Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmi... more Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG a...
IP International Journal of Medical Microbiology and Tropical Diseases, 2021
Bacterial respiratory infections are most commonly causes of illness for all age group patients i... more Bacterial respiratory infections are most commonly causes of illness for all age group patients in ICU. Most of the patients suffer from urosepsis, postoperative disease and lower respiratory infection when admitted in ICU’s. The main purpose of this study is control in ICU’s infection & determine their antibiotic sensitivity pattern for better treatment of patients. Bacteriological profile and their antibiogram from endotracheal aspirate and bronchoalveolar lavage fluid samples from intensive care unit patients.We performed manual culture of Endotracheal aspirate & BAL fluid specimens collected from ICU’s patients. Samples were cultured on Blood agar and Mac-Conkey agar then incubated at 37C for 24 hours. Any growth were further confirmed by Gram stain and appropriate biochemical tests, and then Antibiotic sensitivity test was done. Among the 123 mechanically ventilated patients and 68 of them developed positive samples. In this study 55.3% (68) pathogenic isolates, 4.1% (5) were n...
Indian Journal of Public Health Research and Development, 2019
Background: Majority of the laboratory error occurs in the pre-analytical phase which affects the... more Background: Majority of the laboratory error occurs in the pre-analytical phase which affects the diagnostic accuracy. This study was done to examine the frequency of pre-analytical errors classify them and to identify quality indicators which will further help in minimizing the occurrence of errors. Method:A two-month study was done to identify the pre-analytical errors occurred in the microbiology laboratory from February 15th 2016 to April 15th 2016 (n= 42079). We documented the types and frequency of errors. Result:Improperly/Incompletely filled request form was the major pre-analytical error observed. The total percentage of pre-analytical errors observed was 0.9% Conclusion:Pre-analytical phase in clinical laboratories should be continuously monitored and should be avoided by proper application of quality control.
INTRODUCTION Anaerobic bacteria which constitute a significant proportion of the normal microbiot... more INTRODUCTION Anaerobic bacteria which constitute a significant proportion of the normal microbiota also cause variety of infections involving various anatomic sites. Considering the tedious culture techniques with longer turnaround time, anaerobic cultures are usually neglected by clinicians and microbiologists. AIM To study the frequency of isolation of different anaerobic bacteria from various clinical specimens. MATERIALS AND METHODS A retrospective study to analyse the frequency of isolation of different anaerobic bacteria, was conducted over a period of five years from 2011 to 2015 including various clinical specimens submitted to anaerobic division of Microbiology laboratory. Anaerobic bacteria were isolated and identified following standard bacteriological techniques. RESULTS Pathogenic anaerobes (n=336) were isolated from 278 (12.48%) of overall 2227 specimens processed with an average yield of 1.2 isolates. Anaerobes were isolated as polymicrobial flora with or without aerobic bacterial pathogens in 159 (57.2%) patients. Anaerobic Gram-negative bacilli (140, 41.7%) were the predominant isolates. B. fragilis group (67, 19.9%) were the most commonly isolated anaerobic pathogens. Anaerobes were predominantly isolated from deep seated abscess (23.9%). CONCLUSION Pathogenic anaerobes were isolated from various infection sites. Unless culture and susceptibility tests are performed as a routine, true magnitude of antimicrobial resistance among anaerobic pathogens will not be known. Knowledge of the distribution of these organisms may assist in the selection of appropriate empirical therapy for anaerobic infections.
