Microbiological Profile and Antibiogram of Uropathogens Isolate in Tertiary Care Hospital

Introduction: Urinary tract infections (UTIs) are one of the most common bacterial infections in humans, both in the community and the hospital settings. The distribution of antimicrobial susceptibility data of UTI-causing microorganisms changes from time to time and from place to place. The susceptibility data provided by regional microbiology laboratories helps to choose the empirical antimicrobials to treat UTI. Materials and methods: Total 1381 urine were received in Bacteriology section of microbiology department from January 2022 to August 2022. Urine was processed for culture according to standard operating procedures at Microbiology laboratory, tertiary care hospital. Identification and antibiotic sensitivity testing was performed by automated VITEK-2 compact system. Results: In total, 1381 urine were received during the study period, 433(31.35%) cultures yielded significant pathogens and no organisms were isolated in 941 cultures and some sample was contaminate. The most commonly isolated organism were Escherichia coli (38.8%), followed by Candida spp. 88(20.32%), Klebsiellaspp (13.40%), Pseudomonas aeruginosa (12.24%), Gram positive organisms 12(2%) isolated. E. coli were most susceptible to Amikacin (87%), Fosfomycin (83%), colistin (82%), and tigecycline (78.39%). Klebsiella spp were most susceptible to colistin (72%). Nearly, 75% strains of Klebsiella spp were showing resistance to Carbapenems due to Carbapenemase production. Conclusion: Over enthusiastic use of the antibiotic has resulted in the emergence of drug-resistant bacterial strains in patients. The study of antimicrobial susceptibility patterns of uropathogens in a particular area can guide the clinicians in the rational choice of empirical treatment to prevent the misuse of antibiotics.

Identification and antibiotic susceptibility pattern of Staphylococcus aureus with special reference to methicillin resistant Staphylococcus aureus in tertiary care hospital

Background: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. It is responsible for a wide range of infections including superficial skin infections, food poisoning, osteomyelitis and septicemia. Aim of this study was to identify and to determine antibiotic susceptibility pattern of Staphylococcus aureus from various clinical samples. Materials and methods: Different clinical specimens were collected and processed for routine culture and antibiotic sensitivity test by standard microbiology techniques. Results: A total of 129 S. aureus strains were isolated from various clinical specimens out of which 84 (65.12%) were Methicillin Resistance Staphylococcus aureus (MRSA). 66(51.16%) S. aureus were obtained from indoor (IPD) patients. S. aureus was found higher in male than female. S. aureus was found highly resistant to Benzylpenicillin (94.57%) followed by ciprofloxacin (77.51%), Erythromycin (61.24%), and Cotrimoxazole (51.94%), Clindamycin (44.19%), and Gentamicin (17.05%). 1 (0.78%) of the isolates were resistance to Vancomycin and Linezolid. For urine isolates Nitrofurantoin was drug of choice. Conclusion: Methicillin resistant Staphylococcus aureus was found 65.12% of Staphylococcus aureus isolates. It was most common in males and hospitalized patients. Teicoplanin or Tigecyline seems to be drug of choice followed by Vancomycin, Linezolid, Tetracycline and Gentamicin. It would be helpful to formulating and monitoring the antibiotic policy and ensure proper empiric treatment.

Pediatric idiopathic macular hole � A case report and review of literature

Macular hole in the pediatric age group is usually post-traumatic unlike, the adult counterpart. Herein we describe a case of idiopathic macular hole occurring in a 9-year-old male who presented to us with complaints of diminution of vision in OD (oculus dextrus) for 2 months. The child underwent 25-gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. On follow-up his best-corrected visual acuity improved with type 1 closure of macular hole.

Oral fluid, a substitute for serum to monitor measles IgG antibody.

We have analyzed the suitability and potential of Oral Fluid (OF) to substitute serum in estimating measles IgG antibodies, during community surveys, by comparing the Optical Density (OD) of measles IgG antibodies in OF and serum of 100 apparently asymptomatic children. IgG antibody status was determined using commercially available - Measles IgG Capture ELISA. Sensitivity 89.5%, specificity 90.6% Concordance of 89%, coefficient of correlation r is equal to 0.97 (Karl Pearson's) and rho is equal to 0.86 (Spearman's), was found between OD value of OF and serum. The study emphasizes the potential of OF to surrogate serum in estimating Measles IgG antibody among children. The OF collection is advantageous over blood as it is painless. It is suitable for non-technical staff, easy to transport and less bio-hazardous.

Isolation of measles virus from cerebrospinal fluid of children with acute encephalopathy without rash.

OBJECTIVE: To determine the viral agent involved in cases of acute encephalopathy in children during an outbreak in Northern India. DESIGN: Virological and serological studies using serum and cerebrospinal fluid specimens from patients. METHODS: Serum and CSF specimens were tested by IgM ELISA for IgM antibodies to variety of viruses like Japanese encephalitis, West Nile, Dengue and Measles. The specimens were inoculated into Vero cell monolayer for virus isolation. The viral strains isolated were identified by indirect immunofluorescence test and qualitative in-vitro neutralization test using polyclonal and monoclonal antibodies to measles. Identity of the isolates was reconfirmed using RT-PCR method. RESULTS: Of the 28 specimens tested, 17 had IgM antibodies to measles. Commercial IgM ELISA kits confirmed the serological findings. Vero cell cultures yielded 4 isolates from CSF and 2 from serum specimens of six different patients. Cytopathic effect was typical of measles. Indirect imunofluorescence using polyclonal and monoclonal antibodies to measles HA protein, confirmed the measles etiology. Neutralization tests reconfirmed the measles strain isolation. RT-PCR amplified product was confirmed as measles. CONCLUSION: The isolation of measles virus from CSF and serum of children with acute encephalopathy without rash proved the etiological role of measles virus in this outbreak.

