Background Blood group has been stated to be one of the risk factors associated with viral diseas... more Background Blood group has been stated to be one of the risk factors associated with viral diseases like dengue, hepatitis virus, Norwalk virus and even the coronavirus associated with 2003 severe acute respiratory syndrome (SARS) outbreak. In addition, anti-A antibodies in experimental models have been shown to inhibit the interaction between coronavirus and angiotensin converting enzyme (ACE) receptor of the host target cell, the major receptor involved in viral pathogenesis. Thus, several workers propose an association between ABO blood type and coronavirus disease- 2019 (COVID-19) disease in many previous studies. The present study was undertaken in the Eastern part of India in line with these authors to study the association of ABO blood group of patients with COVID susceptibility and severity. Methods This is a retrospective study over a period of 6 months from June 2020 to November 2020 where patients who underwent quantitative real-time polymerase chain reaction (qRT-PCR) te...
Various studies have documented the variation in the degree of these emotional studies in differe... more Various studies have documented the variation in the degree of these emotional studies in different stages of surgery. In many studies, anxiety during preoperative stage was significantly higher than their postoperative stage.[3] Major depressive disorder has been a frequent complication of surgery. Depression is a frequent cause of morbidity in surgery patients suffering from a wide range of conditions.[4]
The diagnostic evaluation of different enzymes associated to liver such as Alanine Amino Transfer... more The diagnostic evaluation of different enzymes associated to liver such as Alanine Amino Transferase(ALT), Aspartate Amino Transferase(AST) and Gamma Glutamyl Transferase(GGT) can give a easy follow through for detection of liver homeostasis. The hepatic diseases can be better evaluated by analyzing the serum levels of alanine and aspartate amino transferase and Alkaline Phospatase (ALP). The study includes serum level of enzymes of hepatic disorders such as alcoholic liver disease, hepatitis, and liver cirrhosis. The serum level of ALT, AST, GGT and ALP were analysed by their standardized methods . There was a significant relationship between ALT and GGT. Comparative elevation in the above discussed enzyme indicates the nature and degree of the hepatic damage.
In the present research program, polymer nanocomposites have been used as the drug carrier for de... more In the present research program, polymer nanocomposites have been used as the drug carrier for delivery systems of anticancer drug. Chitosan (CS) and sodium alginate (ALG) with different ratios were blended with different wt% of Cloisite 30B solution by solvent evaporation method. Cloisite 30B was incorporated in the formulation as a matrix material component which also plays the role of a co-emulsifier in the nanocomposite preparation. Curcumin with different concentrations were loaded with CS-ALG/ C 30B nanocomposites for studying the in-vitro drug delivery systems. Morphology and structure characterization of nanocomposites were investigated by X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM) and Fourier Transmission Infra Red Spectroscopy (FTIR) respectively. The drug release was studied by changing time, pH and drug concentrations. The kinetics of the drug release was studied in order to ascertain the type of release mechanism. Based on the diffusion as well as the k...
Random Amplified Polymorphic DNA analysis is an excellent tool as a biomarker in determining gene... more Random Amplified Polymorphic DNA analysis is an excellent tool as a biomarker in determining genetic purity and estimating genetic diversity in plant species. Seven species of Ficus genus that are locally available in Hyderabad such as Ficus benjamina, Ficus microcarpa, Ficus elastica, Ficus binnebdjkii, Ficus benghalensis, Ficus religiosa and Ficus carica. Those ficus cultivars were then analysed by using three oligonucletide primer Z13 (5’GACTAAGCCC 3’), Z17 (5’ CCTTCCCACT 3’) and Z18 (5’AGGGTCTGTG 3’). A total of 340 amplified fragments, in which 212 (62.4%) were polymorphic fragments. The number of polymorphic bands scored per primer ranged from 9 (primer Z13) to 25 (primer Z18). Sixty out of 340 RAPDPCR fragments were found to be useful as cultivar specific markers. Genetic similarities among the seven Ficus cultivars were estimated according to RAPD and cultivar distribution on the concensus tree according to banding pattern of RAPD. Results of combined data exhibited that Fic...
