IMSEAR Repository :: Browsing by Author "Jain, Amita"

Browsing by Author "Jain, Amita"

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Aetiology of childhood viral gastroenteritis in Lucknow, north India.
(2015-04) Gupta, Shilpi; Singh, K P; Jain, Amita; Srivastava, Shilpi; Kumar, Vishwajeet; Singh, Mastan
Background & objectives: Due to limited availability of data on viral aetiology of acute gastroenteritis in north India, the present study was planned to detect rotavirus, norovirus, sapovirus and astrovirus in stool samples of both in hospitalized and non-hospitalized children less than five years of age presenting with acute gastroenteritis. Methods: A total of 278 stool samples from equal number of children were tested for rotavirus antigen using ELISA and for norovirus, sapovirus and astroviruses by reverse transcription (RT)-PCR. Results: Of the 169 samples from hospitalized patients, rotavirus, norovirus, sapovirus and astrovirus were detected in 19.5, 2.3, 3.5 and 2.9 per cent samples, respectively. Of the 109 samples collected from the non-hospitalized patients, frequency of rotavirus and sapovirus detection was 9.1 and 1.8 per cent, respectively while norovirus and astrovirus were not detected. Interpretation & conclusions: Rotavirus was the most frequent cause of viral gastroenteritis in both hospitalized and non-hospitalized children. Maximum positivity of the viruses was seen in children less than two years of age.
Antibiotic resistance pattern of group-a beta-hemolytic streptococci isolated from north Indian children.
(2008-10-15) Jain, Amita; Shukla, Vivek Kumar; Tiwari, Vandana; Kumar, Rashmi
Background: The current resistance pattern of GABHS (group-A beta-hemolytic streptococci) in India has not been discussed. Aim: To fill the above-mentioned void, we planned this study to determine the prevalence and degree of antibacterial resistance in GABHS isolates. Settings and Design: Children with acute pharyngo-tonsillitis who had not received antibiotic in the preceding week, attending the pediatric OPD, were prospectively enrolled over a period of 1 year. Throat swabs were collected from each child and transported to microbiology laboratory, as early as possible. Materials and Methods: A throat swab culture for GABHS was done. All GABHS were subjected to antibiotic susceptibility and minimum inhibitory concentration (MIC) test according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: In the present study, 12.6% (55/435) of the children with acute pharyngo-tonsillitis had throat swab culture positive for GABHS. The prevalence of macrolide resistance was 10.2%. The MIC50 for macrolide-resistant strain was 0.5 microg/mL (range, 0.125-8 microg/mL), and MIC90 was 8 microg/mL (range, 0.125-8 microg/mL). Tetracycline and co-trimoxazole resistances were 24.5% and 12.2% respectively. The values of MIC50 for tetracycline- and co-trimoxazole-resistant strains were 4 microg/mL (range, 0.125-32 microg/mL) and 2 microg/mL (range, 0.25-8 microg/mL) respectively. All isolates were sensitive to penicillin G and chloramphenicol on disc diffusion test. However, their MIC50 was 0.032 microg/mL (range, 0.012-0.125 microg/mL) and 2 microg/mL (range, 0.25-4 microg/mL) respectively. Conclusion: High prevalence of antimicrobial resistance found among GABHS needs a longitudinal surveillance of isolates from different centers in India.
Application of enzyme amplified mycobacterial DNA detection in the diagnosis of pulmonary & extra-pulmonary tuberculosis.
