Neutral gas pressure dependence of ion-ion mutual neutralization rate constants using Landau-Zener theory coupled with trajectory simulations

In this computational study, we describe a self-consistent trajectory simulation approach to capture the effect of neutral gas pressure on ion-ion mutual neutralization (MN) reactions. The electron transfer probability estimated using Landau-Zener (LZ) transition state theory is incorporated into classical trajectory simulations to elicit predictions of MN cross sections in vacuum and rate constants at finite neutral gas pressures. Electronic structure calculations with multireference configuration interaction and large correlation consistent basis sets are used to derive inputs to the LZ theory. The key advance of our trajectory simulation approach is the inclusion of the effect of ion-neutral interactions on MN using a Langevin representation of the effect of background gas on ion transport. For H+ - H- and Li+ - H(D)-, our approach quantitatively agrees with measured speed-dependent cross sections for up to ∼105 m/s. For the ion pair Ne+ - Cl-, our predictions of the MN rate constant at ∼1 Torr are a factor of ∼2 to 3 higher than the experimentally measured value. Similarly, for Xe+ - F- in the pressure range of ∼20 000-80 000 Pa, our predictions of the MN rate constant are ∼20% lower but are in excellent qualitative agreement with experimental data. The paradigm of using trajectory simulations to self-consistently capture the effect of gas pressure on MN reactions advanced here provides avenues for the inclusion of additional nonclassical effects in future work.

Development of near-infrared imaging agents for detection of junction adhesion molecule-A protein

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Anti-junctional adhesion molecule-A (JAM-A) monoclonal antibodies (mAb) conjugated with near infra-red fluorescent dye, IR700 – as a JAM-A mAb/IR700 agent was developed.

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An in vivo JAM-A mAb/IR700-specific near infra-red imaging of human-derived prostate and breast cancer xenograft is presented.

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A single injection of the agent is diminished number of mitotic cells in cancerous tissue of mice bearing heterotopic tumors.

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Since, our agent depicts the specific accumulation within the targeted tumors, this agent may be adapted to solid tumor targeted photoimmunotherapy.

Introduction

Prostate and breast cancer are the most prevalent primary malignant human tumors globally. Prostatectomy and breast conservative surgery remain the most common definitive treatment option for the >500,000 men and women newly diagnosed with localized prostate and breast cancer each year only in the US. Morphological examination is the mainstay of diagnosis but margin under-sampling of the excised cancer tissue may lead to local recurrence. In despite of the progress of non-invasive optical imaging, there is still a clinical need for targeted optical imaging probes that could rapidly and globally visualize cancerous tissues.

Methods

Elevated expression of junctional adhesion molecule-A (JAM-A) on tumor cells and its multiple pro-tumorigenic activity make the JAM-A a candidate for molecular imaging. Near-infrared imaging probe, which employed anti-JAM-A monoclonal antibody (mAb) phthalocyanine dye IR700 conjugates (JAM-A mAb/IR700), was synthesized and used to identify and visualize heterotopic human prostate and breast tumor mouse xenografts in vivo.

Results

The intravenously injected JAM-A mAb/IR700 conjugates enabled the non-invasive detection of prostate and breast cancerous tissue by fluorescence imaging. A single dose of JAM-A mAb/IR700 reduced number of mitotic cancer cells in vivo, indicating theranostic ability of this imaging agent. The JAM-A mAb/IR700 conjugates allowed us to image a specific receptor expression in prostate and breast tumors without post-image processing.

Conclusion

This agent demonstrates promise as a method to image the extent of prostate and breast cancer in vivo and could assist with real-time visualization of extracapsular extension of cancerous tissue.

Delivery of drugs into brain tumors using multicomponent silica nanoparticles

Glioblastomas are highly lethal cancers defined by resistance to conventional therapies and rapid recurrence. While new brain tumor cell-specific drugs are continuously becoming available, efficient drug delivery to brain tumors remains a limiting factor. We developed a multicomponent nanoparticle, consisting of an iron oxide core and a mesoporous silica shell that can effectively deliver drugs across the blood-brain barrier into glioma cells. When exposed to alternating low-power radiofrequency (RF) fields, the nanoparticle's mechanical tumbling releases the entrapped drug molecules from the pores of the silica shell. After directing the nanoparticle to target the near-perivascular regions and altered endothelium of the brain tumor via fibronectin-targeting ligands, rapid drug release from the nanoparticles is triggered by RF facilitating wide distribution of drug delivery across the blood-brain tumor interface.

