Evaluation of risk factors in women attending a sexually transmitted infection clinic at a tertiary care centre

Background: Reproductive tract infections (RTIs) continue to present major health, social and economic problems all over the world and their complications are the most important causes of morbidity and mortality for women especially in the developing countries. Interest in RTIs and their management has increased tremendously because presence of a RTI in the sexual partner increases the risk of acquisition of HIV. Aim was to evaluate the risk factors in women attending a sexually transmitted infection clinic at a tertiary care centre and prevalence of RTI in our setup.Methods: The present study was conducted on 318 women of reproductive age group (18-45 years) attending the Reproductive tract infection/ sexually transmitted infection (RTI/STI) clinic at our tertiary care centre, they were evaluated for the prevalence of following RTIs: chlamydia, gonorrhoea, syphilis, bacterial vaginosis, trichomoniasis and candidiasis; and their correlation with clinical features and associated risk factors.Results: The factors found to be significantly associated with RTI were illiteracy, unemployment, past history of RTI in patient and presence of RTI in their partner. The prevalence of RTI in our setup reported 9.7%. The prevalence of candidiasis was maximum (11.5%) followed by chlamydia (4.1%), syphilis (4.1%), bacterial vaginosis (1.73%) and trichomoniasis (0.57%).Conclusions: None of the women was found positive for gonorrhoea. No coexistence of any two diseases found in any patient. Most common presentation was genital discharge (52.8%) followed by lower abdominal pain (45.2%)

ESBL, MBL AND AMP C-β LACTAMASES PRODUCED BY SUPERBUGS: AN EMERGING THREAT TO CLINICAL THERAPEUTICS

Objectives: The present study was undertaken to determine the prevalence of multi drug resistant (MDR) and multiple β-lactamase producing Pseudomonas aeruginosa isolates in lower respiratory tract infection (LRTI) patients at a tertiary care hospital in India.Methods: A total of 80 consecutive, non-duplicate isolates of P. aeruginosa were studied for the presence of class A or B β-lactamase. Antibiotic susceptibility tests and PCR amplification of genes encoding class A (PER-1 and CTX-M 1, 2, 9) and class B β-lactamases (blaVIM-2, blaIMP-1 and blaSIM-1) were performed.Results: Out of 80 P. aeruginosa isolates, 65% (52/80) of the isolates were MDR with 34 being Metallo-β-lactamase (MBL) producers, 23 were extended spectrum β-lactamase (ESBL) producers and 21 were positive for AmpC production. The cross-class resistance rates to other antibiotics was significantly higher in class A and B β-lactamase producers than in non-producers (P<0.05 for fluoroquinolone, aztreonam, ceftazidime and meropenem). Combined disk test (CDT) for MBL highest sensitivity and specificity compared to PCR. Combined disk method (CDM) for ESBL co-related well with PCR (sensitivity and specificity).Conclusion: This study reports the validation of a simple and accurate MBL and ESBL detection method which can be easily integrated into the daily routine of a clinical laboratory.Â

Bacterial and antimicrobial resistance profile of bloodstream infections: A hospital-based study

Background: Bloodstream infections (BSIs) are one of the serious infections causing significant morbidity and mortality among hospitalized patients. Large numbers of cases of treatment failure are being reported due to emergence of drug resistance. Early microbiological diagnosis and determination of antimicrobial susceptibility pattern have been shown to improve treatment outcome. The present study was aimed to determine the bacterial and antimicrobial resistance profile of BSIs in a major tertiary care hospital. Materials and Methods: Blood samples in brain heart infusion (BHI) broth submitted to the microbiology laboratory for culture and sensitivity during a period of 1 year were included in the study. Samples were processed as per standard protocol of laboratory for isolation and identification. The antimicrobial susceptibility profile of bacterial isolates was determined by the disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Out of 4862 blood samples, 494 (10.16%) isolates were obtained. Of these isolates, 256 (51.82%) were Gram-negative and 230 (46.56%) were Gram-positive bacteria. The most commonly identified organism was coagulase-negative Staphylococcus (CoNS) (25.91%) followed by Acinetobacter spp. (20.24%) and Escherichia coli (14.98%). Gram-negative bacteria showed a higher rate of resistance as compared with Gram-positive bacteria. Conclusion: High prevalence of antimicrobial resistance was noted in this study, especially in Gram-negative bacteria. Hence, appropriate treatment of BSIs should be based on the current knowledge of bacterial resistance profile as provided by microbiology laboratory. It would be advisable for the clinicians to mandate antimicrobial sensitivity testing for suspected cases of BSIs

A study on pre-XDR & XDR tuberculosis & their prevalent genotypes in clinical isolates of Mycobacterium tuberculosis in north India

