Antibacterial activity and time kill kinetics of Amlodipine, Thioridazine and Promethazine against pathogenic clinical bacterial isolates

*1Akinjogunla, O. J., 2Umo, A. N., 3Alozie, M. F., 2Oshosanya, G. O., and 1Saturday, G. I.

1Department of Microbiology, University of Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigeria

2Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Akwa Ibom State, Nigeria

3Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria
*Correspondence to: [email protected]

Abstract:
Background: The emergence of multi-drug resistant bacterial strains worldwide has necessitated the scientific search for novel, potent, and affordable antimicrobial agents including medicinal plants and non-antibiotic drugs for therapy of infectious diseases. The objective of this study is to assess in vitro antibacterial activities and time kill kinetics of some non-antibiotic drugs against pathogenic clinical bacterial isolates.

Methodology: In vitro antibacterial activities including minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time kill kinetics of Amlodipine (AML), Thioridazine (THI) and Promethazine (PRO) against Staphylococcus aureus, coagulase negative staphylococci (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae and Pseudomonas aeruginosa clinical isolates were determined using disc diffusion, broth microdilution and plate count techniques.

Results: The mean growth inhibition zones by the disc diffusion assay of AML, THI and PRO against the isolates were ≤15.1±1.0 mm with MIC and MBC values ranging from 12.5 to 50μg/ml and 25 to 100μg/ml respectively. The time-kill assay revealed bactericidal effect of AML, THI and PRO on Gram positive bacteria evidenced by mean log reductions in viable bacterial cell counts ranging from 0.13 Log10 to 2.41 Log10 CFU/ml for S. aureus, 0.88 Log10 to 2.08 Log10 CFU/ml for Streptococcus spp, and 0.26 Log10 to 2.34 Log10 CFU/ml for CoNS after ≤30hrs post inoculation at 1xMIC. The range of log reduction in viable cell counts of Gram-negative bacteria exposed to AML, THI and PRO were E. coli (0.11 to 3.23 Log10 CFU/ml), P. aeruginosa (0.52 to 2.56 Log10 CFU/ml), K. pneumoniae (0.85 to 3.0 Log10 CFU/ml) and Enterobacter spp (0.38 to 2.08 Log10 CFU/ml) after ≤30 hrs post inoculation at 1x MIC.

Conclusion: These findings demonstrate in vitro antibacterial efficacies and time kill kinetics of AML, THI and PRO against pathogenic clinical bacterial isolates, which indicate that these non-antibiotic drugs may be useful therapeutic alternatives in the bid to reduce the burden of infectious diseases associated with antibiotic resistant pathogens.

Keywords: Amlodipine, Thioridazine, Promethazine, Time-Kill, Kinetics, MIC, MBC, bacteria

Received April 8, 2020; Revised July 12, 2020; Accepted July 13, 2020

Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Editor-in-Chief: Prof. S. S. Taiwo

Activité antibactérienne et cinétique de destruction du temps de l’amlodipine, de la thioridazine et de la prométhazine contre les isolats bactériens cliniques pathogènes

*1Akinjogunla, O. J., 2Umo, A. N., 3Alozie, M. F., 2Oshosanya, G. O., et 1Saturday, G. I.

1Département de microbiologie, Université d’Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigéria

2Département de microbiologie médicale et de parasitologie, Faculté des sciences cliniques, Université d’Uyo, Uyo, État d’Akwa Ibom, Nigéria

3Département de microbiologie et biotechnologie pharmaceutiques, Faculté de pharmacie, Université d’Uyo, Uyo, État d’Akwa Ibom, Nigéria *Correspondance à: [email protected]

Abstrait:

Contexte: L’émergence de souches bactériennes multirésistantes dans le monde a rendu nécessaire la recherche scientifique d’agents antimicrobiens nouveaux, puissants et abordables, notamment des plantes médicinales et des médicaments non antibiotiques pour le traitement des maladies infectieuses. L’objectif de cette étude est d’évaluer les activités antibactériennes in vitro et la cinétique de destruction temporelle de certains médicaments non antibiotiques contre les isolats bactériens cliniques pathogènes.

