Introduction: Asymptomatic urinary tract infection refers to occurrence of bacteria in urine without causing symptoms. UTI is more prevalent among retro positive patients compared to people without HIV. Objectives-The study was done to determine prevalence of UTI, common etiologies and antibiotic susceptibility pattern of urinary isolates among HIV seropositive patients attending ART centre for CD4 counts. Materials & Methods:-A total of 109 patients without any symptoms of UTI were included in the study. AST was done using Kirby Bauer disk diffusion method.CD4 count was done using FACS counter. Results: Out of the 109 cases tested, 55 were males, and 54 cases were females. No growth was seen in 60 (55.04%) samples, insignificant bacteriuria in 9(8.26%) samples. Significant growth was seen in 40 samples (36.7%). Among the 54 females, 44% had significant growth. Among 55 males, significant growth was seen in 29.1%. The isolated organisms included Escherichia coli-9(22.5%), Staphylococcus aureus-7(17.5%), Candida albicans-7(17.5%). Bacterial isolates showing resistance to three or more categories of antibiotics were considered Multidrug resistant (MDR). Multidrug resistance was seen among 16 bacterial isolates (48.5%). HIV positive patients with CD4 counts of <200 had higher rates of asymptomatic bacteriuria. Conclusion: Screening of HIV seropositive patients with lower CD4 counts for asymptomatic UTI helps in early diagnosis and appropriate, early management of MDR will reduce morbidity.

Introduction: Diarrhea is one of the most common complaints people living with HIV(PLHIV), occurring in almost 90% of them. Intestinal parasites are one of the main causes of diarrhea in developing countries. Objective: The present study was under taken to detect enteric parasites in PLHIV with different levels of immune status (CD 4+ Counts). Materials and Methods: The study included a total of 209 HIV seropositive subjects. Stool samples from each subject was examined microscopically for the presence of ova and cysts using wet mount preparations and stained smears (modified ZN stain). Results: Enteric pathogens were detected in 57 (27.27%) of the 209 patients. The parasites identified were Cryptosporidium (25), Isospora belli (3), Strongoloides larvae (2), Ascaris ova (1). In our study it was observed that the prevalence of cryptosporidium in HIV sero-positive subjects was 49.01%, 33.33%, 17.6% in those having CD4 <200, 200-499, >500 cells/μl respectively. Conclusion: Intestinal opportunistic parasitic infections were detected in 27.27 % among HIV-seropositive patients. Cryptosporidiumis an important emerging pathogen in HIVseropositive individuals with or without symptoms.Early detection of opportunistic intestinal parasitic infections using simple techniques like wet mount and modified ZN staining will help in the timely management and will improve the quality of life of HIV infected individuals.

Introduction: Foot ulcers are one of the common complications of diabetes mellitus. Diabetic foot ulcer infections are usually polymicrobial infections. For effective treatment, quick isolation and identification of causative organisms with appropriate antibiotic susceptibility testing is needed. Objective: Isolation and identification of bacteria using routine media and HiCrome UTI agar. Materials and Methods: Samples were taken from all Type II diabetes mellitus patients with foot ulcers attending hospital. Samples were collected from deeper portion of the ulcer using 2 sterile swabs and processed using conventional methods and HiCrome UTI agar. Antibiotic susceptibility testing was done on Mueller Hinton agar according to CLSI guidelines. Results: Among 100 samples tested, 138 organisms were isolated as 38% of samples yielded mixed growth. Conventional methods failed to detect 6 (4.3%) isolates form mixed cultures. HiCrome UTI agar isolated all organisms in the cultures including 4 isolates of enterococci and 2 isolates of MSSA, which were missed in conventional methods (p < 0.01). Pseudomonas (22.4%) was commonest organism isolated. Followed by Klebsiella spp. (18.8%), Proteus spp. (15.2%), MSSA (13%), Escherichia coli (11.5%), Citrobacter spp. (7.2%), MRSA (7.2%), Enterococcus spp. (4.3%). Conclusion: Gram negative organisms (75.3%) were predominantly isolated in the study. HiCrome UTI agar can be used for primary identification and quick isolation of organisms where facilities for routine culturing are not available. It is both sensitive and specific in isolating and identifying organisms as in polymicrobial infections.

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BackgroundSevere Corona virus disease (COVID-19) is associated with high mortality. Although single centre intensive care units (ICU) have reported clinical characteristics and outcomes, no large scale multicentric study from India has been published. The present retrospective, multi-centre study was aimed to describe the predictors and outcomes of COVID-19 patients requiring ICU admission from COVID-19 Registry of Indian council of Medical Research (ICMR), India.MethodsProspectively collected data from multiple participating institutions was entered in the electronic National Clinical Registry of COVID 19. We enrolled patients aged>18 years with COVID-19 pneumonia requiring ICU admission between March 2020 and August 2021. Exclusion criteria were negative RT PCR, death within 24 hours of ICU admission, or patients with incomplete data in the registry Their demographic characteristics, laboratory variables, ICU severity indices, treatment strategies and outcomes were analysed.ResultsA total of 5865 patients, with mean age 56±15 years, with 3840/5865 (65.4%) men, were enrolled in the ICMR registry.. Overall mortality was 2535/5865 (43.5%). Non-survivors were older than survivors (58.2±15.4 years vs 53.6 ±14.7 years; P=0.001). Non-survivors had multiple comorbidities (n=1951, 52.9%) with hypertension (47.2%) and diabetes (45.6%) being the most common, higher creatinine (1.6 ± P=0.001, high D-dimer (1.56 vs 1.37, P=0.001), higher CT severity index (16.8±5.2 vs 13.5 ±5.47 ) compared to survivors. Non survivors had longer hospital and ICU stay (P=0.001). On multivariate regression analysis, high NLR (HR 1.017, 95% CI 1.005- 1.029, P=0.001), high CRP (HR 1.008, 95% CI 1.006- 1.010, P=0.001), high D dimer ((HR 1.089, 95% CI 1.065- 1.113, P=0.001) were associated with mechanical ventilation while younger age, (HR 0.974, CI 0.965-0.983, p=0.001), high D dimer (HR-1.014, CI 1.001-1.027, P=0.035) and use of prophylactic LMWH (HR 0.647, CI 0.527-0.794, p=0.001) were independently associated with mortality. ConclusionIn this large retrospective study of 5865 critically ill COVID 19 patients admitted to ICU, overall mortality was 2535/5865 (43.5%). Age, high D dimer, CT Severity score and use of prophylactic LMWH were independently associated with mortality.