Antibiotic susceptibility pattern of Salmonella worthington isolated from neonates--a retrospective study.

Salmonella worthington is an emerging pathogen and has been implicated in a number of outbreaks of neonatal meningitis and septicemia. Over a period of 5 years, a total of 30 strains of this pathogen were isolated from blood and cerebrospinal fluid of neonates suffering from septicemia with or without meningitis. Most of these strains were resistant to the penicillin group of antibiotics, and many were resistant to cefotaxime. Sixty percent of the isolates were resistant to amikacin; 86% were resistant to chloramphenicol, and none were resistant to ciprofloxacin or norfloxacin. Parenteral fluoroquinolone should be included as part of antibiotic therapy in suspected cases of neonatal meningitis due to S. worthington.

Effects of blood lead level on biochemical and hematological parameters in children with neurological diseases of Western Maharashtra, India.

BACKGROUND: Lead is found in small but appreciable quantities in air, soil, drinking water, and food. Exposure to such amounts of lead does not lead to acute lead toxicity but produces subtle effects particularly in children. The aim of this study was to investigate the effects of blood lead level on biochemical and hematological parameters in children with neurological diseases in Western Maharashtra, India, and to estimate the blood lead level by liver and kidney function tests and hematological parameters in children with neurological disorders admitted to the pediatric ward and compare them with healthy controls. METHODS: In this study, 30 children with various neurological disorders admitted to the pediatric ward of Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India, were compared with 30 age- and sex-matched healthy controls. Four milliliters of venous blood was collected for estimation of blood lead level, and biochemical and hematological parameters were determined using standard methods. RESULTS: Blood lead level was significantly increased in the study group (p<0.01, 65.38%) compared to that in the control group. When different neurological conditions were grouped into three groups according to blood lead levels, there was a significant difference between the groups. All other biochemical and hematological parameters were not significantly altered in the study group as compared to the control group. CONCLUSIONS: Neurologically challenged children are more vulnerable to lead intoxication. It is imperative for the parents to take extra care of their children's food habits and limit hand-to-mouth activities to prevent lead intoxication.

Multi-drug resistant Acinetobacter ventilator-associated pneumonia.

BACKGROUND: Ventilator-associated pneumonia (VAP) due to a multi-drug resistant (MDR) Acinetobacter is one of the most dreadful complications, which occurs in the critical care setting. AIMS AND OBJECTIVES: To find out the incidence of Acinetobacter infection in VAP cases, to determine various risk factors responsible for acquisition of Acinetobacter infection and to determine the antimicrobial susceptibility pattern of Acinetobacter. MATERIALS AND METHODS: A total of 60 endotracheal aspirate specimens from intubated patients diagnosed clinically and microscopically as VAP were studied bacteriologically. All clinical details and prior exposure to antibiotics were recorded. RESULTS: An incidence of 11.6% of Acinetobacter VAP cases was recorded. Various underlying conditions like head injury, cerebral hemorrhage and chronic obstructive pulmonary disease (COPD) were found to be associated with Acinetobacter VAP. Acinetobacter strains exhibited MDR pattern. CONCLUSION: Strict infection control measures, judicious prescribing of antibiotics, antibiotic resistance surveillance programs and antibiotic cycling should be adopted to control infections due to these bacteria in patients admitted to intensive care units.

Acinetobacter septicemia in neonates admitted to intensive care units.

BACKGROUND: Acinetobacter species are gaining importance as potential pathogens in neonatal septicemia because of their frequent isolation and multidrug resistance. AIMS AND OBJECTIVES: The aim of the present study was to evaluate the role of Acinetobacter spp. as important pathogens in neonatal blood stream infection, to identify the associated risk factors, and to evaluate the drug sensitivity pattern. MATERIALS AND METHODS: Blood samples of infected neonates were studied bacteriologically. Cases of Acinetobacter septicemia were identified. Speciation of Acinetobacter species was done. Various risk factors were identified. The drug-sensitivity test was done. RESULTS: A total of 26 Acinetobacter septicemia cases were identified by blood culture. Acb complex strains predominated. Institutional birth and preterm birth were identified as the most frequent significant risk factors. 11.3% mortality rate was recorded. Acb complex strains exhibited a multi-drug resistant pattern. No carbapenem resistance was observed. CONCLUSION: Acinetobacter should be added to the list of organisms causing severe nosocomial infection in neonatal intensive care units. Continuous bacteriological surveillance, implementation of infection control policies, careful disinfection of intensive care equipment, and rational antibiotic use are required for control of such infections.