Hemalatha Gurumurthy

Abstract

Background: Pseudomonas aeruginosa, a gram negative bacteria causes lung and nosocomial infections, mostly infect the body after surgery or invasive techniques. There has been a increasing prevalence in drug resistant variants in the recent years. Objectives: 1. To determine the antibiotic susceptibility patterns of P.Aeruginosa; 2. To assess the antibiotics used against P. aeruginosa and the cross resistance pattern existing between them; 3. To evaluate the possible resistance mechanisms of P.aeroginosa by phenotypic techniques. Materials and Methods: Thirty-six consecutive, nonduplicate P. aeruginosa isolates were collected between January to July in the year 2018 from the hospital pus samples. The isolates showed synthesis of pyocyanin and a oxidase positive reaction. Kirby bauer’s disc diffusion method (HIMEDIA). was used for assessing the sensitivity of drugs. Disk approximation test was done to check the prevalence of inducible lactamases. Modified Hodge test was done to assess the metallo-lactamase activity. Double disk synergy method had been preffered to evaluate the extended-spectrum beta-lactamase (ESBL) activity. Results: The most sensitive antibiotic was found to be ciprofloxacin which is followed by amikacin and ceftazidime (p < 0> Conclusion: Strict adherence to the recent trend of “reserve drugs” concept and minimizing the misuse of antibiotics can bring down the drug resistance and morbidity. The addressal of irrational and inappropriate use of antimicrobials among the clinician is the need of the hour. Keywords: Pseudomonas aeuroginosa, Sensitivity, Reisitance.

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Abstract

Introduction: Human immuno deficiency virus infection has become a pandemic. Infection with HIV results in a chronic illness characterized by a progressive decline in cell-mediated immune function. Diarrhoea occurs in almost 90% of patients with HIV in developing countries at sometime during the clinical course, and is the presenting symptom of approximately one third of patients with HIV infection. Aims: To find out the common enteric parasitic pathogens in the HIV infected individuals. To correlate the immune status to the parasitic infection. To find out the symptomatic correlation to the pathogens. Settings and Design: The cross sectional study was carried out in Puducherry for a period of 15 months. Materials and Methods: Two consecutive stool samples were collected from from HIV seropositive patients. The samples were concentrated and subjected to stool concentration, iodine and saline mounts & Kinyoun’s staining. Statistical analysis used: Epi info 6 computer software package [CDC, Atlanta, Georgia, USA, 1995]. Results: Of the 22 diarrhoeic stools of HIV cases, 7(31.8%) yielded parasites on Kinyoun’s staining; all 7(100%) were opportunistic protozoan pathogens. The prevalence of intestinal parasites among the HIV infected patients is as follows: Cryptosporidium sp. and Microsporidium sp., each were found in 6.3% of HIV seropositive cases. Strongyloides was seen in 2.5% of 80 seropositive cases. The mean CD4 counts in cases with parasites are listed as follows: Cryptosporidium sp.-133.2 cells, Microsporidium sp.-896 cells, Strongyloides stercoralis-228.5, Entamoeba histolytica/dispar-522 cells, Giardia sp. - 884 cells. Cryptosporidium sp. and Strongyloides stercoralis are found more in HIV seropositive cases with CD4 counts less than 200 cells; (p=0.002, OR=36, 95% CI=4-56) for Cryptosporidium sp. and ( OR=14.6, 95% CI=1.5-39.6) for Strongyloides stercoralis. There is a significant correlation between CD4 counts Conclusions: The present study shows that Cryptosporidium is the predominant enteric protozoan parasite. Keywords: HIV, Diarrhoea, Cryptosporidium, Kinyoun staining, CD4 counts Key Messages: Enteric parasitic pathogens (opportunistic) in HIV infected individuals is common in patients with normal CD4 counts and antibiotic prophylaxis

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