RESUMEN
In the recent years, it has been noted that microorganisms with acquired resistance to almost all available potent antibiotics are increasing worldwide. Hence, the use of antibiotics in every clinical setup has to be organized to avoid irrational use of antibiotics. This study was aimed to establish the pattern of antibiotic sensitivity and relevance of antimicrobial resistance in aerobic Gram-negative bacilli. A total of 103 aerobic Gram-negative bacteria namely Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Citrobacter koserii, Proteus spp., and Pseudomonas aeruginosa were collected from tertiary care centers around Chennai. Kirby-Bauer Disk Diffusion test and study for genes of cephalosporin, carbapenem, and aminoglycoside resistance were done. A descriptive analysis of the data on altogether 103 clinical urine isolates was performed. All strains showed susceptibility to colistin. The frequency of genes encoding 16S rRNA methylases armA and rmtB were 7.8% and 6.8%, respectively. Among metallo-ß-lactamases, blaVIM, blaIMP, and blaNDM-1 were detected in 6.8%, 3.8%, and 3.8%, respectively. One E. coli strain harbored blaSIM-1 gene. Cumulative analysis of data suggested that 30% of the strains carried more than one resistance gene. The current research evidenced the increasing frequency of resistance mechanisms in India. Combined approach of antibiotic restriction, effective surveillance, and good infection control practices are essential to overcome antibiotic resistance.
Asunto(s)
Antibacterianos/farmacología , Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Metiltransferasas/genética , beta-Lactamasas/metabolismo , Adolescente , Adulto , Anciano , Proteínas Bacterianas/metabolismo , Niño , Preescolar , Femenino , Bacterias Gramnegativas/enzimología , Bacterias Gramnegativas/genética , Bacterias Gramnegativas/aislamiento & purificación , Humanos , Lactante , Masculino , Metiltransferasas/metabolismo , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Adulto Joven , beta-Lactamasas/genéticaRESUMEN
A retrospective analysis of data pertaining to the rural field operation area of the Central Leprosy Teaching and Research Institute, Chengalpattu, Tamil Nadu, was carried out to determine the magnitude of relapse after MDT and its significance with other variables. The study included 3248 leprosy patients who have successfully completed treatment during 1987-2003, of whom 2892 were PB and 356 MB cases. A total of 58 cases of relapse was reported which gives a crude cumulative relapse rate of 1.78% for the 16-year period of follow-up and the rates for PB and MB were 1.9% and 0.84% respectively. With respect to PB cases, 68% of relapses were reported in the first 3 years of RFT. The person-year relapse rate was highly significant with regard to the number of skin lesions (p<0.0002) and nerve involvement (p<0.0002). The person-year relapse rate did not differ significantly between PB and MB leprosy, male and female, and child and adult cases. RFT year cohort relapse rate reveals that the introduction of MB-MDT regimen for PB leprosy had resulted in the reduction of relapses among PB cases after 1998. The relapse rate with reference to the time gap after RFT reveals that relapse declines with passage of time after RFT. The risk of relapse was very low in both PB and MB leprosy which fact emphasizes that proper counselling about signs and symptoms of relapse during RFT is adequate to combat the problem. A majority of relapses occurred in the first three years after RFT. The number of skin lesions and involvement of nerves were the main risk factors for relapse.
Asunto(s)
Leprostáticos/uso terapéutico , Lepra/tratamiento farmacológico , Mycobacterium leprae/crecimiento & desarrollo , Adulto , Niño , Estudios de Cohortes , Quimioterapia Combinada , Femenino , Humanos , India , Modelos Logísticos , Masculino , Minociclina/uso terapéutico , Análisis Multivariante , Ofloxacino/uso terapéutico , Recurrencia , Estudios Retrospectivos , Rifampin/uso terapéutico , Población RuralRESUMEN
A total of 4492 persons from 5 panchayats and 1 town were investigated from the Brugia malayi most endemic taluk of Cherthala, Alappuzha district of Kerala state. The urban area in Cherthala taluk only revealed mf carriers; mf rate was 0.13%. Rural areas in Cherthala taluk were free from infection. Microfilaria rate had declined by 99.5% and disease rate by 90.7% in Cherthala compared to 1934 prevalence. Shedding of sheath by B. malayi microfilariae was recorded for the first time in India. The youngest person with microfilaria and disease manifestation was 4 1/2 and 9 years respectively. All the 3 major vectors, Mansonia annulifera, Ma.uniformis and Culex quinquefasciatus were prevalent throughout. Complete disappearance of brugian filariasis from this taluk is a distinct possibility. The reasons for the drastic decline are discussed.