In recent times, precious metal nanoparticles (i.e., Gold Nanoclusters (AgNCs)) are extremely att... more In recent times, precious metal nanoparticles (i.e., Gold Nanoclusters (AgNCs)) are extremely attractive because of their high fluorescence, good photostability, non-toxicity, excellent biocompatibility and solubility. The biomimetic synthesis has become a promising green pathway to prepare nanomaterials. Over the past few decades, inorganic nanoparticles, whose structures exhibit significantly novel and improved physical, chemical, and biological properties, phenomena, and functionality due to their nanoscale size, have elicited much interest. Nanophasic and nanostructured materials are attracting a great deal of attention because of their potential for achieving specific processes and selectivity, especially in biological and pharmaceutical applications (Faramarzi et al., 2013; Anandhakumar et al., 2011). Discoveries in the past decade have demonstrated that the electromagnetic, optical, and catalytic properties of noble-metal nanocrystals are strongly influenced by shape and size...
Nipah virus is a pleomorphic virus that causes high mortality with unpredictable outbreaks. The v... more Nipah virus is a pleomorphic virus that causes high mortality with unpredictable outbreaks. The virus also shows high zoonotic potential with long term neurological damage after recovery further adding to the disease burden. An in-silico epitope-based vaccine offers a promising solution to supplement wider efforts to control the viral spread. This is achieved through immunoinformatics approach using a plethora of servers available. We derived cytotoxic T-cell, T-Helper, B-cell and IFN-γ targeting epitopes from surface glycoprotein G. Cytotoxic T-cell specific epitopes, HLA-B*4402, chimeric multiepitope vaccine structures were prepared using homology modelling method. The structures were validated using various methods and docking simulation was performed between epitopes and HLA-B*4402. Similarly, the vaccine construct was docked to Toll like receptor-4 and a molecular dynamics simulation was performed to assess stability of interaction. Both the docking simulations showed stable in...
Data on the prevalence and outcomes of coronavirus disease (COVID-19) in children with cancer is ... more Data on the prevalence and outcomes of coronavirus disease (COVID-19) in children with cancer is limited, more so from developing countries. We aimed to evaluate the prevalence, severity and outcome of COVID-19 in pediatric oncology patients by implementing a screening and testing plan. Among 104 children tested, the rate of COVID-19 positivity was 15% and 3% in symptomatic and asymptomatic respectively. Majority had mild illness with uneventful recovery, whereas neutropenia increased the risk of serious illness. Prolonged virus shedding with a median time to negativity of 21 days was observed.
Background: Bloodstream infections (BSIs) account for large-scale morbidity and mortality among c... more Background: Bloodstream infections (BSIs) account for large-scale morbidity and mortality among cancer patients requiring a rational antibiotic policy. In India, there is a paucity of data regarding incidence and pattern of BSI in such patients. Aim: The study was conducted to evaluate the pattern of BSI in cancer patients and their sensitivity and resistance toward antibiotic. Materials and Methods: All the blood culture-confirmed infections among cancer patients treated at a tertiary care institute in Bhubaneswar, Odisha, India, were retrospectively analyzed during the year 2018. Results: A total of 82 patients/episodes had confirmed BSI. Gram-negative bacteria accounted for 43 (52.4%) cases, followed by Gram positive 38 (46.4%) cases and 1 case of candida species. The most common organisms isolated were Klebsiella pneumoniae and Staphylococcus aureus consisting of 17 cases each. The Gram-negative bacterial isolates (n = 43) were sensitive to cefoperazone plus sulbactam, piperacillin plus tazobactam, carbapenem, and colistin in 18 (41.9%), 19 (44.2%), 29 (67.4%), and 40 (93%) episodes, respectively. The sensitivity of Gram-positive bacteria (n = 38) to vancomycin, linezolid, and teicoplanin was seen in 37 (97.3%), 37 (97.3%), and 35 (92.1%) episodes, respectively. Multidrug-resistant bacteria accounted for 17 (39.5%) cases of Gram-negative isolates and 9 (53%) of which were K. pneumoniae. Extended-spectrum beta-lactamase activity was seen in 11 of 26 episodes of Enterobacteriaceae. Four of 17 S. aureus and 3 of 11 coagulase-negative Staphylococci were methicillin resistant, and 1 of 2 cases of Enterococcus was vancomycin resistant. Conclusion: Gram-negative bacteria are the predominant cause of BSI in cancer patients and development of a high degree of resistance to commonly used antibiotics is challenging.
