A Retrospective Study on UTI by Myroides Species: An Emerging Drug Resistant Nosocomial Pathogen.

Aim and background: Myroides (M.) species are ubiquitous in the environment and cause a variety of infections like urinary tract infections (UTI), sepsis, meningitis, cholecystitis, pneumonia, and soft tissue infections, especially among immunocompromised populations. These are usually resistant to multiple antibiotics. This study aimed to demonstrate the clinical profile, underlying comorbidities, and antimicrobial susceptibility of Myroides isolates obtained from nosocomial UTI cases. Materials and methods: A sudden rise in the isolation of Myroides spp. from the repeated urine samples of admitted patients alerted us to conduct this retrospective observational study. Urine cultures that grew M. species were included in this study. Antibiotic susceptibility was performed and the patient's clinical data was analyzed. Results: A total of 14 Myroides spp. isolates were obtained from urine culture. The maximum number of cases (71.4%) were from the Nephrology ward and ICUs. The average (mean) age of patients was 46 years (range 2-80 years). All patients were catheterized. All isolates were multidrug resistant. Minocycline and doxycycline were the only drugs found effective in this study. Conclusions: Myroides species are emerging rare pathogens that can cause UTI in immunocompromised and catheterized patients. Minocycline may be used for treating such infections. How to cite this article: Sahu C, Chaudhary R, Bhartiya C, Patel SS, Bhatnagar N. A Retrospective Study on UTI by Myroides Species: An Emerging Drug Resistant Nosocomial Pathogen. Indian J Crit Care Med 2024;28(4):399-403.

The spectrum of parasitic infections with emphasis on the clinico-epidemiological characteristics and risk factors among immunocompromised and immunocompetent patients at a university hospital in Northern India.

Introduction: Intestinal parasitic infections pose a substantial threat to public health and are a huge burden to the economic development of a developing country. We aimed to identify the spectrum of intestinal parasitic infections with an emphasis on demographic and clinical characteristics observed among immunocompromised and immunocompetent patients. Materials and Methods: This observational study was performed in the Parasitology section of the Department of Microbiology from January 2022 to July 2022. A total of 2628 stool samples were obtained from patients presenting with chief complaints of abdominal pain, distension, vomiting, and foul-smelling feces. All the clinical and diagnostic data of the patients enrolled in the above-mentioned period were extracted from the ward files, hospital electronic records, and laboratory registers. Result: A total of 2628 stool samples were sent to the Parasitology section of the Department of Microbiology. Out of the above-mentioned samples, 70 (70/2628, 2.66%) samples yielded gastrointestinal parasites on microscopic examination. The mean age of the patients included in our cohort study was 32.53 ± 16.21 years with a male predominance of 72.86% (51/70, 72.86%). The most common gastrointestinal parasite identified from stool samples was Giardia lamblia (61/70, 87.14%). All cases of opportunistic gastrointestinal infection caused by Cryptosporidium spp. (4/70, 5.71%) in our study cohort were found to infest the immunocompromised patients. Conclusion: This study determines the spectrum of intestinal parasitic infections among the immunocompromised and immunocompetent individuals and guides physicians in starting appropriate anti-parasitic treatment along with the instillation of strict hand hygiene techniques.

Profile of Amoebic vs Pyogenic Liver Abscess and Comparison of Demographical, Clinical, and Laboratory Profiles of these Patients From a Tertiary Care Center in Northern India.

Background and objective: Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) are the most common causes of liver abscess in developing and developed countries, respectively. Although incidence of liver abscess is low, but mortality is high amongst the patients due to delayed diagnosis. The study was done to find out the prevalence of amoebic and PLA among patients of liver abscess. The clinical, personal, and demographical details were also evaluated to find out the risk factor(s) associated with ALA and PLA, respectively. Method: A retrospective study was conducted to find the prevalence of amoebic and PLA. Clinical, demographic, personal details were evaluated from hospital records. Laboratory parameters such as total leucocyte count, platelets, bilirubin, ESR (Erythrocyte Sedimentation Rate), hemoglobin, glycosylated hemoglobin (HbA1c), alkaline phosphate (ALP), Aspartate aminotransferase (SGOT/AST), Alanine aminotransferase (SGPT/ALT), serum albumin, bilirubin levels, and procalcitonin were recorded. The Ultrasonography (USG) findings regarding the size, location, volume, and number of abscesses were also analyzed. Results: Total of 107 patients of liver abscess were evaluated, and 61.6% of patients were of amoebic etiology, and 25.3% were of pyogenic etiology. Males of 20-60 years of age were predominantly affected with right upper quadrant pain and fever as the most common presentations. ALA patients were found to have solitary abscess in the right lobe involving 6th and 7th segments, with decreased hemoglobin, hyperbilirubinemia, elevated ALP and SGOT, with normal SGPT, and addiction to alcohol. PLA patients had increased HbA1c, increased PCT values, low serum albumin levels, and low platelet-to-white blood cell values. The most common bacteria causing PLA was Escherichia coli (n = 8) followed by Enterobacter cloacae (n = 5). Mortality was seen in 6 patients. Conclusion: Liver abscess is found to have relatively high mortality and morbidity. Therefore, early diagnosis is the only method to prevent mortality and morbidity in these patients. Since the presentation is very nonspecific, evaluation of certain risk factors and laboratory parameters can aid in the diagnosis.

