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June 2020 Volume 6 Issue 2

"Phenotypic and Genotypic Characterization of MRSA in A Tertiary Care Hospital at Kanpur"

R. Sujatha, Deepak S, Nashra A, Arunagiri D

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Background: Methicillin resistant Staphylococcus aureus is a global health challenge nowadays creating problem in antibiotic therapy. This study was aimed to study phenotypic and genotypic characterization of MRSA in order to formulate antibiotic policy for control of MRSA at a tertiary care hospital of Kanpur.

Material and Methods: Clinical samples were processed from hospitalized patients in Rama Medical College Hospital & Research Centre Mandhana, Kanpur. Out of 140 S. aureus isolates 55 were found to be MRSA by disk diffusion method and E- test strip method. Bacterial DNA was extracted and PCR for the detection of Mec A was performed.

Results:  Out of 140 S. aureus isolates, the Prevalence of MRSA was 55 (39.2%). The molecular characterization was performed where the DNA from the test isolates was extracted which was further processed for the PCR for the detection of the Mec A gene. All 55 MRSA samples detected the presence of Mec A gene, which was further confirmed by sequencing. Conclusion: The present study reveals the prevalence of MRSA from the Kanpur region and indicates the magnitude of antibiotic resistance in and around the study area.

“Risk Factors for Catheter Related Bloodstream Infection in Patients at a Hem dialysis Unit and Molecular Characterization of MDR Strains of Staphylococcal Species: A Prospective Study”

Deepak S, R. Sujatha, Nashra A, Arunagiri D

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Background: Catheter-related bloodstream infections are a major complication of central venous catheter use. This study examines risk factors associated with catheter-related bloodstream infections and its Molecular Characterization of MDR S.aureus strains.

Aim and Objectives: This study evaluates the risk factors, antimicrobial resistance and molecular characterization of Staphylococcal species for the development of bloodstream infections in patients undergoing hemo dialysis.

Methods: In this Prospective study, single-center study, chronic renal disease patients on hemo dialysis who presented with positive blood cultures during the study were included during a 1year study period. Quantitative blood cultures (QBC) and catheter tip cultures were performed for the diagnoses according to the standard procedures. Bio film production in catheters was detected by 'tissue culture plate' (TCP) method and molecular characterization of the gram positive resistant staphylococcal isolates was done. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method as per CLSI guidelines and E-test.

Results: Catheter-related blood-stream infections (CRBSI) in Rama Medical College Hospital and Research Centre, Mandhana, Kanpur were 4.74 per 1,000 catheter days.  Of the 3 isolates that caused CRBSI, 2 were MRCONS, 1 was MRSA. Of the 10 Staphylococcus spp, isolated 80% were bio film producers. Of the 2  S. aureus isolates 1 isolate(50%)harbor the mecA gene and identified as methicillin-resistant S. aureus (MRSA) and the remaining 1 (50%) isolates were methicillin-susceptible (MSSA.). All the Staphylococcal isolates including MDR strains   were 100% sensitive to Vancomycin and Linezolid. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Conclusion: Antimicrobial resistance was significantly higher in bio film producing Staphylococcal species in this study.  Infection prevention measures for bloodstream infections related to central venous catheter use should be intensified, as well as judicious use of this route for vascular access for hem dialysis.

"Invitro Investigation of Linezolid Susceptibility against Clinical Samples of Staphylococcus Species”

Nashra A, Deepak S, R. Sujatha, Arunagiri D

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Acinetobacter is an important opportunistic pathogen and is a common cause of hospital acquired infections. Acinetobacter infections are often extremely difficult to treat because of their widespread resistance to the major groups of antibiotics. The study was conducted to determine prevalence and antibiotic susceptibility pattern of Acinetobacter species isolated from various clinical samples.

Aim: Isolation, Identification and Antibiotic susceptibility pattern of Acinetobacter species from clinical samples in   a tertiary care hospital in Kanpur.

 Materials and Methods: The present study was a prospective study conducted at Rama Medical College, Hospital & Research Centre, Kanpur, (U.P.). Total 350 samples were received from admitted patients. The isolated bacteria were identified by colony morphology, gram’s stain, microscopy and standard biochemical tests. The Acinetobacter species isolates were subjected to antibiotic susceptibility test by Kirby Bauer disk diffusion test.

 Results: Out of 350 samples, species 312 were culture positive. Out of 312 isolates 100 (32.05) were Acinetobacter species isolated from ET tube secretions (39%), pus (20%), tracheal aspirate (18%), sputum (16%), Central line (5%) and blood (2%).  Sensitivity was observed to Meropenem was 71%, Piperacillin -Tazobactum 20%, Amikacin 51%, Ceftazidime 12%. The Acinetobacter species showed 100% sensitive to Colistin  

Conclusion: The study will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns of Acinetobacter species in our region

“A Study on the Microbiological Profile of Blood Stream Infections in Patients Admitted in Intensive Care Unit in a Tertiary Care Hospital”

Deepak S, R. Sujatha, Nashra A, Arunagiri.D

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Background: Blood stream infections (BSI) are the major cause of morbidity & mortality among patients admitted in Intensive care unit & surveillance of etiological agents in these infections are important for their prevention & treatment.

Aim and objectives: This study was taken in our institution to evaluate the prevalence of bactericidal in ICU patients in our setup.

Methods: A prospective study was conducted in tertiary care hospital. During the study all the patients were monitored for blood stream infection. Blood sample collected from suspected patient of blood stream infection for detection of causative organism & antimicrobial susceptibility pattern.. All bacteriological isolates were examined and confirmed by biochemical tests as per the standard operative procedures.

Results: A total of 314 blood samples, Blood culture was found to be positive in 27 (8.59%) cases. In BSI positive cases 17(62.29%) were males and 10(37.03%) were females. Maximum number of blood stream infections were from pediatric ICU (66.66%), followed by Medical ICU (33.33%). In the present study incidence of length of stay is more after five day of admission in ICU (74.07%). Total Culture positive cases were 27.Gram positive cocci were 15 (55.55%), Gram negative bacilli were 10 (37.03%) & Candida spp was isolated in 2 (7.40%) of cases. Among GPC, Staphylococcus aurous were 10 (66.66%) was most common organism. Gram negative organism were quite low 37.03% among them Klebsiella spp. (70%) was most common. The antimicrobial susceptibility pattern of isolated organisms showed high resistance to routinely used antimicrobial agents. Fever was presenting symptom in all 100% of cases in the present study. Also the patients with BSI presenting clinically had other conditions like Urinary symptoms & Respiratory distress were seen in 10% of cases.

Conclusion: The systemic approach by studying the culture of organisms from the foci and blood culture and the antibiotic profile may help the clinician to select appropriate empirical antimicrobial agents.

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