Multi-Cellular Immunological Interactions Associated With COVID-19 Infections.

To rapidly prognosticate and generate hypotheses on pathogenesis, leukocyte multi-cellularity was evaluated in SARS-CoV-2 infected patients treated in India or the United States (152 individuals, 384 temporal observations). Within hospital (<90-day) death or discharge were retrospectively predicted based on the admission complete blood cell counts (CBC). Two methods were applied: (i) a "reductionist" one, which analyzes each cell type separately, and (ii) a "non-reductionist" method, which estimates multi-cellularity. The second approach uses a proprietary software package that detects distinct data patterns generated by complex and hypothetical indicators and reveals each data pattern's immunological content and associated outcome(s). In the Indian population, the analysis of isolated cell types did not separate survivors from non-survivors. In contrast, multi-cellular data patterns differentiated six groups of patients, including, in two groups, 95.5% of all survivors. Some data structures revealed one data point-wide line of observations, which informed at a personalized level and identified 97.8% of all non-survivors. Discovery was also fostered: some non-survivors were characterized by low monocyte/lymphocyte ratio levels. When both populations were analyzed with the non-reductionist method, they displayed results that suggested survivors and non-survivors differed immunologically as early as hospitalization day 1.

COVID-19 in pregnancy: A preliminary 50-day review from India.

BACKGROUND: This retrospective review was done to gauge the preliminary experience of COVID-19 in pregnancy during first 50 days of lockdown in a tertiary care hospital of India. METHODS: This was a single-centered study, wherein all the suspected women (as defined by ICMR guidelines) who were tested for SARS-CoV 2 infection by nasopharyngeal/oropharyngeal swabs, and rendered to RT-PCR, were included. Parallel evaluation was performed for women in both groups for sociodemographic and obstetric attributes, risk factors, clinical presentation and feto-maternal outcome. Categorical variables were presented in number and percentage. Qualitative variables were equated using Chi-Square test/Fisher's exact test. A P value of < 0.05 was counted as significant. RESULTS: Amongst 112 suspected cases, seven (6.25%) were found to be positive for SARS COV2. Majority of COVID-19 positive women hailed from urban hotspot areas (57.7%) and were un-booked (57.1%). Most were mild cases, and symptomatic (85.7%), with fever (57.1%) being predominant feature in all suspects; no adverse effects seen on pregnancy and fetus, with uneventful postpartum period. CONCLUSION: No adverse outcome in mother and baby after acquiring SARS-COV2 infection was observed, with maximum cases being mild; fever was the predominant symptom in all suspects, with significantly higher percentage in COVID-19 positives.

Incidence of multidrug resistant pseudomonas aeruginosa isolated from burn patients and environment of teaching institution.

CONTEXT: Pseudomonas aeruginosa is an important pathogen which causes nosocomial infections in immunocompromised patients, especially in hospitalized burn patients. In recent times, it has emerged as a widespread Multi Drug Resistant (MDR) pathogen which requires antibiotic susceptibility testing on a regular as well as a periodic basis. AIM OF THE STUDY: The present study was undertaken to determine the antibiogram of P. aeruginosa which was isolated from inpatients and environmental sources, and to type the strains, based on their antibiogram patterns. SETTINGS AND DESIGN: A prospective study was undertaken with 525 samples (blood and wound swabs) which were taken from 60 patients who were admitted to Vardhman Mahavir Medical College and Safdarjang hospital with burn injuries and with 101 samples which were obtained from environmental sources viz. surgical instruments, dressings, suction devices, sinks, antiseptic solutions, etc. MATERIALS AND METHODS: The strains were cultured and identified by standard microbiological techniques and Kirby- Bauer disc diffusion antibiotic susceptibility testing was done for each. STATISTICAL ANALYSIS: Chi -squire tests were done and p- values of less than 0.05 were considered to be significant. RESULTS: Fifty six strains and two strains, respectively, of P. aeruginosa were isolated from inpatients and environmental samples (one strain from sink and one strain from door wall, among the two) respectively. In total, 58 (81%) P. aeruginosa strains were found to be resistant to aminoglycosides, 41-70% were resistant to beta-lactams - piperacillin, ceftazidime, and aztreonam, 34.5% were resistant to piperacillin-tazobactam, 12.06% were resistant to ciprofloxacin and 13-19% were resistant to carbapenems. All strains were sensitive to colistin. P. aeruginosa was resistant to three of the four 'in-use' drugs i.e. piperacillin+tazobactam, imipenem, ceftazidime, and gentamicin, which was taken as MDR, which depicted MDR percentage as 36.2 (21/58). CONCLUSION: Strategies of optimal prescribing, including control of antibiotic usage, coupled with periodic studies on MDR P. aeruginosa infections in burn patients, appear to be leading priorities which help in improving therapeutic gains in such patients.

Bacterial profile and patterns of antimicrobial drug resistance in intra-abdominal infections: current experience in a teaching hospital.

CONTEXT: Bacterial isolates from intra-abdominal infections, in particular, peritonitis and their unpredictable antimicrobial resistance patterns, continue to be a matter of concern not only globally but regionally too. AIM: An attempt in the present study was made to study the patterns of drug resistance in bacterial isolates, especially gram negative bacilli in intra-abdominal infections (IAI) in our hospital. MATERIALS AND METHODS: From 100 cases of peritonitis, identification of isolates was done as per recommended methods. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) testing were performed following the CLSI guidelines. RESULTS: A total of 133 clinical isolates were obtained, of which 108 were aerobes and 22 anaerobes. Fungal isolates were recovered in only three cases. Escherichia coli (47/108) emerged as the most predominant pathogen followed by Klebsiella spp. (27/108), while Bacteroides fragilis emerged as the predominant anaerobe (12/22). Among coliforms, 61.7% E. coli and 74.1% Klebsiella spp. were ESBL positive. A high level of resistance was observed for beta lactams, ciprofloxacin, amikacin, and ertapenem. Ertapenem resistance (30-41%) seen in coliforms, appears as an important issue. Imipenem, tigecycline, and colistin were the most consistently active agents tested against ESBL producers. CONCLUSION: Drug resistance continues to be a major concern in isolates from intra-abdominal infections. Treatment with appropriate antibiotics preceded by antimicrobial resistance testing aided by early diagnosis, adequate surgical management, and knowledge of antibiotic - resistant organisms appears effective in reducing morbidity and mortality in IAI cases.

Neurocysticercosis in children: clinical findings and response to albendazole therapy in a randomized, double-blind, placebo-controlled trial in newly diagnosed cases.

The clinical findings of neurocysticercosis, diagnosed primarily on the basis of computed tomography (CT), and response to albendazole therapy in a randomized, double-blind, placebo-controlled trial were studied in 72 newly diagnosed children aged 1.5-12 years admitted to hospital in New Delhi, India, during March to July 2000. The lesions by initial CT were mostly single with perilesional oedema, and were located in the parietal lobes. The most common clinical finding was partial seizure (79.2%). The outcome of the albendazole trial was assessed through changes in CT lesions and status of seizure after 6 months of follow-up; about 55% of the lesions had disappeared and about 80% of the children were seizure-free. The frequency of healing of CT lesions in the albendazole-treated group and placebo group was 54.2% and 55.2%, respectively, and the frequency of a seizure-free state in the albendazole-treated group and placebo group was 87.5% and 77.5%, respectively; the differences were not statistically significant. Changes in lesions by CT and the recurrence of seizures after 6 months of follow-up were not related to the number of lesions by initial CT and albendazole was not beneficial in neurocysticercosis in children with ring-enhancing lesions in CT.