Antibiotics sensitivity status and antibiogram patterns of aerobic bacterial isolates from surgical site infections

Background: Surgical Site Infections (SSIs) are the third most common nosocomial infections. Emergence and spread of drug resistant strains have been found to pose a serious challenge in the management of such infections. There is limited information on the epidemiology of such pathogens. The antibiotic sensitivity patterns of aerobic bacterial isolates from post-operative SSIs show wide variations that lead to difficulties in empirical selection of the right kind of drug for treatment. Properly planned studies about antibiotic sensitivities patterns of such isolates can help in judicious management of SSIs and cause reduction in morbidity and mortality.Methods: A total of 50 patients diagnosed by the surgeon and fulfilling the case definition of SSI, were studied for bacteriological analysis. All the clinical specimens were cultured and identified applying standard culture techniques. The aerobic bacterial isolates were subjected to antimicrobial susceptibility testing by Kirby Bauer Disc Diffusion method to arrive at the drug sensitivity patterns. Data were entered in MS Excel spread sheet and analysed using SSPP software version 21.00Results: A total of 32 patterns of sensitivity were observed. For Esch. coli, a total of nine patterns were observed. All strains of Esch. coli were found sensitive to tigecycline (100%) and colistin (100%). For Klebsiella spp. a total of 9 patterns were obtained with TIG-COL being the predominant pattern in 6 cases. For Acinetobacter spp. only colistin was found most effective drug. In case of Pseudomonas aeruginosa, except colistin (100% sensitivity), there were wide variations in sensitivity with imipenem (71%) as next most effective drug. In Proteus spp. - most of the in-use drugs were effective except cephalosporins. Among gram positive organisms, only three strains of Staphylococcus aureus were isolated, and these were MRSA (100%). Two strains of enterococcus were isolated, and these showed sensitivity to linezolid only.Conclusions: Wide variations in sensitivity status observed in the study are suggestive that antibiotic usage should be tailored to individual needs and proper selection of antibiotics for management of SSIs must be guided by laboratory antibiogram.

The normal range of body mass index with high body fat percentage among male residents of Lucknow city in north India.

Background & objectives: Several studies have raised the suspicion that the body mass index (BMI) cut-off for overweight as defined by the WHO may not adequately reflect the actual overweight status. The present study looked at the relationship between BMI and body fat per cent (BF %) / health risks (hypertension and type 2 diabetes) in male residents of Lucknow city, north India to evaluate the validity of BMI cut-off points for overweight. Methods: One thousand one hundred and eleven male volunteer subjects (18-69 yr) who participated in different programmes organized by the Institute during 2005 to 2008 were included in the study. BF% was measured using commercially available digital weight scale incorporating bioelectrical impedance (BI) analyzer. The proposed cut-off for BMI based on BF % was calculated using receiver operating characteristics (ROC) curve analysis. Results: Forty four per cent subjects showed higher BF % (>25%) with BMI range (24-24.99 kg/m2). Sensitivity and specificity at BMI cut-off at 24.5 kg/m3 were 83.2 and 77.5, respectively. Sensitivity at BMI cut-off >25 kg/m2 was reduced by 5 per cent and specificity increased by 4.6 per cent when compared to 24.5 cut-off. Interpretation & conclusions: The study subjects showed higher body fat percentage and risk factors like hypertension and type 2 diabetes at normal BMI range proposed by the WHO. The cut-off for BMI was proposed to be 24.5 kg/m2 for our study population. If overweight is regarded as an excess of body fat and not as an excess of weight (increased BMI), the cut-off points for overweight based on BMI would need to be lowered. However, the confidence of estimate of the BMI cut-off in the present study may be considered with the limitations of BI analysis studies.

Studies on oxidative stress induced nerve conduction deficits in cigarette smokers.

An important role of oxidative stress for the development of vascular and neurological complications has encouraged us to undertake a study to assess the oxidative stress induced nerve conduction deficits among cigarette smokers. Eighteen regular male cigarette smokers and twenty nine male non - smokers were diagnosed for clinical neuro-physiological tests viz., motor and sensory nerve conduction velocity (MNCV and SNCV) and redox status. Significant depletion of reduced glutathione (GSH) level (p < 0.05) and significant increase in malondialdehyde (MDA) level (p < 0.01) was found in smokers compared to non - smokers. Motor and sensory nerve conduction velocity showed no significant difference among smokers compared to non - smokers. The present study shows that smoking can induce oxidative stress among smokers but could not exacerbate to nerve conduction deficits.

Prediction model for peak expiratory flow in North Indian population.

OBJECTIVE: To establish a model for predicting peak expiratory flow rate (PEFR) in North Indian healthy population. Study subjects. Eight hundred and ninety-seven healthy, non-smoker individuals (681 males and 216 females) in the age group of 10-60 years. METHODS: The study was carried out at a health exhibition organised by the Government of Uttar Pradesh, at King George's Medical University, Lucknow. Only healthy, non-smoker individuals were enrolled for the study. Age was noted in completed years and weight in kg and height in cm were taken without shoes. PEFR was measured by Mini Wrights peak flow meter in standing position after prior instructions and demonstration of technique to each individual. The test was performed three times on each subject and best of the three attempts was selected for data computation. The statistical solftware SPSS was used to fit the model and perform residual analysis. RESULTS: The highest reading for males was recorded in the age group of 20 to 24 years and for females in the age group of 25 to 29 years. Using age, height and weight, we established a regression model for predicting PEFR values for males and females separately in the age group 19-60 years. In the age group 10-18 years, the model for predicting PEFR was same for both the sexes. PEFR values were found to be more in males as compared to females. The predictive power of the model as described by explained variation was found to be 80 and 82 percent for males and females, respectively. CONCLUSIONS: Prediction model for north Indian subjects was drafted for age range 10-60 years. While separate models were required for males and females because of sex related differences in the age group 19-60 years, a common model sufficed for age group 10-18 years.