ABSTRACT
Background: Enteropathogenic Escherichia coli( EPEC) is a major cause of diarrhoea in children below 5 years of age. Serotyping is the classical method and PCR detection of virulence factors is a rapid way of detecting diarrhoeagenic Esch.coli. Objectives : To study the role of EPEC in Paediatric diarrhoea by both Serogrouping and Multiplex PCR assay and to analyse the antibiotic susceptibililty pattern of EPEC strains in our area. Materials and Methods : Prospective study of stool samples collected from children with diarrhoea and without diarrhoea who were below 5 years of age was conducted from May to November 2011. EPEC isolates were identified by Serogrouping. Escherichia coli isolates were subjected to Serogrouping and Multiplex PCR assay and those isolates which showed pathogenic genes were further serotyped. Antibiotic susceptibility pattern of EPEC isolates was determined by Clinical and Laboratory Standards Institute guidelines. Results : Among the Escherichia coli isolates in the diarrhoeal group, 36.8% were identified as EPEC by Serogrouping and 38.8% of them were found to possess EAEC genes by molecular characterisation. In the nondiarrhoeal Esch. coli strains , none agglutinated with EPEC polyvalent sera, 46.6% showed EAEC genes out of which 85.7% were of a single serotype O153. Among the Escherichia coli isolates which agglutinated with EPEC polyvalent antisera , 33.3% were positive for Enteroaggregative genes. Conclusion : EPEC is still an important pathogen in paediatric diarrhoeas . O serogrouping can still be relied upon for detection of EPEC. EAEC are present in classical ‘ O ‘ serogroups. Serotype O 153 has an increasing potential for asymptomatic carrier state in children below 5 years of age.
ABSTRACT
Background: Blood stream infections can lead to life threatening sepsis and require rapid antimicrobial treatment . The organisms implicated in these infections vary with the geographical alteration . Further , infections caused by MDR organisms are more likely to increase the risk of death in these patients . Objectives : To study the profile of organisms causing blood stream infections and analyse their antibiotic resistance patterns in our teaching hospital.: Materials and methods : Prospective study of 524 blood samples from clinically suspected cases of bacteraemia was performed over a period of three years. The isolates were identified by standard biochemical tests and antimicrobial resistance patterns were determined by CLSI guidelines. Results : Positive blood cultures were obtained in 22.9% of cases. Among the culture positives , gram positive bacteria accounted for 61.5% of cases ; the most common isolate being Staphylococcus aureus(29.2 %) . Of the gram negative isolates , bacteria belonging to Enterobacteriaceae were the predominant isolate , Klebsiella being the commonest isolate.The most sensitive drugs for gram positive isolates were Amikacin, Erythromycin , Ofloxacin and Piperacillin –Tazobactam.And the most sensitive drugs for gram negative isolates were Amoxyclav and Piperacillin – Tazobactam.The prevalence of MRSA in our Staphylococcal isolates was 37.1% and Vancomycin resistance in these isolates was 25.7%. Vancomycin resistance in E nterococcal isolates was 33.3 % .ESBL prevalence was 32.6 %.Conclusion : Increasing incidence of Drug resistant organisms in blood stream infections calls for increased efforts by clinicians to exercise caution in use of these drugs . Vancomycin should be replaced by simpler drugs like Linizolid or Cotrimoxazole to preserve this useful antibiotic and prolong its therapeutic usefulness.