Bacterial profile from suspected maternal sepsis and colonization cases: A step towards prevention of neonatal sepsis

Background: Transmission of pathogens can occur through direct materno-fetal contact during antepartum period or delivery.Presence of maternal reproductive tract colonization or bacterial infections during pregnancy increases the risk of puerperal sepsisand early onset neonatal sepsis (EONS). This study was thus planned to screen the etiological agents and antibiogramfromsuspected maternal sepsis/ colonization cases.Materials and methods:Data was collected over a period of 1 year (September2017- September 2018). Clinical samples-placental membrane, placental tissue, retained product of conception (RPOCs) and highvaginal swabs (HVS) received for screening of maternal sepsis or colonization were processed as per conventionalmicrobiological techniques. Antimicrobial sensitivity was performed as per CLSI guidelines.Result:A total of 2405 maternalsamples were included in the study. Only about 13.18% ( 317 samples) showed the presence of bacterial isolate, Escherichia coli(39%) was the predominant etiological agent isolated followed by Staphylococcus aureus(18%)and Enterococcus species (17%).There was an alarming level of drug resistance seen in both the gram positive and negative organisms.Conclusion:Introduction ofpathogens into the female genital tract is a major risk factor for development of uterine infections and chorioamnionitis which caneventually lead to puerperal sepsis and Early onset neonatal sepsis. EONS. As seen in the present study the organisms such asEscherichia coli and Staphylococcus aureusisolated from maternal sepsis and colonization cases are the same organismsimplicated from EONS.In view of increase in drug-resistant organisms prompt detection and treatment of maternal infectionsbecomes crucial to prevent neonatal infections.

A Prospective Study On Prevalence Of Aerobic Bacteria In Intensive Care Units And Their Antibiotic Susceptibility Pattern In A Tertiary Care Hospital In Jaipur , Rajasthan.

Introducation: Multi-drug resistant nosocomial infections are one of the leading causes of mortality and morbidity amongst hospitalized patients throughout the world, accounting a major burden on the patients and public health system of any country Method :To determine the prevalence of aerobic bacterial in different clinical specimens received from various Intensive Care Units (MICU, SICU, CCU, PICU, and NICU) and their antibiotic susceptibility pattern in the isolated organisms in a tertiary care hospital in Jaipur, Rajasthan. Result : Out of 500 samples, 213 (43%) samples showed growth while 287 (57%) did not show any growth. In the 213 positive samples 183 (85.92%) were Gram Negative bacilli while 25(1.74%) were Gram Positive Cocci and 5 (2.34%) were candida spp.Out of Gram Negative Isolates Acinetobacter Spp. was found to be maximum 35.2% followed by E.coli 19.7% , Klebsiella spp.19.2%, Pseudomonas 12.2%, Citrobacter 0.93% and Proteus Spp. 0.93%. Among Gram Positive Isolates Staphylococcus aureus was maximum 6.5% followed by Enterococcus 3.75%, CONS 0.93% and streptococcus spp.0. 46%. Candida spp. contributes 2.34% of all positive culture. Conclusion: Isolates are sensitive to combination drugs while more resistant to single drug. Among gram negative bacteria most common isolate was Acinetobacter spp. 75 (35.2%) which were resistant to most of the antibiotics like amoxycillin- clavulanic acid (83%) , cefotaxime (76%), imipenem (71%), piperacillin- tazobactam (53%),cefepime (57%) while sensitive to aztreonam (64%) and cotrimoxazole (64%).

A Prospective Study Of The Prevalence Of Dengue, Malaria And Mix Infections Along With The Correlation Of Hematological Parameters.

