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Background: Respiratory infections among critically ill Patient are associated with high morbidity and mortality. Mechanically ventilated patients are at a high risk of acquiring respiratory infections due to complex interplay between the endotracheal tube, host immunity and virulence of invading bacteria. Irrational use of antibiotics increases the emergence of drug – resistant bacteria. Objectives: The aim of study was to investigate the bacterial isolates in the endotracheal aspirates of mechanically ventilated patients in ICU and see the antimicrobial resistance pattern of bacterial isolates. Methods: Analysis of E.T aspirates of 459 patients over a period of 1 year (Aug 14 to Aug 15) was done. Aspirates were cultured on Blood and MacConkey agar isolation and identification was done using conventional techniques and biochemical reactions. Antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: Out of 459 Samples 365 was found to be positive. Acinetobacter sp (44.65%) was the most common isolate followed by Klebsiella sp (18.63%), Pseudomonas sp (11.23%), Candida (10.46%), Escherichia Coli (7.94%), COPS (3.28%), CONS (2.46%), Enterococci (0.82%), and Citrobacter (0.54%). The gram-negative bacilli were mostly sensitive to Tigecycline, Colistin, Imipenem, Meropenem, Amikacin and Piperacillin/Tazobactam. Gram positive Cocci were mostly sensitive to Vancomycin, Linezolid and Gentamicin. Conclusion: The isolation and antimicrobial resistance pattern of the microorganisms is necessary for their effective management. Endotracheal intubation is one of the major risk factors in causing iatrogenic infections to patients. A local antibiogram for each hospital, based on bacteriological patterns and susceptibility is essential to initiate empirical therapy.
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Background: Hepatitis B virus infection is an important health problem and a leading cause of death worldwide. The most important marker for HBV infection is HBsAg. A proper identification of kit is required for proper diagnosis of infection, as well as disease management and prevention. Aims& Objective: - The aim of the present study was to compare rapid HBsAg detection ICT kits for the screening of HBV infection with gold standard ELISA method. Methods: The study comprised 500 blood samples of pregnant women. These samples were tested with ICT kits of (Hepa Card Company) and ELISA (HEPLISA by J. Mitra.). Results: In present study we found 100% sensitivity, 99.59% specificity, 81.81% positive predictive value ,100%Negative predictive value and 99.60% diagnostic efficiency of rapid card test with comparison to ELISA for HBsAg detection. Conclusion: The present study concluded that the overall performance of the rapid ICT kit for HBsAg was equally sensitive to ELISA and yet they were cheap and quicker. It can be recommended that ELISA comparable rapid devices may be allowed to be used for preliminary screening of HBsAg especially in remote areas or where cost is an issue.
RESUMEN
Background: Hepatitis B virus infection is a major global health problem and India accounts for 10- 15%of the entire pool of HBV carriers of the world. Prevalence of Hepatitis B in pregnant women worldwide is 2.5 to 1.5%, whereas in India it is 2 to 7%. Hepatitis B virus is a double stranded DNA virus. The study was undertaken to determine the seroprevalence of Hepatitis B among the pregnant women in southern part of Rajasthan at a rural based tertiary care teaching hospital. Methods: This is a prospective study conducted at a tertiary care hospital, Udaipur, Rajasthan, from August 2015 to December 2017.Blood samples were collected from 1011 pregnant women with age ranging from 15- 45 years. Screening of HBsAg was done by RPHA method and positive HBsAg tests were confirmed by ELISA. The data of those , who were found to be positive for HBsAg was statistically analyzed with the chi square tests, and results were considered significant if the p value was <0.05. Results: The overall HBsAg seroprevalence rate was 1.28%, among the total 1011 pregnant women included in this study. HBsAg seroprevalence was highest, (1.64%) in 15-25 years of age group, and 1.71% in the second trimester of pregnancy. The correlations of seroprevalence rate of HBsAg among selected age groups and according to second trimester of pregnancy were not found statistically significant. (p value>0.05) Conclusion: In this study the seroprevalence of Hepatitis B surface antigen was 1.28%. To prevent vertical transmission in the pregnant women, they should be screened for HBsAg at the first antenatal visit for appropriate management.