Indian Journal of Microbiology Research

82-83

Authors: Muktikesh Dash

The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.

86-89

Authors: Savita Rani Singhal, Susheela Chaudhary, Smiti Nanda, Pushpa Dahiya.

Introduction: Antepartumhaemorrhage (APH) defined as bleeding from or into the genital tract after 24 weeks of gestation but before the birth of baby. The causes of APH are placenta previa, abruption placentae, local causes and vasa previa. Aims and Objectives: To study the demographic profile and maternal and perinatal outcome in antepartum haemorrhage. Material and Methods: It is a retrospective study done at a tertiary care centre in Haryana over a period of seven months. Case files of 140 patients of antepartum haemorrhage were studied for various parameters and analyzed. Results: Total deliveries were 6227 during the study period, out of which abruption placentae cases were 51.43% and placenta previa were 48.57%. Three maternal death were reported due to abruption placentae and one was due to placenta previa. Perinatal mortality was 68.96% due to abruptio placentae and 16.96% was due to placenta praevia. Conclusion: In antepartum haemorrhage, both mother and foetus are at risk. Proper antenatal care, early diagnosis, early referral and timely management can improve the maternal and perinatal outcome. Keywords: Booked, Unbooked, Antepartum haemorrhage, Placenta previa, Abruption placentae

90-94

Authors: Abhilasha Gupta, Shakun Singh, Rachna Chaudhary, Shipra Nigam.

Introduction: Bacterial vagiriosis (BV) is an extremely prevalent vaginal condition. BV prevalence in pregnancy is 15-30 percent. BV is a polymicrobial, superficial vaginal infection involving a reduction in the amount of hydrogen-peroxide-producing Lactobacillus and an overgrowth of anaerobic and Gram-negative or Gram-variable bacteria. BV can be symptomatic or asymptomatic. BV in pregnancy has been associated with preterm labour and delivery, premature rupture of membranes amniotic fluid infections and post-partum endometritis. Materials and Methods: 500 antenatal women of less than 28 are gestation without known risk for PTL admitted or attending antenatal outpatient clinic in Department of Obstetrics and Gynaecology, LLRM and associated SVBP Hospital in last one year were enrolled after a written and informed consent. We studied the presence of bacterial vaginosis in these women uses NUGENTS criteria and correlated it with adverse pregnancy outcome. Prematurity, PROM and post-partum endometritis were considered as adverse pregnancy outcomes. Result: BV was found in 98 of the 500 women studied. Out of the 98 positive cases, 53 cases were less than 20 weeks gestation and the remaining 45 were between 20-28 weeks gestation. Twenty three of the 98 BV patients had preterm delivery and this association was significant (p<0.0001). Out of the 53 patients of BV diagnosed in 11-20 weeks period of gestation, 12 patients had preterm delivery. The remaining 11 preterm deliveries occurred in BV patients diagnosed after 20 weeks gestation. The association of more number of preterm deliveries in patients with BV diagnosed in 11-20 weeks period of gestation was not significant (p=0.2). Fourteen patients of BV had PROM and this association was also significant (p<0.001). Six patients of BV also had postpartum endometritis. Conclusion: The above results suggest that screening for BV should start in early pregnancy and a high index of suspicion for preterm delivery should be kept in antenatal patients with BV. Key Words: Preterm delivery, Bacterial Vaginosis, Bacterial Vaginosis in pregnancy, Prematurity, Premature rupture of membranes

95-100

Authors: Hema Priya L, Prathap T..

Laparoscopic ovarian cystectomy is the technique of choice in patients with large ovarian endometriomas. However, post operative residual ovarian function remains a major concern. Objectives: The aim of this prospective, randomized study was to compare two different techniques of stripping at the original adhesion site and at the hilus. We also aimed to determine which technique of ovarian cystectomy causes least tissue damage, by histopathology analysis and by determining the residual ovarian volume. Materials and Methods: 32 patients were enrolled, who had laparoscopically confirmed endometriomas > 3 cm in diameter. The patients were randomized into two groups, by a computer generated random number table. Two different techniques (direct stripping vs. excision of a circular rim of tissue) were compared at the original adhesion site (step 1). At step 2, all patients underwent randomization again, and two different techniques (completion of stripping vs. bipolar coagulation and cutting with scissors) were compared at the hilus. Operative time and operative difficulty were evaluated at both steps by the same surgeon. Histopathology confirmation of the loss of normal ovarian tissue was recorded at the original adhesion site, intermediate part and at the hilus. Residual ovarian volume was calculated at the end of six months. Results: The mean operating time and difficulty showed no significant difference at both step1 and step 2 with either technique. However complication rate (hemorrhage) was higher at step 2 in the direct stripping group. On histopathology, primordial follicles were identified in similar number of patients in each group. The residual ovarian volume six months post operatively showed no significant difference in both groups. Conclusion: Both techniques of cystectomy are tissue sparing and can be safely used. Keywords: Endometrioma, Infertility, Chocolate cyst, Laparoscopic cystectomy, Ovarian volume

