Mala Sinha

Profile of dengue infection in Jamnagar city and district, west India

Background and Methods India is one of the countries in the World Health Organization South-East Asia Region that regularly reports outbreaks of dengue fever (DF)/dengue hemorrhagic fever (DHF). As effective control and preventive programmes depend upon improved surveillance data, this study was carried out to report the seroprevalence of dengue virus infection in an area around Jamnagar city, Western India. [1] Methods The laboratory records of clinically suspected dengue patients from July 2008 to June 2011 were analysed retrospectively for the results of immunoglobulin M (IgM) anti-dengue antibodies, tested by dengue monoclonal antibody (IgM) capture enzyme-linked immunosorbent assay (MAC ELISA). Variations in disease incidence by sex, age group and season were assessed. Results A total of 903 serum samples were tested, of which 253 were positive. The majority were males (72%) and in the age group of 16–30 years. The incidence of dengue peaked in October and slowly tapered by December. Conclusion Dengue cases were higher during September to December, in the post-monsoon season. This observation is useful for planning special preventive strategies. The study draws attention to the susceptibility of the male, young adult age group.

Pseudomonas aeruginosa in Nosocomial Infection: Burden in Surgical Site of Tertiary Care Unit

Antibiotic when first introduced was considered as a magic bullet. A single injection of penicillin could eradicate a life threatening infection. Unfortunately with time due to malpractices of natural causes, most of the cheaper antibiotics have lost their efficacy and more and more expensive and complicated antibiotics were introduced and marketed to combat simple infection (Betty et al., 2007). The microbial pathogens, as well as, their antibiotic sensitivity pattern, may change from time to time and place to place. Therefore knowledge of current drug resistance pattern of the common pathogenic bacteria in a particular region is useful in clinical practice.

Bacteriological Profile of Burn Patients in a Tertiary Care Hospital, Jamnagar, Gujarat, India

Burn wound infection is one of the most co mmon causes of mortality and morbidity in burn patients (Sedat et al., 2005). It has been estimated that 75% of all deaths following thermal injuries are related to infections (Vindenes et al., 1995). The rate of nosocomial infections are higher in burn patients due to various factors like nature of burn injury itself, immunocompromised status of the patient, invasive diagnostic and therapeutic procedures and prolonged ICU stay (Pruitt et al., 1998).

Incidence of Multidrug Resistant Pseudomonas Aeruginosa Isolated From Burn Patients Tertiary Care Hospital, Jamnagar, Gujarat, India.

Background: Pseudomonas aeruginosa is a ubiquitous micro-organism that can rapidly acquire resistance to different broad-spectrum antibiotics. Multidrug resistant (MDR) Pseudomonas aeruginosa is an emerging cause of mortality and morbidity in burn patients, which causes 4-60% nosocomial infections in different parts of the world. 1 Objectives:  To isolate Pseudomonas aeruginosa from pus samples of burns patients.  To assess the rates of antibiotic resistance and multidrug resistance among Pseudomonas isolates. Material & Methods: This study was carried out in the Department of Microbiology, Shri M. P. Shah Government Medical College, Jamnagar, Gujarat from September 2014 to June 2015 from burns ward, Guru Govind singh Govt. Hospital Jamnagar. A total of 391 swab samples were tested. The Pseudomonas aeruginosa isolates were identified by their direct microscopy examination,colony morphologies, pigment , Gram’s staining patterns, oxidase test, catalase test, Oxidation fermentation test, Triple sugar iron agar test, Arginine dihydrolase and Sugar fermentation test. Antibiotic sensitivity was determined for Amikacin (30mcg), Netilmycin(30mcg),Gentamycin(10mcg),Ceftazidime(30mcg),Piperacillin(100mcg), Piperacillin + Tazobactum(100mcg/10mcg), Aztreonem (30mcg), Imipenem (10mcg), Meropenem (10mcg), Colistin (10mcg), Polymixin B(300units), Ciprofloxacin(5mcg). Results: Incidence of Pseudomonas aeruginosa from burns patients is 36.45%. Incidence of Multidrug Resistant (MDR) Pseudomonas aeruginosa is 36.48%. Antibiotic susceptibility tests showed high level resistance toGentamycin(93.24%), Ciprofloxacin(89.18%), Amikacin(85.13%), Aztreonem(83.78%), Ceftazidime(81.08%), Netilmicin(75.67%), Piperacillin(72.97%), Piperacillin+Tazobactum(56.76%), Imipenem(14.86%). Resistance to Colistin and Polymixin B were 0%. Conclusions: We conclude that Pseudomonas aeruginosa with high level resistance to Aminoglycosides, Fluoroquinolones & Penicillin group of drugs. Infection in burns continues to be a great problem which is not yet solved and posses a challenge to the microbiologist and the surgeon. Based on the result of the antibiotic susceptibility testing of the various isolates antibiotics are to be administered only on clinical suspicion of sepsis.

