Prevalence and Antimicrobial Susceptibility of Emerging Nosocomial Achromobacter xylosoxidans in a North Indian Tertiary Care Hospital | Chapter 4 | Research Perspectives of Microbiology and Biotechnology Vol. 4

 

The present study evaluates the prevalence and trends of Achromobacter xylosoxidans in clinical specimens and the trend in its sensitivity pattern. Achromobacter xylosoxidans is an emerging nosocomial pathogen that is commonly found in the environment. It may lead to nosocomial infections in hospital settings, particularly in the intensive care unit. It is frequently identified in humidifiers in intensive care units and is also frequently linked to patients who have several comorbidities and are immunocompromised. The Retrospective analysis was done of the culture reports positive for Achromobacter xylosoxidans by VITEK 2 method and its Antimicrobial sensitivity pattern was analysed from period of September 2021 to February 2023. The maximum (54.54%) infection was seen in the age group >50 years. The maximum number (66.2%) of Achromobacter xylosoxidans were isolated from the Suction tip, followed by blood (8%) and the Tracheal Tip (5%). Surgical ICU contributed to the maximum number of infections i.e. 40.2%, followed by Respiratory ICU (22.1%). Maximum sensitivity was seen for Cotrimoxazole and Meropenem (around 80%), followed by Cefoperazone-Sulbactam (74%), Imipenem, Levofloxacin, Ceftazidime (around 65%). The sensitivity was minimal for Ceftriaxone (0%), Aztreonam (1.3%), and Gentamicin (5.2%). The most common risk factors/comorbidities associated with Achromobacter infections was recent ICU admission (87.01%). The variation in antibiotic sensitivity or resistance can be due to the various factors like antibiotics used in patients in primary treatment, the immune status of the patients from which the sample was collected, overuse or misuse of antibiotics, availability of antibiotics, etc. The antibiotic of choice in our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment.

 

 

Author(s) Details

Malvika Singh

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Dimple Raina

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ranjana Rohilla

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Himanshu Narula

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ajay Pandita

Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

 

Please see the link:- https://doi.org/10.9734/bpi/rpmab/v4/274

Prevalence and Antimicrobial Susceptibility of Emerging Nosocomial Achromobacter xylosoxidans in a North Indian Tertiary Care Hospital | Chapter 4 | Research Perspectives of Microbiology and Biotechnology Vol. 4

 

The present study evaluates the prevalence and trends of Achromobacter xylosoxidans in clinical specimens and the trend in its sensitivity pattern. Achromobacter xylosoxidans is an emerging nosocomial pathogen that is commonly found in the environment. It may lead to nosocomial infections in hospital settings, particularly in the intensive care unit. It is frequently identified in humidifiers in intensive care units and is also frequently linked to patients who have several comorbidities and are immunocompromised. The Retrospective analysis was done of the culture reports positive for Achromobacter xylosoxidans by VITEK 2 method and its Antimicrobial sensitivity pattern was analysed from period of September 2021 to February 2023. The maximum (54.54%) infection was seen in the age group >50 years. The maximum number (66.2%) of Achromobacter xylosoxidans were isolated from the Suction tip, followed by blood (8%) and the Tracheal Tip (5%). Surgical ICU contributed to the maximum number of infections i.e. 40.2%, followed by Respiratory ICU (22.1%). Maximum sensitivity was seen for Cotrimoxazole and Meropenem (around 80%), followed by Cefoperazone-Sulbactam (74%), Imipenem, Levofloxacin, Ceftazidime (around 65%). The sensitivity was minimal for Ceftriaxone (0%), Aztreonam (1.3%), and Gentamicin (5.2%). The most common risk factors/comorbidities associated with Achromobacter infections was recent ICU admission (87.01%). The variation in antibiotic sensitivity or resistance can be due to the various factors like antibiotics used in patients in primary treatment, the immune status of the patients from which the sample was collected, overuse or misuse of antibiotics, availability of antibiotics, etc. The antibiotic of choice in our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment.

 

 

Author(s) Details

Malvika Singh

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Dimple Raina

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ranjana Rohilla

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Himanshu Narula

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ajay Pandita

Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences,

Dehradun, Uttarakhand, India.

