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.

Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern

Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.

Study of antibiogram pattern of organisms isolated from urinary tract infections from a tertiary care hospital from central India

Introduction: Urinary tract infections (UTI) are the most common infection encountered in the life of an individual irrespective of age and sex. Varying degree of antibiotic resistance shown by uropathogens against the routinely used antibiotics in the therapeutic regimen is a serious concern in treatment of UTI. This study was aimed at the isolation and demonstration of antibiogram pattern of organism responsible for acute UTI. Materials and methods: Clean catched mid stream urine (CCMSU) specimens collected from patients of different age group were cultured on blood agar and Mac Conkey’s agar by standard loop culture method. These organisms were further identified by standard methods and antibiotic sensitivity was evaluated using Kirby Bauers disc diffusion method in accordance with CLSI guidelines. Results: A total of 1230 samples were collected from both males and females of age group 5 to 80. Among the total, 443 (36%) samples were positive for culture and showed significant bacteruria. Gram negative isolates were responsible for majority of infection and 86.9% isolates and Escherichia coli was the predominant among them (37.2%). Conclusion: Majority of the isolates showed resistance to drugs commonly used to treat UTI. Variations in sensitivity may be due to the inappropriate exposure of different localities as to antibiotics which can drive the development of resistance. From the results of this study, it is certain that choosing drugs for empiric treatment will be challenging as no single common drug can conveniently be recommended for UTI.

Sensibilidad antimicrobiana y mortalidad intrahospitalaria de infecciones comunitarias y nosocomiales en la Unidad de Cuidados Intensivos del Hospital Ángeles del Carmen / Antimicrobial susceptibility and mortality of community and nosocomial acquired infections in the Intensive Care Unit at Hospital Ángeles del Carmen / Susceptibilidade antimicrobiana e mortalidade hospital por infecções comunitárias e nosocomiais na Unidade de Terapia Intensiva do Hospital Ángeles del Carmen

Resumen: Introducción: el manejo de antibióticos en las unidades de cuidados intensivos (UCI) es un tema prioritario. Conocer la epidemiología bacteriana y su sensibilidad es fundamental para aumentar la sobrevida de nuestros pacientes. Material y métodos: se realizó un estudio tipo cohorte retrospectiva en la Unidad de Cuidados Intensivos del Hospital Ángeles del Carmen durante el periodo de 2018 a 2020 en pacientes con infección documentada y con cultivo positivo. Se obtuvo el patrón de sensibilidad antimicrobiana y se analizó de acuerdo al origen Gram, tipo de infección, reactantes de fase aguda y mortalidad. Se realizó comparación de medias y proporciones con χ2, t de Student y ANOVA. Se obtuvieron razones de desventajas (OR) para identificar variables asociadas a resolución. Se consideró un valor de p < 0.05 para significancia estadística. Resultados: se analizaron 308 cultivos bacterianos obtenidos de 188 pacientes, principalmente de origen respiratorio, urinario y torrente sanguíneo (76.7%), de origen nosocomial (65.3%), con predominio de gram-negativos (65%) multidrogorresistentes. La procedencia comunitaria se asoció más a infección que la nosocomial (85 versus 61.7%, OR 3.5, IC 95% 1.93-6.45, p < 0.001). El porcentaje de infección fue mayor en gram-negativos (71.8 versus 66%, OR 1.10, IC 95% de 0.91-1.32, p = 0.297). Las infecciones por gram-positivos tuvieron menor porcentaje de mortalidad que aquéllas por gram-negativos (17.9 versus 30.7%, OR 0.49, IC 95% de 0.27-0.88, p = 0.016) así como las infecciones comunitarias en comparación con nosocomiales (17.8 versus 30.8%, OR 0.48, IC 95% de 0.27-0.86, p = 0.013). Conclusión: las bacterias predominantes en nuestra unidad de cuidados críticos son bacilos gram-negativos multidrogorresistentes, provenientes de infecciones respiratorias, urinarias y de torrente sanguíneo. Las infecciones por gram-positivos y adquiridas en la comunidad se asociaron a menor riesgo de mortalidad.

