Application of whonet for the surveillance of antimicrobial resistance.

World over antimicrobial resistance is a major public health problem. The WHONET software program puts each laboratory data into a common code and file format, which can be merged for national or global collaboration of antimicrobial resistance surveillance. In this study, antimicrobial sensitivity of 4,289 bacterial isolates was studied by Kirby-Bauer disk diffusion method. -lactamase production was assessed by iodometric test method. Extended spectrum -lactamase (ESBLs) were screened by ceftazidime disk sensitivity. Drug resistance was high in most of the isolates. It was maximum (80-94%) for ampicillin, nalidixic acid and cotrimoxazole. It varied between 40-60% for gentamicin, clindamycin, fluoroquinolones and coamoxyclav. It ranged from 21 to 38% for amikacin and third generation cephalosporins. Constitutive -lactamase production was highest in S.aureus (28.9%) and ESBL production was maximum in Klebsiella spp. (53.6%). WHONET software has in-built analysis program which helps in forming hospital drug policy, identification of hospital outbreaks and recognition of quality control problems in the laboratory.

The effect of potassium iodide on the production of acid phosphatase by Sporothrix schenckii.

The present study was undertaken to find out the in vitro effect of potassium iodide (KI) on the production of acid phosphatase by fully characterized strain of S.schenckii isolated from a patient of Cutaneous Sporotrichosis. The enzyme acid phosphatase was estimated during the 3 phases of growth of S.schenckii, without and with three concentrations of KI incorporated in the culture medium. In the control and in the test proper, with various concentrations of KI, no adverse effect of KI was observed on the production of acid phosphatase in early and mid log phase of fungal growth. Whereas in the exponential phase in test proper, there was a statistical significant decrease in the enzyme production with 0.8% and 3.2% of KI. The low activity at 0.8% and 3.2% KI indicates that KI has inhibitory effect on the growth of S.schenckii and has led to decrease in the activity of the enzyme.

Bacterial indices of drinking water from natural sources.

Two hundred forty samples of water from twenty natural sources were subjected to the study for the detection of four bacterial indicators of faecal pollution. The samples were subjected to the detection of coliform, faecal coliform, E. coli, S. faecalis, Cl. welchii and plate count at 37 degrees C and 22 degrees C. All these samples were found unfit for human consumption. MPN for coliforms, E. coli and S. faecalis varied from 3 to 1800 per 100 ml of water, sero to 1800 per 100 ml water and zero to 540 per 100 ml of water respectively. Plate count at 37 degrees C and 22 degrees C varied from 2.5 x 10(3) to > 150 x 10(3) per ml of water. Cl. welchii was detected in 30.4% samples in rainy season and high plate count at 37 degrees C and 22 degrees C was observed during the same period.

Shima drinking water--a bacteriological analysis.

300 water samples, 60 from piped supply and 240 from 20 natural sources were analyzed bacteriologically for four important bacterial indicators every month over a period of one year. The MPN of total coliforms, Escherichia coli, Streptococcus faecalis were detected by multiple tube method and Clostridium perfringens was isolated using litmus milk medium. From piped water supply, only one sample was found unfit for human consumption. The plate count at 37 degrees C and 22 degrees C varied from 0.5 x 10(3) to 15 x 10(3) per ml. of water. From natural sources, MPN indices for coliforms, Esch. coli and S. faecalis varied from 3 to > 1800, 0 to > 1800 and 0 to 540 per 100 ml. of water respectively. About 1/3rd of samples showed presence of Cl. perfringens. The plate count varied from 1.0 x 10(3) to > 150 x 10(3) per ml. of water. Salmonella typhi was isolated in 1.25% samples by membrane filtration technique. The water from all the natural sources was unfit for human consumption whereas piped water supply was of good quality in general.

Neonatal morbidity in a hospital at Shimla.

During the study period there were 2063 live births. Of these 573 (27.8%) were low birth weight (LBW), 277 (13.4%) preterm and 148 (7.1%) small for date (SFD) babies. In all, 263 (12.7%) newborns suffered from one or the other morbidity. Birth asphyxia of varying severity developed in 130 (6.3%) babies [88 LBW and 42 normal birth weight (NBW) (p < 0.001)]. Respiratory distress syndrome was diagnosed in 82 (3.9%) babies, most being due to hyaline membrane diseases (31.7%), which affected 26 (9.4%) of preterm babies. Deep infections were seen in 109 (5.3%) newborns [60 LBW and 49 NBW, (p < 0.001)] and superficial infections were seen in 79 (3.8%) babies [46 LBW and 33 NBW, (p < 0.001)]. Hyperbilirubinemia was detected in 78 (3.8%) babies. In one fifth of the babies, the cause of hyperbilirubinemia remained unidentified even after detailed investigations. Hypothermia was observed in 59 (2.9%) newborns [48 LBW and 11 NBW, (p < 0.001] and congenital malformations were seen in 24 (1.7%) babies. Morbidity was found to be high amongst LBW and preterm babies. The incidence of deep infections and hypothermia was high in our study.

