Indian Journal of Public Health Research & Development

Sneh Lata ¹, Rosy Bala ², Neerja Jindal ³, Nitin Gupta ⁴

Affiliations
1 Senior Resident, Department of Microbiology, GGS Medical College, Faridkot (Punjab), IN
2 Assistant Professor, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
3 Professor & Head, Department of General Medicine, IN
4 Assistant Professor, Department of General Medicine, IN

Abstract

Backround: Serious infections due to methicillin resistant Staphylococcus aureus (MRSA) have become a major clinical challenge. Globally Macrolide-lincosamide streptogramin B family of antibiotics are commonly used to treat such infections as an alternative to vancomycin. The study was to conducted to find out the presence of inducible clindamycin resistance among Staphylococcus aureus and their association with methicillin resistance.

Method: The study conducted over one year (Jan 2016 - Dec 2016) in microbiology department of Guru Gobind Singh Medical College, Faridkot. Two hundred fifteen S.aureus isolates were included in the study. Methicillin resistance was detected by cefoxitin (30μg) disc diffusion method and inducible clindamycin resistance by erythromycin and clindamycin disc approximation test (D-Test).

Results: Of the 215 clinical isolates of S. aureus, 140 (65.11%) were MRSA. Erythromycin and clindamycin resistance was seen in 79.06%(170/215) and 49.30% ( 106/215) respectively. Resistance to erythromycin and clindamycin were higher in MRSA than MSSA (erythromycin resistance:100%v s 22.5% and Clindamycin resistance:70.1% vs 10.6%). Both iMLSB and cMLSBphenotypes are predominant in MRSA.

Conclusion: Detection of MRSA in our study shows the need to improve health care practices and to formulate new infection control policies to control MRSA infections. Inducible and constitutive resistance is comparatively higher in our study in MRSA .So It is necessary to perform D-test for detection of inducible clindamycin resistance among MRSA in routine antibiotic sensitivity testing so that therapeutic failures can be avoided.

Keywords

Staphylococcus aureus, MRSA, Inducible Clindamycin resistance, D-Test.

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Harit ¹, Varsha A. Singh ², Sonia Mehta ³, Shavi Nagpal ³, Rosy Bala ³, Dipankar Biswas ⁴

Affiliations
1 Tutor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
2 Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
3 Assistant Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
4 Tutor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN

Abstract

Background: Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide, despite being a treatable and preventable disease. The emergence of Multi Drug Resistant (MDR) TB had exacerbated the situation further. To prevent the spread of infection & to accelerate the administration of Anti-tubercular treatment, early detection of TB is required. Methodology: This Cross-sectional study was carried out on 236 samples clinically suspected cases of Pulmonary & Extra-Pulmonary Tuberculosis processed for Direct Ziehl-Neelsen Staining, Decontamination by NALC-NaOH and Culture in MGIT tubes & Lowenstein-Jensen Medium. Results: Out of 60 samples, 60(25.42%) were culture positive cases showed highest isolation rate by BACTEC MICRO MGIT as compared to LJ Medium 42(17.79%) with time of detection by BACTEC MICRO MGIT was 17 days and LJ Medium was 33.72 days. The Diagnostic accuracy of BACTEC MICRO MGIT when LJ Medium considered to be gold standard was also exhibited which showed sensitivity of 95.24%, Specificity of 89.69% while Negative Predictive value (NPV) & Positive Predictive value (PPV) was 98.86% and 66.67% respectively. The BACTEC MICRO MGIT detects mycobacteria early, with less contamination rates and has good sensitivity & specificity as compared to LJ Medium. Conclusion: So it can be concluded that BACTEC MICRO MGIT can be used as method of isolation of Mycobacterium tuberculosis either alone or in combination with LJ Medium.

Keywords

Tuberculosis, Pulmonary, Extra-Pulmonary, Lowenstein-Jensen Media, Mycobacterial.

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Nitin Gupta ¹, Rosy Bala ², Varsha A. Singh ³, Harit Kumar ⁴, Shavi Nagpal ², Sonia Mehta ³

Affiliations
1 Assistant Professor, Department of General Medicine, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
2 Assistant Professor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
3 Professor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN
4 Tutor, Department of Microbiology, M.M. Institute of Medical Sciences and Research, Mullana, Maharishi Markandeshwar (Deemed to be University), IN

Abstract

Over the years we have seen many antibiotics have been developed, each one supposedly better than the previous, but still we have not been able to overcome the persistent problem of antibiotic resistance regardless of the potency of the drug. There is an urgent need to develop new antibiotic strategies to overcome this problem that is different from previous efforts. Hence a method should be focused on the area of inhibition of bacterial evolution for resistance-“evolution proof Antibiotics”.

Keywords

Antibiotics, miracle molecules, Anti microbial resistance (ARM), Evolution proof molecules, evolvability factor.

