The impact of the International Nosocomial Infection Control Consortium (INICC) multicenter, multidimensional hand hygiene approach in two cities of India.

The fundamental tool for preventing and controlling healthcare-acquired infections is hand hygiene (HH). Nonetheless, adherence to HH guidelines is often low. Our goal was to assess the effect of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach (IMHHA) in three intensive care units of three INICC member hospitals in two cities of India and to analyze the predictors of compliance with HH.

Impact of an international nosocomial infection control consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India.

Objective: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India.

Methods: This was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network).

An outbreak of post-partum breast abscesses in Mumbai, India caused by ST22-MRSA-IV: genetic characteristics and epidemiological implications.

A cluster of methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses in women who had given birth at a hospital in Mumbai, India was investigated retrospectively. Nineteen of 20 cases were caused by a single clone: pvl-positive, spa type 648 (Ridom t852), ccrB:dru subtype 3:0, ST22-MRSA-IV. Despite the presence of pvl and SCCmec type IV, which are common genetic markers in community-associated MRSA, this outbreak was caused by a healthcare-associated, community-onset MRSA that was common in the hospital environment.

Mixed infection due to Leptospira and Dengue in a patient with pyrexia.

A case of mixed infection due to Leptospira and Dengue in a two and a half-year-old girl with pyrexia is reported. Early detection and institution of appropriate therapy is crucial and lifesaving.

Clostridium ramosum in a case of cerebellar abscess.

A case of cerebellar abscess due to Clostridium ramosum is reported here. The microbiological workup has been discussed.

Role of modified Widal test in the diagnosis of enteric fever.

Objectives: To evaluate the diagnostic specificity of modified Widal for recent infection in comparison with conventional Widal test.

Method: Modified widal test was simultaneously done along with conventional Widal test in serum samples obtained from 50 bacteriologically positive cases of Salmonella typhi infection as well as 50 healthy individuals.

Results: A four-fold difference in the titres was noticed in the 50 sera of the test group and no charge in the titres of the control group.

Seroprevalence of human immunodeficiency virus infection in an infectious disease hospital.

Aims And Objectives: To analyse clinicopathological features of HIV infected patients admitted in an infectious disease hospital in Mumbai.

Material And Methods: Retrospective study of 501 patients admitted from 1st September, 1996 to 28th February, 1998 and screened for HIV status out of clinical suspicion was carried out. HIV seropositivity was established by double confirmation of spot test results with microwell Elisa test.

Human immunodeficiency viruses types 1 and 2 infection among replacement blood donors in Mumbai (Bombay).

Between 1993-96, blood donated by 12,235 replacement blood donors was screened by various Enzyme Linked Immunosorbent Assays for detecting antibodies to Human Immunodeficiency Viruses types 1 and 2 according to the guidelines specified by Indian--Food and Drug Administration. 222 replacement blood donors (1.81%) were found to be seropositive for antibodies to Human Immunodeficiency Virus types 1 and 2.

Increasing prevalence of HIV-2 and dual HIV-1-2 infections among patients attending various outdoor patient departments in Mumbai (Bombay).

Between 1993-96, a serological study was carried out for differentially identifying HIV-1 and HIV-2 infections among the high risk group persons attending the various outdoor patient departments of BYL Nair Municipal Hospital, Mumbai. This study indicates that although HIV-1 is still the predominant virus among the high risk HIV infected persons in Mumbai, dual HIV-1-2 infections are increasing especially among promiscuous heterosexuals and female commercial sex workers. Increases in HIV-2 infections were observed later than dual HIV-1-2 infections, indicating that it is the HIV-1 infected individuals who through continued high risk behavior got infected by HIV-2.

Seroprevalence of IgG antibodies to Helicobacter pylori among gastrointestinal endoscopists, radiologists and paramedical personnel.

Background: The route of transmission of Helicobacter pylori is unknown. Since the organism has been isolated from saliva, gastric juice and stool, medical personnel could be at high risk for acquiring the infection during procedures like gastrointestinal endoscopy.

Aims: To study whether endoscopy is a professional hazard for acquisition of H.

Antibiotics sensitivity pattern of N. gonorrhoeae with special emphasis on norfloxacin and ciprofloxacin.

The current study is carried out to find the in-vitro susceptibility of N. gonorrhoeae to Ciprofloxacin, Norfloxacin, Gentamycin etc. in 110 isolates obtained from acute gonococcal urethritis confirmed by smear examination.

Humoral and cell mediated immune responses in patient with tuberculous meningitis.

