首页 > 最新文献

Indian Journal of Medical Microbiology最新文献

英文 中文
Approach to fever in children 治疗儿童发烧的方法
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-07-01 DOI: 10.1016/j.ijmmb.2024.100650
Muralidharan Jayashree , Narayanan Parameswaran , Karthi Nallasamy , Aakash Chandran Chidambaram , Raajashri Rajasegar , Rahul Dhodapkar , Mala Chhabra , Nivedita Gupta , Harmanmeet Kaur , Anoop Velayudhan , Saumya Deol , Rakesh Lodha , Ravi Vasanthapuram , Valsan Philip Verghese , Winsley Rose

Background

Fever in children is one of the most common reasons for outpatient visits as well as in-patient evaluation, often causing anxiety among parents and caregivers. Fever can be a standalone feature or be associated with other localising symptoms and signs like rash, lymphadenopathy, or any other organ system involvement with or without a focus of infection. The etiologies of fever vary depending on the clinical setting and epidemiology. India being a tropical country, sees a distinct spectrum of tropical infections. Physicians need to stay updated on the prevalent diseases in their region and the unique factors that may influence the clinical presentations and course of fever in the cohort of children they manage. The challenge lies in balancing the benefit of early treatment for severe diseases versus the harms of unnecessary investigations and treatment for self-resolving illnesses.

Objectives

This review aims to provide a comprehensive overview of fever in children, covering its etiology, clinical features, and management strategies. This review offers an algorithmic approach to fever tailored to the Indian setting to guide physicians in identifying the disease based on clinical symptoms and signs, ordering essential laboratory investigations, and initiating appropriate management promptly.

Content

The review categorises fever into various segments like fever with localising signs like rash, lymphadenopathy, fever due to infection localised to a particular organ system, and fever without a focus including fever of unknown origin. It delves into the diverse etiological factors contributing to fever in each of these categories, encompassing infectious and non-infectious origins. It gives pointers to identify the etiology from history, examination, and confirm them with judicious use of diagnostic investigations with emphasis on identifying the red flag signs that require immediate attention, especially in vulnerable groups like neonates and young infants.

背景:儿童发热是门诊就诊和住院评估的最常见原因之一,往往会引起家长和护理人员的焦虑。发热可以是一个独立的特征,也可以伴有其他局部症状和体征,如皮疹、淋巴结病或任何其他器官系统受累,无论是否有感染病灶。发热的病因因临床环境和流行病学而异。印度是一个热带国家,热带传染病的发病范围很广。医生需要随时了解本地区流行疾病的最新情况,以及可能影响所管理儿童群体发热临床表现和病程的独特因素。挑战在于如何平衡早期治疗严重疾病的益处与不必要的检查和治疗自行缓解疾病的害处:本综述旨在全面概述儿童发热,包括其病因、临床特征和管理策略。本综述提供了适合印度环境的发热算法,以指导医生根据临床症状和体征识别疾病,进行必要的实验室检查,并及时采取适当的治疗措施:该综述将发热分为不同的类别,如伴有皮疹、淋巴结病等局部体征的发热,由特定器官系统局部感染引起的发热,以及包括不明原因发热在内的无病灶发热。它深入探讨了导致上述各类发热的各种病因,包括感染性和非感染性发热。它提供了从病史和检查中识别病因的要点,并通过明智地使用诊断检查来确认病因,重点是识别需要立即关注的红色信号,尤其是新生儿和婴幼儿等弱势群体。
{"title":"Approach to fever in children","authors":"Muralidharan Jayashree ,&nbsp;Narayanan Parameswaran ,&nbsp;Karthi Nallasamy ,&nbsp;Aakash Chandran Chidambaram ,&nbsp;Raajashri Rajasegar ,&nbsp;Rahul Dhodapkar ,&nbsp;Mala Chhabra ,&nbsp;Nivedita Gupta ,&nbsp;Harmanmeet Kaur ,&nbsp;Anoop Velayudhan ,&nbsp;Saumya Deol ,&nbsp;Rakesh Lodha ,&nbsp;Ravi Vasanthapuram ,&nbsp;Valsan Philip Verghese ,&nbsp;Winsley Rose","doi":"10.1016/j.ijmmb.2024.100650","DOIUrl":"10.1016/j.ijmmb.2024.100650","url":null,"abstract":"<div><h3>Background</h3><p>Fever in children is one of the most common reasons for outpatient visits as well as in-patient evaluation, often causing anxiety among parents and caregivers. Fever can be a standalone feature or be associated with other localising symptoms and signs like rash, lymphadenopathy, or any other organ system involvement with or without a focus of infection. The etiologies of fever vary depending on the clinical setting and epidemiology. India being a tropical country, sees a distinct spectrum of tropical infections. Physicians need to stay updated on the prevalent diseases in their region and the unique factors that may influence the clinical presentations and course of fever in the cohort of children they manage. The challenge lies in balancing the benefit of early treatment for severe diseases versus the harms of unnecessary investigations and treatment for self-resolving illnesses.</p></div><div><h3>Objectives</h3><p>This review aims to provide a comprehensive overview of fever in children, covering its etiology, clinical features, and management strategies. This review offers an algorithmic approach to fever tailored to the Indian setting to guide physicians in identifying the disease based on clinical symptoms and signs, ordering essential laboratory investigations, and initiating appropriate management promptly.</p></div><div><h3>Content</h3><p>The review categorises fever into various segments like fever with localising signs like rash, lymphadenopathy, fever due to infection localised to a particular organ system, and fever without a focus including fever of unknown origin. It delves into the diverse etiological factors contributing to fever in each of these categories, encompassing infectious and non-infectious origins. It gives pointers to identify the etiology from history, examination, and confirm them with judicious use of diagnostic investigations with emphasis on identifying the red flag signs that require immediate attention, especially in vulnerable groups like neonates and young infants.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100650"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insights into changing patterns of extrapulmonary tuberculosis in North India 洞察北印度肺外结核病的变化模式。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-07-01 DOI: 10.1016/j.ijmmb.2024.100657
Lipika Singhal, Parakriti Gupta, Noorul Aysha K., Varsha Gupta

Purpose

Tuberculosis is one of the dreadful infections and India contributes to substantial burden of TB cases globally. Though majority of cases are pulmonary, extra-pulmonary tuberculosis (EPTB) share significant burden, more in HIV-positive persons. Despite the striking burden, very few studies have been conducted in India and present study was undertaken to determine trends of EPTB at our tertiary care centre.

