ABSTRACT
Introduction: Catheter associated urinary tract infections (CAUTI) is the most common health care associated infection (HAI), accounting for 40% of all HAIs in particularly in patients admitted to intensive care units (ICU) due to their more frequent necessity of urinary catheterization and longer duration of catheter use. Knowledge about Microbiological profile and antimicrobial sensitivity pattern of CAUTI is essential to implement the infection control system in a proper manner.Aims and objectives: To study the rate and microbiological profile of catheter associated urinary tract infections and in patients admitted in Intensive Care Units.Materials and methods: A one-year prospective study was conducted in which urine samples were collected from patients admitted in Medical ICUs on indwelling urinary catheter for >48 hours and processed in Microbiology Department according to standard procedures. CA-UTI rate was calculated and their microbiological profile and various resistance patterns were studied as per CLSI guidelines.Results: Out of 1406 enrolled patients, 64 patients developed CAUTI. Overall CAUTI rate was 4.06/1000 catheter days. Most common isolate in CAUTI cases was Klebsiella spp. (32.3%), followed by Escherichia coli (24.6%). Gram negative isolates showed higher sensitivity to aminoglycosides, imipenam and nitrofurantoin as compared to cephalosporins The Enterococcus spp. were 100% sensitive to linezolid and 71.4% sensitive to both vancomycin and teicoplanin.Conclusion: CAUTI rate in our ICUs was high compared to the benchmarks. Antibiotic sensitivity pattern of the pathogens involved was also low. This study provides the data of predisposing risk factors and its causative microbial flora for CAUTI in our tertiary care.
ABSTRACT
Tuberculosis caused by Mycobacterium tuberculosis has remained a major global health problem worldwide. TB requires prolonged period of time for isolation by conventional culture methods. The emergence and spread of multi drug resistant (MDR-TB) poses great threats and challenges in controlling the infection. MDR-TB is resistant to both first line drugs rifampicin and isoniazid. PCR tests are based on targeting the mutation in rpoB, katG and inhA genes which can detect resistance to these drugs. To compare microscopy, conventional culture and Line probe assay for the detection of M. tuberculosis & detect rifampicin and isoniazid resistance using Lineprobe assay in various clinical samples. A total of 347 suspected patients of tuberculosis were included in the study. Demographic details & clinical presentation was noted. Various samples were received & processed for ZN staining, culture on LJ media and Line probe assay. Out of 347 cases, majority of cases were in the age group of 51-60 years (18.4%). Majority of the population was males (65.1%). Among suspected tuberculosis patients, cough with expectoration (55.9%) was the commonest complaint. Microscopy was positive in 17.3%, conventional culture was positive in 16.1% and line probe assay was positive in 26.2%. Out of 347, 91 were diagnosed with MTB, out of which 85.7% were sensitive to both rifampicin and isoniazid whereas 14.3% showed resistance to either rifampicin / isoniazid or both. LPA & direct microscopy are a good screening method for early diagnosis and detection of drug resistance but are not a complete replacement of conventional culture which is still a gold standard.
ABSTRACT
Introducción: La candidemia se convirtió en una infección importante del torrente sanguíneo que se asocia frecuentemente con índices elevados de mortalidad y morbilidad. Las especies de Candida generan del 70% al 80% de las infecciones micóticas invasivas del torrente sanguíneo y son la cuarta causa más frecuente de infecciones hospitalarias del torrente sanguíneo. La identificación de las especies de Candida es importante, ya que las especies no albicans son cada vez más numerosas y resistentes a las drogas antimicóticas. El objetivo del estudio fue aislar e identificar diferentes especies de Candida asociadas con candidemia y analizar su patrón de susceptibilidad a los antimicóticos. Materiales y métodos: Los pacientes con sospecha de infecciones del torrente sanguíneo (ITS) fueron reclutados durante un período de un año para el estudio prospectivo. Se analizaron las características demográficas, la duración de la internación y los factores de riesgo asociados y la evolución clínica. El análisis de las muestras de sangre tuvo lugar mediante el sistema automatizado BacTAlert. La identificación y la susceptibilidad antimicótica de las levaduras fueron realizadas mediante el uso de dispositivo VITEK-2. Resultados: Las especies de Candida fueron aisladas en 30 de los 3146 cultivos recibidos (0.9%). La mayoría de los casos de candidemia tuvieron lugar en hombres (66%). Los factores de riesgo más frecuentes fueron el uso de antibióticos de amplio espectro, la vía central y la ventilación mecánica. Entre las levaduras aisladas, las especies de Candida no albicans fueron predominantes (60%), en comparación con la especie C. albicans (40%). La especie albicans presentó una susceptibilidad del 100% a los azoles y la anfotericina, en tanto que las especies no albicans fueron resistentes. De los 30 pacientes mencionados, 5 fallecieron. Conclusión: La prevalencia de Candida no albicans fue mayor en comparación con la prevalencia de Candida albicans. Las especies no albicans fueron más resistentes a los antimicóticos. En consecuencia, los pacientes internados deberían ser evaluados para identificar la candidemia.
Introduction: Candidemia has become an important bloodstream infection that is frequently associated with high rates of mortality and morbidity. Candida species account for 70-80% of invasive bloodstream fungal infections and represent the fourth most common nosocomial bloodstream infections. The identification of Candida species is important as the number of non albicans Candida species is increasing and they are becoming more resistant to antifungal drugs. The aim of the study was to isolate and identify various Candida species associated with candidemia and to study their antifungal susceptibility pattern. Materials and methods: Patients suspected of having BSI were enrolled on a one-year prospective study. Patient's demographic details, duration of hospital stay, associated risk factors and outcome were studied. Blood samples were analyzed by BacTAlert automated system. Identification and antifungal susceptibility testing of yeasts was done using VITEK-2 compact system. Results: Of 3146 blood cultures received, Candida species were isolated in 30 samples (0.9%). The majority of candidemia cases were in males (66%). The most common risk factors were use of broad spectrum antibiotics, central line and mechanical ventilation. Among the yeast isolates, non albicans Candida species were predominant (60%) compared to C. albicans (40%). Candida albicans showed 100% susceptibility to azoles and amphotericin whereas non albicans Candida species showed resistance. Of these 30 patients, 5 patients died. Conclusion: Prevalence of non albicans Candida was greater than C. albicans and cases were more resistant to antifungal drugs. Therefore surveillance for candidemia should be carried out in hospitalized patients.