scholarly journals Comparative study among clinical and commensal isolates of Enterococcus faecalis for presence of esp gene and biofilm production

2010 ◽  
Vol 5 (05) ◽  
pp. 365-369 ◽  
Author(s):  
Giridhara PM Upadhyaya ◽  
Umapathy B Lingadevaru ◽  
Ravikumar K Lingegowda
Keyword(s):  
Nosocomial Infection ◽  
Enterococcus Faecalis ◽  
Biofilm Formation ◽  
Tertiary Care ◽  
Care Hospital ◽  
Biofilm Production ◽  
Significant Difference ◽  
High Production ◽  
Stool Specimens

Introduction: Because of increasing difficulty in treating enterococcal infections, effort is being devoted to understanding factors that are responsible for causing nosocomial infection, with a focus toward targeting these factors with new therapeutics. Evidence has emerged that the esp gene mediates biofilm formation in vitro, which helps the organism colonize and cause infection. Methodology: This study was conducted over a four-year period in a tertiary-care hospital. There were 200 clinical pathogenic strains isolated from nosocomial infections and 100 commensals from stool specimens of healthy individuals. The study compared the production of biofilm and detection of the esp gene among clinical and commensal isolates. Results: Among 200 clinical isolates of Enterococcus faecalis 65 (32.5%) isolates were positive for biofilm production and 60 (30%) for the esp gene by PCR. Among 100 commensal isolates, 16     (8%) and 14 (7%) were positive for biofilm formation and the esp gene, respectively. Five clinical and two commensal isolates produced biofilm without any amplification of the esp gene. Conclusion: The study shows a significant difference in production of biofilm and presence of the esp gene between clinical and commensal isolates (P < 0.002). Therefore, it can be concluded that biofilm production has an important role in causing nosocomial infection. Although detection of the esp gene correlates with biofilm production, it may not be the only factor determining the formation of biofilm since few isolates produced biofilm without the esp gene. Strains isolated from indwelling medical devices showed high production of biofilm and esp gene.

scholarly journals Association of Antimicrobial Susceptibility and Treatment Outcome in Acne Vulgaris Patients: A Pilot Study

2020 ◽  
Vol 12 (04) ◽  
pp. 233-238
Author(s):  
Ashvini K. Yadav ◽  
Suneel Bhooshan ◽  
Allen Johnson ◽  
Dinesh P. Asati ◽  
Shashwati Nema ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Antimicrobial Susceptibility ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Care Hospital ◽  
In Vitro Susceptibility ◽  
Persistent Infections ◽  
Significant Difference ◽  
Cutibacterium Acnes

Abstract Purpose Cutibacterium acnes (C. acnes) is an emerging pathogen that is highly resistant to antibiotics and is capable of causing persistent infections that are difficult to treat. Methods & Materials Acne vulgaris patients visiting dermatology OPD of our tertiary care hospital during the study period of 2 months were recruited. Skin swabs were collected, and the sample was processed on 5% sheep-blood agar for anaerobic culture by the GasPak method. Isolates were identified by the standard biochemical test. Antimicrobial susceptibility testing was performed for clinically relevant antibiotics by the E-strip method. The clinical response was evaluated after 1-month follow-up to the prescribed antibiotics. Results Minocycline, doxycycline, ceftriaxone, and tetracycline were the most effective antibiotics. Nonsusceptibility to clindamycin and erythromycin were observed in 11.9% and 31% isolates, respectively, with 9.5% isolates being nonsusceptible to both. For none of the antibiotics we found significant difference in the proportion of susceptible and nonsusceptible isolates between mild, moderate, and severe grades of acne vulgaris. For none of the antibiotic regimens, significant difference was observed between nonresponders and responders. Twenty-seven patients received clindamycin and among them 16 of 19 responders and 6 of 8 nonresponders yielded growth of clindamycin-susceptible isolates (p = 0.57). Conclusion We observed significant prevalence of resistant strains of C. acnes among patients with acne vulgaris. No association was observed between in vitro susceptibility results and treatment outcome.

Short versus prolonged courses of antimicrobial therapy for patients with uncomplicated Pseudomonas aeruginosa bloodstream infection: a retrospective study

2021 ◽  
Author(s):  
Moonsuk Bae ◽  
Yunseo Jeong ◽  
Seongman Bae ◽  
Min Jae Kim ◽  
Yong Pil Chong ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bloodstream Infection ◽  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Propensity Score Analysis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Short Course ◽  
Significant Difference