 

Please see the link:- https://doi.org/10.9734/bpi/rpmab/v4/274

Diagnostic and Management Strategies for Altered Sensorium in HIV/AIDS Patients: A Syndromic Approach | Chapter 7 | Medicine Essentials in Clinical Practice

Managing altered sensorium in individuals with HIV and AIDS is a vital aspect of clinical practice, given the multifaceted factors contributing to cognitive changes in this group. Altered sensorium, which involves disruptions in consciousness, cognition, and perception, can arise from diverse causes such as opportunistic infections, malignancies, metabolic imbalances, or the direct impact of HIV on the central nervous system. Early detection and a thorough evaluation are critical for effective management. The initial workup should include a detailed medical history, comprehensive physical examination, and focused diagnostic tests such as neuroimaging, lumbar puncture, and pertinent laboratory assessments. Common infectious etiologies like cryptococcal meningitis, toxoplasmosis, and cytomegalovirus encephalitis should be considered, as well as non-infectious conditions such as HIV-associated neurocognitive disorders (HAND), primary CNS lymphoma, and progressive multifocal leukoencephalopathy (PML). Treatment plans must be customized based on the underlying cause, incorporating optimized antiretroviral therapy (ART), targeted antimicrobial regimens, and supportive interventions.

A multidisciplinary approach, involving neurologists, infectious disease specialists, and other healthcare providers, is essential for comprehensive care. Moreover, addressing psychosocial factors, ensuring adherence to ART, and regularly monitoring for neurocognitive changes are integral to long-term management.

With advancements in HIV treatment and the increasing age of individuals living with HIV, continued research into the mechanisms, prevention, and management of altered sensorium is vital. Such efforts aim to improve clinical outcomes, enhance quality of life, and mitigate the neurocognitive burden associated with HIV and AIDS.

 

Author (s) Details

 

Rohit Raina
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Preeti Singh Dhoat
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Amandeep Kaur
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

P Arun Kumar
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-92-3/CH7

Determining the Prevalence of Hepatitis B, Hepatitis C and Other Opportunistic Co-Infection in HIV Infected Patients in a Tertiary Care Hospital of North India | Chapter 7 | Issues and Developments in Medicine and Medical Research Vol.10

 Background and Objectives: There is little information on the prevalence and demography of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection in HIV-positive patients, which leads to increased hepatic problems, morbidity, and mortality.

The goal of this study was to determine the prevalence of HBV and HCV in HIV-positive people who visited a tertiary care hospital in north India.
The participants in this 6-month retrospective analysis included a total of 104 HIV-positive cases (January to June 2019). By using a fast detection method and/or an enzyme linked immunosorbent assay (ELISA), samples were analysed for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies. HBV DNA and HCV-RNA were evaluated in HBsAg positive serum samples and Anti HCV positive serum samples, respectively. Along with it, other opportunistic illnesses were investigated. The Institutional Ethics Committee have given their approval to this study.
Results: Of the 104 HIV-positive patients investigated, 11 (10.6 percent) were anti-HCV positive, with 7 (63.6%) of these sera containing HCV-RNA. Three people (2.8%) had chronic HBV co-infection (HBsAg positive), and two out of three (66.7%) of the sera were positive for HBV-DNA. Only one patient (0.9 percent) had triple infection with HBV, HCV, and HIV. Sexual promiscuity (76%) was the most prevalent mechanism of transmission, followed by contaminated needle/unknown (13.5%) and a history of I/V drug consumption (13.5%). (10.5 percent ). The Ludhiana district has the highest proportion of patients (38.5%), followed by the Punjabi district of Hoshiarpur.
Conclusions and interpretation: In HIV positive patients, the prevalence of Hepatitis C (anti HCV) and B (HBsAg) was 10.6% and 2.8 percent, respectively, according to our data. In India, co-infection with HBV and HCV is a common concern among HIV patients. In general, HCV-HIV co-infection is more common than HBV-HIV co-infection. As a result, all HIV patients should be checked for Hepatitis B and C indicators on a regular basis.

Author(s) Details:

Dr. Shikha Garg,
 Department of Microbiology, Amar Hospital Patiala, Punjab, India.

Please see the link here: https://stm.bookpi.org/IDMMR-V10/article/view/5819