Clinicobacteriological profile and antibiotic susceptibility pattern of chronic dacryocystitis in adults

Background: Chronic dacryocystitis is a constant menace to delicate ocular structures. If left untreated, it can lead to sight as well as life-threatening complications. However, such complications may be prevented by timely intervention along with appropriate antibiotic prophylaxis. The objectives are to investigate the current bacterial community profile in adult patients with chronic dacryocystitis attending a referral eye care center in Odisha and to determine their drug susceptibility pattern to commonly used antimicrobial agents. Materials and Methods: An observational study was conducted on 70 adult patients with chronic dacryocystitis. The discharge from the punctum was collected by doing a regurgitation test or lacrimal passage irrigation and sent for microbiological analysis. Results: Out of 70 samples collected, 54 (77.1%) samples showed bacterial growth after 24–48 h of incubation. Among various isolates recovered, 68.5% were gram-positive and 27.8% were gram-negative organisms. Staphylococcus aureus was found to be the most common isolate among gram-positive, and Pseudomonas aeruginosa was most common among gram-negative organisms. Among all drugs used in the susceptibility test; amikacin, piperacilin + tazobactam, and netilmycin were found to be most sensitive and cefixime, and amoxycilin + clavulinic acid was found to be most resistant to gram-positive as well as for gram-negative organisms. Conclusion: Knowledge about the microbiological profile and the drug susceptibility pattern responsible for chronic dacryocystitis in a geographical area is important and should be kept in mind while treating these patients.

Bacteriological Profiles of Pyogenic Wound Infection among Adults with Antibiotic Susceptibility Pattern at a Tertiary Hospital in Nigeria

Aims:A wide variety of aerobic and anaerobic bacteria either singly or in combination has been implicated in pyogenic wound infection and this has been associated with treatment failures due to antibiotic resistance. This study aims at investigating the agentsof pyogenic wound infection and their antibiotic susceptibility.Study Design:A descriptive cross-sectional study conducted at the only tertiary Teaching Hospital in Uyo, Nigeria and carried out on 136 wound samples.Place and Duration of Study: University of Uyo Teaching Hospital, Uyo, Nigeria,between April and October, 2018.Methodology: Aspirated pus or wound swab samples were collected and inoculated on two separate agar plates containing 25% Sheep Blood and incubated aerobically and anaerobically at 37°C for 48 –72 hours. Identification of isolates was performed following standard procedures. Data obtained were analyzed using SPSS software. Results:Of the 136 collected wound samples from 76 (55.9%) males and 60 (44.1%) females patients fromages 20 to 70 years and above, 127 (93.4%) had growth of different bacterial isolates totaling 214 in number. Among these were aerobes 132 (61.6%) anaerobes 82 (38.4%). The Gram-negative aerobes had the highest prevalence 81 (37.9%), while the Gram-positive anaerobes 20 (9.4%) was the least prevalent. Staphylococcus aureus,44 (86.3%) and Pseudomonas aeruginosa, 24 (29.6%), were the predominant Gram-positive and Gram-negative aerobes respectively. Peptococci spp. 8 (40%) andBacteriodes fragilis28 (54.9%)were the predominant Gram-positive and Gram-negative anaerobes respectively.Some rarely reported pathogens revealed include Acinetobacter iwoffi, Enterobacter cloacaeand Stenotrophomonas maltophilia1(1.2%) and they showed 100% resistance to all tested antibiotics. The majority of the Gram-positive aerobes 29 (56.9%) were Vancomycin resistant and there was also an increasing prevalence of Methicillin resistant Staphylococcus aureus(45%).Conclusion:The bacterial agents causing pyogenic wound infection in Uyo comprised of 61.6% aerobes and 38.4% anaerobes. Some rarely reported bacteria such as Enterobacter cloacaeand A. iwofiiimplicated in the infections were resistant to all commonly used antibiotics including Imipenem, a reserved antibiotic. Staphylococcus aureuswas the commonest cause of pyogenic wound infection and up to 45% of them were Methicillin resistant.

Bacteriological Profile of Wound Swab and Pus Samples Using Conventional Media and Chromogenic Medium.

Background: Wound infections continue to be a causeof concern as they can delay healing and cause woundbreakdown. Their effective treatment demands quickisolation and identification of causative organisms withappropriate antibiotic sensitivity pattern. Material andMethods: Wound swab and pus samples received frominpatient as well as outpatient department of all agegroups and both genders were processed usingconventional media as well as chromogenic medium(HiCrome UTI) and results of both were compared.Antibiotic sensitivity testing was done on Vitek 2Compact automated system. Results: Among 342samples, 77% showed growth. Fifty eight percentagewere Gram negative and 42% were Gram positiveorganisms. Polymicrobial growth was seen in 11% ofsamples. HiCrome UTI isolated all organisms inculture. Colony characteristics and colour of all isolateson HiCrome UTI were comparable to theiridentification on Vitek 2 Compact. Among the Grampositive organisms, commonest was MethicillinSensitive Staphylococcus aureus (MSSA 42%)followed by Methicillin Resistant Staphylococcusaureus (MRSA 33%), Enterococcus faecalis (10%),Staphylococcus epidermidis (8%), Staphylococcushaemolyticus (3%), Streptococcus pyogenes (2%) andStreptococcus agalactiae (2%). Most of the Grampositive organisms were sensitive to vancomycin,teicoplanin, linezolid and clindamycin The commonGram negative organisms were E. coli (36%),Klebsiella pneumoniae (20%), Pseudomonasaeruginosa (18%), Proteus mirabilis (7%),Enterobacter cloacae (6%) and Acinetobacterbaumannii (4%). Most of the Gram negative organismswere sensitive to cefepime, beta lactams-betalactamase inhibitors, aminoglycosides and fluoroquinolones. Conclusion: Gram-negative organismspredominated in our study. HiCrome UTI agar can beused as a cost-effective approach for rapid isolation ofall organisms. It gives definite identification ofcommon organisms and thus reduces turn-around-timefor the same. It provides presumptive identification ofinfrequent organisms which can be further confirmedby simple biochemical tests. Hence these properties ofHiCrome UTI agar help serve the purpose especiallyfrom mixed cultures and in resource constraint settings

Incidence of meningitis in term neonates with sepsis and antibiotic sensitivity pattern: an observational study

Background: To find out the incidence of meningitis in neonatal sepsis and antibiotic sensitivity pattern in term neonates.Methods: This prospective observational cohort study was done in a tertiary care hospital located in rural South India for a period of 2 years. Blood culture and lumbar puncture were performed for all term babies with clinically suspected sepsis. Growth, if detected was followed by antibiotic sensitivity testing.Results: Of a total of 50 neonates investigated with blood culture, 32(64%) were found to be culture positive for neonatal septicemia, 16 were diagnosed to have meningitis. Meningitis was present in 4(25%) early onset sepsis cases and in 12(75%) late onset sepsis cases (p-value: 0.008). Blood culture showed growth in all of the 16 cases of meningitis, but Cerebro Spinal Fluid (CSF) culture was positive in 5 cases. The most common presenting features are lethargy, seizures, decreased acceptance of feeds, instability of temperature regulation, vomiting, respiratory distress, and apnea. The most common organism in blood culture was Coagulase Negative Staphylococcus (CONS) (20%) followed by Klebsiella spp. (16%). CONS was most sensitive to Linezolid (100%), Vancomycin (90%). Of the 8 cases of Klebsiella, 62.5% cases were sensitive to Colistin and Tigecycline, 50% to Cotrimoxazole. CSF culture was positive in 5(31.25%) cases. CONS and Enterococci spp. were the most common organisms isolated in CSF.Conclusions: Clinical manifestations of meningitis overlap with those of sepsis and are nonspecific. Significant number of neonates with sepsis have meningitis. Hence, it is necessary to rule out meningitis in neonates presented with clinical features of sepsis. CONS was the most common agent isolated in both blood and CSF culture. Routine bacterial surveillance and study of their resistance patterns must be an essential component of neonatal care which helps in implementation of a rational empirical treatment strategy.

