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March 2023 Volume 9 Issue 1

Identification and antibiotic profile of Pseudomonas aeruginosa from different clinical samples at a tertiary care hospital, Kanpur, Uttar Pradesh.

Isha yadav, R.Sujatha, Nashra Afaq

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Background: Pseudomonas aeruginosa (P. aeruginosa) is an epitome of opportunistic nosocomial pathogen, which causes a wide spectrum of infections and leads to substantial morbidity in immuno-compromised patients. Despite therapy, the mortality due to nosocomial pseudomonal pneumonia is approximately 70%.

Aim and Objective: The aim of this study was to identify and isolate Pseudomonas aeruginosa and to find its antibiotic pattern in different clinical samples.

Material & Methods: This was a retrospective study.  A total 1140 samples were asessed during the time period of one year i.e., January to December 2022. All the samples were collected and process in the microbiology laboratory of RMCH&RC.

Results:  Out of 1140 different clinical samples 62(5.43%) Pseudomonas aeruginosa isolates were isolated and it is more in males(82.2%) than females(17.7%).maximum numbers of isolates were isolated from the pus samples(64.5%), mostly from the surgery ward(27.4%).it is found that Pseudomonas aeruginosa shows maximum sensitivity towards meropenem, imipenem,amikacin and 100% sensitive against piperacillin-tazobactum, polymyxin B and colistin.

Conclusion: As it was more prominent in the patients from surgery ward it is important to follow bundle care and should monitor the use of antibiotic susceptibility pattern of P.aeruginosa which will help in the treatment and will automatically reduce infections rate in the hospitals

To study the Prevalence and Antimicrobial Susceptibility Pattern of Coagulase-negative Staphylococci (CoNS) isolated from various clinical sample at a Tertiary care centre, Uttar Pradesh.

R. Sujatha NashraAfaq

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Introduction: Coagulase negative Staphylococci (CoNS) are one of the most common bacteria found on human skin and on mucous membranes as a normal flora. The presence of CoNS in clinical specimens is frequently associated with an infectious aetiology or contamination. CoNS are significant and commonly encountered pathogens in hospitals and they are occurring as the most preponderant isolates of all nosocomial infections.

Aim and Objective: To study the Prevalence and Antimicrobial Susceptibility Pattern of Coagulase-negative Staphylococci (CoNS) isolated from various clinical sample at a Tertiary care centre.

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, October 2021 to October 2022. A total of 58 CONS were isolated from 426 clinically relevant samples. The organisms were identified using the biochemical test from the clinical samples such as pus,  wound swab, blood, throat swab and urine . The strains were identified as CoNS by colony morphology, Gram stain, catalase test and coagulase test. Bacitracin sensitivity was done to exclude Micrococci and Stomatococcus species. The antibiotic sensitivity testing was performed on Muller-Hinton agar by the Kirby-Bauer’s disc diffusion method according to the CLSI guidelines.

Results: A total of 58 CONS were isolated from 426 clinically relevant samples. Out of the 58 isolates, 39(67.2%) were from wounds, 7(12%) from sputum and least for 1(1.7%) from throat swabs. The highest number of CoNS isolates were Staphylococcus epidermidis 31 (53.4%) and least for Staphylococcus saprophyticus 5 (8.6%). The CoNS in various clinical samples displayed Staphylococcus epidermidis as the predominant species isolated from pus & wound. The antibiotic sensitivity pattern of the isolates revealed 72.4 % resistance to ampicill1in, 53.4 % resistance to Co-trimoxazole and 37.9% resistance to cefoxitin (MRCoNS). There was no resistance to vancomycin and gentamicin observed.

Conclusion The increase in the resistance patterns and prevalence of CoNS is a result of frequent use of intravascular devices and raise in the number of immunocompromised patients in hospitals. This scenario emphasizes the need for rapid identification and speciation of CoNS with their antibiotic susceptibility for improved management of such cases and prevent emergence of drug resistance

Prevalence of Candida species infection among intensive care unit patients at tertiary care hospital, Kanpur, Uttar Pradesh

Akanksha Singh Chauhan, R.Sujatha, Nashra Afaq

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Introduction: The presence of Candida in urine, called Candiduria. Immunocompromised individuals are more susceptible to this infection and it can cause life-threatening complications. Candida albicans is most common isolate in Urinary Tract Infections (UTI) but in recent years this is shifting to non-albicans groups. Researchers found that azole is the drug of choice against Candida infections but due to excess use of these drugs resistance is developing more frequently for azole group drugs and drug resistant isolates are increasing gradually. A unique virulence factor i.e biofilm production, similarly like bacterial species is a crucial factor which contributes to the resistance against antifungal drugs.

Objective: To assess the prevalence of Candida species among intensive care unit patients (ICU).

