ABSTRACT
It has been two years since the global outbreak of the highly contagious and deadly corona virus disease (COVID-19) caused by SARS-CoV-2 first emerged in China. Since then, various diagnostic, prognostic and treatment strategies undertaken to address the pandemic have been dynamically evolving. Predictive and prognostic role of various biomarkers in COVID-19 has been a subject of intense exploration. We aimed to determine the association of Carcinoembryonic antigen (CEA) and various surrogate inflammatory biomarkers with the severity of COVID-19 disease. This retrospective cohort study was carried out on 98 patients admitted in Jaypee Hospital, Noida with COVID-19 disease. Information regarding demographics, laboratory parameters and clinical history was collected from Hospital Information System. Serum levels of CEA and other biomarkers such as Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, and Procalcitonin (PCT) were assessed. Correlation analyses were performed between the parameters and acute respiratory distress syndrome (ARDS) stages. Logistic regression and ROC curve analysis were performed to assess the various parameters for distinguishing COVID-19 patients requiring ICU admission. Mean hospital stay, NLR, CEA, IL-6, CRP, Ferritin (P< 0.0001) and PCT (P =0.01) were significantly higher in ICU patients when compared to general ward patients. NLR, median serum CEA, IL-6, and CRP levels were significantly higher in non-survivor compared to the survivors (P< 0.0001, 0.0341 and 0.0092). CEA correlated well with disease severity based upon ARDS classification and was a better marker to differentiate patient according to ARDS stages (ARDS 0 vs 2 P= 0.0006; 0 vs 3 P< 0.0001; ARDS 1 vs 2 P= 0.0183; 1 vs 3 P=0.0006). The area under the Receiver operating characteristic (ROC) curve for CEA was 0.7467 (95% CI- 0.64885- 0.84459) which revealed the potential of CEA as a biomarker to distinguish COVID-19 patients requiring ICU admission. CEA can be used to predict the severity of COVID-19 associated ARDS as well as patients requiring ICU admission. Along with routine inflammatory biomarkers (NLR, CRP, IL-6, PCT, and ferritin), CEA should be used for early identification of critical COVID-19 positive patients and for assessing prognosis.
ABSTRACT
Aims and objectives: 1. To put culture and sensitivity of urine samples from catheterised patients withsymptomatic and asymptomatic bacteriuria. 2. To detect the biofilm formation by tube adherence and tissueculture plate method. 3. To compare the antibiotic sensitivity between biofilm and non-biofilm formingorganisms. Materials and Methods: The study was conducted in the Department of Microbiology of YenepoyaMedical College and Hospital, Mangalore, India. A total of 100 bacterial isolates obtained from urine samples ofcatheterised patients were included in the study. The processing of the samples (culture and sensitivity) weredone according to standard microbiological techniques. The biofilm formation was done by tube adherence andtissue culture plate method. Results: Out of 100 uropathogens isolated, 96(96%) were Gram negative bacilli.Four isolates were Gram positive cocci. Amongst the Gram negative bacilli, E.coli were 69%, Klebsiellapneumoniae 19%, Acinetobacter species 5% and Pseudomonas aeruginosa 3%. All gram positive cocci wereEnterococci (4%). In the tube adherence method, the number of isolates showing biofilm formation was 51%and non-biofilm producers was 49%. By tissue culture plate method, the number of isolates showing biofilmformation was 63% and non-biofilm producers was 37%.The predominant organism showing biofilm formationwere K.pneumoniae(89%) followed by Acinetobacter spp. (40%).There was significant correlation betweenbiofilm formation and multi-drug resistance. Conclusion: Significant correlation between biofilm productionand multi-drug resistance was observed in our study. The study will help the clinician to take a call on nonresponding uropathogens and decide on better therapeutic options amongst those available in CAUTIs.
ABSTRACT
Aim: To study and compare the microbial flora of dental plaque after the use of a self-contaminated toothbrush and that of a single-use toothbrush. Materials and Methods: The study group included 40 young volunteers from Yenepoya Dental College, who were free from any systemic or oral disease. In these subjects, plaque samples were collected after 1 month use of a self-contaminated toothbrush. Each subject was given a set of 30 new toothbrushes and a toothpaste tube and instructed to use one toothbrush everyday and discard it after use. The plaque samples were collected on a weekly interval and cultured on Mitis Salivarius agar. The colonies were identified and speciated and their count was recorded. Results: Streptococcus mitis, S. mutans, S. sanguis, S. milleri and Candida were recovered from the samples. A highly significant decrease in their numbers was found after the use of a single-use toothbrush (P value 0.001). Conclusions : As a contaminated toothbrush can reintroduce microorganisms into the oral cavity, it may be a sound practice to change the toothbrush as frequently as possible.