Indian Journal of Medical Microbiology IAMM  | About us |  Subscription |  e-Alerts  | Feedback |  Login  
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size
 Home | Ahead of Print | Current Issue | Archives | Search | Instructions  
Users Online: 1042 Official Publication of Indian Association of Medical Microbiologists 
  ~   Site Statistics 
  ~   Addresses 
  ~   Search 
  ~   My Preferences 
  ~   Online Submission 


Export selected to
Reference Manager
Medlars Format
RefWorks Format
BibTex Format
  ~ Table of Contents - Current issue
January-March 2019
Volume 37 | Issue 1
Page Nos. 1-131

Online since Friday, August 16, 2019

Accessed 8,599 times.

PDF access policy
Full text access is free in HTML pages; however the journal allows PDF access only to users from INDIA and paid subscribers.

EPub access policy
Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
View as eBookView issue as eBook
Access StatisticsIssue statistics
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list

Vaccines as a tool to contain antimicrobial resistance p. 1
Rajesh Bhatia
DOI:10.4103/ijmm.IJMM_19_223  PMID:31424002
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Antimicrobial activity of probiotics against endodontic pathogens:- A preliminary study p. 5
Aarti Ashok Bohora, Sharad R Kokate, Smita Khedkar, Ashok Vankudre
DOI:10.4103/ijmm.IJMM_18_333  PMID:31424003
Introduction: The purpose of this study was to evaluate the antibacterial effectiveness of probiotics lactobacilli group and Bifidobacterium against Enterococcus faecalis and Candida albicans in both planktonic stage and biofilm stage. Materials and Methods: Phase 1 of the study was conducted by agar well diffusion method. About 0.5 ml of test pathogen culture was inoculated on 20 ml of molten agar and allowed to solidify. 4–5 circular wells of diameter 8–10 mm were punched in each poured plates and 150 μl of diluted test samples were added to the wells. Phase 2 was deferred antagonism test, wherein purified culture of pathogen strain was streaked at right angle to the original producer growth and incubated at 37°C for 24 h. Zone of inhibition was measured for both the phases. Phase 3 biofilm stage evaluation was conducted by mixing 9 ml of 30% poloxamer 407 and De Man, Rogosa and Sharpe (MRS) broth in a test tube with 500 μl of either pathogen, together with 500 μl of test probiotic strains and incubated (37°C, 48 h), followed by serially diluting the mixture by 1 ml into 9 ml sterile saline till 108 dilutions for evaluation of colony-forming unit/ml counts. Controls were endodontic pathogens in 30% poloxamer with MRS broth and no probiotics. Results: Results were evaluated and statistically analysed using one-way analysis of variance and unpaired t-test. In the planktonic stage, probiotics showed inhibitory activity against endodontic pathogens with valid statistical significance (P < 0.05), while there was no activity by deferred antagonism method. In biofilm stage, all three probiotics showed growth reduction for E. faecalis, while lactobacilli group showed reduction in C. albicans colonies. Conclusion: This preliminary study suggested that probiotics are effective for preventing the growth of endodontic pathogens in vitro. Poloxamer could be utilised as an ideal delivery vehicle for probiotics.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Molecular studies on dengue viruses detected in patients from Central India p. 12
Pradip V Barde, Mohan K Shukla, Piyush Joshi, Lalit Sahare, Mahendra J Ukey
DOI:10.4103/ijmm.IJMM_18_377  PMID:31424004
Purpose: Dengue viruses (DENVs), the causative agents of dengue (DEN), are classified into four serotypes and several genotypes. Identifying circulating serotypes and genotypes has clinical and epidemiological importance; however, limited information in this regard is available from Central India. This laboratory-based study was done to fill this lacuna. Materials and Methods: The samples collected in the acute phase of illness were subjected to DEN NS1 ELISA, and NS1-positive samples (n = 80) were subjected to serotyping; representative samples from each serotype were sequenced to identify genotypes. Results: Seventy-one (88.75%) samples could be serotyped. All the four DENV serotypes with dominance of DENV-3 (n = 33; 47%) were detected. DENV-4 was detected after a gap of 3 years. Cases with multiple DENV serotype infection were identified. Genotyping showed that DENV-1 belonging to genotype III, DENV-2 cosmopolitan (IV), DENV-3 genotype III lineage C and DENV-4 genotype I were in circulation in the year 2016. Conclusion: Our study documents the molecular characteristics of DENV circulating in the area. Detection of heterologous DENV serotype with dominance of DENV-3 emphasises the need for regular molecular monitoring.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Early outcome of culture-negative infection in open fractures of the lower limb: A prospective study p. 19
