[Show abstract][Hide abstract] ABSTRACT: Background: Extended spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae have been occasionally reported as a cause of septicemia outbreak among pediatric patients in medical literature. We aimed to study the source of an outbreak of ESBL-producing K. pneumoniae in the Neonatal Intensive care Unit (NICU) at a tertiary care hospital in South India.Methods: The outbreak was investigated by phenotypically typing the isolates followed by random amplified polymorphic DNA analysis (RAPD). A total of 31 K. pneumoniae, consisting of 27 blood isolates from neonates and 4 environmental isolates were studied. Antibiotic susceptibility patterns were determined using standard disc diffusion methods; ESBL production was tested both phenotypically and genotypically. The strains were typed using two primers AP4 and HLWL74.Results: Except 2 environmental strains, all were found to be ESBL producers and of ESBL types TEM-1, SHV-12 and CTX-M- 15. Two different antibiotic resistance patterns were identified and the RAPD typing revealed two profiles. Phenotypic and genotypic analyses showed that 2 environmental strains had been responsible for the outbreak.Conclusion: Safe clinical practices should be followed in neonatal wards to prevent spread of infection. This is the first report of blaCTX-M-15 producing K.pneumoniae and the first outbreak in our hospital due to CTX-M-15 producing K.pneumoniae.
International Journal of Collaborative Research on Internal Medicine & Public Health. 01/2010;
[Show abstract][Hide abstract] ABSTRACT: Rapid diagnosis is prerequisite for effective treatment and reducing mortality and morbidity of malaria. This study was taken up to compare the efficacy of various methods available, i.e., thick and thin smear, quantitative buffy coat (QBC), plasmodium lactate dehydrogenase and aldolase in blood of patient. A total of 411 samples were collected from patients presenting with classic symptoms of malaria. For traditional microscopy; thick and thin smears were prepared and stained with Leishman's stain, taking thick smear as gold standard, thin smear had a sensitivity and specificity of 54.8% and 100%, respectively. QBC and antigen detection was done using commercially available kits; out of 411 samples, QBC and Malariagen were positive in 66 and 62 cases, with a sensitivity of 78% and 75%, respectively. Leishman's thick smear, although cost effective, is difficult to interpret for inexperienced microscopists; so if facilities are available, QBC should be used for routine diagnosis. In places where facilities are not available, rapid, simple and easy to interpret antigen detection test can be used despite low sensitivity.
Indian Journal of Pathology and Microbiology 01/2009; 52(2):200-2. · 0.68 Impact Factor