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Mcconnell Byrne posted an update 2 days, 10 hours ago
Background There is a need to generate accurate data on temporal trends in incidence rates, aetiology and antimicrobial susceptibility of central line-associated bloodstream infections (CLABSIs) in the Indian setting. Aim To study the incidence, aetiology and antimicrobial susceptibility of CLABSI in adult, paediatric and neonatal intensive care units (NICUs) in a tertiary care private hospital in Mumbai, India. Materials and methods This is a prospective observational study conducted at the adult, paediatric and NICUs of tertiary care private hospital from 2011 to 2018. CLABSI was defined as per the Centers for Disease Control criteria. Surveillance of CLABSI in the intensive care units (ICUs) was conducted using a form adapted from the International Nosocomial Infection Control Consortium surveillance system. The incidence rates of CLABSI (per 1000 central line days), crude mortality, aetiology and antimicrobial susceptibility were calculated and reported. Results Six hundred and eighty-six episodes of CLABSI were recorded, and the overall incidence of CLABSI was 5/1000 catheter days, 4.1 in the adult ICU, 5 in the paediatric ICU and 9 in the newborn ICU. Crude mortality in patients with CLABSI in the adult, paediatric and NICUs was 45%, 30% and 7%, respectively. Of the 752 isolates, 80% were Gram negative, 10% Gram positive and 10% yeast. The prevalence of extended-spectrum beta-lactamase producers was 80%, and rates of carbapenem resistance were on an average 50%. Conclusions The CLABSI rates at a well-equipped tertiary care hospital are still significantly higher than the USA benchmarks. Alarming rates of drug resistance in Gram-negative pathogens were seen.Purpose Identifying infectious pathogens by collecting intravenous blood (IVB) is a well-established procedure, however, the collection of IVB in field epidemiological study is challenging. The dried blood spot (DBS) as an alternative to IVB has been introduced, although, there is a limited study to demonstrate the utility of DBS stored at various storage conditions and transported at different periods. This is an observational study, which evaluates the effectiveness of DBS in field epidemiological studies to identify infectious pathogens. Materials and methods A total of 264 paired DBS samples prepared from IVB, stored at 4°C, -20°C after period 24, 48 and 72 h. Serologically, enzyme-linked immunosorbent assay [ELISA] IgG antibody detected against Helicobacter pylori infection from DBS and compared with IVB. Results Quantitatively, IgG antibody reactivity showed >87% correlation between IVB and DBS samples stored at 4°C or -20°C within 48 h of transport duration. DBS stored at 4°C shows, equal sensitivity 87.5% and specificity 95% before 48 h of transport duration, while at -20°C storage similar sensitivity 87.5% observed but slightly less specificity 86.36% observed as compared to 24 h of transport duration. selleck compound One-way analysis of variance showed, nonsignificant difference at both (-20°C and 4°C) the stored condition with P value (P > 0.851) and (P > 0.477). Kappa values showed good inter-rater reliability between DBS and IVB in a range (0.77-0.81). Conclusion No significant difference was observed in detecting H. pylori when ELISA was conducted using IVB or DBS stored at 4°C and transported even after 48 h. This confirms that DBS collected even in compromised conditions in the field can be used for detecting infection.Background Knowledge of the local microbiological epidemiology helps in formulating protocols for appropriate treatment of hip infections. The aim of this study was to profile the organisms cultured from infected hips. Methods The microbiological profile and sensitivity pattern of organisms in eighty infected hips were reviewed. Results Infection was secondary to arthroplasty in 35, fracture surgery in 34 and primary septic arthritis in 11. Twenty percent of the infections were polymicrobial, whereas the rest were monomicrobial. Fifty-five percent were Gram-positive, of which 45% were Staphylococcus species (36% methicillin-sensitive Staphylococcus aureus, 20% methicillin-resistant S. aureus, and 44% coagulase sensitive Staphylococcal species). All Staphylococcus species were sensitive to vancomycin, but 20% of Enterococcus species were resistant to vancomycin. One-third of the Enterococcus species and 2% of Staphylococcus species were resistant to teicoplanin. Escherichia coli (n = 10) and Pseudomonas sp. (n = 13) were the most common Gram-negative organism. Although 18% of the Gram-negative organisms were carbapenem resistant, all were sensitive to colistin. Conclusion Staphylococcus sp. was the most common pathogen found in hip infections. However, the high incidence of Gram-negative infection requires that prophylactic antibiotics cover these organisms as well. The high resistance to first-line antibiotics should be taken into consideration while making protocols. The knowledge of the microbial profile is especially important when considering arthroplasty for arthritis secondary to hip infections.Context As reports on colistin resistance are slowly emerging from different parts of the world, it is imperative that the clinical microbiology laboratories should generate accurate in vitro colistin susceptibility results. Aim The aim is to generate preliminary data on the diagnostic utility of MicroScan WalkAway 96 Plus Identification ID/ Antimicrobial susceptibility testing AST system in determining in vitro colistin susceptibility of carbapenem-resistant clinical Gram-negative bacterial isolates. Settings and design A pilot study was conducted in a tertiary care teaching hospital located in Rishikesh, Uttarakhand, between May and June 2019. Materials and methods Thirty-four carbapenem-resistant Escherichia coli, Pseudomonas aeruginosa and Acinetobacter spp. isolated from various non-repetitive clinical samples during the study period, were subjected to antibiotic susceptibility testing using MicroScan ID/AST system. Matrix-assisted laser desorption ionization-time-of-flight mass spectrometry was used to g multi drug resistant infections with limited treatment options.