Browsing by Author "M.R. Sen"

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Antibiotic sensitivity pattern of the bacteria isolated from nosocomial infections in ICU
(2002) A.K. Singh; M.R. Sen; S. Anupurba; P. Bhattacharya
The incidence of nosocomial infections in ICU is 4-5 times greater than in general ward. Critically ill patients are always at higher risk of developing nosocomial infections with resistant strains. This study is an attempt to know the antibiotic sensitivity pattern of the common isolates in ICU. Samples comprising urine, blood, endotracheal secretions and throat swabs were collected from 102 ICU patients of them, 56 patients showed evidence of nosocomial infection (54.9%), from whom 120 different organisms were isolated. Antibiotic sensitivity test was done according to Kirby Bauer method. Klebsiella pneumoniae were the most prevalent isolates from respiratory tract infections followed by Proteus spp, Escherichia coli, Staphylococci spp. and Acinetobacter spp. The gram negative enteric bacilli were uniformly resistant to betalactam antibiotics as well as betalactam-betalactamase inhibitors. Resistance to Ciprofloxacin and Ceftriaxone ranged from 50-100% and 25-83.3% respectively. Staphylococci were 100% resistant to penicillin and tetracycline, 80% to cotrimoxazole, 60% to erythromycin and gentamicin and 40% to amikacin. Acinetobacter spp. were highly resistant to most of the antibacterial agents except geutamicin while Pseudomonas spp. showed 75% resistance to it. The increased prevalence of resistant organisms in ICU probably reflects lack of proper antibiotic policy resulting in prolonged and indiscriminate use of antimicrobial agent.
Antimicrobial resistance profile of bacterial isolates from Intensive Care Unit: Changing trends
(2005) S. Anupurba; M.R. Sen
The incidence of antimicrobial resistance has increased over the years resulting in limitation of therapeutic options. Strategies such as appropriate infection control measures and surveillance of resistance pattern are necessary to address the problem of resistance. Knowledge of the pattern of resistance in Intensive Care Units (ICUs) can help to determine antibiotic prescribing policy. A retrospective study has been carried out to determine the bacterial spectrum and the antibiotic resistance pattern of clinical isolates collected from patients admitted to the ICU. The data was compared with a similar study conducted during 1996-97. Amongst the gram-positive organisms Staphylococcus aureus (23%) was the predominant isolate, while Pseudomonas (23%), Acinetobacter (20.8%), Citrobacter (11.7%) accounted for the majority of the gram-negative organisms. Both gram positive and gram-negative organisms exhibited high resistance to most antimicrobial agents used for testing susceptibility. The frequency of resistance has markedly increased as compared to the previous study.
Antiovarian antibody in premature ovarian failure.
(1999) D. Chattopadhyay; M.R. Sen; P. Katiyar; L.K. Pandey
Premature ovarian failure is a syndrome consisting of primary or secondary amenorrhoea, hypergonodotropiremia and hypoestrogenemia in women under the age of 40. An autoimmune mechanism was suggested as possible etiology when Vallolton and Forbes in 1966-67 found antibodies to the cytoplasm of rabbit ova in 29 of 232 tested sera. Immune mechanism in the pathogenesis of premature ovarian failure (POF) is suggested by association of autoimmune phenomenon with POF in some cases and demonstration of circulating antibodies to ovary in serum samples from women with POF. The incidence of presence of antiovarian antibody of POF patients has been reported earlier. Evidence of autoimmunity is present in 18-92% of patients with POF. In the present study we have studied 18 cases of POF without any overt manifestation of autoimmune disorder but the antiovarian antibody was detected, with the idea that this autoantibody might be the cause of ovarian dysfunction which is evident in POF. Presence of antiovarian antibody in 16.67% cases with POF in our study that ovarian antibodies may play a role in or reflect an autoimmune process responsible for the development of POF.
Antitoxoplasma antibody in clinically suspected cases of human toxoplasmosis.