101-103

Authors: Chaitra Shivananjiah, Ashwini Nayak U, Asha Swarup, Sridhar Honappa, Kamya Ramesh Swaminathan, Davis.

Objective: To study the histopathological pattern of endometrium and associated pathological conditions in patients who had abnormal uterine bleeding due to adenomyosis. Material and Methods: This was a study done at M.S. Ramaiah medical college and teaching hospital,Bangalore on 44 patients who underwent hysterectomy due to Abnormal uterine bleeding with adenomyosis from Dec 2013 to Dec 2015. All the quantitative variables were expressed as mean and qualitative variables as percentages. Results: The age of the patients who had adenomyosis ranged from 34 to 65 years, majority (50%) were in the age group of 41-50 years. The commonest histopathological pattern found was proliferative endometrium (n=26, 59.09%). Conclusion: Adenomyosis contributes to a large proportion of patients who present with abnormal uterine bleeding. The associated histopathology varies from proliferative endometrium to endometrial hyperplasia. Estrogen may be a risk factor as it is associated with fibroid and endometrial hyperplasia. Keywords: Adenomyosis, Endometrium, Abnormal uterine bleeding

104-109

Authors: Chitra Andrew, M.A. Fathimunissa, Shivani Gopal.

Background: Prenatal hydronephrosis comprises 20% of the anomalies detected on ultrasound. Adequate information is required to counsel the parents regarding the diagnosis and possible need for further evaluation and postnatal therapy including surgery. The aim of the study is to analyse the postnatal outcomes of neonates with prenatal diagnosis of hydronephrosis. Material and Methods: Fetuses diagnosed with hydronephrosis from January 1, 2014 to May 31, 2015 were identified from the obstetric ultrasound database. 27 fetuses had a diagnosis of hydronephrosis and had complete postnatal follow-up. These were classified on the basis of the severity and bilaterality of hydronephrosis. Postnatal data and follow up was obtained from the hospital records and from the parents over phone when delivery had occurred at another institution. Results: Of 27 fetuses, 15 were diagnosed in second trimester and 13 in the third trimester due to late booking. No fetuses with a normal scan at second trimester subsequently developed hydronephrosis. Of 18 fetuses with mild hydronephrosis, 17 were seen to be normal at prenatal follow up or postnatally. Only one progressed and became severe requiring postnatal surgery. Of the nine fetuses classified as moderate or severe, seven neonates required surgery in the neonatal period. On comparing the two groups, this was found to be statistically significant. (p:0.005). The effect of bilateral hydronephrosis on outcomes could not be assessed due to the small numbers of fetuses in this category. Conclusion: Antenatal diagnosis of fetal hydronephrosis may progress and so parents need to be counselled regarding the need for a follow up scan which will then determine the need for post-natal follow up or treatment. Severity of the hydronephrosis seen antenatally influences the need for surgery in the neonate.

110-114

Authors: Doddarangaiah R Shivanand, Indira Hanumaiah.

