Ankur Goyal

Microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge

Objective: Our aim is to study the microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge in tertiary care teaching centre in Agra region and its application in the empirical treatment of chronic suppurative otitis media (CSOM). Place and Duration : The study was conducted from March 2012 to July 2012 on 125 patients attending the ENT OPD and Microbiology Department having ear inflammation history for more than 3 months. Materials and Methods: Samples were taken from 125 patients (both male and female) in all age groups suffering from CSOM and having ear discharge. Their gram staining, direct microscopy with KOH, culture sensitivity, and biochemical tests were carried out to identify the organisms and to know their sensitivity pattern. Results: It showed the predominance by Staphylococcus species (37.6%), followed by Pseudomonas aeruginosa (32.8%), Klebsiella pneumoniae (4%), and Escherichia coli (3.2%). The susceptibility of Staphylococcus species was high (80-85%) with moxifloxacin, levofloxacin, and doxycycline among the commonly used antibiotics. Sensitivity of Staphylococcus species was low (<50%) with beta-lactam drugs. Pseudomonas aeruginosa was 100% sensitive with colistin, polymyxin B, and carbapenems. It is highly sensitive (80%-90%) to aminoglycosides and piperacillin/tazobactam. Its sensitivity was about 60-70% with the commonly used antibiotics, viz. cephalosporins and fluoroquinolones . Conclusion : The study of microbial pattern and their antibiotic sensitivity determines the prevalent bacterial organisms causing CSOM in local area and to start empirical treatment of otitis media and its complications for successful outcome, thus to prevent the emergence of resistant strains.

Prevalence and Antimicrobial Susceptibility Pattern of Methicillin-resistant Staphylococcus aureus (MRSA) isolates at a Tertiary Care Hospital in Agra, North India - A systemic annual review

A total 1163(10.12%) staphylococcus aureus were isolated from 11496 clinical specimens (2009 - 2012) among which 379 (32.6%) were MRSA. In our retrospective study, we found a continuous increase in MRSA prevalence over the time which was 16.5% in 2009; increased to 22.2% in 2010, 34.6% in 2011 and 37.5% in 2012? The average MRSA prevalence observed during this period was 27.7 %. The overall MRSA prevalence was 3.3% among all clinical specimens tested. No resistance was seen for Vancomycin, Teicoplanin and Linozolid. The highest sensitivity was observed by Doxycyclin (79.04%) & Amikacin (96%) where as the least was by erythromycin (21.18%) & Chloramphenicol (52.2%) for MRSA and MSSA isolates respectively. Females were more prevalent (62%) as compared to males (38%) for MRSA infections.

Bacteriological Evaluation and Their Antibiotic Sensitivity Pattern in Tonsillitis

The Study Was Carried Out On 140 Patients With Signs And Symptoms Of Tonsillitis.Tonsillar Swabs Were Taken And Final Evaluation Was Done On The Basis Of Standard Biochemical Test. The Antimicrobial Susceptibility Test Was Done As Per Guidelines Of CLSI. Out Of 140 Tonsillar Surface Swab Cultures, 135 Cultures Showed Bacterial Isolates. Staphylococcus Aureus Was The Commonest Isolate From 16 Swabs (11.43%), Followed By Streptococcus Pneumoniae In 7 Swabs (5.00%). The Other Isolated Bacteria Includes Pseudomonas Species, E. Coli, Beta Haemolyticstreptococci And Proteus Vulgaris. Out Of 35 Bacterial Isolates, 30 Strains Were Found Sensitive To Netilmycin. Staphylococcus Species Showed Susceptibility Of 81.25% With Netilmycin, 68.75% With Gentamicin. Amoung 16 Staphylococcus Species 6 Were MRSA Which Were 100% Sensitive To Vancomycin. Pneumococcus Species Were 100.00% Resistant With Cefaclor, 85.71% With Gentamicin, And 71.43% With Tobramycin.

Urinary tract infection in pediatrics patients in north India

Background -Urinary tract infection (UTI) is one of the most common bacterial infections seen in patient. It may lead to renal scarring, hypertension, and end-stage renal disease. Early diagnosis is important to preserve renal function of the growing kidney. Aim- The aim of the present study was to assess the prevalence and changing susceptibility pattern of urinary pathogensin febrile paediatrics patients. Methods and Material- Fifty millilitres urine specimen was collected in a sterile container with sterile precaution and used for microscopic examination (pyuria detection) and for culture and sensitivity. Results-Out of total 820 cases 170 showed significant bacteriuria of which 107(62.94%) had fever. Females showed higher positivity in UTI cases than males with ratio of 1.3:1. In our study E.coli was 27.05 % and Klebsiella 18.82% was predominant pathogen isolated. These isolates showed the highest resistance towards first line of drugs Cefadroxil, Amoxicillin and Cefuroxime, being most sensitive to Imipenem cefepime. Conclusion-To successfully eradicate UTI by empiric treatment, knowledge of local etiologic agents and their antibiotic susceptibility is of great value. Key Word: Dysuria, Significant bacteriuria,UTI

Microbiological Investigation of Water Sources as Cause of Acute Watery Diarrhoea Outbreak in District of Mathura, India

Cholera is one of the most important diarrhoeal diseases in India and a major illness of public health importance. Recently there was an outbreak of acute watery diarrhoea in Mathura district, during late OctoberNovember 2016. Objectives: To determine the cause, source and extent of the acute diarrhoeal disease outbreak in district of Mathura by conducting an environmental and microbiological investigation. Materials and Methods: Water samples (1 from pond, 2 from municipal taps, 2 from tube wells and 3 from tanks) were collected from areas reporting the maximum number of cases of acute watery diarrhoea, and tested for diarrhoeagenic pathogens in the laboratory. Isolation and identification of pathogen was done according to the standard methodology. Results: Of the eight water samples tested, four were found to be positive for V. cholerae. The major reason for the outbreak was traced to be contaminated water from one tank, one tap and two tube wells. Conclusion: Our findings demonstrated that water supply of the public water sources, possibly contaminated by the nearby sewerage system, was the probable cause of acute watery diarrhoea outbreak in district of Mathura and the etiological agent was found to be V.cholerae. The people from this area have poor knowledge on proper hygiene. There is urgent need for public awareness against water borne diseases. Also, Mathura being a holy place, is visited by a large number of tourists, who also have access to these public water sources. Continuous surveillance of the outbreak is necessary to contain the spread of transmission.

Seroprevalence of hepatitis B and syphilis co-infection in human immunodeficiency virus-positive antiretroviral therapy attendees and human immunodeficiency virus-negative sexually transmitted infection attendees

Sir, Sexually transmitted diseases (STDs) remain a public health problem of major significance in most part of the world. India has the second highest number of people living with human immunodeficiency virus (HIV).[1] The presence of genital ulcers (syphilis) significantly increases the transmission of HIV to sexual partner. Recent outbreaks of syphilis and increase in hepatitis B cases have raised concern regarding the potential enhancement of STDs. It has recently been found that HIV‐positive patients with hepatitis B virus (HBV) co‐infection are associated with increased risk of progression to severe hepatotoxicity due to antiretroviral therapy (ART) and reduced survival of the patient.[2] Therefore, there is a serious need to consider anti‐HBV therapy in addition to ART in those with dual infection.