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  Citation statistics : Table of Contents
   2003| January-March  | Volume 21 | Issue 1  
 
 
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BRIEF COMMUNICATION
Prevalence of methicillin resistant staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh
S Anupurba, MR Sen, G Nath, BM Sharma, AK Gulati, TM Mohapatra
January-March 2003, 21(1):49-51
PMID:17642975
We report the prevalence of methicillin resistant Staphylococcus aureus (MRSA) infections and their antibiotic susceptibility pattern in our hospital located in eastern Uttar Pradesh. Out of total 549 strains of Staphylococcus aureus isolated from different clinical specimens 301 (54.85%) were found to be methicillin resistant. More than 80% of MRSA were found to be resistant to penicillin, cotrimoxazole, ciprofloxacin, gentamicin, erythromycin, tetracycline, 60.5% to amikacin and 47.5% to netilmicin. However, no strains were resistant to vancomycin. Many MRSA strains (32.0%) were multi-drug resistant. To reduce the prevalence of MRSA, the regular surveillance of hospital associated infection, monitoring of antibiotic sensitivity pattern and formulation of definite antibiotic policy may be helpful.
  55 13,563 0
In vitro activity of cefpirome: A new fourth generation cephalosporin
A Chaudhury
January-March 2003, 21(1):52-55
PMID:17642976
This study was carried out to find the efficacy of Cefpirome in an Indian setting in a tertiary care referral hospital. A total of 516 bacterial isolates from various clinical specimens were tested against cefpirome (Cpo) and compared against the activities of three other cephalosporins, namely cefazolin (Cz), cefuroxime (Cu), and cefotaxime (Ce) as representative of the other three generations. Preliminary testing was done by Kirby Bauer technique. In the gram positive group of organisms (Staphylococcus aureus and coagulase negative staphylococci); 96 strains out of 177 (54.2%) were resistant to Cpo compared to 61.0% for Cz and 72.3% for Cu. In the Enterobacteriaceae group, 66.0% of the isolates were resistant to Cpo compared to 63.2% for Ce; while for Pseudomonas and other non-fermentors, the corresponding figures were 70.7% and 50.0% for Cpo and Ce respectively. The MIC for the strains resistant to Cpo were found to be >16mg/L to >256mg/L. This study highlights that Cpo did not have superior activity against the organisms isolated in our laboratory. However, since its activity against gram positive and gram negative organisms is comparable to those of Cz and Ce respectively, it may be useful for mixed infections for empirical therapy.
  6 12,634 0
ORIGINAL ARTICLE
Comparative study of different microscopic techniques and culture media for the isolation of dermatophytes
S Singh, PM Beena
January-March 2003, 21(1):21-24
PMID:17642969
PURPOSE: To evaluate the usefulness of two different microscopic techniques and three different culture media for the identification and isolation of dermatophytes from clinical samples. METHODS: Skin, hair and nail samples from 260 clinically suspected cases of dermatophytosis were screened by direct microscopic examination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mounts. All the samples were inoculated for culture in Sabouraud dextrose agar (SDA), dermatophyte test medium (DTM) and ready to use enriched dermatophyte medium (EDM). RESULTS: Fungal elements were detected in 157 samples by both the methods but faster and better visualization was noted with 40% DMSO added to 10% KOH. Fungi were recovered from SDA, DTM and EDM in 96.5%, 98.3% and 85.3% of the cases respectively. CONCLUSIONS: When performing direct microscopic examination of skin, hair and nail for dermatophytes, addition of 40% DMSO to the KOH mount gives better and faster results. The efficiency of SDA and DTM was found almost equal and slightly better than EDM. The EDM, although quite efficient with 85.3% isolation rate, requires further evaluation as its ready to use format makes the application and microscopy much easier and faster.
