Browsing by Author "Barnali Kakati"

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    Comparative performance of biofire pneumonia panel and standard culture-based methods for diagnosing pneumonia in critically ill patients: Impact on antibiotic stewardship
    (Elsevier, 2024-04-22) Barnali Kakati; Rajender Singh; Garima Mittal; Nupur Koul
    Introduction: Lower respiratory tract infections (LRTIs) are a common cause of morbidity and mortality worldwide. Accurate identification of the pathogens causing LRTIs is crucial for ensuring of diagnostic and antibiotic stewardship. The Biofire Pneumonia Panel (BFPP) is a molecular diagnostic test that allows rapid detection of various bacterial and viral pathogens. In this study, we compared the performance of BFPP with standard culture methods for the detection of pathogens. Materials and methods: Respiratory samples from 70 patient with suspected LRTIs were tested using both BFPP and standard culture methods. The distribution of isolated bacterial pathogens was analyzed, and the sensitivity and specificity of BFPP were calculated. Additionally, the performance of BFPP in detecting antimicrobial resistance genes was evaluated. The results were compared with those obtained from VITEK-2 antimicrobial susceptibility testing and culture-based methods. Results: Among the suspected LRTI cases, BFPP identified a single pathogen in 32.8% of cases and multiple pathogens in 40% of cases. The standard culture method detected a single pathogen in 47.1% of cases. BFPP showed a sensitivity of 93.9% and a specificity of 45.9% for the total sample. The performance of BFPP in detecting antimicrobial resistance genes varied for different pathogens with overall sensitivity of 40.1% and specificity of 95.9%. Conclusion: The Biofire Pneumonia Panel (BFPP) demonstrated high sensitivity for several bacterial pathogens, indicating its potential as a rapid diagnostic tool. However, its performance varied for different microorganisms, and it had limitations in detecting certain pathogens and antimicrobial resistance genes for which still required more further studies to explore different resistance gene mechanism that can be incorporated in this panel in future. The BFPP can complement standard culture methods as a rapid tool in the diagnosis of LRTIs
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    Elizabethkingia meningoseptica With Targeted Environmental Surveillance in a Tertiary Care Hospital: A Retrospective Cohort Study
    (PUBMED, 2025-01-07) Garima Mittal; Rajender Singh; Manish Mittal; Mani Pant; Barnali Kakati; Saikat Patra
    Introduction Elizabethkingia meningoseptica (E. meningoseptica​​​) ​​​is a multidrug-resistant, non-fermenting Gram-negative bacillus increasingly associated with nosocomial infections, particularly in immunocompromised and critically ill patients. Its intrinsic resistance to multiple antibiotics limits treatment options and contributes to adverse clinical outcomes. Aim and objective The study aimed to investigate the clinical and microbiological characteristics of E. meningoseptica infections among ICU/NICU patients and to explore potential environmental sources through hospital-based surveillance. The objectives of this study were to describe the clinical and demographic profiles of ICU/NICU patients with E. meningoseptica infection; to assess the associated risk factors contributing to these infections; to analyze the antimicrobial susceptibility patterns of the isolated strains using standardized microbiological methods; to evaluate treatment outcomes including morbidity, mortality, and duration of ICU/NICU stay; and to identify potential environmental reservoirs of E. meningoseptica through surveillance activities coordinated by the Hospital Infection Control Committee (HICC). Methods A retrospective cohort study was conducted over 18 months (July 2023 to October 2024) at a tertiary care hospital. A total of 15 patients with culture-confirmed E. meningoseptica infection were included. Demographic, clinical, microbiological, and treatment data were collected. Identification and antimicrobial susceptibility testing were performed using the Vitek-2 automated identification system (bioMérieux, Marcy-l'Étoile, France). HICC conducted routine and targeted environmental sampling as per policy protocol. Results Among the 15 patients with E. meningoseptica infection, nine (60.0%) were adults, and 11 (73.3%) were male individuals. Sepsis was reported in nine (60.0%), and both ventilator-associated pneumonia and septic shock occurred in six patients each (40.0%). Hypertension and diabetes mellitus were present in six (40.0%) and three (20.0%) patients, respectively. Two neonates (13.3%) with low birth weight and prematurity required NICU admission. Outcomes included mortality in six patients (40.0%), discharge in five (33.3%), and four (26.7%) leaving against medical advice. Endotracheal secretions were the most frequent specimen (46.7%), followed by tracheostomy secretions (33.3%) and blood cultures (13.3%). All isolates (100%) were resistant to carbapenems, third-generation cephalosporins, aztreonam, and piperacillin-tazobactam. Resistance to gentamicin, colistin, and cotrimoxazole was observed in 73.3%, 66.7%, and 46.7% of isolates, respectively. Highest susceptibility was seen with minocycline (66.7%), vancomycin (60.0%), and fluoroquinolones (53.3%). Environmental surveillance, conducted from January to March 2023 as part of routine as well as targeted HICC monitoring (as an outbreak of suspected pathogens was suspected from the NICU and ICU), included 98 samples from high-risk ICU/NICU sites such as sinks, ventilators, humidifiers, and suction units. E. meningoseptica was identified in one sample (1.02%), isolated from a NICU sink. Conclusion E. meningoseptica infections are associated with high resistance and mortality. Minocycline, vancomycin, and fluoroquinolones may be effective. Early detection, targeted therapy, and HICC-led surveillance are essential for control.