BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN INTENSIVE CARE UNIT OF TERTIARY CARE HOSPITAL, AURANGABAD.

Introduction: Multidrug resistant nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in the intensive care unit (ICU), where a large number of drugs are administered to the patient which in turn leads to the generation of antibiotic resistant pathogens. Method: Over a period 12 months clinical samples (blood, urine, pus/ wound swabs, respiratory secretions etc) from patient admitted in ICU were processed according to the standard microbiologic methods, and their antimicrobial testing was performed using disk diffusion method. Results: A total of 464 samples, 164 (35.34%) were culture positive in which 133 (81.1%) samples were monomicrobial and 31(63) (18.9%) samples were polymicrobial. Out of 196 isolates were obtained, 127 isolates were Gram negative and 69 isolates were Gram positive organisms. The most common isolate was S. aureus (29.1%) and Klebsiella spp (26%) followed by E.coli (17.3%), Pseudomonas spp (13.8%), Streptococcus spp (5.1%), Acinetobacter spp (4.1%), Citrobacter (2.6%), Proteus Spp (1%) and Coagulase Negative Staphylococcus (1%). Vancomycin and linazolid is more effect against the Gram positive organisms. For Gram negative organism's carbapenems remain the drug of choice followed by amikacin. Conclusion: Institutional antimicrobial surveillance and proper infection control practices are essential to prevent and control multi drug resistant bugs in ICUs and hospital. KEY WORDS: Bacteriological profile; Antimicrobial profile; Intensive Care Unit infections; Nosocomial Infections

BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN INTENSIVE CARE UNIT OF TERTIARY CARE HOSPITAL, AURANGABAD.

Introduction: Multidrug resistant nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in the intensive care unit (ICU), where a large number of drugs are administered to the patient which in turn leads to the generation of antibiotic resistant pathogens. Method: Over a period 12 months clinical samples (blood, urine, pus/ wound swabs, respiratory secretions etc) from patient admitted in ICU were processed according to the standard microbiologic methods, and their antimicrobial testing was performed using disk diffusion method. Results: A total of 464 samples, 164 (35.34%) were culture positive in which 133 (81.1%) samples were monomicrobial and 31(63) (18.9%) samples were polymicrobial. Out of 196 isolates were obtained, 127 isolates were Gram negative and 69 isolates were Gram positive organisms. The most common isolate was S. aureus (29.1%) and Klebsiella spp (26%) followed by E.coli (17.3%), Pseudomonas spp (13.8%), Streptococcus spp (5.1%), Acinetobacter spp (4.1%), Citrobacter (2.6%), Proteus Spp (1%) and Coagulase Negative Staphylococcus (1%). Vancomycin and linazolid is more effect against the Gram positive organisms. For Gram negative organism\u27s carbapenems remain the drug of choice followed by amikacin. Conclusion: Institutional antimicrobial surveillance and proper infection control practices are essential to prevent and control multi drug resistant bugs in ICUs and hospital. KEY WORDS: Bacteriological profile; Antimicrobial profile; Intensive Care Unit infections; Nosocomial Infections

Molecular Detection of Carbapenem Resistance in Clinical Isolates of Klebsiella pneumoniae in Tertiary Care Hospital

