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Background: Mobile phones are communication devices for communication nowadays and have emerged as a need of our life. Mobile phones also act as a reservoir for microorganisms. Human skin, wallets, bags, environment and food items are major sources of contamination for mobile phones. Medical students, healthcare workers and other non-teaching staff nowadays use mobile phones for communication in the workplace. Mobile phone contamination spreads from surfaces to hands. Aims and Objective: Our study was aimed to investigate the contamination of mobile phones by pathogens among health care workers. The objective of this study was to document for the role of mobile phones as sources in nosocomial infections. Materials and Methods: The study was done in Department of Microbiology and Pathology, Era’s Lucknow Medical College and Hospital, including teaching staffs from hospital and college, health care workers in all laboratories and wards. A total of 200 swab samples from various mobile phones of medical and technical staff of various wards, Outpatient Department Treatment, laboratories was collected after taking informed written consent from them. Culture was done on Blood Agar, MacConkey Agar, and Sabouraud’s dextrose agar. After overnight incubation, colonies were identified by Gram’s stain and Biochemical tests. Results: Highest mobile phone users are medical students, residents followed by teaching faculty. Smart phones or touch screen mobiles were used by maximum ie.90.5%. Among the isolated bacteria, Bacillus (39.5%), CONS (19%), E.coli (15.5%), Klebsiella (10.5%), Pseudomonas (5.5%), Staphylococcus aureus (4%), Enterococcus (2.5%). No growth was seen in 3.5%mobile phone sample cultures. Not a single fungal pathogen was isolated. Conclusion: The findings is the present study suggests that the mobile phones used by medical staff and health care workers act as source of transmission vehicles for pathogenic microorganisms.

BACKGROUND Azadirachta indica, commonly known as neem, neem tree or Indian lilac, Limbo, Nim, Nimba, Medusa and Vempu. It is typically grown in tropical and subtropical regions. Neem belongs to family meliaceae. Neem is a native tree of India. It is also called “village pharmacy of south Asia” (India) because of its enormous medicinal properties and people use it most of the time without knowing its multiple advantages. This study was done to know the efficacy of medicinal plant named Azadirachta indica (Neem) against pathogenic microorganisms and about its utility as disinfectant and floor cleaner. METHODS Agar well diffusion method, Culture plate method, inoculum preparation & its subculture methods were used to determine the antimicrobial activity of the neem leaf extract. Different concentrations of neem leaf extracts in culture plates were used for the study. In this method inhibited zones were measured. RESULTS Neem leaf extracts showed considerable antimicrobial activity against four target pathogens. In agar well diffusion method it showed maximum antimicrobial activity against Enterococcus and Staphylococcus aureus. Growth of inhibition was increased as the concentration of the neem extract in agar media increased and was maximum for Staphylococcus aureus. CONCLUSIONS The extract of A. indica, has antimicrobial activity against target pathogens Enterococcus, Staphylococcus aureus, Pseudomonas, and E.coli. With the old medicinal knowledge on neem, better economic and therapeutic utilization can be done by using modern approaches of drug development. KEY WORDS Neem Leaf extract, Antimicrobial Activity, Agar Well Diffusion Test, Zone of Inhibition

Background: Hospital acquired infection (HAI) or Nosocomial Infection (NI) is a well-known entity among patients. The onco-hemological patients are immune-compromised and are at high risk of acquiring these infections. Routine screening of these patients for the presence of micro-organisms, their identification and sensitivity at the time of admission, and during stay, can help us in identifying infections and guiding therapy. Aims and Objective: This study was undertaken to find out the role of routine screening of admitted patients in oncology ward with empirical therapy during neutropenic episodes. Nosocomial Infection Screening (NIS) test was performed for these patients. This test was done to detect Methicillin Resistant Staphylococcus Aureus (MRSA) and Extended Spectrum Beta Lactamases (ESBL) producing Gram Negatives. The NIS results obtained were correlated with organisms isolated from blood cultures. Material and Methods: This retrospective study was done from period of May, 2013 to February,2017 in patients of oncology ward. Only those patients whose NIS test and blood culture was sent to the lab were included in the study. Result: A Total number of 52 NIS tests and blood cultures were included in the study. Among 28 positive NIS samples, 19 samples correlated with blood cultures. Among 24 negative NIS sample 17 correlated with blood cultures. The p value was 0.017, PPV 73%, NPV 64%. SPSS software was used to calculated values. Conclusion: This study showed that NIS test can be used as a tool for predictive marker for septic episodes in these patients.There is a higher probability of developing septic episodes with positive NISsamples.At the same time negative NIS result does not rule out infection.