Méthodologie: activités antibactériennes in vitro, y compris la concentration minimale inhibitrice (CMI), la concentration bactéricide minimale (MBC) et la cinétique de destruction du temps de l’amlodipine (AML), de la thioridazine (THI) et de la prométhazine (PRO) contre Staphylococcus aureus, les staphylocoques à coagulase négative (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae et Pseudomonas aeruginosa ont été déterminés en utilisant des techniques de diffusion sur disque, de microdilution en bouillon et de numération sur plaque.

Résultats: Les zones moyennes d’inhibition de la croissance par le test de diffusion de disque d’AML, THI et PRO contre les isolats étaient ≤15,1±1,0mm avec des valeurs MIC et MBC allant de 12,5 à 50μg/ml et de 25 à 100μg/ml respectivement. Le dosage temporel a révélé un effet bactéricide de la LMA, du THI et du PRO sur les bactéries Gram positives, mis en évidence par des réductions logarithmiques moyennes du nombre de cellules bactériennes viables allant de 0,13 Log10 à 2,41 Log10 CFU/ml pour S. aureus, 0,88 Log10 à 2,08 Log10 CFU/ml pour Streptococcus spp et 0,26 Log10 à 2,34 Log10 CFU/ml pour CoNS après ≤ 30 heures après l’inoculation à 1 x MIC. La plage de réduction logarithmique du nombre de cellules viables de bactéries à Gram négatif exposées à la LMA, au THI et au PRO était E. coli (0,11 à 3,23 Log10 CFU/ml), P. aeruginosa (0,52 à 2,56 Log10 CFU/ml), K. pneumoniae (0,85 à 3,0 Log10 CFU/ml) et Enterobacter spp (0,38 à 2,08 Log10 CFU/ml) après ≤ 30 heures après l’inoculation à 1 x MIC.

Conclusion: Ces résultats démontrent une efficacité antibactérienne in vitro et une cinétique de destruction du temps des LMA, THI et PRO contre les isolats bactériens cliniques pathogènes, ce qui indique que ces médicaments non antibiotiques peuvent être des alternatives thérapeutiques utiles dans le but de réduire le fardeau des maladies infectieuses associées aux antibiotiques pathogènes résistants.

Mots-clés: Amlodipine, Thioridazine, Prométhazine, Time-Kill, Cinétique, MIC, MBC, bactéries

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Antibacterial activity and time kill kinetics of Amlodipine, Thioridazine and Promethazine against pathogenic clinical bacterial isolates

 

Differences in haematological parameters and haemoglobin phenotypes in symptomatic and asymptomatic subjects with Plasmodium falciparum infection in parts of Kaduna metropolis, Nigeria

*

1Dikwa, K. B.,

2Maikaje, D. B., 1Yahaya, U. A., and

3Suleiman, A. B.

1Department of Biological Sciences, Nigerian Defence Academy, Kaduna, Nigeria

2Department of Microbiology, Kaduna State University, Kaduna, Nigeria

3Department of Microbiology, Ahmadu Bello University, Zaria, Nigeria
*Correspondence to: [email protected]

Abstract

Background: Plasmodium falciparum is the leading cause of malaria morbidity and mortality in Nigeria with varied symptoms and haematological consequences. The objective of this study is to assess the differences in haematological parameters and haemoglobin phenotypes in symptomatic P. falciparum infected and apparently healthy asymptomatic individuals in parts of Kaduna metropolis.