Methods

This was a retrospective study conducted over a period of 4 years 3 months. Diagnosis of EPTB was based on suspected clinical features, with positive micobiological evidence with cartridge based nucleic acid amplification test (CBNAAT) with/without microscopy.

Results

A total of 10,560 samples (pulmonary and extra-pulmonary) were received during the study period, of which 3972 were extrapulmonary. Of these, a total of 18% were noted to be positive for EPTB. Trend of positivity revealed highest burden in 2018 and a decline was noted over the years, however, rise in cases was noted in 2022. Pleural, meningitis, musculoskeletal, peritoneal and pericardial TB was more common in males, while lymphadenitis was more common in females (p value: <0.0001). Pleural TB (31%) was the most common presentation, followed by lymphadenitis. A gradual decline in lymphadenitis was noted with significantly increasing trend only for musculoskeletal TB. Rifampicin resistance was detected in 7.45% of positive samples, of which the maximum rate of resistance was noted in lymph node aspirates (11.11%), followed by musculoskeletal and pleural samples.

Conclusion

The present study showed a gradual decline in positivity of EPTB cases over the years. Younger productive age group with more propensity to transmit infection was the most commonly affected, with pleural TB as the most common presentation. Rare presentations of EPTB also contributed major share. Higher rates of resistance underline requisite to strengthen ongoing programs, to achieve the End TB strategy by 2025.

目的:肺结核是可怕的传染病之一,印度在全球肺结核病例中占很大比例。虽然大多数病例都是肺结核,但肺外结核病(EPTB)也造成了很大的负担,尤其是在艾滋病毒呈阳性的人群中。尽管肺结核造成的负担惊人,但在印度进行的研究却寥寥无几,本研究旨在确定我们三级医疗中心的肺外结核病趋势:本研究是一项回顾性研究,历时 4 年 3 个月。EPTB的诊断依据是可疑的临床特征,以及通过盒式核酸扩增试验(CBNAAT)和/或显微镜检查获得的阳性微生物学证据:研究期间共收到 10,560 份样本(肺部和肺外),其中 3,972 份为肺外样本。其中,18%的样本对肺结核呈阳性反应。阳性趋势显示,2018 年的病例数最多,随后逐年下降,但 2022 年的病例数有所上升。胸膜结核、脑膜炎、肌肉骨骼结核、腹膜结核和心包结核在男性中更为常见,而淋巴结炎在女性中更为常见(P 值为 0.05):结论本研究显示,随着时间的推移,EPTB 阳性病例逐渐减少。较年轻的高产年龄组更容易传播感染,是最常受影响的人群,胸膜结核是最常见的表现形式。罕见的 EPTB 病例也占很大比例。较高的耐药率凸显了加强现行计划的必要性,以实现到 2025 年终结结核病的战略。
{"title":"Insights into changing patterns of extrapulmonary tuberculosis in North India","authors":"Lipika Singhal,&nbsp;Parakriti Gupta,&nbsp;Noorul Aysha K.,&nbsp;Varsha Gupta","doi":"10.1016/j.ijmmb.2024.100657","DOIUrl":"10.1016/j.ijmmb.2024.100657","url":null,"abstract":"<div><h3>Purpose</h3><p>Tuberculosis is one of the dreadful infections and India contributes to substantial burden of TB cases globally. Though majority of cases are pulmonary, extra-pulmonary tuberculosis (EPTB) share significant burden, more in HIV-positive persons. Despite the striking burden, very few studies have been conducted in India and present study was undertaken to determine trends of EPTB at our tertiary care centre.</p></div><div><h3>Methods</h3><p>This was a retrospective study conducted over a period of 4 years 3 months. Diagnosis of EPTB was based on suspected clinical features, with positive micobiological evidence with cartridge based nucleic acid amplification test (CBNAAT) with/without microscopy.</p></div><div><h3>Results</h3><p>A total of 10,560 samples (pulmonary and extra-pulmonary) were received during the study period, of which 3972 were extrapulmonary. Of these, a total of 18% were noted to be positive for EPTB. Trend of positivity revealed highest burden in 2018 and a decline was noted over the years, however, rise in cases was noted in 2022. Pleural, meningitis, musculoskeletal, peritoneal and pericardial TB was more common in males, while lymphadenitis was more common in females (p value: &lt;0.0001). Pleural TB (31%) was the most common presentation, followed by lymphadenitis. A gradual decline in lymphadenitis was noted with significantly increasing trend only for musculoskeletal TB. Rifampicin resistance was detected in 7.45% of positive samples, of which the maximum rate of resistance was noted in lymph node aspirates (11.11%), followed by musculoskeletal and pleural samples.</p></div><div><h3>Conclusion</h3><p>The present study showed a gradual decline in positivity of EPTB cases over the years. Younger productive age group with more propensity to transmit infection was the most commonly affected, with pleural TB as the most common presentation. Rare presentations of EPTB also contributed major share. Higher rates of resistance underline requisite to strengthen ongoing programs, to achieve the End TB strategy by 2025.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100657"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“Tinea capitis caused by Microsporum canis: A case study of three family members in India, a non-endemic region "犬小孢子菌引起的头癣:印度非流行区三个家庭成员的病例研究。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-23 DOI: 10.1016/j.ijmmb.2024.100621
Malini R. Capoor , Sheetal Sharma , Sheetal Goenka , Sutapa Das , Shivaprakash M. Rudramurthy , Niti Khunger , Namita kamra

Introduction

Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by Microsporum canis. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family.

Methods

Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin.

Results

Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission.

Conclusion

This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.