mean of 22.48) with p value<0.001. When compared the improvement was significantly better in expe... more mean of 22.48) with p value<0.001. When compared the improvement was significantly better in experimental than control group when assessed immediately after intervention and at 1 month (p<0.001 at both time intervals). Usefulness of intervention was assessed, out of 27 participants in experimental group, 81% were extremely satisfied with the video, 41% preferred video as a mode of information when compared to written and verbal, 70% caregivers felt that watching video helped them to remember the information betterand 92% participants gave opinion that all topics are useful in the video. Conclusion: The addition of video-based education to routine chemotherapy care significantly improves the knowledge of caregivers and help them to retain information regarding the prevention of infections during chemotherapy
center. The median age of the patients was 6 years 10 months (range 4 e 11 years). Four patients ... more center. The median age of the patients was 6 years 10 months (range 4 e 11 years). Four patients (57%) received 4 days of clofarabine in a dose of 40 mg/m2/day as planned, 3 (42%) others received reduced dose. Neutrophil and platelet recovery was achieved in 5 patients (71%) at a median of 18 days (range 15-22 days) and 18 days (16-20 days) respectively. Two (28.5%) failed to recover counts. Only one patient received 2 cycles of clofarabine regimen, while all the other patients (85%) received only one cycle. The complications following clofarabine regimen were as sinusoidal obstructive syndrome (28.5%), deranged hepatic enzymes (28.5%) and febrile neutropenia (100%). Five patients (71%) achieved MRD negativity after one cycle and were consolidated with BMT. Two (28.5%) died on day 5 and day 43 respectively. The cause of death in one was severe SOS/VOD and sepsis while the other was sepsis respectively. Of the 5 the patients who underwent BMT, 5(100%) had neutrophil and platelet engraftment and were discharged with complete donor chimerism. None developed VOD or life-threatening complications post bmt. Conclusion: Clofarabine based chemotherapy is a useful salvage regimen in those with maximum cumulative anthracycline dosed relapse/refractory leukemia patients. It helps achieve MRD negativity for consolidation with BMT. In Indian setting, sepsis seems to be the major complication, requiring dose modification. Severe VOD could be fatal. Posttransplant relapse could be a challenge due to prolonged neutropenia and sepsis.
The pandemic of the novel coronavirus disease, COVID-19 is having a serious impact on pediatric p... more The pandemic of the novel coronavirus disease, COVID-19 is having a serious impact on pediatric patients with cancer. Social distancing, self-quarantining and nationwide lockdown have resulted in restricted movements of patients and families across the country. This has made the optimum management of children with cancer difficult. In this clinical perspective, we discuss the issues related to COVID-19 and pediatric cancer and how we have attempted to optimize the treatment for our patients using telemedicine, reorganizing the day care services, triaging our patients and modifying their treatment plans, partnered with the NGOs and local medical centres to provide care to our patients.
International Journal of Advanced Scientific Research and Management, 2020
The aim of this study was to comparatively phytochemical analysis of stem and root extracts (acet... more The aim of this study was to comparatively phytochemical analysis of stem and root extracts (acetone and chloroform) of Rauvolfia serpentine. It is also called sarpagandha, member of Apocynaceae family. It was admired from olden times used as an antidote of the snake and insects bites. Primary phytochemical analysis of root and stem extracts (acetone and chloroform) of Rauvolfia serpentina indicates the occurrence of alkaloids, tannins, flavonoids, phenols, carbohydrates, glycosides and terpenoids.
Journal of Medical Science And clinical Research, 2018
Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in wo... more Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in women. During pregnancy physiological changes, like frequency, mimic UTI symptoms and therefore bacteriological cultures are needed to confirm the diagnosis. However, in developing countries antibiotic therapy is commonly initiated without culture confirmation. Methods: We have screened bacteriuria among pregnant women with and without UTI symptoms in a tertiary care teaching hospital. A total of 1000 urine samples were evaluated with nitrite and leukocyte esterase tests, using urine culture and/or dipslide with species identification as reference. Results: The prevalence of culture-proven UTI among pregnant women with UTI symptoms was 4%. Since treatment is initiated based only on the presence of symptoms, 96% were erroneously given antibiotics. Further, there is a high prevalence of resistance to commonly used antibiotics, with 18 % ESBL and 36 % multidrug resistant Escherichia coli strains. With culture morphology and biochemical tests were mostly able to identify E. coli and negative cultures. Mixed Gram-negative flora, suggesting fecal contamination was, however, in the majority of cases interpreted as a single pathogenic bacterium and would have resulted in antibiotic treatment. Conclusions. To prevent excessive use of antibiotics, dipslide possibly supported by a combination of nitrite and leukocyte esterase tests can be used. Trained frontline health care professionals correctly diagnosed E. coli UTI and negative urine cultures, which would help preventing antibiotic misuse. In addition, regular screening for antibiotic resistance would improve correct treatment.