Antibiotic resistance has become a serious global threat, mainly due to misuse, overuse of antibiotics and non-compliance with infection control protocol. Superbugs are multidrug-resistant (MDR) and extended drug-resistant (XDR) bacteria, mainly Klebsiella pneumoniae and Escherichia coli from the Enterobacteriaceae family, which cause opportunistic infections and raise death rates and hospital expenditures. The present study was conducted at a tertiary care teaching hospital to study the epidemiology and molecular detection of carbapenem-resistant K. pneumoniae isolated from various clinical specimens. 240 K. pneumoniae isolates were collected from January 2020 to December 2021 at the Bacteriology laboratory, Index Medical College and Hospital, Indore. All isolates were analyzed for carbapenem resistance by the conventional disc diffusion method. All carbapenem-resistant isolates were tested for carbapenemase production using the phenotypic double-disk synergy test (DDST) and modified Hodge test (MHT) as per 2020 CLSI guidelines. All isolates were negative by phenotypic methods, further confirmed by conventional PCR to detect the gene responsible for carbapenemase production. 240 isolates of K. pneumoniae were included during the study periods. Out of 240 isolates, 102 isolates were found resistant to carbapenem drugs. All 102 isolates were confirmed carbapenemase and MBL producers by MHT and DDST tests. Among 102, 60 isolates were found to be MBL producers negative by MHT and DDST tests. Sixty phenotypic negative carbapenem-resistant isolates were tested by conventional PCR. One or more carbapenemase genes were detected in 61.0% of isolates. The blaKPC was detected in 13/60 (21%) isolates, followed by blaNDM 10/60 (16%) isolates, followed by blaVIM in 6/60(10%), blaOXA-48 in 5/60 (8%) and blaIMP in 3/60(5%) isolates. K. pneumoniae produces carbapenemase, which enhances resistance to the carbapenem class of antibiotics. The simultaneous detection of these resistance genes expressed by Klebsiella pneumoniae might be managed by early detection and adhering to antibiotic policies that limit the use of antibiotics

Meropenem Incorporated ZnO Nanoflakes as Nano Antibiotics: Efficient Antimicrobial Activity against Metallo β-lactamase Producing Clinical Isolates

The number of fatalities caused by multidrug-resistant (MDR) bacteria is over 700,000 annually due to widespread antibiotic usage. So, there is a need of new antibiotics, materials that work like antibiotics, or combinations of antibiotics with nanomaterials that could help in treating the infections which is caused by MDR bacteria. The present study describes the synthesis of ZnO nanoflakes using a co-precipitation method. The ZnO nanoflakes and ZnO nanoflakes combinations with carbapenem antibiotics were tested against carbapenem-resistant (CR) clinical isolates. The SEM analysis showed surface morphology of the synthesized nanoflakes-like structure of ZnO. All 67 CR isolates were tested and showed inhibitory action at varying concentrations of ZnO nanoflakes. ZnO nanoflakes were found to have an inhibitory effect against Escherichia coli and Klebsiella pneumoniae at lowest concentration of 1.25 mg.ml-1 of ZnO NPs with average zone size (mean ±SD) 1.91±2.94 mm and 2.00±4.14 mm and the average zone size of ZnO nanoflakes against Acinetobacter baumanni and Pseudomonas aeruginosa was 9.89±0.76 mm and 10.17±0.39 mm at 2.5 mg.ml-1 concentration. The combined action of ZnO nanoflakes with Meropenem 10 mcg demonstrated synergetic activity against CR pathogens, with an average zone of inhibition measuring 15.2 mm in diameter. ZnO nanoflakes illustrated considerable antibacterial activity against MBL-producing gram-negative clinical isolates at the lowest concentration. Chemically synthesized ZnO nanoflakes may offer a superior future expectation as a nano-antibiotic to treat the infection caused by CRE bacteria.The number of fatalities caused by multidrug-resistant (MDR) bacteria is over 700,000 annually due to widespread antibiotic usage. So, there is a need of new antibiotics, materials that work like antibiotics, or combinations of antibiotics with nanomaterials that could help in treating the infections which is caused by MDR bacteria. The present study describes the synthesis of ZnO nanoflakes using a co-precipitation method. The ZnO nanoflakes and ZnO nanoflakes combinations with carbapenem antibiotics were tested against carbapenem-resistant (CR) clinical isolates. The SEM analysis showed surface morphology of the synthesized nanoflakes-like structure of ZnO. All 67 CR isolates were tested and showed inhibitory action at varying concentrations of ZnO nanoflakes. ZnO nanoflakes were found to have an inhibitory effect against Escherichia coli and Klebsiella pneumoniae at lowest concentration of 1.25 mg.ml-1 of ZnO NPs with average zone size (mean ±SD) 1.91±2.94 mm and 2.00±4.14 mm and the average zone size of ZnO nanoflakes against Acinetobacter baumanni and Pseudomonas aeruginosa was 9.89±0.76 mm and 10.17±0.39 mm at 2.5 mg.ml-1 concentration. The combined action of ZnO nanoflakes with Meropenem 10 mcg demonstrated synergetic activity against CR pathogens, with an average zone of inhibition measuring 15.2 mm in diameter. ZnO nanoflakes illustrated considerable antibacterial activity against MBL-producing gram-negative clinical isolates at the lowest concentration. Chemically synthesized ZnO nanoflakes may offer a superior future expectation as a nano-antibiotic to treat the infection caused by CRE bacteria