Abstracts: Background & Objective: A prospective comparative study was done to see the prevalence of Dengue, Malaria and mix infections in the patients attending in tertiary care hospital during a period of March 2013- February 2014. Study also included the pattern of changing Hematological parameters during infections. Methodology: Patients suffering from fever of more than 4-5 days were investigated for Dengue, Malaria and concurrent infections. Peripheral blood smear examination was done for Malaria while Rapid card and IgM & IgG ELISA were done for Dengue. Hematological investigations- CBC, Platelet count was done by sysmex auto analyzer. Results: Total 3650 samples of suspected cases tested for Dengue and Malaria. Out of 3650 samples 934 were positive of Dengue, Malaria and mix infections. Out of 934, 105 were Malaria, 816 Dengue and 13 cases of mix infections were found. In Malaria positive cases Hematological parameters showed anaemia, thrombocytopenia and Eosinophilia while in Dengue cases thrombocytopenia was observed. Conclusion: Prevalence of Dengue is more than Malaria in Moradabad during the study period. Hematological parameters of the cases Dengue, Malaria now are changing their patterns that are a serious matter of concerned. Even mix infections are also building up in the society that’s why Hematological parameters must be monitored regularly.

A Prospective Comparative Study of Semi-Quantitative Slide Widal test& Quantitative Tube Widal test.

Objective: The diagnosis of enteric fever currently depends upon the isolation of Salmonella from a patient, most commonly by blood culture. This facility is not available in many areas where the disease is endemic. The Widal agglutination test which demonstrates the presence of somatic (O) and flagellar (H) agglutinins to Salmonella in the patient's serum using O and H antigen suspension is one of the most utilized diagnostic tests for typhoid fever in developing countries. In the recent past, a rapid slide test was developed which is now the most commonly used technique in local laboratories because of its convenience. The semi-quantitative slide test provides an approximation to the tube test titre. The present study was an attempt to compare the results of semi-quantitative slide agglutination with the quantitative tube method to ascertain any significant difference between two methods. Material and Methods: 300 precollected blood samples of OPD patients were collected over a period of 4 months and subjected to semi-quantitative rapid slide and quantitative tube Widal tests using commercially available Salmonella antigen test kits. Results: From the 300 samples studied, 17(5.7%) serum samples were positive by slide test method while 25(8.7%) seropositive by Tube test method. Present study shows, slight difference in the results obtained by the two methods of Widal test. Conclusion: The Tube Widal test is more sensitive and specific than slide Widal test, especially for rule out prozone phenomena, but slide Widal agglutination test is found to good alternative screening test because less time consuming, easy to perform, cost effective and can be applied in resource poor nations. There is an urgent need for the rational design and evaluation of effective and appropriate diagnostics for typhoid fever.

Candiduria in catheterized intensive care unit patients : Emerging microbiological trends.

Objectives: Urinary tract infection (UTI) as a result of Candida spp. is becoming increasingly common in hospitalized setting. Clinicians face dilemma in differentiating colonization from true infection and whether to treat candiduria or not. The objective of the present study was to look into the significance of candiduria in catheterized patients admitted in the ICUs and perform microbiological characterization of yeasts to guide treatment protocols. Materials and Methods: One hundred consecutive isolates of Candida spp. from the urine sample of 70 catheterized patients admitted in the ICU were collected and stocked for further characterization. A proforma was maintained containing demographic and clinical details. Blood cultures were obtained from all these 70 patients and processed. Species identification of yeasts was done on VITEK. Results: Candiduria was more common at extremes of age. The mean duration of catheter days was 11.1 ± 6 days. Other associated risk factors such as diabetes mellitus and antibiotic usage were seen in 38% and 100% of our study group. Concomitant candidemia was seen in 4.3% of cases. Non-albicans Candida spp. (71.4%) emerged as the predominant pathogen causing nosocomial UTI. Conclusion: The present study reiterates the presence of candiduria in catheterized patients, especially in the presence of diabetes and antibiotic usage. Non-albicans Candida spp. are replacing Candida albicans as the predominant pathogen for nosocomial UTI. Hence, we believe that surveillance for nosocomial candiduria should be carried out in hospitalized patients.

Seroprevalence of hepatitis viruses in patients infected with the human immunodeficiency virus.

