Background: Lower respiratory tract infection (LRTI) is the most common infection causing significant mortality with a 3–5% death rate in adults. The emerging nature of antimicrobial resistance to pathogens makes its treatment more challenging and complicated for physicians. Aims and Objectives: The study was designed to obtain a comprehensive insight into the microbial profile and resistance patterns of the isolated pathogens in LRTI in a tertiary care hospital in Kolkata. Materials and Methods: The cross-sectional observational study was carried out in the Microbiology Department of N.R.S Medical College from January to December 2021. Specimens collected from 782 clinically suspected LRTI cases were processed as per standard laboratory protocol following clinical and laboratory standard Institute guidelines. Results: Out of 782 respiratory samples, 47.83% showed significant bacterial growth. The major risk factor was found to be type II diabetes mellitus (47.44%) followed by chronic obstructive pulmonary disease (36.57%) and smoking (21.35%). 85.56% growth was monomicrobial and Gram-negative organisms (88.50%) predominated. Klebsiella pneumoniae (36.90%) was the most predominant Gram-negative bacilli followed by Pseudomonas aeruginosa (17.11%) and Acinetobacter species (13.90%). Staphylococcus aureus was the predominant Gram-positive isolate (7.49%). Gram-negative organisms showed the highest resistance to penicillin and cephalosporins, whereas the lowest resistance in carbapenems. Piperacillin/tazobactam and levofloxacin showed good susceptibility. Linezolid was the most susceptible antimicrobial followed by vancomycin in the case of Gram-positive organisms. Extended-spectrum β-lactamase was detected as the mechanism of resistance in 31.12% of cases and carbapenemase was detected in 19.64% of cases. Conclusion: Increasing antimicrobial resistance and varied bacterial etiology make it necessary to develop appropriate antibiotic policy and implement antimicrobial stewardship for effective and prompt therapy.
Leptospirosis caused by the bacterium Leptospira, has been classified by the World Health Organisation (WHO) as a neglected tropical disease with worldwide significance. Leptospirosis in endemic places affects adults more frequently and severely than it affects children. There is a lack of data specifically focusing on children, and it is yet unknown why this discrepancy exists. As the majority of human leptospiral infections are mild or asymptomatic in endemic areas, goal of our study was to describe the prevalence of the Leptospira disease spectrum and the variations in clinical manifestations among patients admitted for febrile illness in a tertiary care facility.
Leptospirosis caused by the bacterium Leptospira, has been classified by the World Health Organisation (WHO) as a neglected tropical disease with worldwide significance. Leptospirosis in endemic places affects adults more frequently and severely than it affects children. There is a lack of data specifically focusing on children, and it is yet unknown why this discrepancy exists. As the majority of human leptospiral infections are mild or asymptomatic in endemic areas, goal of our study was to describe the prevalence of the Leptospira disease spectrum and the variations in clinical manifestations among patients admitted for febrile illness in a tertiary care facility.
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.
The chikungunya virus (CHIKV) and scrub typhus infection has scattered worldwide creating human health hazards in India and Asia specific region. We aimed to identify chikungunya, scrub typhus, and their co-infection in dengue-negative samples having undifferentiated febrile illnesses. Enzyme linked immunosorbent assay (ELISA) methods were used to detect the chikungunya and scrub typhus specific IgM antibody by using chikungunya IgM capture ELISA kit and scrub typhus IgM Microlisa ELISA kit, respectively. OD value was measured with the help of BeneSphera (India) ELISA microplate reader. Among 490 suspected patients, 57 (11.63%) samples were tested positive for chikungunya IgM antibodies, while 43 (8.77%) came positive for scrub typhus IgM antibodies, but all samples tested negative for dengue IgM antibodies. Additionally, 5% of the total positive cases were positive for both chikungunya and scrub typhus infection. Our study offers a hypothesis regarding one of the possible causes of the decline in the frequency of scrub typhus and chikungunya cases reported in Kolkata and other districts of West Bengal. As an outcome, physicians treating undifferentiated febrile patients in endemic locations should look for chikungunya, scrub typhus, and existing coinfection between them to avoid delayed diagnosis and provide proper treatment against these infections.
The coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2) is a positive sense single stranded RNA (ssRNA) virus that first appeared in China and has spread throughout the world since late 2019. The SARS-CoV-2 virus causes a mild to severe respiratory infection that affects not just the lungs but also pancreas and other endocrine glands, as well as responsible for ischemic stroke and sexual dysfunctions. Serum pro-calcitonin (PCT) levels have been linked to the severity of coronavirus disease (COVID-19) in several investigations. According to our studies, high PCT levels are linked to a greater risk of severe COVID-19 infection in patients, as well as its involvement and role in a COVID-19 infected cancer survivor. This is the first study we are aware of from India that shows COVID-19 infected people should have regular PCT screening may help clinicians to plan intensive care unit (ICU) placement and detect any recurrence of past illness if any.
Leptospirosis caused by the bacterium Leptospira, has been classified by the World Health Organisation (WHO) as a neglected tropical disease with worldwide significance. Leptospirosis in endemic places affects adults more frequently and severely than it affects children. There is a lack of data specifically focusing on children, and it is yet unknown why this discrepancy exists. As the majority of human leptospiral infections are mild or asymptomatic in endemic areas, goal of our study was to describe the prevalence of the Leptospira disease spectrum and the variations in clinical manifestations among patients admitted for febrile illness in a tertiary care facility.
Background: Lower respiratory tract infection (LRTI) is the most common infection causing significant mortality with a 3–5% death rate in adults. The emerging nature of antimicrobial resistance to pathogens makes its treatment more challenging and complicated for physicians. Aims and Objectives: The study was designed to obtain a comprehensive insight into the microbial profile and resistance patterns of the isolated pathogens in LRTI in a tertiary care hospital in Kolkata. Materials and Methods: The cross-sectional observational study was carried out in the Microbiology Department of N.R.S Medical College from January to December 2021. Specimens collected from 782 clinically suspected LRTI cases were processed as per standard laboratory protocol following clinical and laboratory standard Institute guidelines. Results: Out of 782 respiratory samples, 47.83% showed significant bacterial growth. The major risk factor was found to be type II diabetes mellitus (47.44%) followed by chronic obstructive pulmonary disease (36.57%) and smoking (21.35%). 85.56% growth was monomicrobial and Gram-negative organisms (88.50%) predominated. Klebsiella pneumoniae (36.90%) was the most predominant Gram-negative bacilli followed by Pseudomonas aeruginosa (17.11%) and Acinetobacter species (13.90%). Staphylococcus aureus was the predominant Gram-positive isolate (7.49%). Gram-negative organisms showed the highest resistance to penicillin and cephalosporins, whereas the lowest resistance in carbapenems. Piperacillin/tazobactam and levofloxacin showed good susceptibility. Linezolid was the most susceptible antimicrobial followed by vancomycin in the case of Gram-positive organisms. Extended-spectrum β-lactamase was detected as the mechanism of resistance in 31.12% of cases and carbapenemase was detected in 19.64% of cases. Conclusion: Increasing antimicrobial resistance and varied bacterial etiology make it necessary to develop appropriate antibiotic policy and implement antimicrobial stewardship for effective and prompt therapy.
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.
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