Abstract: Introduction: local identification of antimicrobial susceptibility and resistance patterns must be a priority in intensive care units. Material and methods: a cohort study was conducted in the intensive care unit from 2018 to 2020, identifying patients with an infectious diagnosis and a positive culture, with prospective clinical and laboratory follow-up. Antimicrobial resistance patterns were analyzed according to source, gram, type of infection, acute phase reactants and outcome, comparing means and proportions with χ2, Student t and ANOVA. OR were obtained to identify resolution-associated variables. A p < 0.05 value was considered as statistically significant. Results: 308 cultures were analyzed, obtained from 188 patients. Primary souces were respiratory, urinary and bloodstream (76.7%), 65.3% were from in-hospital infections, and 65% were caused by gram-negative multi-drug resistant bacteria. Community cultures were more associated with infection compares with in-hospital cultures (85 vs 61.7%, OR 3.5, 95% CI 1.93-6.45, p < 0.001). Gram-negative bacteria had a greater association with infection compared with gram-positive (71.8 vs 66%, OR 1.10, 95% CI 0.91-1.32, p = 0.297), but infections caused by gram-positive bacteria had a greater association with resolution (82.1 vs 68.8%, OR 2.07, 95% CI 1.16-3.70, p = 0.019), as well as community infections (82.2 vs 68.7%, OR 2.11, 95% CI 1.18-3.77, p = 0.016). Conclusion: multi-drug resistant gram-negative bacteria were the principal isolates found in respiratory, urine and bloodstream infections in our intensive care unit. Community infections and gram-positive isolates were associated with greater resolution rates.

Resumo: Introdução: a gestão de antibióticos em Unidades de Cuidados Intensivos é uma questão prioritária. Conhecer a epidemiologia bacteriana e sua suscetibilidade é essencial para aumentar a sobrevida de nossos pacientes. Material e métodos: foi realizado um estudo de coorte retrospectivo na Unidade de Terapia Intensiva do Hospital Ángeles del Carmen durante o período de 2018 a 2020, em pacientes com infecção documentada e com cultura positiva. O padrão de sensibilidade antimicrobiana foi obtido e analisado segundo origem, grama, tipo de infecção, reagentes de fase aguda e mortalidade. A comparação de médias e proporções foi feita com χ2, teste t de Student e ANOVA. Razões de desvantagem (OR) foram obtidas para identificar variáveis ​​associadas à resolução. Um valor de p < 0.05 foi considerado para significância estatística. Resultados: foram analisadas 308 culturas bacterianas obtidas de 188 pacientes, principalmente de origem respiratória, urinária e sanguínea (76.7%), de origem nosocomial (65.3%), com predominância de gram-negativos (65%) multirresistentes. A origem comunitária foi mais associada à infecção do que a nosocomial (85 vs 61.7%, OR 3.5, IC 95% 1.93-6.45, p < 0.001). A porcentagem de infecção foi maior para gram-negativos (71.8 vs 66%, OR 1.10, IC 95% 0.91-1.32, p = 0.297). As infecções Gram-positivas tiveram uma taxa de mortalidade menor do que as infecções Gram-negativas (17.9 vs 30.7%, OR 0.49, IC 95% de 0.27-0.88, p = 0.016), bem como infecções comunitárias em comparação com as nosocomiais (17.8 vs 30.8%, OR 0.48, IC 95% de 0.27-0.86, p = 0.013). Conclusão: as bactérias predominantes em nossa unidade de terapia intensiva são bacilos gram-negativos multirresistentes, originários de infecções respiratórias, urinárias e de corrente sanguínea. As infecções gram-positivas e adquiridas na comunidade foram associadas a um menor risco de mortalidade.

Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital

Background:In wide range, urinary tract infection (UTI) is a substantial and second most popular bacterial infection affecting individuals of overall ages worldwide. The chronicity of divergent bacterial isolates and their propensity to various antibiotics may contradict widely, peculiarly in hospitalized patients, this makes the survey of vulnerability pattern extremely mandatory for correct selection of antibiotics. Objective: To appraise antimicrobial susceptibility pattern of the Gram negative organisms identified from urine cultures of hospitalized patients. Methodology:Total 500 urine samples from hospitalized patients with significant bacteriuria were surveyed. Using Blood and MacConckey agar, samples were inoculated. Further identification and investigation of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was interpreted by Modified Kirby- Bauer's disc diffusion method with the group of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) protocols.Results:UTIs were frequent in females 290 (58%). Familiar organism found was Escherichia coli 260 (52%) further accompanied by Klebsiellaspp.120 (24%), Pseudomonas spp.40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp.25(5%) and Acinetobacterspp. 17 (3.4%). Mass of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactamand cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp.Conclusion:To break the continuity of non selective use of antibiotics and to intercept further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy

Isolation, identification and antibiotic sensitivity pattern of aerobic bacteria from burn wound patient admitted in tertiary care hospital

Background: Significant burn injuries induce a state of immunosuppression that predisposes patients to infectious complications, thus the rate of nosocomial infections are higher. Rapidly merging multidrug resistant among the various isolate in indoor burn patients are depending on time-line becoming serious threat for managing therapeutically. Objective of this study is to determine the aetiological factor, prevalence, antimicrobial susceptibility pattern and emerging nosocomial pathogens.Methods: A prospective study was carried in burn ward of K.L.E.’s Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum for the period of 1 year. Pair of wound swab were collected from patient having burnt more than 30% (RULE OF NINE) on 3rd day of stay. Sample were collected aseptically from 30 patients and processed by convectional culture and biochemical identification procedures and tested against commonly used antibiotics.Results: 30 patients that fall under inclusive criteria were enrolled in the study. The total burn surface area (TBSA) ranges from 30-82%. The ratio of female to male patient suffering burn wound in our study is 1.5:1. Aetiology of burn is heat (moist/dry) mostly. Depending upon degree of burn, most of patient suffered from 20 degree (superficial to deep) injury. From 30 swab cultures, 42 isolates were identified during the study in which mixed were 66.66% and one is fungi. The most commonly isolated is Pseudomonas aeruginosa (45.24%) then Klebsiella pneumoniae (19.04%), Acinetobacter spp. (14.28%), Staphylococccus aureus (11.90%). Among gram positive isolates, isolates are found to be most resistant to Erythromycin (100%) and Co-trimoxazole (100%) and sensitive to Vancomycin (71.42%). Among gram negative isolates are found to be most resistant to Gentamicin (91.65%), Ciprofloxacin (82.35%), Ceftazidime (82.35%) and sensitive to Meropenem (52.95%), Piperacillin (35.30%), Carbenicillin (29.41%).Conclusions: Pseudomonas aeruginosa was found to be the most common isolate. The nature of microbial wound colonization and flora changes with time should be taken into consideration in empirical antimicrobial therapy.

Predictors of Post-operative Pulmonary Complications Following Emergency Laparotomy

Background: Post-operative respiratory complications are a major threat following emergency abdominal surgeries. It significantlyincreases post-operative morbidity and mortality. The aim of this study was to determine the incidence and factors affectingpost-operative pulmonary complications (PPCs).Materials and Methods: This is a prospective observational study conducted in 270 patients who got admitted through SOPD,casualty or transferred from other department, and undergoing emergency laparotomy over a period of 1 year (June 1, 2018–May 31, 2019). Patients were included in the study irrespective of age, sex, and occupation. Pre- and post-operative datawere collected through interview and postoperatively patients were monitored clinically and various investigations were doneto record post-operative respiratory complications. Then, their association was analyzed.Results: Two hundred seventy patients were included in the present study and 55 (20.4%) developed PPCs. Pneumonia (20)was the most common PPC followed by atelectasis (15). Elderly patients had more risk. PPCs were more in current smokers(30.98%), patients with pre-existing respiratory diseases (47.1%), duration of surgery more than 3 h. PPCs significantly increasethe duration of hospital stay and mortality.Conclusion: Pulmonary complications are significant among patients undergoing emergency laparotomy that leads to increasedmorbidity and mortality. Predictors of PPCs are smoking, pre-existing respiratory diseases, prolonged duration of surgery, andprolonged intubation.

Antibiotics sensitivity status and antibiogram patterns of aerobic bacterial isolates from surgical site infections