Abstract Background The optimal duration of antimicrobial therapy for uncomplicated Pseudomonas aeruginosa bloodstream infection (BSI) is unknown. We compared the outcomes of short and prolonged courses of antimicrobial therapy in adults with uncomplicated pseudomonal BSI. Methods All patients with uncomplicated P. aeruginosa BSI admitted at a tertiary-care hospital from April 2010 to April 2020 were included. We compared the primary outcome (a composite of the rate of recurrent P. aeruginosa infection and mortality within 30 days after discontinuing antimicrobial therapy) among patients who underwent short (7‒11 days) and prolonged (12‒21 days) courses of antimicrobial therapy using propensity score analysis with the inverse probability of treatment weighting (IPTW) method. Results We evaluated 1477 patients with P. aeruginosa BSI; of them, 290 met the eligibility criteria who received antimicrobial agents with in vitro activity, including 97 (33%) who underwent short-course therapy [median of 9 (IQR = 8‒11) days] and 193 (67%) who underwent prolonged-course therapy [median of 15 (IQR = 14‒18) days]. We found no significant difference in the risk of recurrence or 30 day mortality between the prolonged-course and short-course groups [n = 30 (16%) versus n = 11 (11%); IPTW-adjusted HR = 0.68, 95% CI = 0.34 − 1.36, P = 0.28]. The prolonged-course therapy did not significantly reduce the risk of the recurrence of P. aeruginosa infection within 180 days compared with short-course therapy [n = 37 (19%) versus n = 12 (12%); IPTW-adjusted HR = 0.57, 95% CI = 0.29 − 1.10, P = 0.09]. Conclusions Short-course antimicrobial therapy could be as effective as prolonged-course therapy for uncomplicated P. aeruginosa BSI.

scholarly journals A Cross-Sectional Study on Association between Antibiotic Resistance Pattern and Biofilm Production of E. coli in NonCatheterised UTI Patients at a Tertiary Care Hospital in Kolkata

2021 ◽  
Vol 8 (10) ◽  
pp. 542-546
Author(s):  
Debalina Das ◽  
Parthasarathi Chakrabarty ◽  
Sipra Saha ◽  
Nandita Pal ◽  
Susmita Bhattacharya
Keyword(s):  
Antibiotic Resistance ◽  
Congo Red ◽  
Biofilm Formation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Hospital ◽  
E Coli ◽  
Antibiotic Resistance Pattern ◽  
Biofilm Production

BACKGROUND Urinary tract infections are some of the most common community-acquired as well as nosocomial infections with E. coli being the most common pathogen. There is increased antimicrobial resistance among bacteria worldwide. One of the important mechanisms of resistance and virulence of bacteria is biofilm formation. This study was conducted to find out the association between antibiotic resistance pattern and biofilm formation in E. coli in non-catheterised patients of UTI in a tertiary care hospital. We further wanted to determine the association between the ability of E. coli to form biofilm and their ability to produce extended-spectrum beta-lactamases (ESBLs) and carbapenemase in non-catheterised patients. METHODS Urine samples collected from 300 non-catheterised patients who had symptoms of UTI were inoculated into MacConkey’s agar and blood agar media. Then identification and antibiotic susceptibility tests were done. Phenotypic detection of ESBL production was done by double disc diffusion test and carbapenemase production was done by mCIM (modified carbapenem inactivation method) and eCIM (EDTA carbapenem inactivation method) tests according to Clinical and Laboratory Standards Institute (CLSI) 2019 guideline. Biofilm detection was done by Congo red agar (CRA) method. RESULTS Out of 78 isolates E. coli were the commonest (61.5 %) isolate. Out of 48 E. coli isolates from non-catheterised UTI patients, 26 (54.1%) were biofilm producers. Antibiotic sensitivity pattern among the E. coli isolates showed the highest susceptibility of the strains to amikacin, whereas the least susceptibility was for amoxicillin. Out of 48 E. coli, 20 (41.6 %) were ESBL producers, 16 (33.33 %) E. coli were carbapenemase producers. Significant association was found between ESBL and biofilm production. However, no statistical significance was found between the association of carbapenemase production and biofilm formation. CONCLUSIONS Uropathogenic E. coli is not an uncommon pathogen for biofilm formation even in non-catheterised patients. The antibiotic-resistance rate was higher among biofilm producing E. coli isolates. The biofilm forming ability was found to be significantly higher among ESBL producing strains but was not statistically significant for carbapenemase producing strains of E. coli. KEYWORDS Biofilm, Uropathogen, Congo Red Agar (CRA) Method, UTI, ESBL, Carbapenemase

scholarly journals Assessment of Biofilm Formation among the Clinical Isolates of Escherichia coli in a Tertiary Care Hospital

2020 ◽  
pp. 26-32
Author(s):  
Bedobroto Biswas ◽  
Naik Shalini Ashok ◽  
Deepesh Nagarajan ◽  
Md Zaffar Iqubal
Keyword(s):  
Escherichia Coli ◽  
Tissue Culture ◽  
Biofilm Formation ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Plate Method ◽  
Culture Plate ◽  
Tissue Culture Plate

