Biomedical subjects

Uma Sekar

Publications and source records attributed to Uma Sekar.

4 recordsLinked to original sources

PubMed2006

Renal abscess.

This study analyses the pre-disposing factors, diagnostic modalities, therapeutic options and prognostic factors involved in 7 subjects with renal abscess. Most often they presented with high fever and flank pain. USG and CT were used to establish the diagnosis. Urine culture yielded organisms in five cases and hence empirical antibiotic therapy for Gram-negative organism was offered. Complicated abscess in our series carried high mortality especially in immuno suppressed and cachectic patients.

Abscess↗

PubMed2005

Detection of metallo betalactamase producing Pseudomonas aeruginosa in hospitalized patients.

BACKGROUND & OBJECTIVE: Metallo beta-lactamase (MBL)-mediated resistance to carbapenems is an emerging threat in hospital isolates of Pseudomonas aeruginosa. Though there are several screening methods to detect this enzyme production, the National Committee for Clinical Laboratory Standards (NCCLS) does not have performance standards documented so far. There is not enough information from the Indian subcontinent regarding the prevalence and the screening methods for these enzymes. The present study was undertaken to detect MBL in nosocomial isolates of P. aeruginosa by two screening methods. METHODS: Fifty consecutive P. aeruginosa isolates obtained from hospitalized patients were subjected to susceptibility testing to antipseudomonal drugs by disc diffusion, and minimum inhibitory concentration (MIC) of imipenem was determined. The production of MBL was detected by 4-fold reduction in MIC with imipenem-ethylene diamine tetraacetic acid (EDTA) and the zone size enhancement with EDTA impregnated imipenem and ceftazidime discs. RESULTS: Sixteen per cent of the isolates tested were resistant to imipenem by disc diffusion method of which 87.5 per cent exhibited a zone size enhancement with EDTA impregnated imipenem and ceftazidime discs as well as a 4-fold reduction in MIC with imipenem EDTA. The imipenem susceptible isolates (84%) had normal MIC values and exhibited no zone diameter enhancement with EDTA impregnated antibiotic discs. INTERPRETATION & CONCLUSION: MBL-mediated imipenem resistance in P. aeruginosa is a cause for concern in the therapy of critically ill patients. The two confirmatory methods i.e., zone diameter enhancement with EDTA impregnated imipenem and ceftazidime discs and 4-fold reduction in MIC with imipenem EDTA combination are equally effective for their detection.

Agar↗

PubMed2003

Blastocystis hominis--an emerging cause of diarrhoea in renal transplant recipients.

Blastocystis hominis is an intestinal protozoan that is emerging as an important cause of diarrhea in the immunosuppressed population. We report two cases of diarrhea caused by this organism in renal transplant recipients. The infection was diagnosed promptly by careful stool examination and treated successfully with metronidazole. These case report highlights the fact that unusual parasites like Blastocystis hominis should be looked for and treated in cases of diarrhea occurring in renal transplant recipients. This reduces the rate of post-transplant morbidity and mortality.

Adult↗

PubMed2003

Increase in minimum inhibitory concentration to quinolones and ceftriaxone in salmonellae causing enteric fever.

Multidrug resistance among Salmonella typhi is well known. Reports of treatment failure in enteric fever with Ciprofloxacin made us undertake this study to determine the antibiotic susceptibility pattern of S. typhi and S. paratyphi A isolated from typhoid bacteremia cases, by disc diffusion and MIC by broth dilution method. A total of 50 strains were tested, 48 of Salmonella typhi and 2 of S. paratyphi A. The disc diffusion method was done using ampicillin, chloramphenicol, cotrimoxazole, tetracycline, ciprofloxacin, ofloxacin, cefuroxime and ceftriaxone as antibiotics. The MIC was performed using ciproloxacin, ofloxacin and ceftriaxone based on standard procedure. ACCOT resistance as determined by disc diffusion method was seen in 68% of isolates. All the strains remained susceptible to flouroquinolones cephalosporins and aminoglycosides. The MIC of ciprofloxacin, ofloxacin and ceftriaxone were in the recommended range of susceptibility as given by NCCLS, 14 (28%) strains had MIC of ciprofloxacin greater than 0.5 ug/ml with 4 strains having an MIC of 1.56 ug/ml; 25 (50%) strains had MIC of ofloxacin greater than 0.5 ug/ml and 20 (40%) strains had MIC of ceftriaxone greater than 0.5 ug/ml. The high levels of MIC of ciprofloxacin may account for treatment failure cases. The rising levels of MIC of ofloxacin and ceftriaxone in S. typhi and S. paratyphi is also of concern. We document here the emergence of high levels of MIC not only to ciprofloxacin, but also ofloxacin and ceftriaxone in S. typhi and S. paratyphi A. We recommend that MIC levels of ofloxacin and ceftriaxone should be monitored along with ciprofloxacin in treatment failure cases of enteric fever.

Anti-Bacterial Agents↗