Background: Surgical Site Infections (SSIs) are the third most common nosocomial infections. Emergence and spread of drug resistant strains have been found to pose a serious challenge in the management of such infections. There is limited information on the epidemiology of such pathogens. The antibiotic sensitivity patterns of aerobic bacterial isolates from post-operative SSIs show wide variations that lead to difficulties in empirical selection of the right kind of drug for treatment. Properly planned studies about antibiotic sensitivities patterns of such isolates can help in judicious management of SSIs and cause reduction in morbidity and mortality.Methods: A total of 50 patients diagnosed by the surgeon and fulfilling the case definition of SSI, were studied for bacteriological analysis. All the clinical specimens were cultured and identified applying standard culture techniques. The aerobic bacterial isolates were subjected to antimicrobial susceptibility testing by Kirby Bauer Disc Diffusion method to arrive at the drug sensitivity patterns. Data were entered in MS Excel spread sheet and analysed using SSPP software version 21.00Results: A total of 32 patterns of sensitivity were observed. For Esch. coli, a total of nine patterns were observed. All strains of Esch. coli were found sensitive to tigecycline (100%) and colistin (100%). For Klebsiella spp. a total of 9 patterns were obtained with TIG-COL being the predominant pattern in 6 cases. For Acinetobacter spp. only colistin was found most effective drug. In case of Pseudomonas aeruginosa, except colistin (100% sensitivity), there were wide variations in sensitivity with imipenem (71%) as next most effective drug. In Proteus spp. - most of the in-use drugs were effective except cephalosporins. Among gram positive organisms, only three strains of Staphylococcus aureus were isolated, and these were MRSA (100%). Two strains of enterococcus were isolated, and these showed sensitivity to linezolid only.Conclusions: Wide variations in sensitivity status observed in the study are suggestive that antibiotic usage should be tailored to individual needs and proper selection of antibiotics for management of SSIs must be guided by laboratory antibiogram.

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.

Antimicrobial Susceptibility of Organisms Isolated from Surgical Site Infection in a Tertiary Care Hospital, Bettiah (West Champaran) Bihar, India

Introduction: Surgical site infections are most commonhospitals acquired infections and are an important cause ofmorbidity and mortality. The objective of our study is toconclude the causative bacteria and antimicrobial sensitivityof surgical site infections.Material and methods: A total of 275 various clinicalsamples received in Microbiology Laboratory, GovernmentMedical College, Bettiah (West Champaran) Bihar andAssociated Hospital. from March 2018 to April 2019. Atotal 101 Staphylococcus aureus isolated, were identifiedby standard biochemical methods. Antibiotic susceptibilitytesting was performed by Kirby Bauer Disc Diffusion method.Methicillin resistance was detected by using cefoxitin (30µg)disc diffusion method as per CLSI guidelines 2016.Result: Out of the 275 aerobic bacteria which were isolated,144 were gram positive cocci (52.37%) and 131 were gramnegative bacilli (47.63%). The most common pathogenfollowed by Staphylococcus aureus 101 (36.36%). Otherorganisms were Escherichia, Pseudomonas, Klebsiella,Citrobacter, Proteus, and Enterococcus. The Antimicrobialprofile of 101 Staphylococcus aureus isolates among MRSA,resistance those they were 100% sensitive to linezolidand vancomycin, with moderate sensitivity (71.14%) tocefuroxime, gentamicin and least sensitivity to (23.81%)doxycycline, (20.95%) ciprofloxacin.Conclusion: Isolation of MRSA patients and carriers in thehospitals, regular surveillance, and monitoring of antibioticsusceptibility pattern of the hospital and community of thatregion regularly and formulation of antibiotic policy may helpin reducing the treatment failures.

Antimicrobial sensitivity pattern from clinical isolates at a tertiary care teaching hospital of rural Bengal: a pilot study

Background: Antimicrobial sensitivity pattern from clinical isolates can reveal important information that can help in drafting the hospital antibiotic policy as well as help improve prescribing patterns and patient outcome in a particular region.Methods: Data from the results of the antimicrobial sensitivity pattern of clinical isolates of the patients between 1stJuly and 31st December 2018 were collected on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 blood culture reports were obtained which showed 58 gram positive cultures. Further 46 of the gram positive samples were positive for Coagulase negative Staphylococcus. A total of 305 urine samples were obtained for culture which showed gram negative cultures. Paediatric and medicine wards were the common yielding sites. A total of 242 pus reports were obtained which showed 47 gram positive cultures. A total of 154 wound swab samples were obtained which showed 47 gram positive cultures. For pus and wound swab samples, surgery wards were the common yielding sites. Common gram negative organisms seen were Klebsiella sp., E. coli, Citrobacter sp., Pseudomonas, Proteus and Enterobacter. Gram positive organisms were commonly resistant to Erythromycin, orally active Penicillins, Vancomycin and Teicoplanin and gram negative organisms were commonly resistant to Cephalosporins, Aminoglycosides, Colistin, Fluroquinolones and Meropenem.Conclusions: This study showed that over six months samples of body pus, wound swab, blood culture and urine showed high levels of resistance to commonly used antibiotics. This would provide an outline for development of an effective hospital Infection Control Policy.