Introduction: Multidrug resistance pathogens have been found to be an increasing cause of neonatal sepsis in developing country like India. The present study was conducted to study the multidrug resistant pattern in bacterial isolates of neonatal septicaemia in Neonatal intensive care unit (NICU) of a tertiary referral hospital, Northeastern part of U.P., India. Material and Methods: It was a prospective study in which blood culture sample was taken from 450 neonates who had clinical features of sepsis or had presence of risk factors (one major–prolonged rupture of membranes/evidence of chorioamnionitis, intrapartum fever, foul smelling liquor or two minor–febrile illness of mother 2 weeks prior to delivery, meconium stained liquor amnii, more than 3 vaginal examinations during labour, low birth weight or prematurity, prolonged labour, low Apgar score) over a period one year. Results: A total of 102 (22.7%) suspects were found to be positive for sepsis. In present study, among positive cases of neonatal sepsis, the prevalence of early onset was around three forth as compared to late onset sepsis. Among all gram positive and gram negative isolates Klebseilla pneumoniae was found to be maximum followed by Grp B streptococcus. Out of total isolates only five isolates were MDR, whereas 4 MRSA and 17 ESBL. Conclusion: Presence of Multidrug resistant isolates as well an increasing rate of ESBL producers among neonates noted in this study is alarming. Thus regular monitoring of susceptibility profile of bacterial pathogen is the need of the hour to treat and curtail the increasing trend of neonatal septicemia. Keywords: Neonatal sepsis, Antibiotic susceptibility, Klebseilla pneumoniae Grp B streptococcus.

Scrub typhus is a rickettsial disease. It presents clinically with non-specific febrile signs and symptoms and is often under diagnosed. It is a major public health threat. Due to non- specificity of presentation and lack of awareness, there is delay in treatment. The changing epidemiology of scrub typhus should be kept in mind while attending patients with acute febrile illness. This study was undertaken to find the prevalence rate of scrub typhus at our centre and presenting features among cases. This study was done prospectively for a period of six month (July 2017- December 2017). All the patients presenting with fever, chills,headache, myalgia , breathlessness, encephalitis of more than 5 days duration were included in the study. Detection was done using rapid immune-chromatography (Scrub Typhus Rapid Kit, SD). All positive samples were reconfirmed by the Scrub Typhus Detect ELISA system for IgG/ Ig Mantibodies (In Bios International Inc., Seattle, WA, USA). As per inclusion criteria a total of 134 samples were received in laboratory. Of 134 samples 38 (28%) were positive for Scrub Typhus. Most of the cases were male and belonged to age group 31-60yrs age. Co infection was also seen in 18% of cases. A high index of suspicion should be made, and an early diagnosis and treatment is warranted to prevent disease complications. If left untreated, it can prove fatal. Multi-organ dysfunction especially respiratory impediment and shock are the important dangerous complications that lead to higher case fatality rates.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a new enveloped RNA virus known as Coronavirus (COVID-19) are most prevalent in humans and wild animals. All four species that is alpha, beta, delta and theta have been identified till date and are responsible for human disease; causing influenza like illness (ILI). This virus has similar lineage of Middle East Respiratory Syndrome coronavirus (MERS-CoV) and related Coronavirus (SARS-CoV). This outbreak initially presented as pneumonia-like illness in a group of people in Wuhan, China. The infection was said to be caused by seafood and unusual animals in the wholesale markets of this city. SARS-CoV-2 is highly infectious and has resulted in a rapid pandemic. As of now it has spread to 197 countries with total no of cases in the world being 3.76 million as of early march. The mortality till now is 7.11% .The cases have been increasing since its first discovery in China. In India also the number has been increased. Till now India has total of 39,980 cases and mortality is attributed to be 3.26%. As per data from Ministry of health and family welfare (MoHFW) death is more commonly seen in males with age >60years. Among these most of the deaths were related to other co-morbid conditions. This article will help the readers with an overview of novel Coronavirus spanning around the clinical features, diagnostic modalities, treatment strategies and infection control measures. It will also help in raising awareness among healthcare workers regarding COVID-19 and aid in early recognition of these patients. Moreover, this review will also focus on the most recent information for the effective management, prevention, and treatment of patients worldwide.

Introduction: Asymptomatic bacteriuria is the most common problem in elderly diabetics may be due to high glucose concentration in the urine of such patients that favour the growth of uropathogens. Objective: This study was done to determine the prevalence of asymptomatic bacteriuria in diabetic and non diabetic patients, to determine the uropathogens responsible for ASB and also to know the antimicrobial susceptibility pattern of the pathogens. Materials and Methods: Urine samples were collected from elderly diabetics and non diabetics. Cultures Antibiotic susceptibility tests were performed using standard microbiological technique. Results: ASB was found to be 9.8% and 4.6% in diabetics and non diabetics Escherichia coli were the most common isolates followed by Klebsiella pneumonia, Imipenem, Nitrofurantoin were the most sensitive antibiotics against the urinary isolates. Conclusion: The patients may progress to symptomatic UTI so treatment is advisable in elderly cases of asymptomatic bacteriuria with poorly controlled diabetes but after culture and sensitivity. Keywords: Asymptomatic bacteriurea bacteriuria, Diabetics and non diabetics, Culture, Antibiotic susceptibility.