  6 17,108 8
Nocardia asteroides keratitis in South India
MJ Bharathi, R Ramakrishnan, S Vasu, Meenakshi, A Chirayath, R Palaniappan
January-March 2003, 21(1):31-36
PMID:17642971
PURPOSE: To determine the risk factors, microbiological features, clinical features and other epidemiological characteristics of Nocardia keratitis seen at a tertiary eye care centre in south India. METHODS: We evaluated 31 patients with Nocardia keratitis seen over two years, from September 1999 to September 2001. Corneal scrapings were subjected to microscopy and culture using standard protocols. RESULTS: Out of 2184 corneal ulcers cultured, 31(1.42%) were found to be Nocardia asteroides. All 31(100%) were detected correctly by 10% potassium hydroxide wet mount preparation. The highest percentage of isolates was susceptible to gentamicin(100%) followed by ciprofloxacin(93.55%). Twenty four (77.42%) patients were from rural areas; 22(70.97%) were agricultural workers; 29(93.55%) had history of trauma; 2(6.45%) had previous ocular surgery; 28(90.32%) had ocular injury with soil and sand; and 22(70.97%) had ocular injury while working in the agricultural fields. Ten (32.26%) patients presented at our institute between 15 to 35 days of onset of illness, 26(83.87%) had previous medical treatment, and 15(48.39%) patients had used traditional eye medicines. The average age of the patients was 46.16 years, with a range of 11 to 75 years. No seasonal variation was observed. CONCLUSIONS: A high index of suspicion of Nocardia infection should exist in patients with a history of trauma to the eye by soil or sand. The organisms are sensitive to commonly used topical ocular antibiotics.
  5 6,746 0
SPECIAL ARTICLE
Sporotrichosis in India: First case in a Delhi resident and an update
HS Randhawa, R Chand, AY Mussa, ZU Khan, T Kowshik
January-March 2003, 21(1):12-16
PMID:17642967
PURPOSE: To report the first case of sporotrichosis in a Delhi resident without history of travel to any known endemic area, and to present an update of the disease with special reference to India. METHODS: OThe case was tentatively diagnosed by clinical features, and confirmed by culture and histopathologic examination of a biopsy specimen. The update on the disease is based upon literature review (1932-2001). RESULTS: A 40-year-old female hospital employee developed lymphocutaneous lesions, involving her right middle finger, wrist and forearm following accidental pricking with a hypodermic syringe needle. A definitive diagnosis of sporotrichosis was established by culture of S. schenckii, verification of its dimorphic character, morphology in histopathologic sections and a positive pathogenicity test (intratesticular inoculation) in male white mice. The patient was successfully treated with saturated solution of potassium iodide. Of 205 cases compiled from literature, 91 (44%) came from West Bengal, 56 (28%) from Himachal Pradesh and 45 from Assam whereas the remaining 13 (6.3%) occurred sporadically in other states, including Bihar, Punjab and Karnataka. CONCLUSIONS: The available literature does not provide a true index of regional distribution of sporotrichosis in India. More correctly, it seems to reflect the distribution of groups of investigators with a special interest or expertise in sporotrichosis and S. schenckii. Further studies are likely to reveal new endemic areas for sporotrichosis.
  5 7,616 1
BRIEF COMMUNICATION
Seroprevalence of hepatitis C virus in a hospital based general population in South India
S Bhattacharya, S Badrinath, A Hamide, S Sujatha
January-March 2003, 21(1):43-45
PMID:17642973
Seroprevalence of Hepatitis C virus (HCV) among hospital based general population was determined using a third generation ELISA. The study population comprised of 661 individuals (including 36 health care workers) attending a tertiary care hospital in Pondicherry, south India. The overall seroprevalence was found to be 4.8% (95% confidence interval [CI]=3.2-6.4%). The seroprevalence in males and females was 5.9% (95% CI=3.5-8.3%) and 3.3% (95% CI= 1.2-5.4%) respectively. There was no statistically significant difference in the proportion of individuals who were positive in case of males and females (p>0.05). None of the health care workers tested positive for antibodies to HCV.
  4 5,616 0
CASE STUDY
A case of injection abscess due to salmonella typhi
R Raghunath, AC Ashok, D Sridaran, VA Indumathi, M RS Belwadi
January-March 2003, 21(1):59-60
PMID:17642978
To the best of our knowledge, injection abscess due to Salmonella typhi has not been reported earlier. A patient with fever of unknown origin was diagnosed as suffering from typhoid fever, administered a course of ceftrioxone but patient developed an injection abscess due to S.typhi, abscess was drained and patient was started on ciprofloxacin to which he responded favourably.
  4 5,849 8
ORIGINAL ARTICLE
Search for shiga toxin producing escherichia coli (STEC) including 0157: H7 strains in and around Kolkata
UK Chattopadhyay, S Gupta, S Dutta
January-March 2003, 21(1):17-20
PMID:17642968
PURPOSE: An attempt was made to isolate and characterize Shiga toxin producing E. coli (STEC) from animals handlers, animal products and admitted diarrhoeic children in and around Kolkata. METHODS: A total of 415 samples were processed for detection of STEC by PCR and colony hybridization techniques. RESULTS: 0 (4.81%) samples were found to be positive for STEC. Diarrhoeic cattle accounted for maximum (22.1 %) isolation. CONCLUSIONS: The study showed PCR to be more sensitive than hybridization technique for detection of STEC.
