ABSTRACT
Background: Malaria is a major health problem in many parts of India and some parts of Andhra Pradesh, which is also one of the endemic areas for malaria. Several factors have been attributed to increased morbidity and mortality in malaria especially with altered hematological and coagulation parameters playing an important role. The aim of present study was to study the hematological and coagulation abnormalities that correspond to severity and the final outcome.Methods: The present study was carried out on 100 patients admitted during the period of November 2016 to October 2018 at Narayana Medical College and hospital, Nellore. All of these patients were confirmed by Peripheral Smear or MPQBC or Antigen Assay followed by detailed clinical history, physical examination and investigated with hematological and coagulation parameters. Then subsequently required routine and special investigation which was followed by monitoring the outcome of the patients with respect to morbidity and mortality.Results: Out of 100 patients 20 patients had severe anemia (Hb% <7 gm%) and most of them patients were falciparum and mixed infection cases. Thrombocytopenia was observed in 63% of the patients and severe thrombocytopenia (<50,000 mm3) was seen in 12% of the patients. PT and APTT were increased in 18% and 13% of the cases respectively. BT was increased in 5% of the cases. None of the patients expired in this study.Conclusions: severe anemia is a poor prognostic factor and has adverse outcome. Thrombocytopenia, increased PT, APTT does not have any correlation to mortality.
ABSTRACT
Background: Burkholderia cepacia is highly virulent and multidrug resistant organism to cause fatal and serious infections in ICUs leads to rise in mortality and morbidity. aim of present study was to know the prevalence of Burkholderia cepacia in blood stream infection in Intensive Care Unit and to know the drug susceptibility.Methods: This is a prospective study was carried out in the Intensive Care Unit and Department of Microbiology, Narayana Medical College, Nellore, from February to March 2018. As a part of routine investigations Blood, urine, sputum or tracheal secretions sent for culture and sensitivity to the Microbiology laboratory. By conventional method, all the samples were cultured (except blood) onto Blood agar, Chocolate agar and MacConkey, s agar; incubated for 18-24 hours at 37?C. Blood cultures were performed in BACT/ Alert 3D (Biomeriux), only positives were subculture by conventional method. Further analysis was done in culture positive samples only.Results: A total of 448 patients admitted in ICU were included in the study, from them 586 samples were collected. out of which we got 238 culture positives. Among them 19 patients were positive for Burkholderia cepacia, most of them isolated from blood (78.9%), followed by respiratory secretions (21.1%) and none of them were isolated from urine samples. Most of the isolates were sensitive to Meropenam and Tigecycline (89.4%) followed by minocycline (84.2%), ceftazidime (73.6%), levofloxacin (63.1%). While B. cepacia isolates showed high resistance to cefaperazone-sulbactam, ciprofloxacin, ticarcillin-clavulanic acid with (84.2%), (89.4%), (89.4%) respectively.Conclusions: To conclude that, Burkholderia cepacia is one of the emerging causes of septicemia with multidrug resistance, cross contamination may be the root cause so it should be treated quickly and effectively.