Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital.

Purpose: Central venous catheters (CVCs) though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI) resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC‑BSI) in the intensive care unit (ICU) patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC) and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO) and Gram staining methods. Biofilm production in catheters was detected by ‘tissue culture plate’ (TCP) method. The results were analysed using the computer‑based program statistical package for the social sciences (SPSS). Results: In 25/115 patients, definite diagnosis of CVC‑BSI was made. The mean age was 48.44 ± 17.34 years (cases) vs 40.10 ± 18.24 years (controls) and the mean duration of catheterisation was 25.72 ± 8.73 days (cases) vs 11.89 ± 6.38 days (controls). Local signs of infection (erythema, tenderness and oozing) were found more significantly in CVC‑BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non‑albicans Candida were common CVC‑BSI pathogens. Multidrug‑resistant (MDR) strains were isolated in bacterial agents of CVC‑BSI. Non‑albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion: The incidence of CVC‑BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC‑BSI cases. The menace of multidrug resistance and biofilm formation in CVCs is associated with CVC‑BSI.

ICON 2013: Practical consensus recommendations for hormone receptor-positive Her2-negative advanced or metastatic breast cancer.

The management of hormone receptor‑positive Her2‑negative breast cancer patients with advanced or metastatic disease is a common problem in India and other countries in this region. This expert group used data from published literature, practical experience, and opinion of a large group of academic oncologists, to arrive at practical consensus recommendations for use by the community oncologists.

Unusual metastasis in colorectal cancer.

Metastasis from colorectal carcinoma occurs by either lymphatic or hematogenous spread. The most common sites of colorectal metastasis are the liver and lung. Involvement of the skin, muscles and bones are quite rare. The prognosis in such patients is usually poor. Herewith, we are reporting a case of colonic carcinoma who had cutaneous metastasis, muscular involvement and diffuse skeletal metastasis. At the end, she had brain metastasis, but liver and lung involvement was not observed till the end.

Waldenstrom's macroglobulinemia.

Waldenstrom's macroglobulinemia is an uncommon lymphoplasmacytic lymphoma presenting with hyperviscocity and autoimmune phenomenon. Disease is characterized by bone marrow infiltration by lymphoplasmacytic cells and raised IgM. Bone marrow morphology and immunohistochemistry is important for diagnosis. Course is indolent and anemia and age are most important prognostic factors. Treatment options include alkylating agents, anti-purine anti-metabolites, which though not curative but offer valuable responses. Newer agents like Rituximab and autologous transplant are being tried.

Attachment of spermatozoa to in vitro matured bovine oocytes in TCM-199 and MEM media.

Investigation was undertaken to study the efficacy of TCM 199 and MEM media in the process of oocyte maturation and fertilization after harvesting the oocytes from slaughtered cow and heifer ovaries by aspiration and mincing techniques. Out of 354 number of ovaries, mincing method could yield 1.35 (50.98%) of good quality oocytes per ovary as comparison to 0.61 (55.45%) by aspiration method. The TCM 199 and MEM could record the maturation of 85.71% and 60.26% of oocytes and the rate of sperm penetration was higher in TCM 199 matured oocytes (97.21%) as compared to MEM matured ones (74.46%). The staining of oocytes by aceto-orcein stain was also employed.

Characterisation of non-01 Vibrio cholera isolated from stools of diarrhoeal patients.

A characterisation of the biochemical and physiological properties of 30 strains of non 01 V. cholerae isolated from faecal samples, was undertaken. The strains consistently expressed a large number of characters that define them to be closer to the El Tor biotype than their classical counterparts. They did not show much heterogeneity in their cultural and biochemical properties. The strains were strongly haemolysing (100%), haemagglutinating (96%) and also salt-tolerant, thereby acquiring a unique taxonomic status.