Evaluation Of Hand Hygiene Training And Its Effect On Mdr Bacteria Detection In Various Intensive Care Units Of Era’S Lucknow Medical College

Hand hygiene is nowadays considered as one of the most important measures to prevent transmission and acquisition of HCAIs (health care associated infections). Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of a successful hand hygiene promotion programme. A total of 50 ICU staffs(resident doctors, faculty & nurses e.t.c.) were included in this interventional study. Baseline data of hand hygiene practices of all staffs and pre-intervention hand culture were obtained. Post intervention hand culture were taken after 30 days of training and interactive sessions as well as continous availability of ABHR in the ICU. Results of post-intervention hand culture showed a marked decrease in isolation of bacteria specially those of MRSAand ESBL. MRSAwas low by 35% and in non of the cases ESBL was reported. In all the ICUs frequency of hand hygiene was poor(average 31%) but improved significantly after intervention (70%).Introduction of ABHR was found to be an effective tool for improving hand hygiene. As a result of periodic training, monitoring, surveillance hand cultures and awareness generating campaign, transmission of resistant bacteria can be reduced, thus reducing the burden of nosocomial infection in a hospital set-up.

Prevalence Of Tinea Capitis In A Tertiary Care Hospital,North India

Fungal infections are common in humans worldwide. Hot and humid weather conditions in the tropical countries like India make humans very susceptible to fungal infections. Tinea capitis (TC) is the superficial fungal infection of the scalp and hair. The true incidence of Tinea capitis is unknown. although infection can occur at any age.Tinea capitis is one of the most common infectious conditions in children worldwide.Atotal of 100 subjects were enrolled in study who were attending Dermatology Out Patient Department (OPD) in a tertiary care hospital.Hair sample was taken and culture was done on Sabouraud's Dextrose Agar(SDA).Species identification was done by slide culture.T.tonsurans was most common isolate.

Candida Haemulonii : An Emerging Pathogen in Immunocompromised Patient Showing Resistance to Azoles and Susceptibily to Echinocandins.

Emergence of a new species of non-albicans Candida species in Immunocompromised patient is a very alarming and life threatening trend. Accurate identification and prompt treatment in such patients is necessary to curtail mortality. Candida haemulonii as the name suggests is mostly isolated from blood culture. Susceptibility pattern of such isolates is important as most of them are not susceptible to the commonly used azole group of drugs rather they are susceptible to newer drugs like echinocandins. In such patient automated blood culture and susceptibility should be preferred over conventional blood culture so that early diagnosis and treatment can to some extent decrease the percentage of mortality.

Role of IgG anti-beta-lactoglobulin antibody in the diagnosis of cow's milk protein intolerance in India.

OBJECTIVE: Little is known about cow's milk protein intolerance (CMPI) in India. This study was aimed at finding CMPI cases and determining the role of IgG anti-beta-lactoglobulin antibody in the diagnosis of this condition in India. METHODS: From June 2004 to December 2005, 30 children with presumptive diagnosis of CMPI, based on endoscopic rectal or duodenal biopsy showing excess eosinophils and response to milk withdrawal, were enrolled and studied prospectively. Definite diagnosis was made in 20 children on the basis of positive milk challenge. IgG anti-beta-lactoglobulin antibodies were tested in children with CMPI before and after stopping milk and after milk challenge. Antibody levels were also studied in 27 age-matched disease controls and 50 healthy adults. RESULTS: The median age of 20 children (16 boys) with CMPI was 16.5 (6-36) months. Of them, 18 presented with diarrhea (12 bloody) and 2 had rectal bleeding. The presumptive diagnosis was most often (85%) based on colonic or rectal biopsy findings. Rectal biopsy was diagnostic in all 20 cases irrespective of the mode of presentation compared with duodenal biopsy which was diagnostic in 3 cases (p< 0.0001). There was no difference in antibody levels between cases and controls; the antibody level decreased significantly after milk withdrawal (p< 0.005), but did not rise significantly after milk re-challenge. CONCLUSIONS: CMPI is a common cause of chronic diarrhea in children in northern India. Sigmoidoscopy and rectal biopsy help in establishing the diagnosis in most cases. IgG anti-lactoglobulin antibody test is not useful in diagnosing CMPI in the Indian setting.

HFE, hepcidin and ferroportin gene mutations are not present in Indian patients with primary haemochromatosis.

BACKGROUND: Primary haemochromatosis is characterized by iron overload in the body tissues. It is common in populations of northern European descent. In such populations, 85%-90% of patients with this disease have a C282Y mutation in the HFE gene. In India, the disease is uncommon and the genetic defects associated with it are unknown. We therefore looked for mutations in the HFE and other genes involved in iron metabolism in Indian patients with primary haemochromatosis. METHODS: Five patients (including a brother-sister pair) with primary haemochromatosis diagnosed on clinical, biochemical and histological findings were studied. Genomic DNA was analysed by sequencing for the presence of mutations in all the 6 exons of the HFE gene and for previously described mutations in genes encoding hepcidin antimicrobial peptide and ferroportin. RESULTS: No patient had the C282Y mutation. One had homozygous H63D mutation. No other mutation was found in any HFE exon. Two previously reported splice site mutations in the HFE gene (IVS3 + 1 G/T and IVS5+1 G/A) were not detected. Four of the 5 patients had an HFE splice site mutation (IVS2 + 4 T/C; homozygous 2, heterozygous 2); however, this change was as frequent in 29 healthy subjects (homozygous 9, heterozygous 7), and was present in only 1 of the sibling pair patients, indicating that this represented a polymorphism. No patient had any of the previously described mutations in the genes for hepcidin and ferroportin. CONCLUSION: Our patients with primary haemochromatosis lacked mutations in the HFE, hepcidin and ferroportin genes. Further genetic analysis may help identify novel mutations responsible for primary haemochromatosis in these patients.