Swagata Ganguly Bhattacharjee

Medical College and Hospital, Kolkata

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Suman Kundu

Medical College and Hospital, Kolkata

Kabita Choudhury

Burdwan Medical College & Hospital

Jayanta Bikash Dey

Medical College and Hospital, Kolkata

Somnath Bhunia

Nil Ratan Sircar Medical College and Hospital

Ankita Banik

Nil Ratan Sircar Medical College and Hospital

Kishor Kumar Behera

All India Institute of Medical Sciences Bhubaneswar

Chayanika Banerjee

Chandigarh University

Sonia Deb

Medical College and Hospital, Kolkata

Soumodip Dutta

Cizarina Roy

Medical College and Hospital, Kolkata

Cooperative Institutions

Medical College and Hospital, Kolkata

Nil Ratan Sircar Medical College and Hospital

Bankura Sammilani Medical College

Government of India

All India Institute of Medical Sciences

University College London

Banaras Hindu University

All India Institute of Medical Sciences Bhubaneswar

Chandigarh University

National Institute of Cancer Research and Hospital

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A clinicoepidemiological study of serologically diagnosed acute febrile illness in a teaching hospital, Kolkata

Journal of Family Medicine and Primary Care (2024)

Suman Kundu Priyabrata Mondal Kabita Choudhury Shruti Chakraborty Ankita Banik

A BSTRACT Introduction: Similar presenting manifestations in early phase and lack of awareness of aetiology of acute febrile illness (AFI) are major challenges in management of AFI. Material and Methods: This was a retrospective observational cross-sectional study conducted in the Department of Microbiology, NRS Medical College, from 1 July 2022 to 30 June 2023 in serologically diagnosed febrile patients attending the outpatient department or admitted. Clinical and epidemiological data and laboratory parameters were recorded in a pretested structured questionnaire study tool, and collected data were analysed on MS-Excel sheets with various charts and tables. Results: A total of 1711 serologically diagnosed febrile patients showed preponderance of dengue (38.3%), followed by leptospirosis (25%), scrub typhus (23.9%), malaria (12.6%), and enteric fever (1.92%). A majority of cases were male, less than 40 years of age, and from the rural population (73.2%), except in malaria (urban = 79.6%). The mean duration of fever was 9 days. Febrile cases were recorded maximum during the monsoon and postmonsoon periods (66.5%). The common manifestations are fever, headache (46.2%), pain abdomen (7.8%), nausea, and vomiting (9.4%). Thrombocytopenia with bleeding manifestation was higher in dengue (18%) cases. Mortality in dengue cases was recorded with multiorgan dysfunction syndrome (MODS). Scrub typhus cases showed seizure (8.3%) and altered sensorium (5%) due to fatal meningoencephalitis. Fatality in leptospirosis was mostly due to acute kidney injury (29.5%) and Weil’s disease (4.4%). Conclusion: Misdiagnosis or incorrect diagnosis and delay in initiation of appropriate treatment results in increased morbidity and mortality in AFI. Determination of epidemiological features and clinical manifestations of AFI along with timely correct diagnosis will benefit clinicians in proper treatment initiation, thereby reducing morbidity and mortality.

Case fatality rate

Etiology

10.4103/jfmpc.jfmpc_322_24

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Study on parameters of severity in Dengue infection with both NS1 Antigen and Dengue IgM reactive on the same day, in a tertiary care hospital, Kolkata.

Indian Journal of Medical Microbiology (2021)

Soumodip Dutta Chayanika Banerjee Anindya Ghosh Kabita Choudhury Swagata Ganguly Bhattacharjee

10.1016/j.ijmmb.2021.08.439

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Phenotypic Characterisation, Virulence Determination and Antimicrobial Resistance Pattern of Enterococcus Species Isolated from Clinical Specimen in a Tertiary Care Hospital in Kolkata

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH (2021)

