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Objectives: Bacteroides spp. are anaerobic resident intestinal flora but are also known to cause severe morbidity. They are resistant to a wide variety of antimicrobial agents, including metronidazole, which has been shown to be associated with specific nitroimidazole (nim) resistance genes. Metronidazole resistance is emerging worldwide, although presently it remains at ca. 5%. This study aimed to determine the metronidazole susceptibility and distribution of nim genes in Bacteroides spp. clinical isolates in India. The relationship among strains harbouring nim genes and their susceptibility to metronidazole was also analysed., Methods: A total of 42 Bacteroides spp. clinical isolates were identified using an advanced MALDI-TOF system. Minimum inhibitory concentrations (MICs) for metronidazole were determined by the agar dilution method. Bacterial DNA was extracted and was subjected to nim gene PCR and the amplified PCR products were sequenced to determine the prevalent nim types., Results: Bacteroides fragilis was the most common isolate (64%) among all Bacteroides spp. isolates. Among the total 42 clinical Bacteroides spp. isolates, 29 (69%) were susceptible and 13 (31%) were resistant to metronidazole by the agar dilution method. nim gene PCR performed on 38 isolates showed positivity in 20 isolates (53%), of which 12 had high metronidazole MICs (χ 2 test, P<0.005). On sequencing, these nim genes were most closely related to nimE type., Conclusion: Resistance to metronidazole is consistently emerging worldwide. There is a significant association of the nim gene with metronidazole resistance. Periodic surveillance is needed to detect geographic and temporal trends in nim gene prevalence., (Copyright © 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

Background and Objectives: Anaerobic infections are usually caused by the host's endogenous flora due to a breach in the anatomical barriers and Bacteroides spp. are the most notorious organisms associated with anaerobic infections. The identification of anaerobes has been a challenge since times. MALDI-TOF-MS is a boon for aiding the rapid detection of anaerobic organisms and has helped us to enlist the distribution of various anaerobic pathogens. Materials and Methods: This retrospective analysis (January 2018 to December 2019) was carried out in a tertiary care hospital in North India, in which the anaerobic microbiological profile of all patients admitted to surgical wards, ICU, and OPD of various departments (Orthopedics, Surgery, Gynecology, and Obstetrics) was reviewed. Samples received were immediately processed aerobically (5% sheep blood agar and Mac Conkeyagar) as well as anaerobically (RCM and freshly prepared sheep blood agar) as per the laboratory protocols. Results: Bacteroides fragilis (19.12%) was the most common anaerobe whereas among aerobes Escherichia coli (30.2%) followed by Klebsiella pneumoniae (10.34%) were most commonly isolated. The majority of patients were males (56%) and the most common presentation was with abscesses (21.4%). Polymicrobial infections (69.51%) outnumbered monomicrobial ones (30.48%). Conclusion: There is a paucity of literature on anaerobe isolation from surgical infections from our country which motivated us to study anaerobic infections and the high sample size in our institute enabled us to study surgical infections from an anaerobic perspective. This will add to the knowledge of microbiologists and clinicians. MALDI-TOF MS helped in rapid and accurate identification and hence we could report a wider spectrum of organisms in our study. [ABSTRACT FROM AUTHOR]

