No abstract

No abstract

No abstract

Background: As orthopaedic implants are being increasingly used, managing the implantassociated infections has become a challenge. The aim of this study was to evaluate the bacteriological profile with antibiotic susceptibility patterns and biofilm detection in orthopaedic implant-associated infections. Study Design: Cross-sectional prospective. Place and Duration of Study:The study was conducted in the department of Microbiology and Orthopaedics, Sher-i-Kashmir Institute of Medical Sciences (J&K) India, a tertiary care institute from August 2014 to February 2016. Methods: The study was conducted on 100 patients having orthopaedic implant infections.

Objective: The burden of healthcare-associated infections (HAIs) is higher in low- and middle-income countries, but HAIs are often missed because surveillance is not conducted. Here, we describe the identification of and response to a cluster of Burkholderia cepacia complex (BCC) bloodstream infections (BSIs) associated with high mortality in a surgical ICU (SICU) that joined an HAI surveillance network. Setting: A 780-bed, tertiary-level, public teaching hospital in northern India. Methods: After detecting a cluster of BCC in the SICU, cases were identified by reviewing laboratory registers and automated identification and susceptibility testing outputs. Sociodemographic details, clinical records, and potential exposure histories were collected, and a self-appraisal of infection prevention and control (IPC) practices using assessment tools from the World Health Organization and the US Centers for Disease Control and Prevention was conducted. Training and feedback were provided to hospital staff. Environmental samples were collected from high-touch surfaces, intravenous medications, saline, and mouthwash. Results: Between October 2017 and October 2018, 183 BCC BSI cases were identified. Case records were available for 121 case patients. Of these 121 cases, 91 (75%) were male, the median age was 35 years, and 57 (47%) died. IPC scores were low in the areas of technical guidelines, human resources, and monitoring and evaluation. Of the 30 environmental samples, 4 grew BCC. A single source of the outbreak was not identified. Conclusions: Implementing standardized HAI surveillance in a low-resource setting detected an ongoing Burkholderia cepacia outbreak. The outbreak investigation and use of a multimodal approach reduced incident cases and informed changes in IPC practices.

No abstract

Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. It is an uncommon cause of UTI and sepsis but should be suspected in patients with predisposing factors. The condition has high mortalty and warrants early recognition and treatment. We present here a case of UTI with sepsis by Providencia rettgeri in a young female during post partum period. She had recently delivered a male baby and was catheterized for 10 days. Patient received intravenous antibiotis and recovered completely. …………………………………………………………………………………………………….... Introduction:-The genus Providencia is a member of theEnterobacteriaceae family which commonly dwells in soil, water, and sewage [1]. Human isolates of Providencia species have been recovered from urine, throat, perineum, axilla, stool, blood and wound specimens. The organism is usually isolated from genitourinary and gastrointestinal sources (urine, faeces and perineum), causing diarrhoea and urogenital symptoms .Providencia rettgeri (P. rettgeri) is a motile, gram-negative rod shaped organism and a member of the Enterobacteriaceaefamily [1]. It is inherently resistant to many antibiotics and thus early identification and treatment is needed to treat this infection. We present a case of urinary tract infection during post partum period in a female who had recently delivered and was catheterized.Case report:-A 24 year old young female presented to the OPD with history of dysuria and fever . The fever was high grade and intermittent type. The female had delivered a male baby ten days earlier by cesarian section she had been catheterised for 10 days . General physical examination was normal except for elevated temperature . Heamogram revealed TLC of 12000 . Chest X ray was normal. Urine was sent for culture and sensitivity in our lab. The urine was inoculated on HiCrome agar using a calibrated loop. Inoculated plates were incubated at 35 degree C for 24 hours. Next day plates were examined for colony morphology.Gram smear showed short rod shaped cells ,0.5-0.8 µm. colonies were glossy, white 2-3mm. Providencia rettgeri Was isolated from urine and blood (figure 1).culture revealed that the isolate was resistant to ampicillin, ampicillin/sulbactam, cefazolin, gentamicin, and trimethoprim/ sulfamethoxazole. It was found to be susceptible to ceftriaxone, cefepime, ciprofloxacin, and piperacillin/tazobactam The patient was admitted put on iv ceftrioxone and had complete recovery.

Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.Funding: NoneDisclosures: None