TD Hariharan, Christina Marie Joseph, Sumant Samuel, Divyaa Elangovan, Abel Livingston, Boopalan Ramasamy, Manasseh Nithyananth, Thilak Jepegnanam
DOI:10.4103/ijmm.IJMM_19_143  PMID:31424005
Background: Culture-negative infections in open long bone fractures are frequently encountered in clinical practice. We aimed to identify the rate and outcome of culture-negative infections in open long bone fractures of lower limb. Methodology: A prospective cohort study was conducted from November 2015 to May 2017 on Gustilo and Anderson Grade III open long bone fractures of the lower limb. Demographic data, injury details, time from injury to receiving antibiotics and index surgical procedure were noted. Length of hospital stay, number of additional surgeries and occurrence of complications were also noted. Patients with infected open fractures were grouped as culture positive or culture negative depending on the isolation of infecting microorganisms in deep intraoperative specimen. The clinical outcome of these two groups was statistically analysed. Results: A total of 231 patients with 275 open fractures involving the femur, tibia or fibula were studied. There was clinical signs of infection in 84 patients (36.4%) with 99 fractures (36%). Forty-three patients (51.2%) had positive cultures and remaining 41 patients had negative cultures (48.8%). The rate of culture-negative infection in open type III long bone fractures in our study was 17.7%. There was no statistical difference in the clinical outcome between culture-negative and culture-positive infections. Conclusion: Failure to identify an infective microorganism in the presence of clinical signs of infection is routinely seen in open fractures and needs to be treated aggressively.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Institutional outbreak of varicella in a child welfare institute in Chandigarh, North India p. 24
Mini P Singh, Tripti Rungta, Archit Kumar, Kapil Goyal, Bhavneet Bharti, RK Ratho
DOI:10.4103/ijmm.IJMM_18_264  PMID:31424006
Introduction: Varicella outbreaks are known to occur in developing nations as vaccine coverage is still low. Material and Methods: In the present study, an institutional outbreak from Chandigarh, India, is reported wherein the utility of non-invasive samples such as saliva and urine was studied for the molecular diagnosis of varicella by conventional polymerase chain reaction (PCR), real-time PCR and real-time loop-mediated isothermal amplification (real-time LAMP). Results: The results of the present study showed that saliva and urine samples can be used for outbreak investigation of varicella compared to varicella-zoster virus DNA in vesicular swab samples with reasonable sensitivity. Conclusion: Thus, molecular techniques may be useful in the early identification of the outbreak and timely isolation, and the treatment of cases can further prevent its spread.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Microbiological profile of septic arthritis in adults: Lessons learnt and treatment strategies p. 29
Jerry George, VJ Chandy, John Premnath, TD Hariharan, Anil Thomas Oommen, V Balaji, Pradeep M Poonnoose
DOI:10.4103/ijmm.IJMM_19_134  PMID:31424007
Objective: The aim of this study is to characterise the clinical and microbiological profile of adult patients treated at our orthopaedic unit with septic arthritic between 2006 and 2017. Materials and Methods: A total of 70 patients who were admitted with a diagnosis of septic arthritis between 2006 and 2017 were included in the study. The patients' clinical and epidemiological characteristics were surveyed; microbiological profile and the complications relating to the patients' treatment were identified. Results: Septic arthritis was more common among males (83%). About 75% of the patients presented with a history of fever. The knee was the most commonly affected joint (71%), followed by the hip. While C-reactive protein was found to be consistently >75, total blood white blood