Material & Methods:  An institutional based cross–sectional study was conducted in Department of Microbiology, Rama Medical College Hospital & Research Centre, Kanpur, Uttar-Pradesh, India for a period of 6 months i.e, from January 2023 to June 2023. A total of 60 samples of foley’s tip were collected for this study from Intensive care unit (ICU) and different wards of the hospital belonging to the age group 15 to 75 years of age. 60 foley’s tip samples received. They were processed by standard microbiological procedures. Isolated organisms were speciated as per guidelines.

Result: Among these 60 foley’s tip samples from various wards and ICUs were culture on Hichrome agar to isolate the Candida species. Out of 60 culture samples 45 samples showed positive growth for Candida species and remaining 15 samples was culture negative. In culture positive cases 32 (71.1%) were females and remaining 13(28.88%) were males. Diabetes mellitus was the main co-morbidity factor in Candiduria patients. The incidence rate was high in ICU patients than in non ICU patients. Most the samples were isolated from general medicine and Obstetrics and Gynaecology department followed by general surgery.

Conclusion: Present study found the high prevalence of candiduria and the isolates were biofilm producers with increasing resistance against most common drugs fluconazole which is a major concern for the treatment and management aspects. In immunocompromised patients, it is important to identify the species of Candida isolates as well as their antifungal susceptibility pattern to assist the clinicians in treating the patients with candiduria.



A Study of Urinary Tract Infection in adolescent girls at tertiary care hospital, Kanpur Uttar Pradesh

Meghna Mishra, R.Sujatha, Nashra Afaq

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Introduction: Urinary tract infection (UTI) is very common among females in all age groups. During adolescence, hormonal changes favor vaginal colonization by nephritogenic strains of bacteria, which can migrate to the periurethral area and cause urinary tract infection. It is associated with poor self-esteem, impaired quality of life, social isolation, and depression. Many factors like low water intake, infrequent voiding and poor menstrual and sexual hygiene have been implicated in UTI during adolescence.

Objective: The study aimed at determining the prevalence of E. coli and its antimicrobial susceptibility profiles among adolescence presenting with signs and symptoms of UTI.

Material & Methods- The present cross sectional study was conducted in Department of Microbiology for a period of 6 months i.e, January 2023 to June 2023 at Rama Medical College Hospital & Research Centre, Kanpur, Uttar-Pradesh. A total of 50 cases aged 10-19 years were included and clinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivity patterns were documented.

Result: Out of 50 cases of adolescent girls 13 were culture positive for E. coli and remaining 37 was culture positive for other bacterial pathogens. In which girls belonging to the age group 14-18 years of age are highly affected. The most common symptom was burning during micturition which was present in 30.67% girls followed by frequency and others. Inadequate water intake, poor menstrual and vaginal discharge was the important risk factors. Antibiotic sensitivity pattern of E. coli revealed that maximum sensitivity was seen for to Piperacillin–tazobactam (100%), Polymyxin-B (100%), and Colistin (100%), followed by Meropenem (95.9%) Imipenem (85.7%), Tobramycin (91.3%), Tigecycline (88.2%).

Conclusion: Infections of the urinary tract are one of the commonest infections inadolescent girls and are a major threat for morbidity and mortality.  This study was carried out to determine the susceptibility patterns of the E. coli. This study suggests use ofPiperacillin–tazobactam, Polymyxin -B, Colistin followed by Meropenem, Imipenem, Tobramycin andTigecyclinefor treatment of UTI in adolescent girls based on antimicrobial susceptibility pattern in our region.

Prevalence and Antibiotic Susceptibility Pattern of Klebsiella spp. isolated from various clinical samples at a tertiary care centre

Arpita Kushwaha, R.Sujatha, Nashra Afaq

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Introduction: Klebsiella belongs to the genus of Enterobacteriaceae family, which are ubiquitous in nature. K. pneumoniae and K. oxytocais are the most common pathogen. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality.

Aim: This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples.

Material and Methods: This prospective study was conducted in our tertiary care hospital RMCH&RC, Kanpur for a period of 1 year i.e., during the period from January 2021 to December 2021. A total of 155 non reapeat isolates were obtained from various samples include blood, sputum, urine, and pus etc. Antibiotics sensitivity were tested by Kirby-Bauer's disc diffusion method according to gthe CLSI guidelines 2020.

Results: Out of the 155 isolates, 94 (60%) were male and 61 (40%) were females. Out of 155 isolates, the mean age group was 33-60 years of age. Among 155 Klebsiella isolates, 59 were urine samples, 49 were pus samples, 14 werefolye’s tip, 8 were tracheal tube, 7 were blood cultures, 4 were ET-secretion, 5 were Throat swab, 8 were sputum and 1 were Bone pus.Among the 155 Klebsiellaspp identified, K. oxytoca was 83, and 72 were K. pneumonia species and the sensitivity was noted to be higher to Polymyxin-B (100%) and Colistin (100%).

Conclusions: Thus, this study shows the prevalence rate of Klebsiella oxytoca to be high. Since the frequency of multiple drug resistance among Klebsiella species is alarmingly high, therefore periodic monitoring of antimicrobial susceptibility profile of these agents is much needed, to treat the infection with appropriate antibiotics.

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