Prevalence of Urinary Tract Infection among Hospitalized Covid 19 Patients: A Study in Eastern India.

COVID-19 is the disease caused by SARS-CoV-2. The present hospital based study was performed to find out prevalence of Urinary Tract Infection among COVID 19 patients. The cross sectional study was performed with seven hundred fifty three laboratory confirmed COVID 19 cases over six months (from 1st July to 31st December, 2020). Urine samples collected from laboratory confirmed COVID-19 cases in appropriate sterile manner and were screened for pus cells and bacteria. This was followed by plating on Mac-conkey's agar media and 5% Sheep Blood agar media. Inoculated plates were incubated overnight in aerobic condition at 37°C. Discrete colonies were further studied by Gram staining, tests for motility, battery of biochemical tests. Antibiogram was performed by disk diffusion method as per CLSI guidelines. Species confirmation and MIC (Minimum Inhibitory Concentration) values of the tested antibiotics were detected by automation. Results were analyzed according to standard statistical methods. Ninety urine samples were culture positive (11.95%). Escherichia coli was found to be the commonest pathogen, isolated in forty three cases (47.78%) followed by Enterococcus faecalis in twenty nine (32.22%) and Klebsiella pneumoniae subspp. pneumonia in eighteen occasions (20%). Enterococcus faecalis isolates were sensitive to Vancomycin, Linezolid and Nitrofurantoin and nineteen isolates were resistant to fluroquinolones (65.51%). Majority of the Gram Negative isolates were susceptible to nitrofurantoin (80.32%) where as fifteen carbapenemase producers, thirteen AmpC Betalactamase producers and twenty one Extended Spectrum Beta Lactamase (ESBL) producers have been recorded. Constant awareness regarding the antibiotic guidelines for COVID-19 cases is the need of the hour.

Surgical Site Infection by Methicillin Resistant Staphylococcus aureus- on Decline?

INTRODUCTION: Surgical Site Infection (SSI) is the most common healthcare associated infection that could be averted by antibiotics prophylaxis against the probable offending organisms. As Staphylococcus aureus has been playing a substantial role in the aetiology of SSIs, Methicillin Resistant Staphylococcus aureus (MRSA) happens to be a problem while dealing with the postoperative wound infection. AIM: To determine the prevalence of SSI caused by MRSA and the antibiotic sensitivity pattern of MRSA. MATERIALS AND METHODS: A cross-sectional study was conducted at Nil Ratan Sircar Medical College, Kolkata, West Bengal from July 2009 to December 2012. A total of 19,359 surgical procedures were done of which 3003 culture positive SSIs have been documented. The clinical samples were collected from patients of both sexes and all ages suspected to be suffering from SSI from different specialities. Samples were processed according to CLSI, 2007 guidelines. The isolated strains of Staphylococcus aureus were screened for MRSA by detection of resistance to Cefoxitin disc (zone of inhibition was ≤21 mm) and slidex staph latex agglutination tests were done on cefoxitin resistant strains to spot phenotypic expression of mec A gene. Then PCR was performed for detection of mecA gene. Antibiotic sensitivity test was done following Kirby Bauer technique. RESULTS: In this 3½ year study, 1049 Staphylococcus aureus (34.93%) were reported from 3003 cases of SSI followed by Escherichia coli (20.34%), Klebsiella spp. (18.08%), Pseudomonas spp. (7.99%), Acinetobacter spp. (7.49%) respectively. Among the Staphylococcus aureus, 267 strains were derived as MRSA (25.45%). MRSA were isolated from 167 (62.54%) male patients and 100 (37.45%) female patients having surgical site infections. Inpatients and outpatients distribution of MRSA were 235 (88.01%) and 32 (11.98%) respectively. Majority of the MRSA cases were reported from Surgery (12.49%) and Orthopaedics (11.85%) departments in the age group above 75 years (15.63%). The MRSA strains have been found to be 100% sensitive to linezolid and tigecycline followed by fucidin (92.51%), mupirocin (88.39%), levofloxacin (75.66%) and doxycycline (72.28%). No vancomycin resistant strains were detected, but 3 strains (1.12%) were found to be intermediately susceptible to it (VISA). Incidence of MRSA in SSI has been decreased by 15.17 % in 2012 in comparison to 2009. PCR revealed mecA gene was present in 96.25% of cefoxitin resistant Staphylococcus aureus strains. CONCLUSION: Staphylococcus aureus being the predominant organism causing SSIs, MRSA needs the attention for its resistance to commonly used antibiotics in the hospital like penicillin, cephalosporin group of drugs. Regular monitoring of the MRSA, involved in the SSI of a particular setup is the basic requirement to trim down the incidence of the postoperative wound infections by proper antibiotic prophylaxis.

Incidence of Japanese encephalitis among acute encephalitis syndrome cases in West Bengal, India.

BACKGROUND AND OBJECTIVES: Japanese encephalitis (JE) is the most important cause of acute and epidemic viral encephalitis. Every year sporadic JE cases are reported from the various districts of West Bengal, indicating its endemicity in this state. JE vaccination programme has been undertaken by the State Health Department of West Bengal. This study was aimed at seeing the present scenario of JE among acute encephalitis syndrome (AES) cases in West Bengal. MATERIALS AND METHODS: Blood and/or CSF samples were referred from suspected AES cases to the referral virology laboratory of the Calcutta School of Tropical Medicine from different hospitals of Kolkata. IgM antibody capture ELISA was performed on the CSF and serum samples by JE virus MAC ELISA kit supplied by the National Institute of Virology, Pune. RESULTS: The present study reveals that 22.76% and 5% of the AES cases were positive for JE IgM in 2011 and 2012, respectively. JE is mainly prevalent in children and adolescents below 20 years of age with no gender predilection. Although the percentages of JE positive cases were high in 2011, it sharply decreased thereafter possibly due to better awareness programs, due to mass vaccination, or simply due to natural epidemiological niche periodicity due to herd immunity.