cell (WBC) counts were found not to be reflective of the presence of infection with a mean WBC count of only 13,561/, and Gram stain examination had a poor sensitivity of 47%. Among the co-morbidities, the most prevalent association was with diabetes mellitus. The infectious agent most frequently isolated was Staphylococcus aureus(42.85%). The antibiotic sensitivity pattern has evolved since the early years, with resistant strains becoming increasingly prevalent. Unusually, high incidence of streptococci was noted (30%), contrary to the published literature. One-third of the patients had multi-resistant organisms. Septic arthritis left 70% of the patients with a significant residual disability at 6 months follow-up and had 4.25% mortality. Conclusion: Changing sensitivity patterns of microbes in septic arthritis point to a need for reconsidering empirical antibiotic therapy. Joint damage following infection can lead to significant disability.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Will ceftazidime/avibactam plus aztreonam be effective for NDM and OXA-48-Like producing organisms: Lessons learnt from In vitro study p. 34
Agila Kumari Pragasam, Balaji Veeraraghavan, Baby Abirami Shankar, Yamuna Devi Bakthavatchalam, Alice Mathuram, Biju George, Binila Chacko, Pritish Korula, Shalini Anandan
DOI:10.4103/ijmm.IJMM_19_189  PMID:31424008
Introduction: Carbapenem resistance (CR) in Klebsiella pneumoniae is mainly mediated by bla NDM and bla OXA-48 carbapenemases. Newer Food and Drug Administration-approved antimicrobial ceftazidime/avibactam (C/A) has a potent activity against bla OXA-48-like producers. However, its activity is limited in organisms co-producing bla NDM and bla OXA-48-like. Addition of aztreonam (ATM) to C/A potentially expands the spectrum of coverage for carbapenemase co-producers. With this, we aimed to determine the synergistic activity of combination of C/A plus ATM against bla NDM, bla OXA-48-like and co-producers of bla NDM + bla OXA-48-like producing CR Klebsiella pneumoniae (CRKp). Materials and Methods: A total of 12 isolates of CRKp-harbouring genes encoding bla NDM and bla OXA-48-like were tested. Minimum inhibitory concentrations (MICs) were determined for several antimicrobial agents, including C/A (0.5–8 μg/ml) by broth microdilution method. Checkerboard assay was performed for the combination of C/A plus ATM at varying concentrations. Fold differences in the MIC of C/A with and without addition of ATM were determined to infer synergistic effects. Results: MIC of C/A and ATM ranged from 0.5 to >8 μg/ml and 64 to 2048 μg/ml, respectively. Two isolates were susceptible to C/A with MIC of 0.5 and 1 μg/ml, while others were resistant with MIC of >8 μg/ml. Synergistic effects of >8-fold MIC difference in C/A MIC were noted with addition of ATM at 4 μg/ml. This was observed for all CRKp with profiles of bla NDM, bla OXA-48-like and co-producers of bla NDM + bla OXA-48-like genes, which was a promising effect. Notably, all five of the colistin-resistant CRKp were inhibited with >8-fold MIC difference in the combination of C/A plus ATM at 4 μg/ml. Conclusion: With the increasing burden of CRKp, the use of C/A with ATM combination seems to be very promising, especially for bla NDM, bla OXA-48-like and co-producers of bla NDM + bla OXA-48like carbapenemases.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Genetic characterisation of influenza A(H1N1)pdm09 viruses circulating in Assam, Northeast India during 2009–2015 p. 42
Dipankar Biswas, Mousumi Dutta, Kimmi Sarmah, Kaushal Yadav, Manika Buragohain, Kishore Sarma, Biswajyoti Borkakoty
DOI:10.4103/ijmm.IJMM_18_416  PMID:31424009
Introduction: Influenza A(H1N1)pdm09 virus, since its identification in April 2009, has continued to cause significant outbreaks of respiratory tract infections including pandemics in humans. In the course of its evolution, the virus has acquired many mutations with an ability to cause increased disease severity. A regular molecular surveillance of the virus is essential to mark the evolutionary changes that may cause a shift to the viral behavior. Materials and Methods: Samples of Throat/Nasal swabs were collected from a total of 3715 influenza-like illness cases and screened by Real-time Reverse Transcription-Polymerase Chain Reaction for influenza viruses. Nucleotide sequence analysis was done to identify changes in antigenicity of the virus strains. Results: The present study describes the molecular