Background: The oral cavity is a complex environment which harbours the second largest and most diverse microflora after the gastrointestinal tract. The bacteriome in the oral cavity plays a pivotal role in promoting the health and well-being of human beings. Gingivitis, an inflammation of the gingival tissue, arises due to plaque accumulation on the teeth, often leads to periodontitis. Progression of periodontitis resulting in clinical attachment loss, bone loss and eventually the tooth loss is poorly understood. The present study explores the transitions in microbioata, oxidative stress and polyamine levels during the disease evolution which can contribute to developing effective therapeutic approaches. Methods: Saliva samples were collected from seventy-two individuals after procuring informed consent who were either healthy, gingivitis or stage-specific periodontitis patients. Periodontitis stage was confirmed by clinical and radiographic analysis. Microbiota analysis was carried out by 16S rRNA sequencing on the Nanopore PromethIONsystem platform of Oxford Nanopore technologies. Polyamine levels were quantified with fluorescence spectrophotometer. Ornithine decarboxylase quantification was evaluated by ELISA method. Antioxidant levels of the salivary samples were measured by DPPH, SOD, and catalase assays. Autophagy was measured by acid phosphatase assay. Result: The salivary microbiota exhibited significant changes in their abundance and diversity between healthy individuals and those with conditions such as gingivitis, and chronic periodontitis. A significant increase in polyamines and ornithine decarboxylase was found in gingivitis and various stages of periodontitis. Elevated oxidative stress observed in gingivitis and periodontitis could have resulted in cell death. Conclusion: The current study shows the role of salivary microbiota and polyamines in gingivitis and different periodontitis stages. The progressive elevation of Streptococcus levels from gingivitis to periodontitis, coupled with polyamine concentrations, may serve as a promising identification marker for assessing the severity of periodontal disease. Insight into the oral bacterial flora and associated physiological changes provide a foundation for targeted therapeutic interventions in gingivitis and periodontitis diseases emphasising the importance of personalised oral health management strategies. [ABSTRACT FROM AUTHOR]

Brain abscess accounts for 8% of all intracranial insults in developing countries. Anaerobic infections are missed in most cases due to difficult isolation techniques. This study was done to determine the anaerobic bacteriological profile of brain abscess, their distribution according to sociodemographic variables, anatomical location, management and the outcome during the subjects' stay in a neurosciences' speciality hospital. We included 190 cases of confirmed anaerobic brain abscess from the year 1998–2017. The median age was 22 years with more males (73% of 190 cases) than females. The Bacteroides spp. were the most common (64%) anaerobic organisms isolated followed by Gram positive anaerobic cocci (51%). While 67% of the samples showed purely anaerobic bacteria on culture, remaining were mixed. Chronic suppurative otitis media (CSOM) was the most common predisposing factor. • Anaerobic brain abscess was more common in the second and third decade of life. • The most common site of the abscess was the cerebrum. • Bacteroides spp. were the most common anaerobes isolated from the samples. • Chronic suppurative otitis media was the most common predisposing factor reported. [ABSTRACT FROM AUTHOR]

Modernization, a stressful lifestyle, attachment to a Western diet, and the use of preserved and processed foods lead to a loss of homeostasis of intestinal microbial diversity. The use of refined flour and refined sugar, which lack of micro biota-accessible carbohydrates (MAC), means dietary fiber high salt consumption, and saturated fats in fried and packaged foods cause gut microbiota dysbiosis. Microbial dysbiosis caused by high fat, salt, and lack of fiber causes several metabolic diseases, including asthma. The objective of the study is to develop a hypothetic model that "Ancient Indian diet" which is inspired by thousands of years of Indian science, including Yoga, Ayurveda, and Naturopathy may maintain the diversity of the gut microbiota and may inhibits the asthmatic symptoms by enhancing the growth of antiasthmatic bacteria. A keyword search utilizing the phrases "western diet, beneficial microbiota, asthma, gut microbial dysbiosis, Ancient Indian diet" was conducted electronically search through the SCOPUS,Science Direct, PubMed, Web of Science, and PsycINFO databases. Search criteria are divided into two arms the first one includes different full-text research papers including how Indian diet altered gut microbial composition. The second one, we included the full text including how presence of certain gut microbiota can prevents the asthmatic attack. To And publications that met the eligibility requirements, the first and third authors separately reviewed each publication's title and abstract using the previously described inclusion criteria. We have included 124 research articles, which is published between 1989 to 2024. A plant-based ancient Indian diet increases the diversity of Bacteroidetes, Actinobacteria, Prevotella, Bifidobacterium, Lactobacillus, Ruminococcus, Roseburia, Lactobacillus, Lachnospira, Akkermansia and shows inhibitory effects against Clostridium, E. coli, Staphylococcus, Haemophilus, Moraxella and Neisseria.The ancient Indian diet a low-fat lacto-vegetarian diet maintains gut microbiota homeostasis, and suppresses the growth of pathogenic asthmatic bacteria and promotes the growth of beneficial asthmatic bacteria. [ABSTRACT FROM AUTHOR]

