Namratha W Nandihal

Abstract

Background: Staphylococcus epidermidis is a normal commensal of the skin and mucous membrane of humans and animals. Despite the growing importance of its pathogenesis especially in neonatal septicemia and device associated infections, it is still considered as insignificant isolate in the clinical practice. Hence, the present study is taken up to analyze the sources and risk factors of the isolates and to know their antibiogram along with occurrence of Methicillin resistant S. epidermidis (MRSE). Materials and Methods: 150 clinically significant S. epidermidis isolates from various clinical specimens were considered in this study. Species identification was done by phenotypic methods. The antimicrobial susceptibility test and detection of Methicillin resistance were performed by Kirby-Bauer’s disc diffusion method as per CLSI guidelines. Results: Among 150 S. epidermidis isolates, 78% were recovered from hospital acquired infections. They were commonly isolated in pediatric age group (30%) and among males (60.67%). Total of 34.67% were isolated from pus samples followed by blood (25.33%). Most of the isolates were associated with multiple risk factors like hospitalization, prior antibiotic administration, foreign body in situ and ICU admission. Majority of the isolates expressed resistance towards Penicillin (93.33%), followed by Amoxicillin-Clavulanic acid (76%), Cotrimoxazole (71.33%), Fluoroquinolones (64%), Gentamicin (60%) and Erythromycin (55.33%). Resistance against Amikacin (16.67%), Tetracycline (9.3%) and Linezolid (0.67%) was low. All isolates were sensitive to Vancomycin. Inducible Clindamycin resistance was 18% and MRSE was 68%. Conclusion: Clinical importance and emergence of drug resistance among S. epidermidis infections is growing with the advent of advanced medicine. This warrants the need to implement simple laboratory methods for species identification of the S. epidermidis and to determine the antibiotic resistant patterns on routine basis. Clinical correlation of the isolate is crucial to rule out the colonizers and contaminants.   Keywords: MRSE, CoNS, Cefoxitin, Blood, Device

View Article

Abstract

Background: Coagulase Negative Staphylococci (CoNS) are common inhabitants of skin and mucous membrane, may act as pathogens causing fatal infections especially in immunocompromised patients. CoNS mainly cause infections involving biofilm on implanted biomaterials. Increase in antimicrobial resistance causes difficulties to treat life threatening infections. Despite their growing importance, their speciation is rarely done. Therefore, the present study is undertaken to identify CoNS to the species level and to know their antibiotic susceptibility pattern along with rate of MRCoNS. Materials and Methods: 250 isolates from various clinical specimens were considered in this study. The isolates were identified by colony morphology, Gram staining, catalase, slide and tube coagulase test. Speciation was done by Novobiocin resistance, urease activity, ornithine decarboxylase, pyrrolidonylarylamidase and aerobic acid production from mannose. The antimicrobial susceptibility was performed by Kirby-Bauer’s disc diffusion method as per CLSI guidelines. Results: Among 250 CoNS isolates, commonest species identified was S.epidermidis(59.2%) followed by S.haemolyticus(19.6%) and S.saprophyticus(12.4%). They were commonly isolated in the age group 21 to 30 years (26.8%) and among males(58%). Total of 33.2% were isolated from pus followed by blood(21.6%). Majority species expressed resistance towards nalidixic acid(97.2%) followed by Penicillin(94%), 74.4% to Amoxicillin-Clavulanic acid and 66.4% to Cotrimoxazole. All the isolates were sensitive to Vancomycin. Methicillin resistance among CoNS was 73.2%. Conclusion: The increased recognition of pathogenic potential in CoNS and emergence of drug resistance among them demonstrates the need to adopt simple laboratory methods to identify the species and determine the antibiotic resistant patterns to help the clinicians in treating the infections caused by CoNS. Keywords: CoNS, MRCoNS, Speciation, S epidermidis, S haemolyticus

View Article

Abstract

Introduction: Chikungunya disease is caused by Chikungunya virus, an Alpha virus under the family Togaviridae, transmitted through the vector Aedes spp. mosquitoes.  The sudden onset of very high fever along with rash and severe arthralgia are the main symptoms. It’s a major public health problem similar to other arboviral diseases like Dengue and Japanese B encephalitis infections. Materials and Methods: A cross sectional study was conducted at a tertiary care hospital in north Karnataka. Serum samples of 555 suspected cases of Chikungunya fever were tested for Chikungunya IgM antibodies by ELISA (from NIV, Pune) over a period of 4 years, from January 2013 to December 2016. Results: Of the 555 serum samples tested, 128 (23.06%) were positive for Chikungunya IgM antibodies. The most affected age group was 21 to 30 years 35 (27.34%), followed by 31 to 40 years 26(20.31%). Male to female ratio was 1:1.56. Of the seropositive cases, all the cases presented with the history of fever and joint pain. The maximum number of cases were seen during the monsoon i.e. June 32 (25%), followed by the post monsoon period September 26 (20.31%).)   Conclusions: The seroprevelance of Chikungunya cases in the present study is 23.06% with high prevalence in the monsoon and post monsoon months affecting the productive age group of the population. This reiterates the fact that Chikungunya continues to be a major health concern in our setting and indicates the need for appropriate strategies to reduce the severity of disease. Keywords: ELISA, Serology, Joint pain, Tagoviridae, IgM..

View Article