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Benu Dhawan

Publications and source records attributed to Benu Dhawan.

At least 19 recordsLinked to original sources
PubMed2006

Citrobacter infections in a tertiary care hospital in Northern India.

OBJECTIVES: This prospective study was carried out to look for the frequency of isolation of Citrobacter species from clinical specimens and study their antimicrobial susceptibility pattern. METHODS: Patients from whom Citrobacter species were isolated during routine diagnostic testing from January to December 2004 were included in the study. Isolates were identified by standard biochemical tests. Antimicrobial susceptibility testing was performed by disk diffusion method as per National Committee of Clinical Laboratory Standards (NCCLS) guidelines. RESULTS: Citrobacter species were isolated from a total of 205 patients. Infection was nosocomially acquired in 94.6% patients. One hundred eighty one (88.3%) patients had significant underlying illnesses. Culture yielded Citrobacter koseri in 185 (90.2%) and Citrobacter freundii in 20 (9.8%) patients. The distribution of isolates was as follows: urine (46.2%), respiratory tract (16.3%), blood (15.8%), pus (12.1%) and sterile body fluids (9.3%). Drug resistance was observed to be more in C. koseri as compared to C. freundii. CONCLUSIONS: Citrobacter infections are often nosocomially acquired, seen in patients with significant underlying diseases and isolates are commonly drug-resistant. Adoption of hospital infection control practices and a good antibiotic policy may prevent their spread.

Adolescent↗
PubMed2006

A clinico-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital.

OBJECTIVE: To determine the microbiological profile and antibiotic susceptibility patterns of organisms isolated from diabetic foot ulcers. Also, to assess potential risk factors for infection of ulcers with multidrug-resistant organisms (MDROs) and the outcome of these infections. RESEARCH DESIGN AND METHODS: Pus samples for bacterial culture were collected from 80 patients admitted with diabetic foot infections. All patients had ulcers with Wagner's grade 3-5. Fifty patients (62.5%) had coexisting osteomyelitis. Gram-negative bacilli were tested for extended spectrum beta-lactamase (ESBL) production by double disc diffusion method. Staphylococcal isolates were tested for susceptibility to oxacillin by screen agar method, disc diffusion, and mec A-based PCR. Potential risk factors for MDRO-positive samples were explored. RESULTS: Gram-negative aerobes were most frequently isolated (51.4%), followed by gram-positive aerobes and anaerobes (33.3 and 15.3%, respectively). Seventy-two percent of patients were positive for MDROs. ESBL production and methicillin resistance was noted in 44.7 and 56.0% of bacterial isolates, respectively. MDRO-positive status was associated with presence of neuropathy (P = 0.03), osteomyelitis (P = 0.01), and ulcer size >4 cm(2) (P < 0.001) but not with patient characteristics, ulcer type and duration, or duration of hospital stay. MDRO-infected patients had poor glycemic control (P = 0.01) and had to be surgically treated more often (P < 0.01). CONCLUSIONS: Infection with MDROs is common in diabetic foot ulcers and is associated with inadequate glycemic control and increased requirement for surgical treatment. There is a need for continuous surveillance of resistant bacteria to provide the basis for empirical therapy and reduce the risk of complications.

Blood Glucose↗
PubMed2006

Evaluation of the diagnostic efficacy of PCR for Ureaplasma urealyticum infection in Indian adults with symptoms of genital discharge.

Ureaplasma urealyticum genital infection may lead to severe clinical implications if left undiagnosed and untreated. The present study was conducted to evaluate the diagnostic efficiency of a polymerase chain reaction (PCR) assay and to determine the prevalence of U. urealyticum in Indian adults with symptoms of genital discharge. Cervical swabs, vaginal swabs and male urethral swabs from 100 patients attending an sexually transmitted disease clinic at a tertiary care hospital in Delhi were screened prospectively for infection with U. urealyticum. The prevalence of U. urealyticum was found to be 32% by culture and 45% by PCR. U. urealyticum was recovered from 8 (47%) and 37 (45%) symptomatic men and women, respectively. The agreement between PCR and culture was 93.75%. PCR improved the test sensitivity by 13% compared to culture. The results confirm the need to use a sensitive and reliable molecular method to prevent the underdiagnosis of ureaplasma infection and to facilitate better clinical management of this infection in India.

