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Microbiology and Phage Therapy of Diabetic Foot Ulcer

Thesis Info

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Author

Chaudhry, Waqas Nasir

Program

PhD

Institute

National University of Sciences & Technology

City

Islamabad

Province

Islamabad

Country

Pakistan

Thesis Completing Year

2015

Thesis Completion Status

Completed

Subject

Applied Sciences

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/8390/1/Waqas_Nasir_Chaudhry_HSR_Virology_%26_Immunology_2017_NUST_ISD_21.11.2017.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676726641816

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Diabetic foot infections (DFI) are a major complication of diabetes mellitus. It contributes to the development of gangrene and non-traumatic lower extremity amputations with the life time risk up to 25 %. Since bacteria responsible for chronic wound infections are commonly within polysaccharide matrices known as biofilms, which to a large extent are refractory to antibiotics even when the bacteria are genetically susceptible to their action. In the first part of the study, we identified the neuropathy, ulcer grade, microbial profile, phenotypic and genotypic resistance prevalence of methicillin and ESBL genes in bacterial isolates of DFI patients registered at PIMS, Pakistan. Our results indicated that 46 (92 %) out of 50 patients, had sensory neuropathy. The most prevelant isolate was Staphylococcus aureus (25 %), followed by Pseudomonas aeruginosa (18.18%), E. coli (16.16%), Streptococcus spp (15.15%), Enterococcus spp (9%), Proteus spp (15.15%) and Klebsiella pneumonia (3%). The prevalence of MecA gene was found to be 88 % and 84% phenotypically and genotypically respectively. K. pneumonia had highest percentage of ESBL producers with 66.6 % prevalence by double disc synergy test and 100 % for CTX+CL/CAZ+CL by combination disc test. Pseudomonas aeruginosa had highest (100 %) number of metalo β-lactamase producers by EDTA synergy disk test. Overall prevalence of bla-CTX-M, bla-CTX-M15, bla-TEM, bla-OXA and bla-SHV genes was found to be 76.92, 76.92, 75.0, 57.69 and 84.6 % respectively in gram negative isolates from DFI. Molecular epidemiology of MecA and ESBL genes were found alarmingly high in DFI, posing one of the major cause of antibiotic treatment failure. In the second part of our study we determined whether combinations of antibiotics and bacteriophage were more effective for the treating biofilm populations of Abstract xvii Pseudomonas aeruginosa [the laboratory strain PA14, and the clinical strain, CFBR2)] on plastic surfaces and layers of human epithelial cells. Two newly isolated bacteriophage NP1 and NP3 at a titer of ~1E8 pfu/ml were added individually or as pairs and/or in combination with 1X MIC, 4XMIC and 8X MIC of ceftazidime, colistin, gentamicin or trobramycin to 48 hours PA biofilms in 6 well polystyrene plates. Parallel experiments were performed with 8-hour biofilm populations of epithelial Naso pharyngeal Detroit 562 (ATCC® CCl-138TM). Treatment with phage reduces the viable density of biofilm populations of P. aeruginosa. biofilms by three orders of magnitude as compared to untreated control. In combination with antibiotics phages are more effective than alone and increase efficacy of the antibiotics for treating bacteria in biofilms. In the third part of study we explored co-evolutionary dynamics of resistance between Pseudomonas aeruginosa 14 and its phages NP1 and NP3. Evolutionary dynamics experiments of single and two phages revealed that PA14 can easily evolve resistance against NP1 phage. NP3 phage maintained for 30 serial transfers and we observed host range in evolved bacteria. In cocktail, both phage support each for their long term maintenance in serial transfer experiments. Also, cocktail delayed the evolution of resistance and sustained high phage infectivity, suggesting phage cocktail is promising strategy to control or slow down evolution of resistance in bacteria against bacteriophages.
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عزت مآب اللہ تبارک و تعالیٰ کا لاکھ مرتبہ شکر اور محبوب خدا حضرت محمدﷺ پر کروڑوں درود و سلام ۔ میرے شوہر( نواز بیگ) کی محبتوں، مہربانیوں اور تعاون کا فیض ہے کہ میرا مقالہ پایہ تکمیل تک پہنچا۔ (الحمد اللہ )۔اللہ پاک سے دعا ہے کہ میرے شوہر کا سایہ مجھ پر اور میرے بچوں پر ہمیشہ قائم رہے(امین)۔
استادِ محترم ڈاکٹر فرتاش سید(مرحوم) کی سپاس گزار ہوں جنھوں نے برطانوی لیڈی فرخندہ رضوی (جو پاکستان کی دختر ہونے کا اعزاز رکھتی ہیں) سے میرا ٹیلی فونک رابطہ کرایا۔ وقت نے انھیں مہلت نہ دی کہ وہ بطور نگران مقالہ اس کام کو پایہ تکمیل تک پہنچا سکیں۔اللہ پاک سے دعا ہے کہ انھیں کروٹ کروٹ جنت الفردوس نصیب فرمائے۔
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ضوابط قبول التفرد في رواية الحديث دراسة مع أمثلة من تطبيقات النقاد

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Interference Avoidance Routing for Underwater Wireless Sensor Networks

Packets routing in underwater wireless sensor networks (UWSN) is challenged by the interference generated during packets forwarding by sensor nodes. The lost packets result in wastage of nodes’ battery power in that their retransmission consumes additional power. In order to overcome this challenge, design of interference avoidance routing is one of the promising solutions. Such a routing ensures that the ultimate destination receives packets along the trajectories with the least interference. In this study, three interference avoidance routing protocols: EEIRA (energy efficient interference and route aware), EEIAR (energy efficient interference aware routing) and LF-IEHM (localization-free interference and energy hole minimization), are proposed for UWSN. Network architectures are developed for the deployment of sensor nodes. Classification and review of the novel network, MAC and cross layers protocols are accomplished. The EEIRA protocol involves a unique network architecture and selects the shortest routes with the least interference during packets forwarding towards the ultimate destination. Sensor nodes localization; which involves knowing the three dimensional coordinates of sensor nodes, for the computation of the shortest path in EEIRA is relaxed in EEIAR. The EEIAR also forwards packets along the shortest and the least interference paths using its unique network architecture. However, selection of such paths is based on depth (one dimensional position or single coordinate of the nodes). Localization is difficult to achieve because currents in water make the nodes to change positions. It also consumes extra energy. The LF-IEHM protocol uniquely uses variable transmission range and packet holding time. The variable transmission range avoids the situation when a sensor node does not find any neighbor node for data forwarding that results in packet loss. Also, every node holds a packet for a uniquely chosen packet holding time to minimize simultaneous transmission of packets by sensor nodes. This strategy minimizes interference and the resulting packet loss. Contrary to the conventional approach of route selection that involves coordinates for position specification of nodes, the LF-IEHM uses water pressure a sensor node bears in combination with waiting time to select routing paths. Simulation results reveal that all the three protocols outperform the counterpart schemes in terms of the mentioned performance parameters.