characteristics of influenza A(H1N1)pdm09 viruses detected in Assam of Northeast India during 2009–2015. Influenza A viruses were detected in 11.4% (425/3715), of which influenza A(H1N1)pdm09 viruses were detected in 41.4% (176/425). The nucleotide sequencing of influenza A(H1N1)pdm09 viruses revealed a total of 17 and 22 amino acid substitutions in haemagglutinin (HA) and neuraminidase (NA) genes of the virus, respectively, compared to contemporary vaccine strain A/California/07/2009. The important mutations detected in HA genes of A/Assam(H1N1)pdm09 strains included E391K, K180Q and S202T. Mutation 'N248D' which has an ability to develop oseltamivir resistance was also detected in NA gene of A/Assam(H1N1)pdm09 strains. Conclusions: Regular molecular surveillance of influenza A(H1N1)pdm09 is important to monitor the viral behavior in terms of increase virulence, drug resistance pattern and emergence of novel strains.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comparison of nested polymerase chain reaction and real-time polymerase chain reaction targeting 47kda gene for the diagnosis of scrub typhus p. 50
Seethalakshmi Srinivasan, Saravanan Kalaimani, John Antony Jude Prakash, Thangam Menon
DOI:10.4103/ijmm.IJMM_19_170  PMID:31424010
Introduction: Scrub typhus is a zoonotic infection caused by Orientia tsutsugamushi which is transmitted by Leptotrombidium mites. The disease manifests as a mild-to-severe illness with non-specific clinical symptoms. Rapid diagnosis and prompt treatment are essential for patient management. Both serological and molecular methods are used for the diagnosis of scrub typhus. The present study assessed the usefulness of detection of the gene encoding the 47kDa outer-membrane protein (OMP) for the laboratory diagnosis of scrub typhus. Materials and Methods: Nested polymerase chain reaction (nPCR) and real-time PCR targeting 47 kDa OMP antigen gene of O. tsutsugamushi were performed on ethylenediaminetetraacetic acid blood samples. Results: Six of the 103 (5.8%) patients showed the presence of 47kDa gene by nPCR. Seventy of 103 (67.9%) cases showed the presence of 47kDa gene by qPCR. Among the 70 positive cases, the majority of them were females (40/70, 57.1%). The highest number of positive cases was observed during October–February. Conclusion: Real-time PCR targeting O. tsutsugamushi-specific 47-kDa gene is more sensitive than nPCR and may be the assay of choice for the detection of the organism in patients with suspected scrub typhus.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Sequencing of Porphyromonas gingivalis from saliva in patients with periodontitis and type 2 diabetes mellitus p. 54
Preethi Radhakrishnan, Rubini Anbalagan, Ramya Barani, Monika Mani, Krishna G Seshadri, Padma Srikanth
DOI:10.4103/ijmm.IJMM_18_409  PMID:31424011
Background: Porphyromonas gingivalis is a major periodontal pathogen. Saliva is the most easy, non-invasive microbiological sample for detection of periodontal pathogens. Aim and Objectives: A prospective study on 37 diabetic patients was grouped into well-controlled diabetes with/without periodontitis and uncontrolled diabetic with periodontitis. PCR and sequencing of P. gingivalis was performed in saliva samples. Materials and Methods: DNA was extracted from saliva using Triton X-100 and 16s rRNA gene (404 bp) was amplified by polymerase chain reaction. DNA sequencing was performed for two samples. Results:P. gingivalis was detected in 27.03% (n = 10), of which 30% (n = 9) were diabetic with periodontal disease and 14.3% (n = 1) were diabetic without periodontal disease. The percentage of poor oral hygiene was 50% and 20% in uncontrolled and controlled glycaemic patients, respectively. DNA sequencing of two samples showed 100% identity with the sequences in the GenBank database (Gen Bank accession no: KX640913-KX640914). Conclusion: Type 2 diabetes mellitus and periodontitis are interlinked. Early detection of P. gingivalis and appropriate treatment with doxycycline will also assist in controlling the glycaemic status.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Evaluation of dried blood spots as a feasible alternative to plasma for the detection and quantification of hepatitis c virus in a tropical setting: A pilot study p. 60
Jai Ranjan, Suresh Ponnuvel, Gnanadurai John Fletcher, Raghavendran Anantharam, Kalaivani Radhakrishnan, Visalakshi Jeyaseelan, Priya Abraham
DOI:10.4103/ijmm.IJMM_19_12  PMID:31424012