Subhendu Sikdar Sampa Sadhukhan Amit Kumar Majumdar Somnath Bhunia Soma Sarkar

Introduction: Enterococci are usually normal human commensal of gastrointestinal tract predominantly. They are considered as an important nosocomial pathogen now a day due to its intrinsic as well as increasing acquired antibiotic resistance resulting in a great threat to modern Medicine. Aim: To determine prevalence of Enterococci isolated from clinical specimens with special reference to its virulence and antibiogram conventionally. Materials and Methods: A cross-sectional observational study was conducted over a period of two years (January 2019 to December 2020) with 326 Enterococci, isolated from various clinical specimens received by Department of Microbiology. Enterococci isolated from stool samples were excluded. They were identified and speciated conventionally as per standard laboratory protocol. Gelatinase, haemolysin and biofilm formation was determined for each isolate. Their antibiogram was also determined by disc diffusion methods over Blood agar followed by Minimum Inhibitory Concentration (MIC) testing (as per Clinical and Laboratory Standards Institute (CLSI) guideline). All statistical analysis was done by Chi-square test using Software Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Among the total 4516 samples collected, growth of Enterococci was noted in 7.22% cases. Out of them, E. faecalis (84.05%) out numbered E. faecium. Urine was the most predominant (55.22%) sample. 73.93% isolates produced biofilm whereas 18.40% produced haemolysin and 19.94% produced gelatinase. Most of the isolates were susceptible to vancomycin (94.79%) and linezolid (98.77%). High level gentamicin resistance was seen in 54.6% cases. Ciprofloxacin was the most resistant antibiotic. Vancomycin Resistance Enterococcus (VRE) was detected in 5.21% cases only, out of which Van A type was detected phenotypically in most cases. Conclusion: The high rate of resistance to high-level gentamicin could fail treatment of gentamicin in combination with penicillin group of antibiotics. In clinical samples, the emergence of VRE strains makes treatment options more challenging.

Linezolid

Enterococcus faecalis

Enterococcus faecium

Agar diffusion test

Teicoplanin

10.7860/jcdr/2021/48616.15077

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Microbiological profile and antimicrobial susceptibility patterns of blood stream infections in febrile neutropenic patients with hematological malignancies in a tertiary care hospital, Kolkata

IP International Journal of Medical Microbiology and Tropical Diseases (2024)

Swagata Ganguly Bhattacharjee Sayan Mandal S. Mullick Somnath Bhunia Suman Kundu

Blood stream infection (BSI) in febrile neutropenic (FN) patients with hematological malignancy is a common manifestation with high mortality rate. To reduce mortality knowledge of pathogens causing BSI and their antimicrobial susceptibility patterns are required for timely initiation of appropriate antimicrobial therapy. This study was aimed to characterize the pathogenic spectrum and antimicrobial resistance patterns of BSI in these patients. In this cross-sectional study patients admitted in the Hematology department over a period of one year with laboratory confirmed positive blood cultures were enrolled. Information regarding demographic profiles and microbiological profiles were recorded. Standard procedures were applied to identify the isolates and their resistance patterns in positive blood culture. Data was collected and analyzed on MS-Excel sheet with various charts and tables. During the study period of one year 198 episodes of BSI recorded in 147 FN patients. Majority of isolates were Gram-negative bacilli (GNB: n=107, 54.04%). Among GNB (n=34, 31.77%) was most frequently isolated and in Gram-positive cocci (GPC) majority isolated was (n=37, 62.71%). (n=12, 37.5%) was the commonest fungal pathogen isolated. Susceptibility to penicillin, clindamycin and quinolones were least among GPC. Among GNB higher resistance patterns were observed against ceftazidime, cefepime, cefoperazone-sulbactam, piperacillin-tazobactam and meropenem. All isolates were resistant to fluconazole. This study revealed a significant increase in proportion of Gram-negative non-fermenting bacteria (GNNFB). These findings highlight the necessity for regular revision of institutional antimicrobial policy which will reduce mortality as well as development of resistant pathogens.

