Girish Narayanaswamy

Abstract

Pleural Empyema necessitans refers to the extension of an empyema out of the pleural space and in to the neighbouring chest wall and surrounding soft tissues.Salmonella typhi is a versatile pathogen with amazing potential of infecting almost all organs of its host. Globally, the life threatening illness caused by Salmonella typhi have made this pathogen a serious health concern for infection control professionals. Salmonella typhi usually manifests as a febrile illness with bacteremia after initial entry through the gastrointestinal route, but it can occasionally cause significant disease in extraintestinal sites. Various microbes have been found associated with pleural cavity abscesses that ultimately lead to high morbidity and mortality rates, but pulmonary involvement due to Salmonella infection is rare. We are reporting an unusaual and rare case of pleural cavity abscess caused by Salmonella typhi in a 44 years old febrile patient, admitted to a tertiary care hospital, Bangalore with a complaints of swelling on the left sided chest wall. Diagnosis was made by HRCT THORAX which revealed an well defined hypodense collection with peripheral rim enhancement in anterior chest wall around 7th to 8th costochondral junction, communication with left pleural cavity. Pus was collected from the abscess by incision and drainage. Salmonella enterica serotype typhi was isolated from the sample. Patient was put on appropriate antimicrobial therapy.   Keywords: Empyema necessitans, Salmonella enterica serotype typhi, Pleural cavity abscess, Bacteremia, Extraintestinal Antimicrobial therapy

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Abstract

Background: Bladder infection exists as frequently occurring infectious disease in diabetic mellitus of all distinct age groups. Acute cystitis is recognised as higher frequency in person with diabetes. Urinary Tract infection is most familiar and widespread infection in world-wide. The frequency of urinary tract infection is at peak in patients with diabetic mellitus. Diabetic mellitus (DM) is a group of metabolic impairment characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. It’s a common disease that affects health in many ways and relevant problems one of the leading illness world-wide. Urinary tract infection medical aid experimental is less execution of urine culture and sensitivity. In the present study designed to find out occurrence of bacterial urinary tract infection, Multidrug resistant organisms, health risk and antimicrobial drug medication for UTI’s. Objective: To hypothesize the spectrum of uropathogens and the profile of antibiotic resistance pattern in both diabetic and non-diabetic patient with asymptomatic urinary tract infection. Materials and Methods: The research study was performed for the duration of 6 Months (April-September 2022) in Vydehi Institute of medical science and research centre (VIMS & RC) Whitefield Bangalore. Diabeticas well as non-diabetic patientsabove 18 years of age, from OPD and also admitted in General medicine department of VIMS & RC was considered. A total of 247 diabetic and non-diabetic urine samples from outpatients and inpatients was collected and processed in the microbiology laboratory. In accordance to principle of Clinical and Laboratory Standards Institute, the urine samples was collected and analysed. VITEK 2 Automated system analyser was used to determine Antimicrobial Sensitivity. Results: Bacterial Multidrug Resistant Organism isolates in diabetes mellitus with bacteriuria is 48 (53%). Bacterial isolates in non-diabetic mellitus with bacteriuria is 29 (17%). and is frequently isolated. Gram-negative bacteria are highly resistant to multiple drugs like, Amikacin, Nitrofurantoin, Ceftriaxone, Clavulanic acid, Cefpirome, etc moreover increasingly resistant accessible antibiotics. Conclusion: and was the most familiar isolated microorganisms.   Keywords: E.coli, Klebsiella pneumoniae was the most familiar isolated microorganisms

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Abstract

Background: Acinetobacter baumannii was considered as a leading cause of nosocomial respiratory infection and bacteremia in many hospitals all over the world. However, there was a still a debates whether colonization and/or infection with Acinetobacter baumannii, increases morbidity and mortality independently of the effect of other risk factors.. Aim of the study was to isolate Acinetobacter baumannii among ICU patients, to detect carbapenem resistant Acinetobacter baumannii among ICU patients with Acinetobacter baumannii infections and to determine specific risk factors and outcome of the infections due to CRAB isolates. Materials and Methods: A retrospective study was carried out at Vydehi Institute of Medical Sciences and RC in Bangalore, in the ICU department from June 2021 to May 2022. Results: Among all the patients carbapenem resistance was detected more in patients above 60 years of age, males were predominant than females, most of the patients were on ventilation and in sepsis and mortality rate was high with the increased duration of ICU stays. Conclusion: Acinetobacter baumannii is a highly prevalent microorganism among ICU patients, while its potential to acquire resistance toward commonly used antibiotics represents it as a grave threat to the health care industry. Therefore, signifying the need for its regular monitoring in the health care setups. VAP due to CRAB and excess use of intravascular devices are the most important risk factors for CRAB bacteremia in our ICU. Early implementation of appropriate antimicrobial therapy, particularly in critically ill ICU patients with Carbapenem resistant Acinetobacter baumannii infections, with two or more co morbidities, can be crucial for survival.   Keywords: Carbapenem resistance, Acinetobacter baumannii, Multi drug resistance, Intensive care unit, Cardiac care unit, Cardiothorasic surgery unit, CRAB, VAP.

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