J Postgrad Med
-
Methicillin-resistant Staphylococcus aureus (MRSA) is the most common multidrug-resistant pathogen causing nosocomial infections across the world. MRSA is not only associated with significant mortality and morbidity but also places a large economic strain on our health care system. MRSA isolates are also typically resistant to multiple, non-β-lactam antibiotics. We conducted a prospective study in a tertiary care hospital, to determine the prevalence of MRSA and to establish the clonal distribution of MRSA isolates recovered from various clinical specimens. ⋯ Prevalence of MRSA in our hospital was 39.48%. Most of these isolates were resistant to erythromycin, clindamycin, cotrimoxazole, and ciprofloxacin, whereas high sensitivity was seen to vancomycin followed by gentamicin. CDD and MIC for cefoxitin showed 100% sensitivity, specificity, PPV and NPV as compared to PCR for mecA gene. In maximum number of isolates PFGE type A pattern was seen suggesting clonal relatedness.
-
Recent review of older (≥45-years-old) patients admitted to our trauma center showed that more than one-third were using neuro-psychiatric medications (NPMs) prior to their injury-related admission. Previously published data suggests that use of NPMs may increase patients' risk and severity of injury. We sought to examine the impact of pre-injury NPM use on older trauma patients' morbidity and mortality. ⋯ Large proportion of older trauma patients was using pre-injury NPMs. Several regimens involving NPMs and CMs were associated with increased in-hospital mortality. Additionally, use of ≥3 NPMs was associated with lower 90-day survival.