (5.88%), D- Cycloserine (5.88%), Amikacin (5.04%), Kanamycin (4.20%), P- aminosalicylic acid ( 4.20%) and Rifabutin (3.36%) drugs out of 119 samples in which 107 samples were susceptible to the Pyrazinamide drug in in-vitro antitubercular susceptibility testing. MDR-TB emerged in patients who were resistant to Rifampicin and Isoniazide was 6 in number during this study.
Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice ... more Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice for methicillin resistance Staphylococcus aureus. In MSSA infection, Injudicious and infrequent use of vancomycin has resulted in emergence of the strains with higher vancomycin MIC. Vancomycin MIC is a gold standard test to determine the sensitive(≤2 μg/ml), intermediate (4-8 μg/ml) or resistant (≥16 μg/ml) S. aureus strains, according to the CLSI guidelines. Material and methods: The current study was a comparative study to determine Vancomycin MIC value in MRSA and MSSA. Total 53 Staphylococcus aureus (S. aureus) strains were screened for methicillin resistance using a 30 μg cefoxitin disc (HiMedia, India) on Mueller Hinton agar according to Clinical and Laboratory Standards Institute (CLSI) guideline. Vancomycin MIC (minimum inhibitory concentration) was determined by agar dilution method. Observation: Out of 53 S. aureus isolates, 42 (79%) were methicillin resistant S. aureus (MRSA)...
Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice ... more Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice for methicillin resistance Staphylococcus aureus. In MSSA infection, Injudicious and infrequent use of vancomycin has resulted in emergence of the strains with higher vancomycin MIC. Vancomycin MIC is a gold standard test to determine the sensitive(≤2 μg/ml), intermediate (4-8 μg/ml) or resistant (≥16 μg/ml) S. aureus strains, according to the CLSI guidelines. Material and methods: The current study was a comparative study to determine Vancomycin MIC value in MRSA and MSSA. Total 53 Staphylococcus aureus (S. aureus) strains were screened for methicillin resistance using a 30 μg cefoxitin disc (HiMedia, India) on Mueller Hinton agar according to Clinical and Laboratory Standards Institute (CLSI) guideline. Vancomycin MIC (minimum inhibitory concentration) was determined by agar dilution method. Observation: Out of 53 S. aureus isolates, 42 (79%) were methicillin resistant S. aureus (MRSA)...
GLOBAL JOURNAL FOR RESEARCH ANALYSIS
Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and won... more Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and wonderful antistaphylococcal and antistreptococcal characteristics. The formulation for nasal usage has been permitted by the U.S. Food and Drug Administration to eradicate nasal infections in adults. Healthcare workers possessing S. aureus as healthy carriers can be major origin of infection for the admitted patients. The anterior nares have proved to be the major reservoir for strains of S. aureus in both adult and children masses. To determine the Objective: prevalence of mupirocin susceptibility in S. aureus, coagulase-negative staphylococci (CoNS) and MRSA species by disk diffusion. A total of 100 nasal swabs were collected from health care personnel, aseptically during Materials And Methods: the study period. All the swab samples were processed immediately and isolated by standard microbiological methods. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method....
GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS, 2022
Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and won... more Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and wonderful antistaphylococcal and antistreptococcal characteristics. The formulation for nasal usage has been permitted by the U.S. Food and Drug Administration to eradicate nasal infections in adults. Healthcare workers possessing S. aureus as healthy carriers can be major origin of infection for the admitted patients. The anterior nares have proved to be the major reservoir for strains of S. aureus in both adult and children masses. To determine the Objective: prevalence of mupirocin susceptibility in S. aureus, coagulase-negative staphylococci (CoNS) and MRSA species by disk diffusion. A total of 100 nasal swabs were collected from health care personnel, aseptically during the Materials And Methods: study period. All the swab samples were processed immediately and isolated by standard microbiological methods. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method. Carriage rate of staphylococci was found to be Results: 51% (including 44% of S. aureus and 7% CoNS), out of 100 nasal swabs collected during the study period. Prevalence rate of MRSA is detected to be 60.7% (31/44) in the health care workers. A total of 13 MSSA were detected in the sample collected from the anterior nares and 5 cases of MRCoNS also observed. The present study shows that all the identied S. aureus isolates were susceptible to low level mupirocin (5µg) as well as high level mupirocin (200µg). Nasal carriage of S. aureus is a Conclusions: major threat for public health as they can disseminate the same to the patients as well as to their colleagues. To reduce the prevalence and antimicrobial resistance, emphasis should be given to aseptic precaution, protective measures and topical application of mupirocin for eradication of nasal carriage.
