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Hydro-meteorological parameters significantly influence groundwater storage in unconfined aquifers. Although the unconfined aquifer is closer to the surface, the dry conditions have an impact on the water level. The relationship between the hydro-meteorological parameters and the unconfined groundwater level (GWL) has not received much attention or study. Hence, the impact of hydro-meteorological parameters (e.g. rainfall (RF), air temperature (T), and potential evapotranspiration (PEV)) on the GWL is studied over West Bengal, India. The region is categorized into four zones (zone-1, zone-2, zone-3, and zone-4), considering the geo-hydrological scenario. GWL raised by ≈ 1.63 m, 3.51 m, 3 m, and 2.24 m owing to the RF of ≈ 880 mm, 953 mm, 1083 mm, and 1593 mm during monsoon in zone-1, zone-2, zone-3, and zone-4, respectively. The groundwater table is 6.9 m, 95.2 m, 22.3 m, and 80.2 m in the respective zones during winter. The groundwater flows seasonally from zone-2 to zone-1 and zone-3 and, similarly, from zone-4 to zone-3 and zone-1. In zone-1, as RF increased in monsoon, the shallow GWL occurred, and PEV caused water loss. PEV and T have a dependency on deeper GWL in other seasons. PEV and T are critical factors in zone-2's GWL depletion in all seasons. Winter, pre-monsoon, and post-monsoon showed a correlation between the deeper GWL and PEV and T in zone-3 and zone-4. When sufficient RF occurred, the deeper GWL enhanced to a shallower GWL. In monsoon, recharge of the unconfined aquifer occurred owing to RF. The deeper GWL developed in post-monsoon because of lower RF and increased PEV and T. [ABSTRACT FROM AUTHOR]

The main objective of this research paper was to find out the major governing factors controlling fluoride enrichment in groundwater resources in the Jaipur region of India. Chemical analysis of collected water samples revealed that 36% of the collected groundwater samples exhibit fluoride concentration of more than 1.5 mg/L as per BIS, 10,500 and WHO, 2017. An attempt has been made to discuss occurrence of fluoride alongside its spatial distribution in the study area with respect to geology and groundwater flow direction. Chloroalkaline indices, Gibb's plot, Piper diagram and various inter-ionic bivariant plots have been applied to recognize hydrochemical processes and dissolution trends resulting in high concentration of fluoride in groundwater. There exist five water types in the study area: Ca-HCO3, Na-HCO3, Na-Cl, Ca-Mg-Cl and Ca-Na-HCO3. Due to ion association of excess Cl− emanating from wastewater, Na-HCO3 type water finally gets changed as Na-Cl type in aquifer. In the study area, 82% of water samples enriched in F− concentration (>1 ppm) pertain to Na-Cl type. Geochemical modelling confirms that reduced Ca2+ ion activity due to oversaturation of calcite with respect to fluorite might have triggered the favourable condition for dissolution of fluoride bearing minerals leading to fluoride enrichment in groundwater. To further assess the extent of natural and anthropogenic processes, the data was subjected to multivariate statistical analysis by performing correlation analysis, principal component analysis and hierarchical cluster analysis. [ABSTRACT FROM AUTHOR]

Heterogeneity in lithological and structural characteristics results in variation of specific yield (Sy) value in spatial domain. It also depends upon degree of saturation of aquifer. This imparts temporal variation in Sy value in an aquifer. Bonasuria micro-watershed of Damodar river-basin in India is selected to undertake the study of estimation of temporal variation in Sy based upon monthly ground water budgeting for three non-monsoon months. Sy value gradually changes with progression of summer months. Average specific yield value has been estimated as 0.002593 in March and 0.001446 in April. Determined specific yield values indicate low water storage capacity of the shallow aquifer system. This highlights the need of efficient water management for sustainable development of the area. Present study indicates that this can be achieved through storing the effluent seepage going out of the micro- water shed system as base flow. By constructing appropriate water storage structure at the mouth of the water shed and diverting the same back to the aquifer through suitable means is expected to rejuvenate the aquifer system. Holistically this intervention will lead towards development of sustainable dry-season agricultural practices in the study area. [ABSTRACT FROM AUTHOR]

