Comparing prevalence of Iron Deficiency Anemia and Beta Thalassemia Trait in microcytic and non-microcytic blood donors: suggested algorithm for donor screening

<b>Background:</b> The prevalence of microcytosis in donors and Iron Deficiency Anemia (IDA) and Beta-Thalassemia trait (BTT) in microcytic and non-microcytic donors has not been studied in India. The present study aims at finding the same. <b> Materials and Methods:</b> Initially 925 donor samples were evaluated on cell-counter. Of these, 50 were found to be microcytic. These were subjected to Ferritin and HbA2 determination. Subsequently, an additional 51, age-and-sex matched non-microcytic donor samples were selected to serve as controls. These were subjected to the same tests. <b> Results:</b> The prevalence of microcytosis was 5.4&#x0025; (50/925). Among the microcytic donors, 52&#x0025; were IDA, 36&#x0025; BTT, 8&#x0025; both, and 4&#x0025; none. In case of non-microcytic donors 29.4&#x0025; were IDA, 3.9&#x0025; BTT, and 66.7&#x0025; none. <b> Conclusions:</b> The study revealed a high prevalence of IDA and BTT in blood donors and a higher probability of finding these in the microcytic samples. This prompted authors to suggest an algorithm for screening of blood donors for IDA and BTT. The algorithm recommends doing an hemogram on all donor samples, routinely. Ferritin could be done only in microcytic samples. At levels lower than15 ng/ml, it is diagnosed as IDA, and therefore, HPLC is performed only for non-IDA samples with Ferritin levels higher than 15 ng/ml. By employing this algorithm, a substantial number of IDA and BTT could be diagnosed while keeping the number of Ferritin tests small and the number of HPLC tests even smaller and thus making it cost efficient

Detecting Carbapenemase Production amongst Gram Negative Isolates and its Role in Appropriate Antibiotic Selection

Multidrug resistance has been increasing world wide amongst most microrganisms, and adding to increased rate of both hospital and community acquired infections. Of all resistance mechanisms the alarming spread of carbapenemase producers is most worrisome and needs to be tackled head on. The present study was undertaken with the objective of determining the prevalence of carbapenemase producers and its significance in selecting the appropiate antibiotic for clinical use.The study was undertaken by the department of Microbiology and Immunology of SGRRIM&HS, Dehradun over a period of six months. A total of 1918 varied clinical specimens were subjected to Bacterial identification and antibiotic sensitivity determination. Further carbapenemase production was detected phenotypically using modified carbapenemase inactivation method (mCIM) for randomly selected 152 carbapenem resistant gram negative isolates. Total of 58.55% isolates tested mCIM test positive of which the highest percentage (71.4%) were Pseudomonas spp, while 17.2% isolates were not found to be carbapenemase producers i.e mCIM negative. These results substantiate the importance of differentiating the carbapenemase producers from non producers to aid in rational use of antibiotics

Prevalence of Coagulase Negative Staphylococcus and their Antibiotic Sensitivity Pattern from Various Clinical Samples

Coagulase Negative Staphylococci (CONS) have in the current years been increasingly incriminated as important pathogens. CONS are frequently implicated in various nosocomial infections, particularly blood stream infections and prosthetic infections. The present study was carried out to study the Coagulase Negative Staphylococci isolated from various clinical specimens and to determine their antimicrobial susceptibility patterns. A total of 60 strains of CONS isolated in pure form or isolated twice from various clinical specimens were recruited for the study. All clinical specimens were processed as per the standard laboratory methods. Out of 83 culture positive specimens CONS spp. were isolated in 60 specimens. In the present study maximum isolates i.e 20% isolates were recovered from paediatric ward patients, followed by 18.3% isolates being isolated from patients admitted in ICU. Isolation of CONS was maximum from blood (45%), followed by pus (21.6%) and urine (20%). Predominance of Staphylococcus haemolyticus (25%) and Staphylococcus warneri (20%) was seen. Maximum resistance was seen for ampicillin (80%), followed by resistance for ciprofloxacin (74.3%), erythromycin (73.3%) and the minimum resistance was seen for tigecycline (5%). Methicillin resistant CONS isolates (MRCONS) were seen maximum in blood (p<0.05) followed by urine (p<0.05) and pus (p<0.05). CONS have now evolved as significant cause of nosocomial infections and are progressively showing increased resistance to beta-lactamase stable penicillins. Multidrug resistance patterns have also been reported in MRCONS and these can act as a reservoir for drug resistance in hospitals. Various levels of glycopeptide resistance have also been reported in these isolates