RESUMO
INTRODUCTION: Urinary tract infections (UTIs) are the most common infectious diseases occurring in either the community or healthcare setting. Turnaround time for urine culture is about 24 h, and antimicrobial susceptibility testing (AST) requires another 24 h. Consequently, initial antibiotic therapy is mostly empirical. MATERIALS AND METHODS: This study was conducted at Nizam's Institute of Medical Sciences, Hyderabad. Turbid urine samples which showed pus cells and Gram-negative (GN) bacilli of single morphotype were included. The turbidity of the urine was adjusted to 0.5 McFarland and uploaded directly in the VITEK 2 identification (ID) GN and N-280 panel for AST. The specimen was also inoculated on CHROMagar, and the ID and AST of the isolates from the agar plate were repeated on VITEK 2, and the results were compared. RESULTS: Out of 844 turbid urines screened, 62 met the inclusion criteria. Escherichia coli was the most common isolate (71.9%). Complete agreement for ID was 80.7%, misidentified were 12.2%, and unidentified were 7%. Complete agreement with AST was 94.3%, very major errors 0.5%, major errors 2.2%, and minor errors 3%. CONCLUSION: With a 94.3% agreement for AST and a reduced turnaround time by 24 h, the direct inoculation had a potential clinical benefit for initiating timely and appropriate antibiotic therapy for UTI.
RESUMO
Between 1990 and 2002, 237 hearts were examined at autopsy, including 16 with infective endocarditis; 6 showed fungal endocarditis. The preceding pathology was chronic rheumatic heart disease in 2 patients, one of whom had undergone double valve replacement, 2 patients had been treated for acute lymphoblastic leukemia, and one had protein-energy malnutrition. The underlying cause was unknown in one case. The organisms isolated were Aspergillus in 3 patients, Zygomycota in 1, Candida in 1, and both Candida tropicalis and Aspergillus in 1 patient. Immunosuppressed states are a cause of fungal endocarditis in India, although chronic rheumatic heart disease is the preceding pathology in the majority of patients.
