Purpose: We investigated the persistence of the vaccine-induced immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) in Odisha who received a complete dose of either Covaxin or Covishield vaccine.Methods: This 24-week longitudinal cohort study was conducted from January to July 2021 with participants from 6 healthcare and research facilities of Odisha to understand the dynamicity of the vaccine-induced IgG antibodies against SARS-CoV-2 after the complete dose of vaccines.Results: Serum samples were collected from 614 participants during each follow-up and were tested in two chemiluminescent microparticle immunoassay (CLIA)-based platforms to detect SARS-CoV-2 antibodies both qualitatively and quantitatively. Among these participants, 308 (50.2%) participants were Covishield recipients and the rest 306 (49.8%) participants took Covaxin. A total of 81 breakthrough cases were recorded and the rest 533 HCWs without any history of postvaccination infection showed significant antibody waning either from T3 (Covaxin recipient) or T4 (Covishield recipient). The production of vaccine-induced IgG antibodies is significantly higher (p < 0.001) in Covishield compared with Covaxin. Covishield recipients produced higher median anti-S IgG titer than Covaxin. No statistically significant differences in antibody titers were observed based on age, gender, comorbidities, and blood groups.Conclusion: This 6-month follow-up study documents a 2-fold and 4-fold decrease in spike antibody titer among Covishield and Covaxin recipients, respectively. The clinical implications of antibody waning after vaccination are not well understood. It also highlights the need for further data to understand the long-term persistence of vaccine-induced antibody and threshold antibody titer required for protection against reinfection.

This study has highlighted the high prevalence of ESBL producing in the ICUs of our hospital. An in depth analysis of their antibiogram will be helpful in formulating the antibiotic policy and prevent spread of ESBL strains. It is recommended that ESBL testing should be done routinely to curtail antibiotic resistance and to effectively implement infection control measures.

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Background: Asymptomatic bacteriuria (ASB) is a relatively common condition occurring due to the morphological and physiological changes in the genitourinary tract during pregnancy. If left untreated, it may lead to acute pyelonephritis and adverse fetal and maternal outcomes. The objective was to determine prevalence, risk factors and etiological agents with susceptibility for ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Odisha, India.Methods: A prospective study with 200 pregnant women was conducted, over a period of 4 months, starting from 1st April 2017 to 31st July 2017. The mid- stream clean catch urine specimen was collected and processed in all the cases and other data were collected from the questionnaire given to them. The isolates from all the cases of ASB were identified and antimicrobial susceptibility was tested by Kirby- Bauer disc diffusion method and interpreted.Results: Prevalence of ASB in our study was 25.3%, with maximum prevalence among age group 21-30 yrs, during 3rd trimester, among multigravidae. Previous history of urinary tract infection (UTI), anaemia and diabetes have significant association with ASB. Klebsiella spp. was the predominant isolate in this study followed by Escherichia coli. Nitrofurantoin and Cefixime are safe and effective antibiotics against urinary pathogens in pregnancy.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women for ASB during all trimesters must be considered for preventing the adverse maternal and foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.

Background: Multidrug resistance has emerged as a challenge in health care settings. Again increasing prevalence of multidrug resistant (MDR), extensively drug resistant (XDR) and pan drug resistant (PDR) gram negative bacteria is making the condition more critical because of limited options of antibiotics, increasing morbidity, mortality and hospital stay of the patients. The present study is carried out with an aim to estimate the prevalence of MDR, XDR, PDR gram negative bacteria in a tertiary care hospital.Methods: Total of 912 gram negative bacterial isolates obtained from various samples of indoor patients in a tertiary care hospital, were studied over a period of six months. The bacteria were identified by conventional methods. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method. Minimum inhibitory concentration (MIC) of antibiotics for the resistant isolates were detected by Vitek-2 automated method. MDR, XDR and PDR were determined according to the definitions suggested by European Centre for Disease Prevention and Control (ECDC), and Centers for Disease Control and Prevention (CDC). Prevalence of extended spectrum beta lactamase (ESBL) producers was estimated.Results: Out of 912 isolates, prevalence of MDR, XDR and PDR were 66.12%, 34.32% and 0.98% respectively. Prevalence of MDR and XDR were higher in ICUs than clinical wards (p<0.0001). Prevalence of ESBL producers was 48.4%.Conclusions: The study highlights increased prevalence of multidrug resistant and extensively drug resistant strains in our hospital. Stringent surveillance, proper implementation of hospital infection control practices and antimicrobial stewardship will help in limiting the emergence and spread of drug resistant strains.

