scholarly journals A study of surgical site infections in a tertiary care hospital

2019 ◽  
Vol 6 (11) ◽  
pp. 3911 ◽  
Author(s):  
Ayush Jain ◽  
Anuradha Tolpadi ◽  
Bhupendra Chaudhary ◽  
Ansh Chaudhary ◽  
Ankita Misra
Keyword(s):  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Surgical Site Infections ◽  
Health Concern ◽  
Care Hospital ◽  
Duration Of Surgery ◽  
Common Causes

Background: Health care-associated infections remain as an important public health concern. Surgical site infections (SSIs) are known to be one of the most common causes of nosocomial infections worldwide.Methods: A prospective observational study was conducted across 12 months (May 2018-April 2019) in a tertiary care hospital. The present study includes 223 patients who were undergoing clean and clean contaminated surgery in the hospital. Contaminated and dirty surgeries were excluded. The demographic data of the patient, diagnostic criteria used, associated risk factors, use of prophylactic antimicrobial agents, the type and duration of surgery, clinical evaluation of wound and laboratory data was collected. All the pus samples or wound swabs of clinically suspects of SSI cases received in the Department of Microbiology were inoculated and interpreted according to Centre for Disease Control and Infection guidelines.Results: The study included 223 patients who underwent surgery in the hospital. Amongst them 9 (4%) developed SSI. The incidence of SSI was 4.03%. There was a direct relationship observed between the occurrence of SSI and certain co-morbid conditions such as diabetes. It was also observed that prolonged surgeries above two hours and females were more predisposed to develop a surgical site infection.Conclusions: SSIs being one of the most common causes of nosocomial infections. It was also the most important factor responsible for significant morbidity, mortality, unwanted prolonged hospitalization and additional cost of treatment in surgical patients which can be reduced by strictly following the guidelines of infection control along with judicious and rational use of antibiotics.

scholarly journals Beta-lactamase Profile and Biofilm Production of Pseudomonas aeruginosa Isolated from a Tertiary Care Hospital in Kolkata, India

2020 ◽  
Author(s):  
Soma Sarkar ◽  
Shanta Dutta ◽  
Anjum Namhata ◽  
Chayanika Banerjee ◽  
Mallika Sengupta ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Health Concern ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Automated Method ◽  
Biofilm Production ◽  
Carbapenemase Gene

Introduction: Nosocomial infections caused by Multidrug Resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) have become a major clinical and public health concern. Moreover, the biofilm production protects the bacteria from antibiotics and thereby makes the drugs ineffective. Aim: To find out the β-lactamases profile of antimicrobial resistance and biofilm production of P. aeruginosa isolated from different clinical specimens of patients attending a tertiary care hospital of Kolkata, West Bengal, India. Materials and Methods: A total of 394 consecutive, non-duplicate isolates of P. aeruginosa were identified from 3559 Gram negative bacilli over a period of two years from July 2016 to June 2018. Identification of the isolates and antibiotic sensitivity testing was performed by using automated method and interpreted. Extended Spectrum β-Lactamases (ESBLs), Amp-C β-lactamase (AmpC) and Metallo-β-Lactamases (MBLs) were phenotypically detected by disk synergy test and MBL-encoding genes were detected by multiplex Polymerase Chain Reaction (PCR). Biofilm production was done by tissue culture plate assay. Laboratory data and test results were statistically analysed in counts and percentages using MS Excel 2010 version. Results: Out of 394 strains of P. aeruginosa 288 (73.10%) were isolated from male patients whereas 106 (26.90%) were isolated from female patients. Maximum number of cases (67.26%) were from adult populations. The resistance pattern showed 72.33% resistance to ticarcillin-clavulanic acid followed by ciprofloxacin (53.80%), levofloxacin (50.25%), gentamicin (51.52%), ceftazidime (CAZ) (45.93%), cefoperazone-sulbactam (40.1%), aztreonam (34.77%), imipenem (33.5%), piperacillin/tazobactum (30.96%) and Meropenem (MRP) (29.18%). Out of 394 Pseudomonas spp. isolates, 204 (51.77%) were MDR. Overall, ESBLs, AmpC and carbapenemase (MBL) production was detected in 145 (36.80%), 51 (12.94%) and 49 (12.43%) isolates by phenotypic methods. By genotypic method 53.34% were carbapenemase producing and blaNDM-1 (68.75%) was the most prevalent carbapenemase gene detected followed by blaVIM (18.75%) and co-production of blaNDM-1+ blaVIM was 12.5%. Biofilm production was observed in 158 (40.10%) isolates. Conclusion: Early detection of these β-lactamases production is crucial not only for epidemiological study and effective infection control practices to limit the spread of infection but also for planning appropriate therapy according to the resistance mechanisms of the MDR strains.

scholarly journals A prospective study on risk factors for development of surgical site infections at a tertiary care hospital: a two years study

