Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital.

OBJECTIVE: To study the bacterial pathogens causing neonatal sepsis and their sensitivity pattern so that guidelines can be prepared for empirical antibiotic therapy. MATERIALS AND METHODS: We conducted a prospective analysis of all the cases admitted to the neonatal intensive care unit (NICU) of a tertiary care hospital and studied the culture and sensitivity pattern of organisms isolated. The neonates who presented with signs and symptoms of septicemia, with/without pneumonia and/or meningitis were studied and a detailed record of the maturity, age at onset, sex, birth weight (weight on admission for home deliveries), symptoms and signs along with the maternal risk factors was made. The cases with suspect sepsis were screened using various screening markers. Blood culture was done in all the cases, while cerebrospinal fluid was analysed only in those indicated. Sensitivity of the isolated organism was tested by Kirby Bauer disc diffusion techniques and various drug resistance mechanisms were studied. RESULT: Out of the 190 neonates (M:F=1.22:1) admitted to the NICU, 60 (31.57%) shows blood culture positive. Ninety-five percent cases were due to early onset septicemia. Thirty one neonates had Gram negative, twenty seven had Gram positive septicemia and two had candidial infection. Seventy percent Gram-positive isolates were resistant to penicillin. Ninety percent Gram negative isolates were resistant to gentamycin and ampicillin. Carbapenem resistance mechanisms such as ESBL. CONCLUSION: There is an increasing trend of antibiotic resistance to the commonly used and available drugs. Continuous surveillance for antibiotic susceptibility should be done to look for resistance pattern.

Assessment of biofilm formation in device-associated clinical bacterial isolates in a tertiary level hospital.

BACKGROUND: Biofilm formation is a developmental process with intercellular signals that regulate growth. Biofilms contaminate catheters, ventilators, and medical implants; they act as a source of disease for humans, animals, and plants. AIM: In this study we have done quantitative assessment of biofilm formation in device-associated clinical bacterial isolates in response to various concentrations of glucose in tryptic soya broth and with different incubation time. MATERIALS AND METHODS: The study was carried out on 100 positive bacteriological cultures of medical devices, which were inserted in hospitalized patients. The bacterial isolates were processed as per microtitre plate method with tryptic soya broth alone and with varying concentrations of glucose and were observed in response to time. RESULTS: Majority of catheter cultures were positive. Out of the total 100 bacterial isolates tested, 88 of them were biofilm formers. Incubation period of 16-20 h was found to be optimum for biofilm development. CONCLUSIONS: Availability of nutrition in the form of glucose enhances the biofilm formation by bacteria. Biofilm formation depends on adherence of bacteria to various surfaces. Time and availability of glucose are important factors for assessment of biofilm progress.

Sexually transmitted infections and reproductive tract infections in female sex workers.

The present study was conducted in 300 female sex workers (FSWs) from Surat city in 2005-2006. Vaginal swabs, endocervical swabs and serum samples were collected from each of these FSWs. Vaginal samples were screened for bacterial vaginosis (BV), candidiasis and Trichomonas vaginalis . Endocervical swabs were screened for gonococcal infection. Serological tests for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and syphilis were performed. From a total of 300 FSWs, BV was detected in 40 (13.33%), trichomoniasis in six (2%), candidiasis in 31 (10.33%), HIV seropositivity in 35 (11.66%), HBsAg reactivity in 10 (3.33%) and rapid plasma regain (RPR) reactivity in 20 (6.66%) cases. RPR-positive serum samples were confirmed by the treponema pallidum hemaglutination test. Gonococcal infection was not found in any of the FSWs. Of the total of 35 HIV-positive patients, 20 patients had associated coinfection. Of the 35 HIV-seropositive FSWs, BV was detected in six (17.14%), candidiasis in six (17.14%), syphilis in five (14.28%) and HBsAg in two (5.71%). One (2.85%) HIV-positive FSW was positive for both candidiasis and syphilis.