A Comparative Analysis of Bacterial Growth with Earphone Use

Background: Recently the worldwide usage of earphones has increased especially among the school and college students who have a high rate of sharing among them. Alike airline headsets, headphones and stethoscope ear-pieces, ear phones can easily be a vector of potential pathogens, which can give rise to otitis externa. Purpose: To compare the bacterial growth of the external ear in association with earphone and assess the role of earphones as vector or microorganisms. Material and Methods: 50 voluntary male subjects (age 18-25 years) were chosen and divided into two groups, A and B, according to the use of earphones. Swabs were taken from their left ear and the left earpiece of the earphone. Samples were processed as recommended. Results: In group A, bacteria were found in 20 (80%) ear and 14 (56%) earphone swabs. In group B, bacteria were found in 23 (92%) ear and 17 (68%) earphone swabs. Group B showed heavy growth and a significant increase in the number of bacterial growths after frequent and constant use. Conclusion: Frequent and constant use of earphones increases the bacterial growth in the ear and sharing of earphones might be a potential vector of commensals. It is therefore, always better not to share or else to clean the earphones before sharin

Characterization of antimicrobial resistance mechanisms of multidrug resistant Gram negative bacterial wound infections and their clinical epidemiology from a tertiary care hospital in Karnataka, India

Background: Extended spectrum beta lactamases, AmpC and Metallo-betalactamases in GNB isolates are a common occurrence in most Indian hospitals. The presence of these antimicrobial resistance mechanisms contributes to prolonged hospital stay, poor quality of life, increased morbidity and mortality among patients with these infections. The aim of the study was to analyse the antimicrobial resistance mechanisms of multidrug resistant Gram negative bacterial wound infection and their clinical epidemiology.Methods: A prospective study was conducted for one year among 100 patients of Kasturba Medical College, Manipal admitted with MDR GNB wound infections. The antibiogram and phenotypic resistance mechanisms of the bacterial isolate from these infections were identified using phenyl boronic acid and ethyl diacetate.  The empirical therapy, specific therapy and clinical outcome of the patients were also analyzed.Results: Out of 100 study patients, 152 MDR GNB isolates were obtained.  73% patients were admitted in the surgical wards. 43% patients had diabetes. Ulcers (27%) and abscess (25%) were the most common diagnosis. Escherichia coli (39%), Klebsiella pneumoniae (24%) and Pseudomonas aeruginosa (19%) were the most common isolates. Maximum number of ESBL was seen among Enteric Gram negative bacilli (36%), MBL was seen among Pseudomonas aeruginosa and Acinetobacter species (55% each), AmpC was seen among enteric GNB (10%) and Acinetobacter species (18%). Cefaperazone sulbactam, amikacin and meropenem were the most common antibiotics given as specific therapy. Clinical response was observed among 93% patients.Conclusions: The determination of the antimicrobial resistance mechanisms of GNB isolates from wound infections plays a major role in establishing an antibiotic policy for the treatment of these infections

Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan).

Despite the fact that South Asia is predicted to have the highest number of cases worldwide, melioidosis is a little-known entity in South Asian countries. It has never been heard of by the majority of doctors and has as yet failed to gain the attention of national Ministries of Health and country offices of the World Health Organization (WHO). Although a few centers are diagnosing increasing numbers of cases, and the mortality documented from these institutions is relatively high (nearly 20%), the true burden of the disease remains unknown. In India, most cases have been reported from southwestern coastal Karnataka and northeastern Tamil Nadu, although this probably simply reflects the presence of centers of excellence and researchers with an interest in the disease. As elsewhere, the majority of cases have type 2 diabetes mellitus and occupational exposure to the environment. Most present with community-acquired pneumonia and/or bacteremia, especially during heavy rainfall. The high seropositivity rate (29%) in Karnataka and isolation of B. pseudomallei from the environment in Tamil Nadu and Kerala confirm India as melioidosis-endemic, although the full extent of the distribution of the organism across the country is unknown. There are limited molecular epidemiological data, but, thus far, the majority of Indian isolates have appeared distinct from those from South East Asia and Australia. Among other South Asian countries, Sri Lanka and Bangladesh are known to be melioidosis-endemic, but there are no cases that have conclusively proved to have been acquired in Nepal, Bhutan, Afghanistan or Pakistan. There are no surveillance systems in place for melioidosis in South Asian countries. However, over the past two years, researchers at the Center for Emerging and Tropical Diseases of Kasturba Medical College, University of Manipal, have established the Indian Melioidosis Research Forum (IMRF), held the first South Asian Melioidosis Congress, and have been working to connect researchers, microbiologists and physicians in India and elsewhere in South Asia to raise awareness through training initiatives, the media, workshops, and conferences, with the hope that more patients with melioidosis will be diagnosed and treated appropriately. However, much more work needs to be done before we will know the true burden and distribution of melioidosis across South Asia

