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Background: SARS-CoV-2 infection poses tremendous challenge to the healthcare system of nations across the globe.Healthcare workers (HCWs) are crucial to the ongoing response to the SARS-CoV-2 pandemic. During the course of their work, they are exposed to hazards that place them at the risk of infection. Serological testing for SARS-CoV-2 among healthcare workers, which form a high risk group helps in identifying the burden of hidden infection in an institutional setting. The present study aims to investigate the seroprevalence of IgG antibodies against SARS-CoV-2 among HCWs during 1stand 2ndwave.Material & Methods:A prospective study was conducted at Viral Research and Diagnostic Laboratory, Government Medical College, Amritsar during JuneJuly2020 (1stwave)and April May 2021(2nd wave). During this period, 184 blood samples were collected from healthcare workers from Government Medical College and Hospital, Amritsar. Serum was separated and used for detection of Anti-SARS-CoV-2 IgG antibodies by ELISA technique.Results:Out of the 184 samples, 79 (42.9 %) were found to be seropositive. Higher seropositivity was seen i.e 60.8 % during the 2ndwave (April-May 2021 ) as compared to 25% during 1st wave. The increase in seroprevalence was observed in almost all categories of HCWs, Doctors 44.4% vz 13.04%, nurses 54.8 % vz 34.7 %, lab technicians 72% vz 30.4 % and housekeeping staff 72.2 % vz 21.7%. Also the unvaccinated HCWs showed higher seroprevalence during the second wave and 87.5 % of vaccinated HCWs had demonstrable IgG antibodies.Conclusions:High seropositivity was observed among healthcare workers due to their nature of work. Rise of seropositivity among unvaccinated HCWs during 2ndwave concludes that increase in seroprevalence was attributable to natural infection.The vaccine’s immunological response was also highlighted in the study.
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Background: The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge for healthcare systems worldwide. Earlier to SARS-CoV pandemic, coronaviruses were only thought to cause mild, self-limiting upper respiratory tract infections in humans. COVID 19 presents across a spectrum of symptoms. WHO recommends detection of unique sequences of virus RNA by Nucleic Acid Amplification Test (NAAT) such as real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). The aim of this cross sectional study was analysis and confirmation of Nasopharyngeal/oropharyngeal swab specimen by real-time reverse transcription polymerase chain reaction (RT-PCR).Material & Methods:This was a cross-sectional retrospective study that reviewed records of samples collected from June 2021 to March 2022. Nasopharyngeal/oropharyngeal swab specimen were collected from suspected COVID-19 subjects of various districts of Punjab and referred to Viral Research Diagnostic Laboratory [VRDL], Government Medical College [GMC], Amritsar for laboratory analysis and confirmation by real-time reverse transcription polymerase chain reaction (RT-PCR).Results:During the present study, a total of 11,27,005 samples were analyzed from June 2021 to March 2022 for SARS-CoV-2 detection by ICMR approved COVID-19 RT-PCR kits. Out of total 11,27,005 cases, 24,466 cases (2.17%) were found to be SARS-CoV-2 positive while 11,02,539 cases (97.83%) were SARS-CoV-2 negative.Conclusions:Ever since the COVID-19 global pandemic emerged, the developing countries are facing challenges regarding its diagnosis. Isolation of the infected person will eventually decrease the Reproduction number i.e Ro which will further interrupt the transmission cycle leading to decrease in community spread.
