Indian Journal of Microbiology Research

1-4

Authors: Nancy Suhag, Arti Jain, Navinchandra M. Kaore

In developing countries, along with the Health Care Providers, Inanimate objects plays a critical role in microbial transmission so also the ability of the microorganism to survive on inanimate objects to cause Hospital Acquired Infections. The purpose of this Study was to evaluate transient microbial flora on Biometric System as a potential Source of infection in hospital settings. The Cross-sectional Analytical study was conducted in the Department of Microbiology, attached to a Tertiary Care Hospitals in Central India after obtaining ethical clearance over a time period of two months. Ten out of 30 samples evaluated showed growth of Staphylococcus aureus of which 7 (70%) were found to be MRSA & 3(30%) MSSA when tested using Cefoxitin Disk Diffusion Test. MRSA strain were found to be resistant to Erythromycin, Ampicillin, Clindamycin & Cefepime and both MRSA & MSSA strains were sensitive to Co-trimoxazole. Biometric systems in Medical Hospital were found to be carrying the microorganisms more than that of Dental Hospitals and that too which are being used by Para-Clinical faculties. Present study highlights the need of sensitization & training sessions regarding hand hygiene practices among the health care workers and regular cleaning of inanimate objects like Biometric device for reduction of HAIs.

11-13

Authors: Irfan, Farooq, Subhannaya K

Introduction: In developing countries, umbilical cord infections constitute a major source of neonatal morbidity and pose significant risk for mortality. Methods: Prospective analytical study was conducted at KVG Medical College and Hospital, Sullia with an objective to study the aerobic bacteriological profile of umbilical cord in newborn and their characterization and to compare two umbilical cord care regimens, that is, dry cord care, and 4% chlorhexidine for their impact on colonization and infection. 50 cases, each in category of dry cord care and 4% chlorhexidine application on umbilical cord were studied. Results: The study showed that 4% chlorhexidine application to the umbilical cord though appeared to reduce colonization with S.aureus, fail to inhibit it completely. Conclusion: Antimicrobial application may enhance colonization with more dangerous multidrug resistant staphylococci (MRSA and MR-CONS). 4% chlorhexidine appeared to be superior to dry cord care in preventing clinical manifestation in infants.

17-21

Authors: Mamatha P Samaga

Background: Urinary tract infections (UTI), which are caused by the presence and growth of microorganisms in the urinary tract, are perhaps the single commonest bacterial infections of mankind and in pregnancy, it may involve the lower urinary tract or the bladder. Urinary tract infection in pregnancy is associated with significant morbidity for both mother and baby. Aims and Objectives: This study aimed to assess bacterial profile of urinary tract infection and their antimicrobial susceptibility pattern among pregnant women attending antenatal clinic at District hospital attached to Mandya Institute of Medical Sciences. Material and Methods: This retrospective study was carried out in the Dept. of Microbiology, MIMS, Mandya. The urinary pathogens and their antibiotic susceptibility patterns from January - December 2014(One year) was studied from the records of Microbiology laboratory. Descriptive statistics was used and results were expressed as percentages. Results: A total of 124 urine samples were received from pregnant women and processed in Microbiology laboratory from Jan to Dec 2014 .Among 124 samples, 45(36.2%) samples yielded significant bacterial growth. E.coli (19, 42.2 %) was isolated as predominant pathogen. 14 (73.7%) E. Coli and only 2(40%) Klebsiella were sensitive to nitrofurantoin which can be used in pregnancy. Only 2 (10.5%) E.coli were sensitive to Ampicillin with remaining 17(89.5%) being resistant. Conclusion: This study showed that prevalence of UTI in pregnant women was 36.2%. It was also observed that E. coli (42.2%) was the most frequently isolated bacteria. All pregnant women should be screened for UTI with a urine culture and treated with antibiotics if the culture is positive.

24-26

Authors: Nithya Chinnnusamy, Vijayalaksmi Arumugam, Dillirani Vedachalam

Background: Microscopical examination of expectorated sputum samples is the most commonly followed method in the Microbiological laboratory for diagnosis of lower respiratory tract infections (LRTIs). Sputum sample is usually contaminated with normal resident floral organisms of the oropharynx. For the diagnosis and management of LRTIs, collection of sputum sample, sputum microscopy and culture is very important. The present study was conducted to analyse the importance of the microscopical examination of Gram stained sputum smears and the sputum culture in patients with LRTIs. Materials & Methods: The place of the study was in the department of Microbiology in a tertiary care hospital. The study period was for one year from Jan 2015 to Dec 2015. Gram staining and culture were done for all the 130 sputum samples. Gram stained sputum smears were observed under microscope for presence of organisms, pus cells and epithelial cells. Quality of expectorated sputum samples were assessed by using Bartlett’s grading system. By using standard protocols bacterial isolates were identified. Kirby Bauer disc diffusion method on Mueller Hinton agar was performed for antibiotic susceptibility testing. Results and conclusion: Out of 130 sputum samples, 72 (55.4%) samples were acceptable based on Bartlett’s screening system and 58(44.6%) samples were in the not acceptable category. Among acceptable category, 64(78.05%) samples were showed culture positivity. Among non-acceptable category, 18(21.95%) samples were showed culture positivity. Klebsiella pnemoniae-31.71% was the commonest isolated organism followed by Pseudomonas aeruginosa-14.63% and Staphylococcus aureus -13.41%.In this study authors recommended to receive good quality of sputum and do initial sputum screening for diagnosing clinically relevant LRTIs.

