Peripheral venous catheter related blood stream infection in intensive care unit

Background: Peripheral venous catheter related blood stream infections (PVC-BSI) are a common cause of morbidity and mortality in hospitals. Most of the catheter related blood stream infections occurs due to lack of proper aseptic measures. This study points out the risk factors microbial profile and antimicrobial susceptibility of isolates associated with PVC-BSI. The common organisms causing Catheter related BSI are Staphylococcus aureus (41.1%), and Klebsiella species (17.6%) followed by CONS and Enterococcus species. Objective of present study was to isolate and identify the organisms causing PCV-BSI, perform antimicrobial sensitivity testing of isolated organisms and to identify the associated risk factors and preventive measures that should be used.Methods: The study was conducted over a period of one year from August 2015 to July 2016 in the Department of Microbiology. Study group comprised of all the patients with peripheral venous catheterization who developed signs and symptoms of septicemia after 48 hrs of insertion of PVC. These patients were followed up from the time of catheterization till discharge. Peripheral venous catheter tip was collected under aseptic condition along with peripheral blood samples from a site other than the catheterized one. Samples were collected from patients at any point of time who developed signs and symptoms of septicemia after 48 hrs of catheter insertion. The length of time for which the PVC was in place was recorded.Results: In total, 87 cases were included in the study with mean catheter duration of 4.8 days accounting for 418 catheter days. Out of these 87 cases, 17 cases developed PVC-BSI (19.5%) and 34 cases developed colonization (24.1%). Staphylococcus species (41.1%) was the most common isolate.

Prevalence Of Vulvovaginal Candidiasis In Sexually Active Females With Antifungal Susceptibility Patterns Of The Isolates

Introduction:Vulvovaginal candidiasis (VVC) is the most common fungal infection of lower genital tract of females. It is an important cause of morbidity in young women due to its increasing incidence and is considered as an important public health problem worldwide. In recent years there has been a change in the trend of infections caused by non-albicans Candida species and anti-fungal susceptibility patterns. This study was carried out to assess the prevalence, potential risk factors and detect the antifungal susceptibilities of the isolates. Methods:A prospective study was con-ducted in a tertiary health centre of southern Odisha from January 2016 to December 2017and included 240 clinical-ly diagnosed cases of VVC in the reproductive age group presenting with curdy white discharge with or without pruri-tus, burning, or dysuria. After getting an informed consent and brief history, vaginal swabs were collected and micro-scopic examination, culture and antifungal susceptibility were done. Results: Most common age group affected by VVC belonged to 26-35 years and majority of the cases were from rural areas. A total of 87 Candida species (36.3%) and, 4 Trichosporon asahiiwere isolated. Candida albicans was the most common isolate (52), followed by Candida glabrata. Most of the isolates were sensitive to clotrimazole (90.1%) followed by fluconazole (83.5%). Conclusion:The prevalence of VVC in our study was found to be 36.3%. Low socioeconomic status, low education, oral contra-ceptive pill users and Diabetes were the common predisposing factors. The most common agent causing VVC was Candidia albicans followed by Candida glabrata. Most of the yeasts isolated were sensitive to Clotrimazole followed by fluconazole.

Parasitic Enteropathogens In Hiv Seropositive Patients In Relation To Cd4 Count At A Tertiary Care Hospital

Background: Parasitic Entero pathogens causing diarrhoea is considered as one of the major health problems in HIV infected patients especially those with AIDS. The knowledge of prevalence of these pathogens in a particular area can guide clinicians to provide early clinical management in HIV-associated diarrhea.Objectives: The primary objec-tive of this study was to study the prevalence of parasitic enteropathogens and compare the intestinal parasitic path-ogens in HIV infected diarrhoeal (acute and chronic) and in HIV infected non diarrheal patients and to elucidate the relation between CD4 counts and intestinal parasitic infections Materials and Methods: This study was conducted between Nov 2016 and November 2017 in the Department of Microbiology. Stool samples from 105 HIV seropositive cases with diarrhea and without diarrhea were examined by routine parasitological laboratory procedures. CD4 testing was done to know the CD4 cell count. Results:Out of 105 cases of HIV seropositive cases 15 cases had acute diarrhea, 66 cases had chronic diarrhea and 24 HIV seropositive cases were without diarrhea. Enteric pathogens were detected in 48 (45.7%) number of patients. Isosporasp. was the most common parasite. Other parasites includ-ed Ancylostoma duodenaleand Entamoeba histolytica. The diarrheal HIV-positive patients had lower mean CD4 counts as compared to those without diarrhea. Conclusions: Identification of the etiological agent of diarrhea in pa-tients with HIV/ AIDS is very important as it can help in the initiation of appropriate therapy which helps in reduction of morbidity and mortality in these patients.

A three year retrospective study on the increasing trend in seroprevalence of dengue infection from southern Odisha, India.

Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India. Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification. Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes. Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.

Incidence of Bacterial Enternopathogens Among Hospitalized Children Less Than 5 Years with Diarrhoea in Southern Orissa.

Bacteriological analysis of 1661 stool samples from children (<5 years) with diarrhoea who have been admitted to 3 different hospitals of Southern Orissa from Jan 2007 to Dec 2010 was carried out using standard procedures. Among all the samples, enteropathogens were isolated in 1199 culture positive samples wherein Escherichia coli was isolated in 927 cases( including 136 pathogenic Escherichia coli),Vibrio cholerae O1 in 174 samples; Shigella spp in 50 samples; Salmonella spps.in 18 samples, Klebsiella pneumoniae in 5 samples. The isolation of bacterial enteropathogens was highest during July 2008 followed by August 2006 and Cholera cases were isolated more during rainy season. Vibrio cholerae O1 isolates were resistant to co- trimoxazole, furazolidone and nalidixic acid. Many of the Pathogenic Escherichia coli strains showed varying resistance to ampicillin, furazolidone, cotrimoxazole, ciprofloxacin and nalidixic acid. Shigella spp. and Salmonella spp also showed varying resistance patterns. More studies are necessary to evaluate the contribution of enteropathogens in causing diarrhoeal diseases and to define the changing antibiogram patterns in this region.

Chromogenic Tube Test for Presumptive Identification and Susceptibility Test of Candida Spp.

Chromagar Candida is a new, modified, simple, rapid and cost effective method for the presumptive identification of Candida spp. after preliminary growth. 54 randomly selected clinical isolates of Candida were evaluated including, C.albicans (24), C.tropicalis (13), C.parapsilosis (6), C.krusei (5) & C.glabrata (4). The sensitivity and specificity appeared to be equal to that of conventional identification system except 4 C.glabrata strains which could only be identified by conventional method. Terbinafine, amphotericin B and nystatin were found to be highly sensitive drugs and clotrimazole and fluconazole showed the worst sensitivity results.

Pyopericardium due to infection with Mycobacterium tuberculosis - A rare case report.

Summary: Pyopericardium or purulent pericarditis is a rare entity but usually associated with a high mortality. We report a case of 30-year-old male presenting with pyopericardium due to Mycobacterium tuberculosis. The patient was treated with Anti-tubercular therapy (ATT) alongwith pericardiocentesis and pericardiectomy. The patient responded well to treatment and recovered completely in due course of time.

Bacteremia due to Rhodococcus equi--a case report.

Rhodococcus equi (R. equi) primarily causes zoonotic infections affecting grazing animals and is an unusual cause of infection in immunocompetent human beings. We report a case of bacteremia due to R. equi a rare isolate in a child suffering from protein energy malnutrition