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Background: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. After a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. Currently, WHO recommends detection of unique sequences of virus RNA by rRT-PCR. ICMR also recommends use of CBNAAT using Cepheid Xpert Xpress SARS-CoV2. The aim of this study is to determine the prevalence of SARS-CoV-2 detected through CBNAAT.Material & Methods:This retrospective study was conducted from July 2020 to December 2021 at VRDL, GMC, Amritsar. The study group consisted of all the patients presenting with symptoms of Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI) who presented to hospital. The data was collected and subjected to statistical analysis.Results:During the present study, a total of 1,259 samples were analyzed for SARS-CoV-2 by CBNAAT from July 2020 to December 2021. Out of total 1,259 cases which were included in the study, 327 cases (25.97%) were found to be SARS-CoV-2 positive while 870 cases (69.10%) were SARS-CoV-2 negative and 62 cases were found to be inconclusive. 62 inconclusive samples were further tested by RT-PCR. Out of which, 15 were RT-PCR positive and 47 were RT-PCR negative.Conclusions:The COVID-19 pandemic has put forward unprecedented challenge to the public health system across countries to prepare themselves for this current crisis which included isolation, contact tracing, quarantine and enforcement of a nation wide lockdown starting 25th March, 2020.
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Background: Severe acute respiratory illness due to SARS-CoV-2 represents great global public health concern. The spectrum of disease ranges from mild to life-threatening. Surveillance of hospitalized patients with severe acute respiratory infections (SARI) is an important public health tool used to identify etiologies to understand the disease, track changes in circulating viruses and as an alert mechanism for potential pandemic viruses. We aim to find out the rate of SARS-CoV-2 positivity in SARI cases and further study the epidemiological and clinical characteristics of patients.Material & Methods:A Prospective study was conducted on 200 Severe Acute Respiratory Illness patients admitted at tertiary care hospital. The clinical, demographic, epidemiological, risk factors / co-morbidities of all the patients were recorded. Oropharyngeal and nasopharyngeal samples were collected and tested for SARS-CoV-2 by real time reverse transcriptase (RT-PCR) test.Results:Out of 200 SARI patients, 51 (25.5%) were tested positive for SARS-CoV-2. Maximum cases (54.90%) were in the age group of 41-60 years; males were infected predominantly (52.94%). The most common symptoms of presentation were fever (100%), cough (86.27%), dyspnoea (82.35%) and sore throat (56.86%). Comorbidities associated with COVID-19 were Hypertension (56.86%), Diabetes Mellitus (33.33%), Chronic Obstructive Pulmonary Disease (13.72%) and Coronary Artery disease (9.8%). More than 30% of the patients were admitted in ICU and 9.80% received mechanical ventilation.Conclusions:Evaluation of clinical and epidemiological profiles of SARI patients can help in understanding and managing the outbreak more efficiently. Close monitoring and quarantine will be required to prevent extensive transmission within the community.
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Background: Staphylococcus is notorious for its ability to become resistant to antibiotics. MRSA emerged as nosocomial pathogen in the early 1960. Methicillin Resistant Staphylococcus aureus are implicated in serious infections and nosocomial infection outbreaks, thus limiting the treating options to very few agents such as vancomycin and teicoplanin. Vancomycin has been regarded as the first line drug for the treatment for MRSA but its irrational use lead to emergence of vancomycin resistance. The Aim was to determine the prevalence and resistance of MRSA ,VRSA,VISA isolates from various clinical samples in a tertiary care hospital.Material & Methods:This present prospective study was done in the Microbiology department of Government Medical College. The study was conducted for a period of one and half year i.e from January 2019 to June 2020. All the samples (pus, urine, blood, body fluids, sputum etc) were processed as per standard protocols.Results:Out of 26,471 samples, 6578(24.85%) were found to be culture positive. 1583 isolates were identified as Staphylococcus aureus. Among them 1278(80.7%) were MRSA, 21(1.3%) were VISA and 8(0.5%) were VRSA. Maximum number of MRSA isolates were obtained from orthopaedics ward (22.7%) and Intensive Care Unit and most of them were isolated from pus(45%) followed by blood (19.09%)samples. Among them highest resistance were observed against azithromycin (85.6%), followed by ciprofloxacin (63.5%) and least resistance to rifampicin and doxycycline. Majority of the VISA and VRSA strains were isolated from ICU followed by orthopaedics, surgery. Most of them were isolated from pus followed by blood and urine specimen and most were found to be multidrug resistant while they retained their sensitivity to Linezolid and Teicoplanin.Conclusions:As there is high prevalence of MRSA isolates so the treatment options are limited to vancomycin. Overuse of vancomycin can lead to emergence of VRSA strains. So the need for rational use in the infection-control practices to prevent transmission of MRSA as well as VISA strains. Strict implementation of hand hygiene, decolonization of MRSA carriers,and education of healthcare team will be quite helpful.