导言:头癣是一种主要影响儿童的常见头皮感染,由嗜角质皮癣真菌引起,主要是小孢子菌和毛癣菌。犬小孢子菌主要由猫和狗传染给人类,在印度等非流行地区很少见报道。我们报告了一例来自印度德里的病例,患者一家三口都被诊断出患有由犬小孢子菌引起的头癣。病例中的五岁男孩是通过与猫接触感染的,而他的弟弟和妹妹则是通过家庭中的人际传播感染的:方法:通过临床检查、显微镜分析和分子鉴定技术确诊。抗真菌药敏试验显示,患者对伊曲康唑和特比萘芬敏感,但对格列齐芬耐药:结果:通过口服特比萘芬和外用酮康唑乳膏的治疗,三名患者均获得了成功。分子分型证实了分离物的克隆性,表明存在人际传播:本病例研究强调了在非流行地区诊断和治疗由犬小孢子菌引起的头癣时考虑非典型感染源和人际传播的重要性。它强调了彻底评估接触史和适当的抗真菌治疗对有效控制感染的必要性。
{"title":"“Tinea capitis caused by Microsporum canis: A case study of three family members in India, a non-endemic region","authors":"Malini R. Capoor ,&nbsp;Sheetal Sharma ,&nbsp;Sheetal Goenka ,&nbsp;Sutapa Das ,&nbsp;Shivaprakash M. Rudramurthy ,&nbsp;Niti Khunger ,&nbsp;Namita kamra","doi":"10.1016/j.ijmmb.2024.100621","DOIUrl":"10.1016/j.ijmmb.2024.100621","url":null,"abstract":"<div><h3>Introduction</h3><p>Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by <em>Microsporum canis</em>. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family.</p></div><div><h3>Methods</h3><p>Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin.</p></div><div><h3>Results</h3><p>Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission.</p></div><div><h3>Conclusion</h3><p>This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100621"},"PeriodicalIF":1.4,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rising trend of symptomatic infections due to Hepatitis A virus infection in adolescent and adult age group: An observational study from a tertiary care liver institute in India 青少年和成人年龄组甲型肝炎病毒感染所致症状性感染的上升趋势:印度一家三级肝病研究所的观察性研究。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.ijmmb.2024.100653
Malika Grover , Ekta Gupta , Jasmine Samal , Manya Prasad , Tushar Prabhakar , Ruchita Chhabra , Reshu Agarwal , Bikrant Biharilal Raghuvanshi , Manoj Kumar Sharma , Seema Alam

Background

Hepatitis A Virus (HAV) is the most common cause of Acute Viral Hepatitis (AVH) in children. It causes self-limiting illness and rarely acute liver failure. The shifting pattern in HAV endemicity is rendering adolescents and adults vulnerable to infection.

Methods

In this retrospective study, samples received from 14,807 patients with acute onset icteric illness from January 2014–December 2022 were analyzed. HAV infection was detected by anti-HAV IgM positivity. The cases were divided into 3 age groups, pediatric, adolescents and adults, and clinical presentations were compared.

Results

Overall, 7.72%(1144) were positive for anti-HAV IgM. Of these, 60%(690) were finally included in the study. The positive cases were divided into adults, ≥18 years (44%, 304); pediatric, <12 years (31%, 212) and adolescents (25%,174) age groups. Overall males were predominant [72.4%(500)], with a median age of 16 (IQR:9–21) years. Cases were characterised into AVH (68.1%, 470/690), Acute Liver Failure (ALF) (31.4%, 217/690) and Acute-on-Chronic Liver Failure (0.43%, 3/690).

AVH in the pediatric age group was 69%(146/212), adolescents was 67%(117/174), and adults was 68%(207/304). ALF cases among the 3 groups were 30%(65/212), 33%(57/174), and 31%(95/304) respectively. Overall mortality was seen in 6.52%(45/690), maximum in adolescents with ALF presentation [10.3%(18/174)]. On molecular characterization of infection, viremia was seen in 28.9%(200/690) and all the isolates were Genotype IIIA.

Conclusions

The number of adults experiencing symptomatic HAV infection was seen to increase over the years in the present study. Infection in adolescents was associated with higher mortality and ALF as the clinical presentation.

背景:甲型肝炎病毒(HAV)是儿童急性病毒性肝炎(AVH)最常见的病因。它可引起自限性疾病,很少会导致急性肝功能衰竭。甲型肝炎病毒流行模式的变化使青少年和成人更容易受到感染:在这项回顾性研究中,我们分析了2014年1月至2022年12月期间从14807名急性黄疸型肝炎患者中采集的样本。通过抗 HAV IgM 阳性检测 HAV 感染。病例被分为3个年龄组:儿童、青少年和成人,并对临床表现进行了比较:总体而言,7.72%(1144 例)的病例抗-HAV IgM 呈阳性。其中,60%(690 例)最终被纳入研究。阳性病例分为成人(44%,304 例)和儿童(690 例):在本研究中,有症状的成人 HAV 感染人数逐年增加。青少年感染的死亡率较高,临床表现为 ALF。
{"title":"Rising trend of symptomatic infections due to Hepatitis A virus infection in adolescent and adult age group: An observational study from a tertiary care liver institute in India","authors":"Malika Grover ,&nbsp;Ekta Gupta ,&nbsp;Jasmine Samal ,&nbsp;Manya Prasad ,&nbsp;Tushar Prabhakar ,&nbsp;Ruchita Chhabra ,&nbsp;Reshu Agarwal ,&nbsp;Bikrant Biharilal Raghuvanshi ,&nbsp;Manoj Kumar Sharma ,&nbsp;Seema Alam","doi":"10.1016/j.ijmmb.2024.100653","DOIUrl":"10.1016/j.ijmmb.2024.100653","url":null,"abstract":"<div><h3>Background</h3><p>Hepatitis A Virus (HAV) is the most common cause of Acute Viral Hepatitis (AVH) in children. It causes self-limiting illness and rarely acute liver failure. The shifting pattern in HAV endemicity is rendering adolescents and adults vulnerable to infection.</p></div><div><h3>Methods</h3><p>In this retrospective study, samples received from 14,807 patients with acute onset icteric illness from January 2014–December 2022 were analyzed. HAV infection was detected by anti-HAV IgM positivity. The cases were divided into 3 age groups, pediatric, adolescents and adults, and clinical presentations were compared.</p></div><div><h3>Results</h3><p>Overall, 7.72%(1144) were positive for anti-HAV IgM. Of these, 60%(690) were finally included in the study. The positive cases were divided into adults, ≥18 years (44%, 304); pediatric, &lt;12 years (31%, 212) and adolescents (25%,174) age groups. Overall males were predominant [72.4%(500)], with a median age of 16 (IQR:9–21) years. Cases were characterised into AVH (68.1%, 470/690), Acute Liver Failure (ALF) (31.4%, 217/690) and Acute-on-Chronic Liver Failure (0.43%, 3/690).</p><p>AVH in the pediatric age group was 69%(146/212), adolescents was 67%(117/174), and adults was 68%(207/304). ALF cases among the 3 groups were 30%(65/212), 33%(57/174), and 31%(95/304) respectively. Overall mortality was seen in 6.52%(45/690), maximum in adolescents with ALF presentation [10.3%(18/174)]. On molecular characterization of infection, viremia was seen in 28.9%(200/690) and all the isolates were Genotype IIIA.</p></div><div><h3>Conclusions</h3><p>The number of adults experiencing symptomatic HAV infection was seen to increase over the years in the present study. Infection in adolescents was associated with higher mortality and ALF as the clinical presentation.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100653"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hand hygiene compliance of respiratory physiotherapists: An analysis of trends over eight years including the COVID-19 pandemic period 呼吸道物理治疗师的手部卫生达标情况:包括 COVID-19 大流行期间在内的八年趋势分析。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.ijmmb.2024.100646
Rimjhim Kanaujia , Manisha Biswal , Kulbeer Kaur , Harpreet Kaur , Rupinder Kaur , Harinder Kaur , Manjinder Kaur , Pankaj Arora , Navneet Dhaliwal

