ABSTRACT
During January to December, 1998, analysis of an outbreak of infections in the burn intensive care unit (BICU) of the hospital attached to the Dayanand Medical College, Ludhiana was carried out. A total of 868 clinical samples from 290 patients with more than 40 per cent thermal injury were investigated. These samples included 322 wound swabs, 325 blood and 221 urine samples. Bacterial pathogens were isolated from 80, 62 and 48 per cent samples of pus, blood and urine respectively. Among the nine different pathogens isolated, the more common were Pseudomona aeruginosa from pus, Staphylococcus aureus from blood and Escherichia coli from urine samples. Multidrug resistance was observed among these predominant pathogens. Identical drug susceptibility pattern was depicted by large number of isolates of Ps. aeruginosa, Staph. aureus, Esch. coli and Proteus mirabilis. Similar pathogens with identical drug sensitivity pattern were isolated from environmental samples of the BICU. The ongoing outbreak of hospital acquired infection (HAI) was significantly reduced after strictly adhering to the guidelines for control of HAI.
Subject(s)
Bacteria/drug effects , Burns/complications , Cross Infection/microbiology , Drug Resistance, Microbial , Drug Resistance, Multiple , Humans , Intensive Care UnitsSubject(s)
Adrenal Cortex Hormones/administration & dosage , Azathioprine/administration & dosage , Clinical Trials as Topic , Cyclophosphamide/administration & dosage , Drug Administration Schedule , Drug Therapy, Combination , Humans , Immunosuppressive Agents/administration & dosage , Lupus Nephritis/classification , PrognosisABSTRACT
To define the impact of HIV infection in India, the clinical and laboratory profile and the correlation of CD4 count to the likely opportunistic infection in a cohort of 134 HIV positive patients in Northern India was analysed. Majority of the patients, 72% and 67.8% (children and adults respectively) were asymptomatic, having been detected during routine screening and maintained that status for a median follow-up period of 3 years. Among the symptomatic patients, oropharyngeal candidiasis was the most common opportunistic infection followed closely by tuberculosis (both pulmonary and extra pulmonary) around 3.6-4.0 years from probable HIV infection with a median CD4 of 420-578 per cmm. Infection with Cryptococcosis, Cryptosporidiosis and cytomegalovirus occurred only after a significant fall in CD4 to < 100/cmm usually around 8-10 years from probable HIV infection. Pneumocystis carinii pneumonia was the terminal event among the 12 deaths at a mean CD4 count of 6/cmm. Non specific constitutional symptoms like fever, prolonged diarrhoea and significant weight loss were frequent. In general, the clinical profile of Indian patients with HIV bears much resemblance to African countries owing perhaps to the similar background of poverty, malnutrition and endemic infection.
Subject(s)
AIDS-Related Opportunistic Infections/immunology , Adolescent , Adult , CD4 Lymphocyte Count , Cause of Death , Child , Child, Preschool , Female , Follow-Up Studies , Humans , India , Infant , Male , Middle Aged , Risk FactorsABSTRACT
134 patients testing positive for HIV antibody during the period 1986-1993 were included in the present study. An in-depth analysis of the subjects revealed that the adult males seemed to have the highest propensity for HIV infection in this part of the country. Marital status had no bearing on incidence and route of seropositivity. This was not so in females. Extramarital heterosexual contact was the mode of HIV acquisition in adults in contrast to blood transfusion in children. Clinically, most of these patients were still asymptomatic. At presentation, oral Candidiasis was common. Pneumocystis carinii pneumonia (PCP) was the leading cause of death.
Subject(s)
Adolescent , Adult , Age Distribution , Child , Child, Preschool , Female , HIV Infections/epidemiology , Humans , India/epidemiology , Infant , Male , Middle Aged , Population Surveillance , Risk Factors , Rural Health , Sex Distribution , Sexual Behavior , Socioeconomic Factors , Urban HealthSubject(s)
Adolescent , Adult , Antimalarials , Child , Child, Preschool , Chloroquine , Drug Resistance , Humans , India , Malaria, Falciparum/drug therapy , Microbial Sensitivity Tests , Middle Aged , PrevalenceSubject(s)
Child , Child, Preschool , Humans , Male , Syndrome , Time Factors , Urination Disorders/diagnosisABSTRACT
Clinical aspects of centipede bite as seen in the Andamans are reported. Centipede bite produces excruciating local pain and burning. Local bleeding is common but transient. Occasionally local infection or necrosis develops. Constitutional upset occurs in a small minority. Centipede bites are never fatal and pain-relief is the cornerstone of treatment.