2018 ◽  
Vol 5 (2) ◽  
pp. 460
Author(s):  
Vakamudi Prakash ◽  
Ramalinga Reddy Rachamalli ◽  
Jithendra Kandati ◽  
Sreeram Satish
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Multiple Factors ◽  
The Common

Background: Surgical site infections (SSI) are the second most common Nosocomial infections after urinary tract infections accounting to 20-25% of Nosocomial infections worldwide. Based on the depth of the infections, SSI is classified by CDC as superficial incisional, deep incisional and organ/space. The development of SSI is dependent upon multiple factors like class of wound, immune status, type of surgery, type of anesthesia; surgical techniques etc and are interplay of multiple factors. Objective of the present study was conducted in identifying the predictors, risk factors and incidence rates of SSI at a tertiary care hospital. The study also identifies the causative bacterial pathogens and their antibiotic susceptibility patternMethods: A prospective cross-sectional study was conducted for a period of two years by department of general surgery involving all patients who underwent surgery, and pre-operative, intra operative and risk factors of the cases were collected using standardized data collection form. Specimens from the infected wounds were collected and processed for isolation of pathogens. Antibiotic susceptibility of pathogens was done using standard guidelines.Results: The incidence of SSI in present study was 25.34% with 81.58% superficial SSI and 18.42% deep SSI. Laparotomy was the common procedure and 63.2% of cases were females and 41-60 years was the most common age group. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli were the common pathogens and were sensitive to carbapenems, vancomycin and linezolid. Significant association was observed with presence of pre-morbid analysis, presence of drain, use of povidone iodine alone and development of SSI.Conclusions: In present study the incidence of SSI was significantly high in this hospital and associated with premorbid illness, duration of surgery, presence of drain and use of drain at site of surgery. Staphylococcus aureus was the common pathogen and incidence of MRSA is higher than many other reports. A continuous monitoring and surveillance of patients with a predefined protocol will help in early identification of cases with risk of development of SSI. A feedback of appropriate data to surgeons is highly recommended to reduce the SSI rate in developing countries.

scholarly journals Isolates and their Antibiogram in Different Samples from a Tertiary Care Hospital, Kathmandu.

2016 ◽  
Vol 14 (1) ◽  
pp. 1-8
Author(s):  
Bibek Bhatta ◽  
Roshina Thapa ◽  
Sanjay Shahi ◽  
Sushil Karki ◽  
Yogesh Bhatta ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Appropriate Prescribing ◽  
A Prospective Study ◽  
Klebsiella Spp

Introduction: The emergence and spread of antimicrobial resistance constitutes a major risk for human health by limiting the success of these agents in the therapy. The widespread uses of antibiotics, together with the length of time over which they have been available, have led to major problems of resistant organisms contributing to morbidity and mortality. Knowledge of etiological agent and its sensitivities to available drugs is of immense value to the rational selection and use of antimicrobial agents and to the development of appropriate prescribing policies. The aim of this study was to prepare a local antibiogram of the commonly isolated organism at a tertiary care hospital.Methods: A prospective study was conducted at KMC Teaching Hospital, from April 14th to 17th September 2014. Laboratory data of culture and sensitivity were collected from hospital Microbiology Laboratory and analyzed using SPSS software.Results: In our study most of the isolates were Gram negative with Klebsiella Spp. and Escherichia coli being predominant with many MDR isolates. The isolates were found to be resistant to different groups of drugs. We found least resistance to Chloramphenicol, Imepenem and Amikacin. Most of the resistance was found against Amoxicillin and Erythromycin. Among gram positive S. aureus was predominant with 64.7% MRSA and 23.1% VRSA isolates.Conclusions: The most sensitive drug for gram positive was Chloramphenicol, Cephotaxim and Norfloxacine. The only drug which was 100% sensitive to Gram Negative organism was Chloramphenicol. 

scholarly journals A PROSPECTIVE STUDY OF ADVERSE DRUG REACTIONS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

2019 ◽  
pp. 89-92
Author(s):  
JERIN JAMES ◽  
JAMUNA RANI
Keyword(s):  
Adverse Drug Reactions ◽  
South India ◽  
Causality Assessment ◽  
Tertiary Care Hospital ◽  
Negative Impact ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Health Concern ◽  
Care Hospital ◽  
Drug Reactions

