Many countries in the world are experiencing a recent surge in COVID‐19 cases. This is mainly attributed to the emergence of new SARS‐CoV‐2 variants. Genome sequencing is the only means to detect the evolving virus mutants and emerging variants. Cycle threshold values have an inverse relationship with viral load and lower Ct values are also found to be associated with increased infectivity. In this study, we propose to use Ct values as an early indicator for upcoming COVID‐19 waves. A retrospective cross‐sectional study was carried out to analyze the Ct values of positive samples reported during the first wave and second wave (April 2020–May 2021). Median Ct values of confirmatory genes were taken into consideration for comparison. Ct values below 25, >25–30, and >30 were categorized as high, moderate, and low viral load respectively. Our study found a significantly higher proportion of positive samples with a low Ct value (<25) across age groups and gender during the second wave of the COVID‐19 pandemic. A higher proportion of positive samples with a low Ct value (high viral load) may act as an early indicator of an upcoming surge.
INTRODUCTIONPseudomonas aeruginosa is an aerobic, motile, nutritionally versatile, gram negative bacteria. It is ubiquitous, human opportunistic pathogen and has implications on morbidity, mortality and healthcare costs both in hospitals and in the community.1 Infections caused by P. aeruginosa are frequently life-threatening and difficult to treat causing increased stay in hospital and even increased morbidity and mortality as it exhibits intrinsically high resistance to many antimicrobials and the development of multi-drug resistance in health care settings.2,3 Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum or to each other. They are embedded in a matrix of extracellular polymeric substances (EPS) they have produced, and exhibit an altered phenotype with respect to growth rate and gene transcription.4 Within a biofilm, bacteria communicate with each other by production of chemotactic particles or ABSTRACT Background: Pseudomonas aeruginosa is an ubiquitous pathogen capable of surviving in a variety of environmental conditions. It is increasingly gaining importance as a multidrug resistant nosocomial pathogen. Biofilm acts as a barrier, reducing the penetration of these drugs and consequently, preventing them from exercising their actions. The aim of this study is to isolate and identify Pseudomonas aeruginosa from various clinical specimen and to find out their production of biofilms and their correlation with antibiotic susceptibility pattern. Methods: All Pseudomonas aeruginosa over a period of 1 year were isolated and identified from clinical specimens and antibiotic susceptibility test was done following standard operative procedures. Biofilm detection was done by Congo Red Agar method (CRA). Results: 134 isolates of Pseudomonas aeruginosa was isolated. Maximum isolates were isolated from sputum samples 55 (41%) and most were from wards 68 (51%) giving a probability of increased healthcare associated infections. Biofilm production by the isolates was seen in 39 (29%). All the biofilm producing isolates shows more resistant pattern in comparison to non-biofilm producers. 69% of Imipenem and 82% of Meropenem resistant isolates produce biofilm. All the P. aeruginosa including MDR and biofilm forming strains were sensitive to Colistin. Conclusions: Resistance to antimicrobial agents is the most important feature of biofilm infections. Ability of P. aeruginosa to form biofilms renders antibiotic treatments inefficient and therefore promotes chronic infectious diseases. As a result, infections caused by bacterial biofilms are persistent and very difficult to eradicate.
Background: Acinetobacter is an important opportunistic pathogen and is a common cause of hospital acquired infections. Acinetobacter infections are often extremely difficult to treat because of their widespread resistance to the major groups of antibiotics. The study was conducted to determine prevalence and antibiotic susceptibility pattern of Acinetobacter species isolated from various clinical samples.Methods: Clinical specimens over a period of 2yrs from May 2015 to April 2017 were collected from the patients attending the hospital. Acinetobacter species isolates were identified, and antibiotic susceptibility test was done following standard operative procedures.Results: From 9979 clinical specimens, 3715 were positive for significant bacterial growth of which 111 (2.9%) were culture positive for Acinetobacter spp. Among 111 isolates 109 (98.2%) isolates were Acinetobacter baumanni and 2 (1.8%) were Acinetobacter lwoffii. Maximum isolates were isolated from urine samples 36 (32.4%) and majority of the isolates were from wards (56.7%) giving a probability of increased hospital acquired infections. Maximum resistance was shown by cefipime (80.1%). Imipenem and Meropenem shows resistance of 25.3% and 29.7% respectively. ICU isolates showed extensive resistance in comparison to wards and OPD.Conclusions: Increasing trend of resistance pattern to a large range of antibiotics is a matter of concern. To avoid resistance, antibiotics should be used judiciously, and empirical therapy should be determined for each hospital according to the resistance rates of the hospital. Infection with MDR Acinetobacter species is independently associated with high mortality, emphasizing the need for aggressive infection control strategies.
