Résumé
Introduction: Healthcare associated infections(HAI) bymulti-drug resistant organisms(MDRO) are major cause ofmortality and morbidity having significant impact on qualityof life and economic burden. HAI by carbapenem-resistantPseudomonas aeruginosa (CRPsA) and Acinetobacterbaumannii (CRAB) are emerging threat for their highantibiotic resistance and spread via mobile genetic elements.Objectives of this study were to detect prevalence of CRPsAand CRAB infections in a tertiary care hospital of EasternIndia and to determine their antimicrobial resistance profile.Material and methods: This observational study was done inDepartment of Microbiology from January 2018-June 2019.From HAI patients, different clinical samples were collected.Culture and identification by standard conventional methodsand antimicrobial susceptibility tests by modified KirbyBauer disc-diffusion method following CLSI guidelines wereperformed. CRPsA and CRAB cases were identified whenisolates were resistant to ≥1 carbapenem, 10µg imipenemdisc(zone diameter ≤15mm for P. aeruginosa or ≤18mm forA. baumanii) or meropenem disc (≤15mm for P. aeruginosa or≤14mm for A. baumanii).Result: From 27,043 clinical samples, 1785(6.6%)Acinetobacter baumannii and 777(2.87%) Pseudomonasaeruginosa were isolated. CRAB and CRPsA prevalencewere 74.17% and 62.29% respectively. Carbapenemresistance were further categorised into imipenem-resistantmeropenem-resistant (IRMR) (A. baumanii-63.19%, P.aeruginosa-51.61%), imipenem-resistant-meropenemsensitive (IRMS) (A. baumanii-10.48%, P. aeruginosa-9.13%), meropenem-resistant-imipenem-sensitive (MRIS)(A. baumanii -0.51%, P. aeruginosa -1.54%) phenotypes.Fourth category was imipenem-sensitive-meropenemsensitive (ISMS) (A. baumanii -25.82%, P. aeruginosa-37.71%). Carbapenem-resistant groups showed significantlyhigh resistance for all antibiotics excepting colistin.Conclusion: Carbapenems are often used for treatingMDRO. But high carbapenem-resistance in HAI is alarming,warranting judicious use of antibiotics.
Résumé
Aims: The aim of the study was to know the prevalence, severity, and progression of retinopathy of prematurity (ROP) amongthe screened low birth weight (LBW) and preterm babies and to determine how many of these babies require treatment.Methods: Prospective, observational study was done between August 2018 and March 2019. Screening for the presence ofROP and its severity in 588 eyes of 294 infants below 2000 g birth weight and/or period of gestation <34 weeks in SpecialNewborn Care Units. The retinal findings were documented and staging of ROP was determined, based on the InternationalClassification of ROP guidelines. Further follow-up and treatment were done accordingly.Results: In our study, 14.28% of the total numbers of babies screened were found to have different stages of ROP and 6.5%of the total number needed treatment. Among babies with birth weight above 1250 g, screening of 418 eyes of 209 babieswas done, of which 28 eyes of 14 babies were diagnosed as ROP (6.7%). Of which 12 babies received oxygen and 4 babies(8 eyes) required treatment. Among babies with ≤1250 g body weight, screening of 170 eyes of 85 babies was done, of which56 eyes of 29 babies developed ROP (33%), of which 25 babies received oxygen and 15 babies (30 eyes) required treatmentsuch as laser photocoagulation and intravitreal ranibizumab.Conclusion: ROP is emerging as one of the leading causes of irreversible childhood blindness, if not diagnosed and treatedearly. As very LBW babies are increasingly surviving because of the ever-improving perinatal care, the prevalence of ROP isalso increasing. That’s why regular ocular screening and timely intervention of those babies are to be done to prevent permanentblindness. Moreover, the magnitude of the problem in this part of our country will enable us to prepare our infrastructure to tackle it.
Résumé
A 25-year-old woman presented with gradual dimness of vision in the left eye with history of recurrent cutaneous bullae, photosensitivity and passage of red coloured urine. Examination revealed cataract and high intra-ocular pressure in left eye and symmetrical areas of scleral thinning in both eyes. Systemic features of the patient pointed towards congenital erythropoietic porphyria, which was established by laboratory investigations.