Introduction: Confirmatory diagnosis of hepatitis C virus (HCV) infection (HCV RNA detection) is essential before start of the therapy. HCV RNA detection is not available in many parts of India. Shipment of plasma from distant places to referral laboratories may affect HCV RNA titres. Dried blood spots (DBS) provide an easy alternative for transporting samples to centres where HCV RNA testing is done. Aim: Evaluation of DBS as a feasible alternative to plasma for HCV diagnosis. Methods: In this cross-sectional study, 40 consecutive patients' blood samples were collected from patients referred from the Liver Clinic. Whole blood was spotted onto two Whatman 903TM cards. One card was incubated at ≥37°C and other at 4°C for 15 days, after drying. DBS was eluted and run in Abbott RealTime HCV assay. HCV was also quantified using the Abbott ARCHITECT HCV core antigen assay for 29 of the study patients. Results were compared with normal plasma values. Results: The median log HCV RNA value (in log10IU/mL) of plasma was 5.74, with normalised DBS it was 4.92 (≥37°C) and 4.66 (4°C); difference in plasma and DBS median log values was 0.82 (≥37°C) and 1.08 (4°C) logs, respectively. Interclass correlation values were 0.943, P < 0.0001 (≥37°C) and 0.950, P < 0.0001 (4°C), showing high agreement. The median HCV core antigen value (in fmol/L) for plasma was 325.35, whereas it was 4.77 (≥37°C) and 4.64 (4°C) for DBS samples. Conclusions: DBS can be used for sampling patients from distant resource-limited settings as an alternative to plasma for HCV RNA estimation. Larger studies are required to evaluate the feasibility of DBS in the Indian subcontinent, especially for HCV core antigen estimation.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Microbiological profile and outcomes of two-stage revision hip arthroplasty p. 67
TD Hariharan, VJ Chandy, Jerry George, Ajit Joseph Mathew, John Premnath, Agila Kumari Pragasam, John Jude Prakash, Anil Thomas Oomen, Pradeep Mathew Poonnoose
DOI:10.4103/ijmm.IJMM_19_25  PMID:31424013
Background: Prosthetic joint infection (PJI) is one of the most challenging cases that confront modern orthopaedics. Two-stage revision, which is the standard of care for PJI, is the preferred mode of treatment for these infections. Aims and Objectives: To study the microbiological profile of prosthetic joint infections (PJI) in the hip and to assess the efficacy of a two stage revision surgery for PJI. We also aimed to study the sensitivity and specificity of ESR and CRP in the diagnosis of PJI. Materials and Methods: The microbiological profile, clinical and radiological outcomes of 22 patients who had a two-stage revision for PJI of the hip between 2013 and 2017 were retrospectively analysed. PJI was defined using the criteria provided by the International Consensus Statement on PJI 2013. Results: Staphylococcus aureus was found to be the most common organism in PJI. Debridement was successful in removing the organism in 74% of PJI. At the time of re-implantation (second stage), six joints grew organisms that were different from that isolated at the index debridement - coagulase-negative staphylococci (3cases) and enterococci (3cases). Other infection parameters for these patients were negative. None of the patients who had two-stage revision surgery had clinical evidence of reinfection or radiological evidence of loosening at a mean of 2-year follow-up. An ESR cut off of >30mm/hr had a sensitivity of 75% and specificity of 88% in predicting PJI. A CRP >10mg/L had a sensitivity of 75% and specificity of 69%. The sensitivity and specificity of using both ESR and CRP cut-offs in the diagnosis of infection were 57% and 94%, respectively. The positive predictive value was 94% and negative predictive value was 56%. Conclusion: The outcomes of the study justify a two-stage revision arthroplasty for PJI of the hip. The use of ESR and CRP as screening tests for the success of debridement has value - but should be interpreted with caution.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Colistin-sparing approaches with newer antimicrobials to treat carbapenem-resistant organisms: Current evidence and future prospects p. 72
Balaji Veeraraghavan, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Shalini Anandan, Subramanian Swaminathan, Balasubramanian Sundaram
DOI:10.4103/ijmm.IJMM_19_215  PMID:31424014
