scholarly journals Clinical, Demographic, and Aetiological Profile of Liver Abscess in Children Admitted at a Tertiary Care Hospital - North India

2021 ◽  
Vol 8 (40) ◽  
pp. 3470-3476
Author(s):  
Navya Sree Manugu ◽  
Narayana Lunavath ◽  
Ramu Pedada
Keyword(s):  
Staphylococcus Aureus ◽  
Informed Consent ◽  
Liver Abscess ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Pyogenic Liver Abscess ◽  
Salmonella Typhi ◽  
Amoebic Liver Abscess ◽  
Care Hospital ◽  
Methicillin Resistant

BACKGROUND Amoebic liver abscess is the commonest extra intestinal site of invasive amoebiasis which mainly affects infants and young children. The incidence of pyogenic liver abscess is much higher among children in developing countries than those in developed countries. Diagnosis of liver abscess can be challenging and is often delayed; a high index of suspicion is necessary in children with risk factors. Children have unique set of predisposing causes for liver abscesses. The purpose of this study was to assess the clinical, demographic, and etiological profile of liver abscess in children between 1 month to 12 years of age. METHODS This is a prospective observational study conducted in the Department of Pediatrics, Chacha Nehru Bal Chikistalaya (An Autonomous Institute under Govt. of NCT (National Capital Territory) of Delhi, affiliated to University of Delhi), Delhi from July 2016 to August 2017. All children aged 1 month to 12 years admitted with liver abscess (included consecutively) were enrolled after considering inclusion and exclusion criteria. Written and informed consent was taken from parents/guardians of children aged less than 7 years. Informed assent was taken from children aged more than 7 years, along with written and informed consent from their parents/guardians. Their clinical characteristics, radiological features and laboratory data were analysed. RESULTS Most common age group suffering from liver abscess was 5 - 10 years with male preponderance. Majority of the children belonged to lower socio-economic class and half of them were suffering from malnutrition. Most common clinical presentation of children suffering from liver abscess was fever with pain abdomen and tender hepatomegaly. Majority of the children had leucocytosis, high level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Deranged liver function test with coagulopathy was noted in more than half of the children suffering from liver abscess. Commonest bacterial pathogen was methicillin resistant Staphylococcus aureus followed by Salmonella typhi, Stenotrophomonas maltophilia, coagulase negative Staphylococcus aureus and Staphylococcus hominis. Entamoeba histolytica is a common parasitic agent causing liver abscess in children. CONCLUSIONS Liver abscess should be considered in children presenting with fever and abdominal pain. Most cases involve a single lesion on right lobe of the liver. Methicillin resistant Staphylococcus aureus followed by Salmonella typhi are the two most common pathogens. KEYWORDS Paediatric Liver Abscess, Amoebic Liver Abscess, Pyogenic Liver Abscess, Children

scholarly journals Antibiotic Susceptibility Pattern of Nosocomial Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nepal

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Test Method ◽  
University Teaching ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern

scholarly journals Methicillin Resistant Staphylococcus aureus: Prevalence And Antibiogram In A Tertiary Care Hospital in Western Nepal

2009 ◽  
Vol 3 (09) ◽  
pp. 681-684 ◽  
Author(s):  
Hare Krishna Tiwari ◽  
Ayan Kumar Das ◽  
Darshan Sapkota ◽  
Kunjukunju Sivrajan ◽  
Vijay Kumar Pahwa
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Inhibitory Concentration ◽  
Tertiary Care ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Susceptibility Tests ◽  
Rational Use Of Antibiotics ◽  
Hospital Acquired

Background: Methicillin resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. The current study estimates the prevalence of MRSA strains and investigates their antibiogram in western Nepal. Methodology: A total of 162 S. aureus strains were isolated from various clinical specimens, and antibiotic susceptibility tests were performed using disc diffusion, growth on oxacillin screen agar, and oxacillin minimum inhibitory concentration (MIC). Results: One hundred and twelve (69.1%) strains were found to be MRSA, of which 37 (33.1%) were community acquired and 75 (66.9%) were hospital acquired. Of 112 MRSA strains, 45 (40.1%) were multi-drug resistant. All MRSA strains were found resistant to penicillin, and 91.9%, 87.4%, 77%, and 55.5% were resistant to amoxicillin, ampicillin, trimethoprim/sulfamethoxazole, and cephalexin, respectively. However, low resistance was observed with amikacin (19%), ciprofloxacin (26.5%), and norfloxacin (30.6%). All strains were sensitive to vancomycin. Conclusion: The reported rate of MRSA prevalence is alarming. Given the ability of MRSA to spread from person to person, it is necessary to adhere to rational use of antibiotics and to raise awareness among the concerned communities and tourists who visit this area.

