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Phenotypic Detection Of Extended Spectrum Β- Lactamase, Metallo Β- Lactamase, Ampc Β- Lactamase Among Escherichia Coli At Tertiary Care Hospital

Sun, 01 Jan 2023 00:00:00 GMT

Title: Phenotypic Detection Of Extended Spectrum Β- Lactamase, Metallo Β- Lactamase, Ampc Β- Lactamase Among Escherichia Coli At Tertiary Care Hospital Authors: Virupamma, Dharmasagar. Under the guidance of Dr. Smitha Bagali Abstract: Background: Production of β-lactamase enzymes by Gram-negative bacteria (E coli ) is the most common mechanism to acquire drug resistance to β-lactam antibiotics. Limitations in detecting extended spectrum β-lactamases (ESBL) and Amp-C β-lactamases Metallo β- lactamases have contributed to the uncontrolled spread of bacterial resistance and are of significant clinical concern. Objective : To detect ESBL, AmpC AND MBL among E coli isolates Materials and Methods: A total of 104 isolates (E coli) were selected for detection of ESBL, AmpC and MBL producers These isolates were phenotypically screened and confirmed by confirmatory test by using the Kirby Bauer disk diffusion method. Result: Among 104 isolates ( 80.8%) ESBL ( cefotaxime) producers, (12.5%) Ampc (cefoxitin) producers, and (76.0%) were MBL producers , colistin showed (100% ) sensitive followed by MEM(75%), IPM(74%), AN(65.4%),ETP(62.5%), AMC (60.5%), SFP (53.8%), TZP(48.1%), TIC (48.1%), FOS (47.1%), CAZ (47.1%), TGC (46.2%), FT(36.4%), CRO (31.7%), NOR (30.8%), FOX (27.9%), OFL (24%), CIP (22.1%), NA (20.2%), GM (19.2%), FEP (16.3%), CFM (15.4%), AM (13.5%), CF (7.7%), CXM (1%).towards E coli Conclusion : The present study highlights the necessity to identify the MDR β-lactamases stains for effective therapy in severe as well as mild bacterial infections, thereby enabling to reduce the risk of MDR in Tertiary care hospital and community settings. Further, similar studies in specific geographical regions may be encouraged to have a brief idea of organism-based antibiotic susceptibility patterns and β-lactamase production for effective management and treatment regimes Hence Early detection of β- lactamases among E coli avoid treatment failure and spread of MDR

Utility Of Interferon Gamma Release Assay And Tuberculin Skin Test For Screening Latent Tuberculosis Infection Among Health Care Workers A Comparative Study

Sun, 01 Jan 2023 00:00:00 GMT

Title: Utility Of Interferon Gamma Release Assay And Tuberculin Skin Test For Screening Latent Tuberculosis Infection Among Health Care Workers A Comparative Study Authors: Chaitra, I Patil. Under the guidance of Dr. Rashmi M Karigoudar Abstract: ABSTRACT INTRODUCTION: LTBI is characterized by a state of persistent immune response to Mycobacterium tuberculosis antigens without active TB manifestation. Despite being asymptomatic, individuals with LTBI serve as potential reservoirs for future TB outbreaks if left untreated. The seedbed for developing TB disease and continuous transmission could be latent tuberculosis infection. In healthy persons, the lifetime risk of reactivation of LTBI is 10%, with 5% acquiring active TB disease within the first 5 years following infection. Therefore, early identification and preventive treatment of LTBI among HCWs are crucial steps in TB control and infection prevention efforts AIM & OBJECTIVES OF THE STUDY: This study aimed to assess the distribution of latent tuberculosis infection (LTBI) and associated risk factors among healthcare workers (HCWs) using Tuberculin Skin Test (TST) and Interferon-Gamma Release Assay (IGRA) screening methods. MATERIAL AND METHODS: A structured questionnaire used for individual risk assessment of TB infection among HCWs like sociodemographic characteristics (e.g., age, gender, employed position and duration in that position), knowledge of TB prevention and control practices, History of diabetes mellitus, smoking, BCG vaccination, immunosuppression, current symptoms of tuberculosis, past history of Tuberculosis and treatment taken. History of tuberculosis, recent contact with new active tuberculosis case and have they undergone tuberculin skin test and when it was done. Following the completion of the risk assessment questionnaire, enrolled subjects underwent diagnostic tests to detect latent tuberculosis infection. RESULTS: A total of 73 HCWs participated, with a predominant age group of 20 to 29 years (56.2%). Females comprised 32.9% of the sample, while males constituted 67.1%. Lab technicians represented the majority (74.0%) among occupational roles.Results showed a comparable distribution between TB Skin Test and IGRA results, with 54.8% and 45.2% testing negative, and 50.7% and 49.3% testing negative, respectively. The TB Skin Test exhibited a sensitivity of 64.86%, specificity of 55.56%, PPV of 60.00%, NPV of 60.61%, and accuracy of 60.27%. The IGRA test showed a sensitivity of 55.56%, specificity of 64.86%, PPV of 60.61%, NPV of 60%, and accuracy of 60.27%. Disease prevalence among HCWs was estimated at 50.68%.Analysis of risk factors revealed significant associations with occupation and working hours (P < 0.0001). Lab technicians (38.9%) and attenders (71.4%) showed higher LTBI rates. Doctors and managers also displayed significant associations (P < 0.0001). There were no significant associations with age, gender, smoking history, or BCG immunization. CONCLUSION:In conclusion, this study provides valuable insights into LTBI distribution and risk factors among HCWs. It emphasizes the need for targeted preventive measures, regular screening, and infection control. Understanding occupational risks and working conditions is crucial for effective LTBI management. Further research with larger samples can enhance understanding and guide tailored interventions for LTBI prevention in healthcare settings.