Antimicrobial resistance is on the rise across the globe. Increasing incidence of infections due to carbapenem resistance organisms is becoming difficult to treat, due to the limited availability of therapeutic agents. Very few agents such as colistin, fosfomycin, tigecycline and minocycline are widely used, despite its toxicity. However, with the availability of novel antimicrobials, beta-lactam/beta-lactamase inhibitor-based and non-beta-lactam-based agents could be of great relief. This review covers three important aspects which include (i) current management of carbapenem-resistant infections, (ii) determination of specific types of carbapenemases produced by multidrug-resistant and extensively drug-resistant Gram-negative pathogens and (iii) the currently available novel beta-lactam/beta-lactamase inhibitors and non-beta-lactam-based agents' laboratory findings, clinical outcome and implications.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Bad bug, no test: Tigecycline susceptibility testing challenges and way forward p. 91
Chaitra Shankar, Agila Kumari Pragasam, Balaji Veeraraghavan, Anushree Amladi
DOI:10.4103/ijmm.IJMM_19_207  PMID:31424015
Tigecycline is a reserve antibiotic increasingly used for the treatment of multidrug-resistant bacteria, especially Klebsiella pneumoniae and Acinetobacter baumannii. At present, there are concerns regarding the testing and interpretation of tigecycline susceptibility to bugs such as K. pneumoniae and A. baumannii, which limit clinicians in appropriate usage. Use of appropriate method for testing such as broth microdilution is essential. In addition, tigecycline susceptibility testing is a challenge due to inconsistent results from various antimicrobial susceptibility testing automated platforms. There is a great need to define a suitable methodology along with interpretive criteria, especially for K. pneumoniae and A. baumannii. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Food and Drug Administration (FDA) breakpoints show wide variation and are defined for different set of organisms. Non-species-related pharmacokinetic/pharmacodynamic (PK/PD) breakpoints defined by the EUCAST can be used for organisms such as K. pneumoniae and A. baumannii.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Relative potency of different generic brands of meropenem, colistin and fosfomycin: Implications for antimicrobial therapy and antimicrobial formulary p. 95
Parijat Das, Bishwaranjan Jana, Kingshuk Dhar, Gaurav Goel, Sanjay Bhattacharya, Mammen Chandy
DOI:10.4103/ijmm.IJMM_18_248  PMID:31424016
There is a need of a relatively simple and inexpensive method for the determination of relative potency of various generic brands of antibiotics in comparison to original products. The current study describes an agar diffusion method which can be performed in any microbiology laboratory, is cheap (costs $2 per test) and its results can be available after overnight incubation. The results show that neither all generics are reliable nor are all generic antibiotics of poor quality.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Sonication of antibiotic loaded cement spacers: A valuable technique for detection of infection persistence in two-stage revision for infected joint arthroplasty p. 99
Sujeesh Sebastian, Rajesh Malhotra, Benu Dhawan, Vishnubhatla Sreenivas, Arti Kapil, Rama Chaudhry
DOI:10.4103/ijmm.IJMM_18_313  PMID:31424017
We evaluated the diagnostic utility of sonication of antibiotic loaded cement spacers comparing with periprosthetic tissue cultures for the detection of persisting infection in 14 patients undergoing staged procedures. Sonication improved microbial detection of intraoperative cultures from 14.2% to 28.5% (P = 0.481). Routine sonication of spacers is recommended.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Distribution of human leucocyte antigen-C in HIV-1-infected patients in Mumbai, India p. 102
Nikhil S Bardeskar, Vijay R Chavan, Swati Ahir-Bist, Padmaja Samant-Mavani, Preeti R Mehta, Jayanti Mania-Pramanik
DOI:10.4103/ijmm.IJMM_19_84  PMID:31424018
HIV pathogenesis is known to be highly influenced by host genetic factors, such as human leucocyte antigens (HLAs) HLA-A and HLA-B. However, the role of HLA-C remains largely unexplored. We evaluated HLA-C distribution in 186 HIV-1-infected individuals and compared them to ethnically matched data derived from the Allele Frequency Net Database using Chi-square test with Fisher's exact two-tailed test. The frequency of HLA-C*05 and HLA-C*15 was higher in infected group, whereas the frequency of HLA-C*04 and HLA-C*14 was higher in control group. HLA-C*17, a rare allele, was significantly higher in infected group. These data could be useful in designing and testing vaccines in Indian population.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Use of TaqMan Array card for the detection of respiratory viral pathogens in children under 5 years old hospitalised with acute medical illness in Ballabgarh, Haryana, India p. 105
