Microbial pattern of acute infective exacerbation of chronic obstructive airway disease in a hospital based study.

Chronic bronchitis is associated with acute exacerbation, most often infective in origin. In order to study the bacteriological profile in such cases a total of 58 patients were enrolled in this study from the chest clinic of our hospital. The male to female ratio was 2 to 1. Mean age of study group was 47 years. All patients had increased cough and sputum production. Barlett count, gram stain and sputum cultures were done for all patients. IgM and IgG antibodies for M. pneumoniae by ELISA were estimated in all cases. The etiological diagnosis could be established in 72% cases. S. pneumoniae (25.8%), P. aeruginosa (12%), Klebsiella sp (10.3%), B. catarrhalis (3.4%), S. aureus (1.7%) were isolated. Although M. pneumoniae was not cultured it was demonstrated serologically in 20% of cases. H. influenzae was not isolated in any case. The frequency of isolating an etiological agent increased with severity of dysponea.

Community acquired methicillin resistant Staphylococcsus aureus: a new threat for hospital outbreaks?

Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen. Recently, there have been reports of increasing prevalence of MRSA in the community. We here report an outbreak of post operative wound sepsis by MRSA in the surgical ward of LN hospital. A surveillance study for MRSA was undertaken in the corresponding surgical ward, operation theater and OPD and the source of this outbreak was traced to an outdoor patient with community acquired MRSA infection. A total of 320 clinical and environmental samples were screened for MRSA. Seventy (21.8%) S. aureus were obtained, of which 12.8% were resistant to methicillin. 14% of the MRSA infections were from the community. Nasal carriage rates of MRSA in the screened hospital staff and admitted patients were 5.8% and 4.3% respectively. None of the environmental sites sampled yielded MRSA. A study of antibiogram revealed that all the MRSA were uniformly resistant to penicillin, erythromycin, gentamicin, tobramycin and tetracycline and sensitive to vancomycin. All isolates belonged to the same biotype and were nontypable by the standard set of phages.