Diving deep for the needle in the haystack: An outbreak investigation of bacteremia.

In an Indian oncology setting, between August and December 2021, 56 patients, developed bacteremia. An investigation revealed a contaminated batch of the antiemetic drug palonosetron. The outbreak was terminated by withdrawing the culprit batch and the findings were reported promptly to regulatory authorities.

Invasive Fungal Infection in Hematopoietic Stem Cell Transplant Recipient from an Indian Oncology Setting.

Abdul Ghafur  Invasive fungal infections (IFI) are one of the major causes of morbidity and mortality in post-hematopoietic stem cell transplant (HSCT) recipients. Data from India is limited. The objective of this study was to analyze the incidence, risk factors, and outcomes associated with IFI in our center.

The battle against fungi: lessons in antifungal stewardship from COVID 19 times.

The COVID-19 pandemic has highlighted the detrimental effect of secondary pathogens in patients with a primary viral insult. In addition to superinfections with bacterial pathogens, invasive fungal infections were increasingly reported. The diagnosis of pulmonary fungal infections has always been challenging; however, it became even more problematic in the setting of COVID-19, particularly regarding the interpretation of radiological findings and mycology test results in patients with these infections.

A Case of Severe Bacteremia with Necrotizing Fasciitis of Lower Limb and Fournier s Gangrene in a Post-Allogenic Unrelated Hematopoietic Stem Cell Transplant Recipient.

Bikram Das  Aeromonas is a water-dwelling Gram-negative bacillus primarily associated with gastrointestinal tract diseases. Aeromonas sobria causing gastroenteritis has been reported in India. In immunocompromised host, Aeromonas sobria can also present with severe necrotizing skin and soft tissue infection with a high mortality rate.

Prevalence of faecal carriage of Carbapenemase Producing Enterobacteriaceae in healthy Indian subjects from the community.

Purpose: Faecal carriage of carbapenemase-producing Enterobacterales (CPE) has been extensively investigated in hospitalized patients, but limited data is available on the carriage rate in healthy individuals in India.

Methods: A total of 1000 stool samples were screened for CPE from healthy individuals in Chennai (n ​= ​50), Hyderabad (n ​= ​184) and Mumbai (n ​= ​766). Diluted stool samples were cultured on chromID CARBA SMART plates.

Challenges in implementing antimicrobial stewardship (AMS) in organ transplant centers in India.

Introduction: We, in India, have unique challenges in implementing antimicrobial stewardship (AMS) in our institutions, especially the transplant settings. Identifying challenges, addressing them, and finding innovative solutions to these are the need of the hour.

Challenges: Several challenges in India exists, which hamper implementation of effective AMS like lack of adequately trained personnel (infectious diseases [ID] physicians and clinical pharmacists), missing opportunities of AMS during the timeline, and lack of India-specific outcome measures for AMS programme.

South Asian Declaration-Consensus Guidelines for COVID-19 Vaccination in Cancer Patients.

We provide the South Asian Declaration, containing the consensus guidelines for coronavirus disease 2019 (COVID-19) vaccination in cancer patients.

The Impact of Carbapenem Resistance on Mortality in Patients With Klebsiella Pneumoniae Bloodstream Infection: An Individual Patient Data Meta-Analysis of 1952 Patients.

Introduction: Available evidence from observational studies and meta-analyses has highlighted an increased mortality in patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections (BSI) compared with their carbapenem-susceptible (CSKP) counterparts, but the exact reasons for this outcome difference are still to be determined.

Methods: We updated the search of a previous meta-analysis through four databases up to April 2018. A two-stage individual-patient data (IPD) meta-analysis was conducted, building an adjusting model to account for age, comorbidities and activity of empirical and targeted antimicrobial therapy.

Intestinal carriage of colistin resistant Enterobacteriaceae in hospitalized patients from an Indian center.

There is limited data on the gut colonization rate of colistin resistant (Col-R) bacteria in patients and healthy volunteers in India. Aim of this study was to investigate the stool carriage rate of Col-R in hospitalized patients. Stool samples were inoculated in Eosin Methylene Blue agar plates supplemented with colistin.

Retrospective Study of Nephrotoxicity Rate among Adult Patients Receiving Colistin Compared to β-lactam Antibiotics.

