Candida was isolated in 112 (21.96%) specimens. Of these, Candida albicans was commonly isolated in 50.89% followed by C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. guillermondi and C. pseudotropicalis. Fluconazole resistance was encountered in some isolates. All C. glabrata and C. krusei were uniformly resistant to fluconazole and 8 of 16 C. tropicalis were also resistant to it. But only 7 of 57 isolates of C. albicans were resistant to it. Resistance to Nystatin was seen in 34 isolates. Similarly, emergence of resistance was also seen to Ketoconazole and Itraconazole in 24 of 112 isolates. Amphoterecin B resistance was exhibited by 3 C. albicans, 2 C. tropicalis, 1 C. glabrata and 1 C. krusei strain. C. albicans is an important nosocomial pathogen causing UTI in catheterized patients, nevertheless role of other species of Candida as emergent pathogens and resistance to antifungal drugs needs to be emphasized.
Out of 800 patients admitted for surgery 116 (14.5%) suffered from wound infections. Of these, 57 out of 277 (20.58%) were emergency surgery patients and 59 out of 523 (11.28%) were elective surgery. The infection rate was 32.2% in dirty wounds followed by 29.22% in contaminated wounds, 9.0% in clean-contaminated and 3.85% in clean wounds. There were significantly more infections in wounds with drains (21.79%) than without drains (10.37%) P<0.01). Only 8.37% with pre-operative antibiotic prophylaxis developed infection as compared to 24.83% without antibiotic prophylaxis. The bacterial profile showed polymicrobial flora comprising of Staphylococcus aureus (26.51%), Pseudomonas aeruginosa (18.18%), Escherichia coli (15.9%), Klebsiella pneumoniae (11.36%), Coagulase negative Staphylococcus (6.81%), Bacteroides species (5.30%), Proteus mirabilis (4.54%), Beta Haemolytic Streptococci (3.78%), Peptococcus species (3.03%), Proteus vulgaris and Citrobacter species (2.27%) each. Both Gram positive and Gram negative bacterial isolates were multi drug resistant. Post-operative wound infections are a serious medical problem that has to be tackled due to its increased morbidity, mortality and medical care costs. An active surveillance program is recommended.
A young apparently healthy, non-diabetic, HIV non-reactive woman presented with a mycetoma-like lesion on right buttock. Discharge was scanty, and mycotic grains were not seen. Biopsy of sinus track was obtained for microscopy and culture. Microscopic examination revealed plenty of fungal hyphae in direct microscopic examination of grounded tissues in saline; KOH, Gram's, and H and E-stained smears. All the three inoculated slants of Sabouraud's media yielded heavy growth of Fusarium solani. Presence of numerous hyphal fragments in direct microscopy and heavy growth of F. solani in all three slants indicative of etiological role of fungus in the present case. It is probably a first report of F. soloni mycetoma from India.
PURPOSE:There is grave concern regarding increase in HIV associated Tuberculosis (TB) and emergence of Multi Drug Resistant (MDR) and Extremely Drug Resistant (XDR) TB. It is essential to know prevalence of TB in HIV patients and its association with CD4 count. MATERIAL & METHODS: A total of 362 patients were screened for Pulmonary TB of which 85 (23.48%) were diagnosed as Pulmonary TB by radiology, Ziehl Neelson (ZN) smear and culture. Results: It was commoner in males (28.76%), almost equal in urban (23.64%) & rural (22.45%) people and more frequent in laborers (34.12%). Culture was positive in 34 (40%) out of 85 Pulmonary TB patients of which 33 were M. tuberculosis and one was Rapid grower. The results of the study emphasize that coinfection of TB in HIV/AIDS patients is a concern. There is direct correlation between CD4 counts depletion and Pulmonary TB in HIV/AIDS patient. Hence, regular monitoring of these patients is warranted.
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