Background:Ventilator-associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care unit (ICU) and in spite of advances in diagnostic techniques and management it remains a common cause of hospital morbidity and mortality.Objective:The primary objective of the following study is to determine the incidence, various risk factors and attributable mortality associated with VAP and secondary objective is to identify the various bacterial pathogens causing VAP in the ICU.Materials and Methods:This prospective observational study was carried out over a period of 1 year. VAP was diagnosed using the clinical pulmonary infection score. Endotracheal aspirate (ETA) and bronchoalveolar lavage (BAL) samples of suspected cases of VAP were collected from ICU patients and processed as per standard protocols.Statistical Analysis:Fisher's exact test was applied when to compare two or more set of variables were compared.Results:The incidence of VAP in our study was 57.14% and the incidence density of VAP was 31.7/1000 ventilator days. Trauma was the commonest underlying condition associated with VAP. The incidence of VAP increased as the duration of mechanical ventilation increased and there was a total agreement in bacteriology between semi-quantitative ETAs and BALs in our study. The overall mortality associated with VAP was observed to be 48.33%.Conclusions:The incidence of VAP was 57.14%. Study showed that the incidence of VAP is directly proportional to the duration of mechanical ventilation. The most common pathogens causing VAP were Acinetobacter spp. and Pseudomonas aeruginosa and were associated with a high fatality rate.

Objective: To analyze the factors most related to the incidence of neonatal sepsis at Ulin Hospital of Banjarmasin in 2016 Method: This research used Rapid Miner simulation model with population of all newborns at Ulin Hospital of Banjarmasin in 2016 and the sample size was 210 infants consisting of 105 infants with neonatal sepsis and 105 infants without neonatal sepsis. The analysis used Algorithm C.45 (Decision Tree) to see the accuracy level, and Root Mean Squared Error. Results: The factors most closely related with the incidence of neonatal sepsis were gestational age ≤ 33.5 weeks with the strong power of relationship (0.643), accuracy rate of 80.95%, and mean error rate of 0.401. Conclusion: Infants born with a gestational age < 33.5 weeks are at risk of having neonatal sepsis while those born with a gestation age > 33.5 weeks are at risk when the born with asphyxia complication, birth weight ≤ 3875, and temperature> 37 o C accompanied by labor trauma. Infants born with body temperature ≤ 37 o C are at risk of having neonatal sepsis when it is accompanied by pregnancy complication such as premature rupture of membranes.

Background:The objective of our study was to determine the prevalence of Pseudomonas aeruginosa in the isolates of postoperative wound and its susceptibility pattern to commonly used antibiotics.Materials and Methods:During a 2-year period, specimens were received as postoperative wound swabs in Microbiology Laboratory, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India.Result:Of the 300 bacterial isolates, 89 (29.6%) were P. aeruginosa, followed by Escherichia coli (61, 20.3%), Klebsiella spp. (50, 16.6%), Staphylococcus aureus (43, 14.3%), Proteus spp. (19, 6.3%), Acinetobacter spp. (9, 3.0%), and Citrobacter freundii (2, 0.6%). There was no growth in 27 (9.0%) specimens.Conclusion:P. aeruginosa isolation was higher in male patients and most common in the age group of 21-40 years. The susceptibility pattern showed the organism to be most commonly susceptible to imipenem, followed by meropenem, cefoperazone/sulbactam, ticarcillin/clavulanate, and amikacin.

Purpose:To study the occurrence and characterization of Uropathogenic Escherichia Coli (UPEC) in cases with urinary tract infections.Materials and Methods:A total of 220 symptomatic cases from urinary tract infections and 50 stool samples from apparently healthy individuals were included. The colonies identified as Escherichia Coli were screened for virulence factors, that is, hemolysin, Mannose Resistant and Mannose Sensitive Hemagglutination (MRHA, MSHA), Cell surface hydrophobicity, and Serum resistance.Results:Among the 220 cases 91 (41.36%) were hemolytic, 68 (30.90%) showed MRHA, 58 (26.36%) were cell surface hydrophobicity positive, and 72 (32.72%) were serum-resistant. In 50 controls, three (6%) were hemolytic, six (12%) showed MRHA, nine (18%) showed cell surface hydrophobicity, and 12 (24%) were serum-resistant. The difference between cases and controls for hemolysis and MRHA were significant (P<0.001 and P<0.01, respectively). A total of 14 atypical E. coli were isolated from the urine and all showed the presence of one or the other virulence markers. Out of the 18 mucoid E.coli isolated, 10 were serum-resistant.Conclusions:The present study revealed that out of 220 urinary isolates, 151 could be labeled as UPEC.

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