ABSTRACT
Catheter-Associated Urinary Tract Infection (CAUTI) is the second most commonly reported healthcare associated infection, accounting for upto 40% of all nosocomial infections. Silent catheter associated bacteriuria comprises a huge reservoir of resistant organism in hospitals particularly in critical care units. We prospectively studied 100 newly short term catheterized patients in a tertiary care hospital. Samples collected on day three and daily thereafter for semi quantitative urine culture and pus cell count. Antibiotic sensitivity was tested using Kirby-Bauer disc diffusion method. Out of hundred patients, 32 showed growth on fifth day and remaining 68 samples were culture negative up to seventh day. None of the culture positive samples had pus cells. Escherichia coli (35%) was the predominant isolate followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecium, Candida spp (15% each) and Coagulase negative Staphylococcus (5%). Among the Gram negative organisms, four strains of Escherichia coli and two strains of Klebsiella pneumonia were Extended Spectrum Beta Lactamases (ESBL) producers and 33.3% were Multidrug resistant Pseudomonas aeruginosa. Multidrug resistant pathogens in an asymptomatic short term catheterized patient are a major reservoir in hospitals. This emphasizes the importance of periodic surveillance for nosocomial infections in hospital and the periodic screening will also help us to frame antibiotic policy in a new tertiary care hospital.
ABSTRACT
Methicillin resistance Staphylococcus aureus (MRSA) is an important nosocomial pathogen that causes severe morbidity and mortality worldwide. In recent years, nosocomial outbreaks of methicillin resistance Staphylococcus aureus (MRSA) has become a major infection control problem. Colonized employees are generally asymptomatic; they are a potential reservoir and disseminator of MRSA in hospitals. Nasal screening of health care workers (HCW) for MRSA is performed routinely in several countries, typically when more than one MRSA – colonized patient is identified in high risk ward, such as intensive care unit (ICU). This study was performed at PSG Hospitals to assess the prevalence of MRSA nasal colonization in health care workers and their sensitivity pattern. The prevalence of MRSA carriage among HCW’s was quite low (3.3%) in our institution. It has been recommended that, in case of epidemic in the hospital, all health care workers should be examined for MRSA colonization.
ABSTRACT
Multi drug resistant Pseudomonas aeruginosa (MDRPA) and pan drug resistant Pseudomonas aeruginosa (PDRPA) isolates in critically ill patients are often difficult to treat. Prevalence of MDRPA and their antibiotic profile was investigated to select an appropriate empirical therapy. Moreover lack of sufficient data on prevalence of PDRPA in tertiary care hospitals indicated the need for this study. Pseudomonas aeruginosa was isolated in 245 patients over a period of one and half years from various clinical materials and their antibiotic profile was determined. Minimum inhibitory concentration (MIC) for Imipenem and Meropenam was determined by broth dilution method. Phenotypic confirmation test and EDTA double disk synergy test was used to detect Extended spectrum a-lactamase (ESBL) and Metallo-a-lactamase (MBL) producers respectively. Out of 245 isolates, 54 strains (22 %) and 11 strains (4%) were found to be MDRPA and PDRPA respectively. Carbapenem resistant isolates showed MICs ranging from 16 to > 64 microg/ml. Thirty eight strains (15.5%) were ESBL producers and six (54.5%) among 11 PDRPA were MBL producers. Prevalence of MDR and PDR isolates of Pseudomonas aeruginosa was found to be 22% and 4% respectively, which is less compared to other studies. Majority of the PDRPA isolates were MBL producers which have propensity to spread to other bacteria.