(1990) S. Kar; M.R. Sen; A.N. Gangopadhyay; P.C. Sen
(1) Seventy sera from a variety of patients suffering from different diseases suspected to be caused by Toxoplasma gondii infection and forty from non-toxoplasmic hospital cases and laboratory and hospital staff were collected. (2) Antitoxoplasma antibody was detected in those sera by Indirect Haemagglutination test (IHA test) and Enzyme Linked Immunosorbent Assay (ELISA). (3) Twenty one (30%) sera out of 70 test samples and 2 (5%) out of 40 control samples were positive by ELISA test. With IHA test only 17 (24.3%) of test samples and same 2 (5%) of control samples were positive. (4) Sera collected from Paediatric Department showed the highest positivity (40%) followed by Opthalmological group (35.7%) and obstetrics and Gynaecological group (13.6%). (5) No significant co-relation was found between the seropositivity with sex, diet and history of cat contact of the patients.
Bacteriological profile and antimicrobial resistance of blood culture isolates from a university hospital
(2007) Atul Garg; S. Anupurba; Jaya Garg; R.K. Goyal; M.R. Sen
Context: Blood stream infections are an important cause of mortality and morbidity and are among the most common health-care associated infections. Illness associated with blood stream infection ranges from self-limiting infections to life-threatening sepsis that require rapid and aggressive antimicrobial treatment. Aims: The objective of the study was to describe the pattern of bacterial isolates from the blood cultures in a university hospital and determine their antibiotic resistance, so that the study can provide guidelines for choosing an effective antibiotic therapy in cases of septicaemia. Settings and design: This is a retrospective study of 2,400 blood samples collected from clinically suspected cases of bacteraemia reviewed over a period of 2 years. Methods and material: The isolates were identified by standard biochemical tests and antimicrobial susceptibility testing determined by National Committee for Clinical Laboratory Standards (NCCLS) guidelines. Results: Positive cultures were obtained in 493 (20.5%) cases. Among culture positive isolates, Gram-negative bacteria accounted for 67.5% cases; most common being Pseudomonas spp. (16%) followed by Salmonella typhi and S. paratyphi A (14.2%). Of the pathogenic Gram-positive isolates, Staphylococcus aureus (8.3%) was the predominant isolate followed by Enterococcus faecalis (3.7%). Maximum Gram-negative isolates were sensitive to cefoperazone-sulbactam combination (81%). Vancomycin sensitivity was reported in 100% Staph. aureus and 83.3% Enterococcus faecalis. Conclusions: This study provides information on antibiotic resistance of blood isolates. It may be a useful guide for physicians initiating empiric therapy and will help in formulation of antibiotic therapy strategy in this part of the country.
Burden of different beta-lactamase classes among clinical isolates of AmpC-producing Pseudomonas aeruginosa in burn patients: A prospective study
(Wolters Kluwer Medknow Publications, 2012) V. Kumar; M.R. Sen; C. Nigam; R. Gahlot; S. Kumari
Background: Pseudomonas aeruginosa is one of the most common pathogens causing infections in burns, and shows increasing resistance to -lactam antibiotics by producing different classes of beta-lactamases. It is also not unusual to find a single isolate that expresses multiple -lactamase enzymes, further complicating the treatment options. Thus, in this study, we aimed to determine the coexistence of different beta-lactamase enzymes in clinical isolates of P. aeruginosa in the burn ward. Materials and Methods: A total of 101 clinical isolates of P. aeruginosa from the burn ward were identified and tested for the presence of different beta-lactamase enzymes (extended spectrum beta lactamase (ESBL), Amp C and metallo -lactamases (MBL) from October 2006 to May 2009. In vitro susceptibility pattern of antipseudomonal antibiotics was done by the Kirby Bauer disc diffusion method. Results: A total of 33 (32.7%) isolates were confirmed to be positive for AmpC beta-lactamase. Co-production of AmpC along with ESBL and MBL was reported in 24.5% and 45.5% isolates, respectively. A total of 12 (11.9%) isolates were resistant to three or more antibiotic classes (multidrug resistance). Imipenem and piperacillin/tazobactum showed high sensitivity, with 86.1% and 82.2%, respectively. Conclusion: This study reveals the high prevalence of multidrug- resistant P. aeruginosa producing beta-lactamase enzymes of different mechanisms in this region from burn patients. The emerging antimicrobial resistance in burn wound pathogens poses serious therapeutic challenge. Thus proper antibiotic policy and measures to restrict the indiscriminate use of cephalosporins and carbapenems should be taken to minimize the emergence of this multiple beta -lactamase producing pathogen.