Experimental data of the study on H-rotor with semi-elliptic shaped bladed vertical axis wind turbine

The performance and load test data of the proposed H-rotor with semi-elliptical shaped blade vertical axis wind turbine is carried out at the laboratory using 1 m diameter axial fan. India has a long coastline and low-wind velocity ranging from 3 to 10 m/s which is available everywhere in the country irrespective of climatic conditions. The data article is carried out at different aspect ratios along with tilt of the blades and without tilting of the blades. These data sets provide the researchers to further study experimentally as well as numerically in order to enhance the performance of the proposed VAWT. The data presented here are measured at wind velocity ranging from 3 to 6 m/s. The raw data captured using data acquisition system are processed and presented in a form so as to compare it with other typical VAWT.

Experimental demonstration that a free-falling aerosol particle obeys a fluctuation theorem

We investigate the fluctuating motion of an aerosol particle falling in air. Using a Millikan-like setup, we tracked a 1-μm sphere falling at its terminal velocity. We observe occurrences of particles undergoing upward displacements against the force of gravity, so that negative work is done briefly. These negative-work events have a probability that is shown to obey the work fluctuation theorem. This experimental confirmation of the theorem's applicability to aerosols leads us to develop and demonstrate an application: an in situ measurement of an aerosol particle's mass.

One-pot synthesis of nanochain particles for targeting brain tumors

To synthesize multi-component nanochains, we developed a simple 'one-pot' synthesis, which exhibited high yield and consistency. The nanochains particles consist of parent nanospheres chemically linked into a higher-order, chain-like assembly. The one-pot synthesis is based on the addition of two types of parent nanospheres in terms of their surface chemical functionality (e.g., decorated with PEG-NH₂ or PEG-COOH). By reacting the two types of parent nanospheres at a specific ratio (∼2 : 1) for a short period of time (∼30 min) under rigorous stirring, nanochains were formed. For example, we show the synthesis of iron oxide nanochains with lengths of about 125 nm consisting of 3-5 constituting nanospheres. The chain-like shaped nanoparticle possessed a unique ability to target and rapidly deposit on the endothelium of glioma sites via vascular targeting. To target and image invasive brain tumors, we used iron oxide nanochains with the targeting ligand being the fibronectin-targeting peptide CREKA. Overexpression of fibronectin is strongly associated with the perivascular regions of glioblastoma multiforme and plays a critical role in migrating and invasive glioma cells. In mice with invasive glioma tumors, 3.7% of the injected CREKA-targeted nanochains was found in gliomas within 1 h. Notably, the intratumoral deposition of the nanochain was ∼2.6-fold higher than its spherical variant. Using MR imaging, the precise targeting of nanochains to gliomas provided images with the exact topology of the disease including their margin of infiltrating edges and distant invasive sites.

Self-assembled supramolecular structure of 4-dimethylaminopyridinium p-hydroxy benzoate pentahydrate: synthesis, growth, optical and biological properties

A single crystal of 4-dimethylaminopyridinium p-hydroxybenzoate pentahydrate (DMAPHB) was obtained via a slow evaporation solution growth technique.

Self-assembled supramolecular structure of 1-methyl piperazinium 4-nitrophenolate 4-nitrophenol monohydrate single crystal: Synthesis, growth, thermal and photo physical properties

A new photoactive organic crystal, 1-methyl piperazinium 4-nitrophenolate-4-nitrophenol monohydrate (MP4NPM) has been synthesised at 35 °C. Good quality single crystals of MP4NPM have successfully been grown by slow evaporation solution growth technique. Single crystal X-ray diffraction analysis shows that MP4NPM belongs to monoclinic crystal system with space group P2₁/n. The molecular structure was further confirmed by modern spectroscopic techniques like FT-NMR (both 1D and 2D), FT-IR, UV-Vis-NIR and fluorescence. The UV-Vis-NIR spectrum was performed to understand the range of optical transparency and the results showed its suitability for nonlinear optical applications. Fluorescence emission revealed that MP4NPM can serve as a photo active material. Thermal properties of MP4NPM were investigated using simultaneous TG-DSC analysis. Frequency and temperature dependent dielectric properties were studied in the frequency range 500 Hz-5 MHz and 40-50 °C, respectively. Vicker's microhardness measurements revealed that MP4NPM belongs to the category of soft material. Kurtz and Perry powder technique shows that MP4NPM has SHG efficiency 0.89 times that of potassium dihydrogen phosphate (KDP).