Field methods for the estimation of groundwater unit draft are not fully reliable due to non-uniformity of draft in the time domain. In India, use of norm values recommended by the Groundwater Estimation Committee is in common practice. However, large-scale electrification in agricultural sector has drastically changed the agricultural pumping scenario. Conversion of dieselpowered pump sets to unmetered electrified pump sets and then to metered electrical pump sets has possibly invalidated the unit draft norms in many parts of the country. In this study, a computational method for groundwater unit draft estimation for energized agricultural tube wells is proposed. Availability of detailed minor irrigation census data is the key towards implementation of the method. The method involves utilization of several well-known empirical formulae for arriving at the desired numerical solution. [ABSTRACT FROM AUTHOR]

Summary: Background: The epidemiology, clinical profile and outcome of paediatric candidemia vary considerably by age, healthcare settings and prevalent Candida species. Despite these differences, few comprehensive studies are undertaken. This nationwide study addresses this knowledge gap. Methods: 487 children who contracted ICU‐acquired candidemia at 23 Indian tertiary care centres were assessed for 398 variables spanning demography, clinical characteristics, microbiology, treatment and outcome. Results: Both neonates (5.0 days; range = 3.0‐9.5) and non‐neonatal children (7.0 days; range = 3.0‐13.0) developed candidemia early after ICU admission. Majority of neonates were premature (63.7%) with low birthweight (57.1%). Perinatal asphyxia (7.3%), pneumonia (8.2%), congenital heart disease (8.4%) and invasive procedures were common comorbidities, and antibiotic use (94.1%) was widespread. C tropicalis (24.7%) and C albicans (20.7%) dominated both age groups. Antifungal treatment (66.5%) and removal of central catheters (44.8%) lagged behind. Overall resistance was low; however, emergence of resistant C krusei and C auris needs attention. The 30‐day crude mortality was 27.8% (neonates) and 29.4% (non‐neonates). Logistic regression identified admission to public sector ICUs (OR = 5.64), mechanical ventilation (OR = 2.82), corticosteroid therapy (OR = 8.89) and antifungal therapy (OR = 0.22) as independent predictors of 30‐day crude mortality in neonates. Similarly, admission to public sector ICUs (OR = 3.62), mechanical ventilation (OR = 3.13), exposure to carbapenems (OR = 2.18) and azole antifungal therapy (OR = 0.48) were independent predictors for non‐neonates. Conclusions: Our findings reveal a distinct epidemiology, including early infection with a different spectrum of Candida species, calling for appropriate intervention strategies to reduce candidemia morbidity and mortality. Independent factors identified in our regression models can help tackle these challenges. [ABSTRACT FROM AUTHOR]

Abstract: Two new species of predatory mites, one each of Bdellodes Oudemans (Fam. Bdellidae) and Phytoseius Ribaga (Fam. Phytoseiidae) recorded for the first time from two medicinal plants viz. Ambroma augusta (L.) L.f. (Fam. Sterculiaceae) and Clerodendrum viscosum Vent (Fam. Verbenaceae), respectively, are described in this paper. [Copyright &y& Elsevier]

Objective: The burden of healthcare-associated infections (HAIs) is higher in low- and middle-income countries, but HAIs are often missed because surveillance is not conducted. Here, we describe the identification of and response to a cluster of Burkholderia cepacia complex (BCC) bloodstream infections (BSIs) associated with high mortality in a surgical ICU (SICU) that joined an HAI surveillance network., Setting: A 780-bed, tertiary-level, public teaching hospital in northern India., Methods: After detecting a cluster of BCC in the SICU, cases were identified by reviewing laboratory registers and automated identification and susceptibility testing outputs. Sociodemographic details, clinical records, and potential exposure histories were collected, and a self-appraisal of infection prevention and control (IPC) practices using assessment tools from the World Health Organization and the US Centers for Disease Control and Prevention was conducted. Training and feedback were provided to hospital staff. Environmental samples were collected from high-touch surfaces, intravenous medications, saline, and mouthwash., Results: Between October 2017 and October 2018, 183 BCC BSI cases were identified. Case records were available for 121 case patients. Of these 121 cases, 91 (75%) were male, the median age was 35 years, and 57 (47%) died. IPC scores were low in the areas of technical guidelines, human resources, and monitoring and evaluation. Of the 30 environmental samples, 4 grew BCC. A single source of the outbreak was not identified., Conclusions: Implementing standardized HAI surveillance in a low-resource setting detected an ongoing Burkholderia cepacia outbreak. The outbreak investigation and use of a multimodal approach reduced incident cases and informed changes in IPC practices.