A study was carried out to find out the humoral and cell mediated immunity levels in patients with TBM and healthy controls. For humoral immunity, the amounts of immunoglobulins--IgG, IgM and IgA were quantitated by SRID method. For cell mediated immunity, percentages of total T cells, Th cells and Ts cells and the ratio of Th:Ts cells was studied.

Cellular and humoral factors in colostrum of HIV infected and uninfected lactating mothers.

Objective: To compare the cellular and humoral factors in colostrum from HIV infected and uninfected lactating mothers.

Design: Cross sectional study.

Setting: Maternity Ward.

Effect of honey on multidrug resistant organisms and its synergistic action with three common antibiotics.

A total of 15 bacterial strains (7 Pseudomonas & 8 Klebsiella species) isolated from various samples which showed multi-drug resistance were studied to verify in vitro antibacterial action of honey on the principle of Minimum Inhibitory Concentration (MIC) & its synergism with 3 common antibiotics--Gentamicin, Amikacin & Ceftazidime. The MIC of honey with saline for both organisms was found to be 1:2. The synergistic action was seen in the case of Pseudomonas spp.

High frequency of bacteremia with endoscopic treatment of esophageal varices in advanced cirrhosis.

Objectives: The fregency of bacteremia after endoscopic variceal band ligation (EVL) is reported to be lower when compared to that after endoscopic variceal sclerotherapy (EVS). However, there are conflicting reports on the infectious sequelae after EVL.

Aim: To compare the frequency on bacteremia and infectious sequelae after EVL and EVS in patients with cirrhosis of liver.

Detection of antibodies to HIV in saliva.

Background: Saliva has been recommended as an alternative non-invasive specimen for detection of antibodies to human immunodeficiency virus (HIV) because of the inherent disadvantages of using serum for such testing.

Methods: In a double-blind study, paired serum and saliva specimens were collected from 100 known HIV antibody seropositive and 100 seronegative individuals. The serum was tested in the conventional way while saliva was tested after modifying the routinely used serum enzyme-linked immunosorbent assay so as to detect antibodies to HIV from saliva.

A study of mycotic keratitis in Mumbai.

A total of 1010 clinically suspected cases of mycotic keratitis were studied from 1988 to 1996 for evidence of fungal infection and for identification of the aetiologic agents of keratitis in Mumbai. Of these 367 cases were reported positive by microscopy and culture. Seventy nine percent of the cases were between the ages 21 and 50 years.

Increasing prevalence of dual HIV-1-2 infections among voluntary blood donors in Mumbai (Bombay).

Between 1993 and 1996, we carried out a serological screening for differentially identifying HIV-1 and HIV-2 infections among the high risk group persons admitted in the various wards of BYL Nair Hospital, Mumbai, using the ImmunoComb kit. This study indicates that although HIV-1 is the predominant virus prevalent in Mumbai, dual HIV-1-2 and HIV-2 infections are gradually increasing.

Increasing prevalence of HIV-2 and dual HIV-1-2 infections among high risk group hospital admitted patients in Mumbai (Bombay).

Between 1993 and 1996, we carried out a serological screening for differentially identifying HIV-1 and HIV-2 infections among the high risk group persons admitted in the various wards of BYL Nair Hospital, Mumbai, using the ImmunoComb kit. This study indicates that although HIV-1 is the predominant virus prevalent in Mumbai, dual HIV-1-2 and HIV-2 infections are gradually increasing.

Dental plaque: an unlikely reservoir of Helicobacter pylori.

Background And Aim: Dental plaque has been suggested as a reservoir for Helicobacter pylori, though data in this regard are conflicting. We evaluated the prevalence of H. pylori DNA in dental plaque using polymerase chain reaction (PCR).

Seroprevalence of hepatitis A virus in Mumbai, and immunogenicity and safety of hepatitis A vaccine.

Objectives: Since epidemiologic trends of hepatitis A are changing worldwide, we studied its seroprevalence in Mumbai, which is thought to be a high-endemicity area. The immunogenicity and safety of a hepatitis A vaccine were also studied.

Methods: Six hundred and seventy subjects (456 men; age range 6 mo-60 y) answered a questionnaire on social and medical history.

Spectrum of liver diseases in HIV infection.

Background: Most earlier reports on the spectrum of liver diseases in HIV-infected individuals originated from the West.

Objective: To study the spectrum of liver diseases in HIV-infected individuals.

Methods: Seventy four consecutive HIV-positive patients (57 men; age range 23-75 years, mean 34) were studied prospectively with clinical evaluation, liver function tests, ultrasonography, radioisotope liver scan, markers of hepatitis B (HBV) and C (HCV) viruses, and liver histology whenever necessary.