Anupam Das

Abstract

COVID-19 manifestations have been evolving and affect different parts of the body every time a new wave comes. Association of mucormycosis in COVID-19, Covid Associated Mucormycosis (CAM) affected patients especially affecting paranasal sinuses must be given serious and timely consideration. Prolonged history of uncontrolled diabetes and over the counter use of steroids and abrupt stoppage of steroids are two main factors aggravating the illness, and both these factors must be critically checked. Clinical condition like Mucormycosis are caused by pathogenic moulds of family Mucorales and Aspergillosis is caused by Aspergillus species and both can cause an invasive disease with high case fatality rate, especially in immunosuppressed patients. In the present study we are discussing a case of co-infection in Post COVID-19 patient affected with mucormycosis and aspergillosis. A 55-year-old male patient with Type 2 diabetes mellitus presented post covid with ptosis and diplopia. Mixed infections of Rhizopus arrhizus and Aspergillus flavus were diagnosed by means of fungal microscopy and culture from biopsy sample. Treatment with Amphotericin B was started, the patient responded clinically within 15 days.   Keywords: Post COVID­19, Aspergillosis, diabetes mellitus, immunocompromised, mucormycosis, steroids

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Abstract

Aims and Objectives: Aim of this study was to know the prevalence of Coagulase Negative Staphylococci (CoNS) in Blood Stream Infection (BSI) among patients attending a Superspeciality hospital in North India.  Objective of this study was to compare incidence of CoNS in ICU and ward patients suffering from BSI and their antimicrobial susceptibility pattern. Materials and Methods: This retrospective hospital based study was conducted in the Microbiology Department, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow for a period of two years (January, 2017 -December, 2018). Blood samples from a total of 6498 patients from Out-Patient, In-Patient and Intensive care unit departments were subjected to aerobic and anaerobic bacterial culture. Culture positive broth was subcultured on Blood Agar and MacConkey Agar to isolate pathogens in pure culture. Pure cultured isolates were tested for antimicrobial susceptibility pattern by Kirby Bauer Disk Diffusion method as per CLSI 2018. Results: During the study period, out of total 3284 samples in 2017 and 3214 in 2018, 663 and 595 were found to be culture positive respectively. Staphylococci were isolated from 636 (9.78%) patients (10.2% in 2017 and 9.2% in 2018). Staphylococcus aureus was isolated from 18.8% and CoNS from 81.2% of total Staphylococcal isolates. Among CoNS isolates 70.7% were found to be Methicillin Resistant CoNS (MRCoNS). Discussion and Conclusion: This study observed CoNS as a major cause of BSI as compared to Staphylococcus aureus. The significance of CONS bacteremia should be evaluated better in light of clinical profile of the patient. Better screening and infection control practices in the future can decrease the rate of methicillin resistant CoNS in our centre. Keywords: Coagulase Negative Staphylococcus, Commensal, Blood stream infection, Antimicrobial resistance.

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Abstract

Objective of this study is to know the incidence of biofilm formation by isolates of Candida spp among the patients attending Tertiary health care Superspeciality centre in Lucknow. Material and Methods: A prospective study conducted among patients attending Out-patient department and admitted to In-patient department, and Intensive care unit during the period between January 1st and December 31st 2017. Different samples like endotracheal secretion, urine, blood and pus were collected under sterile conditions and standard fungal tests were performed for identification and appropriate statistical methods were employed to look for association between biofilm and Candida species. Results: Out of the 216 samples included in the study from various departments, 80 samples showed evidence of Candida infections yielding an infection rate of 37%. Among the 99 isolates (32 Candida albicans and 67 Non albicans Candida) subjected for biofilm production, 52 (52.5%) were positive. Conclusion: Non albicans Candida infection has drastically increased in healthcare centres. Biofilms have significant role in the perpetuation of these infections and antifungal resistance primarily with respect to their ability to adhere to various medical devices. Regular monitoring on the sensitivity and biofilm formation will be helpful in optimising therapy and outcome. Keywords: Candida Spp, Biofilms, Microtitre Plate Method.

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