Introduction: White coats are known to be potential transmitt ing agents of multidrug resistant organisms. This study was con ducted to determine the level and type of microbial contamination present on the white coats of medical students in order to assess the risk of transmission of pathogenic micro organisms by this route in a hospital setting. Materials and Methods:A cross sectional survey of the bacterial contamination of white coats in a tertiary care hospital. 100 medical students working in various specialties were included in the study. Swabs were taken from 4 different areas of the white coat -collar, pocket, side and lapel and processed in the Microbiology department according to standard procedures.Results: Although most of the white coats had been washed within the past 2 weeks, the sides of the coats were the most highly contaminated areas followed closely by the collar and pockets. Staphylococcus aureus was the most common isolate followed by coagulase negative Staphylococci and Gram negative non fermenters. Most of the Gram positive cocci were resistant to Penicillin, Erythromycin and Clindamycin. Conclusion:White coats have been shown to harbor potential contaminants and may have a role in the nosocomial transmission of pathogenic microorganisms. Thus, a yearly purchase of white coats and the possession of two or more white coats at any point in time should be made compulsory. There is pressing need to promote scrupulous hand washing before and after attending patients and alternatives to white coats, including universal use of protective gowns, should be considered.

BackgroundCommunity-acquired gram-negative bacillary meningitis is rare to occur without preexisting conditions like trauma, organ dysfunction, and immunocompromised state, and very few case reports with Escherichia coli have been described in literature till now. Presence of ventriculitis along with meningitis makes the incidence further sparse.Case presentationA review of literature identified a total of only 45 community-acquired E. coli meningitis from 1945 till to date. Here, we have described a case of community-acquired E. coli meningitis with ventriculitis in an adult with past history of completely repaired CSF leak secondary to trauma nearly 23 years ago, without current radiological evidence of persistent CSF leak and therefore described as spontaneously acquired. Post-contrast T1 images of MRI were suggestive of subtle ependymal enhancement of ventricles, and patient was treated in lines of ventriculitis. Initial CSF was suggestive of acute pyogenic meningitis, and the organism grown was pan-sensitive E. coli. Patient was treated with antibiotics according to the culture sensitivity pattern and was given a prolonged course of 6 weeks of antibiotic therapy in view of ventriculitis.ConclusionCommunity-acquired E. coli meningitis with possible ventriculitis in adults is described as a rare entity and is likely to be underrated and under-recognized.

Objective:Pseudomonas aeruginosa is one of the leading pathogen causing healthcare-associated infections, particularly in immunocompromised and critically ill patients. The development of carbapenem resistance in P. aeruginosa infections is worrisome. Data specifically comparing the susceptibility of the three available carbapenems are lacking in the Indian subcontinent.Materials and Methods:We evaluated the minimum inhibitory concentrations (MICs) of the three commonly used carbapenems– imipenem, meropenem, and doripenem against, 435 P. aeruginosa isolates obtained from respiratory samples and compared their susceptibility patterns to determine the best possible carbapenem among those available that may be used in combination regimes.Results:Overall, 222 (51.0%) of isolates were susceptible to doripenem followed by imipenem 206 (47.3%) and meropenem 195 (44.8%), respectively. Two hundred and sixty-two (60.23%) strains were intermediate or resistant to at least one carbapenem. The MIC90 of all three carbapenems was >32 μg/ml while the MIC50 of meropenem was 16 μg/ml which was higher than MIC50 of both imipenem (4 μg/ml) and doripenem (2 μg/ml).Conclusion:Our study revealed that doripenem exerted better in vitro activity against the tested bacteria compared to imipenem and meropenem, but the difference was not statistically significant.

objective The diagnosis of acute viral respiratory tract infections (RTI) is a challenge due to overlapping clinical presentations and lack of availability of robust diagnostic methods. This in turn leads to lack of data regarding incidence and seasonality of viral RTIs which could potentially help to implement efficient strategies of antimicrobial stewardship as well as vaccine administration. Here we utilise a commercial Multiplex PCR assay for the early diagnosis of acute respiratory tract infections and discuss their epidemiology. methods A prospective, observational study was conducted over a period of 3 years (2017-2019). Respiratory samples received from outpatients and inpatients with suspected acute RTIs from three multispeciality hospitals located in the twin cities of Hyderabad-Secunderabad were subjected to FilmArray Respiratory Panel (RP) (BioFire Diagnostics, Salt Lake City, Utah, USA). Results were tabulated and statistically analysed. results Of 513 samples, 261 (50.9%) were positive for one or more pathogens. The viruses detected included influenza A H1 2009 (26.0%), human rhinovirus/enterovirus (21.5%), influenza A H3N2 (17.0%), human metapneumovirus (9.4%), influenza B (6.6%), coronavirus (4.9%), parainfluenza virus (4.5%), respiratory syncytial virus (3.1%) and adenovirus (2.1%). The largest number of samples was positive during the monsoon season (43.8%). Influenza A H1 2009 peaked in the monsoon season with another, smaller peak in February. conclusions There is a bimodal peak of respiratory infections relative to the seasons, and vaccine administration should take place in April-May before the advent of the monsoons in this part of the country. Multiplexed PCR may be used as first line for diagnosis of viral infections so that infection control measures can be prioritised and antibiotic administration can be avoided in those who do not require it. keywords multiplex PCR, respiratory tract infections, viral infections, influenza Sustainable Development Goals (SDGs): SDG 3 (good health and well-being)

No abstract