A study of pattern of neonatal infections, socio-demographic correlates; clinical manifestations and bacteriological profile of neonatal infections

Background: In the newborns one of the leading causes of deaths and disease is septicemia. Classical clinical features are absent which poses a challenge for early diagnosis. Hence to prevent the deaths and diseases it is essential to go for early diagnosis and early treatment. Objective of this study pattern of neonatal infections, socio-demographic correlates; clinical manifestations and bacteriological profile of neonatal infections.Methods: A hospital based follow up study was carried out among total of 140 study subjects with age less than 28 days of life were studied over a period of one year. All these subjects were suspected to have neonatal septicaemia. Detailed history, thorough clinical examination was carried out. Samples were sent for culture and sensitivity. Subjects were followed till the outcome.Results: Among 2.02% was the incidence of the neonatal septicemia. Females were less affected than the males. Late onset septicemia was less common. Chest retraction was the most common clinical manifestation. Culture positivity rate was 44.29%. Gram-negative organisms were detected in 20 cases (64.5%). Case fatality rate was 17.14%. 41 babies (58.6%) affected by septicemia belonged to low socio economic status. 63 babies (90%) were diagnosed to have septicemia, 3 babies (4.28%) were affected by Meningitis, 2 babies were affected by pneumonia. 49 babies (50%) Belonged to Hindu both in case and control group,12 babies (42.9%) belonged to Buddhist in case group, 16 babies in control group.Conclusions: Males were more susceptible compared to the female babies as well those with higher birth weight. Late onset septicemia was less common.

Bacteriological and Antimicrobial Susceptibility Profile of Orthopaedic Surgical Site Infections

Background: Orthopedic implant site infection is major component of surgical site infection associated with high morbidity and mortality. Implants are foreign to the body so that orthopedic surgery is at risk of microbiological contamination .The changes in pathogenic flora has lead to emergence of antibiotic resistance creating problems in the management of orthopedic diseases. The aim of this study was to determine the type of bacterial pathogens isolated from surgical site infection (SSI) in Guru Nanak Dev Hospital attached to Govt. Medical College, Amritsar and their antibiotic sensitivity profile. Methods: During this period of study from August 2018 to July 2019, 509 pus samples were sent to microbiology department suspected as surgical site infection, from orthopaedic department of Government Medical College, Amritsar. Standard microbiological techniques were used to identify the organisms and determine the antibiotic susceptibility pattern as per CLSI guidelines. Results: In the study, out of 397 (77.6%) positive cultures, 109 (27.45%) Gram positive organisms were isolated among whom Staphylococcus aureus 92 (23.17%) was most common and 288 (72.54%) Gram negative organisms were isolated among whom Klebsiella species 90 (22.67 %) was most common isolate. Conclusion: S. aureus is the most common organism responsible for SSIs. Antibiotic preference should be made according to local sensitivity pattern of the hospital.

Review of a 7-year record of the bacteriological profile of airway secretions of children with cystic fibrosis in North India