Background: Microorganisms are known to be involved in the formation of biofilm. These biofilms a... more Background: Microorganisms are known to be involved in the formation of biofilm. These biofilms are often seen in chronic wound infections, surgical site infections, implants etc., These are capable of causing recalcitrant infections and most of them are also known to possess high antibiotic resistance. Objectives: This study was conducted to detect the biofilm formation in bacterial isolates from chronic wound infections. Materials and Methods: In the present study, ninety two isolates from chronic wound infections were identified by MALDI-TOF-MS (bioMerieux) and VITEK-2-MS (bioMerieux). These isolates were further screened for biofilm formation by three methods i. e., Tissue Culture Plate method (TCP), Tube Method (TM) and Congo Red Agar (CRA) method. Impact of biofilm production was correlated with the antibiotic resistant pattern. Statistical Analysis: Statistical analysis was done for all three methods considering TCP as Gold Standard and parameters like senitivity and specificity of TM i.e. 47.2 and 100% respectively. Results: Out of 92 isolates, biofilm formation was seen in 72 isolates (78.2%) by TCP method. 64 isolates were strong biofilm producers, 8 isolates were moderate biofilm producers and 20 isolates were nonbiofilm producing. High prevalence of biofilm formation was seen in nonhealing ulcers infected with Staphylococcus aureus followed by Klebsiella pneumoniae. Conclusion: Among three screening methods used for detection of biofilm production, TCP method is considered to be a standard and most reliable for screening of biofilm formation in comparison to TM and CRA.
Journal of Pure and Applied Microbiology, Aug 19, 2022
Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of ... more Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of this study was to determine the drug resistance pattern among the NFGNB isolates causing respiratory tract infections (RTIs). A retrospective analysis of the antimicrobial susceptibility pattern of non-fermenters causing RTIs over four years (2016- 2019) was done and the change in drug resistance pattern was studied. A total of 653 cases were obtained that included 191 (29.2%) Moraxella catarrhalis, 283 (43.3%) Pseudomonas aeruginosa, and 132 (20.2%) Acinetobacter baumannii, 47 (7.2%) Stenotrophomonas maltophilia isolates. A higher resistance (82.6%) was observed for piperacillin-tazobactam and cefpirome, followed by imipenem (79.5%) and ciprofloxacin (76.5 %) for A. baumannii isolates. A sharp decline in resistance pattern for piperacillin, cefpirome, Imipenem and cefoperazone-sulbactam in 2019 and an increasing resistance to gentamycin and ciprofloxacin were noted. Among P. aeruginosa isolates, 94% aztreonam and 83.4% cefoperazone-sulbactam resistance were detected. There was an increased resistance for cefpirome and piperacillin and a decreased resistance for Imipenem was recorded in 2019. In cases of M. catarrhalis, 22.51% of isolates were resistant to ciprofloxacin, followed by erythromycin (18.32%) and tetracycline (17.80 %). S. maltophilia showed a 100% sensitivity for co-trimoxazole and 2.1% resistance for ciprofloxacin. A constantly changing antibiotic-resistant pattern of non-fermenters compels for a continuous update of drug-resistant trends through a longitudinal surveillance program in different geographical areas.
Objective: Aetiological diagnosis can significantly impact the clinical management and outcome of... more Objective: Aetiological diagnosis can significantly impact the clinical management and outcome of acute lower respiratory tract infections (LRTI) in children. There is a paucity of data on etiological agents of acute LRTI among children in Karnataka, especially in Udupi district. Present study provides an insight into the pathogens associated with acute LRTI among children in Udupi district of south coastal Karnataka. Methods: A cross sectional study was performed at a rural hospital in south coastal Karnataka, A total of 50 children clinically diagnosed for acute LRTI and admitted in paediatric ward were enrolled for the study. Nasopharyngeal/throat swab specimens were collected, and nucleic acid was extracted, and Multiplex real-time PCR was performed for detection of bacterial and viral aetiology. Results: S. pneumoniae was detected in 16% (8/50), followed by Respiratory syncytial virus (RSV) 14% (7/50), H. influenzae 8 % (4/50) and M. pneumoniae 2% (1/50). Mixed infection was detected in 28% (14/50) of children. S. pneumoniae and H. influenzae was the most prevalent co-infection and was detected in 10% (5/50) followed by H. Influenzae and RSV (4%, 2/50) co-infection. Conclusion: S. pneumoniae and RSV were the most predominant bacterial and viral pathogens respectively associated with LRTIs among paediatric population in present study. Further we found very high number of cases with mixed infections which signifies the urgent need of much elaborate studies for elucidating the clinical significance of these infections as well as for better understanding of epidemiology of LRTI among children in this region.
