Inclusion of NS1 in the diagnosis of dengue increases the detection rate significantly. In cases of fever, thrombocytopenia is more consistently found in dengue positive rather than dengue negative subjects. It correlates well when NS1 and IgM are detected simultaneously.
Context:Central venous catheter-related bloodstream infection (CRBSI) is associated with high rates of morbidity and mortality in critically ill patients.Aims:This study was conducted to determine the incidence of central venous catheter-related infections (CRIs) and to identify the factors influencing it. So far, there are very few studies that have been conducted on CRBSI in the intensive care unit in India.Settings and Design:This was a prospective, observational study carried out in the medical intensive care unit (MICU) over a period of 1 year from January to December 2004.Materials and Methods:A total of 54 patients with indwelling central venous catheters of age group between 20 and 75 years were included. The catheters were cultured using the standard semiquantitative culture (SQC) method. Statistical analysis used SPSS-10 version statistical software.Results:A total of 54 CVC catheters with 319 catheter days were included in this study. Of 54 patients with CVCs studied for bacteriology, 39 (72.22%) catheters showed negative SQCs and also negative blood cultures. A total of 15 (27.77%) catheters were positive on SQC, of which 10 (18.52%) were with catheter-associated infection and four (7.41%) were with catheter-associated bacteremia; the remaining one was a probable catheter-associated bacteremia. CRIs were high among catheters that were kept in situ for more than 3 days and emergency procedures where two or more attempts were required for catheterization (P < 0.05). In multivariate analysis of covariance duration of catheter in situ for >3 days, inexperienced venupucturist, more number of attempts and emergency CVC were associated with more incidence of CVCBSIs, with P <0.02. The duration of catheter in situ was negatively correlated (-0.53) and number of attempts required to put CVC was positively correlated (+0.39) with incidence of CVCBSIs. Sixty-five percent of the isolates belonged to the CONS group (13/20). Staphylococcus epidermidis showed maximum susceptibility to amikacin, doxycycline and amoxycillin with clavulanic acid and was susceptible to vancomycin (100%). Klebsiella pneumoniae was 100% susceptible to amikacin and ciprofloxacin. Escherichia coli was susceptible to amikacin and cefotaxime.Conclusions:The overall incidence of CRI was 27.77% (15/54). Catheter-associated BSIs were 47.31 per 1000 catheter-days. CRI was low in the catheters inserted by the experienced venipuncturists, elective procedure and CVC kept in situ for ≤3 days. S. epidermidis was the most common isolate.
Gaps and hollow spaces at the implant abutment interface will act as a bacterial reservoir that may cause peri-implantitis. Hence, the sealing ability of O-ring (in addition to polysiloxane) and GapSeal (an antibacterial sealing gel) was evaluated. A total of 45 identical implant systems (ADIN Dental Implant Systems) were divided into 3 groups of 15 implants each: an unsealed group, a group sealed with O-rings, and a group sealed with GapSeal gel. The implant and abutment were gamma sterilized after assembly. Two implants from each group were randomly incubated in sterile brain heart infusion (BHI) broth tubes and checked for sterility. The remaining 13 implants were incubated in BHI broth inoculated with Enterococcus and incubated for 5 days. They were then removed from the tubes, dried aseptically, placed in 2% sodium hypochlorite solution for 30 minutes, and washed with sterile saline for 5 minutes. Next, the assembly was dried aseptically and put in sterile BHI broth tubes and incubated for 24 hours to check surface sterility. Keeping 2 implants as controls from each group, the remaining 11 implants were dismantled group-wise and placed in liquid BHI broth; the test tubes were then shaken thoroughly so that the broth would come in contact with all implant surfaces. The solution from this tube was poured on pre-prepared sterile agar plates and incubated for 24 hours. The colonies formed on the agar plate were then counted using a digital colony counter. The data thus obtained were subjected to statistical analysis by Kruskal-Wallis analysis of variance and Mann-Whitney U test. It was concluded that though microbial growth is seen in all the 3 groups, the least growth was seen in the GapSeal group followed by the O-ring group.
The findings of the study support the hypothesis that toothpaste containing salivary substitutes prevents dental biofilm formation and exhibits antimicrobial property when compared with a placebo dentifrice.
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