Background Peripherally inserted central catheters (PICCs) are central venous catheters inserted peripherally but terminate in great vessels. PICCs are widely used for patients requiring long-term intravenous therapy in both in-patient and out-patient settings. Aim This study was carried out to understand PICC-related complications, specifically infections and causal pathogens, in a tertiary care hospital in Kerala, South India. Methods A retrospective analysis of PICC insertions and follow-up during a 9 years period to look at patient demographics and infections related to PICC was carried out. Results The overall PICC-related complication rate is 28.1% (4.98 per 1000 PICC days). Commonest complication was thrombosis followed by infection, either PICC-associated bloodstream infection (PABSI) or local infection (LI). PABSI noted in this study was 1.34 per 1000 catheter days. The majority (85%) of PABSI were due to Gram-negative rods. The average duration of PICC days for occurrence of PABSI was 14 days and the majority occurred in in-patients. Conclusion Thrombosis and infection were the commonest PICC-related complications. PABSI rate was comparable to that of previous studies.

A bstract Introduction Early identification of etiology is very important for initiating appropriate therapy promptly in patients with meningoencephalitis (ME). BioFire FilmArray ® meningitis/encephalitis (FA-ME) panel is a fully automated multiplex polymerase chain reaction (PCR) that detects 14 pathogens simultaneously in an hour. There is a dearth of studies highlighting its usefulness in ME syndrome in Indian patients. Materials and methods We performed a retrospective analysis of patients, admitted to the Kerala Institute of Medical Sciences Hospital, Thiruvananthapuram, Kerala, South India, with meningitis/encephalitis syndrome who underwent the multiplex PCR test on cerebrospinal fluid (CSF) over a period of 2 years from 2016 to 2018. Patients presenting with clinical diagnosis of acute meningitis, encephalitis, or ME who underwent CSF FA-ME panel were studied. The performance of the FA-ME panel was compared to CSF bacterial culture. Results Two-hundred and fifty-nine patients between December 2016 and December 2018 underwent the FA-ME test in CSF. FA-ME test detected pathogens in 61 (23.6%) out of 259 patients with ME syndrome. Among the pathogens detected by FA-ME panel, enterovirus was the commonest accounting for 29 cases (47.5%), followed by varicella in 11 patients (18%) and pneumococci in 9 (14.8%). CSF bacterial culture yield was low, positive only in 8 (3%) out of 259 cases, and matched with FA-ME panel in only one sample that grew Streptococcus pneumoniae . Bacterial culture yielded seven pathogens in those whose FA-ME panels were negative. Conclusion FA-ME panel improves diagnostic yield as compared to bacterial culture (26.3 vs 3%). FA-ME test helps in the early initiation of targeted antibiotic therapy and greater antibiotic de-escalation. How to cite this article Chandran S, Arjun R, Sasidharan A, Niyas VKM, Chandran S. Clinical Performance of FilmArray Meningitis/Encephalitis Multiplex Polymerase Chain Reaction Panel in Central Nervous System Infections. Indian J Crit Care Med 2022;26(1):67–70.

A bstract Introduction Streptococcus gallolyticus is an important cause of bacteremia and infective endocarditis in adults. Studies from other parts of the world have shown a strong association between S. gallolyticus bacteremia and colonic neoplasia. The profile of S. gallolyticus bacteremia is understudied in Indian population. Materials and methods We retrospectively analyzed the data of 16 patients with S. gallolyticus bacteremia obtained from microbiology registry. BacT/ALERT positive samples were inoculated into blood agar, chocolate agar, and MacConkey agar. Organisms were identified by the VITEK 2 microbial identification system, and susceptibility was done by the microbroth dilution method as per Clinical and Laboratory Standards Institute (CLSI) M100 guidelines. Clinical details were obtained from electronic medical records. Results Majority of our isolates were S. gallolyticus subspecies pasteurianus . Total 16 patients had S. gallolyticus isolated from blood over a 1 year period. The median age was 58 years (IQR: 46.5–66). Eleven were males; type II diabetes mellitus and chronic liver disease were the common comorbidities observed in our patients. None of our patients had underlying infective endocarditis or colonic malignancy. Penicillin sensitivity was 81.2% while all the isolates were susceptible to ceftriaxone. Ampicillin resistance was seen in only one of the isolates. In-hospital mortality was 12.5%. Conclusion Streptococcus gallolyticus subsp. pasteurianus is the commonest subspecies of S. gallolyticus isolated in our population. Unlike previous studies, colonic neoplasia and infective endocarditis were rare in our patients. Type II diabetes mellitus and chronic liver disease were the commonest risk factors identified in patients with S. gallolyticus bacteremia. How to cite this article Niyas VKM, Arjun R, Sasidharan A, Palakunnath GA. Streptococcus gallolyticus Bacteremia: An Experience from a Tertiary Center in South India. Indian J Crit Care Med 2020;24(10):943–945.

How to cite this article: Niyas VKM, Rahulan SD, Arjun R, Sasidharan A. ICU-acquired Candidemia in COVID-19 Patients: An Experience from a Tertiary Care Hospital in Kerala, South India. Indian J Crit Care Med 2021;25(10):1207–1208.

No abstract