Un-Answered Inquiries Of Liraglutide Uncovered

[11] Isolate showing inhibition zone of ��17 mm for cefpodoxime (10 ��g), ��22 mm for ceftazidime (30 ��g), ��27 mm for aztreonam (30 ��g), ��27 mm for cefotaxime (30 ��g), ��25 mm for ceftriaxone (30 ��g) was taken for ESBL confirmation. The confirmation was done by CLSI phenotypic disk confirmatory test using disks of ceftazidime (30 ��g) and ceftazidime-clavulanic acid (30 ��g/10 ��g). Both the disks were placed at least 20 mm apart, centre to centre on Mueller-Hinton agar plate and incubated over night at 37��C. A zone difference of ��5 mm around ceftazidime and ceftazidime-clavulanic acid was taken as ESBL positive. K. pneumoniae ATCC 700603 and E. coli ATCC 25922 were used as positive and negative control respectively.[11] Detection of AmpC ��-lactamase All the isolates were screened for AmpC ��-lactamase by Kirby�CBauer's disk diffusion method using cefoxitin (30 ��g) disk. An isolate demonstrating reduced susceptibility (selleck cefoxitin was taken as screen positive. Screen positive isolates were further confirmed by AmpC sterile disk test. Liraglutide E. coli ATCC 25922 was used as control.[12] Detection of metallo ��-lactamase Organisms showing resistance to any of the three antimicrobials viz., imipenem (10 ��g), meropenem (10 ��g), and ceftazidime (30 ��g) was considered as a screen test positive. Screen positive isolates were confirmed by imipenem ethylenediamine tetracetic acid double disk synergy test Oxymatrine Pseudomonas aeruginosa ATCC 27853 was used as control.[13] Antimicrobial susceptibility testing Antibiotic susceptibility testing was done by Kirby�CBauer's disk diffusion method as per CLSI guidelines.[11] Antimicrobial disks used in the study were purchased from HiMedia Laboratories, Mumbai. Efficacy of tigecycline was evaluated by using United States Food and Drug Administration (US FDA) guidelines since, interpretive criteria for this drug was not proposed by CLSI (susceptible ��19 mm, nonsusceptible ��14 mm).[14] Quality control was achieved by using standard strain of E. coli ATCC 25922. RESULTS During the study period, a total of 318 neonates were suspected to have sepsis. Of these, 114 (36%) cases were culture positive. Among these culture positives, 24 (21%) isolates were identified as K. pneumoniae. Screening for ESBL gave 23 isolates positive, for AmpC it was 20 isolates and for MBL, imipenem gave 2, meropenem gave 14 and ceftazidime gave 23 isolates positive. Results of confirmatory tests of three ��-lactamases are given in Table 1. Among 24 isolates, all except one isolate produced either type of ��-lactamase. AmpC production was more (12.5%) compared to ESBL and MBL production (8% both), and the occurrence of co-production of AmpC + MBL was found in 16 isolates (67%). Table 1 Results of ��-lactamase production Results of antimicrobial susceptibility to cephalosporins and other antimicrobials are given in Tables ?Tables22 and ?and3.3.