scholarly journals Antimicrobial Resistance in Typhoidal Salmonellain a Tertiary Care Teaching Centre in North India

2021 ◽  
Vol 53 (1) ◽  
pp. 1-4
Author(s):  
Juhi Taneja ◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Enteric Fever ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Herd Immunity ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital

Introduction: Enteric fever continues to carry a high burden of morbidity and mortality in India. There have been reports of emergence of ceftriaxone resistant typhoidal Salmonella from Asia. Monitoring of antimicrobial resistance trends in typhoidal Salmonella is crucial to support in clinical decision making. Aim: To study the current susceptibility pattern of typhoidal salmonella isolates in our setup. Methods: This retrospective study was conducted on 144 non-repeat blood-culture isolates of S. Typhi, and S. Paratyphi A obtained from 3926 blood cultures received at 510-bedded tertiary-care hospital of North-India from 2017-2019. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with sensitivity to azithromycin, and chloramphenicol. Result:S. Typhi and S. Paratyphi A in a ratio of 5.2:1 were seen between months of June and July predominantly distributed between 1-10 years age group. S. Typhi resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 21.4%, 25.6%, 12.3% and 28% respectively. S. Paratyphi A resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 4.3%, 17.3%, 34.7% and 21.7% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of ceftriaxone-resistant Salmonella mandates appropriate investigation of all febrile illnesses with blood culture whenever possible. Provision of safe drinking water, good sanitation, hygiene and vaccination strategies are needed to sustain herd-immunity.

scholarly journals Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India – a Seven Year Ambispective Study

2018 ◽  
Vol 61 (4) ◽  
pp. 125-130 ◽  
Author(s):  
Anuradha Makkar ◽  
Shilpi Gupta ◽  
Inam Danish Khan ◽  
Rajiv Mohan Gupta ◽  
KS Rajmohan ◽  
...  
Keyword(s):  
Public Health ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Drug Resistant

Introduction: Enteric-fever is a major public-health problem in developing countries emerging as multidrug-resistant, Nalidixic-acid resistant and extremely drug-resistant Salmonella (Pakistan, 2016), has intensified the use of WHO watch/reserve group antimicrobials such as azithromycin and meropenem. Methods: This ambispective-study was conducted on 782 non-repeat blood-culture isolates of S. Typhi, S. Paratyphi A and S. Paratyphi B obtained from 29,184 blood cultures received at a 1000-bedded tertiary-care hospital of North-India from 2011–2017. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with resistance to ampicillin, chloramphenicol and cotrimoxazole being labeled as multidrug-resistant. Decreased ciprofloxacin-susceptibility and ciprofloxacin-resistance were defined as MIC 0.125–0.5 and >1 μg/ml. Results: S. Typhi and S. Paratyphi A in a ratio of 3.9:1 were seen between July–September predominantly distributed between 6–45 year age group. Resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 6.1%, 13.8%, 16.1 and 5.78% respectively. Multidrug-resistant S. typhi and S. paratyphi A were 2.73% and 1.91% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of multidrug-resistant, Nalidixic-acid resistant and extremely-drug resistant Salmonella mandates ongoing surveillance for targeted empirical therapy and containment of spread. Repeated epidemics call for water, sanitation, hygiene and vaccination strategies to sustain herd-immunity.

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals Clinical spectrum of enteric fever in children admitted to a tertiary care hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 1530
Author(s):  
Jawad Nazir Wani ◽  
Abdus Sami Bhat ◽  
Saleem Yusuf ◽  
Umer Amin Qureshi
Keyword(s):  
Public Health ◽  
Blood Culture ◽  
Health Problem ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Normal White Blood Cell

Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.

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 A clinico-epidemiological study of cutaneous changes in chronic kidney disease

2016 ◽  
Vol 2 (4) ◽  
pp. 103
Author(s):  
Chirag Maheshwari ◽  
Ajay Kumar ◽  
Sanjeev Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Urban Background ◽  
Cutaneous Manifestations

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) has emerged as a major public health problem in South Asia. This is attributable to the increase in prevalence of co-morbidities particularly hypertension and diabetes mellitus. Cutaneous manifestations are observed throughout the course of the disease and serve as markers of the disease and its progression. Early diagnosis and treatment is critical in halting the progression of the disease. The objective was to study the prevalence of co-morbidities as well as cutaneous changes in patients with CKD from a rural or semi-urban background in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients with CKD aged 18 years or above detected and managed at a tertiary care teaching hospital in North India were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The age of the patients ranged from 18 to 78 years. 35 patients (70%) had a rural background while 15 patients (30%) had a semi-urban background. 37 patients (74%) had co-morbidities including hypertension, diabetes mellitus or both. 17 patients (34%) were on conservative management while 33 patients (66%) were undergoing haemodialysis. Skin changes included nephrogenic pruritus in 30 patients (60%), xerosis in 25 patients (50%), cutaneous infections and infestations in 25 patients (50%), pallor in 22 patients (44%), acquired perforating disorders in 6 patients (12%), purpura in 5 patients (10%), hyperpigmentation in 4 patients (8%) and yellow skin in 1 patient (2%). Hair changes were observed in 20 patients (40%), nail changes in 24 patients (48%) and mucosal changes in 20 patients (40%). None of the patients were found to have bullous dermatoses, calcific uraemic arteriolopathy or nephrogenic systemic fibrosis. 4 patients (8%) included in the study initially reported to dermatology OPD with a specific dermatosis and were detected to have CKD.</p><p><strong>Conclusions:</strong> The prevalence of co-morbidities including hypertension and diabetes associated with CKD may be lower in rural and semi-urban populations. Nephrogenic pruritus is the most distressing change which impairs the quality of life in these patients. Cutaneous changes may help in early detection and treatment of CKD. </p>

