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Background: Methicillin resistant Staphylococcus aureus (MRSA) infection traditionally has been associated with healthcare settings, colonizing patients with underlying debilitating health conditions. Now a day, Hospital management has become increasingly aware of issues related to MRSA infections in the patient population. Aims & Objective: To know the prevalence of MRSA amongst hospitalized as well as OPD based patients and to find out and compare the antibiotic resistance patterns of Methicillin resistant and Methicillin sensitive S. aureus. Material and Methods: Total of 534 Staphylococcus aureus isolated from various clinical specimens using the standard procedures during June 2010 to June 2011. Screening and confirmation of MRSA isolates were done by standard methods recommended by Clinical and Laboratory Standards Institute (CLSI). CDC definition was used to classify hospital and community Acquired Methicillin-Resistant Staphylococcus aureus. Antibiotic susceptibility test was done using Kirby-Bauer disk diffusion method. Detailed information regarding duration in hospital stay, ward, unit and clinical history were collected. Results: Out of 534 Staphylococcus aureus recovered from different clinical samples, 152 (28.46%) were found to be Methicillin resistant. 113 out of 152 isolates (74.34%) were Hospital acquired MRSA (HA-MRSA) while 39 out of 152 isolates (25.66%) were Community acquired MRSA (CA-MRSA). The antibiotic susceptibility result shows that MRSA isolates were resistant to multiple antibiotics than MSSA isolates. All isolated MRSA were sensitive to Vancomycin. Conclusion: Measures to control the emergence and spread of MRSA are needed to be improved because there are fewer options available for the treatment of MRSA infections. Thus, together with good professional practice and routine infection control precautions constitute the major measures in controlling and preventing MRSA.
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Background: Quality in the health care institutions is multifaceted & multidimensional with its core element as the customer’s satisfaction. Improvement in the health care services is a long drawn relentless process which can be achieved by implementing a carefully planned Quality Management System. Laboratory services B.J. Medical College & Civil Hospital Ahmedabad, has set its Quality indicators and is monitoring it as a part of continual improvement. One of the Quality indicators is Sample rejection. The laboratory aims to reduce the sample rejections by complying with the standards & recommended guidelines. Methods: This is to monitor & analyze the Sample Rejections as a Quality Indicator for Continual improvement of the Microbiology Department. Primary data collection done before training & secondary data collection done after the training of nursing staff & Resident Doctors. Results: The sample rejection rate of the Microbiology Laboratory in the month of July 2010 was 0.31%. After the training of the nursing staff as well as resident doctors regarding proper collection & transport of samples based on scientific principles, a decreasing trend in the sample rejection rate is observed. i. e. from .31% to 0.11 % in the 13 months duration of study.Conclusion: The implementation of a systematic error-tracking system i.e. monitoring the sample rejections, analysing its trend, taking preventive & corrective actions to reduce the sample rejection rate in daily practice definitely improves the quality of the laboratory results and is a quality indicator for continual improvement of the laboratory.
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Background: The purpose of this study was to isolate the Candida spp. & examine their susceptibility to antifungal drugs from various clinical specimens. One hundred fifty isolates of Candida spp. were included in this study. Clinical history revealed that all patients were on systemic broad spectrum antibacterial drugs. Materials and Methods: Candida spp. was differentiated by germ tube test, culture characteristics on special media for fungus, sugar fermentation, sugar assimilation and growth on corn meal agar. Antifungal drug susceptibility testing against Fluconazole, Ketoconazole, Itraconazole, Voriconazole, Nystatin and Amphotericin B were done on basis of CLSI guidelines on Methylene blue containing Mueller Hinton Agar by disk diffusion method. Result: We found 52% and 48%, C.albicans & Non albicans candida spp., respectively. There were no resistance to Nystatin and Amphotericin B. C.albicans was more susceptible than Non albicans candida. Nystatin & Amphotericin B were susceptible to all isolated Candida spp. In present scenario, Fluconazole is most commonly used empirical antifungal drug, which is more effective to C.albicans than Non albicans Candida. Conclusion: Due to emergence of resistance in Azole group of antifungal among Non albicans candida, it should be mandatory to use antifungal drugs as per the susceptibility testing.
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We report a case of meningitis due to Salmonella paratyphi-B, in an 11 month old male infant. The child was admitted in Emergency department with the complains of generalized convulsion and vomiting. On examination patient appearance of child was lethargic and irritable, had marked neck stiffness, with bulging fontanelle, lumbar puncture was done and sent for routine investigation, microscopy, culture and sensitivity. Later on Salmonella paratyphi-B was isolated from CSF.