Background & objectives: Pre-extensively drug resistant (pre-XDR) and extensively drug resistant tuberculosis (XDR-TB) have been areas of growing concern, and are posing threat to global efforts of TB control. The present study was planned to study the presence of pre-XDR and XDR Mycobacterium tuberculosis and their genotypes in clinical isolates obtained from previously treated cases of pulmonary TB. Methods: A total of 219 isolates obtained from previously treated cases of pulmonary TB were subjected to first-line (streptomycin, isoniazid, rifampicin and ethambutol) and second-line (ofloxacin, kanamycin, capreomycin and amikacin) drug susceptibility testing on solid Lowenstein-Jensen medium by proportion method. Genotyping was done for pre-XDR and XDR-TB isolates using 12 loci Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR). Results: Multi-drug resistance was observed in 39.7 per cent (87/219) isolates. pre-XDR and XDR M. tuberculosis isolates amongst 87 multi-drug resistant (MDR) TB isolates were 43 (49.4%) and 10 (11.4%), respectively. Two most dominant genotypes among pre-XDR and XDR M. tuberculosis isolates were Beijing and Delhi/CAS types. Interpretation & conclusions: Resistance to second-line anti-tubercular drugs should be routinely assessed in areas endemic for TB. Similar genotype patterns were seen in pre-XDR and XDR-TB isolates. Beijing and Delhi/CAS were predominant genotypes

Surveillance of health-care workers for nasal carriage to detect multidrug-resistant Staphylococcus spp. in a tertiary care center: An observational study

Background: Healthcare-associated infection (HCAI) has become a potential risk worldwide. Staphylococcus spp., especially methicillin-resistant Staphylococcus aureus (MRSA) is one of the frequent causes of HCAIs. Coagulase-negative Staphylococcus (CoNS), previously considered as contaminants, now emerged as opportunist nosocomial pathogens for causing HCAIs such as bloodstream infections. Health-care workers (HCWs) play a role in colonizing and transmit microorganism to patient causing HCAIs. The purpose of this study was for surveillance of MRSA and MR-CoNS as nasal colonizer among HCWs and its antimicrobial susceptibility pattern. Materials and Methods: Nasal swabs were collected from 214 HCWs such as doctor, nurse, sweepers, ward boy, and operation theatre (OT) assistant working in Intensive Care Unit and OT and ward. Methicillin resistance among the Staphylococcus spp. isolates were detected using cefoxitin 30 μg disc. Antimicrobial susceptibility profile of the Staphylococcus spp. isolates were also determined for several other antibiotics. Results: Of 214 nasal swabs collected from HCWs, 97.6% of doctors, 93.2% of nurses, and 94.6% of sweepers showed growth of Staphylococcus spp. MRSA was 13%, 6.7%, and 14.2% in samples obtained from anterior nares of doctors, nurses, and sweepers, respectively. MR-CoNS were 41.6%, 32.4%, and 32.1% in samples obtained from anterior nares of doctors, nurses, and sweepers, respectively. Conclusion: Multidrug-resistance Staphylococcus spp. carriage is very high among HCWs in our tertiary care center. Our study created awareness among HCWs by educating them about nasal carriage of MDR organisms

<i style="mso-bidi-font-style:normal"><span style="font-size:11.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-bidi-font-family:Mangal;mso-ansi-language:EN-GB; mso-fareast-language:EN-US;mso-bidi-language:HI" lang="EN-GB">In vitro</span></i><span style="font-size:11.0pt;font-family:"Times New Roman";mso-fareast-font-family: "Times New Roman";mso-bidi-font-family:Mangal;mso-ansi-language:EN-GB; mso-fareast-language:EN-US;mso-bidi-language:HI" lang="EN-GB"> validation of self designed “universal human Influenza A siRNA”</span>

514-521<span style="font-size:11.0pt;font-family: " times="" new="" roman";mso-fareast-font-family:"times="" roman";mso-bidi-font-family:="" mangal;mso-ansi-language:en-gb;mso-fareast-language:en-us;mso-bidi-language:="" hi"="" lang="EN-GB">The genomic variability of Influenza A virus (IAV) makes it difficult for the existing vaccines or anti-influenza drugs to control. The siRNA targeting viral gene induces RNAi mechanism in the host and silent the gene by cleaving mRNA. In this study, we developed an universal siRNA and validated its efficiency in vitro. The siRNA was designed rationally, targeting the most conserved region (delineated with the help of multiple sequence alignment) of M gene of IAV strains. Three level screening method was adopted, and the most efficient one was selected on the basis of its unique position in the conserved region. The siRNA efficacy was confirmed in vitro with the Madin Darby Canine Kidney (MDCK) cell line for IAV propagation using two clinical isolates i.e., Influenza A/H3N2 and Influenza A/pdmH1N1. Of the total 168 strains worldwide and 33 strains from India, 97 bp long (position 137-233) conserved region was identified. The longest ORF of matrix gene was targeted by the selected siRNA, which showed 73.6% inhibition in replication of Influenza A/pdmH1N1 and 62.1% inhibition in replication of Influenza A/H3N2 at 48 h post infection on MDCK cell line. This study provides a basis for the development of siRNA which can be used as universal anti-IAV therapeutic agent.</span