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Background: Coronavirus disease?19 (COVID?19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS?CoV?2), has become a global pandemic, giving rise to a serious health threat globally. Many countries have seen a two?wave pattern in there reported cases during the period of pandemic. Similarly, our country has reported the first peak between March and October 2020 followed by the second peak between April and June 2021. Objectives: The objective of this study was conducted to describe the spatiotemporal patterns and early epidemiological features of COVID?19 cases from November 2020 to May 2021 in the central (Majha) region of Punjab state of India which was considered as the epicenter of the infection. Methods: The multiplexed real?time reverse transcription–polymerase chain reaction (RT?PCR) method was used to detect SARS?CoV?2, with co?amplification of specific target genes using real?time PCR kits. Results: During the second wave, test positivity rate for COVID?19 in our laboratory (the central region of Punjab) was recorded as 4.8%. The study revealed that an increased sustained proportion of COVID?19 incidence is present in young adult age group (20–39 years) with 8.65% positive rate followed by the older age group and least in young ones. It was observed that during the second wave, more symptomatic individuals are positive (10.26%) alongside it was also observed that male population (5.61%) was more prone to infection in comparison to females (3.78%). Whole?genome sequencing carried out on 120 random samples selected from all the districts of Majha region of Punjab state showed two prominent strains, namely alpha variant (95 cases) and delta variant (19 cases). Conclusion: A higher positivity rate in the second wave demonstrates the rapid spread of the new emerging virus variants and warrants the implementation of strict vaccination regimes and quarantine in the affected region.
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Introduction: Enterococci are indigenous flora of theintestinal tract, oral cavity & genitourinary tract of human.Over recent years, there is increased interest in Enterococcinot only because of their serious infections but becauseof their increasing resistance to many antimicrobials.Vancomycin being the only alternative available. But over thetime, there has been increase in Vancomycin Resistance whichhas spread globally. The aim of this study was to determinethe prevalence of Vancomycin Resistant Enterococci (VRE)isolated from various clinical specimens in a tertiary carehospital in North India.Material and methods: A cross-sectional study was conductedin the Department of Microbiology, Government MedicalCollege, Amritsar from July 1st, 2018 to June 30th, 2019. Allthe samples received were processed and identification ofEnterococci was made by using standard microbiologicaltechniques. Antimicrobial susceptibility was performed byKirby Bauer disc diffusion method as per CLSI guidelines.Results: Out of total clinical samples (11,098), 3,551 (31.9%)were found to be culture positive. Among the culture positive,91 (2.56%) isolates were identified as Enterococcus speciescomprising of 37 E.faecalis (41%) and 54 E.faecium (59%).Maximum number of Enterococci were isolated from urinesamples (54.92%) followed by pus & body fluids (38.02%) andblood (7.04%). 9.52% of E.faecium isolates were found to beresistant to vancomycin. All the strains were 100% susceptibleto Linezolid, Teicoplanin & Quinupristin-dalfopristin.Conclusion: Enterococci have become the major pathogenicbacteria that cause hospital-acquired infections due tomultiple-antimicrobial resistance. VRE has emerged asimportant nosocomial pathogen and pose serious threat topatients. Vancomycin should be cautiously used else wewould be left with very few therapeutic options.
