Venus Medicine Research Center

Baddi, India

Venus Medicine Research Center

Baddi, India
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Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Pharmacy Research | Year: 2013

Objective: To compare clinical and bacteriological efficacy as well as tolerability of ceftriaxone-sulbactam with adjuvant disodium edetate (the novel antibiotic adjuvant entity; Elores) in the treatment of skin and skin structure infections (SSSIs) and bone and joint infections (BJIs). Methods: Patients were randomized into group A (ceftriaxone; n 1/4 26 for SSSIs; n 1/4 35 for BJIs) group B (Elores; n 1/4 30 for SSSIs; n 1/4 35 for BJIs). The patients were administered with Elores 3.0 g twice daily and ceftriaxone 2.0 g twice daily in two divided doses for 3-10 days. Results: Out of the total population, percentage of clinically cured patients was 80.33% in Elores group and 30.77% in ceftriaxone group. However, 53.33% patients failed to respond to ceftriaxone in comparison to no clinical failure in Elores group at the end of therapy. There was 23.08% cumulative bacterial eradication in both indications BJIs and SSSIs of group A whereas a significantly higher 85.25% cumulative bacterial eradications was noted with group B in both indications. However, 58.46% cases failed to respond to ceftriaxone bacteriologically. Conclusion: Results of this study indicates that Elores is more safe and effective regimen in treating ESBL producing gram-negative and gram-positive pathogens in comparison to plain ceftriaxone © 2013, JPR Solutions.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Global Journal of Pharmacology | Year: 2014

In this nationwide study we investigated the occurrence of aminoglycoside resistance patterns and prevalence of the aminoglycoside modifying enzymes (AMEs), aac(6), ant(2) and aph(3), in clinical isolates of Acinetobacter species, E. coli, Klebsiella species and Pseudomonas species isolates from various clinical specimens. A total of 319 clinical specimens recovered from urine, blood, wound, catheter tips and sputum were collected and were processed for identification of bacterial isolates in these specimens. The selected bacterial isolates were examined for susceptibility to Potentox, cefepime, amikacin, tobramycin, meropenem, gentamicin, piperacillin plus tazobactam by disc diffusion method. AMEs were detected by polymerase chain reaction (PCR). A total of 255 Gram negative clinical isolates were recovered from clinical specimens that include 9.0 % of Acinetobacter species, 34.9% of Escherichia coli, 29.0% of Pseudomonas species and 27.0% of Klebsiella species. Among the 255 clinical isolates, 75.7% isolates were found to carry AMEs. The AMEs genes found were aac(6) (43.5 to 51.7%), ant(2) (17.4 to 20.2%) and aph(3) (5.6 to 10.1%) of the isolates. The most prevalent AMEs was aac(6). Our data displayed that Potentox was the most active antibacterial agent against AMEs followed by meropenem. Potentox exhibited more than 93% susceptibility to all 3 types of AMEs (aac, ant&aph) whereas meropenem response was almost 20% lesser with susceptibility ranging not more than 73.4%. Piperacillin plus tazobactam was found to be the least active with less than 20% susceptibility. The susceptibility of other antibacterial agents varied between 20% to <40% %. In conclusion 75.7 % isolates carried AMEs that included aac(6), ant(2) and aph(3) which are responsible for resistance. Among the tested drugs, traditionally used aminoglycoside showed the maximum resistance. Surprizingly, broad spectrum antibiotics like meropenem, cefepime and piperacillin tazobactam also exhibited resistance to aminoglycoside modifying enzyme producing strains. However, in this study, Potentox showed excellent in vitro antibacterial activity up to 95 % of all isolates. We suggest that that Potentox which has been introduced recently into clinical settings would allow clinicinas to overcome the aminoglycoside resistance acquired by some bacterial strains. © IDOSI Publications, 2014.