Circulating immune complex in murine autoimmune hepatitis
(1999) D. Chattopodhyay; M.R. Sen
High level of circulating immune complexes (CIC) in the serum has been reported in different forms of hepatitis particularly in complicated cases of vital hepatitis due to hepatitis B virus (HBV) infection. In this study CIC level in experimental autoimmune hepatitis were assessed by detection of polyethylene glycol (PEG) index. The sera of mice with established autoimmune hepatitis (EAH) confirmed by histopathological study showed higher PEG index (C57BL/6 mice: 34.56 ± 6.28 and C3H mice: 31.95 ± 28.99). The control healthy mice showed lower PEG index (C57BL/6 mice: 19.48± 6.85 and C3H mice: 21.27 ± 6.1). The high level of PEG index in EAH was found statistically significant. The role of CIC in the development of autoimmune hepatitis is discussed.
Comparative efficacy of cefpirome & ceftazidime alone or in combination with isepamycin in empiric treatment of septicaemia in patients admitted to ICU
(2004) R.K. Verma; P. Bhattacharyya; M.R. Sen; Geeta Kumari
An analysis was carried out to assess the efficacy, safety and cost effectiveness of Cefpirome (1-2g IV)/Ceftazidime (1-2g IV) alone or in combination with Isepamicin 8-15 mg/kg for empiric treatment of 120 patients of Nosocomial Septicaemia in Intensive Care Unit. Drug was given by random allocation according to the investigator's initial choice of monotherapy or combination therapy and then according to indication and severity of infection. The primary end point was the clinical response at the end of treatment. The result was viewed by blinded observer. 120 patients were divided into 4 groups of 30 cases each. Group I received Cefpirome alone, Group II received Ceftazidime alone, Group III received Cefpirome +Isepamicin and Group IV received Ceftazidime + Isepamicin. The main causative pathogen was gram - negative with Acinetobacter species predominating. Among gram-positive pathogens coagulase-negative staphylococcus predominated. Among clinically evaluable patients with confirmed septicaemia success rate was 50% for Group I and for other Groups it was 100%. In patients with clinically suspected septicaemia success rate obtained were 16.7% for Group I, 44.4% for Group II, 52.2% for Group III, and 48.0% for Group IV. Among monotherapy group adverse reactions were more in Group I than in Group II(16.7% versus 1.3%). Among combination therapy adverse reactions were more in Group III than in Group IV (19.9% versus 13.3%). Regarding cost effectiveness, ICU-stay with Group II was found to be less than that with Group I so Group II antibiotic was found to be more cost effective than Group I antibiotic (Rs. 3080.00 versus Rs. 6304.00). Among combination therapy group- Group IV was more cost effective than Group III (Rs. 8716.80 versus Rs.11151.00) irrespective of less ICU stay with Group III antibiotics. For empiric treatment of Nosocomial Septicaemia in ICU combination therapy may be the best choice. Among combination therapy because of better bacteriological and clinical efficacy, Group III is the better choice irrespective of its high cost, however Group IV antibiotics can also be advocated for empiric treatment of Nosocomial Septicaemia in ICU as it was found to have bacteriological efficacy similar to that of Group III antibiotics and also more cost effective. Among monotherapy Group II is the better choice.
Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study
(2010) Shyam K. Saraf; Awadhesh Yadav; Santosh Nagwani; M.R. Sen
Background: Polymethyl methacrylate (PMMA) antibiotic beads though have proved their utility as a local antibiotic delivery system, however, there are limitations. Decalcified bone matrix (DBM) as a vehicle of antibiotics can serve the purpose, provided a minimum inhibitory concentration is sustained. Healing of the defect and avoiding the second surgery is another advantage. We studied the DBM as the delivery vehicle for vancomycin in controlling the methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis as well as healing of the cavity simultaneously in an experimental study. Materials and Methods: An in vitro study was conducted to optimize vancomycin impregnation in the DBM. For the in vivo study, a unicortical defect was created in the metaphysis of the distal femur in 18 rabbits. After contaminating the defect with MRSA, rabbits were divided into three groups. Group I (eight limbs) received no graft. Defects in group II (11 limbs) were filled with plain DBM chips and in group III (14 limbs), cavities were implanted with vancomycin-impregnated decal bone chips. Rabbits were assessed by clinical, radiological, histological, gross examination and bacterial load assay. High Performance Liquid Chromatography HPLC analysis of vancomycin in group III was done to assess the concentration in DBM chips. Results: In group I, the infection persisted throughout the period of the study. Group II showed the fulminated infection at the grafted site with DBM chips sequestrating out. Vancomycin-impregnated decal chips in group III did not show any sign of infection and eventually incorporated. The bacterial load study showed a progressive load change and HPLC revealed an effective antibiotic concentration up to 3 weeks in both in vitro and in vivo. Conclusion: Decal bone chips were effective as the local antibiotic delivery vehicle in preventing the MRSA osteomyelitis model. It eluted vancomycin significantly and the graft uptake was also excellent. Allogeneic decal grafts eliminated the need for second surgery and acted as an excellent delivery vehicle for antibiotics.
Effect of exogenous 5-hydroxytryptamine on pathogenicity of Entamoeba histolytica in experimental animals
(1989) D.P. Acharya; M.R. Sen; P.C. Sen
[No abstract available]
Effect of lowering the peripheral level of 5-hydroxytryptamine in host on the virulence of Entamoeba histolytica
(1984) I. Ahmad; P.C. Sen; R.B. Kulkarni; M.R. Sen
To ascertain the effect of lowering the peripheral 5-hydroxytryptamine (5-HT) level in the host on the pathogenesis of E. histolytica, p-chlorophenylalanine, a 5-HT synthesis blocker was used. Just weaned albino rats of Charles-Foster strain as the experimental animals and caecal scoring of Neal were used to quantitate the pathogenicity. When infected animals were treated with p-chlorophenylalanine, the caecal scores of all the five strains tested were reduced significantly compared to untreated control animals. Thus lowering of peripheral 5-HT level in the host, decreased the pathogenicity of E. histolytica. Based on these results as also our earlier finding that an increase in peripheral 5-HT level enhances the pathogenicity of the parasite, it is proposed that peripheral 5-HT level is an important host factor modulating the virulence of E. histolytica.
Immunoglobulin G and complement C3 levels in pregnancy induced hypertension.
(1995) G.R. Ramdenee; M. Matah; B.D. Bhatia; M.R. Sen; S. Swain
The immunoglobulin G (IgG) and complement C3 (C3) were measured in the maternal as well cord blood sera of 30 cases of pregnancy induced hypertension (PIH) as well as 9 controls with normotensive pregnancy. A depression of IgG as well as C3 level was observed in the maternal as well as cord sera of the mothers with PIH. These findings suggest decreased immunological status of both mother and her offspring in PIH, irrespective of the gestation and intrauterine growth status.
