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Introduction:Chronic nonhealing ulcers, with varied etio-pathologies, are difficult to manage and warrant meticulous, early and prolonged directed treatment to prevent their development and complications.Methods:Patients of chronic ulcers (>3 months’ duration), having undergone surgical management at our Institute, VCSGGMS&RI-UT, between January 2018 –August 2019, numbering one hundred twenty five (N= 125), were included in this concurrent observational study, aimed at identifying implicated microrganism(s) and their antibiotic susceptibility, for promoting wound healing, along with surgical measures Results:Male patients (M:F :: 87:38; 69.6% males) in the “20-50 year” age-group (74; 59.2%), with diabetic ulcers (35;28.0%), burns etc. (21;16.8%) and traumatic ulcers (18;14.4%) etc. predominated in the chronic non-healing state. Gram positive (68; 54.4%) organisms (including Staphylococcus) were the major isolates from the ulcers; organisms showing higher sensitivity to the newer generations/groups of antibiotics. Uncontrolled Diabetes, other prolonged illnesses &/or under-nutrition were important causative factors, requiring their remediations and also debridements ± skin/flap coverage (45; 36.0%) with prolonged course of antibiotics and occasional amputations (18; 14.4%) for adequate treatment.Conclusion:Skilled intensive multidisciplinary effort is essential to achieve satisfactory healing and prevent disfigurement and to limit disability and death (11; 8.8%) among the patients.
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Introduction: Urinary tract infection in pregnancy isassociated with significant morbidity for both the motherand the baby. The aim of this study was to determine thebacterial profile and antibiotic resistance pattern of the urinarypathogens isolated from pregnant women at Mata GujriMemorial Medical College and Hospital, Kishanganj.Material and methods: A total of 267 pregnant womenwith and without symptoms of urinary tract infection wereenrolled as a study subject from October 2016to october2017.Organisms were identified from mid-stream clean catch urinesamples and antibiotic susceptibility was performed usingbacteriological standard tests. Data were collected usingstructured questionnaires and were processed and analyzedusing SPSS for Windows version 16.Results: Out of 267 pregnant women, 37 were symptomaticand the rest 230 asymptomatic. Bacteriological screening ofurine samples revealed growth of bacteria in 8.5% (7/37) and18.9% (28/230) for symptomatic and asymptomatic pregnantwomen respectively with overall prevalence of 9.5%.The most common isolates detected were E.coli (45.7%)followed by coagulase negative Staphylococcus (17.1%).Gram-negative bacteria showed resistance rates in the rangeof 56.5%-82.6% against trimethoprim/sulfamethoxazole,amoxicillin and ampicillin. Gram positive isolates showedresistant rate ranging from 50-100% against trimethoprimsulphamethoxazole, amoxicillin and ampicillin. Both Grampositive and gram negative bacteria showed high sensitivityagainst Nitrofurantoin with a rate of 82.3% and 87%,respectively. All isolated Gram positive bacterial uropathogenswere sensitive for Amoxicillin-clauvlanic acid.Conclusion: The isolation of bacterial pathogens both fromsymptomatic and asymptomatic pregnant women that areresistance to the commonly prescribed drug calls for an earlyscreening of all pregnant women to urinary tract infection.
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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.
