RESUMEN
PURPOSE: Many isolates of Serratia marcescens, a well-known opportunistic pathogen, can be multidrug resistant. Fluoroquinolones are among the most important groups of antibiotics used for treatment of these organisms. However, fluoroquinolone resistance among S. marcescens isolates is fast increasing. Drug extrusion through efflux pumps like SdeAB/ HasF is one of the major mechanisms of resistance to fluoroquinolones. This study was carried out to analyze, through gene expression analysis of sdeB, the relative contribution of this mechanism toward fluoroquinolone resistance in clinical isolates of Serratia. MATERIALS AND METHODS: Total RNA from 45 clinical isolates of S. marcescens was isolated. Quantitative real-time RT PCR was performed on the extracted RNA to study the gene expression of sdeB and was normalized to the sdeB expression in the standard strain of S. marcescens. RESULTS: Of the 45 isolates analyzed, sdeB expression was found to be elevated in 20 isolates (44%). Of these 20 isolates, eight (40%) were fully resistant to at least one of the fluoroquinolones studied. Conversely, of the 20 isolates that over-expressed sdeB, 12 (60%) were fully sensitive to all fluoroquinolones tested. CONCLUSIONS: Drug efflux pumps are an important means of fluoroquinolone resistance among clinically important species of Serratia. The expression of these pumps can be up-regulated in the presence of antibiotics and have the potential for changing the phenotype from sensitive to resistant, thus contributing to therapeutic failures.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Fluoroquinolonas/farmacología , Perfilación de la Expresión Génica , Proteínas de Transporte de Membrana/biosíntesis , Proteínas de Transporte de Membrana/genética , Serratia marcescens/efectos de los fármacos , Serratia marcescens/genética , Antibacterianos/metabolismo , Antibacterianos/farmacología , Fluoroquinolonas/metabolismo , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa , Infecciones por Serratia/microbiología , Serratia marcescens/aislamiento & purificaciónRESUMEN
OBJECTIVES: To determine the outcome, seasonal variation, and death pattern of snakebite cases admitted at the tertiary health care centre in the last 10 years. METHODS: This was a record-based retrospective descriptive study at the Dr Shankarrao Chavan Government Medical College and Hospital in Vazirabad, a tertiary health care centre in Maharashtra, India. RESULTS: Out of 5 639 admitted snakebite cases, 65.24% were male. The 16 - 45-year age group accounted for 84.7% of cases; 46% were referred from other health centres, mostly from rural areas; 55.2% occurred during July to September, which coincided with the rainy season in this region; 94.6% of the snakebite patients survived; and 5.4% died. Case fatality rates were higher for females (8.78%) and for bites by neurotoxic snakes (8.91%). CONCLUSIONS: Snakebite is a common life-threatening emergency in the study area. Ready availability and appropriate use of antivenom, early referral when required and close monitoring of patients in the hospital will help to reduce mortality from snakebites.
Asunto(s)
Mordeduras de Serpientes/epidemiología , Adolescente , Adulto , Antivenenos/uso terapéutico , Urgencias Médicas , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Prevalencia , Pronóstico , Mordeduras de Serpientes/mortalidadAsunto(s)
Técnicos Medios en Salud/estadística & datos numéricos , África del Sur del Sahara , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/tendencias , Humanos , India , Servicios de Salud Rural/estadística & datos numéricos , Servicios Urbanos de Salud/estadística & datos numéricos , Recursos HumanosRESUMEN
A community based cross sectional study was carried out in married reproductive age group women in Urban Health Centre field practice area of Govt. Medical College, Aurangabad. The study aimed to find out extent and socio-demographic correlates of unmet need for family planning. 20.54% of married women in reproductive age had unmet need for contraception, 3.61% for spacing births and 16.93% for limiting births. The main reasons for unmet needwere, littie perceived risk of pregnancy due to perimenopausal age (32.471/o) lactation (31.16%), ignorance (12.32%) etc.