Letters to the editor
(1994) B.K. Das; Suresh Kumar; M.R. Sen; O.P. Mishra
[No abstract available]
Neonatal listeriosis [3]
(2005) Sumati Srivastava; M.R. Sen; A. Kumar; S. Anupurba
[No abstract available]
Observation on integron carriage among clinical isolates of Klebsiella pneumoniae producing extended-spectrum β-lactamases
(Medknow Publications and Media Pvt. Ltd, 2010) A. Bhattacharjee; M.R. Sen; P. Prakash; A. Gaur; S. Anupurba; G. Nath
Purpose: Klebsiella pneumoniae is considered an important pathogen causing nosocomial and community-acquired infections and is often associated with the production of extended-spectrum -lactamases (ESBL) belonging to SHV and CTX-M families, which are frequently described as a part of complex integrons, facilitate their horizontal transfer to other related as well as unrelated microbes. The present study was undertaken to investigate the occurrence and characterization of integrons among K pneumoniae isolates producing ESBL in a tertiary referral hospital. Materials and Methods: A total of 136 clinical isolates of K pneumoniae were investigated for the presence of ESBL. Their ESBL genes were characterized by multiplex polymerase chain reaction (PCR). Integrase gene PCR was performed to detect the presence of integron. The isolates were further typed by random amplification of polymorphic DNA (RAPD). Result: Out of 136 K pneumoniae isolates, 63 (46%) were confirmed to be ESBL producers. SHV (68%) and CTX-M (67%) ESBL genes were the most common in our study. Of the 63 ESBL-positive isolates, 58 (92%) strains carried integrons; 52 strains (82%) carried only class 1 integron, whereas 6 (9%) isolates harboured both class 2 integrons and the class 1 gene. However, in ESBL negatives, only 29 (40%) strains were positive for class 1 integron and none for class 2 integron. Conclusion: The presence of class 2 integron amongst ESBL-producing K pneumoniae is being described for the first time in this part of the world. The findings of this study strongly suggest that integrons have a role in the dissemination of ESBL-mediated resistance among the nosocomial isolates of K pneumonia.
Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh
(L.V. Prasad Eye Institute, 2003) S. Anupurba; M.R. Sen; G. Nath; B.M. Sharma; A.K. Gulati; T.M. Mohapatra
We report the prevalence of methicillin resistant Staphylococcus aureus (MRSA) infections and their antibiotic susceptibility pattern in our hospital located in eastern Uttar Pradesh. Out of total 549 strains of Staphylococcus aureus isolated from different clinical specimens 301 (54.85%) were found to be methicillin resistant. More than 80% of MRSA were found to be resistant to penicillin, cotrimoxazole, ciprofloxacin, gentamicin, erythromycin, tetracycline, 60.5% to amikacin and 47.5% to netilmicin. However, no strains were resistant to vancomycin. Many MRSA strains (32.0%) were multi-drug resistant. To reduce the prevalence of MRSA, the regular surveillance of hospital associated infection, monitoring of antibiotic sensitivity pattern and formulation of definite antibiotic policy may be helpful.
Prevalence of serum antibodies to TORCH infection in and around Varanasi, North India
(2012) M.R. Sen; B.N. Shukla; Tuhina Banerjee
Background: The acute infections which are caused by Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV-2) during pregnancy are often associated with adverse foetal outcomes and reproductive failures. In the Indian context, the exact seroprevalence of these infections is not known due to unavailability of baseline data. Aims: The present study was undertaken to determine the serological evidence of the acute TORCH infections in women who were in the first trimesters of their pregnancies in and around Varanasi, north India. Settings and Design: This study was carried out in the Sir Sunderlal Hospital, Varanasi and in the Department of Microbiology, Institute of Medical Sciences, BHU, Varanasi, UP, India. The study population involved pregnant women with bad obstetric histories, who were in the first trimester of their pregnancy. Methods and Materials: Sera were collected from the women with Bon and they were tested for the presence of specific IgM antibodies against the TORCH infections by ELISA. Statistical Analysis: A 95% confidence interval was calculated for the positive cases in each of the TORCH components. Results: The specific IgM antibodies were found to be positive in 74(19.4%) cases for toxoplasmosis, in 126 (30.4%) cases for the Rubella virus, in 130 (34.7%) cases for CMV and in 151 samples (33.5%) for the HSV-2 infections. Conclusions: The study showed a high prevalence of the infections which were caused by the TORCH complex amongst pregnant women with bad obstetric histories. Therefore, all the antenatal cases should be routinely screened for the TORCH infections, for carrying out early interventions to prevent foetal loss.
Seroprevalence of Brucellosis in and around Varanasi
(2002) M.R. Sen; B.N. Shukla; R.K. Goyal
[No abstract available]
Serum IgG, IgA and IgM levels of children with idiopathic nephrotic syndrome and response to corticosteroids [1]
(1994) B.K. Das; S. Kumar; M.R. Sen; O.P. Mishra
[No abstract available]