Background Blood group has been stated to be one of the risk factors associated with viral diseas... more Background Blood group has been stated to be one of the risk factors associated with viral diseases like dengue, hepatitis virus, Norwalk virus and even the coronavirus associated with 2003 severe acute respiratory syndrome (SARS) outbreak. In addition, anti-A antibodies in experimental models have been shown to inhibit the interaction between coronavirus and angiotensin converting enzyme (ACE) receptor of the host target cell, the major receptor involved in viral pathogenesis. Thus, several workers propose an association between ABO blood type and coronavirus disease- 2019 (COVID-19) disease in many previous studies. The present study was undertaken in the Eastern part of India in line with these authors to study the association of ABO blood group of patients with COVID susceptibility and severity. Methods This is a retrospective study over a period of 6 months from June 2020 to November 2020 where patients who underwent quantitative real-time polymerase chain reaction (qRT-PCR) te...
Various studies have documented the variation in the degree of these emotional studies in differe... more Various studies have documented the variation in the degree of these emotional studies in different stages of surgery. In many studies, anxiety during preoperative stage was significantly higher than their postoperative stage.[3] Major depressive disorder has been a frequent complication of surgery. Depression is a frequent cause of morbidity in surgery patients suffering from a wide range of conditions.[4]
The diagnostic evaluation of different enzymes associated to liver such as Alanine Amino Transfer... more The diagnostic evaluation of different enzymes associated to liver such as Alanine Amino Transferase(ALT), Aspartate Amino Transferase(AST) and Gamma Glutamyl Transferase(GGT) can give a easy follow through for detection of liver homeostasis. The hepatic diseases can be better evaluated by analyzing the serum levels of alanine and aspartate amino transferase and Alkaline Phospatase (ALP). The study includes serum level of enzymes of hepatic disorders such as alcoholic liver disease, hepatitis, and liver cirrhosis. The serum level of ALT, AST, GGT and ALP were analysed by their standardized methods . There was a significant relationship between ALT and GGT. Comparative elevation in the above discussed enzyme indicates the nature and degree of the hepatic damage.
In the present research program, polymer nanocomposites have been used as the drug carrier for de... more In the present research program, polymer nanocomposites have been used as the drug carrier for delivery systems of anticancer drug. Chitosan (CS) and sodium alginate (ALG) with different ratios were blended with different wt% of Cloisite 30B solution by solvent evaporation method. Cloisite 30B was incorporated in the formulation as a matrix material component which also plays the role of a co-emulsifier in the nanocomposite preparation. Curcumin with different concentrations were loaded with CS-ALG/ C 30B nanocomposites for studying the in-vitro drug delivery systems. Morphology and structure characterization of nanocomposites were investigated by X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM) and Fourier Transmission Infra Red Spectroscopy (FTIR) respectively. The drug release was studied by changing time, pH and drug concentrations. The kinetics of the drug release was studied in order to ascertain the type of release mechanism. Based on the diffusion as well as the k...
Random Amplified Polymorphic DNA analysis is an excellent tool as a biomarker in determining gene... more Random Amplified Polymorphic DNA analysis is an excellent tool as a biomarker in determining genetic purity and estimating genetic diversity in plant species. Seven species of Ficus genus that are locally available in Hyderabad such as Ficus benjamina, Ficus microcarpa, Ficus elastica, Ficus binnebdjkii, Ficus benghalensis, Ficus religiosa and Ficus carica. Those ficus cultivars were then analysed by using three oligonucletide primer Z13 (5’GACTAAGCCC 3’), Z17 (5’ CCTTCCCACT 3’) and Z18 (5’AGGGTCTGTG 3’). A total of 340 amplified fragments, in which 212 (62.4%) were polymorphic fragments. The number of polymorphic bands scored per primer ranged from 9 (primer Z13) to 25 (primer Z18). Sixty out of 340 RAPDPCR fragments were found to be useful as cultivar specific markers. Genetic similarities among the seven Ficus cultivars were estimated according to RAPD and cultivar distribution on the concensus tree according to banding pattern of RAPD. Results of combined data exhibited that Fic...
