Kempegowda Institute of Medical Sciences

This single-centre, hospital-based study from Uttarakhand, India, aimed to describe the genomic characterization data of Salmonella spp. isolated from clinical samples.

This study was performed between January 2019 and January 2023 and included eighteen clinical Gram-negative bacterial isolates which were identified as Salmonella species as per standard microbiological guidelines. The test isolates were sent to the Central Research Laboratory (CRL), Bengaluru, India, for characterization and whole-genome sequencing (WGS). At CRL, the test isolates were revived and subjected to preliminary identification and antibiotic susceptibility testing (AST) using the VITEK 2 Compact system, the results of which were interpreted according to the Clinical Laboratory Standards Institute (CLSI) guidelines 2023.

Of the 18 Salmonella spp. test isolates, twelve belonged to serovar Typhi, five to serovar Paratyphi A, and one isolate to serovar Typhimurium. The serotyping results were further confirmed by WGS in which no disparity was observed. Genotyping results were determined for twelve S. Typhi isolates, of which 41.7 % (5/12) belonged to genotype 4.3.1.2 (H58 LII) and one isolate belonged to genotype 4.3.1.1 (H58 LI), respectively. All isolates were susceptible to ampicillin, chloramphenicol, co-trimoxazole, ceftriaxone and azithromycin. Ciprofloxacin resistance and intermediate susceptibility were observed in 14 and four isolates, respectively. Genes conferring resistance to fluoroquinolones were detected in all test isolates and were mainly associated with mutations on the gyrA and parC genes. Triple mutants bearing gyrA-S83F, gyrA-D87N, and parC-S80I genes were observed in three isolates belonging to genotype 4.3.1.2.1. Genes encoding resistance to other antimicrobial drug classes were not observed in the dataset. The major Pathogenicity islands, SPI-1, SPI-2, SPI-3, SPI-5 and SPI-9, were detected in all test isolates.

This study indicates that Salmonella strains are susceptible to most antibiotics for enteric fever, except fluoroquinolones. However, gathering data from diverse Indian regions is essential to understanding regional variations in Salmonella antimicrobial resistance emergence.

Obesity significantly impacts the outcomes of patients undergoing emergency laparotomy. It complicates emergency laparotomy by prolonging operative times, increasing risks due to comorbidities, impairing wound healing, and heightening respiratory complications, leading to higher morbidity, mortality, and healthcare costs. This study aimed to evaluate the impact of obesity on post-operative outcomes in patients undergoing emergency laparotomy at Kempegowda Institute of Medical Sciences (KIMS) Hospital and Research Centre, Bangalore. It focused on the association between body mass index (BMI) and the incidence of post-operative complications, length of hospital stay, and operative time.

A total of 72 emergency laparotomy patients were grouped by BMI, normal vs. obese, as per the World Health Organization (WHO) classification. Comorbidities and surgical procedures were recorded, excluding laparoscopic cases and underweight patients. Post-operative complications were classified (Clavien-Dindo) and a comprehensive complication index assessed morbidity/mortality during hospitalization.

The study included patients aged 18-88 years, with 48 having normal BMI and 24 classified as obese. Post-operative complications occurred more frequently in obese patients with comorbidities - diabetes (58.3%), hypertension (50%), CKD (4.2%), and IHD (4.2%) - compared to those with normal BMI (diabetes: 14.6%, hypertension: 20%). Notably, 66.7% of normal BMI patients had no complications. Obese patients had significantly longer operative times (by 44.23 minutes) and hospital stays (by 3.5 days).

The study demonstrates a significant impact of obesity on post-operative outcomes in patients undergoing emergency laparotomy. Additionally, the data show that a majority of patients with a normal BMI (66.7%), regardless of whether they had comorbid conditions, did not encounter any complications.

Introduction Liver abscesses remain a significant clinical challenge, particularly in tropical regions, despite advances in diagnostic and therapeutic approaches. This study aimed to compare the clinical outcomes of ultrasonography-guided pigtail catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of liver abscesses. Methods A prospective observational study was conducted at a tertiary care center from October 2021 to March 2023. A total of 94 patients diagnosed with liver abscess were randomly assigned to two groups, with 47 patients each undergoing PCD and PNA. Baseline characteristics, clinical features, laboratory parameters, imaging findings, and treatment outcomes were recorded and analyzed using SPSS version 26 (IBM Inc., Armonk, NY). Results Right upper quadrant pain was the most frequent symptom, with a significantly higher occurrence in the PNA group (p = 0.041). The overall success rate was significantly higher in the PCD group (87.2%) compared to the PNA group (63.8%, p = 0.008). In the PNA group, single aspiration was sufficient in 18 patients (38.3%), whereas 29 patients (61.7%) required two or more aspirations. Time to achieve a 50% reduction in abscess cavity size was significantly shorter in the PCD group (p < 0.001). No significant differences were observed between the groups in hospital stay, time to clinical improvement, or adverse events. Escherichia coli was the most commonly isolated organism. Conclusion Ultrasonography-guided PCD is more effective than needle aspiration in managing liver abscesses, particularly for larger cavities. PCD enables continuous drainage, faster cavity resolution, and fewer repeat interventions, although PNA remains a simpler and cost-effective alternative in select cases.