(2003-12-12) Tiwari, Vandana; Jain, Amita; Verma, R K
BACKGROUND & OBJECTIVES: As isolation of Mycobacterium tuberculosis in culture requires a long time, there is a need for simple rapid method for direct detection of M. tuberculosis from clinical specimens. Amplified nucleic acid hybridization assays such as polymerase chain reaction (PCR) have shown promising results. In the present study, the sensitivity of PCR assay was assessed over smear microscopy for rapid diagnosis of tuberculosis in pulmonary and extra-pulmonary samples from patients suspected to have tuberculosis. METHODS: A total of 37 clinical samples from patients with pulmonary tuberculosis and 133 from patients with extra-pulmonary tuberculosis were subjected to Ziehl-Neelsen staining for smear preparation and PCR for detection of mycobacterial DNA. RESULTS: It was observed that 100 per cent of acid fast bacilli (AFB) positive and 35.7 per cent of AFB negative pulmonary samples and 82.76 per cent of AFB positive and 56.73 per cent of AFB negative extra-pulmonary samples were positive for mycobacterial DNA detection. Total positivity rates of DNA amplification method in pulmonary and extra-pulmonary samples were 75.67 per cent and 61.7 per cent respectively which were significantly higher in comparison with AFB positivity, which was 62.16 per cent in pulmonary and 21.8 per cent in extra-pulmonary samples (P < 0.05 and P < 0.001 respectively). INTERPRETATION & CONCLUSION: Routine application of DNA amplification method in diagnosis of AFB negative patients with pulmonary or extra-pulmonary tuberculosis may be a useful tool for detection of M. tuberculosis.
Association between drug resistance & production of biofilm in staphylococci.
(2012-04) Agarwal, Astha; Jain, Amita
Authors’ response.
(2015-11) Gupta, Shilpi; Singh, K P; Jain, Amita; Srivastava, Shilpi; Kumar, Vishwajeet; Singh, Mastan
Blood zinc levels in children hospitalized with severe pneumonia: a case control study.
(2004-05-08) Kumar, Saket; Awasthi, Shally; Jain, Amita; Srivastava, R C
A case control study was conducted in a referral and teaching hospital in North India on children aged 2 months to 5 years, to compare blood zinc levels in 50 cases of severe pneumonia and 50 age,sex and nutritional status matched controls. Mean blood Zinc levels in cases and controls was 376.1 ug/dL + 225.73 and 538.52 microg/dL +/- 228.0 respectively ( P value 0.0003). In logistic regression model severe pneumonia was associated with lower blood zinc level, use of biomass fuel and isolation of H. Influenzae from nasopharyngeal swab. Cotrimoxazole resistant S. pneumoniae were isolated from 95% of cases and 41.2 % of controls (P = 0. 0004). Therefore, the role of zinc in treatment of severe pneumonia should be investigated.
Comparison of third generation ELISA and conventional nested RT-PCR for detection of HCV among hemodialysis patients.
(2014-08) Prakash, Shantanu; Sankhwar, S N; Jain, Amita; Usman, Kausar; Prasad, Narayan; Saha, D; Singh, K P; Parul, Jain; Singh, Desh Deepak
Hepatitis C virus is one of the main cause of chronic hepatitis in developing countries. The current study was done to evaluate the efficacy of the third generation ELISA compared to nested RT- PCR for establishing the diagnosis of hepatitis C virus (HCV) in patients on hemodialysis. This descriptive, cross-sectional study was carried out on 237 Hemodialysis patients in Lucknow, Uttar Pradesh. The retrospective demographic data of the subjects was collected and the patient’s serum samples were analyzed by ELISA & RT-PCR for HCV. In the present study, of total 21 HCV positive either by ELISA or PCR 12 (57.14%) were positive for both RT-nested PCR and ELISA. Total four (19.05%) patients were positive for HCV by RT-nested PCR and negative by ELISA while five (23.81%) patients were negative for RT-nested PCR and positive for ELISA. PCR method is accredited as a specific and reliable method suitable for screening of HCV and is recommended for establishing exact and final diagnosis of these patients. However third generation ELISA assays have many advantages in the diagnostic setting including ease of automation, ease of use, relative cost-effectiveness, and low variability.
Consensus Guidelines on Evaluation and Management of Suspected Acute Viral Encephalitis in Children in India.