Removal of synthetic textile dyes poses a challenge to the textile industry and a threat to the environment's flora and fauna. These dyes are recalcitrant and not very amenable to physical and chemical techniques of degradation. Hence, several studies on alternative bioremediation methods involving plants, plant roots, single microbes, or a consortium of microbes for the decolorization of dyes have been carried out. In the present study, potent bacteria for dye decolorization were isolated from rhizospheric soil of mangrove plants collected from Kamothe, Navi Mumbai, India. Of the 20 isolates obtained after enrichment, seven isolates were used for further screening of efficient decolorization ability in minimal basal media containing 10% glucose, 2.5% trace metal solution, and 0.1% of Methyl Orange (MO) dye concentration. Physiological parameters to optimize the decolorization of dye at optimum pH, temperature, and incubation time were studied for all the seven isolates. UV–vis and Fourier transform infrared spectroscopy were used to investigate dye decolorization. The seven isolates were characterized morphologically, biochemically, and molecular identification of these bacterial isolates was performed by 16S rRNA sequence analysis. The isolates were identified as Bacillus paramycoides, Pseudomonas taiwanensis, Citrobacter murliniae, Acinetobacter pitti, Exiguobacterium acetylicum, Psychrobacter celer, and Aeromonas taiwanensis. Out of these, Aeromonas taiwanensis has shown exceptional capacity by ~ 100% decolorization of azo dye in minimum time. [ABSTRACT FROM AUTHOR]

Rabindra Sarovar lake is an artificial freshwater lake in the arsenic infested eastern region of India. In this study, using the genome resolved metagenomics approach; we have deciphered the taxonomic diversity as well as the functional insights of the gene pools specific to this region. Initially, a total of 113 Metagenome Assembled Genomes (MAGs) were recovered from the two predominant seasons, that is, rainy (n = 50) and winter (n = 63). After bin refinement and de-replication, 27 MAGs (18 from Winter season and 9 from Rainy season) were reconstructed. These MAGs were either of high-quality (n = 10) or of medium quality (n = 17) that was determined based on genome completeness and contamination. These 27 MAGs spanning across 6 bacterial phyla and the most predominant ones were Proteobacteria, Bacteroidetes, and Cyanobacteria regardless of the season. Functional annotation across the MAGs suggested the existence of all known types of arsenic resistance and metabolism genes. Besides, important secondary metabolites such as zoocin_A, prochlorosin, and microcin were also abundantly present in these genomes. The metagenomic study of this lake provides the first insights into the microbiome composition and functional classification of the gene pools in two predominant seasons. The presence of arsenic metabolism and resistance genes in the recovered genomes is a sign of adaptation of the microbes to the arsenic contamination in this region. The presence of secondary metabolite genes in the lake microbiome has several implications including the potential use of these for the pharmaceutical industry. [ABSTRACT FROM AUTHOR]

Worldwide, millions of individuals have been affected by the prevailing SARS-CoV-2. Therefore, a robust immune system remains indispensable, as an immunocompromised host status has proven to be fatal. In the absence of any specific antiviral drug/vaccine, COVID-19 related drug repurposing along with various other non-pharmacological measures coupled with lockdown have been employed to combat this infection. In this context, a plant based rich fiber diet, which happens to be consumed by a majority of the Indian population, appears to be advantageous, as it replenishes the host gut microbiota with beneficial microbes thereby leading to a symbiotic association conferring various health benefits to the host including enhanced immunity. Further, implementation of the lockdown which has proven to be a good non-pharmacological measure, seems to have resulted in consumption of home cooked healthy diet, thereby enriching the beneficial microflora in the gut, which might have resulted in better prognosis of COVID-19 patients in India in comparison to that observed in the western countries. [ABSTRACT FROM AUTHOR]