Background

Respiratory physiotherapists (RPs) are an integral part of healthcare workers delivering care to intubated patients. Our study aimed to evaluate the effect of awareness campaigns on hand hygiene (HH) compliance among RPs.

Method

An observational single-center study was conducted between 2015 and 2022 in different ICU types in both adult and paediatric settings. The hand hygiene compliance rates were monitored prospectively and the quality improvement interventions included various hand hygiene campaigns and awareness sessions with RPs. Compliance was calculated as a percentage of events over total opportunities observed.

Results

There was a significant increase in compliance rates for all five moments of HH (p-value: <0.05). Overall, mean compliance rate in ICUs was significantly higher than wards for Moment 1 (p-value: 0.0045), Moment 4 (p-value: 0.0372) and Moment 5 (p-value: 0.0036) by 24.2%, 22.7% and 21.5% respectively. Also, paediatric ICUs had higher HH compliance than adult ICUs for Moment 1 (87.5% vs 61.1%; p-value: 0.0459) and Moment 4 (93.7% vs 79.3%; p-value: 0.0255). A significant increase in HH compliance was observed in post-COVID-19 period compared to pre-COVID-19 period with respect to Moment 1, 2 and 5.

Conclusion

This study adds to the almost non-existent literature on this important category of healthcare workers working in respiratory ICUs. Our results project an increase compliance after the HH awareness programmes over the years among RP which is critical to prevent spread infection by multidrug resistant organisms among the hospitals.

背景:呼吸道物理治疗师(RPs)是为插管患者提供护理的医护人员中不可或缺的一部分。我们的研究旨在评估宣传活动对理疗师遵守手卫生(HH)的影响:方法:2015 年至 2022 年期间,我们在成人和儿科不同类型的重症监护病房开展了一项观察性单中心研究。对手卫生依从率进行了前瞻性监测,质量改进干预措施包括开展各种手卫生宣传活动,并为注册护士举办提高认识讲座。符合率以事件占观察到的总机会的百分比计算:结果:所有五个时刻的手卫生达标率都有明显提高(P 值为 0.05):结论:这项研究为几乎不存在的有关呼吸重症监护病房医护人员这一重要类别的文献增添了新的内容。我们的研究结果表明,经过多年的HH宣传计划,RP的依从性有所提高,这对于防止耐多药生物在医院中传播感染至关重要。
{"title":"Hand hygiene compliance of respiratory physiotherapists: An analysis of trends over eight years including the COVID-19 pandemic period","authors":"Rimjhim Kanaujia ,&nbsp;Manisha Biswal ,&nbsp;Kulbeer Kaur ,&nbsp;Harpreet Kaur ,&nbsp;Rupinder Kaur ,&nbsp;Harinder Kaur ,&nbsp;Manjinder Kaur ,&nbsp;Pankaj Arora ,&nbsp;Navneet Dhaliwal","doi":"10.1016/j.ijmmb.2024.100646","DOIUrl":"10.1016/j.ijmmb.2024.100646","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory physiotherapists (RPs) are an integral part of healthcare workers delivering care to intubated patients. Our study aimed to evaluate the effect of awareness campaigns on hand hygiene (HH) compliance among RPs.</p></div><div><h3>Method</h3><p>An observational single-center study was conducted between 2015 and 2022 in different ICU types in both adult and paediatric settings. The hand hygiene compliance rates were monitored prospectively and the quality improvement interventions included various hand hygiene campaigns and awareness sessions with RPs. Compliance was calculated as a percentage of events over total opportunities observed.</p></div><div><h3>Results</h3><p>There was a significant increase in compliance rates for all five moments of HH (p-value: &lt;0.05). Overall, mean compliance rate in ICUs was significantly higher than wards for Moment 1 (p-value: 0.0045), Moment 4 (p-value: 0.0372) and Moment 5 (p-value: 0.0036) by 24.2%, 22.7% and 21.5% respectively. Also, paediatric ICUs had higher HH compliance than adult ICUs for Moment 1 (87.5% vs 61.1%; p-value: 0.0459) and Moment 4 (93.7% vs 79.3%; p-value: 0.0255). A significant increase in HH compliance was observed in post-COVID-19 period compared to pre-COVID-19 period with respect to Moment 1, 2 and 5.</p></div><div><h3>Conclusion</h3><p>This study adds to the almost non-existent literature on this important category of healthcare workers working in respiratory ICUs. Our results project an increase compliance after the HH awareness programmes over the years among RP which is critical to prevent spread infection by multidrug resistant organisms among the hospitals.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100646"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of care bundle audit on compliance to device care bundles and device associated infections in the Critical Care Unit of a tertiary care hospital, Southern India – A before-after interventional study 护理捆绑包审计对印度南部一家三级医院重症监护室器械护理捆绑包依从性和器械相关感染的影响--一项干预前后的研究。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.ijmmb.2024.100651
Dijo Darjees , Sarumathi Dhandapani , Ketan Priyadarshi , Anusha Cherian , Apurba Sankar Sastry

Background

A care bundle comprises a set of evidence-based practices in patient care that are grouped together with the assumption that these practices when performed together will result in better clinical outcomes than when these practices are performed separately. Care bundles for devices when implemented effectively can bring about a reduction in device associated infection rates.

