Prevalence of ESBL in Escherichia coli Isolates Among ICU Patients in a Tertiary Care Hospital.

INTRODUCTION: Resistance to common antibiotics is a matter of grave concern in treating infections in hospital settings especially in Intensive Care Units (ICUs). One of the most commonly used and effective group of antibiotics, cephalosporins, exhibit resistance due to production of Extended Spectrum Beta- Lactamases (ESBLs). The prevalence of ESBL producing Escherichia coli (E.coli) has increased throughout the world and is a major cause of treatment failure in ICUs. As per our knowledge studies were not available on the prevalence of ESBL producing E.coli in ICUs of this region. AIM: To determine the prevalence of ESBLs among Escherichia coli isolates in ICUs of a tertiary care hospital. MATERIALS AND METHODS: A cross sectional study was conducted over a period of 4 years (Sept 2011 to Sept 2015) in the Department of Microbiology, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar. Consecutive non-duplicate isolates of E.coli recovered from 6800 clinical samples of patients admitted to different Intensive Care Units (ICUs) were subjected to ESBL screening test and then to CLSI recommended Phenotypic Confirmatory Disc Diffusion Tests (PCDDT) for ESBL production determination. RESULTS: Out of 6800 samples, 1038 were E.coli isolates and 452(44%) were resistant to third generation cephalosporins. ESBL producing Escherichia coli among them were 276 (61.1%). Paediatric ICU showed the highest prevalence of ESBL E.coli at 80.9%. The highest prevalence of ESBL E.coli was in urine samples (82.6%) followed by pus (9.8%). The most effective antibiotic for ESBL producers was imipenem (96.7% sensitive), followed by amikacin (88.4%) and piperacillin- tazobactum (87%). CONCLUSION: This study has highlighted the high prevalence of ESBL producing E.coli in the ICUs of our hospital. An in depth analysis of their antibiogram will be helpful in formulating the antibiotic policy and prevent spread of ESBL strains. It is recommended that ESBL testing should be done routinely to curtail antibiotic resistance and to effectively implement infection control measures.

Genomic characterization of Nipah virus, West Bengal, India.

An intrafamilial outbreak in West Bengal, India, involving 5 deaths and person-to-person transmission was attributed to Nipah virus. Full-genome sequence of Nipah virus (18,252 nt) amplified from lung tissue showed 99.2% nt and 99.8% aa identity with the Bangladesh-2004 isolate, suggesting a common source of the virus.

Disordered structure and function of liver in HIV/AIDS--a study of thirty cases.

To study abnormalities in liver associated enzymes and histology in AIDS patients with common infections like hepatotrophic viruses and mycobacteria. 30 cases of HIV/AIDS were studied for any significant pattern emerging. The male:female ratio was 4.26:1, occupation being long-distance truck drivers (30%); migrant goldsmiths (27%); migrant labourers (24%). Duration of illness from onset was within three months (46%) and the maximum duration was 26 months (2%). The most common presentation was fever (90%), weakness (79%), weight loss (62%) and diarrhoea (62%). The CD4 cell count was between 200-500/microL (33%). LFT showed hyperglobulinemia in patients having CD4 cell count <500/microL. Rise of alkaline phosphatase was seen in 63% with CD4 cell count <200/microL. 66.6% had HBsAg reactivity, 33.3% had positive anti-HCV antibody and 50% had abnormal liver histology. One third of these had systemic opportunistic infections like tuberculosis. No correlation could be made between hepatic histology and LFT.

No association between seropositivity for hepatitis C virus and lichen planus: a case control study.

BACKGROUND: The epidemiological association of lichen planus (LP) with hepatitis C virus (HCV) infection has been recorded from some countries and HCV RNA3 has been isolated from lesional skin in patients with LP and chronic HCV infection. The observed geographical differences regarding HCV infection and LP could be immuno-genetically related. AIM: To determine whether HCV has a causal relationship with LP. METHODS: Histopathologically proved cases of LP were subjected to antibody to HCV test by the Third Generation Enzyme Immunoassay Kit for the detection of antibody to HCV (Anti-HCV) in human serum or plasma. They were routinely screened in the virology department by the reagent kit, HIVASE 1 + 2, adopting the "direct sandwich principle" for the assay to detect antibodies to HIV-1 and/or HIV-2. There were 150 age and sex matched controls (not suffering from LP) and HIV-I and II negative, and negative for HCV. RESULTS: Of the 104 patients studied only 2 patients (1.92%) of generalized LP with disease duration of more than 3 months were found to be positive for antibodies to HCV. This was not a significant finding and no statistical methods, e.g. Chi square test etc. could be applied. CONCLUSION: Hepatitis C virus is not significant to the causation of LP in India.

First report in India of HIV transmission through artificial insemination.

A case of HIV-1 transmission through artificial inseminations from infertility clinics in Kolkata, is reported.