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5 protocols using pefloxacin

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Antimicrobial Susceptibility Testing of Bacterial Isolates

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Antimicrobial susceptibility testing of the isolated strains was performed using the disk diffusion method (modified Kirby–Bauer method) on Mueller–Hinton agar (HiMedia, India) as recommended by the CLSI, Wayne, United States.
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Susceptibility of the fluoroquinolones including nalidixic acid (30 µg), pefloxacin (5 µg), ciprofloxacin (5 µg), azithromycin (15 µg), chloramphenicol (30 µg), cotrimoxazole(1.25 µg/23.75 µg), cefixime (5 µg), and ceftriaxone (30 µg) (HiMedia Laboratories, India) was done. The results of the antibiotic susceptibility were determined on the basis of interpretative zone diameters as suggested by CLSI. For standardization,
Escherichia coliATCC-25922 was used as the control organism for antibiotic sensitivity.
Further, MICs of all isolates was checked using broth microdilution method as per CLSI guidelines.
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ciprofloxacin concentrations ranged from 0.06 to 16 µg/mL. pefloxacin HiComb (HiMedia),was used for determining the MIC of pefloxacin, which is available as Part A and Part B with concentration of 240 to 0.01 µg/mL and 30 to 0.001 µg/mL, respectively. Antimicrobial susceptibility testing was performed according to the manufacturer’s instructions and interpreted using CLSI guidelines.
E. coliATCC 25922 and
Pseudomonas aeruginosaATCC 27853 served as quality control strains.
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2

Antibiotic Susceptibility of Bacterial Isolates

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The susceptibility to the commercial antibiotics of the bacterial isolates was evaluated using the disc diffusion method. Antibiotics used against Gram-positive bacteria included cefoxitin, benzyl-penicillin, oxacillin, imipenem, gentamicin, ciprofloxacin, moxifloxacin, inducible clindamycin resistance, erythromycin, clindamycin, vancomycin, tetracycline, fusidic acid, and trimethoprim/sulfamethoxazole. On the other hand, antibiotics used against Gram-negative bacteria included temocillin, ampicillin, amoxicillin/clavulanic acid, ticarcillin, ticarcillin/clavulanic acid, piperacillin, piperacillin/tazobactam, cephalothin, cefuroxime, cefotaxime, ceftazidime, ceftriaxone, cefepime, ertapenem, imipenem, meropenem, amikacin, gentamicin, tobramycin, ciprofloxacin, tigecycline, fosfomycin, nitrofurantoin, pefloxacin, minocycline, colistin, and trimethoprim/sulfamethoxazole (Himedia Labs, Mumbai, India) [19 ].
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Antimicrobial Susceptibility Testing Protocol

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Antimicrobial susceptibility testing was performed according to the protocols of the CLSI [44 ]. The results were evaluated according to the EUCAST cut-off values [45 ] using antibiotics applicable to the treatment of patients, namely meropenem (10 µg, MEM10C) from Mast Group Ltd., UK, penicillin-G (10 U, SD028-1PK), ampicillin (10 µg, SD002-1PK), amoxycillin (25 µg, SD129-1PK), amoxycillin/clavulanic acid (20/10 µg, AUG30C), carbenicillin (100 µg, SD004-1PK), cefamandole (30 µg, SD200-1PK), erythromycin (15 µg, SD013-1PK), clarithromycin (15 µg, SD192-1PK), streptomycin (10 µg, SD031-1PK), tetracycline (30 µg, SD037-1PK), doxycycline hydrochloride (30 µg, SD012-1PK), chloramphenicol (30 µg, SD006-1PK), nalidixic acid (30 µg, SD021-1PK), ciprofloxacin (5 µg, SD060-1PK), pefloxacin (5 µg, SD070-1PK), and co-trimoxazole (25 µg, SD010-1PK) from HiMedia, India.
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Antimicrobial Susceptibility Testing of E. coli

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Antimicrobial susceptibility testing was performed via a standard disk diffusion method, also known as the Kirby–Bauer method, according to the protocols of the CLSI [36 ]. We again used antibiotics applicable to the treatment of patients, namely meropenem (10 µg, MEM10C Oxoid ltd, Basingstoke, Hampshire, UK), ampicillin (10 µg, SD002-1PK), amoxycillin (25 µg, SD129-1PK), amoxycillin/clavulanic acid (20/10 µg, AUG30C), carbenicillin (100 µg, SD004-1PK), cefamandole (30 µg, SD200-1PK), erythromycin (15 µg, SD013-1PK), streptomycin (10 µg, SD031-1PK), tetracycline (30 µg, SD037-1PK), doxycycline hydrochloride (30 µg, SD012-1PK), chloramphenicol (30 µg, SD006-1PK), nalidixic acid (30 µg, SD021-1PK), ciprofloxacin (5 µg, SD060-1PK), pefloxacin (5 µg, SD070-1PK) and co-trimoxazole (25 µg, SD010-1PK) from HiMedia, India. The results were evaluated according to the cut-off breakpoint values of EUCAST version 12.0, 2022 [37 ], CLSI, 31st edition [36 ] and the Manual of BBL Products and Laboratory Procedures [38 ]. Breakpoint values of erythromycin for other bacterial species were taken for E. coli.
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5

Antibiotic Susceptibility of E. coli Isolates

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Antibiotic susceptibility of E. coli strains was tested using Mueller-Hinton agar (HiMedia Laboratories Pvt. Ltd., India) which is a standard medium for disk diffusion method (Bauer-Kirby test) as per the guidelines of Global Laboratory Standards for a Healthier World (CLSI) of USA. Disks were tested with a wide range of antimicrobial drugs (HiMedia Laboratories Pvt. Ltd., India): Amoxicillin 10 (µg/disk) (AMO), Ampicillin 10 (µg/disk) (AMP), Meropenem 10 (µg/disk) (MER), Pefloxacin 5 (µg/disk) (PEF), Streptomycin 300 (µg/disk) (STR), Ticarcillin+clavulanic acid 75 (µg/disk) (TIC), Fosfomycin 200 (µg/disk) (FOS), Ceftibuten 30 (µg/disk) (CEF), Ciprofloxacin 10 (µg/disk) (CIP). As a control, the reference strain of E. coli ATCC 2592 was used, which is recommended by the CLSI (https://clsi.org). A total of 205 strains of E. coli were tested: 118 strains were isolated from dust samples (60 strains were isolated from the intensive traffic area and 58 from the recreational area) and 87 strains were isolated from soil samples (44 strains were isolated from the intensive traffic area and 43 - from the recreational area). Each of the 205 strains was tested in three plate replicates for each of the 9 antimicrobial drugs.
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