Background: Pregnancy is a period of profound immunologic, endocrine, metabolic and vascular changes, which makes them venerable for physiological and pathological changes in skin and its appendages. Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. Objectives: To determine the frequency and pattern of dermatoses in pregnancy. Methods: A total of 600 pregnant women attending out- patient department of dermatology and obstetrics at tertiary care hospital having symptoms related to skin, nail and its appendages between June 2014 and July 2015 were studied. Detailed history, clinical examination and relevant investigations were performed. The data was analyzed by using SPSS software version 16. Results: Age of patients ranged from 18 years to 44 years. Primigravida group accounted for about 396 (66%). Commonest physiological changes noted was Striae distensae 288 (48%) followed by Linea nigra 270 (45%), Gingival hyperemia/ gingivitis was seen 20 (3.33%), Pigmentary changes 198 (33%), Melasma 192 (32%). Polymorphic eruption of pregnancy (PEP) 31 (5.6%) was the commonest specific dermatosis followed by Atopic eruption of pregnancy (AEP) 12(2%) Pemphigoid Gestations (PG) 1 (0.16%) and Intrahepatic Cholestasis Pregnancy (ICP) 1 (0.16%) Fungal infection 40 (6.6%) was the commonest infection, followed by bacterial infections 12(2%). 4 patients showed skin scraping positive for Scabies mite. Conclusion: Physiological dematoses are common in Primigravida compared to multigravida. Specific dermatoses of pregnancy are also not uncommon, can be a source of significant distress to the patients which warrants specific care in turn influences the maternal and fetal outcome. The awareness, recognition of these skin conditions, familiarity with their treatment, antepartum surveillance, early diagnosis and prompt treatment is essential for improving maternal and fetal prognosis thus minimizes their morbidity. Keywords: Pregnancy, Cutaneous manifestations, Dermatoses, Fungal infection

115-120

Authors: Chithra Jayakrishnan, Rajalekshmi M, Nithya R, Vijay Narayanan S.

Background: 8-10% pregnancies end in preterm labour or threatened preterm labour which has maternal and foetal complications just due to infections such as bacterial vaginosis, which can be identified by simple tests like Amsel Criteria and treated at the earliest with appropriate antibiotics. Aim: To establish the role of bacterial vaginosis in preterm labour and threatened preterm labour based on Amsel criteria. Materials and Methods: 100 pregnant women with gestational age between 28 and 36 weeks, of which 50 women with symptoms of threatened preterm labour and preterm labour were kept as study group and another 50 pregnant women in the same gestational age without any symptoms of threatened preterm or preterm labour were kept as control group. Examination of vaginal discharge, vaginal pH, microscopy for clue cells and Whiff test, which are Amsel’s criteria, were done. Chi-square test was used to find out the association of variables and p value less than 0.05 was taken as statistically significant. Results: The women in study group had higher incidence of vaginal discharge than control group. All the bacterial vaginosis cases had vaginal pH >4.5. The negative predictive value of vaginal fluid pH > 4.5 in our study is 100%. In our study 27% cases in all groups were found to have whiff test positive. 20% had clue cells on microscope examination. All the Amsel’s criterion was statistically highly significant between the study and the control group. Conclusion: The strong correlation between presence of Bacterial Vaginosis and the incidence of threatened preterm and preterm labour is established. Amsel’s criteria are simple, inexpensive, easily reproducible method of diagnosing BV and can be used on a mass scale. By diagnosing and treating bacterial vaginosis in threatened preterm labour, preterm deliveries can be prevented to a certain extent, if not atleast in order to buy time for the inclusion of steroids which will decrease the perinatal morbidity and mortality by decreasing Respiratory Distress Syndrome and intraventricular haemorrhage. Keywords: Bacterial vaginosis, Amsel’s criteria, Threatened preterm, Preterm labour, Whiff test, Clue cells, Vaginal pH

121-125

Authors: Ruchira Nautiyal, Akansha Srivastava, Nidhi Chauhan, Hemant Kumar Nautiyal.

Introduction: Eclampsia is a preventable malady, yet remains a leading cause of maternal mortality and morbidity worldwide. Magnesium sulphate despite being the anticonvulsant of choice largely remains underutilized in low resource settings due to various constraints. Tailoring the dose as per local needs has given the scope to adopt a lower dose in these countries. We aimed to compare the efficacy of low dose regimen of magnesium sulphate (MgSO4) with Pritchard’s regimen in patients of eclampsia. Method: A prospective cross sectional study was carried out in the department of Obstetrics and Gynecology at Himalayan Institute of Medical Sciences, Dehradun, India over a period of one year which included a total of 60 patients of eclampsia divided into two groups by randomization. Group A received low dose magnesium sulphate (Dhaka regimen) and Group B patients were managed with Pritchard’s regimen of MgSO4. The recurrence of fits, toxicity profile and feto-maternal outcome was studied. Data generated was analyzed using SPSS version 20. Results: Majority of the patients were primigravida (66.67%) and unbooked (73%). Low dose regimen was equally effective in controlling the seizures and only two patients (6.6%) had recurrent seizures (p=1.00). Incidence of loss of deep tendon reflex was 10% with low dose Mgso4 and 13.3% with standard dose (p=0.69). Mean values of serum magnesium in both the groups was comparable. There was one maternal death in our study. Conclusion: With an efficacy comparable to Pritchard’s regimen in controlling eclampsia, low dose Mgso4 is a viable alternative especially at primary and secondary health care levels. Keywords: Dhaka regimen, eclampsia, low dose magnesium sulphate, Pritchard’s regimen, recurrent convulsion

126-129

Authors: Swarooprani N.B., Mita D. Wadekar, Rajakumar S..