Background: Cystic fibrosis (CF) is now a recognised entity in India, with prevalence rates between 1/10,000 and 1/50,000. However, no data were available with regard to the profile of respiratory pathogens in the Indian setting. Materials and Methods: The records of respiratory secretion bacterial cultures of children with CF in a tertiary care hospital in North India from January 2010 to December 2016 were reviewed. Culture data were evaluated; the organisms were noted and their antimicrobial susceptibilities were analysed. The microbiological profile and antimicrobial susceptibility pattern of CF patients were evaluated. Results: A total of 445 samples from 146 children were processed, of which 246 (55%) samples showed bacterial growth. Mixed infections 48 (19.5%) were common in older children. Children aged 3–6 months (62.5%) showed the highest culture positivity. The most commonly isolated organisms were Pseudomonas aeruginosa (52.6%) and Staphylococcus aureus. Children with initial cultures positive for P. aeruginosa had 55% of their subsequent cultures showing polymicrobial infections. P. aeruginosa was most susceptible to ciprofloxacin (89%) and piperacillin-tazobactum (88%). Among the staphylococcal isolates, 38% were methicillin-resistant S. aureus (MRSA). The percentage of MRSA increased from 66% in 2010 to 75% in 2012, followed by a decline to 24% in 2016. Conclusions: The pattern of airway colonisation in the Indian setting is different from the Caucasian population, and P. aeruginosa and Burkholderia cepacia complex appear early. Colonisation with P. aeruginosa benefits from therapy. In case of infection, care must be taken while initiating empiric therapy. It should be based on local antibiograms to prevent the emergence of resistant microbes.

Assessment Of feto maternal hemorrhage in antenatal period in Indian females – need of modifications in Anti D prophylaxis in India.

Objective: -To assess Feto maternal Hemorrhage in pregnant Indian Females. Method: - 516 consecutive antenatal patients attending the Fetal Medicine Department of Vadilal Sarabhai General hospital under NHL Municipal Medical College, Ellis Bridge, Ahmadabad were analyzed for Feto maternal Hemorrhage by Kleihauer Betke test after taking informed consent. Result: - All the 516 antenatal patients including those who underwent invasive procedures like Chorionic villus sampling, Amniocentesis, Amnioinfusion and Intrauterine blood transfusion had Feto maternal Hemorrhage less than 2 ml. Conclusion: - Study shows that Feto maternal hemorrhage in Indian women is very insignificant even after invasive procedures. Feto maternal Hemorrhage has special importance in Rh Negative Women, carrying an Rh positive fetus.FMH can lead to isoimmunization leading to a wide spectrum of antenatal and postnatal fetal complications ranging from anemia to stillbirth. Answer to this is Antenatal Anti –D prophylaxis which is not a standard practice in our setup due to high cost of Anti D. As we have found FMH to be less than 2 ml even a dose of 50 microgram can suffice if given at 26 and 32 weeks of gestation to prevent isoimmunization thus reducing the cost and encouraging the practice of Antenatal Anti D prophylaxis.

Bacteriological profile and multidrug resistance patterns of blood culture isolates in a teaching hospital in South India.

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.

Bacteriological profile of biomedical waste: Management guidelines.

Biomedical waste (BMW) is generated in hospitals, research institutions, health care teaching institutes, clinics, laboratories, blood banks, animal houses and veterinary institutes. Hospital waste management has been brought into focus in India recently, particularly with the notification of the BMW (Management and Handling) Rules, 1998. This study was conducted in Sharda hospital, Greater Noida with the aim to find out bacteriological profile of BMW with study of practices being followed in management and disposal of this waste with standard procedure. Total 500 cases of biomedical waste samples were taken in the study for bacterial culture, 136 samples of biomedical waste showed growth of bacterias. Pseudomonas species was the predominant bacteria isolated from these cultures. This study also suggests about the optimum practice which is to be followed in management of biomedical waste.

Bacteriological Profile of Neonatal Sepsis: A Hospital Based Study.

Introduction: Neonatal sepsis is a major cause of mortality and morbidity in newborn. There are many factors that contribute to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different. Objective: This study was conducted to analyze the organisms responsible for early onset and late onset neonatal sepsis. Materials and Methods: A prospective hospital based study over the period of one year was conducted at neonatal intermediate care unit of Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal. Results: Organisms were isolated in 6.1% of the collected blood samples. The male female ratio of culture proven sepsis was 1.9:1. Escherichia coli were found to be the most common organism in both early onset and late onset sepsis. Staphylococcus aureus was more common in late onset sepsis than early onset sepsis. Conclusion: Escherichia coli were the most common organism in both early onset and late onset sepsis. Staphylococcal aureus was significantly more common in late onset sepsis than early onset sepsis.