Purpose: Patients receiving colistin for carbapenem-resistant gram-negative bacteria (CR-GNB) infections generally have multiple risk factors for nephrotoxicity, so it might be possible that colistin may be erroneously blamed for the nephrotoxicity.

Materials And Methods: We retrospectively analyzed case records of patients who received colistin and those who received antibiotics other than colistin [carbapenem or β-lactam-β-lactamases inhibitors (βL-βLI)] for gram-negative bacteremia. Those patients with preexisting renal failure and those who received antibiotics for <72 hours were excluded from the study.

Tridecaptin M, a New Variant Discovered in Mud Bacterium, Shows Activity against Colistin- and Extremely Drug-Resistant .

The World Health Organization has categorized the Gram-negative superbugs, which are inherently impervious to many antibiotics, as critical priority pathogens due to the lack of effective treatments. The breach in our last-resort antibiotic (i.e.

Knowledge Assessment of E-Bug Assisted Antimicrobial Resistance Education Module in Class VII School Students of South Indian Coastal Town of Manipal.

Antimicrobial resistance (AMR) is a recognized public health threat today globally. Although many active and passive stewardship strategies are advocated to counter AMR clinically, educating school going children on AMR could be a cost-effective measure to minimize AMR development in the future. We implemented NICE's e-bug as a module to educate class VII school students on AMR determinants.

Detection of chromosomal and plasmid-mediated mechanisms of colistin resistance in Escherichia coli and Klebsiella pneumoniae from Indian food samples.

Objectives: Numerous previous publications on the detection of bacterial isolates harbouring the mcr-1 gene from animals and humans strongly suggest an underlying route of transmission of colistin resistance via the food chain. The aim of this study was to investigate the presence of colistin-resistant (Col-R) bacteria in Indian food samples and to identify the underlying mechanisms conferring colistin resistance.

Methods: Raw food material, including poultry meat, mutton meat, fish, fruit and vegetables, collected from food outlets in Chennai, India, were processed to identify Col-R bacteria using eosin methylene blue agar supplemented with colistin.

Monotherapy versus Combination Therapy against Nonbacteremic Carbapenem-resistant Gram-negative Infections: A Retrospective Observational Study.

Background: Superiority of colistin-carbapenem combination therapy (CCCT) over colistin monotherapy (CMT) against carbapenem-resistant Gram-negative bacterial (CRGNB) infections is not conclusively proven.

Aim: The aim of the current study was to analyze the effectiveness of both strategies against CRGNB nonbacteremic infections.

Design: This was a retrospective observational cohort study.

Colistin Nephrotoxicity in Adults: Single Centre Large Series from India.

Context: Limited Indian data are available on the rate of colistin nephrotoxicity and other risk factors contributing to the development of this important side effect.

Aim: This study aims to generate data on colistin nephrotoxicity from a large cohort of Indian patients.

Design: Retrospective cohort study.

Monotherapy versus combination therapy against carbapenem-resistant Gram-negative bacteria: A retrospective observational study.

Background: Colistin-based combination therapy (CCT) is extensively used to treat infections due to carbapenem-resistant Gram-negative bacteria (CRGNB). There are no data available from India on the usefulness of combination therapy, especially in the oncology setup. The aim of this study was to analyze the clinical effectiveness of CCT over monotherapy in patients with CRGNB.

Spectrum of bacteremia in posthematopoietic stem cell transplant patients from an Indian center.

Background: Despite the relatively low prevalence of Gram-positive bacteremic infections in Indian oncology patients, glycopeptides are extensively used for empirical management of febrile neutropenia. Our aim was to analyze the spectrum of bacteremia in posthematopoietic stem cell transplant (HSCT) recipients in our center and make a recommendation on glycopeptide use in this patient population.

Materials And Methods: Retrospective analysis of bacteremic data from HSCT recipients in a tertiary care oncology and transplant center from South India, between 2011 and 2013.

An Essential Pathology Package for Low- and Middle-Income Countries.

Objectives: We review the current status of pathology services in low- and middle-income countries and propose an “essential pathology package” along with estimated costs. The purpose is to provide guidance to policy makers as countries move toward universal health care systems.

Methods: Five key themes were reviewed using existing literature (role of leadership; education, training, and continuing professional development; technology; accreditation, management, and quality standards; and reimbursement systems).

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia.

Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations.