ANTIMICROBIAL PROFILE OF URINARY PATHOGENS TO DETERMINE EMPIRICAL THERAPY FOR URINARY TRACT INFECTIONS IN A RURAL TEACHING HOSPITAL OF WEST BENGAL.

Background: Urinary tract infection (UTI) remains one of the common infections in OPD as well as hospitalized patients with significant morbidity. To acquire knowledge of pathogens and their antibiotic susceptibility pattern area specific studies are necessary to establish an appropriate empirical therapy. Aim: To see the drug resistance patterns of bacterial uropathogens to antimicrobials in our setting. Study design: One year ,Retrospective study ( March 2011 to February 2012) Material and methods: Sent sample from different OPD and IPD were processed by culture on CLED medium to isolate the organism/s. Different biochemical test were used to identify the organism/s. Antibiotic sensitivity testing(AST) were done on Muller Hinton agar by the Kirby Bauer disk diffusion method . The result of AST were analyzed. Results: E.coli (53.6%) was observed to be the predominant uropathogen followed by enterococcus (15.5%). Among fermentative Gram negative bacilli (GNB) commonly isolated E.coli showed maximum resistance to aminoglycosides eg gentamicin 53.6% , Fluroquinolones eg ciprofloxacin 64%, third generation cephalosporins ie ceftriaxone 62.9% and among Gram positive organisms ciprofloxacin resistance were as high as 40%. However imipenam was found to be most effective drug against  GNB followed by nitrofurantoin and Vancomycin agaist gram positive organisms followed by nitrofurantoin again . Conclusion : Nitrofurantoin found to be most useful antibiotic affective against both gram negative and gram positive organisms can be given orallyalso highlighting the main advantage of this drug . Key words: Urinary tract infection (UTI), Uropathogens, Empirical treatemen

Study of biofilm formation among uropathogens isolated from catheter-associated UTI patient from a tertiary care hospital

Background: Catheter-associated urinary tract infection (CAUTI) is a serious health threat and challenging infection. CAUTI accounts for up to 40% of all nosocomial infections. Biofilm provides a survival strategy to microorganisms and ultimately leads to re-infections and recurrence of urinary tract infections (UTI) despite a full course of antibiotics. Aims and Objectives: The present study was conducted to determine the prevalence of CAUTI in suspected UTI patients and prevalence of biofilm-forming uropathogens among CAUTI patients. Materials and Methods: The cross-sectional study was done over a period of 6 months among 95 catheterized CAUTI patients. Biofilm production among isolated uropathogens was tested by tissue culture plate, tube test, and congo red agar method. Isolates were identified as biofilm producer if they were tested positive by any one of the all four methods, and isolates were considered biofilm non-producer in consensus with all four methods. Results: In this study, the prevalence of CAUTI was 68.42%. Among 65 isolates most common uropathogen was 28 (43.07%) Escherichia coli. In this present study, the prevalence of biofilm-forming uropathogens was 58.46% (38). Tissue culture plate was the most sensitive (97.36%) method in detecting biofilm formation followed by modified congo red agar (82.21%), congo red agar (71.05%), and tube test (65.78%). Biofilm productions were significantly associated with female gender, diabetes, and prolonged catheterization. Conclusion: Indwelling urinary catheter acts as a nidus for biofilm formation among microorganisms. Duration of catheterization is inversely associated with UTI. Hence, the need for catheter removal should be assessed daily to prevent infection. Periodic surveillance should be done to detect biofilm formation where prolonged catheterization is inevitable

Unfolding government policies towards the development of climate smart agriculture in India

The main aim of this paper is to map agricultural policies and programmes, with components of climate smart agriculture, implemented by the Government of India (GoI). Although climate resilience is not the explicit goal of these, our analysis shows that the GoI has been spending 15% of the total expenditure for agriculture towards enhancing resilience on agriculture to climate change. This expenditure has been made through micro-irrigation, watershed development and conservation agriculture under National Food Security Mission (NFSM), National Mission for Sustainable Agriculture (NMSA), National Horticulture Mission (NHM), Rasthrya Krishi Vikas Yojana (RKVY), crop insurance, neem coated urea, and weather advisory systems. Moreover, the government of India is committed to invest Rs 838 billion towards development of climate smart agriculture in the coming five years. We can argue that the increase in public expenditure will also attract significant additional investments from farmers, private sectors and state governments. This large resource commitment by the central and state governments and the farmers of India will have a greater impact on agrarian economy and environment only if there is a greater convergence among different programmes and more farmers’ participation in thes