EMERGENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII IN THE INTENSIVE CARE UNIT OF A REFERRAL HOSPITAL OF EASTERN INDIA AND ITS THERAPEUTIC OPTION

Background and objective: Multidrug-resistant Acinetobacter baumannii has one of the most serious nosocomially acquired gram negative infection in Intensive Care Unit (ICU). The gradual increase in incidence of this pathogen reflects their de-novo selection due to antibiotic usages and its ability to spread between patients. This study was undertaken to detect resistance to carbapenems in clinical isolates of A. baumannii in our ICU set up and to assess the rate of carbapenemase and MBL production among the isolates with the therapeutic options available against them. Material and methods: A. baumannii was identified by conventional methodology and susceptibility profile was determined by disc diffusion method. Carbapenem resistant isolates were further checked for mettalo beta lactamases (MBL) assay by EDTA disc synergy test and Minimum inhibitory concentration determination by agar dilution method. Results: 71.87% (n=46) of isolates showed resistance to Imipenem by disc diffusion method. 82.6% (n=38) of isolates were MBL producer both by phenotypic EDTA disc synergy test and MIC determination test by agar dilution method. The susceptibility profiles of A. baumannii strains towards colistin, polymyxin B and tigecycline were 90.62%, 57.81% and 78.12% respectively.Conclusion: Detection as well as awareness of this MBL producing A. baumannii in a hospital set up, coupled with judicious antimicrobial therapy based on sensitivity profiles will help us fight against this deadly menace. KEYWORDS: Acinetobacter baumannii; Carbapenemases; Mettalo beta lactamases

EMERGENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII IN THE INTENSIVE CARE UNIT OF A REFERRAL HOSPITAL OF EASTERN INDIA AND ITS THERAPEUTIC OPTION

Background and objective: Multidrug-resistant Acinetobacter baumannii has one of the most serious nosocomially acquired gram negative infection in Intensive Care Unit (ICU). The gradual increase in incidence of this pathogen reflects their de-novo selection due to antibiotic usages and its ability to spread between patients. This study was undertaken to detect resistance to carbapenems in clinical isolates of A. baumannii in our ICU set up and to assess the rate of carbapenemase and MBL production among the isolates with the therapeutic options available against them. Material and methods: A. baumannii was identified by conventional methodology and susceptibility profile was determined by disc diffusion method. Carbapenem resistant isolates were further checked for mettalo beta lactamases (MBL) assay by EDTA disc synergy test and Minimum inhibitory concentration determination by agar dilution method. Results: 71.87% (n=46) of isolates showed resistance to Imipenem by disc diffusion method. 82.6% (n=38) of isolates were MBL producer both by phenotypic EDTA disc synergy test and MIC determination test by agar dilution method. The susceptibility profiles of A. baumannii strains towards colistin, polymyxin B and tigecycline were 90.62%, 57.81% and 78.12% respectively.Conclusion: Detection as well as awareness of this MBL producing A. baumannii in a hospital set up, coupled with judicious antimicrobial therapy based on sensitivity profiles will help us fight against this deadly menace. KEYWORDS: Acinetobacter baumannii; Carbapenemases; Mettalo beta lactamases

A Case Report of Staphylococcus aureus Induced Cutaneous Botryomycosis in a Patient with Acquired Immune Deficiency Syndrome

Botryomycosis is a rare bacterial infection that can involve the skin and viscera. It is multifocal in development, characterized by granulomatous bacterial infection. The organisms form granules, which are composed of bacterial masses that are adhered to each other. Here, we describe one unusual case of culture proved Staphylococcus aureus induced botryomycosis in patients with the acquired immune deficiency syndrome who was successfully treated

A case report of white grain eumycetoma caused by Scedosporium apiospermum in a tertiary care hospital of the Eastern India

Scedosporium apiospermum and its asexual state Pseudallecheria boydiiare increasingly recognized as an opportunistic pathogen. Here, we describe a white grain eumycetoma of left foot of a 48-year-old female caused by S. apiospermum. Treatment with oral voriconazole was successful

A case report of nonhealing leg ulcer infected with Stenotrophomonas maltophilia in an immunocompetent patient in a Tertiary Care Hospital of Eastern India

Stenotrophomonas maltophilia is an aerobic, motile Gram-negative, nonfermentative bacillus considered as an opportunistic pathogen causing infection typically in individuals with immunosuppression, organ transplantation and malignancies. Contaminated water or medical devices in the hospital environment are the primary causes of infection. Here, we report a case of nonhealing leg ulcer infected with S. maltophilia in an immunocompetent individual

A Retrospective Study on Pre Exposure Hydroxychloroquine and Ivermectin Prophylaxis for COVID-19 in Healthcare Workers in a Tertiary Care Hospital

Background:COVID-19 was declared a ‘pandemic’ by the WHO on 11th March, 2020. The high infectivity and unique transmission potentials of the causative agent of COVID-19, namely, SARS-CoV-2 were the reasons behind its wide-scale spread and made health care workers (HCWs), the most ‘at-risk population’ for acquiring the infection.The administration of HCQs and/or Ivermectin prophylaxis was one of the most commonly used stratagems recommended to protect the HCWs prior to the development of an effective vaccine. But data on its effectiveness, if any, were not conclusive. Also the above strategy was not accepted by many HCWs themselves for a plethora of reasons. Hence a systematic enquiry into the above conundrums was felt to be the need of the hour. Objective: 1.To assesses the effectiveness of HCQs and Ivermectin as pre-exposure prophylaxis (PrEP) drugs against SARS-CoV-2 infection among HCWs in a tertiary care hospital. 2. To identify the reason(s) behind avoidance of PrEPamong HCWs. Materials and methods: We conducted a retrospective study based on an online/ offline/ telephonic survey on HCWs directly related to COVID care services. Results: Total 336 HCWs responded to our survey. There were segregated intotwo cohort groups, namely, those taking PrEP (n=148; exposed) and those avoidingPrEP (n=188; control). In the PrEPgroup, 26 (17.56%) out of 148 participants reported to have tested positive for SARS-CoV-2 during some point of time, whereas, in the control group, 38 (20.21%) out of 188 participants reported to have been SARS-CoV-2 positive. We found no significant reduction SARS-CoV-2 cases in exposed group with relative risk of 0.8691 (95% Confidence Intervals 0.5542 to 1.363, p <0.3181).Conclusions: Our study demonstrated that voluntary consumption of PrEP by HCWs is not associated with a statistically significant reduction in risk of SARS-CoV-2

The Politics of Knowledge: Or, How to Stop Being Eurocentric

In the last 20 years or so, a significant and growing body of work has sought to unveil, challenge and displace the ‘Eurocentric’ biases of the human sciences. The arguments advanced in these works vary, and the aim of this essay is both to survey this literature and to point out the differences between different ‘kinds’ or ‘types’ of ‘anti-Eurocentris