PURPOSE: To comprehensively study the possibility of autoimmune reactivity by hepatitis viruses B and C (HBV & HCV) in Indian chronic liver disease (CLD) patients. METHODS: One hundred and sixty histopathologically proven CLD cases and 100 matched controls were analysed for viral serology for HBV and HCV and autoimmune serology for antinuclear antibody (ANA), anti smooth muscle antibody (ASMA) and Liver kidney microsomal antibody (LKM) using standard immunofluorescence technique. RESULTS: 43.7% of cases were chronic hepatitis B while 16.2% were positive for HCV. CLD-B cases showed ANA positivity in 27.1% and ASMA positivity in 25.7%. CLD-C cases revealed 26.9%, 46.1% and 11.1% positivity for ANA, ASMA and LKM antibodies respectively. These rates and titres of autoantibodies were statistically significant (p=<0.02) when compared with that of controls. Conclusions: Based on the pattern of autoantibody positivity, it could be concluded that chronic HBV infection may induce autoimmune hepatitis (AIH) type I and chronic HCV infection might trigger AIH - Type II in Indian CLD cases.

PURPOSE: To assess the prevalence of subacute sclerosing panencephalitis (SSPE). METHODS: In the period June 96 to December' 98 an analysis for measles virus (MV) antibody was carried out on 103 serum-CSF pairs received from patients clinically suspected of SSPE. Measles antibody was detected in an indirect immunofluorescent assay (IIF) test. RESULTS: Antibody to measles was detectable in 49 (48%) of the serum-CSF pairs tested, a diagnostic criterion for SSPE. Antibody titers ranged from 20 to 1280 in serum and neat to 32 in CSF. The serum: CSF ratio ranged from 5:1 to 80:1. Of the 49 patients diagnosed to have SSPE, 36 were males and 13 females, and the age of the patients at the time of diagnosis of SSPE ranged from 5 to 26 years. Ten of the SSPE patients gave a history of measles vaccination. CONCLUSIONS: Inadequate vaccine coverage and quality of vaccine used continue to have an impact on occurrence of SSPE.

PURPOSE: To identify the specific microbial pathogens responsible for corneal ulceration in South India and compare these profiles with other series. METHODS: All patients with infectious keratitis who presented between 20th September 1999 and 31st March 2001 were evaluated. They were examined by slit-lamp biomicroscopy and corneal scrapings were performed for cultures and smears by using standard protocols. RESULTS: In the 18 months period, 1618 patients with corneal ulcerations were evaluated. Corneal cultures were found to be positive in 1126(69.59%) patients. Of the 1618 patients, 566(34.98%) had bacterial growth, 522(32.26%) had fungal growth, 30(1.85%) had mixed bacterial and fungal growth, 8(0.49%) had Acanthamoeba species growth and the remaining 492(30.41%) were found to be culture negative. The predominant bacterial pathogen isolated was Streptococcus pneumoniae representing 41.85%, followed by Pseudomonas aeruginosa 21.25%. The predominant fungal pathogens isolated were Fusarium species (45.85%) followed by Aspergillus species (24.37%). CONCLUSIONS: Bacterial and fungal infections occurred almost with equal frequency, the predominant bacterial and fungal species isolated being Streptococcus pneumoniae and Fusarium species respectively. The findings of our study show that there is a region wise variation in the predominance of corneal pathogens. This has an important public health implication for the initiation of therapy.

PURPOSE: To investigate the use of arbitrarily primed polymerase chain reaction (AP-PCR) for typing of leptospiral serovars. METHODS: AP-PCR was adopted for identification of laboratory strains of leptospires and leptospiral cultures at serovar level. A primer of 12 bp was used for amplifying DNA of 13 laboratory strains of leptospires as well as culture pellets of leptospires. RESULTS: Each serovar produced distinct DNA fingerprint which was characteristic for each serovar. These patterns were used for typing of 81 serum culture samples obtained from human leptospiral cases. Of these samples, 39 could be typed based on AP-PCR fingerprints belonging to serovars autumnalis, pomona, canicola, javanica, icterohaemorrhagiae, patoc and pyrogenes. These results were confirmed by RAPD fingerprinting of the DNA samples of the respective leptospiral serovars after culturing -*them in EMJH media. One of the important findings of this work was that straight culture sample could be used for AP-PCR assay, without purification of DNA. By having more number of AP-PCR reference fingerprints, more serovars could be typed. CONCLUSIONS: AP-PCR technique provides great potential for simple and rapid identification of leptospires at serovar level, which could be useful in molecular epidemiological studies of leptospirosis.