Ceftolozane/tazobactam is a novel antimicrobial agent with activity against Pseudomonas aeruginosa and other common Gram-negative pathogens. In this study, we determined the antimicrobial susceptibility for a total of 149 clinical isolates of P. aeruginosa for the most commonly used antimicrobials including the new agent ceftolozane/tazobactam (C/T). Broth microdilution was performed to determine the minimum inhibitory concentration against various antimicrobials including C/T. Among the β-lactam/β-lactamase inhibitor, overall susceptibility was 67%, 55% and 51% for C/T, Piperacillin/Tazobactam (P/T) and Cefoperazone/Sulbactam, respectively. The variations in the susceptibility rates were noted among the three different β-lactam/β-lactamase inhibitors. Interestingly, 33% susceptibility was noted for C/T against isolates that were resistant to P/T, indicating the higher activity of C/T. This finding suggests about 33% of the P/T-resistant isolates can still be treated effectively with C/T. C/T could be a better alternative for the treatment of ESBL-producing organism, and thereby usage of higher antimicrobials can be minimised., Competing Interests: There are no conflicts of interest

Background: The emergence of antibiotic resistance among bacterial pathogens in the hospital and community has increased the concern to the health-care providers due to the limited treatment options. Surveillance of antimicrobial resistance (AMR) in frequently isolated bacterial pathogens causing severe infections is of great importance. The data generated will be useful for the clinicians to decide empiric therapy on the local epidemiological resistance profile of the antimicrobial agents. This study aims to monitor the distribution of bacterial pathogen and their susceptibility pattern to the commonly used antimicrobial agents., Materials and Methods: This study includes Gram-negative bacilli collected from intra-abdominal, urinary tract and respiratory tract infections during 2014-2016. Isolates were collected from seven hospitals across India. All the study isolates were characterised up to species level, and minimum inhibitory concentration was determined for a wide range of antimicrobials included in the study panel. The test results were interpreted as per standard Clinical Laboratory Standards Institute guidelines., Results: A total of 2731 isolates of gram-negative bacteria were tested during study period. The most frequently isolated pathogens were 44% of Escherichia coli (n = 1205) followed by 25% of Klebsiella pneumoniae (n = 676) and 11% of Pseudomonas aeruginosa (n = 308). Among the antimicrobials tested, carbapenems were the most active, followed by amikacin and piperacillin/tazobactam. The rate of extended-spectrum beta-lactamase (ESBL)-positive isolates were ranged from 66%-77% in E. coli to 61%-72% in K. pneumoniae, respectively. Overall, colistin retains its activity in > 90% of the isolates tested and appear promising., Conclusion: Increasing rates of ESBL producers have been noted, which is alarming. Further, carbapenem resistance was also gradually increasing, which needs much attention. Overall, this study data show that carbapenems, amikacin and colistin continue to be the best agents available to treat drug-resistant infections. Thus continuous monitoring of susceptibility profile of the clinically important Gram-negative pathogens is of great importance to guide effective antimicrobial therapy., Competing Interests: There are no conflicts of interest

Aminoglycosides are important agents used for treating drug-resistant infections. The current dosing regimen of aminoglycosides does not achieve sufficient serum level concentration for the infected bacterial pathogen interpreted as susceptible based on laboratory testing. Minimum inhibitory concentration was determined for nearly 2000 isolates of Enterobacteriaceae and Pseudomonas aeruginosa by broth microdilution method. Results were interpreted based on CLSI and EUCAST interpretative criteria and the inconsistencies in the susceptibility profile were noted. This study provides insights into the inconsistencies existing in the laboratory interpretation and the corresponding clinical success rates. This urges the need for revising clinical breakpoints for amikacin, to resolve under dosing leading to clinical failure.