(2012-11) Sharma, Suvasini; Mishra, Devendra; Aneja, Satinder; Kumar, Rashmi; Jain, Amita; Vashishtha, Vipin M
Justification: Viral encephalitis is an important cause of mortality and morbidity in children. The etiological agents are varied, and physicians treating such children often feel limited by the lack of uniform guidelines on evaluation and management of these critically ill children in resource-constrained settings. Process: An ‘Expert Group Meeting on Viral Encephalitis in Children’ was held on 19th January, 2012 in Gurgaon, Haryana (under the aegis of PEDICON 2012, the National Conference of Indian Academy of Pediatrics). The invited experts included pediatricians and microbiologists with expertise in the relevant field. Various issues related to the subject were discussed and it was decided to bring out recommendations on the topic. The final recommendations were produced after circulating the draft document, and incorporating/discussing all changes, by e-mail. Objectives: To aid the pediatrician in the evaluation and management of children with suspected viral encephalitis and to assist the public health authorities in acute encephalitis surveillance. These guidelines do not cover viral encephalitis in the neonatal period and in immunocompromised children, Rabies encephalitis, and chronic viral encephalitis such as Subacute sclerosing panencephalitis (SSPE). Recommendations: Recommendation for evaluation and management of suspected viral encephalitis in children are presented. In any acute encephalitis outbreak, pediatricians should be aware of the common viral causes of encephalitis in their area, what information and samples they should collect, and the contact details of the District Surveillance Unit. Pending specific diagnosis and therapy (which may or may not be possible), prompt empirical therapy and meticulous supportive care are important to prevent ongoing brain damage, and improve outcome.
Current status of leprosy as seen in a tertiary care hospital in north India.
(2012-03) Jain, Amita
Dengue in India.
(2012-09) Gupta, Nivedita; Srivastava, Sakshi; Jain, Amita; Chaturvedi, Umesh C
Dengue virus belongs to family Flaviviridae, having four serotypes that spread by the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. Dengue disease presents highly complex pathophysiological, economic and ecologic problems. In India, the first epidemic of clinical dengue-like illness was recorded in Madras (now Chennai) in 1780 and the first virologically proved epidemic of dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India in 1963-1964. During the last 50 years a large number of physicians have treated and described dengue disease in India, but the scientific studies addressing various problems of dengue disease have been carried out at limited number of centres. Achievements of Indian scientists are considerable; however, a lot remain to be achieved for creating an impact. This paper briefly reviews the extent of work done by various groups of scientists in this country.
Detection of extended spectrum beta-lactamase production in clinical isolates of Klebsiella spp.
(2008-04-26) Jain, Amita; Mondal, Rajesh
BACKGROUND & OBJECTIVE: Clinical laboratories need to develop quick screening methods for detection of extended spectrum beta-lactamase (ESBL) producing strains, so that the appropriate medication can be started without delay. In this study, we report the screening sensitivity of four representative antimicrobial agents i.e., cefpodoxime, cefotaxime, ceftazidime and aztreonam, commonly used for ESBL detection in Klebsiella spp. METHODS: A total of 100 clinical isolates of Klebsiella spp. from the cases of neonatal septicaemia at a tertiary care hospital from north India, were screened for ESBL production by Kirby- Bauer's disc diffusion (cefpodoxime, cefotaxime, ceftazidime and aztreonam) and minimum inhibitory concentration (MIC) test by agar dilution methods. Confirmation was done by double disc method. RESULTS: Results showed that 58 of the 100 isolates tested were ESBL positive by confirmatory test and cefpodoxime was more efficient ESBL screening antimicrobial agent than ceftazidime, cefotaxime and aztreonam. INTERPRETATION & CONCLUSION: Using the standard disk diffusion as screening test for identifying ESBL producers, cefpodoxime was found to be the most efficient antimicrobial agent in screening isolates as potential ESBL producers followed by ceftazidime in Klebsiella spp. isolates.
