Indian Journal of Microbiology Research

192-197

Authors: Mallikarjun Koppad, Parameshwar S, Halesh LH, Siddesh KC

Background: The increasing prevalence of Methicillin resistant among staphylococci (MRSA) is an increasing problem. Increasing incidence of infections due to MRSA has led to emphasis on the need for safe & effective agents to treat both systemic & localized Staphylococcal infections. Clindamycin has been used to treat pneumonia & soft tissue and musculoskeletal infections due to MRSA. One important issue in Clindamycin treatment is the risk of clinical failure during therapy caused by MLSB inducible resistance. Objectives: To isolate and identify Staphylococcus aureus and CONS from all clinical samples & to determine the inducible Clindamycin resistance among the Staphylococcus aureus and CONS. Methods: A total of 100 isolates of Staphylococcus aureus and CONS from various samples were isolated. Methicillin resistance was detected by using a 1 μg Oxacillin disc. The D-test was performed using the discs of Clindamycin (CL)(2μg) and Erythromycin (ER)(15μg) placed at a distance of 15mm (centre to centre) along with routine antibiotic susceptibility testing. Results: Among Staphylococcus aureus, MSSA isolates were 32(47.05%) compared to MRSA isolates, 26(38.24%) and among CNS, MSCONS isolates were 8(11.77%) compared to MRCONS 2(2.9%).A total of 12(17.64 %) isolates showed iMLSB, of which 8(11.77%) were MRSA, 2(2.9%) were MSSA and 2(2.9%) MRCONS isolates. Conclusion: Prevalence of inducible Clindamycin resistance among Staphylococcal isolates was significant. Hence the implementation of this D-test routinely, which is simple, reliable & inexpensive will reveals the iMLSB & cMLSB phenotype & prevents the therapeutic failure of Clindamycin.

201-205

Authors: Atit Shah, Amit Mistry, Santoshdev Rathod

Background & Objective: Dermatophytic infections are commonly encountered problem and constitute more than 50 % of cases in dermatology outpatient departments. Dermatomycoses is seen all over the world both in urban and rural areas. Ahmedabad is a tropical area for the development of dermatomycoses. We found lot of cases post-monsoon due to favorable climatic condition of hot & humid atmosphere for the development of fungal infections. Last study carried out was by Shah & Amin et al in 1975. As there was no scientific data available since last 40 years, present study was carried out to see & compare changes in incidence, clinical presentation and etiological agents. Material & Methods: 200 clinically suspected cases of dermatomycoses were examined and subjected to mycological study by KOH & culture on SDA with actidione and DTM. Result & Interpretation: Tinea corporis was the commonest clinical presentation. Maximum incidence was seen in young adults & adolescents in age group of 11-40 years. Males were more affected compared to females. KOH examination & culture were positive in 75.5 % & 41.6 % of cases respectively. Trichophyton mentagrophyte (47.3 %) was commonest fungal isolate followed by Trichophyton rubrum (44.6 %). Trichophyton violaceum was isolated from cases of tinea capitis only. All culture positive isolates grow on both SDA & DTM. Appearance of growth was faster in DTM compared to SDA with actidione.

214-219

Authors: Saraswathy MP

Enterococci are one of the important causes of nosocomial urinary tract infections. They are considered as difficult to treat pathogens, due to their intrinsic resistance to several antimicrobial agents and their tendency to acquire resistance. Hence it is essential to find their resistance pattern constantly to institute empirical therapy and as a measure of infection control in hospitals. This study was carried out in the tertiary care hospital at Melmaruvathur, Tamil Nadu to detect resistance pattern and virulence traits of various uropathogenic Enterococcus species. A total of 100 Enterococcus species were included in the study. Although E.faecalis (87%) was commonest species associated with UTI, there was lenience towards E.faecium (9%), necessitates species level identification in laboratory settings. More than half of the species were isolated as mixture of two (47%) or three bacteria (7%). E.faecalis was sensitive to Vancomycin (100%), Ofloxacin (61%), Ciprofloxacin (59%), erythromycin (46%), Amikacin (41%), tetracycline (36%) and HLGR (23%). Increased incidence of Multidrug resistance and association of mixed infections warrant culture and sensitivity for all urinary tract infections.