GLOBAL JOURNAL FOR RESEARCH ANALYSIS
Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it ... more Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it has an implication in the control of tuberculosis. The terms used to describe resistance to antituberculosis drugs are resistance among new cases (or primary resistance) and resistance among previously treated patients. The resistance among previously treated patients may be due to faulty treatment like prescription of inadequate treatment regimens, interrupted availability or poor quality of drugs, or incomplete treatment adherence while subsequent transmission of these resistant organisms to others will lead to development of disease which is resistant from the beginning called primary resistance. Pakistan is ranked eighth in terms of global estimated burden of tuberculosis cases. Multi-Drug Resistant (MDR) tuberculosis among new cases and MDR among previously treated patients is 3.2% and 35% respectively. Material and methods: - AFB smear examination and grading: - AFB smear examinati...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, Feb 1, 2022
The objective of this study was to isolate, identify, and explore the in-vitro antifungal suscept... more The objective of this study was to isolate, identify, and explore the in-vitro antifungal susceptibility pattern of dermatophytes isolated from clinically suspected cases of dermatophytosis (tinea infections) attending the Dermatology Outpatient Clinic. Methods: This study was conducted at Sohag University Hospital from December 2014 to December 2015. Clinical samples (e.g., skin scrapings and hair stumps) were collected under aseptic precautions. The identification of dermatophytes was performed through microscopic examination using 10% potassium hydroxide (KOH) with 40% dimethyl sulphoxide (DMSO) mounts and culture on Sabouraud dextrose agar (SDA) and on Dermasel agar base media, both supplemented with chloramphenicol and cycloheximide. All dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion (ABDD) method against Clotrimazole, Miconazole, Fluconazole, and Griseofulvin. Data were analyzed via SPSS 16, using Chi square and a screening test (cross-tabulation method). Results: A total of 110 patients of dermatophytosis were studied. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis (49), tinea corporis (30), tinea pedis (16), tinea cruris (9), or tinea barbae (6). The dermatophytes isolates belonged to 4 species: Microsporum canis 58 (52.7%), Microsporum gypseum 23 (20.9%), Trichophyton mentagrophytes 18 (16.4%), and Microsporum audouinii 11 (10%). The most effective antifungal drugs tested were Clotrimazole, followed by Miconazole (95.5% and 84.5% of isolates were susceptible, respectively). Conclusion: Every patient with a tinea infection should be properly studied for a mycological examination and should be treated accordingly. Dermasel agar is more useful as an identification medium in the isolation of dermatophytes. The ABDD method appears to be a simple, cost-effective, and promising method for the evaluation of antifungal susceptibility of dermatophytes.
GLOBAL JOURNAL FOR RESEARCH ANALYSIS, Jul 15, 2022
Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it ... more Objective: Resistance against Mycobacterium tuberculosis (MTB) is important in the sense that it has an implication in the control of tuberculosis. The terms used to describe resistance to antituberculosis drugs are resistance among new cases (or primary resistance) and resistance among previously treated patients. The resistance among previously treated patients may be due to faulty treatment like prescription of inadequate treatment regimens, interrupted availability or poor quality of drugs, or incomplete treatment adherence while subsequent transmission of these resistant organisms to others will lead to development of disease which is resistant from the beginning called primary resistance. Pakistan is ranked eighth in terms of global estimated burden of tuberculosis cases. Multi-Drug Resistant (MDR) tuberculosis among new cases and MDR among previously treated patients is 3.2% and 35% respectively. Material and methods: - AFB smear examination and grading: - AFB smear examination was carried out by direct microscopy using the Ziehl Neelsen (ZN) method. Sputum smear result was examined and interpreted according to the AFB grading. AFB culture and drug susceptibility test: - Culture examinations were done on all diagnostic specimens of AFB smear positivity. Sputum specimens from each patient were processed with sodium hydroxide (NaOH) method-Modied Petroff 's procedure and cultured on Lowenstein-Jensen (LJ) slopes.10 All inoculated LJ drug and control media were incubated at 37ºC. All cultures were examined 48-72 hours after inoculation to detect gross contaminants. Thereafter, cultures were examined weekly, up to eight weeks on a specied day of the week. Typical colonies of M. tuberculosis were rough, crumbly, waxy, non-pigmented (buff coloured) and slow-growers, i.e., only appeared two to three weeks after inoculation. The colony was conrmed by ZN staining. Detection time for MOTT was 25 days. M. tuberculosis positive strains were culture negative when they grew on p-nitro benzoate (PNB) containing medium. Only a few colonies of non-tuberculosis Mycobacteria (NTM – often pigmented, with smooth morphology or PNB positive) were grown as visible colonies on PNB containing medium. Anti-TB drug susceptibility testing: - anti-susceptibility testing perform on pre-formed LJ media with antitubercular drugs Tuberculosis First Line Kit (Total 7 slants) Containing ve antitubercular agent (Isoniazid, Streptomycin, Ethambutol, Rifampicin and Pyrazinamide) 2 controls without any antimicrobial agent. Results: out of 119 samples antitubercular testing against rst line antitubercular drugs such as Pyrazinamide were shows 12 (10.08%) sample were resistance which accounts maximum resistance among rst line antitubercular another rst line antitubercular drugs shows resistance as follows Streptomycin (9.24%), Ethambutol (8.40%), Isoniazid (7.56%), Rifampicin (6.72%), drugs out of 119 samples in which 107 samples were susceptible to the Pyrazinamide drug in in-vitro antitubercular susceptibility testing. Antitubercular resistance against second line antitubercular drugs were shows as follows out of 119 samples antitubercular testing Ethionamide were shows 9 (8.18%) sample were resistance which accounts maximum resistance among second line antitubercular another second line antitubercular drugs shows resistance as follows Clarithromycin (6.72%), Ciprooxacin (5.88%), D- Cycloserine (5.88%), Amikacin (5.04%), Kanamycin (4.20%), P- aminosalicylic acid ( 4.20%) and Rifabutin (3.36%) drugs out of 119 samples in which 107 samples were susceptible to the Pyrazinamide drug in in-vitro antitubercular susceptibility testing. MDR-TB emerged in patients who were resistant to Rifampicin and Isoniazide was 6 in number during this study.
Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice ... more Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice for methicillin resistance Staphylococcus aureus. In MSSA infection, Injudicious and infrequent use of vancomycin has resulted in emergence of the strains with higher vancomycin MIC. Vancomycin MIC is a gold standard test to determine the sensitive(≤2 μg/ml), intermediate (4-8 μg/ml) or resistant (≥16 μg/ml) S. aureus strains, according to the CLSI guidelines. Material and methods: The current study was a comparative study to determine Vancomycin MIC value in MRSA and MSSA. Total 53 Staphylococcus aureus (S. aureus) strains were screened for methicillin resistance using a 30 μg cefoxitin disc (HiMedia, India) on Mueller Hinton agar according to Clinical and Laboratory Standards Institute (CLSI) guideline. Vancomycin MIC (minimum inhibitory concentration) was determined by agar dilution method. Observation: Out of 53 S. aureus isolates, 42 (79%) were methicillin resistant S. aureus (MRSA)...
Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice ... more Introduction: Vancomycin, a glycopeptide antibiotic had been considered to be the drug of choice for methicillin resistance Staphylococcus aureus. In MSSA infection, Injudicious and infrequent use of vancomycin has resulted in emergence of the strains with higher vancomycin MIC. Vancomycin MIC is a gold standard test to determine the sensitive(≤2 μg/ml), intermediate (4-8 μg/ml) or resistant (≥16 μg/ml) S. aureus strains, according to the CLSI guidelines. Material and methods: The current study was a comparative study to determine Vancomycin MIC value in MRSA and MSSA. Total 53 Staphylococcus aureus (S. aureus) strains were screened for methicillin resistance using a 30 μg cefoxitin disc (HiMedia, India) on Mueller Hinton agar according to Clinical and Laboratory Standards Institute (CLSI) guideline. Vancomycin MIC (minimum inhibitory concentration) was determined by agar dilution method. Observation: Out of 53 S. aureus isolates, 42 (79%) were methicillin resistant S. aureus (MRSA)...
GLOBAL JOURNAL FOR RESEARCH ANALYSIS
Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and won... more Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and wonderful antistaphylococcal and antistreptococcal characteristics. The formulation for nasal usage has been permitted by the U.S. Food and Drug Administration to eradicate nasal infections in adults. Healthcare workers possessing S. aureus as healthy carriers can be major origin of infection for the admitted patients. The anterior nares have proved to be the major reservoir for strains of S. aureus in both adult and children masses. To determine the Objective: prevalence of mupirocin susceptibility in S. aureus, coagulase-negative staphylococci (CoNS) and MRSA species by disk diffusion. A total of 100 nasal swabs were collected from health care personnel, aseptically during Materials And Methods: the study period. All the swab samples were processed immediately and isolated by standard microbiological methods. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method....
GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS, 2022
Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and won... more Introduction: Mupirocin (pseudomonic acid A) is an antibacterial agent with topical usage and wonderful antistaphylococcal and antistreptococcal characteristics. The formulation for nasal usage has been permitted by the U.S. Food and Drug Administration to eradicate nasal infections in adults. Healthcare workers possessing S. aureus as healthy carriers can be major origin of infection for the admitted patients. The anterior nares have proved to be the major reservoir for strains of S. aureus in both adult and children masses. To determine the Objective: prevalence of mupirocin susceptibility in S. aureus, coagulase-negative staphylococci (CoNS) and MRSA species by disk diffusion. A total of 100 nasal swabs were collected from health care personnel, aseptically during the Materials And Methods: study period. All the swab samples were processed immediately and isolated by standard microbiological methods. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method. Carriage rate of staphylococci was found to be Results: 51% (including 44% of S. aureus and 7% CoNS), out of 100 nasal swabs collected during the study period. Prevalence rate of MRSA is detected to be 60.7% (31/44) in the health care workers. A total of 13 MSSA were detected in the sample collected from the anterior nares and 5 cases of MRCoNS also observed. The present study shows that all the identied S. aureus isolates were susceptible to low level mupirocin (5µg) as well as high level mupirocin (200µg). Nasal carriage of S. aureus is a Conclusions: major threat for public health as they can disseminate the same to the patients as well as to their colleagues. To reduce the prevalence and antimicrobial resistance, emphasis should be given to aseptic precaution, protective measures and topical application of mupirocin for eradication of nasal carriage.