Rajive Gandhi University of Health Science Bangalore Karnataka

Rajive Gandhi University of Health Science Bangalore Karnataka

RAJIVE GANDHIUNIVERSITY OF HEALTH SCIENCE BANGALORE KARNATAKA.

PROFORMA

FOR REGISTRATION OF SUBJECT FOR DISSERTATION.

1. / NAME OF THE CANDIDATE & ADDRESS / DR. V. PREM RAJ
P.G. STUDENT IN DERMATOLOGY VENEROLOGY AND LEPROLOGY.
NAVODAYAMEDICALCOLLEGEHOSPITAL & RESEARCH CENTRE
MANTRALAYAM ROAD
RAICHUR. 584 103.
2. / NAME OF INSTITUTION. / NAVODAYAMEDICALCOLLEGEHOSPITAL & RESEARCH CENTRE
MANTRALAYAM ROAD
RAICHUR. 584 103.
3. / DURATION OF COURSE / 3YEARS M.D. DERAMTOLOGY
4. / DATE OF ADMISSION TO COURSE / 1ST JUNE 2009
5. / TITLE OF THE TOPIC
“CLINICAL & BACTERIOLOGICAL STUDY OF PRIMARY PYODERMA”
6. / 6.1 / Brief resume of intended work.
Need for the study.
Pyoderma is the pyogenic infection of the skin and its appendages. Pyoderma is quite common and constitutes a major portion of patients in dermatologic clinics.
Pyoderma are defined as infection of the skin and soft tissues(excluding muscle) with pathogens that elicit a polymorphonuclear leucocyte response from the infected host.1 It is one of the commonest clinical condition can be defined as “any bacterial skin disease”.2
Various studies conducted at different places indicates the incidence of pyoderma may account for up to 17% of clinical visits.3 Among the infectious dermatosis, pyoderma was seen in 16.1%.4 Chronic folliculitis was common in young males5 but among 120 children below 12 years of age 48 (40%) were boys and 72 (60%) were girls with pyoderma.6 Impetigo occurs more frequently in early child hood although all ages may be affected.
Pyoderma is most common clinical condition caused by staphylococcal aureus, group A beta hemolytic streptococcus.
Cutaneous bacterial infections are divided in primary and secondary type. Primary infections tend to have a charecteristic morphology and arise in normal skin like impetigo, ecthyma, folliculitis, furuncle, carbuncle and sycosis brabea etc.
Secondary infection originate in diseased skin as a superimposed condition like infected trophic ulcer, infected pemphigus, infected contact dermatitis and infected scabies.
For successful management of pyoderma a detail knowledge of the causative microorganism and their sensitivity to antibiotics is required in addition to their nutritional status, literacy, hygiene, socio economic status.
Pyoderma occurs most frequently among the economically disadvantaged children dwelling tropical and subtropical claimants.7Very few studies have been conducted in this part of Karnataka about this bacterial infection.Hence keeping this view in mind the present study was taken on pyoderma to know clinical pattern & bacteriological study and their latest antibiotic susceptibility patterns.
6.2 / REVIEW OF LITERATURE.
Primary pyoderma constituted 69.5% of cases and rest were of secondary pyoderma. There were 39% cases of impetigo, 13% of folliculitis, 6% of cellulitis, 3.5% of ecthyma, 3% of furunculosis, 1.5% of carbuncle and 0.4% of sycosis barbae. A single infecting organism was isolated from 46.9% cases and more than one type of organisms of 65.46% of cases. No organisms was isolated from 5% of cases.8
Ichpujani et al (1981) have shown the problem of pyoderma being high in developing countries like India.
Bhaskaran et al (1979) shown peak incidence of pyoderma to be in IInd and IIIrd decade followed by first and forth decade.
Roodyn (1976) found furuncles increases rapidly in frequency with approach to puberty. Sutton(1972) and Roberts, Rook(1972) have found Sycosis barbae to be common in 3rd and 4th decades. Prasad (1974) has found folliculitis affecting the scalp is common in childhood.
Chuttani et al (1971) and Mehata et al (1980) have reported pyoderma is common in pre-school children.
Parker and Williams (1961) found staphylococci impetigo to be twice as common as streptcoccal impetigo. Ecthyma occurs most commonly in children in Europe. While in tropics it may occur at any age.
According to fitzpatric et al (1979) systemic disorders like diabetes mellitus, nutritional deficiency, reticulosis, prolonged steroids intake, cancer chemotherapy and other immunosuppressive drugs increase the incidence of pyodermas.
Gurumohan Singh(1980) shown pathogenesity to the surface antigen present in staphylococcus aureus, which give antiphagocytic properties and to be exotoxins (Alpha toxin) alpha toxin and leucocidin.
6.3 / OBJECTIVE OF THE STUDY.
  • To find incidence of pyoderma cases in Raichur
  • To find etiological agent of pyoderma.
  • To know sensitivity pattern of isolated organisms to various antibiotic, which helps in appropriate usage of antibacterial agent.