  4 7,678 0
REVIEW ARTICLE
Antibiotic associated diarrhoea: Infectious causes
A Ayyagari, J Agarwal, A Garg
January-March 2003, 21(1):6-11
PMID:17642966
Nearly 25% of antibiotic associated diarrhoeas (AAD) is caused by Clostridium difficile, making it the commonest identified and treatable pathogen. Other pathogens implicated infrequently include Clostridium perfringens, Staphylococcus aureus, Klebsiella oxytoca, Candida spp. and Salmonella spp. Most mild cases of AAD are due to non-infectious causes which include reduced break down of primary bile acids and decrease metabolism of carbohydrates, allergic or toxic effects of antibiotic on intestinal mucosa and pharmacological effect on gut motility. The antibiotics most frequently associated with C. difficile associated diarrhoea are clindamycin, cephalosporin, ampicillin and amoxicillin. Clinical presentation may vary from mild diarrhoea to severe colitis and pseudomembranous colitis associated with high morbidity and mortality. The most sensitive and specific diagnostic test for C. difficile infection is tissue culture assay for cytotoxicity of toxin B. Commercial ELISA kits are available. Though less sensitive, they are easy to perform and are rapid. Withdrawal of precipitating antibiotic is all that is needed for control of mild to moderate cases. For severe cases of AAD, oral metronidazole is the first line of treatment, and oral vancomycin is the second choice. Probiotics have been used for recurrent cases.
  4 24,670 8
BRIEF COMMUNICATION
Neonatal systemic candidiasis in a tertiary care centre
S Narain
January-March 2003, 21(1):56-58
PMID:17642977
The purpose of this study was to identify infections causing Candida spp. and to examine their susceptibility to antifungal drugs. The study examined 30 isolates of Candida spp. grown from blood culture samples of neonates. Clinical histories revealed that all 30 infants had received systemic broad-spectrum antibiotic therapy, 27/30 were low birth weight, 21/30 suffered from respiratory distress syndrome and 23/30 were preterm. The three species of Candida isolated were Candida albicans (16/30, 53.3%), C. tropicalis (7/30,23.3%), and C. krusei (7/30, 23.3%). Antifungal susceptibility tests against fluconazole and amphotericin B were done based on the NCCLS guidelines for antifungal susceptibility testing. The fluconazole resistance pattern was as follows: 1/16 (6.25%) strain of C. albicans was susceptible, 12/16 (75%) strains were dose dependent susceptibles, and 3/16 (18.75%) were resistant to fluconazole. Among Candida tropicalis, 2/7(29%) strains were susceptible, 4/7 (55.5%) dose dependent susceptible and 1/7 (14.5%) were resistant. All strains of C. krusei were resistant to fluconazole. There was no resistance to amphotericin B.
  3 6,051 0
ORIGINAL ARTICLE
16S rRNA PCR for differentiation of pathogenic and non-pathogenic leptospira isolates
J Shukla
January-March 2003, 21(1):25-30
PMID:17642970
PURPOSE: To determine the risk factors, microbiological features, clinical features and other epidemiological characteristics of Nocardia keratitis seen at a tertiary eye care centre in south India. METHODS: We evaluated 31 patients with Nocardia keratitis seen over two years, from September 1999 to September 2001. Corneal scrapings were subjected to microscopy and culture using standard protocols. RESULTS: Out of 2184 corneal ulcers cultured, 31(1.42%) were found to be Nocardia asteroides. All 31(100%) were detected correctly by 10% potassium hydroxide wet mount preparation. The highest percentage of isolates was susceptible to gentamicin (100%) followed by ciprofloxacin(93.55%). Twenty four (77.42%) patients were from rural areas; 22(70.97%) were agricultural workers; 29(93.55%) had history of trauma; 2(6.45%) had previous ocular surgery; 28(90.32%) had ocular injury with soil and sand; and 22(70.97%) had ocular injury while working in the agricultural fields. Ten (32.26%) patients presented at our institute between 15 to 35 days of onset of illness, 26(83.87%) had previous medical treatment, and 15(48.39%) patients had used traditional eye medicines. The average age of the patients was 46.16 years, with a range of 11 to 75 years. No seasonal variation was observed. CONCLUSIONS: A high index of suspicion of Nocardia infection should exist in patients with a history of trauma to the eye by soil or sand. The organisms are sensitive to commonly used topical ocular antibiotics.