Background: Chronic Suppurative Otitis Media (CSOM) is a one of the major public-health problems and presenting with high prevalence rate in developing countries like India. Necessity to immediate intervention and treatment is required as the persistent infection is associated with increased risk of extracranial and intracranial complications. Aim and Objectives: This study was undertaken to determine the microbial profile of CSOM and also to detect the resistance pattern of bacterial pathogen isolated. Material and Methods: This prospective analytical single centre study was done on patients presenting with ear discharge of more than 6 weeks duration. All the samples were processed for aerobic bacterial and fungal culture and antibiotic susceptibility testing was done by Kirby Bauer Disc Diffusion Method. Results: Analysis of 85 pus samples from CSOM showed 97.6% were culture positive and 2.3% were culture negative. Of 83 culture positive samples, 79 (95.2%) were mono- microbial and 4 (4.8%) were polymicrobial. The predominant organisms isolated from CSOM was Pseudomonas spp (52.9%), followed by Staphylococcus aureus (20.7%). Antimicrobial sensitivity testing showed that 10.7% of Gram negative bacilli were Extended Spectrum Beta-Lactamase (ESBL) producers and 16.6% of Staphylococcus aureus was Methicillin resistant and 33.7% of the 86 isolates were resistant to Ciprofloxacin. Conclusion: In conclusion, our study on microbial profile of CSOM showed Pseudomonas aeruginosa was predominantly isolated followed by Staphylococcus aureus and around 45% of the isolates were resistant to Ciprofloxacin. Knowledge on the predominant isolates and their antibiotic susceptibility pattern of the bacteria isolated from CSOM is very crucial for starting the empirical treatment, prior to availability of susceptibility reports from the laboratory. [ABSTRACT FROM AUTHOR]

We evaluated the prevalence and determinants of bacterial vaginosis (BV) in HIV-infected women from Maharashtra, India. Among 912 HIV-infected women enrolled, BV was diagnosed in 191 (20.9%) and intermediate BV was diagnosed in 258 (28.3%) women. Women with more than two pregnancies had 1.6 times increased risk of BV (95% CI 1.0, 2.5, p-value 0.038), women who were menopausal had 6.2 times increased risk of BV (95% CI 2.4, 15.6, p-value <0.001) and women who were human papillomavirus (HPV) positive had 2.3 times increased risk of BV (95% CI 1.4, 3.9, p-value 0.001). Although we observed significantly increased risk of BV among women diagnosed with cervical intraepithelial neoplasia or worse disease in the univariate analysis (odds ratio 3.5, 95% CI 1.5, 8.1, p-value 0.004), it did not reach statistical significance in the multivariate analysis. Women who had the first sexual intercourse after the age of 18 had significantly lower risk of BV. To conclude, we observed high prevalence of BV in HIV-infected women and increased risk of BV in HPV positive, HIV-infected women. [ABSTRACT FROM AUTHOR]

Aim: To compare the efficacy of pre-incision intravenous single doses of cefazolin versus cefazolin plus azithromycin as an antibiotic prophylaxis in cesarean delivery (CD). Methods: This was a single-center, double blind, randomized controlled trial conducted in the PGIMER, Chandigarh. 200 women undergoing elective/emergency cesarean section were randomized. Group A received single dose of cefazolin plus placebo while Group B received single dose of cefazolin plus azithromycin. Primary outcome evaluated was occurrence of surgical site infections (SSI); secondary outcomes included incidence of febrile morbidity, UTI, endometritis, neonatal outcome, total cost of antibiotics, and duration of hospital stay in both the study arms. Descriptive statistics and χ2 tests were used for analysis of the data. Result: There was an overall significant reduction in the incidence of SSI (15% vs 3%; P = 0.03), endometritis (8% vs 2%; P = 0.048), and post-operative febrile morbidity (17% vs 3%; P = 0.001) with the addition of azithromycin to cefazolin. Duration of hospital stay was almost two days lesser for the cefazolin plus azithromycin group. Subgroup analysis of patients with SSI showed the age, duration of ruptured membranes, and type of anesthesia as important predictors of infection rate. Study observed statistically significant reduction in requirement of additional post operative antibiotics, phototherapy for neonates, hospital stay and cost of therapy in cefazolin plus azithromycin group (P < 0.05). Conclusion: Tertiary care hospitals in developing countries such as India can opt for the cefazolin plus azithromycin as antimicrobial prophylaxis during CD to maximize the efficacy as well as for decreasing the cost burden of postoperative infections. [ABSTRACT FROM AUTHOR]