Introduction: Researchers conducted a literature, technology and patent search that traced the history of understanding the “bacteriostatic and sanitizing properties of copper and copper alloy surfaces” which demonstrated that copper, in very small quantities, has the Copper alloy surfaces have intrinsic properties to destroy a wide range of microorganisms. Today copper, in the form of plumbing tube, copper or copper-alloy surfaces proved to be a significant step in decreasing the fungal and bacterial infections in hospitals. Aims and objective: To know the bactericidal and fungicidal properties of copper for its implication in various areas in preventing nosocomial infection. Material and Methods: Eight sterile petri dishes (four for Blood agar media and four for MacConkey agar media) and two sterile 30 ml screw capped bottles (for Sabouraud’s Dextrose agar media) were taken. Sterile copper discs were placed in four plates of Blood agar and MacConkey agar media and other four plates were without copper discs. In the same way copper piece was placed in one of the bottle with Sabourauds Dextrose agar media. Pure growths of E. coli, Klebsiella and candida were inoculated and incubated. Results: The plates with bacterial and fungal growth were reported accordingly. The growth was significantly reduced in Plates and bottles with copper discs. Conclusion: Copper alloy surfaces have intrinsic properties to destroy a wide range of microorganisms so copper’s use in water supplies and surfaces are recommended.

Introduction: Timely diagnosis of malaria is a challenge in most endemic areas due to lack of resources. The methods most commonly used are microscopy, regarded as the gold standard, and rapid dipstick tests (RDT) which detect antigens in blood. Enzyme-Linked ImmunoSorbent Assay (ELISA) based tests are fast and easy to perform especially when large number of samples have to be tested. p-LDH is a highly sensitive marker of malaria in blood The present study was done to assess the diagnostic performance of a p-LDH based ELISA on samples from clinically suspected malaria patients. Methods: We tested the sensitivity and specificity of a pLDH based, commercially available ELISA kit on both microscopy positive and negative samples. Microscopy was done for all suspected malaria patients and of these 146 samples (73 positive and 73 negative) were tested by the ErbaLisa PAN (LDH) malaria ELISA kit as well SD Bioline malaria antigen test (RDT) based on detection of both HRP-2 and p-LDH common to all four species. Results: The sensitivity of Elisa was 95.9% while specificity was 93.2 % compared to gold standard microscopy while RDTs had 91.8 % sensitivity and 86.3 % specificity. All 67 samples positive by both microscopy and RDT were also positive by ELISA. Conclusion: p-LDH based ELISA promises to be a cost effective and reliable option for diagnosis of malaria in endemic areas like India.

BACKGROUND: Acinetobacter species are one of the most frequent nosocomial pathogen causing bacteremia, urinary tract infection, secondary meningitis, skin and soft tissue infections and in particular nosocomial pneumonia with high mortality rate. The infections due to these are often difficult to treat due to their high antibiotic resistance. AIMS: To Study the prevalence and resistance pattern of Acinetobacter species in hospitalized patients of Era's Lucknow Medical College and Hospital (ELMCH), Lucknow. MATERIALS AND METHODS: Total number of 1850 samples were taken from patients admitted in wards of different Departments of ELMCH from Sep 2012 to Sep 2013. Identification of isolates was done by colony characteristics and biochemical reactions. The resistance patterns of these isolates were studied using various antibiotics by Kirby-Bauer disc diffusion test as per CLSI (Clinical Laboratory Standard Institute) guidelines. RESULTS AND CONCLUSION: 46 isolates were identified as Acinetobacter species. High level of resistance was observed for most of the antibiotics tested. More than 80% of isolates were resistant to amikacin, gentamycin, ceftriaxone, ciprofloxacin and tetracycline. 30.43% of isolates were resistant to cefoperazone/sulbactum and resistance to imipenem and colistin was 23.91% and 19.56% respectively. Acinetobacter species has become a worldwide concern as a cause of serious nosocomial infections. The emergence of increasingly resistant strains causing such infections has become a public health problem. Their early detection is necessary for timely implementation of strict infection control practices and judicious treatment with susceptible antimicrobials.