Bharti Gaur, Siddhartha Saha, A Danielle Iuliano, Sanjay K Rai, Anand Krishnan, Seema Jain, Brett Whitaker, Jonas Winchell, Renu B Lal, Shobha Broor
DOI:10.4103/ijmm.IJMM_18_146  PMID:31424019
Historical specimens collected from hospitalized children were tested for the following 13 viruses: influenza A and B; respiratory syncytial virus (RSV); parainfluenza viruses 1–3; human metapneumovirus; rhinovirus; coronaviruses 229E, OC43, NL63 and HKU1 and Adenovirus using monoplex real-time reverse transcriptase polymerase chain reaction (rRT-PCR). They were retested using TaqMan Array Card (TAC), a micro-fluidic system, capable of simultaneous multi-pathogen testing, to evaluate its sensitivity and specificity against monoplex rRT-PCR. TAC showed high sensitivity (71%–100%) and specificity (98%–100%) for these viruses in comparison to monoplex rRT-PCR. Multi-specimen detection with high sensitivity and specificity makes TAC a potentially useful tool for both surveillance and outbreak investigations.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Combination antifungals as an effective means of salvage in paediatric leukaemia patients with invasive fungal infections p. 109
Jagdish Prasad Meena, Aditya Kumar Gupta, Manisha Jana, Rachna Seth
DOI:10.4103/ijmm.IJMM_18_157  PMID:31424020
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in paediatric leukaemias. Antifungal combinations to treat these patients are being explored. Fourteen children with leukaemias and IFIs were treated with a combination of antifungal agents at our centre. The first antifungal was amphotericin-B in 13 children and voriconazole in one child. In view of no improvement and clinical deterioration, in nine patients, voriconazole was added as the second antifungal agent and in four, it was caspofungin. All patients completed 4–6 weeks of antifungal therapy. The overall mortality attributable to IFI for the cohort was 4/14 (28%).
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Eschar and IgM ELISA in the diagnosis of scrub typhus p. 113
Susmitha Karunasree Perumalla, Sania Paul, K P P. Abhilash, Karthik Gunasekaran, Winsley Rose, Gowri Mahasampath, Prakash John Jude
DOI:10.4103/0255-0857.264495  PMID:31424021
Scrub typhus is one of the leading causes of acute febrile illness in India. This study aimed to determine the best diagnostic tool for the identification of scrub typhus and study the possible association between diagnostics and clinical characteristics. Patients with fever of ≤15 days admitted to the hospital satisfying the case definition of 47 kDa quantitative polymerase chain reaction (qPCR) positivity OR scrub typhus IgM ELISA positivity along with the presence of eschar OR Scrub typhus IgM ELISA positivity along with defervescence of fever within 72 h of initiation of specific therapy were recruited. Of the 116 patients satisfying the case definition, 47 kDa qPCR was positive in 43 (37%) patients, whereas IgM ELISA was positive in 104 (90%) patients and eschar was seen in 59 (51%) patients. The median duration of fever was 7.5 days (interquartile range 6–10 days). Multiorgan dysfunction syndrome (MODS) was described in 44 (37.9%) patients. Two patients (1.8%) succumbed to the illness. Presence of eschar and IgM ELISA positivity were detected in 106 (91%) cases. Scrub typhus, even with MODS, has low mortality because of immediate institution of specific therapy due to physician awareness. The presence of eschar and IgM ELISA positivity can be used to detect a majority of cases of scrub typhus.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Molecular confirmation of the circulating Bacillus anthracis during outbreak of anthrax in different villages of Simdega District, Jharkhand p. 116
Manoj Kumar, Kumari Seema, Amber Prasad, Ashok Kumar Sharma, Banke Lal Sherwal
DOI:10.4103/ijmm.IJMM_19_111  PMID:31424022