Bacteriological Profile and Antibiogram of Bloodstream Infection in a Tertiary Care Hospital, India

Purpose: Blood stream infections (BSIs) are an importantcause of morbidity and mortality worldwide. Continuous orintermittent presence of microorganisms in the circulating bloodis a danger to every organ in the body. BSIs range from selflimiting infections to life threatening sepsis requiring rapid andaggressive antimicrobial treatment.[1] Culture of blood is a vitaltool to diagnose such infections. Antibiotic susceptibilitypatterns help in rationalizing therapy.Objective: The objective of this study was to determine thebacteriological profile and their antibiotic sensitivity patterns ofisolates from blood stream infections.Materials and Methods: This is a retrospective studyconducted from February 2018 to January 2019 at a tertiarycare hospital, RIMS, India. Blood samples were asepticallycollected and incubated in BD Bactec system, a fullyautomated blood culture system for detection of aerobic growthand incubated for 7 days at 37°C. Identification of microbialgrowth was done by standard methods (biochemical tests) andantibiotic sensitivity test was carried out by Kirby-Baur discdiffusion method as per Clinical Laboratory Standards Instituteguidelines (CLSI guidelines).Results: A total of 82 (28%) pathogens were isolated from 289bacteremia suspect patient blood specimens. Gram‑positivecocci (65.85%) were predominant organisms recoveredfollowed by Gram‑negative bacilli (34.15%). Staphylococcusaureus, Klebsiella spp and CoNS, were the primary pathogensisolated. Staphylococcus aureus (48%) was the predominantamong all. Glycopeptides, aminoglycosides, and carbapenems,were the most effective drugs for treating bacteremia.Conclusions: Early diagnosis and appropriate antimicrobialtreatment is the basis for the successful treatment of sepsis.The understanding of local bacteriological profile andantimicrobial susceptibility patterns may help the clinician inrationalizing the empirical treatment strategies.

Prevalence and sensitivity pattern of Staphylococcus aureus from different clinical samples in a Medical College Hospital

Staphylococcus aureus is important organism responsible for wide variety of infections. The present study was conducted to find the prevalence of Staphylococcus aureus in various clinical samples received at the department of Microbiology, Darbhanga Medical College and to assess its sensitivity pattern. It was observed that 20.9% of the samples were positive and 42.2% of the isolated Staphylococcus aureus were methicillin resistant (MRSA). Most common sample was pus (38.4%) followed by urine (20.9%). 42.2% of the samples were resistant to Cefoxitin, Cefotaxime and Amoxicillin. 60.9% were resistant to Erythromycin and 24.4% to Gentamicin. Monitoring of antibiotic sensitivity is essential for better clinical management and preventing antibiotic resistance.

Minimum inhibitory concentration of Brazilian Brachyspira hyodysenteriae strains / Concentração inibitória mínima de cepas Brachyspira hyodysenteriae brasileiras

The objectives of this study were to characterize Brachyspira hyodysenteriae isolates and to evaluate the antimicrobial susceptibility patterns of strains obtained from pigs in Brazil based on the minimal inhibitory concentration test (MIC). The MIC was performed for 22 B. hyodysenteriae isolates obtained from 2011 to 2013 using the following antimicrobial drugs: tylosin, tiamulin, valnemulin, doxycycline, lincomycin and tylvalosin. Outbreaks of swine dysentery were diagnosed based on clinical presentation, bacterial isolation, gross and microscopic lesions, duplex PCR for B. hyodysenteriae and B. pilosicoli and nox gene sequencing. All obtained MIC values were consistently higher or equal to the microbiological cut-off described in the literature. The MIC 90 values for the tested drugs were 8µg/ml for doxycycline, >4µg/ml for valnemulin, 8µg/ml for tiamulin, 32µg/ml for tylvalosin, >64µg/ml for lincomycin and >128µg/ml for tylosin. These results largely corroborate those reported in the literature. Tiamulin, doxycycline and tylvalosin showed the lowest MIC results. All of the samples subjected to phylogenetic analysis based on the nox gene sequence exhibited similar results, showing 100% identity to B. hyodysenteriae. This is the first study describing the MIC pattern of B. hyodysenteriae isolated in Brazil.(AU)

