Rajeev Aravindakshan

All India Institute of Medical Sciences

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Vinod Nambiar

Sohar University

Mohan B Sannathimmappa

Sohar University

Rakesh Kakkar

All India Institute of Medical Sciences

Arti Gupta

All India Institute of Medical Sciences

Limalemla Jamir

All India Institute of Medical Sciences Guwahati

S Sathiyanarayanan

All India Institute of Medical Sciences

Akshay Sharma

St. Jude Children's Research Hospital

Siva Santosh Kumar Pentapati

All India Institute of Medical Sciences

Sai Subhakar Desu

All India Institute of Medical Sciences

Mohan Bilikallahalli Sannathimmappa

Sohar University

Cooperative Institutions

All India Institute of Medical Sciences

Institute of Medical Sciences

All India Institute of Medical Sciences Raipur

All India Institute of Medical Sciences Bhopal

Pushpagiri Medical College

Kasturba Medical College, Manipal

Sohar University

Kasturba Medical College, Mangalore

Manipal Academy of Higher Education

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Clinical Profile and Antibiotic Susceptibility Patterns of Cronobacter sakazakii in the Northern Region of Oman

Saudi Journal of Medicine and Medical Sciences (2025)

Mohan B Sannathimmappa Vinod Nambiar Osama Mohammed Salih Adnan Al-Alawi Mouge Mohammad Salah Al-Fragi Iliana Mani

Abstract Background: Cronobacter sakazakii is an opportunistic pathogen that mostly affects neonates, infants, and elderly people with weakened immune systems. No study has reported the frequency and antibiotic susceptibility patterns of C. sakazakii from Oman, and thus this study was conducted to fill this gap in the literature. Materials and Methods: This single-center retrospective study included C. sakazakii isolates identified from different clinical samples of patients treated at Sohar Hospital, Oman, between January 2017 and December 2023. Bacterial identification and antibiotic susceptibility testing were done using the VITEK II automated microbiological system in accordance with the Clinical Laboratory Standards Institute (CLSI) guidelines. Results: A total of 185 C. sakazakii isolates were included, most commonly from patients aged >60 years (42.7%) and <1 year (11.4%). C. sakazakii strains had high susceptibility (>80%) to most of the tested antibiotics; however, for beta-lactam antibiotics, it ranged from 0% to 50%. Approximately 26.5% of the strains were multidrug resistant. Independent risk factors for increased frequency of multidrug-resistant strains were urinary catheterization ( P = 0.002), surgery ( P = 0.021), previous antibiotic therapy ( P = 0.047), and critical care unit admission ( P = 0.048). About one-fifth of the patients experienced life-threatening C. sakazakii infections such as septicemia (15%) and pneumonia (4.7%). All deaths due to septicemia occurred in the >60 years ( n = 12) and <1 year ( n = 4) age groups. Conclusions: Cronobacter sakazakii isolates from the North Batinah region of Oman were most frequently isolated from elderly and infant patients and had high antibiotic susceptibility; however, the significant resistance against beta-lactams suggests their low effectiveness. The high number of multidrug-resistant strains coupled with the independent risk factors suggests the need for following stricter antibiotic stewardship protocols and infection control practices.

Cronobacter sakazakii

Colistin

10.4103/sjmms.sjmms_136_24

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Clinical profile and antibiotic susceptibility pattern of Enterococcus faecalis and Enterococcus faecium with an emphasis on vancomycin resistance

Biomedical and Biotechnology Research Journal (BBRJ) (2023)

Mohan Bilikallahalli Sannathimmappa Vinod Nambiar Rajeev Aravindakshan ElhamSaid Al-Risi

Background: Enterococci are recognized as an important nosocomial opportunistic pathogens in recent times and are difficult to treat due to their intrinsic and acquired resistance to many antibiotics. In this study, we analyzed the clinical profile and antibiotic susceptibility pattern with an emphasis on vancomycin resistance among Enterococcus faecalis and Enterococcus faecium isolated from various clinical samples. Methods: This retrospective study was carried out in Sohar Hospital, Oman, after obtaining an ethical approval from the Ministry of Health, Oman. Enterococci isolates identified as E. faecalis and E. faecium from the positive bacterial culture in patients' suspicion of bacterial infection during the study period from January 2017 to December 2021 were analyzed. Details of the study population such as demography, clinical samples, and antibiotic susceptibility pattern of the enterococci isolates were extracted from the hospital electronic health record system. The data were entered into Microsoft Excel sheet, cleaned for errors, and statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 26. The quantitative variables were expressed as mean ± standard deviation while qualitative variables presented as frequencies. Results: In total, 132 nonduplicate E. faecalis and E. faecium were studied. E. faecalis (68.9%) was the predominantly isolated species followed by E. faecium (31.1%). The frequency of isolation was more among females (54.5%) and elderly (47.7%) aged more than 60 years. Majority of enterococci were isolated from urine (49.6%), followed by blood (29.1%) and pus/wound swab (11.8%). All isolates were susceptible to linezolid, while all isolates showed resistance to clindamycin. None of the E. faecalis isolates exhibited resistance to vancomycin, while 13.5% of E. faecium isolates were resistant to vancomycin. E. faecium showed higher resistance to beta lactams, ciprofloxacin, and nitrofurantoin (>80%), while E. faecalis demonstrated low resistance to beta-lactams and nitrofurantoin (<10%). Conclusions: Linezolid and vancomycin were effective against Enterococci causing nosocomial infection in our tertiary care hospital. However, continuous and frequent surveillance for resistance patterns is critical for judicious and evidence-based use of antibiotics.

Enterococcus faecium

Enterococcus faecalis

Linezolid

10.4103/bbrj.bbrj_38_23

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Mysterious Outbreak of Acute Neurological Syndrome in Eluru, Andhra Pradesh, India: A Post-outbreak Geo-Spatial Analysis

Cureus (2022)

Sumita Shankar Limalemla Jamir Rakesh Kakkar Rajeev Aravindakshan Mukesh Tripathi

An outbreak characterized by sudden-onset seizures, loss of consciousness, and complete recovery within a few hours was reported from Eluru town in Andhra Pradesh on December 6, 2020. This study was conducted to assess the environmental correlates of the outbreak using geo-mapping tools.A post-outbreak survey was conducted among affected cases in January-February, 2021. A house-to-house survey tool collected information on demographics, clinical profile, and environmental and psychological aspects (Impact of Event Scale). Geo-mapping and news media content analyses were done using QGIS and Atlas.ti software, respectively.A total of 394 cases were studied. The median (interquartile range [IQR]) age of the participants was 27 (17-39) years and comprised mostly male students. There was no clustering of cases within 48 hours of illness onset in the spatial analysis. Loss of consciousness was the first (50.7%) and the most common symptom. All cases were taken to a health facility and were discharged after a median duration of 48 minutes. COVID-19-related and environmental practices were not associated with the clinical manifestations. Awareness about pesticides was low. The outbreak reportedly had a psychological impact on 24.4% of the participants. The most common co-occurring themes in the news media analysis were water contamination and pesticides.The geo-spatial analysis did not find case clustering or points of convergence during the incubation period. The geo-locations did not distribute around water bodies or suspected landmarks although news media projected water contamination and pesticides as probable causes of the outbreak.

Interquartile range

10.7759/cureus.31801

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Citations (1)

Study of the Knowledge, Attitude and Experience of Medical Tourism Among Target Groups with Special Emphasis on South India

Online Journal of Health and Allied Sciences (2009)