Determination of a cut-off value for the serological diagnosis of scrub typhus by detecting anti-Orientia tsutsugamushi immunoglobulin M
(Wolters Kluwer – Medknow, 2023-06) Jain, Amita; Jain, Parul; Rebello, Sanjay C.; Todaria, Moulika; Kaur, Harmanmeet; Gupta, Nivedita; Aggarwal, Neeraj; Vijay, Neetu; Narayan, Jitendra
Background & objectives: The diagnosis of scrub typhus (ST) is usually done using enzyme-linked immunosorbent assay (ELISA) due to its ease of performance and reading objectivity. The cut-off value for ELISA needs to be calculated for each geographical location as it depends on zonal endemicity of the disease. This study was, therefore, undertaken to calculate the pan-India cut-off for anti-Orientia tsutsugamushi (OT) immunoglobulin M (IgM) by ELISA. Methods: Samples from cases (cases of ST) and controls (voluntary, consenting, healthy adults) were collected by a network of 29 laboratories across India and tested for anti-OT IgM by immunofluorescence assay (IFA), the considered gold standard test. These samples were retested by ELISA for anti-OT IgM and their optical densities (ODs) were used for cut-off estimation by receiver operating characteristic (ROC) curve. Results: Anti-OT IgM ELISA ODs from 273 controls and 136 cases were used for the cut-off estimation. The ODs of the anti-OT IgM ELISA on healthy individuals and those of confirmed ST cases ranged from 0.1 to 0.75 and 0.5 to 4.718, respectively. ROC curve-based cut-off for ELISA was calculated as 0.554 at a sensitivity of 95.2 per cent and specificity of 95.1 per cent. A value of >1 was noted to have a specificity of 100 per cent in diagnosing ST. Interpretation & conclusions: The cut-off calculated for India was similar to the previous cut-off that was used until now.
Drug resistance profile among multi-drug resistant tuberculosis patients at diagnosis and correlation with history of anti-tubercular treatment in a tertiary care center
(Medip Academy, 2019-11) Kumar, Rahul; Garg, Rajiv; Kshetrimayum, Silpa; Jain, Amita
Background: Drug Resistant Tuberculosis (DR-TB) is a major threat to the realization of the goal of a TB free world in the near future. It is important to study the reasons for the increasing number of such cases so that effective action can be taken to control this growing epidemic.Methods: Sputum from 36 patients diagnosed with acquired pulmonary Multidrug Resistant Tuberculosis (MDR-TB) were subjected to first- and second-line Drug Sensitivity Testing (DST) after liquid culture in mycobacterium growth Indicator Tube (MGIT). Primary MDR-TB cases were excluded. The relation of the drug sensitivity profile with the history of prior treatment taken was statistically analysed.Results: Majority of the patients had received appropriate treatment, and most had adhered to prescribed treatment. Among the 36 patients, 24(66.7%) were found to be Pre-Extensively Drug Resistant (Pre-XDR-TB) and 4(11.1%) were extensively drug resistant XDR-TB cases. Inappropriate prescription of fluoroquinolone (FQ) was found to be most common. Prior intake of any drug was not found to significantly affect subsequent resistance to that drug.Conclusions: Fluoroquinolone resistance is quite common in patients with DR-TB (66.7%). This study did not find the prior use of FQ or any other drug to significantly affect subsequent resistance to the drug. Primary drug resistance is thus a major concern. 11.1% patients were found to be XDR-TB cases. Hence DST for first- and second-line drugs should be done at the time of diagnosis to avoid failure of treatment with a predesigned regimen.
Glucose & sodium chloride induced biofilm production & ica operon in clinical isolates of staphylococci.