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Introduction: Staphylococcus species is an asymptomaticcolonizer which has exhibited increasing resistance to variousantimicrobial agents in the recent times. Although, theorganism was naturally susceptible to all the antimicrobialagents, it has acquired multi drug resistance via variousmechanisms. In view of rising prevalence antimicrobialresistance, this study was undertaken to study the prevalenceof methicillin resistance and the emergence of linezolidresistance amongst the Staphylococcal isolates obtained fromvarious clinical samples in a tertiary care hospital.Material and Methods: This study was conducted from July2017 to December 2018 in a tertiary care hospital. Clinicalspecimens were processed, and Staphylococcal isolateswere identified using standard microbiological techniques.Antimicrobial resistance pattern of all the Staphylococcalisolates was determined and interpreted as per the latest CLSIguidelines.Results: A total of 989 Staphylococcal isolates were obtainedamongst which 498 (49.44%) were found to be methicillinresistant. Highest antimicrobial resistance was observedto beta lactam antibiotics followed by azithromycin andfluoroquinolones. 26 (2.628%) strains of Staphylococcalspecies were found to be resistant to linezolid while theyretained sensitivity to Vancomycin.Conclusion: The emergence of drug resistance in variousmicroorganisms has been a cause of global concern. Risingtrend of resistance has been observed to methicillin andlinezolid especially in indoor patients of the Intensive careunits. This study highlights the high prevalence of Methicillinresistance in both Staphylococcus aureus and Coagulasenegative Staphylococcus species in a tertiary care hospital inAmritsar, India. Although, linezolid resistance is emerging at aslow pace, adequate measures must be undertaken to preservethe therapeutic armoury.
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Human brucellosis is a major bacterial zoonosis reported worldwide. It is mainly an occupational disease reported in farmers, veterinarians, slaughterhouse workers, animal handlers and meat inspectors. Unavailability of automated blood culture systems makes isolation difficult and diagnosis mainly depends on serological and molecular methods. Materials and Methods: In a prospective study, a total of 127 serum samples, 28 from pyrexia of unknown origin (PUO) cases and 99 from high risk cases like veterinary personnel, butchers, nomads, farmers and gawalas, were serologically tested by Rose Bengal Plate Test (RBPT) and enzyme-linked immumosorbent assay (ELISA) and results were analyzed. Results: Out of 127 samples, 20 were tested positive by RBPT while 24 tested positive by ELISA. None of the PUO cases and veterinary personnel tested positive by RBPT or ELISA. Positivity was more among males, urban area, history of animal contact and consumption of raw milk. ELISA was found to be more sensitive and specific than RBPT. Conclusion: In our study significant prevalence of brucellosis was found among occupationally exposed persons. Most of the positive cases were found to be asymptomatic and those who were symptomatic had non-specific complaints. The findings signified silent presence of disease in our society. RBPT can be used as a rapid screening test in the peripheral resource poor labs and in absence of culture ELISA can be used for further confirmation.
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Surgical Site Infections (SSIs) are the second most commonly reported nosocomial infections after Urinary tract infection following a delivery by caesarean section. They add significantly to the morbidity, mortality and socioeconomic consequences in both patients as well as health care systems. Aim: To study the microbial etiology and antibiogram of post caesarean SSIs. Methods: This prospective study was conducted on pregnant women undergoing elective/emergency caesarean section irrespective of the indication during a study period from Jan 2017 to June 2018. 250 pregnant women undergoing LSCS developing signs and symptoms suggestive of SSI till the 30th post-operative day were included as cases. Under all aseptic precautions, two pus swabs were collected from every post caesarean women enrolled in the study. The first swab was used for gram staining while the other was inoculated on 5% blood agar and Macconkey agar. The isolates were identified by their colony characters and their standard biochemical tests. Antimicrobial susceptibility pattern was performed on Mueller Hinton agar plates by Kirby Bauer disc diffusion methods and interpreted as per latest CLSI guidelines. Results: Among 250 cases suspected of having SSIs, 93 aerobic isolates were obtained. Staphylococcus aureus (41.9%) was the most common organism isolated followed by Acinetobacter baumanii (15.1%), Escherichia coli(11.8%) Klebsiella pneumoniae(9.7%). 15/39(38.4%) of Staphylococcus aureus were observed to be Methicillin resistant. 15/45 (33.3%) of Gram negative isolates were Extended Spectrum Beta- Lactamase producers. Conclusion: Since MRSA is the leading cause of post caesarean SSI and the incidence of multidrug resistant pathogens as a cause of post-operative wound infections is rising with the increased prevalence of ESBL, therefore rational and judicious use of antimicrobials, active surveillance and reporting of SSI, enforcement of aseptic measures, implementation of infection control strategies and their periodic review is the need of an hour to reduce the rate of post caesarean SSIs.
