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B Dhawan

Publications and source records attributed to B Dhawan.

At least 19 recordsLinked to original sources
PubMed2006

Incidence and characterization of Clostridium perfringens isolated from antibiotic-associated diarrhoeal patients: a prospective study in an Indian hospital.

Clostridium perfringens has been reported as causing between 2-15% of all cases of antibiotic-associated diarrhoea (AAD), and may be diagnosed by detection of enterotoxin in faeces. A prospective study comprising 150 diarrhoeal patients and 100 non-diarrhoeal controls was undertaken to assess the incidence of C. perfringens-associated diarrhoea in an Indian hospital. Methods used included C. perfringens culture, reverse passive latex agglutination (RPLA) and enzyme-linked immunosorbent assay (ELISA) for detection of enterotoxin, and polymerase chain reaction (PCR) assay for the presence of enterotoxin gene. Attempts were made to type the isolates by multiplex PCR. Of the 150 diarrhoeal stool samples tested, 13 were culture positive. Of these, four were positive for C. perfringens enterotoxin by RPLA, two were positive by PCR and two were positive by RPLA and ELISA. Twenty-seven samples were positive for culture of C. perfringens in non-diarrhoeal controls but none were positive for enterotoxin either by RPLA or by PCR. The average incidence of C. perfringens AAD using these methods was 2.6%. Toxin typing showed that all the isolates belonged to type A. To conclude, the relatively low incidence of toxigenic C. perfringens suggests that enterotoxigenic C. perfringens is not a major cause of AAD in this population.

Adolescent↗
PubMed2004

Bacteriological and antimicrobial susceptibility profile of soft tissue infections from Northern India.

BACKGROUND: Soft tissue infections require a judicious combination of antimicrobial therapy in addition to surgical debridement to limit tissue loss and preserve life. AIMS: To study the bacterial etiology of soft tissue infections and their antimicrobial susceptibility pattern. SETTINGS AND DESIGN: A single institutional retrospective study of one year duration from January to December 2002. MATERIALS AND METHODS: A total of 5039 consecutive pus samples received in the Bacteriology Laboratory was analyzed from the records. RESULTS: There were a total of 2783 bacterial isolates comprising of 1504 gram negative bacilli and 1279 gram positive cocci. Staphylococcus aureus was the commonest isolate followed by Escherichia coli and Pseudomonas species. Methicillin resistance in S. aureus was found to be 38.56%, high level aminoglycoside resistance was observed in 53.3% enterococci and 66.75% of the gram negative bacilli were extended spectrum beta-lactamase producers. Rifampicin and vancomycin showed best activity for S. aureus; for gram-negative bacilli, piperacillin-tazobactam combination showed best activity. CONCLUSIONS: Continuous monitoring of antimicrobial susceptibility pattern in individual settings together with their judicious use is emphasized to minimize emergence of drug resistant bacteria.

Anti-Bacterial Agents↗
PubMed2003

Antimicrobial resistance profile of nosocomial uropathogens in a tertiary care hospital.

A retrospective analysis was done of the resistance pattern of urinary tract pathogens isolated over a 4 months period in a tertiary care hospital. There were a total of 871 clinical isolates comprising of 793 gram negative bacilli and 78 gram positive cocci obtained from 5477 consecutive urine samples. Extended spectrum beta lactamase production was observed in 71.5% of the gram negative bacilli; of these 6.18% were also inhibitor resistant. High level aminoglycoside resistance was observed in 70.17% of Enterococcus isolates while methicillin resistance was documented in 23.8% of the Staphylococcus isolates. A high level of resistance was also noted for ciprofloxacin. Multidrug resistance is a common problem in hospitals which emphasizes the need for judicious use of antimicrobial agents and their continuous in vitro monitoring.

Cross Infection↗
PubMed2002

A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes.

Patients with hematological malignancies who are receiving chemotherapy suffer prolonged periods of neutropenia, which leads to a greater risk of infection and mortality. A prospective study was conduced to determine the incidence of bacteremia in patients of hematological malignancies over a 2-yr period. A total of 119 episodes of febrile neutropenia occurred among 96 consecutive patients, of which 35 episodes were associated with bacteremia. Forty-four percent of the isolated bacteria were Gram-positive aerobes and 46% were Gram-negative aerobes. Staphylococcus aureus, Enterococcus spp., and Escherichia coli were the most common isolates. Gram-negative bacteremia was associated with a higher mortality. Anaerobes accounted for 4.4% of all isolates. The episodes of anaerobic bacteremia were polymicrobial and had a fatal outcome. A high incidence of antimicrobial resistance among aerobic and anaerobic bacteria was also recorded. Compared to previous years, a shift from a predominating Gram-negative to a Gram-positive etiology was noted. The initial empiric antibiotic regimens should be based on a local knowledge of the most common causative microorganisms, their sensitivity pattern, and the outcome of bacteremia.

