RESUMEN
Diabetes mellitus is one of the most challenging heath problems of the 21st century and is leading cause of death in developed countries. Urinary tract infections are one of the most frequent bacterial infections encountered in diabetes mellitus. We wanted to determine the common pathogens causing urinary tract infection in diabetic patients and their antibiotic resistance pattern. METHODSA total of 550 mid-stream clean catched urine samples were subjected to macroscopic examination, wet film examination, Gram staining, and semi-quantitative culture methods. HiCrome agar was used for early identification of isolates. Samples were inoculated on 5% blood agar, CLED agar and MacConkey agar. Isolates were identified by standard laboratory procedures. RESULTSIn this study, 284 isolates were obtained, and the most common organisms isolated were E. coli. Klebsiella and Proteus species. Gram positive isolates were Enterococcus and MRSA. Patients with diabetes are more prone to have resistant pathogen. CONCLUSIONSThis study concluded that the prevalence of urinary tract infection is higher in females compared to males in diabetes. Gram stain was found to be the best screening test with high sesitivity and specificity. Wet film has comparatively low sesitivity and specificity. It is essential that culture should be done for all samples in diabetes to decrease the morbidity and prevent the occurrence of complications.
RESUMEN
The aim of the study is to screen the multiple drug resistance (MDR) Uropathogenic Escherichia coli (UPEC) fromthe urban area of Namakkal district. To detect UPEC resistant by using different antibiotics and to analyze the virulentcharacteristics of UPEC and amplification of extended-spectrum beta-lactamases genes by multiplex polymerasechain reaction. Total 450 samples individually collected from the urinary tract infection (UTI) patients’ and directstreaked on to the eosin methylene blue agar plates. Significant growth indicates E. coli. HiCrome UTI agar was usedfor rapid identification of uropathogenic E. coli. Out of 450 samples, only 62 isolates of E. coli were subjected tovirulence characteristics, such as slime production (34%), hemolytic activity (56%), and beta-lactamase production(43%). Antibiotic sensitivity test was performed with 13 different antibiotics. Among them, 62 isolates were E. coli,only five were resistant to 10 antibiotics, possess virulence characteristics. Four strains (E-12, E23, E-58, and E-97)have Temoneira, sulfhydryl variable, and cefotaxime hydrolyzing capabilities (CTX-M) antibiotic resistance genes,and E-07 have only CTX-M gene. As E. coli is the main infectious agent in patients with UTI and a potent pathogen,it was difficult to treat with routine antibiotics because day-by-day microbes are resisting to common drugs. Hence,they need alternative therapy
RESUMEN
Background: Sepsis is a global problem causing substantial morbidity and mortality to the patients afflicted with it. Moreover sepsis due to fungal infections, especially, the Candida infections has increased in the recent times due to increase in patients with immunocompromised conditions. They are the normal commensal of the oral cavity, GIT and the mucosal surfaces in the body as well as the pathogens leading to colonization and also infection. Though Candida albicans is the most commonly isolated fungal pathogen from clinical samples, gradually non-albicans Candida species are becoming predominant pathogens. The increased use of anti-fungal agents for treatment and also for prophylaxis especially in ICU patients has lead to development of resistance against commonly used anti-fungal agents in the treatment like various azoles. Thus this study was carried out to identify different Candida species from specimens of clinically diagnosed sepsis patients and their antifungal susceptibility pattern which can be utilized for better management of sepsis patients. Objectives: The objectives of this study were to isolate and identify the species of Candida from different samples of clinically diagnosed sepsis patients and to determine the susceptibility pattern of the Candida species isolates against the commonly used anti-fungal agents from the clinical samples of sepsis patients from a rural based tertiary care and teaching hospital. Khara R, Lakhani SJ, Vasava S. Isolation, Identification and Antifungal Susceptibility Testing of Candida species from Sepsis Patients from a rural based tertiary care and teaching hospital in Vadodara district, Gujarat. IAIM, 2017; 4(7): 151- 160. Page 152 Materials and methods: A total of 100 Candida species were isolated from different samples of clinically diagnosed sepsis patients. These were identified on the basis of gram stain of the samples, colony morphology on Saboraud’s Dextrose agar and HiCrome also germ tube and chlamydospore formation. The antifungal susceptibility testing was done according to CLSI M44-A2 for yeasts. Results: A total of 100 (14.26%) Candida species were isolated out of the total 701 isolates from 1136 different samples cultured from clinically diagnosed sepsis patients. Of these, 53% were C. albicans, 37% C. non-albicans, 6% C. glabrata and 4% C. tropicalis. Also 35% were obtained from blood, 20% from catheterized urine, 19% from sputum, 14% from non-catheterized urine, 7% from ET (Endotracheal) tips/secretions and the smaller percentage from other specimens. The antifungal testing showed a higher resistance to most of the antifungal agents tested with 80% towards clotrimazole, 77% to ketoconazole and 63% to fluconazole and 62% towards itraconazole. However, 80% of Candida species were susceptible to amphotericin B followed by 33% to fluconazole and 80% were susceptible-dose-dependent to nystatin. Conclusion: The findings of our study suggest that Candida species are an important pathogen causing various infections in our patients leading to sepsis as well as a higher resistance to most of the antifungal agents tested poses a real challenge in the management of patients with sepsis due to Candida. Thus routine identification using HiCrome Media and antifungal susceptibility testing by disc diffusion method for yeasts will help in better management of sepsis due to Candida infections.
RESUMEN
This study was undertaken to find media better than routinely used media in isolation of uropathogens.Three hundred urine samples having pus cells >_ 5/ HPF were enrolled for the study. Comparison of isolation and identification of uropathogens among HiCrome UTI Agar media, 5% Sheep Blood agar & MacConkey agar and CLED agar media were done. Among them 95(31.67%) samples showed single growth, 6 (2%) showed mixed growth and 199 (66.67%) showed no growth. Rate of presumptive identification of organisms in primary culture plate were high in HiCrome UTI agar media. For Escherichia coli, it was 94.20% whereas in CLED agar it was 79.71% and by Blood agar and MacConkey agar media in combination it was 82.61%. All the Enterococcus spp. were identified in HiCrome UTI agar media, 33.33% in CLED agar media but none in Blood agar and MacConkey agar media. Among the mixed growth, 100% organisms were identified on HiCrome UTI Agar media due to distinct colour produced by the different organisms, whereas in one (16.67%) sample (mixed Esch.coli and Pseudomonas spp.) organisms were identified on other three media.