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Introduction: Citrobacter infection occurs in a hospital setting in patients with multiple comorbidities and it occasionally causes disease in general population. Neonates and immunocompromised are highly susceptible to Citrobacter infections which are mainly caused by Citrobacter freundii and Citrobacter koseri, the incidence of nosocomial infections caused by antibioticresistant Gram-negative pathogens is increasing. This study was done to know the development of drug resistance in emerging pathogen Citrobacter. Methods: The study was conducted in the department of microbiology in a tertiary care hospital for a period of 1 year. Bacterial identification was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. The antimicrobial susceptibility testing was performed by the Kirby–Bauer disk diffusion technique on Mueller‑Hinton agar, as per the Clinical and Laboratory Standards Institute guidelines. Results: In the present study, 1788 pus samples were processed for a period of 1 year, out of which in 808 pus samples, organisms were isolated. Staphylococcus aureus was isolated in 234 (28.96%) cases. Escherichia coli was isolated in 168 (20.79%) cases, Pseudomonas was isolated in 125 (15.47%) cases, and Proteus was isolated in 32 (3.96%) cases. Enterobacter spp. was isolated in 51 (6.31%) cases. Acinetobacter was isolated in 16 (1.98%) cases. Candida spp. was 17 (2.10%). Citrobacter spp. was isolated in 85 (10.52%) cases. In 85 cases of Citrobacter spp., 58 (68.23%) were C. freundii and 27 (31.76%) were C. koseri. In the present study, Citrobacter spp. was sensitive to amikacin in 36.47% of cases, gentamycin in 48.88% of cases, and levofloxacin in 29.41% of cases. Conclusion: Citrobacter species is an emerging pathogen developing drug resistance. Drug options are limited in the current scenario; hence, injudicious and inadequate use of antibiotics should be avoided.
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Background: Prescription error and irrational prescribing are the avoidable problems imposed on health care delivery system from prescriber side which must be addressed. Periodic prescription audit helps to curtail the error and irrational prescribing.Methods: A prospective observational study was conducted on patients visiting various Outpatient Department of RIMS, Ranchi, Jharkhand on all working days at 11:00 AM to 12:00 PM from 1 August 2018 to 31 July 2019. Various aspects of collected prescriptions were analyzed by using World Health Organization (WHO) prescribing indicators.Results: In this study, out of 700 prescriptions collected, 76 were excluded. Out of total 624 patients analyzed, 382 (61.28%) were male and 242 (38.72%) were female. 48 (7.69%) patients belonged to ?18, 464 (74.36%) to 19-64 and 112 (17.95%) to ?65 years of age group. Tablet (71%) was the most common dosage form. None of prescriptions were having registration number of the doctor. 242 (38.78%) prescriptions did not have a diagnosis duly written. The total no. of drugs prescribed in 624 prescriptions was 2176. Only 32 (5.13%) prescriptions were found to have medicines prescribed in block letters. Antibiotics (29%) were the most common class of drugs prescribed. Average number of drugs per prescription was 3.47. Only 48 (2.20%) drugs were prescribed by their generic name while total of injectables prescribed were 102 (4.68%). Total number of drugs from NLEM was 848 (38.97%). 196 (9.00%) drugs were fixed-dose combination.Conclusions: In our study, we found deficiencies in various parts of prescriptions. Prescribing pattern was not in accordance with WHO recommendation for prescribing practice.
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Introduction: Septicemia is the significant cause of morbidity and mortality in the neonates and is responsible for 30-50% of totalneonatal deaths .Each year in developing countries. It is estimated that 20% of all neonates develop sepsis and approximately1% die of sepsis related causes.In India, according to National Perinatal Database the incidence of neonatal septicemia has beenreported to be 30/1000 live births. The emergence of methicillin resistant Staphylococcus aureus (MRSA) in neonatal patientsis increasing. Early diagnosis and appropriate therapy of septicemia is of utmost importance to prevent morbidity and mortality.Aim and Study: It was to find out the bacteriological profile in neonatal sepsis and study their antimicrobial susceptibilitypattern including detection of MRSA.Methods: This study was conducted for a period of one year in the department of microbiology in a tertiary care hospital. A totalof 283 blood samples were collected using sterile precautions They were processed following standard laboratory protocol.Antibiogram was done using appropriate antibiotics by Kirby-Bauer disc diffusion method. Isolated of Staphylococcus aureuswere tested for methicillin resistance.Results : Blood from 283 neonates with the clinical signs and symptoms of sepsis were collected and samples were processed.Out of which 96 (33.92%) were culture positive.Total 53 (55.2%) Staphylococcus aureus were isolated out of which 27 (50.94%)were MRSA (Methicliin Resistant Staphylococcus aureus).Acinetobacter spp.was isolated in 15 (15.62%) cases.Klebsiella spp.was isolated in 13 (13.54%) cases. Psedomonas spp. was isolated in 3(3.12%) case . Antibiotic sensitivity test of MRSA wasdone and all MRSA isolates were sensitive to Vancomycin.Conclusion: Multidrug resistance among the isolates was common. Early diagnosis and institution of specific antibiotics afterstudying the sensitivity pattern will help in reducing neonatal morbidity and mortality and prevent emergence of drug resistantstrains. An effective infection-control programme, regular antibiotic susceptibility surveillance ,evaluation, and the enforcementand periodic review of the antibiotic policy of the hospital as well as the encouragement of rational antibiotic use will reducethe rates of development of bacterial resistance.