Adolescent↗
PubMed2001

Infections caused by Gemella spp.: case reports from India.

Human infections caused by Gemella spp. are rare. We report here our experience of the isolation of species of Gemellae from various clinical samples. Careful and complete identification of this organism will prevent diagnostic and therapeutic delays and bring more such cases to light.

Adult↗
PubMed2001

Infective complications of central venous catheters in cardiac surgical patients.

Prospective randomised study was conducted over a 24 months period in a cardiac surgical intensive care unit to determine the incidence of infection associated with multilumen venous catheters. The influence of various factors including fever, peripheral blood culture, catheter site, catheter usage for monitoring central venous pressure and/inotrope therapy on infection rates were statistically evaluated. A total of 100 catheters submitted to the Microbiology laboratory were bacteriologically examined. Forty-nine of these were inserted into upper body sites, and 51 were inserted into the femoral vein. Twenty-one were triple-lumen catheters. Catheters were removed when a central line was no longer necessary. Catheter tips were cultured by semiquantitative technique for aerobic and anaerobic bacteria. Bacteremia occurred in 3% of catheter insertions; (Enterococcus faecalis, one; Enterobacter spp. One; Acinetobacter spp., one); and catheter colonisation developed in 24%. Neither catheter colonisation nor catheter related infection were associated with any of the risk factors evaluated. Our data indicates that central venous catheters are safe to use in our patients. The inability to identify "risk factors" for catheter infection emphasise the need to maintain a high index of suspicion.

Adolescent↗
PubMed2001

Group B streptococcal bacteremia in an adult: a case report from India.

The incidence of group B streptococcal bacteremia in adults has increased in recent years, particularly in patients with severe underlying diseases. However, group B still remains an unusual pathogen in adults in developing countries. We report a case of group B streptococcal bacteremia in a non-pregnant adult, the only case reported in our hospital. The organism was only isolated from the blood and responded to specific therapy.

Adult↗
PubMed2000

The incidence of Legionella pneumophila: a prospective study in a tertiary care hospital in India.

The prevalence of Legionella pneumophila causing community-acquired pneumonia (CAP) in patients who were admitted to hospital was investigated. Between April 1997 and December 1998, 60 patients admitted to the All India Institute of Medical Sciences with CAP, were included in the study. Aetiological diagnosis was based on the results of routine microbiological blood culture for bacteria and serological test by enzyme linked immunosorbent assay (ELISA) for L. pneumophila serogroup 1-7. Eight (13%) patients had a conventional bacterial aetiology and nine (15%) had serological evidence of recent infection with L. pneumophila. Legionella pneumophila may be an important cause of CAP in adults in developing countries. Empiric antimicrobial treatment should include a combination of agents to cover both atypical agents and bacterial pathogens.

Adult↗
PubMed1999

Incidence of Clostridium difficile infection: a prospective study in an Indian hospital.

Clostridium difficile is the commonest cause of hospital-acquired diarrhoea. A prospective study comprising of 156 patients and 54 healthy controls was undertaken to assess C. difficile associated diarrhoea (CDAD) incidence in an Indian hospital. Methods used included C. difficile culture and enzyme linked immunosorbent assay (ELISA) for Toxin A. Attempts were made to type isolates by antibiogram and SDS-PAGE. Of the 210 stool samples tested, 12 gave positive results in at least one assay. Of these, 11 were positive by the ELISA method, eight by culture, and seven by both methods. Neither the organisms nor the toxin was found in healthy controls or neonates. The average disease incidence of CDAD estimated by using both methods was 15%. Two antibiotypes of the isolates were obtained and of the isolates characterized by SDS-PAGE, two had identical patterns. This study shows that CDAD is an emerging problem in Indian hospitals. Monitoring should enable the development and implementation of policies and procedures that minimize the risk of this nosocomial pathogen.

Adolescent↗