Introduction: Members of Bacteroides fragilis group are the most frequently isolated anaerobic pa... more Introduction: Members of Bacteroides fragilis group are the most frequently isolated anaerobic pathogens in the clinical laboratory from diverse infection sites. The objective of this study was to characterize B. fragilis isolates from various clinical specimens, to analyze their susceptibility profile toward most common anti-anaerobic antimicrobials, and to study the frequency of nim gene determining resistance to nitroimidazoles. Methods: Specimens processed for anaerobic culture between January 2013 and December 2015 were analyzed. Isolates of B. fragilis group were identified and speciated by mass spectrometry. β-lactamase production was detected using nitrocefin disks. Agar dilution and antimicrobial gradient diffusion methods were performed to study their susceptibility profile. The isolates were screened for nim gene by conventional gel-based polymerase chain reaction. Results: A total of 57 isolates of B. fragilis group were studied. The commonly isolated species was B. fragilis (73.7%), followed by Bacteroides thetaiotaomicron (8.8%), Bacteroides vulgatus (8.8%), and others. Most of the isolates were recovered from deep-seated abscesses (47.4%). All isolates were found to be β-lactamase producers. Metronidazole (Mtz) resistance was observed in 4 (7%) isolates. Higher rate of resistance was observed toward clindamycin (31.6%). None of the isolates tested were found resistant to chloramphenicol, piperacillin-tazobactam, and meropenem. nim genes were present in 4 (11.4%) B. fragilis isolates (n = 35). Conclusions: Resistance to the most commonly used empirical anti-anaerobic drugs including Mtz was noted in the isolates of B. fragilis group. Routine anaerobic cultures when indicated and continual surveillance of antimicrobial resistance among the anaerobic bacterial pathogens is essential.
Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmi... more Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG a...
IP International Journal of Medical Microbiology and Tropical Diseases, 2021
Bacterial respiratory infections are most commonly causes of illness for all age group patients i... more Bacterial respiratory infections are most commonly causes of illness for all age group patients in ICU. Most of the patients suffer from urosepsis, postoperative disease and lower respiratory infection when admitted in ICU’s. The main purpose of this study is control in ICU’s infection & determine their antibiotic sensitivity pattern for better treatment of patients. Bacteriological profile and their antibiogram from endotracheal aspirate and bronchoalveolar lavage fluid samples from intensive care unit patients.We performed manual culture of Endotracheal aspirate & BAL fluid specimens collected from ICU’s patients. Samples were cultured on Blood agar and Mac-Conkey agar then incubated at 37C for 24 hours. Any growth were further confirmed by Gram stain and appropriate biochemical tests, and then Antibiotic sensitivity test was done. Among the 123 mechanically ventilated patients and 68 of them developed positive samples. In this study 55.3% (68) pathogenic isolates, 4.1% (5) were n...
Indian Journal of Public Health Research and Development, 2019
Background: Majority of the laboratory error occurs in the pre-analytical phase which affects the... more Background: Majority of the laboratory error occurs in the pre-analytical phase which affects the diagnostic accuracy. This study was done to examine the frequency of pre-analytical errors classify them and to identify quality indicators which will further help in minimizing the occurrence of errors. Method:A two-month study was done to identify the pre-analytical errors occurred in the microbiology laboratory from February 15th 2016 to April 15th 2016 (n= 42079). We documented the types and frequency of errors. Result:Improperly/Incompletely filled request form was the major pre-analytical error observed. The total percentage of pre-analytical errors observed was 0.9% Conclusion:Pre-analytical phase in clinical laboratories should be continuously monitored and should be avoided by proper application of quality control.
