Indian Journal of Preventive Medicine

Not available

Background and Objective: Catheter-Associated Urinary Tract Infections (CAUTI) are a primary concern in healthcare, leading to increased mortality and morbidity among critically ill patients. This study aimed to identify uropathogens causing CAUTI and assess their antibiotic sensitivity/resistance. Methods: This study was conducted on 100 patients, all aged 18 or above, admitted for more than 48 hours with Foley catheters in place. Microbiologically, we classified the patients confirmed (mCAUTI) and clinically suspected (cCAUTI) based on urine culture results. Results: Out of 100 patients, 21 had positive urine cultures (mCAUTI), while 79 clinically suspected CAUTI cases were culture-negative (cCAUTI). Fever was the most prevalent symptom (67 patients), followed by genitourinary complaints, shock, and altered sensorium. Escherichia coli was the primary isolate among mCAUTI cases, followed by Klebsiella pneumoniae, Acinetobacter baumannii, Enterococcus spp., Enterobacter, and Pseudomonas aeruginosa. Imipenem demonstrated the highest sensitivity against gram-negative isolates, while grampositive isolates exhibited significant drug resistance. Conclusion: The study highlights E. coli and emerging Klebsiella pneumoniae as major CAUTI culprits with rising drug resistance. Urgent, cautious antibiotic practices are vital. Limiting catheter use, stringent aseptic measures, and timely removal are key to reducing CAUTI. Imipenem stands out as the most effective antibiotic, urging its careful use against CAUTI-causing pathogens.

Mpox is a zoonotic viral illness caused by monkeypox virus which belongs to family Poxviridea and genus orthopoxvirus. Smallpox, vaccinia and cowpox are the poxvirus of this genus. Vaccination to smallpox provides some cross immunity against mpox but with cessation of smallpox vaccination, incidence of mpox has gradually increased, especially in endemic area. Mpox is usually a self limiting disease and presents with fever, myalgia, headache, lymphadenopathy and skin lesions. It spread by the body fluid, skin secretion and direct contact with the infected person or animal. Confirm diagnosis is made by detection of virus DNA by PCR. Antibodies are not useful as they do not distinguish between different poxviruses. There is no specific approved treatment for mpox at present but many are under trial. Vaccination for mpox is available and approved by FDA.usually the case fatality is <10% but can increase in high risk group Earlier mpox was endemic in West and Central Africa with sporadic cases in some other part of the world. But the outbreak in 2022 has affected non endemic area with different target population and different clinical presentation. This raised concern and mpox is now considered as disease which can cause another pandemic and therefore efforts are to be made to prevent its further outbreak.

Introduction:During bronchoscopy, a bronchoscope traverses into the bronchial tree to visualise the respiratory tract and send the washings for various investigations. This event could lead to local spread of pre-existing infection, spread of infection from one patient to the other if the bronchoscope is disinfected inadequately, or, isolation of microorganisms from bronchoscopic specimens in a patient who is clinically not infected, i.e. pseudoinfection. This study is one such investigation of an outbreak of bronchoscopic pseudo-infections in a tertiary care hospital. Materials and methods: Bronchoalveolar lavage (BAL) samples were inoculated onto MacConkeyAgar and 5% Sheep Blood Agar and incubated at 37°C overnight. The growths obtained on culture media were processed for identification and antimicrobial susceptibility on Vitek 2 Compact as per manufacturer’s instructions. To investigate the outbreak, 5-10mL of sterile water was flushed through the channels of disinfected bronchoscope and collected in a sterile container. The samples were centrifuged and inoculated onto Mac Conkey Agar and 5% Sheep Blood Agar. The growths obtained were further processed similarly as the BAL samples were processed. Environmental swabs collected from the bronchoscopy unit were also processed as the procedure mentioned above. Results: Bronchoalveolar lavage of 3 patients in a period of 1 week were contaminated with multidrug resistant Klebsiella pneumoniae. Two out of five bronchschope fluid samples were also contaminated with Klebsiella pneumoniae. Among the swabs collected from bronchoscope unit, Klebsiella pneumoniae was isolated from the endowasher detergent box. Conclusion: The risk of propagation of infection via a bronchoscope can be evaded by proper reprocessing and improving the sterilization practices.

Primary amyloidosis is a group of monoclonal plasma cell disorders characterized by the extracellular deposition of immunoglobulin light chain fibrils in multiple organs, leading to progressive multi-organ dysfunction. It is a rare disease that usually occurs in elderly persons and has a poor prognosis. Primary amyloidosis of the gastrointestinal tract is relatively rare, and symptomatic amyloidosis of the stomach is even more seldom. Monoclonal gammopathy often undervalues nephropathy, a rare condition of renal significance. We present the case of a 28-year-old female who presented with recurrent vomiting, abdominal distension, poor oral intake, and weight loss for two months. Her upper GI endoscopy was done, which showed edematous nodular antral mucosa and superficial ulcers in the third part of the duodenum. Biopsies were taken, which showed features suggestive of primary amyloidosis with kappa light chain restriction. A renal biopsy revealed that she had a lot of damage to her tubes, including an unusual intratubular cast with kappa light chain restriction. People often underestimate monoclonal gammopathy of renal significance (MGRS), a rare condition.