Qualification: 
MD, MBBS
vanilkumar@aims.amrita.edu

Dr. Anil Kumar V. currently serves as Professor at the Department of Microbiology, School of Medicine, Kochi.

Publications

Publication Type: Journal Article

Year of Publication Title

2019

Dr. Sanjeev K. Singh, Menon, V. P., Zubair Umer Mohamed, Dr. Anil Kumar V., Nampoothiri, V., Sudhir, S., Moni, M., Dipu, T. S., Dutt, A., Edathadathil, F., Keerthivasan, G., Kaye, K. S., and Patel, P. K., “Implementation and Impact of an Antimicrobial Stewardship Program at a Tertiary Care Center in South India”, Open Forum Infect Dis, vol. 6, no. 4, p. ofy290, 2019.[Abstract]


Background: Antimicrobial resistance is a major public health threat internationally but, particularly in India. A primary contributing factor to this rise in resistance includes unregulated access to antimicrobials. Implementing antimicrobial stewardship programs (ASPs) in the acute hospital setting will help curb inappropriate antibiotic use in India. Currently, ASPs are rare in India but are gaining momentum. This study describes ASP implementation in a large, academic, private, tertiary care center in India.

Methods: An ASP was established in February 2016 consisting of an administrative champion, hospitalist, microbiologist, intensivist, and pharmacists. Antimicrobial stewardship program interventions included postprescriptive audit and establishment of institutional guidelines. The ASP tracked appropriate drug selection including loading dose, maintenance dose, frequency, route, duration of therapy, de-escalation, and compliance with ASP recommendations. Defined daily dose (DDD) of drugs and cost of antimicrobials were compared between the pre-implementation phase (February 2015-January 2016) and post-implementation phase (February 2016-January 2017).

Results: Of 48 555 patients admitted during the post-implementation phase, 1020 received 1326 prescriptions for restricted antibiotics. Antibiotic therapy was appropriate in 56% (742) of the total patient prescriptions. A total of 2776 instances of "inappropriate" antimicrobial prescriptions were intervened upon by the ASP. Duration (806, 29%) was the most common reason for inappropriate therapy. Compliance with ASP recommendations was 54% (318). For all major restricted drugs, the DDD/1000 patient days declined, and there was a significant reduction in mean monthly cost by 14.4% in the post-implementation phase.

Conclusions: Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, Indian hospital demonstrated feasibility and economic benefits.

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2017

Dr. Anil Kumar V., Sachu, A., Mohan, K., Vinod, V., Dinesh, K. Radhakrish, and Karim, S., “Simple low cost differentiation of Candida auris from Candida haemulonii complex using CHROMagar Candida medium supplemented with Pal's medium”, Revista Iberoamericana de Micologia, 2017.[Abstract]


Background: Candida auris is unique due to its multidrug resistance and misidentification as Candida haemulonii by commercial systems. Its correct identification is important to avoid inappropriate treatments. Aims: To develop a cheap method for differentiating C. auris from isolates identified as C. haemulonii by VITEK2. Methods: Fifteen C. auris isolates, six isolates each of C. haemulonii and Candida duobushaemulonii, and one isolate of Candida haemulonii var. vulnera were tested using CHROMagar Candida medium supplemented with Pal's agar for better differentiation. Results: On CHROMagar Candida medium supplemented with Pal's agar all C. auris strains showed confluent growth of white to cream colored smooth colonies at 37. °C and 42. °C after 24 and 48. h incubation and did not produce pseudohyphae. The isolates of the C. haemulonii complex, on the contrary, showed poor growth of smooth, light-pink colonies at 24. h while at 48. h the growth was semiconfluent with the production of pseudohyphae. C. haemulonii complex failed to grow at 42. °C. Conclusions: We report a rapid and cheap method using CHROMagar Candida medium supplemented with Pal's agar for differentiating C. auris from isolates identified as C. haemulonii by VITEK2. © 2017 Asociación Española de Micología.