In recent times, precious metal nanoparticles (i.e., Gold Nanoclusters (AgNCs)) are extremely att... more In recent times, precious metal nanoparticles (i.e., Gold Nanoclusters (AgNCs)) are extremely attractive because of their high fluorescence, good photostability, non-toxicity, excellent biocompatibility and solubility. The biomimetic synthesis has become a promising green pathway to prepare nanomaterials. Over the past few decades, inorganic nanoparticles, whose structures exhibit significantly novel and improved physical, chemical, and biological properties, phenomena, and functionality due to their nanoscale size, have elicited much interest. Nanophasic and nanostructured materials are attracting a great deal of attention because of their potential for achieving specific processes and selectivity, especially in biological and pharmaceutical applications (Faramarzi et al., 2013; Anandhakumar et al., 2011). Discoveries in the past decade have demonstrated that the electromagnetic, optical, and catalytic properties of noble-metal nanocrystals are strongly influenced by shape and size...
Nipah virus is a pleomorphic virus that causes high mortality with unpredictable outbreaks. The v... more Nipah virus is a pleomorphic virus that causes high mortality with unpredictable outbreaks. The virus also shows high zoonotic potential with long term neurological damage after recovery further adding to the disease burden. An in-silico epitope-based vaccine offers a promising solution to supplement wider efforts to control the viral spread. This is achieved through immunoinformatics approach using a plethora of servers available. We derived cytotoxic T-cell, T-Helper, B-cell and IFN-γ targeting epitopes from surface glycoprotein G. Cytotoxic T-cell specific epitopes, HLA-B*4402, chimeric multiepitope vaccine structures were prepared using homology modelling method. The structures were validated using various methods and docking simulation was performed between epitopes and HLA-B*4402. Similarly, the vaccine construct was docked to Toll like receptor-4 and a molecular dynamics simulation was performed to assess stability of interaction. Both the docking simulations showed stable in...
Data on the prevalence and outcomes of coronavirus disease (COVID-19) in children with cancer is ... more Data on the prevalence and outcomes of coronavirus disease (COVID-19) in children with cancer is limited, more so from developing countries. We aimed to evaluate the prevalence, severity and outcome of COVID-19 in pediatric oncology patients by implementing a screening and testing plan. Among 104 children tested, the rate of COVID-19 positivity was 15% and 3% in symptomatic and asymptomatic respectively. Majority had mild illness with uneventful recovery, whereas neutropenia increased the risk of serious illness. Prolonged virus shedding with a median time to negativity of 21 days was observed.
Background: Bloodstream infections (BSIs) account for large-scale morbidity and mortality among c... more Background: Bloodstream infections (BSIs) account for large-scale morbidity and mortality among cancer patients requiring a rational antibiotic policy. In India, there is a paucity of data regarding incidence and pattern of BSI in such patients. Aim: The study was conducted to evaluate the pattern of BSI in cancer patients and their sensitivity and resistance toward antibiotic. Materials and Methods: All the blood culture-confirmed infections among cancer patients treated at a tertiary care institute in Bhubaneswar, Odisha, India, were retrospectively analyzed during the year 2018. Results: A total of 82 patients/episodes had confirmed BSI. Gram-negative bacteria accounted for 43 (52.4%) cases, followed by Gram positive 38 (46.4%) cases and 1 case of candida species. The most common organisms isolated were Klebsiella pneumoniae and Staphylococcus aureus consisting of 17 cases each. The Gram-negative bacterial isolates (n = 43) were sensitive to cefoperazone plus sulbactam, piperacillin plus tazobactam, carbapenem, and colistin in 18 (41.9%), 19 (44.2%), 29 (67.4%), and 40 (93%) episodes, respectively. The sensitivity of Gram-positive bacteria (n = 38) to vancomycin, linezolid, and teicoplanin was seen in 37 (97.3%), 37 (97.3%), and 35 (92.1%) episodes, respectively. Multidrug-resistant bacteria accounted for 17 (39.5%) cases of Gram-negative isolates and 9 (53%) of which were K. pneumoniae. Extended-spectrum beta-lactamase activity was seen in 11 of 26 episodes of Enterobacteriaceae. Four of 17 S. aureus and 3 of 11 coagulase-negative Staphylococci were methicillin resistant, and 1 of 2 cases of Enterococcus was vancomycin resistant. Conclusion: Gram-negative bacteria are the predominant cause of BSI in cancer patients and development of a high degree of resistance to commonly used antibiotics is challenging.
