ABSTRACT
Carbapenem resistance among clinical isolates of Enterobacteriaceae, especially Escherichia coli and Klebsiella pneumoniae, is largely conferred by metallo-β-lactamase (MBL). Fifty-one non repetitive isolates of carbapenem-resistant (Meropenem and Imipenem) E. coli and K. pneumoniae were studied to determine the molecular mechanism for resistance. Presence of blaNDM and blaVIM was determined by polymerase chain reaction (PCR) and DNA sequencing. blaNDM was detected from majority of carbapenem-resistant K. pneumoniae (75%) and E. coli (66.6%). Timely detection and appropriate and aggressive infection control measures are required to control the spread of these bacteria in healthcare settings.
ABSTRACT
BACKGROUND & OBJECTIVES: Members of the genus Acinetobacter are an important cause of nosocomial infections and with widespread resistance to various antibiotics. Extended spectrum beta lactamase (ESBL) associated resistance among Acinetobacter species is now known. The aim of this study was to speciate clinical isolates of Acinetobacter, analyze their resistance patterns, identify the production ESBLs and compare the role of different cephalosporins in detecting ESBL production in the isolates. METHODS: One hundred and fifty clinical isolates of Acinetobacter were speciated by various phenotypic tests. Antibiotic susceptibility was determined by the standard disc diffusion method. ESBL production was detected by the double disk approximation test using clavulanate containing disk and four different cephalosporin disks. Results of the above test were confirmed using the NCCLS phenotypic confirmatory test for ESBLs on a limited number of isolates. RESULTS: Most of the isolates were of respiratory origin. A. calcoaceticus A. baumannii (Acb) complex was the predominant species isolated (75%). Most isolates were resistant to the antibiotics tested including the third generation cephalosporins. Most isolates were sensitive to carbapenems and cefoperazone-sulbactam. ESBL production was detected in 28 per cent of the isolates. In the double disc approximation test, cefepime and cefotaxime could detect most of the ESBLs in Acinetobacter isolates. INTERPRETATION & CONCLUSION: A high level of antibiotic resistance was found in Acinetobacter in our study. Acb complex was the predominant and the more resistant species. Relatively high levels (28%) of ESBL have been detected in Acinetobacter and may reflect the scenario in India. ESBL production in Acinetobacter should be promptly detected and reported as it helps in treating individual cases and also in controlling the spread of these resistant phenotypes to other individuals.
Subject(s)
Acinetobacter/drug effects , Drug Resistance, Bacterial , Microbial Sensitivity Tests , beta-Lactamases/biosynthesisABSTRACT
Hepatitis E virus is recently recognised as an important cause of non-A, non-B hepatitis. A total of 569 serum samples were screened for HEV between April 1997 and March 2000, by a commercially available HEV IgM capture ELISA. The diagnosis was invariably acute viral hepatitis for differential diagnosis of jaundice. The percentage of seropositivity was found to be 18.8% in confirmed Hepatitis E cases.
ABSTRACT
PURPOSE: To study the occurrence of Uropathogenic Escherichia coli (UPEC) in cases with urinary tract infections. METHODS: A total of 220 cases from urinary tract infections and 50 stool samples from apparently healthy individuals were included. The colonies identified as Escherichia coli were screened for virulence factors namely haemolysin, Mannose Resistant and Mannose Sensitive Haemagglutination (MRHA, MSHA), Cell surface hydrophobicity and Serum resistance by recommended methods. RESULTS: Among 220 cases 91(41.36%) were haemolytic, 68(30.9%) showed MRHA, 58(26.36%) were cell surface hydrophobicity positive and 72(32.72%) were serum resistant. In 50 controls 3(6%) were haemolytic, 6(12%) showed MRHA, 9(18%) showed cell surface hydrophobicity and 12(24%) were serum resistant. The difference between cases and controls for haemolysis and MRHA were significant (p< 0.001 and p< 0.01 respectively). A total of 14 atypical Escherichia coli were isolated from urine and all showed the presence of one or the other virulence markers.Out of 18 mucoid Escherichia coli isolated 10 were serum resistant. Interestingly among the 15 Escherichia coli isolated from patients with pyelonephritis 8 were UPEC. CONCLUSIONS: Out of 220 urinary isolates, 151 could be labelled as UPEC.
ABSTRACT
A twenty-six year old female presented to the Ophthalmology OPD with swelling of the upper eyelid. On excision, two long, thin, dead worms were removed. Microscopic and HPE showed the worms to belong to the Dirofilaria species.