ABSTRACT
The problem of diabetes continues to explode in our country today. India now has the dubious distinction of being called, “the diabetic capital of the world”. Diabetic foot ulcerations & infections are one of the leading causes of mortality & morbidity from diabetes. It is the most expensive complication of diabetes & the leading cause of hospitalization when compared to other complication of diabetes. The number of cases & problems associated with diabetic foot infection have dramatically increased in the recent years. In rural Bengal, the problem is grave as detection and treatment initiation is very late.METHODSA prospective observational study was conducted in Medicine & Surgery OPD and IPD of Bankura Sammilani Medical College for twenty weeks. Baseline characteristic were noted, ulcer classification was done followed by swab culture, debridement and antimicrobial therapy. Then outcome was observed.RESULTSMaximum patients were aged between 38 to 58 years, were male and were Wagner 1-3 classification. From culture report S. aureus was predominant followed by Enterobacteriaceae group and anaerobes. Amoxicillin-clavulanic acid combination was the most effective antibiotic followed by amikacin. Treatment was satisfactory with dressing, debridement and appropriate antibiotic.CONCLUSIONSS. aureus, Enterococcus, Pseudomonas aeruginosa, E. coli & Anaerobes were the most common causes of diabetic foot infections in my study, and were sensitive to the conventional antibiotics indicating that there is no evidence to suggest significant resistance to these antibiotics. Hence, their empirical usage, either oral or injectable (depending on the type of foot ulcer) is justified. Proper education regarding footwear & foot care is strongly recommended in such patients.
ABSTRACT
Background@#Term prelabor rupture of membranes (PROM) increases the risk of maternal and neonatal infections. @*Objective@#To compare rates of positive bacterial growth in placental swab cultures done among women who received ampicillin prophylaxis at different timings after term PROM. @*Design@#Matched cohort study. @*Setting@#Department of Obstetrics and Gynecology at Southern Philippines Medical Center in Davao City, Philippines. @*Participants@#120 pregnant women aged ≥18 years old, at ≥37 weeks age of gestation, with PROM: 40 women received ampicillin within 6 hours (6H group), 40 within >6 to 12 hours (12H group), and 40 within >12 to 18 hours (18H group) of onset of PROM. @*Main outcome measures@#Rates of positive bacterial growth in postpartum placental swab cultures; most common bacterial isolates; and signs of intraamniotic infection (IAI).
Subject(s)
Ampicillin , Specimen HandlingABSTRACT
PURPOSE: To know the true carrier rate and the immunologic responses (antistreptolysin O :ASO) to beta-hemolytic streptococci which obtained from normal school children with or without carrying streptococci. And to study the clinical meaning of the number of organisms found in culture. METHODS: One hundred ninty-eight first grade of elementary school children were included. I obtained throat swab culture from tonsil and tonsilar fossa with sterile cotton ball stick and plated on sheep blood agar dish, counted number of colonies of beta-hemolytic streptococci (BHS) after overnight incubation, examined ASO titer (Rantz-Randall method) simultaneously, and differentiated grouping of BHS with Streptex. RESULTS: 1) Of the 198 normal school children, 34 (17.2%) had cultured BHS. 16 (8.1%) were group A, 4 (2.0%) were group C, 2 (1.0%) were group G, and 12 (6.1%) were non-grouping BHS. 2) 14 (22.2%) out of 63 normal children without carrying BHS and 16 (47.1%) out of 34 with carrying BHS had come out above 250 units of ASO. 13 (59.1%) out of 22 group A,C,G streptococcal carriers had showed above 250 units of ASO. The true carrier rate of BHS were 18 (9.0%) out of 198 elementary school children. 3) When I had counted the number of colonies from 34 carrier of BHS, 1+ was 67.6% and 2+ was 17.6%. It was 85.2% of total children with carrier. 4) There were significant differences between the mean titer of logarithmic ASO obtained from group A BHS carrier and that of normal children without carrying BHS (P=0.001), and differences between that of group A and group B,C,G streptococci (P= 0.0005). CONCLUSIONS: The ASO titer obtained from BHS carrier is higher than normal school children, which suggests the possibility of subclinical infection, the possibility of persistent habor of organism since past infection had contracted, and the possibility of replaced old organism in past infection with new organism. It should be performed follow-up study for identifying the persistence of immunologic response in accordance with or without culturing organism.