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December 2022 Volume 8 Issue 4

1. To Study the Phenotypic and Genotypic Characterization Method for the Detection of Methicillin Resistant Staphylococcus aureus Isolates at a Tertiary Care Hospital, Uttar pradesh.

NashraAfaq, R. Sujatha

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Introduction: MRSA strains have become a severe clinical and epidemiological problem in recent years, as resistance to this antibiotic suggests resistance to beta-lactam antibiotics. The aim of the present study was to compare the Phenotypic and Genotypic Characterization Method for the Detection of Methicillin Resistant Staphylococcus aureus.

Aim and Objective:  To Study the Phenotypic and Genotypic Characterization Method for the Detection of Methicillin Resistant Staphylococcus aureus Isolates at a Tertiary Care Hospital, Uttar pradesh.

Material and Methods: This was a cross sectional study conducted in the Department of Microbiology at RMCHRC, Mandhana, Uttar Pradesh for a period of 1 year i.e, November 2021 to November 2022. A total of 965 clinical isolates was studied in which 210 isolates of S. aureus were identified using the biochemical test from the clinical samples such as pus, swab, blood, wound and urine etc. The Comparison of Different Phenotypic Methods including Cefoxitin and Oxacillin Disc Diffusion test and the genotypic method including MecA gene detection for Methicillin Resistant Staphylococcus aureus Isolates was performed.

Results:  A total of 210 S.aureus isolates were identified from a total of 965 clinical samples out of which 58 isolates were identified as the MRSA isolates. The gold standard method was chosen to be the genotypic method as well as the Cexofitin disc diffusion method for the phenotypic detection. The cefoxitin and the Mec A gene by PCR detected all the 58 isoaltes whereas oxacillin was found to be less sensitive. The MRSA isolates were highly susceptible to teicoplanin, vancomycin and linezolid.

Conclusion: The Genotypic method as well as the Cefoxin disc diffusion method was observed to be equally susceptibility for testing of MRSA as comparative to the oxacillin method. Therefore Cefoxitin is better than the other phenotypic method and is highly recommended to be used as a surrogate marker for the detection of Methicillin resistance in S.aureus, in resource constraint setups that cannot afford PCR testing for mecA as a confirmatory test

2. Antibody Titer against Hepatitis-B in Healthcare Workers: A Cross-Sectional Study in Microbilogy Department at Rama Medical Collage Hospital and Research Centre, Kanpur

Aman Singh, R. Sujatha NashraAfaq

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Introduction: Hepatitis is an inflammation of the liver that can reason a variety of health problems and can be fatal.  In developing countries, Hepatitis B vaccination coverage among Healthcare Workers (HCWs) is very low for various reasons. Immunization protection for HCWs for prevention and controlling HBV infection is mandatory for this vaccine preventable disease. Vaccination for doctors, nurses, paramedical staff, and nursing students is mandated for this high-risk prevention of the disease.

Aim: To determine the antibody titer against Hepatitis B in healthcare workers in microbiology department at Rama Medical Collage Hospital and Research Centre, Kanpur.

Material and Methods: This was a cross-sectional study conducted in the department of microbiology, RMCH&RH Kanpur, India for a period of 3 months i.e., from April 2023-June 2023. Serum samples were collected from 36 HCWs and their vaccination history was collected. Those who had taken all three doses of hepatitis B were considered to be fully vaccinated those that had taken two doses as partially vaccinated. Anti HBs antibody Titers were assessed by enzyme linked immunosorbent assay method.

Results: In the present study among 36 samples 10(27.7%) were fully vaccinated, 15(41.6%) were partially vaccinated and 11(30.5%) were not vaccinated, out of which male were 19(52.7%) and females were 17(47.2%). Anti-HBs titers were protective in 12 (33.3%) which belonged 75% (9/12) to vaccinated category and 25% (3/12) to partially vaccinated category.

Conclusion: There is a need for well-planned and clear policies for HBV screening and vaccination in HCWs, especially those who are at a greater risk of exposure to blood or other potentially infectious material.

3. “Antibiotic susceptibility pattern of Escherichia coli isolated from various clinical samples at a tertiary care Hospital in Kanpur”

Meghna Mishra, R. Sujatha, Nashra Afaq

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Introduction: Escherichia coli (E. coli) is one of the most common causative agents of bacterial infections E. coli is the leading cause of urinary tract, ear, wound and other infections in humans. Increasing rates of antimicrobial resistance among E. coli is a growing concern worldwide.

Objective: The aim of this study was to determine antimicrobial susceptibility pattern of E. coli from various clinical samples.

Material and Methods: A retrospective study was done on results of cultures of urine, pus, sputum, semen, central line, and foley’s tip that had been performed from April 2022- March 2023 at the Department of Microbiology, Rama medical college, Kanpur. A total of 159 samples were analysed for isolation and identification of bacteria and antimicrobial susceptibility testing.

Result: The prevalence of Escherichia coli isolates were more common in females (60%) than in males (40%). The most affected age group belongs to 25-35 years of age. Among all the various clinical samples E.coli was most prominent pathogen in the urine sample and in pus sample. In the case of various samples, E. coli was found to be highly susceptible to Polymyxin B (100%) colistin (100%), nitrofurantoin (100%), imipenem (98%),meropenem (94%) and gentamycin (88%)  .

Conclusion: Escherichia coli isolated from various clinical specimens showed differences in antibiotic sensitivity patterns, with highly sensitive to commonly used antibiotics where Nitrofurantoin, Polymyxin B, colistin, imipenem, meropenem and gentamycin were considered appropriate for treatment of E. coli. Regular monitoring of antimicrobial susceptibility is recommended.

4. “Isolation and identification of Acinetobacter species from various clinical samples with special reference to its antibiotic susceptibility pattern at tertiary care hospital, Kanpur, Uttar Pradesh”

Akanksha Singh Chauhan, R. Sujatha, Nashra Afaq

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Introduction: Acinetobacter has emerged as significant hospital pathogen, notoriously known to acquire antibiotic resistance to most of the commonly prescribed antimicrobials. Many risk factors are associated with Acinetobacter infections, especially in patients in intensive care unit (ICU). This study aims to isolate Acinetobacter from various clinical specimens and to determine its antimicrobial sensitivity pattern.

Objective: To find out the factors responsible for causing infection from Acinetobacter species and most effective antibiotic for empirical treatment of infection caused by Acinetobacter species.

Material & Method: An institutional based cross–sectional study was conducted in Department of Microbiology, Rama Medical College Hospital & Research Centre, Kanpur, Uttar-Pradesh, India from January 2022 to December 2023. A total of 1140 clinical samples were collected from different wards of hospital and Intensive Care Unit (ICU) with age group 0-80 years. They were processed by standard microbiological procedures. Isolated organisms were speciated, and antibiotic susceptibility performed as per standard guidelines CLSI 2022.

Result: Among these 1,140 samples, 750 clinical samples from various wards were isolated and ICUs were culture positive and showed growth of different microorganisms. Out of these positive isolates, 40 were identified as Acinetobacter species in which 25 (62.5%) were males & 15 (37.5%) were females and in remaining 710 culture positive samples in which E.coli was more predominant isolate followed by Klebsiella species, Pseudomonas aeruginosa, Candida species, Staphylococcus aureus and Enterococccus species.

Conclusion: Acinetobacter species is an emergent and global hospital-acquired pathogen. Drug resistance pattern of Acinetbacter baumannii is quite alarming in our health care settings, so effective infection control practices and judicious use of antibiotics is mandatory.

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