Clinico-epidemiological study on metal-induced contact dermatitis from North India

Objective: To determine the prevalence of metal sensitization and different clinical patterns in suspected patients of metal induced contact dermatitis

Methods: This was an epidemiological study during which a total of 100 patients suspected and provisionally diagnosed as having contact dermatitis to metals were subjected to a patch test with Indian Standard Battery developed by CODFI [Contact and Occupational Dermatoses Forum of India]. Results were read after 48hrs of application and a second reading, if required, was taken after 72-96hrs

Results: Most of the patients in this series presented with hand eczema [40%], which was followed by dermatitis localized to site of contact with metal [20%] and facial dermatitis including eyelid dermatitis [15%]. Twenty-seven patients showed positive reactions to metal allergens. Crosssensitivity was low and three patients or 11.11% showed sensitization to two metal allergens. No patient showed sensitization to all the three metals. Conclusion: Nickel was the commonest metal allergen identified and it was relevant in 100% of the cases. It showed a strong female preponderance. Patch testing is hence a helpful diagnostic aid in identifying the agents responsible for contact dermatitis and a sincere effort should be made to determine clinical relevance of the test results in every case

Prevalence of metallo- beta-lactamase-producing [MBL] Acinetobacter species in a tertiary care hospital

Acinetobacter causes a wide variety of illness in debilitated and hospitalized patients. Carbapenem resistance in Acinetobacter is an emerging problem and is a cause of concern as many nosocomial infections with Acinetobacter are resistant to most other antibiotics. The present study was aimed to study metallo-beta-lactamase [MBL] production in Acinetobacter species. During one year prospective study, all isolates of Acinetobacter obtained from various clinical samples like respiratory, pus, blood and others were included. Antimicrobial susceptibility testing was done by standard Kirby Bauer disk diffusion method. Metallo beta-lactamase [MBL] detection was done by imipenem-EDTA combined disk method. Among 1017 isolates, 964 were A. baumannii, 48 were A. lwoffii and 5 were A. hemolyticus. Out of these, majority of the isolates were obtained from respiratory samples, followed by pus. A. baumannii showed high level of resistance to cephalosporins, cotrimoxazole and piperacillin. A. lwoffii and A. hemolyticus showed lesser resistance to all antibiotics. Imipenem resistance was observed in 389 [40.3%] isolates of A. baumannii and MBL activity was seen in 80.3% of isolates.MBL positive isolates of A. baumannii showed higher resistance as compared to MBL negative isolates. This study demonstrated that multidrug resistant strains of Acinetobacter are common in tertiary care hospitals. Unwarranted and unrestricted usage of antibiotics is associated with emergence of resistance in nosocomial pathogens. Regular monitoring and documentation of carbapenem resistant is crucial in developing strategies to control infection due to these bacteria