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December 2020 Volume 6 Issue 4

“Study of Microbiological Profile of Osteomyelitis and Antibiotic Resistance Pattern of Bacterial Isolates with Special Reference to MDR Strains at A Tertiary Care Hospital Kanpur”

Nashra A1, Deepak Sameer2, R.Sujatha*, Arunagiri D.3

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Introduction: Osteomyel it is is an inflammatory process that affects bone due to the contiguous infection, direct inoculation, or hematogenous spread of microorganisms. It is an infectious disease that is difficult to diagnose and treatment is complex because of its heterogeneity, path physiology, clinical presentation and management.

Aim: The study aimed to determine microbiological profile osteomyelitis and antibiotic resistance pattern of bacterial isolates with special reference to MDR strains. 

Material and Methods: 100 samples from osteomyelitis cases were aerobically cultured and isolates from culture positives were identified by standard procedures. Antimicrobial susceptibility testing was done following CLSI guidelines 2020. Staphylococcal isolates were screened for methicillin resistance and Gram negative bacilli were screened for MDR production.

Results: Out of 100 samples, 76% were culture positive and 24% were culture negative. Males were more affected than females. Staphylococcal spp. (53.9%) was predominant, E.coli (14.4%) and Klebsiella spp. (11.8%), Pseudomonas aeroginosa(9.2%), Proteus spp (5.2%), CONS (7.3%). Among the MDR strains of GPC-MRSA (7.3%). All the multidrug resistance Staphylococcal isolates were 100% sensitive for Vancomycin, Teicoplanin & Linezolid. Among the MDR strains of GNB ESBL were (73.5%), AmpC (17.6%) and MBL (2.9%) and they were 100% sensitive for Polymixin B and Colistin.

Conclusion: Since the   culture positivity rate is high in our study we conclude that Antibiotic susceptibility pattern will help the clinician to choose appropriate drugs leading to successful treatment and prevention of emergence and dissemination of drug resistant isolates and we have to adhere to proper infection control measures.

“A Comparative Study of Qualitative Latex Agglutination Test and Quantitative Turbido Metric Immunoassay Method for the Detection of C-Reactive Protein from Human Sera” In the Early Stages of Covid Patients at A Tertiary Care Centre, Kanpur”

Deepak Sameer1, R.Sujatha* Nashra A2, Arunagiri D.3

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Introduction: COVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity, CRP detection is the preferred test in evaluation of inflammatory conditions.

Aim of  the  Study: The aim of this study was to compare qualitative slide Latex Agglutination test (LAT) with quantitative Turbidimetric Immunoassay (TIA) method for the detection of CRP,  in  the  early  stages of  Covid  patients at  a teritiary  care  centre, Kanpur.

Material and Methods: Total 50 serum samples were collected from the patients, clinically suspected to have systemic inflammation. The study was carried out from June 2020 to Dec 2020. CRP concentrations were determined in serum samples using commercial qualitative slide LAT (RHELAX-CRP, Tulip) and TIA (SD Bio Sensor, Tulip). Testing was done according to the manufacturer's guidelines for both the tests. All the statistical data (sensitivity, specificity, were calculated by using the SPSS 15.0

Results: In this study, from a total of 50 patients, 31 were males & 19 were females. Majority of the patients were between the age group of 50-60 years. About 30(70%) patients were from the ward, 15 (30%) from the ICU. Out of 50 sera, 33 (66%) were positive & 17 (34%) were negative by TIA while 28 (56%) were positive & (44%) were negative by slide LAT Slide LAT gave false negative results for 5 patients. The sensitivity of the slide LAT was only 54% in comparison to the TIA (100%). Both the tests were equally specific (100%).

Conclusion: The study revealed a significant difference between two methods. It seems that in the early stages of inflammatory disease, quantitative methods are preferred to qualitative methods. Also, in cases that the CRP test results are weakly positive by qualitative methods, they should be controlled by quantitative methods too.

“Aerobic Bacteriological Profile and Antimicrobial Susceptibility Pattern of the Isolates from Pyogenic Infections in A Tertiary Care Hospital: A Retrospective Analysis”

NashraA1, DeepakSameer2, R.Sujatha*, Arunagiri D.3

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Introduction: Pyogenic infections are an important cause of sepsis. These infections are difficult to treat because of the pathogens with increasing antibiotic resistance. It is important to know the pathogens causing the infections and its antibiotic susceptibility for proper management of the patients.

Material & Methods: A retrospective analysis of 50 pus culture samples received in the Department of Microbiology from various departments in the hospital between June 2020 to Dec 2020 was performed. Data regarding the pathogen isolated and its antimicrobial susceptibility were collected and analyzed. The specimens were primarily processed and Identified as per standard methods.  Antibiotic susceptibility testing was done according to CLSI guidelines 2020.

Results:  Out of 50 total samples analyzed, 28 were culture positive with gram negative being 15(53.57%) and gram positive being 13(46.42%). The predominant organism of pyogenic infection was Pseudomonas aeruginosa (40%) followed by E.coli (26%), Klebsiellaspp(20%), and  Acinetobacter spp(13%). Among gram positive, the most common organism was Methicillin-Resistant Staphylococcus aureus (MRSA 53.84%). Pyogenic infections were predominant in males and mono microbial was common over poly microbial infections. Extended Spectrum Beta Lactamases (ESBL) was seen highest in Escherichia coli at the rate of 33.33% and Multi-Drug Resistance (MDR) was high among Klebsiella species and non-fermenting Gram Negative Bacilli (GNB) Pseudomonas spp and Acinetobacter spp. . . . All the multidrug resistant Staphylococcal isolates were 100% sensitive to Vancomycin, Teicoplanin & Linezolid. Among the MDR strains of   GNB were 100% sensitive for Polymixin B and Colistin.

Conclusion: There is a changing trend with gram negative organisms being the commonest cause of pyogenic infections as evidenced across India. Spurious use of drugs would help in reducing the spread of drug resistant isolates. Antibiotic policy formulation would help in empiric therapy with reduction in infection rates

“Sensitization to Inhalant and Food Allergens in Atopic People Living in and Around Kanpur by in Vitro Total and Specific IgE Assay”

Nashra A1, Deepak Sameer2, R.Sujatha*, Arunagiri D.3

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Introduction: Allergy is a condition in which immune system produce a response against antigens (also known as allergens) that results in excessive or exaggerated reactions leading to tissue damage, disease or even death. It is initiated after the first contact with an antigen (e.g. usually harmless microbes, allergens, or self antigens) which “sensitize” the immune system after the second contact leading to overwhelming, uncontrolled strong immunological and pathos-physiological reactions.

Aim: To find out the prevalence of inhalant and food allergies in and around Kanpur, UP.

Material and Methods: 250 peripheral blood samples were taken from atopic patients so that IgE serum levels specific to inhalant allergens and food allergens. Total IgE serum levels (RAST, Phadiatop-250) could be assayed. Specific IgE levels (RAST) greater than or equal to 0.35 UI/ml were defined as positive.

Results: There were no differences according to gender. Total IgE serum levels were observed among atopic. The frequency of main inhalant allergens were: Dermatophagoides Pteronyssinus = 49.2%, Timothy grass = 43.2%, Cotton = 36.4%, Bermuda grass = 32...8. In relation to food allergens we observed: Banana = 71.2%, Lemon = 40%, Carrot = 37.6%, Milk = 34.4%. With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens.

Conclusion: There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization mainly banana.

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