Os objetivos deste trabalho foram a caracterização de isolados de Brachyspira hyodysenteriae e avaliar os padrões de sensibilidade antimicrobiana de isolados obtidos a partir de suínos no Brasil com base no teste de concentração inibitória mínima (MIC). A MIC foi realizada em 22 isolados de B. hyodysenteriae obtidos entre 2011 a 2013 usando os seguintes antimicrobianos: tilosina, tiamulina, valnemulina, doxiciclina, lincomicina e tilvalosina. Surtos de disenteria suína foram diagnosticados com base na apresentação clínica, isolamento bacteriano, lesões macroscópicas e microscópicas, PCR duplex para B. hyodysenteriae e B. pilosicoli e sequenciamento do gene nox. Todos os valores de MIC obtidos foram consistentemente mais elevados ou igual ao ponto de corte microbiológica descrito na literatura. Os valores de MIC 90 para os fármacos testados foram de 8 µg / mL para a doxiciclina, > 4 µg/ml de valnemulina, 8 µg / mL para a tiamulina, 32 µg / ml para tilvalosina, > 64 µg / ml para a lincomicina e > 128 µg / ml de tilosina. Estes resultados corroboram em grande parte com os relatados na literatura. Tiamulina, doxiciclina e tilvalosina apresentaram os menores resultados de MIC. Todas as amostras submetidas à análise filogenética com base na sequência do gene nox exibiram resultados semelhantes, indicando 100% de identidade com B. hyodysenteriae. Este é o primeiro estudo que descreve o padrão MIC de B. hyodysenteriae isoladas no Brasil.(AU)

An analysis on biovars and antimicrobial susceptibility of 78 Ureaplasma strains isolated from respiratory tract of hospitalized infants / 预防医学

Objective To learn the biovars,antimicmbial susceptibility in Ureaplasma species isolated from respiratory tracts of infants hospitalized in tertiary children's hospital,and to provide evidences and clinical basis for the prevention and treatment of Ureaplasma infection in infants.Methods Ureaplasma species cultivation,identification and antibiotic susceptibility testing were performed using Mycoplasma IST2.The primers according to the conservative MB-Ag gene were designed to identify Ureaplasma biovars.Erythmmcin resistant genes (ermA,ermB and ermC) and active effiux transporter genes (mefA/E,msrA/B and mreA) were amplified using PCRs.Results A total of 78 Ureaplasma positive cases,of them,48 Ureaplasma strains were isolated from premature neonates.Biovar 1 was present in 51 (65.38％) strains,and biovar 2 was present in 27 (34.62％) strains.There were no significant differences among sex,premature infant,age,gestational age,birth weight,length of stay (P ＞ 0.05).The drug resistance rates to ciprofloxacin and ofloxacin were 80.77％,and to tetracycline was 1.28％.All strains were sensitive to doxycycline,josamycin and pristinomycin.The drug resistance rates to the macrolide antibiotics (erythromycin,azithromycinand and clarithromycin) were ＜ 12％.There was no statistically significant difference among the drug resistance rates of different biovars and these antibiotics (P ＞ 0.05).Only the methylated enzyme gene (ermB) and the active efilux pump gene (msrA/B) were detected,and the detection rate was 39.74％ and 12.82％ respectively.The ermB gene mainly exists in biovar 2,and the detection rate is 55.56％ (P ＜ 0.05).The msrA/B was balanced distributed between biovar 1 and 2 (P ＞ 0.05).A total of 78 Ureaplasma strains were isolated from 24 cases of neonatal septicemia,30 cases of congenital infection pneumonia,9 cases of retinopathy of prematurity,9 cases of neonatal intracranial hemorrhage,and 15 cases of bronchopulmonmT dysplasia.Conclusion Biovar 1 is more prevalent in Ureaplasma species isolated from infant respiratory tract,and higher detection rate of Ureaplasma is found in the preterm infants.All Ureaplasma strains have high drug resistance to both ciprofloxacin and ofloxacin,but low drug resistance to the macrolide antibiotics (erythromycin,azithromycin and clarithromyc),that could be used as a first choice for the treatment of Ureaplasma infection.Erythromycin resistance gene ermB,mainly exists in biovar 2.

