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22. Epidemiological trends of RF/RHD in school children of Shimla in north India

Author

Negi, Prakash Chand, Kanwar, Anubhav, Chauhan, Renu, Asotra, Sanjeev, Thakur, Jarnail Singh, and Bhardwaj, Ashok Kumar

Subjects
time trends, prevalence, Environmental factors, India, Original Article, heart disease, rheumatic fever, GABHS
Abstract

Background & objectives: There are no active surveillance studies reported from South East Asian Region to document the impact of change in socio-economic state on the prevalence of rheumatic fever/rheumatic heart disease (RF/RHD) in children. Therefore, we conducted a study to determine the epidemiological trends of RF/RHD in school children of Shimla city and adjoining suburbs in north India and its association with change in socio-economic status. Methods: Active surveillance studies were conducted in 2007-2008 in urban and rural areas of Shimla, and 15145 school children, aged 5-15 yr were included and identical screening methodology as used in earlier similar survey conducted in 1992-1993 was used. The study samples were selected from schools of Shimla city and adjoining rural areas by multistage stratified cluster sampling method in both survey studies. After a relevant history and clinical examination by trained doctor, echocardiographic evaluation of suspected cases was done. An updated Jones (1992) criterion was used to diagnose cases of acute rheumatic fever (ARF) and identical 2D-morphological and Doppler criteria were used to diagnose RHD in both the survey studies. The socio-economic and healthcare transitions of study area were assessed during the study interval period. Results: Time trends of prevalence of RF/RHD revealed about five-fold decline from 2.98/1000 (95% C.I. 2.24-3.72/1000) in 1992-1993 to 0.59/1000 (95% C.I. 0.22-0.96/1000) in 2007-2008. (P

Published
2013

26. HISTOLOGICAL VALIDATION OF MYOCARDIAL AMYLOID QUANTIFICATION WITH CARDIAC MAGNETIC RESONANCE T1 MAPPING

Author

Pozo, Eduardo, primary, Castillo-Martin, Mireia, additional, Castellano, Jose, additional, Deochand, Rajiv, additional, Kanwar, Anubhav, additional, de Siqueira, Maria Eduarda Menezes, additional, Rodriguez-Garrido, Jorge, additional, Ramachandran, Sarayu, additional, Cham, Matthew, additional, Narula, Jagat, additional, Cordon-Cardo, Carlos, additional, Fuster, Valentin, additional, and Sanz, Javier, additional

Published
2014
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28. Hiding in Plain Sight: Contaminated Ice Machines Are a Potential Source for Dissemination of Gram-Negative Bacteria and CandidaSpecies in Healthcare Facilities

Author

Kanwar, Anubhav, Cadnum, Jennifer L., Xu, Dongyan, Jencson, Annette L., and Donskey, Curtis J.

Abstract

BACKGROUNDContaminated ice machines have been linked to transmission of pathogens in healthcare facilities.OBJECTIVETo determine the frequency and sites of contamination of ice machines in multiple healthcare facilities and to investigate potential mechanisms of microorganism dispersal from contaminated ice machines to patients.DESIGNMulticenter culture survey and simulation study.SETTINGThe study took place in 5 hospitals and 2 nursing homes in northeastern Ohio.METHODSWe cultured multiple sites on ice machines from patient care areas. To investigate potential mechanisms of microbial dispersal from contaminated ice machines, we observed the use of ice machines and conducted simulations using a fluorescent tracer and cultures.RESULTSSamples from 64 ice machines in the 5 hospitals and 2 nursing homes (range, 3–16 per facility) were cultured. Gram-negative bacilli and/or Candidaspp were recovered from 100% of drain pans, 52% of ice and/or water chutes, and 72% of drain-pan grilles. During the operation of ice machines, ice often fell through the grille, resulting in splattering, with dispersal of contaminated water from the drain pan to the drain-pan grille, cups, and the hands of those using the ice machine. Contamination of the inner surface of the ice chute resulted in contamination of ice cubes exiting the chute.CONCLUSIONSOur findings demonstrate that ice machines in healthcare facilities are often contaminated with gram-negative bacilli and Candidaspecies, and provide a potential mechanism by which these organisms may be dispersed. Effective interventions are needed to reduce the risk of dissemination of pathogenic organisms from ice machines.Infect Control Hosp Epidemiol2018;39:253–258

Published
2018
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32. Emergence of Resistance to Colistin During the Treatment of Bloodstream Infection Caused by Klebsiella pneumoniae Carbapenemase–Producing Klebsiella pneumoniae.