The study of prevalence of Hepatitis B surface antigen during pregnancy

Background: Hepatitis B virus infection is a major public health problem accounting to 400 million chronic infections worldwide and great majority of the transmission of Hepatitis B in India and other developing countries occurs by vertical transmission from an infected carrier mother to the neonate, intrapartum or antenatally. Objective: To determine the prevalence of Hepatitis B surface antigen (HBsAg) in Pregnant Women. Methods: The study was conducted at M.P. Shah Govt. medical college and G.G. hospital, Jamnagar, Gujarat, India during July 2013 to December 2013, including 1810 antenatal women. All of them were evaluated using history, examination, and test for serum HBsAg using Commercial enzyme immunoassay kits. Result: Of the total 1810 antenatal women, 15 were found to be positive for HBsAg (0.83%). Highest prevalence was found in age group 21-25 years (53.3%) followed by age group 26-30 years (33.3%), age group 17-20 and age more than 30 years (6.7%). Conclusion: Hepatitis B is highly infectious, associated with maternal complications and transmission to the child. It is mandatory that all the antenatal women should be screened for HBsAg and appropriately managed.

Prevalence And Antibiotic Susceptibility Pattern Of Methicillin-Resistant Staphylococcus Aureus In A Tertiary Care Hospital, Jamnagar, Gujarat.

Methicillin resistantStaphylococcus aureus(MRSA) is an important nosocomial pathogen. The study was carried out to investigate the prevalence of MRSA and their rate of resistance to different antibiotics used for treatment. Identifi- cation of Staphylococcus aureuswas confirmed by standard methods and the antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Of the 191 isolates of Staphylococcus aureus, 58 isolates were identified as Methicillin Resistance Staphylococcus aureus (30.37%) and 7 were identified as Vancomycin Resistance Staphylococcus aureus (3.75%). During this study sensitivity of MRSA to linezolid is 93.10%, Ampicillin + Sulbactams(58.62%), levofloxacin (53.45%) ,Tetracy- cline (32.75%) , Lincomycin (29.31), Cotrimoxazole ( 13.80%) , Ciprofloxacin 10.34%, Roxythromycin ( 8.62%) and Gentamycin ( 2.74%). Findings presented in this study indicated a high level of resistance to widely used therapeutic agents. So, appropriate knowledge on the current antibiotic susceptibility pattern of MRSA is essential for appropriate therapeutic treatment. The study showed high prevalence of MRSA in hospital setting indicating need of good control measures such as proper hand hygiene and monitoring of susceptibility patterns of MRSA also help in preventing the spread of infections .

Extended Spectrum Beta - Lactamase (ESBL) Mediated Resistance to Antibiotics Among Klebsiella Pneumoniae in In Tertiary Care Hospital, Jamnagar, Gujarat

INTRODUCTION: Resistance bacteria are emerging worldwide as a threat to the favourable outcome of common infections in community and hospitals. Now a days ESBL producing strain in Klebsiella pneumoniae lead to resistance among the organism toward cephalosporin and other antibiotics. AIM: To determine the prevalence and antibiotic susceptibility patterns of Extended Spectrum Beta- Lactamase producing Klebsiella pneumoniae isolated from various clinical sam- ples. MATERIAL & METHODS: Clinical isolates of Klebsiella pneumoniae were confirmed by culture, staining & biochemical reaction. The isolates were subjected to susceptibility testing using Kirby- Bauer method of determining antimicrobial susceptibility and ESBL production was phenotypically determined using double disc synergy test. RESULTS: ESBL production was determined among 115 isolates of Klebsiella pneumoniae, out of 91 (79.13%) were express ESBL. CONCLUSION: Regular monitoring of antibiogram of organ- ism, and avoiding misuse and overuse of antibiotics may reverse the undesired effects of multidrug resistant and ESBL producing Klebsiella pneumoniae.

Candida Urinary Tract Infection (UTI) in Paediatric Population in Jamnagar District

Background: UTI is a common paediatrics problem. It is causing distress to child and parents. Incidence of Candida UTI is increased in last few decades and to be very precise more by Candida non albicans than C.albicans. Aims: Present study was performed to identify Candida spp. in urine in paediatric population. Also we looked for age and sex differentiation if any. Methods: Total 100 samples were tested by microscopy and culture methods during the study period from January 2012 to June 2012. All culture growths were identified by different methods. Results: Candida spp. was identified in 14% (n=100) of samples. C.tropicalis (42.86%) was the predominant pathogen followed by C. albicans (28.57%), C.glabrata (14.29%), C.parapsilosis (7.14%) and C.krusi (7.14%). Candida UTI was identified more in males before 1 year and in female after 1 year. Con- clusion: Fungal (Candida) infection should be one of the differential diagnoses while managing UTI. Non albicans spp. shares good amount of prevalence. Determinants like age and sex should also be considered.