04 Dec 2023
30 Nov 2023
Antibiotic resistance pattern of Enterobacteriaceae isolates from surgical site infections with special reference to multidrug-resistant strains. Surgical site infections (SSI) are the most common hospital-as acquired infections in developing countries. In recent years there is an increasing number of infections caused by multidrug-resistant (MDR) organisms which pose a big therapeutic challenge. The aim of the study was to study the organisms belonging to the Enterobacteriaceae causing the SSI. To study the resistance pattern of the isolates causing SSI particularly those which produce Extended spectrum β lactamases, Metallo- β lactamases & are MDR. This is a retrospective study, isolates obtained from the culture of pus received in the laboratory were studied. All pus samples from SSI were cultured and identified by standard microbiological techniques and antibiotic sensitivity was carried out on Mueller Hinton agar and interpreted according to Clinical Laboratory Standards Institute (CLSI) guidelines. E. coli (48.5%)was the most common isolate. ESBL production was noted in 39 isolates, MBL in 10 isolates. Among the Enterobacteriaceae studied, Klebsiella pneumoniae was a major strain that was MDR. Rational use of antibiotics and adhering to hospital antibiotic policy will prevent the emergence of resistant organisms. Infection surveillance and Hospital Infection Control (HIC) practices should be religiously followed to prevent the spread of these drug-resistant strains.
Tuberculosis (TB) is a communicable disease that has contributed to a great deal of morbidity as well as mortality across the world. Surveys estimate that approximately 40% of the Indian population is infected, the tremendous majority of whom have latent TB. The study has now proven the importance of: TB treatment integrated for managing the comorbidities as well, making communities aware of the importance of preventing NCDs (non-communicable diseases), CVDs, HIV-AIDS, etc among the TB-affected and others. Diagnosis of TB was carried out based on CBNAAT (Cartridge Based Nucleic Acid Amplification Test) results. Subsequently, the subjects were diagnosed with the comorbid conditions if they had a medical history of the comorbidity or newly diagnosed according to the following criteria: ADA (American Diabetes Association) criteria was used for detecting Diabetes mellitus with HbA1c values >= 6.5%, fasting blood sugar >= 126 mg/dL and post-prandial blood sugar >= 200mg/dL. Subjects with HbA1c of 5.7-6.4%, or fasting blood sugar of 100-125 mg/dL, or post-prandial sugar of 140-199 mg/dL were diagnosed as prediabetic. Analysis was carried out using IBM SPSS software and results were obtained. Frequencies & prevalence were calculated. Analyses of categorical variables were performed by the chi-square test. A p-value of <0.05 was considered significant. 84 patients were participated in our study in which 50 (59.5%) were males & 34 (40.5%) were females. Most common age group were 18-30years with 26(30.95%) & 45-60 years 28(33.33%). Various comorbidities were present in 60.7% of patients. The most common comorbidity was diabetes mellitus including pre-diabetes in 43(51.18%) patients. Hyperlipidaemia was second most seen in 32(38.12%) patients, followed by hypertension in 7(8.33%), hypothyroidism in 5(5.95) patients. In our study HIV was seen in only one patient. Tuberculosis was more common in middle-aged males. Pulmonary tuberculosis is more common. Pre-diabetics with diabetes were the most common comorbidity seen in both PTB & EPTB. The incidence of diabetes increases with age. Pre-diabetes also increases the risk of tuberculosis. Hyperlipidemia was second most common comorbidity.
Parasitic infections are considered to be a major health problem globally. The prevalence of infections caused by intestinal parasites with special reference to Soil-transmitted helminth [STH] infections are higher in tropical and subtropical climate than temperate climate. Published reports showing diversity in prevalence, detection methods depending on terrain. Persons working as health care workers providing patient care, work in research and clinical laboratories are at risk of becoming infected with parasitic infections like other microbial infections which may or may not be recognized as they usually occur through accidental exposures. In the same way health care workers infected with parasitic infections can infect the patients, mainly critical care patients who are highly susceptible to various infections due to immunocompromised state and also infect other workers of the hospital. Unfortunately, exposures and infections occurring through accidental exposure in these cases goes unrecognized and also remain unreported. To Estimate the prevalence of intestinal parasitic infections among the health care assistants (cleaning staff, staff taking care of patients, Ambulance drivers and food handlers) of a tertiary care hospital and to determine the associated risk factors among infected participants. A Cross-sectional Study conducted in Department of Microbiology of a tertiary care hospital. Health Care assistant workers in a tertiary care hospital during the study period were study population. Stool samples were tested in a microbiology laboratory of a tertiary care hospital, which included gross and microscopic examination. Prevalence of infection found 3.63% due to 4 positive samples from 110 total samples. 2 positive samples showed the presence of H. nana, 1 showed the presence of A. lumbricoides and 1 positive for Giardia lamblia. Less prevalence in comparison to other study may be due to better knowledge of the importance of hand hygiene practices after COVID Pandemic and due to good Hospital infection control practices.
Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, mainly affecting the skin and peripheral nerves. Leprosy reaction is an immunological complication of leprosy and consists of two types of reactions. Type 1 leprosy is called a reversal reaction (RR), and type 2 is called erythema nodosum leprosum (ENL). Indonesia has the third-highest number of cases of leprosy infection globally, after India and Brazil. To determine the characteristics of leprosy reactions at 13 teaching hospitals in Indonesia for three years, from 2018 to 2020. The highest proportion of cases were found in the age group >14 years (95.33%), while children aged ≤14 years were only 4.6% of the total cases. Leprosy is more common in men (1,642 cases). Multibacillary leprosy is more common (86.19%). Of 2,461 cases, as many as 843 (34.25%) had leprosy reactions, with type 2 reactions being more common than 500 cases (59.31%). Of 13 cities, the most cases of leprosy reaction were reported in Jakarta, with 396 cases with 168 cases (67.47%) of type 1 leprosy reaction. Lucio phenomenon in this study only occurred in 1.9% of 843 cases of leprosy reactions. Leprosy is more common in adolescents and adults, as well as in males. The most common type of leprosy in Indonesia is multibacillary leprosy. Overall, type 2 leprosy reactions in Indonesia are more common than type 1 leprosy reactions.
Familial Mediterranean fever (FMF) is a hereditary, autoinflammatory disease that causes recurrent fever, arthritis, and serositis. The diagnosis of FMF is based on the presentation of typical clinical symptoms and the Mediterranean fever gene (MEFV) test. However, the challenge lies in diagnosing atypical cases. We describe the case of an 18-year-old male patient with heterozygous FMF whose dominant clinical features were recurrent myalgia and muscle stiffness with or without fever. He had intermittent attacks of muscle aches and muscle stiffness with and sometimes without fever for which he was on regular non-steroidal antinflammatory medications. His acute inflammatory markers and serum amyloid A was found high and The diagnosis heterozygous FMF was done after MEFV gene analysis revealed heterozygous MEFV mutation. Recurrent, prolonged, and unresolved muscle aches that was refractory to nonsteroidal anti-inflammatory drugs.so the diagnosis of heterozygous FMF was done and started on colchicine 1mg/day. The muscle aches and muscle stiffness improved dramatically after starting colchicine therapy 1mg/day and the inflammatory markers returned to normal levels. We present an adolescent who is a case of heterozygous FMF presented with history of recurrent myalgia and muscle stiffness and back pain with and without fever since childhood. The patient was treated with colchicine. Based on this case, we suggest that FMF should be kept in mind in the differential diagnosis of patients with myalgia, back aches, muscle stiffness with or without fever.