OBJECTIVE: The co-infection of Hepatitis B and C viruses with HIV accelerates disease progression and also has an effect on the management of patients infected with HIV. The prevalence of HIV co-infection with hepatitis viruses varies widely. This study is planned to evaluate the prevalence of HIV co-infection with Hepatitis B and C viruses in North India. MATERIALS AND METHODS: A total of 1178 patients enrolled in the ART center were retrospectively analyzed for the presence of HBV and HCV on the basis of the presence of HBsAg and anti-HCV markers. RESULTS: In patients infected with HIV, the prevalence of co-infection with HBV was 9.9% (117/1178), the prevalence of co-infection with HCV was 6.3% (74/1178) and the prevalence co-infection with both HBV and HCV was ~1% (12/1178). DISCUSSION: The prevalence rate of HBV and HCV are increasing in patients infected with HIV. Having acquired the knowledge about the importance of such a co-infection, it is essential that all the patients infected with HIV be screened for HBV and HCV co-infection.

Rubella prevalence and its transmission in children.

Rubella is a major cause of birth defects among the TORCH group of agents causing congenital anomalies. Almost all the symptomatic infected infants have long-term neurological sequelae & many asymptomatic infants also develop deafness or psychomotor retardation later in life. In India need for rubella prevention & control is being recognized. Before formulating any kind of rubella vaccination policies, data on the burden of disease is important. Hence the prevalence of rubella in children and their transmission was evaluated. Paired sera of 146 babies with suspected intra uterine infection and their mothers from lower socioeconomic strata was tested for IgM antibodies by commercially available Enzyme immunoassay (EIA) kits. Congenital Rubella Syndrome (CRS) was confirmed in babies presenting with rubella compatible defects with positive IgM antibodies against rubella. It was seen that out of 146-paired samples evaluated, 15-paired samples (10.27%) were positive for IgM antibodies. The transmission rate of rubella virus from mother to child when the mother was infected was around 55.55% according to this study. CRS prevalence of 10.27% among symptomatic infants is significant as a large majority of rubella infection remains undetected and hence the actual burden of the disease may be higher. Since the disease is preventable by an effective vaccination, strategies for rubella immunization should be developed and enhanced.

Characteristics of dual infection of hepatitis B and C viruses among patients with chronic liver disease: a study from tertiary care hospital.

The major causes of chronic liver disease (CLD) are infection with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) either alone or together. The clinical course of the disease varies in cases ofcoinfection with HCV and HBV as compared to single infection. The present study was carried out to determine the occurrence of coinfection of HCV with HBV in CLD patients and to look for the presence of suppressive effect of the two viruses on each other. The severity of liver disease was also assessed and correlated with biochemical profiles. Sera from 150 patients of CLD were tested serologically for the presence of HBsAg, IgG anti HBc and anti-HCV antibodies. HBV DNA and HCV RNA were also detected by amplifying surface region and 5' noncoding-core region respectively by polymerase chain reaction. Forty-seven (31.3%) cases showed the presence of HBsAg or anti IgG-HBc or HBV DNA either alone or together (Group A). Thirty-nine (26%) cases were found to be positive for HCV by detecting either anti-HCV antibodies or HCV RNA (Group B). Coinfection ofHCV with HBV (Group C) could be detected in twenty-four (16%) cases, of these twenty-one cases (87.5%) were positive both for HCV RNA and IgG anti-HBc without the presence of HBV DNA whereas in none of the cases could HBV DNA be detected in the absence of HCV RNA. Forty (26.6%) cases had neither HCV or HBV related CLD. Amongst, the biochemical parameters, the liver function test profiles were altered and found to be statistically significantly in HCV positive cases (Group B) when compared to the negative ones while in case of HBV (Group A) and coinfected (Group C) cases none of the parameters was statistically significant when compared with non-HBV and non-coinfected cases respectively. Thus, coinfection of HCV with HBV is seen in a substantial number of CLD cases. It is also revealed from the present study that HCV infection has a suppressive effect on the replication of HBV as seen by the loss of replicative markers like HBV DNA.