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June 2022 Volume 8 Issue 2

“Diagnostic accuracy of Rapid Antigen Kit (RAT) and RT-PCR assay at a Tertiary Care Centre”

R.Sujatha, Nashra afaq, Deepak Sameer

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Background: The Corona virus Disease-2019 (COVID-19) pandemics have led to significant morbidity, mortality in addition to unprecedented disruption of economic activities globally. Tests with high sensitivity and specificity are crucial for the identification and management of COVID19 patients.

Aim: To validate the diagnostic accuracy of Rapid Antigen Detection Kit with Comparison to RTPCR Assay.

Material and Methods: This was a cross sectional study which was carried in the Department of Microbiology, RMCH&RC for a period of 2 months i.e, in Jan to February2022. The performance of the STANDARD Q COVID-19 Ag Test for the detection of SARS-CoV-2 antigen was evaluated in comparison to RT-PCR KIT Tru PCR in 342 symptomatic patients who presented to health care facility at a tertiary care. Out of two samples taken from each patient, one sample was tested using the STANDARD Q COVID-19 antigen test and the other using RT-PCR (Tru PCR Kit).

Results: A total of 342 samples were included in our study. The Males were 209 (61.11%) and Females were 133 (38.8%). Mean age was found in 21-40 age group, and 51-60 years. Only 6.1% patients were admitted to ICU, 82.74% were IPD patients, 17.25% were OPD patients respectively. RT-PCR ct-value was found between 18-21 and 29-32 cycles. The sensitivity, specificity of the RAT was found to be 54.4%, 99.2% respectively.

Conclusions: Our study results show that the Rapid antigen test has a reasonable sensitivity, high specificity , RAT cannot replace the gold standard RT-PCR assays, they can helped us immensely in detecting and diagnosing COVID-19 at its early stage and also by large scale screening of communities residing in hot-spot areas with high incidence of disease..

“The Rising Threat of Drug Resistant in Pseudomonas (P. Aeruginosa) in Patients Attending a Tertiary Care Hospital, Kanpur.”

R.Sujatha, Nashra afaq, Deepak Sameer

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Introduction: The potentiality of Pseudomonas spp. to produce variety of drug resistance mechanism has led to evolution of drug resistant phenotypes with its ability to rapidly develop resistant to multiple cases of antibiotics. Although the impact of resistance mechanisms on mobile genetic elements is always a concern, the most different change we face with pseudomonas is its ability to rapidly develop resistance driving challenge for clinicians in the treatment of severe patients.
Aim: To determine the rising threat of Drug resistant in Pseudomonas (P. aeruginosa) inpatients attending a tertiary care hospital Kanpur. Materials and Methods: The study was carried out in the Dept. of Microbiology RMCH &RC for a period of 6 months from Jan 2021 to June 2021. A total of 27 isolates of P. aeruginosawere isolated from 302 clinical samples of patients attending a tertiary care centre. Antimicrobial Susceptibility Testing (AST) was performed for all isolates by standard KirbyBauer disc diffusion method on Mueller Hinton Agar (MHA) according to the CLSI guidelines. Phenotypic profiling of Extended Spectrum b-Lactamase (ESBL) and Metallo b-Lactamase (MBL) was performed by disc potentiation test Imipenemase (IMP). The obtained results were statistically analysed.
Result: Out of 302 total clinical samples, 27 isolates were P. aeruginosawith the incidence rate of 8.94%.Males were more as compared to Females with (62.96%) and(37.03%) respectively. The maximum age group was seen in 21-40 age group 33.33%.Among 27 patients IPD patients were (89%) and OPD with (11%). Pus samples was the most common sample isolated (66.66%). Out of 27 isolates 11(40.74%) were ESBL producers and 6 (22.2%) and were MBL producers. Among 27 Pseudomonas isolates, 11 (40%) were MDR phenotypes, 2 (7.4%) were XDR phenotypes and there were no PDR phenotypes isolated in present study as all isolates were 100% sensitive to Colistin and Polymyxin B.
Conclusion: Strict antibiotic policies and regular surveillance programme for antimicrobial resistance should be tailored to fend off the emergence of drug resistant P. aeruginosa. Colistin and Polymyxin B still shows high sensitivity against MDR P. aeruginosa and XDR P. aeruginosa phenotypes. Early detection of b-lactamases should be performed regularly for all clinical isolates of Pseudomonas aeruginosa toguide antibiotic selection and for the better management of serious infection...

