Search

Background: Healthcare associated pneumonia were reported to be the second most common healthcare associated infection in US intensive care units (ICUs). Aims and Objectives: Present study was aimed to determine the antimicrobial susceptibility pattern of isolates from cases of VAP. Methods: Ventilator associated pneumonia was identified as per the definition of Centre for Disease Control and Prevention. Laboratory confirmation was done by quantitative culture method. Thereafter identification of the organism along with its species and its anti-microbial sensitivity were done by Vitek 2 compact system using various ID and ATB strips. Results: A total of 42 clinical isolates were identified from 31 cases of VAP during the entire study period, Acinetobacter baumannii (n=20, 47.6%) was the predominant isolate. Tetracycline was found to be significantly sensitive (P = 0.008) in SICU isolates of A.baumannii when compared to its counterparts of MICU. Conclusions: Significant colonization is a prerequisite for occurrence of any infection. A thorough review of clinic-pathological as well as radiological findings should be performed while reporting a clinical isolate from tracheal aspirates. [ABSTRACT FROM AUTHOR]

Background: Production of metallo-β-lactamase, an enzyme that hydrolyze a variety of β-lactams including carbapenems leaving little therapeutic option is increasing. To manage patients effectively, it is important to know the local prevalence of MBLs in the hospital. Present study was undertaken to determine prevalence of metallo-β-lactamase production along with the clinical profile of Acinetobacter baumannii and Pseudomonas aeruginosa. Methods: Prospective cross sectional study was carried out during December-2010 to November-2011. Relevant demographic and clinical details were collected. Acinetobacter baumannii and Pseudomonas aeruginosa were subjected to antimicrobial susceptibility testing by Kirby-bauer disc diffusion method and mini API system, (bioMerieux-France). Imipenem/meropenem resistant isolates were tested for metallo-β-lactamase production by imipenem-EDTA combined disc test. Results: 81 strains of Acinetobacter baumannii and 28 strains of Pseudomonas aeruginosa were isolated. Most common specimens from which Acinetobacter baumanni and Pseudomonas aeruginosa isolated were from respiratory tract i.e. 47 (58%) and 12 (42.9%) respectively. Majority of the strains of Acinetobacter baumannii 44 (54.3%) and Pseudomonas aeruginosa 17 (60.7%) were isolated from non critical areas. Both organisms showed high prevalence of multidrug resistance with MBLs production of 29.6% in Acinetobacter baumannii and 42.9% in Pseudomonas aeruginosa. Conclusion: Metallo-β-lactamase-mediated carbapenem resistance is a significant threat in hospitalized patients. It should be addressed with rapid detection and stringent infection control measures. [ABSTRACT FROM AUTHOR]

Background and Objectives: Brucellosis is a bacterial zoonosis causing high economic losses worldwide. Because of nonspecific and chronic symptoms, diagnosis requires high clinical suspicion and laboratory confirmation. Prevalence of brucellosis in India, more so in Anand district, is not well studied. This study was conducted as a pilot to find prevalence of human brucellosis among high risk symptomatic cases along with the clinical profile and associated risk factors. Methodology: This is a cross-sectional descriptive study conducted in Anand district of Gujarat, India. Samples from 50 high risk symptomatic cases were subjected to serology, blood culture and genome detection by conventional Polymerase Chain Reaction (PCR) using B4/B5 primers, for detection of brucella infection. Data was analyzed using Epi Info software (version: 3.5.1). Results: We detected sero-prevalence of 14% and genome detection of 16% with no isolation in blood culture. Among them four (8%) were positive by serology and PCR both. Titers in seropositive cases ranged from 1:40 to 1:160. Fever was the most common clinical complain among sero-positive (71.4%) and PCR positive (62.5%) cases. History of direct contact with cattle was present in all serology and PCR positive patients. Consumption of unpasteurized milk or milk products (86%), consumption of uncooked or partially cooked meat (28.5%) and working as veterinarian (14.3%) were other risk factors identified. Conclusions: Thus we found brucellosis to be a significant health problem. A larger Indian study with follow up of positive cases, comparative study for standardization of various diagnostic modalities and response to therapy is strongly needed. [ABSTRACT FROM AUTHOR]

