Study of Resistance Pattern in Mucoid and Non Mucoid Isolates of Pseudomonas aeruginosa from Lower Respiratory Tract Specimens in a Tertiary Care Centre of Western U.P.

Introduction: Respiratory tract infections are a majorcause of ambulatory visits to the family practitioners.However, increase in antibiotic resistant strains of bacteriahas complicated the use of empiric therapy of this commonhuman disease. Among the Gram negative bacilli which arethe commonest pathogen of LRTI, Pseudomonas aeruginosais the most challenging, because of its high rate of resistanceto antimicrobial agent. Objectives: To obtain a comprehensiveinsight into the different resistant types: Multi drug resistant,Extensively drug resistant, Carbapenem Resistant, and MBLproducing Pseudomonas aeruginosa isolated from lowerrespiratory tract specimens and antibiotic susceptibilitydifferences between its mucoid and non mucoid colony typesbased on colony morphology.Material and Methods: A total of 926 lower respiratorytract samples consisting of sputum,pleural fluid,endotrachealaspirates,Bronchoalveolar lavage from patients of all ageand sex , suggestive of LRTI were included . FollowingDirect Gram staining and culture, the organisms wereisolated and Pseudomonas aeruginosa among them wereidentified by standard biochemical tests. The different typesof colony morphologies of Pseudomonas aeruginosa and theantimicrobial susceptibility differences amongst the differentcolony types were statistically analysed.Results: A total 175 (18.8%) Pseudomonas were isolatedfrom different Lower respiratory specimen Out of these, only103 Pseudomonas aeruginosa were found to be clinicallysignificant with 84.5% non mucoid and 11.4% mucoid colonytypes. The mucoid colony types showed high resistanceto Cefepime (35%), followed by Ceftazidime (20%) andAmikacin (15%).Conclusion: The high rate of MDR and XDR Pseudomonasaeruginosa also resistant to Carbapenems from this regionreveals a frightening scenario.As molecular methods are notavailable in majority of resource constrained laboratories ofIndia, the phenotypic methods should be regularly performedto detect the various beta-lactamases, besides strict infectioncontrol practices.

Nebulized N-Acetylcysteine for Management of Plastic Bronchitis

Background: Plastic bronchitis is characterized by formation of extensive obstructiveendobronchial casts and high recurrence rates. Case characteristics: Two children (1-year-old girl, 7-year-old boy) who had recurrent episodes of respiratory distress with acuteworsening. Bronchoscopy revealed membrane-like casts. Both children were managed withnebulized N-acetylcysteine in addition to management for asthma. Outcome: Symptom-free without recurrence for more than 9 months of follow-up. Message: Nebulized N-acetylcysteine may be helpful in prevention of recurrence of plastic bronchitis due to asthma.

Statistical interpretation of weekday/weekend differences of ambient gaseous pollutants, vehicular traffic and meteorological parameters in urban region of Kolkata.

An air quality sampling program has been designed and implemented to collect the concentrations of gaseous pollutants (SO2, NO2 and NH3) at weekdays and weekends from a network of three monitoring stations during November 2003 to May 2004 along a populated urban region of Kolkata. Monitoring of ambient SO2 (sulphur dioxide), NO2 (nitrogen dioxide) and NH3 (ammonia) was done once in a week for 24 h at the residential (Kasba) and industrial (Cossipore) sites while 8 h at the commercial (Lalbazar) site. Average ratio of the weekday/ weekend concentrations of SO2, NO2 and NH3 were 1.41, 1.01 and 0.99 at Kasba; 1.33, 1.13 and 1.10 at Cossipore and 1.09, 1.17 and 1.10 at Lalbazar, respectively. Linear regression analysis between SO2 and NO2 showed good (R2 > 0.70) relationship at weekdays in residential and industrial sites. It also showed moderate (R2 > 0.50) relationship in residential site and good (R2 > 0.70) relationship in industrial sites at weekends. In the commercial site, a strong (R2 > 0.90) linear association has been observed between SO2 and NO2 at weekdays and weekends. Daily average vehicular traffic at weekdays was higher than those on weekends. The spearman rank correlation coefficient showed that measured gaseous pollutants have inverse correlation with meteorological parameters (temperature, relative humidity and wind speed) at all the sites, both on weekdays and weekends.

Benzene, toluene and xylene (BTX) pollution in ambient air: a case study.

Volatile Organic Compounds (VOCs) in presence of sunlight and oxides of nitrogen in atmosphere are considered as precursors for ozone production at the ground level. Concentration of Benzene, Toluene and Xylene (BTX) in ambient air was measured near seven traffic junctions in the city of Nagpur. Air samples were collected using Organic Vapour Sampler and analyzed by Gas Chromatograph equipped with Flame Ionization Detector (FID). Benzene concentration was found to be in the range 9.3 to 28.7 microg/m3, Toluene 3.26 to 21.0 microg/m3 and Xylene 4.9 to 15.0 microg/m3. These values are lower than those found in Metropolitan cities like Mumbai.