Methods

The study was conducted in three phases, 1 month pre-interventional and interventional phases and 11 months of post-interventional phase in a critical care unit. Compliance to care bundles were recorded by direct observation during daily audit rounds. An educational intervention addressing the healthcare workers regarding bundle care approach was conducted and supplemented with bedside “audit and feedback” during the interventional phase. Audit was conducted in the post-interventional period to study the trend of device associated infections and compliance rates.

Results

An increasing trend of month-wise compliance rates to the device care bundles were observed. The month-wise Ventilator Associated Events rates showed a decreasing trend. In the post-interventional phase, the average Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates showed a reduction from their respective baseline rates for the study setting.

Conclusions

An educational intervention targeted at the healthcare workers along with daily audit of care bundle practices in the critical care setting led to an increase in the compliance to device care bundles and a reduction in the incidence of Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates in the critical care setting.

背景:护理捆绑包括一组以证据为基础的病人护理措施,这些措施被组合在一起,假设这些措施一起实施时会比单独实施时产生更好的临床效果。器械护理捆绑包的有效实施可降低器械相关感染率:研究在重症监护病房分三个阶段进行:介入前和介入后的 1 个月,以及介入后的 11 个月。在每日查房时通过直接观察记录护理捆绑包的遵守情况。在介入阶段,对医护人员进行了有关捆绑护理方法的教育干预,并辅以床旁 "审核和反馈"。干预后进行了审计,以研究器械相关感染的趋势和依从率:结果:观察到设备护理捆绑包的月达标率呈上升趋势。每月的呼吸机相关事件发生率呈下降趋势。在干预后阶段,导管相关尿路感染和呼吸机相关事件的平均发生率比研究环境中各自的基线发生率分别降低了 48.6% 和 31.4%:针对医护人员的教育干预措施以及对危重症护理环境中护理捆绑措施的日常审核提高了设备护理捆绑措施的依从性,降低了危重症护理环境中导尿管相关尿路感染和呼吸机相关事件的发生率。
{"title":"Impact of care bundle audit on compliance to device care bundles and device associated infections in the Critical Care Unit of a tertiary care hospital, Southern India – A before-after interventional study","authors":"Dijo Darjees ,&nbsp;Sarumathi Dhandapani ,&nbsp;Ketan Priyadarshi ,&nbsp;Anusha Cherian ,&nbsp;Apurba Sankar Sastry","doi":"10.1016/j.ijmmb.2024.100651","DOIUrl":"10.1016/j.ijmmb.2024.100651","url":null,"abstract":"<div><h3>Background</h3><p>A care bundle comprises a set of evidence-based practices in patient care that are grouped together with the assumption that these practices when performed together will result in better clinical outcomes than when these practices are performed separately. Care bundles for devices when implemented effectively can bring about a reduction in device associated infection rates.</p></div><div><h3>Methods</h3><p>The study was conducted in three phases, 1 month pre-interventional and interventional phases and 11 months of post-interventional phase in a critical care unit. <strong>Compliance to care bundles were recorded by direct observation during daily audit rounds.</strong> An educational intervention addressing the healthcare workers regarding bundle care approach was conducted and supplemented with bedside “audit and feedback” during the interventional phase. Audit was conducted in the post-interventional period to study the trend of device associated infections and compliance rates.</p></div><div><h3>Results</h3><p>An increasing trend of month-wise compliance rates to the device care bundles were observed. The month-wise Ventilator Associated Events rates showed a decreasing trend. In the post-interventional phase, the average Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates showed a reduction from their respective baseline rates for the study setting.</p></div><div><h3>Conclusions</h3><p>An educational intervention targeted at the healthcare workers along with daily audit of care bundle practices in the critical care setting led to an increase in the compliance to device care bundles and a reduction in the incidence of Catheter-associated Urinary Tract Infection, Central Line Associated Bloodstream Infection and Ventilator Associated Events rates in the critical care setting.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100651"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative study of phenotypic-based detection assays for carbapenemases in Acinetobacter baumannii 基于表型的鲍曼不动杆菌碳青霉烯酶检测方法的比较研究。
IF 1.6 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-19 DOI: 10.1016/j.ijmmb.2024.100640
Nouf Al-Rashed , Mohammad Shahid , Nermin Kamal Saeed , Abdullah Darwish , Ronni Mol Joji , Ali Al-Mahmeed , Khalid M. Bindayna

Background

Acinetobacter baumannii is a serious health concern worldwide, causing high mortality rates and limited medical therapy options. Carbapenem resistance is a significant problem in Acinetobacter baumannii isolates. The synthesis of acquired carbapenemases, such as oxacillinases, IMP, NDM, VIM, and KPC enzymes, causes carbapenem resistance.

Methods

A total of 106 non-repetitive, Acinetobacter baumannii isolates were collected from four major hospitals in Bahrain including 78 carbapenem-resistant Acinetobacter baumannii (CRAB), and 28 carbapenem-susceptible Acinetobacter baumannii (CSAB) isolates. Three phenotypic tests were investigated in this study: including CARBA NP, modified carbapenem inactivation method (mCIM)/EDTA-CIM (eCIM), and modified Hodge test (MHT).

Results

CARBA NP was positive in 50 tested CRAB isolates (100%), and the sensitivity was 100%. The MHT was positive in 73/106 isolates (68.8%), while the sensitivity and specificity of the MHT were 77.6% and 100%. Moreover, only 38/106 (35.8%) isolates were positive for mCIM/eCIM. The sensitivity and specificity of mCIM were 40.4% and 100%.

