RESUMEN
BACKGROUND:- New Delhi metallo-β-lactamase 1 (NDM-1) enzyme leads to multidrug resistance and has been detected from bacteria in many countries. The study was done To detect bacteria carrying blaNDM-1 gene from intensive care unit (ICU) patients and correlate the change with increasing duration of ICU stay. METHODS:- Blood and urine samples were collected from 140 patients thrice- 0-2 days, 3-7 days and 7 days of ICU admission. All bacterial isolates resistant to meropenem were evaluated for Metallo-β-lactamase (MBL) production. blaNDM-1 gene was detected using Real Time PCR from the MBLproducers. RESULT:- Overall, 458 samples (229 each) of blood and urine were collected and 75 gram negative bacteria were isolated. From these, 46.7% (35/75) strains were found to be carbapenem resistant and blaNDM-1 gene was detected in 17.3% (13/75). CONCLUSION:- High prevalence of bacteria carrying blaNDM-1 gene was seen in ICU patients increasing the burden on healthcare.
RESUMEN
This study was undertaken to study the occurrence of cholera in young children with a view to define the clinical criteria of diagnosis and endemicity of cholera in Delhi and to compare its clinical profile with rotavirus diarrhea. Hundred children below 3 years of age admitted with acute watery diarrhea were recruited. The severity of diarrhea and degree of dehydration were noted. Stool specimens collected from all cases were subjected to bacterial culture for identification of Vibrio cholerae and rotavirus detection by ELISA and PAGE techniques. Both Vibrio cholerae and rotavirus were detected in 5, Vibrio cholerae alone in 13 and rotavirus alone in 18 cases. Sixty-one percent cases of cholera occurred in children below two years. Rice watery stools were seen only in 28% (5/18) cases of cholera. Three (3/13) cases with cholera alone and 6/18 with rotavirus alone had mild diarrhea. Moderate diarrhea occurred in 3/5 cases with both pathogens, 6/13 with cholera alone and 7/18 with rotavirus alone. Severe diarrhea occurred in 3/5 cases with both pathogens, 4/13 with cholera alone, and 5/18 cases with rotavirus alone. Mild dehydration occurred in 3/5 and severe dehydration in 2/5 children with both pathogens. Only 3/13 children with cholera alone and one child with rotavirus alone were severely dehydrated. It is concluded that considering the diagnosis of cholera solely on clinical grounds and overlap between the clinical spectrum of cholera and rotavirus diarrhea would result in missing many cholera cases in a non-endemic area like Delhi.
RESUMEN
The parasitic causes of diarrhea in children in Delhi were determined by the direct smear technique; stool specimens of 127 children were examined for intestinal parasites. In 59 cases (46.5%) intestinal helminths and protozoa were demonstrated. Ascaris lumbricoides was observed in 1 (0.8%) case, while Trichuris trichiura was the finding in 3 (2.4%). Protozoal parasites included Giardia intestinalis and Entamoeba histolytica in 14 (11%) cases each, Balantidium coli in 3 (2.4%) cases and Cryptosporidium spp in 24 (18.9%) patients. Mixed infection was not seen in any of the cases. Intestinal parasites may increase susceptibility to infection with other intestinal pathogens and therefore with the help of a simple technique, like direct fecal smear examination. rapid diagnosis can be made and specific therapy instituted.