BackgroundObjects frequently touched by patients and healthcare workers in hospitals harbor potential pathogens and may act as source of infectious agents. This study aimed to determine the bacterial contamination of common hospital objects frequently touched by patients, visitors and healthcare workers.MethodsA total of 232 samples were collected from various sites like surface of biometric attendance devices, elevator buttons, door handles, staircase railings, telephone sets and water taps. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Biofilm forming ability of the S. aureus isolates was tested by a microtitre plate method.ResultsA total of 232 samples were collected and 219 bacterial isolates were recovered from 181 samples. Staphylococcus aureus was the most common bacterial isolate (44/219). Majority of S. aureus isolates were recovered from elevator buttons, biometric attendance devices and door handles. Among the S. aureus isolates, 36.3% (16/44) were methicillin resistant Staphylococcus aureus (MRSA) while remaining were methicillin sensitive Staphylococcus aureus (MSSA). Out of 44 S. aureus isolates, 12 (29.5%) were multidrug resistant and 14 (31.8%) were biofilm producers. The majority of MRSA isolates 62.5% (10/16) were biofilm producers. Acinetobacter was the most common Gram negative isolate followed by E coli and Pseudomonas species.ConclusionsHigh bacterial contamination of frequently touched objects with variety of potential pathogens and normal flora was detected. S. aureus was the most common bacterial isolate. Biofilm forming ability offers additional survival advantage to the organisms on these objects. Present study highlights the need of improved hand hygiene among healthcare workers and regular cleaning/disinfection of sites of frequent public contact.
Background Upper respiratory tract is one of the commonest sites for microbial colonization. The colonized individuals are at risk of infections and can be a source of transmission of pathogens. Medical students are frequently exposed to a variety of infectious agents and more likely to get colonized by them. This study was aimed to determine the prevalence and to compare the colonization rates of nasal and pharyngeal bacterial pathogens among preclinical and clinical sciences medical students. Methods This cross-sectional study was conducted among 100 preclinical and 100 clinical sciences medical students. Isolation, identification, and antibiotic susceptibility testing of the isolates were performed by standard microbiological techniques. Results The nasal colonization by S. aureus and MRSA was 35% (70/200) and 19.5% (39/200), respectively. The nasal colonization by S. aureus and MRSA was significantly higher among clinical sciences students as compared to preclinical sciences students. Pharyngeal colonization by Haemophilus influenzae was significantly higher among clinical sciences students as compared to preclinical sciences students. The pharyngeal colonization by beta-hemolytic streptococci (nongroup A) was higher among preclinical sciences students than clinical sciences students. Conclusion The nasal colonization by S. aureus and MRSA was higher among clinical sciences students. Pharyngeal colonization by potential bacterial pathogens was higher among clinical sciences students than preclinical students. Periodic screening of MRSA and potential throat pathogens of clinical sciences students and may reduce the incidences of nosocomial transmission of pathogens.
Hafnia alvei one of the members of family Enterobacteriaceae are related to infections that are uncommon. Believed to be an opportunistic pathogen, it is responsible for causing invasive infections in debilitated elderly people with underlying illnesses. Hafnia alvei infections, however, are extremely rare among immunocompetent neonates. We hereby, report a case of Hafnia alvei bacteremia following bronchopneumonia in an eleven month old male child who was apparently healthy and immunocompetent. To the best of our knowledge, this case report is the first of its kind from Nepal.
Listeria. monocytogenes may cause meningitis, meningoencephalitis, brain abscess, pyogenic arthritis, osteomyelitis, and liver abscesses in the pediatric age group. Listeria meningitis, though common in infants, is extremely infrequent in immunocompetent children. The course of meningoencephalitis by Listeria is often severe and even fatal, especially in those having an underlying predisposing condition. We hereby report a case of meningitis due to L. monocytogenes in a previously healthy three year old female child. The case is reported for its rarity and fatal outcome in an immunocompetent child. A three year old female child was referred to Manipal Teaching Hospital, a tertiary care hospital in western Nepal after three days of treatment with IV ceftriaxone for fever, excessive sleepiness and cough. The child had developed all features of meningitis and was kept on IV ceftriaxone and vancomycin. Culture of her CSF and blood grew L. monocytogenes. However, before the culture and sensitivity report for switch over of the antibiotics could be available, the child died in spite of supportive management for seizures, hypoxia and hypotension. This was an uncommon pathogen to cause meningitis considering the age of the child and her immune status. Thus there should always be a high index of suspicion among the clinicians and microbiologists for such rare pathogens which might be intrinsically resistant to many empirically administered antibiotics.
Multiple myeloma (MM) is a clonal proliferation of plasma cells in the bone marrow resulting in the production of paraproteins. It is more common in elderly adults and presents with nonspecific symptoms like bone pain, pathological fracture, fatigue, and signs of hypercalcemia. Peripheral neuropathy is an atypical presentation. We present a rare case of vasculitic neuropathy (VN) who was also diagnosed with MM at the same time. Nerve conduction study and biopsy showed findings suggestive of demyelinating VN. His serum protein electrophoresis and bone marrow aspirate were consistent with MM. The association between these two conditions remains understudied. So far there is no strong evidence suggesting an association between MM and VN. If VN was just coincidental or a presenting symptom of MM remains a question and warrants further studies.
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