Objective: To assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of time (2013–2017) with a special emphasis on ESBL-producing E. coli. Methods: This retrospective study was carried out in the Department of Microbiology, Kasturba Medical College, Ambedkar Circle, Mangalore. A retrospective time bound analysis of 500 samples/year was performed. The urine samples received from the suspected cases of urinary tract infection (UTI) were processed. Wet mount examinations of urine samples were done. The urine culture was done by a semi-quantitative method on Mac Conkey’s agar, Cysteine Lactose Electrolyte Deficient (CLED) medium, and UTI Chrome agar. Culture plates were incubated for 18–24 hours at 37°C. Urine samples with a colony count of ≥10 5 CFU/ml were considered significant. The uropathogens were identified by their biochemical reactions. The antibiotic susceptibility testing (AST) was carried out using a Vitek Compact 2 system and Modified Kirby Bauer disc diffusion method. Results: Antibiotic resistance of Uropathogenic E.coli to cephalosporins increased from 51 to 58%, Cotrimoxazole: 52 to 59%, Piperacillin tazobactam 9.4 to 23%, Carbapenems 0 to 5.9%. Antibiotic resistance to netilmicin has reduced from 8 to 6.5%, and norfloxacin 59 to 48%. The rates of ESBL production have increased from 45.2 to 59.6% in the 5 years. Conclusion: The increasing antibiotic resistance trends in UTI patients indicate that it is vitally important to use them conservatively. Proper guidelines, management of antibiotic usage, and constant information to the clinicians regarding the sensitivity pattern can help to prevent drug resistance.

Introduction The overall cure rate of childhood cancers is above 79% in the developed world, whereas in the developing world, like in India, it is around 50%. It is vital to know the routes of presentation and factors affecting the presentation of childhood cancers in primary, secondary, and tertiary care to design a better survival strategy in childhood cancer. Objective The aim of this study was to know the factors affecting the time to diagnosis and time to treatment in children with cancers in a single center in South India. Materials and Methods It was a retrospective cohort study of children diagnosed with cancer between January 1, 2014 and December 31, 2016 at the pediatric oncology unit, KMC Hospital Mangalore, India. The patient interval, time to diagnosis, patient's family, economic background, parental education, and referral pattern were recorded, and its impact on the time taken to diagnosis was studied. The data was analyzed using SPSS 20.0 software. Results Out of 111 children, 72 were boys (64.8%). Fifty-one (46%) children belonged to the less than 5-year age group. The most common cancer was acute lymphoblastic leukemia, diagnosed in 50% (56/111) children, followed by acute myeloid leukemia in 14/111(12.6%), brain tumors in 9 (8.1%), and neuroblastoma in 10 (9%) children. The median patient interval/patient delay was 14 days (1–90 days), referral interval was 14 days (1–150 days), and overall time to diagnosis was 41 days (1–194 days). The first contact was the pediatrician in 86/111 (77.4%). Sixty-four percent (71/111) referral came from a secondary care hospital, and the remaining from the outpatient clinics. There was no difference in sex and patient interval (p = 0.278) and overall time to diagnosis (p = 0.4169), age (p = 0.041), mother’s education (p = 0.034), and type of cancer (p = 0.013) were three critical factors that determined the time to diagnosis. Conclusion Majority of the children diagnosed with cancer presented via referral from pediatricians. An equal number of them were referred to as routine and emergency patients. Age, mother's education, and type of cancers were the crucial factors associated with the overall time taken to diagnosis.

Hand, foot, and mouth disease (HFMD) is a common childhood infection caused by human enteroviruses and is clinically characterised by fever with vesicular rash on the hands, feet, and mouth. While enterovirus A71 (EV-A71) and coxsackievirus A16 (CVA16) were the major etiological agents of HFMD in India earlier, the data on recently circulating enteroviruses associated with HFMD are sparse. Here, we describe the molecular epidemiology of enteroviruses associated with HFMD in South India from 2015 to 2017. We used archived enterovirus real-time reverse transcription (RT) PCR-positive vesicle swab and/or throat swab specimens from clinically suspected HFMD cases collected from four secondary-care hospitals in South India between July 2015 and December 2017. PCR amplification and sequencing were done based on the 5’VP1, 3’VP1, VP2, or 5´NCR regions to identify enterovirus types. Genetic diversity among enteroviruses was inferred by phylogenetic analysis. Of the 107 enterovirus RNA real-time RT-PCR-positive HFMD cases, 69 (64%) were typed as CVA6, 16 (15%) were CVA16, and one (1%) was CVA10, whereas in 21 (20%) cases, the virus was not typeable by any of the methods used in the study. The majority of HFMD cases (89, 83%) were in children less than five years old, while 11 (10.3%) were in adults. 5’VP1 yielded the maximum number of enteroviruses genotyped, and phylogenetic analysis showed that the CVA6 strains belonged to subclade D3, while the subclades of CVA16 and CVA10 were B1c and D, respectively. The predominant etiological agent of HFMD in South India during 2015-2017 was CVA6, followed by CVA16 and CVA10. Supplementary Information The online version contains supplementary material available at 10.1007/s00705-022-05561-0.

No abstract