Objective: The objective of this study was to determine the prevalence of adverse drug reactions (ADRs) in a tertiary care teaching hospital in South India and to analyze the causality according to the Naranjo scale. Methods: This study was carried out at the SRM Medical College, Chennai, a tertiary care hospital, which is an ADR monitoring center under Pharmacovigilance Programme of India, over a period of 1 year, from September 2017 to August 2018, after approval by the Institutional Ethics Committee. These ADRs were reported by the clinical pharmacy team of our hospital to the department of pharmacology. The relevant data were collected from the patient case notes, treatment charts, laboratory data reports, ADR notification forms, patient interview, and reporter interviews after written informed consent was obtained from each patient. Patients of either sex of all ages who developed ADR within the hospital were included in the study. Patients who developed ADR outside the hospital were excluded from the study. The collected ADRs were subjected to the Naranjo causality assessment scale. Hartwig’s scale was used to assess the severity of the reaction. The causalities and other aspects of the ADRs were analyzed in detail. Results: A total of 80 ADRs were reported during this study period. The ADRs were most frequently reported in the adult age group (75%) with slight female preponderance (60%). Antibiotics contributed to the maximum number of ADRs which accounted for 52.5% of the total, of which beta-lactams were the highest (37.5%) followed by analgesics. Causality assessment of ADRs by the Naranjo scale showed that the maximum reactions could be categorized as probable (85%) followed by the possible category (15%). The most common presentation of ADR was itching (45%) followed by rashes (30%). Three cases of severe adverse reactions were reported, one case each of anaphylaxis to pantoprazole and diclofenac and one case of Steven–Johnson syndrome to cotrimoxazole. Conclusion: ADRs are a common occurrence but are often not recognized. Even if recognized, they are underreported as many physicians are unaware that all ADRs should be reported to ADR monitoring centers. ADRs are an important cause of morbidity and mortality all over the world and are an important public health concern. It inflicts a negative impact on the treatment and exerts a greater economic burden on the patient if it results in prolongation of the duration of hospitalization or other comorbidities. Therefore, the practicing physicians, as well as the nursing staff, should be sensitized of the importance of ADR reporting to their respective pharmacovigilance centers.

ISOLATED BENZODIAZEPINE TOXICITY AND THE USE OF FLUMAZENIL: AN EYE-OPENING ANTIDOTE CASE REPORT IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 231-233
Author(s):  
Siddharth Panikkar ◽  
Gigy Varkey Kuruttukulam ◽  
Manju Manmadhan ◽  
Jithin Antony Bose ◽  
Jacob Chacko ◽  
...  
Keyword(s):  
Case Report ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Delay In Diagnosis ◽  
Patient Medication ◽  
Common Causes ◽  
Eye Opening ◽  
Ct Brain ◽  
The 1960S

Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological, laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically. Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case report.

Assessing the Prescription Pattern of Antimicrobial Agents in Intensive Care Unit at Tertiary Care Hospital

2020 ◽  
Vol 2 (10) ◽  
pp. 1825-1830
Author(s):  
Avinash Khadela ◽  
Bhavin Vyas ◽  
Nancy Rawal ◽  
Heni Patel ◽  
Sonal Khadela ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescription Pattern

scholarly journals Evaluation of Cardiac Biomarkers in Dengue Myocarditis in a Tertiary Care Hospital in Eastern India

2020 ◽  
Author(s):  
Debojyoti Bhattacharjee ◽  
Jayati Roy Choudhury ◽  
Kasturi Mukherjee ◽  
Kheya Mukherjee
Keyword(s):  
Viral Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Health Concern ◽  
Left Ventricular Ejection ◽  
Cardiac Complications ◽  
Care Hospital ◽  
Ventricular Ejection Fraction

Introduction: Dengue, a vector borne viral infection transmitted by Aedes mosquito has recently become a major public health concern in the tropical regions of the world. In addition to the two major life threatening complications- Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS), a variety of cardiac complications have been recognised, the most common being myocarditis. Aim: To study and compare the quantity of different cardiac biomarkers in patients of Dengue Fever with and without myocarditis. Materials and Methods: This was a hospital-based retrospective observational study done in a Tertiary Care Hospital, Kolkata, West Bengal, India from June 2019 to November 2019. Dengue patients with diagnosed myocarditis on day 7 of fever based on electro and echocardiogram changes of left ventricular ejection fraction less than 50% were considered as cases (n=41). Age and sex matched dengue patients with normal electro and echocardiogram changes were considered as control (n=43). After obtaining Institutional Ethics Committee Clearance, laboratory data were collected from samples coded and assayed for markers of acute cardiac myocyte damage such as total Creatine Kinase (CK), CK-Muscle Brain (CK-MB), Troponin T (Trop T) and cardiac failure biomarker N-Terminal pro Brain Natriuretic Peptide (NT-proBNP). Statistical analysis of the data was performed using Statistical Package for Social Sciences (SPSS 20). Results: Cardiac biomarkers CK, CK-MB, Trop T and NT-proBNP levels in cases were higher compared to controls (p-value <0.05). Trop T and NT-proBNP were positively correlated to each other (r-value: 0.44). Trop T changes could also predict significantly the rise in NT-proBNP in circulation (p<0.05). Conclusion: It reconfirmed the need of routine monitoring of cardiac biomarkers in conjunction with other cardiac function tests in early diagnosis and or management of myocarditis, a severe complication of Dengue Viral Infection (DENV).

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