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Rosy Bala ¹, Nitin Gupta ², Shaveta Kataria ³, Sneh Lata ³, Puneet Saini ⁴, Ritu Garg ⁵

Affiliations
1 Assistant Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
2 Assistant Professor, Department of General Medicine, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, IN
3 Senior Resident, Department of Microbiology, GGS Medical College, Faridkot, IN
4 Medical Officer, PCMS 1, CHC Bharatgarh, (Ropar), Punjab, IN
5 Associate Professor, Department of Microbiology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana

Abstract

Violence against medical professionals at the workplace is not a new phenomenon. In recent times, the reports of doctors getting thrashed by patients or their relatives have made headlines around the world. Almost every doctor has experienced some kind of violence whether physical or verbal at certain stage of their profession. This article aims to discuss the risk factors associated with violence against doctors and the possible steps that are needed to prevent such incidents.

Keywords

Violence, medical professionals, Health care setting.

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Shavi Nagpal ¹, Varsha A. Singh ², Harit Kumar ³, Aditi Pandey ⁴, Sonia Mehta ², Rosy Bala ¹

Affiliations
1 Assistant Professor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
2 Professor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
3 Tutor, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN
4 M.Sc. Medical Microbiology, Department of Microbiology, MMIMSR, Maharishi, Markandeshwar (Deemed to be) University (MMDU), Mullana (Ambala), Haryana, IN

Abstract

Introduction: Diabetic wound infections is a dreaded complication of diabetes and often the leading cause of hospitalization for patients with diabetes worldwide. Infection if not treated timely and properly can even lead to amputation of the infected part. The present study was conducted as an attempt to evaluate the different microorganisms infecting diabetic wounds and to find out the antibiotic susceptibility patterns. Material and Method: A total of 128 patients of diabetic wound infections were included in this study from September 2018 to August 2019. Samples were processed as per standard guidelines, the microorganisms (bacterial and fungal) were isolated and further antibiotic susceptibility pattern for bacterial isolates was studied. Results: Out of 128, 106 (82.82%) yielded growth of microorganisms on culture. Predominance of bacterial growths (73.58%) as a causative etiology in diabetic wound infections were noticed over fungal (26.42%). Gram positive bacterial growths accounted to 39.74%, whereas 60.27% were gram negative growths. Staphylococcus aureus (29.49%) was the most predominant organism isolated, followed by Escherichia coli (25.64%) and Pseudomonas aeruginosa (24.36%). of the Staphylococcus aureus, 73.92% were methicillin resistant while 72.34% among gram negative isolates were ESBL producers with Escherichia coli accounting the highest degree of ESBL production. Linezolid, vancomycinandteicoplanin were the most sensitive drugs for Staphylococcus aureus and Gram‑negative isolates were mostly sensitive to imipenem based on our susceptibility results. Candida species (89.28%) was noted to be the most dominant fungal pathogen in diabetic wound infections. Conclusion: A good knowledge about the microbiological profile of diabetic wound infections and antimicrobial susceptibility patterns of the isolates can be helpful in guiding the clinicians to promptly and effectively treat diabetic wound infections.

Keywords

Diabetic wound infections, Bacterial isolates, Fungal isolates, Antimicrobial Susceptibility, Extended spectrum beta-lactamase (ESBL), Methicillin resistant staphylococcus aureus (MRSA).

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Ritu Garg ¹, Rosy Bala ², Varsha A. Singh ³

Affiliations
1 Associate Professor, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
2 Assistant Professor, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN
3 Professor & Head, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, MMDU, Mullana, Ambala (Haryana), IN

Abstract

Background: Active learning strategies for understanding the subject like microbiology is need of the hour. Small group teaching is considered to nurture active learning by the students. It is a student centered method and promotes active learning. So by keeping in mind the usefulness of the active learning, the present study was planned to assess the perception of students after introducing small group teaching (SGT) in Microbiology. Materials and Method: The study was conducted on 150 MBBS second year professional students in the department of microbiology of Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana. Small group teaching method were conducted for all selected topics. At the end of the sessions of SGT, perceptions of students were taken on feedback questionnaire and analysed on 3 point Likert scale. Result: Total 150 MBBS second Professional Students taken part in Study. Out of 150 students, 142 (94%) students took part in the study. Above 90% stated that it is easy and fun filled method, concepts are clearer and stronger, interaction increased with teachers, retention of the subject increased. Above 80% stated that willingness to study increased, doubts cleared easily, attention in the class increased, increased application of knowledge, sharing of ideas. Above 70% stated that clinical correlation, learn team work, self-directed learning. Conclusion: By Small group teaching, students will be apply their knowledge and will be able to provide effective diagnostic services in the community. Small group teaching can be easily adopted in curriculum by proper management of time and by cooperation of faculty and students.

Keywords

Small group teaching, active learning, student centred teaching method.

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