Introduction: Members of Bacteroides fragilis group are the most frequently isolated anaerobic pathogens in the clinical laboratory from diverse infection sites. The objective of this study was to characterize B. fragilis isolates from various clinical specimens, to analyze their susceptibility profile toward most common anti-anaerobic antimicrobials, and to study the frequency of nim gene determining resistance to nitroimidazoles. Methods: Specimens processed for anaerobic culture between January 2013 and December 2015 were analyzed. Isolates of B. fragilis group were identified and speciated by mass spectrometry. β-lactamase production was detected using nitrocefin disks. Agar dilution and antimicrobial gradient diffusion methods were performed to study their susceptibility profile. The isolates were screened for nim gene by conventional gel-based polymerase chain reaction. Results: A total of 57 isolates of B. fragilis group were studied. The commonly isolated species was B. fragilis (73.7%), followed by Bacteroides thetaiotaomicron (8.8%), Bacteroides vulgatus (8.8%), and others. Most of the isolates were recovered from deep-seated abscesses (47.4%). All isolates were found to be β-lactamase producers. Metronidazole (Mtz) resistance was observed in 4 (7%) isolates. Higher rate of resistance was observed toward clindamycin (31.6%). None of the isolates tested were found resistant to chloramphenicol, piperacillin-tazobactam, and meropenem. nim genes were present in 4 (11.4%) B. fragilis isolates (n = 35). Conclusions: Resistance to the most commonly used empirical anti-anaerobic drugs including Mtz was noted in the isolates of B. fragilis group. Routine anaerobic cultures when indicated and continual surveillance of antimicrobial resistance among the anaerobic bacterial pathogens is essential. [ABSTRACT FROM AUTHOR]

The disease profile in the Indian population provides a unique opportunity for studying the host microbiome interaction in both infectious (amebiasis) and autoimmune diseases like inflammatory bowel disease (IBD) from a similar environment and genetic background. Analysis of fecal samples from untreated amebic liver abscess (ALA) patients, Entamoeba histolytica (Eh)-negative and -positive asymptomatic individuals, and pus samples from naive ALA patients revealed a significant reduction in Lactobacillus in asymptomatic individuals (Eh +ve) and ALA patients. Two anaerobic genera, namely Bacteroides and Peptostreptococcus, were detected in naive ALA pus samples. Analysis of fecal samples from amoebic colitis patients showed a significant decline in population of Bacteroides, Clostridium coccoides and leptum subgroup, Lactobacillus, Campylobacter, and Eubacterium, whereas a significant increase in Bifidobacterium was observed. Mucosa-associated bacterial flora analysis from IBD patients and healthy controls revealed a significant difference in concentration of bacteria among predominating and subdominating genera between ulcerative colitis (UC), Crohn's disease (CD) patients, and controls. In contrast to the mucosal studies, we found a significant increase in lactobacilli population in fecal samples of active UC patients. Another study revealed a significant decrease of Clostridium coccoides and leptum clusters in fecal samples of active UC patients along with decreased concentrations of fecal SCFAs, especially of n-butyrate, iso-butyrate, and acetate. We therefore found similar perturbations in gut microbiome in both infectious and autoimmune diseases, indicating inflammation to be the major driver for changes in gut microbiome. [ABSTRACT FROM AUTHOR]