Bacteriological profile of surgical site infections

Background: The susceptibility and severity of Rheumatoid arthritis are determined by both genetic and environmental factors. Dermatoglyphic patterns of individuals which are formed early in the fetal life are also determined by both genetic and environmental factors. Since both are genetically acquired and environmentally modified, it has been shown that there are particular dermatoglyphic patterns associated with Rheumatoid arthritis. If it is so, dermatoglyphics can serve as an additional tool in the early diagnosis and management of such a disabling disease like rheumatoid arthritis. Although there are some studies which mentioned dermatoglyphic pattern variation in the disease, the results are contradicting. Therefore, the present study was undertaken to find out a possible correlation of some quantitative and qualitative dermatoglyphic variables with Rheumatoid Arthritis. Aim of the study: To study the dermatoglyphic patterns in patients with Rheumatoid Arthritis and control population and to study the correlation between dermatoglyphic patterns and Rheumatoid Arthritis. Materials and methods: We studied 60 patients with Rheumatoid arthritis and 60 controls. All were subjected to detailed medical history and clinical examination. Both quantitative (finger ridge count and pattern intensity) and qualitative (fingerprint pattern) dermatoglyphic parameters were studied and the same were compared with age, sex and disease matched controls. Results: Out of the total 60 cases 12(20%) were male and 48(80%) were females. Of the total 60 controls, 12(20%) were males and 48(80%) were females. Analysis of the qualitative parameters revealed: Significant increase in the number of whorls in both the hands of female patients cases compared to the controls (p-value for right hand 0.001, p-value for left hand 0.004). The decrease in the number of radial loops in both the hands of male and female patients and the decrease was more in the left hand in males and right hand in females (p-value male left hand 0.002, female right hand Saritha K. Narayanan, Christopher C. Pais, Pradeep Kumar Shenoy. Use of palmar dermatoglyphics in rheumatoid arthritis - A case-control study. IAIM, 2017; 4(12): 70-76. Page 71 0.003). Decrease in the number of arches in the left hand of female patients compared to the controls (p-0.10). Analysis of the quantitative parameters showed: A statistically significant increase in the finger ridge count of individual hand and the total finger ridge count in both male and female patients compared to the controls (p-value males: right hand 0.003, left hand 0.004, right plus left hand 0.002; p-value females right hand.0000, left hand 0.000, right plus left hand 0.000). A statistically significant increase in the pattern intensity of fingers in female patients compared to the controls (p-value: right hand 0.006, left hand 0.001, right plus left hand 0.000). Conclusion: The findings of this work demonstrate the association between some of the qualitative and quantitative parameters of dermatoglyphics and Rheumatoid arthritis suggesting that dermatoglyphics can represent an anatomical, non-invasive, inexpensive tool for screening high-risk population and thus facilitate early detection and management.

Asymptomatic bacteriuria in type 2 diabetic women patients who are attending Medicine OPD of Government Dharmapuri Medical College, Dharmapuri

Introduction: Infection is a leading cause of hospitalization among diabetic patients. Diabetes is associated with increased risk of developing infection increased severity of infection and prolonged hospital stay. Urinary tract infection, respiratory tract infection and soft tissue infection are common infections with increased incidence of diabetes. Altered host defenses, vascular abnormalities, frequent hospital admissions are responsible for increased incidence. Aim of the study: To find out the prevalence of Asymptomatic Bacteriuria in type 2 diabetic women, to analyze the spectrum of organisms responsible for Asymptomatic Bacteriuria in this group and its antimicrobial sensitivity pattern. Materials and methods: There was 164 participants in the study group and 56 non-diabetic women in the control group GROUP-I: Women with type 2 diabetes were recruited randomly from the Female patients of General Medicine OPD and Diabetic OPD, Government Dharmapuri Medical College Hospital, Dharmapuri. GROUP-II: Women without diabetes were selected randomly from the general population. They were relatives and friends of inpatients admitted in general medical ward. The following laboratory data were included: fasting plasma glucose, blood urea, serum creatinine, albuminuria, glycosuria, and leucocyturia. These patients were evaluated for microvascular and macrovascular complications of diabetes. Results: Overall the prevalence of ASB was 22.56% in the study group and 5.36% in control group. G. Ranjani. Asymptomatic bacteriuria in type 2 diabetic women patients who are attending Medicine OPD of Government Dharmapuri Medical College, Dharmapuri. IAIM, 2017; 4(9): 36-42. Page 37 Conclusion: Asymptomatic bacteriuria was significantly more among diabetics with nephropathy. Simple bedside method to screen asymptomatic bacteriuria is leucocyturia and it has a positive predictability (72.7%) to detect bacterial isolates. Among asymptomatic bacteriuria, gram-negative isolates were greater than gram-positive ones Isolates were resistant to most of the commonly used antimicrobials (Ciprofloxacin, Ofloxacin, Gentamicin, and Cefotaxime) in clinical practice.