Aims: Identification and grading of the Escherichia coli according to their biofilm production capability. Study Design:  Cross-sectional study. Place and Duration of Study: This was conducted in Department Microbiology at M.S. Ramaiah Medical college and Hospital, Bengaluru from March 2017 to August 2017. Methodology: A total of 55 non repetitive Escherichia coli isolates were identified from various clinical samples like urine, pus ,tissue and peritoneal fluids .All the organisms were isolated in pure culture and biofilm formation was detected in vitro by Gold standard TCP (Tissue culture plate) method. Organisms were incubated for an extended period of 48 hours and the biofilms were detected by acetone alcohol elution method. Organisms were categorized as strong, moderate, weak and no biofilm producers based on the obtained OD value of the elute. Results: Majority of the isolates of Escherichia coli were obtained from catheterized urine culture (67.03%) followed by pus (25.50%).Most of the isolates were capable of forming biofilm in vitro by tissue culture plate method except a few (9.1%). 40% of the isolates were strong biofilm formers which had >4 ODC. 25.5% showed medium biofilm-forming capability and rest 25.5% showed weak biofilm formations in vitro. Conclusion: The ability to form biofilm from a species can give us a better understanding of the biofilm-related infections pertaining to the particular group. Detection of biofilms remains a most important determinant to approximate the incidence of such infections. Categorization of organisms according to their biofilm formation may help us understand the frequency of biofilm-associated infections, and thus take necessary precautions to avoid the problem. Further studies involving the detection of biofilm may be conducted and the tests can be implemented in routine diagnostic microbiology to assess the usefulness of the methods in detection of biofilm-related infections.

scholarly journals Strawberry Extract’s Effects on Enterococcus faecalis and Porphyromonas gingivalis Biofilms in vitro

2017 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Armelia Sari Widyarman ◽  
Stephanie Brigitta Widjaja ◽  
Erik Idrus
Keyword(s):  
Enterococcus Faecalis ◽  
Porphyromonas Gingivalis ◽  
Biofilm Formation ◽  
Oral Bacteria ◽  
Inhibition Effect ◽  
Extract Concentration ◽  
Significant Difference ◽  
Negative Controls ◽  
Optimal Incubation

<p><strong>Background</strong>: <em>Enterococcus faecalis </em>(<em>E. faecalis</em>)<em> </em>and<em> Porphyromonas gingivalis</em> (<em>P. gingivalis</em>) are oral bacteria related to root canal infection and periodontal disease pathogenesis. Strawberries (<em>Fragaria x ananassa</em>) fruit are rich in vitamins and minerals, have antibacterial and antioxidant effects.<strong> Objective</strong>: This study investigated the inhibition effect of strawberry extract on monospecies and multispecies <em>E. faecalis </em>and<em> P. gingivalis </em>bacteria grown as biofilms<em> in vitro.</em> <strong>Methods:</strong> This study used <em>E. faecalis</em> ATCC 29212 <em>and P. gingivalis</em> ATCC 33277. It analyzed<strong> </strong>the effect of strawberry extract on bacteria biofilm formation using a biofilm assay on microplate wells. Five concentrations of strawberry extracts were used (100%, 50%, 25%, 12.5%, and 6.25%), and the inhibition effect was observed after a 1h, 3h, 6h, and 24h incubation period. Biofilms without the strawberry extract were used as the negative controls, and crystal violet and safranin (0.5%<sup>w</sup>/<sub>v</sub>) were used to count the biofilm mass. The biofilms grown on microplates were counted using an ELISA reader at 450 nm after 200 mL of 90% ethanol was added to attract the absorbed stain. The strawberry extract inhibition effectiveness on the biofilm formation of each bacterium tested was analyzed using one-way Anova, where p&lt;0.05 was defined as a significant difference. <strong>Result</strong>: The strawberry extract inhibited the tested monospecies and multispecies bacteria biofilm formation. The optimal strawberry extract concentration for the inhibition of either monospecies biofilms was 100%. However, the optimal incubation time for the strawberry extract to inhibit the multispecies biofilm formation was 24h, which was the study’s biofilm maturity phase.<strong> Conclusions: </strong>The 100%<strong> </strong>strawberry extract concentration inhibited the formation of both the monospecies and multispecies <em>E. faecalis </em>and <em>P. gingivalis</em> biofilms. Future studies are needed to evaluate the potential of strawberry extract as an alternative dental therapy.</p>

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

2021 ◽  
Vol 8 ◽  
pp. 204993612110365
Author(s):  
Kundan Mishra ◽  
Suman Kumar ◽  
Sandeep Ninawe ◽  
Rajat Bahl ◽  
Ashok Meshram ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Myeloid Leukemia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean ◽  
Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

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