(2013-08) Agarwal, Astha; Jain, Amita
Background & objectives: All colonizing and invasive staphylococcal isolates may not produce biofilm but may turn biofilm producers in certain situations due to change in environmental factors. This study was done to test the hypothesis that non biofilm producing clinical staphylococci isolates turn biofilm producers in presence of sodium chloride (isotonic) and high concentration of glucose, irrespective of presence or absence of ica operon. Methods: Clinical isolates of 100 invasive, 50 colonizing and 50 commensal staphylococci were tested for biofilm production by microtiter plate method in different culture media (trypticase soy broth alone or supplemented with 0.9% NaCl/ 5 or 10% glucose). All isolates were tested for the presence of ica ADBC genes by PCR. Results: Biofilm production significantly increased in the presence of glucose and saline, most, when both glucose and saline were used together. All the ica positive staphylococcal isolates and some ica negative isolates turned biofilm producer in at least one of the tested culture conditions. Those remained biofilm negative in different culture conditions were all ica negative. Interpretation & conclusions: The present results showed that the use of glucose or NaCl or combination of both enhanced biofilm producing capacity of staphylococcal isolates irrespective of presence or absence of ica operon.
In silico designing of siRNA targeting PB 1 gene of Influenza A virus and in vitro validation.
(2014-08) Jain, Bhawana; Jain, Amita; Prakash, Om; Singh, Ajay Kr; Dangi, Tanushree; Singh, Mastan; Singh, Kaleshwar P
Genomic variability makes Influenza A virus (IAV) ‘the least susceptible’ to existing vaccines or anti-influenza drugs. siRNA targeting viral gene silents the gene by cleaving mRNA. Present study aimed to develop siRNA targeting polymerase basic 1 (PB1) gene and to validate its efficiency in vitro. siRNA was designed rationally, targeting the most conserved region of PB1 gene of IAV strains. Total 147 strains worldwide and 42 Indian strains, when aligned, showed seven sets of conserved regions (> 30 bp stretch and < 5% mismatches). To choose the most efficient siRNA, three levels screening method was developed. Finally one pair of siRNA was chosen due to its unique position in conserved region. siRNA efficacy was confirmed in vitro on Madin Darby Canine Kidney (MDCK) cell line propagating two clinical isolates i.e. Influenza A/H3N2 [A/India/LKO864/ 2011(H3N2)] and Influenza A/pandemicH1N1 [A/India/LKO2151/2012(H1N1)]. The longest ORF was targeted by the selected siRNA, which showed 57 % inhibition in replication of Influenza A/pdmH1N1 and 60.6 % inhibition in replication of Influenza A/H3N2 at 72 hpi and 48 hpi respectively on MDCK cell line. This study shows that siRNA targeting PB1 may be moderately effective in controlling IAV replication so can be used as anti-IAV therapeutic agent.
In vitro validation of self designed “universal human Influenza A siRNA”.
(2015-08) Jain, Bhawana; Jain, Amita; Prakash, Om; Singh, Ajay Kr; Dangi, Tanushree; Singh, Mastan; Singh, KP
The genomic variability of Influenza A virus (IAV) makes it difficult for the existing vaccines or anti-influenza drugs to control. The siRNA targeting viral gene induces RNAi mechanism in the host and silent the gene by cleaving mRNA. In this study, we developed an universal siRNA and validated its efficiency in vitro. The siRNA was designed rationally, targeting the most conserved region (delineated with the help of multiple sequence alignment) of M gene of IAV strains. Three level screening method was adopted, and the most efficient one was selected on the basis of its unique position in the conserved region. The siRNA efficacy was confirmed in vitro with the Madin Darby Canine Kidney (MDCK) cell line for IAV propagation using two clinical isolates i.e., Influenza A/H3N2 and Influenza A/pdmH1N1. Of the total 168 strains worldwide and 33 strains from India, 97 bp long (position 137-233) conserved region was identified. The longest ORF of matrix gene was targeted by the selected siRNA, which showed 73.6% inhibition in replication of Influenza A/pdmH1N1 and 62.1% inhibition in replication of Influenza A/H3N2 at 48 h post infection on MDCK cell line. This study provides a basis for the development of siRNA which can be used as universal anti-IAV therapeutic agent.
Influenza virus genotypes circulating in and around Lucknow, Uttar Pradesh, India, during post pandemic period, August 2010 - September 2012.