Background: Human immunodeficiency virus (HIV) infection is a major threat in the world population and in the control of tuberculosis in developing countries. HIV-TB co infected patients with CD4 counts above 200 cells/cu µl, are likely to have typical symptoms and most of the sputum shows positive for acid fast bacilli (AFB). Patient withCD4 count less than 200 are with high risk of getting (Tuberculosis) TB, but diagnosis is difficult as there is more chances of sputum becoming negative, which requires sputum culture for diagnosis of (TB). Although sputum smear negativity is high in most cases of dual infection, particularly in patients with low immunity, it is an essential component in the diagnosis of tuberculosis in countries like India. Methodology: A cross sectional study of 50 HIV-TB patients admitted to tertiary care hospital were studied for correlation between CD4 count and sputum smear results. Results: 50 HIV-TB patients studied for a period of 1 year. Majority were in the age group of 30-40 years 20 (78%). In the study 29 (58%) were males and 21(42%) were females. The common presentations were cough 48 (96%), fever 44 (88%), weight loss 42(84%) and diarrhoea 25(50%). Mean CD4 count being 146.6±88. Most patients had CD4 count < 200 cells/cu µl. Mean CD4 count in sputum positive TB was 254.8±77.3 and in sputum negative TB was 97.2±33.8. Conclusion: Patients with CD4 count > 200cells/cuµl are likely to have sputum positive pulmonary TB and typical presentations. Patients with CD4count < 200cells/cuµl are more of sputum negative pulmonary TB with atypical presentations which poses diagnostic difficulty and needs newer diagnostic tests. Key words: HIV-TB co infected patients, CD4 count, Sputum for AFB

130-135

Authors: rupti B. Naik, Lavanya J., Vijaykumar Mane, Amruthkishan K. Upadhya.

Background: Enterococci were known to be less virulent in healthy individuals, but recently have become important opportunistic pathogens, especially in hospitalized patients because of their ability to colonize the gastrointestinal tract for long periods which is a crucial factor in the development of drug resistance and have become a major obstacle for treatment. Objective: 1. To determine the species of Enterococci isolated from various clinical samples. 2. To determine the antimicrobial susceptibility pattern of Enterococci. Material and Methods: A cross sectional study was conducted at a private tertiary care hospital in Shivamogga district of Karnataka, using secondary data of Enterococcal species isolated from various clinical samples such as urine, blood, pus, sputum, sterile body fluids which were maintained in the Microbiology laboratory registers for a period of 1 year from January 2014 to December 2014. Standard protocols were followed for Enterococcus isolation, identification and to assess their antibiotic susceptibility. Analysis was done using MS Excel 2010. Results: Out of 66 enterococcal isolates from various clinical samples majority i.e. 32 (48.48%) were isolated from urine followed by pus 22 (33.33%). Majority of the Enterococcus were isolated from females 34 (51.51%). E. faecalis was the predominant isolate i.e. 56 (84.84%). All the isolates were susceptible to Linezolid and Vancomycin. Maximum resistance was seen against Penicillin i.e. 26 (76.47%). Conclusion: Considering the general scenario of increasing drug resistance and prevalence of wide variety of Enterococcus species there is a need to carry-out regular surveillance of antimicrobial resistance of enterococci to recommend appropriate therapy. Key words: Antimicrobial susceptibility pattern, Clinical samples, Enterococcus species

136-140

Authors: Mythri B.A., Asha B. Patil, Divya A., Pooja Mansabdar, Sharon V. A..