Purpose: A systematic epidemiological study on intensive care unit (ICU)-acquired candidemia across India., Method: A prospective, nationwide, multicentric, observational study was conducted at 27 Indian ICUs. Consecutive patients who acquired candidemia after ICU admission were enrolled during April 2011 through September 2012. Clinical and laboratory variables of these patients were recorded. The present study is an analysis of data specific for adult patients., Results: Among 1,400 ICU-acquired candidemia cases (overall incidence of 6.51 cases/1,000 ICU admission), 65.2 % were adult. Though the study confirmed the already known risk factors for candidemia, the acquisition occurred early after admission to ICU (median 8 days; interquartile range 4-15 days), even infecting patients with lower APACHE II score at admission (median 17.0; mean ± SD 17.2 ± 5.9; interquartile range 14-20). The important finding of the study was the vast spectrum of agents (31 Candida species) causing candidemia and a high rate of isolation of Candida tropicalis (41.6 %). Azole and multidrug resistance were seen in 11.8 and 1.9 % of isolates. Public sector hospitals reported a significantly higher presence of the relatively resistant C. auris (8.2 vs. 3.9 %; p = 0.008) and C. rugosa (5.6 vs. 1.5 %; p = 0.001). The 30-day crude and attributable mortality rates of candidemia patients were 44.7 and 19.6 %, respectively. Logistic regression analysis revealed significant independent predictors of mortality including admission to public sector hospital, APACHE II score at admission, underlying renal failure, central venous catheterization and steroid therapy., Conclusion: The study highlighted a high burden of candidemia in Indian ICUs, early onset after ICU admission, higher risk despite less severe physiology score at admission and a vast spectrum of agents causing the disease with predominance of C. tropicalis.

Enteric fever, caused by Salmonella enterica, remains an unresolved public health problem in India and antimicrobial therapy is the main mode of treatment. The objective of this study was to characterize the Salmonella enterica isolates from Kolkata with respect to their antimicrobial resistance (AMR), virulence profiles and molecular subtypes. Salmonella enterica blood isolates were collected from clinically suspected enteric fever patients attending various hospitals in Kolkata, India from January 2009 to June 2013 and were tested for AMR profiles by standard protocols; for resistance gene transfer by conjugation; for resistance and virulence genes profiles by PCR; and for molecular subtypes by Pulsed Field Gel Electrophoresis (PFGE). A total of 77 Salmonella enterica serovar Typhi (S. Typhi) and 25 Salmonella enterica serovar Paratyphi A (S. Paratyphi A) from Kolkata were included in this study. Although multidrug resistance (resistance to chloramphenicol, ampicillin, co-trimoxazole) was decreasing in S. Typhi (18.2%) and absent in S. Paratyphi A, increased resistance to fluoroquinolone, the current drug of choice, caused growing concern for typhoid treatment. A single, non-conjugative non-IncHI1 plasmid of 180 kb was found in 71.4% multidrug resistant (MDR) S. Typhi; the remaining 28.6% isolates were without plasmid. Various AMR markers (blaTEM-1, catA, sul1, sul2, dfrA15, strA-strB) and class 1 integron with dfrA7 gene were detected in MDR S. Typhi by PCR and sequencing. Most of the study isolates were likely to be virulent due to the presence of virulence markers. Major diversity was not noticed among S. Typhi and S. Paratyphi A from Kolkata by PFGE. The observed association between AMR profiles and S. Typhi pulsotypes might be useful in controlling the spread of the organism by appropriate intervention. The study reiterated the importance of continuous monitoring of AMR and molecular subtypes of Salmonella isolates from endemic regions for better understanding of the disease epidemiology.

The present study was undertaken to investigate the high incidence of multiresistant Gram-negative bacilli causing neonatal septicaemia. Samples of neonatal blood from 728 suspected cases were obtained in brain heart infusion broth with sodium polyanethol sulfonate. All Gram-negative rods isolated were subsequently subjected to routine antimicrobial susceptibility testing and tests for extended-spectrum beta-lactamase (ESBL) production, as per NCCLS recommendations. ESBL was detected in 86.6% of Klebsiella spp., 73.4% of Enterobacter spp. and 63.6% of Escherichia coli strains. It was also observed that 74.4-80.9% of these ESBL producers were resistant to cefotaxime and 47.6-59.5% were resistant to ceftazidime in routine susceptibility testing. Some ESBL producers (36.3-61.5%) were found to be susceptible to either or both cephalosporins used in this study. It is concluded that indiscriminate use of third-generation cephalosporins may be responsible for the selection of ESBL-producing multiresistant strains in the neonatal intensive-care unit (NICU).