Pushpa Devi

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in Northern India

Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab. Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008–February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method. Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin. Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.

Seroprevalence of HIV infection among the patients attending various emergency departments in a tertiary care hospital.

Emergency departments (EDs) receive patients from every background, socioeconomic group and health status. Hence, EDs can play a critical role in offering human immunodeficiency virus (HIV) testing and help in the national strategy of early HIV detection. The present study was conducted on 400 patients attending various EDs after taking Institutional Review Board approval. They were screened for HIV antibodies by three rapid/simple assay tests having different principles/antigens as per the NACO guidelines. Twenty-three (5.75%) of the 400 patients were HIV reactive. Fifteen (65.22%) of the 23 HIV-reactive patients were unaware of their reactive status. Majority of the HIV-reactive (65.22%) patients were from the Medicine emergency followed by Orthopaedics and Surgery (13.04%). Seven (30.43%) had history of fever of more than 1 month duration. Eight (34.78%) of them were later on clinically diagnosed as having various opportunistic infections. Thus, the study emphasizes the need for expansion of routine voluntary HIV counseling and testing to all the patients who come to the ED and practicing universal work precautions by health care workers.

Comparison of Enzyme-Linked Immunosorbent Assay and Immunochromatography for Rotavirus Detection in Children Below Five Years with Acute Gastroenteritis.

BACKGROUND Group-A rotaviruses are responsible for 30 to 60% of severe watery diarrhea cases in young children. Timely diagnosis of rotavirus infection helps to determine appropriate treatment and prevents unnecessary use of antibiotics. AIM To compare Immunochromatography (ICG) with standard ELISA test for diagnosis of and to determine incidence, clinical socio-epidemiological profile and possible risk factors associated with rotavirus infection in children below five years with acute gastroenteritis. SETTINGS AND DESIGN A prospective study performed from February 2013 to April 2014 in Microbiology and Paediatrics Departments, Government Medical College, Amritsar, Punjab, India. MATERIALS AND METHODS Hundred stool samples from children below five years diagnosed with acute gastroenteritis were taken and tested by ICG and standard ELISA test. STATISTICAL ANALYSIS Performed using the SPSS software for Windows, version 17.0. P-values calculated using χ(2) test for categorical variables. A p < 0.05 was considered significant. RESULTS Maximum cases with ICG showed a sensitivity of 95.24% and specificity of 97.47% when compared to ELISA. Incidence of rotavirus diarrhea was 21% using ELISA and 23% using ICG. With ELISA rotavirus infection was highest in age group 6 months to 24 months (83.3%) and in male (90.47%). The infection was maximum during November to April and presented with triad of diarrhea, vomiting, fever (76.2%). Majority of cases had watery diarrhea in high percentage (90.47%). Severe dehydration (76.19%), respiratory symptoms (38.09%), bottle feeding (52.38%), malnourished children (47.61%), children playing with toys (47.6%) and submersible water pump (61.95%) as a source of drinking water associated with rotavirus infection were found to statistically significant. CONCLUSION ICG shows a good agreement with ELISA and has the advantage of being a quicker, cost-effective and useful for testing single specimen, convenient, not requiring additional equipment, readily available, simple to perform and easy-to-read results.

Assessment of bacteriological quality of drinking water from various sources in Amritsar district of northern India

INTRODUCTION Safe water is a precondition for health and development and is a basic human right, yet it is still denied to hundreds of millions of people throughout the developing world. Water-related diseases caused by insufficient safe water supplies, coupled with poor sanitation and hygiene, cause 3.4 million deaths a year, mostly in children. METHODOLOGY The present study was conducted on 1,317 drinking water samples from various water sources in Amritsar district in northern India. All the samples were analyzed to assess bacteriological quality of water for presumptive coliform count by the multiple tube test. RESULTS A total of 42.9% (565/1,317) samples from various sources were found to be unfit for human consumption. Of the total 565 unsatisfactory samples, 253 were from submersible pumps, 197 were from taps of piped supply (domestic/public), 79 were from hand pumps, and 36 were from various other sources A significantly high level of contamination was observed in samples collected from submersible pumps (47.6%) and water tanks (47.3%), as these sources of water are more exposed and liable to contamination. CONCLUSIONS Despite continuous efforts by the government, civil society, and the international community, over a billion people still do not have access to improved water resources. Bacteriological assessment of all sources of drinking should be planned and conducted on regular basis to prevent waterborne dissemination of diseases.

Comparative study of effect of Withania somnifera as an adjuvant to DOTS in patients of newly diagnosed sputum smear positive pulmonary tuberculosis

BACKGROUND Ashwagandha (Withania somnifera Linn.) a rejuvenative herb has long been used as an immunomodulator in Indian subcontinent. As immunity plays an important role in pathogenesis and treatment of tuberculosis (TB), so role of W. somnifera as an adjuvant has been studied on selected parameter. METHOD A randomized, double-blind placebo-control study was conducted in two groups of 60 newly diagnosed sputum smear positive pulmonary TB patients on Directly Observed Treatment - short course (DOTS) regime. W. somnifera root extract or placebo capsules were given as add-on therapy for duration of 12 weeks. Effects on sputum conversion, Hemoglobin (Hb), body weight, Erythrocyte Sedimentation Rate (ESR), RBC counts, WBC counts, CD4 and CD8 counts, Serum Glutamic-Oxaloacetic Transaminase (SGOT), Serum Glutamic-Pyruvic Transaminase (SGPT), serum uric acid and HRQL (Health Related Quality of Life) Index scores were studied. RESULTS At the end of 8 weeks, sputum conversion was seen in 86.6% patients in study group and 76.6% in placebo group. At the end of 12 weeks a highly significant increase was seen in both CD4 and CD8 counts in study group. A raised SGOT and SGPT levels (>35IU/L) were observed in 16.6% and 33.3% patients in study group; 43.33% and 53.33% in the placebo group of patients. Elevated serum uric acid levels (>6mg/dl) were observed in 20% and 33.33% in study and placebo group respectively. Average gain in HRQL score was better in patients of study group. CONCLUSION Use of W. somnifera as an adjuvant in conjunction with anti-TB drugs used as DOTS showed a favorable effect on symptoms and immunological parameters in patients with pulmonary TB.