Background: Neonatal sepsis is a clinical syndrome which is characterised by signs and symptoms of infection which may or may not be accompanied by bacteraemia within the first month of life. The bacteriological profile of neonatal sepsis is under constant change with the advances in the diagnosis and treatment. Blood culture is still the mainstay of investigation of potential sepsis in spite of the recent advances in molecular diagnosis of fungal and bacterial sepsis. Most common bacterial organisms responsible for neonatal septicaemia in developing countries like Bangladesh, India, Nigeria, Pakistan, are Klebsiella, Escherichia coli, Enterobacter etc. The present study was undertaken to describe the spectrum of the isolates in cases of neonatal septicaemia, and their antimicrobial susceptibility pattern. The study was carried out over a one year period. Method: A total of 357 suspected patients of neonatal septicaemia were included in the study. Blood samples were collected with aseptic precautions preferably prior to the initiation of empiric antibiotic therapy. The bottles were incubated aerobically at 370 C for 7 days and subcultured on blood agar and Mac Conkey agar. If growth appeared the isolates were processed as per standard microbiological techniques and the isolates were identified. Antibiotic sensitivity testing was performed on Mueller‑Hinton agar plates by modified Kirby‑Bauer disk diffusion method as per Clinical Laboratory Standard Institute guidelines. Results: Of the 357 samples studied, growth was observed in 154 samples. Gram positive organisms constituted 37.66% and gram negative bacilli constituted 62.34% of the isolates. The predominant pathogens isolated were Klebsiella species, Coagulase Negative Staphylococci, Staphylococcus aureus followed by Non fermenting gram negative bacilli. 71.43% of the Staphylococcus aureus isolates were found to be methicillin resistant.96.05% of the Enterobacteriaceae were found to be Extended Spectrum Beta Lactamase (ESBL) producers. 33.33% of the Pseudomonas isolates were found to be metallo-beta-lactamase (MBL) producers. Conclusion: This study shows that Klebsiella species, Coagulase Negative Staphylococci, Staphylococcus aureus and Non-fermenting gram negative bacilli were the commonest organisms associated with Neonatal sepsis. An alarmingly high rate of MRSA and ESBL producers was observed. This study stresses that antimicrobial resistance is a universal problem and it stresses the need for surveillance. Keywords: Sepsis, neonate, infection, bacterial, bacterial infections

140-142

Authors: Deepika Verma, Ratnamala Thakur, Sunita Mishra, Abhyuday Verma.

Background: Referral services for identification & referral of high risk pregnancies are an integral part of maternal and child health services. This study was aimed to incidence of referral cases of obstetrics/gynaecology analyze and to analyse the availability of adequate essential care for obstetric and gynaecological emergencies at health centers at periphery level. Methods: 156 consecutively referred cases at Sri Aurobindo Medical College and PGI, Indore from various peripheral and private hospitals were included in the study and prospectively analysed for the cause of obstetric/gynaecological treatment referral, treatment obtained before arrival, delays during various points of treatment. Results: Out of 156 cases studied, 118 cases (75.64%) were of obstetrics and 38 cases (24.35 %) were of gynaecology. Neonatal ICU care post delivery (n=28, 23.7%) was the most common cause of referral, followed by cases due to obstructed labour (n=27, 22.8 %). Out of 38 cases of gynaecology, maximum cases were of Ca Ovary (n=15, 39.4%), followed by those of uterire prolapsed (n= 14, 36%). Neonatal mortality in referred cases was observed in 8 cases, while obstetrics deaths were observed in 3 cases. Lack of facilities at peripheral health centre and lack of blood bank facilities were dominant reasons for referring the cases. Conclusion: In view of the above findings, there is need for social and clinical interventions to fill the gaps in the current referring practices, to strengthen and improve quality of services, infrastructure and availability of trained manpower at peripheral health centres. Key words: Referral cases, Obstetrics, Gynaecology, Obstructed labour

143-147

Authors: Hemant G. Deshpande, Anika G. Ansari, Parveen S. Choudhary, Chandrakant S Madhav.

