Journal of Microbiology and Related Research

Background: Dermatophytosis is one of the commonest superficial infections encountered in humans. Some of the non-infectious dermatological disorders resemble superficial fungal infections and should be differentiated by appropriate mycological examination. Aim:To determine the prevalence, species distribution and epidemiological parameters of Dermatophytosis in patients suspected of Dermatophytosis attending Dermatology OPD of SKIMS-MC hospital. Settings and design: The study was conducted in the department of microbiology at SKIMS-MC Hospital for a period of six months from July 2017 to December 2017. Result: Out of 214 cases, 73 (34.12%) were positive.2 cases were KOH positive culture negative, 09 cases were KOH negative and culture positive and 56 cases were both KOH and culture positive. In addition 06cases of contaminant were observed. Trichophyton species was isolated in 61 (93.8%) cases and Microsporum species was isolated in 4 (6.1%) cases. T. rubrum was commonest isolate followed by T. mentagrophytes. Most of dermatophytic cases were seen in rural patients (74.7%) as compared to urban cases (25.2%). M. canis was isolated in one case of onychomycosis. Occupation wise, most cases were seen in farmers (37.7%). Tinea corporis was commonest (36.9%) body site infection followed by Tinea unguium (31.5%). Conclusion: The mycological profile of Dermatophytosis may alter because of environment, socioeconomic condition, profession. The epidemiological survey forms backbone for proper diagnosis and treatment. The identification of etiological agent is must for initiation of proper therapy.

Keywords: Dermatophytes; Mycosis; Tinea; Trichophyton.

Background: Changing trend in the causative agents of urinary tract infection (UTI) and their antibiogram requires area specific sensitivity data for formulation of empirical therapy guidelines. Aim: To determine the etiological agents of UTI and their susceptibility patterns. Setting and Study Design: Cross sectional study was carried out in the department of Microbiology of a tertiary care teaching hospital. Materials and Methods: A total of 500 midstream clean catch urine specimens were subjected to culture and the isolates were identified by standard methods. Antibiotic susceptibility testing was carried out by Kirby-Bauer Disc diffusion method. Staphylococcal isolates were tested for methicillin resistance and Gram negative bacilli (GNB) for extended spectrum beta lactamase production (ESBL) as per CLSI guidelines. Statistical analysis: The results were expressed in percentages and proportions. Results: Significant growth was noted in 44.2% of cases. E.coli was the most common isolate (41.2%) followed by Enterococcus species (19%). Majority of GNB were susceptible to Amikacin (73.6%). All Gram positive cocci (GPC) were sensitive to Vancomycin. Linezolid and Nitrofurantoin sensitivity was seen in 98.2% and 80.4% of GPC respectively. Methicillin resistant Co-agulase negative Staphylococci constituted 63.6% of Staphylococcal isolates. ESBL was detected in 7.4% of GNB. Conclusion: E.coli was the most common isolate. Amikacin can be considered for empirical treatment of GNB and Nitrofurantoin for GPC. Imipenem, Vancomycin and Linezolid should be used only after obtaining culture and sensitivity report. Higher methicillin resistance observed among Coagulase negative Staphylococci is an alarming sign.

Keywords: Antibiotic resistance; Amikacin; E.coli; Nitrofurantoin; Uropathogens.

Introduction: Antinuclear antibodies (ANA’s), are one of the most important tests in immunology, although very informative it faces major challenges. Confronting a positive ANA in a patient without clinical disease but consistent symptoms, is a game changer for the treating physician. This study aims to determine the rate & pattern of ANA positivity and understand its distribution pattern and clinical diagnosis in cases evaluated at a tertiary care centre. Materials and Methods: This observational analytical study was carried out for a period of one year. A single serum sample was collected from patients ranging from age groups 10 to 65 yrs suspected to have an autoimmune disease. Samples were tested by indirect immunofluoresence (IIF) and patterns were recorded and analysed. Results: Among the 150 tests done, 15 (10%) cases were ANA global test positive, with a mean age was 40 and greater positivity among females patients 16 (17.3%) (p-value <0.001). The most common pattern encountered was the nucleoplasm fine granular variety 10 (40%) followed by nucleoplasm coarse granular 5 (20%).Various other patterns were also observed with a predominance of cell nuclei homogenous pattern 4 (16%). ANA positivity was observed in 95% of Systemic lupus erythematosus (SLE) and mixed connective tissue disorders (MCTD) and in 25-70% of the cases with Sjögren syndrome, Systemic sclerosis (SS) and Rheumatoid arthritis (RA). Some ANA’s showed weak fluorescence detectable before the actual onset of clinical symptoms being apparent and was particularly seen in suspected cases of SLE. Conclusion: The rate and distribution of pattern types correlated well with the autoimmune condition and even borderline or weak intensity fluorescent patterns should be reported and the patients having them should be followed-up regularly.

