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 ].
Cefuroxime
Manufactured by HiMedia
Sourced in India
Cefuroxime is a broad-spectrum cephalosporin antibiotic used in the treatment of various bacterial infections. It functions by inhibiting the synthesis of the bacterial cell wall, effectively killing or preventing the growth of susceptible microorganisms.
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Lab products found in correlation
Ampicillin, by HiMedia (11 mentions)
Gentamicin, by HiMedia (10 mentions)
Ciprofloxacin, by HiMedia (9 mentions)
Amikacin, by HiMedia (9 mentions)
Cefotaxime, by HiMedia (8 mentions)
Imipenem, by HiMedia (7 mentions)
Meropenem, by HiMedia (6 mentions)
Levofloxacin, by HiMedia (6 mentions)
Ceftazidime, by HiMedia (5 mentions)
Piperacillin tazobactam, by HiMedia (5 mentions)
Ofloxacin, by HiMedia (5 mentions)
Cotrimoxazole, by HiMedia (5 mentions)
Piperacillin, by HiMedia (4 mentions)
Cefepime, by HiMedia (4 mentions)
Tobramycin, by HiMedia (4 mentions)
Chloramphenicol, by HiMedia (4 mentions)
Tetracycline, by HiMedia (4 mentions)
Ticarcillin, by HiMedia (3 mentions)
Ertapenem, by HiMedia (3 mentions)
Ticarcillin clavulanic acid, by HiMedia (3 mentions)
12 protocols using cefuroxime
1
Antibiotic Susceptibility of Bacterial Isolates
2
Antibiotic Susceptibility Screening of Isolates
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Antibiotic drug susceptibility was determined by spreading overnight grown culture of the isolates on MRS agar plates as a lawn. Standard antibiotic discs (tetracycline, erythromycin, ampicillin, gentamycin, penicillin, chloramphenicol, cefuroxime, cefoperazone, levofloxacin, norfloxacin, Hi-Media, Mumbai) were placed on the surface of the MRS agar medium aseptically. Plates were incubated for 24 h at 37 °C and observed for zones of inhibition.
3
Antimicrobial Susceptibility Testing on Pseudomonas and Enterobacteriaceae
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The antimicrobial susceptibility was performed by the Kirby Bauer's disc diffusion technique on Mueller-Hinton agar, as per Clinical Laboratory Standard Institute (CLSI) guidelines [5 ]. The antibiotics tested were as follows (potency in μg/disc): Ampicillin (10), Cefuroxime (30), Cefotaxime (30), Piperacillin (100), Ticarcillin (75), Piperacillin-Tazobactam (100/10), Ticarcillin-Clavulanic acid (75/10), Ceftazidime (30), Cefepime (30), Aztreonam (30), Imipenem (10), Meropenem (10), Ertapenem (10), Colistin (10), Gentamicin (10), Tobramycin (10), Amikacin (30), Netilmicin (30), CiprOfloxacin (5), LevOfloxacin (5), Lomefloxacin (10), and Ofloxacin (5) (HiMedia Laboratories Pvt. Ltd., Mumbai, India). P. aeruginosa ATCC 27853, E. coli ATCC 25922, E. coli ATCC 35218, and K. pneumoniae ATCC 700603 were used as quality control strains.
4
Antibiotic Susceptibility Testing of Bacillus
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Antibiotic discs consisting of amikacin (30 μg), amoxyclav (30 μg), ampicillin (10 μg), ampicillin/sulbactum (10 μg/10 μg), cefixime (5 μg), ceftriaxone (30 μg), cefuroxime (30 μg), cefuroxime axetil (30 μg), cefotaxime (30 μg), cefoxitin (30 μg), co-trimoxazole (25 μg), gentamicin (10 μg), meropenem (10 μg), ofloxacin (5 μg), tetracycline (30 μg), and ticarcillin/clavulanic acid (75/10 μg) were purchased from Himedia, India. The susceptibility test of Bacillus strains was done as described by the Clinical Laboratory Standards Institute (CLSI) [26 ].