A total of 874 fecal specimens (446 diarrheal cases and 428 controls) from diarrheal children admitted in the Infectious Diseases Hospital, Kolkata and age and sex matched asymptomatic subjects from an urban community were assessed for the prevalence of enterotoxigenic Bacteroides fragilis (ETBF). Isolates of B. fragilis were tested for the presence of enterotoxin gene (bft) by PCR. The detection rate of ETBF was 7.2% (63 of 874 specimens) that prevailed equally in diarrheal cases and controls (7.2% each; 32 of 446 cases and 31 of 428 controls). Male children up to one year age group was significantly (p<0.05) associated with ETBF infection as compared to children > 2 years of age in cases and controls. In 25 ETBF isolates, the bft gene was genotyped using PCR-RFLP and only two alleles were identified with prevalence rate of 40% and 60% for bft-1 and bft-3, respectively. All the ETBF isolates were susceptible for chloramphenicol and imipenem but resistant to clindamycin (48%), moxifloxacin (44%) and metronidazole (32%). Resistance of ETBF to moxifloxacin (44%) and metronidazole is an emerging trend. Pulsed-field gel electrophoresis (PFGE) revealed that majority of the ETBF isolates are genetically diverse. In the dendrogram analysis, two clusters were identified, one with ETBF resistant to 5–8 antimicrobials and the other cluster with metronidazole and moxifloxacin susceptible isolates from diarrheal cases. To our knowledge, this is the first detailed report on ETBF from India indicating its clinical importance and molecular characteristics. [ABSTRACT FROM AUTHOR]

Background: Abscesses are often polymicrobial in nature and require judicious combination of antimicrobial therapy in addition to surgical debridement for cure. Objectives: To find out the prevalence of aerobes and anaerobes in abscess and their antimicrobial susceptibility pattern. Methods: This prospective analysis included 120 pus samples from patients with superficial and deep abscesses, attending surgical departments over a period of one year. Both aerobic and anaerobic cultures were done and all isolates were subjected to antibiotic sensitivity using modified Kirby-Bauer disc diffusion method. Results: Out of total 134 isolates, 74.17% were aerobes, 20.83% were anaerobes and 5% were mixed infections. 106 (88.33%) were monomicrobial and 14 (11.67%) were polymicrobial. Staphylococcus aureus was predominant isolate (41.04%), followed by E.coli (17.91%) and Peptostreptococcus spp. (14.18%). Methicillin resistance in S. aureus was found to be 32.7% and 32.6% of the gram negative bacilli were extended spectrum beta-lactamase producers. All the anaerobes were sensitive to metronidazole, followed by chloramphenicol and clindamycin (91-100%). Conclusions: Continuous monitoring of antimicrobial susceptibility pattern in individual settings together with their judicious use is emphasised to minimise emergence of drug-resistant bacteria. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the present study was to identify the true prevalence of hemorrhage in the abscess using T2*-weighted angiography (SWAN) imaging and to study its influence on diffusion tensor imaging (DTI) metrics. Methods: Fifteen patients of brain abscess underwent conventional, SWAN, and DT imaging on a 3-T MRI followed by its confirmation with histology. DTI metrics were quantified by region-of-interest analysis on hemorrhagic and non-hemorrhagic regions of the abscess wall. Prussian blue staining was performed on excised abscess walls to confirm hemorrhage on histology. Results: Eleven of 15 patients showed evidence of hemorrhage on both Prussian blue staining as well as SWAN imaging. Fractional anisotropy (FA) and linear anisotropy (CL) values were significantly higher, while spherical anisotropy was significantly lower in hemorrhagic compared to non-hemorrhagic regions of the abscess wall. Conclusion: Hemorrhage in the abscess wall is a common feature and may not always indicate neoplasm. The presence of intracellular iron in addition to concentrically laid collagen fibers may have synergistic effect on FA and CL values in the abscess wall. Inclusion of SWAN to MRI protocol will define the true prevalence of hemorrhage in brain abscess. [ABSTRACT FROM AUTHOR]