A magnetoencephalography study of multi-modal processing of pain anticipation in primary sensory cortices

Pain anticipation plays a critical role in pain chronification and results in disability due to pain avoidance. It is important to understand how different sensory modalities (auditory, visual or tactile) may influence pain anticipation as different strategies could be applied to mitigate anticipatory phenomena and chronification. In this study, using a countdown paradigm, we evaluated with magnetoencephalography the neural networks associated with pain anticipation elicited by different sensory modalities in normal volunteers. When encountered with well-established cues that signaled pain, visual and somatosensory cortices engaged the pain neuromatrix areas early during the countdown process, whereas the auditory cortex displayed delayed processing. In addition, during pain anticipation, the visual cortex displayed independent processing capabilities after learning the contextual meaning of cues from associative and limbic areas. Interestingly, cross-modal activation was also evident and strong when visual and tactile cues signaled upcoming pain. Dorsolateral prefrontal cortex and mid-cingulate cortex showed significant activity during pain anticipation regardless of modality. Our results show pain anticipation is processed with great time efficiency by a highly specialized and hierarchical network. The highest degree of higher-order processing is modulated by context (pain) rather than content (modality) and rests within the associative limbic regions, corroborating their intrinsic role in chronification.

Immunomodulatory drugs target IKZF1-IRF4-MYC axis in primary effusion lymphoma in a cereblon-dependent manner and display synergistic cytotoxicity with BRD4 inhibitors

Primary effusion lymphoma (PEL) is an aggressive type of non-Hodgkin lymphoma localized predominantly in body cavities. Kaposi’s sarcoma-associated herpes virus is the causative agent of PEL. PEL is an incurable malignancy and has extremely poor prognosis when treated with conventional chemotherapy. Immunomodulatory drugs (IMiDs) lenalidomide and pomalidomide are FDA approved drugs for the treatment of various ailments. IMiDs display pronounced anti-proliferative effect against majority of PEL cell lines within their clinically achievable concentrations, by arresting cells at G₀/G₁ phase of cell-cycle, and without any induction of KSHV lytic-cycle reactivation. Although microarray examination of PEL cells treated with lenalidomide revealed activation of interferon (IFN) signaling, blocking the IFN pathway did not block the anti-PEL activity of IMiDs. The anti-PEL effects of IMiDs involved cereblon-dependent suppression of IRF4 and rapid degradation of IKZF1, but not IKZF3. Small hairpin-RNA (shRNA) mediated knockdown of MYC enhanced the cytotoxicity of IMiDs. Bromodomain and extraterminal domain (BET) proteins are epigenetic readers which perform a vital role in chromatin remodeling and transcriptional regulation. BRD4, a widely expressed transcriptional coactivator, belongs to BET family of proteins, which has been shown to co-occupy the super-enhancers associated with MYC. Specific BRD4 inhibitors were developed which suppress MYC transcriptionally. Lenalidomide displayed synergistic cytotoxicity with several structurally distinct BRD4 inhibitors (JQ-1, IBET151, and PFI-1). Furthermore, combined administration of lenalidomide and BRD4 inhibitor JQ-1 significantly increased the survival of PEL bearing NOD.SCID mice in an orthotopic xenograft model as compared to either agent alone. These results provide compelling evidence for clinical testing of IMiDs alone and in combination with BRD4 inhibitors for PEL.

Interaction of collagen like peptides with gold nanosurfaces: a molecular dynamics investigation

In this study, an attempt has been made to understand the interaction between collagen like peptides (CPs) with a gold nanosurface (AuNS) using a classical molecular dynamics simulation.

Substitution effect on chalcone based materials for corrosion and photocrosslinking applications

Hydroxy (–OH) and benzyloxy (–OCH₂Ph) substituted chalcone based crystalline materials were synthesized and characterized; these materials exhibited high corrosion inhibitor efficiency and enhanced photo-crosslinking applications.

Effect of precursor concentration on the properties and tuning of conductivity between p-type and n-type Cu1−XCdXS2 thin films deposited by a single step solution process as a novel material for photovoltaic applications

Cu_1−XCd_XS₂ thin films were deposited from precursor solutions having different concentrations of cation sources, by a single step solution process at room temperature.

