A study on biomarkers of sepsis and potential role of procalcitonin and ferritin marker in diagnosis, prognosis and treatment.

Objectives: To evaluate the potential value of serum procalcitonin and serum ferritin levels in patients with clinically suspected and proven sepsis and their comparison with established inflammatory markers like C-reactive protein (CRP) and total leukocyte count. Materials and Methods: A total of 60 clinically suspected cases of sepsis were included in this study and each patient was investigated for serum S. ferritin, procalcitonin, and CRP and blood cultures using the BacT/Alert system. Results: Serum procalcitonin at a cut-off value of >2 ng/ml is a valuable biomarker for early diagnosis in sepsis patients due to bacterial infection and has a greater predictive value than serum ferritin, CRP, or any other biomarkers.

The burden of mycobacteria species among children from postvaccination abscess in Southern India.

Background: From the time vaccines were introduced, their impact has been beyond measurable. Mycobacteria are pathogens increasingly isolated from postvaccination abscess. Identification of these pathogens plays a very crucial role in the management of these babies. We aimed to determine Mycobacterial spp occurrence from vaccination abscess, draw local antibiogram, and guide management of babies with vaccination abscess. Methods: Babies with postvaccination abscess from 2016 to 2020 were included. Pus collected during incision and drainage was processed as per the standard guidelines. Mycobacterium isolates were identified by conventional methods, and all samples were confirmed by polymerase chain reaction. All babies underwent incision and drainage, and all were started with amoxicillin and clavulanic acid and changed later as per the sensitivity report. Results: Mycobacterium abscessus was isolated from 17% (12) pus samples from 71 postdiphtheria pertussis and tetanus vaccination, and Mycobacterium bovis was isolated from 83.3% (10) babies with post-Bacillus Calmette-Guérin vaccination. The mean interval between injection and abscess formation was 32.75 days in case of M. abscessus, whereas it was 50.4 days in case of M. bovis. All the M. abscessus were sensitive to linezolid, amikacin, and clarithromycin, whereas no treatment except incision and drainage was required for M. bovis. Conclusion: There is an increased incidence of Mycobacterial spp infection in postvaccination abscess. All babies with M abscessus responded well with combination antibiotic therapy plus drainage of abscesses, whereas M. bovis was treated by incision and drainage, and no further antibiotics were given.

Three cases of Arcanobacterium pyogenes-associated soft tissue infection.

Arcanobacterium pyogenes is an established but often unrecognized human pathogen. A. pyogenes may also be misidentified as Arcanobacterium haemolyticum, which gives remarkably similar results in conventional biochemical tests. In this study, we have reported three cases of wound infections associated with A. pyogenes and also on the bacteriological characteristics which are relevant for identification of these isolates. The negative reverse CAMP test, the ability to produce acid from xylose and to hydrolyse gelatin and the positive beta-glucuronidase test clearly differentiated A. pyogenes from other closely related species. All three isolates were uniformly susceptible to penicillin, ampicillin, amoxicillin-clavulanic acid, ceftriaxone and gentamicin, variably susceptible to tetracycline and erythromycin and uniformly resistant to cotrimoxazole. Only a few confirmed cases have been reported throughout the world and therefore the diagnostic evaluation of this organism is emphasized.

Antibiotic Sensitivity and Plasmid Profiles of Escherichia coli Isolated from Pediatric Diarrhea.

BACKGROUND: The emergence of drug resistance among diarrheagenic Escherichia coli (E. coli) in the pediatric population is an important cause of morbidity and mortality in developing countries. MATERIAL AND METHODS: Isolation and identification of E. coli strains from stool specimens are carried out according to standard techniques. Antibiotic susceptibility testing was performed using disc-diffusion method. Plasmid profiling and conjugation experiments were done to analyze the antibiotic resistance transfer from one bacterium cell to another through plasmid. RESULTS: Out of 170 pediatric diarrheal samples, 105 (61.76%) E. coli strains were isolated. About 90% of E. coli strains were resistant to most of the antimicrobial agents tested. All the isolates were resistant to ampicillin, imipenem and cotrimoxazole and were sensitive to amikacin. The resistance to antibiotics shows 29 different antibiotic resistance patterns. About 67 (64%) strains of E. coli isolates harbored plasmids, and 51 (76.1%) of them were able to transfer their plasmids. The plasmid sizes ranged from 1.0 to 25 kb, the most common plasmid of size 4.8 kb being detected in all the plasmid-harbored E. coli strains. The results of transconjugation show that all the transconjugant colonies were carrying 4.8-kb plasmid and were resistant to ampicillin, imipenem and cotrimoxazole. CONCLUSION: There is an increase in the prevalence of drug resistance among E. coli isolates, and conjugal transfer of plasmids has greatly contributed to the rapid spread of antibiotic resistance among E. coli isolates.