Activity of Meropenem Combined with RPX7009, a Novel β-Lactamase Inhibitor,against Gram-Negative Clinical Isolates in New York City

Multidrug-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are endemic to hospitals in New York City and other regions. RPX7009 is a novel β-lactamase inhibitor with activity against serine carbapenemases. We tested the activity of meropenem plus RPX7009 against 4,500 recent Gram-negative clinical isolates from 11 New York City hospitals. The meropenem-RPX7009 combination was found to have excellent in vitro activity against Escherichia coli, K. pneumoniae, and Enterobacter spp., including multidrug-resistant (MDR) KPC-producing strains. Overall, 131/133 (98.5%) KPC-producing Enterobacteriaceae strains were inhibited by meropenem (≤1 μg/ml) plus RPX7009 (8 μg/ml). In a limited number of strains, the combination appeared to have reduced activity against KPC-producing K. pneumoniae isolates with diminished ompK35 and ompK36 expression. The addition of RPX7009 did not affect the activity of meropenem against Acinetobacter baumannii and Pseudomonas aeruginosa. The meropenem-RPX7009 combination shows promise as a novel agent against KPC-producing Enterobacteriaceae and deserves further study. Other approaches will be needed to address multidrug-resistant A. baumannii and P. aeruginosa, which typically possess different mechanisms of carbapenem resistance.     

Local knowledge,use pattern and geographical distribution of Moringa oleifera Lam. (Moringaceae) in Nigeria

Ethno-pharmacological relevance

All parts of Moringa oleifera are medicinally valuable with overlapping uses in treating myriads of ailments and diseases including body pains and weakness, fever, asthma, cough, blood pressure, arthritis, diabetes, epilepsy, wound, and skin infection. Moringa also has robust ability to challenge terminal diseases such as HIV/AIDs infections, chronic anemia, cancer, malaria and hemorrhage. The present study was to obtain ethnobotanical information on the use and local knowledge variation, geographical distribution, and to collect different landraces of Moringa oleifera from the different agro-ecological regions in Nigeria, for further studies.

Materials and methods

Ethnobotanical data were collected through face to face interviews, semi structured questionnaires and discussions with selected people who had knowledge about the plant. The fidelity level (FL %) and use value for different use categories of Moringa oleifera and its parts were estimated. The variation in ethnobotanical knowledge was evaluated by comparing the mean use value among ethnic, gender and age groups using sample T test. Garmi GPS was used to determine the locations (latitude and longitude) and height in different areas to assess the geographical spread of the species.

Results

Seven (7) categories of use (Food, medicine, fodder, fencing, firewood, gum and coagulant) were recorded for Moringa oleifera. Food and medicinal uses showed highest fidelity level while the leaves and the seeds were the plant parts most utilized for the same purposes. There were significant differences among the ethnic, gender and age groups regarding the ethno-botanical use value. The geographical distribution pattern shows that the Moringa oleifera is well distributed in all ecological zones of Nigeria, well adapted to the varied climatic conditions and gaining unprecedented awareness among the people.

Conclusion

Though considered an introduced species, Moringa oleifera has found wide acceptance, recognition and usefulness among the various ethnicities in the studied areas. The sources of introduction, domestication and ethnic differentiation influenced the distribution pattern across the geographical areas.     

Ethnobotanical survey for potential anti-malarial plants in south-western Nigeria

Aim of study

The ethnobotanical study surveyed the different types of medicinal plants used for the treatment of malaria in the south-western region of Nigeria.

Materials and methods

Information was collected by interviewing indigenous people, using a semi-structured questionnaire. Collected plant samples were identified and authenticated in Forestry Research Institute of Nigeria, Ibadan, Nigeria.

Results

A total of 151 respondents were interviewed of which 64% were females and 36% males. This population comprised of herbal medicine sellers (39%), traditional doctors (15%), housewives (24%) and farmers (22%). Twenty two plants species used in the treatment of malaria belonging to 18 families were identified and compiled detailing information such as common and vernacular names, parts used, methods of preparation and previous scientific reports. Of the plants identified during the survey, Azadirachta indica (12.9%), Alstonia congensis (11.9%) and Cymbopogon citratus (11.3%) showed the highest incidence of encounter whereas Nauclea latifolia recorded the lowest incidence of encounter (0.2%). The traditional usage of Persea americana and Ludwigia peruviana in the treatment of malaria is reported here for the first time.

Conclusion

Though a large number of traditionally used plants for the treatment of malaria were identified, scientific validation of the traditional claims of anti-malarial properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-malarial drugs, as well as in the conservation of this rich diversity of anti-malarial plants.     

Activity of Eravacycline against Enterobacteriaceae and Acinetobacter baumannii,Including Multidrug-Resistant Isolates,from New York City

Eravacycline demonstrated in vitro activity against a contemporary collection of more than 4,000 Gram-negative pathogens from New York City hospitals, with MIC₅₀/MIC₉₀ values, respectively, for Escherichia coli of 0.12/0.5 μg/ml, Klebsiella pneumoniae of 0.25/1 μg/ml, Enterobacter aerogenes of 0.25/1 μg/ml, Enterobacter cloacae 0.5/1 μg/ml, and Acinetobacter baumannii of 0.5/1 μg/ml. Activity was retained against multidrug-resistant isolates, including those expressing KPC and OXA carbapenemases. For A. baumannii, eravacycline MICs correlated with increased expression of the adeB gene.     

Activity of Imipenem with Relebactam against Gram-Negative Pathogens from New York City

Imipenem with relebactam was active against Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp., including K. pneumoniae carbapenemase (KPC)-producing isolates. Loss of OmpK36 in KPC-producing K. pneumoniae isolates affected the susceptibility of this combination. Enhanced activity was evident against Pseudomonas aeruginosa, including isolates with depressed oprD and increased ampC expression. However, the addition of relebactam to imipenem did not provide added benefit against Acinetobacter baumannii. The combination of imipenem with relebactam demonstrated activity against KPC-producing Enterobacteriaceae and multidrug-resistant P. aeruginosa.     

The eosinophil as a therapeutic target in asthma: beginning of the end,or end of the beginning?

A major goal in asthma therapy is to reduce or prevent the inflammatory response associated with bronchial hyperresponsiveness, reversible airway obstruction and airway remodelling. However, because of the complex nature of the disease, a single target for such an ideal therapeutic approach remains elusive. To ensure a more rational design of anti-asthma drugs, recent investigations have attempted to elucidate the roles of inflammatory cellular components in asthma. Such studies have shown that eosinophilic infiltration is a prominent feature in the pathophysiology of asthma. Nonetheless, the role of the eosinophil in asthma has been questioned following recent human studies investigating the efficacy of a novel therapeutic strategy targeted at eosinophils.