scholarly journals Trends in antimicrobial susceptibility of blood culture-positive typhoid fever over half a decade in adults attending a tertiary care teaching hospital in South India

2019 ◽  
Vol 8 (11) ◽  
pp. 2523
Author(s):  
Mohammed Rafiuddin Rashed ◽  
Ashish Yadav ◽  
Ramakrishna Pai Jakribettu
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Tertiary Care ◽  
Developed Countries ◽  
Salmonella Typhi ◽  
Health Concern ◽  
Care Hospital ◽  
Acid Sensitivity ◽  
Amoxicillin Clavulanic Acid ◽  
Fever Treatment

Background: Typhoid fever is a public health concern in developing countries. Developed countries have also been influenced due to tourism. The drugs used for treating typhoid fever can and have been rendered unusable due to resistance. Monitoring and updating the Salmonella antibiogram is needed to prevent therapeutic failures. This study confirms to the same goal.Methods: This study was conducted retrospectively in a tertiary care hospital in North Kerala with data collected from 2013 to 2017. Years were categorized into four quarters to analyze seasonality. Positive blood culture samples of adults, identified to be Salmonella typhi or paratyphi were subjected to antimicrobial sensitivity.Results: 37 Salmonella isolates were included. July-September quarter was found to have maximum incidence of typhoid fever followed by April-June quarter. All isolates were 100% sensitive to ceftriaxone, chloramphenicol, and amoxicillin-clavulanic acid. Sensitivity lacked for nalidixic acid (48.65%), ciprofloxacin (48.65%) and levofloxacin (70.27%). Sensitivity to ampicillin and cotrimoxazole was 86.49% and 91.89%. Azithromycin efficacy was good overall (94.59%) with resistant isolates emerging in final year of this study.Conclusions: Monsoon is most conducive for typhoid fever occurrence followed by summer. This study confirms utility of ceftriaxone and futility of quinolones and fluoroquinolones in typhoid fever treatment. Azithromycin has started showing emergence of resistance. Ampicillin and cotrimoxazole cannot be relied upon due to variability in sensitivity patterns. Chloramphenicol showed full efficacy throughout the study period which is encouraging. Amoxicillin-clavulinic acid, surprisingly was 100% effective throughout study period. However, no contemporary data is available for comparison.

scholarly journals Typhidot IgM as a reliable and rapid diagnostic test for typhoid fever among children in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 1677
Author(s):  
Mohammad Ashfaque Ansari ◽  
Amit Kumar Thakur ◽  
Atindra Mishra ◽  
Md Jaffer Rain
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Predictive Value ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Antibiotics Resistance ◽  
Major Public Health Problem ◽  
Care Hospital

Background: Typhoid fever still continues to be a major public health problem in Nepal. A clinical spectrum of typhoid varies widely. It causes significant complication as well as mortality. A simple, reliable, affordable and rapid diagnostic test has been a long felt need of the clinicians to prescribe specific medication, adopt prevention of the emergence of antibiotics resistance and overall reduce the disease burden in the community.Methods: The prospective descriptive study was performed in 125 children between 2 years to 15 years of age admitted to the Pediatrics Department from September 2017 to September 2018. Blood culture, Typhidot rapid IgM were performed. MEDCALC software was used to calculate 95% confidence interval for sensitivity, specificity, predictive value positive, predictive value negative and accuracy. Kappa test was used to determine the agreement between Typhidot IgM and blood culture methods.Results: The study consisted of 125 children with acute febrile illness for more than 3 days with clinical symptomatology, consistent with typhoid fever. The reliability of Typhidot IgM in relation with blood culture and the study lighten that sensitivity 92.3% (95% CI: 63.9, 99.8), specificity 49.1% (95% CI: 39.5, 58.7), PPV 17.4% (95% CI: 14.2, 21.1), NPV 98.2% (95% CI: 89.2, 99.7) and accuracy 53.6% (95% CI: 44.5, 62.6). The two methods i.e. Typhoid IgM and blood culture shows significant agreement with p value 0.004.Conclusions: The present study demonstrates that Typhidot IgM has all the attributes of an ideal screening test.

