Pathogen-Directed Antimicrobial Stewardship Audit Rounds: Evaluation of an Objectively Planned, Clinical Microbiology-Driven Antimicrobial Stewardship Approach to Influence Antimicrobial Prescriptions of Prescribers.

Introduction: Correct and prompt antimicrobial prescription modifications by the treating team based on the culture and antimicrobial susceptibility test (AST) reports are crucial. Pathogen-directed antimicrobial stewardship (PD-AMS) audit rounds are a clinical microbiology-driven approach to combine prompt appropriate patient management goals with goals of preventing irrational and improper use of antimicrobials.

Methods: The study was a prospective before-after interventional study to evaluate the effectiveness of PD-AMS audit rounds in modifying antimicrobial usage by prescribers on an individual patient basis.

Accuracy of various matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based rapid identification methods-As a tool to augment diagnostic stewardship in blood culture laboratory, South India.

Background: Blood stream infection is a medical emergency associated with high morbidity and mortality. Prompt identification of bloodstream infection-causing microorganisms directly from positive blood culture will significantly enhance patient care by reducing the turnaround time of pathogen recognition.

Methods: A total of 256 freshly flagged positive blood culture bottles were subjected to Gram staining.

Clinical profile and risk factors associated with Elizabethkingia anophelis infection in neonates born in a tertiary care hospital-a case-control study and outbreak investigation.

The objective of this study was to determine the risk factors associated with Elizabethkingia anophelis infection in neonates admitted to a tertiary care neonatal intensive care unit (NICU). A case-control study was undertaken as part of the outbreak investigation for E. anophelis sepsis in a tertiary care NICU in South India.

Implementation of surgical site infection care bundle in patients undergoing gastrointestinal surgeries.

Purpose: Surgical site infection (SSI) is one of the frequent healthcare associated infections linked with significant morbidity, prolonged hospitalization, and death. SSI can be reduced by implementation of customized care bundle components as per standard guidelines. Hence this study was undertaken with the objective to implement care bundle in patients undergoing elective gastrointestinal surgeries and assess their impact on SSI rate.

Impact of care bundle audit on compliance to device care bundles and device associated infections in the Critical Care Unit of a tertiary care hospital, Southern India - A before-after interventional study.

Background: A care bundle comprises a set of evidence-based practices in patient care that are grouped together with the assumption that these practices when performed together will result in better clinical outcomes than when these practices are performed separately. Care bundles for devices when implemented effectively can bring about a reduction in device associated infection rates.

Methods: The study was conducted in three phases, 1 month pre-interventional and interventional phases and 11 months of post-interventional phase in a critical care unit.

Quality assessment of platelet concentrates prepared by platelet-rich plasma, buffy-coat, and apheresis methods in a tertiary care hospital in South India: A cross-sectional study.

Introduction: In blood banking and transfusion medicine, it is of paramount importance to improve transfusion safety and provide a higher quality of product to maximize the therapeutic outcomes and minimize the risk of developing transfusion-associated complications for patients receiving a blood transfusion.

Materials And Methods: This was a cross-sectional study conducted at the department of transfusion medicine in a tertiary care hospital of South India from February 2019 to December 2020. The primary objective of the study was to assess the quality of platelet concentrates (PC) prepared by platelet-rich plasma (PRP), buffy-coat (BC), and apheresis method.

Effect of Electronic Infrared Tap With Voice Reinforcement on Hand Hygiene Compliance of Healthcare Personnel.

Objective: To assess the efficacy of an electronic infrared tap with voice reinforcement to improve hand hygiene compliance among health care workers.

Method: This pre-post intervention study used an automated electronic infrared tap with voice reinforcement as intervention in the neonatal intensive care unit (NICU) and the pediatric intensive care unit (PICU). Hand hygiene adherence rates of health care workers were monitored using a video camera.

Early- vs Late-onset Ventilator-associated Pneumonia in Critically Ill Adults: Comparison of Risk Factors, Outcome, and Microbial Profile.