Background and Objectives: The term ‘cervical incompetence’ is used to describe a disorder in which painless cervical dilatation led to recurrent second trimester pregnancy losses .Structural weakness of cervical tissue was thought to cause or contribute to these adverse outcomes. The diagnosis has also been applied to women with one or two such losses/deliveries or at risk for such a loss/delivery. The aims and objectives of this study were to study the maximum gestational age upto which pregnancy can reach after cerclage, the morbidity of the procedure in terms of complications of the surgery, days of hospital stay, cost effectiveness, etc. and to estimate if cerclage prevents preterm birth and perinatal mortality and morbidity in women with previous preterm birth and short cervical length. Methods: A hospital based prospective study including 50 cases of Modified Shirodkar’s Cerclage and 50 cases of McDonald’s Cerclage, from July 2012 to September 2014 at Dr. D.Y. Patil Medical College and Hospital, Pimpri. Results: The average gestational age up to which pregnancy continued in patients with Modified Shirodkar’s Cerclage was 36 weeks compared to patients with McDonald’s Cerclage which was 33 weeks. Conclusion: Modified Shirodkar’s Cerclage was found to be a comparatively better method of cerclage than McDonald’s Cerclage in terms of preventing preterm birth. Women undergoing Modified Shirodkar’s Cerclage carried their pregnancy significantly longer, had lower neonatal admission rates and suffered a lower cost for maternal and neonatal care. They also showed higher birth weights and lower neonatal death rates. Key Words: Cervical Incompetence, Modified Shirodkar’s Cerclage, McDonald’s Cerclage

149-150

Authors: Saleem M., Gopal R., Sunil S. Shivekar, Mangaiyarkarasi T..

Background: Scrub typhus & Dengue fever are being increasingly reported from tropical countries including India. Both of them are vector borne with a peak incidence during post monsoon period, although prevalent throughout the year. These infections have a common clinical presentation in the early stages most often except when characteristic ‘Eschar’ is seen or the patient presents with complications of dengue. Although these infections are common ‘Co-infection’ have been rarely reported. Materials and Methods: Patients attending Sri Manakula Vinayagar Medical College and Hospital, were serologically tested for dengue and scrub typhus as suggested by physicians. Results: A total of 15 cases of dual infection with scrub typhus and dengue is reported in this paper. Conclusion: A high index of clinical suspicion and failure of therapeutic response should alert the clinician to the possibility of dual infection which carries a high morbidity and mortality and investigation for the same. Key words: Dengue, Scrub typhus, Dual infection, Puducherry, India

158-161

Authors: Pragati Abhimanyu Bulle, Dilip Gedam, Suchita Tekam, Priti Shendre.

India has the third highest number of estimated people living with HIV in the world. According to the HIV Estimations 2012, the estimated number of people living with HIV/AIDS in India was 20.89 lakh, with an estimated adult (15-49 age group) HIV prevalence of 0.27% in 2011. India has demonstrated an overall reduction of 57% in the annual new HIV infections among adult population from 2.74 lakh in 2000 to 1.16 lakh in 2011, reflecting the impact of various interventions and scaled-up prevention strategies under the National AIDS Control Programme (NACP). This HIV infection is not only common in males but also in females and in female commercial sex workers facing the major problem. Hence the present study was conducted to study the impact of Targeted Interventions on HIV in female sex workers. A total of 351 commercial sex workers were screened for HIV. Seroprevalence of HIV in female sex workers was found to be 0.28%. Conclusion: The seroprevalence of HIV in high risk group can be reduced by the effective implementation of Targeted Intervention Programme of NACO. Key words: Female sex workers, HIV, AIDS, NACO

175-179

Authors: Mita D Wadekar, Lavanya Jagdish, Swaroopa Rani N.B., Ravi Kumar Gupta.

Urinary tract infection (UTI) is one of the commonest infections worldwide. Although, the spectrum of etiological agents causing UTI have not changed but the antimicrobial susceptibility profile among them is changing over time and area specifically along with increase in antimicrobial resistance. Hence, this study was done to analyse the etiological agents and susceptibility pattern of E. coli, the most common UTI pathogen. Antibiotic susceptibility pattern and bacteria isolated from urine of patients who visited hospital between January 1 to December 31, 2015 was done. Bacteria were identified by standard microbiological methods and susceptibility test was done according to Kirby Bauer disc diffusion method. Of 107 urine samples, E. coli 73 (67.7%) was the most common isolate followed by Staphylococcus and Klebsiella spp. Most of E. coli isolates were sensitive to amikacin and nitrofurantoin. Out of total E. coli isolates, 57 were ESBL producers and 28 were MBL producers. The result indicates increase in multidrug resistant strains of E. coli. Further, study indicates the need for periodic monitoring of drug susceptibility pattern in a way to prevent the spread, and development of antimicrobial resistant strains, eventually. Keywords: E. coli, urinary tract infection, antibiotic resistance

185-189

Authors: Dan Amitabha, Roy Bibhash, Pasi A R, Jalaludeen M, Kunal Kanti De.