31-36

Authors: Ranjana Hawaldar, Sadhna Sodani, Hemlata Bhilware

Introduction: Typhoid fever or enteric fever, is an endemic disease in many developing countries specially India and the Indian Subcontinent. In the past decade, resistance of Salmonella to multiple drugs is on the rise specially resistant to ampicillin, chloramphenicol and cotrimoxazole. This resistant pattern has resulted in use of Fluoroquinolones and third generation Cephalosporins as first line drugs.)The present study was under taken to study the antibiotic susceptibility pattern of S.typhi isolated from blood cultures in our microbiology laboratory. Materials and Methods: 766 patients suspected of having typhoid fever of different age groups and sex visiting our Microbiology department for blood culture were included in the study from January 2015 to December 2015. Gram negative non lactose fermenting colonies were subjected to identification and antibiotic susceptibility testing in Vitek II (Biomerieux) according to CLSI guidelines. Results: Out of 766 blood cultures, 32 cases of S.typhi were isolated. 561 cultures were sterile and 73 showed growth of other bacteria. Colistin, Cefuroxime, Imipenem, Meropenem showed 100% sensitivity. Piperacillin/Tazobactam, Tigecyline. Cefoperazone/Sulbactam were sensitive in 93.75% isolates. Amoxicillin/Clavulanic Acid (90.62%), Ceftazidime(87.5%), Trimethoprim/Sulfamethoxazole (87.5%), Ticarcillin(84.37%), Ampicillin (81.25%),Cefepime(78.12%), Cefalotin(75%), Amoxycillin(65.62%), Cefixime(59.37%). Cefoxitin(43.75%), Amikacin(31.25%), Gentamicin(6.75%), Ciprofloxacin was found to be resistant in all 32 cases(100%). Conclusion: There has been a reemergence in the sensitivity of Salmonella Typhi to Ampicillin, Ceftazidime, Cefuroxime Ceftriaxone, Cefoperazone/Sulbactum Cefipime and Amoxyclav and 100% resistance to Ciprofloxaxin and to Amikacin & Gentamycin. Cefuroxime, Ceftriaxone, Cefoperazone/Sulbactum seem to be good therapeutic options is our setting atpresent.

40-43

Authors: Lavanya Jagdish, Mita D Wadekar, Manoj Jais, Ravi Kumar Gupta

Background: The increase in number of healthcare associated infections has resulted in huge burden on medical care in the form of morbidity, mortality, and cost. In the current era of high pathogen loads and antimicrobial resistance, items used in patient care such as cotton gowns, are becoming source of cross transmission of infections. In this study, comparative microbial load of cotton gown was made with that of newly introduced disposable plastic gowns. Methods: A total of 100 samples from cuffs and pockets of cotton gowns; and 100 samples from abdominal area of plastic gowns were taken from doctors and nurses working in a pediatric ICU and nursery. Samples were processed as per standard microbiological procedures for microbial growth followed by antimicrobial susceptibility testing. Results were compared using paired T test and chi square test. Results: 50% of cotton gown samples and 20% of plastic gown samples showed statistically significant microbial growth (<0.01). Gram positive cocci survived better on cotton gowns whereas plastic gowns promote Gram negative bacilli. Out of two areas covered, gowns from pediatric nursery (40 cotton and 10 plastic gowns) were more contaminated than that of PICU (10 cotton and 10 plastic gowns). Interpretation & conclusions: Overall, plastic gowns showed less microbial contamination than that of cotton gowns. The result suggest that the healthcare associated infections in more details so as to implement strict guidelines for the evaluation and restriction of articles, such as cotton gowns, which probably contributes to infections in critical areas.

47-52

Authors: Deol Amit, Tripathi Kiran, Nema Shashwati

Introduction: Jail lacks adequate health facilities resulting in greater burden of illness than other members of society due to the factors like poor sanitation, poor personal hygiene and ignorance. Prevalence of Intestinal parasitic infections and urinary tract infections have been studied extensively in community in various set up and different age groups, but yet to be explored in prison inmates whose health problems are often neglected. Methodology: A Cross sectional study was conducted at central Jail of Bhopal for a period of 2 months among 114 prison inmates. Proforma containing structured questionnaire was also filled. 114 stool samples and 111 urine samples were obtained. Stool samples examined using saline, iodine wet mount. Urine samples processed for aerobic bacterial culture, isolates identified by standard microbiology techniques. Antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion method as per CLSI guidelines. Results: Intestinal parasites found among 7.9% prison inmates. Protozoan parasites contributed 7.0% and intestinal helminth 0.9%. Significant growth of uropathogens obtained in 9.91% urine samples. 6.31% were gram negative bacilli (GNB) and 3.60% gram positive cocci (GPC). GNB isolates were more sensitive for imipenem followed by amikacin. GPC showed maximum sensitivity for vancomycin and linezolid. Conclusions Our study showed low prevalence rate of both intestinal and urinary tract infections among prison inmates of central jail Bhopal. This may be attributed to maintenance of adequate sanitary conditions in jail premises.