Background: Ventilator-associated pneumonia (VAP) is one of the most frequent hospital-acquired infections, which develops in mechanically ventilated patients after 48 hours of mechanical ventilation. The purpose of this study was to determine the incidence rate, various risk factors, microbiological profile, and outcome of early- vs late-onset ventilator-associated pneumonia (VAP) in medical intensive care unit (MICU).

Materials And Methods: This prospective study was conducted on 273 patients admitted to the MICU in JIPMER, Puducherry, from October 2018 to September 2019.

Procalcitonin for Detecting Culture-Positive Sepsis in Neonates: A Prospective, Multicenter Study.

Introduction: It is unclear if serum procalcitonin (PCT) estimated at sepsis suspicion can help detect culture-positive sepsis in neonates. We evaluated the diagnostic performance of PCT in culture-positive sepsis in neonates.

Methods: This was a prospective study (February 2016 to September 2020) conducted in four level-3 units in India.

Feasibility of Using Ceftazidime-Avibactam as a Therapeutic Option for Bloodstream Infections Caused by Multidrug-Resistant Enterobacterales and Pseudomonas aeruginosa Based on Its Susceptibility Profile.

Background In the era of increased antimicrobial resistance, there are limited therapeutic options available for the treatment of bacteremia caused by multidrug-resistant organisms (MDROs). This study aims to find out the feasibility of using ceftazidime/avibactam (CZA) as a therapeutic option for bloodstream infections caused by multidrug-resistant (MDR) Enterobacterales and based on its susceptibility profile. Materials and methods The isolates were routinely subjected to antimicrobial susceptibility testing (AST) by an automated AST system (VITEK-2).

Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study.

Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole-resistant Candida spp. isolates in low- and middle-income countries (LMICs) compared to high-income countries (HICs).

Clinical Profile and Outcome of Neonates with Elizabethkingia Sepsis.

Elizabethkingia, an emerging nosocomial pathogen is a gram-negative bacillus causing NICU outbreaks. This case series from a tertiary care hospital, South India describes the clinical profile and outcome of 92 neonates with culture-positive elizabethkingia sepsis over a period of 2 y. Elizabethkingia sepsis predominantly affected preterm neonates and the common clinical features were respiratory distress, apnea, and poor feeding.

Comparison of hand hygiene compliance among healthcare workers in Intensive care units and wards of COVID-19: A large scale multicentric study in India.

Background: Hand hygiene is a significant component involved in preventing transmission of health care associated infections including COVID-19. Compliance to hand hygiene among the health care workers (HCWs) requires evaluation and timely feedback. "You can't improve what you can't measure" is a famous saying and this multicentric study was designed to measure hand hygiene compliance and have birds eye view on hand hygiene compliance in COVID Intensive care units (ICUs) and wards across India.

Impact of conducting hand hygiene audit in COVID-19 care locations of India-A large scale national multicentric study - HHAC study.

Purpose: Hand hygiene (HH), the core element in infection prevention in healthcare, especially for multidrug resistant organism's transmission. The role of HH audits and HH adherence rates in the COVID-19 pandemic, especially in resource limited settings, are yet to be established.

Methods: A nationwide multicenter study was conducted in India, involving public, private, teaching and non-teaching COVID healthcare facilities (COVID-HCFs) using the IBhar mobile application based on WHO's hand hygiene audit tool.

Case Report: Bloodstream Infection with Toxigenic Corynebacterium diphtheriae and Gram-Negative Sepsis in a Child with Burns.

Corynebacterium (C.) diphtheriae is the agent for a contagious infection, diphtheria. It may manifest as pharyngitis with pseudomembrane formation and cervical lymphadenopathy, cutaneous infection, or as an asymptomatic carrier.

Effectiveness of Multimodal Intervention to Improve Blood Culture Collection in the Emergency Department.

Introduction: The blood culture (BC) contamination was a significant problem in our hospital, especially in the emergency department (ED). The study, therefore, was undertaken to improve the BC collection in the ED.

Methods: The study was conducted for 1 year divided into two phases of 6 months each: Preintervention phase and intervention phase (regular and phlebotomist groups).

Bacteremia due to obligate anaerobes following large bowel surgery in a tertiary care hospital in South India.