Conclusion

CARBA NP was ideal for phenotypic detection of carbapenemase production, followed by MHT. The m/eCIM demonstrated a lower detection rate in CRAB. Consequently, combining tests would be more accurate. The mCIM/eCIM can easily distinguish between MBLs and serine-carbapenemases due to the frequent co-production of these enzymes in A. baumannii. In hospital setups where molecular characterization tests are not available, CARBA NP seems to be an alternative test in combination with MHT or mCIM/eCIM.

背景:鲍曼不动杆菌是全球严重的健康问题,导致高死亡率和有限的医疗选择。在鲍曼不动杆菌分离株中,碳青霉烯类耐药性是一个重要问题。获得性碳青霉烯酶(如奥沙西林酶、IMP、NDM、VIM 和 KPC 酶)的合成会导致碳青霉烯类耐药性:方法:从巴林的四家主要医院共收集了 106 个非重复性鲍曼不动杆菌分离株,包括 78 个耐碳青霉烯类鲍曼不动杆菌(CRAB)和 28 个碳青霉烯类鲍曼不动杆菌(CSAB)分离株。本研究对三种表型检测方法进行了研究:包括 CARBA NP、改良碳青霉烯灭活法(mCIM)/ EDTA-CIM (eCIM)和改良霍奇试验(MHT):CARBA NP 在 50 个检测的 CRAB 分离物中呈阳性(100%),灵敏度为 100%。改良霍奇检测(MHT)在 73/106 个分离株(68.8%)中呈阳性,灵敏度和特异性分别为 77.6% 和 100%。此外,只有 38/106 个分离物(35.8%)对 mCIM /eCIM 呈阳性。mCIM 的灵敏度和特异性分别为 40.4% 和 100%:结论:CARBA NP 是表型检测碳青霉烯酶产生的理想方法,其次是 MHT。在 CRAB 中,m/eCIM 的检出率较低。因此,联合检测会更准确。mCIM /eCIM 可以轻松区分 MBLs 和丝氨酸碳青霉烯酶,因为鲍曼不动杆菌中经常同时产生这些酶。在无法进行分子鉴定检测的医院中,CARBA NP 似乎是与 MHT 或 mCIM /eCIM 结合使用的另一种检测方法。
{"title":"Comparative study of phenotypic-based detection assays for carbapenemases in Acinetobacter baumannii","authors":"Nouf Al-Rashed ,&nbsp;Mohammad Shahid ,&nbsp;Nermin Kamal Saeed ,&nbsp;Abdullah Darwish ,&nbsp;Ronni Mol Joji ,&nbsp;Ali Al-Mahmeed ,&nbsp;Khalid M. Bindayna","doi":"10.1016/j.ijmmb.2024.100640","DOIUrl":"10.1016/j.ijmmb.2024.100640","url":null,"abstract":"<div><h3>Background</h3><p><em>Acinetobacter baumannii</em> is a serious health concern worldwide, causing high mortality rates and limited medical therapy options. Carbapenem resistance is a significant problem in <em>Acinetobacter baumannii</em> isolates. The synthesis of acquired carbapenemases, such as oxacillinases, IMP, NDM, VIM, and KPC enzymes, causes carbapenem resistance.</p></div><div><h3>Methods</h3><p>A total of 106 non-repetitive, <em>Acinetobacter baumannii</em> isolates were collected from four major hospitals in Bahrain including 78 carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB), and 28 carbapenem-susceptible <em>Acinetobacter baumannii</em> (CSAB) isolates. Three phenotypic tests were investigated in this study: including CARBA NP, modified carbapenem inactivation method (mCIM)/EDTA-CIM (eCIM), and modified Hodge test (MHT).</p></div><div><h3>Results</h3><p>CARBA NP was positive in 50 tested CRAB isolates (100%), and the sensitivity was 100%. The MHT was positive in 73/106 isolates (68.8%), while the sensitivity and specificity of the MHT were 77.6% and 100%. Moreover, only 38/106 (35.8%) isolates were positive for mCIM/eCIM. The sensitivity and specificity of mCIM were 40.4% and 100%.</p></div><div><h3>Conclusion</h3><p>CARBA NP was ideal for phenotypic detection of carbapenemase production, followed by MHT. The m/eCIM demonstrated a lower detection rate in CRAB. Consequently, combining tests would be more accurate. The mCIM/eCIM can easily distinguish between MBLs and serine-carbapenemases due to the frequent co-production of these enzymes in <em>A. baumannii</em>. In hospital setups where molecular characterization tests are not available, CARBA NP seems to be an alternative test in combination with MHT or mCIM/eCIM.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100640"},"PeriodicalIF":1.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current trends in antimicrobial resistance of ESKAPEEc pathogens from bloodstream infections – Experience of a tertiary care centre in North India 血流感染 ESKAPEEc 病原体抗菌药耐药性的当前趋势 - 印度北部一家三级医疗中心的经验。
IF 1.6 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-14 DOI: 10.1016/j.ijmmb.2024.100647
Menal Gupta, Veenu Gupta, Rama Gupta, Jyoti Chaudhary

Introduction

Bloodstream infections (BSI) due to ESKAPEEc pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli), cause significant mobility and mortality worldwide and are among the most common healthcare associated infections. Rising rates of antimicrobial resistance (AMR) in India are alarming, because of the high infection rates and poor control of antibiotic use. This single-centre, retrospective study was undertaken to identify the patterns of distribution and antimicrobial resistance of ESKAPEEc pathogens in bloodstream infections.

Methodology

Blood samples from patients with suspected BSI were cultured and antimicrobial susceptibility testing was performed on automated systems (BD Bactec Fx/BactAlert 3D and Vitek2). The microbiological data on bacterial BSI was retrieved from the laboratory records and antimicrobial resistance profiles were analysed.

