Bacterial and fungal infections are a major cause of morbidity and mortality among neutropenic patients. The choice of empiric antimicrobial regimen is based on susceptibility pattern of locally prevalent pathogens. From 64 febrile neutropenic patients with clinical sepsis, blood and other appropriate clinical specimens were processed to determine bacterial and fungal spectrum and their antimicrobial susceptibility pattern. Risk factors for developing sepsis were determined by case-control study. 68 organisms were recovered. Fifteen (22.05%) were Gram-positive cocci with predominance of methicillin Sensitive S. aureus (10.29%), 47 (69.11%) were Gram-negative rods with predominance of Klebsiella pneumoniae (30.88%) and four were Non albicans Candida. 81% and 60% of Klebsiella and E. coli were ESBL producers. All species of Candida were sensitive to amphoterecin B and voriconazole. Duration and extent of neutropenia, chemotherapy, immunosuppressive therapy, altered mucosal barriers and presence of central venous lines were statistically significant risk factors for developing sepsis. Gram-negative bacteria were the predominant isolates. The choice of therapy in neutropenic patients should be formulated based on local spectrum of microbes and local and regional resistance patterns.
Parasitic infections affect tens of millions of pregnant women worldwide, and directly or indirectly lead to a spectrum of adverse maternal and fetal/placental effects. To determine the prevalence of intestinal parasites in pregnant women and its association with various factors. Stool specimens were collected from pregnant women in a clean, wide mouth, leak-proof screw capped container. Formol ether Concentration technique was performed to increase the yield of the eggs and larvae. Modified Acid Fast staining was done for opportunistic parasitic infections. Out of the 300 pregnant women screened for presence of intestinal parasites, the prevalence of intestinal parasites was 42.67%. Protozoa (88.65%) were predominant than the helminths (11.34%). The prevalence of intestinal parasites was more in the second and the third trimester as compared to the first trimester. Primigravida women had greater positivity of intestinal parasites than the multigravida. Out of 220 anemic females, 115 (52.27%) had presence of intestinal parasites showing an association between anemia and intestinal parasites. Intestinal parasitosis showed a significant correlation with eosinophilia. Two independently collected stool specimens for routine stool examination should be sufficient to ensure adequate diagnostic sensitivity. Routine screening of stool samples for intestinal parasites, especially in anemic, malnourished and women with eosinophilia should be considered as a part of the routine antenatal care. Considering the fact that sanitation and hygiene is suboptimal in most parts of the country, there should be a strong emphasis on the recommendations in the national guidelines regarding deworming in pregnancy.
Background: Pregnant women often experience more severe intestinal parasitic infections than their non-pregnant counterparts. Intestinal parasitic infections also disturb pregnancy at the maternal and fetal level. Objective of the study was to find out the prevalence of intestinal parasites in pregnant women and its relationship with various socio-demographic factors.Methods: A single stool specimen was collected. A saline and iodine mount was examined microscopically to demonstrate the intestinal parasites. Formol ether Concentration technique was performed to increase the yield of the eggs and larvae. Modified acid-fast staining was done for opportunistic parasitic infections.Results: In this study 300 pregnant women were screened for presence of intestinal parasites. The prevalence of intestinal parasites was 42.67%. Women who practiced hand washing regularly and had knowledge about parasites had lesser infection. The dietary practice of taking green leafy vegetables had protective effect during pregnancy. The prevalence of intestinal parasites was almost same in both rural and urban women. Higher prevalence of intestinal parasites was found in lower socioeconomic class. Women who used river as source of water supply had slightly more prevalence than those who used municipal water. The prevalence of hookworm infection was more in women who never wore sandals.Conclusions: The high prevalence of intestinal parasites in the pregnant women indicates faecal pollution of soil and domestic water supply. Education and awareness regarding intestinal parasites need to be done during their routine antenatal visits. Emphasis should be made on consistent hand washing, consumption of washed leafy vegetables and use of footwear. Deworming of pregnant women should be considered in the national guidelines.
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