A bluish-green emitting organic compound methyl 3-[(E)-(2-hydroxy-1-naphthyl)methylidene]carbazate: spectroscopic, thermal, fluorescence, antimicrobial and molecular docking studies

The present paper describes the physicochemical properties and biological activities of a Schiff base compound which was grown by the slow evaporation solution growth technique.

Green synthesis of Au–Ag bimetallic nanocomposites using Silybum marianum seed extract and their application as a catalyst

An eco-friendly and non-toxic method for the synthesis of Au–Ag bimetallic nanocomposites has been carried out successfully. Silybum marianum seed extract plays an important role in the reduction and stabilization of the Au–Ag bimetallic nanocomposites.

Sexual dysfunction among men in secondary care in southern India: Nature, prevalence, clinical features and explanatory models

BACKGROUND

Sexual dysfunction, common in general medical practice, is under-recognized and inadequately managed resulting in significant morbidity and reduction in quality of life. We examined the nature, prevalence, clinical features and explanatory models of illness among men with sexual dysfunction in a general healthcare setting.

METHODS

We recruited 270 consecutive men attending a general health clinic. Participants were evaluated using a structured interview. The International Index of Erectile Function-5, the Chinese Index of Premature Ejaculation-5, Short Explanatory Model Interview and the Revised Clinical Interview Schedule were used to assess sexual dysfunction, explanatory models and psychiatric morbidity.

RESULTS

Premature ejaculation and erectile dysfunction were reported by 43.0% and 47.8% of men, respectively. The most common perceived causes were loss of semen due to masturbation and nocturnal emission. Popular treatments were herbal remedies and resources used were traditional healers. The factors associated with erectile dysfunction were diabetes mellitus, financial stress, past history of psychiatric treatment and common mental disorders such as depression and anxiety; those associated with premature ejaculation were common mental disorders, older age and financial debt. Sexual dysfunctions and concerns were under-diagnosed by physicians when compared to the research interview.

CONCLUSION

There is a need to recognize sexual problems and effectively manage them in general medical settings. The need for sex education in schools and through the mass media, to remove sexual misconceptions, cannot be under-emphasized.

Factor VIIa binding to endothelial cell protein C receptor protects vascular barrier integrity in vivo

BACKGROUND

Recent studies have shown that factor VIIa binds to endothelial cell protein C receptor(EPCR), a cellular receptor for protein C and activated protein C. At present, the physiologic significance of FVIIa interaction with EPCR in vivo remains unclear.

OBJECTIVE

To investigate whether exogenously administered FVIIa, by binding to EPCR, induces a barrier protective effect in vivo.

METHODS

Lipopolysaccharide(LPS)-induced vascular leakage in the lung and kidney,and vascular endothelial growth factor (VEGF)-induced vascular leakage in the skin, were used to evaluate the FVIIa-induced barrier protective effect. Wild-type, EPCR-deficient, EPCR-overexpressing and hemophilia A mice were used in the studies.

RESULTS

Administration ofFVIIa reduced LPS-induced vascular leakage in the lung and kidney; the FVIIa-induced barrier protective effect was attenuated in EPCR-deficient mice. The extent of VEGF-induced vascular leakage in the skin was highly dependent on EPCR expression levels. Therapeutic concentrations of FVIIa attenuated VEGF-induced vascular leakage in control mice but not in EPCR-deficient mice.Blockade of FVIIa binding to EPCR with a blocking mAb completely attenuated the FVIIa-induced barrier protective effect. Similarly, administration of protease activated receptor 1 antagonist blocked the FVIIa induced barrier protective effect. Hemophilic mice showed increased vascular permeability, and administration of therapeutic concentrations of FVIIa improved barrier integrity in these mice.

CONCLUSIONS

This is the first study to demonstrate that FVIIa binding to EPCR leads to a barrier protective effect in vivo. This finding may have clinical relevance, as it indicates additional advantages of using FVIIa in treating hemophilic patients.