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.

Background: Diabetic foot ulcers (DFUs) are the most common and serious complications in uncontrolled diabetes. Infections are predominantly polymicrobial, with aerobic Gram-positive, anerobic, and fungal infections. Early detection of fungal infection and initiation of appropriate treatment in DFUs may lead to better healing and avoid amputations. The primary objective was to find out the prevalence of DFUs getting infected with fungus and the secondary objective was to identify the appropriate methodology for the detection of the fungus in DFUs.Materials and methods: This was a cross-sectional observational study carried out in a tertiary care hospital with a sample size of 60 DFUs. Microbiological analysis was done by swab culture and deep tissue culture. Observational data were collected and the significance level was statistically analyzed.Results: In the present study, the prevalence of fungal infections in DFUs was 31.7%. Only fungal tissue was positive in 15%, the fungal swab was positive in 8.33%, and both tissue and swab were positive in 8.33%. All these patients were treated with antifungal treatment as per the culture report in addition to appropriate antimicrobial therapy. Conclusion:A fungal culture should be done in all patients with non-healing DFUs. Both fungal swab and tissue culture testing should be advocated in patients with DFUs for better mycological evaluation. The addition of antifungal medications may provide better outcomes in selected cases.

Hepatitis C virus (HCV) continues to be a major disease burden affecting about 200 million people in world. Using blood donors as a prevalence source may underestimate the real prevalence of the virus because the donors are highly selected population. Presently more evidences support intravenous drug use as leading risk factor for the spread of virus. OBJECTIVES: The study aims at finding out the seroprevelance of Hepatitis C virus in high risk individuals as well as healthy blood donors. SETTINGS AND DESIGN: The study group comprise of 350 subjects which included 150 healthy voluntary donors as control group and 200 subjects taken from different high risk population like intravenous drug abuser (50), patients on long term haemodialysis (40), patients with chronic liver disease (50), HIV positive cases (30), health care workers (30). STATISTICAL ANALYSIS USED: Percentage. RESULTS: Seropositivity for anti HCV antibody was found to be 12% (24/200) among high risk population and 0.66 % (1/150) in healthy voluntary blood donors. Among different high risk groups, maximum prevalence rate 28% (14/50) was found in I.V drug abusers. Fifty percent (7/14) of the seropositive parenteral drug abusers were male in the age group of 21-30 years followed by 35.7% (5/14) in 31-40 years of age group. Only one female (7.14%) between 21-30 years was found to be sero-reactive for antiHCV antibody. In HIV co-infected cases 13.33 % (4/30) were seropositive for antiHCV antibody. In chronic liver disease (two hepatocellular carcinoma, one cirrhosis and one chronic hepatitis) and long standing haemodialysis, the prevalence rate for anti HCV was found to be 8% (4/50) and 5% (2/40) respectively. None of the health workers (0/30) found to be sero-reactive for antiHCV antibody. CONCLUSIONS: HCV poses a serious worldwide health problem affecting people from all walks of life in every country. In the present study 12% and 0.66% HCV prevalence was noticed in high risk group and healthy blood donors respectively. Among high risk group maximum prevalence (58.33%) was found in IV drug abusers. Prevention should target the reduction of virus transmission by health education, risk reduction counseling and thorough HCV screening following the suggestion of CDC,