Manu C.,Venus Medicine Research Center | Anurag P.,Venus Medicine Research Center
Journal of Pharmacy Research | Year: 2013

Objective: The aim of the present study was to identify the vanA gene among clinical isolates of vancomycin-resistant Staphylococcus aureus (VRSA). Thereafter, transfer of vanA gene through conjugation from vanA positive VRSA to a vancomycin-sensitive S. aureus was evaluated. Next, we examined the effect of various concentrations of chemicals including ethylenediaminetetraacetic acid (disodium edetate), ethylene glycol tetraacetic acid (EGTA) and boric acid on conjugation. Methods: A total of fourteen clinical isolates of VRSA were analyzed for the presence of vanA gene using previously reported primer by polymerase chain reaction (PCR). The vanA positive isolate of VRSA served as donor and vancomycin-sensitive S. aureus (vanA negative) served as recipient. Conjugation was carried out according to the broth mating method in the absence and presence of various concentrations of chemicals. Results: The vanA gene was detected in eight of the clinical isolates of VRSA. Findings of our study revealed that vanA gene was successfully transferred in-vitro from VRSA donor to vancomycin-sensitive recipient S. aureus by a broth making procedure suggesting possibility of horizontal gene transfer (HGT). Of the evaluated chemicals on conjugation, disodium edetate and EGTA found to be inhibiting the conjugal transfer of vanA gene from donor to recipient. Interestingly, it was observed that disodium edetate at a concentration of 10 mM and above strongly inhibited conjugal transfer of vanA gene from donor to recipient while EGTA inhibited the same at 120 mM. However, boric acid failed to prevent conjugal transfer of vanA gene from donor to recipient. Conclusion: Bacteria transfer antibiotic resistance from one gram-positive species of bacteria to other bacterial species and thus generating multi-drug resistant bacterial strains. From above study, it can be conclude that disodium edetate at 10 mM and above exhibited a potential effect on the inhibition of transfer of vancomycin resistant gene vanA from vancomycin-resistant S. aureus to vancomycin-sensitive S. aureus. Therefore, the inhibition of conjugation process by 10 mM EDTA can be potentially a novel approach to combat spreading of antibiotic resistant gene. © 2013, JPR Solutions.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Pharmacy Research | Year: 2013

Background: Lower respiratory tract infections (LTRIs) and urinary tract infections (UTIs) are the leading causes of death world-wide. Treatment of these infections require the use of antibiotics with enhanced activity against a broad spectrum of respiratory and urinary pathogens. This study was designed to study clinical and bacteriological efficacy aswell as tolerability of ceftiaxone + disodium edtate + sulbactam (the novel Antibiotic Adjuvant Entity; Elores) in adultpatients in the treatment of lower respiratory tract infections (LRTIs) and urinary tract infections (UTIs). Methods: A randomized, open-label, multicenter study was conducted on 297 patients which included 204 in UTIs and 93 in LRTIs. A total of 148 patients were there in Elores group with 102 cases of UTIs and 46 LRTIs; 149 in ceftriaxone group with 102 cases of UTIs and 47 LRTIs. The patients received 3-10 days of treatment with Elores 3.0 g twice daily and ceftriaxone 2.0g twice daily in two divided doses. Results and discussion: Clinical cure rates in ITT (Intend to treat) populations of Elores were 83.33% (85/102), 91.30% (42/46) in the UTIs and LRTIs, respectively, and 34.31% (35/102), 31.91% (15/47) in the ceftriaxone group for UTIs and LRTIs, respectively. The corresponding bacterial eradication rates were 95% (57/60) and 97.05% (33/34) for Elores in the UTIs and LRTIs, respectively and 80.64% (50/62) and 71.42% (10/14) for ceftriaxone in the UTIs and LRTIs, respectively. Adverse reaction were observed in 20.59% (21/102) and 15.22% (7/46) in Elores groupsof UTIs and LRTIs, respectively and 36.27% (37/102) and 31.91% (14/47) in ceftriaxone groups of UTIs and LRTIs, respectively. Conclusions: Results obtained in the present study, together with microbiological evaluation data suggest thatElores is more effective and safe antibacterial agent for the treatment of LRTIs and UTIs infections. © 2013, JPR Solutions; Published by Reed Elsevier India Pvt. Ltd.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Pharmacy Research | Year: 2013