Studies on Lead Sulfide (PbS) Semiconducting Thin Films Deposited from Nanoparticles and Its NLO Application

Nanoparticle Lead sulfide was synthesized via simple chemical method and deposited on glass substrates at different substrate temperatures by thermal evaporation technique. The synthesized nanoparticle PbS was analyzed and confirmed by X-ray diffraction (XRD), Scanning electron microscopy SEM with EDX and thermogravimetry. The structural, optical, morphological and electrical properties of the deposited films were studied using XRD, UV-Vis, Raman, SEM with EDX, atomicforce microscopy AFM and Hall Effect measurements. The thickness of the deposited samples was measured using thickness profilometer. The Raman shift in the peak occurs toward lower energy with increasing substrate temperature deposited lead sulfide. The Z-scan study with open aperture was carried out at 532 nm using 5 ns laser pulse on the deposited films which shows that nonlinear absorption arises from saturable absorption process. The deposited PbS film exhibits p-type conductivity in Hall measurement.

Self-assembled supramolecular structure of N,N,N′,N′-tetramethylethylenediammonium-bis-(4-nitrophenolate): synthesis, single crystal growth and photo physical properties

The synthesis, growth and structure of a novel organic third order nonlinear optical (NLO) crystal namely, N,N,N′,N′-tetramethylethylenediammonium-bis(4-nitrophenolate) (TMEDA4NP) is presented.

Salivary proteomics in bisphosphonate-related osteonecrosis of the jaw

OBJECTIVE

The objective of this study was to identify differentially expressed salivary proteins in bisphosphonate-related osteonecrosis of the jaw (BRONJ) patients that could serve as biomarkers for BRONJ diagnosis.

SUBJECTS AND METHODS

Whole saliva obtained from 20 BRONJ patients and 20 controls were pooled within groups. The samples were analyzed using iTRAQ-labeled two-dimensional liquid chromatography-tandem mass spectrometry.

RESULTS

Overall, 1340 proteins were identified. Of these, biomarker candidates were selected based on P-value (<0.001), changes in protein expression (≥1.5-fold increase or decrease), and unique peptides identified (≥2). Three comparisons made between BRONJ and control patients identified 200 proteins to be differentially expressed in BRONJ patients. A majority of these proteins were predicted to have a role in drug metabolism and immunological and dermatological diseases. Of all the differentially expressed proteins, we selected metalloproteinase-9 and desmoplakin for further validation. Immunoassays confirmed increased expression of metalloproteinase-9 in individual saliva (P = 0.048) and serum samples (P = 0.05) of BRONJ patients. Desmoplakin was undetectable in saliva. However, desmoplakin levels tended to be lower in BRONJ serum than controls (P = 0.157).

CONCLUSIONS

Multiple pathological reactions are involved in BRONJ development. One or more proteins identified by this study may prove to be useful biomarkers for BRONJ diagnosis. The role of metalloproteinase-9 and desmoplakin in BRONJ requires further investigation.

Melioidosis :an emerging infection in India

BACKGROUND

Melioidosis caused by the gram-negative bacterium Burkholderia pseudomallei is endemic in Southeast Asia but may be under-diagnosed and under-reported in the Indian subcontinent. This study was undertaken to analyse the clinical presentation and epidemiological risk factors for melioidosis in India.

METHODS

We carried out a retrospective study of 32 culture proven cases of melioidosis at a tertiary care hospital in South India between 2005 and 2010.

RESULTS

Thirty two culture confirmed cases of melioidosis were included in the study. Patient age varied from 4 to 60 years with a median age of 42.5 years. Males constituted 75% of cases and 78.12% of cases were from rural areas. Three-fourth (24 of 32) had at least one risk factor that predisposed to melioidosis: diabetes (43.75%) followed by alcoholism (21.87%) were the commonest. Fever was the most common symptom (68.75%) and mean duration of symptoms was 2.34 months before diagnosis. More than half of the cases (56.25%) presented as disseminated disease with the remainder having localised disease, usually septic arthritis or abscesses. Three fourth of patients (75%) were treated successfully on follow-up, with a regimen of parenteral ceftazidime followed by oral doxycycline and cotrimoxazole.

CONCLUSION

Melioidosis is an emerging infection in India especially in males from rural areas, with diabetes and alcoholism being the commonest risk factors. Both sepsis with bacteraemia and localised disease involving joints or focal abscess were common presentations. Diagnosis is readily made by culturing the organism from appropriate clinical specimens and identifying non-fermenting Gram negative bacteria to the species level. As there was an excellent response in 75% of patients, early suspicion, culture confirmation and therapy is warranted in India.

Mucormycosis in patients without cancer: a case series from A tertiary care hospital in South India

BACKGROUND

Mucormycosis (Zygomycosis) is a life-threatening infection. We attempted to analyse clinical features and risk factors of Mucormycosis cases in a tertiary care referral institution in India, in patients without underlying malignancy.