Colony Count, Microbial↗
PubMed2006

Emerging resistance to carbapenems in a tertiary care hospital in north India.

BACKGROUND AND OBJECTIVES: Carbapenems are beta-lactam antibiotics, presently considered as most potent agents for treating multi-drug resistant Gram-negative bacilli infections. In India carbapenems available for use are meropenem and imipenem, introduced recently. Resistance to these has been reported in a few bacteria especially Pseudomonas spp. We therefore retrospectively evaluated the antibiotic susceptibility pattern to these agents amongst various clinical isolates in a tertiary care hospital in north India. METHODS: In this study Gram-negative bacterial pathogens isolated from clinical samples were tested for extended spectrum beta lactamase (ESBL) production. All ESBL positive bacteria were tested for meropenem and imipenem activity pattern using NCCLS guidelines. A total of 2626 consecutively isolated Gram-negative bacteria, which tested positive for ESBL production by the double disk diffusion method, were included. RESULTS: The different bacteria isolated were Pseudomonas spp. 759, Acinetobacter spp. 676, Escherichia coli 569, Klebsiella spp. 343, Enterobacter spp. 150, Citrobacter spp. 57 and Proteus spp. 72. Overall resistance to meropenem was more (22.16%) than imipenem (17.32%). Maximum resistance was seen in Pseudomonas spp. M(R) 37.6 per cent, I(R) 30 per cent. In isolates from intensive care units (ICU) resistance to carbapenems was significantly higher than non-ICU patients. INTERPRETATION AND CONCLUSION: Resistance to meropenem and imipenem was seen in various clinical isolates of Gram-negative ESBL-positive bacteria. There is a need to alarm our clinicians for judicious use of antibiotics.

Anti-Bacterial Agents↗
PubMed2006

Case report vancomycin -resistant Enterococcus faecium VanA phenotype: first documented isolation in India.

In recent years, vancomycin-resistant enterococci, especially Enterococcus faecium has emerged as an important nososcomial pathogen and represents a serious threat to patients with impaired host defences. We report infection with vancomycin-resistant Enterococcus faecium in a 3-year-old child with patent ductus arteriosus. The organism, isolated from a central venous catheter tip, exhibited a high-level resistance to vancomycin (minimum inhibitory concentration > or = 256 microg/ ml) and was also resistant to teicoplanin. The child probably died due to sepsis from this highly resistant organism. To the best of our knowledge, this is the first reported isolation of VanA phenotype Enterococcus faecium in India.

Bacterial Proteins↗
PubMed2005

Brain abscess due to Enterococcus avium.

We report the first case of brain abscess due to Enterococcus avium in a 19-year-old man with chronic otitis media since childhood. The patient presented to the emergency department in a comatose condition. Contrast-enhanced brain computed tomography scan showed a hypodense area with ring enhancement in the right temporal lobe and mass effect with subfalcine and transtentorial herniation. Emergency temporal burr hole operation was performed and pus drained out, but the patient succumbed to his illness. Culture of the aspirated pus yielded growth of gram-positive cocci identified as E avium, an infrequent pathogen of human infections. The association of E avium with brain abscess further extends the clinical spectrum of this rare pathogen.

Adult↗
PubMed2005

Species prevalence and antimicrobial susceptibility of enterococci isolated in a tertiary care hospital of North India.