scholarly journals Paradigm Shift in Antimicrobial Resistance Pattern of Bacterial Isolates during the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Vikas Saini ◽  
Charu Jain ◽  
Narendra Pal Singh ◽  
Ahmad Alsulimani ◽  
Chhavi Gupta ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Hospital Infection Control ◽  
And Staphylococcus Aureus

Antimicrobial resistance (AMR) is an emerging public health problem in modern times and the current COVID-19 pandemic has further exaggerated this problem. Due to bacterial co-infection in COVID-19 cases, an irrational consumption of antibiotics has occurred during the pandemic. This study aimed to observe the COVID-19 patients hospitalized from 1 March 2019 to 31 December 2020 and to evaluate the AMR pattern of bacterial agents isolated. This was a single-center study comprising 494 bacterial isolates (blood and urine) that were obtained from patients with SARS-CoV-2 admitted to the ICU and investigated in the Department of Microbiology of a tertiary care hospital in Delhi, India. Out of the total bacterial isolates, 55.46% were gram negative and 44.53% were gram positive pathogens. Of the blood samples processed, the most common isolates were CoNS (Coagulase Negative Staphylococcus) and Staphylococcus aureus. Amongst the urinary isolates, most common pathogens were Escherichia coli and Staphylococcus aureus. A total of 60% MRSA was observed in urine and blood isolates. Up to 40% increase in AMR was observed amongst these isolates obtained during COVID-19 period compared to pre-COVID-19 times. The overuse of antibiotics gave abundant opportunity for the bacterial pathogens to gradually develop mechanisms and to acquire resistance. Since the dynamics of SARS-COV-2 are unpredictable, a compromise on hospital antibiotic policy may ultimately escalate the burden of drug resistant pathogens in hospitals. A shortage of trained staff during COVID-19 pandemic renders it impossible to maintain these records in places where the entire hospital staff is struggling to save lives. This study highlights the extensive rise in the use of antibiotics for respiratory illness due to COVID-19 compared to antibiotic use prior to COVID-19 in ICUs. The regular prescription audit followed by a constant surveillance of hospital infection control practices by the dedicated teams and training of clinicians can improve the quality of medications in the long run and help to fight the menace of AMR.

scholarly journals Study of anaemia profile in a tertiary care hospital in Karnataka, India

2020 ◽  
Vol 7 (4) ◽  
pp. 582
Author(s):  
Appu Patil
Keyword(s):  
Tertiary Care ◽  
Public Health Problem ◽  
Severe Anaemia ◽  
Common Finding ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Common Cause ◽  
Working Age ◽  
Systemic Examination ◽  
A Prospective Study

Background: Anaemia is a major public health problem worldwide especially in developing countries like India. Nutritional cause of anaemia continues to predominate as the most common cause of anaemia. Objective of this study is to determine the clinical and laboratory profile of anaemia among patients admitted to our hospital.Methods: Our study was a prospective study in which thirty nine patients of anemia admitted to Medicine ward in SNMC and HSK hospital were studied for their clinical and laboratory characteristics. Duration of the study was 7 months from July 2019 to January 2020.Results: Anaemia was more common among females (65.1% of total patients). Patients aged less than 60 years contributed to 85% of patients. Pallor was the universal finding present in 100% of patients. On systemic examination haemic murmurs on auscultation was the most common finding present in 28.2% followed by hepatomegaly (17.94%). Microcytic and dimorphic anaemia constitute the bulk of anaemia.Conclusions: Nutritional anaemia particularly iron deficiency anaemia is the most common cause of anaemia. It tends to affect the working age group and females predominantly. Patients continue to present with severe anaemia to the hospital.

scholarly journals Cost of Hemodialysis in a Tertiary Care Hospital in North India

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 47-50
Author(s):  
Mushtaq Ahmad ◽  
Ajaz Mustafa ◽  
M Saleem Najar ◽  
Farooq Ahmad Jan ◽  
Anil Manhas ◽  
...  
Keyword(s):  
Average Cost ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cost Effective ◽  
Chronic Hemodialysis ◽  
North India ◽  
Care Hospital ◽  
Effective Treatment Option ◽  
Cost Effective Treatment ◽  
Cost Efficient

BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem with significant health consequences and involvement of high cost on treatment worldwide. Although renal transplant is a cost effective treatment option for ESRD, use of hemodialysis in patients with ESRD patients remains one of the most resource intensive and expensive therapeutic intervention. OBJECTIVE: To estimate cost of hemodialysis treatment for patients with ESRD that would help in making policy decisions and enable cost efficient utilization of ESRD programme and hemodialysis. METHODS: 58 patients with ESRD on chronic hemodialysis were incorporated in the present study at a tertiary care teaching hospital between January 2010 to December 2010. Patients who survived less than 3 months after commencement of treatment were excluded. RESULTS: Mean age of the study patients was 46.4±8 in yrs. Among the 54 patients studied 51 % were male. 86% of patients received three sessions of hemodialysis weekly, with duration per session varying between 2 - 4 hours. Average cost was Rs. 2001.84 per session. Estimated total annual burden was Rs. 209449.10 per patient. Average cost borne by hospital was Rs. 951.84 per session/patient (47.55 % of cost bone by the patient); cost born by hospital per patient per year was Rs. 123647.70. Principal expenses (% wise) were: staff salary cost 20.84 %, instrument cost (purchased locally from market) 32.50%, salary cost 20.84%, and rental cost 18.20 %. CONCLUSION: The costs estimated in this study comparable with national average cost of hemodialysis in India but lower as compared to that in other SARC countries; approaches to reduce cost further are needed. JMS 2012;15(1):47-50.

scholarly journals Prevalence and outcome of anaemia among pregnant women attending tertiary care hospital in Visakhapatnam

2017 ◽  
Vol 5 (1) ◽  
pp. 203
Author(s):  
Radha Kumari Paladugu ◽  
Srinivas Jagath Pentakota ◽  
Sushma N.
Keyword(s):  
Socioeconomic Status ◽  
Developing Countries ◽  
Pregnant Women ◽  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Developed Countries ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Study Population

Background: Anaemia in pregnancy is now considered as a major public health problem, caused by iron deficiency. WHO has estimated that prevalence of anaemia in developed and developing countries in pregnant women is 14% in developed countries and 51 percent in developing countries and 65-75% in India. Various programmes regarding anaemia prophylaxis and maternal health have been implemented but still the prevalence of anaemia related complications among pregnant women continues to be high. Hence the present study was conducted to study the prevalence and pregnancy outcome as a result of anaemia in a tertiary care center in Visakhapatnam. Methods: A cross sectional descriptive study was carried out from June 2016 to August 2016 in the Department of Obstetrics and Gynecology among postnatal women in King George hospital, Visakhapatnam. A semi-structured questionnaire was prepared and information regarding age, socioeconomic status, parity, gestational age interval between pregnancies and outcome and complication of pregnancy were collected. Results: Mean age of study population is 22.4 years. Out of 100 women involved in the study 65 are from urban areas 29 from rural areas and 6 from tribal areas. Majority of the study population 66% were having HB% between 8-11% i.e. mild anaemia. When Outcome of pregnancy was seen in relation to anaemia majority of the women had live births (90%) followed by 7% IUDs and 2% still births. Conclusions: Majority of the women are in the age group of 20-24 years. Socioeconomic status is directly related to anaemic status of the women. Majority of the women had complication of puerperal sepsis. 

scholarly journals Identification of Risk Factors for Typhoid Fever in Children Admitted in a Tertiary Care Hospital

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Soma Halder ◽  
◽  
Md. Ekhlasur Rahman ◽  
Mst Mukta Sarker ◽  
Fabia Hannan Mone ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Group ◽  
Major Public Health Problem ◽  
Care Hospital

Enteric fever remains a major public health problem in developing countries like Bangladesh. Improvement in the health facility, vaccination, and health-related awareness program the incidence of enteric fever among children is not decreased. The study aimed to find out the risk factors for enteric fever in hospitalized children in a tertiary care hospital. Methodology: We conducted a hospital-based case-control study to identify the risk factors in children residing in Dhaka city. We enrolled 50 enteric fever cases as a case group and 50 age-matched febrile patients as a control group. Result: Out of 50 cases, 2 patients were below one year and most of them were pre-school aged 26(52%). Univariate analysis showed that enteric fever is more who take food with the help of the mother and caregiver (OR=7.1); 95% CI= 26.7 -61.3) and never or rarely wash hands before preparing food and before feeding (OR= 5.7; 95% CI= 23.2 -52.8). Cases were eating outdoors at the mobile food vendors and consuming ice-cream regularly (OR=2.28; 95% CI=1- 39) whereas the control group also took street food but less frequently. Conclusion: Enteric fever is an exclusive food and water-borne systemic disease and one of the major public health problems in Bangladesh. Not only overcrowding, unsafe drinking water are the common risk factors but also hand washing both children and caregiver, poor food habit is the important risk factors. So, health education to children and food handlers may reduce the incidence of enteric fever in children.

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