mean of 22.48) with p value<0.001. When compared the improvement was significantly better in expe... more mean of 22.48) with p value<0.001. When compared the improvement was significantly better in experimental than control group when assessed immediately after intervention and at 1 month (p<0.001 at both time intervals). Usefulness of intervention was assessed, out of 27 participants in experimental group, 81% were extremely satisfied with the video, 41% preferred video as a mode of information when compared to written and verbal, 70% caregivers felt that watching video helped them to remember the information betterand 92% participants gave opinion that all topics are useful in the video. Conclusion: The addition of video-based education to routine chemotherapy care significantly improves the knowledge of caregivers and help them to retain information regarding the prevention of infections during chemotherapy
center. The median age of the patients was 6 years 10 months (range 4 e 11 years). Four patients ... more center. The median age of the patients was 6 years 10 months (range 4 e 11 years). Four patients (57%) received 4 days of clofarabine in a dose of 40 mg/m2/day as planned, 3 (42%) others received reduced dose. Neutrophil and platelet recovery was achieved in 5 patients (71%) at a median of 18 days (range 15-22 days) and 18 days (16-20 days) respectively. Two (28.5%) failed to recover counts. Only one patient received 2 cycles of clofarabine regimen, while all the other patients (85%) received only one cycle. The complications following clofarabine regimen were as sinusoidal obstructive syndrome (28.5%), deranged hepatic enzymes (28.5%) and febrile neutropenia (100%). Five patients (71%) achieved MRD negativity after one cycle and were consolidated with BMT. Two (28.5%) died on day 5 and day 43 respectively. The cause of death in one was severe SOS/VOD and sepsis while the other was sepsis respectively. Of the 5 the patients who underwent BMT, 5(100%) had neutrophil and platelet engraftment and were discharged with complete donor chimerism. None developed VOD or life-threatening complications post bmt. Conclusion: Clofarabine based chemotherapy is a useful salvage regimen in those with maximum cumulative anthracycline dosed relapse/refractory leukemia patients. It helps achieve MRD negativity for consolidation with BMT. In Indian setting, sepsis seems to be the major complication, requiring dose modification. Severe VOD could be fatal. Posttransplant relapse could be a challenge due to prolonged neutropenia and sepsis.
The pandemic of the novel coronavirus disease, COVID-19 is having a serious impact on pediatric p... more The pandemic of the novel coronavirus disease, COVID-19 is having a serious impact on pediatric patients with cancer. Social distancing, self-quarantining and nationwide lockdown have resulted in restricted movements of patients and families across the country. This has made the optimum management of children with cancer difficult. In this clinical perspective, we discuss the issues related to COVID-19 and pediatric cancer and how we have attempted to optimize the treatment for our patients using telemedicine, reorganizing the day care services, triaging our patients and modifying their treatment plans, partnered with the NGOs and local medical centres to provide care to our patients.
International Journal of Advanced Scientific Research and Management, 2020
The aim of this study was to comparatively phytochemical analysis of stem and root extracts (acet... more The aim of this study was to comparatively phytochemical analysis of stem and root extracts (acetone and chloroform) of Rauvolfia serpentine. It is also called sarpagandha, member of Apocynaceae family. It was admired from olden times used as an antidote of the snake and insects bites. Primary phytochemical analysis of root and stem extracts (acetone and chloroform) of Rauvolfia serpentina indicates the occurrence of alkaloids, tannins, flavonoids, phenols, carbohydrates, glycosides and terpenoids.
Journal of Medical Science And clinical Research, 2018
Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in wo... more Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in women. During pregnancy physiological changes, like frequency, mimic UTI symptoms and therefore bacteriological cultures are needed to confirm the diagnosis. However, in developing countries antibiotic therapy is commonly initiated without culture confirmation. Methods: We have screened bacteriuria among pregnant women with and without UTI symptoms in a tertiary care teaching hospital. A total of 1000 urine samples were evaluated with nitrite and leukocyte esterase tests, using urine culture and/or dipslide with species identification as reference. Results: The prevalence of culture-proven UTI among pregnant women with UTI symptoms was 4%. Since treatment is initiated based only on the presence of symptoms, 96% were erroneously given antibiotics. Further, there is a high prevalence of resistance to commonly used antibiotics, with 18 % ESBL and 36 % multidrug resistant Escherichia coli strains. With culture morphology and biochemical tests were mostly able to identify E. coli and negative cultures. Mixed Gram-negative flora, suggesting fecal contamination was, however, in the majority of cases interpreted as a single pathogenic bacterium and would have resulted in antibiotic treatment. Conclusions. To prevent excessive use of antibiotics, dipslide possibly supported by a combination of nitrite and leukocyte esterase tests can be used. Trained frontline health care professionals correctly diagnosed E. coli UTI and negative urine cultures, which would help preventing antibiotic misuse. In addition, regular screening for antibiotic resistance would improve correct treatment.
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