ABSTRACT
CoNS when exposed to repeated or prolonged treatment with mupirocin ointment, may become a reservoir of high-level resistance determinants and then pass on this resistance to S. aureus. CoNS usually tends to be reservoirs of antimicrobial resistance factors, hence they generally lead to recurrence of multi-drug resistance. Hence, it is imperative to identify and discriminate the strains of S. aureus and CoNS. We wanted to analyse mupirocin resistance in coagulase negative Staphylococcus isolated from a rural population. METHODSThis study was performed in the Department of Microbiology, SMCH (Ghaziabad) among indoor as well as OPD patients of a tertiary care hospital. All coagulase negative Staphylococcus strains were taken from patient’s clinical specimens visiting the OPD or from patients getting treatment from the hospital. CoNS were identified by standard biochemical tests. An inhibition zonal area < 21 mm was considered as resistant. RESULTSMupirocin resistance was found to be 7 % in MRCoNS and 5 % in MSCoNS. MupRH and MupRL were 5 % and 7 % respectively. Only 5 (5 %) isolates showed MIC more than 512 µg / mL as described. CONCLUSIONSIn case of emergence of mupirocin resistance, other decolonization options ought to be considered.
ABSTRACT
Background: Healthcare Associated Infections (HAIs) are a major cause of high morbidity, disability, mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Handwashing is one of the fundamental measures for preventing transmission of hospital-acquired infections.Methods: This cross-sectional observational study was conducted in the surgical ICU from January to February 2018 to evaluate the presence of adhesion to the different aspects of HH. Inclusion criteria included all nurses and allied healthcare workers of surgical ICU while all other HCWs were excluded. Two observers collected all HH data. During this analysis, 3000 HH opportunities were observed. HH compliance was tested for all 5 moments as per WHO guidelines. Data thus collected were entered into a computer-based spreadsheet for analysis using SPSS statistical software (version 20) (IBM Corp., NY, USA).Results: Overall hand hygiene compliance observed as per WHO Guidelines was 79.8%. Nurses had an adherence rate of 77.8%; allied staff adherence was 81.8%. Nurses’ compliance after touching patient surroundings was lowest at 60.7%. 96% staff was aware of the facts like diseases prevented by hand washing, ideal duration of HH, reduction of health care associated infections.Conclusions: Overall, the involved ICUs showed low levels of adherence to best hygiene practices with overall compliance of 79.2%. This suggests the need to implement immediate strategies for infection control in the ICUs. A multidisciplinary intervention could be effective in preventing and control the HAI risk.
ABSTRACT
Background: Carbapenem resistance in Gram Negative Bacilli is an emerging threat in tertiary care centers which is mediated by Metallo-β-lactamase (MBL) enzyme. As per the National committee for Clinical Laboratory Standards (NCCLS), still does not have documented standard procedure from there several screening methods to detect their enzyme. Some subcontinents of India still awaiting to see prevalence and screening methods to detect enzyme which is responsible for Carbapenem Resistance. Aim: The present study was undertaken to early detection of MBL by screening methods in Gram Negative Bacilli isolated from hospital and the prevalence MBL production in carbapenem resistant bacterial isolates. Materials and methods: 176 consecutive different Gram Negative Bacilli (GNB) isolated from hospitalized patients which were tested antimicrobial susceptibility for different antibiotics including Carbapenem drugs as Imipenem by Kirby Bauer Disc Diffusion (CLSI 2010) and screening of Metallo-β-lactamase production by method as Imipenem- EDTA combined disc synergy test (ICDST) and Imipenem-Double Disc Synergy Test (I-DDST) which determine the MBL by zone size enhancement with EDTA Impregnated Imipenem. Munesh Kumar Sharma, Dakshina Bisht, Shekhar Pal. Detection of Metallo-β-lactamase producing Gram Negative Bacteria in clinical isolates in Tertiary care Hospital - A prospective study. IAIM, 2019; 6(4): 107-111. Page 108 Results: Out of 176 Gram Negative Bacilli, 20.45% (n=36) of isolates were resistance to Imipenem by disc diffusion method and 94.44% (n=34) by DDST EDTA impregnated Imipenem and 88.89% (n=32) showed enhancement of zone size ≥7 mm with EDTA impregnated Imipenem CDST. Imipenem susceptible bacteria strains did not show any enhancement with EDTA impregnated antibiotic disc. Conclusion: Critically ill patient’s therapy is cause of concern for MBL mediated imipenem resistance gram Negative Bacilli. Two methods used for supplementary support in treatment of patients. In both methods of detection DDST is more effective.