58-64

Authors: Trupti B. Naik, Mita D. Wadekar, Amruthkishan Upadhya, Vijaykumar Mane

Background: Orthopedic wound infections are one of the important causes of morbidity and are difficult to treat. With the development of antimicrobial resistance, the situation has further worsened and it has become difficult to manage them by conservative means leading to further deterioration in health and wellbeing of the patients. To avoid such complications, orthopedic wound infections need to be managed at the earliest by microbial isolation and appropriate antibiotic administration. Objectives: 1. To study the profile of aerobic bacteria affecting the orthopedic wounds. 2. To study the pattern of their antibiotic susceptibility. Methods: A Cross sectional study was conducted using secondary data of orthopedic wound infection cases maintained in the microbiology laboratory registers for a period of 1 year from September 2014 to August 2015. The bacteriological agents were isolated, identified and their antibiotic susceptibility patterns were determined using standard protocols. Analysis was done using MS Excel 2010. Results and interpretation: Our study yielded 249 (56.08%) positive culture cases. Prevalence of Gram positive bacteria was more than Gram negative bacteria. Staphylococcus aureus was the predominant causative agent followed by Pseudomonas aeruginosa. The prevalence of MRSA was 25%. All the Gram positive cocci isolates were sensitive to linezolid and vancomycin. Members of Enterobacteriaceae family showed high sensitivity to Meropenem followed by amikacin. Polymyxin B and piperacillin-tazobactam were the most effective antibiotics among non-fermenters. All the Gram negative bacteria were resistant to penicillin and cephalosporins. Conclusion: Microbial analysis of samples and their antibiogram is recommended for proper management of Orthopaedic wounds.

69-73

Authors: Hiral K Patel, Parimal H Patel, Alka B Nerurkar

Background: Superficial mycotic infections constitute the bulk of mycotic diseases. Superficial mycoses are limited to skin, hair, and nails. The superficial fungal infections commonly encountered are dermatophytosis, candidiasis and pityriasis versicolor. Aim of this present study is mainly to evaluate the mycological profile of superficial mycoses with their causal association with its clinical presentation. Method: The study was carried out at Department of Microbiology, GMERS Medical College, Valsad from November 2014 to April 2015.73 various Skin scrapings, nail clippings and scalp scrapings were the clinical specimens taken for the study. Direct Microscopy was done with KOH (10% for skin and scalp and 40% for nail).Culture was done on Sabouraud’s dextrose agar. The isolate were identified by colonial morphology, pigment production and direct examination of smear from the colony by tease mount and cellophane tape mount lactophenol cotton blue preparation & slide culture. Results: Out of 73 samples, 44 (60.27%) were KOH positive and 33 (45%) were Culture positive. The commonest isolate was Trichophyton spp 16 (49%) followed by Candida spp. 7(21%) and other molds like pseudoallescheria boydii, Fusarium, Penicillium, Aspergillus 5(15%). Tinea corporis 30 (42%) was the most common clinical presentation. The commonest age group involved was 19-59 years. Conclusion: The present study signifies the importance of mycological examination in diagnosis of superficial fungal infections. It is helpful to study fungal species commonly associated with superficial mycosis with various clinical presentation and also for further treatment.

77-81

Authors: Dineshraj Ravi, Vasanthi Rompicherla, Gowthami Govindan, Priyadarshini Shanmugam

Background: Enterococci are gram positive cocci which reside as commensal microbial flora in gastrointestinal tract, vagina, biliary tract and male urethra. E.faecalis is the predominant species followed by E.faecium. Resistance against glycopeptides and aminoglycosides are being increasingly demonstrated and that is conferred upon largely by van A gene. Aims: To isolate and speciate Enterococci from various clinical samples, antibiogram pattern determination, followed by genotyping of vancomycin resistant Enterococci. Settings and Design: Prospective study. Materials and Methods: 200 Enterococcal isolates were collected and processed for speciation based on battery of phenotypic characteristics. Antibiotic sensitivity testing was performed as per CLSI guidelines 2014 for glycopeptide and aminoglycoside antibiotics. Enterococci which were resistant to vancomycin were subjected to polymerase chain reaction for van A gene detection. Statistical analysis used: Nil. Results: Of the 200 isolates 5 were resistant to vancomycin and teicoplanin (2.5%), 30 were resistant to high level gentamicin (15%). van A gene was detected in 3 of the 5 vancomycin resistant isolates. E.faecium was observed to be more resistant to the antimicrobials. Conclusions: If the vancomycin resistance in Enterococci gets dispersed throughout the world, it may pose a challenge in the treatment of Gram positive infections and may lead to treatment failure. Further treatment options may not be available. Hence these infections have to be prevented and the sequence of development of resistance to higher drugs has to be controlled by active surveillance and prevention.