INTRODUCTION Anaerobic bacteria which constitute a significant proportion of the normal microbiot... more INTRODUCTION Anaerobic bacteria which constitute a significant proportion of the normal microbiota also cause variety of infections involving various anatomic sites. Considering the tedious culture techniques with longer turnaround time, anaerobic cultures are usually neglected by clinicians and microbiologists. AIM To study the frequency of isolation of different anaerobic bacteria from various clinical specimens. MATERIALS AND METHODS A retrospective study to analyse the frequency of isolation of different anaerobic bacteria, was conducted over a period of five years from 2011 to 2015 including various clinical specimens submitted to anaerobic division of Microbiology laboratory. Anaerobic bacteria were isolated and identified following standard bacteriological techniques. RESULTS Pathogenic anaerobes (n=336) were isolated from 278 (12.48%) of overall 2227 specimens processed with an average yield of 1.2 isolates. Anaerobes were isolated as polymicrobial flora with or without aerobic bacterial pathogens in 159 (57.2%) patients. Anaerobic Gram-negative bacilli (140, 41.7%) were the predominant isolates. B. fragilis group (67, 19.9%) were the most commonly isolated anaerobic pathogens. Anaerobes were predominantly isolated from deep seated abscess (23.9%). CONCLUSION Pathogenic anaerobes were isolated from various infection sites. Unless culture and susceptibility tests are performed as a routine, true magnitude of antimicrobial resistance among anaerobic pathogens will not be known. Knowledge of the distribution of these organisms may assist in the selection of appropriate empirical therapy for anaerobic infections.
Background: Microorganisms are known to be involved in the formation of biofilm. These biofilms a... more Background: Microorganisms are known to be involved in the formation of biofilm. These biofilms are often seen in chronic wound infections, surgical site infections, implants etc., These are capable of causing recalcitrant infections and most of them are also known to possess high antibiotic resistance. Objectives: This study was conducted to detect the biofilm formation in bacterial isolates from chronic wound infections. Materials and Methods: In the present study, ninety two isolates from chronic wound infections were identified by MALDI-TOF-MS (bioMerieux) and VITEK-2-MS (bioMerieux). These isolates were further screened for biofilm formation by three methods i. e., Tissue Culture Plate method (TCP), Tube Method (TM) and Congo Red Agar (CRA) method. Impact of biofilm production was correlated with the antibiotic resistant pattern. Statistical Analysis: Statistical analysis was done for all three methods considering TCP as Gold Standard and parameters like senitivity and specificity of TM i.e. 47.2 and 100% respectively. Results: Out of 92 isolates, biofilm formation was seen in 72 isolates (78.2%) by TCP method. 64 isolates were strong biofilm producers, 8 isolates were moderate biofilm producers and 20 isolates were nonbiofilm producing. High prevalence of biofilm formation was seen in nonhealing ulcers infected with Staphylococcus aureus followed by Klebsiella pneumoniae. Conclusion: Among three screening methods used for detection of biofilm production, TCP method is considered to be a standard and most reliable for screening of biofilm formation in comparison to TM and CRA.
Journal of Pure and Applied Microbiology, Aug 19, 2022
Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of ... more Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of this study was to determine the drug resistance pattern among the NFGNB isolates causing respiratory tract infections (RTIs). A retrospective analysis of the antimicrobial susceptibility pattern of non-fermenters causing RTIs over four years (2016- 2019) was done and the change in drug resistance pattern was studied. A total of 653 cases were obtained that included 191 (29.2%) Moraxella catarrhalis, 283 (43.3%) Pseudomonas aeruginosa, and 132 (20.2%) Acinetobacter baumannii, 47 (7.2%) Stenotrophomonas maltophilia isolates. A higher resistance (82.6%) was observed for piperacillin-tazobactam and cefpirome, followed by imipenem (79.5%) and ciprofloxacin (76.5 %) for A. baumannii isolates. A sharp decline in resistance pattern for piperacillin, cefpirome, Imipenem and cefoperazone-sulbactam in 2019 and an increasing resistance to gentamycin and ciprofloxacin were noted. Among P. aeruginosa isolates, 94% aztreonam and 83.4% cefoperazone-sulbactam resistance were detected. There was an increased resistance for cefpirome and piperacillin and a decreased resistance for Imipenem was recorded in 2019. In cases of M. catarrhalis, 22.51% of isolates were resistant to ciprofloxacin, followed by erythromycin (18.32%) and tetracycline (17.80 %). S. maltophilia showed a 100% sensitivity for co-trimoxazole and 2.1% resistance for ciprofloxacin. A constantly changing antibiotic-resistant pattern of non-fermenters compels for a continuous update of drug-resistant trends through a longitudinal surveillance program in different geographical areas.