“NEWS ON AIR!” - AIR SURVEILLANCE REPORT FROM INTENSIVE CARE UNITS OF A TERTIARY CARE HOSPITAL

ABSTRACTBackground: The role of airborne microorganisms in the nosocomial infections is debatable since past. Very limited and inconclusive data availableabout the contribution of the air microflora, especially the multidrug resistant (MDR) one, to the hospital-acquired infections in the Intensive CareUnits (ICUs).Objective: To analyze the microbial population and their antimicrobial susceptibility pattern of the indoor air in relation to the nosocomial infectionsin the different ICUs at different periods in the tertiary care hospital.Methods: Microbial monitoring of the air was performed in 5 different ICUs for 1 year by passive sampling method.Results: A total of 221 air samples were collected for 1 year from five different ICUs. 92.53% were Gram-positive bacteria and 8.11% were Gramnegativebacteria. Staphylococcus spp. (34.21%) and Acinetobacter spp. (63.04%) were the most common isolated bacteria among Gram-positiveand Gram-negative organisms, respectively, and among the fungal isolates, all of them were Aspergillus spp. (5.84%) from the air sample. Ventilatorassociatedpneumonia was the most common nosocomial infection and Acinetobacter spp. was the frequently isolated MDR organism.Conclusion: Air could be the major source of nosocomial infections by MDR Gram-negative organisms in the ICUs which require special attention andsurveillance.Keywords: Air sampling, Intensive Care Units, Multidrug-resistant organisms, Nosocomial infection

REDUCED SUSCEPTIBILITY OF MRSA TO VANCOMYCIN

Objective: This study was conducted to observe the antibiogram, vancomycin MIC (Minimum Inhibitory Concentration), and inducible clindamycin resistance in clinical isolates of MRSA (Methicillin-Resistance Staphylococcus aureus).Methods: Drug resistance pattern was studied by Kirby-Bauer disc diffusion methods. MIC of vancomycin was determined by agar dilution method.Results: MRSA was found to be highly resistant to gentamicin (76%), erythromycin (67.03%) and ciprofloxacin (65.09%) while glycopeptides showed uniform susceptibility.Conclusion: Though there was no drug resistance observed against vancomycin and linezolid, it's wise to use these antibiotics safely as emerging resistance has been reported for these drugs from all over the world

An Assessment of Relevance of Sputum Sample Examination in Patients with Tuberculous Pleural Effusion

Background: Utility of chest-X ray findings as a reference diagnostic modality in cases of tubercular pleural effusion is well acknowledged. In advent of increasing reports, regarding the absence of visible lung lesions among patients suffering with tubercular pleural effusion, reliability on radiographic findings alone is questionable. In this context, need for a more reliable diagnostic tool in addressing this diagnostic challenge arises. Aim: The present study was undertaken to evaluate the relevance and utility of sputum specimen and adenosine deaminase (ADA) level examination in patients with tubercular pleural effusion, having no visible lesions on radiological examination. Materials and methods Methods: A total 81 cases of suspected tubercular pleural effusion were selected from the inpatient wards of a tertiary care hospital, over a period of eight months (May to December, 2013). Sputum and pleural fluid specimens from all these patients were collected for microbiological investigations such as smear microscopy using Ziehl-Neelsen and Auramine-O staining, mycobacterial culture using conventional method. ADA level was also tested from all pleural fluid specimens. Results: Of the 81 cases, culture positivity from sputum specimens was observed among 13 (16.1%), smear positivity from sputum specimens (3, 3.7%) and smear and culture positivity from pleural fluid specimens (1, 1.23%) cases. High levels of ADA, ranging from 115 IU/L to 203 IU/L were observed among (8, 22.2%) subjects. Conclusion: Our study findings suggest the reliability of smear examination and culture from sputum specimens over pleural fluids specimens and also high sensitivity of ADA as a biomarker in the diagnosis of tubercular pleural effusion.Keywords: Tuberculous pleural effusion, Mycobacterium tuberculosis, Diagnosis, Adenosine deaminase (ADA

