Ashish Jitendranath

Abstract

Neonatal sepsis due to Salmonella species, though rare, can result in increased morbidity and mortality. Amongst the different species of Salmonella, most commonly presents as a case of gastroenteritis. We present a case of a newborn with sepsis, who was treated successfully and had recovered.   Keywords: Salmonella, Typhimurium, Ceftriaxone, Stool

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Abstract

Background and Rationale: Enterococci have long been recognised as low virulence bacteria occurring as commensals in the human intestine. However in the last two decades they emerged as one of the leading causes of nosocomial infections with the development of resistance to antibiotics. So appropriate identification and characterization and antimicrobial susceptibility testing of Enterococcal species is necessary for management and prevention of these infections. Materials and Methods: 150 isolates of Enterococcal species were obtained from various clinical samples. Characterisation was done by standard Microbiological methods and antibiotic susceptibility testing was done by Kirby- Bauer disc diffusion method and Vancomycin MIC tested by E- test. Results: Out of 150 isolates from various clinical samples like urine 93(62%), pus 45(30%), blood 7(4.6%) and other body fluids 5(3%), E.faecalis 131(87.3%) was the predominant isolate followed by E.faecium 14(9.3%), E.avium 2(1.3%), E.raffinosus 2(1.3%) and E.durans 1(0.6%). All isolates were sensitive to Vancomycin, Teicoplanin and Linezolid. Sensitivity to High level Gentamicin was 92%. Rate of resistance to Penicillin 150(100%), Tetracycline 95(63.3%), Ciprofloxacin 103(68.6%) and Ampicillin 67(44.6%). Conclusions: Even though no Vancomycin resistant strains were isolated from our study, there is incidence of Vancomycin resistant Enterococci are emerging as potent pathogen. So methods for characterization, antimicrobial susceptibility testing and MIC of Vancomycin should be done routinely for Enterococcal species. Keywords: Enterococcus, Efaecalis, Efaecium, High level Gentamicin, Vancomycinresistant Enterococci

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Abstract

Ventilator associated events (VAE) by Centers for Disease Control and Prevention (CDC) was created to overcome the difficulty in surveillance of ventilator associated pneumonia (VAP). Pathogens causing VAP vary from hospitals to hospitals thus necessitating the need for local surveillance. The objective was to calculate the incidence of VAE in our hospital, to assess various organisms responsible for PVAP and to analyse their sensitivity to different antibiotics. The study retro-prospectively analysed 53 patients by consecutive sampling who were intubated from January 2018 to November 2018 in Neuro surgery ICU of our hospital. We used CDC’s guidelines to report VAE. Patient’s case files were traced using their MRD numbers and data regarding causative organism and their culture and sensitivity reports were obtained. Out of 53 intubated patients, we had eight VAE. All of them were reported as possible ventilator associated pneumonia (PVAP). Prolonged ventilator days (> 5 days) were associated with increased risk of VAE in our study. The incidence and VAE rate per 1000 ventilation days were 15.1 % and was 29.6 respectively. Six patients (75%) had monomicrobial aetiology in which two patients died. Remaining two patients (25%) had polymicrobial aetiology. Klebsiella pneumoniae was seen in majority (n=6) of the patients. Colistin had the highest sensitivity to the isolates while Ampicillin was resistant to all four organisms. All of the organisms isolated were MDR pathogen which was resistant to most of the regular anti-biotics. Therefore, it is important to frame local antibiotic policies and precautions to prevent VAE in the future. Keywords: VAE, E coli, Acinetobacter.

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