Background: Amebic dysentery is caused by the protozoan parasite Entamoeba histolytica and the ingestion of quadrinucleate cyst of E. histolytica from fecally contaminated food or water initiates infection. Excystation occurs in the lumen of small intestine, where motile and potentially invasive trophozoites germinate from cysts. The ability of trophozoites to interact and digest gut bacteria is apparently important for multiplication of the parasite and its pathogenicity; however the contribution of resident bacterial flora is not well understood. We quantified the population of Bacteroides, Bifidobacterium, Ruminococcus, Lactobacillus, Clostridium leptum subgroup, Clostridium coccoides subgroup, Eubacterium, Campylobacter, Methanobrevibacter smithii and Sulphur reducing bacteria using genus specific primers in healthy (N = 22) vs amebic patients (E. histolytica positive, N = 17) stool samples by Real-time PCR. Results: Absolute quantification of Bacteroides (p = .001), Closrtridium coccoides subgroup (p = 0.002), Clostridium leptum subgroup (p = 0.0001), Lactobacillus (p = 0.037), Campylobacter (p = 0.0014) and Eubacterium (p = 0.038) show significant drop in their population however, significant increase in Bifdobacterium (p = 0.009) was observed where as the population of Ruminococcus (p = 0.33) remained unaltered in healthy vs amebic patients (E. histolytica positive). We also report high prevalence of nimE gene in stool samples of both healthy volunteers and amebic patients. No significant decrease in nimE gene copy number was observed before and after the treatment with antiamebic drug. Conclusions: Our results show significant alteration in predominant gut bacteria in E. histolytica infected individuals. The frequent episodes of intestinal amoebic dysentery thus result in depletion of few predominant genera in gut that may lead to poor digestion and absorption of food in intestine. It further disturbs the homeostasis between gut epithelium and bacterial flora. The decrease in beneficial bacterial population gives way to dysbiosis of gut bacteria which may contribute to final outcome of the disease. Increase in the copy number of nimE gene harboring bacteria in our population reflects possible decrease in the availability of metronidazole drug during treatment of amoebiasis. [ABSTRACT FROM AUTHOR]

Under the Agreement on Trade-Related Intellectual Property Rights, the World Trade Organization members are required to enforce product patents for pharmaceuticals. In this paper we empirically investigate the welfare effects of this requirement on developing countries using data for the fluoroquinolones subsegment of the systemic anti-bacterials segment of the Indian pharmaceuticals market. Our results suggest that concerns about the potential adverse welfare effects of TRIPS may have some basis. We estimate that the withdrawal of all domestic products in this subsegment is associated with substantial welfare losses to the Indian economy, even in the presence of price regulation. The overwhelming portion of this welfare loss derives from the loss of consumer welfare. (JEL F13, L65, O34). [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of pathogens in diabetic foot infections, in relation to parameters like Wagner's grading, duration of diabetes and healing time., Material and Methods: A group of 654 (M:F, 433:221) type 2 diabetic patients with foot ulcers were studied. Specimens like pus, wound exudate and tissue were processed for smear for Gram's staining, aerobic and anaerobic culture, and biochemical identifications., Results: In 654 diabetic patients, 728 pathogens were isolated. Aerobic pathogens were isolated in 437 (66.8%) patients and anaerobic pathogens were isolated in 217 (33.2%). As Wagner's grading increased, the prevalence of anaerobic pathogens also increased. Neuropathy was common in diabetic patients infected with both aerobic and anaerobic pathogens. Ulcers infected with anaerobic pathogens showed a longer healing time than ulcers infected with aerobic pathogens. There was no significant difference in peripheral vascular disease (PVD) in patients selected for the study. Among aerobic pathogens, Enterobacteriaceae family (48%), Staphylococcus species (spp) (18.2%), Streptococcus spp (16.8%) and Pseudomonas spp (17%) were seen frequently. Among anaerobes Peptostreptococcus spp and Clostridium spp formed 69.4%. Gram-negative anaerobes like Bacteroides spp and Fusobacterium spp were present in 30.6%. Healing time was longer when strict aerobic pathogen Pseudomonas spp and strict anaerobic pathogens were present (136.1 +/- 28.6 and 136.4 +/- 34.7 days, respectively)., Conclusions: Diabetic foot infection is polymicrobial in nature. The healing time of wound infected with anaerobic pathogens was higher than those infected with aerobic pathogens. Anaerobic pathogens increased with the Wagner's grading. Presence of neuropathy increased the risk of foot infection.