Isolation, Identification and Antimicrobial Susceptibility pattern of Pseudomonas Aeruginosa from Various Clinical Specimens at a North India Hospital.

Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacilli. It is an opportunistic human pathogen and plays an important role in nosocomial infection. It is hard to treat because some factor and several mechanisms are involved in resistant organism. Aim: Isolation, Identification and Antimicrobial susceptibility pattern of Pseudomonas aeruginosa. Methods: This study was conducted during October 2014 to September 2015.Total 2492 samples were collected in which 822 samples show growth. Out of 822, 68 samples were positive for Pseudomonas aeruginosa on the basis of their growth on culture media, oxidase test and biochemical tests. The Antimicrobial susceptibility test of isolates was performed by Kirby-Bauer disc diffusion method according to CLSI guidelines (2014). Results: Majority of Pseudomonas aeruginosa was isolated from pus, urine and swab. The isolated pathogens were maximum sensitivity to Imepenem (88.24%) followed by Meropenem (83.82%), Piperacillin-Tazobactam (82.35%) and were maximum resistance to Gentamicin (61.76%), Tobramycin (60.29%).Conclusion: To conclude, Imepenem, Meropenem and Piperacillin-Tazobactam were found to be the most effective antimicrobial drugs. It should be used in limit. The use of Gentamicin and Tobramycin should be reduced.

Antibiotic Susceptibility Pattern Among CSOM Patients Attending AIMSR.

Background and Aim: CSOM causing deafness is seen in more than one third of the population in developing countries and is responsible for more than two thirds of deafness in children thereby causing intellectual and educational problems which have a profound impact on the society. Knowledge of the pathogens responsible for CSOM and their antibiotic sensitivity can assist in the selection of the appropriate treatment regimen in these cases. Objective: To identify the bacteria causing CSOM in our hospital area and to determine their antibiotic sensitivity. Methodology: Prospective study of 20 samples from clinically suspected cases of CSOM was performed over a period of two months. Samples were subjected to culture and the isolates were identified by standard biochemical tests. Antibiotic sensitivity testing was performed by modified Kirby-bauer disc diffusion technique as per CLSI guidelines. Results: The predominant organism isolated was Staphylococcus aureus. No other organism was isolated in our study. The antimicrobial sensitivity of the isolates in our study showed 100% sensitivity to ciprofloxacin,ofloxacin and netilmycin followed by 75% sensitivity to cefotaxime and ceftriaxone. Conclusion: The bacterial pathogens causing CSOM are unique to each geographical area. There is a high carriage of Staphylococcus aureus strains in the external auditory canal and upper respiratory tract prevalent in our hospital area. Quinolones and third generation cephalosporins are the most effective drugs for CSOM in our hospital area and can be considered for empiric therapy of these cases.

Current Microbial Isolates from Wound Swab and Their Susceptibility Pattern in a Private Medical College Hospital in Dhaka city.

Background: Wound infection is one of the major health problems that are caused and aggravated by the invasion of pathogenic organisms where empiric treatment is routine. Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern. Materials and method: A total of 263 wound swab and pus samples were collected during the period of January to December 2012 from Delta Medical College and Hospital, Dhaka, Bangladesh. Swabs from the wound were inoculated on appropriate media and cultured and the isolates were identified by standard procedures as needed. Antimicrobial susceptibility testing was performed by disk diffusion method according to ‘The Clinical Laboratory Standard Institute’ guidelines. Results: In this study 220 bacterial isolates were recovered from 263 samples showing an isolation rate of 83.65%. The predominant bacteria isolated from infected wounds were Staphylococcus aureus 89 (40.45%) followed by Escherichia coli 62 (28.18%), Pseudomonas aeruginosa 34 (15.45%), Enterococci 18 (8.18%), Acinetobacter 5 (2.27%), Klebsiella 9 (4.09%) and Proteus 3 (3.36%). Staphylococcus aureus was sensitive to linezolid (94.38%), fusidic acid (91.01%), vancomycin (87.64%), amikacin (74.15%) and gentamicin (73.03%). Among the Gram negative isolates Escherichia coli was predominant and showed sensitivity to imipenem (93.54%) amikacin (83.87%) colistin (53.22%) and piperacillin and tazobactum (53.22%) and pseudomonas showed sensitivity to amikacin (73.52%), imipenem (70.58%) and colistin (70.58%). Conclusion: Staphylococcus aureus was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates help to assist the clinician in appropriate selection of empirical antibiotics against wound infection.