7. / 7.1 / MATERIAL AND METHODS
SOURCE OF DATA
Patient attending skin out patient department and admitted inNavodaya medical college hospital and research centre Raichur.From November 2009 to October 2010. One hundred cases would be taken for study.
7.2 / METHOD OF COLLECTION OF DATA.
{INCLUDING SAMPLING PROCEDURES IF ANY}
All pyoderma cases attending out patient department Navodaya medical College Hospital & Research Centre Raichur. A sample of pus was collected before antibiotic therapy was started. Specimens of pus were collected aseptically with the help of two sterile swabs. In case of intact pustular lesions the pustule was ruptured with a sterile needle and material was collected on two sterile swabs. The swabs were transported immediately to the laboratory. One of the two swabs collected one was used for gram stain and microscopic examination and other for culture. The antibiotic susceptibility testing was performed on Mueller Hinton agar and blood agar by Kirby Bauer disc diffusion method.
Inclusion Criteria:-
All patients having pustules, nodules, crusted lesions are included in study.
Exclusion Criteria:-
Patients who have received antibiotic therapy systemic and topical antibiotic. Patients developing bacterial infection over diseased skin.
7.3 / DOES THE STUDY REQUIRES ANY INVESTIGATION OR INTERVENTION TO CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS.
Yes, Skin swab from pustular lesions are taken for gram staining, culture & sensitivity.
7.4 / HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?
Yes, Ethical clearance has been obtained from ethical committee of Navodaya Medical College Hospital & Research Centre Raichur.
8. / LIST OF REFERENCES.
  1. Resnik SD. Staphylococcal skin infections. Pydermas and toxin mediated syndromes in: John Harper, Arnold, Orange, Neil prose editors, Text book of Pediatrics Dermatology Vol 1, London, Oxford, Black Well Science 2000; 369-383pp.
  2. Jasuja Dk, Gupta Sk, Arora DR, Gupta V. Bacteriology of primary Pyodermas. Ind journal dermatol venereol leprol.2001; 67:132-134.
  3. Sandick NS. Current aspects of bacterial infection of the skin Dermatology clinic: 1997: 15127-341-348.
  4. Bhatia V. extent and pattern of pediatric dermatosis in rural area of central India. Ind journal dermatol venereol leprol.1997; 63:22-5.
  5. Kumarasinghe Spw, Kumarasinge. Chronic folliculitis. Ind journal dermatol venereol leprol.1996;62:79-82.
  6. Mathew Ms, Garg Br, Kanungo R. A Clinical bacteriological study of primary pyoderma of children. Ind journal dermatol venereol leprol.1992;58:183-187.
  7. Bisno La, Stevans Le. Strptococcus pyogens. Mandel Gl, Bennet Je, Dolin R, editors. Principles and practice of infectious diseases. 6th edn, volume 2. Philadelphia, Churchill Livingstone, 2005; 2369-2378pp.
  8. Ghadage DP, Sali YA. Bacteriological study of pyoderma with special reference to antibiotic susceptibility to newer antibiotics. Indian J Dermatol Venereol Leprol 1999;65:177-81.

9. / Signature of the Candidate
10. / Remarks of guide
11. / 11.1 / Guide / DR. S. B. ATHANIKAR.
MD (DERMATOLOGY)
PROF & HOD DEPT OF DERMATOLOGY.
NMCH & RC RAICHUR.
11.2 / Signature
11.3 / Co-Guide {if any}
11.4 / Signature
11.5 / Head of the
Department / DR. S. B. ATHANIKAR.
MD (DERMATOLOGY)
PROF & HOD DEPT OF DERMATOLOGY.
NMCH & RC RAICHUR.
11.6 / Signature
12 / 12.1 / Remarks of the Chairmen & Principal
12.2 / Signature
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