Monitoring and Outcomes of Central Line-Associated Bloodstream Infections in a Tertiary Care Intensive Care Unit.

Background Central line-associated bloodstream infections (CLABSIs) are significant healthcare-associated infections that increase morbidity, mortality, and healthcare costs. This study aims to analyze the frequency, microbiology, risk factors, and outcomes of CLABSI in an adult intensive care unit. Methods We conducted a hospital-based, prospective surveillance study in the critical care unit of a tertiary care hospital. We included patients with a central line (CL) from admission until discharge or line removal. Data collection focused on patient demographics, comorbidities, CL insertion site, and CLABSI rates. The incidence of CLABSI was calculated per 1,000 CL-days, and statistical analysis was performed using the Chi-square test. Results Of the 169 patients enrolled, 123 episodes of bloodstream infections were recorded, 56 (45.5%) of which were CLABSIs. The organisms most frequently isolated were Klebsiella pneumoniae (n = 14; 24.6%), Enterobacter cloacae complex (n = 11; 19.3%), Klebsiella species (n = 7; 12.28%), and Acinetobacter baumannii (n = 7; 12.28%). The overall CLABSI rate was 24.70 per 1,000 CL-days. No significant association was found between CLABSI and patient age, gender, or the site of CL insertion. However, a significant relationship was observed between CLABSI and the presence of comorbid conditions (p = 0.001). The study also noted a high rate of antibiotic resistance among the isolated pathogens. Conclusions Our results emphasize the need for stringent infection control measures and suggest that comorbid conditions significantly increase the risk of CLABSI. Addressing antibiotic resistance and implementing effective prevention strategies are essential for reducing the burden of CLABSIs.

Evaluation of Serological Tests for the Diagnosis of Syphilis.

Background Syphilis remains a significant public health concern in India. Ensuring the accuracy of diagnostic tests is crucial for effectively managing this disease. Objectives This study aims to assess the detectability of syphilis using commercially available non-treponemal and treponemal tests due to observed discrepancies in test results, which can lead to confusion and anxiety among healthcare providers and patients. Materials and methods We analyzed 2312 serum samples using the rapid plasma reagin (RPR), Treponema pallidum hemagglutination assay (TPHA), enzyme-linked immunosorbent assay (ELISA), and modified TPHA rapid test, interpreting the results according to the manufacturers' instructions. We evaluated the diagnostic accuracy of all four tests. Concordance between the traditional and reverse algorithms was determined by calculating the percentage of agreement and the kappa (κ) coefficient. Results Of the 2312 samples tested, 34 (1.5%) were positive, and 2098 (90.7%) were negative across all four tests. Comparing the test results with clinical diagnosis, TPHA and TP-ELISA showed the highest sensitivity at 96.08%, while RPR demonstrated the highest specificity at 100%. The agreement between the traditional and reverse algorithms was moderate, with a 97.3% agreement and a κ value of 0.53. Conclusion Reliance on a single serological test for syphilis screening presents limitations. A combined approach using both RPR and TPHA tests can more accurately diagnose and confirm syphilis. This combination strategy is cost-effective and relatively simple to implement.