In view of the rising incidence of Anaerobic bacteremia(AB), the use of anaerobic blood culture bottles have been recommended in addition to the aerobic blood culture bottles. The need to perform antimicrobial susceptibility testing(AST) for anaerobes has become mandatory owing to increasing metronidazole resistance. The frequency of AB following large bowel surgery and the metronidazole susceptibility for members of the Bacteroides fragilis group were determined.

Evaluation of the Performance of Direct Susceptibility Test by VITEK-2 from Positively Flagged Blood Culture Broth for Gram-Negative Bacilli.

Timely initiation of antimicrobial therapy in patients with blood stream infection is absolutely necessary to reduce mortality and morbidity. Most clinical microbiology laboratories use conventional methods for identification and antimicrobial susceptibility testing (AST) that involve biochemical methods for identification followed by AST by disk diffusion. The aim of the current study is to assess the various errors associated with direct susceptibility testing done from blood culture broth using automated AST system-Vitek-2 compact compared with the reference method of AST done from bacterial colonies.

Increasing Trend of Vancomycin-resistant Enterococci Bacteremia in a Tertiary Care Hospital of South India: A Three-year Prospective Study.

Vancomycin-resistant enterococci (VRE) are emerging as an important multidrug-resistant pathogen causing nosocomial infections, predominantly bacteremia and urinary tract infections. VRE bacteremia has caused a significant increase in the duration of the hospital stay and mortality and had caused high public health threat due to limited treatment options. Between October 2017 and September 2020, all consecutive patients with culture-proven bloodstream infection with species, isolated for the first time, were included in the study.

Procalcitonin and C-Reactive Protein as an Early Predictor of Infection in Elective Gastrointestinal Cancer Surgery-a Prospective Observational Study.

Background: Postoperative infections are a common entity following elective gastrointestinal surgery among which intra-abdominal infection is notorious and life threatening. Early detection could reduce postoperative morbidity and permit safe and early discharge. This study was aimed to establish the usefulness of procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day 3 as reliable markers for early detection of intra-abdominal infection and other postoperative infections following elective gastrointestinal cancer surgery.

Rare isolation of Nocardia farcinica in a fatal case of disseminated nocardiosis in an immunocompetent person.

Nocardia species can cause various types of infections including, pulmonary, cutaneous, disseminated & CNS diseases. Here, we report a case of disseminated nocardiosis, probably secondary to pulmonary foci, in an immunocompetent patient. Blood culture showed gram-positive bacilli, which on culture grew aerial chalky white growth showed the acid-fast, gram-positive filamentous bacteria.

Effect of combined colistin and meropenem against meropenem resistant and by checkerboard method: A cross sectional analytical study.

Background: Meropenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa are the two most common nosocomial pathogens causing ventilator-associated pneumonia. To combat this resistance, different combinations of antibiotics have been evaluated for their efficacy in laboratories as well as in clinical situations.

Aim: The aim of the study was to investigate the effect of combined colistin and meropenem against meropenem-resistant isolates of A.

A Rare Case Report of Non-toxigenic Corynebacterium diphtheriae Bloodstream Infection in an Uncontrolled Diabetic With Peripheral Vascular Disease.

usually causes respiratory diphtheria, which is considered as a disease of toxemia but never bacteremia. Over the last few decades, cutaneous diphtheria has been increasingly reported owing to the emergence of the non-toxigenic strain, which causes locally necrotic and ulcerative lesions. Bacteremia is very rare, but the existing evidence in the literature suggests that the organism can rarely cause invasive infections such as septicemia, endocarditis, and osteoarthritis.

Clinical outcomes of suspected Catheter Related Blood Stream Infection at a tertiary care center in south India.

Background: Catheter related blood stream infection (CRBSI) makes up a significant proportion of Hospital acquired infection and increases the morbidity and mortality of those affected.

Aims And Objectives: Primary aim was to study the clinical outcomes of patients with suspected Catheter Related Blood Stream Infection (CRBSI).

Results: Of the 150 participants suspected of having CRBSI, 100(67%) had CRBSI, 26(16%) patients were colonizers and 24(17%) patients had BSI from another source.