DRUG RESISTANCE PATTERNS OF CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN TERTIARY CARE CENTER OF SOUTH INDIA

Objectives: Staphylococcus aureus were initially described in 1961 and emerged in the last decade as one of the most important nosocomial pathogens. The current study was undertaken to provide data for empirical selection of appropriate antibiotics for the treatment of diseases caused by S. aureus. Methods: Various clinical samples like pus, urine, stool, sputum, blood and other body fluids of patients were selected for study from June 2012 to June 2013. Staphylococcus aureus were identified by various biochemical tests and antimicrobial susceptibility testing of the isolates were performed by Kirby Bauer disc diffusion method. Detection of the MRSA was done by Oxacillin disc diffusion method.Results: A total of 137 isolates of S. aureus were obtained over duration of 12 months. These included isolates from the sample of pus, urine, sputum, body fluids. Out of 137 S. aureus strains isolated, 62 (45.3%) were identified as MRSA and 75 (54.7%) were identified as MSSA based on oxacillin disk diffusion method. Anti-biograms revealed the high level of resistance among MRSA isolates when compared to MSSA isolates The most effective agent against MRSA isolates was linezolid (96.8%sensitive), followed by tetracycline (90.9%) and piperacillin/tazobactam (80.6%).Conclusion: The prevalence of MRSA in our hospital was high. Therefore to reduce the incidence of infections due to MRSA, we suggest implementation of the strict antibiotic policy guidelines and continuous monitoring of antibiotic susceptibility patterns of such pathogens.Â

Sodium Hypochlorite Sedimentation Technique: A Simple Way to Enhance Sensitivity of Ziehl-Neelsen Stain in Diagnosis of Smear Negative Pulmonary Tuberculosis

Background: With the looming global HIV pandemic, the problem of tuberculosis tiptoes as a perpetual companion. Smear negative pulmonary tuberculosis which pose substantially a challenge for diagnosis, hoots this combination into noxious health problem. There is, therefore, an urgent need to establish more sensitive, safe and fairly rapid methodologies that could confirm diagnosis particularly in smear negative pulmonary tuberculosis patients. Aim: This study was carried out to establish whether, 3.5% sodium hypochlorite overnight sedimentation method improves the sensitivity of Ziehl-Neelsen (ZN) stain in samples declared as smear negative. Material and Methods: A total of 605 direct ZN smear negative sputum specimens were examined after concentration with 3.5% sodium hypochlorite overnight sedimentation method. Results: Forty one (6.77%) samples were found to be positive when smears were repeated after performing sodium hypochlorite sedimentation technique. Sensitivity and specificity of this method was found to be 76.31% and 97.88% respectively. Conclusion: 3.5% Sodium hypochlorite sedimentation technique has the potential to improve the diagnosis in tuberculosis in smear negative pulmonary tuberculosis cases especially in resource poor countries

Sequence of oral manifestations in rhino-maxillary mucormycosis

Mucormycosis, caused by saprophytic fungi of the order Mucorales of the class Zygomycetes, is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. These fungi are ubiquitous, found in soil, bread molds, decaying fruits and vegetables. The most common form of mucormycosis is rhinocerebral and is usually seen in uncontrolled diabetes mellitus or in immunocompromised patients. This fungus invades the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of palatal perforation by rhino-maxillary mucormycosis in an immunocompromised patient. The aim of this article is to draw attention to the clinical presentation and pathogenesis of mucormycosis and to emphasize the need for high degree of suspicion in its diagnosis and management

RAPIDIRON Trial follow-up study — the RAPIDIRON-KIDS Study: protocol of a prospective observational follow-up study

Abstract Background Anemia is a worldwide problem with iron deficiency being the most common cause. When anemia occurs in pregnancy, it increases the risk of adverse maternal, fetal, and postnatal outcomes. It induces preterm births and low birth weight (LBW) deliveries, long-term neurodevelopmental sequelae, and an increased risk of earlier onset of postnatal iron deficiency. Anemia rates are among the highest in South Asia, and India’s National Family Health Survey (NFHS-5) for 2019–2021 indicated that over half of pregnant women, and more than 65% of children, in the country are classified as anemic (Sciences IIfP, National Family Health Survey-5, 2019–21, India Fact Sheet). In 2021, the parent RAPIDIRON Trial (Derman et al., Trials 22:649, 2021) was initiated in two states in India, with the goal of assessing whether a dose of intravenous (IV) iron given to anemic women during early pregnancy results in a greater proportion of participants with normal hemoglobin concentrations in the third trimester and a lower proportion of participants with LBW deliveries compared to oral iron. As a follow-up to the RAPIDIRON Trial, the RAPIDIRON-KIDS Study will follow the offspring of previously randomized mothers to assess, neurobehavioral, hematological, and health outcomes. Methods This prospective observational cohort study will follow a subset of participants previously randomized as part of the RAPIDIRON Trial and their newborns. Study visits occur at birth, 6 weeks, 4 months, 12 months, 24 months, and 36 months and include blood sample collection with both maternal and infant participants and specific neurobehavioral assessments conducted with the infants (depending on the study visit). The primary outcomes of interest are (1) infant iron status as indicated by both hemoglobin and ferritin (a) at birth and (b) at 4 months of age and (2) the developmental quotient (DQ) for the cognitive domain of the Bayley Scales of Infant Development Version IV (BSID-IV) at 24 months of age. Discussion This RAPIDIRON-KIDS Study builds upon its parent RAPIDIRON Trial by following a subset of the previously randomized participants and their offspring through the first 3 years of life to assess neurodevelopmental and neurobehavioral (infants, children), hematological, and health outcomes. Trial registration ClinicalTrials.gov NCT05504863 , Registered on 17 August 2022. Clinical Trials Registry – India CTRI/2022/05/042933 . Registered on 31 May 2022