Evaluation of bacteriological contamination pattern of open fractures of extremities in tertiary care hospital

Background: Open fractures and associated complications like infection are fairly common in developing countries due to rising incidence of high velocity trauma. Primary goal of study is to evaluate the pattern of bacteriological contamination of open fractures of extremities in tertiary care hospital.Methods: A total of 316 patients of all the age group, both the sexes with open fractures of extremities presented within 6 hours were taken in to study. 1st swab taken at the time of primary wound examination followed by 2nd culture swab on just after debridement followed by 3rd culture swab on the day of 1st aseptic dressing followed by 4th culture swab if infection continues or asepsis score is more than 20 till the duration of 4 days. Culture and sensitivity reports were collected for studying pattern of bacterial isolates and their sensitivity.Results: Infection developed in 22.5% of the patients with open fractures of extremities in whom most of bacterial infections were caused by gram-negative organisms (80.3%). Cultures on admission were positive in 41 patients, out of which 11 patients had developed infection in the final cultures but with different flora. While cultures taken at 1st aseptic dressing were found to be positive in 51 cases, out of which 31 had developed infection with prognostic value of 57%.Conclusions: We concluded that cultures obtained at 1st aseptic dressing are far more predictive than pre and post-debridement cultures in management of patients with open fractures of extremities and are important in formulating an antibiotic policy.

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Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

International Journal of STD & AIDS ◽

10.1177/0956462420918682 ◽

2020 ◽

Vol 31 (7) ◽

pp. 705-707

Author(s):

Venkateshwaran Sivaraj ◽

Rudiger Pittrof ◽

Olubanke Davies ◽

Ranjababu Kulasegaram

Keyword(s):

Bacterial Infections ◽

Substance Misuse ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hiv Positive ◽

Care Hospital ◽

Hiv Viral Load ◽

Cd4 Cell Count ◽

Cell Counts ◽

Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

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Microbiological Screening and Antimicrobial Sensitivity Profiling of Wound Infections in a Tertiary Care Hospital of Bangladesh

European Journal of Medical and Health Sciences ◽

10.34104/ejmhs.020.01010106 ◽

2020 ◽

pp. 101-106

Keyword(s):

Wound Infection ◽

Primary Care Physicians ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Treatment Modalities ◽

Care Hospital ◽

Bacterial Isolates ◽

Gram Positive ◽

Gram Negative ◽

Antimicrobial Sensitivity

Wound infection is a major problem in hospitals in developing countries. Wound infection causes morbidity and prolonged hospital stay thus this prospective study was conducted for a period of seven months (January 2019 to July 2019). A total of 217 specimens (wound swabs and pus exudates) from wound infected patients in a Tertiary Care Hospital in Bangladesh. A retrospective study of the microbiological evaluation was done by cultural growth as well as Gram staining and biochemical examination to identify the bacterial isolates. Finally, the antimicrobial vulnerability testing was performed by Kirby-Bauer disc diffusion conventional method. A total of 295 samples were tested. Out of which 217 (73.5%) were found culture positive. E. coli was the most predominant gram-negative isolates whereas Staphylococcus aureus and Coagulase-negative Staphylococcus were the most commonly isolated gram-positive organisms. Antimicrobial sensitivity profile of bacterial isolates revealed imipenem, meropenem, amikacin, and nitrofurantoin to be the most effective antimicrobials against gram-negative isolates, whereas imipenem, meropenem, amikacin, nitrofurantoin, amoxiclav, and gentamicin were the most effective drugs against gram-positive isolates. The result of this examination contributes to the identification of basic causative microbes involved in wound infection and findings of antibiotic susceptibility patterns can be helpful for primary care physicians to optimize the treatment modalities, articulate policies for empiric antimicrobial therapy, and to minimize the rate of infection among wound infected patients.

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A STUDY OF BACTERIAL ISOLATES AND THEIR SENSITIVITY PATTERN TO ANTIBIOTICS IN EMPYEMA THORACIS CASES IN A TERTIARY CARE HOSPITAL

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/934 ◽

2018 ◽

Vol 7 (38) ◽

pp. 4178-4181

Author(s):

Amiya Kumar Dwari ◽

Sumanta Jha ◽

Somnath Sarkar ◽

Swapnendu Misra ◽

Subhankar Chakraborty ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Empyema Thoracis ◽

Bacterial Isolates ◽

Sensitivity Pattern

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Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal

Tropical Medicine and Health ◽

10.1186/s41182-021-00368-2 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Susil Pyakurel ◽

Mehraj Ansari ◽

Smriti Kattel ◽

Ganesh Rai ◽

Prasha Shrestha ◽

...

Keyword(s):

Bacterial Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Resistant Bacteria ◽

Growth Media ◽

Care Hospital ◽

Drug Resistant ◽

Biochemical Tests

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

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