“Seroprevalence of Hepatitis B Surface Antigen, Antibodies to the Hepatitis C Virus, and Human Immunodeficiency Virus at a Tertiary Care Centre, Kanpur-A Retrospective Study”

R.Sujatha, Divi Agarwal

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Introduction: Hepatitis B, hepatitis C, and HIV infections are a serious global and public health problem. To assess the magnitude and dynamics of disease transmission and for its prevention and control, the study of its seroprevalence is important.
Aim: This study was undertaken to estimate the seroprevalence of hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C (anti-HCV Ab) and human immunodeficiency virus (antiHIV Ab) in a tertiary care hospital, Kanpur India.
Material and Methods: This was a retrospective study conducted in the Department of Microbiology, Rama Medical College, Hospital & Research Centre, Mandhana,Kanpur, for a period of 1 year. Study period= Jan.1st 2021 to Dec. 31st 2021. The data of viral markers was retrieved fromMedical Record and Hospital Information System over a period of 12 months from patients attending OPDs and admitted to various IPDs within the hospital-based lab for the detection of HBsAg and anti-HCV Antibodies and anti-HIV Antibodies using rapid card tests and further confirmation of all reactive samples by a micro particle enzyme immunoassay(Erba Lisa by Transisia, Biomedical Ltd)
Results: Theseroprevalence of HBsAg was found to be 3.85%, of anti-HCV Ab as 3.51%, and of anti-HIV Ab as 0.34%.
Conclusion: The study throws light on the magnitude of viral transmission in the community (Hepatitis B Virus) infection is showing aincreasing trend and theHCV(Hepatitis C Virus) infection, a fluctuating trend. Attempt should be made to reducethe incidence of HBV and HCV by simple preventive measures likepublic education, screening of blood and blood products, increasing public awareness about importance of vaccination for HBV

“Molecular Characterization of Blaimp-1 Gene and Identification of Metallo-Beta-Lactamase Producers among Carbapenem Resistant Pseudomonas Aeruginosai isolated from Hospitalized Patients in a Tertiary Care Hospital, Kanpur”

R.Sujatha, Nashra afaq, Deepak Sameer

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Introduction: Pseudomonas aeruginosa has the ability to persist in both community as well as the hospital settings. It is an important cause of multidrug-resistant nosocomial infections. Carbapenems are the drug of choice for the infections caused by Pseudomonas aeruginosa but worldwide emergence of carbapenem resistance Pseudomonas aeruginosa including resistance to beta-lactams, Aminoglycosides, and Fluoroquinolones represents an extraordinary threat to public health.
Aim and Objectives: To study the Molecular Characterization of blaIMP-1 gene and study of metallo-beta-lactamase producers among carbapenem resistant Pseudomonas aeruginosa isolated from Hospitalized Patients in a Tertiary care hospital, Kanpur.
Material and Methods: This was a cross sectional study conducted in the Department of Microbiology, in a Rama medical college hospital & Research centre Kanpur, over a period of one year from March 2021 to March 2022. Ethical clearance was duly obtained from the Institute Ethical Committee for conducting the study. A total of 200 clinical samples were included in our study. The direct microscopic examination and biochemicals test for identification of P. aeruginosa was done. The isolates were then subjected to antimicrobial susceptibility testing by KirbyBauer disk diffusion method according to CLSI guidelines. All positive isolates were further tested by Imipenem- Ethylene diamine tetraacetic acid combined disc test and Modified Hodge Test (MHT) for the MBL detection. Isolates tested positive in the phenotypic test are subjected to conventional PCR for detection of the gene coding for MBLs. The DNA Extraction of the test isolates was carried out followed by the PCR.
Results: Out of 200 clinical isolates, there was 86 (43%) isolated from urine, 37 (18.5%) from trachea, 32 (16%) from lesion, 27 (13.5%) from blood, 18 (9%) from pus. There was 130 isolates which was found resistant to imipenem. Of the 130 imipenem resistant isolates, 108(83%) was MBL producer as determined by CDDT. All MBL producing isolates was found resistant to the examined antibiotics. The results of amplified genes by PCR showed that 28 MBL-producing isolates contained blaIMP-1.
Conclusion: The screening for MBL production in microbiology laboratories is very important for the treatment of patients, specially hospitalized patients and also to prevent the possible spread of resistance to other Gram-negative organisms because of their broad-spectrum drug resistance which creates a therapeutic challenge to the clinicians

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