Blood stream

Tertiary care

Hematologic Neoplasms

10.18231/j.ijmmtd.2024.029

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Pathogenic Menace of MDR Bacteria in Stool and Throat Swab Surveillance Cultures of Hematopoietic Stem Cell Recipients and Evaluation of Post-Transplant Bloodstream Infections: A Cross-Sectional Study from A Tertiary Care Teaching Hospital of Kolkata, India

National Journal of Medical Research (2025)

Kabita Choudhury Sonia Deb Suman Kundu B. Dhar Tuphan Kanti Dolai

Background Infections with multidrug-resistant organisms (MDRO) may pose a threat to hematopoietic stem cell transplant recipients. Pre-transplant surveillance culture of stool and throat swabs may guide antibiotic therapy in these groups of patients. We have conducted this study to determine the profile of organisms isolated from stool and throat swab cultures, their susceptibility pattern, and the presence of MDRO to detect post-transplant bloodstream infections in this tertiary care teaching hospital in Kolkata. Methods This cross-sectional study was conducted over a period of one year between 1st January to 31st December 2023. Pre-transplant surveillance culture of stool and throat swabs were performed on seventy patients from the Department of Hematology and processed in the Department of Microbiology using standard laboratory guidelines and their antibiotic susceptibility was done as per CLSI 2023 guidelines. The organisms were phenotypically screened for drug resistance and molecular confirmation was done for carbapenemases producers. Bloodstream infections in these recipients were detected by blood culture. Results There were 70 transplant recipients in whom stool surveillance culture yielded maximum incidence of Escherichia coli of which 32.8% were MDRO. Throat surveillance culture yielded Escherichia coli with 51.8% MDRO. blaNDM was the most common carbapenemases gene detected. Post-transplant the incidence of bloodstream infections detected by blood culture was seen in 32 recipients with Acinetobacter baumannii being the predominant Gram-negative isolate. Conclusion Colonization with MDRO in HSCT recipients before transplant is a potential threat. Performing stool and throat surveillance cultures before transplantation can inform empirical antibiotic strategies and tailored individualized antibiotic treatment.

Throat

Tertiary care

Hematopoietic stem cell

10.55489/njmr.150120251035

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Surgical site infection: Clinico- bacteriological Profile and antibiogram in a tertiary care hospital in Kolkata

Panacea Journal of Medical Sciences (2023)

Subhendu Sikdar Kabita Choudhury Swati Basu Swagata Ganguly Bhattacharjee Sonia Deb

Surgical site infections (SSIs) are a major health care associated infections and possess a great challenge to clinicians. It increases duration of hospital stay, associated morbidity and mortality and treatment cost. For prompt and appropriate management, it is necessary to understand the appropriate microbial etiology and its antimicrobial susceptibility pattern. To determine the prevalence of SSI along with its clinico-bacteriological profile and antibiogram and to correlate with the risk factors. A cross-sectional study was conducted in the Department of Microbiology of Nil Ratan Sircar Medical College & Hospital, Kolkata for a period of one year (2020-2021). Post-operative surgical site infections within 30 days after surgery were included in the study. All samples were collected from clinically suspected SSI cases and processed in the lab as per standard laboratory protocol. Vitek®2 compact system (BIOMERIEUX) was used for further identification and antimicrobial susceptibility testing. All Gram negative pathogens resistant to 3rd generation cephalosporins were screened for ESBL and AmpC. Carbapenem resistant isolates were subjected to Carba NP test for carbapenemase production. Out of 6582 surgeries, clinically suspected SSIs were detected in 220 cases. Among these 220 patients, 186 patients were confirmed as SSI in the laboratory, SSI rate being 2.83%. In 62.27% cases, growth was mono-microbial. Growth of gram negative organisms were noted in 58.72% cases and gram positive growth was 38.53%. (57.14%) was the predominant isolates followed by (35.94%). Diabetes mellitus, obesity and using prophylactic antibiotic >2 hours prior to surgery were found to be significantly associated. For gram positive organism, Vancomycin and Linezolid were found to be most susceptible antimicrobials and for gram negative organisms, it was Polymyxin B and Meropenem. Most of the gram negative organisms were ESBL producer (67.97%). Rapidly emerging multi drug resistant organisms are complicating the management of surgical site infection day by day and possessing significant burden to health care system. For implementation of appropriate antimicrobial policy, it is important to identify bacteriological profile and antibiogram in every hospital.

