ABSTRACT
Background: Harbouring of potential pathogens in operationtheatres (OTs) and intensive care units (ICUs) of hospital is amajor cause of patient’s morbidity and mortality. Environmentalmonitoring by the microbiological testing of surfaces andequipments is useful to detect changing trends of types andcounts of microbial flora. High level of microbial contaminationindicates the needs for periodic surveillance aimed at earlydetection of bacterial contamination levels and prevention ofhospital acquired infections.Aim: The aims of the study were to count CFU (colony formingunit) rate of indoor air, to identify bacterial colonization ofsurface and equipments isolated from Operation theatres, ICUsand Labour room of a teaching hospital in district Kangra,Himachal Pradesh.Methods: This retrospective study, analyzing themicrobiological surveillance data from OTs over a period of 2years from January2017 to December2018 was conducted at atertiary care hospital. Air sampling of 8 OT’s, 4 ICU’s and 1 LRwere done by settle plate method. Swabs were taken fromdifferent sites, equipments and bacterial species were isolatedand identified from them as per standard guidelines.Result: A total of 105 air samples were collected for 2 yearfrom 8 OT’s, 4 ICU’s and 1 LR. The bacterial CFU/m3 /mincounts of air from all OTs ranged from Superspeciality OTSshowed less bacterial CFU rate of air (0-5 CFU/m3) followed byOpthalmology OT (5-8 CFU/m3) and highest in Gynae (30-46CFU/m3). CCU showed less bacterial CFU rate (10-15CFU/m3) followed by Surgery ICU (28-35 CFU/m3) and highestin PICU (38-42 CFU/m3), Labour room showed 42-51 CFU/m3.Bacterial species were isolated from 43.85 % out of total 157swab samples taken from all OTs and ICUs. The mostcommon isolate was Bacillus species 46% followed by CONS(22%). Pathogenic organisms isolated were 10% Gramnegative bacilli which included 3% Non-Fermenters, thecommon isolate was Klebsiella spp. amongst gram negatives.
ABSTRACT
Background: Enteric fever or Typhoid fever is caused mostlyby Salmonella enterica serovar Typhi and Salmonella entericaserovar Paratyphi is an important public health challenge forIndia, especially with the spread of antimicrobial resistance.The situation is further complicated by increased incidence insome parts of the country of S. Paratyphi A as a cause ofenteric fever. This serovar is not prevented by currentlyavailable typhoid vaccines and represents an increasing threatto human health.Purpose: The present study was undertaken to analyse thetrend in prevalence of culture-positive typhoid fever during thelast three years and to determine antimicrobial susceptibilityprofile of Salmonella Typhi and Salmonella Paratyphi Aisolated from patients of enteric fever in this part of the country.Material: This retrospective study incorporates a three years,(January 2015-December2018) laboratory data comprising52isolates of Salmonella. Cultures were identified by standardmethods. Antimicrobial susceptibility was done againstchloramphenicol, amoxicillin, co-trimoxazole, ciprofloxacin,ceftriaxone, cefixime and azithromycin as per correspondingCLSI guidelines for each year.Results: Salmonella enterica serotype Typhi (S. Typhi) wasthe more frequent serotype isolated i.e., 73% with theremaining 27% being Salmonella enterica serotype Paratyphi A(S. Paratyphi A). There was emergence of S. Paratyphi Aserotype in 2017-18. Antimicrobial susceptibility forchloramphenicol, amoxicillin and co-trimoxazole, ciprofloxacinand ceftriaxone was found to be 97.2%, 88.5%, 90.5%, 66.8%,99.4% for S. Typhi and 100%, 90.1% and 92.8%, 71.5%, 100%for S. Paratyphi A.Conclusion: The present study confers Salmonella ParatyphiA as the rapidly emerging pathogen of enteric fever. Theantibiogram of Salmonella Typhi and Salmonella Paratyphi Ashowed decreased susceptibility to fluoroquinolones and anotable decrease in the multi drug resistant strains ofSalmonella isolates with re-emergence of susceptibility to firstline antibiotics.