5
Antimicrobial Susceptibility of Isolates
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The susceptibilities of isolates to the antimicrobial agents ampicillin (10 μg), cefuroxime (30 μg), cefotaxime (30 μg), chloramphenicol, (30 μg), cotrimoxazole (25 μg), gentamicin (30 μg), amikacin (30 μg), ciprofloxacin (5 μg), and levofloxacin (5 μg) (HiMedia Laboratories, India) were determined with Kirby-Bauer disc diffusion method in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines [16 ]. The reference strain E. coli ATCC 25922 was included as quality control in the susceptibility assays. According to the international standard definitions for acquired resistance, and relative to the panel of antibiotics tested, multidrug resistant (MDR) phenotype was defined as in vitro non-susceptibility to ≥1 agent in ≥3 antimicrobial categories [17 (link)]: penicillins, cephalosporins, beta-lactamase inhibitor combinations, fluoroquinolones, aminoglycosides, chloramphenicol, folate pathway inhibitors, tetracyclines, macrolides and glycopeptides.
6
Antibiotic Susceptibility of Gram-Negative Bacteria
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The susceptibilities of Gram-negative bacteria (GNB) to the antimicrobial agents ampicillin (10 µg) amoxicillin/clavulanate (30 µg), cefuroxime (30 µg), cefotaxime (30 µg), chloramphenicol (30 µg), cotrimoxazole (25 µg), gentamicin (10 µg), amikacin (30 µg), ciprofloxacin (5 µg), tetracycline (30 µg) and levofloxacin (5 µg) (HiMedia Laboratories, India) were determined with Kirby-Bauer disc diffusion method in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines [16 ]. Erythromycin (30 µg), oxacillin (30 µg), and vancomycin (30 µg) were included for Gram positive bacteria (GPB). The reference strain E. coli ATCC 25922 and Staphylococcus aureus ATCC 10221 were included as quality controls in the susceptibility assays. Relative to the panel of antibiotics tested for each isolate, and according to the international standard definitions for acquired resistance, multidrug resistant (MDR) phenotype was defined as in vitro non-susceptibility to ≥1 agent in ≥3 antimicrobial categories [17 (link)]: penicillins, cephalosporins, beta-lactamase inhibitor combinations, fluoroquinolones, aminoglycosides, chloramphenicol, folate pathway inhibitors, tetracyclines, macrolides and glycopeptides.
7
Antibiotic Susceptibility Testing Protocol
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The disc diffusion technique and determination of minimum inhibitory concentration (MIC) were performed in accordance with the Clinical Laboratory Standard Institute, 2016.[13 ] The antibiotics tested were amikacin (30 μg), gentamicin (10 μg), tobramycin (10 μg), imipenem (10 μg), ciprofloxacin (5 μg), piperacillin/tazobactam (100 μg/10 μg), cefotaxime (30 μg), cefazolin (30 μg), and cefuroxime (30 μg) (Himedia laboratories, Mumbai, Maharashtra, India). The MIC for amikacin was determined by agar dilution method.
8
Antibiotic Susceptibility Testing of Bacterial Isolates
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The susceptibility of bacterial isolates against recommended antibiotics was tested by the modified Kirby–Bauer disk diffusion method on Mueller Hinton agar (HiMedia, India) following guidelines of Clinical and Laboratory Standards Institute (CLSI), Wayne, USA [9 ]. Antibiotics that were tested in our study include amoxycillin clavulanate (amc 20/10 μg), ampicillin (amp 10 μg), amikacin (ak 30 μg), ceftazidime (caz 30 μg), ceftazolin (30 μg), cefuroxime (cfm 30 μg), ciprofloxacin (cip 5 μg), cloxacillin (cox 30 μg), cotrimoxazole (cot 25 μg), fosfomycin (fo 200 μg), gentamicin (gen 10 μg), imipenem (imp 10 μg), meropenem (mrp 10 μg), nitrofurantion (300 μg), piperacillin-tazobactam (pit 100/10 μg), teteracycline (te 30 μg), and vancomycin (VAN 30 μg) (HiMedia Laboratories, India). Further, elucidations of antibiotic susceptibility results were made conferring to the zone size interpretative standards of CLSI [9 ]. MDR isolates, resistant to at least one antimicrobial from three different groups of first-line drugs, tested were identified according to the combined guidelines of the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC) [10 (link)]. Escherichia coli ATCC 25922, Staphylococcus aureus (ATCC 25923), and Pseusdomonas aeruginosa (ATCC 27853) were used as a control organism for antibiotic susceptibility testing.