The unprecedented demand for testing for the ongoing coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to an acute shortage and limited availability of test reagents for which pooling of samples has been recommended in areas with low prevalence. Con-
Introduction The COVID-19 pandemic has shaken the entire world ever since its emergence in March 2020. The disease manifestation of COVID-19 has been more severe, with a high degree of mortality in the elderly than in the young population. The cycle threshold (Ct ) value obtained in the real-time polymerase chain reaction (RT-PCR) has been used as the surrogate marker of viral load. Therefore, assessing Ct value and clinical status among different age groups with SARS-CoV-2 infection is required to understand the viral kinetics and to assess the transmission potential of that particular age group. Purpose The aim of this study was to compare the viral load and clinical status among different age groups with COVID-19 infection. Methods and materials A retrospective cross-sectional study was carried out to analyze the Ct values of SARS-CoV-2 positive samples reported from April 2020 till May 2021. The results of 13,820 RT-PCR (reverse transcriptase-polymerase chain reaction) positive samples were included for analysis of Ct values. Ct values of confirmatory genes were taken into consideration, and Ct values below 25, >25 to 30, and >30 were categorized as high, moderate, and low viral load, respectively. Age group was stratified into ≤18 years (young), 18-60 years (adult), and >60 years (elderly). The data were analyzed using SPSS Windows Version 25.0. Results The mean Ct values were 27.9, 26, and 26.2 in the young, adult, and elderly age groups, respectively. The mean Ct values of young patients were significantly higher as compared to adult and elderly patients (p<0.05). The percentage of high viral load (Ct<25) was found to be significantly higher in adults and elderly (44.6% & 43.7%) as compared to young (32.2%) (p<0.001). Majority of the COVID-19 positive cases younger than 18 years (75.9%) were asymptomatic as compared to 64.5% and 59.7% in the adult and elderly age groups, respectively. Conclusion This study observed a significantly high proportion of viral load in the adult and elderly population, which plays a substantial contribution to SARS-CoV-2 transmission, whereas the majority of the young population being asymptomatic plays a major role as silent transmitters. The study reemphasizes the need for strict adherence to COVID-appropriate behaviors.
The rapidly mutating Omicron SARS-CoV-2 variant has replaced the previous dominant SARS-CoV-2 variants like alpha, and delta resulting in the amplification of coronavirus disease 2019 (COVID-19) cases. The present study was conducted to compare the clinical profile and vaccination status in patients infected with Omicron and non-Omicron SARS-CoV-2 variants. MethodsAll patients who tested positive for coronavirus disease 2019 (COVID-19) during the study period (January 2022 to February 2022) were further tested for detection of SARS-CoV-2 Omicron variant by using Omisure kit (TATA MD CHECK RT-PCR, TATA MEDICAL AND DIAGNOSTICS LIMITED, Tamil Nadu, INDIA). Clinicodemographic factors and vaccination status were compared between both Omicron and non-Omicron groups. ResultsA total of 1,722 patients who tested positive for COVID-19 were included in the study, of which 656 (38.1%) were Omicron and 1,066 (61.9%) were non-Omicron SARS-CoV-2 variants. Blood group and vaccination status were the major predictors for Omicron. The proportion of male patients was 58.4% in the Omicron group and 57.9% in the non-Omicron group. Maximum cases (86.2%) belonged to >18-60 years age group, 7.3% to >60 years age group, and least to 0-18 years (6.5%). The average age of the study participants was 35.4 ± 14.5 years. Vaccinated participants had less chance of having Omicron than the unvaccinated participants (p-value -0.003). Fever and loss of smell were found to be significantly associated with the non-Omicron SARS-CoV-2 variant. (p-value < 0.05). ConclusionThe present study reflects that the clinical course of the disease is milder in Omicron as compared to the non-Omicron variant. However rapid rise in cases can badly affect the healthcare system demanding good preparedness to tackle all the predicaments. Good Vaccination coverage should be of utmost priority irrespective of the variant type.
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