The objective of present study was to conduct a microbial surveillance in India to find the prevalence of carbapenemases producing genes among multidrug resistant Acinetobacter baumannii isolates isolated from various clinical specimens of ICU patients and to evaluate the comparative antimicrobial susceptibility of Elores with other drugs among these strains. Methods: Phenotypic characterization of isolates was carried out by the disc diffusion method. The prevalence of carbapenemase producing gene was studied using polymerase chain reaction (PCR). Antibiotic susceptibility study was performed according to the Clinical Laboratory Standards Institute method (CLSI, 2009) in all carbapenemase producing clinical isolates. Results: Among the four hundred and fifty four (454) isolates, three hundred and seventy one (371) (81.71%) isolates were found to be carbapenemase producing. Further screening of these isolates revealed that approximately 86.5% (321/371) isolates were carbapenemase positive via PCR method. The highest percentage of carbapenemase producers were confirmed via PCR in urine specimen 95.1% (137/144) followed by respiratory secretion 91.6% (11/12), blood 82.6% (95/115), pus 79.7% (55/69), and fluid 74.1% (23/31). In non-fermentor carbapenemase producing A. baumannii, none of the antibiotics yielded percentage susceptibility >40% except Elores which showed 93-96% susceptibility. Colistin appeared to be the second most active antibiotic with 21-32% susceptibility followed by tigecycline (21-25%), doripenem (9-14%) and each of imipenem and meropenem (1-4%). None of the isolates was found to be susceptible to piperacillin plus tazobactam. Interestingly, penems (doripenem, imipenem and meropenem) exhibited 71-91% resistant and 6.8 e14.3% intermediate response to carbapenemase producing A. baumannii isolates. Conclusion: Results of the present study revealed that Elores was the most active amongst commonly used antibiotics in ICU settings, which showed 93-96% susceptibility, therefore can be a potent antibacterial option for the treatment of infections caused by carbapenemase producing A. baumannii. © 2013, JPR Solutions.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
American Journal of Infectious Diseases | Year: 2013

Multidrug resistant Methicillin-Resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community acquired infections and is on the rise. The aim of this investigation was to explore the prevalence of MRSA and heterogeneous Glycopeptide Intermediate Staphylococcus aureus (hGISA) in various clinical samples, to investigate the various antibiotic resistant determinant genes among these strains collected from north and west Indian hospitals and to evaluate the response of various drugs to these strains. A total of 413 clinical specimens collected from different hospitals were processed for the screening of S. aureus and MRSA. All the MRSA strains were further screened for hGISA on Mueller-Hinton agar containing 8 μg mL-1 teicoplanin or 6 μg mL-1 vancomycin. hGISA confirmed by the E-test method with a dense inoculum and a simplified method of population analysis. Susceptibility study was conducted according to the Clinical and Laboratory Standards Institute (CLSI) methods. Among 211/413 S. aureus clinical isolates, 61.6% (130/211) of the isolates were confirmed to be MRSA which included maximum isolates from pus, blood, urine, wound swab and ear swab samples in decreasing order. hGISA strains were found in 8/130 (6.1%) isolates. Vancoplus, a novel antibiotic adjuvant entity was found to be susceptible in 96.1 to 97.8% MRSA strains and showed intermediate response in 2.2 to 3.8% of isolates. Linezolid appeared to be second most active antibiotic with 48.0 to 81.2% susceptibility, followed by teicoplanin (41.3 to 56.2% susceptibility). There was 8.7 to 9.6% resistance observed in Linezolid which was increased to 48% in teicoplanin, to >60% in daptomycin and >75% in vancomycin. Interestingly, none of the isolates were susceptible to ceftriaxone and cefoperazone plus sulbactam. From the above study it can be concluded that prevelance of MRSA has reached a significant level and Vancoplus is the most effective drug in MRSA as well as hGISA organisms in comparison to comparator drugs. © 2013 Science Publication.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Microbial and Biochemical Technology | Year: 2012

