Sumita Rajeevan

Abstract

Background and Objective: Urinary tract infections (UTI) are amongst the most common bacterial infections in developing countries. The etiology of UTI and the antibiotic resistance of uropathogenes vary in regions and change through times. Regular surveillance of the changing trends in its bacteriological profile and antibiotic sensitivity pattern is therefore mandatory. This study aims to find out the changing trends in the prevalence and antibiotic susceptibility patterns of urinary isolates of over five consecutive years. Materials and Methods: A retrospective, record based study was conducted on all culture and sensitivity (C/S) reports of urine samples obtained in the microbiology laboratory in a tertiary care centre, Central Kerala (January 2012- December 2016). The C/S reports which were positive for significant growth were analyzed to find out its prevalence and antibiotic susceptibility patterns. Descriptive statistics was used for data analysis and the results were expressed in percentages. Result: Of the 14105, urine specimens received, 27.93% were positive. Highest rate of UTI is seen in female patients (67.58%) and geriatric age group 47.58%. E.coli and Klebsiella are the two most common isolates from all five years of study period and constituted ~ 72% of total. The year wise analysis of antibiotic resistance showed fluctuating pattern. The resistance rate to drugs like Piperacillin –tazobactam and carbepenem showed increasing drug resistance. E.coli was found to be more sensitive to Amikacin and nitrofurantoin. Conclusion: Drug resistant strains are markedly high in our area. Antibiotic resistance does not show a consistent trend over years and vary from region to region. Therefore each institution should have an antibiotic policy based on the local antibiogram which is to be renewed regularly. Keywords: Urinary tract infections, Antibiotic resistance patterns, Bacteriological profile.

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Abstract

Dengue fever is one of the major public-health concerns in India and it has shown an increasing trend in Kerala since 2006. This study is aimed to study the serological and hematological parameters of patients with dengue fever in a tertiary referral center and teaching hospital. Materials and Methods: A retrospective study was performed, during the period of three years, from January 2016 to December 2018. A total of 2126 serum samples from clinically probable cases of dengue were added in the study. All the samples included were tested for NS1 antigen, IgM, and IgG antibodies, using the immunochromatographic test (ICT) Dengue Day 1 Test (J.Mitra & Co. Pvt. Ltd., New Delhi). Laboratory tests of dengue positive parameters and its hematological profile was co-related. Results: Out of 2126, 393 samples (18.48%) were positive for dengue. Among them 383 (97.45%) were grouped as primary dengue infection, 10 (2.54%) as secondary dengue infection. Higher rate of cases were in males and the age group of 21years to 30 years were chiefly affected. Maximum cases were found in monsoon and post monsoon seasons. Leucopenia and thrombocytopenia was more consistently associated with dengue infection Conclusions: Thrombocytopenia and leucopenia are prima facie and are indicators for provisional and initial diagnosis of dengue infection. Defining primary and secondary dengue infection will be helpful to clinicians for optimal management to achieve a favorable outcome. Keywords: NS1 Antigen, IgM antibody, IgG antibody, Thrombocytopenia, Leukopenia.

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