Prevalence of Salmonella typhi in among febrile patients in a tertiary care hospital of South West Rajasthan.

Background: Salmonella enterica, serotype typhi, remains the predominant Salmonella species causing enteric fever in India. The mode of Salmonella typhi transmission is considered to be predominantly vehicle-borne through contaminated water or food. In India, the incidence of Salmonella typhi occurs between the months of April and June (dry season) followed by July and September (monsoon season). Typhoid fever may be difficult to distinguish clinically from other febrile illnesses and if left untreated, intestinal, neuropsychiatric, and other complications develop in some patients. Objective: The aim of this study was to determine the prevalence of S. typhi in bloodstream infections and its antimicrobial susceptibility pattern among patients with febrile illness. Methodology: Febrile patients admitted in the hospital who were prescribed blood culture tests and whose samples were sent to microbiology laboratory were included in the study. All blood samples (average 5 mL for adults and 2-3 mL for pediatric age group) were immediately inoculated into Bac-T ALERT aerobic blood culture bottles containing sodium polyethanol sulfonate as an anticoagulant (0.025%). If growth was isolated, isolated colony characteristics of growth and Gram stain were assessed. On Gram staining, typical nonlactose fermenting Gram negative bacilli were further subjected to species identification and detection of antimicrobial susceptibility pattern on the VITEK2. Results: In this study period, a total of 511 blood culture (paired) samples were processed, out of which 47 isolates of Salmonella were obtained. Among these isolates, 33 (70.23%) were from males, and 14 (29.77%) were from females. Amongst these, 35 (74.4%) patients were from rural, 8 (17%) were from subrural, and 4 (8.5%) were from urban areas. Out of the total 47 isolates of Salmonella, 42 (89.36%) were Salmonella typhi, 2 (4.25%) were Salmonella paratyphi A and B each, and 1 (2.12%) was Salmonella enterica. Antimicrobial susceptibility pattern of Salmonella isolates revealed that all the isolates of Salmonella species were highly susceptible (95%-100%) to third generation cephalosporins (ceftazidime, ceftriaxone, cefepime, cefoperazone-sulbactam) and other higher antibiotics such as betalactamase inhibitors - piperacillin tazobactam (95%-100%) and Ticarcillin-clavulanic acid (100%). They were also highly susceptible (100%) to carbapenams (imipenem, merpenem, doripenem, and ertapenem) but showed a fairly decreased susceptibility was towards nalidixic acid with 15% for Salmonella typhi and 50% for other Salmonella isolates. Conclusion: Surging drug-resistant Salmonella enterica cases, the level of resistance was not as high as predicted in our study population. Multidrug-resistant (MDR) trends may vary; therefore, drug susceptibility testing side-by-side to empirical therapy is mandatory, especially in developing countries where there is a practice of self-medication.

A study of isolation and identification of bacteria from lake water in and around Udaipur, Rajasthan.

INTRODUCTION: Water is an essential nutrient which plays an important role in digestion, absorption of food and elimination of waste products by urine. Udaipur also known as 'City of Lakes' or even the 'Venice of East' due to its unique and beautiful lake system has an exceptional importance at national and international levels. The aquatic systems are mostly dominated by bacteria and fungi and in the natural environments micro-organisms have very specific roles with regard to the recycling of materials and purification of water. Presence of coliform bacteria in the water indicates the fecal pollution of water. METHODS: Water from all the three lakes were included for the assessment of their water quality parameters. Biological parameters like MPN of coliforms and presence of bacterial and cyanobacterial contaminants were read. The MPN (Most Probable Number) of Coliform was determined by the Presumptive Coliform Count (Multiple Tube Method) in 100 ml of sample water. CONCLUSION: The coliform bacteria is the primary bacterial indicator for fecal pollution in water. The purpose of study was to make people aware about the bacterial load in water bodies. Based on this, categorical representation of water was unacceptable for the purpose of swimming and bathing.

Detection and distribution of genotypes of Hepatitis C in a tertiary care hospital.

Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis and hepatocellular carcinoma. Thus, this study was undertaken for detection and to observe genotypic distribution of the virus in this geographical region. AIMS AND OBJECTIVES: The aim of the study was to quantitatively detect HCV RNA in Hepatitis C patients and to determine the distribution pattern of its genotypes by real time polymerase chain reaction. MATERIALS AND METHODS: This is a retrospective study conducted in a tertiary care hospital. In seropositive Hepatitis C patients, quantification of HCV-RNA was done by real time PCR and in HCV-RNA positive samples, genotyping for HCV was conducted. RESULT: A total of 300 patients were recruited in the study, of which 165 were anti HCV positive and among them, 127 were HCV-RNA positive. These positive samples were further subjected to genotype determination using real time PCR. 98 samples were positive for genotype, where genotype 3 was seen in 90 patients, genotype 1, in 3 patients and genotype 4, in 5 patients. CONCLUSION: Knowledge of genotype is crucial for management of HCV infection and prediction of prognosis. Patients infected with HCV genotype 1 and 4 will have to receive IFN and ribavirin for a period of 48 weeks and show a poor sustained viral response. On the contrary, patients infected with HCV genotype 2 and 3 are reported to have better response to therapy.