Tracking Vancomycin MIC Creep: A Five Year Analysis

Methicillin resistant Staphylococcus aureus (MRSA) is a known human pathogen capable of causing community and hospital acquired infections worldwide. Treatment options available for MRSA infections are limited, with vancomycin being one of the most common drugs used. It is described in the literature that vancomycin can be ineffective against MRSA isolates with MIC values between 1-2 mg/litre. This slow and steady shift of vancomycin MIC values towards higher side over a period of time is known as “MIC creep”. The present retrospective study was carried out over five year period from January 2019 to June 2023. Staphylococcus aureus isolates from all clinical samples isolated during study period were included in the study. MIC50, MIC90, geometric mean MIC values were determined and analysed using Microsoft Excel. In the present study, the prevalence of MRSA was high (79.6%) in pus and tissue samples followed by blood sample (9.7%). Most of the MRSA isolates (55.80%) in present study exhibited vancomycin MIC of 1 µg/ml, there is no increasing trend of MIC values over a five year period. MIC creep is a slow and steady process which is multifactorial in origin. Regular monitoring of vancomycin MIC trend is advisable as vancomycin is the first-line treatment for culture proven severe infection with MRSA

Clinico-mycological profile of diagnosed cases of dermatophytosis in a tertiary care hospital, Pune: A Cross-Sectional Study

Background: Dermatophytes are keratinophilic fungi that cause superficial infections of the skin, hair, and nails. The prevalence of dermatophytosis is influenced by factors, such as climate, age, gender, lifestyle, and socioeconomic status. In tropical and subtropical regions, like India, hot and humid conditions contribute to its high incidence. This study aimed to isolate and identify dermatophytes from clinically diagnosed cases of dermatophytosis. Methods: A total of 100 clinically diagnosed cases were examined by direct microscopy (KOH mount) and fungal culture on Sabouraud dextrose agar (SDA) and Dermatophyte Test Medium (DTM). Results: The most common clinical presentation was Tinea corporis (42%), followed by Tinea cruris (25%) and Tinea unguium (21%). Out of 100 samples, 53 were culture-positive. The predominant isolates were Trichophyton rubrum (30%), Trichophyton mentagrophytes (20%), and Trichophyton violaceum (13.3%). Among culture media, SDA yielded 92.45% isolates, while DTM showed higher sensitivity (96.22%). Conclusion: Isolation and identification of dermatophytes are crucial for accurate diagnosis, effective treatment, and epidemiological surveillance. Understanding the local prevalence and etiological agents aids in managing therapeutic challenges and preventing transmission

Phenotypic characterization of Acinetobacter species and their resistance pattern in a tertiary care hospital

is an emerging opportunistic pathogen and increasingly implicated in hospital acquired infection especially in intensive care unit. The infection caused by spp. is difficult to control due to multi drug resistance which limits its therapeutic options. This study was undertaken to isolate from various clinical samples and to speciate isolates. Efforts were made to study the antimicrobial susceptibility pattern of species and to detect metallo beta lactamase producing strains. Clinical samples blood, urine, sputum, pus, body fluids and ETT sample received in microbiology laboratory were processed according to the standard laboratory procedure. Identification and antimicrobial susceptibility testing was done by VITEK-2 automated method. All the isolates that showed resistance to Imipenem were tested for Metallo – Beta – Lactamase (MBL) production by phenotypic test, Imipenem-EDTA-combined disc test method. Out of total 100 spp isolated from clinical samples, 80 were isolated from critical care units. baumannii was common spp 88 (88%), followed by A.complex 10 (10%). Isolation rate of species was highest from blood (27%) specimens followed by ETT (19%). 44% strains of were isolated from respiratory samples. 84(84%) spp, were carbapenem resistant. Out of 84 carbapenems resistant strains 48 (57%) were MBL positive strains by combined disc test. Emergence of MBLs producing strains of is alarming and reflects excessive use of carbapenems. Therefore early detection and prompt infection control measures is important to prevent further spread of MBLs to other Gram negative bacilli.</jats:p

Impact of interventions on the incidence of thrombophlebitis in peripheral venous cannulation in a tertiary care teaching hospital

Background: In hospitalized patients the use of intravenous devices like cannula are indispensable. Nearly about 80% of hospitalized patients require peripheral venous cannulation, as a part of therapy. Thrombophlebitis is one of the prevalent complications of peripheral venous cannulation.Method: The present study was aimed to find the incidence of thrombophlebitis after peripheral venous cannulations in the patients admitted in a tertiary care teaching hospital. Impact of regular trainings and interventions on the incidence and grades of thrombophlebitis was also studied. The study was conducted for period of 1 year.Result: The total of 28850 cannulations carried out on 11686 patients was observed. Phlebitis was diagnosed in 1821 peripheral venous cannulations, giving the incidence of 6.3%. As per Visual Infusion Phlebitis (VIP) score, 1527 (83.86%) were grade 1 phlebitis, 274 (15.04%) were with grade 2 phlebitis and 20 (1.10 %) were grade 3 phlebitis. Regular surveillance, training and timely interventions were carried out during this period and the effect of these interventions was noted in the monthly phlebitis rate. Phlebitis rate reduced from 9.89% in January to 3.99% in the month of December. There was also reduction in grade 2 thrombophlebitis (from 21.05% in January to 6.09% in December). In the last 4 months of study period grade 3 phlebitis was not reported.Conclusions: A significant reduction in the incidence of phlebitis associated with peripheral intravenous cannulations may be achieved by regular surveillance, training and timely interventions.</jats:p