Keywords: Antinuclear antibodies; Indirect immunofluoresence; Systemic lupus erythematosis.

Background: Bloodstream infections (BSIs) are one of the most important infections responsible for morbidity and mortality among hospitalized patients worldwide. The emergence of resistant bacteria makes it a requisite to know the prevailing antibiotic susceptibility pattern of the pathogens causing bloodstream infections. Objectives: The present study was undertaken to analyze the various microorganisms causing BSIs and study the antimicrobial resistance patterns of Acinetobacter spp. in a tertiary care hospital. Material and methods: A total of 2700 blood specimens from clinically suspected cases of BSIs were studied for a period of 2 years from January 2017 to December 2018. Blood specimens were processed following aseptic guidelines and cultured for 7 days. Growth was identified using biochemical tests. All isolates of Acinetobacter spp. were subject to antibiotic sensitivity testing using Clinical and Laboratory Standards Institute (CLSI) guidelines. Result: Out of 2700 specimens, 404 (15%) yielded growth. Out of these, 48% were Gram positive isolates and 52% were Gram negative isolates. Among Gram positive isolates, Coagulase negative Staphylococcus (CONS) was the most predominant organism (31%) followed Staphylococcus aureus (11%). Among Gram negative isolates, Acinetobacter spp. (16%) were the predominant isolates, followed by Escherichia coli (10.6%), Citrobacter spp. (8%), Pseudomonas spp. (6.5%) and Klebsiella spp. (6%). Out of 64 (16%) isolates of Acinetobacter spp. 5 (8%) were multidrug resistant (MDR), 5 (8%) were extensive drug-resistant (XDR) and 2 (3%) were Pandrug-resistant (PDR). Conclusion: Successful treatment of sepsis depends on early diagnosis and appropriate antimicrobial therapy. The knowledge of etiology and the antibiogram of isolated pathogens help in framing the antibiotic policies for any healthcare institute and improve infection control practices by formulating those policies for empirical antibiotic therapy.

Keywords: Bloodstream infections (BSIs); Sepsis; Blood culture, Antibiotic susceptibility testing; Multi-drug resistant (MDR); Extensive Drug-resistant (XDR); Pandrug-resistant (PDR); Intensive care unit (ICU).

Introduction: Moraxella catarrhalis is a gram negative, aerobic, oxidase positive diplococcus. It is frequently found as a commensal of the upper respiratory tract. In recent years Moraxella has gained importance as a pathogenic organism causing upper respiratory tract infections in apparently healthy children and in elderly population. The present prospective study was carried out in the microbiology department of our diagnostic centre with the aim of studying the prevalence of Moraxella catarrhalis in respiratory specimens and to study the antibiogram. Materials and Methods: This was a prospective study carried out in Microbiology department of our diagnostic centre between July to December 2018. A total of 886 patients of both sexes registered for culture and sensitivity testing were included in the study. Samples were collected by following thorough aseptic techniques in sterile containers/swabs and were plated on 5% sheep blood agar and Maconkey agar and incubated at 37°C for 18-24 hours. Isolated organism was identified by Gram’s stain and colony morphology and further by biochemical tests. Antibiotic sensitivity was done on Vitec II (Biomerieux) Results: Moraxella catarrhalis was isolated in 16 out of 886 total specimens received for culture with an incidence of 1.81%. Moraxella catarrhalis was isolated in 7 sputum samples and in 9 (56.25%) throat swab specimens. Out of 108 sputum samples, no growth was observed in 66 (61.11%) patients and Moraxella was isolated in 7 (6.48%) cases. Out of 126 throat swab specimens, no growth was observed in 51.59% patients and Moraxella was isolated in 9 (7.14%)patients Conclusion: Clinical interest in M. catarrhalis has gained momentum in recent years only, so the epidemiological data are lacking regarding the prevalence of M. catarrhalis infection. More studies with larger sample size are required to correctly assess the pathogenecity and resistance pattern of M. catarrhalis.

Keywords: Moraxella; Beta lactamase; Commensals; Upper respiratory tract.

