Sunita M Bhatawadekar

Abstract

Background: is an emerging opportunistic pathogen and increasingly implicated in hospital acquired infection especially in intensive care unit. The infection caused by spp. is difficult to control due to multi drug resistance which limits its therapeutic options. This study was undertaken to isolate from various clinical samples and to speciate isolates. Efforts were made to study the antimicrobial susceptibility pattern of species and to detect metallo beta lactamase producing strains. Materials and Methods: Clinical samples blood, urine, sputum, pus, body fluids and ETT sample received in microbiology laboratory were processed according to the standard laboratory procedure. Identification and antimicrobial susceptibility testing was done by VITEK-2 automated method. All the isolates that showed resistance to Imipenem were tested for Metallo – Beta – Lactamase (MBL) production by phenotypic test, Imipenem-EDTA-combined disc test method. Results: Out of total 100 spp isolated from clinical samples, 80 were isolated from critical care units. baumannii was common spp 88 (88%), followed by A.complex 10 (10%). Isolation rate of species was highest from blood (27%) specimens followed by ETT (19%). 44% strains of were isolated from respiratory samples. 84(84%) spp, were carbapenem resistant. Out of 84 carbapenems resistant strains 48 (57%) were MBL positive strains by combined disc test. Conclusion: Emergence of MBLs producing strains of is alarming and reflects excessive use of carbapenems. Therefore early detection and prompt infection control measures is important to prevent further spread of MBLs to other Gram negative bacilli.   Keywords: Acinetobacter spp, Carbapenem resistance

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Abstract

Aim: To determine efficacy of different hand washing solutions and various drying methods. Settings and Design: This is a prospective study carried out on health care workers at ICU, & Wards in the Tertiary care hospital, from western India for a period of 1 year 6 months. The study was approved by ethical committee of Medical College and Hospital. Materials and Methods: Two hand hygiene procedures were compared in this study. Handrubbing with alcohol based solution and handwashing with unmedicated soap. Fingertips of the HCW\’s dominant hand were gently pressed for 5 seconds on sheep blood agar before and after hand hygiene.1 Colony count was performed after 24 hours of incubation. 60 different samples were collected for each method. Out of these 60 handwashing samples, 30 dried hands by paper towels and 30 by cloth towels. Main outcome measure was bacterial reduction of hand contamination. Results: 120 HCWs were included in the study. The average reduction in the number of colony-forming units after handwashing was 80% for alcoholic solution and 43.16% for soap and water. The average reduction in the number of colony-forming units was 49.10 when hands were dried with paper towels as compared to 37.23 with cloth towels. CONS were the main bacteria colonising the hands of 60% of health care workers. Conclusions: Alcoholic hand rub is effective and should be followed as standard method for hand hygiene of HCWs in the hospital. It will help to reduce transmission of HAIs and to prevent the spread of antibiotic drug resistance.   Keywords: Hand Hygiene, Alcohol based Handrub, Drying paper Towelss

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Abstract

Introduction: Central line associated bloodstream infection (CLABSI) is a major contributing factor in-hospital mortality and morbidity. CLABSI are considered among the first and most "preventable" classes of nosocomial infections. The most serious complications are bacteremia, sepsis and death. The definitive diagnosis of catheter infection can be made by using a combination of clinical signs and symptoms together with the laboratory confirmed blood culture techniques. Aim and Objectives: To study the rate of CLABSI in ICU patients. To identify bacteria causing CLABSI and to study their antibiotic sensitivity pattern. Materials and Methods: This Prospective study was done over a period of 2 years (January 2014–December 2015). CLABSI was diagnosed based on Clinical criteria (Fever, chills&Hypotension) and Laboratory criteria (Qualitative blood cultures through device and Differential time to positivity or semi quantitative catheter segment culture). Results: For the year 2014 & 2015 rate of CLABSI was 7.35 and 5.10 per 1000 central line days. Rate of CLABSI in year 2015 has reduced as compared to year 2014. Out of total 19 isolates 12 were Gram positive cocci (63.15%): five coagulase negative staphylococci (CONS) (26.3%), four S. aureus (21.05%) and three Enterococci spp (15.7%). Six Gram negative bacilli were isolated: Two E.coli (ESBL) (10.5%), two Acinetobacter baumannii (10.5%), one K. pneumoniae (5.26%) and one Serratia Marcescens. One non albicans candida was isolated from CLABSI Conclusion: The 6.08 rate of CLABSI per 1000 catheter days, for 2014 to 2015, was a matter of concern. This work will help in better management of patients as well as in prevention of Catheter related blood stream infection, especially due to multi drug resistant organisms like MRSA & ESBL. Keywords: CLABSI, Bacterial profile, Multidrug resistant, I.C.U

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