Exposure of Indian children to hepatitis A virus & vaccination age.

It is known that 90 per cent of children in India are exposed to hepatitis A virus (HAV) by the age of six years. The aim of the study was to determine when in early childhood maximum HAV infections take place and to deduce an appropriate age for vaccination against HAV. Blood samples of 499 children between the ages of three days and six years were collected and tested for the presence of antibodies against hepatitis A. A statistically significant negative correlation between IgG anti-HAV and age was observed (P < 0.01) up to 11.67 months when IgG anti-HAV positivity was found to be minimum (9.25%). Subsequently a significant positive correlation was noted (P < 0.01). Exposure to HAV was 28.9 per cent soon after the waning of maternal antibodies in the 13-15 month age group which increased to 52.5 per cent by two years of age and 90.9 per cent by 6 yr. It is concluded that in addition to other preventive measures, if children in India are to be vaccinated against hepatitis A they should be immunised against HAV by 9-10 months of age when the maternal antibodies disappear.

Comparative efficacy of three measles vaccines in Indian children.

A Comparative study of three types of measles vaccines was undertaken among 1005 children. Of these 527 were vaccinated with the Serum Institute of India (SII) vaccine, 230 with Schwarz (SC) and 248 were vaccinated with Edmonston-Zegreb (EZ) vaccine (imported from Zegreb). Though the majority of children reacted favourably with all the three vaccines (SII: 98.43%; SC: 93.40%; EZ: 93.0%) with a rise in titre, but the percentage of seroconversion was significantly higher with the SII vaccine (p < 0.01). The Schwarz and Edmonston Zagreb vaccines showed significantly less GM titre as compared with the other age group i.e. 9-12 months (p < 0.05). With Serum Institute of India (SII) vaccine the GM titres were almost similar in the different age groups. The overall GM titre obtained with the SII vaccine was significantly higher than the SC vaccine (p > 0.001) as well as the EZ vaccine (p > 0.001). It is of interest to note that among the infants, 22.5% children had measles antibody in them before vaccination.

IgG & IgM antibodies against measles virus in unvaccinated infants from Pune: evidence for subclinical infections.

IgG and IgM class of antibodies to measles virus were estimated in the plasma samples of 211 unvaccinated infants living under overcrowded conditions in Pune, Maharashtra. IgG antibodies to measles virus, in high titres, were detected in 52.1 per cent and IgM antibodies in 31.3 per cent of the infants studied. Most of the infants with IgM antibodies to measles virus had not suffered from an attack of measles. A history of contact with an older child with overt measles was available for 13.3 per cent of the 211 infants studied. Among these infants with such a contact history, 82.1 per cent had IgM antibodies to measles virus. These observations suggest that many infants studied by us, had experienced subclinical measles infections and many times older children with measles at home or in the neighbourhood might have transmitted such infections.

Measles outbreak in a tribal population of Thane district, Maharashtra.

In March 1992, an outbreak of measles, in the tribal population of Vavar village, Mokhada Taluk, Thane district, Maharashtra, was investigated. Two hamlets of Vavar village namely Sagpanipada (epidemic in October, November 1991) and Behedpada (epidemic in January, February 1992) were affected. In both hamlets, measles cases were confined to children below 10 yrs and 96% of the cases occurred in children below 6 yrs. Attack rates were 52.7% and 51.4% and case fatality rates were 31.2% and 15.6% at Sagpanipada and Behedpada, respectively. All the convalescent patients' sera possessed IgM antibodies against measles. A clear drop in IgM and a rise in IgG antibodies against measles was observed in 35 paired samples from convalescent patients. Fifty four per cent of sera from controls, possessed IgM antibodies. Migrating population appeared to have imported measles which flared up in an epidemic among the susceptibles. Priority immunization of the children of remote isolated populations may prevent such epidemics.

Experience with a measles vaccine manufactured in India.

Five hundred and twenty seven children between 7 months and 2 years of age were vaccinated with measles vaccine manufactured by the Serum Institute of India. The sero-conversion rate in children who had no antibodies previous to vaccination was 98.4% as tested in HI. Ninety per cent of children who had pre-vaccination measles antibodies showed a two-fold or more rise in HI antibodies. The side reactions of the vaccine were negligible.

Serological studies on subacute sclerosing panencephalitis.

This study reports the clinical picture and measles virus antibody titres in 32 patients with cases of suspected subacute sclerosing panencephalitis (SSPE). The history of myoclonic jerks, mental regression, inability to walk and slurred speech, were noted in these cases. The EEG showed generalised periodic complexes in twenty nine patients and only in three patients the EEG was not available. In all the above mentioned patients measles occurred at an early age (within a year).

Localization of arboviral antigen in brain tissues from patients with encephalitis.

Brain tissues from 38 patients with a clinical suspicion of encephalitis or encephalopathy were examined by two immunoenzymatic techniques for the detection of arboviral antigen. Group B arboviral antigen was identified in 23 of these tissues. This simple method could be used for the diagnosis of the causal agent of encephalitis.