Background: On 12th September 2011, unusual poultry deaths were reported from a poultry farm at Putimari Christianpara under Tehatta Gram Panchayat. On 14th September there were more deaths accordingly, samples were collected and sent to the Regional Disease Diagnostic Laboratory, Kolkata. Preliminary reports confirmed the presence of avian influenza. High Security Disease Detection Laboratory at Bhopal confirmed avian influenza. The state Govt notified the outbreak as avian influenza on 19th September 2010. This outbreak was investigated and epidemiological characteristic & containment measures were described. Material and Methods: Operational definition of avian influenza was established. Fever surveillance in animals and human beings was conducted within 10 kms radius of epicenters. Culling was conducted. All health workers, and cullers were examined and prophylaxis was administered. Results: Out of total 56 Gram Panchayat 25(45%) were affected. Out of 568 villages 131(23%) were affected. Out of 131 affected villages 22 were in the core area and the rest outside. Population affected was estimated to be 400007. Mean population covered per day was 104603 (26%). Conclusion: In all 217 cases were detected with upper respiratory tract but none matched the case definition of avian influenza. Key words: Avian Influenza, H5N1, Surveillance, Culling, Nadia District, West Bengal

197-202

Authors: ohan Sundaram, Dinesh Babu, Karthikeyan Dhandapani.

Introduction: Now days many drug resistant bacteria has been isolated from bacteraemia cases. And these bacteria threaten the patient’s life with associated biofilm production around the implants like Intravenous catheters, Venflons, etc. Aim: to identify the prevalence of drug resistance among GNB (Gram Negative Bacteria) isolated from blood culture and to check their ability to produce biofilm by invitro method. Materials and Methods: A total of 365 blood samples were collected and processed from clinically diagnosed septicaemia patients. These samples were processed to isolate the bacteria with ABST by using standard CLSI guidelines. Biofilm production was identified by Tube method, Congo red agar method and Tissue culture plate method. Result: Out of 365, 62 (17%) blood samples were isolated with gram negative bacilli. Out of 62 isolates, 17 (27.4%) were identified as Escherichia coli, 13 (21%) were identified to be Acinetobacter spp, 12 (19.3%) were Pseudomonas spp, 08 (13%) were Salmonella spp, 06 (9.6%) were isolated as Klebsiella spp. Citobacter spp and Enterobacter spp were isolated with 03 (4.8%) each. Among these 62 isolates, 28 (45.2%) were identified to be either ESBL or MDR isolates, 18 (29%) isolates produces biofilm by all three methods. Among the biofilm producers, (55.55%) were found to be the drug resistance bacteria. Conclusion: Result of this Blood culture reveals the increased rates of drug resistance bacteria which were due to improper use of antibiotics. And the major drug resistant bacteria are associated to produce Biofilm which makes the treatment to be more challenging. Key words: Biofilm production, Septicaemia, ESBL & MDR isolates, Drug resistance

209-212

Authors: Girish Babu RJ, Madhuri K.R

Background: Dengue is currently the second most prevalent vector borne disease in the world. Dengue fever and its more serious forms, dengue hemorrhagic fever and dengue shock syndrome, are becoming important public health problems. Since there is no immune prophylactic or specific antiviral therapy available, clinico-microbiological diagnosis plays a vital role in patient management and implementation of control measures. Objective: To study the clinical and laboratory profile of Dengue cases admitted at Sri Siddhartha Medical College and Hospital. Materials and Methods: A hospital based prospective study was carried out from June to December 2015 in Sri Siddhartha Medical College and Hospital. 150 seropositive cases aged between 18-75 years admitted in the medical wards were included. Clinical profile of the patients was noted. Rapid immunochromatography test and ELISA was performed to detect NS1 antigen, IgM and IgG antibodies. Platelet count, total leucocyte count and routine laboratory investigations were also analysed. Results & Discussion: Out of 150 seropositive cases, 88 were males and 62 were females. The commonest presenting symptom was fever. In majority of cases thrombocytopenia ranged from 50,000 – 100,000/cu.mm. NS1 antigen, IgM and IgG antibodies were found Seropositive in 70%, 7%, and 3% cases respectively. In remaining 20% of cases, more than one marker was seropositive. Conclusion: High degree of clinical suspicion, supported by laboratory evidences like thrombocytopenia and specific dengue serological tests help in early diagnosis of dengue. Keywords: Dengue, clinical profile, IgM, IgG, NS1