PURPOSE: The present study was undertaken to determine the prevalence of asymptomatic bacteriuria in school going children of different age groups and sex and to isolate the organisms responsible for asymptomatic bacteriuria and to know their antimicrobial susceptibility pattern. METHODS: A total of 1817 school children were screened by collecting mid-stream urine and isolating the organisms. RESULTS: Asymptomatic bacteriuria was observed in 192 cases (10.57%) with female preponderance over male. The maximum isolates were E.coli (32.8%). Followed by Klebsiella pneumoniae (22.4%) and Staphylococcus aureus (15.1%). CONCLUSIONS: In the present study there was a steady increase in the incidence of asymptomatic bacteriuria in different age groups. Most of the isolates were resistant to one or more antibiotics.

PURPOSE: To study the diferences between pathogenic and saprophytic leptospires. METHOD: A total of 275 samples were collected from different sources out of which 107 were subjected to PCR and bacteriological culturing. Two sets of primers were used for detection of leptospiral DNA and differentiation of pathogenic and saprophytic leptospires. Differentiation was also carried out by conventional methods. RESULTS: Twenty seven samples were found positive by PCR ut of which 26 were pathogenic and one was saprophytic. Culturing in EMJH medium yielded four isolates, of which isolates from sera were found to be pathogenic and isolate from water was found to be saprophytic. CONCLUSION: From the present study, it was concluded that PCR is simple, specific and rapid method for detection as well as differentiation of leptospires when compared to conventional methods.

Gonococcal infection remains still a major cause of morbidity among sexually active individuals. Diagnosis of the infection in a female case is more difficult than that in a male. This was a prospective study among 269 female commercial sex workers (CSWs) to screen them for gonococcal infection, comparing the rapid method of identification of gonococci by polymerase chain reaction (PCR) with the selective culture method. A total of 92 (34.2%) CSWs were identified positive for Neisseria gonorrhoeae by combination of the two methods. The PCR method identified 87 of the specimens to harbour cppB gene of N. gonorrhoeae, whereas culture method identified 83 specimens showing colonies of gonococci. Taking into consideration of the total positive cases (92), the PCR method showed a sensitivity of 94.57%, whereas sensitivity of culture method was 90.22%. The selective culture method appears to be the most applicable in the identification of gonococci from clinical specimens, particularly in the less resourceful countries like Bangladesh.

One hundred ninety (190) serum samples and 52 control samples consisting of high risk individuals were screened for anti HCV antibody by 3rd generation ELISA test. The prevalence rate was found to be 1.57% in total but it was 2.12% in healthy voluntary blood donors. All were males between the age group of 21 to 40 years. All the control samples were found to be seronegative for anti HCV ab.

Four hundred and fifty four blood samples of clinically diagnosed septicemic neonates were collected over a period of six months from the neonatal ICU of Kalawati Saran Children Hospital, New Delhi. 144 samples were culture positive; out of which 50 (34.7%) were Candida isolates. 92% isolates were Candida tropicalis, 4% were C. albicans and C. kefyr each. The study emphasises the changing pattern of Candida species and their importance in blood stream infections in neonates.

A study of 192 strains of Coagulase negative staphylococcus (CONS) showed that Staphylococcus epidermidis was the most common species, 158 (82.29%) isolated from all clinical specimens followed by S. saprophyticus (30, 15.62%) isolated mainly from urine. Slime production was exhibited by 77 (48.7%) strains of S. epidermidis and 8 (26.6%) of S. saprophyticus and the difference in the slime producing activity was statistically significant (p<0.005). Antibiotic susceptibility testing against 15 commonly used antibiotics showed multidrug resistance with more than 90% resistance to penicillin, more than 50% to cephalexin and ciprofloxacin and more than 20% to methicillin, thus, highlighting the importance of species identification and antibiotic susceptibility testing for clinical isolates of CONS.

Opportunistic infection is common following renal transplantation. Prompt diagnosis and management can be life saving. Four different types of opportunistic respiratory infections diagnosed at our center during the period of January 1998 to December 2000 are discussed. Of the four cases one had Aspergillus, second had Sporothrix, third had Nocardia and fourth case Actinomyces species. Microbiologist has an important role to play by being aware of such opportunistic infections and helping the clinician to make early aetiological diagnosis.

Diseases due to non-toxigenic strains of Corynebacterium diphtheriae are being increasingly reported. These diseases have been found to occur in vaccinated individuals. We report two cases of diphtheria with myocarditis and polyneuritis caused by non-toxigenic strains of C. diphtheriae. The virulence factors of this organism and the pitfalls in diagnosis have also been discussed.