Résumé
Background: Tuberculosis (TB) is a communicable disease and it ranks second of all infectious agents due to co-infection with HIV . The causative agent of tuberculosis is a group of mycobacteria known as Mycobacterium tuberculosis complex. Mycobacterium tuberculosis complex consist of M. tuberculosis, M. bovis, M. africanum, M. microti, M. canetti. In PCR study, Most commonly sensitivity is higher in smear positive samples (95-100%) rather than smear negative specimens (46-63%). OBJECTIVE: To detection of Mycobacterium tuberculosis complex by Line Probe Assay. Methods: The study was done from non-interventional approaching study of 50 suspected patients of tuberculosis had visited the TB chest/ DOTS centre. Sputum sample collected early morning in a wide- mouth container from the patients having history of cough more than 2 weeks. Methodology used Z-N staining and for detection of MTB complex was done using MTBDR plus assay, multiplex PCR DNA strip assay (Hain Lifescience, Nehren, Gernamy) which is commercially available. M. tuberculosis secreted an important protein is MPT64, a 24-kDa protein. The major culture filtrate protein (24-kDa) is MPT64 encoded by the RD2 region genes and has been exposed to be an exact antigen that differentiates the M. tuberculosis complex from the mycobacteria other than tuberculosis (MOTT) Species. Results: In 50 samples, out of which 10 (20%) were smear positive & 40(80%) were smear negative. Out of 10 smear positive, 9 (90%) were MTB (Mycobacterium tuberculosis) & 01 (10%) was NTM (Non-tuberculous Mycobacteria) by PCR method. Out of 40 smear negative, 30 (75%) were positive by PCR method. Out of 30, 28(93%) were MTB & 02(7%) were NTM. Rests of the 10(25%) samples were found negative for M. tuberculosis complex. Conclusions: This study proved that PCR is a specific and sensitive method in comparison of sputum microscopy after staining with Z-N technique and it helpful the clinicians ability to diagnose and treat the patients on time. This will ensure early treat to patients and prevent further transmission of disease.
Résumé
Introduction: Blood stream infections are one of the important cause of morbidity and mortality all over the world. Bacteraemia ranges from self-limiting infections to life-threatening septicaemia that requires rapid and aggressive antimicrobial treatment. The mortality rate ranges from 20% to 50% in cases of bacteraemia infections. Aim and Objective: The present study was undertaken to know the profile of gram negative organism causing bacteraemia with their Antibiogram from suspected cases. Material and Method: During a one-year period, 400 blood samples were taken from bacteraemia suspected patients. Blood culture was done by using BacT/Alert 3D system. Further identification of organism was done by different biochemical test. Antimicrobial sensitivity pattern was determined by Kirby Bauer Disc Diffusion method according to CLSI guidelines. Result: Out of 400 samples, the total number of culture positive cases were found to be 131 giving culture positive rate of 32.75%. Gram positive organism were more than gram negative organism, constituting about 75 (57.69%) of total isolates. 56(42.74%) Gram negative organism were isolated in this study. Most frequent pathogen identified among gram negative bacteria were Klebseilla 24(42.8%), followed by E. coli 18(32.14%), Acinetobacter 10(17.85%), Pseudomonas 2(3.57%) and Salmonella 2(3.57%) respectively. Isolated gram negative organism was highly sensitive to Polymyxin B 51(91.07%). After Polymyxin B isolated gram negative bacteria show high sensitivity for Levofloxacin(60.71%), Cefixime (57.78%), Gentamicin, Meropenem, Piperacillin/tazobactum (50%), Cefepime (44.64%) with least sensitivity for Ampicillin/Sulbactum (14.28%). Conclusion: The present study provides information about gram negative pathogens responsible for blood stream infection along with their sensitivity towards commonly used antimicrobial. Antibiotic sensitivity pattern of isolates provides useful guidelines to clinicians in initiating empiric therapy and help in management of blood stream infections.
Résumé
Background: It has been estimated that symptomatic urinary tract infections (UTI) occurs in around 7 million patients visiting to emergency units and 100,000 hospitalizations annually. It continues to be the most common cause of infection in hospitalized patients accounting approximately 40% of hospital acquired infections, and is the second most common cause of bacteraemia in hospitalized patients. Objective: a) To study the prevalence of UTI and its etiology in patients coming to the hospital. b) To study the susceptibility pattern of the isolate. Methods: The study was performed on 630 midstream urine positive samples taken from all age group patients, either male or female. Samples were collected prior administration of antibiotics in a sterile container. In case of cathetized patients, it is collected directly from catheter. Samples were inoculated on CLED agar. By colony count the stage of bacteraemia was assessed. To know the causative organism , colony morphology as well biochemical test were done. Results: The prevalence of Urinary Tract Infections (UTI) was evaluated in 630 patients attending Teerthanker Mahaveer Medical College & Research Centre, Moradabad for the duration of one year from February 2016 to January 2017. Results showed 215 (34.12%) patients were positive. Out of 215 positive cases 41(19.06%) were gram positive organisms and rest 174 (80.94%) were gram negative organisms. The most common pathogenic organisms were Escherichia coli accounting for 98(45.19%) urinary isolates. Among gram positive organism Enterococcus 26(12.09%) were the most common. In-vitro antibiotic susceptibility tests revealed that the gram negatives bacteria were sensitive to quinolones and Carbapenems, while the gram positive isolates were sensitive to glycopeptides antibiotics. Conclusions: The findings suggested the need for regular screening for the presence of symptomatic or asymptomatic bacteriuria for different populations and constant monitoring of susceptibility to commonly used anti-microbial agents.