The present prospective study was carried out to determine the species distribution and antimicrobial susceptibilities of enterococci isolated from clinical samples in a tertiary care hospital of North India. Enterococcus species isolated from blood, urine, pus, sterile fluids and the hospital environment from October 2003 to January 2004 were identified by standard biochemical tests. Antimicrobial susceptibility testing was performed by the disk diffusion method as per NCCLS guidelines. Out of a total of 105 Enterococcus species recovered during the study period, E. faecium (42.90%) and E. faecalis (40.00%) constituted the predominant isolates. Enterococcus faecium was the commonest blood culture isolate while E. faecalis predominated pus and urine samples. Other species isolated were E. mundtii, E dispar, E. durans, E. avium, E. raffinosus and E. gallinarum. High-level aminoglycoside resistance was detected in 73.3% of isolates. Resistance to vancomycin, teicoplanin and linezolid was not detected. Prevalence of a wide variety of Enterococcus species in clinical samples together with their variable antimicrobial susceptibility patterns emphasizes the need for routinely carrying out detailed speciation and in vitro susceptibility testing of enterococcal isolates in the clinical bacteriology laboratory.

Anti-Bacterial Agents↗
PubMed2005

Comparative in vitro activity of beta-lactam/beta-lactamase inhibitor combinations against gram negative bacteria.

BACKGROUND & OBJECTIVE: Currently, the use of beta-lactamase inhibitors in combination with beta-lactam antibiotics represents an effective measure to combat a specific resistance mechanism of beta-lactamase producing organisms. Knowledge about the susceptibility profile of bacteria to different combination agents available is essential to guide appropriate treatment of severe infections in hospitalized patients. The present study compares the in vitro activity of three commercially available beta-lactam/beta-lactamase inhibitor combinations (piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid) against beta-lactamase producing gram negative bacteria in a tertiary care hospital in north India. METHODS: A total of 9004 consecutively isolated extended spectrum beta-lactamase (ESBL) producing gram negative bacteria isolated from various clinical samples from patients admitted to the All India Institute of Medical Sciences, New Delhi, from September 2003 to August 2004 were included in the study. These isolates were screened for ESBL production by the inhibitor based test recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Antibiotic susceptibility testing was carried out by disc diffusion method as per NCCLS guidelines. RESULTS: Of the 9004 isolates tested, 3232 (35.89%) were sensitive and 568 (6.31%) were resistant to all three combination agents, and rest 5204 (57.80%) were resistant to at least one of the combinations. Susceptibility to piperacillin/tazobactam, cefoperazone/sulbactam, and ticarcillin/clavulanic acid was 81.37, 76.06 and 45.48 per cent respectively. Piperacillin/tazobactam exhibited significantly (P<0.05) greater antimicrobial activity against Pseudomonas spp., Escherichia coli and Klebsiella spp. compared to cefoperazone/sulbactam. INTERPRETATION & CONCLUSION: Overall piperacillin/tazobactam was observed to be the best combination agent followed by cefoperazone/sulbactam in our setting. This difference in activities of these combination agents needs to be evaluated further by ascertaining their efficacy in clinical studies.

Anti-Bacterial Agents↗
PubMed2004

Melioidosis; the remarkable imitator: recent perspectives.

Melioidosis is an important public health problem in some regions of the world. It is endemic in South East Asia. The clinical spectrum of melioidosis is extremely broad, and melioidosis requires awareness on the part of the clinician and the existence of a laboratory capable of isolating and identifying Burkholderia pseudomallei, the etiological agent of melioidosis. Beta-lactams such as ceftazidime is currently the treatment of choice. There is no vaccine licensed for human use. There is an urgent need for rapid diagnostic techniques and effective treatments that are affordable in countries where the disease is endemic.

Burkholderia pseudomallei↗
PubMed2004

Group C streptococcal bacteremia: a case report from India.

Group C streptococci are a common cause of infection in animals and a rare cause of bacteremia in human beings. The entity is often seen in elderly people with a severe underlying illness. We report here the only case of Group C streptococcal bacteremia reported in our hospital, caused by Streptococcus equisimilis, a beta-hemolytic Group C streptococcus. The patient was a 10-year old male with a known history of aplastic anemia. In spite of specific therapy with penicillin, the outcome was fatal.

Child↗