Dinoprostone has been administered either vaginally or intra

Dinoprostone has been administered either vaginally or intracervically, rather successfully and without serious side effects in normal pregnancies. The most important adverse reaction of dinoprostone is uterine hyperstimulation. The incidence of uterine hyperstimulation ranged from 5% to 16% in patients treated with controlled-release dinoprostone. This condition generally resolves within 15 minutes after removal of the insert, and patients experiencing hyperstimulation gave birth to healthy babies without requiring a CS. Cardiotocogrophic abnormalities are monitored in 3–10% of women receiving dinoprostone; most of these abnormalities also resolve quickly after insert removal. With regard to dinoprostone administration and uterine hyperstimulation frequency, results of our study are similar to others.
Introduction Pseudomonas aeruginosa infections are prevalent in immunocompromised and SB525334 Supplier patients, causing numerous acute and chronic infections. These pathogens are capable of surviving in different environmental conditions by utilizing their diverse metabolic and virulence patterns.P. aeruginosa is capable of colonizing the respiratory tract in spite of its different ecological origin. Virulence genes have a different level of intrinsic expression, which leads to a variable level of pathogenicity in infected individuals. Mainly, these infections arise due to development of drug resistance patterns, biofilm formation, and virulence factor production. Biofilm, a source of chronic and persistent infection, presents strong resistance to the immune system and antibiotics. Growth of P. aeruginosa in varying environments can enhance pigment production. Their outer membrane proteins (OprI and OprL) activated the immune system of a patient and emerged as a strong candidate for P. aeruginosa vaccine development. Additionally, fluctuation in environmental conditions can enhance elastase expression in these pathogens.P. aeruginosa is capable of producing two types of phospholipase, of which the hemolytic type (PlcH) hydrolyzes sphingomyelin along with phosphatidylcholine. Virulence factor ToxA was reported from patients having lung infection, while ExoS is more prevalent in cystic fibrosis patients. The expression of cellular and extracellular virulence factors of P. aeruginosa is regulated via cell signaling pathways. The strong correlation between virulence genes and source of infection can help control these infections in the community. The most effective mechanism that regulates their expression was quorum sensing, and therefore targeting these key regulators will improve therapeutic success in the future. The present study documented the extent of pigment production, biofilm formation, and presence of virulence factors in beta-lactamase-producing P. aeruginosa. To the best of our knowledge, this is the first report to reveal the status of P. aeruginosa virulence factors in Pakistan.
Methods Beta-lactamase-producing P. aeruginosa (n=54) isolates were screened in randomly collected samples from pus, urine, blood, sputum, and wounds. Both phenotypic and molecular methods were used to identify beta-lactamase-producing P. aeruginosa (data not shown). All beta-lactamase-producing isolates were further processed for evaluation of pigment production and biofilm formation. Subsequently, these clinical isolates were subjected to the detection of six virulence genes (OprI, OprL, LasB, PlcH, ExoS, and ToxA) using polymerase chain reaction (PCR).
Results Beta-lactamase-producing isolates (n=54) were further analyzed for phenotypic and virulence gene profiles. P. aeruginosa produced characteristic pigments in the form of pyoverdin or pyocyanin. A total of 92.59% (n=50) isolates produced these pigments. Among pigment-producing isolates, 64% (n=32) demonstrated pyoverdin and 36% (n=18) exhibited pyocyanin, as shown in Table 2. All isolates were further evaluated for biofilm production using the tube method. Ultimately, 85.18% (n=46) isolates produced biofilms, which were classified as strong, moderate, and weak on the basis of their appearance. Among biofilm-producing isolates, 47.88% (n=22) produced strong, 30.43% (n=14) moderate, and 21.73% (n=10) weak biofilm patterns. Isolates that had not produced an observable amount of biofilm were classified as nonproducers and their strength was 17.39% (n=8), as demonstrated in Table 2.