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Introduction: Antimicrobial resistance is a cause of globalconcern as resistance is emerging enormously in hospitaland community settings. The occurrence of resistance tocephalosporins due to production of Extended SpectrumBeta- Lactamases is known worldwide. Hence, this studywas undertaken to detect the prevalence and antimicrobialresistance pattern of ESBL-producing gram-negative bacteriaisolated from various clinical samples received from theindoor patients of a tertiary care hospital.Material and Methods: Clinical specimens received fromthe patients admitted in Guru Nanak Dev Hospital, Amritsarfrom January 1, 2018 to June 30, 2018 were included inthe study. The samples were processed based on standardmicrobiological techniques. ESBL screening and confirmationwere done based upon CLSI guidelines. Antimicrobialresistance pattern of ESBL producing gram negative bacteriawas determined.Result:- A total of 8147 samples were received out of which1061(13.02%) gram negative bacteria were isolated. 227(21.97%) of the gram negative isolates were positive onscreening and 107 (10.08%) were confirmed to be ESBLproducers phenotypically. Maximum antimicrobial resistancewas observed to ciprofloxacin and amikacin. All the isolateswere sensitive to sulbactam ceftriaxone and imipenem.Conclusion: The present study highlights the prevalenceof ESBL-producing gram negative bacterial isolates in atertiary care hospital in Amritsar, Punjab. Measures such asthe establishment of antimicrobial stewardship activities,monitoring surveillance and infection control programmes,emphasizing on effective hand hygiene practices together withcoherent antibiotic policies should be enforced in the hospitalsto arrest the spread of ESBLs
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Fusarium infections are important problem worldwide, cause a broad spectrum of infections in human including superfi cial infections as well as locally invasive and disseminated infections. We report a rare case of perinephric abscess caused by Fusarium chlamydosporum in a child who had a recent episode of pyelonephritis. This case illustrates the ever increasing spectrum of rare but offending pathogenic fungi in an immunocompetent host. Fungal infections should always be suspected in patients having one or the other underlying risk factor or who are unresponding to antibacterial therapy. Early diagnosis of infection with a specifi c pathogen may lead to changes in antifungal therapy and may be critical for an improved outcome
Subject(s)
Anti-Bacterial Agents/administration & dosage , Diabetic Foot/complications , Diabetic Foot/microbiology , Diabetic Foot/surgery , Drainage , Female , Humans , Middle Aged , Paratyphoid Fever/complications , Paratyphoid Fever/diagnosis , Paratyphoid Fever/microbiology , Pseudomonas Infections/complications , Pseudomonas Infections/diagnosis , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/isolation & purification , Salmonella paratyphi A/isolation & purification , Skin Diseases, Bacterial/complications , Skin Diseases, Bacterial/diagnosis , Skin Diseases, Bacterial/microbiology , Skin Diseases, Bacterial/surgery , Skin Ulcer/complications , Skin Ulcer/microbiologyABSTRACT
Bacteraemia due to nonfermentative gram negative bacilli appears to be increasing in frequency particularly in hospitalized patients with severe underlying illness. A total of 159 (79.50%) organisms were isolated from blood cultures of 200 seriously ill patients. Out of these, 73 (45.91%) were nonfermentative gram negative bacilli. Pseudomonas aeruginosa was the commonest isolate (32.88%) followed by Acinetobacter spp. (23.28%) and Burkholderia cepacia (10.96%). Analysis of antimicrobial susceptibility testing showed multidrug resistant pattern with majority of the isolates being resistant to three or more drugs.