(2014-03) Dangi, Tanushree; Jain, Bhawana; Singh, Ajay Kumar; Mohan, Madan; Dwivedi, Mukesh; Singh, J V; Kumar, Rashmi; Singh, K P; Chaddha, M S; Mishra, A C; Jain, Amita
Background & objectives: During the post influenza pandemic period, continuous surveillance of influenza virus and its subtypes is mandatory to help the policy makers to take effective and appropriate decisions. Therefore, this study was planned to determine the pattern of influenza virus activity in context to various meteorological and clinical parameters in and around Lucknow, Uttar Pradesh, India, during post pandemic period August 2010 - September 2012. Methods: Nasal swabs/throat swabs/nasopharyngeal aspirates of 2669 patients were collected. One-step real time PCR for detection of influenza virus was done according to the Centers for Disease Control and Prevention (CDC) protocol. Results: Influenza positivity was 15.8 per cent (423/2669) in symptomatic patients. Of the 423 total positives, 192 (7.2%) were influenza A and 231 (8.7%) were influenza B. Positivity for influenza virus was significantly (P=0.001, OR=2.9, CI=1.9-4.3) higher in patients with Influenza like illness (ILI) (17.4%, 396/2271) than those with severe acute respiratory illness (SARI) (6.8%, 27/398). Influenza A positive samples were subtyped as; pdmH1N1 (67.2%, 129/192) and seasonal H3N2 (32.8%, 63/192). It significantly correlated with monthly mean rainfall, humidity and dew point while atmospheric pressure was inversely related. No significant association was found with temperature and wind speed. Clinical variations were observed between different strains of Influenza virus. Interpretation & conclusions: The findings provide a clear picture of different clinical presentations of various strains of influenza A and B viruses and epidemiology of influenza infection from Lucknow (UP), India. The seasonality of influenza virus infection showed variation in relation to different environmental factors. Pandemic H1N1 caused more systemic infection than seasonal influenza A/H3N2 virus.
Initial drug resistance pattern among Pulmonary Tuberculosis patients.
(2013-07) Gupta, Harshita; Kant, Surya; Jain, Amita; Natu, S M; Ahluwalia, Savita
Background: Drug resistant tuberculosis (DRTB) is an emerging problem that adversely affects treatment outcomes and public health in the developing world. Objective: To determine the initial drug resistance pattern among pulmonary tuberculosis patients registered under the Revised National Tuberculosis Control Programme. Study Design: A cross-sectional study design. Setting: Two urban Directly Observed Treatment Supervised (DOTS) centres in Lucknow District of Uttar Pradesh. Methods: The present study consisted of newly diagnosed sputum smear-positive for acid-fast bacilli (AFB) cases at the time of registration under the tuberculosis control programme. All sputum smear positive cases were subjected to culture and drug-susceptibility testing by 1% proportion method on Lowenstein-Jensen (LJ) medium. Results: A total of 185 newly diagnosed sputum smear positive for AFB in pulmonary tuberculosis patients were subjected to culture and drug sensitivity test. Among 185 isolates, 170 (91.4%) isolates were culture positive. Of these 170 isolates, 169 (99.4%) were M. tuberculosis and one (0.5%) was Mycobacterium other than tuberculosis (MOTT). Out of 99.4% M. tuberculosis positive isolates, 21.3% were resistant to at least one drug. Resistance pattern of 21.3% strains of M. tuberculosis showing resistance to single, double, triple, and quadruple drugs were 5.9%, 10.7%, 2.4% and 2.4% respectively. Multi-drug resistance (MDR) was observed in 4.7% isolates. Conclusion: The present study highlights the high rate of drug resistance pattern among the new sputum smear positive pulmonary tuberculosis patients and also high MDR tuberculosis. Routine surveillance of drug resistance profile of patients provides useful information for adopting new strategies of effective treatment within National Tuberculosis Control Programmes in order to combat the threat of MDR-TB in the general population.