scholarly journals Sore Throat and Methicllin Resistant Staphylococcus Aureus Positive Pharyngo-Tonsillitis in a Tertiary Hospital

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 177-181
Author(s):  
Md Abdus Salam ◽  
Md Mahabub Alom ◽  
Md Sultan Mahmud
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Sore Throat ◽  
Pathogenic Bacteria ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Throat Swab ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Methicillin Resistant

Background: Antimicrobial resistance in health care-associated pathogens is a growing concern for healthcare and for public health. In response to these concerns, medical experts, professional societies and agencies, such as the Centers for Disease Control and Prevention (CDCP), have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. Objectives: The purpose of the study was to observe the disease pattern and demographic characteristics of patient attending at the outpatient department of Otolaryngology in a tertiary care hospital suffering from sore throat and methicillin resistant Staphylococcus Aureus (MRSA) positive pharyngo-tonsillitis. Materials and Methods: This is a retrospective study carried out at the outpatient department of Otolaryngology in Khwaja Yunus Ali Medical College and Hospital for the period of January, 2016 to December, 2017. Data were collected based on history, clinical examinations and culture and sensitivity report of throat swab of the patients. Result: A total of 339 patients were studied of which 49.56% were male and 50.44% were female. The mean age was 30 years; maximum patient (36.28%) belongs to 21-30 years of age. Maximum patient (76%) were come from out of Sirajganj district specially North Bengal. Regarding result of throat swab of C/S 58.11% patients were MRSA positive, 26.84% patients were MRSA negative and15.04% patients has no growth. Conclusion: It is illogical to treat all sore throats with antibiotics. A large scale multi-center study should be performed in the country. A uniform data system should be constructed for Chronic Pharyngo-tonsillitis caused by Methicillin resistant Staphylococcus aureus in Bangladesh. KYAMC Journal Vol. 9, No.-4, January 2019, Page 177-181

scholarly journals METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIAGE AMONG HEALTH-CARE PROFESSIONALS OF A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (3) ◽  
pp. 346
Author(s):  
Latha T ◽  
Anil K Bhat ◽  
Manjunatha Hande H ◽  
Chiranjay Mukhopadyay ◽  
Elsa Sanatombi Devi ◽  
...  
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Health Care Professionals ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carrier Status ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Orthopedic Patients

 Objective: The aim of this study was to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrier status in anterior nares and hands of health-care professionals working in orthopedic wards of a tertiary care hospital and to decolonize them to reduce spread of MRSA to their patients.Methods: The study was conducted in a super specialty, tertiary care teaching hospital. The samples were collected from anterior nares, palm, web spaces, and fingertips of 140 health-care professionals (48 doctors, 74 nurses, and 18 technicians) working in orthopedic wards using sterile pre-moistened swabs. MRSA carrier status was identified by Kirby-Bauer disc diffusion method.Result: Most (76.4%) of the health-care professionals were <30 years of age and 51% were male. MRSA in anterior nares of doctors was 4.3%, nurses 1.4%, and technicians 0.7% and none had MRSA in their hands. Methicillin-sensitive Staphylococcus aureus (MSSA) growth was more among nurses (nurses - 5.7%, doctors - 2.1%, and technicians - 1.4%) in anterior nares. In addition, 1.4% nurses’ hands were colonized with MSSA. Both MRSA and MSSA carriers were decolonized effectively and repeat sampling showed no growth.Conclusion: Health-care professionals have a greater chance of transmitting MRSA to patients and orthopedic patients are more susceptible for infection. Although MRSA carrier status was not very high among orthopedic health-care professionals compared to previous studies, it cannot be ignored. Nasal mupirocin and bath with chlorhexidine soap were effective in decolonization. Periodic screening and treatment of colonizers would help in elimination of MRSA carriage.

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