  3 7,365 0
CORRESPONDENCE
Human dirofilariasis
KG Bhat, G Wilson, S Mallya
January-March 2003, 21(1):65-65
PMID:17642982
  2 3,897 0
Shortcomings of acridine orange staining for malarial parasite
S Das
January-March 2003, 21(1):66-66
PMID:17642983
  2 3,988 0
CASE STUDY
Tubercular pancreatic abscess: A case report
R Lal, B Mishra, V Dogra, A Mandal
January-March 2003, 21(1):61-62
PMID:17642979
Primary involvement of the pancreas in bacterial and parasitic diseases is exceptional. Infection of the pancreas is usually secondary to necrosis and inflammation after serious necrotizing pancreatitis. Although a rare manifestation of a common disease, pancreatic tuberculosis can present to a clinician as a difficult diagnostic dilemma. The clinical manifestation may vary from painless obstructive jaundice to fever of unknown origin. Here, we report a case of pancreatic tuberculosis in a young alcoholic patient.
  1 6,878 0
BOOK REVIEW
Book Review - I
S Sharma
January-March 2003, 21(1):67-67
  - 2,786 0
Book Review - II
G Sridharan
January-March 2003, 21(1):67-67
  - 2,612 0
BRIEF COMMUNICATION
Comparative evaluation of conventional methods and elisa based IgG antibodies detection for diagnosis of helicobacter pylori infection in cases of dyspepsia
U Arora, A Aggarwal, K Singh
January-March 2003, 21(1):46-48
PMID:17642974
Seventy five gastric biopsy specimens and 75 serum samples of same patients complaining of dyspepsia were collected. Biopsy specimens were processed for rapid urease test, gram staining and culture. Serum samples were used for detecting IgG antibodies against 128kDa external protein (Cog A) of H.pylori using a commercially available ELISA kit. Rapid urease test was positive in 54 (72%), culture in 21 (28%) and gram staining in 15 (20%). Significant IgG levels were detected in 57 (76%) cases. It was therefore concluded that for diagnosis of H.pylori infection in cases of dyspepsia, determination of IgG levels can act as an important screening procedure.
  - 6,911 0
CORRESPONDENCE
An outbreak of leptospirosis in Mumbai
S Chandrasekaran
January-March 2003, 21(1):63-63
PMID:17642980
  - 3,230 0
Author's reply
A De
January-March 2003, 21(1):63-63
  - 2,353 0
Mycological and serological study of pulmonary aspergillosis in Central India
M Shahid, A Malik
January-March 2003, 21(1):64-64
PMID:17642981
  - 3,603 0
Author's reply
AM Kurhade
January-March 2003, 21(1):0-0
  - 1,758 0
EDITORIAL
Editorial
R Kanungo
January-March 2003, 21(1):5-5
PMID:17642965
  - 3,153 4
ORIGINAL ARTICLE
In vitro activity of norfloxacin against uropathogens and drug efficacy in simulated bladder model under diabetic conditions
H Anandkumar, A Dayanand, CS Vinodkumar, I Kapur
January-March 2003, 21(1):37-42
PMID:17642972
PURPOSE: The in vitro activity of norfloxacin was determined to maximize the correlation between susceptibility testing of the drug and the results of clinical therapy of urinary tract infection in diabetics. This study was carried out to observe the effect of changing concentration of norfloxacin on the growth of uropathogens under diabetic conditions. METHODS: The standard broth microdilution method was carried out to determine the minimum inhibitory concentration (MIC) using Mueller Hinton broth by varying pH of the medium (5.0, 5.5, 6.0, 6.5 and 7.0) and glucose concentration (100, 250, 500, 1000 and 2000 mg/dL). A specially designed mechanical bladder model system simulating hydrokinetic conditions that exist in the urinary tract of diabetics was employed. RESULTS: The loss of activity of norfloxacin was more pronounced (> four folds) at pH 5.0 and 2000 mg/dL sugar concentration. These findings were consistent with the experiment 'in vitro simulated bladder model' by exposing bacterial growth to varied norfloxacin and sugar concentration. CONCLUSIONS: Although norfloxacin is a drug of choice for non-diabetic and diabetic individuals with mild to moderate glucosuria, in severe diabetic individuals norfloxacin may not be an effective drug.
  - 6,146 0

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

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