Author

Kanwar, Anubhav, Marshall, Steven H, Perez, Federico, Tomas, Myreen, Jacobs, Michael R, Hujer, Andrea M, Domitrovic, T Nicholas, Rudin, Susan D, Rojas, Laura J, and Kreiswirth, Barry N

Abstract

We report the emergence of colistin resistance in Klebsiella pneumoniae carbapenemase (KPC)–producing Klebsiella pneumoniae after 8 days of colistin-based therapy, resulting in relapse of bloodstream infection and death. Disruption of the mgrB gene by insertion of a mobile genetic element was found to be the mechanism, which was replicated in vitro after exposure to subinhibitory concentrations of colistin and meropenem. [ABSTRACT FROM AUTHOR]

Published
2018
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33. Impact of Antibiotic Treatment on the Burden of Nasal Staphylococcus aureusamong Hospitalized Patients

Author

Kanwar, Anubhav, Cadnum, Jennifer L., Jencson, Annette L., and Donskey, Curtis J.

Abstract

We examined the impact of systemic antibiotics on the burden of nasal Staphylococcus aureusin hospitalized patients. Of 1,482 patients, 237 (16%) had nasal methicillin-susceptible S. aureus(MSSA) and 92 (6%) had nasal methicillin-resistant S. aureus(MRSA) on admission.

Published
2018
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34. A cold hard menace: A contaminated ice machine as a potential source for transmission of carbapenem-resistant Acinetobacter baumannii.

Author

Kanwar A, Domitrovic TN, Koganti S, Fuldauer P, Cadnum JL, Bonomo RA, and Donskey CJ

Subjects
Cross Infection etiology, Cross Infection microbiology, Disease Reservoirs microbiology, Humans, Refrigeration, Acinetobacter Infections etiology, Acinetobacter baumannii drug effects, Acinetobacter baumannii genetics, Carbapenems therapeutic use, Equipment Contamination, Ice adverse effects, beta-Lactam Resistance genetics
Abstract

During an investigation of potential sources of transmission of multidrug-resistant gram-negative bacilli on a spinal cord injury unit, we recovered genetically related carbapenem-resistant Acinetobacter baumannii isolates from the stool of 3 patients, the hands of a nurse, and an ice machine water outlet spout and drain. Our findings suggest that contaminated ice machines could serve as a potential reservoir for dissemination of multidrug-resistant gram-negative bacilli., (Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.)

Published
2017
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35. Epidemiological study of hypertension in natives of Spiti Valley in Himalayas and impact of hypobaric hypoxemia; a cross-sectional study.

Author

Negi PC, Bhardwaj R, Kandoria A, Asotra S, Ganju N, Marwaha R, Sharma R, and Kanwar A

Subjects
Adult, Altitude, Cross-Sectional Studies, Diabetes Mellitus epidemiology, Female, Glucose Tolerance Test, Humans, India epidemiology, Life Style, Male, Middle Aged, Obesity epidemiology, Prevalence, Socioeconomic Factors, Young Adult, Adaptation, Physiological, Hypertension epidemiology, Hypoxia complications
Abstract

Hypertension is the result of interaction between genetic vulnerability and exposure to unhealthy lifestyle. However, studies investigating the impact of cardiovascular adaptive response to hypobaric hypoxia and extreme cold in natives of high altitude on the development of hypertension have yielded conflicting results. A community based cross-sectional study was carried out in an unique population of Spiti valley of Greater Himalayas residing at an altitude of 3100-3500 m (group 1) and 3500 m and above (group 2) to evaluate the impact of altitude of residence on prevalence of hypertension. 413 subjects, age 20 years and above were selected by stratified cluster random sampling technique and screened for recording socio-demographic profile, anthropometrics, fasting blood sugar and blood pressure. There was no significant difference in the mean age (40.1 vs.38.0 years) and gender distribution (65.7% vs. 61.4% females) between the two groups. The overall prevalence of hypertension was 22.5% and achieved higher significance in group 1 (27.5%) compared to group 2 (19%); p < 0.041. The socioeconomic profile and lifestyle of group from higher altitude was significantly different with people being less educated, agriculture as main occupation compared to the group at lower altitude. On comparison, the same group had a lower prevalence of obesity 17.4% vs. 35.9% (p < 0.000), Diabetes 0.4% vs. 4.1% (p < 0.03) and impaired fasting glucose 5% vs. 11.1% (p < 0.06). Obesity, age and altitude of residence were significantly associated as independent predictors of prevalence of hypertension in this study. Hypobaric hypoxia thus appears to have a protective effect from developing hypertension. The prevalence of hypertension in natives of Spiti valley is thus influenced by lifestyle related risk factors, age and possibly altitude of residence.

Published
2012

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