Objective: Infection by extended spectrum beta-lactamase (ESBL) producing strains of Escherichia coli and Klebsiella spp. is variably associated with presence of co-morbid conditions, predisposing factors and poor outcome. Objective of this study was to determine the prevalence of ESBL producing strains along with the outcome and risk factors in patients infected with such strains. Materials and Methods: This observational study was conducted on 6910 clinical samples. E coli & Klebsiella spp. were identified with detection of ESBL production according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Patients' clinical and demographic details along with risk factors and co-morbid conditions, type of response to antimicrobial therapy, length of hospital stay and mortality were collected. Results: 69.62% out of 563 E.coli and 62.80% out of 342 Klebsiella spp. were isolated from 6910 samples were ESBL producers respectively. Male:Female ratio was 1.36:1 and 2.37:1 for E coli and Klebsiella spp. respectively. Blood Stream Infection (p=.006), soft tissue infections (p=0.08), genital tract infections (p=0.03) and admission in intensive care units were significantly associated with risk of infection by Klebsiella spp. Immunosuppressive therapy (p=0.02) and diabetes mellitus (p=0.04) were significant comorbid conditions in ESBL producing E coli infections. The mean duration of hospital stay for ESBL producing E coli and Klebsiella spp. was 13.65 ± 12.6 and 17.89 ± 14.76 days with mortality of 8.6% and 13.34% respectively. Conclusions: Several co-morbid conditions and invasive devices were significantly associated with infection by ESBL-producing, strains of E. coli and Klebsiella spp. with longer duration of hospital stay and increased mortality in comparison to ESBL non-producers. [ABSTRACT FROM AUTHOR]

Background & objectives: Urinary tract infection is a common clinical condition affecting neonates to geriatric patients. Present study was undertaken to identify and characterize different uropathogens, to assess antimicrobial resistance pattern and, to find out factors associated with urinary tract infections. Methods: Observational study was carried out during February-2015 to January-2016 in a tertiary care teaching hospital. Relevant demographic and clinical details were collected. Identification and antimicrobial susceptibility testing of uropathogens was done by using VITEK®2-Compact microbiology systems. Results: From the 1,167 urine samples analyzed, 192 (16.5%) were positive for bacterial and fungal infections. UTIs were more frequent in males 109 (56.8%) and its incidence varied with age affecting the elderly patients more i.e. 57 (29.7%). E. coli was the most common pathogen implicated in UTI i.e. 82 (42.7%). Distribution of sample from intensive care units and various wards were similar i.e. 96 (50%) each. 112 (58.3%) patients had a urinary catheter; majority of the patients had 8-29 days of catheterization i.e. 46.4%. Resistance to antimicrobials was common but highly variable in our study. Predominant clinical conditions in the catheterized patients were cardio vascular failure followed by respiratory ailments. Interpretation & conclusion: E. coli was the most common etiological agent of UTI. Distribution of urine sample from intensive care units and various wards were similar. Majority of the patients were catheterized in ICU. [ABSTRACT FROM AUTHOR]

Background & objectives: Stenotrophomonas maltophilia causes opportunistic infections and is emerging as an important hospital-acquired pathogen. Present study was undertaken to investigate the prevalence, clinical profile, associated factors and antimicrobial susceptibility of S. maltophilia. Methods: Cross sectional retrospective study was conducted whereby patients' details including type of infection, hospital stay, indwelling devices, comorbid conditions and outcome till discharge were collected from January 2012 to March 2016. Identification and antimicrobial susceptibility were done by using Vitek2-compact-microbiological system. Results: 45 (0.17%) S.maltophilia strains were isolated from 27,132 samples received, forming 1.63% of total non-fermenters. Prevalence of S.maltophilia infection ranged from 0.06% in 2012 to 0.26% in 2015. Common sites involved were respiratory tract i.e. 55.5%, followed by bloodstream (20%), urinary tract (13.3%) and soft tissue (11.1%). 64.4% patients were male, and adults (26.7%) between 51-60 years of age. 66.7% of the isolates were from critical care units followed by wards (33.3%). Co-morbid conditions observed were COPD with respiratory complications i.e. 26.7% followed by cardiovascular diseases 22.2%, malignancy 11.1%, post surgical patients 11.1%, complicated UTI and trauma 8.8% each, CNS complications 6.7%, burns and cellulitis 2.2% each. All patients had exposure to broad-spectrum antibiotics and 66.6% had indwelling devices. 17.8% isolates were resistant to trimethoprim-sulfamethoxazole. Mortality observed was 20%. Interpretation & conclusion: S maltophilia is an emerging pathogen and its prevalence has gradually increased at our hospital. ICUs are the main hospital sites and respiratory infections main clinical condition. [ABSTRACT FROM AUTHOR]