Browsing by Author "Loomba, Poonam"
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Item Bacteriological Profile Of Nosocomial Pneumonia Patients In A Superspeciality Hospital.(2016-05) Tiwari, Urvashi; Loomba, Poonam; Dogra, Vinita; Mishra, BibhabatiBackground: To ascertain the bacteriological profile of patients with nosocomial pneumonia in endotracheal cultures and correlation with blood cultures. Methodology: 559 endotracheal aspirates were collected using mucous traps from 180 patients of suspected nosocomial pneumonia patients over 2 years. The samples were processed and a colony count of 104cfu/ml was taken as the cut-off to differentiate between pathogens and colonizers. Identification and sensitivity of bacterial isolates was done with the help of Vitek 2. Blood for culture was processed as per standard techniques. Results & Conclusion: Klebsiella sp.(33%) was the commonest bacteria isolated, followed by Acinetobacter baumanii, Pseudomonas sp., Escherichia coli and Staphylococcus aureus. 25% of Acinetobacter spp. and 40% of Pseudomonas spp were pandrug resistant. Mostly non-fermenters were sensitive to Tigecycline and Colistin. Enterobacteriaceae showed highest resistance for Cephalosporins and Cotrimoxazole but were mostly sensitive to Tigecycline. Staphylococcus aureus was uniformly sensitive to Linezolid and Teicoplanin. Blood cultures were positive in 52 (9.3%) patients of which pulmonary origin bacteremia was present in 33 patients while non-pulmonary origin bacteremia was present in 19 patients. The pulmonary care bundle along with rational use of antibiotics will go a long way to improve treatment outcome, patient morbidity and mortality.Item Cryptococcal granulomas in an immunocompromised HIV-negative patient.(2008-10-15) Taneja, Juhi; Bhargava, Aradhana; Loomba, Poonam; Dogra, Vinita; Thakur, Archana; Mishra, BibhabatiDisseminated cryptococcosis usually occurs in immunocompromised individuals with defective cell-mediated immunity, most commonly seen with HIV infection. We present a case of disseminated cryptococcosis in an HIV-negative male patient who presented with headache, fever, altered sensorium of short duration and multiple cutaneous lesions. An emergency CT scan of the head showed multiple intracranial and intraventricular granulomas. Routine laboratory investigations were within the normal range. A CSF examination revealed capsulated yeasts on India ink and a culture yielded cryptococcus neoformans. A cryptococcal antigen test by latex agglutination kit was positive. A biopsy revealed multiple capsulated yeasts cells in the cutaneous lesions, which were consistent with cryptococcus neoformans. The patient was successfully treated with Amphotericin B and Fluconazole with regression of cranial and cutaneous lesions.Item Effect of trimethoprim-sulfamethoxazole vs. norfloxacin on fecal E. coli resistance pattern and efficacy in patients receiving prophylaxis for spontaneous bacterial peritonitis(Medip Academy, 2018-11) Dutta, Siddhartha; Chawla, Shalini; Srivastava, Siddharth; Loomba, Poonam; Roy, VandanaBackground: Spontaneous Bacterial Peritonitis (SBP) is an infection of ascitic fluid. It is highly mortal and recurrent condition, so prophylaxis with Norfloxacin (NOR) or Trimethoprim-sulfamethoxazole (TMP-SMX) seems to play an important role in the prevention of further episodes of SBP. Aims of the study were to assess the effect of TMP-SMX/NOR on the sensitivity pattern of fecal E. coli after long term prophylaxis in Spontaneous Bacterial Peritonitis (SBP) and to compare the efficacy of TMP-SMX and NOR in prophylaxis of SBP.Methods: An interventional, prospective, open label, single center study conducted in Maulana Azad medical college, New Delhi, India. 52 patients of SBP or with high risk of SBP were screened and finally 39 patients were recruited. Stool sensitivity testing of fecal E. coli was done and they were divided into TMP-SMX group(n=18) and NOR group(n=21) according to sensitivity. After 45±3 days (7 weeks) their stool sample was re-examined for change sensitivity pattern of E. coli. Efficacy variables like any episode of SBP, fever (FEV) resolution of ascites (ASC), bacteremia (BACT), extraperitoneal infection (EPI), liver transplantation (LT) or death (D) were noted throughout the period of 24 weeks.Results: Resistance developed in 60% vs. 48% in TMP-SMX vs. NOR group(p=0.46) after 45 days of prophylaxis. By the end of 24 weeks, Incidence of SBP (29%vs. 25%, p>0.99), episodes of FEV(P=0.60), EPI(p>0.99), ASC(p>0.99) and death (14% vs. 16%, p>0.99) were almost similar in both the groups (TMP-SMX vs. NOR) respectively.Conclusions: Both TMP-SMX and NOR showed same degree of resistance and found equi-efficacious when administered as long-term prophylactic therapy in SBP. TMP-SMX can be a suitable as well as cost effective alternative to NOR for the prophylaxis of SBP.Item Post-operative sinus formation due to Mycobacterium abscessus: A case report.(2013-07) Haider, Mehvash; Banerjee, Priyanka; Jaggi, Tavleen; Husain, Jasmin; Mishra, Bibhabati; Thakur, Archana; Dogra, Vineeta; Loomba, PoonamSummary: Mycobacterium abscessus is ubiquitously found rapidly growing mycobacteria. Although it is an uncommon pathogen, it has been known to cause cutaneous infection following inoculation, minor trauma or surgery. This communication reports an immuno-competent patient developing multiple sinuses due to Mycobacterium abscessus in the post- operative period.