Results

10.7% of the blood culture samples showed bacterial growth during the study period (adult > paediatric and intensive care unit (ICU) > ward > outpatient department (OPD)). E. coli (24%) and K. pneumoniae (20.5%) were the predominant species isolated, followed by S. aureus (9.5%) and A. baumanni (9%). High rates of resistance to third generation cephalosporins, β-lactam-β-lactamase inhibitor combinations (BL-BLI) and carbapenems was observed, in Gram-negative isolates, especially from ICU patients. Methicillin-resistant S. aureus (MRSA) isolates increased from 67% to 88% over the five-year period. Vancomycin-resistance among Enterococcus isolates also escalated to 40% in 2022 with 11% linezolid resistance.

Conclusion

The study revealed that more than 77% of bloodstream infections were caused by ESKAPEEc pathogens, with high rates of resistance to most antimicrobials. This reinforces the importance of monitoring the frequency of bacteria and antibiograms in individual treatment and hospital infection control programs.

导言:由 ESKAPEEc 病原体(粪肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、肠杆菌属和大肠埃希菌)引起的血流感染 (BSI) 在全球范围内造成严重的流动性和死亡率,是最常见的医疗相关感染之一。由于感染率高且抗生素使用控制不力,印度抗生素耐药性(AMR)的上升令人担忧。这项单中心回顾性研究旨在确定血流感染中 ESKAPEEc 病原体的分布模式和抗菌药耐药性:对疑似 BSI 患者的血液样本进行培养,并使用自动系统(BD Bactec Fx/ BactAlert 3D 和 Vitek2)进行抗菌药敏感性检测。从实验室记录中检索了细菌性 BSI 的微生物学数据,并对抗菌药耐药性概况进行了分析:研究期间(成人 > 儿童和重症监护室 > 病房 > 门诊部 (OPD)),10.7%的血液培养样本出现细菌生长。大肠杆菌(24%)和肺炎双球菌(20.5%)是主要分离菌种,其次是金黄色葡萄球菌(9.5%)和鲍曼不动杆菌(9%)。在革兰氏阴性菌分离株中,尤其是来自重症监护室患者的分离株中,对第三代头孢菌素、β-内酰胺-β-内酰胺酶抑制剂组合(BL-BLI)和碳青霉烯类的耐药率很高。耐甲氧西林金黄色葡萄球菌(MRSA)分离株在五年内从 67% 上升到 88%。2022 年,肠球菌分离物中耐万古霉素的比例也上升到 40%,耐利奈唑胺的比例为 11%:研究显示,超过 77% 的血流感染是由 ESKAPEEc 病原体引起的,对大多数抗菌药物的耐药率都很高。这加强了在个人治疗和医院感染控制计划中监测细菌和抗生素使用频率的重要性。
{"title":"Current trends in antimicrobial resistance of ESKAPEEc pathogens from bloodstream infections – Experience of a tertiary care centre in North India","authors":"Menal Gupta,&nbsp;Veenu Gupta,&nbsp;Rama Gupta,&nbsp;Jyoti Chaudhary","doi":"10.1016/j.ijmmb.2024.100647","DOIUrl":"10.1016/j.ijmmb.2024.100647","url":null,"abstract":"<div><h3>Introduction</h3><p>Bloodstream infections (BSI) due to ESKAPEEc pathogens (<em>Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa, Enterobacter</em> spp. and <em>Escherichia coli</em>), cause significant mobility and mortality worldwide and are among the most common healthcare associated infections. Rising rates of antimicrobial resistance (AMR) in India are alarming, because of the high infection rates and poor control of antibiotic use. This single-centre, retrospective study was undertaken to identify the patterns of distribution and antimicrobial resistance of ESKAPEEc pathogens in bloodstream infections.</p></div><div><h3>Methodology</h3><p>Blood samples from patients with suspected BSI were cultured and antimicrobial susceptibility testing was performed on automated systems (BD Bactec Fx/BactAlert 3D and Vitek2). The microbiological data on bacterial BSI was retrieved from the laboratory records and antimicrobial resistance profiles were analysed.</p></div><div><h3>Results</h3><p>10.7% of the blood culture samples showed bacterial growth during the study period (adult &gt; paediatric and intensive care unit (ICU) &gt; ward &gt; outpatient department (OPD)). <em>E. coli</em> (24%) and <em>K</em>. <em>pneumoniae</em> (20.5%) were the predominant species isolated, followed by <em>S</em>. <em>aureus</em> (9.5%) and <em>A. baumanni</em> (9%). High rates of resistance to third generation cephalosporins, β-lactam-β-lactamase inhibitor combinations (BL-BLI) and carbapenems was observed, in Gram-negative isolates, especially from ICU patients. Methicillin-resistant <em>S. aureus</em> (MRSA) isolates increased from 67% to 88% over the five-year period. Vancomycin-resistance among <em>Enterococcus</em> isolates also escalated to 40% in 2022 with 11% linezolid resistance.</p></div><div><h3>Conclusion</h3><p>The study revealed that more than 77% of bloodstream infections were caused by ESKAPEEc pathogens, with high rates of resistance to most antimicrobials. This reinforces the importance of monitoring the frequency of bacteria and antibiograms in individual treatment and hospital infection control programs.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100647"},"PeriodicalIF":1.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pk Pd and antibiotic of choice Pk Pd 和首选抗生素。
IF 1.6 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-14 DOI: 10.1016/j.ijmmb.2024.100648
Vishal Wadhwa
{"title":"Pk Pd and antibiotic of choice","authors":"Vishal Wadhwa","doi":"10.1016/j.ijmmb.2024.100648","DOIUrl":"10.1016/j.ijmmb.2024.100648","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100648"},"PeriodicalIF":1.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigation of SCCmec types using the real time PCR method in cefoxitin-resistant Staphylococcus aureus isolates 利用实时 PCR 法研究耐头孢西丁金黄色葡萄球菌分离物中的 SCCmec 类型。
IF 1.6 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-06-14 DOI: 10.1016/j.ijmmb.2024.100649
Mustafa Sağlam , İbrahim Halil Kılıç , Yasemin Zer

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that can cause many community and hospital-acquired infections. This study was conducted to investigate the SCCmec gene types responsible for methicillin resistance in MRSA isolates isolated from hospitalised patients.

