ABSTRACT
Laboratory diagnosis of shigellosis using conventional culture technique is limited by lower sensitivity and higher turnaround time. Here, we have evaluated the role of polymerase chain reaction from stool samples after enrichment in Escherichia coli medium for detection of Shigellae. The technique not only increased the sensitivity but also decreased the turnaround time.
Subject(s)
Bacteriological Techniques/methods , Dysentery, Bacillary/diagnosis , Feces/microbiology , Molecular Diagnostic Techniques/methods , Polymerase Chain Reaction/methods , Shigella/isolation & purification , Specimen Handling/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Sensitivity and Specificity , Time Factors , Young AdultSubject(s)
Anti-Bacterial Agents/therapeutic use , Daptomycin/therapeutic use , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , Vancomycin-Resistant Enterococci/isolation & purification , Anti-Bacterial Agents/pharmacology , Daptomycin/pharmacology , Enterococcus faecalis/drug effects , Enterococcus faecalis/isolation & purification , Enterococcus faecium/drug effects , Enterococcus faecium/isolation & purification , Humans , India , Microbial Sensitivity Tests , Vancomycin-Resistant Enterococci/drug effectsABSTRACT
BACKGROUND: There is a huge need to develop molecular typing methods which are simple to perform, rapid and cost effective to confirm clonality of nosocomial isolates in outbreak situations. OBJECTIVES: The aim of the study was to investigate a hospital outbreak of multi-drug resistant (MDR) Klebsiellapneumoniae septicemia in a paediatric surgery intensive care unit (PSICU) using a repetitive extragenic palindromic polymerase chain reaction (REP-PCR). MATERIALS AND METHODS: MDR Klebsiella pneumoniae isolates from an outbreak of nosocomial sepsis were typed byREP-PCR using consensus primers. Isolates from different intensive care units (ICUs) but with similar antibiogram were also genotyped for comparison. RESULTS AND CONCLUSION: A cluster of twelve MDR K Pneumoniae septicemia cases was identiï¬ed at the PSICU by genotyping using REP-PCR. Surveillance cultures failed to pick up any source of infection. REP-PCR was found to be a rapid and simple tool for investigation outbreaks in hospitals. Due to early detection we could initiate infection control practices with focus on hand washing and prevent the further transmission of the organism.
Subject(s)
Bacterial Infections/diagnosis , Cross Infection/diagnosis , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Klebsiella pneumoniae/isolation & purification , Molecular Typing/methods , Polymerase Chain Reaction/methods , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Cluster Analysis , Cross Infection/epidemiology , Cross Infection/microbiology , Genotype , Humans , India/epidemiology , Infant , Infant, Newborn , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/genetics , Male , Molecular Epidemiology/methods , Retrospective Studies , Tertiary Care Centers , Time FactorsABSTRACT
Chryseobacterium spp are widely distributed in nature but data of their isolation from clinical samples is scanty. Here, we report the first case of AmpC producing C. gleum causing pyonephrosis in a patient having bilateral nephrolithiasis on double J (DJ) stent. The present isolate was resistant to vancomycin, erythromycin, clindamycin, carbapenems and ciprofloxacin and susceptible to tetracycline and minocycline. The patient was treated with tetracycline and recovered without the need for removal of the DJ stent. The environmental surveillance carried out to trace the nosocomial origin of the isolate was negative. Since antimicrobial susceptibility of this isolate is different from previous reports, we emphasise that in vitro susceptibility testing should be sought to choose optimal antimicrobial agents for these Nonfermentative Gram-Negative Bacilli (NFGNBs) with different susceptibility patterns.
Subject(s)
Chryseobacterium/isolation & purification , Flavobacteriaceae Infections/diagnosis , Flavobacteriaceae Infections/pathology , Nephrolithiasis/complications , Pyonephrosis/diagnosis , Pyonephrosis/pathology , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/metabolism , Chryseobacterium/drug effects , Chryseobacterium/enzymology , Drug Resistance, Multiple, Bacterial , Flavobacteriaceae Infections/drug therapy , Flavobacteriaceae Infections/microbiology , Humans , Male , Middle Aged , Pyonephrosis/drug therapy , Pyonephrosis/microbiology , Tetracycline/administration & dosage , Treatment Outcome , beta-Lactamases/metabolismSubject(s)
Bacterial Infections/diagnosis , Culture Media/chemistry , Microbiological Techniques/methods , Mycoses/diagnosis , Urinary Tract Infections/diagnosis , Urine/microbiology , Bacteria/isolation & purification , Bacterial Infections/microbiology , Chromogenic Compounds , Humans , Mycoses/microbiology , Pilot Projects , Tertiary Care Centers , Urinary Tract Infections/microbiology , Yeasts/isolation & purificationABSTRACT
The threat posed by increased transmission of drug-resistant pathogens within healthcare settings and from healthcare settings to the community is very real and alarming. Although the developed world has taken strong steps to curb this menace, there has been little pressure on developing countries to take any corrective action. If the reporting of alarming rates of healthcare-associated infections (HCAIs) from hospitals in India and many other developing countries was made mandatory, it would help to force stakeholders (e.g. healthcare workers, legislators, administrators and policy makers in hospitals) to acknowledge and tackle the problem. This would introduce quality control in a long neglected area of health care, and enable patient empowerment which is practically non-existent in India. Healthcare institutions should commit towards enforcing 'zero tolerance' towards lapses in prevention of HCAIs. Public pressure would force the Indian Government to acknowledge the problem, and to allocate more funds to improve resources and infrastructure; this could substantially elevate the standard of health care given to the average Indian. Despite the numerous challenges, overall public benchmarking of HCAIs is a commendable goal that would go a long way towards tackling this menace in developing countries such as India.
Subject(s)
Cross Infection/epidemiology , Cross Infection/prevention & control , Mandatory Reporting/ethics , Benchmarking/standards , Compliance , Developed Countries , Developing Countries , Health Personnel , Hospitals/ethics , Humans , India , Infection Control/legislation & jurisprudence , Legislation, Hospital/standardsABSTRACT
Few hospitals in India perform regular surveillance for healthcare-associated infections (HAIs) and use of indwelling devices and antimicrobials. The aim of this study was to conduct two one-day point prevalence surveys of HAIs and use of indwelling devices and antimicrobials in a large 1800-bed tertiary care hospital in India. The overall prevalence of HAIs was 7%, and surgical site infections were the most common (33%). Indwelling devices were present in 497 (27%) patients, and 915 (50%) patients were receiving antimicrobials. This study helped to generate robust baseline data on the prevalence of HAIs and use of indwelling devices and antimicrobials in the study hospital.