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A large amount of crude oil is spilled annually into the terrestrial and aquatic environments in Nigeria. This tends to upset the natural equilibrium of the marine environment as a microbial habitat. Thus, there is a need to evaluate the effect of exposure to crude oil on bacterial load and diversity using Iko River and Odoro Ikot pond as the study and pristine sites respectively. The bacterial isolates were molecularly identified using the 16S rRNA sequencing protocol. The total heterotrophic bacterial count (THBC) in the surface water (SW), sub-surface water (SSW) and sediment segments of Iko River ranged from 2.23±0.87 to 9.67 ± 0.43 x 106 CFU/ML while the THBC in the SW, SSW and sediment segments of the pristine site (Odoro Ikot pond) ranged from 1.87±0.53 to 4.8± 0.04x106 CFU/ML. The sediment had a significantly higher (P<0.05) THBC than the water segments (SW and SSW) in both Iko River and Odoro Ikot pond. The hydrocarbon utilizing bacteria (HUB) count in Odoro Ikot pond ranged from 0.40 ± 0.01 to 1.10 ± 0.03 x 106 CFU/ML while the HUB count in Iko River ranged from 0.53 ± 0.02 to 0.93 ± 0.04 x 106 CFU/ML, making Iko River have a higher number of total heterotrophic bacteria and hydrocarbon utilizing bacteria than Odoro Ikot pond. The Proteobacteria isolates had the highest bacterial diversity (77%) while members of the Firmicutes phylum had a 23% bacterial diversity. However, higher bacterial count and diversity were obtained from the sediment segment than from the water segments in both Iko River and Odoro Ikot pond implying that the sediment is more favourable for bacterial growth. Although the bacterial profile was affected by exposure to crude oil, there were variations in the phylogenetic diversities obtained from the different water segments attributable to crude oil concentration.
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Background: India has the largest diabetic population of 50.8 million that could reach an epidemic proportion by 2030. Diabetic foot infection is one of the dreaded complications of diabetes. Only a few studies that focus on patterns of diabetic foot infection in our region, where diabetic foot care is inadequate. This study evaluated microbial and clinical characteristics of diabetic foot infections that will be helpful in taking appropriate measures for their management. Aim and objectives: This study was undertaken to evaluate the clinical and the microbial characteristic of diabetic foot infection in patients. The ulcers were graded and swab samples were collected under aseptic condition. Materials and methods: In this prospective study conducted during 2016-2017, Totally 100 diabetic foot patients underwent detailed history, clinical examination, and laboratory investigations including parameters of systemic infections. Microbial culture and sensitivity were performed at the time of presentation. Results: Among 100 cases, 27 (43.5%) had mono-microbial infection, 22 (35.5%) had poly-microbial infection, and 13 (21%) had sterile culture. Altogether 82 bacteria were isolated from 49 cases. Among 82 bacterial isolates, 56 (68.3%) were Gram negative while 26 (31.7%) were Gram-positive bacteria. Escherichia coli was the most common pathogen isolated followed by Staphylococcus aureus. Conclusion: Gram-negative bacteria were most prevalent in diabetic foot infection. It is not uncommon to have culture reports negative despite clinical evidence of infection. This study suggests that piperacillin/ tazobactam should be the treatment of choice on an empirical basis prior to a definitive bacteriological study and in cases with negative culture reports.
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Introduction: CSOM is a massive public health problem with incidence higher in developing countries like India, especially among low socio-economic society because of malnutrition, overcrowding, poor hygiene, inadequate health care, and recurrent upper respiratory tract infections. It is associated with various complications like persistent otorrhoea, hearing impairment, mastoiditis, labyrinthitis, facial nerve paralysis to more serious intracranial abscesses etc. The knowledge of microbiological profile is essential to enable efficacious treatment of this disease & thereby reducing the potential risk of complications. Methodology: This study was aimed to determine the microbial profile & their antimicrobial resistance pattern using Kirby Bauer disc diffusion method among the patients suffering from CSOM between April 2013 to March 2014. Results: Out of 216 samples processed, isolates were seen in 145 (67.1%) cases with male to female ratio of 1.5: 1 and age group affected was 10-20 years. Most common organism isolated was Pseudomonas spp. (49%) followed by S. aureus (35.9%). Pseudomonas spp. showed high degree of resistance to gentamicin (57.7%) and ciprofloxacin (53.5%). Also, S. aureus was found resistant to ciprofloxacin (61.5%) and cotrimoxazole (40.4%). Conclusion: Management of CSOM consists mainly of eradicating infection and closure of tympanic membrane. Periodical monitoring of bacterial isolates and their antibiotic susceptibility pattern is necessary for administering appropriate antibiotics for empirical treatment and also helps in reducing the potentially disabling and fatal complications of CSOM.