Extended Spectrum Of Beta Lactamases, Ampicillinase C And Metallo Beta Lactamases In Emerging Multi Drug Resistant Gram-Negative Bacteria In Intensive Care Unit

Sun, 01 Jan 2023 00:00:00 GMT

Title: Extended Spectrum Of Beta Lactamases, Ampicillinase C And Metallo Beta Lactamases In Emerging Multi Drug Resistant Gram-Negative Bacteria In Intensive Care Unit Authors: Aishwarya, S Kandakur. Under the guidance of Dr. Sanjaya Wavare Abstract: ABSTRACT The study titled "Extended Spectrum Beta-Lactamases Ampicillinase C and Metallo Beta Lactamases in Emerging Multi-Drug Resistant Gram-Negative Bacteria in Intensive Care Units" presents a comprehensive investigation into the prevalence, impact, and clinical implications of Extended Spectrum Beta-Lactamases (ESBLs), Ampicillinase C (AmpC), and Metallo Beta-Lactamases (MBLs) in multi-drug resistant Gram-negative bacteria within Intensive Care Units (ICUs). The rising incidence of antimicrobial resistance (AMR) represents a global health crisis, particularly with Gram-negative bacteria in healthcare settings, posing significant threats to patient outcomes and increasing healthcare costs. This study aims to elucidate the distribution and implications of these resistance mechanisms, informing targeted interventions and optimizing antimicrobial stewardship in ICU settings. The background of the study highlights the rapid evolution of AMR as a formidable challenge, emphasizing the critical role of ICUs as epicentres for the emergence and spread of multi-drug resistant pathogens. The prevalence of AMR among Gram-negative bacteria has reached alarming levels, necessitating effective intervention strategies. The study focuses on ESBLs, AmpC, and MBLs, enzymes that confer resistance to a broad spectrum of antibiotics, underscoring the urgency of understanding their epidemiology to guide empiric antibiotic therapy and implement effective infection control measures. The study's rationale is rooted in the urgent need to address the escalating threat posed by antimicrobial resistance within ICUs, where the presence of multi-drug resistant pathogens significantly compromises treatment options. The comprehensive investigation aims to deepen understanding of the molecular mechanisms driving resistance and develop targeted interventions to mitigate its impact. The methodology encompasses a cross-sectional study design, detailing sample collection, processing, laboratory procedures, and data analysis. This rigorous approach facilitates the systematic conduct of the study, generating reliable data for analysis and interpretation. The results reveal a notable predominance of males in the patient population and a diverse age distribution across children, young adults, middle-aged adults, and older adults. The sample distribution illustrates a variety of sources, with blood samples constituting the largest proportion, indicating the severity of bloodstream infections. The prevalence of bacterial isolates showcases a range of species, with K. pneumoniae and Ps. aeruginosa being the most prevalent, reflecting the widespread challenge posed by MDR pathogens in ICUs. The prevalence of resistance mechanisms highlights the concerning levels of antimicrobial resistance, with ESBL-producing, AmpC-producing, and MBL-producing strains showcasing significant prevalence. The study also explores the association between resistance mechanisms and clinical outcomes, revealing correlations with prolonged ICU stays, the requirement for advanced treatments, and increased mortality rates. Comparisons between phenotypic and molecular methods using Vitek data highlight both strengths and limitations of each approach in detecting resistance mechanisms. The discussion delves into the emergence of MDR Gram-negative bacteria as a significant threat, emphasizing the importance of precise diagnostic methods, targeted treatment strategies, and the impact of resistance mechanisms on patient care. In conclusion, this study provides critical insights into the prevalence and implications of ESBLs, AmpC, and MBLs in Gram-negative bacteria within ICUs, underscoring the urgent need for comprehensive antimicrobial stewardship and infection control programs to combat the rising tide of antibiotic resistance. The findings contribute to the broader understanding of microbial dynamics within ICUs and highlight the imperative for ongoing surveillance, research, and policy efforts aimed at mitigating the public health impact of antimicrobial resistance.

Detection Of Metallo Beta-Lactamases In Carbapenem-Resistant Acinetobacter Baumannii By Phenotypic Methods

Sun, 01 Jan 2023 00:00:00 GMT

Title: Detection Of Metallo Beta-Lactamases In Carbapenem-Resistant Acinetobacter Baumannii By Phenotypic Methods Authors: Poojashree, S . Under the guidance of Dr.Jyothi P Abstract: Introduction : Acientobacter baumannii is an emerging multidrug resistant opportunistic pathogen that causes a variety of nosocomial infections .in recent years, carbapenem resistance in A.baumannii has increased due to ambler class B Metallo β-lactamases or class D OXA Carbapenemases. Objective : 1)Isolation and identification of Acinetobacter baumannii from various clinical samples. 2)To know the antibiotic susceptibility pattern of of Acinetobacter baumannii isolates. 3)Comparison of phenotypic tests for the detection of MBL in Acinetobacter baumannii Isolates. Materials and materials: Ninety one Acinetobacter baumannii were subjected to Imipenem isolates were subjected to a two different phenotypic tests; MBL screening was done by imipenem- EDTA double disc synergy test, imipenem- EDTA combined disc test. Result: Out of 91 Acinetobacter baumannii isolates,80 were imipenem resistant .MBL positive isolates were detected by DDST 60(65.9%) , and CDT 27 (29 .7%). Conclusion: DDST is more effective than CDT to detect MBL producing isolates.