BACKGROUND: Typhoid fever, caused by Salmonella Typhi, is endemic in the Indian sub-continent including Bangladesh, South-east and Far-east Asia, Africa and South Central America. The disease can occur in all age group with highest incidence among children. A simple, reliable, rapid and early diagnostic test has been a long felt need of the clinicians. Blood culture is regarded as the gold standard for diagnosis. However, this requires laboratory equipment and technical training that are beyond the means of most primary health care facilities in the developing countries. To fulfill the purpose the present study was carried out in the Department of Microbiology, Era's Lucknow Medical College and Hospital for the period from Oct 2012 to Mar 2013. MATERIALS AND METHODS: 300 blood samples, collected aseptically from patients clinically diagnosed of Typhoid fever, were evaluated by blood culture, Tube and Slide Widal test RESULTS: This study included 300 cases having clinical suspicion of typhoid fever. Subjects were investigated by blood culture, Tube & Slide Widal agglutination tests. Among them, 42(14%) were subsequently confirmed by blood culture for S. Typhi, 123(41%) and 150(50%) cases were positive as having significant titre of Slide and Tube Widal agglutination tests respectively. Thus, in comparison to the gold standard test i:e blood culture, Tube and Slide Widal test were better and consumed less time. Comparing Slide and Tube Widal test, Tube is better. CONCLUSION: Tube& Slide Widal agglutination test is found to be better and could be applied as a good alternate in resource poor nation. Further, it is simple to perform, reliable when compared to blood culture test, and rapid, with results being available in 18 hrs when compared to 48 hours for blood culture.

Enterobacte r species are increasingly a cause of nosocomial meningitis among neurosurgery patients, but risk factors for these infections are not well defined. It was found that external cerebrospinal fluid (CSF) drainage devices, isolation of Enterobacter species from a non-CSF culture, prolonged administration of antimicrobial drugs before the diagnosis of meningitis that were inactive in vitro against Enterobacter species, immunosuppression and advanced age are also independent risk factors for Enterobacter Meningitis. Despite favourable treatment outcomes, EM is a serious infection associated with Enterobacter species colonization or infection at other surgical sites, with selective antimicrobial pressure, and with invasive CNS devices. The treatment is difficult because of inability of many of the antibiotics that are active against these bacteria to achieve adequate concentration in CSF. However third generation cephalosporins are active against gram negative bacilli and also achieved high concentration in CSF.

Background: Superficial mycoses or superficial cutaneous fungal infections are the most common mycotic infections worldwide, which involve outermost covering of skin and its appendages like hair and nail. The patients invariably try to neglect such type of infections and seek medical attention usually for cosmetic reasons and not because of discomfort. At least 10% of world’s population has dermatophyte infection. Dermatophytes are by far the most significant cutaneous fungi because of their widespread involvement of population and their worldwide prevalence. The dermatophytes are a group of closely related keratinophillic fungi that invade keratinised tissues-skin, hair and nails of humans and animals to produce an infection called as dermatophytoses or ring worm. Dermatophytes colonise superficial dead or desquamating layers of skin and its appendages. Superficial mycoses have become a significant health problem affecting children, adolescents and adults in developing countries. The present study was planned to characterise the different dermatophytes, non dermatophytes, budding yeast like fungi and other fungi in various types of superficial mycoses cases and there distribution in urban and sub urban population. Specimens like skin, hairs and nail were collected and subjected to KOH wet mount preparation and culture on SDA further identification was done by LCB mount and slide culture technique. Out of 400 patients attending dermatology OPD various superficial fungal infection Specimens were collected and dermatophyte sps. were identified. T. tonsurans was the most common isolated spp from T.capitis. T. mentagrophytes was the most commonly isolated spp. from T.corporis. Candida sps. was isolated from T. cruris. NDM were isolated from T. pedis. From cases of T. unguium.

Enterococci have emerged as important nosocomial pathogens from a variety of clinical conditions and the major reason for this is the trend of increasing antimicrobial resistance and enterococcal bacteraemia results in a high mortality. The present study was undertaken to determine the occurrence, species prevalence, antibacterial resistance, with a special reference to vancomycin and high level aminoglycoside resistance. Material and methods: The study was conducted on blood culture isolates. The antibiotic susceptibility of isolates by the Kirby Bauer disc diffusion method was done according to the CLSI guidelines. Screening tests for high level aminoglycosides and vancomycin and minimum inhibitory concentration (MIC) tests for vancomycin was done. The blood specimens were cultured and suspected growths were identified to species level and found to consist mostly of E. fecalis (70%). VRE accounted for 2 (91%) isolates and high level aminoglycoside resistance was seen in 47.82 and 60.86 isolates. The E. faecium isolates were more drug resistant than the E. faecalis isolates. Linezolid and Teicoplanin showed good anti-enterococcal activity. This study shows an emergence of Vancomycin resistant enterococcus (VRE) along with increased rate of multidrug-resistant enterococci. Regular surveillance of antimicrobial susceptibilities and treatment of enterococcal infections should be done effectively to limit the spread of multidrug resistance.