9
Antibiotic Susceptibility Testing Protocol
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The antimicrobial susceptibility test was performed by the Kirby-Bauer disc diffusion technique on Mueller-Hinton agar, as per Clinical Laboratory Standard Institute (CLSI) guidelines.[9 ] The antibiotics tested were as follows (potency in μg/disc): Ampicillin (10), cefuroxime (30), cefpodoxime (CPD) (30), ceftazidime (30), cefepime (30), cefotaxime (30), piperacillin (100), ticarcillin (75), piperacillin-tazobactam (100/10), ticarcillin-clavulanic acid (75/10), aztreonam (30), imipenem (IP) (10), meropenem (10), ertapenem (10), colistin (10), gentamicin (10), tobramycin (10), amikacin (30), netilmicin (30), ciprofloxacin (5), levofloxacin (5), lomefloxacin (10), and ofloxacin (5) (Hi-Media Laboratories Pvt., Ltd., Mumbai, India). Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922, E. coli ATCC 35218 and Klebsiella pneumoniae ATCC 700603 were used as quality control strains.
10
Antimicrobial Susceptibility of Salmonella Newport
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Ninety seven S. Newport isolates, received at the National Salmonella and Escherichia Centre, Central Research Institute, Kasauli, India, from various medical, veterinary and research institutes throughout the country, during January 2010 to December 2013 constituted the material for the study. Bacterial isolates were identified on the basis of culture characteristics, Gram staining and conventional biochemical tests11 . Isolates identified as salmonellae were further subjected to serotyping1 using an array of various Salmonella antisera (Statens Serum Institute, Copenhagen, Denmark; Denka Seiken Co. Ltd., Tokyo Japan).
Antimicrobial susceptibility testing: All serologically confirmed S. Newport isolates were tested for antimicrobial susceptibility by disc diffusion method12 using the following 12 antimicrobials (Hi Media Laboratories, Pvt. Ltd., Mumbai, India): ampicillin (10 μg), ceftazidime (30 μg), cefotaxime (30 μg), cefuroxime (30 μg), chloramphenicol (30 μg), trimethoprim-sulphamethoxazole (co-trimoxazole) (1.25/23.75 μg), kanamycin (30 μg), norfloxacin (10 μg), ciprofloxacin (5 μg), nalidixic acid (30 μg), tetracycline (30 μg), and nitrofurantoin (300 μg), according to the Clinical and Laboratory Standards Institute (CLSI) guidelines and interpretative criteria12 . Escherichia coli ATCC 25922 was used as standard strain.
Antimicrobial susceptibility testing: All serologically confirmed S. Newport isolates were tested for antimicrobial susceptibility by disc diffusion method12 using the following 12 antimicrobials (Hi Media Laboratories, Pvt. Ltd., Mumbai, India): ampicillin (10 μg), ceftazidime (30 μg), cefotaxime (30 μg), cefuroxime (30 μg), chloramphenicol (30 μg), trimethoprim-sulphamethoxazole (co-trimoxazole) (1.25/23.75 μg), kanamycin (30 μg), norfloxacin (10 μg), ciprofloxacin (5 μg), nalidixic acid (30 μg), tetracycline (30 μg), and nitrofurantoin (300 μg), according to the Clinical and Laboratory Standards Institute (CLSI) guidelines and interpretative criteria12 . Escherichia coli ATCC 25922 was used as standard strain.
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