Methods: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines.
Results: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate.
Conclusion: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals.
AIM OF THE REVIEW: This review aims to present up-to-date information regarding the taxonomy, botany, distribution, ethnomedicinal uses, phytochemistry, pharmacology and toxicological profile of G. pentaphylla. The presented information was analyzed critically to understand current work undertaken on this species and explore possible future prospects for this plant in pharmaceutical research.
MATERIALS & METHODS: Bibliographic databases, including Google Scholar, PubMed, Web of Science, ScienceDirect, SpringerLink, Wiley Online Library, Semantic Scholar, Europe PMC, Scopus, and MEDLINE, were explored thoroughly for the collection of relevant information. The structures of phytoconstituents were confirmed with PubChem and SciFinder databases. Taxonomical information on the plant was presented in accordance with The Plant List (version 1.1).
RESULTS: Extensive phytochemical investigations into different parts of G. pentaphylla have revealed the presence of at least 354 secondary metabolites belonging to structurally diverse classes including alkaloids, amides, phenolic compounds, flavonoids, glycosides, aromatic compounds, steroids, terpenoids, and fatty derivatives. A large number of in vitro and in vivo experiments have demonstrated that G. pentaphylla had anticancer, antimutagenic, antibacterial, antifungal, anthelmintic, mosquitocidal, antidiabetic, antihyperlipidemic, anti-oxidant, anti-inflammatory, analgesic, antipyretic, anti-arsenicosis, and wound healing properties. Toxicological studies have established the absence of any significant adverse reactions and showed that the plant had a moderate safety profile.
CONCLUSIONS: G. pentaphylla can be suggested as a source of inspiration for the development of novel drugs, especially anticancer, antimicrobial, anthelmintic, and mosquitocidal agents. Moreover, bioassay-guided investigations into its diverse classes of secondary metabolites, especially the large pool of nitrogen-containing alkaloids and amides, promises the development of novel drug candidates. Future pharmacological studies into this species are also warranted as many of its traditional uses are yet to be validated scientifically.