Aims and Objectives: Molecular confirmation of the circulating Bacillus anthracis during outbreak of anthrax in different villages of Simdega district, Jharkhand, India. Materials and Methods: Blood samples with swabs from skin lesions (eschar) were collected from the suspected cases of Anthrax from October 2014 to June 2016 from Simdega district, Jharkhand. All the swabs were inoculated on polymyxin lysozyme EDTA thallous acetate media, nutrient agar media as well as 5% sheep blood agar media. Gamma-phage lysis was done. DNA extraction was done using a QIAamp DNA Mini Kit (QIAGEN, Valencia, CA, USA) and subjected to polymerase chain reaction (PCR) using anthrax-specific primers. Results: On Gram and acid fast staining, purple rods and pink-coloured anthrax spores were detected. Capsular and M'Fadyean staining was done. Gamma-phage lysed B. anthracis culture. Of 39 suspected cases, 8 were culture and PCR positive and showed gamma-phage lysis. 3 deaths were reported. Discussion and Conclusion: The conventional and real-time PCR methods are suitable for both the clinical and the epidemiological practice.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Primary amoebic meningoencephalitis in an infant p. 120
Neetu Mittal, Lokesh Mahajan, Zahid Hussain, Parakriti Gupta, Sumeeta Khurana
DOI:10.4103/ijmm.IJMM_18_371  PMID:31424023
Primary amoebic meningoencephalitis is rare but fatal disease encountered in immunocompetent individuals. Here, we present a case of a previously healthy 8-month-old female child, who presented with features of meningoencephalitis of 2 days' duration. Rapidly moving trophozoites of amoeba were observed in cerebrospinal fluid, which were confirmed to be Naegleria fowleri on polymerase chain reaction. Broad-spectrum antimicrobial therapy with ceftriaxone, vancomycin, amphotericin B and acyclovir was initiated. However, the patient deteriorated and left the hospital against medical advice. The isolation of N. fowleri in this case demands for increased awareness for prompt diagnosis and management in view of its high mortality.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Knee and the farm animals: An unusual presentation of Brucella melitensis masquerading as tuberculosis p. 123
Raman Sardana, Abhishek Vaish, Aditya Merh, Hena Butta, Raju Vaishya, Leena Mendiratta
DOI:10.4103/ijmm.IJMM_19_213  PMID:31424024
In many developed countries, brucellosis has been successfully eradicated. However, brucellosis, with its myriad presentations, continues to be a clinical and diagnostic challenge in primarily agrarian countries such as India. We present a case of a rare manifestation of brucellosis i.e., septic arthritis of the knee joint associated with a lytic lesion of the proximal tibia. The patient belonged to a Brucella endemic country, and clinical features were of chronic reactive knee arthritis with synovial hypertrophy and effusion. Advanced diagnostic methods played a pivotal role in excluding the diagnosis of tuberculosis, and thus unnecessary administration of antitubercular therapy and initiating focused narrowed anti-Brucella management, achieving the goal of antimicrobial stewardship also.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Pulmonary Mycobacterium kyorinense disease: A case report and review of literature p. 127
Rajagopalan Saranathan, Chandrasekaran Padmapriyadarsini, Gomathi Narayanan Sivaramakrishnan, Bhavani K Perumal, Silambuchelvi Kannayan, Bency Joseph, Narendran Gopalan, Luke Elizabeth Hanna
DOI:10.4103/ijmm.IJMM_19_94  PMID:31424025
We report here the first case of pulmonary infection due to Mycobacterium kyorinense in a 55-year-old hypertensive woman treated for pulmonary tuberculosis earlier on two occasions. She presented with productive cough, intermittent episode of left-sided chest pain, loss of appetite, low-grade fever, and breathlessness. Sputum cultures revealed non-tuberculous mycobacteria (NTM). She remained persistently symptomatic with sputum cultures positive for acid-fast bacilli even after 6 months of treatment. Hence, a 16SrRNA gene amplification and sequencing were done that revealed M. kyorinense. Based on the guidelines of the American Thoracic Society, she was started on weight-based dosing of clarithromycin, levofloxacin, ethambutol, isoniazid and injection amikacin daily. The patient improved symptomatically and became culture-negative after 3 months of therapy with the above regimen and continued to be culture negative for 12 months of treatment. She continues to remain symptom-free without evidence of any clinical or bacteriological relapse.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04