Antibiogram

Etiology

Carbapenem

10.18231/j.pjms.2023.058

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Rise in antifungal resistance of Candida species from clinical samples in a tertiary care hospital, Kolkata.

Indian Journal of Medical Microbiology (2021)

Chayanika Banerjee Swagata Ganguly Bhattacharjee Soma Sarkar Soumodip Dutta

Tertiary care

10.1016/j.ijmmb.2021.08.391

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Susceptibility Pattern of Blood Stream Infections in Neonatal Sepsis: Striking Alarm in Era of Antibiotic Resistance

International Journal of Research and Review (2022)

Cizarina Roy Swagata Ganguly Bhattacharjee Subrata Datta

Neonatal blood stream infections are significantly associated with increased morbidity and mortality in the recent years. In this study, we aim to determine the bacteriological profile and antibiotic susceptibility pattern of culture positive neonatal sepsis in the NICU of a tertiary teaching hospital in Kolkata. This retrospective study was conducted in the Department of Microbiology of a tertiary care teaching hospital in Kolkata between August, 2020 to July, 2021. All the neonates [both inborn / out born] admitted to NICU with the clinical diagnosis of sepsis during the specified period were screened for BSI. The blood was cultured in BACTAlert and analysed by VITEK 2. Out of 200 neonates with sepsis, 30 had culture positive sepsis of which 60% were Gram positive, rest were Gram negative. Staphylococcus aureus and Coagulase negative Staphylococcus (CoNS) were predominant (35.2%), Klebsiella was the predominant Gram negative organisms. Babies with birth weight ≤ 2 kg and gestational age 33 to 37 weeks were affected. Mortality was seen in 36.3% babies. Significant proportion of multidrug resistant isolates posed a great threat to neonatal survival. Hence modification of therapy based on anti-microbial surveillance pattern of the Institution with implementation of proper escalation and de-escalation of therapy is warranted. Keywords: antibiotic resistance, blood stream infections, culture positive sepsis

Neonatal Sepsis

Blood Culture

Coagulase

Blood stream

10.52403/ijrr.20220830

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A Study on the Magnitude of Non-Fermenter Gram-Negative Bacilli and their Antibiotic Susceptibility Pattern in Clinical Samples from a Tertiary Care Hospital, Kolkata

Journal of Comprehensive Health (2024)

Kabita Choudhury Suman Kundu Somnath Bhunia Tanvi Mallick Swagata Ganguly Bhattacharjee

Background: Non-fermenting Gram-negative bacilli (NFGNB) were initially considered non-pathogenic contaminants but now have emerged as major pathogens because of increased isolation from clinical samples and emerging resistance to common antibacterial agents. Objectives: The study aims to determine the magnitude of NFGNB in clinical samples received at the Department of Microbiology, Nil Ratan Sircar Medical College, Kolkata, for a period of one year. Material and Methods: The samples were processed according to standard procedures; for identification and antibiotic susceptibility test, Vitek 2 Compact (Biomerieux © ) was used. Results: Out of 725 bacterial isolates, 169 (23.31%) NFGNB were identified during the entire study period. Pseudomonas spp. ( n = 84) was isolated most frequently, followed by Acinetobacter spp. ( n = 73), Burkholderia cepacia ( n = 7), and Stenotrophomonas maltophilia ( n = 5). Both Pseudomonas spp. and Acinetobacter spp. showed greater susceptibility to piperacillin-tazobactam and poor susceptibility against cefepime. Conclusion: It is necessary to identify these drug resistant pathogens in healthcare setup. The antibiotic susceptibility pattern of these pathogens needs to be monitored to guide clinicians in better patient care and management by initiating proper antibiotic therapy.

Stenotrophomonas maltophilia

Cefepime

Stenotrophomonas

Acinetobacter baumannii

Tazobactam

10.25259/jch_4_2023

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A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

Indian Journal of Microbiology Research (2024)

Swagata Ganguly Bhattacharjee Ankita Banik Sharanya Haldar Suman Kundu Somnath Bhunia

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

Antimicrobial Stewardship

10.18231/j.ijmr.2024.005

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