Bacteriological profiles and antibiotic susceptibility of neonatal sepsis in a university hospital of Northern India.

Context: Knowledge of epidemiology of bacterial isolates and their anti-biograms in hospital settings is necessary for prompt empirical anti-microbial therapy of neonatal sepsis. Aims: To study risk factors, bacteriological profiles, and anti-biograms of blood culture isolates of both early and late onset neonatal sepsis. Settings and Design: It is a prospective observational study conducted from January 2020 till July 2021 at our tertiary care center. Material and Methods: Neonates (0-28 days) admitted to this neonatal intensive care unit clinically suspected with sepsis were subjected to blood cultures, and the isolates were identified both biochemically and by the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system. Antibiotic susceptibility testing (AST) was performed as per CLSI guidelines. Statistical Analysis: Chi-square test was used. Results: Out of 280 suspected cases of neonatal sepsis, 43 (15.3%) cases showed positive blood culture. Of these, the majority (30, 69.8%) had late-onset neonatal sepsis. Major pre-disposing risk factors were pre-term birth and a low birth weight (26, 60.5%). Gram-negative bacteria and Gram-positive bacteria were isolated in 25 (58.1%) and 18 (41.9%) blood cultures, respectively. Klebsiella pneumoniae (37.5%) was the most predominant pathogen in both early-onset (23.1%) and late-onset (46.7%) sepsis. Coagulase negative Staphylococcus (34.8%) was the second most common organism and was more common in late onset (23.2%) neonatal sepsis. A high level of antibiotic resistance was noted in Klebsiella pneumoniae isolates, even to amikacin (76.5%) and carbapenems (66.7%). Conclusion: Increased resistance in bacterial isolates of neonatal sepsis emphasizes the need of AST of bacterial isolates for proper antibiotic administration.

Evaluation of seven commercial RT-PCR kits for COVID-19 testing in pooled clinical specimens.

There are more than 350 real-time polymerase chain reaction (RT-PCR) coronavirus disease-2019 (COVID-19) testing kits commercially available but these kits have not been evaluated for pooled sample testing. Thus, this study was planned to compare and evaluate seven commercially available kits for pooled samples testing. Diagnostic accuracy of (1) TRUPCR SARS-CoV-2 Kit (Black Bio), (2) TaqPath RT-PCR COVID-19 Kit (Thermo Fisher Scientific), (3) Allplex 2019-nCOV Assay (Seegene), (4) Patho detect COVID-19 PCR kit (My Lab), (5) LabGun COVID-19 RT-PCR Kit (Lab Genomics, Korea), (6) Fosun COVID-19 RT-PCR detection kit (Fosun Ltd.), (7) Real-time Fluorescent RT-PCR kit for SARS CoV-2 (BGI) was evaluated on precharacterised 40 positive and 10 negative COVID-19 sample pools. All seven kits detected all sample pools with low Ct values (<30); while testing weak positive pooled samples with high Ct value (>30); the TRUPCR Kit, TaqPath Kit, Allplex Assay, and BGI RT-PCR kit showed 100% sensitivity, specificity, and accuracy. However, the Fosun kit, LabGun Kit, and Patho detect kit could detect only 90%, 85%, and 75% of weakly positive samples, respectively. We conclude that all seven commercially available RT-PCR kits included in this study can be used for routine molecular diagnosis of COVID-19. However, regarding performing pooled sample testing, it might be advisable to use those kits that performed best regarding positive identification in samples' pool, that is TRUPCR SARS-CoV-2 Kit, TaqPath RT-PCR COVID-19 Kit, Allplex 2019-nCOV Assay, and BGI Real-time RT-PCR kit for detecting SARS CoV-2.