FRS is a continuous spectrum of disease varying in presentation, treatment and long-term sequelae. Correct identification of the fungus remains essential for appropriate treatment.

Scedosporium apiospermum previously known as Monospermum apiospermum is a ubiquitous fungus found in soil, polluted water and sewage. It causes broad spectrum of diseases, including soft tissue infections, septic arthritis, osteomyelitis, ophthalmic infections, sinusitis, pneumonia, meningitis, brain abscesses, endocarditis and disseminated infection. In recent years, it has been shown to be pathogenic for both immunocompetent and immunosuppressed patients. It is a significant opportunist with very high levels of antifungal resistance. We report here a case of invasive lung infection due to S. apiospermum in an immunocompetent patient who responded to antifungal therapy and surgical treatment.

No abstract

No abstract

Healthcare-associated infections (HCAIs) are a major concern and associated with noticeable morbidity and mortality. To combat this, the simple strategy is hand hygiene (HH). In a resource constraint settings one of the important reason for poor hand hygiene compliance is irregular supply of HH products. This study was done to assess the cost effectiveness and acceptability of WHO recommended locally made alcohol based hand rub. The study was carried out in 28 HCPs working in an IMCU. Samples for the assessment of the microbial hand contamination were collected by direct fingerprint of their dominant hand onto the blood agar plates at three different time point. Group A samples collected in random. Group B samples collected immediately after patient physical examination. Group C were group B representatives collected after cleaning their hands with locally made isopropyl alcohol based hand rub. No significant difference in colony count between the groups A and B was observed. On the other hand, there was a statistically significant difference in colony count between the groups B and C (P=0.05). It means that the rubbing of the hands using locally made WHO recommended hand sanitizer enabled to eradicate the bacterial flora remarkably from the hands of HCPs.

No abstract

Pneumonia is a common illness accounting for majority of hospitalizations worldwide with significant mortality and morbidity. Antimicrobial therapy, being the main stay of treatment, the choices of antibiotics depends on the nature of the etiologic agents and the host factors. The current study was aimed to identify the bacterial & fungal etiologic agents of Community Acquired Pneumonia (CAP) in Immunocompromised (IC) patients, with their antimicrobial resistant pattern and to analyze the associated immunocompromised states. Various respiratory samples from study group of 75 immunocompromised patients with features of pneumonia were collected, processed and the isolates were identified with their antimicrobial susceptibility& resistance pattern according to CLSI guidelines. The results were analyzed statistically. Diabetes mellitus is the most common immunocompromised state (48%) associated with CAP. Monomicrobial and polymicrobial infection rates were 80.36% and 19.64% respectively. Gram negative pathogens and fungal pathogens were identified in 60% and 25.37% of culture positive cases respectively. Diabetes mellitus is commonly found in association with polymicrobial infection (19.44%) and fungal infection (16.66%). Drug resistant strains comprise about 75% of MRSA strains, 72.72 % of ESBL producers and 3.44% of Amp C producers. As the number of elderly people with associated IC state is on rise, with change in the pattern of microbial etiologic agents causing CAP, a prior knowledge of the host and microbial factors will help in formulating empirical antimicrobial therapy and proper treatment thereby curbing the spread of infections by drug resistant pathogens and the associated morbidity and mortality.

No abstract