Isolation And Antimicrobial Susceptibility Pattern Of Staphylococcus Aureus.

Introduction- Staphylococcus aureus is one of the principal human pathogens that colonizes healthy individuals as well as causes severe infections in hospitalized patients. They have differential ability to spread and cause outbreaks in hospitals. The study was done to isolate S.aureus from various clinical samples and to know their antibiogram. Methodology- The study included a total of 312 Staphylococcus aureus strains isolated from various clinical specimens. The specimens received were processed further for identification by standard microbiological procedures like direct microscopic examination, culture and various standard identification methods. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method on Mueller-Hinton agar as per CLSI guidelines. Result- A total of 312 isolates of S. aureus were obtained from various clinical samples. Male to female ratio was 1.6:1. Infection rate was more in age group 46-60 years. Staphylococcus aureus isolates were more commonly obtained from surgery department (38.78%) followed by orthopedics. All the strains were 100% sensitive to Vancomycin, Netilmicin, Linezolid and Teicoplanin. Higher resistance was noted against Penicillin(94.87%), Trimethoprim/Sulfamethoxazole(72.44%).Lower resistance was noted against Nitrofurantoin(13.33%). Conclusion- The determination of the anti-microbial susceptibility is also crucial for an optimal therapy, for epidemiological purposes and for infection control measures.

Intestinal Parasitic Infections among HIV/AIDS Patients with Diarrhoea at Rural Tertiary Care Teaching Hospital Of Maharashtra.

Background and Objective: Opportunistic intestinal parasites usually cause mild and self- limiting infections in immunocompetent individuals but in the case of people living with HIV/AIDS (PLHA) they cause severe, chronic or frequent gastrointestinal disease. The spectrum of intestinal parasites causing infections in PLHA varies from country to country and region to region within the country. Therefore it is very necessary to know the relative frequencies of specific intestinal parasites causing diarrhoea in PLHA in different regions of the country to devise appropriate management strategies. The present study was conducted with an aim to document the prevalence pattern of various intestinal parasites in PLHA in rural tertiary care teaching hospital of Maharashtra. Methods: Stool samples collected from HIV infected individuals with diarrhoea were screened for the presence of intestinal parasites by standard parasitological protocol. Results and Interpretation: The incidence of HIV infection was high in age group 26-35 years followed by 16-25 years age group. The incidence of HIV infection was high in males as compared to females. Out of 124 stool samples screened, 44 (35.48%) showed presence of intestinal parasites. Cryptosporidium parvum followed by Entamoebahistolytica and Isospora belli were the most common intestinal parasite. Conclusion: Opportunistic intestinal parasitic infections still pose as a problem in rural parts of India. This underscores the importance of screening of stool samples of PLHA. It can be also suggested that along with prompt diagnosis and treatment of opportunistic infection, clean potable water supply, improved sanitation and health education is necessary for preventing opportunistic infection in PLHA.

HIV Prevalence and the Correlation of Different Opportunistic Infection with CD4 Cell Count.

In India, an opportunistic infection with HIV and associated complications accounts for considerable proportion of mortality. There exists definite CD4 cell count correlation with opportunistic infection in HIV patients. Objectives: To document the prevalence of HIV with correlation of different opportunistic infection with CD4 cell count. Material and Method: A total of 174 HIV positive patients either hospitalised or ART POD were studied for finding the spectrum of opportunistic infection and for HIV prevalence. Various samples were collected as per symptoms and clinical presentation. Result: Among opportunistic infection, most common were bacterial infection with 72.5%, followed by fungal infection 42.1% and parasitic infection with 25.8%. TB in 21 patients and candidacies in 5 patients were found in CD4 cell count <500 cell/μl followed by chronic diarrhoea with CD4 cell count <200 cell / μl. Conclusion: Prevalence of HIV infection in persons attending ICTC is 11.3%. TB is the most common opportunistic infection followed by candidacies and diarrhoea.

Bacteriological Study of Infective Endocarditis from a Rural Area of Maharashtra.

Background: To evaluate the role of blood culture in infective endocarditis patients attending a rural hospital of Maharashtra, India. Material and methods: One hundred thirty-eight blood samples from 46 patients with clinical diagnosis of infective endocarditis were investigated. Blood culture was done. After growth, Gram-staining, biochemicals and antibiotic sensitivity testing was performed. Results: Blood culture yielded a positive result in 24 cases. All the organisms isolated were gram-positive cocci. Staphylococcus aureus was the predominant organism isolated followed by Streptococcus viridans. Most of the organisms were sensitive to cephalexin and ciprofloxacin. Conclusion: The initial therapy in our hospital may be aimed at gram-positive organisms and cephalexin and ciprofloxacin can be used as first-line drugs. This shows the role of microbiology is important in diagnosis of causative organisms responsible for infective endocarditis and their antibiotic susceptibility testing, which will be helpful in early and specific treatment.

ESBLs — A Challenge to the Clinicians.

Introduction: Treatment of extended spectrum betalactamase (ESBL) producing strains of Enterobacteriaceae has emerged as a major challenge in hospitalized critical as well as community based patients. Infections due to ESBL producers range from uncomplicated urinary tract infection to life threatening sepsis. Methods: We conducted a study to detect the presence of these enzymes in isolates in tertiary care hospital. A total 318 non-repetitive isolates were screened for resistance to any of five screening agents by CLSI (formerly NCCLS) disc diffusion method. Those with suspicious profile were checked for ESBL production by phenotypic confirmation test as recommended by CLSI Disc potentiation method. Various cephalosporin- b-lactamase inhibitor combinations were also tested. Results: Of the 269(84.59%) screen-positive isolates, only 219(81.41%) were identified as ESBL producers. From 219, only 136(62.10%) of Escherichia coli and 83(37.89%) Klebsiella pneumoniae were ESBL producers. Conclusion: Tests for the detection of ESBL producing Escherichia coli and Klebsiella pneumoniae should be carried out in all diagnostic centres routinely because drug resistance patterns are constantly changing.

Phage Types of multidrug resistant Salmonella species in a rural area of Maharashtra, India.

Objective: The aim of the present study is to know Phage typing and antimicrobial susceptibility pattern of Salmonella species. Methods:Atotal of 32 Salmonella species isolated from stool and blood specimen were included in the study. They were sent for phage typing to Lady Hardinge Medical College, New Delhi. Antimicrobial susceptibility was done by using Kirby Bauer disc diffusion method. Results: Majority of Salmonella typhi belongs to phage type E1 and biotype I. Decreased susceptibility of the isolate was observed to Ampicillin, Cotrimoxazole, Cephalexin and Gentamicin. Majority of the isolates were sensitive to Ciprofloxacin. Conclusion: Predominant phage type was E1. The antibiotic sensitivity pattern is changing and resistant cases are emerging due to inappropriate use of antibiotics.

Neonatal Septicemia Predominant Bacterial Species and Antibiotic Resistance.

A prospective study was undertaken over a period of one year to determine various organisms responsible for neonatal septicemia and their antibiotic sensitivity pattern in a rural area. 1-2 ml of blood from the clinically suspected cases of neonatal septicemia was cultured in Brain Heart Infusion Agar- Brain Heart Infusion Broth (BHIA-BHIB). Out of 54 cases, blood culture was positive in 38 (70.37%) cases. Gram negative septicemia was encountered in 32 (84.21%) of these neonates. E. coli (31.57%) was the commonest followed by Pseudomonas (21.05%). Most gram negative isolates were sensitive to Amikacin and Ciprofloxacin. Majority of the isolates were resistant to Ampicillin and Gentamicin.