Résumé
Introduction: Acute coronary syndrome (ACS) comprise the majority of hospital admissions and encompass a high risk of inhospital mortality. This study aimed to understand and assess the characteristics of hospitalized ACS patients, trends in theirmanagement as per evidence based medicine, and its impact on outcome. Materials & Methods: This was a prospective,observational study conducted at a tertiary care hospital in India during January 2018 to December 2018. All consecutive patientssuspected of ACS having age ≥ 18 years were admitted. During hospitalization, a case report form was filled out for patients withdiagnosis of ACS. It included data on demographic, clinical and electrocardiographic characteristics of the patients, diagnosis &treatment modalities. Treatment outcome was mentioned in terms of TIMI grading & in hospital complications. Results: A total of112 consecutive patients admitted in cardiac ICU were enrolled. Out of them 72 (64.28%) were males and 40 (35.72%) werefemales. Mean age of study cohort was 55.98±10.68 years. Most commonly associated conventional risk factors wereHypertension and diabetes [65 (58.04%) hypertensives and 33 (29.46%) diabetics]. Medical management was offered to 78(69.64%) whereas, 34 (30.36%) underwent PTCA or CABG. TIMI flow grading assessment done in 62 patients of which 1/3rdpatients showed TIMI grade 3.Conclusion: The present study showed higher ACS prevalence among patients who were in sixth toseventh decade of life, most commonly males, and associated with conventional risk factors, hypertension and diabetes.
Résumé
Background: Staphylococcus aureus has emerged over the past several decades as a leading cause of hospital-associated and community acquired infections. Methicillin resistant S. aureus (MRSA), which are often resistant to several classes of antibiotics, is the most common cause of nosocomial infections and pose a great threat to the world. Vancomycin is regarded as the first-line drug for treatment of MRSA but resistance to this drug is being reported now a day.Methods: It was carried out for a period between January 2014 to June 2017 in the microbiology diagnostic laboratory. MRSA detection was performed by cefoxitin disk diffusion method. Screening for the vancomycin intermediate and the vancomycin resistant S. aureus (VISA and VRSA respectively) was carried out by using vancomycin screen. MIC (minimum inhibitory concentration) of vancomycin was tested by agar dilution method and E strip on all MRSA isolates.Results: A total of 287 S. aureus clinical isolates were included in the study. All MRSA were inoculated on vancomycin screen agar. Visible growth was present in 8 isolates. Five (3.73%) MRSA isolates with MIC of 4 were termed VISA (vancomycin intermediate S. aureus) by agar dilution method. Six isolates had the MIC of 4 and were termed as VISA.Conclusions: As disc diffusion method is not recommended by CLSI for S. aureus, vancomycin screen agar and MIC determination by either of the methods viz. agar dilution or E test can be used.