Material and methods

MRSA isolates isolated from samples sent from various clinics to Gaziantep University Hospital Microbiology Laboratory between March 2021–January 2022 were included in the study. Bacteria were identified using by VITEK 2 automated system. Cefoxitin (FOX) resistance was determined by the disc diffusion method according to EUCAST standards. Cefoxitin resistance was confirmed by the Penicillin Binding Protein 2′ latex agglutination test. Types of mecA, mecC, coa, nuc, Panton Valentin Leukocidin (PVL), ccrC2, class A mec, SCCmec types in isolates detected as MRSA were investigated by real-time PCR.

Results

In this study, 116 isolates meeting the study criteria were examined. By detecting the nuc and coa genes in all isolates by PCR, the phenotypic identification of S.aureus was confirmed. While the mecA gene was detected in all MRSA isolates, no mecC gene was detected in any isolates. Detected SCCmec types were as follows; SCCmec Type 1 (2.6%), Type II (28.4%), Type III (12.9%), Type IVa (11.2%), Type IVb (3.4%), Type IVc (3.4%), Type IVg (12.1%), Type V (0.9%), Type VII (4.3%), Type VIII (18.1%), Type IX (0.9%), Type XII (1.7%). On the other hand, SCCmec Type VI, X, XI and XIII were not found in any isolate. It was determined that four of the MRSA isolates (3.4%) carried the PVL gene that two (50%) of these were found in SCCmec Type VIII.

Conclusion

Monitoring of FOX resistance is an effective and safe method for determination of MRSA isolates. The change in the mec gene causes resistance, which should be monitored regularly with molecular methods. Our study is the first study in Turkey.

背景:耐甲氧西林金黄色葡萄球菌(MRSA)是一种重要的病原体,可引起多种社区和医院感染。本研究旨在调查从住院患者中分离出的 MRSA 耐甲氧西林的 SCCmec 基因类型:研究对象包括 2021 年 3 月至 2022 年 1 月期间从各诊所送往加济安泰普大学医院微生物实验室的样本中分离出的 MRSA。使用 VITEK 2 自动系统对细菌进行鉴定。头孢西丁 (FOX) 耐药性是根据 EUCAST 标准通过盘扩散法测定的。头孢西丁耐药性通过 "青霉素结合蛋白 2 "乳胶凝集试验确认。通过实时 PCR 检测被检测为 MRSA 的分离株中的 mecA、mecC、coa、nuc、Panton Valentin Leukocidin(PVL)、ccrC2、A 类 mec、SCCmec 类型:本研究共检测了 116 例符合研究标准的分离株。通过 PCR 检测所有分离物中的 nuc 和 coa 基因,确认了金黄色葡萄球菌的表型鉴定。虽然在所有 MRSA 分离物中都检测到了 mecA 基因,但没有在任何分离物中检测到 mecC 基因。检测到的 SCCmec 类型如下:SCCmec 1 型(2.6%)、II 型(28.4%)、III 型(12.9%)、IVa 型(11.2%)、IVb 型(3.4%)、IVc 型(3.4%)、IVg 型(12.1%)、V 型(0.9%)、VII 型(4.3%)、VIII 型(18.1%)、IX 型(0.9%)和 XII 型(1.7%)。另一方面,没有在任何分离物中发现 SCCmec VI、X、XI 和 XIII 型。经测定,4 个 MRSA 分离物(3.4%)携带 PVL 基因,其中 2 个(50%)在 SCCmec VIII 型中发现:结论:监测 FOX 耐药性是确定 MRSA 分离物的一种有效而安全的方法。mec基因的变化会导致耐药性,因此应定期使用分子方法进行监测。我们的研究是土耳其的首次研究。
{"title":"Investigation of SCCmec types using the real time PCR method in cefoxitin-resistant Staphylococcus aureus isolates","authors":"Mustafa Sağlam ,&nbsp;İbrahim Halil Kılıç ,&nbsp;Yasemin Zer","doi":"10.1016/j.ijmmb.2024.100649","DOIUrl":"10.1016/j.ijmmb.2024.100649","url":null,"abstract":"<div><h3>Background</h3><p>Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) is an important pathogen that can cause many community and hospital-acquired infections. This study was conducted to investigate the SCCmec gene types responsible for methicillin resistance in MRSA isolates isolated from hospitalised patients.</p></div><div><h3>Material and methods</h3><p>MRSA isolates isolated from samples sent from various clinics to Gaziantep University Hospital Microbiology Laboratory between March 2021–January 2022 were included in the study. Bacteria were identified using by VITEK 2 automated system. Cefoxitin (FOX) resistance was determined by the disc diffusion method according to EUCAST standards. Cefoxitin resistance was confirmed by the Penicillin Binding Protein 2′ latex agglutination test. Types of mecA, mecC, coa, nuc, Panton Valentin Leukocidin (PVL), ccrC2, class A mec, SCCmec types in isolates detected as MRSA were investigated by real-time PCR.</p></div><div><h3>Results</h3><p>In this study, 116 isolates meeting the study criteria were examined. By detecting the nuc and coa genes in all isolates by PCR, the phenotypic identification of <em>S.aureus</em> was confirmed. While the mecA gene was detected in all MRSA isolates, no mecC gene was detected in any isolates. Detected SCCmec types were as follows; SCCmec Type 1 (2.6%), Type II (28.4%), Type III (12.9%), Type IVa (11.2%), Type IVb (3.4%), Type IVc (3.4%), Type IVg (12.1%), Type V (0.9%), Type VII (4.3%), Type VIII (18.1%), Type IX (0.9%), Type XII (1.7%). On the other hand, SCCmec Type VI, X, XI and XIII were not found in any isolate. It was determined that four of the MRSA isolates (3.4%) carried the PVL gene that two (50%) of these were found in SCCmec Type VIII.</p></div><div><h3>Conclusion</h3><p>Monitoring of FOX resistance is an effective and safe method for determination of MRSA isolates. The change in the mec gene causes resistance, which should be monitored regularly with molecular methods. Our study is the first study in Turkey.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"50 ","pages":"Article 100649"},"PeriodicalIF":1.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0255085724001245/pdfft?md5=e089f12366c6c4d5f840d425c87e6a2d&pid=1-s2.0-S0255085724001245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Indian Journal of Medical Microbiology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1