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Background: Bacterial meningitis is a global public health issue. C-reactive protein (CRP) has suitable diagnostic value in distinguishing between bacterial and aseptic meningitis especially in cases of negative bacterial culture of the blood and spinal fluid. Aim and Objective: The objective of this study was to estimate the serum level of CRP among pediatric meningitis cases with bacterial etiology. Materials and Methods: The hospital-based descriptive cross-sectional study was performed in a tertiary care pediatric hospital in Eastern India from June to August, 2021 with 150 samples. Patients fulfilling the inclusion criteria were selected for this study after obtaining informed consent. Cerebrospinal fluid sample was collected as per standard guidelines. Phenotypic identification of bacteria including antimicrobial susceptibility testing was done by automation (Vitek 2 compact, bioMerieux). Quantitative estimation of CRP was performed in a solid phase and sandwich-format immunometric assay using a gold antibody conjugate. Human rights, welfare, and autonomy were protected as per national ethical guidelines. Results: Median age (Inter Quartile Range) of 150 cases was 3(1–4.5) year. Escherichia coli (60.52%, 23/38) was the commonest isolate (P < 0.00000001 by Binomial test calculation) followed by Klebsiella pneumoniae (34.24%, i.e., 13/38). A total of 43/150 (28.66%) participants had higher serum CRP. Serum CRP was raised more in Gram-negative bacterial etiology (36 out of 38, 94.73%). Mean serum CRP was higher in Gram-negative cases (P < 0.05). Conclusion: Serum CRP was found significantly higher in meningitis caused by Gram-negative bacteria.
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Background: Contamination in a bacteriology laboratory setup may result in erroneous interpretation. Aim and Objective: To estimate the bacterial isolates from different surfaces of the bacteriology laboratory of a tertiary care hospital. Materials and Methods: A total number of 165 samples were taken from different surfaces of the laboratory including tabletops, floor, walls, and workbench tops at the beginning of morning session for consecutive thirty working days (June 2019). Surface swab technique was followed using pre-incubated Nutrient agar (Basal plate), Mac-conkey’s agar (Selective and differential media), and Blood agar plates (enriched media). Aerobic incubation was done overnight at 37°C. Discrete colonies were studied by Gram, Ziehl-Neelsen, and Albert staining followed by the tests for motility and a series of biochemical reactions. Results: Out of 165 collected swabs, growth was observed in 23 (13.93%). Out of these 23 isolates, none was from the workbench top. Majority (47.82% i.e., 11/23) was from the floor. Amongst 23 isolates, 14 (60.86%) were Gram-positive in nature and 7 (30.43%) found to be motile. Isolated bacteria comprised Micrococcus spp. (34.78% i.e., 8/23), Pseudomonas spp. (17.39%,4/23), Coagulase-negative Staphylococcus spp. (13.04% i.e., 3/23), Bacillus spp. (13.04%, i.e., 3/23) and Acinetobacter spp. (21.73% i.e., 5/23). From floor, majority of the isolates were Micrococcus spp. (45.45%, i.e., 5/11) whereas in wall, mostly Bacillus spp. (33.33%, i.e., 3/9) and tabletop, all of the isolates were Coagulase-negative Staphylococcus spp. Conclusion: Vigilant disinfection and maintenance of personal hygiene of laboratory workers are essential to eliminate contamination.
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Background: Urinary pathogens develop lesser resistance against Nitrofurantoin than other antimicrobials such as Fluoroquinolones, Cotrimoxazole, and Carbapenems. Aim and Objective: The objective of this study was to estimate the sensitivity pattern of the urinary isolates against Nitrofurantoin in uncomplicated Urinary tract infection (UTI). Materials and Methods: The descriptive cross-sectional study was performed from January 1, 2020, to June 30, 2020, with 759 cases with signs and symptoms of uncomplicated UTI. Aseptically collected midstream urine was inoculated on Nutrient Agar Media, MacConkey’s Agar media, and Blood Agar media for bacterial isolation. Antimicrobial susceptibility testing was done by disk diffusion technique on Mueller Hinton Agar (Kirby Bauer technique) as per Clinical Laboratory Standards Institute guidelines. Results: Out of total of 759 urine samples, in 165 cases bacterial pathogens were isolated (21.73%). Only 17 were resistant to Nitrofurantoin (10.30%) whereas resistance to Fluoroquinolone (Ciprofloxacin) was in 58 isolates (35.15%) and Cotrimoxazole, in 37 isolates (22.42%). Resistance against Carbapenem antibiotics (Imipenem and Meropenem) was found in 29 isolates (17.57%). All the Nitrofurantoin resistant isolates were Gram-negative. Majority of the Nitrofurantoin resistant isolates were Klebsiella pneumonia (8 out of 17, i.e, 47.05%). All Nitrofurantoin resistant isolates were sensitive to Colistin and Tigecycline. Five out of 17 Nitrofurantoin resistant isolates were sensitive to Meropenem and Imipenem (29.41%). The Fischer exact test reveals that Nitrofurantoin is effective against the isolates resistant to Fluoroquinolones, Cotrimoxazole, and Carbapenems. Conclusion: Nitrofurantoin, even today, remains a good choice for empirical therapy for uncomplicated UTI.