Non-fermenters in urinary tract infection.

Sixty four (4.4%) strains of non-fermenting gram negative bacteria (NFGNB) were isolated out of 1,380 bacterial isolates from 7,784 urine samples, of which 43 were isolated from male patients and 21 from female patients. P. aeruginosa was found to be the commonest (67.2%) followed by A. lwoffi (7.8%), A. anitratus and P. acidovorans testosterani (6.2% each), P. maltophilia and P. denitrificans (4.8% each), P. putida and P. vesiculare (1.5% each). Forty two(65.6%) of these isolates were isolated as pure cultures and 22(34.4%) as predominant organisms. Most of these isolates i.e. 50-88.8% were sensitive to Norfloxacin and Ofloxacin and 22.2% to 66.6% of these isolates were sensitive to Gentamycin and Cephalexin whereas 11.1% of these isolates were sensitive to Co-trimoxazole and Ampicillin. All of these isolates were resistant to Penicillin and Tetracycline.

Neonatal sepsis in hospital born babies.

Incidence of neonatal sepsis in a study carried out among hospital born babies was found to be 5.3 per cent significantly high (10.9%) amongst low birth weight compared to (3.1%) normal birth weight babies. Sepsis related mortality also exceeded significantly in low birth weight babies. Positive cultures were obtained in 36.7 per cent of babies with sepsis. The organisms identified were Staphylococcus pyogenes (40%), E. coli (27.5%), Klebsiella spp. (15%), Staphylococcus epidermidis (10%) and Enterobacter spp. (7.5%). Gram negative bacilli predominated in early onset (< 72 hrs. of life) and gram positive cocci in late onset. Mortality with early onset culture positive neonatal sepsis was significantly high compared to late onset. The bacterial isolates obtained were found to be resistant to routinely used antibiotics (penicillin, ampicillin and gentamycin). Third generation cephalosporins and aminoglycosides (netilmycin) were found to be effective in treatment of neonatal sepsis.

Specificity of antisera to sex steroid II--effect of unsaturation in ring-B of testosterone.

In a testosterone coated tube enzyme immunoassay format, a structurally modified enzyme label 6-dehydrotestosterone-17-hemisuccinate-penicillinase (6-DT) shows lower crossreactivity (25%) towards 5 alpha-dihydrotestosterone (5 alpha-DHT) as compared to testosterone-17-hemisuccinate-penicillinase (45%). The antiserum, generated against testosterone-3-0-carboxymethyloxime-BSA conjugate, showed high crossreactivity with 5 alpha-DHT when evaluated with a RIA (44.8%) using tritiated testosterone tracer. The results suggest that the conformational changes in the new modified testosterone heterologous enzyme tracer (6-DT) brings about desired changes in crossreactivity of antisera against 5 alpha-DHT. The new assay format presents a novel approach to minimize interference due to 5 alpha-DHT crossreactivity in testosterone immunoassays.

Sporotrichosis of abdominal wall.

A rare case of sporotrichosis of abdominal wall has been described from high mountainous region of Himachal Pradesh. Its clinical importance has been discussed in the light of available literature.

Nocardia associated with pulmonary tuberculosis.

A total of 209 cases of pulmonary tuberculosis were screened for the presence of Nocardia in their sputa. In 2.9 per cent of the cases Nocardia asteroides was isolated. The increasing importance of this microorganism has been discussed in the light of other reports from India.

Health status of nurses and yoga. I. Baseline data.

In this ongoing ICMR project on "Effect of Yoga on the Health of Nurses", some baseline data on the health of nurses of Nehru Hospital, P.G.I., Chandigarh are reported. This was obtained before the start of yoga therapy in selected cases and collected with the help of six psychological tools. Out of a total of 501 nurses, 452 (90.2%) could be contacted and studied. Mean age was 30.43 years and mean years of service 9.93 years. Mean scores on the psychological tests indicated poor health status of nurses, average neuroticism, depressive tendencies and role stress. Sense of Well-Being was high in them. The data is discussed in the light of researches in this area. This is the first of a series of three articles to be published in the Journal.