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2016

Sweatha V. Nair, Baranwal, G., Chatterjee, M., Sachu, A., Dr. Anil Kumar V., Chinchu Bose, Dr. Asoke Banerji, and Dr. Raja Biswas, “Antimicrobial Activity of Plumbagin, a Naturally Occurring Naphthoquinone from Plumbago Rosea, against Staphylococcus Aureus and Candida Albicans”, International Journal of Medical Microbiology, vol. 306, pp. 237-248, 2016.[Abstract]


Candida albicans and Staphylococcus aureus are opportunistic pathogens. Despite causing a number of independent infections, both pathogens can co-infect to cause urinary tract infections, skin infections, biofilm associated infections, sepsis and pneumonia. Infections of these two pathogens especially their biofilm associated infections are often difficult to treat using currently available anti-bacterial and anti-fungal agents. In order to identify a common anti-microbial agent which could confer a broad range of protection against their infections, we screened several phytochemicals and identified plumbagin (5-hydroxy-2-methyl-1,4-naphthoquinone), a phytochemical from Plumbago species as a potent antimicrobial agent against S. aureus and C. albicans, with a minimum inhibitory concentration of 5 μg/ml. Antimicrobial activity of plumbagin was validated using an ex-vivo porcine skin model. For better understanding of the antimicrobial activity of plumbagin, a Drosophila melanogaster infection model was used, where D. melanogaster was infected using S. aureus and C. albicans, or with both organisms. The fly's survival rate was dramatically increased when infected flies were treated using plumbagin. Further, plumbagin was effective in preventing and dispersing catheter associated biofilms formed by these pathogens. The overall results of this work provides evidence that plumbagin, possesses an excellent antimicrobial activity which should be explored further for the treatment of S. aureus and C. albicans infections.

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2015

D. Mathai, Dr. Anil Kumar V., Paul, B., Sugumar, M., John, K. R., Manoharan, A., and Kesavan, L. M., “Fecal carriage rates of extended-spectrum β-lactamase-producing escherichia coli among antibiotic naive healthy human volunteers”, Microbial Drug Resistance, vol. 21, pp. 59-64, 2015.[Abstract]


Introduction: Higher prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli fecal carriage has been reported in the nosocomial setting than in the community. We tried to determine the fecal carriage of ESBL-producing E. coli among healthy volunteers in a relatively isolated community. Materials and Methods: This study was conducted on 115 healthy adult volunteers from whom one fecal sample was collected and was plated on selective media. Each morphotypes were identified, characterized, and ESBL phenotype was confirmed by double-disk potentiation method. Molecular characterization of ESBL gene was done using multiplex polymerase chain reaction and pulse-field gel electrophoresis (PFGE) was done to identify their clonal relation. Results: ESBL-producing E. coli had a prevalence of 19% (22/115) among the healthy volunteers in the community. CTX-M was the predominant type, showed a presence 95.5% (21/22), TEM 63%, SHV 9%, and both TEM and CTX-M were present in 63.6% (14/22), all three present in 4.5% (1/22). The lineage using PFGE showed a single clone in 17 isolates. Seven isolates were type A (all TEM & CTX-M), six were type A1 (all TEM & CTX-M except 2), four were type A2 (all CTX-M), and three belonged to types B, C, and D respectively Conclusion: High prevalence rate of 19% in the community indicated by this study implies the possibility of sustained ESBL carriage even among isolated population, which could serve as a reservoir for enriching the ESBL pool in the hospital. Clonal relations also indicate a possible epidemiological source that needs to be evaluated. © Copyright 2015, Mary Ann Liebert, Inc. 2015.

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2015

Dr. Anil Kumar V. and S. Khan, “Defining Multidrug Resistance in Gram-negative Bacilli”, Indian Journal of Medical Research, vol. 141, pp. 491-493, 2015.

2014

Dr. Anil Kumar V., “Susceptibility testing of staphylococcus aureus”, Indian Journal of Medical Research, vol. 139, p. 646, 2014.

2012

Dr. Anil Kumar V., “Article published elsewhere as abstract”, Indian Journal of Medical Microbiology, vol. 30, pp. 253-254, 2012.

2012

Dr. Anil Kumar V., “Recent updates on Methicillin resistant Staphylococcus aureus typing”, Indian Journal of Medical Microbiology, vol. 30, p. 374, 2012.