MRSA: the leading pathogen of orthopedic infection in a tertiary care hospital, South India

Background: The rate of infection is high and heterogeneous in developing countries. This study aimed to find the rate and pattern of infection in a tertiary care hospital with a goal to improve the infection control practices.Methods: The study was conducted in the orthopedic units of a multispecialty teaching hospital. Medical records of major orthopedic surgery adult patients without immunosuppression state were included. The bacterial culture report of the wound swabs were noted over a period of one year. The bacterial culture testing was performed by a recommended method.Results: Among 2,249 orthopedic surgery patients, 83.7% were males, 49.1% had open wounds during admission and 32.2% patients were infected. Majority (64.2%) of the injuries were in the lower limb with 19.4% patients having undergone multiple surgeries during hospitalization. A total of 946 pathogens were grown from 725 specimens. Staphylococcus aureus was the max- imum (48.4%) followed by Pseudomonas aeruginosa (26.3%) and E coli (16.7%). Among them, 57.3% were Methicillin Resistant Staphylococcus aureus (MRSA) and was the leading pathogen causing infection among orthopedic patients.Conclusion: MRSA infection was high. Consequent to this, an interventional program entitled ‘Extended Infection Control Measures' was designed to reduce the burden of infection.Keywords: MRSA, orthopedic, infection, South India

Antimicrobial Property of Silver Nanoparticles: Effects of Concentration and Temperature on Bacterial Isolates

Importance of hospital environment in patient-care has been recognized widely in infection prevention and control. Inappropriate antibiotic use led to emergence of resistant strains that are difficult to treat with the available antibiotics. Progress in nanotechnology led to enhancement of nanoparticles with physicochemical characteristics and functionality that overcomes the constraints of common antimicrobials. Aim was to investigate effective antimicrobial role of Silver nanoparticle (Ag-NPs) against clinically important bacterial strains and observe effects of varying storage temperatures on Ag-NPs antimicrobial activity. Different concentrations of Ag-NPs were tested against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii using diffusion method. Zone of inhibition (ZOI) for each organism was directly proportional to concentration of Ag-NPs used. Mean ZOI values at different concentrations were significantly different for all organisms with p-value <0.001 for E. coli, S. aureus, P. aeruginosa and 0.004 for A. baumannii. Variation in storage temperature hardly showed any effects on the antimicrobial property of the Ag-NPs. Scanning electron microscopy (SEM) showed morphological and size variations in Ag-NPs exposed cells when compared to control strains, especially for S. aureus, E. coli and P. aeruginosa. Damaged cell membrane areas can be clearly distinguished in E. coli and P. aeruginosa thus suggesting bacterial membrane disruption. These finding can help design a larger study where Ag-NPs can be used in various medical instruments which are usually kept at room temperatures. Also, outcomes of this study may help in designing proper implants, prosthesis and equipment coated with minimum concentration of nanoparticles that might be considered safe for medical applications

Identification and Preservation of Intestinal Parasites Using Methylene Blue-Glycerol Mount: A New Approach to Stool Microscopy

We have tried a new approach to routine stool microscopy by using a combination of methylene blue and glycerol in wet mount preparation of fresh faecal samples for the demonstration of medically important intestinal parasites. This combination was evaluated for finding differences in the details and clarity of morphology and internal structures of parasites under low- and high-power microscopy as compared to iodine and saline mount. It was further evaluated to estimate the time taken by methylene blue-glycerol mount to dry up as compared to iodine and saline wet mount