Rajeev Aravindakshan Sanam Latif

Medical tourism aims at providing cost-effective customized health care in collaboration with the tourism industry in distant locations wherein the hospitality component is handled efficiently so that fixing appointments, making arrangements for accommodation and other logistics become hassle-free for the patient. This allows more concentration on the procedure at hand and the interaction between the medical fraternity and the patient becomes smoother. More and more hospitals in India are gearing up to provide such services to neighbouring countries and even to the developed nations across the world. The purpose of this study was to study the knowledge, attitude and experiences of the population of a suitable cross-section regarding the emerging scenario of medical tourism with special interest vis-a-vis Non Resident Indians (NRIs) specifically to the state of Karnataka and Mangalore in particular. It was found that compared to the locals (kannadigas or non-kannadigas), the Non-resident Indians were more dissatisfied with the health care facilities available in their proximity. Though a majority of them do have medical insurance, it still looks as if the care is more cost-effective when sourced to India. NRIs are more aware of the potential of medical tourism through their communication with the medical fraternity as well as the general public and 11.1% of NRIs have really utilized the services of medical tourism. An e-mail survey which was also conducted among a number of foreigners yielded the interesting fact that they indeed had a greater awareness regarding medical tourism with an emphasis on health tourism. The reason why these foreigners opted for medical tourism was due to the substandard medical care available in their locality, rather than due to the cost of medical care as such.

Fraternity

Hospitality

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Citations (2)

Quinolone resistant typhoid outbreak in an extended joint family.

PubMed (1999)

Rajeev Aravindakshan

Quinolone

Enteric fever

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New normal of academic virtual conference

Journal of Education and Health Promotion (2022)

Arti Gupta Limalemla Jamir Rajeev Aravindakshan Dhrubajyoti J. Debnath S Sathiyanarayanan

In COVID pandemic, attending the continuing medical education, workshops, and conferences with physical attendance is not possible. We designed, developed, and hosted the first of its kind academic virtual/online conference at par with an in-person academic conference to disseminate the expertise of the renowned subject experts along with researchers to present their research work due to the ongoing pandemic. We, in this article, had summarized the most critical steps in order to make the process easier for first-timers while providing our more comprehensive walkthroughs on each step. We choose a live session of the speakers on the Zoom meeting mode to retain the atmosphere of a live conference. WhatsApp, Google (Google Meet and E-mail), and Kahoot were other platforms to communicate with speakers, researchers, and participants to seamlessly participate. A number of advantages in terms of protection for delegates/speakers and their families came from the Virtual Conference on Nutrition and Health, restricting the spread of COVID-19, low budget for organizers, economically much cheaper alternatives both for speakers and participants, dissemination of knowledge, time productive, and meeting research paper presentation eligibility for a professional course. When one is new to technology, try adding an innovative aspect as a starting point to future virtual and in-person events, and seeing how it works is imperative. Ensuring Internet bandwidth, updated hardware, or webcam and/or microphone functionality at the participant end is critical.

Attendance

Presentation (obstetrics)

10.4103/jehp.jehp_353_21

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Citations (3)

Diabetic foot infections

Journal of Education and Health Promotion (2021)

Mohan Bilikallahalli Sannathimmappa Vinod Nambiar Rajeev Aravindakshan Mohammad Saleem Jawad Al Khabori Asma Hamed Sulaiman Al-Flaiti

BACKGROUND: In diabetic foot infections (DFIs), the diversity of microbial profile and ever-changing antibiotic-resistance patterns emphasize accurate characterization of microbial profile and antibiotic susceptibility pattern. The aim of the study was to investigate the pathogens associated with DFI and their antibiotic susceptibility patterns. MATERIALS AND METHODS: A cross-sectional retrospective study was conducted at a tertiary-care hospital, Oman. The socio-demographic and microbiological profile and antibiotic susceptibility patterns of pathogens isolated from patients with DFIs from January 2013 to December 2018 were reviewed. Quantitative and qualitative variables were expressed as mean ± standard deviation and percentages, respectively. A Chi-square test was used for testing the association between multidrug-resistant (MDR) organisms and variables. RESULTS: In total, 233 isolates recovered from 133 clinical specimens with an average of 1.8 organisms per specimen were included in the study. Fifty-six and forty-four percent of specimens showed monomicrobial and polymicrobial growth of two or more organisms, respectively. The frequency of isolation was predominant among males (65%). Aerobic Gram-negative rods were predominantly (75%) isolated compared to Gram-positive organisms (25%). Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated Gram-positive and Gram-negative bacteria, respectively. Thirty-eight percent of them were MDR strains. Gram-negative organisms showed fairly good susceptibility ranging from 75% to 100% to carbapenems, aminoglycosides, and piperacillin-tazobactam. While doxycycline and trimethoprim-sulfamethoxazole showed good susceptibility toward Gram-positive organisms. CONCLUSION: DFIs are often polymicrobial with a predominance of Gram-negative pathogens. This study recommends the use of carbapenems and doxycycline for empirical therapy of Gram-negative and Gram-positive bacterial DFIs, respectively.

