Spectrum of pathogens and their antimicrobial susceptibility pattern isolated from bronchoalveolar lavage specimens at a hilly area in Uttarakhand.

Background: Lower respiratory tract infections (LRTIs) are associated with significant morbidity and mortality in all age groups, especially young children and the elderly population. Various gram-positive and gram-negative organisms such as Streptococcus spp., Pseudomonas spp., and Klebsiella spp. have been implicated as a pathogen in bronchoalveolar lavage (BAL) specimens collected from such patients. Aims and Rationale of the Study: The present study is aimed at assessing the spectrum of the bacterial isolates and determining the antimicrobial resistance obtained from the BAL fluid from admitted patients at various wards and intensive care units (ICUs) of a tertiary care hospital in Dehradun. This will be the stepping stone in our efforts toward becoming a future antimicrobial steward and framing local antibiograms based on such data. Material and Methods: Two hundred BAL specimens were collected from patients admitted to various wards and ICUs of the hospital who were suffering from LRTI. The BAL specimens were subjected to direct microscopy and culture. Identification and susceptibility testing were performed. Results: The most predominant isolates were Pseudomonas aeruginosa (16/39 (41.02%)) followed by Klebsiella pneumoniae (7/39 (17.94%)) and Acinetobacter spp. (6/39 (15.38%)). Sixty-five percentage of Pseudomonas aeruginosa, 71% of Klebsiella pneumoniae, and 83% of Acinetobacter spp. showed intermediate results with colistin. Conclusion: Nonfermenters constitute a significant group of organisms isolated from bronchoalveolar lavage (BAL) specimens in patients with lower respiratory tract infections (LRTIs). Hence, it is extremely important to correctly identify and determine the resistance pattern of such isolates so that appropriate empirical therapy can be initiated for the benefit of the patient.

Microbial profile and antibiotic resistance pattern of water supply in a tertiary care hospital of Uttarakhand.

Background and Objectives: In healthcare settings, hospital water and water-related devices can act as a reservoir for waterborne infections. Potable water, sinks, faucet aerators, showers, tub immersion, toilets, dialysis water, water baths, eyewash stations, and dental-unit water stations have all been linked to nosocomial outbreaks. This study aimed to determine the microbial profile and pattern of antibiotic resistance in the water supply of a tertiary care hospital in Uttarakhand. Materials and Methods: This is a 1-year prospective study which was carried out by the Department of Microbiology and Immunology at Sri Mahant Indersh Hospital (SMIH), Dehradun. A total of 154 water samples were collected from the AC outlets, ventilators in the Intensive care unit (ICUs), Operation theatre (OTs), and High dependency unit (HDUs), scrub stations, pantry, and blood bank, patient's bathroom, private ward, septic ward, labour room, transplant unit, laboratory, scope rinse water, the dialysis unit and tank throughout the hospital, including tap water (pre and post flush [25%]), tap swabs (24%), drinking water (9%), AC outlets (13%), and other areas (3%). Results: 30 of the 154 (19.5%) water samples tested were culture-positive. The most contaminated water samples were tap swabs (27%, n = 8/30). A total of nine organisms were isolated, of which the most predominant was Pseudomonas aeruginosa (40%; 12/30), followed by Legionella pneumophila (13%; 4/30), Acinetobacter baumanii (10%; 3/30), Klebsiella pneumoniae (10%; 3/30), Escherichia coli (7%; 2/30), Enterococcus faecalis (7%; 2/30), Aspergillus flavus (7%; 2/30), Stenotrophomonas (3%; 1/30), and Fusarium spp. (3%; 1/30). Gram-negative bacilli and non-lactose fermenting (GNB and NLF) showed a high rate of contamination, 53.3% (n = 16/30). P. aeruginosa showed resistance to gentamicin and amikacin (42%), imipenem (50%), levofloxacin (58%), and colistin (25%), while Acinetobacter baumanii showed resistance to gentamicin and amikacin (67%), minocycline (63%), and levofloxacin, imipenem and colistin (33%). Conclusion: The study's findings show that a variety of microorganisms are contaminating hospital water supplies and can be a source of hospital-acquired infections. A suitable and robust surveillance program for hospital water supplies, as well as strict adherence to infection control practices, is strongly advised.

Reliable differentiation of Pneumocystis pneumonia from Pneumocystis colonisation by quantification of Major Surface Glycoprotein gene using real-time polymerase chain reaction.

A clear differentiation between pneumonia due to Pneumocystis jirovecii and "colonisation" is required for optimal case management. A quantification of fungal burden using major surface glycoprotein (MSG) gene-based real-time PCR was undertaken for the same. Lower respiratory tract samples collected from 104 patients of clinically suspected Pneumocystis pneumonia (PCP) were subjected to quantitative PCR using MSG gene. Based on whether or not the cases were treated for PCP, the efficacy of qPCR to differentiate between "diseased" and "colonised" was evaluated. Standard curve of plasmid-cloned gene and receiver operating characteristic curve defined a cut-off of Ct ≤ 25 to diagnose PCP and Ct within 26-39.3 range to depict colonisation. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the qPCR was 100%, each for diagnosing PCP. MSG-gene-based qPCR is a robust tool for the reliable differentiation of Pneumocystis pneumonia from colonisation.

Impurity-band induced transport phenomenon and thermoelectric properties in Yb doped PbTe(1-x)I(x).

In the present investigation, we report the effect of ytterbium (Yb) impurity band on charge transport and thermoelectric properties in PbTe1-xIx. The temperature dependent interaction of Yb-states with charge carriers and host energy-bands is found to significantly affect the electrical transport parameters in all the investigated samples. Our result indicates that, in the presence of Yb band, the carrier concentration did not increase as effectively as it was found in pristine PbTe with increasing iodine content. An anomalous switching of positive thermopower into negative was found in the samples with lower iodine content. Such phenomena were explained by the redistribution of charge carriers within the different available bands and promotion of vacancy like defects via substitutional impurity. Due to the optimum doping levels, the sample with the highest iodine content showed a decent figure of merit with a peak value of 0.69 at 575 K in the sample with x = 0.007.