Sadaf Khursheed Baba, Abiroo Jan, Mohd Suhail Lone, Dalip K Kakru, Bashir Ahmad Fomda, Gulnaz Bashir, Nadeem Ahmad Bhat,
Volume 17, Issue 3 (May-Jun 2023)
Abstract
Background and objectives: Conventional culture and sensitivity methods take around 48 hours to generate antibiotic sensitivity results after a blood culture is flagged as positive by automated systems. However, it is imperative to initiate early targeted antibiotic therapy for effective management of sepsis and to reduce morbidity, mortality, and cost of treatment. This study aimed to evaluate the direct sensitivity test (DST) as a potential tool to obtain quicker antibiotic susceptibility results from positive BacT/ALERT blood culture vials and the VITEK-2 system (the reference method).
Methods: Blood culture bottles flagged as positive by BacT/ALERT were Gram-stained. Cultures with polymicrobial growth were excluded from the study. The isolates were then simultaneously cultured and processed for the DST using the disk diffusion method. Agreements or errors were interpreted according to the Clinical and Laboratory Standards Institute’s guidelines.
Results: Among 76 Gram-positive isolates, we observed 99.2% essential agreement between the DST and AST. The rate of minor and major errors was 4.04% and 1.18%, respectively. Among 75 Gram-negative isolates, we observed 98.99% essential agreement between the DST and AST. The rate of minor and major errors was 4% and 2%, respectively. No very major error was seen in either Gram-negative or -positive isolates.
Conclusions: The DST results are available earlier than the AST results, which can ultimately help in the early initiation of targeted antibiotic therapy.
Sahar Siddiqui, Mohd Suhail Lone, Umer Qureshi, Rayees Khanday,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Staphylococcus aureus (S. aureus) is a common pathogen that causes both community and hospital-acquired infections Objectives: To identify clinico-microbial profiles of S aureus acquired in the community and in the hospital. Methods This study was conducted from January 2021 to December 2022 in Postgraduate Department of Pediatrics Children Hospital Srinagar J&K on patients aged one month to 18 years suspected of having S. aureus sepsis or disseminated disease. Results: There were 56 patients identified with S aureus septicemia (SAS) over the study period; 37(66.10%) had community acquired S aureus sepsis (CASS) and 19(33.90%) hospital acquired S aureus sepsis (HASS). 35(62.50%) affected belonged to male gender; 40(71.43%) patients belonged to rural area. Localized musculoskeletal symptoms (91.90%) were the most commonpresentation P value < 0.05. Pleuropulmonary disease and necrotizing soft tissue disease were significantly associated with patients of HASS and CASS respectively. The common disease presentation was pneumonia followed by abscess. Septic shock, respiratory failure, multi organ dysfunction, etc were the common complications seen more often in HASS. Out of 50 patients who had SAS in cultures, 48 were Methicillin resistant S aureus (MRSA) and 2 were Methicillin sensitive S aureus (MSSA). The survival rate from CASS was 94.60% and from HASS was 89.50% Conclusions: CASS and HASS affects children, is multifocal, and has high morbidity associated. The sensitivity pattern of Staphylococcus aureus in our settings as well as globally has undergone a dramatic change with rise in proportion of Methicillin resistance and needs to been addressed urgently.