Methodology: A total of 1000 subjects; 500 symptomatic and 500 apparently healthy subjects asymptomatic for malaria, were recruited from selected hospitals and National Blood Bank in Kaduna metropolis. Blood samples were collected for thick and thin film microscopy to determine malaria parasitaemia and parasite species identification respectively. Haematological parameters were determined using automated blood analyser (KX-21N, Sysmex, Japan) and haemoglobin phenotypes by alkaline cellulose acetate electrophoresis. Continue reading “Differences in haematological parameters and haemoglobin phenotypes in symptomatic and asymptomatic subjects with Plasmodium falciparum infection in parts of Kaduna metropolis, Nigeria”

Evidence of virological failure in patients on second-line anti-retroviral therapy in Southwestern Nigeria: an indication for HIV drug resistance testing

*Usman, S. O., Ajayi, O. M., Ebiekura, O., Egbonrelu, N., Ebhojie, G., and Ariyo, A.O
APIN Public Health Initiatives, Abuja, Nigeria

*Correspondence to: [email protected]

Abstract:
Background: In sub-Saharan Africa where genotypic anti-retroviral (ARV) drug resistance testing is rarely performed and poor adherence is blamed for the inability to achieve viral suppression and treatment failure, programmatic approaches to preventing and handling these are essential. This study was aimed at assessing the virological outcomes among HIV patients receiving second-line anti-retroviral therapy (ART) in Southwestern Nigeria.

Methodology: This was a 5-year observational retrospective study of randomly selected people living with HIV (PLWHIV) who have been switched to second-line ART for at least six months before the commencement of the study in multiple comprehensive ART sites across the three levels of care, in Ondo and Ekiti States, Southwestern Nigeria, from January 2015 to December 2019. Quantitative viral load analysis was done using polymerase chain reaction (PCR) assay. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.0.

Results: A total of 249 (71 males and 178 females) subjects eligible for the study were recruited using simple random sampling technique. The mean age (± SD) of the subjects was 44.21 ± 11.45 years. The mean number of years the patients have been on ART regimen was 7.92 ± 2.68 years. The mean number of years the patients were on first line ART regimen before being switched to second line was 4.27 ± 2.63 years. Patients with viral load <1000 RNA copies/ml (suppressed viral load) were 216 (86.7%) out of which 113 (45.4%) had viral load <20 RNA copies/ml while 33 (13.3%) had viral load >1000 RNA copies/ml (unsuppressed viral load or virological failure).

Conclusion: About 13% of the patients on second line ART had unsuppressed viral load of more than 1000 RNA copies/ml indicating virological failure. Thus, critical factors such as poor adherence to ART and drug resistance chiefly contributing to virological failure have to be routinely checked.

Keywords: suppression, ART, resistance, virological, failure, Nigeria

Received Apr 26, 2021; Revised Jun 9, 2021; Accepted Jun 13, 2021

Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Editor-in-Chief: Prof. S. S. Taiwo

Preuve d’échec virologique chez les patients sous traitement antirétroviral de deuxième intention dans le sud-ouest du Nigeria: une indication pour le test de résistance aux médicaments contre le VIH

*Usman, S.O., Ajayi, O.M., Ebiekura, O., Egbonrelu, N., Ebhojie, G., et Ariyo, A.O.
Initiatives de santé publique de l’APIN, Abuja, Nigéria

*Correspondance à: [email protected]

Abstrait:
Contexte: En Afrique subsaharienne, où les tests génotypiques de résistance aux antirétroviraux (ARV) sont rarement effectués et où une mauvaise observance est imputée à l’incapacité d’obtenir la suppression virale et l’échec du traitement, des approches programmatiques pour les prévenir et les gérer sont essentielles. Cette étude visait à évaluer les résultats virologiques chez les patients VIH recevant un traitement antirétroviral (TAR) de deuxième intention dans le sud-ouest du Nigeria.

Méthodologie: Il s’agissait d’une étude rétrospective d’observation de 5 ans portant sur des personnes vivant avec le VIH (PVVIH) sélectionnées au hasard et passées à un TAR de deuxième intention pendant au moins six mois avant le début de l’étude dans plusieurs sites de TAR complets aux trois niveaux. de soins, dans les États d’Ondo et d’Ekiti, dans le sud-ouest du Nigéria, de janvier 2015 à décembre 2019. L’analyse quantitative de la charge virale a été effectuée à l’aide d’un test de réaction en chaîne par polymérase (PCR). Les données ont été analysées à l’aide du logiciel Paquet statistique pour les sciences sociales (SPSS) version 24.0.

Résultats: Un total de 249 (71 hommes et 178 femmes) sujets éligibles à l’étude ont été recrutés à l’aide d’une technique d’échantillonnage aléatoire simple. L’âge moyen (± ET) des sujets était de 44,21±11,45 ans. Le nombre moyen d’années pendant lesquelles les patients ont été sous traitement antirétroviral était de 7,92±2,68 ans. Le nombre moyen d’années pendant lesquelles les patients étaient sous traitement antirétroviral de première ligne avant de passer en deuxième ligne était de 4,27 ± 2,63 ans. Les patients avec une charge virale <1000 copies d’ARN/ml (charge virale supprimée) étaient 216 (86,7%) dont 113 (45,4%) avaient une charge virale <20 copies d’ARN/ml tandis que 33 (13,3%) avaient une charge virale >1000 ARN copies/ml (charge virale non supprimée ou échec virologique).

Conclusion: Environ 13 % des patients sous TAR de deuxième ligne avaient une charge virale non supprimée de plus de 1000 copies d’ARN/ml indiquant un échec virologique. Ainsi, les facteurs critiques tels qu’une mauvaise adhésion au TARV et la résistance aux médicaments contribuant principalement à l’échec virologique doivent être systématiquement vérifiés.

Mots clés: suppression, TAR, résistance, virologique, échec, Nigeria.

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Evidence of virological failure in patients on second-line anti-retroviral therapy in Southwestern Nigeria: an indication for HIV drug resistance testing

 

 

Non-enteric adenovirus among children with gastroenteritis in Warri, Southern Nigeria

Correspondence

*1,2Osazuwa, F., 2Johnson, W., and 2Grobler, H. S. 1MDS Molecular Services, Sub-Saharan African Office, Jabi, Abuja, Nigeria 2MDS Molecular Services, Johannesburg, South Africa                                

*Correspondence to: [email protected]; +2348100792725

Received Feb 17, 2021; Revised Apr 17, 2021; Accepted Apr 18, 2021

Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source. Editor-in-Chief: Prof. S. S. Taiwo

Adénovirus non entérique chez les enfants atteints de gastroentérite à Warri, dans le sud du Nigéria

*1,2Osazuwa, F., 2Johnson, W., et 2Grobler, H. S. 1MDS Molecular Services, Bureau de l’Afrique subsaharienne, Jabi, Abuja, Nigéria 2MDS Molecular Services, Johannesburg, Afrique du Sud *Correspondance à: [email protected]; +2348100792725

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Non-enteric adenovirus among children with gastroenteritis in Warri, Southern Nigeria

Antimicrobial Stewardship Implementation in Nigerian Hospitals: Gaps and Challenges

*1Iregbu, K. C., 1Nwajiobi-Princewill, P. I., 1Medugu, N., 2Umeokonkwo, C. D.,           3Uwaezuoke, N. S., 4Peter, Y. J., 5Nwafia, I. N., 6Elikwu, C., 7Shettima, S. A.,          8Suleiman, M. R., 9Awopeju, A. T. O., 10Udoh, U., 11Adedosu, N., 12Mohammed, Y.,13Oshun, P., 14Ekuma, A., 15Manga, M. M., 16Osaigbovo, I. I., 17Ejembi, C. J.,          18Akujobi, C. N., 19Samuel, S. O., 20Taiwo, S. S., and 13Oduyebo, O. O.