scholarly journals Validity of Immunochromatographic Test for Antibody in Diagnosis of Typhoid Fever in Children Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 20-24
Author(s):  
Zabeen Choudhury ◽  
Mohammed Rezaul Karim ◽  
Rasheda Samad ◽  
Shanjana Islam
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Tertiary Care ◽  
False Negative ◽  
Care Hospital ◽  
Immunochromatographic Test ◽  
True Negative ◽  
College Hospital ◽  
Cross Sectional

Background: To determine the Validity of Immunochromatographic Test (ICT) in diagnosis of typhoid fever in children admitted in a tertiary care hospital.Methods: This cross sectional study was carried out the in Pediatric & Medicine wards of Chittagong Medical College Hospital (CMCH), Chittagong during the period July 2012 to June 2013. A total number of 150 clinically suspected cases of typhoid fever (Age >6 months to18 years) were enrolled in this study. After taking informed written consent, detailed history & clinical examination were completed. A blood culture sample was taken on the day of admission before starting antibiotic. On the 5th day onwards of appearance of fever, blood sample was taken to perform ICT. Patients received standard medical treatment of the admitting wards.Results: Blood C/S for Salmonella typhi was found positive in 16(10.7%) cases. Positive ICT for typhoid fever was found in 37(24.7%) cases. Among then, IgM was 18(12.0%) IgM+IgG were 8(5.3%) and IgG was 11(7.3%). ICT found true positive in 14, false positive in 23, false negative in 2 and true negative in 111 cases, where blood culture considered as gold standard. The difference was statistically significant (p<0.05) between two groups. Immunochromatographic Test (ICT) showed sensitivity 87.5%, specificity 82.8%, accuracy 83.3%, positive predictive value 37.8% and negative predictive value 98.2% for identification of typhoid fever.Conclusion: The present study has shown high sensitivity & specificity of ICT, it can be used as a useful & prospectful diagnostic tool.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 20-24

scholarly journals 683. Epidemiology and Microbiology of Infective Endocarditis: A Six Year Experience

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S444-S444
Author(s):  
Niyas Vettakkara Kandy Muhammed ◽  
Rajalakshmi Ananthanarayanan ◽  
Aswathy Sasidharan
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Detection System ◽  
Tertiary Care ◽  
Prosthetic Valve Endocarditis ◽  
Health Indicators ◽  
Developed Countries ◽  
Care Hospital ◽  
Duke Criteria

Abstract Background The epidemiology and microbiology of infective endocarditis (IE) is not well studied in India. Studies from developed countries report a culture positivity of more than 90% in IE, while in India it has been lower (40–70%). Viridans Group Streptococci (VGS) are the commonest organism identified from previous Indian studies. The state of Kerala in India has better health indicators compared to the rest of India and it is likely that the epidemiology of IE in Kerala may be different. We therefore studied the epidemiology and microbiology of IE in patients admitted to a tertiary care hospital in Kerala over six years (2015 – 2020). Methods An electronic medical record search was conducted to identify patients who satisfied definite or possible IE criteria as per modified Duke criteria. Three sets of blood cultures were sent in BacT/Alert blood culture bottles for all suspected cases of IE. Blood culture was done using BacT-ALERT 3D automated microbial detection system (bioMérieux, France) and organisms were identified using VITEK-2 system. Transthoracic echocardiogram was done for all patients and a transoesophageal echocardiogram was done when indicated. Results 70 patients satisfied the inclusion criteria. Majority (70.4%) were male; mean age was 50.7±16.3 years. 71% patients had underlying valvular heart disease. Diabetes mellitus (53.5%) was the most common comorbidity followed by chronic kidney disease (18.3%). Mitral valve was most commonly affected (53.5%) followed by the aortic valve (19.7%) and both valves were involved in 5.7%. Right sided valves were affected in 8.5%. Prosthetic valve endocarditis accounted for 10% of cases. No echocardiographic evidence of endocarditis was seen in 11.3%. Blood culture was positivity was 64.8%. Staphylococcus aureus (20%) was the most common organism isolated, followed by VGS (17.1%). 50% of the Staphylococcus aureus isolated were methicillin resistant. Among 57 patients in whom an outcome was recorded, mortality was 12.2%. Microbiology profile of infective endocarditis Conclusion Staphylococcus aureus has emerged as the most common etiological agent of IE in our study, in contrast to previous studies from India where VGS was predominant. The high prevalence of MRSA is of concern. Disclosures All Authors: No reported disclosures