Objective: Aetiological diagnosis can significantly impact the clinical management and outcome of... more Objective: Aetiological diagnosis can significantly impact the clinical management and outcome of acute lower respiratory tract infections (LRTI) in children. There is a paucity of data on etiological agents of acute LRTI among children in Karnataka, especially in Udupi district. Present study provides an insight into the pathogens associated with acute LRTI among children in Udupi district of south coastal Karnataka. Methods: A cross sectional study was performed at a rural hospital in south coastal Karnataka, A total of 50 children clinically diagnosed for acute LRTI and admitted in paediatric ward were enrolled for the study. Nasopharyngeal/throat swab specimens were collected, and nucleic acid was extracted, and Multiplex real-time PCR was performed for detection of bacterial and viral aetiology. Results: S. pneumoniae was detected in 16% (8/50), followed by Respiratory syncytial virus (RSV) 14% (7/50), H. influenzae 8 % (4/50) and M. pneumoniae 2% (1/50). Mixed infection was detected in 28% (14/50) of children. S. pneumoniae and H. influenzae was the most prevalent co-infection and was detected in 10% (5/50) followed by H. Influenzae and RSV (4%, 2/50) co-infection. Conclusion: S. pneumoniae and RSV were the most predominant bacterial and viral pathogens respectively associated with LRTIs among paediatric population in present study. Further we found very high number of cases with mixed infections which signifies the urgent need of much elaborate studies for elucidating the clinical significance of these infections as well as for better understanding of epidemiology of LRTI among children in this region.
Introduction: Members of Bacteroides fragilis group are the most frequently isolated anaerobic pa... more Introduction: Members of Bacteroides fragilis group are the most frequently isolated anaerobic pathogens in the clinical laboratory from diverse infection sites. The objective of this study was to characterize B. fragilis isolates from various clinical specimens, to analyze their susceptibility profile toward most common anti-anaerobic antimicrobials, and to study the frequency of nim gene determining resistance to nitroimidazoles. Methods: Specimens processed for anaerobic culture between January 2013 and December 2015 were analyzed. Isolates of B. fragilis group were identified and speciated by mass spectrometry. β-lactamase production was detected using nitrocefin disks. Agar dilution and antimicrobial gradient diffusion methods were performed to study their susceptibility profile. The isolates were screened for nim gene by conventional gel-based polymerase chain reaction. Results: A total of 57 isolates of B. fragilis group were studied. The commonly isolated species was B. fragilis (73.7%), followed by Bacteroides thetaiotaomicron (8.8%), Bacteroides vulgatus (8.8%), and others. Most of the isolates were recovered from deep-seated abscesses (47.4%). All isolates were found to be β-lactamase producers. Metronidazole (Mtz) resistance was observed in 4 (7%) isolates. Higher rate of resistance was observed toward clindamycin (31.6%). None of the isolates tested were found resistant to chloramphenicol, piperacillin-tazobactam, and meropenem. nim genes were present in 4 (11.4%) B. fragilis isolates (n = 35). Conclusions: Resistance to the most commonly used empirical anti-anaerobic drugs including Mtz was noted in the isolates of B. fragilis group. Routine anaerobic cultures when indicated and continual surveillance of antimicrobial resistance among the anaerobic bacterial pathogens is essential.
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Papers by Kiran Chawla