A Retrospective Study of Clinical and Laboratory Profile of Dengue Fever in Tertiary Care Hospital, Wardha, Maharashtra, India

Dengue disease is caused by dengue virus which is a vector born viral infection. The prevalence of dengue has increased dramatically from past few decades. The clinical symptoms vary from asymptomatic to severe hemorrhagic fever leads to high morbidity and mortality. Method- This retrospective study was carried out during January 2019 to December 2019. The laboratory test was done by using J Mitra & Co on Day 1 of their visit to the hospital which shows NS1, IgM and IgG reactivity towards dengue fever. The clinical profile information data was collected from patient records. Out of 640 samples 62.18% (398) was positive. The percentage of positive males and females were 60.78%, 64.23% respectively. The highest prevalence of dengue infection was observed more in age group between 31-40 years (81.69%) and least prevalence in age group 71-80 years (36.36%). Most of the patients were positive for NS1Ag121 (30.4%) followed by IgM positive 87 (21.9%) & 59 (14.8%) positive for both IgM and NS1 Ag The highest number of infections was seen during October (75.8%) post monsoon season. All patients had a fever, followed by head ache (82%) and body pains (66.4%), 64.84% stayed in the hospital less than 5 days. In tropical and sub-tropical regions dengue is still a leading public health problem especially during rainy and post monsoon seasons. Both NS1 Ag and IgM detection in early acute phase has potential diagnostic value. So, to reduce mortality there need to initiate community-based cohort studies to predict the pace of dengue spread based on clinical presentation and laboratory findings during epidemics in India. Aedesaegypti is a common vector for transmission of DENV, CHIKV and ZIKV, so there is a need to screen for these infections in endemic areas

Effectiveness of homoeopathic therapeutics in the management of childhood autism disorder

Background and Objectives: Childhood autism is severe and a serious disorder. A study was conducted by Spandan holistic institute of applied Homoeopathy, Mumbai, with the objective of demonstrating the usefulness of homeopathic management in autism. Materials and Methods: Sixty autistic children of both sexes, ≤12 years were selected for this study. It was nonrandomized, self-controlled, pre and post-intervention study, wherein the initial 6 months of observation period was used as the control period and the same patients were thereafter treated for 1 year and compared with post-intervention findings. Results: The study demonstrated significant improvement of autistic features with mean change in ATEC score (ATEC 1 -pre-treatment with ATEC 5 -post-treatment) was 15.12 and ATEC mean percent change was 19.03. Statistically significant changes in ATEC scores were observed in all the quarters analyzed through repeated measures ANOVA, with F-value 135.952, P = 0.0001. An impact was observed on all core autistic features, which included communication, 12.61%, socialization, 17%, sensory awareness, 18.82%, and health and behavior, 29% (P = 0.0001). Significant improvement was observed in behavior by Autistic Hyperactivity Scale, AHS 1 36 to AHS 5 14.30 with F-value 210.599 (P = 0.0001). Outcome assessment was carried out using MANOVA, which showed statistically significant changes in post-treatment scores, P < 0.005. Total 88.34% cases showed improvement, 8.33% showed status quo, and 3.33% cases worsened. Nine out of 60 cases showed a reversal of CARS putting them into non-autistic zone, P = 0.0001. A sharp decrease (34%) in ATEC scores, in the first quarter implied positive effect of homoeopathic medicines, prescribed, as per the homoeopathic principles. Conclusion: The study has demonstrated usefulness of homoeopathic treatment in management of neuropsychological dysfunction in childhood autism disorder, which is reflected in significant reduction of hyperactivity, behavioral dysfunction, sensory impairment as well as communication difficulty. This was demonstrated well in psychosocial adaptation of autistic children