METHODS

We retrospectively analyzed data of patients diagnosed as having Mucormycosis over a 10 year period of 2000-2010. Patients with a histopathology report and/or a Microbiology report of Zygomycetes or Mucor from a biopsy specimen were included in the study.

RESULTS

Out of the 27 cases, rhino-orbital/rhino-cerebral involvement occurred in 12 (44.4%) patients, pulmonary involvement in 3 (11.1%) cases, soft tissue involvement in 11 (40.7%) cases and gastrointestinal involvement in one patient (3.7%). Diabetes mellitus is the main risk factor, followed by renal failure and trauma. Mean ESR value of these patients was 118 mm/1 hour. Mean WBC count was 20 x 10(9)/L, and neutrophil count 82%. The mean absolute neutrophil count (ANC) was 16.8 x 10(9)/L.

CONCLUSION

The interesting finding in our study was the presence of neutrophilic leucocytosis and high ESR in most of the patients. In a predisposed individual, especially in a diabetic, in countries with high environmental fungal burden; presence of high ESR and neutrophilic leucocytosis with a compatible clinical presentation should raise suspicion of Mucormycosis.

Growth and characterization of Methyl 2-amino-5-bromobenzoate crystal for NLO applications

Good quality single crystal of organic Methyl 2-amino-5-bromobenzoate (M2A5B) was grown using slow evaporation solution growth technique. The grown crystal was confirmed by single crystal X-ray diffraction. The functional groups and vibrational frequencies were identified using FT-IR and FT-Raman spectral analyses. The presence of hydrogen and carbon atoms in the grown sample was confirmed with proton and carbon NMR spectral studies. The optical energy band gap of the title compound is found to be 2.7 eV from the optical transmission spectra. The refractive indices n(x), n(y), and n(z) were found to be 1.569, 1.587 and 1.600, respectively using Brewster's angle method. The melting point of the material obtained with melting point apparatus is 74°C. Thermal stability of the grown crystal was studied by thermogravimetric analysis (TGA) and differential thermal analysis (DTA). The mechanical behaviour of the grown crystal was analyzed with Vicker's microhardness tester. The particle size dependent second harmonic generation efficiency for M2A5B was evaluated by Kurtz-Perry powder method using Nd:YAG laser, which established the existence of phase matching.

Estradiol regulates insulin dependent stimulation of LDL-receptor expression in HepG(2) cells

The low density lipoprotein, one of the major vehicle for extraneous cholesterol, internalizes into the cells through the process of LDL-receptor mediated endocytosis. The expression of LDL-receptor on the cell surface is a function of various hormone regulated transcription of the receptor gene. The present study elucidates the differential expression pattern of LDL-receptor protein in human hepatoma HepG(2) cells by the influence of two hormones, insulin and estrogen (β-estradiol), as compared to the basal level expression of the receptor protein. The combined effect of insulin and β-estradiol reveals that β-estradiol is the ultimate regulator between these two hormones and supershades the message of insulin on LDL-receptor expression. The receptor protein level immunobloted by anti LDL-receptor antibody after treating cells with insulin, β-estradiol and mixture of both also reflects the same phenomena. This comparative study makes it consistent that cell saturation with sterol (β-estradiol) is the prime regulator of LDL-receptor expression between the two hormones, insulin and estrogen.

"Save Antibiotics, Save lives": an Indian success story of infection control through persuasive diplomacy

Background

Carbapenem resistant Enterobacteriaceae is a worldwide threat, with increasing prevalence in many countries. Restricted usage of higher end antibiotics, especially carbapenem is of great importance in tackling these super bugs. Purpose of this retrospective study was to analyse the impact of antibiotic stewardship activities on the prevalence of carbapenem resistant Enterobacteriaceae in our hospital.

Findings

In the first Quarter of 2009, average usage of carbapenem group of antibiotics was 955 vials a month while in 2010, the usage dropped to 745 vials per month. Carbapenem resistant E.coli rate dropped from 3.7% in 2009 to 1.6% in 2010 and Klebsiella rate reduced from 6% in 2009 to 3.6% in 2010.

Conclusions

Strict antibiotic stewardship strategies in conjunction with good infection control practices are useful in restricting higher end antibiotic usage and reducing the prevalence of carbapenem resistant Enterobacteriaceae.