scholarly journals Estimating the burden of enteric fever in Chhattisgarh: A single-center study on culture-positive cases from a newly built tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 234-239 ◽  
Author(s):  
Debabrata Dash ◽  
Padma Das ◽  
Anudita Bhargava ◽  
Ujjwala Nitin Gaikwad ◽  
Sanjay Singh Negi ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Central India ◽  
Empiric Therapy ◽  
Blood Stream ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
Culture Positive

Abstract BACKGROUND: Enteric fever is the most common cause of community acquired blood stream infections in under developed and developing countries. The enteric fever is exclusive to humans and transmitted through the faeco-oral route. Though India is an endemic zone for enteric fever, the data is very scarce from Central India. The present study was undertaken to determine the prevalence of enteric fever in this region and to know the antimicrobial susceptibility pattern of the isolated typhoidal Salmonellae. MATERIAL AND METHOD: We conducted a retrospective analysis of blood culture positive cases of enteric fever over a period of two years (December 2015 to December 2017). All blood cultures submitted for suspected enteric fever and associated symptoms were included in the study. Relevant demographic, clinical and laboratory data were analyzed. RESULT: A total of 51 cases (3.56%) were of typhoidal Salmonella from a total of 1430 blood culture submission. Salmonella Typhi were 70.5% while Salmonella Paratyphi A were 29.5% of the total isolated Salmonellae. The most vulnerable age group was 10-19years (41.2%). The mean minimum inhibitory concentration of ciprofloxacin for Salmonella Typhi and Salmonella Paratyphi A are 1.20 and 1.97 μg/ml respectively. All the isolates were susceptible to ceftriaxone. Highest isolation was in the July – September quarter (35.3%). CONCLUSION: There is a high prevalence of the disease which needs urgent focus on safe water, sanitation services and also to establish guidelines for empiric therapy for enteric fever.

scholarly journals Bacteriological profile and antimicrobial susceptibility patterns of blood culture isolates among febrile patients in a Tertiary care hospital, Bangladesh

2020 ◽  
Vol 27 (2) ◽  
pp. 114-122
Author(s):  
Hasina Iqbal ◽  
Nabeela Mahboob ◽  
Mushtaque Ahmed ◽  
Kazi Zulfiquer Mamun ◽  
Abdur Rahim ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
High Morbidity ◽  
Care Hospital ◽  
Candida Spp ◽  
Acid Sensitivity ◽  
Enterococcus Spp