1National Hospital Abuja, Nigeria; 2Alex Ekwueme Federal Teaching Hospital, Abakaliki; 3Federal Medical Centre, Jabi, Abuja, Nigeria; 4University of Abuja Teaching Hospital, Gwagwalada; 5University of Nigeria Teaching Hospital, Enugu; 6Babcock University Teaching Hospital, Ilishan-Remo, Nigeria; 7Federal Medical Centre, Yola; 8Federal Medical Centre, Katsina; 9University of Port Harcourt Teaching Hospital, Port Harcourt; 10University of Calabar Teaching Hospital, Calabar; 11Federal Medical Centre, Owo; 12Usmanu Danfodiyo University Teaching Hospital, Sokoto; 13Lagos University Teaching Hospital, Lagos; 14University of Uyo Teaching Hospital, Uyo; 15Federal Teaching Hospital, Gombe; 16University of Benin Teaching Hospital, Benin-City; 17Ahmadu Bello University Teaching Hospital, Zaria; 18Nnamdi Azikiwe University Teaching Hospital, Nnewi; 19Irrua Specialist Teaching Hospital, Irrua; 20Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria.

*Correspondence to: [email protected]

Corrigendum to: Iregbu et al. Afr. J. Clin. Exper. Microbiol. 2021; 22 (1): 60-66. //dx.doi.org/10.4314/ajcem.v22i1.8

In the published article, there was an error in the initial of the author, “Mohammed A”, instead of “Mohammed Y”. This error has been corrected as appropriate. Continue reading “Antimicrobial Stewardship Implementation in Nigerian Hospitals: Gaps and Challenges”

Applying lessons learnt from Ebola for effective COVID-19 response in Africa

*1Aiyenuro, A. E., 2Onyeani, C. O., and 2Uche, N. C.

 1Team Lead and Research Analyst, Research4Knowledge, Lagos, Nigeria                                                   

1Network officer, Loving Gaze IO, SHOPS Plus Tuberculosis USAID Project                                          

2Department of Medical Laboratory Science, University of Nigeria, Nsukka

3Quality Assurance Officer, Loving Gaze IO, SHOPS Plus Tuberculosis USAID Project

*Correspondence to: [email protected]; +2348138642956

 

Abstract:

 The Ebola virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission via direct contact with blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids. In December 2019, a novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) emerged in Wuhan, China, attracting the notice of regional authorities and rapidly drawing global attention. In less than 4 months, COVID-19 spread through almost all countries and regions. The COVID-19 pandemic is wreaking havoc on the world economy, in addition to creating the current global public health crisis. According to the World Health Organization (WHO), 28,616 cases of Ebola were detected, and 11,310 people died during the outbreak in Guinea, Liberia and Sierra Leone. As of 17th December 2020, COVID-19 has killed 1,658,062 people, and positive cases have topped 74 million globally. Africa has suffered several outbreaks of Ebola Virus Disease (EVD); learning from the past is a good way to prepare for the future. We hope to highlight some of the lessons learnt from Africa’s response to previous epidemics that can help in the fight against the ravaging coronavirus pandemic.  Continue reading “Applying lessons learnt from Ebola for effective COVID-19 response in Africa”

Neglect of common infectious disease outbreaks during the COVID-19 pandemic: an impending crisis in Nigeria?

Soyemi, T.

Lagos State University College of Medicine, Ikeja, Lagos, Nigeria

Correspondence to: [email protected]; +2348128388296

Abstract:

Infectious diseases are major challenges of healthcare system in Nigeria. The coronavirus disease-19 (COVID19) pandemic has disrupted many systems including healthcare at all levels by creating disparities in the treatment, prevention, resource allocation and control of diseases in Nigeria. Premised on the foundation of circulating news and fact-checking platforms, this paper provides empirical evidence on varying perceptions on COVID-19 pandemic and apparent neglect of other infectious diseases while giving a critical analysis and comparison between them. Continue reading “Neglect of common infectious disease outbreaks during the COVID-19 pandemic: an impending crisis in Nigeria?”

A review of COVID-19 vaccines strategies and anti-vaxxers theories

*1Adesokan, A., and 2Obeid, M. A.

