The study aims to characterize community-acquired sepsis patients admitted to our 1300-bedded tertiary care hospital in South India from the Surviving Sepsis Campaign (SSC) guideline-compliant e-sepsis registry stratified by focus of infection. The prospective observational study recruited 1009 adult sepsis patients presenting to the emergency department at the center based on Sepsis-2 criteria for a period of three years. Of the patients, 41% were between 61 and 80 years with a mean age of 57.37 ± 13.5%. A total of 13.5% (136) was under septic shock and in-hospital mortality for the study cohort was 25%. The 3 h and 6 h bundle compliance rates observed were 37% and 49%, respectively, without significant survival benefits. Predictors of mortality among patients with bloodstream infections were septic shock (p = 0.01, OR 2.4, 95% CI 1.23–4.79) and neutrophil-to-lymphocyte ratio (p = 0.008, OR 1.01, 95% CI 1.009–1.066). The presence of Acinetobacter (p = 0.005, OR 4.07, 95% CI 1.37–12.09), Candida non-albicans (p = 0.001, OR16.02, 95% CI 3.0–84.2) and septic shock (p = 0.071, OR 2.5, 95% CI 0.97–6.6) were significant predictors of mortality in patients with community-acquired pneumonia. The registry has proven to be a key data source detailing regional microbial etiology and clinical outcomes of adult sepsis patients, enabling comprehensive evaluation of regional community-acquired sepsis to tailor institutional sepsis treatment protocols.

Vaccination is the most important prophylactic measure taken to curb COVID-19 pandemics. This study was undertaken to throw light on the safety of Covishield vaccine among health care workers (HCWs) and to assess the co-variates associated with incidence of adverse events. This prospective observational study was conducted in a tertiary care center in South India as part of the HCW vaccination drive. All consenting HCWs who received the first dose of Covishield vaccine and developed ADRs were included in this study. After vaccination, all beneficiaries were monitored for AEFI for a period of half an hour and later followed up through telephone and google survey forms on day 2 and day 7 of vaccination. The data was subsequently collated into spreadsheet format and analyzed. The study included 1264 consenting healthcare workers who were predominantly youth, aged 15–24 years (n = 583, 46 %) and with a female preponderance of 76 % (n = 960). Past history of COVID-19 infections was reported among 4.6 % (58) of the study population. Postvaccination symptoms were majorly reported during the first (40 %) and second day (44 %) after vaccination with a high prevalence of both local (n = 1083, 85 %) and systemic symptoms (n = 1065, 84 %). The mean duration of symptoms was observed to be 1.4 ± 0.81 days post vaccination. Symptoms were observed significantly high among females (76.7 %, p = 0.013). The prevalence of systemic (88 % vs 80 %) (p < 0.001) and allergic symptoms (7 % vs 3 %; p = 0.03) were observed to be significantly high among respondents with <25 years of age. The systemic and allergic symptoms following vaccination were reported to be low among healthcare workers who had a previous history of COVID-19 infection. COVID vaccination has been observed to be safe and well tolerated with more systemic symptoms reported among younger age group and females.

Introduction: The emergence of Carbapenem-resistant Enterobacteriaceae (CRE) is a major public health threat in India posing challenges in infection management. Our study aims to address the regional incidence of monomicrobial CRE in a metropolitan area of Kerala and characterize prescriptions in relation to clinical management. Methodology: The multicentre, prospective observational study was conducted in secondary and tertiary care centres jointly following public-private partnership model in Ernakulam district of Kerala, India from October 2018 to October 2019. Results: The overall incidence of monomicrobial CRE-positive cases from the study hospital network was found to be 0.855 per 1000 patient-days. Among the available data in the cohort, 77 % (312/405) were observed to attain clinical cure and in-hospital all-cause mortality was at 20% (83/410). The proportion of patients with clinical cure to treatment was found to be significantly higher than clinical failure among patients with urinary tract infections (p < 0.001, OR 2.88, 95% CI 1.73 – 4.79) and pneumonia (p < 0.001, OR 0.36, 95% CI 0.21 - 0.6) at 87% and 61% respectively in comparison to other infections. The prevalence of colistin resistance among the total number of patients recruited with isolated monomicrobial CRE was found to be at 3%. Conclusions: Our prospective study on the regional epidemiology of monomicrobial CRE has revealed notable incidence and all-cause mortality. The antimicrobial regimens for clinical management detailed in the study and the assessment of focus of infection-based clinical cure status rates indicate the need of optimized antimicrobial therapy to improve treatment practices in CRE infections.