Study of Invasive Pneumococcal Infection in Adults with Reference to Penicillin Resistance.

BACKGROUND: Invasive pneumococcal infections often prove rapidly fatal, even where good medical treatment is readily available. In developed countries, up to 20% of people who contract pneumococcal meningitis die; however, in developing world, mortality is closer to 50%, even among hospitalized patients. The World Health Organization estimated 600,000-800,000 adult deaths each year from pneumococcal pneumonia, meningitis, and sepsis. AIMS: This study aims to estimate isolation rate of invasive pneumococcal infection in adults, to determine the antimicrobial susceptibility profile of Streptococcus pneumoniae isolates and to study the associated risk factors. MATERIALS AND METHODS: A total of 120 patients with suspected invasive infection such as meningitis, septicemia, and pleural effusion, were included in the study. Various clinical specimens such as pus, cerebrospinal fluid, and other sterile body fluids were processed for isolation and identification of S. pneumoniae. Kirby-Bauer disc diffusion method was performed to determine the antimicrobial susceptibility profile. Minimum inhibitory concentration test was performed to determine the penicillin resistance. RESULTS: Of 120 patients, 40 (33.33%) cases were proven by culture to have an invasive pneumococcal infection. The most common clinical condition observed was meningitis followed by pneumonia with pleural effusion and sepsis. Pneumococcal isolates exhibited 40% resistance to cotrimoxazole and 12.73% to chloramphenicol. Two meningeal isolates exhibited penicillin resistance. Comorbidities observed in 21 (52.5%) cases were mainly Diabetes mellitus, smoking, and alcoholism. CONCLUSIONS: Invasive pneumococcal infection has poor prognosis and penicillin-resistant strains have become increasingly common. This study emphasizes the importance of judicious use of antibiotics, especially to refrain their use in mild self-limiting upper respiratory infections.

Opportunistic free: Living amoeba now becoming a usual pathogen?

Acanthamoeba species cause granulomatous Acanthamoeba encephalitis in immunocompromised patients. We report a case of acute purulent meningoencephalitis with a focal neurological deficit caused by Acanthamoeba species in a 2 years immunocompetent child.

Bacteriological Profile of Neonatal Septicemia in a Tertiary Care Hospital from Western India.

Neonatal septicemia is an important cause of morbidity and mortality. The present study was undertaken to determine the bacteriological profile and antimicrobial susceptibility pattern of prevalent pathogens isolated from the blood of septicemic neonates from Neonatal Intensive Care Unit (NICU). A total of 180 blood samples of septicemic neonates were studied bacteriologically. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method in accordance to Clinical Laboratory Standards Institutes (CLSI) guidelines. 26.6% (48 out of 180) cases of septicemia could be confirmed by blood culture. Of these, 66.7% cases were of early onset septicemia (EOS) and 33.3% were of late onset septicemia (LOS). Klebsiella pneumoniae was the predominant pathogen (35.4%) among the Gram-negative pathogens and Staphylococcus aureus (22.9%) was the predominant Gram-positive pathogen. 28% of K. pneumoniae and E. coli isolates were extended spectrum beta-lactamase (ESBL) producers. 18.1% of the Staphylococcus isolates were methicillin-resistant S. aureus (MRSA). Multi-drug-resistance pattern was observed with all the isolates. Ciprofloxacin and aminoglycosides were the most effective drugs against Gram-positive and Gram-negative isolates. This study highlights the predominance of Gram-negative organisms in causing neonatal sepsis and emergence of multi-drug-resistant strains in our set up.

Study of Aetiology and Anti-biogram of Uropathogens in Children-A Retrospective Analysis.

OBJECTIVES: Urinary Tract Infections (UTIs) are the most common serious bacterial infections which are seen during infancy. The aim of the present study was to evaluate aetiology, and antimicrobial resistance patterns among infants and children who approached our hospital for treatment of UTIs. METHODS: In this observational study which was carried out from 2007 to 2010, 1575 urine samples which were collected from children with suspected UTIs were studied. Demographic characteristics, aetiological agents and antimicrobial resistance were evaluated. RESULTS: UTIs were more common in the 0-1 year age group, among males. Among females, UTIs were commonly seen after 2 years of life. The most common isolated pathogen was Escherichia coli spp (45.12%), followed by Klebsiella spp (18.17%) and Enterococcus spp (9.23%). Isolated pathogens were highly resistant to ampicillin, co-trimoxazole, and norfloxacin (82%-98%) and highly sensitive to gentamicin (83%),amikacin (76.5%), and nitrofurantoin (71.5%). CONCLUSION: The most common pathogen which caused UTIs in children was E. coli spp. The isolated pathogens were highly resistant to commonly used antibiotics, ampicillin and co-trimoxazole, while they were highly sensitive to gentamicin, amikacin and nitrofurantoin. So, these antibiotics may be used as alternative drug therapies for the treatment of UTIs.