1PreciseMed, Glasgow, United Kingdom                                 

2Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University Irbid, Jordan

*Correspondence to: [email protected]; [email protected]

Abstract:

In what is a global record time of getting the COVID-19 vaccines available within 11 months, the world has equally been faced with several myths and conspiracy theories dissuading the public from accepting vaccination as an important measure in the response to the pandemic. We reviewed the leading conspiracy theories and balanced these with the scientific basis of viral transmission and replication and the broad role of vaccination in tackling this challenge. We briefly examined the design of the leading vaccines, and provided recommendations for worldwide COVID-19 distribution, acceptance and use. Continue reading “A review of COVID-19 vaccines strategies and anti-vaxxers theories”

Prognostic implication of hypocalcaemia in COVID-19: a systematic review

1Azeez, T. A.,2Lakoh, S., 3Bamidele, O. T., 4Ekhaiyeme, E., and 5Nwosu, S. A.

1Endocrinology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria                           

2Infectious Diseases Unit, Department of Medicine, College of Medicine and Allied Health Sciences, Freetown, Sierra Leone

3Department of Chemical Pathology, Babcock University Teaching Hospital, Ilisan Remo, Nigeria                 

4Endocrinology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria

5College of Medicine, University of Ibadan, Ibadan, Nigeria

*Correspondence to: [email protected]; +2347035728747

 

 

 

Abstract:

Coronavirus disease-2019 (COVID-19) has been declared as a pandemic affecting several millions of people worldwide. It has varied clinical manifestations ranging from asymptomatic to critical illness. It has led to the mortality of several affected individuals. However, the prognosis seems to vary from one person to the other and efforts are being made to identify the prognostic factors. Hypocalcaemia has been identified as a poor prognostic factor with a high frequency among individuals affected with COVID-19. This review aims to estimate the prevalence of hypocalcaemia among COVID-19 patients and identify the poor prognostic factors associated with the presence of hypocalcaemia in COVID-19 patients. Electronic medical databases were searched for publications on the prognostic implications of hypocalcaemia in COVID-19 infection, and relevant articles were selected for systematic review following PRISMA algorithm. The prevalence of hypocalcaemia among patients with COVID-19 was 40.0-74.4%. There was a significant association between the rate of hospital admission, intensive care unit (ICU) admission as well as septic shock and hypocalcaemia in patients with COVID-19. Hypocalcaemia is also associated with a higher mortality rate in these patients. COVID-19 patients with hypocalcaemia tend to have elevated C-reactive protein, interleukin6, alanine transaminase, procalcitonin, serum creatinine and low albumin. Hypocalcaemia is common in COVID-19 patients and is a poor prognostic factor in these patients. Presence of hypocalcaemia is associated with a severe illness and even death. Continue reading “Prognostic implication of hypocalcaemia in COVID-19: a systematic review”

Recent advances in the pathophysiology and management of sepsis: a review

*1Adegboro, B. A., 1Imran, J., 2Abayomi, S. A., 3Sanni, E. O., and 4Biliaminu, S. A.

Departments of 1Medical Microbiology and Immunology, 2Department of Medical Microbiology, LAUTECH Teaching Hospital, Ogbomoso, Nigeria  3Haematology, and 4Chemical Pathology, Nile University of Nigeria, Abuja, Nigeria

*Correspondence to: [email protected]

Abstract:

Sepsis is a syndrome consisting of physiological, pathological and biochemical anomalies caused by infectious agents. It causes clinical organ dysfunction, which is identified by an acute increase in the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score of two or more points. SOFA score is a score of three components that can be easily used at the bedside to track the clinical status of a patient while on admission, and these are altered respiratory rate of ≥ 22 breaths/minute, altered mental status, and systolic blood pressure of ≤ 100 mmHg. A patient with SOFA score of ≥ 2 has an attributable 2 – 25-fold increased risk of mortality compared to a patient with SOFA score of ˂ 2. This present review provides information on the new definition of sepsis and septic shock, aetiology, pathophysiology, biochemical, pathological and haematological changes, morbidity and mortality parameters, management, and prognostic factors in patients with sepsis. Continue reading “Recent advances in the pathophysiology and management of sepsis: a review”