Drishti Sagar

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Abstract

Background: Klebsiella pneumoniae is a notorious superbug that is rapidly becoming the most common nosocomial pathogen to be isolated from intensive care settings. Objective: To determine the burden of Klebsiella pneumoniae and associated risk factors of late onset sepsis among neonates admitted into neonatal intensive care unit (NICU). Materials and Methods: A prospective study was conducted among 200 neonates admitted into the NICU of Sassoon General Hospital from January 1, 2019 to December 31, 2019. Neonates 72hrs after birth were included in the study. A detailed case history format of patient information was prepared. Blood sample was subjected to identification by culture and real time polymerase chain reaction (RT-PCR). Neonates who were positive by blood culture were confirmed as having sepsis. Results: Frequency of Klebsiella pneumoniae was 33.3% by blood culture and 38.1% by RT-PCR. Most of the septic neonates were males (n=6; 60%), formula fed (n=7; 70%), extremely low birth weight (n=6; 60%), delivered through caesarean section (n=6, 60%) and were preterm (n=7; 70%). Mortality was seen in 2 (20%) cases. All the isolates were sensitive to meropenem, piperacillin + tazobactam, amikacin, polymyxin B and colistin. Conclusion: Occurrence of Klebsiella pneumoniae was 33.3% in late onset neonatal sepsis by blood culture. Low birth weight, formula feeding, prematurity and caesarean section were associated with a higher risk of sepsis in these patients. Antimicrobial stewardship and hospital infection control measures are need of the hour in preventing late onset neonatal sepsis. Keywords: Klebsiella pneumoniae, late onset neonatal sepsis, neonatal intensive care unit, nosocomial, preterm, real time polymerase chain reaction

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Abstract

Enteric infections by are a frequent cause of diarrhea among immunocompromised and HIV infected patients but there are limited reports of their occurrence in immunocompetent patients. Cryptosporidiosis is a faeco-orally transmitted protozoan infection and is one of the leading causes of chronic parasitic diarrhea. Here we report a case series of cryptosporidiosis from three different patients where two patients are immunocompetent and one is a post renal transplant case. All the patients came with watery diarrhea for which stool samples were collected and examined by modified Ziehl Neelsen acid fast staining (Kinyoun’s method). On microscopic examination of smear, multiple, pink, round to oval acid fast oocysts of 4-6µm diameter were seen against a blue background morphologically resembling . Early diagnosis and prompt initiation of antiparasitic drugs aids in timely treatment and prevention of disseminated cryptosporidiosis. Keywords: Cryptosporidium, Diarrhea, Immunocompetent, Kinyoun’s method, Nitazoxanide.

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