The aim of the present work was to study the prevalence of Extended-spectrum β-lactamases (ESBLs) and Metallo-β-lactamases (MβLs) among 464 E. coli clinical isolates obtained from various clinical specimens; and to study the susceptibility of various drugs against E. coli isolates. Phenotypic characterization and susceptibility studies were performed according to the methods described in Clinical and Laboratory Standards Institute guidelines (CLSI, 2010). The prevalence of ESBLs and MβLs was analyzed with Polymerase Chain Reaction (PCR), using the previously reported primers. Among the four hundred sixty four isolates, 186 (40.08%) isolates were ESBLs positive, 75 (16.16%) isolates were MβLs positive, and 80 (17.24%) were both ESBLs and MβLs positive. The remaining 123 (26.50%) were non ESBLs and MβLs. TEM-types ESBLs (blaTEM-1, blaTEM-2, and blaTEM-50) were found in approximately 57% isolates. The prevalence of SHV-types, CTX-M-types and OXA-type was 29.03, 11.82 and 2.15%, respectively. Among the MβLs, the frequency of distribution of NDM-1, IMP-1, VIM-1 and KPC-types was 37.39, 21.33, 18.66, and 22.66%, respectively. In general, 92.6% E. coli isolates were susceptible to ceftriaxone plus EDTA plus sulbactam (CSE1034), followed by meropenem (74.4%), imipenem (71.2%), piperacillin plus tazobactam (52.1%), cefoperazone plus sulbactam (46.0%) and amoxycillin plus clavulanic acid (23.6%). Similarly, amoxycillin plus clavulanic acid showed the highest percentage of resistance (72.8%), followed by cefoperazone plus sulbactam (43.6%), piperacillin plus tazobactam (39.3%), imipenem (23.3%), meropenem (20.3%) and ceftriaxone plus EDTA plus sulbactam (CSE1034) (2.5%). Results of the present study revealed that most of the clinical isolates were susceptible to ceftriaxone plus EDTA plus sulbactam (CSE1034), and can be a potent antibacterial agent for the treatment of severe bacterial infections caused by E. coli.© 2012 Manu C, et al.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Proteomics and Bioinformatics | Year: 2012

The aim of the present investigation was to characterize the prevalence of extended-spectrum β-lactamases (ESBLs) and metallo β-lactamases (MBLs), and to study the antibiotic susceptibility profile among 250 clinical isolates of Acinetobacter baumannii. Phenotypic characterization was carried out by double disc synergy method and the prevalence of ESBLs and MBLs antibiotic resistant determinants were analyzed with Polymerase Chain Reaction (PCR). Susceptibility studies were performed by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines 2009. Among the two hundred fifty isolates, two hundred nine isolates (83.6%) were positive for ESBLs whereas one hundred sixty seven isolates (79.9%) were positive for both ESBLs and MBLs. Moreover, five isolates (2.3%) which were positive for MBL on disc diffusion test, but negative in PCR showed MBL activity by spectrophotometric assay. Susceptibility study showed that all of the isolates were found to be more susceptible to ceftriaxone plus ethylenediaminetetraacetate plus sulbactam (90-93%), followed by meropenem (50-53%), imipenem (42-45%), cefoperazone plus sulbactam (40-42%), piperacillin plus tazobactam (38-42%) and amoxicillin plus clavulanic acid (28-31%). Among the ESBLs, TEM-types were varied from 82 to 87% followed by SHV-types (67-78%), CTX-M types (60 to 67) and OXA types (51 to 56%) in all of the isolates. Among the MBLs, NDM-1 varied from 40 to 49% followed by IMP-1 (51 to 55%), VIM-1 (55 to 59%) and KPC (47 to 55%) in all of the isolates. Moreover, results of the present study revealed that all of the clinical isolates were susceptible to ceftriaxone plus EDTA plus sulbactam and can be a potent antibacterial agent for the treatment of severe bacterial infections caused by A. baumannii. © 2012 Chaudhary M, et al.