Intravenous device associated blood stream staphylococcal infection in paediatric patients.
(2011-08) Jain, Amita; Agarwal, Astha; Verma, Raj Kumar; Awasthi, Shally; Singh, K P
Background & objectives: Intravenous device (IVD) associated nosocomial blood stream infections due to staphylococci are major cause of morbidity and mortality. The present study was carried out to assess the frequency of staphylococcal IVD associated infections in a paediatric ward of a tertiary case hospital. Prevalence of resistance to commonly used antimicrobials in hospital acquired staphylococcal isolates was also tested. Methods: Children admitted in paediatric wards with IVD for more than 48 h were enrolled. Blood, IVD tip at the time of removal, skin swab at the site of insertion of IVD and nasal swab were collected and cultured by standard protocol. All staphylococcal isolates from any source were analyzed for antimicrobial susceptibility by disk diffusion method. Genotyping matching of those staphylococcal isolates was done which were isolated from different sites of the same patient, but were phonotypically similar. Genotype of blood isolate was compared with genotype of isolate from nose/IVD/skin. Results: Staphylococcus aureus was the most frequent blood isolate (8.7%) followed by Candida (2.9%), coagulase negative staphylococci (CoNS 2.6%), Pseudomonas spp. (0.4%), Klebsiella spp. (0.3%) and Escherichia coli (0.1%). Isolation of microorganisms from blood was significantly higher in patients whose skin, IVD and nose were colonized by same microorganism (P<0.001). None of the staphylococcal isolate was found to be resistant to glycopeptides (vancomycin and teicoplanin). High penicillin and oxacillin resistance was present in both S. aureus (penicillin resistance; 76.8%, oxacillin resistance; 66.7%) and CoNS (penicillin resistance; 73.3%, oxacillin resistance; 60.0%). Among CoNS biotypes, S. haemolyticus was commonest blood isolate while S. epidermidis was commonest isolate from Skin/nose. Only 33.3 per cent of S. aureus blood stream infections and most of S. epidermidis and S. haemolyticus blood infections were IVD associated. Interpretation & conclusions: Staphylococci were the major causative agent of nosocomial blood stream infections. All episodes of septicaemia due to S. epidermidis and S. haemolyticus were IVD associated while only 1/3 of S. aureus septicaemia was IVD associated.
Management Information Systems (HMIS): A Method for Strengthening HMIS in Uttar Pradesh, India.
(2015) Pandey, Chandrashekar; Khobragade, Pravin; Jain, Amita; Ghosh, Amit
Objectives: Estimates from robust cross sectional surveys have brought into question the accuracy of HMIS of VAS in India, including potential errors as HMIS data is rolled up at various levels from health worker- to state-level, limiting the usefulness of these data for program feedback and improvement. In response, we sought to identify errors in monitoring data at different levels, suggest corrective action and establish coverage by a cross sectional survey triangulated with HMIS data. Methods: This exercise was conducted in 16 districts where 48 primary health centers (PHCs) were selected randomly. Data on Vitamin A coverage recorded at districts, PHCs, sub-health centers (SHCs) and health worker/volunteer level were cross-verified with coverage figures recorded at their respective constituent units. Discrepancies between coverage data recorded at health facilities and that aggregated from their constituent units were computed. A 30X7 cluster survey was also undertaken in each of these centers to establish population-based coverage. Results: Overall, there was a 7% discrepancy between figures reported by PHCs and that aggregated from their SHCs. In some PHCs the discrepancy was as large as 40%. The cross-sectional household survey identified 10% higher coverage than that reported by the state government (52% vs 42%). District specific findings were used to identify and facilitate systemic changes in reporting and data compilation. Conclusions: This is a cost-effective method and useful exercise for improving internal data quality and minimizing reporting error. The involvement of government functionaries in the process increased the ownership of study results and facilitated corrective actions.

Browsing by Author "Jain, Amita"

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