Introduction: Blood transfusion is associated with several risks which particularly includes Transfusion Transmissible Infections (TTI’s) like Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Immunodefeciency Virus (HIV), Syphilis and Malaria. The aim of the study was to find out the prevalence and changing trends of these infections among blood donors in the study area. Materials and Methods: A retrospective analysis of blood donor’s records was done from January 2011 to December 2018. HIV, HBV and HCV infections were tested using ELISA (Enzyme linked Immunosorbent assay) technique. Syphilis was tested by RPR (Rapid plasma reagin) test. Malaria is reported after screening the stained blood smears. Results: Total 14,545 blood donors were screened, comprising of 10,458 voluntary donors and 4,087 replacement donors. The overall seroprevalence of HBV, HIV, HCV and Syphilis was 0.62%, 0.13%, 0.10% and 0.02% respectively with no Malaria infected donor. Conclusion: Though the prevalence of Transfusion transmissible infections is decreasing, there is a need for adopting strict donor selection criterion and use of sensitive screening tests that can minimize the risk of acquiring these infections.

Keywords: Blood donors; Transfusion transmissible Infections; Prevalence.

Introduction: Blood stream infections are the 13th leading cause of death, and over the past 2 decades the ageadjusted death rate from septicemia has risen by 78%, The impact on patient outcome is tremendous; Blood stream infections increase the mortality rate, prolong patient stay in an intensive care unit and in the hospital, and generate substantial extra costs Material and Methods: Three samples were collected in cases of suspected or sonographically diagnosed congenital heart disease spacing venipuncture at least 30 minutes apart. The blood which had drawn was immediately inoculated into blood culture bottle containing brain heart infusion broth. Results: Out of 65 cases studied growth of Bacteria was obtained in 18 cases (27%) of blood samples. Bacterial isolates: 20, Gram Negative Bacilli: 11 (61%), Gram Positive cocci: 06 (33%), Fungal isolate 1, Candida albicans: 1 (5%). Conclusion: Blood culture provides a valuable guide to the clinicians in selecting an appropriate antimicrobial regiment to improve the therapeutic outcome. Culture positivity rate was 32%. Most common gram negative bacilli isolated were Klebsiella. Neonates showed high culture positivity rate.

Keywords: Blood stream; ICU; Infections.

Background: Citrobacter is a Gram negative, non- sporing bacillus belonging to the family of Enterobacteriaceae. Citrobacter species are primary inhabitants of intestinal tract, often found in human faces. They can also be found in soil, sewage, food, and animal feces. Nowadays Citrobacter species are emerging as important nosocomial pathogens due to reduced host defences leading to urinary tract infections, neonatal sepsis, pulmonary infections, brain abscess, meningitis and blood stream infections. In health care settings, Citrobacter species have become an increasing cause of concern as they are becoming multidrug resistant (MDR) leading to high morbidity and mortality in the patients. Objectives: to assess the antibiotic resistance pattern of Citrobacter species isolated from various clinical samples at VIMS hospital, Ballari. Materials and Methods: A retrospective study was done on results of culture and antimicrobial susceptibility of isolates of Citrobacter species from urine, pus, sputum and blood samples obtained for a duration of 6 months, at VIMS, Ballari. Samples were processed for routine microscopy and culture and Citrobacter specieswere identified by standard methods. Antimicrobial susceptibility testing was performed as per CSLI guidelines by Kirby-bauer disc diffusion method. Results: Out of 82 isolates of Citrobacter spp, majority were from urine (63.4%), followed by sputum (17%), pus (13.4%) and blood (6%). The prevalence of Citrobacter infections was high among male patients (58.5%) than females (41.4%). Citrobacter koseri was the predominant species 56 (68.2%) isolated. Anti-biograms of Citrobacter isolates revealed that effective antimicrobial agent against Citrobacter isolates was imipenem (91.8% sensitive), followed by Piperacillin/Tazobactam (58.3%) and Amikacin (53.4%). Conclusion: Citrobacter spp are emerging as one of the important pathogens causing nosocomial infections. Emergence of multi-drug resistant Citrobacter species is also alarmingly high. Hence routine monitoring of drug susceptibility pattern of the isolates in a particular area helps to identify the resistance trend prevalent in that particular area which in turn helps to suggest empirical treatment options to the clinicians.

Keywords: Citrobacter species; Gram negative bacilli; Bacterial flora; Multidrug resistance nosocomial infections; Antimicrobial resistance.

Background: Intramuscular injections are a routine procedure performed in the hospital settings mainly for therapeutic purpose. Improperly performed injections may lead to complications of which abscess formation is the most common particularly, where aseptic precautions are not followed. In our study, the organisms causing these abscesses were isolated and identified followed by the study of their antibiotic sensitivity patterns. Thus the trend of their sensitivity pattern was observed over the past seven years duration from January 2012 to December 2018 and used to frame the hospital antibiotic policy.

Keywords: Gluteal abscess, deltoid abscess; Complications; Intramuscular injection; Multidrug resistant Staphylococcus aureus (MRSA).