Chaudhary M.,Venus Medicine Research Center | Payasi A.,Venus Medicine Research Center
Journal of Proteomics and Bioinformatics | Year: 2013

The rising antibiotic resistance against commonly used drugs is of great concern. Drug susceptibility testing and Polymerase Chain Reaction (PCR) assay were used to determine the antibiotic susceptibility patterns and prevalence of genes encoding extended-spectrum-β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) among 515 isolates of Pseudomonas aeruginosa isolated from various clinical specimens. Susceptibility of isolates to seven antibiotics was tested using disc diffusion method according to the guidelines defined by Clinical Laboratory Standard Institute. Isolates showing resistance to any of the two cephalosporins (ceftriaxone, ceftazidime and cefotaxime) were subjected to PCR for the prevalence of ESBL and MBL gene characterization. Out of the 515 isolates, 235 (45.63%) were considered as ESBL positive; 87 (16.89%) were MBL positive and 74 (14.36%) had co-produced both ESBL and MBL. The frequency of TEM-type, SHV-type and AMP-C type ESBLs were 45.10, 26.0, and 28.93%, respectively. Among the MBLs, the frequency of distribution of NDM-1, IMP-1 and VIM-1 was 24.13, 28.73 and 47.12%, respectively. The rate of susceptibility of ESBL producing P. aeruginosa towards various antibacterial agents were as follows: piperacillin+tazobactam (84.3%), doripenem (83.8%), ceftriaxone plus ethylenediamminetetraacetic acid plus sulbactam; Elores (74.1%), imipenem (66.5%), meropenem (54.7%), ceftazidime (44.8%) and cefepime (28.5%). Isolates harboring MBL and ESBL+MBL genes were resistant to almost all antibiotics except Elores (97.3 and 95.1% susceptibility) and doripenem (11.3 and 19.5% susceptibility). From the above results, it can be concluded that Elores was highly potent against MBL producing P. aeruginosa. However, suceptibility of Elores to ESBL producing P. aeruginosa was comparable to piperacillin plus tazobactam. © 2013 Chaudhary M, et al.


Objective: To study the prevalence of extended-spectrum β-lactamases (ESBLs) among 663 clinical isolates obtained from various parts of India and to study the occurrence of different variants of ESBLs among these isolates. Methods: Phenotypic characterization and susceptibility studies were performed according to the methods described in Clinical and Laboratory Standards Institute guidelines. The occurrence of ESBL variants was analyzed with PCR using the previously reported primers. Results: Among the six hundred sixty three isolates, the identified isolates were Acinetobacter baumannii (72), Escherichia coli (218), Klebsiella pneumoniae (30), Klebsiella oxytoca (63), Pseudomonas aeruginosa (264) and Staphylococcus aureus (16). PCR results revealed that approximately 89.0% of Pseudomonas aeruginosa isolates were positive for ESBL followed by Escherichia coli (85.3%), Klebsiella pneumoniae (76.6%), Klebsiella oxytoca (73.0%), Acinetobacter baumannii (72.2%) and Staphylococcus aureus (31.2%). The overall prevalence of ESBL was 82.5%. The presence of TEM type ESBLs were the predominant (in 186 isolates), followed by SHV (138), OXA (92), CTX-M (65), AmpC (33), KPC (28) and blaZ (5). Of the drugs involved in the study, CSE1034 was found to be the most efficacious against all of ESBL positive clinical isolates showing susceptibility approximately 95.7% with minimal inhibitory concentration values between 0.125 and 8.000 μg/mL for all strains tested. The susceptibilities of penems (meropenem and imipenem and cilastatin) ranged between 83% and 93% for all the isolates. The susceptibilities of other drugs like piperacillin and tazobactam, amoxicillin and clavulanic acid, cefoperazone and sulbactam were <45% for all the isolates. Conclusions: Results of the present study indicated that majority of the isolates was susceptible to CSE1034 and it could be a potent antibacterial agent for the treatment of severe bacterial infections caused by such organisms. © 2014 Hainan Medical College.

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