231-235

Authors: Pooja Singh.Gangania. Varsha A. Singh, Sunil Sekhar Ghimire

Background: Postoperative wound infections are found to be the cause of morbidity and mortality in the surgical patients. The wound that drain purulent discharge, with bacteria identified on culture is Postoperative infection. Wound draining pus, wounds that are opened by the surgeon; and wounds that the surgeon considers infected are considered postoperative wound infection. Objectives: Bacterial isolation and antibiotic susceptibility patternof postoperative wound infected patients and to find the correlation between their age, sex and the site of infection. Material and methods: 200post surgical patients with wound infections admitted in different surgical wards wereincluded. Pus and serous fluid samples from the wounds were collected. Gram staining &culture was done via conventional techniques followed by AST by Kirby Bauer disk diffusion technique. Results:Gram negative (27.5%) were predominant over gram positive (11.5%).In gram positive organism maximum isolates were S.Aureus followed by Enterococcus and streptococcus In gram negative organism’s maximum isolate was E.coli followed by Pseudomonas Aeruginosa ,klebsiella& Proteus. Conclusion:E.coli (14.5%) was the commonest pathogen isolated due to more laprotomy surgical procedures followed by equal rate of Staphyalococcusaureus (7%) and Pseudomonas aeruginosa (7%), Klebsiella (3.5%), Proteus (2.5%), Enterococcus (2.5%) and Streptococcus (2%). First generation of Cephalosporins and most of the Aminoglycosides were sensitive against gram positives whereas successive generations of cephalosporins were sensitive against gram negatives including some penicillin drugs like Ampicillin, Amoxicillin, and Pipracillin-Tazobactum which were sensitive for both gram positive and gram negative organisms.

238-243

Authors: Jayanta Debnath, Pradip Kumar Das

Background:Sepsis is the commonest cause of neonatal mortality and is influenced by the quality of intrauterine life, host and environmental factors. The present study was undertaken to identify the aetiological agents causing neonatal septicemia and analyze the antibiotic susceptibility pattern, so as to guide the Pediatrician in formulating an empirical antibiotic policy against the predominant pathogens in this geographical area of North East India. Methods:On clinical suspicion of septicemia, atleast two sets of test for blood culture were performed and such neonates included in the study. Antimicrobial Susceptibility Testing was subsequently performed following Kirby Bauer Disc Diffusion method. The data obtained from culture proven septicemia was analyzed. Results:Blood culture was positive in 41.1% clinically suspected cases of septicemia. Early Onset Septicemia was confirmed in 73(57.5%) and Late Onset Septicemia in 54(42.5%) neonates. The Gram Positive organisms (51.1%) predominated over Gram negative organisms (48.9%). Staphylococcus aureus (34.6%) was the most predominant isolate followed by Klebsiellapneumoniae (24.4%). The antibiotic sensitivity pattern of the gram positive blood culture isolates indicates that all isolates were sensitive to Vancomycin. The Cephalosporins, Clindamycin and Amikacin were found significantly sensitive to Staphylococcus aureus(95.5%). All Gram negative isolates were sensitive to Imipenem followed by Piperacillin-tazobactum and Amikacin. Conclusion:Amikacin along with a third generation Cephalosporin like Cefotaxime were chosen to be the first line regimen for treatment of cases of septicemia in our setting. The predominant isolate of Staphylococcus aureus along with significant association of maternal risk factors indicates the possibility of cross infection in NICU from index case, for which emphasis need to be laid on Hospital infection control strategies.

246-248

Authors: Nandini Chatterjee, Mohua Bose, Suvajit Das, Sudipta Kumar Dey, Kaushik Mukhopadhyay. Chandan Chatt

Pulmonary nocardiosis, though a well recognized entity, is often missed due to its clinicoradiological similarities with tuberculosis. We present the case of an immunocompetent young girl of eighteen years with fever cough and weight loss, who was later diagnosed to be suffering from Pulmonary nocardiosis.