Background: Bacterial bloodstream infections (BSI) are a major problem for health care personnel’s, which leads to high morbidity and mortality of patients. Early and timely diagnosis and appropriate medication will be the best way to save the lives of affected ones. Aim: The aim of the present study was to determine the bacterial profile of bloodstream infections and their antibiotic susceptibility pattern. Methods: This descriptive cross-sectional study was carried out at the Microbiology Laboratory, Popular diagnostic Ltd, Dhanmondi, Dhaka over a three months periods, from November’ 2017 to January’ 2018. A total 822 blood culture samples were screened. The positive blood cultures were examined and the organisms were identified as per standard procedures. Antimicrobial susceptibility testing was performed for all isolates by using disk diffusion technique, according to CLSI guidelines 27. Results: From total blood culture samples, 105 (12.77%) were positive. The most common isolated pathogens were Salmonella Typhi, 59 (56.19.5%). Other isolates are Salmonella paratyphi A & B, 11(10.47%); Eschericia coli 14 (13.33%); Klebsiella spp, 05(04.76%); Acinetobacter spp.11 (10.47%) Enterococcus spp. 02 (01.90%); Staphylococcus aureus, 02 (01.90%) and one Candida spp (0.95%). S. Typhi showed 100% sensitivity against Ceftriaxone and Cefixime, and also more than 80% sensitive against first-line drugs (Chloramphenicol and Co-trimoxazole). Almost all the strains were found resistant towards Nalidixic acid (sensitivity 05.71%). Most of the Staphylococcus aureus and Enterococcus spp were susceptible to Vancomycin and Linezolid. More than 80% of E. coli and Klebsiella spp.are sensitive to Imipenem and Meropenem and least sensitivity show against Ciprofloxacin, Cephradine and Ceftriaxone. Conclusion: Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 114-122

scholarly journals Stool shedding of Salmonella Typhi in children with blood culture-confirmed typhoid fever

2020 ◽  
Vol 101 ◽  
pp. 123
Author(s):  
M. Srinivasan ◽  
S. Giri ◽  
S. Kulandaipalayam Natarajan ◽  
N. Kumar ◽  
V.R. Mohan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Salmonella Typhi

DIETARY ASSESSMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS VISITING TERTIARY CARE HOSPITAL OF LAHORE

2020 ◽  
pp. 5-10
Author(s):  
OJS Admin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Dietary Assessment ◽  
Tertiary Care ◽  
Health Concern ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Chronic Obstructive Pulmonary Disorder ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Disorder

Chronic obstructive pulmonary disorder (COPD) is an aggravating and major health concern throughout the world. It is estimated that in upcoming years chronic obstructive pulmonary disease will be rankedas third common reason of mortality and fifth common cause of disablement worldwide.

scholarly journals Clinical outcome of infants younger than two months in children ward of a tertiary care hospital, Nepal

2016 ◽  
Vol 3 (2) ◽  
pp. 15-18
Author(s):  
Ganesh Shah ◽  
Dinesh Dharel ◽  
Anish K Shah ◽  
Bikal Sapkota ◽  
Asmita Bhattarai
Keyword(s):  
Blood Culture ◽  
Clinical Outcome ◽  
Skin Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Facility ◽  
Clinical Profile ◽  
Care Hospital ◽  
Young Infants ◽  
Level Hospital

 Introductions: Newborn and young infants are most vulnerable for preventable deaths, particularly in developing countries. This study was conducted to see the clinical profile and outcome of infants less than two months of age admitted in children ward of Patan Hospital.Methods: This descriptive retrospective study was conducted at Patan Hospital, over 12 months from April 2014 to March 2015. Hospital records of all admitted infants aged less than two months were reviewed. The demographic characteristics, clinical profile and clinical outcome were descriptively analyzed.Results: Out of 2062 admissions in children ward, 614 (29.8%) were infants aged less than two months, out of which 482 were neonates less than 28 days. Among these neonates, 114 were inborn. Out of 436 infections, blood culture was positive in 37 (8.9%). There were 4 (0.04%) deaths, 4 (0.04%) referral and 22 (0.25%) left against medical advice. Infection 436 (436) was the commonest cause of illness, of which neonatal sepsis was 163 (37.4%), pneumonia 130 (30%) staphylococcal skin infection 39 (8.7%) and UTI 34 (7.8%). There were 71 (11.6%) cases of neonatal hyperbilirubinemia. Blood culture was positive in 55 (9%) with CONS being the commonest organism isolated; 19 (51.3%).Conclusions: Children ward contributes significantly to the care of sick infants less than two months of age, especially out born ones, requiring neonatal care facility in tertiary level hospital of Nepal. As most admissions are for infection, followed by hyperbilirubinemia, pediatrics wards need to be equipped and staffed accordingly to meet the need of sick young infants.Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):15-18

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