Foot (prosody)

10.4103/jehp.jehp_1552_20

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Citations (14)

Efficacy of tamsulosin and silodosin as medical expulsive therapy in the management of distal ureteral stones: a randomized controlled study

International Surgery Journal (2016)

Albert As Santosh Pillai Anila Mary Rajeev Aravindakshan

Background:Alpha blockers are being commonly used as adjuvants in the medical management for the expulsion of ureteral stones. The present randomized study aims to evaluate the efficacy of Tamsulosin and Silodosin as medical therapy in the management of symptomatic distal ureteral stones.Methods: In this randomized control study the 120 patients enrolled were allotted to three groups. Patients in group 1 received tablet Tamsulosin 0.4 mg/day, group 2 received tablet Silodosin 8mg/day and group 3 served as the control group. Parameters noted were the blood pressure, stone position (% of expulsion in each group), adverse events noted and number of hospital visits. All patients were followed up weekly for a period of 28 days.Results:Study showed that both Tamsulosin (80% success) and Silodosin (85 %success rate) are equally efficacious when compared to the control group. Group 1 and Group 2 required less of pain killers and also had less frequent hospital admissions due to painful episodes as compared to the control group. Usual adverse reaction seen with alpha blockers like orthostatic hypotension and retrograde ejaculation were reported by some subjects in the test groups. Incidence of retrograde ejaculation was found to be more with the Silodosin group.Conclusions:Both the drugs appear to be effective in the medical management of distal ureteral stones. But Tamsulosin scores over Silodosin as it’s well tolerated and with good stone expulsion rates.

Tamsulosin

Silodosin

Retrograde ejaculation

10.18203/2349-2902.isj20161125

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Citations (8)

Unregulated Sale of Nimesulide in India

Australasian Medical Journal (2008)

Devesh Oberoi Harmeen Goraya Aditya Mungee Suyash Sharma Amit Dang

Nimesulide

10.4066/amj.2009.144

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Independent predictors of cardiac parasympathetic dysfunction in type 2 diabetes mellitus.

PubMed (2008)

N. K. Subbalakshmi Prabha MR Adhikari Rajeev Aravindakshan K Asha P S Jeganathan

Although the clinical implications of diabetic autonomic neuropathy have been described, the clinical determinants of parasympathetic dysfunction in type 2 diabetes mellitus are not clear. We investigated the clinical determinants of heart rate response to deep breathing in type 2 diabetes mellitus.This study involved 207 randomly selected patients with type 2 diabetes mellitus and 141 healthy controls. Heart rate response to deep breathing was measured in all the subjects. Heart rate response to Valsalva manoeuvre and active standing was measured in lesser numbers. Data analysis was done using unpaired Student's t-test, Pearson's correlation test and multiple regression.Heart rate response to deep breathing, Valsalva manoeuvre and active standing was lower in patients with diabetes mellitus than in controls (p-value is less than 0.0001, 0.01 and 0.01, respectively). Age, female gender and presence of somatic neuropathy were the independent predictors of reduced heart rate response to deep breathing (p-value is 0.001). Independent positive correlation was found between resting heart rate and heart response to deep breathing (p-value is 0.02). Factors associated with depressed heart rate response to deep breathing, but not independently predictive, were duration of diabetes mellitus, presence of hypertension, coronary artery disease, foot ulcer and retinopathy. Mean heart rate response to deep breathing of 47 patients with diabetes mellitus free of all complications was lower compared to controls (p-value is less than 0.01).Our data suggests that parasympathetic dysfunction mainly coexists with somatic neuropathy. It may be isolated, or precede detection of other complications. Age and female gender are the other predictors of reduced heart rate response to deep breathing in type 2 diabetes mellitus.

Valsalva maneuver

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Citations (13)